Serdar Akyildiz - Academia.edu (original) (raw)
Papers by Serdar Akyildiz
Clinical Otolaryngology, 2020
Both CO2 transoral laser microsurgery (CO2 TOLMS) and radiotherapy (RT) are standard of care in e... more Both CO2 transoral laser microsurgery (CO2 TOLMS) and radiotherapy (RT) are standard of care in early glottic carcinoma. However, previous studies focus on voice outcomes rather than swallowing outcomes. This study aimed to compare the late post‐treatment effects of CO2 TOLMS and RT treatment on swallowing function in T1 glottic carcinoma.
Clinical Otolaryngology, 2017
Ethical approval: "All procedures performed in studies involving human participants were in accor... more Ethical approval: "All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards." Informed consent: "Informed consent was obtained from all individual participants included in the study." Conflict of Interest: The authors declare that they have no conflict of interest.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, Jan 11, 2015
The aim of this study is to assess the effect of partial superficial parotidectomy and facial ner... more The aim of this study is to assess the effect of partial superficial parotidectomy and facial nerve dissection to electrophysiologic parameters of intraoperative facial nerve monitoring such as nerve stimulation threshold, stimulus amplitude and latency. Twenty-five patients who underwent partial superficial parotidectomy for benign parotid gland mass were included in the study. After the identification of the facial nerve main trunk, minimum stimulation threshold, latencies and amplitudes of the orbicularis oculi (electrode 1) and orbicularis oris (electrode 2) electrodes at 0.50 milliamperes (mA) were recorded. All of the recordings were repeated after the completion of parotidectomy. Median nerve dissection duration was calculated and size of the tumors was measured during macroscopic pathology. The median minimum nerve stimulation threshold was 0.15 mA [interquartile range (IQR) = 0.05] before and 0.15 mA (IQR = 0.08) after the parotidectomy (p = 0.02). Median nerve dissection d...
International journal of otolaryngology, 2009
The purpose of this article is to present a rare case of localized, solitary amyloid tumor of ton... more The purpose of this article is to present a rare case of localized, solitary amyloid tumor of tongue base and emphasize some of the characteristic features of challenging clinical and histopathologic diagnosis. In this paper, we focused on the clinical and pathological specifications of this rare tumor, so any unnecessary examinations or measures may be spared. Negative staining of amyloid material with AAC and osseous metaplasia noted in the histopathologic examination may not be thought as definite criteria for localized amyloidosis, but a supporter of localized, solitary amyloid tumor diagnosis.
Acta Oto-laryngologica, 2014
p53 overexpression (&... more p53 overexpression (>5%) in the surgical margins was more valuable than in the primary tumor tissue for the prediction of local recurrence among surgically treated early glottic cancers. This is the first study to compare p53 values in both primary tumor and surgical margin tissues of the same patients with early glottic cancers. To assess the prognostic value of p53 expression in the surgical margins of early glottic cancers treated with external laryngeal surgery in the prediction of local recurrences. Fifteen patients with early glottic cancer with local recurrences (group 1) and 15 without any recurrences (group 2) were included in the study. p53 expression was determined in both the tumor and the tumor-negative surgical margins. Median p53 in the primary tumor was 55% (interquartile range (IQR) = 67) and 5% (IQR = 71) in groups 1 and 2, respectively (p = 0.178). Median p53 in the surgical margin was 11% (IQR = 13) and 2% (IQR = 2) in groups 1 and 2, respectively (p = 0.001). In the logistic regression analysis only surgical margin p53 value was significant in the prediction of recurrences (odds ratio (OR) = 1.68, 95% CI = 1.1-2.6, p = 0.017). Receiver operating characteristic (ROC) curve analysis demonstrated that the area under the curve was 0.86 (p = 0.002) and 0.65 (p = 0.180) in the surgical margin and the primary tumor, respectively.
Kulak burun bogaz ihtisas dergisi : KBB = Journal of ear, nose, and throat, 2005
Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a po... more Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a potentially life-threatening serious disease such as a dural arteriovenous fistula (dAVF) of the transverse or sigmoid sinus. If left untreated, dAVFs may lead to focal neurologic symptoms, intracranial hypertension, or hemorrhage, and finally to death. We report two cases of dAVF presenting with pulsatile tinnitus. Following diagnosis, both patients underwent transarterial embolization, after which their symptoms resolved.
