Résumé/Abstract Objectif: Le but de cette étude était d'utiliser une technique immunohistoch... more Résumé/Abstract Objectif: Le but de cette étude était d'utiliser une technique immunohistochimique pour déterminer l'expression du facteur de croissance vasculaire endothélial (FCVE) dans les polypes nasaux. Méthode: Le groupe d'étude est composé ...
Fibrovascular polyps occur most commonly in the cervical esophagus and are extremely rare in the ... more Fibrovascular polyps occur most commonly in the cervical esophagus and are extremely rare in the hypopharynx. In this paper, we report a case of fibrovascular polyp of a 52-year-old female, who presented with progressive dysphagia and weight loss and regurgitating a mass from her mouth. By the endoscopic examination, a polyp covered by normal mucosa with a wide stalk was detected at the hypopharynx. The pedicle of the mass was identified under general anesthesia and the 13 × 3 × 2 cm mass was completely resected perorally. Histopathological examination of the tumor showed oedematous subepithelial fibrous stroma, surrounded by squamous epithelium and containing many congested vascular structures. No recurrence was detected over one year of follow-up. This case highlights the need for clinicians to be aware of this rare entity and to develop the best approach to patient management.
The aim of the study was to determine the heights of the anterior skull base and the distances be... more The aim of the study was to determine the heights of the anterior skull base and the distances between the anterior nasal spine and the skull base at three levels by means of coronal and reformatted sagittal images of computed tomography. The present study was performed on coronal and reformatted sagittal CT scans of 30 patients with sinonasal complaints. On the coronal view, the heights of the cribriform plate, the roof of ethmoid, and lateral lamella and the medial take-off angle between the ethmoid roof and cribriform plate were measured at different levels. On the reformatted sagittal images the distances from the nasal spine to the anterior cranial base at three different levels were measured. Then, the side-to-side variability of these measurements was statistically compared. The variations with normal distribution and abnormal distribution were analysed by paired t test and Wilcoxon paired-signed rank test, respectively. A statistically significant difference was detected only between the right and left sides in the height of the lateral lamella at the crista galli level (p < 0.05). The lateral lamella at the crista galli level on the left side was higher than on the right side. No statistically significant differences between the left and the right sides were noted in the heights and the distances of other data (p > 0.05). The normal anatomy of the anterior skull base has been described in detail on coronal and reconstructed sagittal computed tomography. These measurements may be helpful in the presurgical evaluation of patients undergoing endoscopic sinus surgery to optimize surgical safety.
The pollution in the Golden Horn is one of the most important environmental problems of Istanbul.... more The pollution in the Golden Horn is one of the most important environmental problems of Istanbul. Alluvium carried by Alibey and Kagithane creeks, and domestic and industrial wastewater discharges are the major sources of the pollution. In the upstream, a part of 3 to 4 km long ...
Kulak Burun Bogaz Ihtisas Dergisi Kbb Journal of Ear Nose and Throat, 2007
OBJECTIVES: We investigated the effect of intranasal packing placed after septoplasty or alternat... more OBJECTIVES: We investigated the effect of intranasal packing placed after septoplasty or alternatively suturing the septum without inserting a packing on systemic oxygen saturation and patient comfort.PATIENTS AND METHODS: The study involved 37 patients who underwent septoplasty for isolated septum deviation. Intranasal packing was used in 18 patients (5 women, 13 men; mean age 30+/-10 years; range 18 to 47 years), while 19 patients (5 women, 14 men; mean age 31+/-12 years; range 18 to 54 years) underwent nasal septal suturing. To evaluate systemic oxygen saturations, partial oxygen saturations were measured pre- and postoperatively by pulse oximetry. The effect of intranasal packing and suturing on patient comfort was assessed by a visual analog scale before and 48 hours after surgery, five days after removal of nasal packing, and 30 days after surgery.RESULTS: Postoperative systemic oxygen saturations exhibited higher levels in the sutured group, but this did not reach significance (p>0.05). The incidence of nasal obstruction was significantly higher with nasal packing (p<0.05). In general, headache and facial pain were more common with nasal packing, while suturing was associated with a higher frequency of nasal crusting, postnasal discharge, and reduced sense of smell (p>0.05).CONCLUSION: Considering that, albeit not significantly, intranasal packing used after septoplasty decreases systemic oxygen saturation more than suturing and thus, has more adverse effects on patient comfort, suturing the septum may be a better alternative, particularly in elderly patients with chronic systemic diseases.
