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    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.
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    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.
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    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.