Sinan Basoglu - Academia.edu (original) (raw)

Papers by Sinan Basoglu

Journal of Medical Updates, 2013

Journal of Medical Updates, 2012

Journal of Medical Updates, 2012

Journal of Medical Updates, 2013

Journal of Craniofacial Surgery, 2014

The aim of our study was to determine the effectiveness of intratympanic α-lipoic acid injection ... more The aim of our study was to determine the effectiveness of intratympanic α-lipoic acid injection as an otoprotective agent against cisplatin-induced ototoxicity in guinea pigs. Twenty-four adult male albino guinea pigs with normal hearing were divided into 4 groups. The guinea pigs received intraperitoneal cisplatin in group 1, intraperitoneal cisplatin and intratympanic α-lipoic acid in group 2, intratympanic α-lipoic acid in group 3, as well as intraperitoneal cisplatin and intratympanic saline in group 4. Distortion-product otoacoustic emission measurements were obtained for both ears at the following time points: before administration (baseline recording) and on day 3 (72 h later). In group 1 (cisplatin), significant deterioration was observed at all frequencies on day 3 (P < 0.05). In group 2 (cisplatin + α-lipoic acid), deterioration was observed at all frequencies on day 3; however, this deterioration did not reach a statistical significance (P > 0.05). In group 3 (α-lipoic acid), no significant difference was observed between baseline and day 3 (P > 0.05). In group 4 (cisplatin + saline), deterioration was observed at all frequencies on day 3; however, this deterioration did not reach a statistical significance (P > 0.05). Cisplatin-induced hearing loss in the guinea pigs may be limited to some extent by the concomitant use of α-lipoic acid. Dose-dependent changes in the possible effects of α-lipoic acid need further investigation. Future morphologic studies may contribute to expose clearly the protective effect of α-lipoic acid.

Journal of Craniofacial Surgery, 2014

To present the results of the traumatic intratemporal facial nerve injury that have undergone fac... more To present the results of the traumatic intratemporal facial nerve injury that have undergone facial nerve decompression by using middle cranial fossa (MCF) approach. A retrospective study Tertiary referral center In this study, 13 patients who developed facial paralysis due to temporal bone trauma and undergone decompression by using MCF approach in Department of Otorhinolaryngology of İzmir Katip Celebi University Research and Training Hospital between January 1993 and December 2012 were presented retrospectively. Patients were assessed in terms of side, etiology, fracture type, House-Brackmann (HB) grade, electroneuronography (ENOG), electromyography (EMG), hearing loss, operation time, and the region of the injury. The fracture was at the right side in 7 (53.8%) and at the left side in 6 patients (46.1%). The type of temporal bone fracture was longitudinal in 6 (46.1%), transverse in 2 (15.3%), and mixed in 5 patients (38.4%). Total axonal degeneration in EMG and ENOG were seen in all patients, who were HB grade 6 at preoperative assessment. Mean operation time was 30 days. The lesion in all patients was at the region of geniculate ganglion. There was conductive hearing loss in 7 patients (53.8%), sensorineural in 4 (30.7%), and mixed in 1 patient (7.6%); hearing was normal in 1 patient (7.6%). Seven patients (53.8%) improved to HB grade 2. In the light of the information obtained from HRCT, ENOG, and EMG, we believe that better results can be achieved with facial nerve decompression that is performed before 1 month, and geniculate ganglion region may be better controlled by MCF approach.

International Journal of Pediatric Otorhinolaryngology, 2012

To evaluate the effectiveness of micronized flavonoid fraction in preventing cisplatin ototoxicit... more To evaluate the effectiveness of micronized flavonoid fraction in preventing cisplatin ototoxicity in a guinea pig model. This study was conducted on 23 guinea pigs in the Animal Laboratory of Izmir Atatürk Training and Research Hospital. Animals were divided into three groups: Group 1 consisted of eight animals receiving cisplatin only; Group 2 contained eight animals receiving cisplatin+micronized flavonoid fraction; and Group 3 contained seven animals that received micronized flavonoid fraction only. Their cochlear reserve was evaluated by measuring the distortion product otoacoustic emission on days 0 and 7. In Groups 1 and 2, the intragroup signal-noise ratios were statistically different at all frequencies tested (based on negative ranks, p<0.05). In Group 3, the intragroup signal-noise ratios did not differ significantly at the frequencies tested (p>0.05). Comparison of the three groups showed statistically significant differences among the groups (p<0.05). The post hoc Bonferroni correction showed statistically significant differences among all three groups (p<0.016). The median signal-noise ratio of the three groups tended to increase (z-value was positive for all the frequencies tested; p<0.01). Micronized flavonoid fraction (Daflon) is effective against cisplatin-induced ototoxicity in guinea pigs.

