Volkan Sünter - Academia.edu (original) (raw)

Papers by Volkan Sünter

European Archives of Oto-Rhino-Laryngology, 2018

Purpose To evaluate the course of lower cranial nerves (CNs) within the neck in relation to surro... more Purpose To evaluate the course of lower cranial nerves (CNs) within the neck in relation to surrounding structures and anatomic landmarks via a cadaveric dissection study. Methods A total of 70 neck dissections (31 bilateral, 8 unilateral) were performed on 39 adult fresh cadavers [mean (SD) age: 38.5 (11.2) years, 29 male, 10 female] to identify the course of lower CNs [spinal accessory nerve (SAN), vagus nerve and hypoglossal nerve] within the neck in relation to surrounding structures [internal jugular vein (IJV), common carotid artery (CCA)] and distance to anatomical landmarks (cricoid cartilage, hyoid bone, digastric muscle). Results SAN travelled most commonly anterior to IJV (51.4%) at the level of jugular foramen, while travelling lateral to IJV at the post belly of digastric (55.7%) and inferior to digastric muscle (90%) in most neck dissections. Vagus nerve travelled lateral to CCA in majority (94.3%) of dissections, while medial (2.9%), posterolateral (1.4%) and posterior (1.4%) positions were also noted. Average distance of hypoglossal nerve was 27.7 (9.7) mm to carotid bifurcation, 9.3 (3.9) mm to hyoid bone, and 54.7 (18.0) mm to the inferior border of cricoid cartilage. Conclusion In conclusion, our findings indicate that anatomic variations are not rare in the course of lower CNs within the neck in relation to adjacent structures, and awareness of these variations together with knowledge of distance to certain anatomic landmarks may help the surgeon to identify lower CNs during neck surgery and prevent potential nerve injuries.

Praxis of Otorhinolaryngology, 2020

Bu çalışmada İstanbul'da yaşayan hastalarda idiyopatik ani sensörinöral işitme kaybının (İASNİK) ... more Bu çalışmada İstanbul'da yaşayan hastalarda idiyopatik ani sensörinöral işitme kaybının (İASNİK) etiyolojisinde meteorolojik koşulların rolü araştırıldı. Hastalar ve Yöntemler: Çalışmada 1 Ocak 2008 ve 31 Mayıs 2015 tarihleri arasında İASNİK tanısı ile başvuran 670 hastanın (379 erkek, 291 kadın; ort. yaş 45.3±15.6 yıl; dağılım, 10-98 yıl) kayıtları retrospektif olarak incelendi. Karşılaştırmada kullanılan hava parametreleri ortalama günlük sıcaklık (°C), ortalama nem (%), ortalama rüzgar hızı (metre/ saniye) ve ortalama atmosfer basıncı (hektopaskal) idi. Bulgular: İdiyopatik ani sensörinöral işitme kaybı en sık Mart, Nisan, Mayıs ve Haziran aylarında görüldü. Ortalama atmosferik basınçlar İASNİK ile ilişkili (pozitif) günlerde İASNİK ile ilişkili olmayan (negatif) günlere göre istatistiksel olarak daha düşüktü (p=0.005). Nem pozitif günlerde anlamlı derecede daha yüksekti (p=0.002). Ortalama sıcaklık pozitif günlerde negatif günlere göre anlamlı derecede daha yüksekti (p<0.001). Sonuç: İdiyopatik ani sensörinöral işitme kaybı ilkbaharda daha sık görülür. Düşük atmosfer basıncı, yüksek sıcaklık ve yüksek nem İASNİK ile ilişkilidir. Anahtar sözcükler: Etiyoloji, idiyopatik ani sensörinöral işitme kaybı, meteorolojik koşul, hava. ABSTR ACT Objectives: This study aims to investigate the role of meteorological conditions in the etiology of idiopathic sudden sensorineural hearing loss (ISSHL) in patients living in Istanbul.

