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Öğe 1,25(OH)(2)D-3 and specific IgE levels in children with recurrent tonsillitis, and allergic rhinitis(Elsevier Ireland Ltd, 2013) San, Turhan; Muluk, Nuray Bayar; Cingi, CemalObjectives: We investigated 1,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3] and specific immunoglobulin E (IgE) levels in children with recurrent tonsillitis (RT) plus allergic rhinitis (AR). Methods: Thirty children with RT + AR were included in the study group, and 30 healthy children comprised the control group. AR-related symptoms were determined using a symptom scale. 1,25(OH)(2)D-3 and specific IgE measurements were made in both groups. Results: The 1,25(OH)(2)D-3 value was significantly lower in the RT + AR group than in the control group. Specific IgE (mixed) panels were in normal limits in both groups; whereas specific IgE (mixed) grass pollen panel value of RT + AT group was significantly higher than that of the control group. Higher nasal itching, nasal obstruction, and concha edema scores were related to significantly higher specific IgE values for the (mixed) grass pollen panel, whereas higher sneeze scores were related to higher specific IgE values for the (mixed) pediatric panel. Conclusions: Children with grass pollen allergy may not be exposed to sufficient sunlight. With reduced 1,25(OH)(2)D-3, T helper cells may increase, and allergic response also increases. As allergic events increased, these children did not go outside and thus lacked sun exposure. This vicious cycle must be broken, and children with RT + AR should have sunlight exposure to increase 1,25(OH)(2)D-3 levels. (C) 2013 Elsevier Ireland Ltd. All rights reserved.Öğe A Comparison of Diagnostic Accuracy of Superior Semicircular Canal Dehiscence in MDCT and MRI, and Coexistence with Tegmen Tympani Dehiscence(Thieme Medical Publ Inc, 2021) İnal, Mikail; Muluk, Nuray Bayar; Şahan, Mehmet H.; Asal, Neşe; Şimşek, Gökçe; Arıkan, Osman K.Objective Tegmen tympani dehiscence in temporal multidetector computed tomography (MDCT) and superior semicircular canal dehiscence may be seen together. We investigated superior semicircular canal dehiscence in temporal MDCT and temporal magnetic resonance imaging (MRI). Methods In this retrospective study, 127 temporal MRI and MDCT scans of the same patients were reviewed. In all, 48.8% (n = 62) of cases were male, and 51.2% (n = 65) of cases were female. Superior semicircular canal dehiscence and superior semicircular canal-temporal lobe distance were evaluated by both MDCT and MRI. Tegmen tympani dehiscence was evaluated by MDCT. Results Superior semicircular canal dehiscence was detected in 14 cases (5.5%) by temporal MDCT and 15 cases (5.9%) by temporal MRI. In 13 cases (5.1%), it was detected by both MDCT and MRI. In one case (0.4%), it was detected by only temporal MDCT, and in two cases (0.8%), it was detected by only temporal MRI. Median superior semicircular canal-to-temporal distance was 0.66 mm in both males and females in temporal MDCT and temporal MRI. In both temporal MDCT and temporal MRI, as superior semicircular canal-to-temporal lobe distance increased, the presence of superior semicircular canal dehiscence in temporal MDCT and temporal MRI decreased. Tegmen tympani dehiscence was detected in eight cases (6.3%) on the right side and six cases (4.7%) on the left side. The presence of tegmen tympani dehiscence in temporal MDCT and the presence of superior semicircular dehiscence in MDCT and MRI increased. Conclusion Superior semicircular canal dehiscence was detected by both MDCT and MRI. Due to the accuracy of the MRI method to detect superior semicircular dehiscence, we recommend using MRI instead of MDCT to diagnose superior semicircular canal dehiscence. Moreover, there is no radiation exposure from MRI.