Nuray Bayar Muluk | KIRIKKALE UNIVERSITY-TURKEY (original) (raw)

Papers by Nuray Bayar Muluk

Research paper thumbnail of A new grafting technique for tympanoplasty: tympanoplasty with a boomerang-shaped chondroperichondrial graft (TwBSCPG)

European Archives of Oto-Rhino-Laryngology, 2013

The aim of this study was to introduce a new grafting technique in tympanoplasty that involves us... more The aim of this study was to introduce a new grafting technique in tympanoplasty that involves use of a boomerang-shaped chondroperichondrial graft (BSCPG). The anatomical and functional results were evaluated. A new tympanoplasty with boomerang-shaped chondroperichondrial graft (TwBSCPG) technique was used in 99 chronic otitis media patients with central or marginal perforation of the tympanic membrane and a normal middle ear mucosa. All 99 patients received chondroperichondrial cartilage grafts with a boomerang-shaped cartilage island left at the anterior and inferior parts. Postoperative followups were conducted at months 1, 6, and 12. Preoperative and postoperative audiological examinations were performed and air-bone gaps were calculated according to the pure-tone averages (PTAs) of the patients. In the preoperative period, most (83.8 %) air-bone gaps were C16 dB; after operating using the TwBSCPG technique, the airbone gaps decreased to 0-10 dB in most patients (77.8 %). In the TwBSCPG patients, the mean preoperative air-bone gap was 22.02 ± 6.74 dB SPL. Postoperatively, the mean postoperative air-bone gap was 8.70 ± 5.74 dB SPL. The TwBSCPG technique therefore decreased the postoperative air-bone gap compared to that preoperatively (p = 0.000, z = -8.645). At the 1-month follow-up, there were six graft perforations and one graft retraction. At the 6-month follow-up, there were nine graft perforations and three graft retractions. At 12 months, there were seven graft perforations and four graft retractions. During the first year after the boomerang tympanoplasty surgery, graft lateralization was not detected in any patient. Retractions were grade 1 according to the Sade classification and were localized to the postero-superior quadrant of the tympanic membrane. The TwBSCPG technique has benefits with respect to postoperative anatomical and audiological results. It prevents perforation of the tympanic membrane at the anterior quadrant and avoids graft lateralization due to placement of the graft under the manubrium mallei. Given these benefits, the TwBSCPG technique seems to be a good alternative for grafting in tympanoplasties.

Research paper thumbnail of Is there a relationship between cribriform plate dimensions and septal deviation angle?

European Archives of Oto-Rhino-Laryngology, 2014

The aim of this retrospective study was to investigate the relationship between cribriform plate ... more The aim of this retrospective study was to investigate the relationship between cribriform plate (CP) dimensions and septal deviation degree. Coronal paranasal CT scans of 99 patients were reviewed. We measured depth and width of cribriform plate on both sides and compared with septal deviation side and septal deviation degree. Deviation angles were 6.85 ± 1.47°for right deviations; and 7.11 ± 1.63°for the left deviations. The mean depth of CP was 5.08 ± 1.57 mm at the right side and 5.06 ± 1.59 mm at the left side; and the mean width of CP was found 4.71 ± 1.36 mm at the right side and 4.56 ± 1.51 mm at the left side. When CP dimensions were evaluated according to the septal deviation side, mean width of CP was 4.69 ± 1.36 mm at ipsilateral side (deviated side); and 4.58 ± 1.51 mm at the contralateral side. The mean depth of CP was 4.9 ± 1.56 mm at the ipsilateral side (deviated side); and 5.22 ± 1.58 mm at the contralateral side. The CP depth at the contralateral side was significantly higher than that of the ipsilateral side (deviated side). In right SD, ipsilateral and contralateral CP depth increased. As deviation angle increased, ipsilateral and contralateral CP width, right and left CP width increased. Ipsilateral and contralateral CP width; and additionally ipsilateral and contralateral CP depth increased together. In other words, right and left CP width; and CP depth increased simultaneously. It is well known that the higher incidence of intracranial penetration is on the side where the position of the ethmoid roof (ER) is lower. The presence of septal deviation, the possibility of the deeper CP at the contralateral side should be taken into consideration to avoid iatrogenic injury.

Research paper thumbnail of Effects of intrauterine and extrauterine exposure to GSM-like radiofrequency on distortion product otoacoustic emissions in infant male rabbits

International Journal of Pediatric Otorhinolaryngology, 2009

We investigated the effects of 1,800 MHz GSM-like Radiofrequency (RF) on the cochlear functions o... more We investigated the effects of 1,800 MHz GSM-like Radiofrequency (RF) on the cochlear functions of female infant rabbits by Distortion Product Otoacoustic Emission (DPOAE) recordings upon intrauterine (IU) and/or extrauterine (EU) exposure.

Research paper thumbnail of Effects of GSM-like radiofrequency on distortion product otoacoustic emissions of rabbits: comparison of infants versus adults

International journal of pediatric otorhinolaryngology, 2009

The aim of this study is to investigate the potential hazardous effects of 1800 MHz Global System... more The aim of this study is to investigate the potential hazardous effects of 1800 MHz Global System for Mobile Communications-like (GSM-like) Radiofrequency (RF) exposure on the cochlear functions of female infant and adult rabbits by measuring Distortion Product Otoacoustic Emission (DPOAE) response amplitudes. Eighteen each one-month-old New Zealand White female rabbits and eighteen each 13-month-old adult rabbits were included into the study. They were randomly divided into four groups. Nine infant rabbits (Group 1) were not exposed to 1800 MHz GSM-like RF (Infant Control, C-In). Nine infant rabbits (Group 2) were exposed to 1800 MHz GSM-like RF, 15 min daily for 7 days after they reached one-month of age (Infant RF, RF-In). Nine adult rabbits were not exposed to 1800 MHz GSM-like RF, 15 min daily for 7 (Adult Control, C-Ad). Nine adult rabbits were exposed to 1800 MHz GSM-like RF, 15 min daily for 7 days (Adult RF, RF-Ad). Cochlear functions were assessed by DPOAEs at 1.0-8.0 kHz....