International Journal of Pediatric Otorhinolaryngology, 2014

The aim of this study is to compare the effects of the absorbable gelatin sponge (AGS), microporo... more The aim of this study is to compare the effects of the absorbable gelatin sponge (AGS), microporous polysaccharide hemospheres (MPH), and Ankaferd on wound healing after middle ear trauma and to evaluate their ototoxicity in an experimental guinea pig model. Middle ear mucosal trauma was created in 21 healthy adult guinea pigs. MPH, Ankaferd, and AGS were applied into the right tympanic bulla of the guinea pigs (7 ears for each treatment modality). The left ears of the seven animals were used as the sham group. At the fourth postoperative week (28-30 days), the guinea pigs were decapitated. Apoptosis was investigated, and the expression of Bcl-xl, Apaf, p53, cytochrome 3, and caspase 3 were evaluated. The Ankaferd and AGS groups demonstrated significantly lower epithelial thickness, inflammation, and capillary dilatation than did the control group (p<0.001, <0.001, /0.001, <0.001/, 0.005, and 0.005, respectively). A statistically significant decrease in Bcl-xl staining was observed in the middle ears of animals treated with MPH (p=0.003). There was significantly higher caspase 3 expression in the Ankaferd and AGS groups than in the control group (p<0.001 and p=0.002, respectively). Light microscopy indicates that Ankaferd and AGS create less inflammation and increased caspase expression, which seems to induce inflammatory cell apoptosis. Ankaferd seems to be a promising hemostatic agent in otology.

International Journal of Pediatric Otorhinolaryngology, 2013

Most microorganisms that cause infection in the external auditory canal and tympanum reproduce re... more Most microorganisms that cause infection in the external auditory canal and tympanum reproduce readily in an alkaline environment. Thus, pH-decreasing components, such as ototopical agents, acetic acid, or boric acid, are preferred [1]. Ear drops are used in the treatment of otitis externa and infection of the middle ear in the presence of tympanic membrane perforation. The ototoxic properties and therapeutic effects of ototopical agents commonly preferred for the treatment of chronic suppurative otitis media (CSOM) and external otitis have become a significant topic of research today. The toxicity revealed in the inner ear structures can be related to the cochlea, the vestibule, or both of these systems. Ototoxicity is defined here as a loss of more than 15 dB in two or more frequencies, or a loss of more than 20 dB in one or more frequency [2]. Studies have demonstrated the positive effects of aluminum acetate-usually at 13%-dissolved in water named as Burow's solution, administered because of its acidic and antiseptic characteristics over a wide confidence interval [3]. Boric acid solutions are also especially effective in the treatment of CSOM and external otitis due to their acidifying characteristics. Ö ztü rkcan et al. evaluated hearing after the administration of 4% boric alcohol solution prepared with 70% alcohol and 4% eau boric solution prepared with distilled water in guinea pigs with perforated tympanic membranes, and established that hearing loss was significant in the group that was administered the alcohol solution [4]. In this study, we investigated whether the ototoxic effects of 4% boric alcohol solutions prepared with various degrees of alcohol differed.

International Journal of Pediatric Otorhinolaryngology Extra, 2013

Otolaryngology -- Head and Neck Surgery, 2012

Objective To describe 2 subapproaches of the middle fossa approach: the transillumination method ... more Objective To describe 2 subapproaches of the middle fossa approach: the transillumination method and transection of lines using the foramen spinosum, greater superficial petrosal nerve, and trigeminal impression to locate the malleus head for safe identification and decompression of the geniculate ganglion and facial nerve. Study Design Cadaver study. Setting A tertiary university hospital anatomy laboratory. Subjects and Methods The present study was conducted using 7 formalin-fixed cadaver heads (14 sides). A 0° endoscope was introduced into the external ear canal toward the posterosuperior quadrant of the tympanic membrane, after which transillumination was used to locate the malleus head. The brightest point indicated the convergence of the greater superficial petrosal nerve and a line drawn along the superior semicircular canal. An additional line was drawn parallel to the petrous ridge from the foramen spinosum and along the pathway of the greater superficial petrosal nerve. A...

Otolaryngology -- Head and Neck Surgery, 2012

Head and neck squamous cell carcinomas readily metastasize to adjacent cervical lymph nodes. This... more Head and neck squamous cell carcinomas readily metastasize to adjacent cervical lymph nodes. This is seen frequently in laryngeal squamous cell carcinoma (LSCC), and neck dissection may be performed in addition to excision of the primary lesion. The aim of this study was to define the frequency of level IIb metastasis to the lymph nodes in patients who underwent selective neck dissection because of LSCC. Cross-sectional study with planned data collection in a tertiary referral hospital. Eighty-one patients diagnosed with LSCC were accepted into the study. One hundred forty-eight neck dissection specimens were examined histopathologically, and those with level IIb metastasis were identified. The frequency of level IIb metastasis was evaluated in accordance with the primary tumor site, clinical N stage, central tumor presence, and T stage. Forty-seven of 81 patients were clinically N-, and 34 patients were clinically N+. Level IIb metastasis was seen in 5 (6%) of 81 patients, representing 5 of 148 neck dissection specimens. Two of these 5 patients were clinically N+ (6%), and 3 were clinically N- (6%). The relationship between level IIb metastasis and clinical N stage was not statistically significant (P ≥ .05). Likewise, no statistically significant relationships between the other parameters and level IIb involvement were found. Level IIb nodal involvement is very rare in LSCC. Therefore, the area can generally be preserved in elective neck dissection to lessen morbidity and, specifically, to avoid damaging the function of the spinal accessory nerve.

