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Öğe Bromelain: a candidate to enhance wound healing after endonasal surgeries(Verduci Publisher, 2023) Esen, E.; Muluk, Nuray Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.OBJECTIVE: In the present study, we investigated the topical bromelain's cytotoxic effects on mouse fibroblast NIH/3T3 cells via cell culture study. MATERIALS AND METHODS: In this cell culture study, Dulbecco's Modified Eagle Medium ( DMEM) with fetal bovine serum (FBS, 10%) and penicillin/streptomycin (1%) was used as a cell growth medium for NIH/3T3 mouse fibroblast cells. MTT test was performed in 96-well plates seeded with NIH/3T3 cells 5x103/ well and under standard cell culture conditions. Bromelain doses of 3.13 to 100 mu M were administered to the wells and incubated for 24, 48, and 72 hours in the same cell culture conditions. For Confocal microscopic evaluation, NIH/3T3 cells were plated on cover slips in 6-well plates (105 cells/ well) and treated with 100 mu M concentration of bromelain for 24 h. Untreated cells were used as controls. RESULTS: M TT r esults s howed t hat b romelain is not cytotoxic on mouse fibroblast NIH/3T3 cells. All three incubation times of 24, 48, and 72 hours bromelain initiated cell growth. A statistically significant rise in cell growth was detected in the only applied highest dose of 100 mu M bromelain for all incubation times except for 24 hours. The nontoxic effect was further investigated by using confocal microscopy by applying the highest bromelain dose of 100 mu M to NIH/3T3 mouse fibroblast cells. Confocal micrographs showed that bromelain did not change the morphology of mouse fibroblast cells at the incubation time of 24h. In untreated cells and bromelain-treated cells, the nucleus of NIH/ 3T3 cells was undamaged and compact, and the cytoskeleton was fusiform and non-fragmented. CONCLUSIONS: Bromelain is not cytotoxic on mouse fibroblast NIH/ 3T3 cells and enhances cell growth. If clinical trials will confirm this, it is possible that bromelain will be used topically in humans to enhance wound healing, in rhinosinusitis and chronic rhinosinusitis with nasal polyps and endonasal surgeries due to its anti-inflammatory effects.Öğe Biologics in allergic rhinitis(Verduci Publisher, 2023) Muluk, Nuray Bayar; Cingi, C.This paper aims to review biologics in allergic rhinitis (AR). Biologic agents of Omalizumab, Dupilumab, Mepolizumab, Reslizumab, and Benralizumab are reviewed in detail. The search is performed in Pubmed, Google, Google Scholar and EBSCO Academic Search Ultimate (EKUAL) database of Kirikkale University Library from 2021 to 2000, and randomized and/or placebo-controlled studies, review papers, meta-analysis, and reports are taken into consideration. The search was performed with the keywords of allergic rhinitis, biologics, biologic agents, Omalizumab, Dupilumab, Mepolizumab, Reslizumab, Benralizumab, Anti IgE, Anti-IL-4/IL-13, Anti IL-5. Search is also performed in the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) web systems. Biological agents such as monoclonal antibodies (MAb) in treatment are called biological therapy or biotherapy. Omalizumab is a humanized Anti-Ig Emonoclonal antibody. Omalizumab treatment improved the Daily Nasal Rescue Medication Score (DNSSS) and decreased the use of antiallergic drugs in seasonal and perennial AR and rhino-conjunctivitis. Omalizumab is also used in specific immunotherapy patients with allergic rhinitis and reduced allergic reactions associated with allergen immunotherapy, such as anaphylaxis. Dupilumab is an Anti-IL-4/IL-13 biologic agent. Dupilumab treatment significantly improved sino-nasal Outcome Test (SNOT-22) total scores in perennial allergic rhinitis. Anti-IL-5 monoclonal antibodies of Mepolizumab, Reslizumab Benralizumab reduce the number of eosinophils in the blood and tissue, corticosteroid addiction and asthma attacks are reduced, and their use in the treatment of severe eosinophilic asthma has been approved. Biologics, especially Omalizumab, and Dupilumab, may be used more in allergic rhinitis.