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Öğe Benign vokal kord patolojisi nedeniyle opere edilen hastaların retrospektif incelenmesi(2019) Taş, Burak Mustafa; Şimşek, Gökce; Balcı, Mahi; Kılıç, RahmiAmaç: Kliniğimizde opere olan benign vokal kord lezyonları hastaların patolojik ve klinik verilerinin sunulması ve dağılım yüzdelerinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Çalışma Kırıkkale Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Anabilim Dalında Aralık 2013 - Mart 2017 tarihleri arasında benign vokal kord lezyonları tanısı alan hasta dosyalarının retrospektif olarak değerlendirilmesi ile gerçekleştirilmiştir.Bulgular: Ortalama yaşları 47,8 olan toplam 108 hastanın verileri incelendi. Hastaların 24’ü (%22,3) kadın 84’ü (%77,7) erkek idi. Hastaların patoloji sonuçları 61 (%56,4) vokal kord polipi, 20 (%18,5) değişik derecelerde keratotik lezyon olan lökoplazi, 11 (%10,1) Reinke ödemi, 7 (%6,4) larengeal kist, 6 (%5,5) vokal kord nodülü, 2 (%1,8) larinks papillomatozu ve 1 (%0,9) larengosel olarak kaydedildi. Hastaların 76’sının (%70,3) anamnezinde sigara öyküsü olduğu gözlendi.Sonuç: Benign vokal kord lezyonları bulunan hastaların patoloji sonuçlarında en sık vokal kord polipi ile karşılaşılmaktadır. Her kliniğin benign vokal kord lezyonları patoloji sonuçlarının değerlendirilmesi ile ülkemizdeki benign vokal kord lezyonları sonuçlarının dağılımı ile ilgili veriler oluşturulabilir.Öğe Bilateral Nasoalveolar Cyst Causing Nasal Obstruction(2018) Tozar, Mesut; Şimşek, Gökce; Taş, Burak Mustafa; Daphan, Birsen Ünal; Kılıç, RahmiNasoalveolar cysts, non-odontogenic in origin, are soft-tissue lesions of the upper jaw, are derived from nasolacrimal canal epithelium, and are mostly unilateral but sometimes bilateral. Another theory about its etiology is that it occurs because of embryonic fissure cysts. These lesions are thought to be developmental. They can cause swelling and nasal obstruction in the upper lip, alar area, and palate. In this case report, we discuss the role of nasoalveolar cysts in nasal obstruction and how they can be bilateral. A 31-year-old female patient visited our clinic with complaints of nasal obstruction and swelling in front of the nose for 2 years. An anterior rhinoscopic examination revealed a mass and stenosis in both nasal vestibules. Computed tomography revealed a mass-like nasoalveolar cyst in the inferior alar region. Under general anesthesia, a 1-cm mass from the right side and a 2-cm mass from the left side were excised, which were pathologically confirmed as nasoalveolar cysts. Nasoalveolar lesions are rare and mostly unilateral. Bilateral nasoalveolar cysts should be considered in the differential diagnosis of nasal obstruction.Öğe Boyun travması: migrate yabancı cisim(2019) Taş, Burak Mustafa; Şimşek, Gökce; Daphan, Çağatay; Öğden, Mustafa; Gültekin, Yıldırım; Kılıç, RahmiBoyunda yabancı cisim olguları iyatrojenik veya travmatik olabilirler. Ateşli silah yaralanmaları, kesici-delici alet yaralanmaları ile oluşan olgular bunlara örnek gösterilebilir. Büyük arter ve venler, trakea ve nöral yapılar hasara uğrayabilir. Yabancı cismin boyun yapıları ve fasiyaları içerisinde migrate olması nadir ancak beklenen bir durumdur. Bu yüzden yabancı cisimler beklenmedik yerlerde bulunabilir. Bizim olgumuzda 37 yaşında erkek hasta boyunda birçok kesi ve yabancı cisim nedeniyle tarafımıza danışıldı. Hastanın radyolojik görüntülemesinde servikal vertebra anteriorunda yabancı cisim izlendi ve acil ameliyata alındı. Migrate olan yabancı cisim operasyon sonrasında hastanın nazofarenksinde bulundu ve çıkarıldı. Kulak-Burun-Boğaz hekimliği pratiğinde karşımıza çıkabilecek olan boyunda yabancı cisimlere vital yapılara yakınlığı nedeniyle dikkat edilmelidir.Öğe Does melatonin alleviate ototoxic effect caused by administration of cisplatin?