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Öğe Cartilage Tympanoplasty with Island Technique: A Comparison with the Temporalis Muscle Fascia Technique(Aves, 2009) Kalcioglu, M. Tayyar; Firat, Yezdan; Selimoglu, ErolObjective; To evaluate hearing results and failures of tympanoplasty techniques with either island cartilage or temporalis muscle fascia. Materials & Methods; Retrospective evaluation of selected cases operated by the same surgery team between 2000 and 2008. A total of 307 patients with a tympanic membrane perforation or retraction due to chronic otitis media were treated surgically with tympanoplasty with or without mastoidectomy. From these 96 cases who had primary repair of tympanic membrane perforation or retraction with intact ossicular chain and normal middle ear were included into the study. Tympanic membrane perforation was reconstructed by using fascia in 36 while cartilage island graft was used in 60 patients. Temporalis muscle fascia was preferred for simple perforations while cartilage was used in more difficult cases such as retractions or total or subtotal perforations. Preoperative and postoperative pure-tone average air-bone gaps were compared at 250, 500, 1000, 2000 and 4000 Hz frequencies. Postoperative failures were compared. Results; Main outcomes of both techniques were similar for hearing results and prevalence of failures. Closure of air-bone gaps after surgery were 14.98, 12.5, 9.67, 8.67, and 7.01 dB for cartilage group and 15.42, 11.67, 8.34, 7.36, and 8.61 dB for fascia group respectively. The differences were not statistically significant. Graft survival rates were 86.1% in the fascia group and 95% in the cartilage group. Conclusion; Both techniques show similar functional and hearing results. Cartilage tympanoplasty with island technique may be chosen according to patient's condition like atelectatic ear, adhesive otitis and retraction pockets, totally or sub totally perforation of tympanic membrane or revision tympanoplasty.Öğe Congenital Muscular Torticollis in Older Children: Treatment With Z-Plasty Technique(Lippincott Williams & Wilkins, 2014) Ekici, Nur Yucel; Kizilay, Ahmet; Akarcay, Mustafa; Firat, YezdanCongenital muscular torticollis (CMT) is a common congenital disorder of the musculoskeletal system in neonates and infants. The aim of this study was to evaluate the results of inferior Z-plasty in older children with CMT. They had mean age of 10 years (range, 5-14 years) and were followed up for 1 to 6 years. Postoperative protocol included a neck exercise program composed of active and passive movements in all cases and immobilization with a cervical collar in only 4 patients. This study concluded that surgical management of older children with CMT using Z-lengthening gives excellent clinical and functional results. The procedure is much more effective than other techniques and relatively complication-free and safe. Postoperative cervical collar and a well-planed physiotherapy protocol go a long way toward ensuring good to excellent results. Early diagnosis and treatment are necessary for good results.Öğe Do Comorbidities Influence Objective and Subjective Recovery Rates of Nasal Polyposis?(Lippincott Williams & Wilkins, 2010) Akarcay, Mustafa; Ekici, Nur; Miman, Murat C.; Firat, Yezdan; Bayindir, Tuba; Selimoglu, ErolObjectives: To investigate the clinical and laboratory outcomes both objectively and subjectively in nasal polyposis patients with or without comorbidity (CoM; asthma and allergy). Patients and Methods: Thirty-three nasal polyposis patients (13 women and 20 men) were included into the study. Their mean age was 39.23 +/- 9.13 years. CoM(+) and CoM(-) nasal polyposis patients were compared with each other. Evaluations contained endoscopic nasal examination, acoustic rhinometry, rhinomanometry, visual analog scale score of nasal blockage, olfactory function score, respiratory function test, skin prick tests, and paranasal sinus computed tomography. Results: Recovery was statistically significant in all observed evaluations for endoscopic and radiologic staging, nasal obstruction, and sense of smell compared with the first evaluation in all patients regardless of the subgroups. Although objective measurements of respiratory functions did not show any change, clinical improvement was detected in CoM(+) patients with a decrease of need to their antiasthmatic medical treatment. Conclusions: Results of CoM(+) patients led to no statistical difference when compared with CoM(-) subgroup. When applying predefined nasal polyposis treatment protocol, the polyp patients with CoMs do not need close follow-up compared to the patients without CoMs.