Research paper thumbnail of Association between atopy, mastoid pneumatization and tympanometric findings

European Archives of Oto-Rhino-Laryngology, 2014

abnormal tympanograms was significantly higher in the atopic group than in the control group. Mor... more abnormal tympanograms was significantly higher in the atopic group than in the control group. Moreover, the presence of atopy was found to be associated with an almost 4.5-fold increased risk of having an abnormal tympanogram. Individuals with abnormal tympanograms (type BB or CC) demonstrated significantly lower right and left mastoid volumes than did individuals with normal type A tympanograms. Atopic individuals demonstrated significantly lower right and left mastoid volumes than did subjects in the control group. This study suggests a direct association between atopy and mastoid cell volumes. It was found that the mastoid cell systems of atopic individuals are less pneumatized, and tympanometric measurements are worse in atopic subjects. Therefore, the authors suggest that when a medical or surgical treatment is planned for ear disease in atopic individuals, atopy is an important factor that should be taken into consideration.

Research paper thumbnail of Abilities of Pragmatic Language Usage of the Children with Language Delay After the Completion of Normal Language Development Training

Objectives: A child may pronounce words clearly, have a large vocabulary, use long, complex sente... more Objectives: A child may pronounce words clearly, have a large vocabulary, use long, complex sentences and correct grammar,
and still have a communication problem if he or she has not mastered the rules for appropriate social language. It is known that
functional or pragmatic language usage is not problematic for children who have completed normal language development
process. We investigated whether children who have previously had receptive, expressive, or mixed language development
delays will likely have problems in the use of pragmatic language after formal training.
Materials and Methods: Two different subject groups composed of 67 children between the ages of 3-6 and classified as the
ones with and without language delay. Children with language delay received educational treatment, auditory processing and
speech and language training. Training was consisted of acoustic signal perception, auditory discrimination, auditory comprehension,
conception training, phonological processing training, speech sound processing; and speech and language education. The
average of training period was between 1 to 2 years. Their receptive and expressive language was tested at 6 month-interval. In
children whose language development was compatible with chronological age, pragmatic language performance was evaluated.
Children’s pragmatic language usage skills were evaluated in both groups with Descriptive Pragmatics Profile (DPP) by using the
rating technique (never, sometimes, often, always), in terms of the abilities “Conversational Routines and Skills” (CRS); Asking
for, Giving and Responding to Information”(AGRI). The Chi Square Test was used for statistical analysis.
Results: Only four of nineteen items were similar (1. Waves or says hello/goodbye (in CRS part), 2. Demonstrates turn-taking
rules during play and/or in classroom (in CRS part), 3. Gives and accepts hugs (in AGRI part) and 4. Asks for help from others (in
AGRI part) (p>0.05), whereas the fifteen items were significantly different between groups (p<0.05).
Conclusion: In our study, it was concluded that in DPP items which were not required the use of language (waves, demonstrates
turn-taking rules during play, gives and accepts hugs, asks for help from others), there was no delay. We suggest that during the
critical early language development period, children who have receptive and expressive language delays will also demonstrate
delay in pragmatic language usage.

Research paper thumbnail of The Potential Protective Effects of 2-aminoethyl Diphenylborinate against Inner Ear Acoustic Trauma: Experimental Study Using Transmission and Scanning Electron Microscopy

The Journal of International Advanced Otology, 2015

In this prospective experimental study, we investigated the preventive effects of 2-aminoethyl di... more In this prospective experimental study, we investigated the preventive effects of 2-aminoethyl diphenylborinate (2-APB) in rats exposed to acoustic trauma (AT). Light microscopic, transmission electron microscopic (TEM), and scanning electron microscopic (SEM) examinations were performed.

Research paper thumbnail of The effects of septoplasty on disease-specific and general quality of life: A retrospective longitudinal trial

Praxis of Otorhinolaryngology, 2014

Research paper thumbnail of Total removal of an unruptured orbital hydatid cyst

Canadian Journal of Ophthalmology / Journal Canadien d'Ophtalmologie, 2001

Research paper thumbnail of A survey on chronic rhinosinusitis: opinions from experts of 50 countries

