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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 Cinnamaldehyde is an effective anti-inflammatory agent for treatment of allergic rhinitis in a rat model(Elsevier Ireland Ltd, 2016) Hanci, Deniz; Altun, Huseyin; Cetinkaya, Erdem Atalay; Muluk, Nuray Bayar; Cengiz, Betul Peker; Cingi, CemalObjectives: The effect of cinnamaldehyde on the treatment of allergic rhinitis (AR) was investigated in rat model. Methods: Twenty-eight female Wistar albino rats were randomly divided into four groups: Group 1 (control) (C), Group 2 (AR with no treatment) (AR + NoTr), Group 3 (AR + Azelastine HCl) (AR + Aze), and Group 4 (AR + cinnamaldehyde) (AR + Cin). At day 21, AR + Aze rats were given an Azelastine HCl drop, and AR + Cin rats were given cinnamaldehyde intranasally. In all groups, allergic symptoms histopathological results were evaluated. Results: The AR + NoTr group showed the worst allergic symptoms, cilia loss and greater inflammation. In the AR + Aze and AR + Cin groups, allergic symptom scores were higher than those in the control group. However, between AR + Aze and AR + CM groups, there were no significant differences in the allergic symptom scores Histopathological analysis revealed vascular congestion and an increase in goblet cell numbers in the AR + Cin group. However, AR + Cin rat nasal mucosa had less plasma cell infiltration compared with the AR + NoTr group. In rats from the AR + Aze group, analysis of the nasal mucosa revealed less eosinophil infiltration than that seen in the AR + NoTr group. A lower score for mast cell (MC) infiltration was observed in the nasal mucosa of rats treated with Azelastine HCl compared with cinnamaldehyde. Conclusions: In this study we observed that both Azelastine HCl and cinnamaldehyde reduced allergic symptoms in an AR rat model. Cinnamaldehyde decreased vascular congestion as well as plasma cell, eosinophil, and inflammatory cell infiltration into the lamina propria. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Öğe Effects of Lateral Osteotomy on Nasal Sound Intensity Levels in Patients Who Underwent Rhinoplasty(Lippincott Williams & Wilkins, 2014) Acar, Mustafa; Ulusoy, Seckin; Seren, Erdal; Muluk, Nuray Bayar; Cingi, Cemal; Hanci, DenizWe investigated the effects of lateral osteotomy on nasal sound intensity levels in 34 patients who underwent rhinoplasty. Four groups were evaluated: group 1, preoperative rhinoplasty with lateral osteotomy (Preop-RPwithLO); group 2, postoperative rhinoplasty with lateral osteotomy (Postop-RPwithLO); group 3, preoperative rhinoplasty without lateral osteotomy (Preop-RPwithoutLO); and group 4, postoperative rhinoplasty without lateral osteotomy (Postop-RPwithoutLO). By sound analysis, low-frequency (Lf; 500-1000 Hz), medium-frequency (Mf; 1-2 kHz), and high-frequency (Hf; 2-4 and 4-6 kHz) nasal sound intensities were defined. Mf-left values of Postop-RPwithLO were significantly lower than those of Preop-RPwithLO, and Mf-left values of Postop-RPwithoutLO were significantly higher than those of Postop-RPwithLO and Preop-RPwithoutLO. Hf-right values of Preop-RPwithoutLO were significantly higher than those of Postop-RPwithLO and Postop-RPwithoutLO. Hf-total values of Postop-RPwithoutLO were significantly lower than those of Preop-RPwithoutLO. Nasal airway width decreased and nasal sounds, especially Mf sound intensities, increased in the nonlateral osteotomy group (group 4). When lateral osteotomy is performed, the nasal air passage may be adjusted as required by the surgeon, the air passage in the nasal valve region may not be narrowed, and nasal sound intensities may decrease. During postoperative follow-ups, increased Mf and Lf nasal sound intensities should be considered for the narrowness of the nasal passage and lower patency of the nasal cavities. Nasal sound analysis is a noninvasive technique and can also be used to evaluate nasal patency in septoplasty and rhinoplasty patients and children and for cases in which official reports are needed in addition to acoustic rhinometry measurements.