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Öğe Adenosine deaminase, xanthine oxidase, superoxide dismutase, glutathione peroxidase activities and malondialdehyde levels in the sera of patients with head and neck carcinoma.(2004) Kalcioglu M.T.; Kizilay A.; Yilmaz H.R.; Uz E.; Güleç M.; Ozturan O.; Akyol O.OBJECTIVES: Clinical and epidemiological findings have provided evidence supporting a role of free radicals in the etiology of cancer. Scavengers and inhibitors of free radical processes have been demonstrated to prevent or delay the neoplastic process. PATIENTS AND METHODS: Adenosine deaminase, xanthine oxidase, superoxide dismutase, and glutathione peroxidase activities and malondialdehyde levels were measured in the sera of 35 patients with head and neck cancers and were compared to those of healthy control subjects. RESULTS: Serum adenosine deaminase activity was found to be significantly increased in the patient group (p<0.001). Compared to the control group, glutathione peroxidase and xanthine oxidase activities and malondialdehyde levels were slightly higher and serum superoxide dismutase activity was slightly lower in the patient group, with none reaching statistical significance. CONCLUSION: The results indicate that serum adenosine deaminase activity may be helpful in the diagnosis and follow-up of head and neck cancers. Further studies with a larger cohort of patients are needed to clarify the exact mechanism of adenosine deaminase elevation.Öğe Approaches to twisted noses and results of treatment(2002) Ozturan O.; Miman M.C.; Yigit B.; Cokkeser Y.; Kizilay A.; Aktaş D.OBJECTIVES: The aim of this study was to address the multiplicity of surgical techniques and pitfalls in the treatment of twisted noses. PATIENTS AND METHODS: Fifty-nine patients (43 males, 16 females; mean age 27 years; range 17 to 47 years) with vertical axis deviation of the nose were surgically treated. Thirty patients had C-type and 29 patients had I-type twisted noses. Deviation angles were measured before nd at least six months after the operation. Correction of deviations was graded according to the ideal angular values and the two groups were compared. RESULTS: Significant correction was achieved in both types of twisted noses (p < 0.01). The results of the I-twisted noses were significantly closer to the ideal angles compared to those of the C-twisted noses (p < 0.05). Three patients underwent revision surgery. CONCLUSION: To correct functional and aesthetic problems in twisted noses, an external approach can be employed to straighten the nose by releasing, mobilizing, aligning and reinforcing the nasal anatomic structures. Cartilage grafts may be used to camouflage persistent deformities. C-twisted noses require more experience in, and familiarization with, a large number of surgical techniques.Öğe Bacterial etiology of otitis media with effusion; focusing on the high positivity of Alloiococcus otitidis(2002) Kalcioglu M.T.; Oncel S.; Durmaz R.; Otlu B.; Miman M.C.; Ozturan O.The etiology of otitis media with effusion (OME) is unclear. The bacterial analyses of middle ear effusion (MEE) in OME may reveal important information regarding its etiology. Alloiococcus otitidis, Heamophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis were investigated by using microbiologic culture and a multiplex PCR method in the middle ear fluid of 32 children (54 samples) with chronic OME. PCR yielded positive results in 18 (33.3%) middle ear effusions while culture resulted positive for 3 (5.6%). The PCR method detected A. otitidis in 10 (18.5%) specimens, H. influenzae in 7 (13%), M. catarrhalis in 4 (7.4%) and S. pneumoniae in 2 (3.7%) specimens. The multiplex PCR method enhances the detection rate significantly compared to that of the conventional culture method. A. otitidis is the most common detected pathogen in the MEE of the OME.Öğe Bending of the upper lateral cartilages for nasal valve collapse.