Öğe A narrative-style review of non-surgical rhinoplasty: Indications, outcomes, and limitations(Churchill Livingstone, 2024) Dilber, Muhammet; Muluk, Nuray Bayar; Cingi, CemalThe aim of this narrative-style review was to evaluate non-surgical rhinoplasty in terms of indications, outcomes, and limitations. Both 'PubMed' and 'Science Direct' were reviewed by all authors, in order to reach consensus with regard to the chosen studies. Studies published from 1980 to 2023 were searched using the key terms non-surgical rhinoplasty, dermal filler, thread lifting, and botulinum toxin, and relevant papers were selected. Non-surgical rhinoplasty refers to the use of injectable temporary fillers to augment selected areas of the nose, in order to achieve improved appearance or function in select patients. It includes the use of dermal fillers, thread lifting, and botulinum toxin injections. The perfect dermal filler would be inexpensive, safe, painless to inject, hypoallergenic, and long lasting. In addition, it should produce consistent and predictable results, feel natural under the skin, take little time to inject, be ready to use, exert no downtime on the patient, and have a low risk of complications. Regions of the nose treated with filler injections include the frontonasal angle, dorsum, nasolabial angle, and columella. Thread lifting and botulinum toxin injection are the other methods of non-surgical rhinoplasty. Dermal fillers, thread lifting, and botulinum toxin injections can be used as non-surgical rhinoplasty. Dermal fillers and botulinum neurotoxin can be used alongside each other to allow minimally invasive resculpting of the nasal region and midface, compensating for a reduction in tissue volume and the formation of rhytides.Öğe A new preservation technique for dehumping the dorsum(Verduci Publisher, 2023) Azizli, E.; Muluk, Nuray Bayar; Dündar, R.; Cingi, C.OBJECTIVE: We aimed to offer a new preservation strategy for dehumping the dorsum by using a variation of the cartilage push- down ( Ishida) technique. PATIENTS AND METHODS: Three hundred patients (42 males and 258 females) had surgical procedures. All procedures were closed- surgery-type, primary-case procedures performed through a closed incision. Low cartilaginous septal strip resection was performed on 269 individuals, whereas high septal strip resection was performed on the remaining 31 patients. The bony cap is shielded as a separate unit and preserved, so protected from any potential damage. The cartilage roof is separated from the bone roof and lowered while wearing the bony cap component. As a result, less concealment is required. However, it is ineffective on dorsal profiles that are sharp or S-shaped, as opposed to flat. Thus, the modified cartilage push-down with bony cap rasping procedure can be carried out. The sharp hump on the bony crown of the skull is smoothed out and filled. Therefore, the bony cap above the central cartilage roof is much thinner. Because the hump is less likely to appear again, concealment is unnecessary. A median of 8.5 months was spent following-up (6-14 months). RESULTS: According to our method, among men (n=42), the hump size ranged from minor (n=5) to medium (n=25) to big (n=12). There were 258 women, 88 of whom had a little hump, 160 had a medium hump, and 10 had a huge hump. Indicative of surgeon satisfaction with low cartilaginous septal strip excision vs. high septal strip resection include the following: with a total of 269 patients, 35 males, and 234 females had low cartilaginous septal strip resections, with 98 and 96% success rates, respectively, for the surgeons. There were 31 patients, seven men and 24 women, who all underwent high septal strip resections, with a 98% and 96% success rate for the surgeons. It was found that there was a correlation between the size of the hump and the level of satisfaction felt by its bearers. Rates of male satisfaction with humps ranged from 100% for little humps to 100% for medium humps to 99% for huge humps. Satisfaction percentages among women ranged from 98% in the case of little humps to 96% among medium humps and 95% among large humps. CONCLUSIONS: O ur t echnique o f m odification of the cartilage push-down (Ishida)1 method is applied for dehumping the dorsum. High satisfaction percentages were obtained from the patients and surgeons. This technique may be a good option for patients who need dehumping.