Otolaryngology - Head and Neck Surgery, 2007

This study evaluates the vocal cord and arytenoid mobility in relation to the tumoral involvement... more This study evaluates the vocal cord and arytenoid mobility in relation to the tumoral involvement of the cricoarytenoid joint (CAJ), thyroarytenoid (TA) muscle, and posterior cricoarytenoid (PCA) muscle in whole-organ sections of total laryngectomy specimens. The study was prospectively carried out between 1998 and 2003 and involved 133 primary squamous cell carcinoma cases of larynx or pyriform sinus that were treated with total laryngectomy. Preoperative mobility of vocal cords and arytenoids were evaluated separately and correlated with histopathologic findings. In cases with fixed vocal cord CAJ, TA muscle, and PCA muscle were involved in 42.4%, 72.9%, and 27.1% of the cases, respectively, while in cases with fixed arytenoid these structures were affected in 40%, 66.3%, and 25.3% of the cases. Weight effect seemed to play a role in 60% and 50% of the cases of supraglottic and pyriform sinus carcinoma, respectively. Careful evaluation of the mobility of the cord arytenoid unit separately helps the surgeon to better understand the patterns of tumoral extension guiding for the appropriate surgery which should be undertaken.

Journal of Craniofacial Surgery, 2013

This study evaluated the outcome in adult patients with laryngotracheal stenosis (LTS) and assess... more This study evaluated the outcome in adult patients with laryngotracheal stenosis (LTS) and assessed the effect of procedures on their quality-of-life scores. The study included 15 adult patients with LTS (11 males [73.3%], 4 females [26.7%]; mean age, 32 years [range, 10-52 years]) treated at the Department of Otolaryngology Head and Surgery Clinic, İzmir Atatürk Research Hospital, Turkey, from 1997 to 2008. Success of the surgery is evaluated by decanullation rate, Short form-36 (SF-36), and the Medical Research Council dyspnea scale. The etiology of the LTS was intubation related in 14 cases (93.3%) and idiopathic in 1 case. According to the Myers-Cotton classification, 2 (13%), 8 (54%), and 5 (33%) patients were at stages 2 to 4, respectively. Fourteen patients had a mean follow-up of 57 months (range, 24-256 months). The stenotic segment involved 1 to 3 cm (mean, 1.7 cm) of trachea, and 2 to 5 tracheal rings (mean, 3.1) were resected. Postoperative decannulation was achieved in 13 patients (86.6%). In the short form-36 questionnaire, all of the parameters except for "role-emotional" were found to be significant (P < 0.01). The Medical Research Council dyspnea scale assessment revealed a significant (P < 0.001) decrease postoperatively. Segmental resection with primary anastomosis is an effective method and can be used as the first option in selected cases of advanced stenosis.

European Archives of Oto-Rhino-Laryngology, 2010

Tympanosclerosis is a sequel of chronic otitis media characterized by the deposition of calcareou... more Tympanosclerosis is a sequel of chronic otitis media characterized by the deposition of calcareous plaques following hyaline degeneration in the fibrous layer of the tympanic membrane and inside middle ear mucosa. It usually results from prior middle ear infections. In this study, results of treatment and clinical findings of the patients with tympanosclerosis are presented. Our objective is to determine the changes in middle ear caused by tympanosclerosis and intervene in the more problematic zone and find out the more useful treatment protocol for patients. Preoperative features, middle ear findings detected during surgery and postoperative hearing levels of the patients who were operated in our clinic between January 1996 and June 2006 due to tympanosclerosis were evaluated. Surgical treatment was performed on a total of 37 patients including 25 females and 12 males between ages of 11 and 71. Preoperative tympanic membranes perforations were presented at a rate of 91% and average airway bone gap was 37.8 dB. Bilateral involvement was present in 59%. Conductive-type hearing loss was present at a rate of 81%, whereas mixed-type hearing existed at a rate of 19%. Sclerotic plaques were most commonly localized in the attic with a rate of 72%. Post-op outcome was found to be 27% in the patients with air bone gap between 0-20 dB. The best hearing result belonged to type 1 patients. Cases in which stapes footplate was fixated had the worst result in terms of hearing. Teflon piston was only applied in one patient. Our tympanoplasty success was found to be 67%. The most common treatment method of tympanosclerosis is surgery. Stapedectomy is recommended in surgery instead of mobilization techniques. However, there is often recurrence and there is no curative treatment. Therefore rehabilitation with hearing device can be preferred as an adjunct. In the recent experimental studies, good results with topical or systemic agents have also been promising.

