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Öğe 1,25(OH)(2)D-3 and specific IgE levels in children with recurrent tonsillitis, and allergic rhinitis(Elsevier Ireland Ltd, 2013) San, Turhan; Muluk, Nuray Bayar; Cingi, CemalObjectives: We investigated 1,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3] and specific immunoglobulin E (IgE) levels in children with recurrent tonsillitis (RT) plus allergic rhinitis (AR). Methods: Thirty children with RT + AR were included in the study group, and 30 healthy children comprised the control group. AR-related symptoms were determined using a symptom scale. 1,25(OH)(2)D-3 and specific IgE measurements were made in both groups. Results: The 1,25(OH)(2)D-3 value was significantly lower in the RT + AR group than in the control group. Specific IgE (mixed) panels were in normal limits in both groups; whereas specific IgE (mixed) grass pollen panel value of RT + AT group was significantly higher than that of the control group. Higher nasal itching, nasal obstruction, and concha edema scores were related to significantly higher specific IgE values for the (mixed) grass pollen panel, whereas higher sneeze scores were related to higher specific IgE values for the (mixed) pediatric panel. Conclusions: Children with grass pollen allergy may not be exposed to sufficient sunlight. With reduced 1,25(OH)(2)D-3, T helper cells may increase, and allergic response also increases. As allergic events increased, these children did not go outside and thus lacked sun exposure. This vicious cycle must be broken, and children with RT + AR should have sunlight exposure to increase 1,25(OH)(2)D-3 levels. (C) 2013 Elsevier Ireland Ltd. All rights reserved.Öğe A narrative-style review of non-surgical rhinoplasty: Indications, outcomes, and limitations(Churchill Livingstone, 2024) Dilber, Muhammet; Muluk, Nuray Bayar; Cingi, CemalThe aim of this narrative-style review was to evaluate non-surgical rhinoplasty in terms of indications, outcomes, and limitations. Both 'PubMed' and 'Science Direct' were reviewed by all authors, in order to reach consensus with regard to the chosen studies. Studies published from 1980 to 2023 were searched using the key terms non-surgical rhinoplasty, dermal filler, thread lifting, and botulinum toxin, and relevant papers were selected. Non-surgical rhinoplasty refers to the use of injectable temporary fillers to augment selected areas of the nose, in order to achieve improved appearance or function in select patients. It includes the use of dermal fillers, thread lifting, and botulinum toxin injections. The perfect dermal filler would be inexpensive, safe, painless to inject, hypoallergenic, and long lasting. In addition, it should produce consistent and predictable results, feel natural under the skin, take little time to inject, be ready to use, exert no downtime on the patient, and have a low risk of complications. Regions of the nose treated with filler injections include the frontonasal angle, dorsum, nasolabial angle, and columella. Thread lifting and botulinum toxin injection are the other methods of non-surgical rhinoplasty. Dermal fillers, thread lifting, and botulinum toxin injections can be used as non-surgical rhinoplasty. Dermal fillers and botulinum neurotoxin can be used alongside each other to allow minimally invasive resculpting of the nasal region and midface, compensating for a reduction in tissue volume and the formation of rhytides.Öğe A safety investigation into topical effects of naproxen sodium on nasal epithelial cells and potential toxicity in local application(W B Saunders Co-Elsevier Inc, 2023) Dundar, Riza; Muluk, Nuray Bayar; Sezer, Canan Vejselova; Kaya, Furkan; Kutlu, Hatice Mehtap; Cingi, CemalObjectives: We examined how topically-applied naproxen sodium affects human nasal epitheliocytes in culture. Methods: Samples of healthy human primary nasal epithelium (NE) harvested during septoplasty from volunteers without rhinosinusitis were incubated in cell culture. