Baha Sezgin - Academia.edu (original) (raw)

Papers by Baha Sezgin

Journal of Craniofacial Surgery

European Archives of Oto-Rhino-Laryngology, 2020

Background It is generally accepted that achalasia is limited to the pathology of the esophageal ... more Background It is generally accepted that achalasia is limited to the pathology of the esophageal body and lower esophageal sphincter. However, patients with achalasia still have symptoms such as aspiration and weight loss after even a succesfull treatment, suggesting that additional oropharyngeal pathologies may be frequent in patients with achalasia. Objective The aim of the study was to assess the oropharyngeal/hypopharyngeal swallowing functions of patients with naive-achalasia. Methods We evaluated the oropharyngeal functions with fiberoptic endoscopic evaluation of swallowing (FEES) and highresolution manometry (HRM) in 36 patients with naive-achalasia(mean age 47.8 ± 14.7; 20F, 20M) diagnosed with and upper gastrointestinal endoscopy, HRM, radiology compared the results with 40 healthy volunteers (mean age 48.25 ± 12.37; 23F, 17M) as controls. The Beck Depression Inventory (BDI) and the MD Anderson Dysphagia Inventory (MDADI) were used for psychological analysis and to assess quality of life. Results Mean integrated relaxation pressure (IRP) values were significantly higher (12.7 ± 10.9) for all patients compared to controls (0 ± 4.40). In the presence of pharyngeal residue IRP was 18.6 ± 11.8 mmHg compare to patients without pharyngeal residue which was 7.2 ± 6.4 mmHg (p < 0.05). Resting pressures were 105.7 ± 60.4 mmHg in study group vs 116 ± 55.1 mmHg in the control group (NS). In the study group we determined that residues of semisolid and liquid food were significantly higher in the vallecula, retrocricoid region, pharyngeal wall, and piriform sinuses with FEES. The average MDADI score was 58.1 ± 19.8 and 87.6 ± 10.7 in the study and control groups, respectively (p < 0.05). Depression may be significantly higher in achalasia patients based on the BDI. Conclusion Relaxation of the upper esophageal sphincter is insufficient especially in patient with residue. This finding is supported by the presence of residue during FEES evaluation. In the assessment of patients with achalasia, in the presence of residue symptoms,oropharyngeal phases of swallowing should be examined with FEES. Furthermore, the effect of exercises to improve the pathological findings should be evaluated.

Turkiye Klinikleri Journal of Case Reports, 2018

Introduction: Neoplasms of the salivary glands comprise 3-12% of head and neck tumors. Type of su... more Introduction: Neoplasms of the salivary glands comprise 3-12% of head and neck tumors. Type of surgery to be performed varies according to the location, histopathology and facial nerve involvement, while the most commonly applied methods currently are superficial, total and radical parotidectomy. The aim of this study was to retrospectively evaluate the 434 cases that were operated on for parotid mass between January 2008 and December 2016 in a tertiary university hospital. Results: Demographic data, histopathologic type, clinical findings and symptoms, type of surgery, early and late complications, recurrence were retrospectively reviewed and evaluated. Postoperative evaluations revealed a non-neoplastic mass in 40 (9.22%) patients , while 37 (8.52%) had malignant neoplastic mass, 344 (79.26%) patients had benign neoplastic mass. and 13 (2.99%) patients had hematolymphoid mass. Recurrence was found in 2 patients (0.048%) who underwent surgery and histopathological diagnosis in all ...

Indian Journal of Otolaryngology and Head & Neck Surgery

Pediatric Surgery International

Medical Oncology, 2022

Paranasal sinus tumors are a rare type of cancer. Most of these tumors are of epithelial origin a... more Paranasal sinus tumors are a rare type of cancer. Most of these tumors are of epithelial origin and 80% of them are maxillary sinus squamous cell carcinoma. The WNT signaling pathway is an essential embryonic regulatory pathway known to play an important role in many cancers, including head and neck cancers. However, the effect of this pathway in maxillary sinus tumors has not been studied before. The aim of the study was to determine the changes in the regulatory genes of the WNT signaling pathway in maxillary sinus tumors. For this purpose, total RNA was isolated from the pathological preparations of 85 patients who had previously been operated on for squamous cell maxillary sinus tumor, and gene expression changes were evaluated by real-time RT-qPCR. The interactions among proteins encoded by genes, whose expression levels were found to be decreased and increased, were determined by protein–protein interaction (PPI) network analysis using string database, and signaling pathways that they are involved in were examined by Reactome database. A significant decrease in the expression of 28 genes compared to the control (fold change < 2.00 and p-value < 0.05) and a significant increase in the expression of 23 genes (fold change < 2.00 and p-value < 0.05) were detected. According to in silico analysis results, Signal Transduction (REACTOME:R-HSA-162582) and Signaling by WNT (REACTOME:R-HSA-195721) pathways were determined as most regulated pathways and FZD4-LRP5 and BCL9-CTNNB1 were determined as the strongest interactions. The current study contributes to illuminating the genetic regulation of maxillary sinus carcinoma in which genetic knowledge is limited. Our findings take attention to the dysregulations of the WNT signaling pathway that may support maxillary sinus carcinogenesis. The results will pave the way for further studies that investigate the therapy target potential of the WNT signaling pathway in this rare cancer.