Öğe A safety investigation into topical effects of naproxen sodium on nasal epithelial cells and potential toxicity in local application(W B Saunders Co-Elsevier Inc, 2023) Dündar, Rıza; Muluk, Nuray Bayar; Sezer, Canan Vejselova; Kaya, Furkan; Kutlu, Hatice Mehtap; Cingi, CemalObjectives: We examined how topically-applied naproxen sodium affects human nasal epitheliocytes in culture. Methods: Samples of healthy human primary nasal epithelium (NE) harvested during septoplasty from volunteers without rhinosinusitis were incubated in cell culture. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assays may be utilised when assessing cellular damage (toxicity), as evidenced by DNA fragmentation, nuclear condensation, alteration in the outer plasma membrane and cytoskeletal alteration. This was the method used in the study. Cultured epitheliocytes were incubated with naproxen sodium for 24 h at 37 ???C. The MTT assay was then performed and the cells' morphology was examined by confocal microscopy. Additionally, cellular proliferation was assessed by the artificial scratch method followed by light microscopy. Results: The results indicated that naproxen sodium does not cause any cytotoxic effects upon nasal epithelial cells when applied topically. There was no evidence indicating cytotoxicity on the nasal epitheliocytes in culture for the 24 h period over which the drug was applied. In particular, there was no alteration in cellular morphology, damage to the intracellular organelles structure or the cytoskeleton secondary to naproxen sodium. Furthermore, cellular proliferation occurred normally in these conditions, as on scratch test. Conclusion: Topical naproxen sodium may be used on nasal epithelial cells without inducing toxicity. This agent is therefore suitable, given its known anti-inflammatory effects, for use in patients suffering from diseases involving nasal and paranasal sinusal inflammation, including rhinosinusitis (both chronic and acute) and nasal polyposis which should be investigated. In the future, topical medication forms for nasal usage should be developed.Öğe Abilities of Pragmatic Language Usage of the Children with Language Delay After the Completion of Normal Language Development Training(Aves, 2009) Şahin, Semra; Yalçınkaya, Fulya; Muluk, Nuray Bayar; Bülbül, Selda Fatma; Çakır, İsmailObjectives: A child may pronounce words clearly, have a large vocabulary, use long, complex sentences and correct grammar, and still have a communication problem if he or she has not mastered the rules for appropriate social language. It is known that functional or pragmatic language usage is not problematic for children who have completed normal language development process. We investigated whether children who have previously had receptive, expressive, or mixed language development delays will likely have problems in the use of pragmatic language after formal training. Materials and Methods: Two different subject groups composed of 67 children between the ages of 3-6 and classified as the ones with and without language delay. Children with language delay received educational treatment, auditory processing and speech and language training. Training was consisted of acoustic signal perception, auditory discrimination, auditory comprehension, conception training, phonological processing training, speech sound processing; and speech and language education. The average of training period was between 1 to 2 years. Their receptive and expressive language was tested at 6 month-interval. In children whose language development was compatible with chronological age, pragmatic language performance was evaluated. Children's pragmatic language usage skills were evaluated in both groups with Descriptive Pragmatics Profile (DPP) by using the rating technique (never, sometimes, often, always), in terms of the abilities "Conversational Routines and Skills" (CRS); Asking for, Giving and Responding to Information"(AGRI). The Chi Square Test was used for statistical analysis. Results: Only four of nineteen items were similar (1. Waves or says hello/goodbye (in CRS part), 2. Demonstrates turn-taking rules during play and/or in classroom (in CRS part), 3. Gives and accepts hugs (in AGRI part) and 4. Asks for help from others (in AGRI part) (p>0.05), whereas the fifteen items were significantly different between groups (p<0.05). Conclusion: In our study, it was concluded that in DPP items which were not required the use of language (waves, demonstrates turn-taking rules during play, gives and accepts hugs, asks for help from others), there was no delay. We suggest that during the critical early language development period, children who have receptive and expressive language delays will also demonstrate delay in pragmatic language usage.