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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 ANİ İŞİTME KAYIPLI HASTALARDA RUTİN HEMOGRAM İÇİNDEKİ İNFLAMATUAR MARKIRLARIN PROGNOZA ETKİSİ(2021) Tan, Mehmet; Cengiz, Deniz Uğur; Karakaş, Oğuz; Bayındır, TubaÖz: Bu çalışma; ani işitme kayıplı (AİK) hastaların hemogram sonuçlarının hastalığın derecesi ve prognozuna etkisini değerlendirmektedir. Çalışmaya, 2015-2020 yılları arasında kliniğimizde AİK tanısı konulan 325 hastanın 70’i dâhil edildi. Hastaların tedavi öncesindeki rutin hemogram parametreleri ve işitme testleri incelendi. Hastalar ile benzer özelik taşıyan sağlıklı bireylerden kontrol gurubu oluşturuldu. Hastalar işitme kaybı derecesi kaybına göre de 3 guruba ayrıldı. Çalışmamızda; hemoglobin, trombosit hacmi (MPV), platelet, nötrofil, nötrofil lenfosit oranı (NLO) ve platelet lenfosit oranı (PLO), platelet x nötrofil / lenfosit (PxN/L) değerleri karşılaştırıldı. AİK’lı gurup ile kontrol gurubu arasında hemoglobin, nötrofil, lenfosit, MPV, PLO, NLO, PxN/Ldeğerleri açısından istatiksel fark saptandı. Hastalığın tanı aşamasında yapılan rutin ve ucuz bir tetkik ile AİK tanısında ve prognozunda bu parametreler yeni bir belirteç olarak kullanılabilir.Öğe Are long-term auditory results following ossiculoplasty with bone cement as successful as early-middle period results?(W B Saunders Co-Elsevier Inc, 2020) Kalcioglu, M. Tayyar; Yalcin, Muhammed Zeki; Kilic, Osman; Tuysuz, Ozan; Tan, Mehmet; Ozdamar, Osman IlkayPurpose: Bone-cement (BC) ossiculoplasty is one of the options to solve ossicular chain problems. Many authors reported successful results in the early or mid-follow-up period; however, there is no long-term result in the literature. We aim to evaluate long term results of BC ossiculoplasty. Materials and methods: Forty-eight patients who underwent BC ossiculoplasty as incudostapedial re-bridging by the same surgeon were invited to evaluation. Postoperative otomicroscopic examination was performed. Preoperative and post-operative audiological results after longer follow up and graft success rate were noted. Results: Fourteen patients came for control examination. The follow-up period was between 87 and 135 months (mean 102 months). None of the patients had graft failure. Ten patients had early postoperative follow-up results (between 10 and 52; mean 24 months). In the comparison of preoperative and early postoperative air-bone gap, there were significant differences in all frequencies while the comparison of preoperative and long-term postoperative results showed a significant difference only in 250 and 500 Hz. Early postoperative results were better than late with significant difference only in the 2000 and 4000 Hz. Conclusions: As reported by many studies, bone cement application provides a significant auditory improvement in the early postoperative period. The results of the present study showed that this early auditory success may decrease over time with a long-term follow-up. Further studies should be conducted with larger patient groups to clarify the long-term benefits of this treatment and possible causes for its deterioration.Öğe Assessment of mucosal changes associated with nasal splint in a rabbit model(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2015) Tan, Mehmet; Kalcioglu, M. Tayyar; Sahin, Nurhan; Bayindir, Tuba; Samdanci, Emine; Filiz, AliyeIntroduction: There is no consensus on duration of the nasal splint after nasal septum surgeries. The pressure of nasal splint on the mucosa may cause tissue necrosis and nasal septum perforation. Objectives: To investigate the histopathological changes of the nasal mucosa caused by nasal splints in a rabbit model. Methods: No splint was used in group A. Bilateral silicone nasal splints were placed for five, ten, and 15 days in groups B, C, and D, respectively. Biopsy of the nasal mucosa was performed after removal of splint. Histopathologic evaluations were performed. The severity and depth of the inflammation were scored. Results: Group A had a normal histological appearance. Comparison of the results of groups B, C, and D with group A demonstrated statistically significant differences with regards to the severity of histopathological findings. There was no statistically significant difference between groups B and C. There were statistically significant differences between the groups B and D, and also between groups C and D. Conclusions: Longer duration of nasal splint had a higher risk for septal perforation. Therefore, removal of the splint as soon as possible may be helpful for preventing potential perforations. (C) 2015 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. All rights reserved.