European Archives of Oto-Rhino-Laryngology, 2010

Nasal breathing is completely ceased after total laryngectomy. This results in some structural ch... more Nasal breathing is completely ceased after total laryngectomy. This results in some structural changes in the nasal mucosa, which has been described in numerous studies. This study investigates the changes that appear in the paranasal sinus mucosa. Eight patients who had undergone total laryngectomy at least 1-year ago were enrolled. Under general anesthesia, maxillary sinuses were examined with an endoscope inserted through canine fossa. 1-2 mm mucosal tissues for biopsy were taken from posterior wall of the maxillary sinus. Specimens were evaluated under an electron microscope. Control tissues for biopsy were obtained from two patients who had been operated for other reasons and analyzed under transmission electron microscopy. Results showed that in the control specimens, the epithelial cells appeared normal under transmission electron microscopy. Samples taken from two larygectomees in their first postoperative year were also completely normal. Samples from other larygectomees demonstrated ciliary loss, abundant degenerative vacuoles in ciliated epithelial cells and detachments in the interepithelial junctional complexes. The intracellular respiratory mechanisms such as the mitochondria, golgi complex and endoplasmic reticulum cisternae, and the integrity of the cellular or the nuclear membrane were spared. We conclude that the cessation of nasal breathing resulted in degenerative changes that could be reversible in the transmission electron microscopic examination of maxillary sinus mucosa. These changes emerged after 2 years following total laryngectomy. Nevertheless, these changes did not have any negative influence on the clinical outcome in this group of patients.

European Archives of Oto-Rhino-Laryngology, 2008

If the jugular bulb normally surrounded by a bony layer in jugular fossa is anatomically over the... more If the jugular bulb normally surrounded by a bony layer in jugular fossa is anatomically over the inferior surface of the bony annulus, in the middle ear or over the basal turn of cochlea, it is then named as high jugular bulb (HJB). It may be dehiscent or aberrant. It is reported to occur in 5% of the temporal bone specimens. In accordance with the literature jugular bulb compression, jugular vein ligation and embolization are suggested in such cases. In both of the presented cases, there was bleeding from jugular bulb during surgery and jugular bulb was compressed with bone wax and Surgicel, but sigmoid sinus has been compressed after failure to stop bleeding through jugular bulb compression. Venous MR angiographies showed no Xow in postoperative controls. Although it is very rarely seen clinically, we present two HJB cases and diVerent treatment perspectives accompanied by literature.

Acta Oto-laryngologica, 2013

Vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window tech... more Vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique is an effective and durable procedure for the management of patients with bilateral vocal fold immobility. To review the long-term results of bilateral vocal fold immobility in 26 patients treated with vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique over a 6-year period. This retrospective study examined patients with a minimum follow-up of 1 year. The main outcome measures used were the modified Medical Research Council (MRC) dyspnoea scale and the assessment of voice quality pre- and postoperatively using the Likert method. The mean follow-up period was 23.77 ± 12.01 months. All patients reported marked symptomatic improvement in dyspnoea (p = 0.0001). The voice quality worsened as expected; however, this difference did not reach a significant level (p = 0.642). Transient microaspiration was noted in seven of the patients and resolved in 1 or 2 days. The procedure was performed for the contralateral vocal fold in one case, due to the loss of suture tension. No patient showed aspiration postoperatively or during follow-up. All patients were regularly followed up for the beginning of movement of the lateralized or contralateral vocal folds in our outpatient clinic.

Acta Oto-laryngologica, 2011

All patients treated with this new lateralization technique had a good quality of life and no dys... more All patients treated with this new lateralization technique had a good quality of life and no dyspnea at rest or upon exertion. We believe that this technique is an important addition to the many surgical techniques for the treatment of bilateral vocal cord paralysis (BVCP). Most techniques used in the treatment of BVCP result in a prolapse of the laryngeal soft tissues into the endolarynx owing to Bernoulli's principle. We have developed a new lateralization technique to more effectively prevent this prolapse. The lateralization was initially tested on six cadaver larynges before being performed in five clinical cases with BVCP, who suffered from dyspnea at rest. Average follow-up was 17.6 months. As in type 1 thyroplasty, a rectangular piece of cartilage was excised horizontally from the thyroid lamina and placed on the defect in the vertical plane. Then, the vocal and ventricular folds were lateralized with crossing sutures, particularly in the posterior region. Dyspnea was eliminated postoperatively. All patients were successfully decannulated. Postoperative voice quality was socially acceptable. Airways were improved postoperatively, as evaluated via fiberoptic laryngoscopy and CT. The mean preoperative and postoperative rima openings were 1.3 mm (range 0.5-2.6) and 6.4 mm (range 3.4-8.1), respectively.