Öğe Acoustic Rhinometry(Springer International Publishing, 2019) Çetinkayam, Erdem Atalay; Yılmaz, Mustafa Deniz; Muluk, Nuray BayarIn acoustic rhinometry (AR), an audible acoustic signal is transmitted into the nasal cavity, the reflected sounds are measured, and the resulting electrical signals are analyzed by software that provides a graphical presentation of two-dimensional area section-length relationships. This method is used worldwide in both clinical facilities and research laboratories. It can also be applied to objectively evaluate rhinal patency. The credibility of the method is maximal in the front nasal passage, which acts as a rhinal valve. The advantage of an objective measurement tool is that it provides functional data and is easy to use in research to assess nasal airway resistance. AR may also allow for the visualization of dynamic airway processes. Nonetheless, any assessment method should be used under the same ambient conditions, accounting for factors such as subject resting time, body position, and temperature. AR is a noninvasive, quick method which is performed readily with least patient cooperation. These characteristics account for why the method has been shortly recognized by many as noninvasive and it measures nasal cavity volumes and cross-sectional areas via sound pulse technology. A spark generator produces a 150-10, 000 Hz sound pulse, it proceeds along a 90-cm Bakelite wave tube 1.5 cm in diameter. The wave enters the nasal airway via a Perspex nosepiece. This chapter provides fundamental knowledge on AR and attempts to incorporate vital aspects of the method, particularly from an objective perspective. © Springer Nature Switzerland AG 2020.Öğe Acute Tonsillopharyngitis in Children(Springer International Publishing, 2021) Demir, Necdet; Muluk, Nuray Bayar; Chua, DennisTonsillopharyngitis can be defined as a condition in which the pharynx and/or palatine tonsils become acutely infected and is accompanied by sore throat, difficulty swallowing, pyrexia and lymphadenopathy in the cervical region. It can be diagnosed clinically, diagnosis being confirmed microbiologically or via the rapid antigen test [1]. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.Öğe Aesthetic analysis of the ideal eyebrow shape and position(Springer, 2016) Yalcinkaya, Esin; Cingi, Cemal; Soken, Hakan; Ulusoy, Seckin; Muluk, Nuray BayarThe aesthetic importance of the eyebrow has been highlighted for centuries. In this paper, we investigated ideal eyebrow. Eyebrows and eyelids, varies among different races, ages and genders. It is considered to be of primary importance in facial expression and beauty. We present one form of the ideal eyebrow aesthetic and discuss methods of optimising surgical results. For the modern acceptable concept of the ideal brow, the medial brow should begin on the same vertical plane as the lateral extent of the ala and the inner canthus and end laterally at an oblique line drawn from the most lateral point of the ala through the lateral canthus. The medial and lateral ends of the brow lie approximately at the same horizontal level. The apex lies on a vertical line directly above the lateral limbus. Individual perceptions and expectations also differ from person to person. The brow should over lie the orbital rim in males and be several millimetres above the rim in female. Male tend to have a heavier, thicker brow with a little arch present. There are some pitfalls in brow aesthetics. Overelevation creates an unnatural, surprised and unintelligent look which is the most common surgical mistake in brow lifting. Medial placement of the brow peak would create an undesired 'surprised' appearance. Moreover, a low medial brow with a high lateral peak induces an angry look. Overresection of the medial brow depressors may lead to widening and elevation of the medial brow, which creates an insensitive look and can also lead to glabellar contour defects. It is impossible to define an ideal eyebrow that is suitable for every face. However, one must consider previously described criteria and other periorbital structures when performing a brow surgery.