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Öğe Advanced Stage Buccal Carcinoma: Effect of Local Extension on Prognosis(Aves Press Ltd, 2017) Comert, Ela; Tuncel, Umit; Turan, Fatih; Kilic, Caner; Atabey, PinarBACKGROUND/AIMS The aim of this study was to evaluate the effects of alveolar mucosa, bone, cheek skin, and lip invasion of buccal carcinoma on locoregional recurrence and survival rates. MATERIALS and METHODS The study included 36 patients with T3-T4a buccal carcinoma. Both T3 and T4a tumors were divided into two subgroups: T3 tumors limited to buccal mucosa, T3 tumors with the involvement of alveolar mucosa, T4a tumors with bone invasion, and T4a tumors with skin and/or lip invasion. RESULTS In T3-T4a tumors, the rates of tumors limited to the buccal mucosa, tumors involving alveolar mucosa, bone of either the maxilla or mandible, and skin and/or lips were 25%, 22.2%, 33.3%, and 19.4%, respectively. The 3-year disease-free survival rate of patients with T3 and T4a tumors was 70.6% and 52.6%, respectively. The 5-year disease-free survival rate of patients with T3 and T4a tumors was 58.8% and 42.1%, respectively. Regarding the 3- and 5-year survival rates, no statistically significant difference was observed between T3 and T4a tumors and between their subgroups. CONCLUSION Despite the lack of statistical significance, there seemed to be a trend toward worse survival among the patients with bone invasion.Öğe Association between superoxide dismutase 2, glutathione peroxidase 1, xeroderma pigmentosum group d gene variations, and head and neck squamous cell cancer susceptibility(Inst Bioloska Istrazivanja Sinisa Stankovic, 2022) Kose, Gulcin; Oz, Merve Demirbugen; Comert, Ela; Suzen, Halit SinanAs oxidative stress is implicated in the pathogenesis of head and neck squamous cell cancer (HNSCC), the functions of antioxidant enzyme systems and DNA repair proteins are critical in the development of cancer. To investigate the role of genetic polymorphisms of the antioxidant superoxide dismutase 2 (SOD2) Val16Ala, glutathione peroxidase 1 (GPX1) Pro198Leu, and the DNA repair Xeroderma Pigmentosum Group D (XPD) Lys751Gln genes under exogenous risk factors, including smoking and alcohol consumption, in HNSCC carcinogenesis, we conducted a case-control study on 139 unrelated cases and 265 non-cancer controls. Polymorphisms were analyzed in additive, dominant and recessive genetic models, individually and in an interaction model. Carriers of the T allele of SOD2 were associated with an increased risk for HNSCC in males and smokers; similarly, the T allele of GPX1 was associated with elevated risk in the overall and smoker subgroup. A 12.47-fold increased risk was observed for the carriers of GPX1 TT, SOD2 CT and XPD CC genotypes for HNSCC. This is the first study presenting the potential roles of SOD2, GPX1 and XPD polymorphisms in interaction and under three genetic models in the development of HNSCC. The results suggest that these polymorphisms slightly modify the risk in HNSCC development individually but are significantly higher when they functioned and were evaluated together.Öğe Detection of microplastics in patients with allergic rhinitis(Springer, 2023) Tuna, Aysegul; Tas, Burak M.; Kankilic, Gokben Basaran; Kocak, Furkan M.; Sencan, Ziya; Comert, Ela; Bayar Muluk, NurayObjectiveWe aimed to investigate the relationship between microplastics, which are a worldwide health and environmental issue, and their relationship to allergic rhinitis.Materials and methodsA total of 66 patients participated in this prospective study. The patients were divided into two groups. While there were 36 patients with allergic rhinitis in group 1, there were 30 healthy volunteers in group 2. The participants' age, gender and Score for Allergic Rhinitis results were noted. Microplastics were examined in the nasal lavage fluids of the patients and their numbers noted. The groups were compared on these values.ResultsThere was no significant difference between the groups in terms of age and gender. There was a significant difference between the allergic rhinitis group and the control group in terms of the Score for Allergic Rhinitis results (p < 0.001). In the allergic rhinitis group, the microplastic density in the nasal lavage was significantly higher than in the control group (p = 0.027). Microplastics were detected in all participants.ConclusionsWe found more microplastics in allergic rhinitis patients. According to this result, we can say that there is a relationship between allergic rhinitis and microplastics.