Amac: Parotis kitlelerinin tanisinda ince igne aspirasyon biyopsisi (IIAB)'nin degerini ve do... more Amac: Parotis kitlelerinin tanisinda ince igne aspirasyon biyopsisi (IIAB)'nin degerini ve dogrulugunu belirlemek amaclanmistir. Yontem ve Gerec: Ege Universitesi Kulak Burun Bogaz Anabilim Dalinda 2005-2009 yillari arasinda, parotiste kitle nedeniyle opere edilen hastalar icinde operasyon oncesi IIAB yapilan 44 hastanin verileri retrospektif olarak incelendi. IIAB biyopsisinin tanisal degeri operasyon sonrasi piyesin histopatolojik sonuclari ile karsilastirilarak incelendi. Bulgular: Hastalarin 33'u erkek (%75), 11'i kadin (%25) olup yas ortalamasi 54 (yas araligi: 7-89) idi. IIAB, 44 hastanin 6'sinda non-diagnostik olarak bildirildi (%14). Kalan 38 hastanin 28'inde IIAB benign olarak rapor edildi (%74). Bunlarin 25 tanesi postoperatif histopatolojide benign kitle olarak dogrulandi (%89). IIAB de malign olarak bildirilen 10 olgunun ise postoperatif olarak 8'i dogrulandi (%80). Buna gore malign olgulari saptamada IIAB'nin sensitivitesi %73, spesifisitesi ...
Acta Oto-Laryngologica
Abstract Background: Retrospective analysis of extracapsular dissection (ECD) and superficial par... more Abstract Background: Retrospective analysis of extracapsular dissection (ECD) and superficial parotidectomy (SP). Aims/objectives: Comparing the outcomes of ECD and SP in surgery of benign parotid masses. Material and methods: Total of 136 patients included in the study. The inclusion criteria were pathologically proven benign FNA biopsy, lack of deep lobe invasion and single tumour diameter lower than 4 cm, absence of radiologically and clinically malignant lesion and facial paralysis at the time of diagnosis. Objectives: Drain volumes and seroma presence, clinical evaluation of face nerve function; signs of infective complications were collected from patients’ clinic chart. Complications and recurrence rates were obtained from follow-up forms. Results: The mean follow-up period was 42.53 ± 14.88 months. In SP group, three patients with disease recurrence were found, 8 (10.2%) had early facial nerve paralysis (grade 2 and 3) and 11 (14.1%) had Frey’s syndrome. No postoperative complication, early facial paralysis and recurrence were observed in ECD group. Conclusion and significance: ECD procedure was found to be as successful as SP in the selected patient group in approach to the pathologically proven and single benign parotid masses with similar recurrence and lower complication rates compared to the SP.
Cancers of the oral cavity are frequent tumors in ENT practice. They constitute an important grou... more Cancers of the oral cavity are frequent tumors in ENT practice. They constitute an important group of diseases considering morbidity and mortality. Many studies reported show that these malignancies may vary in sex, age and tumor localization in different countries. 231 cases in Aegean ...
Turkish Archives of Otorhinolaryngology
Journal of Neurogastroenterology and Motility, 2016
Background/Aims Gastroesophageal reflux disease (GERD) is one of the main causes of chronic cough... more Background/Aims Gastroesophageal reflux disease (GERD) is one of the main causes of chronic cough. We evaluated the role of microaspiration in the pathogenesis of reflux-related cough by determining the amount of lipid-laden macrophages (LLMs) in bronchoalveolar lavage (BAL) specimens. Methods A total of 161 cases of chronic cough were evaluated, and 36 patients (average age 48.2 years) were recruited for this single center prospective study. Patients with a history of smoking, angiotensin converting enzyme inhibitor usage, any abnormality on pulmonary function tests, abnormal chest X-rays, occupational or environmental exposures, or upper airway cough syndrome were excluded. GERD was evaluated by 24-hour esophageal impedance-pH monitoring. BAL specimens for LLM determination were obtained from 34 patients by flexible bronchoscopy. Results Patients with pathological intra-esophageal reflux according to multichannel intraluminal impedance and pH monitoring had higher LLM positivity in BAL specimens than patients without pathological reflux (8/14 in reflux positive group vs 1/22 in reflux negative group; P = 0.004). The BAL cell distribution was not different between the 2 groups (P = 0.574 for macrophages, P = 0.348 for lymphocytes, P = 0.873 for neutrophils and P = 0.450 for eosinophils). Conclusions Our results confirm the role of the microaspiration of refluxate in the pathogenetic mechanism of chronic cough. While bronchoscopy is indicated in patients with chronic cough, in addition to the routine airway evaluation, BAL and LLM detection should be performed. LLM can be used to diagnose aspiration in reflux-related chronic cough. Future studies are needed to evaluate the response to antireflux medications or surgery in patients with LLM positivity.