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assays may be utilised when assessing cellular damage (toxicity), as evidenced by DNA fragmentation, nuclear condensation, alteration in the outer plasma membrane and cytoskeletal alteration. This was the method used in the study. Cultured epitheliocytes were incubated with naproxen sodium for 24 h at 37 ???C. The MTT assay was then performed and the cells' morphology was examined by confocal microscopy. Additionally, cellular proliferation was assessed by the artificial scratch method followed by light microscopy. Results: The results indicated that naproxen sodium does not cause any cytotoxic effects upon nasal epithelial cells when applied topically. There was no evidence indicating cytotoxicity on the nasal epitheliocytes in culture for the 24 h period over which the drug was applied. In particular, there was no alteration in cellular morphology, damage to the intracellular organelles structure or the cytoskeleton secondary to naproxen sodium. Furthermore, cellular proliferation occurred normally in these conditions, as on scratch test. Conclusion: Topical naproxen sodium may be used on nasal epithelial cells without inducing toxicity. This agent is therefore suitable, given its known anti-inflammatory effects, for use in patients suffering from diseases involving nasal and paranasal sinusal inflammation, including rhinosinusitis (both chronic and acute) and nasal polyposis which should be investigated. In the future, topical medication forms for nasal usage should be developed.Öğe Aesthetic analysis of the ideal eyebrow shape and position(Springer, 2016) Yalcinkaya, Esin; Cingi, Cemal; Soken, Hakan; Ulusoy, Seckin; Muluk, Nuray BayarThe aesthetic importance of the eyebrow has been highlighted for centuries. In this paper, we investigated ideal eyebrow. Eyebrows and eyelids, varies among different races, ages and genders. It is considered to be of primary importance in facial expression and beauty. We present one form of the ideal eyebrow aesthetic and discuss methods of optimising surgical results. For the modern acceptable concept of the ideal brow, the medial brow should begin on the same vertical plane as the lateral extent of the ala and the inner canthus and end laterally at an oblique line drawn from the most lateral point of the ala through the lateral canthus. The medial and lateral ends of the brow lie approximately at the same horizontal level. The apex lies on a vertical line directly above the lateral limbus. Individual perceptions and expectations also differ from person to person. The brow should over lie the orbital rim in males and be several millimetres above the rim in female. Male tend to have a heavier, thicker brow with a little arch present. There are some pitfalls in brow aesthetics. Overelevation creates an unnatural, surprised and unintelligent look which is the most common surgical mistake in brow lifting. Medial placement of the brow peak would create an undesired 'surprised' appearance. Moreover, a low medial brow with a high lateral peak induces an angry look. Overresection of the medial brow depressors may lead to widening and elevation of the medial brow, which creates an insensitive look and can also lead to glabellar contour defects. It is impossible to define an ideal eyebrow that is suitable for every face. However, one must consider previously described criteria and other periorbital structures when performing a brow surgery.Öğe All Around the Nose: Basic Science, Diseases and Surgical Management(Springer International Publishing, 2019) Cingi, Cemal; Muluk, Nuray BayarThis book is designed to provide all the information required for a sound understanding of diseases of the nose and paranasal sinuses and the surgical techniques used in their management. After an opening section on basic science, clinical and radiological assessment is explained and individual chapters focus on conditions ranging from infectious diseases, allergic rhinitis, and nasal polyposis to trauma, malignancies, and skin diseases. A wide variety of surgical techniques are then described with the aid of high-quality illustrations, covering nasal airway procedures and surgical approaches to the paranasal sinuses, including diverse endoscopic and image-guided procedures, nasal reconstruction, and endonasal and external rhinoplasty. The book is a collaborative project between the new generation of Turkish specialists and well-known experts from across the world. It will be of value for ENT doctors in all countries, as well as for students and trainees and those working in ENT-related fields such as maxillo-facial surgery, pediatrics, allergology, neurology, infectious diseases, and neurosurgery. © Springer Nature Switzerland AG 2020.