Journal of Medical Updates, 2013

Journal of Medical Updates, 2012

Journal of Medical Updates, 2012

Journal of Medical Updates, 2013

Journal of Craniofacial Surgery, 2014

The aim of our study was to determine the effectiveness of intratympanic α-lipoic acid injection ... more The aim of our study was to determine the effectiveness of intratympanic α-lipoic acid injection as an otoprotective agent against cisplatin-induced ototoxicity in guinea pigs. Twenty-four adult male albino guinea pigs with normal hearing were divided into 4 groups. The guinea pigs received intraperitoneal cisplatin in group 1, intraperitoneal cisplatin and intratympanic α-lipoic acid in group 2, intratympanic α-lipoic acid in group 3, as well as intraperitoneal cisplatin and intratympanic saline in group 4. Distortion-product otoacoustic emission measurements were obtained for both ears at the following time points: before administration (baseline recording) and on day 3 (72 h later). In group 1 (cisplatin), significant deterioration was observed at all frequencies on day 3 (P < 0.05). In group 2 (cisplatin + α-lipoic acid), deterioration was observed at all frequencies on day 3; however, this deterioration did not reach a statistical significance (P > 0.05). In group 3 (α-lipoic acid), no significant difference was observed between baseline and day 3 (P > 0.05). In group 4 (cisplatin + saline), deterioration was observed at all frequencies on day 3; however, this deterioration did not reach a statistical significance (P > 0.05). Cisplatin-induced hearing loss in the guinea pigs may be limited to some extent by the concomitant use of α-lipoic acid. Dose-dependent changes in the possible effects of α-lipoic acid need further investigation. Future morphologic studies may contribute to expose clearly the protective effect of α-lipoic acid.

Journal of Craniofacial Surgery, 2014

To present the results of the traumatic intratemporal facial nerve injury that have undergone fac... more To present the results of the traumatic intratemporal facial nerve injury that have undergone facial nerve decompression by using middle cranial fossa (MCF) approach. A retrospective study Tertiary referral center In this study, 13 patients who developed facial paralysis due to temporal bone trauma and undergone decompression by using MCF approach in Department of Otorhinolaryngology of İzmir Katip Celebi University Research and Training Hospital between January 1993 and December 2012 were presented retrospectively. Patients were assessed in terms of side, etiology, fracture type, House-Brackmann (HB) grade, electroneuronography (ENOG), electromyography (EMG), hearing loss, operation time, and the region of the injury. The fracture was at the right side in 7 (53.8%) and at the left side in 6 patients (46.1%). The type of temporal bone fracture was longitudinal in 6 (46.1%), transverse in 2 (15.3%), and mixed in 5 patients (38.4%). Total axonal degeneration in EMG and ENOG were seen in all patients, who were HB grade 6 at preoperative assessment. Mean operation time was 30 days. The lesion in all patients was at the region of geniculate ganglion. There was conductive hearing loss in 7 patients (53.8%), sensorineural in 4 (30.7%), and mixed in 1 patient (7.6%); hearing was normal in 1 patient (7.6%). Seven patients (53.8%) improved to HB grade 2. In the light of the information obtained from HRCT, ENOG, and EMG, we believe that better results can be achieved with facial nerve decompression that is performed before 1 month, and geniculate ganglion region may be better controlled by MCF approach.

International Journal of Pediatric Otorhinolaryngology, 2012

To evaluate the effectiveness of micronized flavonoid fraction in preventing cisplatin ototoxicit... more To evaluate the effectiveness of micronized flavonoid fraction in preventing cisplatin ototoxicity in a guinea pig model. This study was conducted on 23 guinea pigs in the Animal Laboratory of Izmir Atatürk Training and Research Hospital. Animals were divided into three groups: Group 1 consisted of eight animals receiving cisplatin only; Group 2 contained eight animals receiving cisplatin+micronized flavonoid fraction; and Group 3 contained seven animals that received micronized flavonoid fraction only. Their cochlear reserve was evaluated by measuring the distortion product otoacoustic emission on days 0 and 7. In Groups 1 and 2, the intragroup signal-noise ratios were statistically different at all frequencies tested (based on negative ranks, p<0.05). In Group 3, the intragroup signal-noise ratios did not differ significantly at the frequencies tested (p>0.05). Comparison of the three groups showed statistically significant differences among the groups (p<0.05). The post hoc Bonferroni correction showed statistically significant differences among all three groups (p<0.016). The median signal-noise ratio of the three groups tended to increase (z-value was positive for all the frequencies tested; p<0.01). Micronized flavonoid fraction (Daflon) is effective against cisplatin-induced ototoxicity in guinea pigs.

