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Öğe Blood Parameters as Indicators of Upper Airway Obstruction in Children With Adenoid or Adenotonsillar Hypertrophy(Lippincott Williams & Wilkins, 2015) Simsek, Gokce; Karacayli, Ceren; Ozel, Aysenur; Arslan, Bengi; Muluk, Nuray Bayar; Kilic, RahmiAdenotonsillar hypertrophy (ATH) is the most common cause of obstructive sleep apnea in children. This study aimed to evaluate the blood parameters of children with ATH who underwent surgery. Methods: The study included a review of the medical records of 130 children who underwent adenoidectomy or adenotonsillectomy with a diagnosis of adenoid hypertrophy and/or chronic tonsillitis. Patients were classified into 3 groups: group 1 (n = 69) underwent adenoidectomy, group 2 (n = 61) underwent adenotonsillectomy, and group 3 consisted of 82 healthy children. White blood cell count, platelet count, hemoglobin levels, mean platelet volume, and platelet distribution width values were the primary outcome measures. Results: Mean platelet volume, platelet distribution width and hemoglobin values decreased in the groups that underwent surgery. Whereas the decrease in group 1 was insignificant, it was significant in group 2. White blood cell count values increased in both group 1 (adenoidectomy) and group 2 (adenotonsillectomy), but the increase in group 2 was significant. No significant difference in platelet count was detected before versus after the operation. Conclusions: Upper airway obstruction caused by ATH remarkably changes the blood parameters related to chronic hypoxia. Significant improvement can be achieved after adenotonsillectomy rather than adenoidectomy alone.Öğe Comparison of Intratympanic Oxytocin and Dexamethasone in Cisplatin Ototoxicity: An Experimental Study(Springer India, 2024) Tas, Burak Mustafa; Ozel, Goekce; Azman, Musa; cakmak Karaer, Isil; Kilic, RahmiAlthough it is widely used, there is still no valid treatment for ototoxicity caused by the antineoplastic drug cisplatin. In this study, we aimed to investigate the efficacy of intratympanic resveratrol and intratympanic dexamethasone treatment in cisplatin-induced ototoxicity. We also compared intratympanic atosiban (oxytocin antagonist) and oxytocin in cisplatin ototoxicity. In this study, 30 rats (60 ears) were used by separating into 5 groups. Cisplatin, oxytocin, dexamethasone, atosiban and 0.9% NaCl were administered intraperitoneally to all groups separately. Auditory Brainstem Response and Distortion Product Otoacoustic Emission tests were performed on all groups before and 72 h after the procedure. Pre-treatment values were higher than post-treatment values in all groups (p < 0.001). There was no significant prolongation of the post-treatment Auditory Brainstem Response I-IV interval in the oxytocin and dexamethasone groups (p > 0.05). There was no significant decrease in the frequencies of 2832 and 4004 after treatment in the oxytocin and dexamethasone group compared to pre-treatment in Distortion Product Otoacoustic Emission. As a result, it has been shown that intratympanic oxytocin may be an option that can be used in the treatment, although it is not as effective as dexamethasone in preventing cisplatin ototoxicity.Öğe Comparison of the protective efficacy between intratympanic dexamethasone and resveratrol treatments against cisplatin-induced ototoxicity: an experimental study(Springer, 2019) Simsek, Goekce; Tas, Burak Mustafa; Muluk, Nuray Bayar; Azman, Musa; Kilic, RahmiPurpose The main aim of this study was to compare the efficacy of intratympanic administration of dexamethasone and resveratrol in preventing cisplatin ototoxicity by measuring acoustic brainstem response (ABR) and distortion product otoacoustic emission (DPOAE). Methods Forty rats (80 ears) were divided into five groups. Cisplatin was administered intraperitoneally to the first group (n = 8). Group 2 (n = 8) received cisplatin after resveratrol had been administered intratympanically. Group 3 (n = 8) received cisplatin after dexamethasone had been administered intratympanically. Group 4 (n = 8) received cisplatin after sodium chloride (NaCl) had been given intratympanically. Group 5 (n = 8) received cisplatin after dimethylsulfoxide (DMSO) had been given intratympanically. ABR and DPOAE tests were performed on all groups before and 72 h after the procedure. Results ABR threshold values in rats that received dexamethasone and resveratrol were found to be less affected than those observed in the other post-cisplatin groups. ABR-IV and ABR-I-IV interval values were significantly reduced in rats that had been given dexamethasone and resveratrol compared to the other groups. After cisplatin treatment, otoacoustic emission (OAE) amplitudes were significantly decreased in Groups 1, 4, and 5 for all frequencies, while OAE values were sustained in the resveratrol and dexamethasone groups (Groups 2 and 3). At OAE frequency 5652, dexamethasone was more significantly associated with protective than resveratrol was, while no significant difference was found between the two groups at other OAE frequencies. Conclusion In conclusion, intratympanic dexamethasone and intratympanic resveratrol treatments may provide a significant protection against cisplatin-induced ototoxicity.Öğe The effects of pressure-controlled and volume-controlled ventilation modes on the nasal mucociliary activity during general anaesthesia.(Allied Acad, 2017) Yaman, Ferda; Arslan, Bengi; Kose, Emine Arzu; Kilic, Rahmi; Apan, AlpaslanThe aim of this prospective randomized, double-blind study was to investigate the effects of pressure controlled and volume controlled ventilation on mucociliary clearance under general anaesthesia maintained with total intravenous anaesthesia. After approval by the Ethics Committee, 60 patients scheduled for tympanoplasty or tympanomasteidectomy under general anaesthesia were enrolled in the study. In Group I (n=30), the lungs of the patients were ventilated using volume-controlled mode with 8 ml/kg tidal volume. In Group II (n=30) pressure controlled ventilation mode was used with 10 cm H2O pressure support. Mucociliary clearance was assessed by in vivo saccharine transit time in preoperative and postoperative periods. The groups showed no significant differences regarding age, height, body mass index, peak and plateau airway pressures. Saccharine transit time values did not differ significantly between the groups. In conclusion, volume-controlled and pressure-controlled ventilation modes have no significant impact on nasal saccharine transit time.Öğe Evaluation of Olfactory Sensation, Acoustic Rhinometry, and Quality of Life of the Patients With Nasal Septal Deviation(Lippincott Williams & Wilkins, 2019) Akay, Hatice Guzelkucuk; Muluk, Nuray Bayar; Inal, Mikail; Simsek, Gokce; Kilic, RahmiObjectives: Nasal septum deviations are deformities that occur in the cartilage and bones of the septum. The aim of the present study is to evaluate the patients with septum deviation according to the acoustic rhinometry measurements in terms of changes in smell function and the effects on quality of life. Methods: Twenty patients with septum deviation between the ages18 to 75 years old and 20 subjects without septum deviation were included in the study. Control group consisted of the 20 subjects with no septal deviation. After ENT examinations, acoustic rhinometry measurements, the SF-36 quality of life scale, and the Brief Smell Identification Tests were applied to all patients. Type of septum deviation is classified according to Mladina classification by anterior rhinoscopy examination, nasal endoscopy, and paranasal computed tomography. Results: The study indicated that the most common deviation type was Mladina Type 3 (65%). Bilateral total smell score of the women in the septum straight group is significantly lower than the men in terms of total smell scores by gender (P< 0.05). The total smell score values in septum group were significantly lower than those of the control group (P< 0.05). According to the individual smell values, cinnamon, banana, and soap odors of the septum deviation group were seen to be significantly lower than the septum straight group (P< 0.05). Conclusion: The results of the study indicated that olfactory dysfunction occurs in patients with septum deviation. Therefore, treatment of septum deviation is necessary for the improvement of nasal obstruction besides the treatment of the smell dysfunction.