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Öğe Ankaferd Blood Stopper Is More Effective Than Adrenaline Plus Lidocaine and Gelatin Foam in the Treatment of Epistaxis in Rabbits(Elsevier Science Inc, 2011) Kelles, Mehmet; Kalcioglu, M. Tayyar; Samdanci, Emine; Selimoglu, Erol; Iraz, Mustafa; Miman, Murat Cem; Haznedaroglu, Ibrahim C.BACKGROUND: Epistaxis is an important emergency that can sometimes be life threatening without effective intervention. Persistent and recurrent bleeding can lead to aspiration, hypotension, hypoxia, or even severe and mortal cardiovascular complications. Providing prompt hemostasis is important, and the hemostatic method used must be easily and locally applicable, efficient, and inexpensive. OBJECTIVE: The aim of this study was to assess the hemostatic efficacy of Ankaferd Blood Stopper (ABS) in an experimental epistaxis model and to determine the histopathologic alterations with topical ABS application. METHODS: Twenty-eight New Zealand rabbits were evaluated in 4 study groups. Topical ABS, gelatin foam (GF), adrenalin + lidocaine (AL), and serum physiologic as negative control (C) were applied to the animals for controlling epistaxis. The bleeding was generated with a standard mucosal incision in all groups. Cotton pieces soaked with ABS, AL, C, and GF were applied to the nasal bleeding area. Time of hemostasis was recorded. Tissue samples were obtained after hemostasis for histopathologic examination. The samples were stained with hematoxylin and eosin (HE) and phosphotungstic acid hematoxylin (PTAH) and were examined under a light microscope. In this experimental study, the observers were blind to ABS, AL, and C but not to GF, because of its solid nature. RESULTS: Median durations required for hemostasis in ABS, AL, GF, and C groups were recorded as 30, 90, 90, and 210 seconds, respectively. The time until termination of bleeding in the ABS group was significantly shorter than that in the AL, GF, and C groups (P = 0.002, P = 0.002, and P = 0.001, respectively). On histopathologic evaluation, after staining with HE, minimal fibrin at the incision edges and a few extravasated erythrocytes were observed in the C, AL, and GF groups. In the ABS group, a dark amorphous material surrounded by fibrin, filling the space between the edges of incisions, was noticed. Fibrin was determined in the C, GF, and AL groups with PTAH stain and in the positive control group. In the ABS group, it was observed that the amorphous substance surrounded by fibrin seen in the HE sections was not stained with PTAH. CONCLUSIONS: Topical nasal ABS application controlled epistaxis faster than C, GF, and AL in this animal bleeding model. The bleeding model used here might fail to replicate the type of injury that would be likely to result in life-threatening bleeding in humans, which should be considered a limitation of the present study. The histopathologic findings in the nasal incision area suggest that ABS might affect global hemostasis by inducing a unique protein network formation, potentially representing a different mechanism of action among conventional antihemorrhagic applications. (Curr Ther Res Clin Exp. 2011;72:185-194) (C) 2011 Elsevier HS Journals, Inc. All rights reserved.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 Craniofacial features of children with celiac disease(Lippincott Williams & Wilkins, 2013) Selimoglu, Mukadder A.; Kelles, Mehmet; Erdem, Tamer; Ertekin, Vildan; Karabiber, Hamza; Selimoglu, ErolBackground and goalsGrowth retardation is one of the most important signs of childhood celiac disease (CD); however, it is not very well known whether craniofacial growth is also affected. We aimed to carry out a detailed craniofacial morphological study to derive a conclusion on the craniofacial features of children with CD.Participants and methodsEighty-four 2-16-year-old children with biopsy-proven CD and 84 age-matched and sex-matched healthy children were included. Of these, 37 children (44.0%) had been newly diagnosed and 47 (56.0%) were on a gluten-free diet. Anteroposterior and lateral photographs were evaluated using the Scion Image software program for the measurements of the distances between reference points on the face.ResultsExcept for nasofrontal angle (nfa), nasolabial angle (nla), pronasale height (prnh), nasal dorsum height (ndh), and nasal radix height (nrh), all measurements were significantly greater in patients compared with controls. In celiac children, all facial proportions except forehead/face height (t-gl/t-gn) and nose length/face height (n-ns/t-gn) were significantly different from those of controls. Except for nla, prnh, ndh, nrh, t-gl/t-gn, face height to total face height ratio (sn-gn/t-gn), n-sn/t-gn, ear length to face height ratio (s-sba/t-gn), and face width to face height ratio (z-z/t-gn), all measurements were statistically different in those on a gluten-free diet and newly diagnosed children.ConclusionMost of the facial measurements and proportions of celiac children were different from those of controls. Our data confirm those of a previous study reporting that the forehead proportion is not altered in childhood CD. Pathophysiological mechanisms underlying these alterations are not clear but disruptions of growth during certain critical periods may be responsible.