International Journal of Pediatric Otorhinolaryngology, 2014

The aim of this study is to compare the effects of the absorbable gelatin sponge (AGS), microporo... more The aim of this study is to compare the effects of the absorbable gelatin sponge (AGS), microporous polysaccharide hemospheres (MPH), and Ankaferd on wound healing after middle ear trauma and to evaluate their ototoxicity in an experimental guinea pig model. Middle ear mucosal trauma was created in 21 healthy adult guinea pigs. MPH, Ankaferd, and AGS were applied into the right tympanic bulla of the guinea pigs (7 ears for each treatment modality). The left ears of the seven animals were used as the sham group. At the fourth postoperative week (28-30 days), the guinea pigs were decapitated. Apoptosis was investigated, and the expression of Bcl-xl, Apaf, p53, cytochrome 3, and caspase 3 were evaluated. The Ankaferd and AGS groups demonstrated significantly lower epithelial thickness, inflammation, and capillary dilatation than did the control group (p<0.001, <0.001, /0.001, <0.001/, 0.005, and 0.005, respectively). A statistically significant decrease in Bcl-xl staining was observed in the middle ears of animals treated with MPH (p=0.003). There was significantly higher caspase 3 expression in the Ankaferd and AGS groups than in the control group (p<0.001 and p=0.002, respectively). Light microscopy indicates that Ankaferd and AGS create less inflammation and increased caspase expression, which seems to induce inflammatory cell apoptosis. Ankaferd seems to be a promising hemostatic agent in otology.

International Journal of Pediatric Otorhinolaryngology, 2013

Most microorganisms that cause infection in the external auditory canal and tympanum reproduce re... more Most microorganisms that cause infection in the external auditory canal and tympanum reproduce readily in an alkaline environment. Thus, pH-decreasing components, such as ototopical agents, acetic acid, or boric acid, are preferred [1]. Ear drops are used in the treatment of otitis externa and infection of the middle ear in the presence of tympanic membrane perforation. The ototoxic properties and therapeutic effects of ototopical agents commonly preferred for the treatment of chronic suppurative otitis media (CSOM) and external otitis have become a significant topic of research today. The toxicity revealed in the inner ear structures can be related to the cochlea, the vestibule, or both of these systems. Ototoxicity is defined here as a loss of more than 15 dB in two or more frequencies, or a loss of more than 20 dB in one or more frequency [2]. Studies have demonstrated the positive effects of aluminum acetate-usually at 13%-dissolved in water named as Burow's solution, administered because of its acidic and antiseptic characteristics over a wide confidence interval [3]. Boric acid solutions are also especially effective in the treatment of CSOM and external otitis due to their acidifying characteristics. Ö ztü rkcan et al. evaluated hearing after the administration of 4% boric alcohol solution prepared with 70% alcohol and 4% eau boric solution prepared with distilled water in guinea pigs with perforated tympanic membranes, and established that hearing loss was significant in the group that was administered the alcohol solution [4]. In this study, we investigated whether the ototoxic effects of 4% boric alcohol solutions prepared with various degrees of alcohol differed.

International Journal of Pediatric Otorhinolaryngology Extra, 2013

Otolaryngology -- Head and Neck Surgery, 2012

Objective To describe 2 subapproaches of the middle fossa approach: the transillumination method ... more Objective To describe 2 subapproaches of the middle fossa approach: the transillumination method and transection of lines using the foramen spinosum, greater superficial petrosal nerve, and trigeminal impression to locate the malleus head for safe identification and decompression of the geniculate ganglion and facial nerve. Study Design Cadaver study. Setting A tertiary university hospital anatomy laboratory. Subjects and Methods The present study was conducted using 7 formalin-fixed cadaver heads (14 sides). A 0° endoscope was introduced into the external ear canal toward the posterosuperior quadrant of the tympanic membrane, after which transillumination was used to locate the malleus head. The brightest point indicated the convergence of the greater superficial petrosal nerve and a line drawn along the superior semicircular canal. An additional line was drawn parallel to the petrous ridge from the foramen spinosum and along the pathway of the greater superficial petrosal nerve. A...

Otolaryngology -- Head and Neck Surgery, 2012

Head and neck squamous cell carcinomas readily metastasize to adjacent cervical lymph nodes. This... more Head and neck squamous cell carcinomas readily metastasize to adjacent cervical lymph nodes. This is seen frequently in laryngeal squamous cell carcinoma (LSCC), and neck dissection may be performed in addition to excision of the primary lesion. The aim of this study was to define the frequency of level IIb metastasis to the lymph nodes in patients who underwent selective neck dissection because of LSCC. Cross-sectional study with planned data collection in a tertiary referral hospital. Eighty-one patients diagnosed with LSCC were accepted into the study. One hundred forty-eight neck dissection specimens were examined histopathologically, and those with level IIb metastasis were identified. The frequency of level IIb metastasis was evaluated in accordance with the primary tumor site, clinical N stage, central tumor presence, and T stage. Forty-seven of 81 patients were clinically N-, and 34 patients were clinically N+. Level IIb metastasis was seen in 5 (6%) of 81 patients, representing 5 of 148 neck dissection specimens. Two of these 5 patients were clinically N+ (6%), and 3 were clinically N- (6%). The relationship between level IIb metastasis and clinical N stage was not statistically significant (P ≥ .05). Likewise, no statistically significant relationships between the other parameters and level IIb involvement were found. Level IIb nodal involvement is very rare in LSCC. Therefore, the area can generally be preserved in elective neck dissection to lessen morbidity and, specifically, to avoid damaging the function of the spinal accessory nerve.