Öğe Allergic rhinitis during pregnancy(Springer International Publishing, 2022) Muluk, Nuray Bayar; Cingi, Cemal; Scadding, GlenisWhilst she is pregnant, a woman may develop an atopic disorder for the first time, such as rhinitis, urticaria, angioedema, or allergic eczema, or she may already have such a condition. However, whereas there has been extensive investigation of asthma during pregnancy, other atopic conditions during this period have been somewhat neglected by researchers [1]. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.Öğe Anaphylaxis: Definition, History, and Epidemiology(Springer International Publishing Ag, 2020) Cingi, Cemal; Muluk, Nuray Bayar[Abstract No tAvailable]Öğe An anatomical study of pneumatized crista galli(Springer, 2017) Mladina, Ranko; Antunovic, Romano; Cingi, Cemal; Muluk, Nuray Bayar; Skitarelic, Neven; Malic, MislavThe literature data on the incidence of pneumatization of the crista galli based on patients' computed tomography (CT) scans ranges from 3 to 37.5%. This study investigated for the first time the incidence of crista galli pneumatization based on CT scans of human skulls. The study examined 102 randomly selected human skulls (>= 20 years of age; 76 males, 26 females). Skulls were scanned in a fixed position using cone beam computed tomography (CBCT) with a field of view of 145 x 130 mm and an isotropic voxel size of 0.25 mm. The scans were recorded in Digital Images and Communications in Medicine format. The CBCT images were analyzed using OnDemand3DTM software. A 2-mm contiguous slice thickness was used in the axial and coronal planes. The width, length, and height (cranial-caudal dimension) of the pneumatized space within the crista galli were measured. The crista galli was found to be pneumatized in even 68 (66.6%) of the 102 skulls. Two types of pneumatized crista galli (PCG) were identified: PCG alone (surrounded by bony walls) and PCG + spongiosis (surrounded by spongy bone). Of the 68 pneumatized skulls, 31 were PCG alone (45.58%) and 37 were PCG + spongiosis (54.42%). The pneumatized regions had a width of 0.9-6.6 mm, length of 2.8-12.9 mm, and height of 3.6-17.1 mm. No statistically significant differences have been found regarding the sex and age. Regarding the proportions of pneumatization, the three types of crista galli have been determined resulting in new, practical classification: type S (small), type M (moderate), and type L (large). The crista galli is not always a compact bone; in some cases, it is filled with spongy bone or pneumatized. In respect of proportions of pneumatization, there are three types of pneumatized crista galli: small, moderate, and large. Pneumatized crista galli can play an important role in clinical work, both as an inflamed sinus or other pathologies (sinusitis cristae galli, mucocoelae) or as a morphologic barrier in neurosurgical approaches to some tumors of the anterior skull base.Öğe Anosmia and Hyposmia: Overview(Turkiye Klinikleri, 2024) Öztürk, Zeynel; Bayar Muluk, Nuray; Oğuz, Oğuzhan; Aynaci, Sevilay; Manole, Felicia; Cingi, CemalApproximately 95% to 99% of chemosensation is at-tributed to the sense of smell, whereas taste is responsible for the re-maining chemosensation. One who suffers from anosmia is unable to detect smells. In addition to being acquired or congenital, it can be ei-ther transitory or permanent. Disorders in olfaction can be brought on through pathologic conditions at any level through the olfactory path-way. These disturbances can occur at multiple levels. Conductive or sensorineural deficiencies are two categories that can be used to cate-gorize them. In diseases classed as conductive, also known as transport disorders, there is an interruption in transmitting an odorant stimulus to the olfactory neuroepithelium. Loss of sense of smell can be brought on by any mechanical obstruction that prevents scents from reaching the olfactory neurons. Several inflammatory processes can cause this ob-struction, including uncomplicated infections that result in mucus plugs or nasal polyps. Some neurological causes have the potential to cause the disease. The more central brain structures are affected by the pres-ence of sensorineural abnormalities. Tests of olfactory function have been created to give a valid measurement of olfactory dexterity. These smell tests examine the threshold of odor perception and odor identifi-cation. The butanol threshold test, the “University of Pennsylvania Smell Identification Test (UPSIT),” and the “Sniffin' Sticks” test are some of the tests included in this category. In this review, olfactory disorders are presented with a detailed literature survey. © 2024 Turkey Association of Society of Ear Nose Throat and Head Neck Surgery.