Aesthetic Plastic Surgery, Apr 13, 2011
Background The aim of this study was to compare the facial photogrammetric analysis results of th... more Background The aim of this study was to compare the facial photogrammetric analysis results of the Turkish population who are pleased with their facial appearance with the facial analysis data of patients who underwent rhinoplasty in order to find the most prominent objective facial measurements that lead patients to surgical correction of the nose. Methods Forty rhinoplasty patients (20M, 20F) and 40 people without nasal deformity (20M, 20F) were included in this study. Rhinobase software was used for photogrammetric facial analysis. Results The differences in the nasofrontal angle (NFA), nasolabial angle (NLA), chin projection (CP), middle facial height (MFH), and tip deviation angle (TDA) between the patient and the control groups and between the males and females were statistically significant (P \ 0.05). Conclusion The most significant differences between the control group and the patient group were crooked nose, obtuse NFA, acute NLA, chin underprojection, and increased MFH.
Clinical and Experimental Otorhinolaryngology, 2016
Objectives. Bilateral vocal fold abductor paralysis (BVFAP) both deteriorates quality of life and... more Objectives. Bilateral vocal fold abductor paralysis (BVFAP) both deteriorates quality of life and may cause life-threatening respiratory problems. The aim of this study was to reduce respiratory symptoms in BVFAP patients using cricothyroid (CT) botulinum toxin (BTX) injection. Methods. Before and 2 weeks and 4 months after bilateral BTX injection into the CT muscles under electromyography; alterations in respiratory, acoustic, aerodynamic and quality of life parameters were evaluated in BVFAP patients with respiratory distress. For the respiratory evaluation modified Borg scale and spirometry, for the voice and aerodynamic evaluations Voice Handicap Index-30 (VHI-30), GRBAS, acoustic analysis (sound pressure level, F0, jitter%, shim-mer%, noise-to-harmonic ratio) and maximum phonation time and for the quality of life assessment Short Form-36 (SF-36) form were used. Results. All patients were female with a mean age of 47±8.1 years. There was a mean time of 11.8±5.5 (minimum 2, maximum 23) months between BVFAP development and BTX injection. In all cases, other than one case with unknown aetiology, the cause of vocal fold paralysis was prior thyroid surgery. In total 18.6±3.1 units of BTX were applied to the CTs. In the preinjection period, and the 2nd week and 4th month after injection, the Borg dyspnea scale was 7.3/5.3/5.0, FIV1 (forced inspiratory volume in one second) was 1.7/1.7/1.8 L, peak expiratory flow (PEF) was 1.4/1.7/2.1 L/sec, maximum phonation time was 7.0/6.4/6.2 seconds and VHI-30 was 63.2/52.2/61.7 respectively. There was no significant alteration in acoustic analysis parameters. Many of the patients reported transient dysphagia within the first week. There were insignificant increases in SF-36 sub-scale values. Conclusion. After BTX injection, improvements in the mean Borg score, PEF and FIV1 values and SF-36 sub-scale scores showed the restricted success of this approach. This modality may be kept in mind as a transient treatment option for patients refused persistent tracheotomy or ablative airway surgeries.
Kulak Burun Bogaz Ihtisas Dergisi Kbb Journal of Ear Nose and Throat, Feb 1, 2005
Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a po... more Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a potentially life-threatening serious disease such as a dural arteriovenous fistula (dAVF) of the transverse or sigmoid sinus. If left untreated, dAVFs may lead to focal neurologic symptoms, intracranial hypertension, or hemorrhage, and finally to death. We report two cases of dAVF presenting with pulsatile tinnitus. Following diagnosis, both patients underwent transarterial embolization, after which their symptoms resolved.
