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Öğe Acoustic impedance study of peritubal myoclonus(Taylor & Francis As, 2002) Yetiser, S.; Kazkayasi, M.; Civitci, D.An audible clicking sound coexistent with the contractions of the peritubal muscles is thought to be an isolated form of palatal myoclonus that presents with myoclonal contractions of the soft palate, larynx, pharynx and, sometimes, cervicofacial area. Acoustic impedance measurements, by demonstrating the relation between the muscle contract ions and the clicking noise, represent one of the ways in which the diagnosis can be confirmed. This paper reports the impedance changes following various maneuvers and simultaneous electromyography recordings in four patients with peritubal myoclonus and confirms the accuracy and simplicity of these tests. The pathology of peritubal myoclonus and its treatment options are discussed.Öğe Certain anatomical relations and the precise morphometry of the infraorbital foramen-canal and groove: An anatomical and cephalometric study(Lippincott Williams & Wilkins, 2001) Kazkayasi, M.; Ergin, A.; Ersoy, M.; Bengi, O.; Tekdemir, I.; Elhan, A.Objectives: To determine and to standardize the certain anatomical relations, and the precise size, course, and location of the infraorbital foramen, canal, and groove for facilitating surgical and invasive procedures. Study Design: This anatomical study consisted of two main steps, namely, the examination of skulls and the cephalometric analysis of the skulls. Measurements of the skulls and of the radiograms were performed. Methods: Thirty-five adult bony heads (70 sides) were studied regarding the localization and dimensions of the infraorbital groove (IOG), infraorbital canal (IOC), and infraorbital foramen (IOF) as well as their relationships with different anatomical landmarks. The cephalometric analysis of the skulls was measured for evaluating the relationships of certain anatomical points and the distances of the skulls in the cephalometric analysis. For this purpose, 13 different distances and two angles were measured on anteroposterior and lateral craniographies. Differences between data of skull and cephalogram measurements were analyzed by the Student t test. The Pearson correlation test was used in the statistical analysis of the 15 values in the cephalogram. Results: Examination of the 70 sides of the 35 bony heads revealed that the shape of the IOF was oval in 34.3%, round in 38.6%, and semilunar in 27.1% of all skulls. The IOF was single in 94.3% and double in 5.7% of the cases. The average distance from the IOF to the infraorbital margin and to the lateral process of the canine tooth in vertical direction and to the lateral nasal border in horizontal direction were 7.19 +/- 1.39 mm, 33.94 +/- 3.15, and 17.23 +/- 2.64 mm, respectively. In cephalometric analysis, when S-N (the distance between the center of the sella turcica and the nasion) and N-ANS (the distance between the nasion and the anterior nasal spine) distances were used as independent parameters for the linear analysis, the correlation of the three values for both independent parameters were statistically significant. Conclusion: While the IOF has no statistically significant changes with regard to the size of the skull, expressive changes take place in the course and the length of the IOG and IOC. Meticulous preoperative evaluation of the IOF and the route of the infraorbital nerve are necessary in patients who are candidates for maxillofacial surgery and regional block anesthesia If these measurements are taken into account, there will be little surgical risk, and this will be helpful in identifying the extent of the operative field.Öğe Facial nerve paralysis due to chronic otitis media(Lippincott Williams & Wilkins, 2002) Yetiser, S.; Tosun, F.; Kazkayasi, M.Objective: To present the characteristics of facial paralysis caused by chronic otitis media. The role of cholesteatoma. bony dehiscence, the duration of the disease, and the results of surgical therapy in facial paralysis were reviewed. Study Design: Retrospective case review. Setting: Tertiary care referral center. Patients: A total of 24 patients (6 women, 18 men: age range. 17-74 yr) with facial paralysis were included in the study. Intervention: Canal wall down mastoidectomy was performed in 14 patients (58.3%), modified radical mastoidectomy was performed in seven patients (25%), and intact canal wall mastoidectomy was performed in three patients (16.7%). All patients had decompression of the fallopian canal from the geniculate ganglion to the stylomastoid foramen without opening the epineural sheath. Results: Eighteen patients (75%) had gradual onset of facial paralysis. The most common associated symptom with facial paralysis was vertigo in six patients. Twelve patients (50%) had no associated symptoms. Facial paralysis was the sole complication in 2 1 patients (87.9%), Three patients had multiple complications, Labyrinthitis was