Otolaryngology - Head and Neck Surgery, 2007

This study evaluates the vocal cord and arytenoid mobility in relation to the tumoral involvement... more This study evaluates the vocal cord and arytenoid mobility in relation to the tumoral involvement of the cricoarytenoid joint (CAJ), thyroarytenoid (TA) muscle, and posterior cricoarytenoid (PCA) muscle in whole-organ sections of total laryngectomy specimens. The study was prospectively carried out between 1998 and 2003 and involved 133 primary squamous cell carcinoma cases of larynx or pyriform sinus that were treated with total laryngectomy. Preoperative mobility of vocal cords and arytenoids were evaluated separately and correlated with histopathologic findings. In cases with fixed vocal cord CAJ, TA muscle, and PCA muscle were involved in 42.4%, 72.9%, and 27.1% of the cases, respectively, while in cases with fixed arytenoid these structures were affected in 40%, 66.3%, and 25.3% of the cases. Weight effect seemed to play a role in 60% and 50% of the cases of supraglottic and pyriform sinus carcinoma, respectively. Careful evaluation of the mobility of the cord arytenoid unit separately helps the surgeon to better understand the patterns of tumoral extension guiding for the appropriate surgery which should be undertaken.

Journal of Craniofacial Surgery, 2013

This study evaluated the outcome in adult patients with laryngotracheal stenosis (LTS) and assess... more This study evaluated the outcome in adult patients with laryngotracheal stenosis (LTS) and assessed the effect of procedures on their quality-of-life scores. The study included 15 adult patients with LTS (11 males [73.3%], 4 females [26.7%]; mean age, 32 years [range, 10-52 years]) treated at the Department of Otolaryngology Head and Surgery Clinic, İzmir Atatürk Research Hospital, Turkey, from 1997 to 2008. Success of the surgery is evaluated by decanullation rate, Short form-36 (SF-36), and the Medical Research Council dyspnea scale. The etiology of the LTS was intubation related in 14 cases (93.3%) and idiopathic in 1 case. According to the Myers-Cotton classification, 2 (13%), 8 (54%), and 5 (33%) patients were at stages 2 to 4, respectively. Fourteen patients had a mean follow-up of 57 months (range, 24-256 months). The stenotic segment involved 1 to 3 cm (mean, 1.7 cm) of trachea, and 2 to 5 tracheal rings (mean, 3.1) were resected. Postoperative decannulation was achieved in 13 patients (86.6%). In the short form-36 questionnaire, all of the parameters except for "role-emotional" were found to be significant (P < 0.01). The Medical Research Council dyspnea scale assessment revealed a significant (P < 0.001) decrease postoperatively. Segmental resection with primary anastomosis is an effective method and can be used as the first option in selected cases of advanced stenosis.

European Archives of Oto-Rhino-Laryngology, 2010

Tympanosclerosis is a sequel of chronic otitis media characterized by the deposition of calcareou... more Tympanosclerosis is a sequel of chronic otitis media characterized by the deposition of calcareous plaques following hyaline degeneration in the fibrous layer of the tympanic membrane and inside middle ear mucosa. It usually results from prior middle ear infections. In this study, results of treatment and clinical findings of the patients with tympanosclerosis are presented. Our objective is to determine the changes in middle ear caused by tympanosclerosis and intervene in the more problematic zone and find out the more useful treatment protocol for patients. Preoperative features, middle ear findings detected during surgery and postoperative hearing levels of the patients who were operated in our clinic between January 1996 and June 2006 due to tympanosclerosis were evaluated. Surgical treatment was performed on a total of 37 patients including 25 females and 12 males between ages of 11 and 71. Preoperative tympanic membranes perforations were presented at a rate of 91% and average airway bone gap was 37.8 dB. Bilateral involvement was present in 59%. Conductive-type hearing loss was present at a rate of 81%, whereas mixed-type hearing existed at a rate of 19%. Sclerotic plaques were most commonly localized in the attic with a rate of 72%. Post-op outcome was found to be 27% in the patients with air bone gap between 0-20 dB. The best hearing result belonged to type 1 patients. Cases in which stapes footplate was fixated had the worst result in terms of hearing. Teflon piston was only applied in one patient. Our tympanoplasty success was found to be 67%. The most common treatment method of tympanosclerosis is surgery. Stapedectomy is recommended in surgery instead of mobilization techniques. However, there is often recurrence and there is no curative treatment. Therefore rehabilitation with hearing device can be preferred as an adjunct. In the recent experimental studies, good results with topical or systemic agents have also been promising.