Öğe Endoscopic versus microscopic approach to type 1 tympanoplasty in children(Elsevier Ireland Ltd, 2014) Dundar, Riza; Kulduk, Erkan; Soy, Fatih Kemal; Aslan, Mehmet; Hanci, Deniz; Muluk, Nuray Bayar; Cingi, CemalObjectives: We investigated the outcomes of the endoscopic versus microscopic approach to type 1 tympanoplasty in pediatric patients. Methods: In this retrospective study, the outcomes of 61 ears of 60 pediatric patients (33 male and 27 female) who underwent type 1 tympanoplasty were evaluated. One patient underwent a bilateral operation. The age range of the patients was 7-16 years. Group 1 underwent tympanoplasty with an endoscopic technique (n = 32), and Group 2 underwent tympanoplasty with the conventional microscopic technique (n = 29). A boomerang-shaped chondroperichondrial graft was used in both groups. The outcomes were analyzed in terms of the hearing gain, duration of surgery, and graft success rate. Results: In both groups, the postoperative air-bone gap (ABG) was significantly lower than the preoperative ABG. There were no significant differences between the preoperative and postoperative ABG values (in dB) in either group. The mean operative duration in Group 1 was significantly lower than that in Group 2 (51.37 vs. 67.03 min, respectively). In the preoperative evaluation, 65.6% of patients in Group 1 had larger perforations and 34.4% had smaller perforations. In Group 2, 58.6% and 41.3% of patients had larger and smaller perforations, respectively. Perforations were detected in two (6.25%), four (12.50%), and four (12.50%) of the patients in Group 1 at postoperative months 1, 6, and 12, respectively. Perforations were detected in two (5.71%) patients in Group 2 at postoperative months 1, 6, and 12. At 12 months postoperatively, there were smaller perforations in four (12.5%) of the children in Group 1 and in two (5.71%) of the children in Group 2. The difference between the perforation conditions (larger vs. smaller) was not significant in either group. The preoperative and postoperative increases in the ABG were associated. The operative duration was shorter in Group 1 than in Group 2. Conclusion: In pediatric patients undergoing type 1 tympanoplasty, especially if the external ear canal is narrow and the anterior canal wall is prominent, the endoscopic and microscopic approaches appear to give equal results in terms of easy visualization of the entire tympanic membrane and no requirement for extra intervention to evaluate the ossicular system. A shorter operative duration is an advantage of the endoscopic tympanoplasty technique. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Öğe Immunotherapy in all aspects(Springer, 2016) Hanci, Deniz; Sahin, Ethem; Muluk, Nuray Bayar; Cingi, CemalAllergen immunotherapy is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy. In this review, we presented the important topics in immunotherapy. The important aspects of immunotherapy are considered to be "ImmunologA +/- cal responses to immunotherapy"; "The principal types of immunotherapy"; "Effectiveness"; "Indications"; "Contraindications"; "Allergen immunotherapy in children"; "Safety"; and "Anaphylactic reactions after immunotherapy". The principal types of immunotherapy are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy. Both of them can be used in indicated cases. When using SCIT, physicians must be more careful because of reported rare fatal cases. The risks and benefits of continuing allergen immunotherapy in patients who have experienced severe systemic reactions should be carefully considered.Öğe Is There a Relationship Between Snoring Sound Intensity and Frequency and OSAS Severity?