Idiopathic cervical dystonia (CD) is a focal dystonia characterized by involuntary contraction of... more Idiopathic cervical dystonia (CD) is a focal dystonia characterized by involuntary contraction of the muscles of the neck causing twisting movements and abnormal head and neck postures. Its etiology is unclear; however, intracerebral neuronal circuit pathologies are highly considered. On the contrary, benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo diagnosed. We present a patient with CD suffering from severe vertigo who was diagnosed with BPPV. This is a very unique case representing the co-occurrence of a rare central nervous system pathology and a peripheral inner ear disease. The cause and effect relation between two pathologies is under scope. We present a 55-year-old woman with CD attended our clinic with severe vertigo and nausea. Left posterior semicircular canal BPPV (PSCC BPPV) was diagnosed. Involuntary head and neck muscle contractions caused by CD appear to have contributed to the development of BPPV in this case. However, increased neuronal activities causing CD could also have led to BPPV in the vestibular nuclear level. Further investigations are essential. Peripheral vestibular pathologies and their association with CD are not clearly determined in the literature so far. To our knowledge, there are no other cases reported regarding this co-occurrence.
Tonsillectomy is one of the surgical procedures that are frequently performed by ear, nose, and t... more Tonsillectomy is one of the surgical procedures that are frequently performed by ear, nose, and throat surgeons. The procedure is associated with many intraoperative and postoperative complications, and the nature of the operation site hampers surgical interventions. Cervicofacial subcutaneous emphysema is characterized by the presence of air within the fascial planes of the head-neck region because of various reasons. It may develop iatrogenically or spontaneous-ly because of trauma. Herein, we report a 4-year-old male patient who presented to our clinic with complaints of frequent tonsillitis and snoring and who developed subcutaneous emphysema involving only the maxillofacial region following tonsillectomy. In addition, treatment strategies have been discussed, taking current literature into account.
High-intensity noise sources with an increase in air traffic and sudden changes in atmospheric pr... more High-intensity noise sources with an increase in air traffic and sudden changes in atmospheric pressure can cause hearing loss in pilots. The main goal of this research is to examine hearing loss due to age, the total flight hours and aircraft types and to evaluate the effects of personal conditions that can influence the hearing level. We examined the data of 234 Turkish pilots aged between 25 and 54 years who were examined due to the aviation Law for annual control from January 2005 to January 2014 at Başkent University Medical Faculty, Ankara Hospital. The audiometric results of the pilots were used. While 1, 2, 3, 4, 6, and 8 KHz were used for the airway threshold, 1, 2, and 4 KHz were used for the bone conduction threshold. Results: According to the data of the 234 pilots, there was a significant correlation between high-frequency hearing loss and the total flight hours and pilots' ages. The average hearing loss was higher, particularly in the left ear, in pilots using helicopters than in those using other aircraft types. There was no statistically significant correlation between hearing loss and diabetes, hypercholesterolemia, high blood pressure, anemia, obesity, and smoking. A significant cor relation was observed between high frequency hearing loss and the total flight hours, pilots' age, and aircraft types in our study.
Ankara Üniversitesi tıp fakültesi mecmuası, Oct 27, 2020
Laryngocele is an air-filled sac which originates from the saccule of the ventricle. It is one of... more Laryngocele is an air-filled sac which originates from the saccule of the ventricle. It is one of the rarest lesions of the larynx. Certain occupational and chronic inflammatory diseases may play role in the formation of laryngocele, but the etiology in the majority of them is unclear. When infected, the air inside of the laryngeal saccule replaced by purulent fluid and it becomes laryngopyocele. These lesions may lead to dysphagia, roughness, and dyspnea. There are limited number of cases in the literature. In the presented case here, laryngopyocele showed suspicious mass appearance in the radiological imaging and its diagnosis was confirmed by intraoperative direct laryngoscopy. Laryngoceles are clinically asymptomatic unless they reach large sizes. As internal laryngoceles and laryngopyoceles may also be related to tumors originated from laryngeal ventricles, it is highly important to evaluate the lesion borders before the operation.
Upper airway obstruction and sleeping disorders are important issues in syndromic children, inclu... more Upper airway obstruction and sleeping disorders are important issues in syndromic children, including mouth, lower-upper jaw, or all facial abnormalities. Tonsillectomy and/or adenoidectomy is required because of systemic problems and upper airway obstruction that increase the existing systemic problems, except those anomalies. However, tonsillectomy and/or adenoidectomy are mostly avoided because of the tendency to cause both intubation/ perioperative systemic problems and respiratory complications in the postoperative period and in delays in the oral intake. However, these surgeries are sometimes required. In this context, we present our experience related with performing tonsillectomy and/or adenoidectomy in syndromic children admitted to our hospital. We retrospectively examined the data on tonsillectomy and/or adenoidectomy performed in syndromic patients in our clinic between 2001 and 2011. We did not observe any postoperative complications in adenoidectomy and/or tonsillectomy performed by the same surgeon in 14 syndromic cases. It should be noted that respiratory problems may arise from many different anatomical regions in syndromic patients. Therefore, surgery should be performed taking into consideration all of these factors in these patients. These patients must be hospitalized in the postoperative period.