(2002) Ozturan O.; Miman M.C.; Kizilay A.BACKGROUND: As a consequence of removal of the nasal hump, the upper lateral cartilages are separated from the septal cartilage in reductive rhinoplasty. A decrease in the nasal airway cross-sectional area and collapse of the internal nasal valve (INV) are inevitable unless additional surgical measures are taken. OBJECTIVE: To determine the efficacy of the horizontal mattress bending suture in treating patients with nasal valve collapse. METHODS: Each upper lateral cartilage was separately bent to a certain degree with a horizontal mattress suture following nasal dorsum reduction in the external septorhinoplasty as a preventive or corrective measure for the INV stenosis. The efficacy of this suture was assessed in 28 patients who presented with tension nose by comparing the INV angles preoperatively and 12 months postoperatively, as determined photographically by means of a rigid nasal endoscope. RESULTS: The mean +/- SD preoperative INV angle was calculated as 9.1 degrees +/- 4.2 degrees (range, 0 degrees -18.3 degrees ). The mean postoperative INV angle was increased to 25.3 degrees +/- 3.8 degrees (range, 18.4 degrees -34.5 degrees ) (P<.001). CONCLUSIONS: This method reconstitutes the normal anatomy of the INV, reestablishes stiffness or resistance of the nasal side walls so that they do not bend inwardly with inspiration, improves the airflow at this area, and avoids postoperative nasal valve stenosis in functional-cosmetic rhinoplasty cases that require considerable nasal hump reduction.Öğe A case of necrotizing sialometaplasia in the upper lip.(2003) Kizilay A.; Erdem T.; Mizrak B.; Bayindir T.; Ozturan O.Necrotizing sialometaplasia is a benign, reactive, and self-limiting inflammatory disorder with clinical and histologic features resembling carcinoma. A fifty-eight-year-old woman presented with a firm submucosal mass on the right side of the upper lip, measuring 0.5 cm. Histopathologic examination of the incisional biopsy specimen was reported as adenoid cystic carcinoma, resulting in removal of the mass with a large excision and reconstruction of the primary site. However, final histopathologic diagnosis of the excised mass was necrotizing sialometaplasia. No recurrences occurred during a three-year follow-up. This report draws attention to the difficulty in distinguishing between necrotizing sialometaplasia and adenoid cystic carcinoma.Öğe Comparison of clinical differences between patients with allergic rhinitis and nonallergic rhinitis(Medquest Communications LLC, 2013) Akarcay M.; Miman M.C.; Erdem T.; Oncel S.; Ozturan O.; Selimoglu E.We conducted a retrospective study to investigate the clinical differences between subtypes of rhinitis patients. Our findings were based on a detailed history and nasal examination. The study population was made up of 910 patients who had at least two rhinitis symptoms. These patients were categorized into one of three rhinitis groups: nonallergic rhinitis (NAR), seasonal allergic rhinitis (SAR), and perennial allergic rhinitis (PAR); there were 212 patients (23.3%) in the NAR group, 473 (52.0%) in the SAR group, and 225 (24.7%) in the PAR group. In addition to demographic data, we compiled information on the season when each patient presented, specific symptoms and their triggers, parental history, associated allergic diseases (e.g., skin, lung, and eye allergies), and nasal examination findings. The SAR patients represented the youngest of the three groups. Most SAR patients presented in spring and summer, and this group had the highest incidence of eye itchiness, pharyngeal itchiness, eye redness, and palatal itchiness. In terms of triggering factors, a visit to a green area was significantly more common in the SAR patients, while detergent odor, sudden temperature change, and cold air were significantly more common in the NAR patients. On nasal examination, a pale nasal mucosa was significantly more common in the NAR group. In clinical practice, it is crucial to differentiate between allergic and nonallergic rhinitis. We conclude that relevant information from the history can predict allergic rhinitis. Future studies of prevalence should take into consideration the important findings of our study, including the significance of age and the seasonality of exacerbation of rhinitis symptoms.Öğe Determination of allergen-specific IgE in patients with atopy or allergy symptoms(2003) Miman M.C.; Ozerol I.H.; Ozturan O.; Erdem T.OBJECTIVES: We investigated the role of specific IgE assay in the diagnosis in patients found to be atopic or allergic by history and physical examination. PATIENTS AND METHODS: Serum specific IgE levels were measured by the chemiluminescent assay in 143 adults (58 females, 85 males; mean age 34.3 years; range 16 to 62 years) and in 113 children (62 girls, 51 boys; mean age 10.2 years; range 5 to 16 years) with rhinitis, asthma, or dermatitis. The results were analyzed in six groups depending on the specific IgE level (no specific IgE, very low, low, moderate, high, and very high levels). The specific IgE threshold for a negative or positive result was accepted as 0.70 IU/ml. Allergen-specific