(Sage Publications Inc, 2016) Acar, Mustafa; Yazici, Demet; Muluk, Nuray Bayar; Hanci, Deniz; Seren, Erdal; Cingi, CemalObjectives: We investigated the relationship between snoring sounds and severity of obstructive sleep apnea syndrome (OSAS). Methods: A total number of 103 snoring patients (60 males and 43 females) were evaluated by means of polysomnographic findings and snoring sound recordings. Snoring sound intensity was assessed using fast Fourier transform (FFT) method by measuring maximal frequency (Fmax) and average snoring sound intensity level (SSIL). Results: Maximal frequency and SSIL are correlated with apnea-hypopnea index (AHI), REM AHI, and severity of the OSAS. So, as the severity of the OSAS increased, so did the Fmax and SSIL of the snoring recordings, meaning patients started snoring louder with more frequency. In older patients, in females, in severe OSAS group, and in patients with higher body mass index (BMI), AHI and AHI REM values and SSIL and Fmax values increased. As mean oxygen (O-2) saturation and lowest O-2 saturation decreased, SSIL and Fmax values increased. Conclusion: Maximal frequency and SSIL analysis of the snoring sound increased in severe OSAS patients. People should be aware of the importance of snoring sounds. In particular, patients with snoring sounds increasing in intensity and of higher frequency should discuss with their physicians the possibility of OSAS.Öğe Otolaryngological findings in mucopolysaccharidosis(Deomed Publ, Istanbul, 2014) Cingi, Cemal; Muluk, Nuray Bayar; Hanci, Deniz; Sahin, Ethem; Acar, MustafaIn this review paper, we reported otolaryngological problems in patients with mucopolysaccharidoses (MPSs). Mucopolysaccharidoses are a group of lysosomal storage diseases, each of which is produced by an inherited deficiency of an enzyme involved in the degradation of acid mucopolysaccharides, now called glycosaminoglycans (GAGs). The mucopolysaccharidoses consist of a group of 7 metabolic disorders, known as mucopolysaccharidoses types I-VII. In all groups, there are clinical and otolaryngological manifestations. In MPS patients, upper airway obstruction, obstructive sleep apnea, restriction of mouth opening, middle ear effusion, hearing and breathing problems, etc. are reported as common otolaryngological findings. Increasing awareness of MPS's among ENT doctors will be a life saving attempt for MPS suspected patients who admit an ENT doctor rather than a pediatrician. In MPS patients, tracheotomy may be difficult due to short neck. Due to mouth opening restriction, patients should be evaluated carefully before tonsillectomy and adenoidectomy operations. Airway problems must be evaluated before anesthesia. All ENT doctors should be noticed to be aware of these problems.Öğe Potential protective effect of N-acetyl cysteine in acoustic trauma: An experimental study using scanning electron microscopy(Wroclaw Medical Univ, 2017) Ada, Servet; Hanci, Deniz; Ulusoy, Seckin; Vejselova, Djanan; Burukoglu, Dilek; Muluk, Nuray Bayar; Cingi, CemalBackground. Oxidative stress has been associated with pathological processes involved in acoustic trauma. Objectives. In this prospective experimental study, we investigated the potential preventive effect of N-acetyl cysteine (NAC) in rats exposed to acoustic trauma (AT). Light microscopic and scanning electron microscopic (SEM) evaluations were performed. Material and methods. Healthy Wistar albino rats (n = 18) were divided into 3 groups: group 1 (control group, n = 6), group 2 (acoustic trauma group, n = 6), and group 3 (AT+NAC group, n = 6). The rats in group 2 were exposed to AT. The rats in group 3 received NAC at a dose of 100 mg/kg/day by gavage for 7 days, and then 10 min after the 7th-day dose, they were exposed to AT. Results. From light and scanning electron microscopy evaluations in the control group, the cochlear structure and epithelium were normal. In group 2 (AT group), extensive hair cell loss was observed in the cochlea by light microscopy evaluation. In the SEM evaluation, various epithelial damage and loss of stereocilia were also observed. In group 3 (AT+ NAC group), decreased damage with preserved cochlear structures was seen by light microscopy. In the SEM evaluation, although stereocilia loss was also seen, nearly normal cell structures and vertical and symmetrical alignment of stereocilia structures were observed compared to the AT group. Conclusions. NAC reduced cochlear damage due to acoustic trauma. Because NAC has antioxidant capacity, AT mat have caused an increase in free radicals and death of outer hair cells. NAC is an antioxidant agent and it prevented cochlear damage due to AT in rats.