Benign paroxysmal positional vertigo (BPPV) is a clinical entity characterized by acute, brief pa... more Benign paroxysmal positional vertigo (BPPV) is a clinical entity characterized by acute, brief paroxysmal attacks of rotational vertigo induced by head position changes. It is the most common peripheral vestibular pathology and is seen more frequently in women. However, to our knowledge, there is very limited data on the association between BPPV and pregnancy in both English and Turkish literature. We present four pregnant women diagnosed with BPPV for the first time during gestation and revise the etiological factors of BPPV and the role of pregnancy-related changes in BPPV.
Özet: Hipoksi parametreleri, fiziksel de¤iflkenler ve obstrüktif uyku apnesinin fliddet derecesi ... more Özet: Hipoksi parametreleri, fiziksel de¤iflkenler ve obstrüktif uyku apnesinin fliddet derecesi Amaç: Farkl› fliddet derecesinde obstrüktif uyku apnesi (OUA) olan hastalarda hipoksiyle fiziksel parametreler aras›ndaki iliflkinin belirlenmesi. Yöntem: Bu çal›flma bir gecelik polisomnografik incelemeyle de¤erlendirilmifl 259 erkekte uygulanan retrospektif çapraz kesitsel bir ça-l›flmad›r. OUA'n›n fliddet derecesi apne/hipopne indeksine (AH‹) göre derecelendirildi: normal/basit horlama (n=31); hafif derecede OU-A (n=70); orta derecede OUA (n=63); fliddetli derecede OUA (n=95). Farkl› fliddet derecesinde OUA's› olan hastalar, oksijen satürasyonu <%90 (ST90) veya minimal oksijen satürasyonu (min SaO2) olan en uzun veya en k›sa toplam uyku süresine göre altgruplara ayr›ld›. Bulgular: Ortalama AH‹ 20.4 olay/saat idi. Tek de¤iflkenli analize göre ST90, AH‹ (r=0.772; p≤0.001) ve Epworth uykululuk ölçe¤i (ESS) (r=0.344; p≤0.001) ile korelasyon gösterirken min SaO2, AHI (r=-0.748; p≤0.001) ve ESS (r=-0.319; p≤0.001) ile tersine korelasyon gösterdi. Çok de¤iflkenli do¤rusal regresyon modelinde ST90 ba¤›m-s›z olarak AH‹, ESS ve boyun çevresiyle korele idi, min SaO2 ise ba-¤›ms›z olarak AH‹, ESS ve vücut kitle indeksi (VK‹) ile iliflkiliydi. A¤›r derecede OUA geçiren hastalarda en düflük ve en yüksek min Sa-O2'si olan altgruplarda VK‹, modifiye Mallampati skoru, boyun ve bel çevresi ve retroglossal Müller derecesi anlaml› derecede farkl›yd›. Oksijen satürasyonu <%90 ile karakterize uyku zaman› yüzdesi (CT90) <%10 hastalarda, ST90'›n üst s›n›r› 36 dakika olup min SaO2'nin alt s›-n›r›n›n %70'ine tekabül etmekteydi. Sonuç: Hipoksi parametreleri OUA fliddet derecesi kategorilerine göre anlaml› de¤ifliklikler göstermektedir. Fiziksel parametrelerin hiçbiri fliddetli OUA geçiren hastalar d›fl›nda OUA hastalar›nda hipoksi parametreleriyle klinik aç›dan yararl› iliflkiler içinde de¤ildir.
Otalji, ya da kulağa lokalize ağrı acil servislerde. Pediatri ve otorinolaringoloji kliniklerinde... more Otalji, ya da kulağa lokalize ağrı acil servislerde. Pediatri ve otorinolaringoloji kliniklerinde sık rastlanılan bir semptomdur. Kulak ağrısı yaşanılan durumlarda tedavinin etkin olabilmesi, etiyolojiye yönelik tedavilerin yanı sıra, etkili ağrı kontrolünü sağlamakla mümkün olmaktadır. Ağrı için oral veya lokal tedaviler kullanılmaktadır. Son zamanlarda lokal anestezikler sıklıkla tercih edilmektedir. Ancak hasta seçimi, doz ayarlanması, etkinlik süresi ve yan etkiler, kulak zarında perforasyon olup olmaması konusunda hekimlerin bilinçli ve dikkatli olması önemlidir. Bu derleme ile en sık kullanılan lokal anesteziklerden biri olan Lidokainin (amid grubu lokal anestezik) otaljideki etkinliği ve güvenilirliği tartışılacaktır.
