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Öğe Angiographic embolization in epistaxis: Our clinical experience and results(2021) Cicek, Mehmet Turan; Yildirim, İsmail Okan; Bayindir, Tuba; Sarac, Kaya; Tan, Mehmet; Aslan, Mehmet; Ozer Ozturk, EbruAim: Nosebleed, more commonly called epistaxis is a general clinical problem, and the most of bleedings can be treated non-invasive approach. However, because of persistent and sometimes life-threatening bleeding, additional treatment such as super-selective embolization may be required. In this study, we report our data on the endovascular treatment of persistent epistaxis. Materials and Methods: Between January 2010 and December 2019, all patients who were followed up at Inonu University Turgut Ozal Medical Center Otorhinolaryngology Clinic due to recurrent persistent nosebleed and required endovascular treatment were retrospectively screened. Demographic data, cause of epistaxis, localization of the bleeding, the clinical significance of the bleeding, interventional approach, complications related to treatment, and results were evaluated. Results: All of 18 patients with intractable epistaxis were included in the study. Depending on the etiology of epistaxis, patients were determined into three groups: idiopathic epistaxis (10/18), iatrogenic or traumatic epistaxis (7/18), and nasopharyngeal cancer (1/18). Nine of 18 patients required blood transfusions. The internal maxillary artery was embolized unilaterally in 12 of 18 (66%) and bilaterally in 2 of 18 (11%) procedures. Four patients were not embolized because of bleeding originated from ethmoidal branches of the ophthalmic artery. These four patients were operated on (endoscopic ethmoidectomy and bleeding control). Long-term success rates of embolization were 14 of 14. Major complications (transient hemiparesis) occurred in one patient after embolization. Conclusion: Endovascular approach proves to be effective for intractable and fatal epistaxis. Embolization has a good risk-benefit ratio in persistent bleeding. However, if bleeding is originated by the ethmoidal branches of the ophthalmic artery, embolization may not be performed to avoid visual complications.Öğe Angiographic embolization in epistaxis: Our clinical experience and results(2021) Cicek, Mehmet Turan; Yildirim, Ismail Okan; Bayindir, Tuba; Sarac, Kaya; Tan, Mehmet; Aslan, Mehmet; Ozer Ozturk, EbruAbstract: Aim: Nosebleed, more commonly called epistaxis is a general clinical problem, and the most of bleedings can be treated non-invasive approach. However, because of persistent and sometimes life-threatening bleeding, additional treatment such as super-selective embolization may be required. In this study, we report our data on the endovascular treatment of persistent epistaxis. Materials and Methods: Between January 2010 and December 2019, all patients who were followed up at Inonu University Turgut Ozal Medical Center Otorhinolaryngology Clinic due to recurrent persistent nosebleed and required endovascular treatment were retrospectively screened. Demographic data, cause of epistaxis, localization of the bleeding, the clinical significance of the bleeding, interventional approach, complications related to treatment, and results were evaluated. Results: All of 18 patients with intractable epistaxis were included in the study. Depending on the etiology of epistaxis, patients were determined into three groups: idiopathic epistaxis (10/18), iatrogenic or traumatic epistaxis (7/18), and nasopharyngeal cancer (1/18). Nine of 18 patients required blood transfusions. The internal maxillary artery was embolized unilaterally in 12 of 18 (66%) and bilaterally in 2 of 18 (11%) procedures. Four patients were not embolized because of bleeding originated from ethmoidal branches of the ophthalmic artery. These four patients were operated on (endoscopic ethmoidectomy and bleeding control). Long-term success rates of embolization were 14 of 14. Major complications (transient hemiparesis) occurred in one patient after embolization. Conclusion: Endovascular approach proves to be effective for intractable and fatal epistaxis. Embolization has a good risk-benefit ratio in persistent bleeding. However, if bleeding is originated by the ethmoidal branches of the ophthalmic artery, embolization may not be performed to avoid visual complications.