Öğe Anti-IgE treatment in allergic rhinitis(Elsevier Ireland Ltd, 2019) Muluk, Nuray Bayar; Bafaqeeh, Sameer Ali; Cingi, CemalObjectives: To review the efficacy of anti-IgE therapy in allergic rhinitis (AR). Methods: Literature search was performed using the PubMed and Proquest Central databases at Kirikkale University Library. Results: Although the skin prick testing in patients suffering from AR is positive (indicating that antigen-specific Immunoglobulin E has been produced), there is no association with overall circulating IgE levels. Correlation was lacking between circulating IgE level and either skin prick tests or laboratory testing for specific IgE. Omalizumab binds to uncomplexed IgE in man more avidly than does Fc-epsilon. The effect of omalizumab is to lower the level of IgE and downgrade production of FceRI receptors (which bind IgE) in mast cells and basophils, causing less mast cell recruitment and responsivity and thus diminishing eosinophilic infiltration and activation. Anti-IgE therapy through omalizumab may shorten the lifetime of mast cells and causes dendritic cells to downgrade their production of FceRI. There are reports indicating benefit from omalizumab in managing food allergies, nasal polyp formation, essential anaphylaxis, AR, venom allergy and eczema. Omalizumab acts to lessen circulating IgE levels, whilst reducing production of FceRI by mast cells and basophils. The fact that omalizumab influences how eosinophils respond may be down to disruption of the antigen-IgE-mast cell interactions, with mast cells being recruited at lower levels and thus chemotactic eosinophilic recruitment via cytokines being greatly reduced. Omalizumab has the effect in cases of perennial AR of blocking the increased eosinophilic recruitment and tissue infiltration initiated by seasonal antigens. Likewise, in omalizumab-treated cases, circulating unbound IgE levels showed significant decreases. For patients with perennial AR, the average daily nasal severity score was significantly reduced where omalizumab was administered, compared to placebo. Conclusion: Omalizumab has efficacy in ameliorating symptoms and reduces the necessity for additional medication in both seasonal and perennial allergic rhinitisÖğe Antileukotrienes in adenotonsillar hypertrophy: a review of the literature(Springer, 2016) Kar, Murat; Altintoprak, Niyazi; Muluk, Nuray Bayar; Ulusoy, Seckin; Bafaqeeh, Sameer Ali; Cingi, CemalWe assessed the use of antileukotrienes for treating adenotonsillar hypertrophy. We reviewed the current literature on the anatomy of adenotonsillar tissue, adenotonsillar hypertrophy/hyperplasia (and the associated pathophysiology and symptoms), and the effects of antileukotrienes used to treat adenotonsillar hypertrophy. Leukotrienes (LTs) are inflammatory mediators produced by a number of cell types, including mast cells, eosinophils, basophils, macrophages, and monocytes. There are several types (e.g., LTA4, LTB4, LTC4, LTD4, and LTE4). By competitive binding to the cysLT1 receptor, LT-receptor antagonist drugs such as montelukast, zafirlukast, and pranlukast block the effects of cySHLTs, improving the symptoms of some chronic respiratory diseases. High numbers of LT receptors have been found in the tonsils of children with obstructive sleep apnea. Antileukotrienes reduce the apnea-hypopnea index and adenotonsillar inflammation. Antileukotrienes may be useful for children with adenotonsillar hypertrophy due to their anti-inflammatory effects, which help to reduce adenotonsillar inflammation.Öğe Antileukotrienes in Upper Airway Inflammatory Diseases(Current Medicine Group, 2015) Cingi, Cemal; Muluk, Nuray Bayar; Ipci, Kağan; Şahin, EthemLeukotrienes (LTs) are a family of inflammatory mediators including LTA(4), LTB4, LTC4, LTD4, and LTE4. By competitive binding to the cysteinyl LT1 (CysLT(1)) receptor, LT receptor antagonist drugs, such as montelukast, zafirlukast, and pranlukast, block the effects of CysLTs, improving the symptoms of some chronic respiratory diseases, particularly bronchial asthma and allergic rhinitis. We reviewed the efficacy of antileukotrienes in upper airway inflammatory diseases. An update on the use of antileukotrienes in upper airway diseases in children and adults is presented with a detailed literature survey. Data on LTs, antileukotrienes, and antileukotrienes in chronic rhinosinusitis and nasal polyps, asthma, and allergic rhinitis are presented. Antileukotriene