Öğe Bell paralizisinde tanı ve tedavi yöntemleri(KBB-Forum, 2011) Bayındır, Tuba; Tan, Mehmet; Selimoğlu, ErolÖz: Fasiyal sinir paralizileri birçok farklı nedene bağlı olarak görülebilir. Bu nedenler arasında; genetik faktörler, viral infeksiyona bağlı gelişen vasküler iskemi ve inflamasyon, otoimmun hastalıklar, temporal kemik fraktürleri, baş-boyun tümörleri, santral sinir sistemi lezyonları yer almaktadır. Ancak tüm bu bilinen nedenlere karşın fasiyal paralizilerin büyük çoğunluğu “idiopatik” ya da “Bell paralizisi” olarak karşımıza çıkmaktadır. Bell paralizisinde hastaların yaklaşık %80-85'inde ilk üç ay içerisinde spontan ve tam iyileşme görülür. Ancak prognozu olumsuz etkileyen faktörlerde göz önüne alındığında bu hastalara erken dönemde tedavi başlanması gerektiği kabul edilmektedir. Tedavide kortikosteroidlerin erken dönemde kullanılmaya başladığında etkili olduğu bilinmektedir. Kortikosteroid tedavisi ile birlikte ya da tek başına antiviral ajanların da tedavide rutin olarak kullanılması ile ilgili, kesin ve yeterli klinik kanıtlar ise henüz elde edilememiştir. Ayrıca Bell paralizili hastaların az bir kısmında erken dönemde yapılacak dekompresyon cerrahisini destekleyen yayınlar olmakla birlikte, tedavideki yeri hala tartışmalıdır ve ileri çalışmalarla desteklenmesi gerekmektedir. Biz de bu derleme ile Bell paralizinin tanı ve tedavisini mevcut literatürler ışığında tartışmayı amaçladık. Başlık (İngilizce): Diagnosis and management of bell palsy Öz (İngilizce): A variety of disorders can affect the function of the facial nerve, such as genetic factors, vascular iskemia and inflammation according to viral infections, otoimmune diseases, temporal bone fractures, head and neck tumours, central nervous system tumours. Despite all of these known conditions the most common presentation of facial paralysis is still “idiopathic”, or “Bell paralysis”. Spontaneous and complete recovery in first three months expected in 80-85% of all patients with Bell paralysis. But early treatment should be considered if recognized the factors effecting prognosis negatively. It has been known that the early administration of corticosteroids improves the chance of full recovery. But there remains insufficient clinical evidences supporting the routine use of antiviral medications with or without corticosteroid therapy. In addition, in a few group of patients, early phase facial nerve decompression surgery techniques are supported by literatures, whereas it remains still highly controversial issue and necessary to support by further studies. In this review we aimed to discuss the diagnosis and treatment procedures of Bell's palsy in the lights of literature.Öğe Burun tamponunun kalış süresine bağlı olarak oluşan mukozal değişikliklerin histopatolojik olarak değerlendirilmesi (deneysel çalışma)(İnönü Üniversitesi, 2012) Tan, MehmetBu deneysel çalışmada tavşanların burnuna yerleştirilen tamponların kalış süresi ile dokuda oluşacak histopatolojik değişikliklerin saptanması ve böylece nazal tamponun kalış süresi ile olası perforasyon arasında bağlantı olup olmadığının araştırılması planlanmıştır. Gereç ve Yöntem: Toplam 28 tavşan randomize seçilerek yedişer tavşandan oluşan dört grup oluşturuldu. Kontrol grubu olan grup A için tampon uygulanmadı. Anestezi sağlandıktan sonra iki taraflı uygun büyüklükte hazırlanan silikon nazal splint kullanılarak burun tamponu uygulandıp 4/0 ipek ile sütüre edildikten sonra B grubunda 5, C grubunda 10 ve D grubunda ise 15 gün süreyle tampon burunlarında tutuldu. Grup A da hemen, diğer gruplar için ise belirlenen bekleme süreleri sonunda tekrar anestezi uygulanarak tamponlar çıkartıldıktan sonra kolümelladan yaklaşık 1 cm uzaklığından nazal septal mukozadan 0,5x0,5 cm ebadında biyopsiler alındı. Bulgular: Kontrol grubunda (A) normal histolojik görünüm mevcuttu. B,C ve D grubunda A grubuna göre histomorfolojik bulguların şiddeti açısından gruplar arasında istatistiksel olarak anlamlılık mevcuttu (p <0.005). Tamponun kalış süresi uzadıkça inflamasyonun şiddeti de artış gösteriyordu. B ile C grubu arasında istatistiksel olarak anlamlılık mevcut değildi (p > 0.005). B ile D grubu ve C ile D grubu arasında istatistiksel olarak anlamlılık mevcuttu (p<0.005). Mukozal ülserasyon da inflamasyona benzer şekilde nazal tamponun en uzun kaldığı 