European Archives of Oto-Rhino-Laryngology, 2016

Chronic rhinosinusitis (CRS) is a very prevalent inflammatory disease. Treatments vary in differe... more Chronic rhinosinusitis (CRS) is a very prevalent inflammatory disease. Treatments vary in different countries. In the present study, we explored the approaches of physicians in 50 countries. In this cross-sectional study, a rhinosinusitis survey (RSS) was completed by Honorary and Corresponding Members (otorhinolaryngologists) of the Italian Society of Rhinology. In 79.1 % of the 50 countries, the proportion of patients suffering from CRS was 15 %. Nasal symptoms were more intense in winter (46 % of countries), and spring and autumn (22 %). The most common symptoms were nasal obstruction (86 %), postnasal drip (82 %) and headache (52 %). The most common investigative modalities in the assessment of CRS are paranasal sinus CT, fiberoptic endoscopy, and anterior rhinoscopy. CRS patients were principally treated by otorhinolaryngologists (70 %). Medical treatments included nasal corticosteroids (90 %), nasal washes (68 %), and nasal decongestants (32 %). In 88 % of countries, more than 50 %, or &amp;amp;quot;about 50 %&amp;amp;quot;, of all patients reported subjective symptom improvement after treatment. In most of the countries, surgery was required by 20-35 % of all CRS patients. During post-surgery follow-up, nasal washes (90 %), nasal corticosteroids (76 %), and systemic antibiotics (32 %) were prescribed. In 20-40 % of all patients, CRS was associated with nasal polyps. In such patients, the medical treatment options were nasal corticosteroids (90 %), systemic corticosteroids (50 %), nasal washes (46 %), and systemic antibiotics (34 %). Treatment of CRS patients varies in different countries. Paranasal sinus CT is the most common investigative modality in the assessment of CRS, and nasal corticosteroids are the first-line treatment, in the absence or presence of nasal polyps.

Research paper thumbnail of Otolaryngological findings in mucopolysaccharidosis

Journal of Medical Updates, 2014

Research paper thumbnail of Epidemia of Tularemia in Central Anatolia

J Anim Vet Adv, 2010

Abstract: Tularemia is a zoonotic disease caused by Francisella tularensis which can be transmitt... more Abstract: Tularemia is a zoonotic disease caused by Francisella tularensis which can be transmitted to humans by tick bites contaminated water handling infected materials and inhalation. The different clinical types are ulceroglandular, glandular, oropharyngeal, oculoglandular, typhoidal ...

Research paper thumbnail of Mukopolisakkaridoz hastalarındaki otolarengolojik bulgular

Journal of Medical Updates, 2014

Research paper thumbnail of Are serum levels of trace elements in children with auditory neuropathy within normal limits? – A pilot study

Clinical Investigative Medicine, Jun 1, 2010

To determine whether trace elements that are essential for neural function play a role in the pat... more To determine whether trace elements that are essential for neural function play a role in the pathophsiology and etiology of auditory neuropathy (AN).. Materials and methods: Patients diagnosed with auditory neuropathy consisted of eight children (two male, six female). The blood tests including the measurement of sodium, potassium, chloride, calcium, phosphorus, iron, copper and magnesium were done in children with AN during their routine care. Results: Of the eight children with AN, many had serum levels outside the normal range: one had low sodium, two had low potassium, one had low chloride, two had high zinc and three had low zinc, two had low calcium and two had higher than normal phosphorus. Conclusion: Although some serum trace element levels in our patients were higher or lower than normal values, the mean values were within normal limits. Thus, we were unable to detect a relationship between serum trace element levels and AN-. In the future, larger studies should be conducted to confirm these findings.

Research paper thumbnail of The role of MMP-2, MMP-9, and TIMP-1 in the pathogenesis of nasal polyps: Immunohistochemical assessment at eight different levels in the epithelial, subepithelial, and deep layers of the mucosa

Ear, nose, & throat journal

We conducted a prospective study to investigate the role of matrix metalloproteinase-2 (MMP-2), m... more We conducted a prospective study to investigate the role of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the pathogenesis of nasal polyps. Our study group consisted of 24 patients-21 men and 3 women, aged 23 to 70 years (mean: 45.97 ± 11.60)-with nasal polyposis who underwent functional endoscopic sinus surgery. For comparison purposes, we assembled a control group of 11 patients-6 men and 5 women, aged 18 to 56 years (mean: 29.90 ± 14.22)-without nasal polyps who underwent septoplasty and/or rhinoplasty. We analyzed 36 polyp specimens obtained from the study group (10 from the nasal cavity, 10 from the maxillary sinus, and 16 from the ethmoid sinus) and 11 tissue specimens from the control group (each control provided 1 specimen from the inferior turbinate). We then calculated the mean number of these cells in the epithelium, subepithelial layer of the lamina propria, and the deep paraglandular layer...

Research paper thumbnail of Different anesthetic agents-soaked sinus packings on pain management after functional endoscopic sinus surgery: which is the most effective?

European Archives of Oto-Rhino-Laryngology, 2015

In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sin... more In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sinus packs on pain management after functional endoscopic surgery (FESS). One hundred and fifty patients with the diagnosis of bilateral chronic sinusitis with or without nasal polyps who underwent FESS were included into the study. Their pre-operative Lund-Mackay computerized tomography (CT) Scores were similar. We applied anesthetic agents of 2 % lidocaine HCl, 0.25 % Bupivacaine HCl, 0.2 % Ropivacaine, 2 % Prilocaine and 0.9 % NaCl (Saline) in groups 1-5 onto the sinus packs after FESS. At postoperative period, acetaminophen (250 mg/5 ml) was used in 10-15 mg/kg per dose (4 times a day). Bleeding grade, operation duration, postoperative number of gauze/24 h, additional painkiller need, pain values at 1, 2, 4, 8, 12 and 24 h were noted. Lund-Kennedy endoscopic scores were also evaluated at 1st, 2nd and 4th weeks postoperatively. In saline group, 93.3 % of the patients needed additional painkiller. Whereas, in Bupivacaine group, additional painkiller use (20.0 %) is less than the other groups. In Bupivacaine group, number of gauze/24 h use was lower than lidocaine, ropivacaine and prilocaine groups. In our study, except 1st and 24th hours, pain values of groups can be written in ascending order (from less to higher) as Bupivacaine, Lidocaine, Prilocaine, Ropivacaine and Saline. In the first hour, pain values of groups can be written in ascending order (from less to higher) as Lidocaine, Prilocaine, Bupivacaine, Ropivacaine and Saline. In the 2nd week, in the Bupivacaine and Lidocaine Groups separately, postoperative Lund-Kennedy scores were lower than the Prilocaine and Saline Groups. In the 1st month, Lidocaine Group&#39;s Lund-Kennedy scores were significantly lower than the Saline Group. Synechia values were not different between groups. Bupivacaine help the lower pain values and less additional painkiller need after FESS. Therefore, we recommend to use Bupivacaine soaked sinus packs after FESS for achieve less pain values and to improve patient satisfaction.

