Selcuk Gunes - Academia.edu (original) (raw)
Papers by Selcuk Gunes
Dev Frontal Mukoselde Tedavi Yaklaşımımız; Üç Olgu Sunumu
Kocaeli tıp dergisi, 2015
The turkish journal of ear nose and throat, Oct 11, 2019
A chondrosarcoma is a malignant tumor originating from cartilage and may occur in any part of the... more A chondrosarcoma is a malignant tumor originating from cartilage and may occur in any part of the body. It occurs most commonly in the posterior lamina of the cricoid cartilage, followed by the thyroid cartilage, arytenoid cartilage, vocal cords, and epiglottis. In the literature, 25 cases of tracheal chondrosarcoma were reported between 1964 and 2017, but only two cases of cricoid cartilage chondrosarcoma. Currently, no consensus on chondrosarcoma treatment has been established yet, due to the rarity of the condition, and no therapeutic protocol has been shown to be clearly superior to others. Herein, we present the third case of a cricoid chondrosarcoma in the literature. We used a surgical procedure different from those employed earlier; we employed an extralaryngeal, extraesophageal approach. We describe the diagnosis, treatment, and follow-up results in the light of current literature.
The turkish journal of ear nose and throat, Nov 25, 2018
Objectives: This study aims to evaluate our department's approach to the treatment of hypopharyng... more Objectives: This study aims to evaluate our department's approach to the treatment of hypopharyngeal tumors, the features of the tumors, the survival analyses and to present our results in the light of the literature. Patients and Methods: Eighty-one hypopharyngeal tumor patients and four patients with undefined primary origin, those patients with undefined origin have tumors that infiltrate both hypopharynx and cervical esophagus, totally 85 patients (56 males, 29 females; mean age 54.6±13.4 years; range, 23 to 81 years) who underwent surgical treatment, were included in this study. Demographic data, tumor characteristics, and treatment protocols were recorded retrospectively. Results: Patients were classified on the primary subsite of the hypopharynx: 51% originated from the sinus piriformis, 29% from the postcricoid area, 15% from the posterior wall of the pharynx and only 5% from the cervical esophagus. The relationship between sex and hypopharyngeal subsite was statistically significant (p<0.001); postcricoid tumors were more prominent in female patients. Also, patients with a history of tobacco use had a tendency for tumors originating from the piriform sinus (p<0.001). Additionally, highly significant differences were revealed between clinical and pathological T and N staging (p<0.001). Estimated 60-month survival rate was 45%. Conclusion: The majority of patients in the study group were not old-aged or alcohol consumers; particularly none of the female patients had any bad habit as a predisposing factor suggested in the etiology. The relationships between tumor site and smoking show that if the campaign against smoking is successful, the rate of sinus piriformis cancer will decrease. For a significant number of patients, primary surgical reconstruction was possible, which shortens postoperative recovery time and accelerates postoperative adjuvant therapy. Therefore, survival rates were found to be high.
The turkish journal of ear nose and throat, Feb 12, 2019
Objectives: This study aims to investigate the prevalence of individuals with central auditory pr... more Objectives: This study aims to investigate the prevalence of individuals with central auditory processing disorder (CAPD) among children with neurodevelopmental disorder, to establish whether there is an objective screening test parameter that identifies individuals with neurodevelopmental disorder without CAPD, and to scan the history of these individuals for a unique feature. Patients and Methods: The study included 94 patients (69 males, 25 females; mean age 8.5±1.2 years; range, 7 to 13 years) with specific learning disorder (SLD) and/or attention deficit hyperactivity disorder (ADHD). After assessment by child and adolescent psychiatry, the Staggered Spondaic Word (SSW) test was performed in addition to a full audiologic evaluation. Results: Twenty-four patients (27.2%) with SLD and/or ADHD had CAPD according to SSW criteria. Twenty-eight patients had SLD, 27 had ADHD, and 39 had mixed-type neurodevelopmental disorder. Central auditory processing disorder rate was significantly higher in the mixed group than in the ADHD group (p<0.05). There was a significant relationship between term birth and the absence of CAPD. Auditory Brainstem Response test revealed a significant correlation between the III-V wave interval evaluation in the left ear and CAPD frequency. Conclusion: A significant proportion of patients with SLD and/or ADHD in this study had CAPD. Patients with mixed-type neurodevelopmental disorder in particular were at risk for CAPD. Success of rehabilitation may increase if combined with CAPD-specific programs.