Öğe Evaluation of Clinical Features and Olfactory Functions in COVID-19: A Multicentre Study(Springernature, 2023) Tas, Burak Mustafa; Alpaydin, Turgay; Akcali, Sinem; Kaygusuz, Sedat; Erol, Oezlem Ozluk; Sencan, Ziya; Comert, ElaIntroductionCoronavirus Disease-2019 (COVID-19) causes olfactory loss one of the initial diagnostic criteria. The brief smell identification test (BSIT) is an objective test frequently used in olfactory dysfunction. This study aimed to observe the changes in olfactory functions and clinical features in a short time in COVID-19.MethodsIn this prospective study involving 64 patients, the BSIT was performed at two different times; at the time of first application and on the 14th day. Demographic features, laboratory findings, body mass index (BMI), blood oxygen saturation values (SpO2), complaints at first admission, fever, follow-up place, and treatment schemes were noted.ResultsThere was a significant difference between the BSIT scores at the first admission and when the polymerase chain reaction (PCR) became negative on the 14th day (p<0.001). Low oxygen saturation values at first admission were associated with low BSIT scores. No relationship was found between olfactory functions and complaints at admission, fever, follow-up place, and treatment schemes. ConclusionAs a result, negative effects of COVID-19 on olfactory functions have been demonstrated even in the short follow-up period. In addition, low saturation values at first admission were associated with low BSIT scores.Öğe Expansion sphincter pharyngoplasty: analyzing the technique based on anatomy(SPRINGER, 2021) Comert, Ela; Comert, Ayhan; Sencan, ZiyaPurpose The purpose of this study is to evaluate the effect of the different surgical techniques of expansion sphincter pharyngoplasty (ESP) on the dimensions of the oropharyngeal airway. Methods The techniques that were evaluated included the preservation and transection of the palatopharyngeus (PP) and superior pharyngeal constrictor (SPC) muscle attachment and transposition of the PP muscle to the hamulus of the medial pterygoid plate and the palatal musculature. Surgical techniques were applied in twenty half heads. Results The preservation of the PP-SPC attachment inhibited the transposition of the PP muscle to the hamulus and resulted in comparable enlargement in the medial-lateral dimension in the oropharyngeal airway when the PP muscle was transposed to the palatal musculature. After transection of the PP-SPC attachment, significant enlargement was observed in anterior-posterior and medial-lateral directions in the oropharyngeal airway when the PP muscle was transposed both to the hamulus and the palatal musculature. The distances measured after both the transposition techniques were similar. Conclusion The present study is a basic study demonstrating how different techniques of ESP affect the position of the soft palate. The PP-SPC attachment can be transected in the patients with anterior-posterior palatal and lateral wall collapse to pull the soft palate anteriorly in addition to prevent the lateral wall collapse. The PP-SPC attachment can be preserved in the patients with only lateral wall collapse. Nevertheless, the clinical consequences of these static changes need to be evaluated in clinical studies.Öğe In response of Detection of microplastics in patients with allergic rhinitis(Springer, 2024) Tuna, Aysegul; Tas, Burak M.; Kankilic, Gokben Basaran; Kocak, Furkan M.; Sencan, Ziya; Comert, Ela; Bayar Muluk, Nuray[Abstract No tAvailable]Öğe In Response to Role of Microplastics in Chronic Rhinosinusitis Without Nasal Polyps(Wiley, 2024) Tas, Burak M.; Tuna, Aysegul; Kankilic, Gokben B.; Kocak, Furkan M.; Sencan, Ziya; Comert, Ela; Muluk, Nuray B.[Abstract No tAvailable]Öğe Jugular Bulb Anatomy for Lateral Skull Base Approaches(Lippincott Williams & Wilkins, 2018) Comert, Ela; Kilic, Caner; Comert, AyhanBackground: This study was designed to define the detailed anatomical relations of the jugular bulb with the facial nerve, sigmoid sinus, otic capsule, and internal acoustic canal allowing the safe management of the jugular bulb. Methods: Thirty-five formalin-perfused cadaveric temporal bones that had well mastoid and petrous pneumatization without any neurovascular variations on computed tomography scan were selected for the study. The bones were dissected via translabyrinthine approach. Results: The dome of the jugular bulb was located under the facial nerve in 21 of the cases (60%), in the mastoid cavity in 8 of the cases (22.9%), and in the tympanic cavity in 6 of the cases (17.1%). Significant difference was observed only between the temporal bones in which the dome of the jugular bulb was located in the mastoid cavity and under the facial nerve with regard to the mastoid cortex-lateral semicircular canal measurement (P = 0.04). Conclusion: Because of the high variability of the position of the dome of the jugular bulb, the precise knowledge of the relations of the jugular bulb and the preoperative radiologic verification of possible variations are essential to avoid the problems associated with its position and to decide the approach individually.