Research paper thumbnail of The Presence of Clival Foramen Through Multidetector Computed Tomography of the Skull Base

The Journal of craniofacial surgery, 2015

Technological advancements in the diagnostic radiology recently permitted reviewing the normal an... more Technological advancements in the diagnostic radiology recently permitted reviewing the normal anatomy through multidetector computed tomography (MDCT) imagination. The aim of this paper is retrospectively investigation of the clival foramen and canal through MDCT. One hundred eighty-six MDCT scans were reviewed. First, images were taken at axial plane, and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these three-dimensional images (3-D imaging). The images were evaluated as clival foramen "present" or "absent." In our 186 patients, evaluation of MDCT showed that clival foramen was absent in 66.7% (n = 124) of patients. Only 33.3% (n = 62) of patients had a clival foramen. In 3-D images, clival canal and clival foramen were shown more clearly compared with the MDCT. Knowledge of the clival canal might be useful in patients of questionable clival fracture or during neurosurgical operations in this r...

Research paper thumbnail of The role of platelet-derived growth factor in the pathogenesis of sinonasal polyps: immunohistochemical assessment in epithelial, subepithelial and deep layers of the mucosa. Bayar Muluk N, Arıkan OK, Atasoy P, Kılıç R, Tuna Yalçinozan E. Clin Exp Otorhinolaryngol. 2013 Sep;6(3):152-60. doi: 10.3...

Research paper thumbnail of Inducible nitric oxide synthase (iNOS) in sinonasal polyp pathogenesis

B-ENT

We investigated the role of inducible nitric oxide synthase (iNOS) in the pathogenesis of sinonas... more We investigated the role of inducible nitric oxide synthase (iNOS) in the pathogenesis of sinonasal polyps. Adult patients (21 men, 3 women) with nasal polyposis underwent functional endoscopic sinus surgery. Nine adults without polyps (6 men) who underwent septoplasty and/or rhinoplasty served as controls. Polyp specimens came from three regions: the maxillary sinus (10), ethmoid sinus (14), and nasal cavity (10). Control group samples (9) came from the inferior turbinate. Specimens were evaluated in eight mucosal layers for count and distribution of inflammatory cells and iNOS expression. An iNOS positivity index (PI) was determined for the epithelium (E), subepithelial layer of the lamina propria (SE), and deep paraglandular layer of the mucosa (D). Polymorphonuclear cell (PMNC) % values of the ethmoid and maxillary sinus and overall ethmoid sinus PI were significantly higher in the polyp group. Patients with longer polyp duration, D-perivascular (D-pv), and a higher Brinkmann index had decreased ethmoid sinus D PIs. However, in older patients and patients with longer polyp duration, perivascular PIs increased in maxillary sinus SE and D, respectively. Furthermore, as PMNC % and iNOS-PMNC PI increased, SE_glandular and epithelial_apical iNOS values decreased. In the ethmoid and maxillary sinuses, iNOS_D_. endothelial values increased but decreased in the nasal cavity. iNOS may play a role in sinonasal polyp pathogenesis, especially in mucosal SE and D layers. Increased vascular permeability, stromal edema, inflammatory cell migration into the stroma of the mucosa, and increased mucosal gland secretion may result in polyp formation.

Research paper thumbnail of Effects of subjective tinnitus on sleep quality and Mini Mental Status Examination scores

B-ENT

Effects of subjective tinnitus on sleep quality and mini mental status examination scores. Object... more Effects of subjective tinnitus on sleep quality and mini mental status examination scores. Objectives: We investigated the effects of subjective tinnitus on sleep quality and Mini Mental Status Examination (MMSE) scores of participants. Methods: The study group consisted of 15 patients, including 21 ears with tinnitus (6 bilateral, 9 unilateral). The control group consisted of 8 healthy patients with normal hearing and no tinnitus (16 ears). We assessed sleep quality using the Mini Sleep Questionnaire (MSQ) and mental health using the MMSE. Results: Sleep delay (SD) was significantly higher in tinnitus patients (5.28 ± 2.23) compared to controls (3.25 ± 2.56) (p = 0.018). Subjective tinnitus loudness level (STLL) scores were higher and sleep quality was impaired in females, older patients, and patients with lower MMSE scores. Sleep quality was also worse in patients with longer tinnitus duration. In younger and well educated patients, MMSE scores were higher. Higher STLL scores and shorter tinnitus duration were associated with lower MMSE scores. Patients with newly developed tinnitus reported more disturbances and showed greater effects on mental and cognitive functioning. Conclusion: In subjective tinnitus patients, sleep delay values increased. Long tinnitus duration and high STLL scores may affects patients' cognitive functions as shown by decreased MMSE scores. Furthermore, mental status changes in tinnitus patients were frequently overlooked.