(2019) Tokgöz, Sibel Alıcura; Şimşek, Gökce; Vuralkan, Erkan; Çalışkan, Murat; Besaltı, Ömer; Akın, IstemihanAim: In this study, it was aimed to experimentally investigate the protective effects of melatonin in the cisplatin-induced ototoxicity. Material and Methods: Ten Wistar-albino rats were included in the study. Two equal groups were generated randomly as cisplatin and melatonin groups. Rats’ underwent Auditory Brainstem Response (ABR) and Distortion Product Otoacoustic Emission (DPOAE) testing before the drug administration and the results were recorded. Both tests were repeated 72 hours after the cisplatin administration in all rats. Results: Significant difference was found between the I-IV interval values before the treatment and after the treatment both in cisplatin and melatonin group. As well as the significant difference in hearing threshold value changes, statistically, significant differences in ABR-I and ABR-IV interval variations were also seen between the cisplatin and melatonin groups. A statistically significant decrease was found between the initial and final control SNR (signal-to-noise ratio) levels within the cisplatin group in the evaluations at 2000Hz, 3000Hz and 4000Hz. Statistically, significant differences were observed between SNR levels when the melatonin group was compared with the cisplatin group. Conclusion: Melatonin appears to reduce cisplatin-induced ototoxicity in rats. Although, the use of supplementary therapies targeting to reduce the toxic effects in clinical studies is still a controversial point.Öğe THE EFFECT OF CERVICAL MANIPULATION TREATMENT IN BENIGN PAROXYSMAL POSITIONAL VERTIGO PATIENTS WITH NECK PAIN(2020) Kültür, Turgut; Şimşek, Gökce; Agir, HaticeObjective: Recurrence is common in the treatment of Benign Paroxysmal Positional Vertigo (BPPV) with an Epley maneuver. Methods such as manipulation are also effective in treatment. The study was aimed to determine the effect of cervical manipulation added to the Epley maneuver in treatment of patients with BPPV who has cervical lordosis and neck pain. Material and Methods: Patients diagnosed with BPPV who has flattened cervical lordosis with at least level 6 neck pain in VAS and over 18 years of age were included in the study. Patients were stratified into two groups according to age and gender. In the first and control examination one month later, cervical manipulation was performed in addition to Epley maneuver to the first group (combined therapy), and only Epley maneuver to the second group. Patients were examined with video-head-impulse test (VHIT), the severity of neck pain determined with VAS and symptoms were questioned with the vertigo symptom scale (VSS) prior and after treatment. Results: There was no difference between the groups in terms of VAS-pain, VSS and VHIT parameters before treatment (p? 0.05). While there was no difference in vestibulo-ocular reflex (VOR) gains between the study groups (p? 0.05), there was a significant difference in terms of VSS and VAS-pain (p = 0.01), after treatment. When compared by pathological VHIT findings, there was a significant difference in terms of improvement in favor of the combined treatment group after treatment (p = 0.02). At intragroup comparisons, VSS, VAS-pain, values were significantly decreased after treatment in both groups (p=0.01). While intragroup pathologic VHİT findings were considered before and after treatment, there was no significant difference in improvement after treatment in the Epley group (p?0.05). Contrarily difference was significant in the combined treatment group (p=0.01). Conclusion: Epley and manipulation therapy are more successful when applied together.Öğe The Epidermoid Cyst Containing Free Teeth in The Maxillary Sinus(2018) Taş, Burak Mustafa; Şimşek, Gökce; Akay, Neşet; İnal, Mikail; Kılıç, RahmiEpidermoid cysts (EC) are the most common tumors of the skin. They are usually asymptomatic and small-sized. They are more common at young ages. They grow slowly and are painless. The wall of EC is covered with epidermis-like epithelium. EC are rarely seen in sinuses. In our case, a 16-year-old female presented with complaints of swelling and headache that started from the left eye and extended to the upper lip. A biopsy was performed at another hospital of the patient who had previously received medical treatment but had no complaints. A cystic mass containing teeth was observed in the left maxillary sinus on imaging. The cystic mass was excised along with the wall. Pathological results supported the diagnosis of EC. Treatment of EC are surgical and recurrence rates are low. Although many masses are observed in the sinonasal region, epidermoid cysts are rare. It is important to distinguish epidermoid cysts from malignant masses that exhibit expansile growth characteristics. Keywords: Headache, epidermoid cyst, maxillary sinusÖğe EVALUATION OF THE EFFECTIVENESS OF ALPHA LIPOIC ACID