Journal of Craniofacial Surgery, Jun 1, 2018
The aim is to investigate the impact of degree of mastoid pneumatization on the affected side of ... more The aim is to investigate the impact of degree of mastoid pneumatization on the affected side of Bell palsy (BP). Study Design: Retrospective study in tertiary academic hospital. Methods: In total, 52 patients who were diagnosed with as BP were included in the study. Each patient was staged using House-Brackmann (HB) staging system. All patients underwent temporal bone computed tomography imaging. House-Brackmann scores, side of the BP, and mastoid pneumatization of all of patients were evaluated in the present study. Results: Regarding the degree of the mastoid pneumatization, there were no significant differences between the affected side and the unaffected side (P ¼ 0.439). The degree of the mastoid pneumatization of the affected side and the unaffected side did not differ between males and females (P ¼ 0.918 for the affected side, P ¼ 0.765 for the unaffected side, respectively). A negative correlation between the age and mastoid pneumatization of each side was found (P ¼ 0.001, P ¼ 0.025, respectively). There was no significant correlation between HB score and the degree of the mastoid pneumatization of each side (P ¼ 0.789, P ¼ 0.703). Conclusion: As a conclusion, the degree of the mastoid pneumatization is not one of the risk factors for BP. Further randomized studies with larger numbers of patients are needed to confirm these findings.
Carotid Artery Aneurysm
Journal of Craniofacial Surgery, 2017
Temporal bone fractures can occur as a result of various head trauma. The most common cause of th... more Temporal bone fractures can occur as a result of various head trauma. The most common cause of the hemotympanum is traumatic temporal bone fracture. Facial paralysis and hearing loss can be seen associated with temporal bone fracture. The development of the internal carotid artery aneurysm after temporal bone fracture is extremely rare. In this article, the authors evaluated carotid artery aneurysm that developed after temporal fracture and aneurism compressed by coagulated blood mass which showed itself as a hemotympanum. The internal carotid artery aneurysm that induced by temporal bone fracture and presented as hemotympanum has not been reported yet. This patient is the first case in the literature. Diagnosis, treatment, and follow-up options will be discussed in the light of current literature.
Surgical and Radiologic Anatomy, Mar 27, 2019
Objective Anatomic variations have curicial importance during neck surgery. We present a fenestra... more Objective Anatomic variations have curicial importance during neck surgery. We present a fenestrated internal jugular vein variation and the accessory nerve passing through it. Also, we discuss preoperative diagnosis of this variation using ultrasonography. Method The possible recognition of this variation by ultrasonography is introduced. Results The accessory nerve in an internal jugular vein fenestration can be seen using ultrasonography. Conclusion Preoperative identification of this rare variation may secure surgeon from potential complications.
Otolaryngology, Mar 6, 2017
Medullary thyroid carcinoma (MTC) is a neuroendocrine (NE) tumor and is very rarely observed. MTC... more Medullary thyroid carcinoma (MTC) is a neuroendocrine (NE) tumor and is very rarely observed. MTC originates from the parafolliculer C cell and can show various histopathological patterns. Head and neck paragangliomas are seen rarely. Paragangliomas in the head and neck region are usually non-functional. MTC should be considered in the differential diagnosis of paragangliomas in the head and neck region. A high degree of clinical investigation is needed to determine the rare potential etiology underlying this condition. Because patients with MTC can present different clinical manifestations, otolaryngologist must be aware of MTC and its rare medical presentations. This case presented here highlights the importance of serum calcitonin levels in the differential diagnosis of paragangliomas in the head and neck region.
Çocuklarda düşük D vitamini düzeyleri ile üst solunum yolu enfeksiyonu görülme sıklığı arasındaki ilişki
Kulak burun boğaz uygulamaları, 2015
Yaşlılarda Ses ve Yutma Bozuklukları
Otolaryngology, Mar 6, 2017
Background: Many factors are associated with the development of recurrent tonsillitis. These incl... more Background: Many factors are associated with the development of recurrent tonsillitis. These include patient incompliance, premature cessation of antibiotherapy, inadequate antibiotic absorbance, bacterial tolerance, bacterial load, bacterial biofilms, and immune system deficiencies. Objective: To compare between recurrent tonsillitis patients undergoing three to seven tonsillitis episodes per year within less than two years with controls having less than three tonsillitis episodes per year on the basis of vitamin D levels. Study design: A retrospective review of clinical charts. Methods: A total of 426 patients were enrolled in this study. The patients were divided into two groups according to the number of acute tonsillitis episodes: Those who had less than three episodes per year (Group A) and those with three to seven episodes per year (Group B). The patients in Group A were assigned to the control group. Each patient in Group B was considered as a potential candidate for recurrent tonsillitis. The total number of episodes of acute tonsillitis within one year, demographic characteristics of the patients and the mean serum 25-hydroxyvitamin D levels of both groups were compared. Results: Group A consisted of 277 patients (132 women, 145 men; mean age 4.40±2.46 years; range 2 to 10 years), while Group B consisted of 149 patients (66 women, 83 men; mean age 5.22±2.26 years; range 2 to 10 years). The mean serum vitamin D levels of Group A and Group B were 57.83±23.10 nmol/L and 48.03±31.36 nmol/L, respectively. Serum vitamin D level of Group B was lower than the Vitamin D levels of Group A which was statistically significant (p=0.001, p<0.01, respectively). Conclusion: This is the first study investigating vitamin D levels among patients for the diagnosis of recurrent tonsillitis during the follow-up. However, further prospective randomizedcontrolled studies are conducted to gain a better understanding as to whether vitamin D supplementation would reduce the tonsillectomy rates in the diagnosis of recurrent tonsillitis.