Öğe Agility Skills, Speed, Balance and CMJ Performance in Soccer: A Comparison of Players with and without a Hearing Impairment(Mdpi, 2023) Yapıcı, Hakan; Soylu, Yusuf; Gülü, Mehmet; Kutlu, Mehmet; Ayan, Sinan; Muluk, Nuray Bayar; Aldhahi, Monira, I.This study investigates the differences in agility, speed, jump and balance performance and shooting skills between elite hearing-impaired national team soccer players (HISP) and withouthearing-impairment elite soccer players (woHISP). Players were divided into two groups, the HISP group (n = 13; 23.5 +/- 3.1 years) and the woHISP group (n = 16; 20.6 +/- 1.4 years), and were tested in three sessions, seven apart, for metrics including anthropometrics, speed (10 m, 20 m and 30 m), countermovement jump (CMJ), agility (Illinois, 505, zigzag), T test (agility and shooting skills), and balance. The results showed that 30 m, 20mand 10msprint scores, agility/ skills (sec), shooting skills (goals), zigzag, Illinois, and 505 agility skills, and countermovement jump scores were significantly lower among players with hearing impairments (p < 0.05). There were no significant T test differences between HISP and woHISP (p > 0.05). The HISP showed right posterolateral and posteromedial, and left posterolateral and posteromedial scores that were lower than the woHISP group (p < 0.05). Anterior scores were not significantly different between each leg (p > 0.05). In conclusion, the HISP group showed higher performance scores for speed (10 m, 20 m and 30 m), CMJ, agility (Illinois, 505, zigzag) and T test (sec and goals), but not balance. Hearing-impaired soccer players are determined by their skill, training, and strategy, not their hearing ability.Öğe Alar Base Surgery(Springer International Publishing, 2019) Koç, Bülent; Muluk, Nuray Bayar; Choi, Ji YunThe concept of narrowing the nasal alar base is external wedge excision technique in correction of the excess alar flare while hiding the incision in the alar-facial groove. Weir first described the alar base resection in 1892. In 1931, Joseph and Milstein described narrowing the nostril base and vestibular floor. In 2007, Foda described the combined alar base excision technique for nasal base narrowing in cases of a wide alar base with excessive nasal flare. The alar base plays an important role in the overall appearance and balance of the nose. The alar base, however, is not often evaluated independently during nasal examinations at the time of surgery. As a result, it is one of the most frequently encountered imperfections during secondary rhinoplasty. Deformities of the nasal alar base are a common finding in secondary rhinoplasty. Although some are recognized easily, many deformities are subtle and will be identified only during a detailed examination by the surgeon. A primary deformity that does not occur at the beginning or develops as a secondary deformity, for example, excessive flaring, may develop after reconstruction of the tip projection. When narrowing the alar base, a limited resection is preferred to a comprehensive, since resecting additional alar tissue is simple while having to reconstruct a stenotic alar is a complicated process. In this chapter, alar base surgery is discussed in all aspects. © Springer Nature Switzerland AG 2020.Öğe All Around the Nose: Basic Science, Diseases and Surgical Management(Springer International Publishing, 2019) Cingi, Cemal; Muluk, Nuray BayarThis book is designed to provide all the information required for a sound understanding of diseases of the nose and paranasal sinuses and the surgical techniques used in their management. After an opening section on basic science, clinical and radiological assessment is explained and individual chapters focus on conditions ranging from infectious diseases, allergic rhinitis, and nasal polyposis to trauma, malignancies, and skin diseases. A wide variety of surgical techniques are then described with the aid of high-quality illustrations, covering nasal airway procedures and surgical approaches to the paranasal sinuses, including diverse endoscopic and image-guided procedures, nasal reconstruction, and endonasal and external rhinoplasty. The book is a collaborative project between the new generation of Turkish specialists and well-known experts from across the world. It will be of value for ENT doctors in all countries, as well as for students and trainees and those working in ENT-related fields such as maxillo-facial surgery, pediatrics, allergology, neurology, infectious diseases, and neurosurgery. © Springer Nature Switzerland AG 2020.