Öğe Can isolated sudden sensorineural hearing loss (SSNHL) and idiopathic acute facial paralysis (Bell's palsy) be symptoms of COVID-19?(W B Saunders Co-Elsevier Inc, 2021) Aslan, Mehmet; Cicek, Mehmet TuranObjectives: The symptoms of COVID-19 at the time of presentation mainly include fever, cough, respiratory distress and myalgia. On the other hand, as neurological symptoms, disruption of taste and smell and cerebrovascular pathologies are well-known, whereas other neurological symptoms and signs are being newly recognized. Sudden-onset sensorineural hearing loss (SSNHL) and idiopathic acute facial paralysis (Bell's palsy) are otologic emergencies that are frequently encountered by otorhinolaryngology specialists. Although there are many articles describing SSNHL and Bell's palsy in the literature, the literature describing their relationship to COVID-19 is limited. In our study, we aimed to present the neuro-otologic relationship of SSNHL and Bell's palsy with COVID-19. Material and methods: The pretreatment real-time oronasopharyngeal PCR tests, COVID-19 symptomatology and COVID-19 infection statuses of patients who presented to our clinic with isolated SSNHL and Bell's palsy between April 2020 and April 2021 were questioned, and the data of the patients were collected. Throughout their treatment, the patients were followed-up in terms of COVID-19 infection. This is a prospective study. Moreover, to observe the change in the incidence, the data of patients visiting between January 2019 and January 2020 were also collected. The data of the patients were statistically analyzed using SPSS. Results: The study included a total of 177 patients. The SSNHL group consisted of 91 patients, and the Bell's palsy group consisted of 86 patients. Neither group showed a statistically significant difference in comparison to the year without the pandemic in terms of the patient numbers (incidence), sex, age, morbidity, response to treatment or social habits. There was a statistically significant difference in age only in the Bell's palsy group, but this difference was not medically significant. Conclusion: As a result of our study, we did not observe a relationship between COVID-19 and cases of SSNHL and Bell's palsy. It is recommended to apply standard otologic treatment to isolated SSNHL and Bell's palsy patients whose association with COVID-19 is not determined.Öğe The Complication of Tension Pneumocephalus After Septoplasty(Lippincott Williams & Wilkins, 2021) Cicek, Mehmet Turan; Tan, MehmetThis paper presents a case of tension pneumocephalus with severe headache 2 days after septoplasty surgery. In such cases, endoscopic sinus surgery (ESS) or open approach can be used for repair of the defect. However, pneumocephalus, especially caused by minor defects, improves spontaneously with conservative treatment. In our case, the pneumocephalus was responsive to conservative treatment with bed rest, head elevation. His examinations in the 3rd and 8th months after discharge were uneventful and CT scan revealed no signs of pneumocephalus. In severe headaches developing after septoplasty, the possibility of intracranial complications should be evaluated. Simple conservative treatment should be tried before surgery, but then the patient should be examined at regular intervals.Öğe Endovascular Treatment of Carotid Pseudoaneurysm Bleeding Due to Parapharyngeal Abscess(Lippincott Williams & Wilkins, 2020) Cicek, Mehmet Turan; Yildirim, Ismail Okan; Gunduz, EmrahCarotid artery pseudoaneurysm are a rare complication of deep neck infections, especially in the antibiotic era. Although it is rare, it may result in life-threatening conditions. Here, the authors present a case of pseudoaneurysm of the carotid artery caused by parapharyngeal abscess and causing massive oropharyngeal bleeding and treat with endovascular approach in a 40-year-old woman presenting with neck swelling and fever.