Kafkas Journal of Medical Sciences, 2021
Türk otolarengoloji arşivi, Jan 18, 2019
Objective: We present 11 patients with distant metastases to the head and neck from an infraclavi... more Objective: We present 11 patients with distant metastases to the head and neck from an infraclavicularly located primary tumor and discuss the management strategies including the clinical presentation, treatment modalities, and prognosis. Methods: The retrospective data of the pathology reports and operation notes of 1239 patients who had undergone any kind of oncological surgical intervention between 2005 and 2017 were analyzed. All of the 11 patients included in the study were evaluated in our department's tumor board, and all patients with an operable lesion had undergone surgery. Inoperable patients were treated with chemotherapy and/or radiotherapy. Results: The average age of the patients was 64.3 (48-88) years. Primary tumors were located in the lung (2), breast (2), ovary (2), prostate (2), kidney (1), and colon (1) and the primary lesion could not be determined in one patient. The most common symptom was newly occurred painless swelling (9/11, 81.8%) at the metastatic site. Four patients without any other distant metastases were operated. Of these four patients, two died during follow-up due to systemic disease, and the other two are alive and disease-free. Three of the seven inoperable patients were treated with chemotherapy and the other four with radiotherapy. The prognosis of this group was worse. Conclusion: Although metastasis to the head and neck is not common, it is vital to keep in mind while approaching a patient with a lesion at the head and neck region especially if there is a history of lung, breast, and genitourinary cancers. Despite the poor prognosis, diminishing the tumor burden would increase the treatment success.
Kocaeli tıp dergisi, 2022
Objective: Management of clinical node-negative neck in early-stage oral cavity squamous cell car... more Objective: Management of clinical node-negative neck in early-stage oral cavity squamous cell carcinoma is still controversial. There are three main options to consider as watch-and-wait, elective neck dissection, and sentinel node biopsy. Method: Patients were grouped as clinical node-negative and pathologic node-negative (group 1) and clinical node-negative and pathologic node-positive (group 2). Factors thought to affect occult metastasis such as age, tumor diameter, tumor thickness, perineural invasion, lymphovascular invasion, and differentiation were investigated using the Mann-Whitney U test, the Chisquare test, and Fisher's exact test. Results: From 27 eligible patients, there were 12 (44.4%) females and 15 (66.6%) males. Sixteen patients were evaluated in group 1 and 11 were evaluated in group 2. The mean age of the patients was 58.20±14.05 years. The occult metastasis rates were 34% and 51% for T1 and T2 tumors, respectively. The mean tumor diameter was 24.78±12.79 mm, and the mean tumor thickness was 11.37±7.62 mm. The difference in mean values of tumor thickness between the groups was significant (p=0.024), but age (p=0.622) and tumor diameter (p=0.443) were not significantly different. The ROC analysis cutoff values for age, tumor diameter, and tumor thickness were 60 years, 23 mm, and 9.5 mm, respectively. Tumor thickness and lymphovascular invasion were significantly different between the groups, but age, differentiation, clinical T stage, and perineural invasion were not different. Conclusion: The high rates of occult metastasis in our series imply that elective neck dissection seems a more appropriate choice for early-stage oral cavity squamous cell carcinoma rather than watch-and-wait.
Brazilian Journal of Otorhinolaryngology, 2020
Introduction: Benign paroxysmal positional vertigo is a common vestibular disorder that accounts ... more Introduction: Benign paroxysmal positional vertigo is a common vestibular disorder that accounts for one fifth of hospital admissions due to vertigo, although it is commonly undiagnosed. Objective: To evaluate the effects of betahistine add-on therapy in the treatment of subjects with posterior benign paroxysmal positional vertigo. Methods: This randomized controlled study was conducted in a population of 100 subjects with posterior benign paroxysmal positional vertigo. Subjects were divided into the Epley maneuver + betahistine group (group A) and Epley maneuver only (group B) group. Subjects were evaluated before and 1-week after the maneuver using a visual analog scale and dizziness handicap inventory Results: One hundred subjects completed the study protocol. The Epley maneuver had an overall success rate of 95% (96% in group A; 94% in group B, p = 0.024). Groups A and B had similar baseline visual analog scale scores (6.98 ± 2.133 and 6.27 ± 2.148, respectively, p = 0.100). After treatment, the visual analog scale score was significantly lower in both groups, and was significantly lower in group A than group B (0.74 ± 0.853 vs. 1.92 ± 1.288, respectively, p = 0.000).