Öğe Neurovascular anatomy of pronator quadratus for reanimation of blepharoptosis(Springer France, 2022) Igde, Murat; Yilmaz, Mehmet; Gungor, Yigit; Saglam, Murat Enes; Salman, Necati; Tapan, Mehmet; Comert, ElaPurpose Pronator quadratus (PQ) is a quadrilateral muscle on a volar distal side of the forearm. The purpose of this study was to establish a novel surgical technique for reanimation of the upper eyelid for severe ptosis using PQ functional free muscle flap. Methods The current study is a cadaveric study, designed to assess a PQ free flap transfer that lies between the frontalis muscle and the upper eyelid. Fourteen PQ from fourteen embalmed cadavers were dissected, and their neurovascular pedicles were isolated. Then they were transferred to the area on the contralateral side between the frontalis muscle and upper eyelid tarsal cartilage. Measurements of the PQ flap, antebrachial region, orbitofrontal region, recipient vessels, and motor nerve were performed using a caliper. The extendibility of neurovascular pedicles was evaluated by measurements of lengths. In addition, the diameter of PQ flap vascular pedicle vessels was compared with recipient vessels. Results The mean width of the proximal border of PQ was 41.92 +/- 2.05 mm and the distal border of the PQ was 42.84 +/- 4.04 mm. The mean PQ artery (type II, Mathes-Nahai flap classification) length was found to be 117.72 +/- 7.77 mm. The mean diameter of the anterior interosseous nerve was 1.89 +/- 0.08 mm. The mean diameter of the uppermost branch of the frontal branch of the facial nerve was 1.18 +/- 0.25 mm. The length and diameter of neurovascular pedicles of muscle flaps were adequate for microvascular anastomoses and neurorrhaphy. Conclusions The results of this anatomical study demonstrate that the PQ free flap transfer has anatomical features that are suitable and compatible with the surgical treatment of blepharoptosis.Öğe Pronator quadratus musculo-osseous free flap for wide hard palatal defect reconstruction: An anatomical study(Elsevier Sci Ltd, 2023) Igde, Murat; Salman, Necati; Gungor, Yigit; Yilmaz, Mehmet; Comert, Ela; Saglam, Murat Enes; Baykara, YigitWide hard palate defects include congenital and acquired defects that are six square centimeters or larger in size. Obturator prostheses and autologous soft tissue transfers have been used to reconstruct palatal defects. This study aims to repair wide, hard palatal defects by using a pronator quadratus musculo-osseous free flap to achieve subtotal reconstruction. Seventeen formalin-fixed cadavers were dissected. Free musculo-osseous pronator quadratus flaps were prepared after a 12 cm curvilinear volar skin incision. Standard 30 x 23 mm (690 & PLUSMN; 52.12 mm2) hard palate defects were made by chisels and saws. A subcutaneous tunnel was created between the mandibular edge cross point of the facial vessels and the retromolar trigone through the subcutaneous to the superficial musculoaponeurotic system by dissection. Area measurements of the pedicle and palate defects were performed by the ImageJ program (National Institutes of Health, Bethesda, MD, USA) on drawings over an acetate layer of materials. Mandibular distances of gonion-facial vessel cross point (a), goniongnathion (m), and facial vessels' cross point-retromolar entrance point (h) were measured. Ratios of h/m and a/m were calculated. The mean pronator quadratus area was 2349.39 & PLUSMN; 444.05 mm2, and the arterial pedicle pronator quadratus diameter was 2.32 & PLUSMN; 0.34 mm. The mean pedicle length of the pronator quadratus was 117.13 & PLUSMN; 8.10 mm. Study results showed that musculo-osseous pronator quadratus flaps' bone and muscle parts perfectly fit on the defects in all cadavers. Pronator quadratus musculo-osseous flap is a feasible surgical option for wide, hard palatal defect reconstruction strategies.