15 günde en fazla olup 2 olguda ise makroskopik perforasyon gelişmişti. Histopatolojik incelemede 5 günde tamponu alınanların beşinde mukoaza hafif inflamasyon diğer ikisinde submukozaya uzanan orta derecede inflmasyon saptandı.10. gün tampon alınanların iki tanesinde mukozayı tutan hafif inflamasyon gözlenirken beşinde mukoza ve submukozayı da tutan orta derecede inflamasyon görülmüştür. Tamponların 15. gün alındığı deneklerde ise iki makroskopik perforasyon görülmüş, histopatolojik incelemede ise bir hayvanda mukoza ve submukozayı tutan orta şiddetinde inflamasyon saptanırken diğer dört denekte submukozaya uzanan şiddetli inflamasyon bulguları, iki hayvanda da perforasyonla seyreden şiddetli enflamasyon görüldü. Sonuç: Tüm bu veriler bir arada değerlendirildiğinde nazal tamponların kalış süreleri uzadıkca nazal mukozada inflamasyonun artmasına ve bunun nazal mukozada geri dönüşümsüz harabiyetler ortaya çıkarabileceği görüşündeyiz. Ayrıca septoplasti operasyonlarından sonra gelişebilecek septal perforasyonlar ile burun tamponunun kalış süresi arasında ilişki olabileceği düşünülebilir. Bu konuda klinik çalışmalara ihtiyaç vardır.Öğe Comparison of the hematological parameters of chronic otitis patients with and without cholesteatoma(2021) Tan, Mehmet; Uslu, NurullahCholesteatoma leads to hearing loss and various complications by causing bone erosion in the middle ear and mastoid in chronic otitis media (COM) patients. The mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR) and hematological parameters are proinflammatory markers. The purpose of this study is to compare the MPV, NLR and other hematological parameters of chronic otitis patients with and without cholesteatoma. It was planned to retrospectively assess the blood values of inpatients receiving chronic otitis surgery in the period of 2019-2020. Those who received tympanomastoidectomy due to COM with cholesteatoma were in one group, while another group consisted of COM patients without cholesteatoma who received only tympanoplasty. Each group contained 100 individuals. Our study aimed to investigate the relationship of these groups with hemoglobin, neutrophil, platelet, NLR and MPV values. There was a statistically significant difference between the tympanoplasty group and the cholesteatoma group in terms of age, neutrophil and MPV values (p<0.05). The median neutrophil value was calculated as 3.8500 in the tympanoplasty group and 4.7540 in the cholesteatoma group. The median neutrophil value of the patients in the cholesteatoma group was higher. The median MPV value in the tympanoplasty group was 10.3, and that in the cholesteatoma group was 9.7. The median MPV value in the tympanoplasty group was higher. Significant results were obtained in terms of the MPV and neutrophil values. Using a hemogram test which is inexpensive and easily applied as a proinflammatory marker may be an exclusion criterion between diseases.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 Efeito da genisteina na ototoxicidade induzida pela cisplatina e estresse oxidativo(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2022) Tan, Mehmet; Toplu, Yuksel; Varan, Emrah; Sapmaz, Emrah; Ozhan, Onural; Parlakpinar, Hakan; Polat, AlaadinObjetivo: A cisplatina e um agente antineoplasico usado em adultos e criancas para o tra-tamento de diversas lesoes malignas. Pode causar ototoxicidade irreversivel. A genisteina e um fitoestrogeno que funciona como antioxidante e inibidor do ciclo celular ao inibir as enzi-mas DNA topoisomerase e tirosina-quinase. O efeito protetor da genisteina na prevencao da ototoxicidade induzida pela cisplatina e os niveis de estresse oxidativo foram investigados. Metodo: Trinta e dois ratos Sprague Dawley foram usados em 4 grupos (controle, cisplatina, cis-platina + genisteina, genisteina). As medidas das emissoes otoacusticas por produto de distorcao foram tomadas nos dias 1, 2 e 5 do protocolo do teste. Foram medidos os niveis sericos de malondialdeido, superoxido dismutase, catalase, glutationa peroxidase, estado antioxidante total, estado oxidante total e indice de estresse oxidativo. Resultados: A audicao do grupo cisplatina + genisteina foi melhor do que a do grupo cisplatina. Enquanto os parametros malondialdeido, estado oxidante total e indice de estresse oxidativo diminuiram significantemente no grupo cisplatina + genisteina em comparacao com o grupo cisplatina, o superoxido dismutase mostrou aumento significantemente (p < 0,05). Conclusao: A genisteina apresentou efeitos positivos contra a ototoxicidade com seu efeito antioxidante. Nivel de evidencia: Nivel 3. (c) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Publicado por Elsevier Editora Ltda. Este e um artigo Open Access sob uma licenca CC BY (http:// creativecommons.org/licenses/by/4.0/).