kulak burun boğaz ve baş boyun cerrahisi dergisi, 2019
rankial anomaliler, boyun lateralinde en sık karşılaşılan konjenital boyun patolojileridir. Bu an... more rankial anomaliler, boyun lateralinde en sık karşılaşılan konjenital boyun patolojileridir. Bu anomaliler en sık kist şeklinde ortaya çıkmaktadırlar. 1 Brankial kist üzerinde enfeksiyon gelişebildiği gibi, karsinom geliştiğine dair yayınlar da literatürde bulunmaktadır. 1,2 Karsinomlar arasında da skuamöz hücreli karsinomlar daha sık görülmesine rağmen primer papiller karsinom oldukça nadirdir. Brankial kleft kisti (BKK) papiller karsinomu, benign BKK veya metastatik papiller karsinomundan klinik olarak ayırt edilemeyebilmektedir. BKK papiller karsinomunun tanısı, histopatolojik incelemeden sonra ayırıcı tanıya giren diğer hastalıklar dışlandıktan sonra konabilmektedir. Ayırıcı tanıda boyamalar da yardımcı olabilmektedir. Bölgesel metastaz yapan BKK papiller karsinomunun tedavisi %20 oranında cerrahi rezeksiyon ve boyun diseksiyonudur. Postoperatif dönemde radyoterapi seçeneği de tedavi protokolüne eklenebilmektedir. 3 Bu çalışmada, brankial kist zemininde gelişen papiller karsinom olgusunun tartışılması amaçlanmıştır.
Özet: Hipoksi parametreleri, fiziksel de¤iflkenler ve obstrüktif uyku apnesinin fliddet derecesi ... more Özet: Hipoksi parametreleri, fiziksel de¤iflkenler ve obstrüktif uyku apnesinin fliddet derecesi Amaç: Farkl› fliddet derecesinde obstrüktif uyku apnesi (OUA) olan hastalarda hipoksiyle fiziksel parametreler aras›ndaki iliflkinin belirlenmesi. Yöntem: Bu çal›flma bir gecelik polisomnografik incelemeyle de¤erlendirilmifl 259 erkekte uygulanan retrospektif çapraz kesitsel bir ça-l›flmad›r. OUA'n›n fliddet derecesi apne/hipopne indeksine (AH‹) göre derecelendirildi: normal/basit horlama (n=31); hafif derecede OU-A (n=70); orta derecede OUA (n=63); fliddetli derecede OUA (n=95). Farkl› fliddet derecesinde OUA's› olan hastalar, oksijen satürasyonu <%90 (ST90) veya minimal oksijen satürasyonu (min SaO2) olan en uzun veya en k›sa toplam uyku süresine göre altgruplara ayr›ld›. Bulgular: Ortalama AH‹ 20.4 olay/saat idi. Tek de¤iflkenli analize göre ST90, AH‹ (r=0.772; p≤0.001) ve Epworth uykululuk ölçe¤i (ESS) (r=0.344; p≤0.001) ile korelasyon gösterirken min SaO2, AHI (r=-0.748; p≤0.001) ve ESS (r=-0.319; p≤0.001) ile tersine korelasyon gösterdi. Çok de¤iflkenli do¤rusal regresyon modelinde ST90 ba¤›m-s›z olarak AH‹, ESS ve boyun çevresiyle korele idi, min SaO2 ise ba-¤›ms›z olarak AH‹, ESS ve vücut kitle indeksi (VK‹) ile iliflkiliydi. A¤›r derecede OUA geçiren hastalarda en düflük ve en yüksek min Sa-O2'si olan altgruplarda VK‹, modifiye Mallampati skoru, boyun ve bel çevresi ve retroglossal Müller derecesi anlaml› derecede farkl›yd›. Oksijen satürasyonu <%90 ile karakterize uyku zaman› yüzdesi (CT90) <%10 hastalarda, ST90'›n üst s›n›r› 36 dakika olup min SaO2'nin alt s›-n›r›n›n %70'ine tekabül etmekteydi. Sonuç: Hipoksi parametreleri OUA fliddet derecesi kategorilerine göre anlaml› de¤ifliklikler göstermektedir. Fiziksel parametrelerin hiçbiri fliddetli OUA geçiren hastalar d›fl›nda OUA hastalar›nda hipoksi parametreleriyle klinik aç›dan yararl› iliflkiler içinde de¤ildir.