Modiolar deficiency has been reported as representing the mildest form of cochlear dysplasia. In ... more Modiolar deficiency has been reported as representing the mildest form of cochlear dysplasia. In this study the authors aimed to determine baseline values of the mid-modiolar area and modiolus volume in normal subjects. In this way they aimed to improve the detection of previously underdiagnosed subtle cochlear dysplasia in patients with sensorineural hearing loss.
Anatomic variations of the vital structures adjacent to the sphenoid sinus can be jeopardized dur... more Anatomic variations of the vital structures adjacent to the sphenoid sinus can be jeopardized during functional endoscopic sinus surgery (FESS). The knowledge of the size and extent of pneumatization of the sphenoid sinus (SS) is an important condition for adequate surgical treatment of its disease. The bony anatomic variations of SS as well as its relationship with adjacent vital structures were reviewed in this paper. The study was performed on 267 patients with a complaint of chronic or recurrent sinusitis. Computed tomographic (CT) scans were obtained upon completion of therapy. The evaluations of the sphenoid sinuses were regarded separately, so as 534 sides were examined. Especially bony anatomic variations as well as mucosal abnormalities of the sphenoid sinuses were examined. Pneumatization of the pterygoid process and anterior clinoid process were found in 39.7% and 17.2% of the patients respectively. Vidian canal protrusion was found in a total of 158 sides of which 60 were bilateral. These entities were encountered usually when pneumatization of the pterygoid process occurred. Carotid canal and optic canal protrusions were found in 5.2% and 4.1% of the patients respectively. Mucosal thickening, and polyps or cysts of sphenoid sinuses were detected in 20.6% and 4.5% of the patients respectively. There was a statistically significant correlation between pterygoid pneumatization and vidian canal protrusion (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and vs. foramen rotundum protusion (p = 0.004). While the optic canal protrusion was found significantly associated with the anterior clinoid pneumatization (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), there was no statistically significant correlation between a carotid canal protrusion and anterior clinoid pneumatization (p = 0.250). Sphenoid sinus surgery is very risky, because of changing variations of the cavity. We are in the opinion that detailed data from CT scans of SS will enable the surgeon to interpret any anatomic variations and pathological conditions before initiation of the surgical therapy.
In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sin... more In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sinus packs on pain management after functional endoscopic surgery (FESS). One hundred and fifty patients with the diagnosis of bilateral chronic sinusitis with or without nasal polyps who underwent FESS were included into the study. Their pre-operative Lund-Mackay computerized tomography (CT) Scores were similar. We applied anesthetic agents of 2 % lidocaine HCl, 0.25 % Bupivacaine HCl, 0.2 % Ropivacaine, 2 % Prilocaine and 0.9 % NaCl (Saline) in groups 1-5 onto the sinus packs after FESS. At postoperative period, acetaminophen (250 mg/5 ml) was used in 10-15 mg/kg per dose (4 times a day). Bleeding grade, operation duration, postoperative number of gauze/24 h, additional painkiller need, pain values at 1, 2, 4, 8, 12 and 24 h were noted. Lund-Kennedy endoscopic scores were also evaluated at 1st, 2nd and 4th weeks postoperatively. In saline group, 93.3 % of the patients needed additional painkiller. Whereas, in Bupivacaine group, additional painkiller use (20.0 %) is less than the other groups. In Bupivacaine group, number of gauze/24 h use was lower than lidocaine, ropivacaine and prilocaine groups. In our study, except 1st and 24th hours, pain values of groups can be written in ascending order (from less to higher) as Bupivacaine, Lidocaine, Prilocaine, Ropivacaine and Saline. In the first hour, pain values of groups can be written in ascending order (from less to higher) as Lidocaine, Prilocaine, Bupivacaine, Ropivacaine and Saline. In the 2nd week, in the Bupivacaine and Lidocaine Groups separately, postoperative Lund-Kennedy scores were lower than the Prilocaine and Saline Groups. In the 1st month, Lidocaine Group&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Lund-Kennedy scores were significantly lower than the Saline Group. Synechia values were not different between groups. Bupivacaine help the lower pain values and less additional painkiller need after FESS. Therefore, we recommend to use Bupivacaine soaked sinus packs after FESS for achieve less pain values and to improve patient satisfaction.