Öğe Association between superoxide dismutase 2, glutathione peroxidase 1, xeroderma pigmentosum group d gene variations, and head and neck squamous cell cancer susceptibility(Inst Bioloska Istrazivanja Sinisa Stankovic, 2022) Köse, Gülçin; Oz, Merve Demirbugen; Cömert, Ela; Suzen, Halit SinanAs oxidative stress is implicated in the pathogenesis of head and neck squamous cell cancer (HNSCC), the functions of antioxidant enzyme systems and DNA repair proteins are critical in the development of cancer. To investigate the role of genetic polymorphisms of the antioxidant superoxide dismutase 2 (SOD2) Val16Ala, glutathione peroxidase 1 (GPX1) Pro198Leu, and the DNA repair Xeroderma Pigmentosum Group D (XPD) Lys751Gln genes under exogenous risk factors, including smoking and alcohol consumption, in HNSCC carcinogenesis, we conducted a case-control study on 139 unrelated cases and 265 non-cancer controls. Polymorphisms were analyzed in additive, dominant and recessive genetic models, individually and in an interaction model. Carriers of the T allele of SOD2 were associated with an increased risk for HNSCC in males and smokers; similarly, the T allele of GPX1 was associated with elevated risk in the overall and smoker subgroup. A 12.47-fold increased risk was observed for the carriers of GPX1 TT, SOD2 CT and XPD CC genotypes for HNSCC. This is the first study presenting the potential roles of SOD2, GPX1 and XPD polymorphisms in interaction and under three genetic models in the development of HNSCC. The results suggest that these polymorphisms slightly modify the risk in HNSCC development individually but are significantly higher when they functioned and were evaluated together.Öğe Assessment of olfactory function by Sniffin' sticks in bakery workers exposed to flour dust(Verduci Publisher, 2022) Altintas, M.; Kar, M.; Muluk, Nuray Bayar; Cingi, C.OBJECTIVE: This study used the Sniffin' Sticks test battery to evaluate olfactory function in employees of a bakery exposed to flour dust. SUBJECTS AND METHODS: The study enrolled 43 individuals with exposure ( i.e., to flour) plus 41 healthy volunteers as controls. Olfactory function was assessed in these subjects through the use of the Sniffin' Sticks test battery. The overall score was calculated by adding up the scores for each of the 12 separate odors. A score of 6 or less was deemed anosmia, from 7 to 10 hyposmia, and a score of 11 or 12 was taken to indicate no impairment of olfaction. RESULTS: There was a statistically significant difference between the scores obtained in the exposure group (10.09 +/- 2.29) and the control group (10.73 +/- 2.07), the exposure group having a lower score (p<0.05). Within the exposure group, men and women did not score differently (p>0.05). Furthermore, in this group, the overall score did not correlate significantly with age, sex, length of employment, or use of tobacco or alcohol use (p>0.05). Using the scheme employed in this study, 9.3% of the exposed workers were anosmic, compared to 9.8% in the controls, whereas 34.9% of baker workers were hyposmic, compared to just 14.6% of the controls. Thus, our study shows that impairment of the ability to smell was present in 44.2% of individuals exposed occupationally to flour dust. CONCLUSIONS: This study reveals that being exposed to flour dust reduces the ability to smell normally. In order to minimize the impact of being exposed, workplaces should ensure adequate ventilation and provide workers with protective facemasks.Öğe Are preservation rhinoplasty techniques safer than structural ones?