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Öğe Alternative products to treat allergic rhinitis and alternative routes for allergy immunotherapy(OceanSide Publications Inc., 2016) Ipci K.; Oktemer T.; Muluk N.B.; Şahin E.; Altintoprak N.; Bafaqeeh S.A.; Cingi C.Background: Some alternative products instead of immunotherapy are used in patients with allergic rhinitis (AR). Methods: In this paper, alternative products to treat allergic rhinitis and alternative routes for allergy immunotherapy are reviewed. Results: Alternative products and methods used instead of immunotherapy are tea therapy, acupuncture, Nigella sativa, cinnamon bark, Spanish needle, acerola, capsaicin (Capsicum annum), allergen-absorbing ointment, and cellulose powder. N. sativa has been used in AR treatment due to its anti-inflammatory effects. N. sativa oil also inhibits the cyclooxygenase and 5-lipoxygenase pathways of arachidonic acid metabolism. The beneficial effects of N. sativa seed supplementation on the symptoms of AR may be due to its antihistaminic properties. To improve the efficacy of immunotherapy, some measures are taken regarding known immunotherapy applications and alternative routes of intralymphatic immunotherapy and epicutaneous immunotherapy are used. Conclusion: There are alternative routes and products to improve the efficacy of immunotherapy. Copyright © 2016, OceanSide Publications, Inc., U.S.A.Öğe Can MDCT Scan of the Temporal Bone Looking at Pneumatization Predict Surgical Vulnerability of the Facial Nerve?(SAGE Publications Ltd, 2019) Inal M.; Muluk N.B.; Şahan M.H.; Asal N.; Şimşek G.; Arıkan O.K.Objectives: The aim of this study is to investigate the scutum–cochleariform process (CP) and scutum–promontorium distances according to the mastoid pneumatization condition. Methods: Two hundred temporal multidetector computed tomography scans (90 males and 110 females) were evaluated retrospectively. The scutum-CP and scutum–promontorium distances were measured. Facial canal dehiscence (FCD) in the tympanic segment and mastoid pneumatization were also evaluated. Results: The distances between scutum-CP and scutum–promontorium were not different between males and females and between right and left sides. Facial canal dehiscence in the tympanic segment was detected: 5.6% (right) and 7.8% (left) in males and 5.5% (right) and 10.0% (left) in females. Grade 4 (100%) pneumatization was detected mainly in 55.6% to 57.8% of the patients in both genders. Grade 0 (0%) pneumatization (sclerosis) was detected in 22.2% to 28.2% of both males and females. In more pneumatized mastoids, the scutum-CP and scutum–promontorium distances increased. In sclerotic mastoids, the scutum-CP and scutum–promontorium distances decreased. Facial canal dehiscence rates were not related to the mastoid pneumatization levels. Conclusion: Cochleariform process is an important landmark to localize the tympanic segment of the facial canal. In sclerosed mastoids, scutum-CP and scutum–promontorium distances decreased. There was no relationship between FCD rates and mastoid pneumatization levels. It may be due to the development of FCD that occurs during the intrauterine period. In endoscopic and classic ear surgeries, mastoid pneumatization must be evaluated preoperatively to avoid facial nerve injuries. © The Author(s) 2019.Öğe A case of a nasal polyp originating in the cribriform plate(2013) Arikan O.K.; Muluk N.B.; Cirpar O.Nasal polyps were once believed to originate in sinus cavities, and from there to pass through ostia and into the nasal cavity. However, data gained from subsequent anatomic studies revealed that they can actually originate in numerous locations in the sinonasal area. We report a case of a nasal polyp that originated in the cribriform plate, which is a very rare site of origin for a nasal polyp.Öğe Chondroid syringoma of the upper lip: a case report.(2004) Arikan O.K.; Erdogan S.; Muluk N.B.; Koç C.Chondroid syringoma (mixed tumor of the skin) is a rare benign neoplasm of the sweat glands which often occurs in the head and neck region. We present a 73-year-old white farmer man with a mass in the anterior surface of the upper lip that was histologically diagnosed as a chondroid syringoma after surgical wide excision. There were no signs of recurrence during a follow-up of 14 months.