The journal of international advanced otology, 2015
To date, studies in all populations showed that mutations in the gene of Gap junction protein bet... more To date, studies in all populations showed that mutations in the gene of Gap junction protein beta 2 (GJB2) play an important role in non-syndromic autosomal recessive congenital hearing loss. The aim of this study was to evaluate GJB2 gene of patients with hearing loss in our region using deoxyribonucleic acid (DNA) sequencing method and to demonstrate region-specific mutation and polymorphism distribution. Patients who had bilateral severe sensorineural non-syndromic hearing loss identified by audiologic evaluation were included. Peripheral blood samples were collected and the GJB2 gene exon1 and exon 2 regions were amplified by polymerase chain reaction (PCR). Obtained PCR products were sequenced by the DNA sequence analysis method (SeqFinder Sequencing System; ABI 3130; Foster City, CA, USA) and analyzed using the SeqScape software. Of the 77 patients, 16 had homozygous or heterozygous mutation. The mutation of 35delG, which is known as the most frequent mutation of GJB2 gene, w...
We investigated the efficacy of bupivacaine, lidocaine, and saline infiltrations to peritonsillar... more We investigated the efficacy of bupivacaine, lidocaine, and saline infiltrations to peritonsillar region and uvula and soft palate regions for pain relief after tonsillectomy and modified cautery-assisted uvulopalatopharyngoplasty (MCAUP) in patients with obstructive sleep apnea. In this prospective study, 91 patients (32-65 years old) with obstructive sleep apnea underwent tonsillectomy and MCAUP and were divided into 3 groups. In group 1 patients (n = 31), 0.25% bupivacaine HCl + 1/200,000 epinephrine (10 mL); in group 2 patients (n = 31), 1% lidocaine HCl + 1/200,000 epinephrine (10 mL); and in group 3 patients (n = 29), 0.9% saline (10 mL) were injected to peritonsillar region and uvula and soft palate regions. Operation duration, amount of bleeding, and analgesic requirement and visual analog scale for pain at rest and at swallowing were evaluated in all groups. Mean body mass index values were between 27.0 and 27.3 kg/m in all groups. Their apnea-hypopnea index values were between 15.3 and 16.9 per hour, and there were no significant differences between their body mass index and apnea-hypopnea index values. Duration of operation of patients in the bupivacaine group was significantly lower than that of patients in the lidocaine and saline groups. In addition, in the lidocaine group, operation duration was significantly lower than that in the saline group. Bleeding amount and postoperative analgesic requirement of the saline group were significantly higher than those of the bupivacaine and lidocaine groups. Although both these measures (operation duration and amount of bleeding) were statistically significant, a mean operating time of 44.3 versus 46.0 minutes and 64.4-mL versus 68.4-mL blood loss for the bupivacaine and lidocaine groups were clinically irrelevant and not too important. In terms of visual analog scale for pain at rest and/or swallowing, Bupivacaine provided more relief than lidocaine and saline injections. The lidocaine provides pain relief less than bupivacaine and more than saline at rest and/or swallowing. We recommend the use of bupivacaine injections in peritonsillar, uvular, and soft palate regions during tonsillectomy + MCAUP operations. It reduces operation duration and provides more pain relief postoperatively. When patients had cardiac problems, lidocaine may also be recommended because of its cardiac depressant and antiarrhythmic effects and positive effects for pain relief compared with saline injections.
The Journal of International Advanced Otology, 2015
To determine whether there is an association between otitis media with effusion and laryngopharyn... more To determine whether there is an association between otitis media with effusion and laryngopharyngeal reflux in children. This study included 31 children with otitis media with effusion. The pepsinogen level in the middle ear fluid of all patients was measured by sandwich enzyme-linked immunosorbent assay. Each patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s middle ear fluid was investigated for Helicobacter pylori (H. pylori) using the Campylobacter-like organism (CLO) test. The middle ear pepsinogen levels were compared with those in the serum. The correlation between pepsinogen levels and H. pylori positivity in the middle ear fluid was investigated. The mean middle ear pepsinogen level (211.69 ng/mL) was significantly higher than that in the serum (24.18 ng/mL) in patients with otitis media with effusion. The middle ear aspirates of six patients (19%) were positive for H. pylori, and the correlation between H. pylori positivity and increased pepsinogen levels in the middle ear fluid was statistically significant in patients with otitis media with effusion. We detected higher pepsinogen levels and H. pylori positivity rates in the middle ear fluid than in the serum of patients with otitis media with effusion. These results support the role of laryngopharyngeal reflux in the pathogenesis of otitis media with effusion.