Öğe Effect of Intranasal Estrogen on Vocal Quality(Mosby-Elsevier, 2009) Firat, Yezdan; Engin-Ustun, Yaprak; Kizilay, Ahmet; Ustun, Yusuf; Akarcay, Mustafa; Selimoglu, Erol; Kafkasli, AyseThe objective of this study was to evaluate the effect of intranasal estrogen therapy on female vocal quality. Thirty-two women who had surgically induced menopause were included into the study group and examined through hall year for this study. Estrogen treatment was proposed to all of the patients. Twenty-three of them accepted the treatment protocols including oral (n = 12) (2 mg estradiol; Estrofem; Novo Nordisk, Denmark) and intranasal (n = 11) (300 mcg 17beta-estradiol; Aerodiol; Servier, Chambray-les-Tours, France) form of estrogen. The rest of patients refused estrogen treatment and those patients constituted the control group (n = 9). Vocal changes were evaluated with Voice Handicap Index (VHI) and acoustic analysis of voice variations (fundamental frequency [F0], SD F0, jitter, shimmer, normalized voice energy, and harmonics-to-noise ratio) at baseline and after 1-year follow-up. According to VHI, while voice improvement was not clear in oral estrogen group, it was significant at intranasal estrogen group. Voice quality in patients treated with hormone replacement therapy (HRT) was significantly higher than patients without HRT. But between two treatment groups, there were no any statistical discrepancy. According to acoustic analysis, vocal stability among the women who use HRT was significantly better than those who did not use. Intranasal estrogen exerted the most significant effects on vocal stability. The data of our study support that voice undergoes changes in lack of estrogen in surgically induced menopausal women. Taken together with the relevant studies, while oral estrogen replacement therapy shows a favorable influence on voice quality, it seems to be more pronounced with intranasal estrogen than oral form.Öğe The effect of resveratrol in tracheal tissue of rats exposed to cigarette smoke(Taylor & Francis Ltd, 2009) Kurus, Meltem; Firat, Yezdan; Cetin, Asli; Kelles, Mehmet; Otlu, AliObjective: The aim of this study was to evaluate the effect of resveratrol on the tracheal tissue of rats exposed to cigarette smoke. Materials and methods: 40 adult Wistar albino rats were divided into four groups for an experiment of 6 weeks. Animals in group 1 were controls (n = 10). Rats in group 2 were exposed to cigarette smoke only, and rats in group 3 received daily intraperitoneal injections of resveratrol (10 mg/kg/d). Animals in group 4 were exposed to both cigarette smoke and intraperitoneal injections of resveratrol. Rats of all groups were sacrificed using cervical dislocation. The tracheas were removed and embedded in paraffin blocks. Sections of 4-5 mu m thickness were prepared from the blocks. These sections were stained with hematoxylin and eosin, periodic acid-Schiff, and Alcian blue and viewed with a Leica DFC 280 light microscope. Results: Tracheal sections showed that, in group 2 (cigarette smoke group), there was desquamation of epithelial cells into the tracheal lumen, loss of cilia in the epithelial layer, an increase of goblet cells, activation of serous glands at the submucosa, and cell infiltration. In group 4 (cigarette smoke + resveratrol group), all these findings also existed but only a few sections were affected. It was observed that cigarette smoking caused morphological changes such as epithelial degeneration in the upper airway. These morphological changes were correlated with the amount of toxic substances in the cigarette smoke. Conclusion: We found that resveratrol had a preventive role in the histopathological changes caused by cigarette smoking in the rat trachea.