Öğe Evaluation of the vestibular system with video head impulse test in pregnant women with hyperemesis gravidarum(WILEY, 2020) Tulmac, Ozlem B.; Kilic, Rahmi; Yaman, Selen; Aktulum, Fatma; Simsek, Gokce; Erdinc, SevalAim We aimed to evaluate the semicircular canal functions of the vestibular system in pregnant women with hyperemesis gravidarum. Methods This is a prospective case-control study. Among pregnant women in their first trimester (<14. gestational weeks) who presented to our outpatient clinic, 36 patients diagnosed with hyperemesis gravidarum defined as persistent nausea and vomiting requiring intravenous hydration or loss of at least 5% of prepregnancy weight and 34 healthy pregnant without nausea and vomiting were included. Otorhinolaryngologic examination and video head impulse test (vHIT) was performed to all patients. Vestibular-ocular reflex (VOR) gain and gain asymmetry were assessed between groups. Results The VOR gains in each semicircular canal did not differ between hyperemesis and control groups. Using a VOR gain cut-off value of 0.8, the groups were compared in terms of the frequency of low values. In the hyperemesis group, abnormally low gain values of left anterior canal were more frequently observed than in the control group (32 [88.9%], 22 [64.7%], respectively,P= 0.01). In left anterior-right posterior (LARP) plane VOR gain asymmetry was higher in hyperemesis group (13.5 [1.0-71.0], 6.0 [0.0-35.0],P= 0.001). No significant gain asymmetry was detected between the groups in the other planes. Conclusion Semicircular canal functions were not abnormal globally in women with hyperemesis gravidarum. However, higher LARP plane asymmetry and low LA gain in women with hyperemesis suggests need for further research to clarify functional role of vestibular system on hyperemesis gravidarum.Öğe High-Dose Ropivacaine versus Bupivacaine for Posttonsillectomy Pain Relief in Adults(Bmc, 2008) Arikan, Osman Kursat; Şahin, Saziye; Kazkayasi, Mustafa; Muluk, Nuray Bayar; Akpinar, Serpil; Kilic, RahmiObjective: To compare the efficacy and safety of preincisional high-dose ropivacaine with bupivacaine in relieving posttonsillectomy pain. Design: A prospective, randomized, double blind, placebo-controlled clinical trial. Setting: University hospital. Patients: Before the incision, 58 subjects were randomly assigned to receive 10 mL of 10 mg/mL ropivacaine hydrochloride with epinephrine (n = 19, group 1), 10 mL of 2.5 mg/mL bupivacaine with epinephrine (n = 20, group 2), or saline with epinephrine (n = 19, group 3) as a placebo. Main Outcomes Measures: Postoperative pain, additional analgesic drug consumption, otalgia, operating time, amount of intraoperative blood loss, and possible complications were assessed. The intensity of pain was scored on a visual analogue scale. The patients were followed up for 10 days after surgery. Results: There were no statistically significant differences between the demographic and operational characteristics of the patient groups. Statistically significant differences were determined between in the mean intensity of constant and swallowing pain values of group 1 and group 2 or 3, at 4, 8, and 12 hours, and on days 1, 2, 3, and 4, postoperatively. However, no statistical differences were determined between the groups on days 5, 7, and 10. A lower amount of additional analgesic drug was consumed by the ropivacaine group than by the bupivacaine group, and by the bupivacaine group than by the control group, and the differences were statistically significant. Conclusion: Preincisional infiltration of the tonsils with high-dose ropivacaine markedly decreased the intensity of pain after tonsillectomy when compared with bupivacaine or placebo, especially until postoperative day 4 in adults.