Öğe An Extraordinary Complication of Chronic Tonsillitis: Perforation of Posterior Plica(Lippincott Williams & Wilkins, 2021) Cicek, Mehmet Turan; Aslan, MehmetTonsillitis is a very common condition. It is usually of viral origin, is self-limiting, is generally treated conservatively in practice. Complications can be divided into non-suppurative and suppurative. According to the literature search, there is no reported case of posterior plica perforation caused by recurrent tonsil infections. The authors aimed to present the first case of posterior plica perforation caused by recurrent tonsillitis in the literature.Öğe Is diffusion-weighted magnetic resonance imaging (DW-MRI) a requirement for suspected cholesteatoma in patients to undergo primary surgery?(2020) Tan, Mehmet; Ozer, Ebru; Bayindir, Tuba; Cicek, Mehmet Turan; Erbay, Mehmet FatihAim: In this study, the aim was to investigate the correlation of preoperative diffusion-weighted magnetic resonance imaging (DW-MRI) with postoperative pathology findings in patients undergoing tympanomastoidectomy with suspicion of primary cholesteatoma.Materials and Methods: The study consisted of the retrospective evaluation of preoperative MRIs, surgical findings and pathology results of patients who underwent tympanomastoidectomy and had preoperative DW-MRI at the Department of Otorhinolaryngology between the years 2017 and 2019.Results: The study was conducted with 199 patients who underwent tympanomastoidectomy surgery. A retrospective examination of patient files revealed that 80 (40.2%) of the patients underwent echoplanar diffusion-weighted magnetic resonance imaging (DW-MRI) because of suspected cholesteatoma in the preoperative period. Of these 80 patients, cholesteatoma was detected in 22 (27.5%) as a result of pathological analysis and/or surgery, but no diffusion restriction was found in MRI interpretation; in 44 (55%) of them, both cholesteatoma in pathological analysis and/or surgery and diffusion restriction in MRI interpretation were detected. In 10 (12.5%) of these 80 patients, cholesteatoma was not detected either in the MRI interpretation or in the pathological analysis and/or surgery. In the remaining 4 (5%) patients, there was a cholesteatoma suspicion in MRI, but it was not detected as a result of pathological analysis or surgery. In this study, the sensitivity of MRI for the diagnosis of cholesteatoma was 66.6%, and its specificity was 71.4%.Conclusion: MRI provides moderately (66.6%) reliable information in the diagnosis of cholesteatoma patients. However, it is more reliable (71.4%) when it comes to exclusion of the disease. Therefore, it should not be used as the sole determining factor in patients who will undergo primary surgery with suspected cholesteatoma. As much as our study results provide guidance for a more accurate use of imaging methods, series with higher numbers of patients are needed.Öğe Is it taboo to elevate the tympanomeatal flap? Outcomes of endoscopic transcanal type 1 cartilage tympanoplasty with double-layer crescent graft technique(Aves, 2021) Aslan, Mehmet; Cicek, Mehmet Turan; Tan, Mehmet; Yalcin, Muhammed ZekiObjective: In this study, we aimed to examine the surgical and functional results of tympanoplasty performed with a double-layer crescent graft technique. We also aimed to investigate the anatomical and functional results of type 1 tympanoplasty with a large series without elevation of the tympanomeatal flap. Methods: The anatomical and functional results of 245 patients treated with endoscopic type 1 tympanoplasty by double-layer crescent graft between January 2015 and January 2019 were retrospectively evaluated in terms of age, sex, tympanic membrane perforation size, complication, functional hearing before and after surgery, and duration of the operation. Results: The participant cohort was 59.2% women (n=145) and 40.8% men (n=100), and the average age was 30.8286 +/- 10.29897 years (minimum 13, maximum 56). Overall, the anatomical success rate was 91.83%; in patients with medium tympanic membrane perforation of 25%-75%, it was 94.9%; and in patients with large perforation of > 75%, it was 88%. When complications were examined, the rates of graft perforation, lateralization, and retraction rates were 8.1%, 8.1%, and 3.6%, respectively. The average operation time was 33.0449 +/- 3.02348 minutes. Conclusion: Endoscopic double-layer crescent graft tympanoplasty is a successful method to ensure anatomical and physiological results in medium and large tympanic membrane perforations. In addition, it was observed that the operation could be performed with a shorter surgical time without elevating the tympanomeatal flap, and its anatomical and functional results were successful.