(Verduci Publisher, 2023) Bafaqeeh, Sameer Ali; Muluk, Nuray Bayar; Cingi, CemalThis narrative review paper evaluates the preservation rhinoplasty (PR) technique in all aspects. The literature survey was performed in PubMed, EBSCO, UpToDate, and Proquest Central databases of Kirikkale University, Google and Google Scholar databases. The advent of the preservation rhinoplasty (PR) approach has led to a radical shift in the mind-set surrounding rhinoplasty procedures. K-area ( keystone region) loss, lateral cartilage collapse, and nasal stenosis are all avoidable with preservation measures. The nasal bones, the superior lateral cartilage, the quadrilateral cartilage, and the perpendicular blade of the ethmoid meet at the point known as Zone K. The variety of problems that might develop due to carelessness in this area demonstrates the significance of maintaining the nose's stability and structure. The three components of a preservation rhinoplasty (PR) procedure are (1) preserving the scroll ligament complex by elevating the soft tissue envelope (STE) in a subperichondrial-subperiosteal plane, (2) preserving the nasal dorsum without creating an open roof deformity, and (3) preserving the alar cartilages and achieving the desired shape using sutures rather than excision. Dorsal preservation is one of the three components that make up PR. However, the two concepts are not synonymous. PR involves elevating a skin sleeve from the subperichondrial-subperiosteal plane, preserving the osteocartilaginous dorsum, maintaining the alar cartilages with minor excision and using sutures to achieve the desired form.Öğe Applied surgical methods and outcomes in crooked nose rhinoplasty(Verduci Publisher, 2023) Azizli, Elad; Oğuz, Oğuzhan; Muluk, Nuray Bayar; Sarı, Hüseyin; Dilber, Muhammet; Uyar, Yavuz; Cingi, CemalOBJECTIVE: In this retrospective and multicentric study, we investigated applied surgical methods in rhinoplasty for crooked nose deformity. PATIENTS AND METHODS: The retrospective data for 300 crooked nose deformity cases (191 males and 109 females) were used in our study. Classification of the initial deformities was performed as (1) I-shaped crooked nose deformity, (2) C-shaped crooked nose deformity, (3) Reverse C-shaped crooked nose deformity, and (4) S-shaped crooked nose deformity. As an operation technique, L-strut septoplasty was performed. The applied surgical methods in rhinoplasty to correct the crooked nose are evaluated and classified. RESULTS: Our results showed that initial deformities in crooked nose patients were I-shaped crooked nose deformity (34%), C-shaped crooked nose deformity (28%), Reverse C-shaped crooked nose deformity (21.3%), and S-shaped crooked nose deformity (16.7%). L-strut septoplasty was performed, and the results of the applied methods to correct the crooked nose were evaluated and classified. It was noticed that more than one procedure was applied to each case: (1) double-side lateral osteotomy (86.6%), (2) wedge bone resection on one side of the osteotomy (7.3%), (3) single-side lateral osteotomy (6%), (4) symmetric spreader grafts (56%), (5) asymmetric spreader grafts (10.6%), (6) shaving of the transverse wing of dorsal septum (8%), (7) correction of deviated dorsal septum (16.3%), (8) displaced anterior nasal spine (12.6%), (9) clocking suture (dorsal septal rotation suture) (9%), (10) dorsal septal scoring and splinting graft (8.3%), and equalizing lateral cruses (12.6%). CONCLUSIONS: I-shaped and C-shaped crooked nose deformities were mainly detected in crooked nose deformity patients. Correcting the crooked nose, double- side lateral oste- otomy, and symmetric spreader grafts were the most applied techniques to correct the crooked nose. Other rhinoplasty techniques were also applied to these patients; more than one technique was needed.