& COPY; 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Öğe Radiological Evaluation of the Effect of Laryngopharyngeal Reflux on the Thickness of Inferior Turbinate, Maxillary Sinus Mucosa and Nasal Septal Body(Springer India, 2024) Tas, Burak Mustafa; Sarikaya, Pelin Zeynep Bekin; Sencan, Ziya; Comert, Ela; Muluk, Nuray BayarBackground We investigated the relationship between Laryngopharyngeal Reflux (LPR) and maxillary sinus mucosal thickness (MSMT), inferior turbinate mucosal thickness (ITMT), inferior turbinate width (ITW) and nasal septal body thickness (NSBT), which can be signs of chronic rhinosinusitis and allergic rhinitis.Methods The study, which included 87 patients, was designed as two groups. While 42 of the patients were included in the Laryngopharyngeal Reflux group, 45 were included in the control group. Age and gender information of the patients were noted. MSMT, ITMT, ITW and NSBT values were measured in patients who had Paranasal Sinus Computed Tomography. MSMT, ITMT and ITW were measured as right and left. Both groups were evaluated in terms of these values.Results Right ITMT, bilateral ITW and MSMT values were found to be significantly higher in the LPR group than in the control group (p < 0.05). MSMT values were higher in males (p < 0.05). The left-ITT and NSBT values were not significantly different between the LPR group and the control group, but both values were higher in the LPR group than in the control group (p > 0.05). In the LPR group, there were positive correlations between ITMT and ITW values of the right side; and left side separately (p < 0.05).Conclusion It has been shown that Laryngopharyngeal Reflux increases maxillary sinus mucosal thickness, inferior turbinate thickness and width, and nasal septal body thickness, which can be signs of chronic rhinosinusitis and allergic rhinitis. The negative effects of LPR on nasal and paranasal mucosa and structures were demonstrated in this study.Öğe Role of Microplastics in Chronic Rhinosinusitis Without Nasal Polyps(Wiley, 2024) Tas, Burak Mustafa; Tuna, Aysegul; Kankilic, Goekben Basaran; Kocak, Furkan Melih; Sencan, Ziya; Comert, Ela; Bayar Muluk, NurayObjective: We aimed to examine the relationship between chronic rhinosinusitis without nasal polyps and microplastics. Methods: A total of 80 patients participated in this prospectively planned study. The patients were divided into two groups. Group 1 had 50 patients with chronic rhinosinusitis without nasal polyps, whereas Group 2 had 30 healthy volunteers. The age and gender of the participants were noted. Nose Obstruction Symptom Evaluation questionnaire was applied to the patients. The patients performed nasal lavage with saline. Microplastics were examined in the collected nasal lavage fluids, and their numbers were noted. The groups were compared on these values. Results: The mean age was 38.06 +/- 14.15 years in the chronic rhinosinusitis group without nasal polyps and 33.60 +/- 11.68 years in the control group. There was no significant difference between the groups in terms of age and gender. There was a significant difference in the number of microplastics between the chronic rhinosinusitis group without nasal polyps and the control group (p < 0.001). Microplastics were detected in all participants. Conclusions: We found more microplastics in patients with chronic rhinosinusitis without nasal polyps. According to this result, we can say that there may be a relationship between chronic rhinosinusitis and microplastics.Öğe Surgical anatomy of the transcanal infracochlear approach(Springer, 2022) Comert, Ela; Comert, AyhanPurpose The objective of this study is to describe the detailed surgical anatomy of the infracochlear approach to prevent complications and to compare the postauricular transcanal microscopic and endoscopic approaches to reach the petrous apex. Methods Cadaver heads were dissected using a binocular surgical microscope, endoscopes, and an electric drill. The dimensions of the access field that could be reached and manipulated with surgical instruments and straight drill via postauricular transcanal microscopic and endoscopic approaches were evaluated. Results Both postauricular microscopic and transcanal endoscopic approaches were considered to be inapplicable in cases with a tympanic cavity located jugular bulb closer than 3 mm to the cochlea. This relationship was seen in 3 (9%) sides of the cadavers. In 4 specimens (12%), a cochlear aqueduct with an open lumen was detected. Both postauricular microscopic and transcanal endoscopic approaches reached a nearly identic dissection area. Detailed anatomy of the approach and measurements about the topography of the third portion of the facial nerve from the tympanic cavity were presented. Conclusion Both traditional microscopic postauricular and endoscopic transcanal approaches provided comparable access areas to the inferior petrous apex with wide exposure, and radiologic measurements were compatible. A tympanic cavity located jugular bulb in close relation with cochlea was the only instance that restricted the applicability of this technique.