Öğe Clinical efficacy of immunotherapy in allergic rhinitis(OceanSide Publications Inc., 2016) Oktemer T.; Altintoprak N.; Muluk N.B.; Senturk M.; Kar M.; Bafaqeeh S.A.; Cingi C.Background: Aeroallergen immunotherapy (AIT) should be considered for patients who exhibit symptoms of allergic rhinitis (AR), rhinoconjunctivitis, and/or asthma after natural exposure to allergens and who also demonstrate specific immunoglobulin E antibodies against relevant allergens. Methods: In this paper, clinical efficacy of immunotherapy in allergic rhinitis is reviewed. Result: Subcutaneous allergen immunotherapy (SCIT) is effective for seasonal and perennial AR. Sustained effectiveness requires several years of treatment. SCIT may prevent the development of allergic asthma in children with AR. Sublingual allergen immunotherapy (SLIT) is currently considered an alternative treatment to the subcutaneous route. The use of SLIT has been included in international guidelines for the treatment of AR with or without conjunctivitis. Conclusion: Patients treated with SCIT are at risk of both local and systemic adverse reactions; however, in most cases, symptoms are readily reversible if they are recognized early and treated promptly. The safety profile of SLIT is good; therefore, SLIT can be self-administered by patients in their homes. In this article, we reviewed the efficacy and safety of allergen immunotherapy. Copyright © 2016, OceanSide Publications, Inc.Öğe Clinical evaluation of the vestibular impairment using video head impulse test In children with acute otitis media(Elsevier Ireland Ltd, 2021) Cömert E.; Şencan Z.; Koçak F.M.; Şimşek G.; Muluk N.B.Objectives: The objectives of the present study were to evaluate the vestibular impairment in children with acute otitis media (AOM) and dizziness by using video head impulse test (vHIT) and to compare their results with healthy children. Methods: The study included two groups of subjects. The patient group consisted of 34 pediatric patients with AOM and dizziness and the control group consisted of 35 healthy children, age between 4 and 15. The age, gender, mean vHIT gains and gain asymmetry values were compared between groups for each canal. In both groups, mean vHIT gains were compared between the right and left sides. Additionally, mean vHIT gains and the presence of saccades according to AOM stages were analyzed. Results: The comparison of vHIT gains between affected and unaffected sides in patients revealed a significant decrease only in the anterior canal plane on the affected side. Covert saccades were observed in 32% of the patients. When comparing the AOM stages and the presence of saccades in patients, no difference was detected between stages. Conclusion: vHIT is a useful vestibular test for the evaluation of vestibular impairment in children with an applicability rate of 92% in healthy children and 70% in patients with AOM and dizziness. The patients with AOM and dizziness are presented with a decrease in vHIT gains and the presence of cover saccades only in vertical canal planes, supporting that slight vestibular impairment in these patients may represent pathologic vHIT results only in vertical canal planes. © 2020 Elsevier B.V.Öğe Does Septorhinoplasty-Related Periorbital Edema Affect Intraocular Pressure and Retina?(SAGE Publications Ltd, 2019) Dikici O.; Özmen S.; Dikici G.K.; Muluk N.B.; Akkuzu Ç.Ç.Background: Open rhinoplasty has been performed for over 50 years. Rhinoplasty procedures have a risk of complications and it is important to follow each step diligently in order to avoid complications. Periorbital edema is the most common complication of septorhinoplasty. As far as we are aware, there are no studies in the available literature examining the impact of the septorhinoplasty on intraocular pressure and the retina. Objectives: The aim of this study was to evaluate the effects of septorhinoplasty-related periorbital edema on intraocular pressure and the retina by means of objective tests. Methods: Ten patients with phase 4 periorbital edema (5 males and 5 females) who underwent open rhinoplasty with bilateral lateral osteotomies were enrolled in the study. All the patients were examined by an eye specialist for visual acuity, intraocular pressure, retinal nerve fiber layer, and ganglion cell complex pathologies with optical coherence tomography preoperatively and postoperatively on the seventh day. Results: Preoperative and postoperative best-corrected visual acuity; intraocular pressure; average, superior, and inferior retinal nerve fiber layer thickness; and total, superior, and inferior ganglion cell complex thickness in both eyes for all patients were within normal limits. There was no statistical difference between preoperative and postoperative values (P >.05). Conclusion: We concluded that periorbital edema after septorhinoplasty causes no significant complications affecting intraocular pressure and visual acuity. We believe that when osteotomies and local anesthetic injections are undertaken correctly, periorbital complications do not affect vision. © The Author(s) 2019.