drugs are classified into two groups: CysLT receptor antagonists (zafirlukast, pranlukast, and montelukast) and LT synthesis inhibitors (5-lipoxygenase inhibitors such as zileuton, ZD2138, Bay X 1005, and MK-0591). CysLTs have important proinflammatory and profibrotic effects that contribute to the extensive hyperplastic rhinosinusitis and nasal polyposis (NP) that characterise these disorders. Patients who receive zafirlukast or zileuton tend to show objective improvements in, or at least stabilisation of, NP. Montelukast treatment may lead to clinical subjective improvement in NP. Montelukast treatment after sinus surgery can lead to a significant reduction in eosinophilic cationic protein levels in serum, with a beneficial effect on nasal and pulmonary symptoms and less impact in NP. Combined inhaled corticosteroids and long-acting beta-agonists treatments are most effective for preventing exacerbations among paediatric asthma patients. Treatments with medium-or high-dose inhaled corticosteroids, combined inhaled corticosteroids and LT receptor antagonists, and low-dose inhaled corticosteroids have been reported to be equally effective. Antileukotrienes have also been reported to be effective for allergic rhinitis.Öğe Antioxidant activities of curcumin in allergic rhinitis(Springer, 2016) Altintoprak, Niyazi; Kar, Murat; Acar, Mustafa; Berkoz, Mehmet; Muluk, Nuray Bayar; Cingi, CemalWe investigated the antioxidant effects of curcumin in an experimental rat model of allergic rhinitis (AR). Female Wistar albino rats (n = 34) were divided randomly into four groups: healthy rats (control group, n = 8), AR with no treatment (AR + NoTr group, n = 10), AR with azelastine HCl treatment (AR + Aze group, n = 8), and AR with curcumin treatment (AR + Curc group, n = 8). On day 28, total blood IgE levels were measured. For measurement of antioxidant activity, the glutathione (GSH) level and catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities were measured in both inferior turbinate tissue and serum. Malondialdehyde (MDA) levels were measured only in inferior turbinate tissue, and paraoxonase (PON) and arylesterase (ARE) activities were measured only in serum. Statistically significant differences were found for all antioxidant measurements (GSH levels and CAT, SOD, GSH-Px activities in the serum and tissue, MDA levels in the tissue, and PON and ARE activities in the serum) between the four groups. In the curcumin group, serum SOD, ARE, and PON and tissue GSH values were higher than the control group. Moreover, tissue GSH levels and serum GSH-Px activities in the curcumin group were higher than in the AR + NoTr group. In the azelastine group, except MDA, antioxidant measurement values were lower than in the other groups. Curcumin may help to increase antioxidant enzymes and decrease oxidative stress in allergic rhinitis. We recommend curcumin to decrease oxidative stress in allergic rhinitis.Öğe Applied surgical methods and outcomes in crooked nose rhinoplasty(Verduci Publisher, 2023) Azizli, Elad; Oguz, Oguzhan; Muluk, Nuray Bayar; Sari, Huseyin; Dilber, Muhammet; Uyar, Yavuz; Cingi, CemalOBJECTIVE: In this retrospective and multicentric study, we investigated applied surgical methods in rhinoplasty for crooked nose deformity. PATIENTS AND METHODS: The retrospective data for 300 crooked nose deformity cases (191 males and 109 females) were used in our study. Classification of the initial deformities was performed as (1) I-shaped crooked nose deformity, (2) C-shaped crooked nose deformity, (3) Reverse C-shaped crooked nose deformity, and (4) S-shaped crooked nose deformity. As an operation technique, L-strut septoplasty was performed. The applied surgical methods in rhinoplasty to correct the crooked nose are evaluated and classified. RESULTS: Our results showed that initial deformities in crooked nose patients were I-shaped crooked nose deformity (34%), C-shaped crooked nose deformity (28%), Reverse C-shaped crooked nose deformity (21.3%), and S-shaped crooked nose deformity (16.7%). L-strut septoplasty was performed, and the results of the applied methods to correct the crooked nose were evaluated and classified. It was noticed that more than one procedure was applied to each case: (1) double-side lateral osteotomy (86.6%), (2) wedge bone resection on one side of the osteotomy (7.3%), (3) single-side lateral osteotomy (6%), (4) symmetric spreader grafts (56%), (5) asymmetric spreader grafts (10.6%), (6) shaving of the transverse wing of dorsal septum (8%), (7) correction of deviated dorsal septum (16.3%), (8) displaced anterior nasal spine (12.6%), (9) clocking suture (dorsal septal rotation suture) (9%), (10) dorsal septal scoring and splinting graft (8.3%), and equalizing lateral cruses (12.6%). CONCLUSIONS: I-shaped and C-shaped crooked nose deformities were mainly detected in crooked nose deformity patients. Correcting the crooked nose, double- side lateral oste- otomy, and symmetric spreader grafts were the most applied techniques to correct the crooked nose. Other rhinoplasty techniques were also applied to these patients; more than one technique was needed.