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Öğe Could nasal septal deformities type 5 and 6 be a predictive factor of the individual genetic predilection for the onset of an acute coronary syndrome?(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2016) Caric, T.; Mladina, R.; Cingi, C.; Skitarelic, N.; Raguz, M.; Bergovec, M.; Muluk, N. B.Objectives: the possible impact of nasal septal deformities (SD) on cardiac pathology has not been well studied, despite growing evidence among data showing that upper airway obstruction has a negative effect on cardiac function in general and a "deviated nasal septum" being considered one of the most frequent factors responsible for impaired nasal breathing. Methods: a retrospective, case-control, double-blind study was performed on 249 patients who survived an acute coronary syndrome (ACS) attack. All patients underwent coronary angiography and were divided into coronary angiography positive (123 pts) and coronary angiography negative (126 pts) groups. The quality of nasal breathing was not considered in this study, but morphological aspects of the nasal septum (nasal septal deformities) were observed by anterior native rhinoscopy and endoscopic examination of the nose following the application of superficial anaesthesia. Mladina classification of nasal septal deformities was used. Results: there was a statistically significant difference between coronary angiography negative and positive patients in Mladina type 1 to Mladina type 7 groups (p=0.000, X-2=54.605). The incidence of nasal SD types 5 and 6 was higher in the group of ACS patients with the positive coronary angiography, whereas general distribution of the particular types of nasal septal deformities as they appear in the general population was found in the coronary angiography negative group. Conclusion: the fact that types 5 and 6 are inherited deformities and not related to trauma against the nose suggests the possible genetic predisposition for the onset of ACS with positive coronary angiography.Öğe Do viral infections have a role in benign paroxysmal positional vertigo?(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2015) Hanci, D.; Ulusoy, S.; Muluk, N. B.; Cingi, C.Do viral infections have a role in benign paroxysmal positional vertigo? Objectives: To investigate the role of viral infection in benign paroxysmal positional vertigo (BPPV). Methods: In this retrospective study, 483 patients with BPPV were included in the study group. The control group consisted of 461 healthy subjects. In both groups, serologic analysis of viral agents (HSV1, HSV2, Herpes zoster, EBV, CMV, adenovirus, influenza, and parainfluenza virus) was performed. Results: With the exception of influenza and parainfluenza, all viral serology values were higher in the BBPV group than the control group. We also observed seasonal variation. The BPPV group exhibited elevated values for HSV1 and adenovirus in March and May, for Herpes zoster, adenovirus, and influenza in April, for HSV1 in June, and for HSV1 and CMV in September, compared to the control group. In October, the BPPV group showed increased values for all of the viruses studied, compared to the control group. Conclusion: BPPV is associated with positive viral serology, particularly during certain months of the year, mainly in spring and autumn. Viral infection might promote BPPV attacks due to the development of vestibulopathy or induce secondary BPPV via viral infection-related neurolabyrinthitis.Öğe Effects of subjective tinnitus on sleep quality and mini mental status examination scores(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2010) Muluk, N. B.; Tuna, E.; Arikan, O. K.Objectives: We investigated the effects of subjective tinnitus on sleep quality and Mini Mental Status Examination (MMSE) scores of participants. Methods: The study group consisted of 15 patients, including 21 ears with tinnitus (6 bilateral, 9 unilateral). The control group consisted of 8 healthy patients with normal hearing and no tinnitus (16 ears). We assessed sleep quality using the Mini Sleep Questionnaire (MSQ) and mental health using the MMSE. Results: Sleep delay (SD) was significantly higher in tinnitus patients (5.28 +/- 2.23) compared to controls (3.25 +/- 2.56) (p = 0.018). Subjective tinnitus loudness level (STLL) scores were higher and sleep quality was impaired in females, older patients, and patients with lower MMSE scores. Sleep quality was also worse in patients with longer tinnitus duration. In younger and well educated patients, MMSE scores were higher. Higher STLL scores and shorter tinnitus duration were associated with lower MMSE scores. Patients with newly developed tinnitus reported more disturbances and showed greater effects on mental and cognitive functioning. Conclusion: In subjective tinnitus patients, sleep delay values increased. Long tinnitus duration and high STLL scores may affects patients' cognitive functions as shown by decreased MMSE scores. Furthermore, mental status changes in tinnitus patients were frequently overlooked.Öğe Is it possible to define the ideal lips?(Pacini Editore, 2018) Kar, M.; Muluk, N. B.; Bafaqeeh, S. A.; Cingi, C.The lips are an essential component of the symmetry and aesthetics of the face. Cosmetic surgery to modify the lips has recently gained in popularity, but the results are in some cases disasterous. In this review, we describe the features of the ideal lips for an individual's face. The features of the ideal lips with respect to facial anatomy, important anatomical landmarks of the face, the facial proportions of the lips and ethnic and sexual differences are described. The projection and relative sizes of the upper and lower lips are as significant to lip aesthetics as the proportion of the lips to the rest of the facial structure. Robust, pouty lips are considered to be sexually attractive by both males and females. Horizontal thirds and the golden ratio describe the proportions that contribute to the beauty and attractiveness of the lips. In young Caucasians, the ideal ratio of the vertical height of the upper lip to that of the lower lip is 1:1.6. Blacks, genetically, have a greater lip volume. The shape and volume of a person's lips are of great importance in the perception of beauty by humans. The appearance of the lips in part determines the attractiveness of a person's face. In females. fuller lips in relation to facial width as well as greater vermilion height are considered to be attractive.