Öğe Effects of Osteotomy on Hemodynamic Parameters and Depth of Anesthesia in Rhinoplasty Operations(NLM (Medline), 2020) Gencay I.; Muluk N.B.; Kilic R.; Yazici I.; Aydin G.; Sencan Z.; Tozar M.BACKGROUND: Bleeding during rhinoplasty leads to many undesirable effects, such as loss of vision in the surgery area, complications during the procedure, and postoperative complications. The most important effect that increases bleeding is hemodynamic changes during surgery. Considering that osteotomy is the most challenging process in rhinoplasty, this study aimed to examine the hemodynamic changes during osteotomy and changes in the depth of anesthesia. METHODS: A total of 50 patients, aged 18 to 65 years with an ASA (American Society of Anesthesiology) score of 1 and 2, who underwent osteotomy during rhinoplasty under general anesthesia, were examined retrospectively. After routine monitoring, the patients underwent general anesthesia induction and endotracheal intubation. Before the surgery, they received remifentanil 1??g/kg as an intravenous bolus followed by 0.5??g/(kg·min) as intravenous infusion until the end of the surgery. The hemodynamic parameters and depth of anesthesia [bispectral index (BIS) values] of the patients were examined before anesthesia, 10?minutes before osteotomy, during osteotomy, and 10?minutes after osteotomy. RESULTS: A significant difference was found in heart rate (beats/min), systolic and diastolic blood pressures (mm Hg), and BIS values of the patients measured before, during, and after osteotomy (P < 0.001). The heart rate, systolic and diastolic blood pressures, and BIS values were significantly higher during osteotomy. Until the 10th minute after osteotomy, all 4 parameters nearly reached the values measured before osteotomy. CONCLUSIONS: Osteotomy directly affects hemodynamic parameters and depth of anesthesia. Hence, it is of utmost importance that the analgesic need and depth of anesthesia are adequately monitored and adjusted during osteotomy. By suppressing hemodynamic stress responses, the amount of bleeding can be reduced, thus increasing the surgical success and the patient's comfort.Öğe Evaluation of the efficacy of curcumin in experimentally induced acute sinusitis in rats(Medquest Communications LLC, 2016) Birdane L.; Cingi C.; Muluk N.B.; San T.; Burukoglu D.We investigated the possible beneficial effects of curcumin (CMN) in the treatment of sinusitis. An experimentally induced sinusitis model was created in rats, and the results were evaluated histologically. Thirty-two healthy, female Sprague Dawley rats weighing 270 to 310 g each, were randomly divided into four groups. Group 1 was the control group. In Groups 2 to 4, experimentally induced acute sinusitis was developed, and the rats in those groups were given saline, sulbactam-ampicillin, and CMN, respectively, for 10 days. Then all rats were dissected, and samples of sinus mucosa were taken. Histologic examination was performed via light microscopy. In the sinusitis + antibiotic group, values of inflammation, vascular congestion, vascular dilatation, and subepithelial glandular atrophy were significantly higher; and values of mucosal damage and cilia loss, and hyperplasia of goblet cells, were not significantly different from those in the control group. In the sinusitis + CMN group, values of inflammation, vascular congestion, and vascular dilatation were significantly higher; and values of mucosal damage and cilia loss, hyperplasia of goblet cells, and subepithelial glandular atrophy were not significantly different from those of the control group. Histologic examination revealed that in the sinusitis + CMN group, a nearly normal appearance of the epithelial tissue and reduced cellular inflammation in connective tissue were observed. Minimal vascular congestion in connective tissue remained. The efficacy of CMN in acute sinusitis may be related to its potent anti-inflammatory effects on modulation of various inflammatory cytokines. When low side effects are taken into account, CMN therapy may be a promising option in the treatment of acute sinusitis. © 2016 Vendome Group, LLC All rights reserved.Öğe Is there a correlation between body proportion and choice of profession?(Walter de Gruyter GmbH, 2016) Cingi C.C.; Muluk N.B.; Hanci D.; Güngör E.O.; Cingi C.Objective: We made anthropometric measurements to compare body proportions of university students and to investigate the tendency of the students with more developed bodies in choosing profession for university education. Methods: A total of 204 male students [group 1: students of School of Physical Education and Sports" (SPESp) (n=88), group 2: students of Faculty of Fine Arts (FFArts) (n=59), and group 3: students of Faculty of Medicine (FMed) (n=57)] were included, and anthropometric measurements were performed. Results: "Height"; "chest circumference"; "difference of inspiration and expiration of chest circumference" values of the SPESp students were higher than the others (FFArts and FMed). In the SPESp students, chest circumference and chest expansion capacity by inspiration developed more. This shows the positive impact of sport on respiratory functions. Additionally, the legs are longer in students engaged in regular sports. Conclusion: Exercise is important for all subjects in terms of body development, growth, and oxygenization and to decrease cardiovascular risk factors. For the development of the ideal body anthropometric rates, obesity prevention, and for the growth of healthy generations, governments should give importance to sports and take incentive measures to increase children and young people's interest in the sport. © 2016 by De Gruyter 2016.