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Öğe Amikacin ototoxicity enhanced by Ginkgo biloba extract (EGb 761)(Elsevier Science Bv, 2002) Miman, MC; Ozturan, O; Iraz, M; Erdem, T; Olmez, EAn animal study was realized to investigate the possible beneficial effect of EGb 761 as an antioxidant agent on amikacin ototoxicity by measuring distortion product otoacoustic emissions (DPOAEs). Twenty-eight adult rats were grouped equally as follows. Group amikacin: rats received amikacin 600 mg/kg/day intramuscularly between postnatal days (PND) 30 and PND44. Group amikacin/EGb 761: rats received amikacin 600 mg/kg/day intramuscularly between PND30 and PND44 and EGb 761 100 mg/kg/day orally between PND30 and PND50. Group EGb 761: rats received equivolume saline intramuscularly between PND30 and PND44 and EGb 761 100 mg/kg/day orally between PND30 and PND50. No treatment group: rats received nothing, Group amikacin was found to be affected only on the last measurement day of study (PND57). The frequencies greater than 2002 Hz were significantly reduced compared with the amplitudes of PND30 (P < 0.05). Group amikacin/EGb 761 was most and earliest affected by amikacin-induced ototoxicity. DPOAE amplitudes were found in this group to be decreased at 2-6 kHz starting on PND50. The results of Group EGb 761 and No treatment group were not significantly changed. For the DPOAE input/output amplitude thresholds, Group amikacin (P < 0.05) and Group amikacin/EGb 761 (P < 0.01) had significantly elevated thresholds on PND57, except at 5 kHz for Group amikacin (P = 0,06), According to the results of the study, EGb 761 may be regarded as a facilitating drug for the development of amikacin ototoxicity. The results of the present study may warn against concomitant use of aminoglycosides, specifically amikacin, with EGb 761. (C) 2002 Elsevier Science B.V. All rights reserved.Öğe Autoclaving the ossicles provides safe autografts in cholesteatoma(Elsevier Sci Ltd, 2002) Miman, MC; Aydin, NE; Öncel, S; Özturan, O; Erdem, TObjective: The choice of the graft in ossicular chain reconstruction during middle ear surgery for cholesteatoma is a subject still discussed on. In order to clarify the discussion of reuse of the autologous ossicles obtained during middle ear surgery for cholesteatoma. we evaluated the probability of residual disease histologically and the safety of the ossicles after autoclavization, the most promoting alternative method to eradicate residual cholesteatoma and infection on them. Methods: The specimens used in this study were eroded twenty-seven ossicles (22 incuses, 5 malleoli) which were removed from the 27 consecutive patients operated because of cholesteatomato us middle ear disease. They were grouped as follows: Group 1, Fifteen ossicles examined histopathologically directly. Group 2, Five ossicles autoclaved for 20 min at 134 C and then examined histopathologically. Group 3, Five ossicles autoclaved for 20 min at 134 C after mechanical surface cleaning by a fine diamond drill, examined histopathologically. Group 4, Two ossicles removed from two different patients were placed in their mastoid cavities in order to be examined after access in the second-look operation. While one ossicle was only autoclaved, the other was mechanically cleaned by a drill before autoclavization (for 20 min at 134 C). The ossicles were examined histopathologically after the removal at the second stage operation performed 12 months later. Results: In Group 1, all ossicles showed evidence of periosteal thickening. Additional findings were surface cholesteatoma or epithelia in 13 ossicles, surface inflammation in 12 ossicles, granulation tissue in 10 ossicles, osteitis in six ossicles. In Group 2, all five ossicles had preserved their lamellar structure but, no vital cells were seen. The lacunes that had the osteocytes was almost completely empty. The inflammatory cells were eliminated from the ossicles. In Group 3, ossicles were found well preserved with their lamellar structures and contours, with empty lacunes and eliminated inflammatory cells. In Group 4, in two ossicles of this group the lacunes were replaced by the new migrated viable osteocytes with evidence of new bone formation and neovascularisation. No new inflammatory focus or epithelia were found on the surfaces of the ossicles. The shape and the contour of the ossicles remained unchanged. Conclusion: In cholesteatoma surgery, ossicles with minimal erosion and adequate thickness can be used after autoclavization. In this study, it was observed histopathologically that the autoclaving autologous ossicles before ossiculoplasty in cholesteatomatous middle ear is a safe and reliable method. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Öğe Dose-dependent dual effect of melatonin on ototoxicity induced by amikacin in adult rats(Springer, 2005) Erdem, T; Ozturan, O; Iraz, M; Miman, MC; Olmez, EThe aim of this animal study was to reveal the dose-dependent effects of melatonin on aminoglycoside ototoxicity by utilizing distortion product otoacoustic emissions (DPOAEs). Forty-four adult ( aged 12 months) rats were divided into five groups. Rats of the control group ( group C) were injected with vehicle, while the melatonin group ( group M) received melatonin ( 4 mg/kg per day); there were four rats in each of these groups. The study groups consisted of 12 rats per group, and they were treated as follows: 600 mg/kg per day amikacin ( group A), amikacin plus a low dose (0.4 mg/kg per day) melatonin ( group AML) and amikacin plus high dose ( 4 mg/kg per day) melatonin ( group AMH) for 14 days. During the serial measurements on days 0, 5, 10 and 15, the DPOAE results of groups C, M and AML were not significantly changed. Amikacin ototoxicity findings for input/output (I/O) functions were detected on the 3rd measurement of the study in group A. High-dose melatonin clearly enhanced and accelerated amikacin-induced ototoxicity. The DP-gram amplitudes and I/O amplitudes were reduced, and I/O thresholds were increased in group AMH. Group AMH was the group that was affected the most and earliest by amikacin. Our study results showed that while low-dose melatonin protected the inner ear from ototoxicity, high dose melatonin facilitated amikacin-induced ototoxicity, possibly via the vasodilatory effect, leading to an increased accumulation of amikacin in the inner ear. Probably, the protective effect of the melatonin at a dose of 0.4 mg/kg per day is related to its antioxidant properties. Apparently, the vasodilatory effect of melatonin seems to be more prominent than its antioxidant effect in high doses.Öğe Effects of chronic exposure of electromagnetic fields from mobile phones on hearing in rats(Elsevier Sci Ltd, 2003) Kizilay, A; Ozturan, O; Erdem, T; Kalcioglu, MT; Miman, MCObjective: Little attention has been paid to the effects of electromagnetic field (EMF) of mobile phones on hearing. The aim of this study is to investigate the effects of chronic exposure to EMF emitting from mobile phones on the inner ear of adult and developing rats using distortion product otoacoustic emissions (DPOAEs). Methods: EMF of mobile phones exposure was scheduled according to a sham-exposure controlled experimental design. Every day seven of 14 adult and four newborn rats were exposed to 1-h mobile phone EMF for 30 days, while the other seven adult rats were assigned to control group. DPOAEs were measured in both groups before and after the chronic exposure to EMF. The newborn rats were tested following similar exposure beginning on the 2nd day after birth. Results: No measurable EMF associated changes in DPOAEs either in adult or developing rat inner ears were determined (P > 0.05). Conclusion: It was concluded that chronic exposure of EMF, as long as 30 days 1 h per day, emitting from a mobile phone did not cause any hearing deterioration in adult and developing rats, at least at outer and middle ear and cochlear levels. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.Öğe The effects of the chorda tympani damage on submandibular glands: biometric changes(Elsevier Sci Ltd, 2003) Miman, MC; Sigirci, A; Ozturan, O; Karatas, E; Erdem, TObjective: It was aimed to analyze the biometric changes in ipsilateral submandibular glands of patients with unilateral chorda tympani (ChT) section during otological operations, compared with change in size of the contralateral glands and with those of healthy subjects. Method: 29 patients with unilateral complete ChT section and 29 healthy subjects with identical ages, genders, and weights to the patient group were examined ultrasonographically. The patients having a mean duration to follow-up examination of 32 months (2-84 months) were subdivided into two groups by their time to follow-up as short-term patient group (2-12 months. 14 patients) and long-term patient group (13-84 months. 15 patients). The ultrasonographic dimensions and volumes of submandibular glands were compared statistically between the groups. Results: In the patient group. the glands on the contralateral, non-operated side were found to be greater than the ipsilateral. denervated glands in terms of both paramandibular depth dimension (P <0.05) and volume (P <0.01). The differences could be determined only in long-term patient group. When comparing the submandibular glands of the patient group with those of the control group, it was found that paramandibular depth dimension and volume of the submandibular g-lands on the contralateral, non-operated side were statistically greater (P <0.01). There was no difference between submandibular glands on the operated side of the patient group and those of the control group (P >0.05). Conclusion: The late (13-84 months) biometric results of ChT damage on submandibular gland were significant for increase in the size of the contralateral, non-denervated submandibular gland. An atrophying effect was not ascertained in the submandibular glands denervated parasympathetically due to the section of the ChT. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Öğe Effects of the chorda tympani damage on submandibular glands: scintigraphic changes(Cambridge Univ Press, 2004) Yagmur, C; Miman, MC; Karatas, E; Akarcay, M; Erdem, T; Ozturan, OThe aim of this study is to compare the scintigraphic results of a denervated submandibular gland with the contralateral normal side in patients with unilateral chorda tympani damage. Sixteen patients (11 women and five men with a mean age of 27) with unilateral proven chorda tympani damage during their previous ear surgery were included in the study. The perfusion ratio (PR), concentration ratio (CR) and stimulated excretion ratio (SER) were calculated scintigraphically and the results from the salivary glands on opposite sides were compared. For submandibular glands, the perfusion ratio (PR), concentration ratio (CR) and stimulated excretion ratio (SER) were found to be 0.65 +/- 0.21, 0.70 +/- 0.21, 0.79 +/- 0.37, respectively. All ratios resulted from statistically decreased radioactivity accumulation on the affected side (P<0.05). Chorda tympani damage negatively affects the function of the ipsilateral submandibular glands despite the absence of atrophy. Dynamic salivary gland scintigraphy is a practical and valuable method of disclosing the decreased capacity of perfusion, concentration and secretion function in unilateral neurological deprivation.Öğe Effects of the electromagnetic field of mobile telephones on hearing(Taylor & Francis As, 2002) Ozturan, O; Erdem, T; Miman, MC; Kalcioglu, MT; Oncel, SThe widespread use of mobile telephones has given rise to concern about the potential influences of electromagnetic fields (EMFs) on human health. Anatomically, the ear is in close proximity to the mobile telephone during use. Hearing loss due to mobile telephone use has not been described in the medical literature however, if there is a subtle cochlear involvement, it might be detected by means of changes in evoked otoacoustic emissions (OAEs), Thirty volunteers with normal hearing were exposed to mobile telephone EMFs for 10 min and evoked OAEs were measured before and after exposure. No measurable change in evoked OAEs was detected and none of the subjects reported a deterioration in hearing level. To the best of our knowledge, this is the first study on the effects of EMFs emitted by mobile telephones on hearing. It was concluded that a 10-min exposure to the EMF emitted from a mobile telephone had no effect on hearing, at least at outer ear. middle ear and cochlear levels.Öğe Exploration of the early auditory effects of hyperlipoproteinemia and diabetes mellitus using otoacoustic emissions(Springer-Verlag, 2003) Erdem, T; Ozturan, O; Miman, MC; Ozturk, C; Karatas, EAlthough the relationship between hearing loss and hyperlipoproteinemia (HLP) or diabetes mellitus (DM) has been shown in many clinical investigations, this concept is still controversial. A prospective study was designed to search for the existence of subclinical auditory dysfunction related to HLP and DM by transient-evoked (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) in patients with hearing levels better than 30 dB. Evoked otoacoustic emissions were utilized to investigate subclinical auditory dysfunction. Fifteen hypercholesterolemic patients (28 ears), 21 hypertriglyceridemic patients (42 ears) and 21 DM patients (40 ears) were eligible for investigation. The results of the DPOAEs and TEOAEs of the study groups were compared with the control group composed of individuals with similar ages and with normal blood lipids and glycemia. This group consisted of 22 people (44 ears). There was no difference in the existence of TEOAEs at all frequencies among the groups (P>0.05). No differences were found in the amplitudes of the DPOAES between the groups except at 4 kHz (P>0.05). The difference was caused by the hypertriglyceridemia group (P=0.014) and the non-insulin-dependent diabetes mellitus (NIDDM) group (P=0.012) when compared with the control group. The mean DPOAE amplitudes of the hypertriglyceridemic and NIDDM groups at 4 kHz were higher, than those of the control group. The decreased DPOAE amplitudes at 4 kHz in hypertriglyceridemic and diabetic patients without clinical findings are compatible with the sensorineural hearing loss observed with hyperviscosity and increased noise susceptibility, as was shown before in these patients. Longitudinal investigations should be performed with otoacoustic emissions to help with the early prediction of the prospective effects of HLP and DM on the auditory system.