Öğe Milestones of language development in Turkish children(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2013) Muluk, N. B.; Bayoglu, B.; Konuskan, B.; Anlar, B.Objectives: Language delays are common in childhood, may be associated with delays in other areas of development, and can affect school performance. Various tests designed for general developmental screening or specifically for language are used to assess developmental status in preschool children. Knowledge of the probabilities of normal developmental milestones may simplify detection of problems and delays. The aim of this study was to determine the milestones of language development in Turkish children. Patients and methods: We assessed data from application of the Denver II Developmental Screening Test's Turkish standardization to 1,993 children, 976 (49.0%) boys and 1,017 (51.0%) girls aged 0.6-82.0 months. We used binary logistic regression to analyze the predicted probability of accomplishing the language items on the Denver II Developmental Screening Test. Results: We determined the sequence of assessed language items and the ages associated with accomplishing those items, as well as the ages at which 25, 50, 75, and 100% of children passed the items. Language items followed a sequential route. Graphs had polynomial slopes. Conclusion: Curves for normal development allow detection of aberrations in the predicted course of language development, and may facilitate earlier diagnosis of delays in language.Öğe The results of national newborn hearing screening (NNHS) data of 11,575 newborns from west part of Turkey(Verduci Publisher, 2014) Ulusoy, S.; Ugras, H.; Cingi, C.; Yilmaz, H. B.; Muluk, N. B.OBJECTIVE: In this study, we aimed to review the National Newborn Hearing Screening (NNHS) programme data obtained from Corlu, located in west part of Turkey for the last 4 years. SUBJECTS AND METHODS: A total 11575 newborns that were either born in Corlu State Hospital or referred from other Health Care Centers, between September 2009 and November 2012 were included into the study. Automated-Transient Evoked Otoacoustic Emission (A-TEOAE) test and Automated-Auditory Brainstem Response (A-ABR) were used as screening tests. When the newborn had failed at the initial A-TEOAE test, then the test was repeated after 15 days. If the same result was obtained at the second test; the newborns were referred for ENT examination. A-TEOAE and A-ABR screening tests were performed as the third stage evaluation. The failed newborns were referred for clinical ABR test. RESULTS: Out of 11575 newborns, 593 (5.12%) had failed the test and they were referred for clinical ABR. Out of these 593 neonates, 470 had passed the diagnostic ABR test at the referral center. Bilateral and unilateral sensori-neural hearing loss (SNHL) was detected at 15 and 7 babies respectively, 10 of 22 of these babies had risk factors such as family history of hearing loss, and parental consanguinity. CONCLUSIONS: The final hearing impairment and risk factor rates of our study was similar with literature. Although referral rates and the number of default babies gradually decreased in the last 4 years; definitive diagnosis and hearing aid initiation times need to improvement.Öğe Smell functions in patients with multiple sclerosis: a prospective case-control study(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2016) Kandemir, S.; Muluk, N. B.; Melikoglu, B.; Dag, E.; Inal, M.; Sahin, O.Objectives: The aim of this study is to evaluate the smell function in patients with multiple sclerosis (MS). Methods: Twenty subjects (six males, 14 females) who were diagnosed as having MS, based on the 2010 Revised McDonald criteria, and 20 healthy individuals (six males, 14 females) were included in this study. In order to measure smell identification abilities, each subject completed the 12-item Brief Smell Identification Test (BSIT). Central and peripheral regions of smell were measured using cranial magnetic resonance (MR) images. The central regions of smell (the temporal lobe insular gyrus and the corpus amygdala) and the peripheral regions of smell (the olfactory bulb, tract and sulcus) were examined in the cranial MR images. Regions of smell were also evaluated for the presence of MS lesions (plaques). Results: The total BSIT scores of the subjects in the MS group were found to be significantly lower than those of the control group (p< 0.05). In the MS group, measurement values of the central regions of smell (right corpus amygdala diameter, right and left corpus amygdala) were significantly higher than those of the control group (p< 0.05). There were no MS lesions in the peripheral regions of smell, but MS lesions were observed in the central regions: the right temporal lobe insular gyrus (four patients, 20.0%); the left temporal lobe insular gyrus (two patients, 10.0%); and the right corpus amygdala (one patient, 5.0%). While these results are not sufficient for statistical analysis, the total smell scores of these patients were found to be low. Conclusion: There is a deterioration in the smell functions of patients with MS. Therefore, we highly recommend that ENT specialists use the easily accessible and reliable BSIT for the diagnosis of smell disorders.