Öğe Telephonic Analysis of the Snoring Sound Spectrum(Sage Publications Inc, 2014) Seren, Erdal; Ilhanli, Ilker; Muluk, Nuray Bayar; Cingi, Cemal; Hanci, DenizObjective: Snoring is a sound caused by vibration of collapsed and/or unsteady airway walls of the pharynx and soft palate. We compared stored spectra of snoring sounds recorded via cell phone (CP) and a microphone placed over the head (head phone [HP]). Methods: Thirty-four snoring patients were included in this prospective study. Groups were identified by reference to body mass index (BMI) values: group I, BMI <25 kg/m(2) (n = 8); group 2, BMI 25 to 29 kg/m(2) (n = 10); and group 3, BMI >= 30 kg/m(2) (n = 16). Snoring sounds were recorded using CPs and HPs and digitally analyzed. We identified the frequencies with the highest snoring powers (F-max values) and snoring sound intensity levels (SSILs). Results: F-max ranged from 520 to 985 Hz in HP recordings and from 845 to 1645 Hz in CP recordings. Snoring sound intensity level values increased in proportion to BMI and were 6 to 24 dB in HP recordings and 19 to 52 dB in CP recordings. Thus, the CP values of F-max and SSIL were higher than the HP values. In obese patients of group 3, almost all F-max and SSIL values were higher than those of groups 1 and 2. In particular, the CP F-max values were elevated in such patients. The advanced technologies used in modern CPs may allow some snoring sounds in susceptible individuals to be defined as oronasal. Conclusion: Cell phone technology allows snoring to be evaluated in patients located in areas remote from a hospital. To explore the intensity of snoring and to postoperatively monitor the efficacy of surgery used to treat snoring, telephonic sound analysis is both new and effective and reduces the need for patient attendance at a hospital. Those experiencing severe snoring and/or who are obese should be told of what can be done to solve such problems.Öğe Updating the role played by immunotherapy for allergic rhinitis: meta-analysis(Wiley, 2015) Cingi, Cemal; Muluk, Nuray Bayar; Hanci, Deniz; Ulusoy, Seckin; Sahin, FezanBackgroundAlthough the effectiveness of allergen monotherapy immunotherapy for allergic rhinitis (AR) has been well established by many prior studies, other aspects of immunotherapy are still incompletely documented by high-quality studies. The many published papers describe various results. The aim of the present study was to conduct a meta-analysis on the effectiveness of allergen immunotherapy. MethodsA total of 56 homogeneous studies were included in the analysis. The inclusion criteria used to select articles were as follows: (1) placebo-controlled clinical trials; (2) the use of immunotherapy; (3) participants and/or physicians were or were not blinded to immunotherapy or placebo assignment (single-blinding, double-blinding, or no-blinding studies); and (4) randomization or not of those in the immunotherapy and placebo groups. ResultsBetween 2003 and 2013, 114 placebo-controlled clinical trials were reported in Medline. Studies describing recovery rates in immunotherapy and placebo groups numbered 56. The distribution of such works was homogeneous (heterogeneity chi-square = 16.11; degrees of freedom [df] = 55; p = 1.000). The extent of recovery in immunotherapy groups was 53.671-fold greater than in placebo groups (Mantel-Haenszel [M-H] pooled risk ratio [RR] = 53.671; 95% confidence interval [CI], 36.981 to 77.893; z = 20.96; p < 0.001). ConclusionOur meta-analysis suggests that immunotherapy is associated with a recovery rate 53.671-fold that of placebo.