Öğe Morphometric Analysis of the Fronto-maxillary Sinuses in Adult Patients with Traumatic Septal Deviations(Bentham Science Publ Ltd, 2019) Inal, Mikail; Simsek, Gokce; Kaya, Ahmet; Kilic, RahmiObjective: The aim of the current study was to investigate a change in the volume of the frontal and maxillary sinuses in patients with nasal septum deviations due to physical trauma. Materials and Methods: Paranasal sinus computed tomography data of 100 patients admitted to Kirikkale University medical faculty hospital between November 2013 and June 2014 were retrospectively analyzed. The side of the nasal septal deviation, the deviation angle, the severity of the deviation, and bilateral frontal and maxillary sinus volumes were calculated using a computer program. The relationship between sinus volumes and deviated septum characteristics was investigated. Results: The maxillary sinus volumes did not differ between the two genders. However, the female patients had significantly decreased frontal sinus volumes when compared with the male patients (p < 0.05). A right-sided septal deviation was found to be associated with a significantly decreased maxillary sinus volume (p < 0.001), and the severity of the deviation was a significant determinant of the maxillary sinus volume (p < 0.001). The age of the patient at the time of the septal trauma was significantly associated with their maxillary sinus volumes. Patients who had experienced this trauma after 12 years of age had significantly increased maxillary sinus volumes when compared with those who experienced the trauma before the age of 12. Conclusion: A distorted septal anatomy was found to be a significant parameter for developing paranasal sinuses. Right-sided and severe traumatic deviations with an onset before the age of 12 were significantly associated with a decreased maxillary sinus volume.Öğe Olfactory acuity based on Brief Smell Identification Test (BSIT R ?) in migraine patients with and without aura: A cross-sectional, controlled study(Elsevier Sci Ltd, 2022) Kandemir, Sueheyla; Pamuk, A. Erim; Glu, Yasin Habipo; Ozel, Gokce; Muluk, Nuray Bayar; Kilic, RahmiObjective: The aim of this study was to evaluate olfactory acuity in migraine patients with and without aura (MwA and MwoA) Material and methods: The study included 30 MwA patients, 30 MwoA patients, and 30 ageand gender-matched controls. Demographic features and odor-related symptoms (osmophobia, odor offensiveness, and odor-triggered attack status) were noted. Olfactory acuity was measured using the Brief Smell Identification Test (BSIT (R)), a 12-item derivative of the University of Pennsylvania Smell Identification Test (UPSIT (R)). BSIT (R) scores were compared between the migraine patients and controls. Results: The mean BSIT (R) score did not differ significantly between the MwA patients (8.7 +/- 0.9) and MwoA (9.17 +/- 0.9) patients (P = 0.094); however, the mean score in the control group was higher (10.4 +/- 0.6) than in the MwA and MwoA patients (P < 0.001). The mean BSIT (R) score did not differ significantly between patients with and without odor-triggered migraine attacks (9 +/- 0.9 and 8.8 +/- 0.8, respectively) (P = 0.4). Osmophobia and odor-triggered attacks were more common in the MwA patients than in the MwoA patients (odor-triggered attacks: 66% vs. 40% [P = 0.04]; osmophobia: 76.6% vs. 60% [P = 0.16]) Conclusion: Olfactory acuity is lower during attack-free periods in migraine patients, as compared to controls. Migraine aura status does not affect olfactory acuity. Odor-triggered attacks, osmophobia, and offensive odors between attacks were more common in the MwA patients than in the MwoA patients. (c) 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.