Öğe The Effect of Beta Glucan on Cisplatin Ototoxicity(Springer India, 2014) Bayindir, Tuba; Iraz, Mustafa; Kelles, Mehmet; Kaya, Serdar; Tan, Mehmet; Filiz, Aliye; Toplu, YukselThis study was undertaken to investigate the effect of betaglucan in ameliorating cisplatin ototoxicity. Rats were divided into four groups: cisplatin (C), cisplatin plus beta glucan (CB), beta glucan (B), and control (K). Distortion product otoacoustic emissions were elicited in 0th, 1st, and 5th days. For the group C differences were observed at 8,003 and 9,515 Hz between 0th and 5th days' measurements. In the group CB there were differences at frequencies of 3,996, 4,757, 5,660, and 6,726 Hz between 0th and 5th days' measurements. For the group B there were significant recovery in some frequencies. The observation of significant deterioration in terms of hearing in the group treated with cisplatin plus betaglucan may be suggested that depended on the increase of permeability and tissue conductance into the inner ear which may be caused by betaglucan. Further long-term follow-up studies by using different doses may clarify this matter.Öğe Effects of Covid-19 on the audio-vestibular system(W B Saunders Co-Elsevier Inc, 2021) Tan, Mehmet; Cengiz, Deniz Ugur; Demir, Ismail; Demirel, Sumeyye; Colak, Sanem Can; Karakas, Oguz; Bayindir, TubaPurpose: It was aimed to investigate the effects of COVID-19 infection on hearing and the vestibular system. Methods: Twenty-six patients whose treatment had been completed and who had no previous hearing or balance complaints were included in the study. Patients diagnosed with the disease by PCR were included in the study. Patients with at least one month of illness were included in the study. The hearing of patients was evaluated with transient evoked otoacoustic emissions (TEOAE) and pure-tone audiometry. Bedside tests, the European Evaluation of Vertigo scale (EEV), Video Head Impulse Test (vHIT), Ocular Vestibular Myogenic Evoked Potential (oVEMP), Cervical Vestibular Myogenic Evoked Potential (cVEMP) and Videonystagmography (VNG) tests were applied to evaluate the vestibular system. Results: A statistically significant difference was found between the COVID-19 positive and control groups according to the mean values of the 4000 Hz and 8000 Hz in both the right and left ears (p < 0.05). No statistically significant difference was found in the other frequencies and TEOAE. No statistically significant difference was found between the COVID-19 positive and control groups in terms of their normal or pathological VNG saccade, optokinetic and spontaneous nystagmus values (p > 0.05). The normal and pathological VNG head shake values were found to be significantly different between the COVID-19 positive and control groups (p < 0.05). Conclusion: The high frequencies in audiometry in the COVID-19 positive group were worse than those in the control group. In the vestibular system, especially in oVEMP and cVEMP, asymmetric findings were obtained in comparison to the control group, and a low gain in vHIT was shown. This study shows that the audiovestibular system of people with COVID-19 infection may be affected.Öğe Evaluation of the Protective Effect of Beta Glucan on Amikacin Ototoxicity Using Distortion Product Otoacoustic Emission Measurements in Rats(Korean Soc Otorhinolaryngol, 2013) Bayindir, Tuba; Filiz, Aliye; Iraz, Mustafa; Kaya, Serdar; Tan, Mehmet; Kalcioglu, Mahmut TayyarObjectives. This experimental study investigated the possible protective effect of beta glucans on amikacin ototoxicity. Methods. Thirty-eight rats with normal distortion product otoacoustic emissions (DPOAEs) were divided into four groups. Group K was the control group. Group A was injected intramuscularly (i.m.) with amikacin 600 mg/kg/day between days 1-15. Group AB was given beta glucan gavage 1 mg/kg/day on days 0-15 and given amikacin 600 mg/kg/day i.m. on days 1-15. Group B was administered only beta glucan gavage, 1 mg/kg/day, on days 0-15.The DPOAEs were elicited in different frequency regions between 2,003 and 9,515 Hz, as distortion product diagrams (DPgrams), before and after the medication was administered, in all groups, on days 1, 5, 10, and 15. Results. No