Supraclavicular artery island flap for head and neck reconstruction
Acta Chirurgiae Plasticae, 2021
BACKGROUND The ablative surgical resection has a critical importance for achieving better oncolog... more BACKGROUND The ablative surgical resection has a critical importance for achieving better oncological outcomes for patients with head and neck cancer. However, radical surgical resections reveal the reconstruction requirement of complex anatomical structures. Microvascular free flaps have been recommended as a gold standard treatment choice for head and neck reconstruction following definitive oncological surgery. The supraclavicular artery island flap (SCAIF) is a thin and reliable fasciocutaneous pedicled flap that is simple and quick to harvest. MATERIAL AND METHODS A total of 19 patients who underwent head and neck reconstruction with SCAIF were included in this study. The SCAIF was used for the reconstruction of oncological defects in 17 patients while it was used for the reconstruction of a skin defect on the lower face following radiotherapy in 1 patient and for cervical open wound (blast injury) closure in 1 patient. RESULTS There were neither intraoperative nor postoperative major complications in any patient. The SCAIF has been used successfully in 18 of 19 patients for head and neck reconstructive surgery. Partial necrosis of the skin was detected in 1 patient (5.3%) only, while a total flap failure has not occurred in any patient. The partial skin necrosis was seen in an area of 1.5 cm of the distal end of the flap and was managed conservatively with local wound care. Wound dehiscence has not appeared in the flap donor area in any patient. CONCLUSION The SCAIF constitutes a good alternative to free flaps, providing almost equivalent functional results and requiring less operative time and surgical effort.
Turkish Archives of Otorhinolaryngology, 2021
Objective: Among other complications of endoscopic skull base surgery, delayed epistaxis has not ... more Objective: Among other complications of endoscopic skull base surgery, delayed epistaxis has not been given much importance. This report presents postoperative delayed nosebleed cases in a large number of patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of lesions. Methods: Three hundred and sixty three patients who were reached to the sellar region by endoscopic endonasal transsphenoidal route and operated was included in the study. Retrospective chart reviewing of these patients was performed. The correlation between the duration of nosebleeds, bleeding location, treatment methods and comorbidities of the patients were evaluated. Results: Ten patients (3.6%) reported delayed epistaxis in the postoperative period and were referred to the otolaryngology department. Postoperative epistaxis occurred between days 7th and 33 th (mean 16.5) days. The treatment consisted of chemical silver nitrate cauterization in two patients, return to the operating room in three patients, nasal packing in five patients. Conclusion: Delayed postoperative epistaxis often has no obvious etiology, and intervention requires teamworking. Well-coordinated teamworking of the neurosurgeon with other specialities such as neuroradiology and otorhinolaryngology is needed to achieve better results.
Turkish Archives of Otorhinolaryngology, 2020
Objective: To understand the variations and normal course of the accessory nerve (CNXI) to help m... more Objective: To understand the variations and normal course of the accessory nerve (CNXI) to help more accurate and confident neck dissection. Methods: The course of the CNXI in the neck, its relationship to the surrounding anatomic structures and the factors affecting its course were investigated. Results: A total of 100 neck dissections were performed on 50 fresh cadavers. Eleven division variations were observed at the anterior triangle. The location of CNXI at the posterior border of the sternocleidomastoid muscle (PBSCM) was investigated and the ratio between the distance from the mastoid apex (MAA) to CNXI at the PBSCM and the distance from MAA to the posterior border where the PBSCM is attached to the clavicle increased as height of the subject increased (p<0.05). Conclusion: It must be kept in mind that it is better to search for CNXI in taller subjects more inferiorly at the posterior border of the sternocleidomastoid muscle.
ENT Updates, 2020
Objective: To compare intact and diseased ears for Eustachian tube (ET) length and width in patie... more Objective: To compare intact and diseased ears for Eustachian tube (ET) length and width in patients with unilateral chronic otitis media (COM), and to assess the relationship between cholesteatoma spread, stapes erosion, lateral semicircular canal (LSCC) fistula and ET width and length retrospectively. Methods: Subjects with unilateral COM (122 subjects with 244 ears) who underwent surgery for cholesteatoma were evaluated retrospectively for this study. The width of the distal orifice of the bony segment and the length of the bony segment of the ET for both the diseased and healthy ear were measured. Subjects' healthy and diseased ears were compared for ET length and width. The diseased sides were compared to assess the relationship between ET dimensions and cholesteatoma spread, stapes erosion and LSCC fistula. Results: The mean ET length and width in healthy and diseased ears was 11.38±1.7 and 1.43±0.37 mm, and 10.99±1.6 and 1.27±0.35 mm, respectively; the difference was statistically significant (p<0.001). No significant differences were found in terms of ET length and width between the subjects with and without stapes erosion and LSCC fistula (p=0.765, p=0.573, and p=0.436, p=0.790, respectively). No significant relation was found between cholesteatoma spread and ET length and width (p=0.647). Conclusion: ET dysfunction is frequently associated with COM. Chronic otitis media with cholesteatoma is significantly related to ET length and width. Measurement of ET length and width in CT scans is a basic method that can be used in clinical practice.