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat
Hemangiomas are the most common vascular tumors and von Willebrand disease is the most common inh... more Hemangiomas are the most common vascular tumors and von Willebrand disease is the most common inherited bleeding disorder. In this article, we report a 21-year-old female who had von Willebrand disease presenting with 1x1 cm lesion of the tongue. The lesion was located at the anterior one-third in midline tongue throughout full-thickness. The patient was administered cryoprecipitate preoperatively. Then the lesion was excised under local anesthesia. Histopathological examination revealed a hemangioma. No complication such as bleeding or infection after the operation was observed.
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat, 2003
We evaluated the factors that have considerable significance on the outcome of open cavity proced... more We evaluated the factors that have considerable significance on the outcome of open cavity procedures in the treatment of cholesteatoma. The study included 66 patients (43 males, 23 females; mean age 47 years; range 21 to 69 years) who underwent surgery for cholesteatoma. Of these, 56 patients completed at least a five-year follow-up. Mucosal infections and granulation tissue formation occurred in seven patients (10%) in the early postoperative period. Retraction pockets developed in three patients (4%); of these, only one patient required excision because of deep localization. Drum perforations that occurred in two patients (3%) were repaired by myringoplasty. Revision surgery was performed in four patients (7.1%) due to residual cholesteatoma within a five-year follow-up. The height of the facial ridge was found as the most important factor related to a successful outcome of open-technique procedures. Other factors included the creation of a smooth mastoid cavity with round edges,...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2013
The purpose of this study is to evaluate the relationship between poor oral hygiene and middle ea... more The purpose of this study is to evaluate the relationship between poor oral hygiene and middle ear infections. 59 children between 3-12 age intervals were included in this study. The ears were examined by microscope. The findings were marked according to Kempthorne clinical scale and tympanograms were performed. For data analysis of dental caries, dft and DMFT indexes were used in accordance with WHO (World Health Organization) criteria for oral health surveys. The oral hygiene status was determined by using Simplified Oral Hygiene Index of Greene and Vermillion. The scores of 0-1 were classified as low, and of 2-3 as high oral hygiene index (OHI-S). The low OHI-S was taken as the control group (30 patients). The high OHI-S was taken as the study group (29 patients). The effusion scores, the compliance values and the middle ear pressure values in the two groups were compared. The difference between the effusion score values of the control and study groups was found to be statistically meaningful (p = 0.338, and the v 2 = 2.167). The compliance values of the control and study groups did not differ meaningfully statistically (p = 0.671). However, there was a statistically meaningful low middle ear pressure (p = 0.044, v 2 = 4.069) in the control group. Since this finding is expected in the study group, instead of the control group, we did not make an issue of this result. We conclude from these clinical results that there is no statistically meaningful relation between the oral hygiene index and the middle ear.
International Journal of Antimicrobial Agents, 2007
2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to i... more 2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to itraconazole (18%), to fluconazole (59%), and, to a lower extent, to amphotericin B (88.3%) and to voriconazole (94%). Furthermore, the number of C. glabrata strains resistant to at least one antifungal steadily increased from 0 in 2003 to 10 strains in 2005. Conclusions: The results of this study indicated that the pattern of Candida species isolated during the years varied in our clinical setting, showing an increasing incidence of non-albicans species, particularly C. glabrata and C. tropicalis. The susceptibility data evidenced that strains of C. albicans were highly susceptible to the test drugs, together with an increasing rate of C. glabrata strains resistant to antifungals. The usage of azoles in the prophylaxis of fungal infections in our hospital probably influenced the diffusion of non-albicans species, some of which are frequently resistant to these drugs.
Objective: The purpose of this study is to evaluate the relation between poor oral hygiene and to... more Objective: The purpose of this study is to evaluate the relation between poor oral hygiene and tonsillar hypertrophy. Methods: 80 children of ages between 3 and12 who consulted with Pedodontics at Baskent University Istanbul Hospital, were included in this study. For data analysis of dental caries, dft index for primary teeth (d = decayed, f = filled, t = teeth) and DMFT index for permanent teeth (D = decayed, M = Missing due to caries, F = filled, T = Teeth) were used in accordance with WHO (World Health Organization) criteria for oral health surveys. The oral hygiene status was determined by using Simplified Oral Hygiene Index of Greene and Vermillion. The oral hygiene index scores of 0-1 were classified as low, and of 2-3 as high oral hygiene index scores. The low oral hygiene index score group was taken as the control group (42 patients). The high oral hygiene index score group was taken as the study group (38 patients). Tonsil sizes were evaluated on the Brodsky L. Scala. Resul...
KBB-Forum: Elektronik Kulak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi, 2005
... Keywords: Patulous eustachian tube, autophony. The patulous Eustachian tube (tuba aperta) is ... more ... Keywords: Patulous eustachian tube, autophony. The patulous Eustachian tube (tuba aperta) is a benign condition that may be over-looked or misdiagnosed. It is a distressing condition for the patient due to symptoms such as autophonia ie. ...