Research paper thumbnail of A new grafting technique for tympanoplasty: tympanoplasty with a boomerang-shaped chondroperichondrial graft (TwBSCPG)

European Archives of Oto-Rhino-Laryngology, 2013

The aim of this study was to introduce a new grafting technique in tympanoplasty that involves us... more The aim of this study was to introduce a new grafting technique in tympanoplasty that involves use of a boomerang-shaped chondroperichondrial graft (BSCPG). The anatomical and functional results were evaluated. A new tympanoplasty with boomerang-shaped chondroperichondrial graft (TwBSCPG) technique was used in 99 chronic otitis media patients with central or marginal perforation of the tympanic membrane and a normal middle ear mucosa. All 99 patients received chondroperichondrial cartilage grafts with a boomerang-shaped cartilage island left at the anterior and inferior parts. Postoperative followups were conducted at months 1, 6, and 12. Preoperative and postoperative audiological examinations were performed and air-bone gaps were calculated according to the pure-tone averages (PTAs) of the patients. In the preoperative period, most (83.8 %) air-bone gaps were C16 dB; after operating using the TwBSCPG technique, the airbone gaps decreased to 0-10 dB in most patients (77.8 %). In the TwBSCPG patients, the mean preoperative air-bone gap was 22.02 ± 6.74 dB SPL. Postoperatively, the mean postoperative air-bone gap was 8.70 ± 5.74 dB SPL. The TwBSCPG technique therefore decreased the postoperative air-bone gap compared to that preoperatively (p = 0.000, z = -8.645). At the 1-month follow-up, there were six graft perforations and one graft retraction. At the 6-month follow-up, there were nine graft perforations and three graft retractions. At 12 months, there were seven graft perforations and four graft retractions. During the first year after the boomerang tympanoplasty surgery, graft lateralization was not detected in any patient. Retractions were grade 1 according to the Sade classification and were localized to the postero-superior quadrant of the tympanic membrane. The TwBSCPG technique has benefits with respect to postoperative anatomical and audiological results. It prevents perforation of the tympanic membrane at the anterior quadrant and avoids graft lateralization due to placement of the graft under the manubrium mallei. Given these benefits, the TwBSCPG technique seems to be a good alternative for grafting in tympanoplasties.

Research paper thumbnail of Is there a relationship between cribriform plate dimensions and septal deviation angle?

European Archives of Oto-Rhino-Laryngology, 2014

The aim of this retrospective study was to investigate the relationship between cribriform plate ... more The aim of this retrospective study was to investigate the relationship between cribriform plate (CP) dimensions and septal deviation degree. Coronal paranasal CT scans of 99 patients were reviewed. We measured depth and width of cribriform plate on both sides and compared with septal deviation side and septal deviation degree. Deviation angles were 6.85 ± 1.47°for right deviations; and 7.11 ± 1.63°for the left deviations. The mean depth of CP was 5.08 ± 1.57 mm at the right side and 5.06 ± 1.59 mm at the left side; and the mean width of CP was found 4.71 ± 1.36 mm at the right side and 4.56 ± 1.51 mm at the left side. When CP dimensions were evaluated according to the septal deviation side, mean width of CP was 4.69 ± 1.36 mm at ipsilateral side (deviated side); and 4.58 ± 1.51 mm at the contralateral side. The mean depth of CP was 4.9 ± 1.56 mm at the ipsilateral side (deviated side); and 5.22 ± 1.58 mm at the contralateral side. The CP depth at the contralateral side was significantly higher than that of the ipsilateral side (deviated side). In right SD, ipsilateral and contralateral CP depth increased. As deviation angle increased, ipsilateral and contralateral CP width, right and left CP width increased. Ipsilateral and contralateral CP width; and additionally ipsilateral and contralateral CP depth increased together. In other words, right and left CP width; and CP depth increased simultaneously. It is well known that the higher incidence of intracranial penetration is on the side where the position of the ethmoid roof (ER) is lower. The presence of septal deviation, the possibility of the deeper CP at the contralateral side should be taken into consideration to avoid iatrogenic injury.

Research paper thumbnail of Effects of intrauterine and extrauterine exposure to GSM-like radiofrequency on distortion product otoacoustic emissions in infant male rabbits

International Journal of Pediatric Otorhinolaryngology, 2009

We investigated the effects of 1,800 MHz GSM-like Radiofrequency (RF) on the cochlear functions o... more We investigated the effects of 1,800 MHz GSM-like Radiofrequency (RF) on the cochlear functions of female infant rabbits by Distortion Product Otoacoustic Emission (DPOAE) recordings upon intrauterine (IU) and/or extrauterine (EU) exposure.

Research paper thumbnail of Effects of GSM-like radiofrequency on distortion product otoacoustic emissions of rabbits: comparison of infants versus adults

International journal of pediatric otorhinolaryngology, 2009

The aim of this study is to investigate the potential hazardous effects of 1800 MHz Global System... more The aim of this study is to investigate the potential hazardous effects of 1800 MHz Global System for Mobile Communications-like (GSM-like) Radiofrequency (RF) exposure on the cochlear functions of female infant and adult rabbits by measuring Distortion Product Otoacoustic Emission (DPOAE) response amplitudes. Eighteen each one-month-old New Zealand White female rabbits and eighteen each 13-month-old adult rabbits were included into the study. They were randomly divided into four groups. Nine infant rabbits (Group 1) were not exposed to 1800 MHz GSM-like RF (Infant Control, C-In). Nine infant rabbits (Group 2) were exposed to 1800 MHz GSM-like RF, 15 min daily for 7 days after they reached one-month of age (Infant RF, RF-In). Nine adult rabbits were not exposed to 1800 MHz GSM-like RF, 15 min daily for 7 (Adult Control, C-Ad). Nine adult rabbits were exposed to 1800 MHz GSM-like RF, 15 min daily for 7 days (Adult RF, RF-Ad). Cochlear functions were assessed by DPOAEs at 1.0-8.0 kHz....