Association of Antrochoanal Polyps with Contralateral Site Sinus Obliteration
European Journal of Rhinology and Allergy, 2020
Dev Frontal Mukoselde Tedavi Yaklaşımımız; Üç Olgu Sunumu
Kocaeli tıp dergisi, 2015
The turkish journal of ear nose and throat, Oct 11, 2019
A chondrosarcoma is a malignant tumor originating from cartilage and may occur in any part of the... more A chondrosarcoma is a malignant tumor originating from cartilage and may occur in any part of the body. It occurs most commonly in the posterior lamina of the cricoid cartilage, followed by the thyroid cartilage, arytenoid cartilage, vocal cords, and epiglottis. In the literature, 25 cases of tracheal chondrosarcoma were reported between 1964 and 2017, but only two cases of cricoid cartilage chondrosarcoma. Currently, no consensus on chondrosarcoma treatment has been established yet, due to the rarity of the condition, and no therapeutic protocol has been shown to be clearly superior to others. Herein, we present the third case of a cricoid chondrosarcoma in the literature. We used a surgical procedure different from those employed earlier; we employed an extralaryngeal, extraesophageal approach. We describe the diagnosis, treatment, and follow-up results in the light of current literature.
The turkish journal of ear nose and throat, Nov 25, 2018
Objectives: This study aims to evaluate our department's approach to the treatment of hypopharyng... more Objectives: This study aims to evaluate our department's approach to the treatment of hypopharyngeal tumors, the features of the tumors, the survival analyses and to present our results in the light of the literature. Patients and Methods: Eighty-one hypopharyngeal tumor patients and four patients with undefined primary origin, those patients with undefined origin have tumors that infiltrate both hypopharynx and cervical esophagus, totally 85 patients (56 males, 29 females; mean age 54.6±13.4 years; range, 23 to 81 years) who underwent surgical treatment, were included in this study. Demographic data, tumor characteristics, and treatment protocols were recorded retrospectively. Results: Patients were classified on the primary subsite of the hypopharynx: 51% originated from the sinus piriformis, 29% from the postcricoid area, 15% from the posterior wall of the pharynx and only 5% from the cervical esophagus. The relationship between sex and hypopharyngeal subsite was statistically significant (p<0.001); postcricoid tumors were more prominent in female patients. Also, patients with a history of tobacco use had a tendency for tumors originating from the piriform sinus (p<0.001). Additionally, highly significant differences were revealed between clinical and pathological T and N staging (p<0.001). Estimated 60-month survival rate was 45%. Conclusion: The majority of patients in the study group were not old-aged or alcohol consumers; particularly none of the female patients had any bad habit as a predisposing factor suggested in the etiology. The relationships between tumor site and smoking show that if the campaign against smoking is successful, the rate of sinus piriformis cancer will decrease. For a significant number of patients, primary surgical reconstruction was possible, which shortens postoperative recovery time and accelerates postoperative adjuvant therapy. Therefore, survival rates were found to be high.
The turkish journal of ear nose and throat, Feb 12, 2019
Objectives: This study aims to investigate the prevalence of individuals with central auditory pr... more Objectives: This study aims to investigate the prevalence of individuals with central auditory processing disorder (CAPD) among children with neurodevelopmental disorder, to establish whether there is an objective screening test parameter that identifies individuals with neurodevelopmental disorder without CAPD, and to scan the history of these individuals for a unique feature. Patients and Methods: The study included 94 patients (69 males, 25 females; mean age 8.5±1.2 years; range, 7 to 13 years) with specific learning disorder (SLD) and/or attention deficit hyperactivity disorder (ADHD). After assessment by child and adolescent psychiatry, the Staggered Spondaic Word (SSW) test was performed in addition to a full audiologic evaluation. Results: Twenty-four patients (27.2%) with SLD and/or ADHD had CAPD according to SSW criteria. Twenty-eight patients had SLD, 27 had ADHD, and 39 had mixed-type neurodevelopmental disorder. Central auditory processing disorder rate was significantly higher in the mixed group than in the ADHD group (p<0.05). There was a significant relationship between term birth and the absence of CAPD. Auditory Brainstem Response test revealed a significant correlation between the III-V wave interval evaluation in the left ear and CAPD frequency. Conclusion: A significant proportion of patients with SLD and/or ADHD in this study had CAPD. Patients with mixed-type neurodevelopmental disorder in particular were at risk for CAPD. Success of rehabilitation may increase if combined with CAPD-specific programs.