IgE antibodies were sought for 35 allergens in adults, and for 19 allergens in children. RESULTS: Specific IgE levels were positive (>0.70 IU/ml) in 92 adults (64.34%) and in 50 children (44.25%). Hypersensitivity to individual allergens ranged between 20.08% and 41.96% in adults, and between 17.70% and 28.32% in children. Fourteen adults and eight children showed sensitivity to a single allergen; the remaining patients were sensitive to at least two allergens. CONCLUSION: Detection of sensitivity to allergens is complementary to findings obtained by history and physical examination and may help to reveal allergic etiology in patients presenting with a similar symptom profile.Öğe Dimensions of the sinus tympani and its surgical access via a retrofacial approach(Annals Publishing Company, 1996) Ozturan O.; Miller III C.C.; Bauer C.A.; Jenkins H.A.The sinus tympani (ST) is a critical anatomic region of the temporal bone. It lies medial to the facial nerve, between the ponticulus and the subiculum, and therefore is not easily visualized by routine surgical approaches to the middle ear and mastoid. This limited access makes the ST a site that is notorious for residual cholesteatoma. An extensive evaluation of the anatomic dimensions of the ST was made from human temporal bones. Three hundred twenty-seven bones were examined at four standardized levels to describe the dimensions and anatomic relationships of the ST with other structures of the temporal bone. The region of the stapedial tendon was found to be the most limited anatomic substructure in the vicinity of the ST. This study demonstrates the feasibility of a retrofacial approach to the ST as an aid in eradication of otherwise hidden disease.Öğe Dural bone defects and encephalocele associated with chronic otitis media or its surgery(2002) Kizilay A.; Aladag I.; Cokkeser Y.; Ozturan O.OBJECTIVES: We investigated the incidence of dural bone defects and encephalocele following radical mastoidectomy or open cavity tympanoplasty. PATIENTS AND METHODS: We retrospectively evaluated 190 operations of 182 patients (97 males, 85 females; mean age 30.6 years; range 9 to 70 years) who underwent radical mastoidectomy (n=89) or open cavity tympanoplasty (n=101). Follow-up examinations included otomicroscopy. Patients with documented dural bone defects on examination or operation records were further evaluated by axial and coronal computed tomography scans of the temporal bone. Those with suspected encephalocele were studied by magnetic resonance imaging. RESULTS: Dural bone defects were detected in 17 patients perioperatively. Of these, 14 defects were associated with chronic otitis media. Three iatrogenic bone defects were induced during obliteration of lateral sinus thrombosis. The mastoid tegmen was the most common site of defects (41%) and the most common etiologic factor was cholesteatoma (84%). Encephalocele was detected in one patient in whom radical mastoidectomy with lateral sinus obliteration was performed due to lateral sinus thrombophlebitis. Encephalomalasia was found nearby the defect area in two patients. CONCLUSION: Dural bone defects associated with chronic otitis media are not rare, the most common cause being cholesteatoma. Repair of dural lacerations requires watertight closure to prevent the occurrence of encephalocele.Öğe The effect of endoscopic sinus surgery on quality of life(2003) Akarçay M.; Kizilay A.; Miman M.C.; Cokkeser Y.; Ozturan O.OBJECTIVES: We assessed the effects of endoscopic sinus surgery on quality of life of patients with nasal polyposis or chronic sinusitis. PATIENTS AND METHODS: Thirty patients (5 females, 25 males; mean age 36 years; range 17 to 58 years) who underwent endoscopic sinus surgery were prospectively evaluated. The diagnoses were nasal polyposis in 15 patients and chronic sinusitis in 15 patients. Primary and revision operations were performed in 23 patients and seven patients, respectively. The quality of life was evaluated before and six months after surgery with the use of the Chronic Sinusitis Survey (CSS), and Medical Outcomes Study Short Form-12 (SF-12). Prior to administration, the two questionnaires were translated and adapted to Turkish. Computed tomography (CT) findings were scored before and six months after surgery according to the Lund-Mackay system. The results of the surveys were compared with CT scores. RESULTS: The postoperative SF-12 and CSS scores of all the patients improved significantly. Computed tomography scores were not found in correlation with improvements in the SF-12 and CSS scores. CONCLUSION: Endoscopic sinus surgery results in significant improvement in the quality of life of patients with nasal polyposis and chronic sinusitis, which may not be reflected by CT scores.