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 The Score for Allergic Rhinitis study in Turkey, 2020(Dergipark Akad, 2021) Cingi, Cemal; Muluk, Nuray Bayar; Susaman, Nihat; Kucukcan, Nagehan; Kar, Murat; Altintas, Mustafa; Altin, FaziletObjective: This study aimed to determine how prevalent allergic rhinitis (AR) is in Turkey and to compare the current prevalence with the figures obtained 10 years earlier. Methods: This study included 9,017 participants. The minimum number of participants required from each center was determined via a stratified sampling technique according to regional demographic characteristics as ascertained from the last census. For each region, both men and women were administered the score for allergic rhinitis (SFAR) questionnaire and a score for each participant was calculated based on the responses supplied. Results: A total of 9,017 individuals (55.3% men and 44.7% women) took part in this study. Of these, 94.4% were urban residents and 5.6% lived in a rural setting. Of the men, 38.5% self-reported as suffering from AR. The corresponding figure in women was 40.5%. The overall prevalence of AR, as deduced on the basis of the SFAR, was found to be 36.7%. Comparing the prevalence in different regions, we found that AR was the least prevalent in the Black Sea region with a frequency of 35.8%. The highest prevalence was in the Mediterranean region, where the prevalence was 37.7%. There was no statistical significance in the apparent differences in prevalence between different geographical regions. Despite this, however, there was a clear increase in the frequency of AR over the preceding decade. This increase was most pronounced in the South-Eastern Anatolian region, where the frequency rose from 21.0% to 36.9%. Conclusion: Our results indicate that there has been a marked increase in the prevalence of AR in every region in Turkey over the last 10 years. This could be related to living conditions in urban environments. Alterations in lifestyle, urban living, air pollution causing impairments in immune defense mechanisms, and other aspects of modern lifestyles may account for the increase in AR in Turkey.Öğe Effect of peritonsillar prilocaine infiltration on post-tonsillectomy pain in pediatric population(Cukurova Univ, Fac Medicine, 2021) Taş, Burak Mustafa; Erden, Burak; Şimşek, GökçePurpose: This study aims to evaluate the efficacy of peritonsillar prilocaine in post-tonsillectomy pain by using the Visual Analog Scale (VAS). Materials and Methods: A total of 40 pediatric patients were included in this study. There were 20 patients in the prilocaine group (Group 1) and 20 patients in the control group (Group 2). In Group 1, peritonsillar prilocaine infiltration was performed. In Group 2, peritonsillar saline infiltration was performed. VAS scores of at the postoperative 1st, 4th, 12th and 24th hours and on the 2nd, 3rd, 4th, 5th, 6th and 7th days were evaluated. In addition, the presence of nausea and vomiting and the number of additional doses of intravenous paracetamol administered in the first 24 hours were evaluated. Results: When the groups were compared, a significant reduction in post-tonsillectomy pain was observed in the prilocaine group at the 1st, 4th and 12th hours compared to the control group. There was no significant difference between the two groups in other scores. There was no significant difference between the groups for nausea and vomiting and consumption of paracetamol values. Conclusion: Peritonsillar prilocaine infiltration was effective in post-tonsillectomy pain at the 1st, 4th and 12th hours postoperatively. Thus, peritonsillar prilocaine infiltration can be used in post-tonsillectomy pain because it is fast and effective.Öğe Left vocal cord paralysis due to lymphadenopathy of mediastinal tuberculosis(Deomed Publ, Istanbul, 2013) Dikici, Oğuzhan; Muluk, Nuray BayarThough there are a lot of causes of vocal cord paralysis, such as trauma, cancer and surgery; idiopathic cases are also found. Vocal cord paralysis can be also seen in cases of mediastinal mass or tuberculosis which cause mediastinal lymphadenopathy. In this paper, a patient complaining of hoarseness with the diagnosis of left vocal cord paralysis was presented. Thoracic computed spiral tomography showed conglomerated mediastinal lymphadenopathy and biopsy was reported as granulomatous inflammation. Antituberculostatic therapy was administered to the patient and his follow-up procedures are continuing currently.