Öğe Are preservation rhinoplasty techniques safer than structural ones?(Verduci Publisher, 2023) Bafaqeeh, Sameer Ali; Muluk, Nuray Bayar; Cingi, CemalThis narrative review paper evaluates the preservation rhinoplasty (PR) technique in all aspects. The literature survey was performed in PubMed, EBSCO, UpToDate, and Proquest Central databases of Kirikkale University, Google and Google Scholar databases. The advent of the preservation rhinoplasty (PR) approach has led to a radical shift in the mind-set surrounding rhinoplasty procedures. K-area ( keystone region) loss, lateral cartilage collapse, and nasal stenosis are all avoidable with preservation measures. The nasal bones, the superior lateral cartilage, the quadrilateral cartilage, and the perpendicular blade of the ethmoid meet at the point known as Zone K. The variety of problems that might develop due to carelessness in this area demonstrates the significance of maintaining the nose's stability and structure. The three components of a preservation rhinoplasty (PR) procedure are (1) preserving the scroll ligament complex by elevating the soft tissue envelope (STE) in a subperichondrial-subperiosteal plane, (2) preserving the nasal dorsum without creating an open roof deformity, and (3) preserving the alar cartilages and achieving the desired shape using sutures rather than excision. Dorsal preservation is one of the three components that make up PR. However, the two concepts are not synonymous. PR involves elevating a skin sleeve from the subperichondrial-subperiosteal plane, preserving the osteocartilaginous dorsum, maintaining the alar cartilages with minor excision and using sutures to achieve the desired form.Öğe Are temporomandibular disorders associated with habitual sleeping body posture or nasal septal deviation?(Springer, 2016) Yalcinkaya, Esin; Cingi, Cemal; Muluk, Nuray Bayar; Ulusoy, Seckin; Hanci, DenizNumerous factors can be considered for the etiology of temporomandibular disorders (TMD). The aim of the present study was to investigate whether the presence of both nasal septal deviation (NSD) and habitual prone sleeping posture (HPSP) predisposes TMD. We evaluated 200 subjects in 4 groups. Group I (NSD-, HPSP-/control group), Group II (NSD+, HPSP-), Group III (NSD-, HPSP+), Group IV (NSD+, HPSP+). All patients were examined according to the research diagnostic criteria to determine the presence of TMD. Group IV had the highest value for TMD incidence (44 %). Thus, we found that the presence of both NSD and HPSP parameters increased TMD incidence in Group IV compared to the control group (p = 0.000). Additionally, Group IV showed significantly higher values than Group II (p = 0.012) and Group III (p = 0.039). For Group III (NSD-, HPSP+), TMD was determined higher compared to the control group (p = 0.009). A statistically higher value of presence of TMD was determined in Group II (NSD+, HPSP-) than control group (p = 0.029). The incidence of TMD was significantly higher in women than men (p = 0.020). We concluded that one having an unilateral obstructive nasal septal deviation in addition to a habit of sleeping in prone position must be alert for potential TMD.