IN THE TREATMENT OF BELL'S PALSY(2022) Taş, Burak Mustafa; Şimşek, Gökce; Okumuş, Müyesser; Tozar, MesutObjective: This study aims to evaluate the efficacy of alpha-lipoic acid in the treatment of Bell’s palsy by using the House-Brackmann grading system and electromyography.Material and Methods: A total of 33 patients were included in this retrospective study. Patients were divided into two groups. Group 1 included 18 patients who received 300 mg daily alpha-lipoic acid in addition to Bell’s palsy treatment. Group 2 included 15 patients who only received Bell’s palsy treatment. House-Brackmann grading score at admission, 21st day and at 3rd month were noted in both groups. The results of electromyography performed at 21st day were also scanned. Patients were classified as good prognosis (neuropraxia) and poor prognosis (axonotmesis and neurotmesis) according to electromyography results. The two groups were compared according to House-Brackmann grades and electromyography results.Results: Group 1 consisted of 10 women and 8 men, while Group 2 consisted of 6 women and 9 men. There was no difference between the two groups according to whether Bell’s palsy was on the right or left side. House-Brackmann grading score of the groups at 21st day and 3rd month were significantly lower than House-Brackmann grading score at admission. There was no significant difference between the two groups according to House-Brackmann grades. There was no difference between the groups in terms of compound muscle action potential ratio and prognosis.Conclusion: Although alpha-lipoic acid is used for nerve regeneration in various diseases, it did not demonstrate a significant effect on Bell’s palsy treatment in our study.Öğe EVALUATION OF TREATMENT RESULTS APPLIED IN SUDDEN HEARING LOSSES TREATED IN OUR CLINIC(2020) Erden, Burak; Şimşek, Gökce; Kılıç, RahmiPurpose: Sudden sensorineural hearing loss (SSNHL) is sensorineural hearing loss over 30 dB, which develops abruptly in less than three days, affecting three or more frequencies. Prognostic factors affecting the treatment results and treatment outcomes of patients with SSNHL were examined in this study. Material and method: Between 2011 and 2014, 65 cases included in 68 ear studies. All patients were given steroids, vasodilator drugs (betahistine) and vitamin B. In the treatment of patients who did not show significant audiological improvement in 5 days, in the event that they gave consent, 0.5-0.7 cc 250 mg methylprednisolone of intratympanic was added per day in addition to systemic steroid therapy and salvage treatment was performed. Anamnesis details and clinical findings of patients, audiological configurations and degrees of hearing loss, treatment start times, vertigo and tinnitus relationship with the SSNHL and the effects of these factors on prognosis were examined in this study. Results: In this study, 31 of the cases were male and 34 were female. The age range was between 12-75 (average 44.2). It was observed that twelve (17.6%) cases had mild, 23 (33.8%) had moderate, 24 (35.3%) had advanced and 9 (13.2%) had very advanced SSNHL. In patients treated early, statistically significant results were obtained in terms of positive response to treatment (p<0.05). Statistically significant results were obtained in terms of hearing loss degree and good response to treatment in patients with SSNHL (p<0.05). There was no significant differences between tinnitus and vertigo and SSNHL relationship (p>0.05). Conclusion: Early treatment and low degrees of SSNHL severity are positive prognostic factors.Öğe Göz Küresinin Etmoid Sinüse Travmatik Dislokasyonu(2021) Onaran, Zafer; Şimşek, Gökce; Konuk, OnurTravmaya bağlı göz küresinin paranazal sinüslere dislokasyonu nadir bir durumdur. Göz küresinin bütünlüğünü koruyarak yer\rdeğiştirmesi hızlı ve uygun müdahale edildiği taktirde fonksiyonel ve kozmetik düzelme sağlanabilecek bir rahatsızlıktır. Bu yazıda 36\ryaşında düşme neticesinde görme kaybı şikayetiyle acil servise başvuran hastada saptanan göz küresinin etmoid sinüse dislokasyonu ve\rtedavi süreci tartışılmıştır.