significant changes in the DPgrams were observed in group K. In group A, significant deterioration was observed at the 8,003 and 9,515 Hz frequencies on day 10, and at the 3,991, 4,557, 5,660, 6,726, 8,003, and 9,515 Hz frequencies on day 15. For group AB, statistically significant deterioration was observed at the 2,824, 8,003, and 9,515 Hz frequencies on day 15. The results for group B showed a significant improvement of hearing at the 2,378, 2,824, 3,363, and 3,991 Hz frequencies on day 1, at the 3,363, 3,991, and 8,003 Hz frequencies on day 10, and at the 8,003 Hz frequency on day 15. Conclusion. This study suggests that amikacin-induced hearing loss in rats may be limited to some extent by concomitant use of beta glucan.Öğe Evaluation of utricular and saccular function in BPPV patients: The role of VEMP in diagnosis(2020) Ugur Cengiz, Deniz; Emekci, Tugba; Demirel, Sumeyye; Can Colak, Sanem; Tan, MehmetAim: The pathological cause of Benign Paroxysmal Positional Vertigo (BPPV) is the degeneration of the otolith organs (utricle and sacculus). Vestibular Evoked Myogenic Potentials (VEMP) assess the functions of the otolith organs. The objective of this research was to evaluate the otolith organ functions of patients with unilateral idiopathic BPPV (canalolithiasis of the posterior and lateral semicircular canals) by cVEMP and oVEMP tests. Material and Methods: The study prospectively included 35 patients with BPPV (canalolithiasis of the posterior and lateral semicircular canals) and 30 healthy individuals. Bilateral cVEMP and oVEMP tests were administered to all participants. Participants were divided into three groups: control, BPPV-affected ear, and unaffected ear.Results: In our study, cVEMP and oVEMP abnormalities were statistically significantly different both between the affected and unaffected ear groups and between the affected ear and control groups. There were statistically significant differences in the cVEMP and oVEMP amplitude values both between the affected and unaffected ear groups and between the affected ear and control groups. Also, the asymmetry ratios of the cVEMP and oVEMP tests were statistically significantly different between the case group and the control group. The cVEMP and oVEMP wave latencies (p1, n1, p1-n1) were not statistically significantly different among the BPPV-affected ear, unaffected ear, and control groups. The results of measurements were not statistically significantly different between the posterior and lateral canal involvement subgroups of BPPV patients.Conclusion: Abnormal cVEMP and oVEMP test results, which are observed more frequently in patients with BPPV compared to the control group, indicate utricular and saccular degeneration. Higher oVEMP abnormality ratios compared to those of cVEMP in BPPV patients suggest that utricular dysfunction may be more common than saccular dysfunction.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 Pediatric tracheotomy: Results of a single center study on 46 patients(2022) Tan, Mehmet; Gündüz, Emrah; Çelik, Hatice; Bayındır, TubaIn this study, we aimed to present our tracheotomy experiences in pediatric patients in our hospital. We reviewed the data by analyzing pediatric tracheotomy retrospectively in terms of indications, follow-up and complications. Forty-six pediatric patients who underwent tracheotomy between 2014 and 2021 were included. The indications were examined under five headings according to the diagnoses that led to the tracheotomy of the patients. These were prolonged intubation, upper airway obstruction, craniofacial anomalies, neuromuscular disorders, and postoperative-traumatic sequelae. Twenty-three (50%) of these patients were girls, and 23 (50%) were boys. The mean age of the patients was 53.8±62.9 months. The youngest patient was a 1-day-old newborn, while the oldest patient was 15 years old. Pediatric tracheotomy was performed in 14 patients for prolonged intubation, 12 patients for craniofacial anomalies, 7 patients for upper airway obstruction, 7 patients for postoperative-traumatic sequelae and 6 patients for neuromuscular disorders. Preoperative or postoperative complications were seen in 10 of the patients. The intubation time of the patients who underwent elective tracheotomy was calculated as 25.7±17.1 days. Of these patients, the shortest duration of intubation was 6 days, and the longest duration was 90 days. The smallest diameter of the tracheostomy cannula inserted in the patients was 2.5 mm, while the largest was 7 mm, and the mean was 4.5 mm. In the follow-ups, it was observed that only 6 of the patients were decannulated, 11 of them died, and the remaining 29 continued their lives with tracheostomy. As a result, although pediatric tracheotomy is rare, it is a life-saving surgical procedure for the appropriate indications and can be successfully performed with manageable complications, contrary to expectations, with the appropriate surgical technique and adequate postoperative care.