Öğe Allergic rhinitis during pregnancy(Springer International Publishing, 2022) Muluk, Nuray Bayar; Cingi, Cemal; Scadding, GlenisWhilst she is pregnant, a woman may develop an atopic disorder for the first time, such as rhinitis, urticaria, angioedema, or allergic eczema, or she may already have such a condition. However, whereas there has been extensive investigation of asthma during pregnancy, other atopic conditions during this period have been somewhat neglected by researchers [1]. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.Öğe Allerjik rinit tedavisinde kullanılan topikal nazal kortikosteroidlerin göz içi basıncına etkisi(2001) Taner, Pelin; Muluk, Nuray Bayar; Akarsu, Cengiz; Koç, CanAllerjik rinit sık tekrarlayan ve tedavisi uzun sürebilen bir hastalıktır. Allerjik rinit tedavisinde topikal nazal kortikosteroidler önemli bir yer tutmaktadır. Son yıllarda inhaler/nazal kortikosteroidlerin göz içi basıncında artmaya yol açabildiğine yönelik çalışmalar yayınlanmaktadır. Bu çalışmada aller/ik rinit tedavisinde yeni bir seçenek olarak sunulan mometazon furoat ile daha önce piyasaya sürülmüş olan budesonidin göz içi basıncı üzerindeki kısa ve uzun dönem etkileri araştırılmıştır. Allerjik rinit nedeniyle, 6 hafta süre ile mometazon furoat tedavisi verilen 29 olgu ile budesonid tedavisi verilen 20 olgu göz içi basıncı değişiklikleri yönünden ortalama 50 gün ( 40-58 gün) izlendi. Her iki gruptaki olguların göz içi basınçları ilaç tedavisi başlanmadan önce, 6 haftalık tedavi bitiminde ve tedavi bitiminden sonraki 1. ayda ölçüldü. Her iki grupta (Mometazon furoat ve budesonid) tedavi öncesi ve sonrası; ve tedavi öncesi ve tedavi sonrası 1. aydaki kontrolde; ve gruplar arasında tedavi öncesi, sonrası ve tedavi sonrası 1. ayda ölçülen göz içi basınçları arasında istatistiksel olarak anlamlı bir fark saptanmadı.Bu bulgular ışığında, allerjik rinit tedavisinde 6 hafta süre ile uygulanan topikal nazal kortikosteroidlerin, göz içi basıncında artışa yol açmadıkları düşünüldü.Öğe An evaluation of ketoprofen as an intranasal anti-inflammatory agent(Verduci Publisher, 2022) Altıntaş, M.; Muluk, Nuray Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.OBJECTIVE: The objective of the study was to evaluate the effect of ketoprofen when locally applied to tissue-cultured nasal epithelium. MATERIALS AND METHODS: Healthy primary nasal epithelial cells were grown in a tissue culture medium. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide) assay was used to evaluate cytotoxicity. Markers of cellular injury revealed by the MTT assay include fragmentation of DNA, condensed nuclei, and changes affecting the cellular outer membrane and cytoskeleton. Epithelial cells at body temperature in cell culture were exposed over a 24- hour period to ketoprofen. Following the MTT assay, the confocal microscopic examination was performed. The extent to which epithelial cells remained capable of proliferating was evaluated by inducing a scratch injury, waiting for the repair to occur, and then examining the result with the ordinary light microscope. RESULTS: Topically applied ketoprofen does not affect the viability of tissue-cultured nasal epithelial cells within a 24-hour period. Furthermore, there were no cellular morphological alterations observed which would indicate toxicity from ketoprofen. In the scratch assay, the cells regained a normal confluent appearance within 24 hours. Thus, ketoprofen neither increases nor alters the rate at which nasal epithelial cells proliferate. CONCLUSIONS: Ketoprofen, when applied topically for 24 hours to nasal epithelial cells in cell culture, does not cause any alterations in cellular appearance which would suggest impairment of the ability to proliferate or indicate a cytotoxic effect. Extrapolating from these results, it appears acceptable to use ketoprofen topically within the nose in cases of rhinosinusitis (acute or chronic) or nasal pain since there is minimal risk of local toxic injury.