Dysphagia, 2021

Dysphagia is one of the most common and important complications of stroke. It is an independent m... more Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics.

The Turkish Journal of Pediatrics, 2020

Background and objectives. Rhinosinusitis is one of the most common infections of childhood. Rhin... more Background and objectives. Rhinosinusitis is one of the most common infections of childhood. Rhinosinusitis usually limits itself in the pediatric age group, however orbital and intracranial complications may arise in some of the patients. The purpose of the study was to retrospectively analyse the previous treatments and outcomes in pediatric rhinosinusitis patients with orbital complications. Methods. The effect and prognosis of medical treatment and endoscopic sinus surgery are reported in this study. Twenty-five pediatric patients diagnosed with complicated rhinosinusitis between January 2008-February 2016 were included in the study. Orbital complications, examination findings, radiological imaging and blood counts were retrospectively collected from patient files. The duration of hospitalization, source of the infection, complications, previous medical and surgical treatments were also retrospectively assessed. Results. Average age of the patients were 8.84 ± 4.02 years (range: 1-16 years). The mean length of stay in hospital was 6.72 ± 3.28 days. Hospitalization in surgically treated group was higher than primarily medically treated group. However this difference could not reach to a statistically significant level (p >0.05). Mean hospitalization time was found 5.21 ± 2.51 and 8.43 ± 2.87 days in patients diagnosed with preseptal cellulitis and subperiosteal abscess respectively. Hospitalization in patients with subperiosteal abscess was higher than preseptal cellulitis and a statistically significant difference was detected (p <0.05). Conclusion. Morbidity and mortality of orbital complications which are the most common complications of pediatric rhinosinusitis, could significantly be reduced by using appropriate treatment methods and an early diagnosis. Conservative therapy is an effective method for patients with preseptal cellulitis and most cases of orbital cellulitis in children.

Facial Plastic Surgery, 2020

Different treatment modalities have been applied for nonmelanoma skin cancers (NMSCs) of the head... more Different treatment modalities have been applied for nonmelanoma skin cancers (NMSCs) of the head and neck area. One of the most important points after surgical treatment is the selection of appropriate reconstruction methods. The aim of this study is to investigate the efficacy and feasibility of the use of both defect size reduction with sutures and secondary healing with delayed reconstruction with full-thickness skin grafts in NMSC patients. In total, 18 (42.8%) male and 24 (57.2%) female patients with NMSC were operated. Defect size was measured both after excision and just before repair, and the approximate defect area was calculated with ImageJ software. Reconstruction was performed after 14 days in all patients in the second session, using free skin grafts. There were 18 (42.8%) male and 24 (57.2%) female patients. The mean age was 70.5 (45–82) years. The mean follow-up period was 40.3 (16–68) months. The mean defect area measured after excision was 8.44 ± 1.91 cm2. After 14...

Molecular Biology Reports, 2020

Although there are many studies on the role of PI3K/AKT/mTOR pathway and autophagy genes in the m... more Although there are many studies on the role of PI3K/AKT/mTOR pathway and autophagy genes in the mechanism of head and neck cancer formation and prognostic significance, there is no study investigating the role of the genes in paranasal sinus carcinomas. The aim of the study was to assess the role of the PI3K/AKT/mTOR pathway and autophagy related gene expression changes in squamous cell carcinoma of paranasal sinuses with and without neck metastasis. Eight paranasal squamous cell carcinoma patients (five without and three with neck metastasis) were included. Tissues were obtained during the surgery. Total RNA was isolated from the tissues and cDNA synthesis was performed. Expression levels of the genes were determined using qRT-PCR method. The results were evaluated using the 2 −∆∆Ct method, and fold changes of the gene expression levels in primary tumor and neck metastasis tissues were calculated according to the normal tissue. Expression levels of both PI3K/AKT/mTOR pathway and positive regulators of autophagy were significantly increased in metastasisrelated two groups, especially in neck metastasis tissues. The increase in PI3K/AKT/mTOR pathway and autophagy related gene expression levels may support the metastatic character in paranasal squamous cell carcinomas. This is the first study to assess autophagy related genes in paranasal sinus cancer at transcriptome-level. Support of the transcriptome-level findings by the further protein analyses will contribute to the illumination of the rare paranasal sinus cancer molecular biology.