ORL, 2016
The aim of this study was to report the post-surgical and oncologic outcomes of patients who unde... more The aim of this study was to report the post-surgical and oncologic outcomes of patients who underwent supracricoid partial laryngectomy (SCPL). 90 patients who underwent SCPL between 1994 and 2014 were reviewed. 45 patients underwent cricohyoidopexy (CHP) and 45 patients cricohyoidoepiglottopexy (CHEP). Median nasogastric (NG) tube removal time, decannulation time, overall survival, disease-free survival and local control rates were calculated. The effect of the type of surgery on functional and oncologic outcomes were assessed. Median NG tube removal time was 16.5 days (IQR = 10) and 14 days (IQR = 9) in CHP and CHEP patients, respectively (p > 0.05). Median decannulation time was 30 days (IQR = 26) and 19 days (IQR = 15) in CHP and CHEP patients, respectively (p < 0.05). Resection of one arytenoid significantly increased NG tube removal time. Median follow-up time was 55 months. There were 15 oncologic failures and the median time interval for tumor recurrence was 9 months. Five-year overall survival rate was 80.4%. The 3- and 5-year disease-free specific survival rates were 81.7 and 76.7%, respectively. Given the more extensive surgery applied for CHP, functional outcomes were better in patients with CHEP. Resection of an arytenoid had a negative outcome on swallowing.
ORL, 2016
The aim of this study was to report the post-surgical and oncologic outcomes of patients who unde... more The aim of this study was to report the post-surgical and oncologic outcomes of patients who underwent supracricoid partial laryngectomy (SCPL). 90 patients who underwent SCPL between 1994 and 2014 were reviewed. 45 patients underwent cricohyoidopexy (CHP) and 45 patients cricohyoidoepiglottopexy (CHEP). Median nasogastric (NG) tube removal time, decannulation time, overall survival, disease-free survival and local control rates were calculated. The effect of the type of surgery on functional and oncologic outcomes were assessed. Median NG tube removal time was 16.5 days (IQR = 10) and 14 days (IQR = 9) in CHP and CHEP patients, respectively (p > 0.05). Median decannulation time was 30 days (IQR = 26) and 19 days (IQR = 15) in CHP and CHEP patients, respectively (p < 0.05). Resection of one arytenoid significantly increased NG tube removal time. Median follow-up time was 55 months. There were 15 oncologic failures and the median time interval for tumor recurrence was 9 months. Five-year overall survival rate was 80.4%. The 3- and 5-year disease-free specific survival rates were 81.7 and 76.7%, respectively. Given the more extensive surgery applied for CHP, functional outcomes were better in patients with CHEP. Resection of an arytenoid had a negative outcome on swallowing.
European Archives of Oto-Rhino-Laryngology, 2016
The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable a... more The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable and safe, providing sufficient hemostasis and reducing operating time. The aim of this study was to evaluate efficacy of this technique in patients undergoing selective neck dissections. This study was carried out as a prospective controlled study at an otolaryngology department of a tertiary medical center between July 2013 and July 2015. Twenty-five patients older than 18 years who underwent unilateral selective neck dissection for head and neck cancer were included in the study. In the control group (group 2, 10 patients) only monopolar and bipolar diathermy was used; in the Ligasure group (group 1, 15 patients) Ligasure was used for hemostasis and dissection in addition to the conventional techniques. Cervical lymphadenectomy time, operation time, preoperative hemoglobin levels, preoperative hematocrit levels, postoperative hemoglobin levels, postoperative hematocrit levels, total neck drainage and drain removal time were analyzed and compared between the groups. Median operation time in group 1 and 2 were 95 min (IQR = 35) and 142.5 min (IQR = 63), respectively. Median cervical lymphadenectomy time in group 1 and 2 were 55 min (IQR = 23) and 102.5 min (IQR = 49), respectively. Median operation time and cervical operation time were significantly lower in group 1 (p < 0.05). In conclusion, LigaSure™ vessel sealing system is a safe, efficacious technique and significantly lowers cervical lymphadenectomy and operation time in selective neck dissections compared to controls. Given the superb hemostatic properties, this technique should be in the surgeon's armamentarium when possible.