Öğe The Role of CD68 (+) Histiocytic Macrophages in Nasal Polyp Development(THIEME MEDICAL PUBL INC, 2020) Bayar Muluk, Nuray; Arikan, Osman Kursat; Atasoy, Pinar; Kilic, Rahmi; Tuna Yalcinozan, EdaObjectives The aim of this study was to investigate the role of CD68 (+) histiocytic macrophages (H-M) in the nasal polyp pathogenesis. Materials and Methods The study group consisted of 24 adult patients with nasal polyposis. The control group consisted of 11 adult patients without nasal polyps. A total of 36 nasal polyp samples (10-nasal cavity, 10-maxillary sinus, and 16-ethmoid sinus) from the study group and 11 inferior turbinate samples from the control group were analyzed by immunohistochemical staining, with monoclonal antibodies against CD68 (+) H-M. Results CD68 positivity was significantly higher than the control group in the subepithelial (SE) layer of the ethmoid sinus, and deep layers of nasal cavity, maxillary, and ethmoid sinuses. In SE and deep layers of ethmoid and maxillary sinuses, CD68 positivity was significantly higher than that of the epithelial layer. In the deep layer, histiocytic macrophages tended to gather around eosinophils. Conclusion The high numbers of CD68 (+) histiocytic macrophages mainly located in deep layer of lamina propria may be responsible for the phagocytosis of eosinophils within the polyp tissue. Therefore, it may be concluded that increased macrophages in nasal polyps do not trigger the growth of nasal polyps. Instead, they may serve to reduce the number of eosinophils in already-developed nasal polyps.Öğe The Role of Platelet-Derived Growth Factor in the Pathogenesis of Sinonasal Polyps: Immunohistochemical Assessment in Epithelial, Subepithelial and Deep Layers of the Mucosa(Korean Soc Otorhinolaryngol, 2013) Muluk, Nuray Bayar; Arikan, Osman Kursat; Atasoy, Pinar; Kilic, Rahmi; Yalcinozan, Eda TunaObjectives:The aim of this study is to investigate the role of platelet-derived growth factor (PDGF) in the pathogenesis of sinonasal polyps. Methods. Study group (groups 1-3) consisted of nasal polyp samples of patients with sinonasal polyps and the control group consisted of inferior turbinate samples of patients without nasal polyp. In group 1, 14 specimens from ethmoid sinus; in group 2,10 specimens from nasal cavity; in group 3,10 specimens from maxillary sinus; and in group 4 (control), 9 specimens from inferior turbinate were included. By immunohistochemical staining technique, the PDGF positivity index (PI) in mucosal layers and in the inflammatory cells were assessed at the epithelium (EP), subepithelial layer of lamina propria (SE), and deep paraglandular layer of the mucosa (D). Results. Polymorphonudear cell (PMNC)-percentage (%) values of ethmoid and maxillary sinus, and the PDGF PI from all cells of ethmoid sinus and nasal cavity were significantly higher than those of the control group. As mononuclear cell-% (MNC-%) increased, the PDGF_EP_basal PI, PDGF_SE_endothelial PI, and PDGF_D_endothelial PI decreased. As PMNC-PDGF PI increased, the PDGF_D_perivascular PI decreased and PDGF_D_endothelial PI increased. As PDGF-MNC PI increased, the PDGF_EP_apical PI, PDGF_SE_endothelial PI, and PDGF_D_endothelial PI decreased. As PDGF-all cells (PMNCs, MNCs, and fibroblasts) PI increased, the PDGF_EP_basal PI and PDGF_D_endothelial PI decreased, and the PDGF_D_perivascular PI increased. Conclusion. We concluded that the PDGF systems play important roles in polyp pathogenesis. Fibroblast-derived PDGF may be more important than MNC-derived PDGF in polyp developing process. Increased perivascular-PDGF-PI in deep layers of the mucosa may result in sinonasal polyp formation by causing an increase in vascular permeability and extracellular edema, and thus promoting migration of inflammatory cells to extracellular area. Tissue oxygenization may be important for the initiation of PDGF release system. Because of this reason, nasal obstruction should be medically treated earlier, and, if necessary, by surgical approaches.Öğe The Efficacy of Gabapentin plus Dexamethasone for Postoperative Analgesia Following Septoplasty: A Prospective Randomized Placebo-Controlled Trial(Sage Publications Inc, 2023) Kandemir, Suheyla; Pamuk, A. Erim; Ozel, Gokce; Gencay, Isin; Kilic, RahmiAims: This study aimed to compare the efficacy of gabapentin, dexamethasone, and gabapentin + dexamethasone for pain control after septoplasty. Materials and Methods: This prospective randomized trial included 120 patients that underwent septoplasty and were randomly divided into 4 groups: group G (preoperative gabapentin 600 mg p.o.); group D (intraoperative dexamethasone 8 mg i.v.); group GD (preoperative gabapentin 600 mg p.o. + intraoperative dexamethasone 8 mg i.v.); group