Idiopathic cervical dystonia (CD) is a focal dystonia characterized by involuntary contraction of... more Idiopathic cervical dystonia (CD) is a focal dystonia characterized by involuntary contraction of the muscles of the neck causing twisting movements and abnormal head and neck postures. Its etiology is unclear; however, intracerebral neuronal circuit pathologies are highly considered. On the contrary, benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo diagnosed. We present a patient with CD suffering from severe vertigo who was diagnosed with BPPV. This is a very unique case representing the co-occurrence of a rare central nervous system pathology and a peripheral inner ear disease. The cause and effect relation between two pathologies is under scope. We present a 55-year-old woman with CD attended our clinic with severe vertigo and nausea. Left posterior semicircular canal BPPV (PSCC BPPV) was diagnosed. Involuntary head and neck muscle contractions caused by CD appear to have contributed to the development of BPPV in this case. However, increased neuronal activities causing CD could also have led to BPPV in the vestibular nuclear level. Further investigations are essential. Peripheral vestibular pathologies and their association with CD are not clearly determined in the literature so far. To our knowledge, there are no other cases reported regarding this co-occurrence.
Tonsillectomy is one of the surgical procedures that are frequently performed by ear, nose, and t... more Tonsillectomy is one of the surgical procedures that are frequently performed by ear, nose, and throat surgeons. The procedure is associated with many intraoperative and postoperative complications, and the nature of the operation site hampers surgical interventions. Cervicofacial subcutaneous emphysema is characterized by the presence of air within the fascial planes of the head-neck region because of various reasons. It may develop iatrogenically or spontaneous-ly because of trauma. Herein, we report a 4-year-old male patient who presented to our clinic with complaints of frequent tonsillitis and snoring and who developed subcutaneous emphysema involving only the maxillofacial region following tonsillectomy. In addition, treatment strategies have been discussed, taking current literature into account.
High-intensity noise sources with an increase in air traffic and sudden changes in atmospheric pr... more High-intensity noise sources with an increase in air traffic and sudden changes in atmospheric pressure can cause hearing loss in pilots. The main goal of this research is to examine hearing loss due to age, the total flight hours and aircraft types and to evaluate the effects of personal conditions that can influence the hearing level. We examined the data of 234 Turkish pilots aged between 25 and 54 years who were examined due to the aviation Law for annual control from January 2005 to January 2014 at Başkent University Medical Faculty, Ankara Hospital. The audiometric results of the pilots were used. While 1, 2, 3, 4, 6, and 8 KHz were used for the airway threshold, 1, 2, and 4 KHz were used for the bone conduction threshold. Results: According to the data of the 234 pilots, there was a significant correlation between high-frequency hearing loss and the total flight hours and pilots' ages. The average hearing loss was higher, particularly in the left ear, in pilots using helicopters than in those using other aircraft types. There was no statistically significant correlation between hearing loss and diabetes, hypercholesterolemia, high blood pressure, anemia, obesity, and smoking. A significant cor relation was observed between high frequency hearing loss and the total flight hours, pilots' age, and aircraft types in our study.
Ankara Üniversitesi tıp fakültesi mecmuası, Oct 27, 2020
Laryngocele is an air-filled sac which originates from the saccule of the ventricle. It is one of... more Laryngocele is an air-filled sac which originates from the saccule of the ventricle. It is one of the rarest lesions of the larynx. Certain occupational and chronic inflammatory diseases may play role in the formation of laryngocele, but the etiology in the majority of them is unclear. When infected, the air inside of the laryngeal saccule replaced by purulent fluid and it becomes laryngopyocele. These lesions may lead to dysphagia, roughness, and dyspnea. There are limited number of cases in the literature. In the presented case here, laryngopyocele showed suspicious mass appearance in the radiological imaging and its diagnosis was confirmed by intraoperative direct laryngoscopy. Laryngoceles are clinically asymptomatic unless they reach large sizes. As internal laryngoceles and laryngopyoceles may also be related to tumors originated from laryngeal ventricles, it is highly important to evaluate the lesion borders before the operation.
Upper airway obstruction and sleeping disorders are important issues in syndromic children, inclu... more Upper airway obstruction and sleeping disorders are important issues in syndromic children, including mouth, lower-upper jaw, or all facial abnormalities. Tonsillectomy and/or adenoidectomy is required because of systemic problems and upper airway obstruction that increase the existing systemic problems, except those anomalies. However, tonsillectomy and/or adenoidectomy are mostly avoided because of the tendency to cause both intubation/ perioperative systemic problems and respiratory complications in the postoperative period and in delays in the oral intake. However, these surgeries are sometimes required. In this context, we present our experience related with performing tonsillectomy and/or adenoidectomy in syndromic children admitted to our hospital. We retrospectively examined the data on tonsillectomy and/or adenoidectomy performed in syndromic patients in our clinic between 2001 and 2011. We did not observe any postoperative complications in adenoidectomy and/or tonsillectomy performed by the same surgeon in 14 syndromic cases. It should be noted that respiratory problems may arise from many different anatomical regions in syndromic patients. Therefore, surgery should be performed taking into consideration all of these factors in these patients. These patients must be hospitalized in the postoperative period.