Öğe Aspirin-exacerbated respiratory disease and current treatment modalities(Springer, 2017) Sakalar, Emine Guven; Muluk, Nuray Bayar; Kar, Murat; Cingi, CemalAspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis, and acute upper and lower respiratory tract reactions to the ingestion of aspirin (acetylsalicylic acid, ASA) and other cyclooxygenase-1 inhibiting non-steroidal anti-inflammatory drugs. AERD affects 0.3-0.9 % of the general population. AERD generally occurs due to abnormalities in mediators and expression of arachidonic acid biosynthesis. Local IgE responses to staphylococcal enterotoxins may also be responsible for eosinophilic activation in the nasal polyp tissues of AERD patients. Clinical features of AERD include the onset of nasal congestion with anosmia, progressing to chronic pansinusitis and nasal polyps that regrow rapidly after surgery. Aspirin desensitization, Leukotriene-modifying agents, biologic agents, management of asthma, chronic rhinosinusitis, and nasal polyposis are recommended as treatment modalities. Immunotherapy is prescribed only to those AERD patients who experience clear seasonal or perennial allergy symptoms in addition to the symptoms attributable to chronic nasal polyposis. There are also investigational and dietary therapies. In this review, the important aspects of AERD will be presented, along with a literature survey.Öğe Association between atopy, mastoid pneumatization and tympanometric findings(Springer, 2015) Kaymakci, Mustafa; Yanik, Bahar; Erel, Fuat; Muluk, Nuray Bayar; Cingi, CemalThe purpose of this study was to reveal whether the presence of atopy plays any unfavorable role in the development of a healthy middle ear as evaluated by tympanometry or in the degree of mastoid pneumatization as measured by mastoid volume. 33 atopic patients with positive skin prick test results (atopic group) and 30 healthy subjects (control group) were included in this study. Tympanometric tests were performed in all participants, and the results were classified as type A to C. Mastoid cell volumes were measured by three-dimensional temporal computed tomography. Both the right and left mastoid volumes were significantly lower in the atopic group than in the control group. Tympanogram types among all participants showed that the number of individuals with 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.Öğe Calculation of an Optic Nerve Injury Risk Profile Before Sphenoid Sinus Surgery(Lippincott Williams & Wilkins, 2017) Cetinkaya, Erdem Atalay; Koc, Koray; Kucuk, Mehmet Fatih; Koc, Pinar; Muluk, Nuray Bayar; Cingi, CemalObjectives: Our objective was to analyze variations in the optic nerve (ON) course and surrounding structures in an effort to construct an optic nerve injury risk profile before endoscopic intranasal sphenoidal, or endoscopic endonasal transphenoidal, skull-base surgery, and eventually to construct and formulate a common classification by combining the known classes. The authors used computed tomography (CT) toward this end. Methods: The authors retrospectively reviewed 200 consecutive CT scans (400 sides) of the paranasal sinuses. The pneumatization of the anterior clinoid process, the relationships of the ONs to the sphenoidal sinuses, and ON dehiscence were evaluated. The authors then created a formula by which risk profiles can be constructed for patients for whom sphenoid or parasellar surgery is planned. Results: Pneumatization of the anterior clinoid process was evident in 28.25%. Dehiscence of the bony wall of the ON was evident in 9.5%. The ON course lay adjacent to the sphenoidal sinus, causing sinus wall indentation, in 23%. Cumulative optic nerve injury risk scoring showed that, radiologically, surgery on 8.5% and 1.5% of sphenoid sinuses described here carried severe or critical risk of ON injury, respectively. Conclusions: Head-and-neck surgeons and neurosurgeons should be aware of variations in ON course. The authors composed an optic nerve injury risk classification category based on the sum of individual weights of each of these classes. Reductions in ON injuries require careful evaluation of potential variant anatomies. Preoperative CT scans must be meticulously reviewed to avoid ON injury.Öğe Challenges in rhinology(Springer International Publishing, 2020) Cingi, Cemal; Bayar Muluk, Nuray; Scadding, Glenis K.; Mladina, RankoThis book examines in detail many rhinologic issues that are not covered in other books, are still not completely understood, and can be difficult to deal with clinically In each chapter, three authors - a young otorhinolaryngologist, a senior author, and an international expert - elaborate on a specific issue, such as the role of immunotherapy in treating nasal polyps, the management of rhinitis during pregnancy, how rhinitis can differ in adults and children, how to choose between open or endonasal rhinoplasty, the ideal form of anesthesia for nasal surgery, etc The volume will appeal to a wide readership, from otorhinolaryngologists to allergists and facial plastic surgeons, as well as trainees and students in related fields. © Springer Nature Switzerland AG 2021.