Journal of Craniofacial Surgery, Jun 1, 2018
The aim is to investigate the impact of degree of mastoid pneumatization on the affected side of ... more The aim is to investigate the impact of degree of mastoid pneumatization on the affected side of Bell palsy (BP). Study Design: Retrospective study in tertiary academic hospital. Methods: In total, 52 patients who were diagnosed with as BP were included in the study. Each patient was staged using House-Brackmann (HB) staging system. All patients underwent temporal bone computed tomography imaging. House-Brackmann scores, side of the BP, and mastoid pneumatization of all of patients were evaluated in the present study. Results: Regarding the degree of the mastoid pneumatization, there were no significant differences between the affected side and the unaffected side (P ¼ 0.439). The degree of the mastoid pneumatization of the affected side and the unaffected side did not differ between males and females (P ¼ 0.918 for the affected side, P ¼ 0.765 for the unaffected side, respectively). A negative correlation between the age and mastoid pneumatization of each side was found (P ¼ 0.001, P ¼ 0.025, respectively). There was no significant correlation between HB score and the degree of the mastoid pneumatization of each side (P ¼ 0.789, P ¼ 0.703). Conclusion: As a conclusion, the degree of the mastoid pneumatization is not one of the risk factors for BP. Further randomized studies with larger numbers of patients are needed to confirm these findings.
Carotid Artery Aneurysm
Journal of Craniofacial Surgery, 2017
Temporal bone fractures can occur as a result of various head trauma. The most common cause of th... more Temporal bone fractures can occur as a result of various head trauma. The most common cause of the hemotympanum is traumatic temporal bone fracture. Facial paralysis and hearing loss can be seen associated with temporal bone fracture. The development of the internal carotid artery aneurysm after temporal bone fracture is extremely rare. In this article, the authors evaluated carotid artery aneurysm that developed after temporal fracture and aneurism compressed by coagulated blood mass which showed itself as a hemotympanum. The internal carotid artery aneurysm that induced by temporal bone fracture and presented as hemotympanum has not been reported yet. This patient is the first case in the literature. Diagnosis, treatment, and follow-up options will be discussed in the light of current literature.
Surgical and Radiologic Anatomy, Mar 27, 2019
Objective Anatomic variations have curicial importance during neck surgery. We present a fenestra... more Objective Anatomic variations have curicial importance during neck surgery. We present a fenestrated internal jugular vein variation and the accessory nerve passing through it. Also, we discuss preoperative diagnosis of this variation using ultrasonography. Method The possible recognition of this variation by ultrasonography is introduced. Results The accessory nerve in an internal jugular vein fenestration can be seen using ultrasonography. Conclusion Preoperative identification of this rare variation may secure surgeon from potential complications.
Otolaryngology, Mar 6, 2017
Medullary thyroid carcinoma (MTC) is a neuroendocrine (NE) tumor and is very rarely observed. MTC... more Medullary thyroid carcinoma (MTC) is a neuroendocrine (NE) tumor and is very rarely observed. MTC originates from the parafolliculer C cell and can show various histopathological patterns. Head and neck paragangliomas are seen rarely. Paragangliomas in the head and neck region are usually non-functional. MTC should be considered in the differential diagnosis of paragangliomas in the head and neck region. A high degree of clinical investigation is needed to determine the rare potential etiology underlying this condition. Because patients with MTC can present different clinical manifestations, otolaryngologist must be aware of MTC and its rare medical presentations. This case presented here highlights the importance of serum calcitonin levels in the differential diagnosis of paragangliomas in the head and neck region.
Çocuklarda düşük D vitamini düzeyleri ile üst solunum yolu enfeksiyonu görülme sıklığı arasındaki ilişki
Kulak burun boğaz uygulamaları, 2015
Yaşlılarda Ses ve Yutma Bozuklukları
Otolaryngology, Mar 6, 2017
Background: Many factors are associated with the development of recurrent tonsillitis. These incl... more Background: Many factors are associated with the development of recurrent tonsillitis. These include patient incompliance, premature cessation of antibiotherapy, inadequate antibiotic absorbance, bacterial tolerance, bacterial load, bacterial biofilms, and immune system deficiencies. Objective: To compare between recurrent tonsillitis patients undergoing three to seven tonsillitis episodes per year within less than two years with controls having less than three tonsillitis episodes per year on the basis of vitamin D levels. Study design: A retrospective review of clinical charts. Methods: A total of 426 patients were enrolled in this study. The patients were divided into two groups according to the number of acute tonsillitis episodes: Those who had less than three episodes per year (Group A) and those with three to seven episodes per year (Group B). The patients in Group A were assigned to the control group. Each patient in Group B was considered as a potential candidate for recurrent tonsillitis. The total number of episodes of acute tonsillitis within one year, demographic characteristics of the patients and the mean serum 25-hydroxyvitamin D levels of both groups were compared. Results: Group A consisted of 277 patients (132 women, 145 men; mean age 4.40±2.46 years; range 2 to 10 years), while Group B consisted of 149 patients (66 women, 83 men; mean age 5.22±2.26 years; range 2 to 10 years). The mean serum vitamin D levels of Group A and Group B were 57.83±23.10 nmol/L and 48.03±31.36 nmol/L, respectively. Serum vitamin D level of Group B was lower than the Vitamin D levels of Group A which was statistically significant (p=0.001, p<0.01, respectively). Conclusion: This is the first study investigating vitamin D levels among patients for the diagnosis of recurrent tonsillitis during the follow-up. However, further prospective randomizedcontrolled studies are conducted to gain a better understanding as to whether vitamin D supplementation would reduce the tonsillectomy rates in the diagnosis of recurrent tonsillitis.