Benign paroxysmal positional vertigo (BPPV) is a clinical entity characterized by acute, brief pa... more Benign paroxysmal positional vertigo (BPPV) is a clinical entity characterized by acute, brief paroxysmal attacks of rotational vertigo induced by head position changes. It is the most common peripheral vestibular pathology and is seen more frequently in women. However, to our knowledge, there is very limited data on the association between BPPV and pregnancy in both English and Turkish literature. We present four pregnant women diagnosed with BPPV for the first time during gestation and revise the etiological factors of BPPV and the role of pregnancy-related changes in BPPV.
Özet: Hipoksi parametreleri, fiziksel de¤iflkenler ve obstrüktif uyku apnesinin fliddet derecesi ... more Özet: Hipoksi parametreleri, fiziksel de¤iflkenler ve obstrüktif uyku apnesinin fliddet derecesi Amaç: Farkl› fliddet derecesinde obstrüktif uyku apnesi (OUA) olan hastalarda hipoksiyle fiziksel parametreler aras›ndaki iliflkinin belirlenmesi. Yöntem: Bu çal›flma bir gecelik polisomnografik incelemeyle de¤erlendirilmifl 259 erkekte uygulanan retrospektif çapraz kesitsel bir ça-l›flmad›r. OUA'n›n fliddet derecesi apne/hipopne indeksine (AH‹) göre derecelendirildi: normal/basit horlama (n=31); hafif derecede OU-A (n=70); orta derecede OUA (n=63); fliddetli derecede OUA (n=95). Farkl› fliddet derecesinde OUA's› olan hastalar, oksijen satürasyonu <%90 (ST90) veya minimal oksijen satürasyonu (min SaO2) olan en uzun veya en k›sa toplam uyku süresine göre altgruplara ayr›ld›. Bulgular: Ortalama AH‹ 20.4 olay/saat idi. Tek de¤iflkenli analize göre ST90, AH‹ (r=0.772; p≤0.001) ve Epworth uykululuk ölçe¤i (ESS) (r=0.344; p≤0.001) ile korelasyon gösterirken min SaO2, AHI (r=-0.748; p≤0.001) ve ESS (r=-0.319; p≤0.001) ile tersine korelasyon gösterdi. Çok de¤iflkenli do¤rusal regresyon modelinde ST90 ba¤›m-s›z olarak AH‹, ESS ve boyun çevresiyle korele idi, min SaO2 ise ba-¤›ms›z olarak AH‹, ESS ve vücut kitle indeksi (VK‹) ile iliflkiliydi. A¤›r derecede OUA geçiren hastalarda en düflük ve en yüksek min Sa-O2'si olan altgruplarda VK‹, modifiye Mallampati skoru, boyun ve bel çevresi ve retroglossal Müller derecesi anlaml› derecede farkl›yd›. Oksijen satürasyonu <%90 ile karakterize uyku zaman› yüzdesi (CT90) <%10 hastalarda, ST90'›n üst s›n›r› 36 dakika olup min SaO2'nin alt s›-n›r›n›n %70'ine tekabül etmekteydi. Sonuç: Hipoksi parametreleri OUA fliddet derecesi kategorilerine göre anlaml› de¤ifliklikler göstermektedir. Fiziksel parametrelerin hiçbiri fliddetli OUA geçiren hastalar d›fl›nda OUA hastalar›nda hipoksi parametreleriyle klinik aç›dan yararl› iliflkiler içinde de¤ildir.
Otalji, ya da kulağa lokalize ağrı acil servislerde. Pediatri ve otorinolaringoloji kliniklerinde... more Otalji, ya da kulağa lokalize ağrı acil servislerde. Pediatri ve otorinolaringoloji kliniklerinde sık rastlanılan bir semptomdur. Kulak ağrısı yaşanılan durumlarda tedavinin etkin olabilmesi, etiyolojiye yönelik tedavilerin yanı sıra, etkili ağrı kontrolünü sağlamakla mümkün olmaktadır. Ağrı için oral veya lokal tedaviler kullanılmaktadır. Son zamanlarda lokal anestezikler sıklıkla tercih edilmektedir. Ancak hasta seçimi, doz ayarlanması, etkinlik süresi ve yan etkiler, kulak zarında perforasyon olup olmaması konusunda hekimlerin bilinçli ve dikkatli olması önemlidir. Bu derleme ile en sık kullanılan lokal anesteziklerden biri olan Lidokainin (amid grubu lokal anestezik) otaljideki etkinliği ve güvenilirliği tartışılacaktır.