Öğe Experimental otoacoustic emission and auditory brainstem response changes by stellate ganglion blockage in rat(W B Saunders Co-Elsevier Inc, 2008) Firat, Yezdan; Kizilay, Ahmet; Ozturan, Orhan; Ekici, NurIntroduction: To investigate the effect of stellate ganglion (SG) block on hearing in rats. Materials and methods: Sixteen male adult rats were randomly divided into 2 equal groups. Both groups underwent preblock auditory brainstem responses (ABRs) in response to tone bursts at 4, 6, and 8 kHz and otoacoustic emissions in response to distortion products as a function of f2 frequency at 1, 2, 4, and 6 kHz. Local anesthetic (0.2 mL of 2% prilokain) was administered to the left SG of the study group by posterior cervical percutaneous approach for cervical sympathetic blockage. In the control group, 0.2 mL of physiological saline was injected to the left SG. Postblock hearing evaluations were made after 15 minutes of injections. Results: Both Dp-gram and I/O function records suggested that whereas hearing thresholds were not affected in lower frequencies after SG blockage, it tended to increase at higher frequencies. In ABR records, waves I and II showed marked latency shift across all frequencies. The interpeak latency of waves I and II was shortened after blockage. Saline injection did not show any significant ABR or distortion-product otoacoustic emission threshold shift across frequencies at 60, 70, 80, and 90 dB sound pressure level. Conclusion: Our data demonstrate that SG block improved the hearing parameters in rats with normal cochlear blood flow. To recommend SG blockage as a treatment option in the vascular pathologies of cochlea, further investigation should assess the efficiency of ganglion blockage in hearing parameters of rats with impaired cochlear blood flow. (C) 2008 Elsevier Inc. All rights reserved.Öğe Grisel syndrome: Nontraumatic atlantoaxial rotatory subluxation(Lippincott Williams & Wilkins, 2008) Harma, Ahmet; Firat, YezdanGrisel syndrome is the subluxation of atlantoaxial joint as a result of infectious or inflammatory processes of the head and neck region. The etiopathogenesis of this clinical entity is not clear yet. Early interventions (antibiotherapy, cervical traction, and immobilization) are critical to avoid catastrophic outcome. Early detection of pediatric atlantoaxial subluxation is essential. It requires a combination of clinical assessment and appropriate radiographic imaging. In this report, we present a clinical and radiologic follow-up of a Grisel syndrome; by this way, we discuss the role of radiology on the diagnosis of this rare entity and preview the relevant literature.Öğe The Histopathological Effect of Resveratrol in Thyroid Tissue of Rats Exposed to Cigarette Smoke(Ortadogu Ad Pres & Publ Co, 2009) Kurus, Meltem; Sogutlu, Gokhan; Firat, Yezdan; Esrefoglu, Mukaddes; Yologlu, Saim; Ozturk, Feral; Otlu, AliObjective: The aim of this study was to assess the histopathological effect of resveratrol in thyroid tissue of rats exposed to cigarette smoke. Material and Methods: Forty adult, male Wistar Albino rats were divided into four groups for an experiment of 6 weeks duration. Group I was the control group. Rats in group 2 were exposed to cigarette smoke only and rats in group 3 received daily intraperitoneal injections of resveratrol (10 mg/kg/d). Animals in group 4 were exposed to both cigarette smoke and intraperitoneal injections of resveratrol. Rats of all groups were sacrificed; their thyroid glands were removed and were examined histopathologically. Results: While the control group and the resveratrol group had normal thyroid tissue, in the group exposed to cigarette smoke there was a significant decrease in follicles and differentiation of epithelial cells from cubic to flat cells. There was intracytoplasmic vacuolization in some epithelial cells, irregularity in follicular cells decreasing area and cell infiltrations. On the other hand, we observed significant improvement in these histopathological differences in the group that was exposed to both cigarette smoke and resveratrol. Conclusion: Resveratrol has healing effects on the damage of thyroid tissue of rats that are exposed to cigarette smoke at a dose and duration tested in this study.