Öğe The levels of plasma and salivary antioxidants in the patient with recurrent aphthous stomatitis(Wiley, 2005) Karincaoglu, Y; Batcioglu, K; Erdem, T; Esrefoglu, M; Genc, MBACKGROUND: Despite plenty of research, the cause of recurrent aphthous stomatitis (RAS) remains obscure. It has been proposed that, the aetiological factors such as local trauma, smoking, vitamin deficiencies and viral infections lead to aphthae formation via final common pathway based on increased oxidative stress. The aim of this investigation was to evaluate the antioxidant enzyme superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSHPx) alterations in plasma and saliva, and in addition uric acid (UA) in saliva, in patients with RAS and healthy controls. METHODS: Thirty-two patients with RAS and 30 healthy controls were included into the study. The SOD, CAT, GSHPx and UA levels were measured in plasma and saliva in study and control groups. RESULTS: In the RAS group, although the mean SOD (P < 0.001) and CAT (P < 0.05) levels of plasma were lower, GSHPx (P < 0.001) levels were higher than control group. The salivary concentrations of the SOD (P < 0.001), CAT (P < 0.05) and GSHPx (P < 0.001) in RAS group were entirely opposite to plasma concentrations. UA were not significant between RAS group and controls. CONCLUSION: Since we found salivary SOD and CAT levels were high whereas plasma levels were low, it has been thought that, salivary defence mechanisms via antioxidant agents may be stimulated against to the ulcerous lesion. We consider that the organism might mobilize the antioxidant potential to the sites where they were needed. At this point, decrease of SOD and CAT levels in the plasma may be related to this shift. It is also thought that GSHPx secretion in the saliva may also be increased but the increase in its turnover may be responsible for the diminished activity.Öğe Maxillary sinus hypoplasia(Int Rhinologic Soc, 2002) Erdem, T; Aktas, D; Erdem, G; Miman, MC; Ozturan, OMaxillary sinus hypoplasia (MSH) is an uncommonly, encountered condition by otolaryngologists. Pie computerized tomography (CT) scans provide valuable data about the anatomic details of the paranasal sinuses. MSH may, be misdiagnosed as an infection or a neoplasm of the maxillary, sinuses. Variations of the other paranasal structures, especially the uncinate process associated with MSH were defined. MSH shows three distinct hypoplasia patterns. Type I MSH characteristics are mild hypoplasia of the maxillary sinus, normal uncinate process and a well-developed infundibular passage. Significant hypoplasia of the maxillary, sinus, hypoplastic or absent uncinate process and absent or pathologic infundibular passage are seen in Type II MSH. Type III MSH is characterized by the absence of an uncinate process and cleft-like maxillary, sinus hypoplasia. In this study a series of 18 patients with MSH were presented. Twelve cases of unilateral and 6 cases of bilateral maxillary, antrum hypoplasia were evaluated and 13 MSH hype 1, 7 MSH type II and 4 MSH type III were detected. Three ethmomaxillary sinuses, an overpneumatized posterior ethmoid cell into the orbit and the maxillary sinus were determined. Our series showed that the uncinate process anomalies related to MSH malY lead to inadvertent orbital complications and therefore should be kept in mind.Öğe Nasal pyriform aperture stenosis in adults(Ocean Side Publications Inc, 2004) Erdem, T; Ozturan, O; Erdem, G; Akarcay, M; Miman, MCBackground: Congenital nasal pyriform aperture stenosis (CNPAS) leading to respiratory insufficiency in infants has been well documented. Nevertheless, the nasal pyriform aperture stenosis (NPAS) entity in adulthood has not been discussed at all. The normative data of the width of the pyriform aperture, which has not been revealed before, is necessary for evaluation of the adult subjects with nasal bony inlet stenosis. The aim of this study was to define the normative data about the pyriform aperture width measured in 80 adult subjects with paranasal sinus symptoms without nasal obstruction. and, additionally, to report the surgical results of two representative cases with NPAS. Methods: The nasal bony inlet width measurements have been achieved in axial computerized tomographic sections to establish normative data. The maximal distance between the nasal processes of the opposite maxillary bones was measured. Two adult males complaining of nasal obstruction with overt pyriform aperture stenosis were treated surgically via a sublabial approach. Results: The mean widest dimension of the nasal pyriform aperture was 21.6 +/- 2.2 mm (range, 17-27 mm) in 80 adult subjects. This width was 21.9 +/- 2.1 mm (range 18-27 mm) in men and 21 +/- 2.2 mm (range, 17-26 mm) in women. Stenotic pyriform apertures in two patients were widened surgically by drilling via a sublabial approach from 12 and 10 mm to 24 and 21 mm, respectively. Conclusion: NPAS should be included in the list of differential diagnosis for nasal obstruction. Surgical enlargement using a sublabial approach was found an effective and adequate treatment in pyriform aperture stenosis.