Molecular Imaging and Radionuclide Therapy, Jun 1, 2022

Objectives: The important roles of integrins in tumor invasion, migration and proliferation are w... more Objectives: The important roles of integrins in tumor invasion, migration and proliferation are well known. In this study, we investigated the presence of integrin α3 and β1 receptors in tumor tissue, metastatic lymph node (LN) and normal thyroid tissue of patients diagnosed with thyroid cancer (TCa) and showed the prognostic and diagnostic value of these molecules as well as peptide-receptor. Methods: Sixty-one patients with TCa were included in this study. The presence of integrin α3 and β1 expression was investigated by immunohistochemical methods from tumor tissue after total thyroidectomy. TNM system was used in tumor staging. The relationship between prognostic properties such as tumor size, LN metastasis, capsular invasion and the presence of integrin α3 and β1 expression was investigated. Results: Classical type papillary TCa was the most common subtype in our study group with 31.1%. Integrin β1 was expressed in 4.9% (n=3) of normal tissue, 57.4% (n=35) of tumor tissue and 16.4% (n=10) of metastatic LN; integrin α3 was expressed in 50.8% (n=31) of normal tissue, 67.2% (n=41) of tumor tissue and 9.8% (n=6) metastatic LN. Integrin β1 expression was observed 21.3% (n=13), integrin α3 in 14.8% (n=9) and integrin α3 and β1 expression in 36.1% (n=22). Integrin β1 expression increased statistically significantly in the presence of LN metastasis and capsular invasion (p=0.022, 0.014, respectively). Furthermore, the expression of integrin α3 was found to be statistically significant in primary tumors of patients with LN metastasis (p=0.045). Conclusion: Our study showed a significant increase in integrin α3 and β1 expression in LN metastasis or thyroid capsule invasion in tumor. Thus, it appears that the demonstration of the presence of integrin α3 and β1 expression in TCa is not only a prognostic biomarker but also has value as a potential theranostic target with peptide-bound radioactive agents.

Istanbul Medical Journal

The present study detect false-negative cytology performed in our clinic and to investigated poss... more The present study detect false-negative cytology performed in our clinic and to investigated possible reasons for false negativity.

Turkish Archives of Otorhinolaryngology, 2019

Objective: To compare the acoustic parameters and the cost effectiveness achieved after endoscopi... more Objective: To compare the acoustic parameters and the cost effectiveness achieved after endoscopic cordectomy using radiofrequency microdissection electrodes (ECRM) with those of transoral laser cordectomy and radiotherapy. Methods: The study included 81 disease-free patients previously treated for early larynx carcinoma (30 with ECRM, 27 with transoral laser cordectomy, 24 with primary radiotherapy). Post-treatment voice analysis was performed in all patients. Additionally, the cost effectiveness of all treatment procedures was calculated. Results: The GRBAS (G: Grade, R: Roughness, B: Breathiness, A: Asthenia, and S: Strain) scale showed a significant difference between the groups (p<0.001). The mean values for perceptive assessment score in the radiotherapy group were significantly lower than those in the ECRM group (p<0.05). There were no significant differences between the ECRM group and the transoral laser cordectomy group in terms of the perceptive assessment scores (p>0.05 for all). Percent jitter, percent shimmer and fundamental frequency (F0) were significantly different in the radiotherapy group than the ECRM and the transoral laser cordectomy groups (p<0.05). Maximum phonation time (MPT) in the radiotherapy group was significantly longer than the ECRM and transoral laser cordectomy groups (p<0.001). There were no significant differences between the ECRM group and the transoral laser cordectomy group in terms of the MPT (p>0.05). The mean cost of the ECRM technique was statistically lower than the other treatment techniques (p<0.05). Moreover, the length of hospital stay after ECRM was statistically significantly shorter than was after laser cordectomy (p<0.05). Conclusion: Objective and perceptive voice analysis after ECRM showed comparable results with transoral laser cordectomy, but poorer results than radiotherapy. Cost effectiveness of ECRM was found to be better than the other two treatment techniques

European Archives of Oto-Rhino-Laryngology, 2018

Purpose Pediatric population may be more prone to complications in comparison to adults because o... more Purpose Pediatric population may be more prone to complications in comparison to adults because of the variability of developmental changes of paranasal sinuses and skull base. Knowledge of standard columellar distances regarding age in addition to anatomical landmarks is an important guide during functional endoscopic sinus surgery. We aimed to identify standard distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid sinus ostiums and provide an objective reference graph in regard to age in children. Methods Subjects who are older than 1 year and younger than 18 years who had undergone a head-and-neck, maxillofacial or temporal bone region high resolution computed tomography scan during the last 3 years were obtained from radiological database. The distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid sinus ostiums were measured and nasofrontal and nasosphenoid angles were calculated. Results A total number of 119 children (73 boys, 46 girls) were reviewed. The average age was 7.7 ± 5.0 years. All subjects had normal sinonasal anatomy. We found statistically significantly positive correlation between age and all distances (p < 0.001). Although all measured distances of boys were greater than girls, this difference did not reach statistical significance. Additionally, nasosphenoidal angles were significantly obtuse in boys (p < 0.05). Conclusions Our columellar distance graphic can provide further improvement of surgeon confidence while performing endoscopic sinus surgery or skull base surgery.