the most common associated complication. Facial paralysis was associated with congenital cholesteatoma in one patient. Four-teen patients (58.3%) demonstrated dramatic recovery within 3 months after surgery. Intraoperatively. cholesteatomas were found in 17 of the patients (70.8%). The fallopian canal was intact in four patients (none of them had a cholesteatoma), and 20 patients had bone destruction or dehiscence (three patients had no cholesteatoma). The tympanic segment was the most common site of involvement in 14 patients (58.3%). Conclusion: A middle ear cholesteatoma was present in the majority of patients with facial paralysis caused by chronic otitis media, Gradual onset of facial paralysis was the most frequent pattern, Facial paralysis presented poor prognosis regardless of the presence of a cholesteatoma, There was no statistical difference among the results of surgical techniques.Öğe Immunologic abnormalities and surgical experiences in recurrent facial nerve paralysis(Lippincott Williams & Wilkins, 2002) Yetiser, S.; Satar, B.; Kazkayasi, M.Objective: To document immunologic findings in patients with recurrent facial paralysis (RFP) and to compare the results of the surgery with the results of medical treatment. Study Design: Retrospective case review. Setting: Tertiary care referral center. Patients: Nine patients with RFP were reviewed. Intervention: Patients underwent nonspecific antibody detection, protein electrophoresis (in blood and cerebrospinal fluid [CSF]) and oligoclonal band determination for immunoglobulin G, A, and M (in CSF). The extended subtotal facial nerve decompression via the transmastoid and transattic route was performed in four patients. Five patients received medical treatment only (steroids, vitamin 13). Results: Two patients had the complete and four patients had the oligosymptomatic form of Melkersson-Rosenthal syndrome. The other three patients were diagnosed with idiopathic RFP. Serum immunoglobulin G was high in seven of nine patients (77%). CSF protein electrophoresis demonstrated an elevated albumin fraction in six of nine patients (66%). CSF immunoglobulin G was high in four of nine patients (44%). The oligoclonal band in CSF was negative in all patients. Mean follow-up time was 5.2 +/- 2.6 years and 3 +/- 1.5 years for surgically treated patients and medically treated patients, respectively. None of the patients who underwent the surgery demonstrated recurrence. Although marked recovery was observed in patients who had received medical treatment, three of them had recurrence during the follow-up period. Conclusion: Serologic test results have demonstrated immune system involvement in cases of idiopathic RFP and in cases of Melkersson-Rosenthal syndrome, providing no distinction between the two. There was no sign substantiating local antibody production in CSF, which implies that the elevated antibodies in CSF were peripheral in origin. Although the serologic test results were not conclusive for a specific diagnosis, they support an immune-mediated pathogenesis. Despite the small number of patients who underwent the extended transmastoid facial nerve decompression, our follow-up data were suggestive for the prevention of recurrences.Öğe Minnesota multiphasic personality inventory profile of patients with chronic sinusitis(Int Rhinologic Soc, 2001) Bayar, N.; Oğuztürk, O.; Kazkayasi, M.; Koç, M.C.Chronic sinusitis is one of the most common diseases in the general population. We investigated the personality traits of non-psychiatric patients in chronic sinusitis and non-sinusitis groups. In this study we evaluated 25 patients with chronic sinusitis and 25 subjects as a control group. In the analysis of the psychiatric status, MMPI profiles were used. We found that the depression and social introversion subscales were higher in males, whereas the hypochondriasis and social introversion subscales were higher in females with chronic sinusitis. It is concluded that the psychological functions of the patients with chronic sinusitis are poorer than in the non-sinusitic group.Öğe The morphometric and cephalometric study of anterior cranial landmarks for surgery(Georg Thieme Verlag Kg, 2008) Kazkayasi, M.; Batay, F.; Bademci, G.; Bengi, O.; Tekdemir, I.Objective: The aim of this work was to determine reliable bony landmarks for the anterior skull base and to standardize some specific dimensions among the frontal sinus and neighboring structures for safe anterior cranial surgery. Methods: The study consisted of a topographical anatomic examination and cephalometric analysis of the skull. Thirty adult skulls (60 sides) were studied regarding the localization and dimensions of the supraorbital foramen (SOF), frontal sinus (FS), frontozygomatic fissure, infraorbital foramen, anterior nasal spine, and nasion. Differences between the measurement of skulls and cephalograms were analyzed by Student's t test. The Pearson correlation test was used for statistical analysis of the