Öğe An evaluation of the efficacy of indomethacin in experimentally induced acute sinusitis in rats(Verduci Publisher, 2022) Kurt, Y.; Muluk, Nuray Bayar; Yildirim, C.; Dönmez, D. Burukoğlu; Erol, K.; Cingi, C.OBJECTIVE: We evaluated how efficacious indomethacin, at two different doses, is in the treatment of an experimental model of sinusitis in rats. MATERIALS AND METHODS: Twenty-one Wistar albino rats (all male) were sorted at random into one of three groups: 1(st) group (n=7) was placebo. 2(nd) group (n=7). These rats had sinusitis induced experimentally, following indomethacin 3 mg/kg, 5 days was administered to them. 3(rd) group (n=7). These rats had sinusitis induced experimentally, following indomethacin 6 mg/kg, 5 days was administered to them. The animals' sinonasal mucosae were examined histopathologically by standard light microscopy. RESULTS: Experimental sinusitis was observed in the 2(nd) and 3(rd) groups, but not in the rats administered a placebo. Although the in-flammatory features of sinusitis were found to be significantly decreased in the animals administered indomethacin 3 mg/kg (the 2(nd) group), this anti-inflammatory effect was even greater in the 3(rd) group, where indomethacin 6 mg/kg had been administered. Indomethacin at either dose was superior to placebo in reducing inflammatory features of sinusitis. CONCLUSIONS: Topical use of indomethacin nasal drops decreased the inflammatory features in experimentally induced acute sinusitis. Moreover, a higher dose of indomethacin (6 mg/kg) was more efficacious than a lower dose (3 mg/kg). The present study is valuable as an initial step in showing the need to undertake human trials to see the effect of indomethacin nasal drops on sinusitis in humans. In acute rhinosinusitis, the use of topical anti-inflammatory drops may help to decrease the symptoms and may be used adjunctively with antibiotic treatment.Öğe Anaphylaxis: Definition, History, and Epidemiology(Springer International Publishing Ag, 2020) Cingi, Cemal; Muluk, Nuray Bayar[Abstract No tAvailable]Öğe Anatomical Considerations: The Relationship Between The Vertebral Artery And Transverse Foramina At Cervical Vertebrae 1 To 6 In Patients With Vertigo(2018) Kültür, Turgut; Muluk, Nuray Bayar; Iyem, Cihan; Inal, Mikail; Burulday, Veysel; Alpua, Murat; Çelebi, Umut OrkunObjective: In this study, we aimed to investigate the relationship between the size of the vertebral artery and that of the transverse foramina at the C1 to C6 vertebral level in patients suffering from vertigo thought to be related to vertebrobasilar insufficiency (VBI). Materials and Methods: In this retrospective study, two groups were compared in terms of cervical computed tomography (CT): 22 adult patients with vertigo; and a control group consisting of 23 healthy adult indivıduals. Measurement of the vertebral artery and transverse foramina (i.e. sagittal and transverse dimensions, plus area) were performed bilaterally at levels C (cervical vertebra) 1 to C6. Results: For the cases group, at C6 level the right vertebral artery area, sagittal and transverse diameter were larger than in the control group at the level of statistical significance. At C1 level, the area of the right transverse foramina in the cases group was significantly higher than in the control group. At levels C1 to C5, the values obtained for vertebral artery area were positively correlated with the values for the ipsilateral transverse foramina (transverse foramen sagittal and transverse dimensions plus areas). Where the sagittal or transverse dimensions of the transverse foramina, or the area of the transverse foramina were found to be decreased, vertebral artery areas were also observed to have decreased at C1 to C5 levels. Conclusion: We concluded that a decrease in diameter of the bony structures or transverse foramina may cause a decrease in the cross-sectional area of the vertebral artery on the ipsilateral side. Since it is only the left vertebral artery which is dominant for cerebral blood flow, any compensatory increase in right vertebral artery area cannot offset decreased cerebral blood flow. Decreased blood flow (i.e. VBI) on the left side may play a role in the development of vertigo.