Turkiye Klinikleri Kbb Dergisi, 2002
Turkiye Klinikleri Journal of Surgical Medical Sciences, 2006
Clinical Otolaryngology, 2020
Both CO2 transoral laser microsurgery (CO2 TOLMS) and radiotherapy (RT) are standard of care in e... more Both CO2 transoral laser microsurgery (CO2 TOLMS) and radiotherapy (RT) are standard of care in early glottic carcinoma. However, previous studies focus on voice outcomes rather than swallowing outcomes. This study aimed to compare the late post‐treatment effects of CO2 TOLMS and RT treatment on swallowing function in T1 glottic carcinoma.
Clinical Otolaryngology, 2017
Ethical approval: "All procedures performed in studies involving human participants were in accor... more Ethical approval: "All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards." Informed consent: "Informed consent was obtained from all individual participants included in the study." Conflict of Interest: The authors declare that they have no conflict of interest.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, Jan 11, 2015
The aim of this study is to assess the effect of partial superficial parotidectomy and facial ner... more The aim of this study is to assess the effect of partial superficial parotidectomy and facial nerve dissection to electrophysiologic parameters of intraoperative facial nerve monitoring such as nerve stimulation threshold, stimulus amplitude and latency. Twenty-five patients who underwent partial superficial parotidectomy for benign parotid gland mass were included in the study. After the identification of the facial nerve main trunk, minimum stimulation threshold, latencies and amplitudes of the orbicularis oculi (electrode 1) and orbicularis oris (electrode 2) electrodes at 0.50 milliamperes (mA) were recorded. All of the recordings were repeated after the completion of parotidectomy. Median nerve dissection duration was calculated and size of the tumors was measured during macroscopic pathology. The median minimum nerve stimulation threshold was 0.15 mA [interquartile range (IQR) = 0.05] before and 0.15 mA (IQR = 0.08) after the parotidectomy (p = 0.02). Median nerve dissection d...
International journal of otolaryngology, 2009
The purpose of this article is to present a rare case of localized, solitary amyloid tumor of ton... more The purpose of this article is to present a rare case of localized, solitary amyloid tumor of tongue base and emphasize some of the characteristic features of challenging clinical and histopathologic diagnosis. In this paper, we focused on the clinical and pathological specifications of this rare tumor, so any unnecessary examinations or measures may be spared. Negative staining of amyloid material with AAC and osseous metaplasia noted in the histopathologic examination may not be thought as definite criteria for localized amyloidosis, but a supporter of localized, solitary amyloid tumor diagnosis.
Acta Oto-laryngologica, 2014
p53 overexpression (&... more p53 overexpression (>5%) in the surgical margins was more valuable than in the primary tumor tissue for the prediction of local recurrence among surgically treated early glottic cancers. This is the first study to compare p53 values in both primary tumor and surgical margin tissues of the same patients with early glottic cancers. To assess the prognostic value of p53 expression in the surgical margins of early glottic cancers treated with external laryngeal surgery in the prediction of local recurrences. Fifteen patients with early glottic cancer with local recurrences (group 1) and 15 without any recurrences (group 2) were included in the study. p53 expression was determined in both the tumor and the tumor-negative surgical margins. Median p53 in the primary tumor was 55% (interquartile range (IQR) = 67) and 5% (IQR = 71) in groups 1 and 2, respectively (p = 0.178). Median p53 in the surgical margin was 11% (IQR = 13) and 2% (IQR = 2) in groups 1 and 2, respectively (p = 0.001). In the logistic regression analysis only surgical margin p53 value was significant in the prediction of recurrences (odds ratio (OR) = 1.68, 95% CI = 1.1-2.6, p = 0.017). Receiver operating characteristic (ROC) curve analysis demonstrated that the area under the curve was 0.86 (p = 0.002) and 0.65 (p = 0.180) in the surgical margin and the primary tumor, respectively.
Kulak burun bogaz ihtisas dergisi : KBB = Journal of ear, nose, and throat, 2005
Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a po... more Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a potentially life-threatening serious disease such as a dural arteriovenous fistula (dAVF) of the transverse or sigmoid sinus. If left untreated, dAVFs may lead to focal neurologic symptoms, intracranial hypertension, or hemorrhage, and finally to death. We report two cases of dAVF presenting with pulsatile tinnitus. Following diagnosis, both patients underwent transarterial embolization, after which their symptoms resolved.