Öğe Idiopathic Orbital Inflammatory Syndrome: Pseudotumor Orbita(2018) Taş, Burak Mustafa; Şimşek, Gökce; Onaran, Zafer; Burulday, Veysel; Kılıç, RahmiThe idiopathic orbital inflammatory syndrome (pseudotumor orbita) is an unexplained disease that mimicsthe complications of acute rhinosinusitis. Intense polymorphic lymphoid infiltration develops with inflammation. The masses in the orbita can be seen by 5% to 8%. It can cause nonspecific orbital symptoms, such as proptosis and swelling on eyelids. In our case, the patients presented to the eye outpatient clinic with swelling complaint and acute atopic conjunctivitis treatment was initiated but the patients who did not regression complaints were submitted. The patient’s magnetic resonance imaging (MRI) showed bilateral lateral rectus muscle thickening. Idiopathic orbital inflammatory syndrome (pseudotumor orbita) responded to the steroid treatment. Idiopathic orbital inflammatory syndrome (pseudotumor orbita) is benign, but can be confusedwith sinusitis complications with high morbidity and mortality.Öğe Inadvertent Injection of Sodium Hypochlorite to Oral Mucosa(2019) Akay, Neşet; Şimşek, Gökce; Taş, Burak Mustafa; Kılıç, RahmiIt is important to carefully use sodium hypochloride(NaOCI) in its clinical applications. Non-careful use of cytotoxic agents(NaOCI,etg) may cause serious complications. In this case report, a treatment approach to paresthesia and tissue necrosis after inadvertent injection of 1% NaOCl solution into oral mucosa is presented.. Pain, edema, loss of sensation, redness on the cheek, and difficulty in swallowing was seemed during the patient’s clinical examination. The patient was experiencing severe pain and a burning sensation during injection. The patient was administered intraoral drugs,such as antibiotics (amoxicillin 1000 mg two times per a day for two week),alpha lipoic acid (300 mg one times per a day for one mounth), and debridement of oral mucousa .Consequently, re-epithelialization of necrotic tissue was observed in the 3rd month. All symptoms disappeared completely in the 6th month.Öğe THE EFFECT OF ACROMEGALY ON OLFACTORY FUNCTIONS(2021) Akkoca, Özlem; Kavuzlu, Ali; Omma, Tülay; Öçal, Ramazan; Şimşek, Gökce; Kaytez, Selda; Çelik, HaticeObjective: The aim of this study is to compare the olfactory functions of patients with active acromegaly and patients in biochemical remission. Meterials and Methods: The study was conducted by forming 2 groups of patients diagnosed with acromegaly and a control group. Group 1 consisted of active acromegaly patients. Group 2 included patients who were determined to have biochemical remission. Group 3 were healthy volunteers. The olfactory functions were evaluated with the Brief Smell Identification Test(BSIT). Results: A total of 69 patients were included in the study. The median value of blood insulin-like growth factor 1 (IGF-1) in Group 1 was statistically significantly higher than in Group 2(p <0.001). A statistically significant difference was found between the groups in respect of the BSIT scores(p <0.001). BSIT scores in Group 1 were observed to be significantly lower than both Group 2 and Group 3 (p = 0.001). There was no significant difference between Group 2 and Group 3(p = 1.000). A negative correlation was determined between the BSIT scores and IGF-1 values in Group 1(r = -0.983, p <0.001), (r = -0.629, p <0.01). Conclusions: Active acromegaly causes a decrease in olfactory functions compared to the patients in biochemical remission and this function loss is negatively correlated with IGF-1 levels.Öğe Wegener Granulomatosis: Operated Nasal Septal Perforation(2018) Taş, Burak Mustafa; Şimşek, Gökce; Balcı, Mahi; Akay, Hatice Güzelküçük; Kılıç, RahmiWegener’s granulomatosis is an idiopathic necrotizing granulatous vasculitis that can hold small and medium arteries, upper respiratory tract, lung and kidney involvement. It’s an ANCA associated vasculitis. c-ANCA positivity is considered very sensitive. In our case, a 40-year-old female patient was admitted to our hospital with complaints of nasal bleeding and crusting. The patient was operated due to idiopathic nasal septal perforation, was seen saddle nose deformity and 3x4 cm in size perforation in anterior septum and 1x2 cm in size perforation in posterior septum. Nasal biopsies of the patient with C-ANCA positivity were taken and the result of pathology came in harmony with Wegener’s granulomatosis. The patient was directed to the related clinic for the treatment of Wegener’s granulomatosis. Wegener Granulomatosis, which enters the diagnosis of idiopathic nasal septal perforation, is a disease that should be kept in mind.