kulak burun boğaz ve baş boyun cerrahisi dergisi, 2019
rankial anomaliler, boyun lateralinde en sık karşılaşılan konjenital boyun patolojileridir. Bu an... more rankial anomaliler, boyun lateralinde en sık karşılaşılan konjenital boyun patolojileridir. Bu anomaliler en sık kist şeklinde ortaya çıkmaktadırlar. 1 Brankial kist üzerinde enfeksiyon gelişebildiği gibi, karsinom geliştiğine dair yayınlar da literatürde bulunmaktadır. 1,2 Karsinomlar arasında da skuamöz hücreli karsinomlar daha sık görülmesine rağmen primer papiller karsinom oldukça nadirdir. Brankial kleft kisti (BKK) papiller karsinomu, benign BKK veya metastatik papiller karsinomundan klinik olarak ayırt edilemeyebilmektedir. BKK papiller karsinomunun tanısı, histopatolojik incelemeden sonra ayırıcı tanıya giren diğer hastalıklar dışlandıktan sonra konabilmektedir. Ayırıcı tanıda boyamalar da yardımcı olabilmektedir. Bölgesel metastaz yapan BKK papiller karsinomunun tedavisi %20 oranında cerrahi rezeksiyon ve boyun diseksiyonudur. Postoperatif dönemde radyoterapi seçeneği de tedavi protokolüne eklenebilmektedir. 3 Bu çalışmada, brankial kist zemininde gelişen papiller karsinom olgusunun tartışılması amaçlanmıştır.
Özet: Hipoksi parametreleri, fiziksel de¤iflkenler ve obstrüktif uyku apnesinin fliddet derecesi ... more Özet: Hipoksi parametreleri, fiziksel de¤iflkenler ve obstrüktif uyku apnesinin fliddet derecesi Amaç: Farkl› fliddet derecesinde obstrüktif uyku apnesi (OUA) olan hastalarda hipoksiyle fiziksel parametreler aras›ndaki iliflkinin belirlenmesi. Yöntem: Bu çal›flma bir gecelik polisomnografik incelemeyle de¤erlendirilmifl 259 erkekte uygulanan retrospektif çapraz kesitsel bir ça-l›flmad›r. OUA'n›n fliddet derecesi apne/hipopne indeksine (AH‹) göre derecelendirildi: normal/basit horlama (n=31); hafif derecede OU-A (n=70); orta derecede OUA (n=63); fliddetli derecede OUA (n=95). Farkl› fliddet derecesinde OUA's› olan hastalar, oksijen satürasyonu <%90 (ST90) veya minimal oksijen satürasyonu (min SaO2) olan en uzun veya en k›sa toplam uyku süresine göre altgruplara ayr›ld›. Bulgular: Ortalama AH‹ 20.4 olay/saat idi. Tek de¤iflkenli analize göre ST90, AH‹ (r=0.772; p≤0.001) ve Epworth uykululuk ölçe¤i (ESS) (r=0.344; p≤0.001) ile korelasyon gösterirken min SaO2, AHI (r=-0.748; p≤0.001) ve ESS (r=-0.319; p≤0.001) ile tersine korelasyon gösterdi. Çok de¤iflkenli do¤rusal regresyon modelinde ST90 ba¤›m-s›z olarak AH‹, ESS ve boyun çevresiyle korele idi, min SaO2 ise ba-¤›ms›z olarak AH‹, ESS ve vücut kitle indeksi (VK‹) ile iliflkiliydi. A¤›r derecede OUA geçiren hastalarda en düflük ve en yüksek min Sa-O2'si olan altgruplarda VK‹, modifiye Mallampati skoru, boyun ve bel çevresi ve retroglossal Müller derecesi anlaml› derecede farkl›yd›. Oksijen satürasyonu <%90 ile karakterize uyku zaman› yüzdesi (CT90) <%10 hastalarda, ST90'›n üst s›n›r› 36 dakika olup min SaO2'nin alt s›-n›r›n›n %70'ine tekabül etmekteydi. Sonuç: Hipoksi parametreleri OUA fliddet derecesi kategorilerine göre anlaml› de¤ifliklikler göstermektedir. Fiziksel parametrelerin hiçbiri fliddetli OUA geçiren hastalar d›fl›nda OUA hastalar›nda hipoksi parametreleriyle klinik aç›dan yararl› iliflkiler içinde de¤ildir.
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat
Hemangiomas are the most common vascular tumors and von Willebrand disease is the most common inh... more Hemangiomas are the most common vascular tumors and von Willebrand disease is the most common inherited bleeding disorder. In this article, we report a 21-year-old female who had von Willebrand disease presenting with 1x1 cm lesion of the tongue. The lesion was located at the anterior one-third in midline tongue throughout full-thickness. The patient was administered cryoprecipitate preoperatively. Then the lesion was excised under local anesthesia. Histopathological examination revealed a hemangioma. No complication such as bleeding or infection after the operation was observed.