Öğe Mechanism of action of allergen immunotherapy(OceanSide Publications Inc., 2016) Şahin E.; Bafaqeeh S.A.; Güven S.G.; Çetinkaya E.A.; Muluk N.B.; Coşkun Z.O.; Cingi C.Background: Allergen immunotherapy (AIT) leads to the production of antiallergen immunoglobulin (IgG) or "blocking antibody" in the serum and an increase in antiallergen IgG and IgA in nasal secretions. There is also a decrease in the usual rise in antiallergen IgE that occurs after the pollen season. Methods: In this paper, mechanisms of action of allergen immunotherapy is reviewed. Results: Regulatory T (Treg) cells and their cytokines, primarily interleukin (IL) 10 and transforming growth factor beta, suppress T-helper type 2 immune responses and control allergic diseases in many ways. AIT induces a shift in the proportion of IL-4-secreting T-helper type 2 cells in favor of IL-10-secreting inducible Treg cells specific for the same allergenic epitope that increases in number and function. Different types of inducible Treg control several facets of allergic inflammation. There are two main types of immunotherapy: subcutaneous immunotherapy and sublingual immunotherapy. Subcutaneous immunotherapy is efficacious and is indicated for the reduction of seasonal symptoms. Sublingual immunotherapy involves the regular self-administration and retention of allergen extract under the tongue for 1-2 minutes before the extract is swallowed. The allergens cross the mucosa in 15-30 minutes and are then captured by tolerogenic dendritic cells and processed as small peptides. Next, via the lymphatic system, a systemic immune response is created to produce an early decrease in mast cell and basophil degranulation. Conclusion: AIT is indicated for the treatment of moderate-to-severe intermittent or persistent symptoms of allergic rhinitis. AIT can be administered to those >5 years of age and has been shown to be safe in children as young as 3 years of age. In this article, AIT and other types of immunotherapies were discussed as well as the indications for immunotherapy. Copyright © 2016, OceanSide Publications, Inc.Öğe The presence of Clival foramen through Multidetector computed tomography of the skull base(Lippincott Williams and Wilkins, 2015) Inal M.; Muluk N.B.; Ozveren M.F.; Celebi U.O.; Simsek G.; Burulday V.; Bilgili M.Y.K.Objectives: Technological advancements in the diagnostic radiology recently permitted reviewing the normal anatomy through multidetector computed tomography (MDCT) imagination. The aim of this paper is retrospectively investigation of the clival foramen and canal through MDCT. Materials and Methods: One hundred eighty-six MDCT scans were reviewed. First, images were taken at axial plane, and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these three-dimensional images (3-D imaging). The images were evaluated as clival foramen ''present'' or ''absent.'' Results: In our 186 patients, evaluation of MDCT showed that clival foramenwas absent in 66.7% (n=124) of patients. Only 33.3% (n=62) of patients had a clival foramen. In 3-D images, clival canal and clival foramen were shown more clearly compared with the MDCT. Conclusions: Knowledge of the clival canal might be useful in patients of questionable clival fracture or during neurosurgical operations in this region. During life the canal contained a vein connecting the basilar plexus with the venous plexus of the vertebral canal, and inferior petrosal sinuses. Before the surgical interventions in the clival region, the presence of the clival canal and foramen should also be known due to its vascular contents. By multidetector computed tomography and 3-D images, clival canal and foramen may be viewed preoperatively. Copyright © 2015 by Mutaz B. Habal, MD.Öğe The role of MMP-2, MMP-9, and TIMP-1 in the pathogenesis of nasal polyps: Immunohistochemical assessment at eight different levels in the epithelial, subepithelial, and deep layers of the mucosa(Medquest Communications LLC, 2015) Muluk N.B.; Arikan O.K.; Atasoy p.; Kiliç R.; Yalçinozan E.T.We conducted a prospective study to investigate the role of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the pathogenesis of nasal polyps. Our study group consisted of 24 patients-21 men and 3 women, aged 23 to 70 years (mean: 45.97 ± 11.60)-with nasal polyposis who underwent functional endoscopic sinus surgery. For comparison purposes, we assembled a control group of 11 patients-6 men and 5 women, aged 18 to 56 years (mean: 29.90 ± 14.22)-without nasal polyps who underwent septoplasty and/or rhinoplasty. We analyzed 36 polyp specimens obtained from the study group (10 from the nasal cavity, 10 from the maxillary sinus, and 16 from the ethmoid sinus) and 11 tissue specimens from the control group (each control provided 1 specimen from the inferior turbinate). We then calculated the mean number of these cells in the epithelium, subepithelial layer of the lamina propria, and the deep paraglandular layer of the mucosa. In general, we found that MMP-2, MMP-9, and TIMP-1 values were higher in the nasal polyp group. These