Öğe Otolaryngological findings in mucopolysaccharidosis(Deomed Publ, Istanbul, 2014) Cingi, Cemal; Muluk, Nuray Bayar; Hanci, Deniz; Şahin, Ethem; Acar, MustafaIn this review paper, we reported otolaryngological problems in patients with mucopolysaccharidoses (MPSs). Mucopolysaccharidoses are a group of lysosomal storage diseases, each of which is produced by an inherited deficiency of an enzyme involved in the degradation of acid mucopolysaccharides, now called glycosaminoglycans (GAGs). The mucopolysaccharidoses consist of a group of 7 metabolic disorders, known as mucopolysaccharidoses types I-VII. In all groups, there are clinical and otolaryngological manifestations. In MPS patients, upper airway obstruction, obstructive sleep apnea, restriction of mouth opening, middle ear effusion, hearing and breathing problems, etc. are reported as common otolaryngological findings. Increasing awareness of MPS's among ENT doctors will be a life saving attempt for MPS suspected patients who admit an ENT doctor rather than a pediatrician. In MPS patients, tracheotomy may be difficult due to short neck. Due to mouth opening restriction, patients should be evaluated carefully before tonsillectomy and adenoidectomy operations. Airway problems must be evaluated before anesthesia. All ENT doctors should be noticed to be aware of these problems.Öğe Sisplatin Ototoksisitesi(2017) Taş, Burak Mustafa; Şimşek, GökçeOtotoksisite çeşitli ilaçlar ve kimyasal maddelerin koklea ve vestibüler organda oluşturduğu hücresel dejenerasyon ve fonksiyon bozukluğudur. Sisplatin (Cis-diamindiklorplatinum II), özellikle baş-boyun tümörlerinde, ürogenital sistem, santral sinir sistemi, solunum sistemi ve özefagus kanserleri olmak üzere birçok malign hastalığın tedavisinde, erişkinlerde ve çocuklarda kullanılmakta olan antineoplastik bir ajandır. Sisplatinin nefrotoksisite ve geri dönüşümsüz ototoksisite dışında diğer önemli doz sınırlayıcı yan etkileri nörotoksisite, gastrointestinal sistem ve kemik iliği toksisitesidir. Sisplatin ototoksik etkisini reaktif oksijen ürünleri ve DNA hasarı ile göstermektedir. Sisplatin ototoksisitesinde klinik olarak başlangışta yüksek frekanslarda, sonrasında konuşma sesini de içeren düşük frekanslarda, bilateral, sensorinöral işitme kaybı görülür. Günümüzde sisplatin bağımlı ototoksisiteyi önlemede standart bir tedavi bulunmamaktadır. Bu derlemede sisplatin ototoksisitesinin tanımı, etki mekanizması, güncel tedavi seçenekleri güncel literatür bilgileri eşliğinde tartışılmıştırÖğe 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 The Epidermoid Cyst Containing Free Teeth in The Maxillary Sinus(2018) Taş, Burak Mustafa; Şimşek, Gökce; Akay, Neşet; İnal, Mikail; Kılıç, RahmiEpidermoid cysts (EC) are the most common tumors of the skin. They are usually asymptomatic and small-sized. They are more common at young ages. They grow slowly and are painless. The wall of EC is covered with epidermis-like epithelium. EC are rarely seen in sinuses. In our case, a 16-year-old female presented with complaints of swelling and headache that started from the left eye and extended to the upper lip. A biopsy was performed at another hospital of the patient who had previously received medical treatment but had no complaints. A cystic mass containing teeth was observed in the left maxillary sinus on imaging. The cystic mass was excised along with the wall. Pathological results supported the diagnosis of EC. Treatment of EC are surgical and recurrence rates are low. Although many masses are observed in the sinonasal region, epidermoid cysts are rare. It is important to distinguish epidermoid cysts from malignant masses that exhibit expansile growth characteristics. Keywords: Headache, epidermoid cyst, maxillary sinusÖğe Effervescent tablets: a safe and practical delivery system for drug administration(2016) İpçi, Kağan; Öktemer, Tuğba; Birdane, Leman; Altıntoprak, Niyazi; Muluk, Nuray