Öğe Objective evaluation of the effects of intravenous lidocaine on tinnitus(Elsevier Science Bv, 2005) Kalcioglu, MT; Bayindir, T; Erdem, T; Ozturan, OObjective: Tinnitus is one of the most common and distressing otological symptoms. Although numerous therapeutic modalities have been tried, there is no consensus regarding effective therapeutic agents up to now. The effects of lidocaine on tinnitus have been reported in literature using either subjective or audiologic tests. Nevertheless, the otoacoustic emissions (OAEs) have not been utilized to demonstrate lidocaine's effect on the cochlea in the English literature. The aim of this study was to evaluate the effect of lidocaine on tinnitus by considering the alterations with tinnitus, it induces on OAEs and subjective symptoms. Methods: This study was performed in 30 patients with tinnitus. Twenty-eight of the patients had normal hearing and two of them evidenced mild sensorineural hearing loss. To determine the severity of tinnitus, the patients were required to fill out a tinnitus scoring scale before lidocaine infusion on the same day. Then, lidocaine was administered intravenously to each patient at a dose of mg/kg body weight over a period of 30 min. Spontaneous otoacoustic emissions (SOAEs) and distortion product otoacoustic 1.5 mg emissions (DPOAEs) were measured three times; namely before lidocaine injection, at 25 min after injection and on the next day. The severity of tinnitus was scored again 1 d, 1 wk and 1 mo after lidocaine administration. Results: Immediately after infusion, four patients (13.3%) declared total suppression of tinnitus, whereas three patients (10%) reported only partial relief in tinnitus subjectively. The patients, who had a subjective improved response (group 1) were compared with the patients, who had no response (group 2). Statistically significant changes (p < 0.05) in DPOAE response/growth or input/output (I/O) functions were observed at 1, 2, 3, 4 and 6 kHz frequencies in lidocaine responders and at 1, 2, 3, 4 and 5 kHz frequencies in no responders at different primary stimulus levels. Statistically significant changes (p < 0.05) were seen at 2 kHz for 53 dB and at 3 kHz for 62 dB SPL primaries in both groups. When the significant results of these two groups were compared with each other, differences were found insignificant. Conclusion: Systematic OAE measurements revealed that no changes occurred in SOAE and DPOAE levels in that alterations disappeared the next day. Subjective relief from tinnitus was stated in some of the patients and lasted for 4 wk at longest. (C) 2004 Elsevier B.V. All rights reserved.Öğe A radiological anatomic study of the cribriform plate compared with constant structures(Int Rhinologic Soc, 2004) Erdem, G; Erdem, T; Miman, MC; Ozturan, OBackground: Understanding of the anterior skull base anatomy is crucial to avoid intracranial violations during endoscopic surgery. The aims of this study were to define the normative data about cribriform plate depth and the relationship between this dimension and the measurements of the adjacent anatomical structures such as middle turbinate length, maximal vertical orbital height and distance between the ethmoid roof and the nasal floor. Patients and Methods: Paranasal computerized tomographic scans of 136 healthy adults were included into the study. The cribriform plate depth compared to the ethmoid roof and the adjacent anatomical structures mentioned above were measured bilaterally. Results: The maximal vertical orbital height was detected as the most constant anatomic measurement. We found the mean level dfference between the ethmoid roof and the cribriform plate as 6.1 +/- 2.3 (range 1-12 mm) on the left side and 6.1 +/- 2.2 (1-15 mm) of the right side. The middle turbinate was significantly longer in the Keros Type I group than in the other groups (p<0,05). Furthermore, the distance between the ethmoid roof and the nasal floor was lowest in the Keros Type I group (p<0,01). The distance between the ethmoid roof and the nasal floor was statistically higher in Keros group 3 among all groups (p<0,01). The deeper the cribriform plate, the higher the nasal cavity. Conclusion: To the best of our knowledge, our study has a unique feature by including the data of the constant anatomical structures comparing with the cribriform plate depth. Since in the group with excessive cribriform plate depth, the middle turbinate was short, care should be taken especially during middle turbinate resections.