Öğe Topographical Anatomy of the Superficial Temporal Artery(Turkish Neurosurgical Soc, 2023) Guler, Tugba Morali; Comert, Ayhan; Gungor, Yigit; Guner, Yahya Efe; Sayaci, Yagiz Emre; Korkmaz, Ali Can; Comert, ElaAIM: To describe in detail the gross anatomy of the superficial temporal artery (STA), its course and branches, its relationships with the branches of the facial nerve, and certain anatomical and surgical landmarks to preserve these structures in daily neurosurgical practice, and to use the STA during revascularization surgery.MATERIAL and METHODS: This cadaveric study was conducted on 16 cadaver heads bilaterally, in which 32 silicon/latex-injected STAs were dissected using a microdissection technique in a neuroanatomy laboratory. The distances between the facial nerve, tragus, STA, superficial temporal vein (STV), and imaginary lines created between important anatomical landmarks were measured. The curvilinear lengths of STA and STV were also measured.RESULTS: The average distances of the most posteriorly located branch of the facial nerve to the frontal region and the tragus at the midpoint of zygoma in the horizontal plane, at the superior border of the zygoma and at the level of the superior border of the parotid gland, were measured as 25.39, 29.84, and 15.56 mm, respectively. The average distance directly measured between the tragus and STA was 39.29 mm, and that between the tragus and STV was 20.26 mm. The average curvilinear lengths of the frontal and parietal branches of STA were 97.63 and 96.45 mm, respectively.CONCLUSION: Understanding the clinical anatomy of the STA and its branches and its relationships with other structures is of critical importance for a successful and noncomplicated surgery. Our findings will be useful not only for surgical approaches such as pterional craniotomy and orbitozygomatic approaches but also for cerebral revascularization.Öğe Video head impulse test in children with otitis media with effusion and dizziness(ELSEVIER IRELAND LTD, 2020) Tozar, Mesut; Comert, Ela; Sencan, Ziya; Simsek, Gokce; Muluk, Nuray Bayar; Kilic, RahmiObjective: The objectives of the study were to evaluate the vestibular impairment in children with otitis media with effusion (OME) and dizziness by using vHIT test, and to compare their results with healthy children. Methods: The study population consisted of 30 pediatric patients with OME and dizziness and 30 healthy children, age between 4 and 15. Otoscopic and tympanometric examination and vHIT testing were performed to all subjects. vHIT test parameters were compared between pediatric patients with OME and dizziness and healthy children. Additionally, the differences of the mean vHIT gains between tympanogram types, otoscopic findings and the presence of saccades were analyzed. Results: The mean vHIT gains and gain asymmetry values of patients with OME and dizziness and healthy children were comparable. No significant difference was observed between the mean vHIT gains of patients with type B and type C2 tympanogram. Covert saccades were observed in 57% of the patients with OME and dizziness. None of the patients had over saccades and none of the healthy children had saccades. Conclusion: Our study is a preliminary study analyzing the vestibular impairment in children with OME and dizziness using vHIT test. Based on our results, it can be assumed that the children with OME and dizziness usually don't have a great vestibular impairment that can be detected with vHIT test. The covert saccades detected in this patient group are accepted as a sign of slight vestibular impairment.Öğe Voice and Quality-of-Life Outcomes of Diode Laser for Tis-T1a Glottic Cancer(Sage Publications Inc, 2020) Sencan, Ziya; Comert, Ela; Tuncel, Umit; Kilic, CanerThe aim of this prospective study was to analyze the voice and quality-of-life outcomes of microscopic diode laser surgery (MDLS). The study was conducted on a series of 46 patients with Tis-T1a glottic carcinoma treated with microscopic endolaryngeal diode laser surgery. Patients were asked to complete the Voice Handicap Index and quality-of-life questionnaires of the European Organization for Research and Treatment of Cancer. When comparing the pre- and postoperative scores, there were significant difference on the physical scores (P = .014) of the patients who underwent type III cordectomy and functional (P = .022), emotional (P = .002), and overall scores (P = .005) of the patients who underwent type IV cordectomy, in the direction of better quality of voice after MDLS. The postoperative functional, physical, emotional, and overall scores of groups were significantly increased with the extension of resection.