Öğe An anatomical study of pneumatized crista galli(Springer, 2017) Mladina, Ranko; Antunovic, Romano; Cingi, Cemal; Muluk, Nuray Bayar; Skitarelic, Neven; Malic, MislavThe literature data on the incidence of pneumatization of the crista galli based on patients' computed tomography (CT) scans ranges from 3 to 37.5%. This study investigated for the first time the incidence of crista galli pneumatization based on CT scans of human skulls. The study examined 102 randomly selected human skulls (>= 20 years of age; 76 males, 26 females). Skulls were scanned in a fixed position using cone beam computed tomography (CBCT) with a field of view of 145 x 130 mm and an isotropic voxel size of 0.25 mm. The scans were recorded in Digital Images and Communications in Medicine format. The CBCT images were analyzed using OnDemand3DTM software. A 2-mm contiguous slice thickness was used in the axial and coronal planes. The width, length, and height (cranial-caudal dimension) of the pneumatized space within the crista galli were measured. The crista galli was found to be pneumatized in even 68 (66.6%) of the 102 skulls. Two types of pneumatized crista galli (PCG) were identified: PCG alone (surrounded by bony walls) and PCG + spongiosis (surrounded by spongy bone). Of the 68 pneumatized skulls, 31 were PCG alone (45.58%) and 37 were PCG + spongiosis (54.42%). The pneumatized regions had a width of 0.9-6.6 mm, length of 2.8-12.9 mm, and height of 3.6-17.1 mm. No statistically significant differences have been found regarding the sex and age. Regarding the proportions of pneumatization, the three types of crista galli have been determined resulting in new, practical classification: type S (small), type M (moderate), and type L (large). The crista galli is not always a compact bone; in some cases, it is filled with spongy bone or pneumatized. In respect of proportions of pneumatization, there are three types of pneumatized crista galli: small, moderate, and large. Pneumatized crista galli can play an important role in clinical work, both as an inflamed sinus or other pathologies (sinusitis cristae galli, mucocoelae) or as a morphologic barrier in neurosurgical approaches to some tumors of the anterior skull base.Öğe Anesthesia for Rhinoplasty(Springer International Publishing, 2019) Demir, Necdet; Muluk, Nuray Bayar; Velentin, Peter TomazicNasal innervation is performed through either the mucosal (internal) or skin (external) part of the nose. Externally, the nose is innervated with the ophthalmic and maxillary nerves and the nerves to the superior tip are furnished through the infratrochlear, supratrochlear, and external nasal branch of the anterior ethmoid nerves. The infraorbital nerve furnishes both the inferior and lateral nose regions, which extend to eyelids. The naso-sinus cavity can be categorized into three parts: (1) lateral walls, (2) nasal septum, and (3) the cribriform plate. The anterior and posterior ethmoid nerves provide nerve endings to the lateral nasal wall and the posterior nasal cavity is innervated by the sphenopalatine ganglion. The septum is furnished with nerve endings from the anterior and posterior ethmoid nerves and the sphenopalatine ganglion, while the olfactory nerve supplies the cribriform plate (cranial nerve I). Nasal anesthetic block can be acquired using topical and infiltration methods. Topical ointments can be used as an aerosol or swabbed in the nasal cavity using a cotton-tipped applicator. These methods numb the sphenopalatine, nasopalatine, and the anterior and posterior ethmoid nerves. If required, the external nose can be numbed by anesthetizing the anterior ethmoid, the infraorbital, and/or the nasopalatine nerves. Often, it is necessary to reduce anxiety during a nasal block. Sometimes topical or internal anesthesia may be necessary for children or uncooperative patients. Other times, deep sedation may be required depending on the patient. © Springer Nature Switzerland AG 2020.