Research paper thumbnail of Association between atopy, mastoid pneumatization and tympanometric findings

European Archives of Oto-Rhino-Laryngology, 2014

abnormal tympanograms was significantly higher in the atopic group than in the control group. Mor... more abnormal tympanograms was significantly higher in the atopic group than in the control group. Moreover, the presence of atopy was found to be associated with an almost 4.5-fold increased risk of having an abnormal tympanogram. Individuals with abnormal tympanograms (type BB or CC) demonstrated significantly lower right and left mastoid volumes than did individuals with normal type A tympanograms. Atopic individuals demonstrated significantly lower right and left mastoid volumes than did subjects in the control group. This study suggests a direct association between atopy and mastoid cell volumes. It was found that the mastoid cell systems of atopic individuals are less pneumatized, and tympanometric measurements are worse in atopic subjects. Therefore, the authors suggest that when a medical or surgical treatment is planned for ear disease in atopic individuals, atopy is an important factor that should be taken into consideration.

Research paper thumbnail of Abilities of Pragmatic Language Usage of the Children with Language Delay After the Completion of Normal Language Development Training

Objectives: A child may pronounce words clearly, have a large vocabulary, use long, complex sente... more Objectives: A child may pronounce words clearly, have a large vocabulary, use long, complex sentences and correct grammar,
and still have a communication problem if he or she has not mastered the rules for appropriate social language. It is known that
functional or pragmatic language usage is not problematic for children who have completed normal language development
process. We investigated whether children who have previously had receptive, expressive, or mixed language development
delays will likely have problems in the use of pragmatic language after formal training.
Materials and Methods: Two different subject groups composed of 67 children between the ages of 3-6 and classified as the
ones with and without language delay. Children with language delay received educational treatment, auditory processing and
speech and language training. Training was consisted of acoustic signal perception, auditory discrimination, auditory comprehension,
conception training, phonological processing training, speech sound processing; and speech and language education. The
average of training period was between 1 to 2 years. Their receptive and expressive language was tested at 6 month-interval. In
children whose language development was compatible with chronological age, pragmatic language performance was evaluated.
Children’s pragmatic language usage skills were evaluated in both groups with Descriptive Pragmatics Profile (DPP) by using the
rating technique (never, sometimes, often, always), in terms of the abilities “Conversational Routines and Skills” (CRS); Asking
for, Giving and Responding to Information”(AGRI). The Chi Square Test was used for statistical analysis.
Results: Only four of nineteen items were similar (1. Waves or says hello/goodbye (in CRS part), 2. Demonstrates turn-taking
rules during play and/or in classroom (in CRS part), 3. Gives and accepts hugs (in AGRI part) and 4. Asks for help from others (in
AGRI part) (p>0.05), whereas the fifteen items were significantly different between groups (p<0.05).
Conclusion: In our study, it was concluded that in DPP items which were not required the use of language (waves, demonstrates
turn-taking rules during play, gives and accepts hugs, asks for help from others), there was no delay. We suggest that during the
critical early language development period, children who have receptive and expressive language delays will also demonstrate
delay in pragmatic language usage.

Research paper thumbnail of The Potential Protective Effects of 2-aminoethyl Diphenylborinate against Inner Ear Acoustic Trauma: Experimental Study Using Transmission and Scanning Electron Microscopy

The Journal of International Advanced Otology, 2015

In this prospective experimental study, we investigated the preventive effects of 2-aminoethyl di... more In this prospective experimental study, we investigated the preventive effects of 2-aminoethyl diphenylborinate (2-APB) in rats exposed to acoustic trauma (AT). Light microscopic, transmission electron microscopic (TEM), and scanning electron microscopic (SEM) examinations were performed.

Research paper thumbnail of The effects of septoplasty on disease-specific and general quality of life: A retrospective longitudinal trial

Praxis of Otorhinolaryngology, 2014

Research paper thumbnail of Total removal of an unruptured orbital hydatid cyst

Canadian Journal of Ophthalmology / Journal Canadien d'Ophtalmologie, 2001

Research paper thumbnail of A survey on chronic rhinosinusitis: opinions from experts of 50 countries