Öğe A functional and aesthetic solution for saddle nose deformity: the use of the inferior turbinate bone.(2003) Ozturan O.; Erdem T.; Miman M.C.; Erguvan R.The use of a new autologous material, the inferior turbinate bone, for nasal augmentation is presented together with surgical treatment of a 24-year-old male patient with moderately severe saddle nose deformity. In the postoperative period, no complications were observed. Photographs and three-dimensional computed tomography views obtained 13 months after the operation showed that the reconstruction area was highly free of postoperative resorption. The patient's complaints disappeared, and he was satisfied with functional and cosmetic results. Moreover, a histologic evaluation which was made to assess the depth of the glandular component showed that the inferior turbinate bone could be used over the nasal dorsum in a smoother shape, retaining its overlying soft tissue.Öğe Graft materials used in the reconstruction of saddle nose(2002) Erdem T.; Ozturan O.A large number of graft materials, either biologic or alloplastic, has been described in the reconstruction of saddle nose deformity to provide a structural support to the nasal dorsum and tip. Although autogenous materials are thought to be more advantageous, there is still no consensus regarding the most suitable surgical graft material for saddle nose. Each graft material presents some advantages and disadvantages. This article reviews current knowledge about graft materials used in the treatment of saddle nose deformity.Öğe Laryngotracheal reconstruction of the congenital glotto-subglottic stenosis with autogenous thyroid cartilage interposition: a case report.(2002) Ozturan O.; Kizilay A.; Miman M.C.; Oncel S.; Kalcioglu M.T.; Erdem T.Surgical correction of grade III glotto-subglottic stenosis in a two-month-old girl was illustrated in a staged manner. Firstly, a silicone keel was placed via anterior thyrotomy following a tracheotomy. Secondly, laryngotracheal reconstruction was performed by interposing an autogenous thyroid cartilage anteriorly between the edges of the longitudinally divided cricoid cartilage and the upper tracheal rings. A stent was maintained for two months. The glottis and subglottis appeared patent and healed following removal of the stent. A meaningful voice and rather comfortable respiration were observed during a 13-month follow-up. The use of thyroid cartilage autograft offers many advantages in laryngotracheal reconstruction with considerably less technical difficulty.Öğe Laser assisted eustachian tuboplasty: a case report(2005) Erdem T.; Ozturan O.; Miman M.C.; U?raş M.Surgical treatment of eustachian tube dysfunction is still challenging. Placement of a transtympanic ventilation tube may not be successful and may require multiple applications. We presented a 47-year-old male patient with chronic recurrent otitis media with effusion and retraction due to eustachian tube dysfunction, in whom the number of previous transtympanic tube insertions amounted to 18. He underwent laser assisted eustachian tuboplasty in both ears with endoscopic guidance under general anesthesia. The mucosal, submucosal, and partially the cartilaginous tissues in the posterior pillow of the nasopharyngeal orifice of the eustachian tube were ablated by Nd:YAG and holmium:YAG laser. Following surgery, air conduction thresholds decreased from 37 dB to 22 dB, and from 38 dB to 33 dB for the right and left ears, respectively. The preoperative tympanogram curve, which was of type B for both ears was found as type C-1 on the right side, and type C-2 on the left. Limited improvement seen in the left ear was ascribed to insufficient ablation of the posterior pillow of the eustachian tube. No complications were encountered within a follow-up of 12 months.