The combined effects of erythromycin-tetracycline-sulfamethoxazole (ETS) and sulfamethoxazole-tet... more The combined effects of erythromycin-tetracycline-sulfamethoxazole (ETS) and sulfamethoxazole-tetracycline (ST) antibiotics on the performance of anaerobic sequencing batch reactors were studied. A control reactor was fed with wastewater that was free of antibiotics, while two additional reactors were fed with ETS and ST. The way in which the ETS and ST mixtures impact COD removal, VFA production, antibiotic degradation, biogas production and composition were investigated. The effects of the ETS mixtures were different from the ST mixtures, erythromycin can have an antagonistic effect on sulfamethoxazole and tetracycline. The anaerobic pre-treatment of these antibiotics can represent a suitable alternative to the use of chemical treatments for concentrations at 10mg/L of S and 1mg/L of T; 2mg/L of E, 2mg/L of T and 20mg/L of S for the ST and ETS reactors respectively, which corresponds to min 70% COD removal efficiency.
Nasal polyps were once believed to originate in sinus cavities, and from there to pass through os... more Nasal polyps were once believed to originate in sinus cavities, and from there to pass through ostia and into the nasal cavity. However, data gained from subsequent anatomic studies revealed that they can actually originate in numerous locations in the sinonasal area. We report a case of a nasal polyp that originated in the cribriform plate, which is a very rare site of origin for a nasal polyp.
Spread of manure pathogens is of considerable concern due to use of manure for land application. ... more Spread of manure pathogens is of considerable concern due to use of manure for land application. In this study, the effects of four static pile treatment options for bovine manure on die-off of a generic Escherichia coli, E. coli O157:H7 surrogate, Salmonella Senftenberg, Salm. Typhimurium, and Listeria monocytogenes were evaluated. Bovine manure spiked with these bacteria were placed in cassettes at the top, middle, and bottom sections of four static pile treatments that reflect minimal changes in pile construction with and without straw. Temperatures were monitored continuously during the 28 day self-heating period. E. coli and salmonellae were reduced from 8 to 9 log10 CFU g(-1) to undetectable levels (<1.77 log10 MPN g(-1)) at 25-30 cm depths within 7 days in all pile sections except for the manure-only pile in which 3-4 logs of reduction were obtained. No L. monocytogenes initially present at 6.62 log10 CFU g(-1) were recovered from straw-amended piles after 14 days, in cont...
Clinical and investigative medicine. Médecine clinique et experimentale, 2010
To determine whether trace elements that are essential for neural function play a role in the pat... more To determine whether trace elements that are essential for neural function play a role in the pathophysiology and etiology of auditory neuropathy (AN). Patients diagnosed with auditory neuropathy consisted of eight children (two male, six female). The blood tests including the measurement of sodium, potassium, chloride, calcium, phosphorus, iron, copper and magnesium were done in children with AN during their routine care. Of the eight children with AN, many had serum levels outside the normal range: one had low sodium, two had low potassium, one had low chloride, two had high zinc and three had low zinc, two had low calcium and two had higher than normal phosphorus. Although some serum trace element levels in our patients were higher or lower than normal values, the mean values were within normal limits. Thus, we were unable to detect a relationship between serum trace element levels and AN-. In the future, larger studies should be conducted to confirm these findings.
Clinical and Experimental Otorhinolaryngology, 2013
Objectives. The aim of this study is to investigate the role of platelet-derived growth factor (P... more Objectives. The aim of this study is to investigate the role of platelet-derived growth factor (PDGF) in the pathogenesis of sinonasal polyps.
This article describes a modification of the incisionless otoplasty. We investigated the complica... more This article describes a modification of the incisionless otoplasty. We investigated the complication rates, recurrence risks, and patient satisfaction with this modified procedure. In total, 26 patients (49 ears) complaining of prominent ear were operated on. Auriculocephalic distances were measured at three different levels, pre-operatively, at the end of the surgery, and at 4 weeks and 6 months after surgery to evaluate the efficacy of the technique. Patient satisfaction was evaluated using a visual analog scale and the global aesthetic improvement scale was applied by an independent non-participating plastic surgeon at 6 months after the surgery. The mean loss of medialization was ~1 mm at 4 weeks after surgery and 2 mm at 6 months after surgery for all levels. According to visual analog scale, patient or parent satisfaction increased significantly. The global aesthetic improvement scale rated the patients as 93.9 % &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;improved&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and 6.1 % as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no change.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; No rating was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;worse.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; There are many advantages of this technique. The operation is not time-consuming, does not require a dressing, and it can be performed in adults with local anesthesia under office conditions, with no need for hospitalization. After the operation, patients can return to their daily activities immediately. It is associated with a low complication rate and high patient satisfaction. This technique is a good option for otoplasty in patients with isolated, inadequate development of anti-helical ridge, and with soft auricular cartilage.