differences became less so as patients' ages and the duration of polyps increased. We conclude that the most important role that MMP-2 plays in polyp growth may be in terms of perivascular localization and an increase in vascular permeability, which causes inflammatory cell migration and edema in the extracellular matrix. An increase in MMP-2 in glandular tissue may lead to hydrolysis of tissue matrix components. The degraded extracellular matrix may result in fibrosis of the polyps. An increase of MMP-9 in the apical part of the epithelium in the polypoid tissue of the nasal cavity, maxillary sinus, and ethmoid sinus may facilitate the epithelial and endothelial cell migration that is observed during polyp development and growth. © 2015 Vendome Group, LLC All rights reserved.Öğe Sleep problems of adolescents: A detailed survey(Medquest Communications LLC, 2015) Muluk N.B.; Bulbul S.F.; Turğut M.; Ağirtaş G.We investigated the sleep problems and sleep habits of adolescents at three public primary schools and two high schools. Our study included 428 Turkish school children (244 girls and 184 boys). We used a questionnaire to determine the time they went to sleep at night; waking time in the morning incidence of nightmares, snoring, daytime sleepiness, and intrafamilial physical trauma; concentration difficulty in class; and school success. The students were divided into age-related groups (group 1 = 11 to 13 years of age; group 2 = 14 to 15 years; group 3 = 16 to 18 years). The time they went to sleep was mostly between 10 and 11 p.m. in groups 1 and 2, and 11 to 12 p.m. in group 3. Difficulty in falling asleep was reported by 16.8 to 19.6% of the students in the three groups. Difficulty in waking up in the morning was reported by 12.7% of group 1, 16.0% of group 2, and 16.8% of group 3. Snoring was present in 12.1% of females and 22.0% of males. The occurrence of one nightmare in the preceding 3 months was reported by 11.3% of the students; 17.9% of the students reported having nightmares several times. Daytime sleepiness was present in 65.1%, and concentration difficulty was present in 56.8% of the students. We conclude that difficulty in falling asleep, snoring, and daytime sleepiness may be seen in adolescents who are in both primary and high schools. Watching inappropriate programs and movies on television and intrafamilial physical trauma may cause nightmares and sleeping problems in these adolescents. Students and families should be educated about the importance of sleep in academic performance. Countries' public health policies should address sleep problems and related educational activities. © 2015 Vendome Group.Öğe A study of language development and affecting factors in children aged 5 to 27 months(Medquest Communications LLC, 2016) Muluk N.B.; Bayoğlu B.; Anlar B.We conducted a study to assess the factors that affect language development in infants and toddlers using data obtained during developmental screening. Our study group consisted of 505 children-244 (48.3%) boys and 261 (51.7%) girls, aged 5 to 27 months. The children were divided into four age groups: group 1, which we designated as the "6 months" group (age range: 5 to 7 mo); group 2, designated as the "12 months" group (11 to 13 mo); group 3, designated as the "18 months" group (17 to 19 mo); and group 4, designated as the "24 months" group (23 to 27 mo). In addition to demographic data, we compiled data using the Denver II Developmental Screening Test, as well as neurologic examination findings and medical histories. At 6 months, the social item "Works for toy out of reach" was positively related to all language development items. Two gross motor development items-"Pull to sit, no head lag" and "Lifts chest with arm support"-were related to the "Turns to sound" and "Turns to voice" items, respectively. Overall, children whose mothers had higher education levels and who were living in higher socioeconomic areas showed significantly greater language development, as did boys, specifically. At 12 months, higher maternal ages, some gross motor development items, and some social items were related to better language development, and children living in higher socioeconomic areas had a significantly increased ability to pass the "4 words other than mama/dada" item. At 18 months, the ability of girls to pass the "4 words other than mama/dada" item increased, and children who passed the "4 words other than mama/dada" item did not pass the "Throws ball" gross motor item. At 24 months, children whose mothers were older had better "Combines 2 words" and "Speech half intelligible" items, girls had better "Comprehends prepositions (such as under/above)" skills, and boys had better "Shows 4 parts of doll" skills. We conclude that language items appear to change together with gross motor items and social development, and that they can be influenced by a family's socioeconomic level. However, as children get older, language development diverges from gross motor development. © 2016 Vendome Group, LLC All rights reserved.