Amac: Parotis kitlelerinin tanisinda ince igne aspirasyon biyopsisi (IIAB)'nin degerini ve do... more Amac: Parotis kitlelerinin tanisinda ince igne aspirasyon biyopsisi (IIAB)'nin degerini ve dogrulugunu belirlemek amaclanmistir. Yontem ve Gerec: Ege Universitesi Kulak Burun Bogaz Anabilim Dalinda 2005-2009 yillari arasinda, parotiste kitle nedeniyle opere edilen hastalar icinde operasyon oncesi IIAB yapilan 44 hastanin verileri retrospektif olarak incelendi. IIAB biyopsisinin tanisal degeri operasyon sonrasi piyesin histopatolojik sonuclari ile karsilastirilarak incelendi. Bulgular: Hastalarin 33'u erkek (%75), 11'i kadin (%25) olup yas ortalamasi 54 (yas araligi: 7-89) idi. IIAB, 44 hastanin 6'sinda non-diagnostik olarak bildirildi (%14). Kalan 38 hastanin 28'inde IIAB benign olarak rapor edildi (%74). Bunlarin 25 tanesi postoperatif histopatolojide benign kitle olarak dogrulandi (%89). IIAB de malign olarak bildirilen 10 olgunun ise postoperatif olarak 8'i dogrulandi (%80). Buna gore malign olgulari saptamada IIAB'nin sensitivitesi %73, spesifisitesi ...
Acta Oto-Laryngologica
Abstract Background: Retrospective analysis of extracapsular dissection (ECD) and superficial par... more Abstract Background: Retrospective analysis of extracapsular dissection (ECD) and superficial parotidectomy (SP). Aims/objectives: Comparing the outcomes of ECD and SP in surgery of benign parotid masses. Material and methods: Total of 136 patients included in the study. The inclusion criteria were pathologically proven benign FNA biopsy, lack of deep lobe invasion and single tumour diameter lower than 4 cm, absence of radiologically and clinically malignant lesion and facial paralysis at the time of diagnosis. Objectives: Drain volumes and seroma presence, clinical evaluation of face nerve function; signs of infective complications were collected from patients’ clinic chart. Complications and recurrence rates were obtained from follow-up forms. Results: The mean follow-up period was 42.53 ± 14.88 months. In SP group, three patients with disease recurrence were found, 8 (10.2%) had early facial nerve paralysis (grade 2 and 3) and 11 (14.1%) had Frey’s syndrome. No postoperative complication, early facial paralysis and recurrence were observed in ECD group. Conclusion and significance: ECD procedure was found to be as successful as SP in the selected patient group in approach to the pathologically proven and single benign parotid masses with similar recurrence and lower complication rates compared to the SP.
Cancers of the oral cavity are frequent tumors in ENT practice. They constitute an important grou... more Cancers of the oral cavity are frequent tumors in ENT practice. They constitute an important group of diseases considering morbidity and mortality. Many studies reported show that these malignancies may vary in sex, age and tumor localization in different countries. 231 cases in Aegean ...
Turkish Archives of Otorhinolaryngology
Journal of Neurogastroenterology and Motility, 2016
Background/Aims Gastroesophageal reflux disease (GERD) is one of the main causes of chronic cough... more Background/Aims Gastroesophageal reflux disease (GERD) is one of the main causes of chronic cough. We evaluated the role of microaspiration in the pathogenesis of reflux-related cough by determining the amount of lipid-laden macrophages (LLMs) in bronchoalveolar lavage (BAL) specimens. Methods A total of 161 cases of chronic cough were evaluated, and 36 patients (average age 48.2 years) were recruited for this single center prospective study. Patients with a history of smoking, angiotensin converting enzyme inhibitor usage, any abnormality on pulmonary function tests, abnormal chest X-rays, occupational or environmental exposures, or upper airway cough syndrome were excluded. GERD was evaluated by 24-hour esophageal impedance-pH monitoring. BAL specimens for LLM determination were obtained from 34 patients by flexible bronchoscopy. Results Patients with pathological intra-esophageal reflux according to multichannel intraluminal impedance and pH monitoring had higher LLM positivity in BAL specimens than patients without pathological reflux (8/14 in reflux positive group vs 1/22 in reflux negative group; P = 0.004). The BAL cell distribution was not different between the 2 groups (P = 0.574 for macrophages, P = 0.348 for lymphocytes, P = 0.873 for neutrophils and P = 0.450 for eosinophils). Conclusions Our results confirm the role of the microaspiration of refluxate in the pathogenetic mechanism of chronic cough. While bronchoscopy is indicated in patients with chronic cough, in addition to the routine airway evaluation, BAL and LLM detection should be performed. LLM can be used to diagnose aspiration in reflux-related chronic cough. Future studies are needed to evaluate the response to antireflux medications or surgery in patients with LLM positivity.