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 Does Aluminum Cause Ototoxicity in Rats?(Aves, 2011) Selimoglu, Erol; Bayindir, Tuba; Iraz, Mustafa; Gul, Mehmet; Durgun, Yesim; Erdem, Tamer; Kalcioglu, TayyarBackground: Aluminum (Al) is a nonessential and toxic metal to which humans are frequently exposed. Except one study which revealed adverse effects of serum Al levels on the auditory functions in hemodialysis patients, there is not any other study on the effects of Al on auditory functions. Study design: Acute and chronic effects of Al on rat auditory system were investigated in that randomized controlled study. Methods: Forty five male Sprague-Dawley rats were included. Rats were divided into six groups according to the dose and route of Aluminum chloride (AlCl3): in groups A (n=7), B (n=9), and C (n=9), intraperitoneally (IP) AlCl3 was injected in doses of 1 mg/kg, 5mg/kg, and 80mg/kg, respectively; in control group (group K, n=6), saline was injected IP; in groups D (n=7) and E (n=7) oral AlCl3 was administered in doses of 5mg/kg, and 50mg/kg, respectively. OAE measurement was performed for four times in IP AlCl3 groups; before and on the 1st, 7th, and 14th days after aluminum administration. In oral group OAE measurement was performed before and on the 1st, 2nd, and 3rd months after aluminum administration. The distortion product otoacoustic emissions (DPOAEs) at 2f1-f2 were recorded and analyzed. Histological examination of the cochlea was performed. Results: DPOAE measurements of all groups before and after AlCl3 administrations were not statistically different. Histological examination revealed normal stria vascularis, spiral ganglion and organ of cord in all groups. Conclusion: Neither acute nor chronic administration of AlCl3 in aforementioned doses and routes caused neither clinical nor histological ototoxicity.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 Effects of rapid maxillary expansion on conductive hearing loss(E H Angle Education Research Foundation, Inc, 2008) Kilic, Nihat; Kiki, Ali; Oktay, Huesamettin; Selimoglu, ErolObjective: To test the null hypothesis that rapid maxillary expansion (RME) with a rigid bonded appliance has no effect on conductive hearing loss (CHL) in growing children. Materials and Methods: Fifteen growing subjects (mean age 13.43 +/- 0.86 years) who had narrow maxillary arches and CHL participated in this study. Three pure-tone audiometric and tympanometric records were taken from each subject. The first records were taken before RME (T1), the second after maxillary expansion (T2) (mean = 0.83 months), and the third after retention (mean = 6 months) and fixed appliance treatment (approximately 2 years) periods (T3). The data were analyzed by means of analysis of variance (ANOVA) and least significant difference (LSD) tests. Results: Hearing levels of the patients were improved and air-bone gaps decreased at a statistically significant level (P < .001) during active expansion (T2-T1) and the retention and fixed appliance treatment (T2-T3) periods. Middle ear volume increased in all observation periods. However, a statistically significant increase was observed only in the T2-T3 period. No significant change was observed in the static compliance value. Conclusions: The hypothesis is rejected. RME treatment has a positive and statistically significant effect on both improvements in hearing and normal function of the eustachian tube in patients having transverse maxillary deficiency and CHL.Öğe Endoscopic Removal Technique of a Huge Ethmoido-Orbital Osteoma(Lippincott Williams & Wilkins, 2009) Miman, Murat C.; Bayindir, Tuba; Akarcay, Mustafa; Erdem, Tamer; Selimoglu, ErolOsteomas are slow-growing benign tumors of the paranasal sinuses. They originate from the sinus wall and generally fills the sinus cavity. Many osteomas arc asymptomatic and diagnosed incidentally on radiographs. The well-circumscribed, dense bony appearance on radiographs is usually diagnostic. Osteomas become symptomatic when they extend to the orbit or cranium. We report a rare case of ethmoido-orbital osteoma. Case reports and a review of the literature concerning osteoma and surgical techniques are presented. Treatment is not recommended in asymptomatic osteomas. If treatment is indicated, external or endoscopic approach can be chosen. The choice of surgical approach depends on the size of the lesion, location, and the experience of the surgeon.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.