Turk Otolarengoloji Arsivi/Turkish Archives of Otolaryngology, 2018

Objective: The purpose of this study was to analyze previous treatments and outcomes in patients ... more Objective: The purpose of this study was to analyze previous treatments and outcomes in patients with malignant otitis externa (MOE) retrospectively. The efficacy of medical and surgical treatments was also evaluated. Methods: This study included 25 patients diagnosed with MOE and treated at the Department of Otorhinolaryngology, Ege University School of Medicine between 2006 and 2017. The duration of hospitalization, Hemoglobin A1c (HbA1c) levels of the patients, erythrocyte sedimentation rate (ESR), source of the infection, complications, and previous medical and surgical treatments were also retrospectively assessed. Results: The mean age of the patients (7 females and 18 males) was 69.68±11.29 years. The mean length of hospital stay in patients with HbA1c levels ≤6 and in patients with HbA1c levels >6 was 26.86 and 33.39 days, respectively. The mean hospitalization time was significantly longer in patients with HbA1c levels >6 (p<0.05). Additionally, elderly patients (age>65 years) had a significantly longer hospital stay in our study (p<0.05). ESR was found to be 52.76±32.49 (9-108) mm/h at the first examination and 14.92±1.22 (4-32) mm/h at the time of discharge. Conclusion: MOE is an aggressive disease that requires conservative management, and ESR proved to be a good indicator of treatment response. Long-term antibiotherapy are recommended for treatment.

Asian Journal of Surgery, 2019

Background: Impairment in voice and swallowing functions are common after thyroidectomy. We aimed... more Background: Impairment in voice and swallowing functions are common after thyroidectomy. We aimed to evaluate the objective functional voice and swallowing outcomes in a series of patients undergoing thyroidectomy. Methods: A total of 43 consenting patients who underwent thyroidectomy were prospectively recruited. Subjective evaluation of swallowing was assessed with 'Swallowing Impairment Score' and 'MD Anderson Dysphagia Inventory'. Fiberoptic endoscopic evaluation of swallowing (FEES) was applied for objective evaluation. Also, functional oral intake scale (FOIS) and functional outcome swallowing scale (FOSS) were used for swallowing assessment. Voice evaluation was assessed with videostrobolaryngoscopy (VSL) and 'The Multi-Dimensional Voice Program (MDVP)' was used for capturing and analyzing the voice samples. All evaluations were performed preoperatively and on 1st day, 2nd week and 6th months postoperatively. This study is registered with ClinicalTrials.gov, number NCT03436186. Results: According to the objective analyses there was no difference between pre-and postoperative scores for the intake of fluid and thickened liquid food. There was a significant difference regarding light and moderate residual accumulation in solid food intake (p Z 0. 013). FOSS showed no difference, but FOIS revealed specific functional limitation (p Z 0. 034). Subjective data showed no correlation with objective findings (p > 0.05). Regarding voice evaluation, a significant increase was observed in standard deviation of average fundamental frequency and degree of subharmonics (p < 0.01). * This paper was presented during the 7th Symposium of ESES 2017 and awarded as one of the four best abstracts on general topics.

European Archives of Oto-Rhino-Laryngology, 2018

Purpose Swallowing functions are affected after total maxillectomy operations and adjuvant chemor... more Purpose Swallowing functions are affected after total maxillectomy operations and adjuvant chemoradiotherapy. The purpose of our study is to assess the role of xanthan gum based thickening agents on swallowing and hydration of maxillectomy patients on a randomized controlled fashion. Methods 12 of the 22 patients diagnosed with maxillary carcinoma and planned to undergo total maxillectomy was identified as study group and 10 of them were identified as control group. The study group used "xantham based liquid thickener" for liquid foods up to 3 months postoperatively and the control group did not use. Dysphagia-related quality of life, bioimpedance analysis, EAT-10 scores, swallowing functions were evaluated both preoperative and postoperative period. Results The mean age of the study group was 56 ± 9.87, and 41.6% were women. The mean age of control group was 60 ± 15.63, and 50% were women. Postoperative EAT-10 scores were statistically significant higher than preoperative scores in both groups (p < 0.05). In both of the study and control groups, a statistically significant reduction in dysphagia related quality of life was detected postoperatively (p < 0.05). Intracellular water, extracellular water and total body water detected statistically significant higher in study group at postoperative month three. Conclusion Swallowing functions are affected due to total maxillectomy and radiotherapy. With this study, it has been shown that, total maxillectomy and radiotherapy reduce dysphagia-related quality of life. Swallowing dysfunction and dehydration has been shown to affect total maxillectomy patients. Using of 'xanthan gum-based fluid thickener' helps to maintain intracellular water, extracellular water, and total body water.