Résumé/Abstract Objectif: Le but de cette étude était d'utiliser une technique immunohistoch... more Résumé/Abstract Objectif: Le but de cette étude était d'utiliser une technique immunohistochimique pour déterminer l'expression du facteur de croissance vasculaire endothélial (FCVE) dans les polypes nasaux. Méthode: Le groupe d'étude est composé ...
Fibrovascular polyps occur most commonly in the cervical esophagus and are extremely rare in the ... more Fibrovascular polyps occur most commonly in the cervical esophagus and are extremely rare in the hypopharynx. In this paper, we report a case of fibrovascular polyp of a 52-year-old female, who presented with progressive dysphagia and weight loss and regurgitating a mass from her mouth. By the endoscopic examination, a polyp covered by normal mucosa with a wide stalk was detected at the hypopharynx. The pedicle of the mass was identified under general anesthesia and the 13 × 3 × 2 cm mass was completely resected perorally. Histopathological examination of the tumor showed oedematous subepithelial fibrous stroma, surrounded by squamous epithelium and containing many congested vascular structures. No recurrence was detected over one year of follow-up. This case highlights the need for clinicians to be aware of this rare entity and to develop the best approach to patient management.
The aim of the study was to determine the heights of the anterior skull base and the distances be... more The aim of the study was to determine the heights of the anterior skull base and the distances between the anterior nasal spine and the skull base at three levels by means of coronal and reformatted sagittal images of computed tomography. The present study was performed on coronal and reformatted sagittal CT scans of 30 patients with sinonasal complaints. On the coronal view, the heights of the cribriform plate, the roof of ethmoid, and lateral lamella and the medial take-off angle between the ethmoid roof and cribriform plate were measured at different levels. On the reformatted sagittal images the distances from the nasal spine to the anterior cranial base at three different levels were measured. Then, the side-to-side variability of these measurements was statistically compared. The variations with normal distribution and abnormal distribution were analysed by paired t test and Wilcoxon paired-signed rank test, respectively. A statistically significant difference was detected only between the right and left sides in the height of the lateral lamella at the crista galli level (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The lateral lamella at the crista galli level on the left side was higher than on the right side. No statistically significant differences between the left and the right sides were noted in the heights and the distances of other data (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). The normal anatomy of the anterior skull base has been described in detail on coronal and reconstructed sagittal computed tomography. These measurements may be helpful in the presurgical evaluation of patients undergoing endoscopic sinus surgery to optimize surgical safety.
The pollution in the Golden Horn is one of the most important environmental problems of Istanbul.... more The pollution in the Golden Horn is one of the most important environmental problems of Istanbul. Alluvium carried by Alibey and Kagithane creeks, and domestic and industrial wastewater discharges are the major sources of the pollution. In the upstream, a part of 3 to 4 km long ...
Kulak Burun Bogaz Ihtisas Dergisi Kbb Journal of Ear Nose and Throat, 2007
OBJECTIVES: We investigated the effect of intranasal packing placed after septoplasty or alternat... more OBJECTIVES: We investigated the effect of intranasal packing placed after septoplasty or alternatively suturing the septum without inserting a packing on systemic oxygen saturation and patient comfort.PATIENTS AND METHODS: The study involved 37 patients who underwent septoplasty for isolated septum deviation. Intranasal packing was used in 18 patients (5 women, 13 men; mean age 30+/-10 years; range 18 to 47 years), while 19 patients (5 women, 14 men; mean age 31+/-12 years; range 18 to 54 years) underwent nasal septal suturing. To evaluate systemic oxygen saturations, partial oxygen saturations were measured pre- and postoperatively by pulse oximetry. The effect of intranasal packing and suturing on patient comfort was assessed by a visual analog scale before and 48 hours after surgery, five days after removal of nasal packing, and 30 days after surgery.RESULTS: Postoperative systemic oxygen saturations exhibited higher levels in the sutured group, but this did not reach significance (p>0.05). The incidence of nasal obstruction was significantly higher with nasal packing (p<0.05). In general, headache and facial pain were more common with nasal packing, while suturing was associated with a higher frequency of nasal crusting, postnasal discharge, and reduced sense of smell (p>0.05).CONCLUSION: Considering that, albeit not significantly, intranasal packing used after septoplasty decreases systemic oxygen saturation more than suturing and thus, has more adverse effects on patient comfort, suturing the septum may be a better alternative, particularly in elderly patients with chronic systemic diseases.