Journal of Voice, 2017

The study aimed to evaluate the existence of sex hormone receptors in the subunits of vocal fold.... more The study aimed to evaluate the existence of sex hormone receptors in the subunits of vocal fold. Study Design. This is a cadaver study. Methods. The androgen, estrogen, and progesterone receptors were examined in the epithelium (EP), superficial layer of the lamina propria (SLP), vocal ligament (VL), and macula flava (MF) of the vocal folds from 42 human cadavers (21 male, 21 female) by immunohistochemical methods. Their staining ratios were scored and statistically compared. Results. The androgen receptor score was significantly higher for the MF than for the EP and SLP (P < 0.001 and P = 0.001, respectively). The androgen receptor score was significantly higher for the VL than for the EP and SLP (P < 0.001 and P = 0.001, respectively). No significant difference was noted in the androgen receptor scores between the MF and VL and between the EP and SLP. The estrogen receptor score showed no significant difference between the MF and VL, whereas all other areas showed statistically significant differences (P < 0.001). No significant differences were observed between the EP and SLP in terms of progesterone receptor scores, but statistically significant differences were detected among the other areas. Conclusion. Sex hormone receptors exist within several subunits of the vocal fold, mostly in the MF and VLs.

Introduction Otitis media is a chronic inflammation and infection of the middle ear and mastoid c... more Introduction Otitis media is a chronic inflammation and infection of the middle ear and mastoid cavity characterized by hearing loss and ear discharge (1). Type 1 tympanoplasty is tympanic membrane perforation repair, first performed by Berthold (1878) and later popularized by wullstein and Zollner (1950) (2). Many methods and graft materials have been used in tympanic membrane perforation repair until today. The most commonly used graft material is the temporal fascia (3). Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), eosinophil lymphocyte ratio (ELR), basophil lymphocyte ratio (BLR) and lymphocyte monocyte ratio (LMR) are increasingly used in many medical disciplines. In chronic inflammatory pathologies, the number of neutrophils and platelets increases, while the number of lymphocytes decreases (4). The prognostic value of NLR and PLR as indicators of systemic inflammatory response in many types of cancer has found a wide range of research areas (5). On the other hand, it has been suggested

Medeniyet Medical Journal

Objective: Malignant otitis externa (MOE) is a serious disease affecting mainly the elderly diabe... more Objective: Malignant otitis externa (MOE) is a serious disease affecting mainly the elderly diabetic patients that may result in mortality. It was aimed to evaluate the relationship between treatment responses and clinical and radiologic parameters among progress of the disease. Secondary aim was to present our clinical outcomes in the treatment of malignant otitis externa. Method: This study was retrospectively conducted in a single center. Reviewed data included history of complaints, duration of symptoms, addition of hyperbaric oxygen treatment, presence of surgical intervention, pathological findings, culture positivity and microorganism, laboratory findings, scintigraphy, imaging modalities and outcome of disease. Result: A total of 26 cases with malignant external otitis including 17 females (65.4%) and nine males (34.6%) patients were included in our study. Duration of symptoms before the initiation of treatment, and hyperbaric oxygen treatment did not positively influence th...

Turkish Archives of Otorhinolaryngology

Objective To investigate the prevalence of tonsillar human papillomavirus infection in İstanbul, ... more Objective To investigate the prevalence of tonsillar human papillomavirus infection in İstanbul, the most populous city of Turkey. Methods Tonsil specimens were obtained from 206 cadavers aged 18 to 89 years. Tonsillectomy was performed during routine autopsy for each subject in the 24 hours after death. After dissolution, tissues were processed with the polymerase chain reaction (PCR) method to identify HPV DNA. The data obtained from the DNA sequencer were processed in the database of GenBank®. Results One hundred sixty-six (80.6%) male and 40 (19.4%) female cadavers were included in the study. One case demonstrated HPV-16, one had HPV-82, one had HPV-55 and one had HPV-13. All four cases were male. Prevalence of tonsillar HPV was 1.94% and of HPV 16 was 0.48%. Conclusion The prevalence of tonsillar HPV infection was found 1.94% and of HPV 16 0.48% in our study.