Öğe The Protective Effect of Chrysin Against Cisplatin Induced Ototoxicity in Rats(Springer India, 2014) Kelles, Mehmet; Tan, Mehmet; Kalcioglu, M. Tayyar; Toplu, Yuksel; Bulam, NazireOtotoxicity is a common side effect of cisplatin chemotherapy. The aim of this study was to investigate the potential protective effect of chrysin against cisplatin-induced ototoxicity. Thirty-four adult female Wistar albino rats were separated into four groups: a cisplatin group (Group A), with cisplatin administered to ten rats once daily for three consecutive days at doses of 8 mg/kg body weight intraperitoneally (i.p.); a cisplatin plus chrysin group (Group B), with 8 mg/kg of cisplatin administered i.p. daily to ten rats for three consecutive days and 25 mg/kg of chrysin administered via oral gavage in a corn oil for 5 days: a chrysin group (Group C), with 25 mg/kg of chrysin administered via oral gavage in corn oil for 5 days to seven rats; and a control group (Group D), with 5 ml/kg of corn oil administered to seven rats via oral gavage for 5 days. Distortion product otoacoustic emission measurements were performed in the same ear of the rats under general anesthesia at baseline and on the first and fifth days after drug administration. No significant differences were noted between the measurements either in the chrysin group or in the control group. In the cisplatin group, there was a significant worsening of hearing compared to baseline and the measurements on the fifth day at all frequencies. In the statistical analysis, a statistically significant difference was observed at 5039, 6351, 8003, and 10078 Hz frequencies between the measurements on the first and fifth days. In the cisplatin plus chrysin group, there were statistically significant differences at frequencies of 2,003 and 5,039 Hz between the measurements at baseline and on the fifth day, at 3,175 and 5,039 Hz between the measurements on the first and fifth days, and at 8,003 and 100,078 Hz between the measurements at baseline and on the first day. According to these results, this study demonstrates that cisplatin-related ototoxicity can be prevented in rats by the administration of chrysin.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 The use of bone cement for ossicular chain defects(Springer, 2013) Kalcioglu, M. Tayyar; Tan, Mehmet; Fleerakkers, JelleBone cement is a good and cheap option for some ossicular chain problems such as incudostapedial re-bridging. The purpose of this retrospective study is to evaluate the audiologic results after reconstruction of three different types of ossicular chain defects, using bone cement. Group 1 consists of 42 patients who underwent an ossiculoplasty using bone cement between the damaged long process of the incus and an intact stapes superstructure. Group 2 consists of 46 patients in which incus interposition between malleus and stapes superstructure was performed, using bone cement to fix the interposed incus. For group 3, consisting of 32 patients who had a present malleus, a defective long process of the incus and a missing stapes superstructure, a re-shaped incus was placed between the stapes footplate and the malleus and bone cement was again used as a fixator. Preoperative and postoperative pure-tone audiometric findings were obtained and hearing differences were assessed. The mean preoperative and postoperative air-bone gaps were 34.8 and 15.6, 35 and 18.4, and 43.4 and 19.8 for groups 1, 2, and 3, respectively. There was a significant improvement in hearing outcomes in all the groups when comparing preoperative and postoperative mean air-bone gaps (p < 0.001). The postoperative air-bone gap was a parts per thousand currency sign20 dB in 76 % of patients in group 1, 64 % of patients in group 2, and 46 % of patients in group 3. Bone cement is an effective and cheap option for some ossicular chain problems such as incudostapedial re-bridging. It may also be used to fix the interposed incus to the stapes superstructure and/or malleus to avert displacement.