Modiolar deficiency has been reported as representing the mildest form of cochlear dysplasia. In ... more Modiolar deficiency has been reported as representing the mildest form of cochlear dysplasia. In this study the authors aimed to determine baseline values of the mid-modiolar area and modiolus volume in normal subjects. In this way they aimed to improve the detection of previously underdiagnosed subtle cochlear dysplasia in patients with sensorineural hearing loss.
Anatomic variations of the vital structures adjacent to the sphenoid sinus can be jeopardized dur... more Anatomic variations of the vital structures adjacent to the sphenoid sinus can be jeopardized during functional endoscopic sinus surgery (FESS). The knowledge of the size and extent of pneumatization of the sphenoid sinus (SS) is an important condition for adequate surgical treatment of its disease. The bony anatomic variations of SS as well as its relationship with adjacent vital structures were reviewed in this paper. The study was performed on 267 patients with a complaint of chronic or recurrent sinusitis. Computed tomographic (CT) scans were obtained upon completion of therapy. The evaluations of the sphenoid sinuses were regarded separately, so as 534 sides were examined. Especially bony anatomic variations as well as mucosal abnormalities of the sphenoid sinuses were examined. Pneumatization of the pterygoid process and anterior clinoid process were found in 39.7% and 17.2% of the patients respectively. Vidian canal protrusion was found in a total of 158 sides of which 60 were bilateral. These entities were encountered usually when pneumatization of the pterygoid process occurred. Carotid canal and optic canal protrusions were found in 5.2% and 4.1% of the patients respectively. Mucosal thickening, and polyps or cysts of sphenoid sinuses were detected in 20.6% and 4.5% of the patients respectively. There was a statistically significant correlation between pterygoid pneumatization and vidian canal protrusion (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and vs. foramen rotundum protusion (p = 0.004). While the optic canal protrusion was found significantly associated with the anterior clinoid pneumatization (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), there was no statistically significant correlation between a carotid canal protrusion and anterior clinoid pneumatization (p = 0.250). Sphenoid sinus surgery is very risky, because of changing variations of the cavity. We are in the opinion that detailed data from CT scans of SS will enable the surgeon to interpret any anatomic variations and pathological conditions before initiation of the surgical therapy.
In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sin... more In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sinus packs on pain management after functional endoscopic surgery (FESS). One hundred and fifty patients with the diagnosis of bilateral chronic sinusitis with or without nasal polyps who underwent FESS were included into the study. Their pre-operative Lund-Mackay computerized tomography (CT) Scores were similar. We applied anesthetic agents of 2 % lidocaine HCl, 0.25 % Bupivacaine HCl, 0.2 % Ropivacaine, 2 % Prilocaine and 0.9 % NaCl (Saline) in groups 1-5 onto the sinus packs after FESS. At postoperative period, acetaminophen (250 mg/5 ml) was used in 10-15 mg/kg per dose (4 times a day). Bleeding grade, operation duration, postoperative number of gauze/24 h, additional painkiller need, pain values at 1, 2, 4, 8, 12 and 24 h were noted. Lund-Kennedy endoscopic scores were also evaluated at 1st, 2nd and 4th weeks postoperatively. In saline group, 93.3 % of the patients needed additional painkiller. Whereas, in Bupivacaine group, additional painkiller use (20.0 %) is less than the other groups. In Bupivacaine group, number of gauze/24 h use was lower than lidocaine, ropivacaine and prilocaine groups. In our study, except 1st and 24th hours, pain values of groups can be written in ascending order (from less to higher) as Bupivacaine, Lidocaine, Prilocaine, Ropivacaine and Saline. In the first hour, pain values of groups can be written in ascending order (from less to higher) as Lidocaine, Prilocaine, Bupivacaine, Ropivacaine and Saline. In the 2nd week, in the Bupivacaine and Lidocaine Groups separately, postoperative Lund-Kennedy scores were lower than the Prilocaine and Saline Groups. In the 1st month, Lidocaine Group&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Lund-Kennedy scores were significantly lower than the Saline Group. Synechia values were not different between groups. Bupivacaine help the lower pain values and less additional painkiller need after FESS. Therefore, we recommend to use Bupivacaine soaked sinus packs after FESS for achieve less pain values and to improve patient satisfaction.