Öğe Monitoring of cisplatin ototoxicity by distortion-product otoacoustic emissions(Elsevier Ireland Ltd, 1996) Ozturan O.; Jerger J.; Lew H.; Lynch G.R.Cisplatin is one of the most commonly used chemotherapeutic agents. However, ototoxicity, in particular, damage to the outer hair cells of the cochlea, is one of its major side effects. Otoacoustic emissions are acoustical signals that originate from the contractile activity of the outer hair cells. They are transmitted from the cochlea to the external ear canal via the middle ear apparatus. Testing is quick, painless, objective, and non- invasive. Distortion-product otoacoustic emissions (DPOAEs) are one of the evoked types of otoacoustic emissions. They are quite sensitive to any insult to the outer hair cells, even before damage is manifested in pure tone audiometry (PTA). A patient, who was on cisplatin chemotherapy due to prostate cancer, was monitored periodically for ototoxicity using DPOAEs and PTA. DPOAEs were found to detect ototoxicity one course of chemotherapy earlier than PTA during cisplatin chemotherapy. The clinical application and sensitivity of DPOAEs in monitoring ototoxicity were discussed.Öğe A report of four cases of acute mediastinitis occurring following tracheoesophageal puncture in laryngectomees.(2004) Kalcioglu M.T.; Kizilay A.; Saydam L.; Soysal O.; Ozturan O.; Kuzucu A.Tracheoesophageal puncture is a simple procedure for speech rehabilitation of total laryngectomy patients. Despite its relative simplicity this is not an innocent technique without complications. The goal of this study was to determine the incidence of acute mediastinitis as an early postoperative complication related to this procedure and to present outcomes of non-surgical conservative management in this complication. Blom-Singer voice prosthesis was used for 51 secondary tracheoesophageal puncture procedures in 45 patients between 1994 and 2002 according to the technique described by Blom and Singer. In the postoperative period, four patients (7.8%) developed mediastinitis related to this procedure. Of these, one patient had iatrogenic perforation of the posterior esophageal wall. A false dissection plane occurred in the tracheo-esophageal party wall in three patients which subsequently resulted in mediastinitis. Mediastinitis was diagnosed by clinical and radiological findings. All of these patients required prolonged hospitalization, intravenous antibiotics, and chest tube insertion. Only one patient underwent major surgical procedure to treat this complication. In conclusion, tracheoesophageal puncture for voice restoration is now regarded as a routine procedure usually performed in outpatient conditions. However, our experience demonstrates that this technique may be associated with significant complications such as mediastinitis. If mediastinitis is recognised earlier, it may be treated with conservative measures in most of the cases.Öğe Serum nitric oxide levels in patients with head and neck squamous cell carcinoma.(2007) Kizilay A.; Kalcio?lu M.T.; Ozu?urlu F.; Ozyurt H.; Alada? I.; Ozturan O.; Akyol O.OBJECTIVES: We determined serum nitric oxide (NO) levels in patients with head and neck squamous cell carcinoma (SCC) and sought correlations with TNM staging, tumor localization, and tumor grade. PATIENTS AND METHODS: Serum samples were obtained from 36 patients (mean age 63 years; range 37 to 80 years) with head and neck SCC prior to treatment and from 20 healthy individuals (mean age 56 years; range 30 to 72 years) as controls. Tumor staging was based on the criteria of the American Joint Committee of Cancer staging system in 2002. Thirteen patients had stage I-II, and 23 patients had stage III-IV tumors and all had well- or moderately-differentiated SCC (grade 1-2). Serum NO levels were analyzed by a spectrophotometric method based on the determination of total nitrite levels in serum and compared between the patient and control groups. RESULTS: The mean serum NO levels were 20.08+/-1.40 micromol/l and 13.57+/-0.99 micromol/l in cancer patients and controls, respectively (p=0.001). There were no correlations between NO levels and age, sex, tumor stage, localization, and histological grade. CONCLUSION: These data suggest that head and neck SCC is associated with increased serum NO levels, which may play a role in tumor growth.Öğe Successful use of botulinum toxin injection in the treatment of salivary fistula following parotidectomy(2003) Kizilay A.; Aladag I.; Ozturan O.A twenty-year-old woman underwent right superficial parotidectomy for pleomorphic adenoma. On the 10th postoperative day she presented with a salivary fistula, for which repeated aspirations with pressure dressings were applied for a month. Despite decreases in the salivary fluid volume, reaccumulation persisted. Following aspiration of the salivary fluid, 40 units of botulinum toxin was injected into the pouch. On the second day of injection, the discharge ceased and the pouch disappeared. No side effects were observed and the patient remained symptom-free during four-month follow-up.