European Archives of Oto-Rhino-Laryngology, 2010

Nasal breathing is completely ceased after total laryngectomy. This results in some structural ch... more Nasal breathing is completely ceased after total laryngectomy. This results in some structural changes in the nasal mucosa, which has been described in numerous studies. This study investigates the changes that appear in the paranasal sinus mucosa. Eight patients who had undergone total laryngectomy at least 1-year ago were enrolled. Under general anesthesia, maxillary sinuses were examined with an endoscope inserted through canine fossa. 1-2 mm mucosal tissues for biopsy were taken from posterior wall of the maxillary sinus. Specimens were evaluated under an electron microscope. Control tissues for biopsy were obtained from two patients who had been operated for other reasons and analyzed under transmission electron microscopy. Results showed that in the control specimens, the epithelial cells appeared normal under transmission electron microscopy. Samples taken from two larygectomees in their first postoperative year were also completely normal. Samples from other larygectomees demonstrated ciliary loss, abundant degenerative vacuoles in ciliated epithelial cells and detachments in the interepithelial junctional complexes. The intracellular respiratory mechanisms such as the mitochondria, golgi complex and endoplasmic reticulum cisternae, and the integrity of the cellular or the nuclear membrane were spared. We conclude that the cessation of nasal breathing resulted in degenerative changes that could be reversible in the transmission electron microscopic examination of maxillary sinus mucosa. These changes emerged after 2 years following total laryngectomy. Nevertheless, these changes did not have any negative influence on the clinical outcome in this group of patients.

European Archives of Oto-Rhino-Laryngology, 2008

If the jugular bulb normally surrounded by a bony layer in jugular fossa is anatomically over the... more If the jugular bulb normally surrounded by a bony layer in jugular fossa is anatomically over the inferior surface of the bony annulus, in the middle ear or over the basal turn of cochlea, it is then named as high jugular bulb (HJB). It may be dehiscent or aberrant. It is reported to occur in 5% of the temporal bone specimens. In accordance with the literature jugular bulb compression, jugular vein ligation and embolization are suggested in such cases. In both of the presented cases, there was bleeding from jugular bulb during surgery and jugular bulb was compressed with bone wax and Surgicel, but sigmoid sinus has been compressed after failure to stop bleeding through jugular bulb compression. Venous MR angiographies showed no Xow in postoperative controls. Although it is very rarely seen clinically, we present two HJB cases and diVerent treatment perspectives accompanied by literature.

Acta Oto-laryngologica, 2013

Vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window tech... more Vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique is an effective and durable procedure for the management of patients with bilateral vocal fold immobility. To review the long-term results of bilateral vocal fold immobility in 26 patients treated with vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique over a 6-year period. This retrospective study examined patients with a minimum follow-up of 1 year. The main outcome measures used were the modified Medical Research Council (MRC) dyspnoea scale and the assessment of voice quality pre- and postoperatively using the Likert method. The mean follow-up period was 23.77 ± 12.01 months. All patients reported marked symptomatic improvement in dyspnoea (p = 0.0001). The voice quality worsened as expected; however, this difference did not reach a significant level (p = 0.642). Transient microaspiration was noted in seven of the patients and resolved in 1 or 2 days. The procedure was performed for the contralateral vocal fold in one case, due to the loss of suture tension. No patient showed aspiration postoperatively or during follow-up. All patients were regularly followed up for the beginning of movement of the lateralized or contralateral vocal folds in our outpatient clinic.

Acta Oto-laryngologica, 2011

All patients treated with this new lateralization technique had a good quality of life and no dys... more All patients treated with this new lateralization technique had a good quality of life and no dyspnea at rest or upon exertion. We believe that this technique is an important addition to the many surgical techniques for the treatment of bilateral vocal cord paralysis (BVCP). Most techniques used in the treatment of BVCP result in a prolapse of the laryngeal soft tissues into the endolarynx owing to Bernoulli's principle. We have developed a new lateralization technique to more effectively prevent this prolapse. The lateralization was initially tested on six cadaver larynges before being performed in five clinical cases with BVCP, who suffered from dyspnea at rest. Average follow-up was 17.6 months. As in type 1 thyroplasty, a rectangular piece of cartilage was excised horizontally from the thyroid lamina and placed on the defect in the vertical plane. Then, the vocal and ventricular folds were lateralized with crossing sutures, particularly in the posterior region. Dyspnea was eliminated postoperatively. All patients were successfully decannulated. Postoperative voice quality was socially acceptable. Airways were improved postoperatively, as evaluated via fiberoptic laryngoscopy and CT. The mean preoperative and postoperative rima openings were 1.3 mm (range 0.5-2.6) and 6.4 mm (range 3.4-8.1), respectively.