cephalogram. Results: Examination of the 60 sides of the bony heads revealed that the shape of the SOF was a foramen in 25 sides (41%), a notch in 29 sides (49%), and a groove in 6 sides (10%). A total of 20 (33%) SOFs were inside the FS and the mean distance was 6.3 + 1.34 mm from the lateral border of the sinus, 27 (45%) of SOFs were outside of the FS and the mean distance was 8.8 + 2.01 mm, and 13 (22%) of SOFs were at the border of the FS. According to our measurements the medial border of the craniotomy should be placed approximately 43 mm lateral to the nasion to avoid entering into the frontal sinus. Conclusion: To plan and to decide the convenient and safe anterior midline skull base approach and to avoid postoperative complications, bony landmarks and anatomic measurements around the SOF and FS will be helpful for the surgeon to constitute a simplification of topographic anatomy.Öğe Over-expression of p53 and c-erbB-2 oncoproteins in laryngeal carcinoma(Springer, 2001) Kazkayasi, M.; Hücümenoğlu, S.; Siriner, G.İ.; Hücümenoğlu, M.An immunohistochemical analysis of over-expression of p53 and c-erbB-2 proteins was performed on 27 biopsies of laryngeal carcinoma. The aim of this study was to investigate whether there is a correlation between over-expression of these proteins and the clinicopathological features of the tumor and to reveal any possible prognostic value. Paraffin sections of laryngeal carcinoma were studied using immunohistochemical staining with mouse and rabbit monoclonal antibodies, respectively, for p53 and c-erbB-2 proteins. The positive controls were paraffin-embedded specimens from ten breast carcinomas previously shown to express these proteins. Ten benign laryngeal nodules were immunohistochernically stained as negative controls. Samples from 74% of 27 patients with laryngeal carcinomas demonstrated positive nuclear and cytoplasmic (or membranous) staining for p53 protein and 48% were positive for c-erbB-2 protein. In the present study, while there was a slight difference in the frequency of p53 over-expression among stage I-II and stage III-IV tumors, there was no difference in the frequency of p53 over-expression among primary and recurrent tumors. There was no statistically significant correlation between over-expression of the p53 and c-erbB-2 proteins and the age of the patients, tumor site, tumor grade, clinical stage, histopathological grading of the tumor, alcohol consumption, and clinical outcome. There was a statistically significant correlation between immunostaining of p53 and c-erbB-2 proteins (P = 0.037). While it was found that over-expression of p53 was significantly associated with the presence of lymph node metastasis (P = 0.006), there was no association between the expression of c-erbB-2 and lymph node status. The data demonstrated increased expression of p53 and c-erbB-2 proteins, presumed to be mutant, in laryngeal carcinomas. Hence, we conclude that p53 and c-erbB-2 over-expression as detected by immunohistochemical staining in larynx carcinomas is not predictive of poor survival or disease-free survival.Öğe Surgery of nasal contact point headache: assessment with quality of life(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2018) Yalcinozan, E. T.; Kazkayasi, M.; Muluk, N. Bayar; Gokce, B.; Erdemoglu, A. K.Objectives: The purpose of this study was to determine the efficiency of surgery in the treatment of referred headaches which might originate from nasal mucosal contact points. Methods: This study involved 20 patients who had complaints of headaches for three months or longer in duration and had nasal mucosal contact points in the physical examination. The patients were examined during the preoperative and postoperative period with nasal endoscopy, topical lidocaine tests, computerized tomography of paranasal sinuses, a visual analogue scale, the short-form 36-item health survey and acoustic rhinometry. The type of surgery required was decided according to the localization of the nasal mucosal contact point. Results: The differences in the comparison of the visual analogue scale scores between the preoperative period after the lidocaine test and the postoperative period of the eighth week and 24th week were statistically significant (p<0.013). The scores of the short-form 36-item health survey from the preoperative period, postoperative eighth week, and postoperative 24th week showed statistically significant differences in a paired comparison test (p<0.017). No statistically significant differences were observed in acoustic rhinometry results between the preoperative period, the postoperative eighth week and the postoperative 24th week. In the first-year period, the visual analogue scale and short-form 36-item health survey scores designated a statistically significant improvement (p>0.05). Conclusions: This study points out the importance of rhinologic surgery for nasal mucosal contact points which might be the cause of referred headaches.