Aesthetic Plastic Surgery, Apr 13, 2011
Background The aim of this study was to compare the facial photogrammetric analysis results of th... more Background The aim of this study was to compare the facial photogrammetric analysis results of the Turkish population who are pleased with their facial appearance with the facial analysis data of patients who underwent rhinoplasty in order to find the most prominent objective facial measurements that lead patients to surgical correction of the nose. Methods Forty rhinoplasty patients (20M, 20F) and 40 people without nasal deformity (20M, 20F) were included in this study. Rhinobase software was used for photogrammetric facial analysis. Results The differences in the nasofrontal angle (NFA), nasolabial angle (NLA), chin projection (CP), middle facial height (MFH), and tip deviation angle (TDA) between the patient and the control groups and between the males and females were statistically significant (P \ 0.05). Conclusion The most significant differences between the control group and the patient group were crooked nose, obtuse NFA, acute NLA, chin underprojection, and increased MFH.
Clinical and Experimental Otorhinolaryngology, 2016
Objectives. Bilateral vocal fold abductor paralysis (BVFAP) both deteriorates quality of life and... more Objectives. Bilateral vocal fold abductor paralysis (BVFAP) both deteriorates quality of life and may cause life-threatening respiratory problems. The aim of this study was to reduce respiratory symptoms in BVFAP patients using cricothyroid (CT) botulinum toxin (BTX) injection. Methods. Before and 2 weeks and 4 months after bilateral BTX injection into the CT muscles under electromyography; alterations in respiratory, acoustic, aerodynamic and quality of life parameters were evaluated in BVFAP patients with respiratory distress. For the respiratory evaluation modified Borg scale and spirometry, for the voice and aerodynamic evaluations Voice Handicap Index-30 (VHI-30), GRBAS, acoustic analysis (sound pressure level, F0, jitter%, shim-mer%, noise-to-harmonic ratio) and maximum phonation time and for the quality of life assessment Short Form-36 (SF-36) form were used. Results. All patients were female with a mean age of 47±8.1 years. There was a mean time of 11.8±5.5 (minimum 2, maximum 23) months between BVFAP development and BTX injection. In all cases, other than one case with unknown aetiology, the cause of vocal fold paralysis was prior thyroid surgery. In total 18.6±3.1 units of BTX were applied to the CTs. In the preinjection period, and the 2nd week and 4th month after injection, the Borg dyspnea scale was 7.3/5.3/5.0, FIV1 (forced inspiratory volume in one second) was 1.7/1.7/1.8 L, peak expiratory flow (PEF) was 1.4/1.7/2.1 L/sec, maximum phonation time was 7.0/6.4/6.2 seconds and VHI-30 was 63.2/52.2/61.7 respectively. There was no significant alteration in acoustic analysis parameters. Many of the patients reported transient dysphagia within the first week. There were insignificant increases in SF-36 sub-scale values. Conclusion. After BTX injection, improvements in the mean Borg score, PEF and FIV1 values and SF-36 sub-scale scores showed the restricted success of this approach. This modality may be kept in mind as a transient treatment option for patients refused persistent tracheotomy or ablative airway surgeries.
Kulak Burun Bogaz Ihtisas Dergisi Kbb Journal of Ear Nose and Throat, Feb 1, 2005
Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a po... more Pulsatile tinnitus associated with normal otoscopic findings may present as the only sign of a potentially life-threatening serious disease such as a dural arteriovenous fistula (dAVF) of the transverse or sigmoid sinus. If left untreated, dAVFs may lead to focal neurologic symptoms, intracranial hypertension, or hemorrhage, and finally to death. We report two cases of dAVF presenting with pulsatile tinnitus. Following diagnosis, both patients underwent transarterial embolization, after which their symptoms resolved.