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat, 2003
We evaluated the factors that have considerable significance on the outcome of open cavity proced... more We evaluated the factors that have considerable significance on the outcome of open cavity procedures in the treatment of cholesteatoma. The study included 66 patients (43 males, 23 females; mean age 47 years; range 21 to 69 years) who underwent surgery for cholesteatoma. Of these, 56 patients completed at least a five-year follow-up. Mucosal infections and granulation tissue formation occurred in seven patients (10%) in the early postoperative period. Retraction pockets developed in three patients (4%); of these, only one patient required excision because of deep localization. Drum perforations that occurred in two patients (3%) were repaired by myringoplasty. Revision surgery was performed in four patients (7.1%) due to residual cholesteatoma within a five-year follow-up. The height of the facial ridge was found as the most important factor related to a successful outcome of open-technique procedures. Other factors included the creation of a smooth mastoid cavity with round edges,...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2013
The purpose of this study is to evaluate the relationship between poor oral hygiene and middle ea... more The purpose of this study is to evaluate the relationship between poor oral hygiene and middle ear infections. 59 children between 3-12 age intervals were included in this study. The ears were examined by microscope. The findings were marked according to Kempthorne clinical scale and tympanograms were performed. For data analysis of dental caries, dft and DMFT indexes were used in accordance with WHO (World Health Organization) criteria for oral health surveys. The oral hygiene status was determined by using Simplified Oral Hygiene Index of Greene and Vermillion. The scores of 0-1 were classified as low, and of 2-3 as high oral hygiene index (OHI-S). The low OHI-S was taken as the control group (30 patients). The high OHI-S was taken as the study group (29 patients). The effusion scores, the compliance values and the middle ear pressure values in the two groups were compared. The difference between the effusion score values of the control and study groups was found to be statistically meaningful (p = 0.338, and the v 2 = 2.167). The compliance values of the control and study groups did not differ meaningfully statistically (p = 0.671). However, there was a statistically meaningful low middle ear pressure (p = 0.044, v 2 = 4.069) in the control group. Since this finding is expected in the study group, instead of the control group, we did not make an issue of this result. We conclude from these clinical results that there is no statistically meaningful relation between the oral hygiene index and the middle ear.
International Journal of Antimicrobial Agents, 2007
2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to i... more 2005 resistant to at least one antifungal. Conversely, C. glabrata showed low susceptibility to itraconazole (18%), to fluconazole (59%), and, to a lower extent, to amphotericin B (88.3%) and to voriconazole (94%). Furthermore, the number of C. glabrata strains resistant to at least one antifungal steadily increased from 0 in 2003 to 10 strains in 2005. Conclusions: The results of this study indicated that the pattern of Candida species isolated during the years varied in our clinical setting, showing an increasing incidence of non-albicans species, particularly C. glabrata and C. tropicalis. The susceptibility data evidenced that strains of C. albicans were highly susceptible to the test drugs, together with an increasing rate of C. glabrata strains resistant to antifungals. The usage of azoles in the prophylaxis of fungal infections in our hospital probably influenced the diffusion of non-albicans species, some of which are frequently resistant to these drugs.
Objective: The purpose of this study is to evaluate the relation between poor oral hygiene and to... more Objective: The purpose of this study is to evaluate the relation between poor oral hygiene and tonsillar hypertrophy. Methods: 80 children of ages between 3 and12 who consulted with Pedodontics at Baskent University Istanbul Hospital, were included in this study. For data analysis of dental caries, dft index for primary teeth (d = decayed, f = filled, t = teeth) and DMFT index for permanent teeth (D = decayed, M = Missing due to caries, F = filled, T = Teeth) were used in accordance with WHO (World Health Organization) criteria for oral health surveys. The oral hygiene status was determined by using Simplified Oral Hygiene Index of Greene and Vermillion. The oral hygiene index scores of 0-1 were classified as low, and of 2-3 as high oral hygiene index scores. The low oral hygiene index score group was taken as the control group (42 patients). The high oral hygiene index score group was taken as the study group (38 patients). Tonsil sizes were evaluated on the Brodsky L. Scala. Resul...
KBB-Forum: Elektronik Kulak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi, 2005
... Keywords: Patulous eustachian tube, autophony. The patulous Eustachian tube (tuba aperta) is ... more ... Keywords: Patulous eustachian tube, autophony. The patulous Eustachian tube (tuba aperta) is a benign condition that may be over-looked or misdiagnosed. It is a distressing condition for the patient due to symptoms such as autophonia ie. ...
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