Bayar; Passalı, Desiderio; Lopatin, AndreyEfervesans, bir sıvı içinde oluflan kimyasal reaksiyon sonucu, çözünme ve gaz kabarcıklarının oluflması olarak tarif edilmektedir. Tıbbi kullanımda efervesan tabletler, verilen ilacın hızlı emilimini sa¤lamaya yönelik bir özellik taflımaktadır. Verilen ilaç, e¤er su içinde yeterli dozda ve kolayca çözünürse daha hızlı ve etkin flekilde emilim sa¤lanacaktır. Kö- pürme reaksiyonu için genellikle sitrik, malik, tartarik, adipik veya fumarik asitler kullanılmaktadır. En sık tercih edilen, ürüne hafif bir limon aroması da veren sitrik asittir. Tartarik, adipik ve fumarik asitler, suda çözünürlükleri daha düflük oldu¤u için daha az miktarlarda kullanılırlar. Uygun ilaç dozu alımının sa¤lanması, ilaca uyumun kolaylafltı- rılması, hızlı ve daha iyi emilim, hastanın sıvı alımının artırılması ve bü- yük tabletlerin yutulma zorlu¤unun ortadan kaldırılması için efervesan tabletler kullanılmaktadır. Bu derlemede, teknolojik açıdan efervesan tabletler de¤erlendirilmifl, avantaj ve dezavantajları tanımlanmıfltır.Öğe Tonsillar and Parotid Gland Metastases of Breast Cancer: Two Cases and A Literature Review(2019) Cengiz, Abdurrahman; Cömert, Ela; Tunçel, Ümit; Dilek, Gülay; Benzer, EmineBreast cancer is the most common tumor in women. One in eight women is affected by this disease in her lifetime. Both parotid gland and tonsillar metastases of breast cancer are extremely rare. Here, we present two separate cases of parotid gland and tonsillar metastases of breast carcinoma mimicking second primary tumors. The patient having parotid gland metastasis had disseminated disease and received palliative chemotherapy and hormone therapy. The other patient who had tonsillar metastasis underwent surgery without significant morbidity. Surgical resection of isolated tonsillar metastasis appears to have an influence on survival as the patient is free of disease at 12 months post-surgery.Öğe Yenidoğan İşitme Taraması Sonuçlarımız(2016) Şimşek, Gökçe; Tursun, Serkan; Azman, Musa; Kılıç, RahmiAmaç: Bilateral işitme kaybı, erken teşhis edildiğinde birey için önemli bir morbidite nedeni olmaktan çıkan bir durumdur. Günümüzde yenidoğan işitme taraması protokollerinin yaygınlaşması; daha çok işitme kaybı tanısının koyulmasına ve erken tedavi uygulamalarına olanak sağlamıştır. Bu yazıda Aralık 2013 ile Aralık 2015 tarihleri arasındaki yenidoğan işitme taraması sonuçlarımızı sunmayı amaçladık.Gereç ve Yöntemler: Çalışmamızda Aralık 2013 ile Aralık 2015 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi Kulak Burun Boğaz Anabilim Dalı Odyoloji Ünitesinde yenidoğan işitme taraması sonuçları retrospektif olarak incelendi. Ek olarak işitme kaybına neden olabilecek risk faktörleri araştırıldı. Risk faktörü olan bebekler direk olarak işitsel beyin sapı cevabı (ABR) ile tarandı. Risk faktörü bulunmayan yenidoğanlar geçici uyarılmış otoakustik emisyon (TEOAE) ile tarandı. Bulgular: Toplam 2700 yenidoğan işitme taraması yapıldı. Direk ABR testi uygulanan bebek sayısı 762 (%28.22) idi. Bu bebeklerin 37'sinde (%4.85) sensorinöral işitme kaybı tespit edildi. Risk faktörü bulunmayan 1938 yenidoğan arasından birinci TEOAE ve ABR testinden 1107 (%57.12) bebek kalırken, ikinci TEOAE ve ABR testinden 496 (%25.59) bebek kaldı. Bir aylık süre sonunda risk faktörü bulunmayan 1938 bebeğin hepsi taramadan geçti. Ailede işitme kaybı öyküsü, %38.23 oran ile en sık rastlanan risk faktörü olarak bulundu.Sonuç: Doğumdan sonraki ilk üç gün içinde TEOAE testi ile tarama programı başlamalıdır. İşitme kaybı açısından riskli bebeklerin anamnez ile tespit edilip, direk ABR testine tabi tutulması gereklidir. Bu konuda ailelerin bilgilendirilmesi ve testten kalan bebeklerin doğru merkezlere yönlendirilmesinin önemli olduğunu düşünmekteyizÖğe Does melatonin alleviate ototoxic effect caused by administration of cisplatin?