The journal of international advanced otology, 2015
To date, studies in all populations showed that mutations in the gene of Gap junction protein bet... more To date, studies in all populations showed that mutations in the gene of Gap junction protein beta 2 (GJB2) play an important role in non-syndromic autosomal recessive congenital hearing loss. The aim of this study was to evaluate GJB2 gene of patients with hearing loss in our region using deoxyribonucleic acid (DNA) sequencing method and to demonstrate region-specific mutation and polymorphism distribution. Patients who had bilateral severe sensorineural non-syndromic hearing loss identified by audiologic evaluation were included. Peripheral blood samples were collected and the GJB2 gene exon1 and exon 2 regions were amplified by polymerase chain reaction (PCR). Obtained PCR products were sequenced by the DNA sequence analysis method (SeqFinder Sequencing System; ABI 3130; Foster City, CA, USA) and analyzed using the SeqScape software. Of the 77 patients, 16 had homozygous or heterozygous mutation. The mutation of 35delG, which is known as the most frequent mutation of GJB2 gene, w...
We investigated the efficacy of bupivacaine, lidocaine, and saline infiltrations to peritonsillar... more We investigated the efficacy of bupivacaine, lidocaine, and saline infiltrations to peritonsillar region and uvula and soft palate regions for pain relief after tonsillectomy and modified cautery-assisted uvulopalatopharyngoplasty (MCAUP) in patients with obstructive sleep apnea. In this prospective study, 91 patients (32-65 years old) with obstructive sleep apnea underwent tonsillectomy and MCAUP and were divided into 3 groups. In group 1 patients (n = 31), 0.25% bupivacaine HCl + 1/200,000 epinephrine (10 mL); in group 2 patients (n = 31), 1% lidocaine HCl + 1/200,000 epinephrine (10 mL); and in group 3 patients (n = 29), 0.9% saline (10 mL) were injected to peritonsillar region and uvula and soft palate regions. Operation duration, amount of bleeding, and analgesic requirement and visual analog scale for pain at rest and at swallowing were evaluated in all groups. Mean body mass index values were between 27.0 and 27.3 kg/m in all groups. Their apnea-hypopnea index values were between 15.3 and 16.9 per hour, and there were no significant differences between their body mass index and apnea-hypopnea index values. Duration of operation of patients in the bupivacaine group was significantly lower than that of patients in the lidocaine and saline groups. In addition, in the lidocaine group, operation duration was significantly lower than that in the saline group. Bleeding amount and postoperative analgesic requirement of the saline group were significantly higher than those of the bupivacaine and lidocaine groups. Although both these measures (operation duration and amount of bleeding) were statistically significant, a mean operating time of 44.3 versus 46.0 minutes and 64.4-mL versus 68.4-mL blood loss for the bupivacaine and lidocaine groups were clinically irrelevant and not too important. In terms of visual analog scale for pain at rest and/or swallowing, Bupivacaine provided more relief than lidocaine and saline injections. The lidocaine provides pain relief less than bupivacaine and more than saline at rest and/or swallowing. We recommend the use of bupivacaine injections in peritonsillar, uvular, and soft palate regions during tonsillectomy + MCAUP operations. It reduces operation duration and provides more pain relief postoperatively. When patients had cardiac problems, lidocaine may also be recommended because of its cardiac depressant and antiarrhythmic effects and positive effects for pain relief compared with saline injections.
The Journal of International Advanced Otology, 2015
To determine whether there is an association between otitis media with effusion and laryngopharyn... more To determine whether there is an association between otitis media with effusion and laryngopharyngeal reflux in children. This study included 31 children with otitis media with effusion. The pepsinogen level in the middle ear fluid of all patients was measured by sandwich enzyme-linked immunosorbent assay. Each patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s middle ear fluid was investigated for Helicobacter pylori (H. pylori) using the Campylobacter-like organism (CLO) test. The middle ear pepsinogen levels were compared with those in the serum. The correlation between pepsinogen levels and H. pylori positivity in the middle ear fluid was investigated. The mean middle ear pepsinogen level (211.69 ng/mL) was significantly higher than that in the serum (24.18 ng/mL) in patients with otitis media with effusion. The middle ear aspirates of six patients (19%) were positive for H. pylori, and the correlation between H. pylori positivity and increased pepsinogen levels in the middle ear fluid was statistically significant in patients with otitis media with effusion. We detected higher pepsinogen levels and H. pylori positivity rates in the middle ear fluid than in the serum of patients with otitis media with effusion. These results support the role of laryngopharyngeal reflux in the pathogenesis of otitis media with effusion.