European Archives of Oto-Rhino-Laryngology, 2016

Chronic rhinosinusitis (CRS) is a very prevalent inflammatory disease. Treatments vary in differe... more Chronic rhinosinusitis (CRS) is a very prevalent inflammatory disease. Treatments vary in different countries. In the present study, we explored the approaches of physicians in 50 countries. In this cross-sectional study, a rhinosinusitis survey (RSS) was completed by Honorary and Corresponding Members (otorhinolaryngologists) of the Italian Society of Rhinology. In 79.1 % of the 50 countries, the proportion of patients suffering from CRS was 15 %. Nasal symptoms were more intense in winter (46 % of countries), and spring and autumn (22 %). The most common symptoms were nasal obstruction (86 %), postnasal drip (82 %) and headache (52 %). The most common investigative modalities in the assessment of CRS are paranasal sinus CT, fiberoptic endoscopy, and anterior rhinoscopy. CRS patients were principally treated by otorhinolaryngologists (70 %). Medical treatments included nasal corticosteroids (90 %), nasal washes (68 %), and nasal decongestants (32 %). In 88 % of countries, more than 50 %, or &amp;amp;quot;about 50 %&amp;amp;quot;, of all patients reported subjective symptom improvement after treatment. In most of the countries, surgery was required by 20-35 % of all CRS patients. During post-surgery follow-up, nasal washes (90 %), nasal corticosteroids (76 %), and systemic antibiotics (32 %) were prescribed. In 20-40 % of all patients, CRS was associated with nasal polyps. In such patients, the medical treatment options were nasal corticosteroids (90 %), systemic corticosteroids (50 %), nasal washes (46 %), and systemic antibiotics (34 %). Treatment of CRS patients varies in different countries. Paranasal sinus CT is the most common investigative modality in the assessment of CRS, and nasal corticosteroids are the first-line treatment, in the absence or presence of nasal polyps.

Research paper thumbnail of Otolaryngological findings in mucopolysaccharidosis

Journal of Medical Updates, 2014

Research paper thumbnail of Epidemia of Tularemia in Central Anatolia

J Anim Vet Adv, 2010

Abstract: Tularemia is a zoonotic disease caused by Francisella tularensis which can be transmitt... more Abstract: Tularemia is a zoonotic disease caused by Francisella tularensis which can be transmitted to humans by tick bites contaminated water handling infected materials and inhalation. The different clinical types are ulceroglandular, glandular, oropharyngeal, oculoglandular, typhoidal ...

Research paper thumbnail of Mukopolisakkaridoz hastalarındaki otolarengolojik bulgular

Journal of Medical Updates, 2014

Research paper thumbnail of Are serum levels of trace elements in children with auditory neuropathy within normal limits? – A pilot study

Clinical Investigative Medicine, Jun 1, 2010

To determine whether trace elements that are essential for neural function play a role in the pat... more To determine whether trace elements that are essential for neural function play a role in the pathophsiology and etiology of auditory neuropathy (AN).. Materials and methods: Patients diagnosed with auditory neuropathy consisted of eight children (two male, six female). The blood tests including the measurement of sodium, potassium, chloride, calcium, phosphorus, iron, copper and magnesium were done in children with AN during their routine care. Results: Of the eight children with AN, many had serum levels outside the normal range: one had low sodium, two had low potassium, one had low chloride, two had high zinc and three had low zinc, two had low calcium and two had higher than normal phosphorus. Conclusion: Although some serum trace element levels in our patients were higher or lower than normal values, the mean values were within normal limits. Thus, we were unable to detect a relationship between serum trace element levels and AN-. In the future, larger studies should be conducted to confirm these findings.

Research paper thumbnail of The role of MMP-2, MMP-9, and TIMP-1 in the pathogenesis of nasal polyps: Immunohistochemical assessment at eight different levels in the epithelial, subepithelial, and deep layers of the mucosa

Ear, nose, & throat journal

We conducted a prospective study to investigate the role of matrix metalloproteinase-2 (MMP-2), m... more We conducted a prospective study to investigate the role of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the pathogenesis of nasal polyps. Our study group consisted of 24 patients-21 men and 3 women, aged 23 to 70 years (mean: 45.97 ± 11.60)-with nasal polyposis who underwent functional endoscopic sinus surgery. For comparison purposes, we assembled a control group of 11 patients-6 men and 5 women, aged 18 to 56 years (mean: 29.90 ± 14.22)-without nasal polyps who underwent septoplasty and/or rhinoplasty. We analyzed 36 polyp specimens obtained from the study group (10 from the nasal cavity, 10 from the maxillary sinus, and 16 from the ethmoid sinus) and 11 tissue specimens from the control group (each control provided 1 specimen from the inferior turbinate). We then calculated the mean number of these cells in the epithelium, subepithelial layer of the lamina propria, and the deep paraglandular layer...

Research paper thumbnail of Different anesthetic agents-soaked sinus packings on pain management after functional endoscopic sinus surgery: which is the most effective?

European Archives of Oto-Rhino-Laryngology, 2015

In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sin... more In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sinus packs on pain management after functional endoscopic surgery (FESS). One hundred and fifty patients with the diagnosis of bilateral chronic sinusitis with or without nasal polyps who underwent FESS were included into the study. Their pre-operative Lund-Mackay computerized tomography (CT) Scores were similar. We applied anesthetic agents of 2 % lidocaine HCl, 0.25 % Bupivacaine HCl, 0.2 % Ropivacaine, 2 % Prilocaine and 0.9 % NaCl (Saline) in groups 1-5 onto the sinus packs after FESS. At postoperative period, acetaminophen (250 mg/5 ml) was used in 10-15 mg/kg per dose (4 times a day). Bleeding grade, operation duration, postoperative number of gauze/24 h, additional painkiller need, pain values at 1, 2, 4, 8, 12 and 24 h were noted. Lund-Kennedy endoscopic scores were also evaluated at 1st, 2nd and 4th weeks postoperatively. In saline group, 93.3 % of the patients needed additional painkiller. Whereas, in Bupivacaine group, additional painkiller use (20.0 %) is less than the other groups. In Bupivacaine group, number of gauze/24 h use was lower than lidocaine, ropivacaine and prilocaine groups. In our study, except 1st and 24th hours, pain values of groups can be written in ascending order (from less to higher) as Bupivacaine, Lidocaine, Prilocaine, Ropivacaine and Saline. In the first hour, pain values of groups can be written in ascending order (from less to higher) as Lidocaine, Prilocaine, Bupivacaine, Ropivacaine and Saline. In the 2nd week, in the Bupivacaine and Lidocaine Groups separately, postoperative Lund-Kennedy scores were lower than the Prilocaine and Saline Groups. In the 1st month, Lidocaine Group&#39;s Lund-Kennedy scores were significantly lower than the Saline Group. Synechia values were not different between groups. Bupivacaine help the lower pain values and less additional painkiller need after FESS. Therefore, we recommend to use Bupivacaine soaked sinus packs after FESS for achieve less pain values and to improve patient satisfaction.