Kafkas Journal of Medical Sciences, 2021
Türk otolarengoloji arşivi, Jan 18, 2019
Objective: We present 11 patients with distant metastases to the head and neck from an infraclavi... more Objective: We present 11 patients with distant metastases to the head and neck from an infraclavicularly located primary tumor and discuss the management strategies including the clinical presentation, treatment modalities, and prognosis. Methods: The retrospective data of the pathology reports and operation notes of 1239 patients who had undergone any kind of oncological surgical intervention between 2005 and 2017 were analyzed. All of the 11 patients included in the study were evaluated in our department's tumor board, and all patients with an operable lesion had undergone surgery. Inoperable patients were treated with chemotherapy and/or radiotherapy. Results: The average age of the patients was 64.3 (48-88) years. Primary tumors were located in the lung (2), breast (2), ovary (2), prostate (2), kidney (1), and colon (1) and the primary lesion could not be determined in one patient. The most common symptom was newly occurred painless swelling (9/11, 81.8%) at the metastatic site. Four patients without any other distant metastases were operated. Of these four patients, two died during follow-up due to systemic disease, and the other two are alive and disease-free. Three of the seven inoperable patients were treated with chemotherapy and the other four with radiotherapy. The prognosis of this group was worse. Conclusion: Although metastasis to the head and neck is not common, it is vital to keep in mind while approaching a patient with a lesion at the head and neck region especially if there is a history of lung, breast, and genitourinary cancers. Despite the poor prognosis, diminishing the tumor burden would increase the treatment success.
Kocaeli tıp dergisi, 2022
Objective: Management of clinical node-negative neck in early-stage oral cavity squamous cell car... more Objective: Management of clinical node-negative neck in early-stage oral cavity squamous cell carcinoma is still controversial. There are three main options to consider as watch-and-wait, elective neck dissection, and sentinel node biopsy. Method: Patients were grouped as clinical node-negative and pathologic node-negative (group 1) and clinical node-negative and pathologic node-positive (group 2). Factors thought to affect occult metastasis such as age, tumor diameter, tumor thickness, perineural invasion, lymphovascular invasion, and differentiation were investigated using the Mann-Whitney U test, the Chisquare test, and Fisher's exact test. Results: From 27 eligible patients, there were 12 (44.4%) females and 15 (66.6%) males. Sixteen patients were evaluated in group 1 and 11 were evaluated in group 2. The mean age of the patients was 58.20±14.05 years. The occult metastasis rates were 34% and 51% for T1 and T2 tumors, respectively. The mean tumor diameter was 24.78±12.79 mm, and the mean tumor thickness was 11.37±7.62 mm. The difference in mean values of tumor thickness between the groups was significant (p=0.024), but age (p=0.622) and tumor diameter (p=0.443) were not significantly different. The ROC analysis cutoff values for age, tumor diameter, and tumor thickness were 60 years, 23 mm, and 9.5 mm, respectively. Tumor thickness and lymphovascular invasion were significantly different between the groups, but age, differentiation, clinical T stage, and perineural invasion were not different. Conclusion: The high rates of occult metastasis in our series imply that elective neck dissection seems a more appropriate choice for early-stage oral cavity squamous cell carcinoma rather than watch-and-wait.
Brazilian Journal of Otorhinolaryngology, 2020
Introduction: Benign paroxysmal positional vertigo is a common vestibular disorder that accounts ... more Introduction: Benign paroxysmal positional vertigo is a common vestibular disorder that accounts for one fifth of hospital admissions due to vertigo, although it is commonly undiagnosed. Objective: To evaluate the effects of betahistine add-on therapy in the treatment of subjects with posterior benign paroxysmal positional vertigo. Methods: This randomized controlled study was conducted in a population of 100 subjects with posterior benign paroxysmal positional vertigo. Subjects were divided into the Epley maneuver + betahistine group (group A) and Epley maneuver only (group B) group. Subjects were evaluated before and 1-week after the maneuver using a visual analog scale and dizziness handicap inventory Results: One hundred subjects completed the study protocol. The Epley maneuver had an overall success rate of 95% (96% in group A; 94% in group B, p = 0.024). Groups A and B had similar baseline visual analog scale scores (6.98 ± 2.133 and 6.27 ± 2.148, respectively, p = 0.100). After treatment, the visual analog scale score was significantly lower in both groups, and was significantly lower in group A than group B (0.74 ± 0.853 vs. 1.92 ± 1.288, respectively, p = 0.000).