C (placebo control). Results: The median VAS score was significantly lower in groups G and GD at 1, 2, 4, 6, 12, and 24 hours postsurgery than in group C (P < .008 for all). The median VAS score was significantly lower in group D than in group C at 1, 2, and 4 hours postsurgery (P < .008 for all). There weren't any significant differences in the VAS score between groups D, G, and GD at any time point. Groups G, D, and GD had a significantly lower frequency of rescue analgesic use than group C; however, there were no differences between groups G, GD, and C (P < .001 and P = .108, respectively). Conclusion: Gabapentin, dexamethasone, and gabapentin + dexamethasone are equally more effective analgesics during the first 4 hours postsurgery than placebo. The addition of dexamethasone to gabapentin does not provide extra analgesia. Both gabapentin and gabapentin + dexamethasone have a more prolonged analgesic effect than dexamethasone alone.Öğe Topical Application of Arnica and Mucopolysaccharide Polysulfate Attenuates Periorbital Edema and Ecchymosis in Open Rhinoplasty: A Randomized Controlled Clinical Study(Lippincott Williams & Wilkins, 2016) Simsek, Gokce; Sari, Elif; Kilic, Rahmi; Muluk, Nuray BayarBackground: The purpose of this study was to investigate the effects of local arnica and mucopolysaccharide polysulfate treatment on the regression of postoperative edema and ecchymosis in patients who have undergone open technique rhinoplasty. Method: One hundred eight patients were included in the study. Participants were randomized into three groups, all of whom had undergone rhinoplasty. Group 1 (n = 36) received postoperative arnica cream treatment, and group 2 (n = 36) received postoperative mucopolysaccharide polysulfate cream treatment. Group 3 (n = 36, control group) consisted of patients who received no postoperative local treatments. Patients were evaluated for 24 hours on days 2, 5, 7, and 10 after the operation. For the evaluation of postoperative edema and ecchymosis, a scale ranging from 0 to 4 was used, and the groups were compared. Results: In groups 1 and 2, postoperative ecchymosis was significantly less than in the control group during postoperative days 1, 5, and 7 (p < 0.005). The regression of the edema was also more rapid in groups 1 and 2 than in the control group during evaluations on postoperative days 1, 5, and 7 (p < 0.005). Neither edema nor ecchymosis was significantly different between groups 1 and 2 (p > 0.005). Conclusions: The authors' results suggest that a rapid regression of edema and ecchymosis may be achieved by local treatments of arnica and mucopolysaccharide polysulfate cream. In addition, there are no significant differences between these two treatment regimens. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.Öğe Transposition of lingual thyroid gland to the submandibular region by transoral approach(Elsevier Sci Ltd, 2017) Akbay, Ercan; Simsek, Gokce; Kilic, RahmiThe purpose of this case report is to demonstrate surgical technique of only functional but symptomatic lingual thyroid gland transposition to submandibular region by transoral approach without mandibulotomy and tongue-splitting. A 37-year-old female patient was admitted to our hospital with dysphagia and apnea symptoms. Physical examination revealed 3 cm x 3 cm lingual thyroid gland was detected at the tongue base. The patient was euthyroid and thyroid gland was not detected in the neck. Under general anesthesia, right submandibular gland excision and transposition of lingual thyroid tissue to submandibular region with dorsal lingual artery axis flap were performed by transoral approach. Thyroid hormones remained normal in the postoperative period. In conclusion transoral transposition of lingual thyroid to submandibular region as a flap without mandibulotomy is a minimally invasive and function preserving alternative approach. Besides preserving thyroid functions, this transoral surgical technique can be preferred by patients who avoid skin incision for esthetic concerns. (C) 2016 Elsevier Ireland Ltd. All rights reserved.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.