Öğe A Rare Cause of Headache That Should Be Kept in Mind: Isolated Concha Bullosa Fungus Ball(Lippincott Williams & Wilkins, 2020) Gunduz, Emrah; Cicek, Mehmet Turan; Bozoglu, Mehmet; Tan, Mehmet; Bayindir, TubaConcha bullosa is characterized by pneumotization of the middle turbinate and is a common variation of sinonasal anatomy and is often asymptomatic. The presence of a fungus ball in concha bullosa and the associated clinic symptoms are very rare. Concha bullosa fungus balls are a rare differential diagnosis in a patient presenting to the otorhinolaryngology outpatient clinic with headache. In this article, the authors aimed to present an isolated fungus ball case in concha bullosa as a rare cause of headache differential diagnosis.Öğe A Rare Cause of Respiratory Distress in Newborn: Huge Nasal Chondromesenchymal Hamartoma; Patient Report(Lippincott Williams & Wilkins, 2022) Cicek, Mehmet Turan; Bayindir, Tuba; Aslan, Mehmet; Sigirci, Ahmet; Gunduz, EmrahNasal chondromesenchymal hamartoma is a rare benign tumor of the sinonasal tract in pediatrics and only few cases in infantile, early pediatric, and adolescent population have been reported. Nasal chondromesenchymal hamartoma commonly presents as respiratory difficulty, intranasal mass, or facial swelling and typically arises from the nasal septum or vestibule, lest frequently maxillary or ethmoid sinuses, orbit, nasopharynx, and oropharynx. The authors report a case of nasal chondromesench- ymal hamartoma that caused respiratory distress since birth, in a 4- week-old (28 days) infant which was arised from the medial aspect of the middle turbinate, an unexpected localization.Öğe Successful localization of abnormal parathyroid tissue with ultrasound-guided methylene blue dye injection before surgery for metastatic or recurrent thyroid cancers and parathyroid adenomas(W B Saunders Co-Elsevier Inc, 2023) Koca, Cigdem Firat; Yildirim, Ismail Okan; Cicek, Mehmet Turan; Aslan, MehmetObjectives: A surgery to be performed on a previously operated neck includes difficulties such as increased risk of complications and prolonged operation time. The aim of the present study is to analyze the benefit of pre -anesthetic ultrasound-guided injection of methylene blue into parathyroid adenomas and abnormal lymph nodes to simplify their safe and satisfactory extraction. Methods: We analyzed the case series records of 14 patients who were operated for reoperative neck surgery due to recurrent thyroid cancer (8 patients) and parathyroid adenoma (6 patients) and in the technique; 0.2 ml of a 1:5 dilution of 1 % methylene blue solution was injected directly onto the target during real-time ultrasound guidance before the operating room. Results: In adenomas, ultrasound-guided methylene blue injection was successfully applied in all cases, an average of 33.1 min before entering the operating room (range = 28-38 min). There were no complications related to dye injection. For patients with recurrent thyroid tumors, preoperative ultrasound-guided methylene blue injection was successfully applied in all patients, on average 27.5 min before entering the operating room (range = 20-35 min). No complications occurred due to dye injection. The blue stained lesion was easily identified during surgery. Conclusions: We analyzed the feasibility of the injection process, the certainty of defining pathological lymph nodes, and the complications of the procedure. Preoperative administration of methylene blue preserved its intraoperative efficacy and maintained the easy the detection of reoperative or primary pathologies. The present study suggest that methylene blue dye injection is a safe, sufficient, and quietly effective method for identifying recurrent tumors and parathyroid adenomas in scarred reoperative neck surgeries. Our cases had comparatively short operative times and lower complication rates.