Supraclavicular artery island flap for head and neck reconstruction
Acta Chirurgiae Plasticae, 2021
BACKGROUND The ablative surgical resection has a critical importance for achieving better oncolog... more BACKGROUND The ablative surgical resection has a critical importance for achieving better oncological outcomes for patients with head and neck cancer. However, radical surgical resections reveal the reconstruction requirement of complex anatomical structures. Microvascular free flaps have been recommended as a gold standard treatment choice for head and neck reconstruction following definitive oncological surgery. The supraclavicular artery island flap (SCAIF) is a thin and reliable fasciocutaneous pedicled flap that is simple and quick to harvest. MATERIAL AND METHODS A total of 19 patients who underwent head and neck reconstruction with SCAIF were included in this study. The SCAIF was used for the reconstruction of oncological defects in 17 patients while it was used for the reconstruction of a skin defect on the lower face following radiotherapy in 1 patient and for cervical open wound (blast injury) closure in 1 patient. RESULTS There were neither intraoperative nor postoperative major complications in any patient. The SCAIF has been used successfully in 18 of 19 patients for head and neck reconstructive surgery. Partial necrosis of the skin was detected in 1 patient (5.3%) only, while a total flap failure has not occurred in any patient. The partial skin necrosis was seen in an area of 1.5 cm of the distal end of the flap and was managed conservatively with local wound care. Wound dehiscence has not appeared in the flap donor area in any patient. CONCLUSION The SCAIF constitutes a good alternative to free flaps, providing almost equivalent functional results and requiring less operative time and surgical effort.
Turkish Archives of Otorhinolaryngology, 2021
Objective: Among other complications of endoscopic skull base surgery, delayed epistaxis has not ... more Objective: Among other complications of endoscopic skull base surgery, delayed epistaxis has not been given much importance. This report presents postoperative delayed nosebleed cases in a large number of patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of lesions. Methods: Three hundred and sixty three patients who were reached to the sellar region by endoscopic endonasal transsphenoidal route and operated was included in the study. Retrospective chart reviewing of these patients was performed. The correlation between the duration of nosebleeds, bleeding location, treatment methods and comorbidities of the patients were evaluated. Results: Ten patients (3.6%) reported delayed epistaxis in the postoperative period and were referred to the otolaryngology department. Postoperative epistaxis occurred between days 7th and 33 th (mean 16.5) days. The treatment consisted of chemical silver nitrate cauterization in two patients, return to the operating room in three patients, nasal packing in five patients. Conclusion: Delayed postoperative epistaxis often has no obvious etiology, and intervention requires teamworking. Well-coordinated teamworking of the neurosurgeon with other specialities such as neuroradiology and otorhinolaryngology is needed to achieve better results.
Turkish Archives of Otorhinolaryngology, 2020
Objective: To understand the variations and normal course of the accessory nerve (CNXI) to help m... more Objective: To understand the variations and normal course of the accessory nerve (CNXI) to help more accurate and confident neck dissection. Methods: The course of the CNXI in the neck, its relationship to the surrounding anatomic structures and the factors affecting its course were investigated. Results: A total of 100 neck dissections were performed on 50 fresh cadavers. Eleven division variations were observed at the anterior triangle. The location of CNXI at the posterior border of the sternocleidomastoid muscle (PBSCM) was investigated and the ratio between the distance from the mastoid apex (MAA) to CNXI at the PBSCM and the distance from MAA to the posterior border where the PBSCM is attached to the clavicle increased as height of the subject increased (p<0.05). Conclusion: It must be kept in mind that it is better to search for CNXI in taller subjects more inferiorly at the posterior border of the sternocleidomastoid muscle.
ENT Updates, 2020
Objective: To compare intact and diseased ears for Eustachian tube (ET) length and width in patie... more Objective: To compare intact and diseased ears for Eustachian tube (ET) length and width in patients with unilateral chronic otitis media (COM), and to assess the relationship between cholesteatoma spread, stapes erosion, lateral semicircular canal (LSCC) fistula and ET width and length retrospectively. Methods: Subjects with unilateral COM (122 subjects with 244 ears) who underwent surgery for cholesteatoma were evaluated retrospectively for this study. The width of the distal orifice of the bony segment and the length of the bony segment of the ET for both the diseased and healthy ear were measured. Subjects' healthy and diseased ears were compared for ET length and width. The diseased sides were compared to assess the relationship between ET dimensions and cholesteatoma spread, stapes erosion and LSCC fistula. Results: The mean ET length and width in healthy and diseased ears was 11.38±1.7 and 1.43±0.37 mm, and 10.99±1.6 and 1.27±0.35 mm, respectively; the difference was statistically significant (p<0.001). No significant differences were found in terms of ET length and width between the subjects with and without stapes erosion and LSCC fistula (p=0.765, p=0.573, and p=0.436, p=0.790, respectively). No significant relation was found between cholesteatoma spread and ET length and width (p=0.647). Conclusion: ET dysfunction is frequently associated with COM. Chronic otitis media with cholesteatoma is significantly related to ET length and width. Measurement of ET length and width in CT scans is a basic method that can be used in clinical practice.
Association of Antrochoanal Polyps with Contralateral Site Sinus Obliteration
European Journal of Rhinology and Allergy, 2020