Öğe Incontinentia pigmenti: a case report and literature review(Turkish J Pediatrics, 2009) Emre, Sinan; Firat, Yezdan; Gungor, Serdal; Firat, Ahmet Kemal; Karincaoglu, YeldaIncontinentia pigmenti (IP) is a rare, X-linked dominant disorder that presents at or soon after birth with characteristic cutaneous signs. The eyes and central nervous system are the next most commonly affected systems. We aimed to describe the ophthalmological, neurological and radiodiagnostic findings of a patient with IP and bilateral retinal detachment. Clinical and laboratory findings of a four-month-old female baby who did not have light fixation and had neurological maturation retardation are presented. Characteristic skin lesions of IP were noted especially at the extremities, bilaterally. On neurological examination, motor and mental maturation were retarded and axial hypotonia was noted. Bilateral retinal detachment was the cause of absent eye fixation noted during ophthalmologic examination, and the detachments were also documented by ultrasonography and magnetic resonance imaging (MRI). Otologic examination was normal. Focal left frontal lobe atrophy, corpus callosum hypoplasia and prominence of right hemisphere were also noted on MRI. MR spectroscopy revealed negative lactate peak at the involved left frontal lobe. Bilateral retinal detachment is a probable finding in IP and patients with neurological symptoms should be investigated for associated sight- threatening ocular pathologies.Öğe Isolated preauricular pits and tags: is it necessary to investigate renal abnormalities and hearing impairment?(Springer, 2008) Firat, Yezdan; Sireci, Sule; Yakinci, Cengiz; Akarcay, Mustafa; Karakas, Hakki Muammer; Firat, Ahmet Kemal; Kizilay, AhmetWe investigated the incidence and co-existence of hearing impairment and renal abnormalities in healthy children with preauricular tags and pits. Study population consists of 13,740 primary school children from routine health check. Thirty-five children with preauricular tags and pits were noted. Control group consisted of 91 patients without pits and tags, who underwent renal ultrasound and were scheduled to pediatric outpatient clinic. Urinanalysis, renal ultrasound, otoacoustic emission were performed in both the groups. The prevalence of renal abnormality (1/36; 2.7%) and hearing impairment (1/36; 2.7%) in patients with preauricular tags and pits was similar to that of control group (3/91; 3.2% and 4/91; 4.3%) (P = 0.87, P = 0.64, respectively). According to our results, it is not necessary to investigate hearing or urinary abnormality in patients with preauricular tag or pit, unless there is an association of a syndrome or family history of hearing or renal impairment.Öğe Second Primary Cancer Occurrence on Forehead Flap After Reconstruction of Nasal Carcinoma(Lippincott Williams & Wilkins, 2008) Firat, Yezdan; Kizilay, Ahmet; Akarcay, Mustafa; Miman, Murat CemWe reported a case of basal cell carcinoma on the flap which was initially treated with excision of squamous cell carcinoma and forehead flap reconstruction of nasal dorsum. After 8 years of reconstruction, basal cell carcinoma was developed on the flap surface. This may be due to a recurrence, or a second primary tumor, or an activation of a dormant tumor with perturbing factors like surgery. In this report, our purpose was to discuss the possible etiopathogenesis, most appropriate diagnostic procedures, and treatment protocol for a carcinoma of the flap which has been used to reconstruct the previous cutaneous cancer.Öğe Spontaneous intracranial hypotension with pituitary adenoma (vol 7, pg 47, 2006)(Springer, 2008) Firat, Ahmet K.; Karakas, Hakki M.; Firat, Yezdan; Kahraman, Bayram; Erdem, Guelnur[Abstract Not Available]Öğe Traumatic Thrombosis of Internal Carotid Artery Sustained by Transfer of Kinetic Energy(Lippincott Williams & Wilkins, 2012) Kalcioglu, Mahmut Tayyar; Celbis, Osman; Mizrak, Bulent; Firat, Yezdan; Selimoglu, ErolA 31-year-old male patient with a fatal thrombosis of the internal carotid artery caused by gun shot injury was presented in this case report. The patient was referred to the hospital with a diffuse edema on his left cheek. On otolaryngologic examination, there was a bullet entrance hole at the left mandibular corpus. No exit hole could be found. The finding from his axial computed tomography of neck and paranasal sinuses was normal. On neurological examination, a dense right hemiparesis was observed. In his cerebral angiogram, left common carotid artery was totally obliterated. Diffuse ischemia was observed in the left cerebral hemisphere. Despite intensive interventions, the patient died 4 days after the accident. In the autopsy, a large thrombosis was obtained in the left common carotid artery. This case emphasizes a fatal kinetic energy effect in vascular structures. It is stressed that a gun shot injury could be fatal with its indirect kinetic energy effects at subacute phase.