The combined effects of erythromycin-tetracycline-sulfamethoxazole (ETS) and sulfamethoxazole-tet... more The combined effects of erythromycin-tetracycline-sulfamethoxazole (ETS) and sulfamethoxazole-tetracycline (ST) antibiotics on the performance of anaerobic sequencing batch reactors were studied. A control reactor was fed with wastewater that was free of antibiotics, while two additional reactors were fed with ETS and ST. The way in which the ETS and ST mixtures impact COD removal, VFA production, antibiotic degradation, biogas production and composition were investigated. The effects of the ETS mixtures were different from the ST mixtures, erythromycin can have an antagonistic effect on sulfamethoxazole and tetracycline. The anaerobic pre-treatment of these antibiotics can represent a suitable alternative to the use of chemical treatments for concentrations at 10mg/L of S and 1mg/L of T; 2mg/L of E, 2mg/L of T and 20mg/L of S for the ST and ETS reactors respectively, which corresponds to min 70% COD removal efficiency.
Nasal polyps were once believed to originate in sinus cavities, and from there to pass through os... more Nasal polyps were once believed to originate in sinus cavities, and from there to pass through ostia and into the nasal cavity. However, data gained from subsequent anatomic studies revealed that they can actually originate in numerous locations in the sinonasal area. We report a case of a nasal polyp that originated in the cribriform plate, which is a very rare site of origin for a nasal polyp.
Spread of manure pathogens is of considerable concern due to use of manure for land application. ... more Spread of manure pathogens is of considerable concern due to use of manure for land application. In this study, the effects of four static pile treatment options for bovine manure on die-off of a generic Escherichia coli, E. coli O157:H7 surrogate, Salmonella Senftenberg, Salm. Typhimurium, and Listeria monocytogenes were evaluated. Bovine manure spiked with these bacteria were placed in cassettes at the top, middle, and bottom sections of four static pile treatments that reflect minimal changes in pile construction with and without straw. Temperatures were monitored continuously during the 28 day self-heating period. E. coli and salmonellae were reduced from 8 to 9 log10 CFU g(-1) to undetectable levels (<1.77 log10 MPN g(-1)) at 25-30 cm depths within 7 days in all pile sections except for the manure-only pile in which 3-4 logs of reduction were obtained. No L. monocytogenes initially present at 6.62 log10 CFU g(-1) were recovered from straw-amended piles after 14 days, in cont...
Clinical and investigative medicine. Médecine clinique et experimentale, 2010
To determine whether trace elements that are essential for neural function play a role in the pat... more To determine whether trace elements that are essential for neural function play a role in the pathophysiology and etiology of auditory neuropathy (AN). Patients diagnosed with auditory neuropathy consisted of eight children (two male, six female). The blood tests including the measurement of sodium, potassium, chloride, calcium, phosphorus, iron, copper and magnesium were done in children with AN during their routine care. Of the eight children with AN, many had serum levels outside the normal range: one had low sodium, two had low potassium, one had low chloride, two had high zinc and three had low zinc, two had low calcium and two had higher than normal phosphorus. Although some serum trace element levels in our patients were higher or lower than normal values, the mean values were within normal limits. Thus, we were unable to detect a relationship between serum trace element levels and AN-. In the future, larger studies should be conducted to confirm these findings.
Clinical and Experimental Otorhinolaryngology, 2013
Objectives. The aim of this study is to investigate the role of platelet-derived growth factor (P... more Objectives. The aim of this study is to investigate the role of platelet-derived growth factor (PDGF) in the pathogenesis of sinonasal polyps.
This article describes a modification of the incisionless otoplasty. We investigated the complica... more This article describes a modification of the incisionless otoplasty. We investigated the complication rates, recurrence risks, and patient satisfaction with this modified procedure. In total, 26 patients (49 ears) complaining of prominent ear were operated on. Auriculocephalic distances were measured at three different levels, pre-operatively, at the end of the surgery, and at 4 weeks and 6 months after surgery to evaluate the efficacy of the technique. Patient satisfaction was evaluated using a visual analog scale and the global aesthetic improvement scale was applied by an independent non-participating plastic surgeon at 6 months after the surgery. The mean loss of medialization was ~1 mm at 4 weeks after surgery and 2 mm at 6 months after surgery for all levels. According to visual analog scale, patient or parent satisfaction increased significantly. The global aesthetic improvement scale rated the patients as 93.9 % &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;improved&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and 6.1 % as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no change.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; No rating was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;worse.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; There are many advantages of this technique. The operation is not time-consuming, does not require a dressing, and it can be performed in adults with local anesthesia under office conditions, with no need for hospitalization. After the operation, patients can return to their daily activities immediately. It is associated with a low complication rate and high patient satisfaction. This technique is a good option for otoplasty in patients with isolated, inadequate development of anti-helical ridge, and with soft auricular cartilage.
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