ORL, 2016
The aim of this study was to report the post-surgical and oncologic outcomes of patients who unde... more The aim of this study was to report the post-surgical and oncologic outcomes of patients who underwent supracricoid partial laryngectomy (SCPL). 90 patients who underwent SCPL between 1994 and 2014 were reviewed. 45 patients underwent cricohyoidopexy (CHP) and 45 patients cricohyoidoepiglottopexy (CHEP). Median nasogastric (NG) tube removal time, decannulation time, overall survival, disease-free survival and local control rates were calculated. The effect of the type of surgery on functional and oncologic outcomes were assessed. Median NG tube removal time was 16.5 days (IQR = 10) and 14 days (IQR = 9) in CHP and CHEP patients, respectively (p > 0.05). Median decannulation time was 30 days (IQR = 26) and 19 days (IQR = 15) in CHP and CHEP patients, respectively (p < 0.05). Resection of one arytenoid significantly increased NG tube removal time. Median follow-up time was 55 months. There were 15 oncologic failures and the median time interval for tumor recurrence was 9 months. Five-year overall survival rate was 80.4%. The 3- and 5-year disease-free specific survival rates were 81.7 and 76.7%, respectively. Given the more extensive surgery applied for CHP, functional outcomes were better in patients with CHEP. Resection of an arytenoid had a negative outcome on swallowing.
ORL, 2016
The aim of this study was to report the post-surgical and oncologic outcomes of patients who unde... more The aim of this study was to report the post-surgical and oncologic outcomes of patients who underwent supracricoid partial laryngectomy (SCPL). 90 patients who underwent SCPL between 1994 and 2014 were reviewed. 45 patients underwent cricohyoidopexy (CHP) and 45 patients cricohyoidoepiglottopexy (CHEP). Median nasogastric (NG) tube removal time, decannulation time, overall survival, disease-free survival and local control rates were calculated. The effect of the type of surgery on functional and oncologic outcomes were assessed. Median NG tube removal time was 16.5 days (IQR = 10) and 14 days (IQR = 9) in CHP and CHEP patients, respectively (p > 0.05). Median decannulation time was 30 days (IQR = 26) and 19 days (IQR = 15) in CHP and CHEP patients, respectively (p < 0.05). Resection of one arytenoid significantly increased NG tube removal time. Median follow-up time was 55 months. There were 15 oncologic failures and the median time interval for tumor recurrence was 9 months. Five-year overall survival rate was 80.4%. The 3- and 5-year disease-free specific survival rates were 81.7 and 76.7%, respectively. Given the more extensive surgery applied for CHP, functional outcomes were better in patients with CHEP. Resection of an arytenoid had a negative outcome on swallowing.
European Archives of Oto-Rhino-Laryngology, 2016
The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable a... more The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable and safe, providing sufficient hemostasis and reducing operating time. The aim of this study was to evaluate efficacy of this technique in patients undergoing selective neck dissections. This study was carried out as a prospective controlled study at an otolaryngology department of a tertiary medical center between July 2013 and July 2015. Twenty-five patients older than 18 years who underwent unilateral selective neck dissection for head and neck cancer were included in the study. In the control group (group 2, 10 patients) only monopolar and bipolar diathermy was used; in the Ligasure group (group 1, 15 patients) Ligasure was used for hemostasis and dissection in addition to the conventional techniques. Cervical lymphadenectomy time, operation time, preoperative hemoglobin levels, preoperative hematocrit levels, postoperative hemoglobin levels, postoperative hematocrit levels, total neck drainage and drain removal time were analyzed and compared between the groups. Median operation time in group 1 and 2 were 95 min (IQR = 35) and 142.5 min (IQR = 63), respectively. Median cervical lymphadenectomy time in group 1 and 2 were 55 min (IQR = 23) and 102.5 min (IQR = 49), respectively. Median operation time and cervical operation time were significantly lower in group 1 (p < 0.05). In conclusion, LigaSure™ vessel sealing system is a safe, efficacious technique and significantly lowers cervical lymphadenectomy and operation time in selective neck dissections compared to controls. Given the superb hemostatic properties, this technique should be in the surgeon's armamentarium when possible.
Turkiye Klinikleri Kbb Dergisi, 2002
Turkiye Klinikleri Journal of Surgical Medical Sciences, 2006