Journal of Otology & Rhinology

Ceruminous adenocarcinomas of external auditory canal (EAC) are uncommon malignant tumors. They o... more Ceruminous adenocarcinomas of external auditory canal (EAC) are uncommon malignant tumors. They originate from the apocrin ceruminous glands of EAC. These tumors have varied clinical and histological manifestations. Therefore, controverseries currently exist are regarding their terminology, classification, histopathological features, diagnosis and treatment. Wetli et al categorized these tumors in to the four types according to histological features. These types are ceruminous adenomas, ceruminous adenocarcinomas, adenoid cystic carcinomas and pleomorphic adenomas.

Otolaryngology, 2014

Onodi cells represent a type of posterior ethmoid cells in the sphenoid sinus; here, Pneumatisati... more Onodi cells represent a type of posterior ethmoid cells in the sphenoid sinus; here, Pneumatisation occurs as a result of posterolateral. In the case reported, a 37-year-old Male patient was referred to our clinic with complaints of approximately 4-5 years of Headaches, nasal congestion and snoring. Paranasal sinus computed tomography (CT) scans showed left isodense lesions exhibiting the isolated Onodi cell. Surgery was planned to remove the Onodi cell mucocele using the endoscopic approach. The Lesion had expanded to completely fill the Onodi cell; lesion was totally removed by Aspiration. Fifteen months postoperatively, the patient underwent CT, and Onodi cells with completely normal aeration were observed. Onodi cells, the optic nerve and the internal carotid artery are in close proximity to one another, and therefore the existence Of Onodi cells are important information. Therefore, elucidating the detailed anatomy of the paranasal sinuses and the recognition of variations amongst them will facilitate accurate diagnosis of patients, as well as physicians’ management of complications which may occur.

All Around the Nose, 2019

Various surgical routes are defined to access the paranasal sinuses. Frontal, ethmoid, and maxill... more Various surgical routes are defined to access the paranasal sinuses. Frontal, ethmoid, and maxillary sinus pathologies have been approached externally using trephination, osteoplastic flap, external frontoethmoidectomy, and Caldwell-Luc procedures. These traditional techniques often resulted in undesirable perioperative and postoperative morbidity. In addition these external techniques are insufficient for the pathologies that invade the sphenoid sinus. Over the last 30 years, due to technological advancements the endoscopic surgical approaches to the paranasal sinuses and surrounding structures have gained popularity. These technological advancements are improved telescopes, angled powered instrumentations, and navigation systems. Endoscopic approach with angled telescopes provides a better vision of the relevant surgical anatomy and operation field when compared to external approaches. Besides, even though open techniques are being done less than endoscopic approaches, they still ...

Turkish Archives of Otorhinolaryngology, Oct 1, 2019

Istanbul Medical Journal

Results: Total polyp grade in PNS-CT of UPG was higher than APG (p<0.05). There was no significan... more Results: Total polyp grade in PNS-CT of UPG was higher than APG (p<0.05). There was no significant difference in Plt, Neu %, Lym %, Eos %, ELR of APG, UPG, and CSG (p>0.05). RDW in CSG was lower than APG and UPG (p<0.05), and it showed no significant difference between APG and UPG (p>0.05). Conclusion: Extent of unilateral sinonasal polypoid disease does not affect the severity of systemic inflammation. The effects of antrochoanal polyps on systemic inflammation are similar to the effects of unilateral sinonasal polyps.

European Archives of Oto-Rhino-Laryngology, 2018

Praxis of Otorhinolaryngology, 2020

Molecular Imaging and Radionuclide Therapy, Jun 1, 2022

Istanbul Medical Journal

Turkish Archives of Otorhinolaryngology, 2019

European Archives of Oto-Rhino-Laryngology, 2018

Journal of Voice, 2017

Medeniyet Medical Journal

Turkish Archives of Otorhinolaryngology

Journal of Otology & Rhinology

Otolaryngology, 2014

All Around the Nose, 2019

Turkish Archives of Otorhinolaryngology, Oct 1, 2019

Istanbul Medical Journal