Research paper thumbnail of The Presence of Clival Foramen Through Multidetector Computed Tomography of the Skull Base

The Journal of craniofacial surgery, 2015

Technological advancements in the diagnostic radiology recently permitted reviewing the normal an... more Technological advancements in the diagnostic radiology recently permitted reviewing the normal anatomy through multidetector computed tomography (MDCT) imagination. The aim of this paper is retrospectively investigation of the clival foramen and canal through MDCT. One hundred eighty-six MDCT scans were reviewed. First, images were taken at axial plane, and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these three-dimensional images (3-D imaging). The images were evaluated as clival foramen "present" or "absent." In our 186 patients, evaluation of MDCT showed that clival foramen was absent in 66.7% (n = 124) of patients. Only 33.3% (n = 62) of patients had a clival foramen. In 3-D images, clival canal and clival foramen were shown more clearly compared with the MDCT. Knowledge of the clival canal might be useful in patients of questionable clival fracture or during neurosurgical operations in this r...

Research paper thumbnail of The role of platelet-derived growth factor in the pathogenesis of sinonasal polyps: immunohistochemical assessment in epithelial, subepithelial and deep layers of the mucosa. Bayar Muluk N, Arıkan OK, Atasoy P, Kılıç R, Tuna Yalçinozan E. Clin Exp Otorhinolaryngol. 2013 Sep;6(3):152-60. doi: 10.3...

Research paper thumbnail of Inducible nitric oxide synthase (iNOS) in sinonasal polyp pathogenesis

B-ENT

We investigated the role of inducible nitric oxide synthase (iNOS) in the pathogenesis of sinonas... more We investigated the role of inducible nitric oxide synthase (iNOS) in the pathogenesis of sinonasal polyps. Adult patients (21 men, 3 women) with nasal polyposis underwent functional endoscopic sinus surgery. Nine adults without polyps (6 men) who underwent septoplasty and/or rhinoplasty served as controls. Polyp specimens came from three regions: the maxillary sinus (10), ethmoid sinus (14), and nasal cavity (10). Control group samples (9) came from the inferior turbinate. Specimens were evaluated in eight mucosal layers for count and distribution of inflammatory cells and iNOS expression. An iNOS positivity index (PI) was determined for the epithelium (E), subepithelial layer of the lamina propria (SE), and deep paraglandular layer of the mucosa (D). Polymorphonuclear cell (PMNC) % values of the ethmoid and maxillary sinus and overall ethmoid sinus PI were significantly higher in the polyp group. Patients with longer polyp duration, D-perivascular (D-pv), and a higher Brinkmann index had decreased ethmoid sinus D PIs. However, in older patients and patients with longer polyp duration, perivascular PIs increased in maxillary sinus SE and D, respectively. Furthermore, as PMNC % and iNOS-PMNC PI increased, SE_glandular and epithelial_apical iNOS values decreased. In the ethmoid and maxillary sinuses, iNOS_D_. endothelial values increased but decreased in the nasal cavity. iNOS may play a role in sinonasal polyp pathogenesis, especially in mucosal SE and D layers. Increased vascular permeability, stromal edema, inflammatory cell migration into the stroma of the mucosa, and increased mucosal gland secretion may result in polyp formation.

Research paper thumbnail of Effects of subjective tinnitus on sleep quality and Mini Mental Status Examination scores

B-ENT

Effects of subjective tinnitus on sleep quality and mini mental status examination scores. Object... more Effects of subjective tinnitus on sleep quality and mini mental status examination scores. Objectives: We investigated the effects of subjective tinnitus on sleep quality and Mini Mental Status Examination (MMSE) scores of participants. Methods: The study group consisted of 15 patients, including 21 ears with tinnitus (6 bilateral, 9 unilateral). The control group consisted of 8 healthy patients with normal hearing and no tinnitus (16 ears). We assessed sleep quality using the Mini Sleep Questionnaire (MSQ) and mental health using the MMSE. Results: Sleep delay (SD) was significantly higher in tinnitus patients (5.28 ± 2.23) compared to controls (3.25 ± 2.56) (p = 0.018). Subjective tinnitus loudness level (STLL) scores were higher and sleep quality was impaired in females, older patients, and patients with lower MMSE scores. Sleep quality was also worse in patients with longer tinnitus duration. In younger and well educated patients, MMSE scores were higher. Higher STLL scores and shorter tinnitus duration were associated with lower MMSE scores. Patients with newly developed tinnitus reported more disturbances and showed greater effects on mental and cognitive functioning. Conclusion: In subjective tinnitus patients, sleep delay values increased. Long tinnitus duration and high STLL scores may affects patients' cognitive functions as shown by decreased MMSE scores. Furthermore, mental status changes in tinnitus patients were frequently overlooked.