(2019) Tokgöz, Sibel Alıcura; Şimşek, Gökce; Vuralkan, Erkan; Çalışkan, Murat; Besaltı, Ömer; Akın, IstemihanAim: In this study, it was aimed to experimentally investigate the protective effects of melatonin in the cisplatin-induced ototoxicity. Material and Methods: Ten Wistar-albino rats were included in the study. Two equal groups were generated randomly as cisplatin and melatonin groups. Rats’ underwent Auditory Brainstem Response (ABR) and Distortion Product Otoacoustic Emission (DPOAE) testing before the drug administration and the results were recorded. Both tests were repeated 72 hours after the cisplatin administration in all rats. Results: Significant difference was found between the I-IV interval values before the treatment and after the treatment both in cisplatin and melatonin group. As well as the significant difference in hearing threshold value changes, statistically, significant differences in ABR-I and ABR-IV interval variations were also seen between the cisplatin and melatonin groups. A statistically significant decrease was found between the initial and final control SNR (signal-to-noise ratio) levels within the cisplatin group in the evaluations at 2000Hz, 3000Hz and 4000Hz. Statistically, significant differences were observed between SNR levels when the melatonin group was compared with the cisplatin group. Conclusion: Melatonin appears to reduce cisplatin-induced ototoxicity in rats. Although, the use of supplementary therapies targeting to reduce the toxic effects in clinical studies is still a controversial point.Öğe Screening 5 and 6 year-old children starting primary school for development and language(2016) Yılmaz, Deniz; Muluk, Nuray Bayar; Bayoğlu, Birgül; İdil, Şefay Aysun; Anlar, BanuYılmaz D, Bayar-Muluk N, Bayoğlu B, İdil A, Anlar B. Screening 5 and 6 year-old children starting primary school for development and language. Turk J Pediatr 2016; 58: 136-144. Beginning school is an important milestone for children. Children's readiness for school involves cognitive, physical, and emotional development. Certain school programs allow children to start first grade after 66 months of age, together with 72 month-old children. In order to estimate school readiness, we screened children before starting first grade and compared their school performance according to their age and socio-demographic characteristics. Marmara School Readiness, Denver II developmental screening, and language assessment tests were applied. Language delays were more frequent and school readiness test scores were lower in the younger group compared to older children. However, school achievement did not differ between the two age groups. Preschool education, parental income and education affected performance in most tests. Preschool screening seems effective in detecting children with lower than average developmental skills, and the school system may provide a practical opportunity for providing support to those children.Öğe Relation between optic and carotid canals with sphenoid sinus in patients with communicant hydrocephalus: a computed tomography evaluation study(SAGE PUBLICATIONS LTD, 2020) Sencan, Ziya; Muluk, Nuray Bayar; Yilmazsoy, Yunus; Özdemir, Adnan; Mutlucan, Havva MeltemBackground There are neuro-ophthalmologic findings in patients with communicant hydrocephalus (CH). Purpose To investigate the relationships of the optic canal and carotid canal classifications at sphenoid sinus and anterior clinoid process (ACP) pneumatization in patients with CH. Material and Methods In this multicentric retrospective cross-sectional study, the cranial computed tomography (CT) images of 38 patients with CH (20 men, 18 women) and 40 controls (25 men, 15 women) were included. Optic and carotid canal classification at sphenoid sinus, ACP pneumatization, and sphenoid sinus septation were evaluated. Results In the CH group, type 3 optic canal was detected in 21.1% of the patients and type 4 optic canal was detected in 2.6% of the patients on the left side which was significantly different from the control group (P<0.05). In the CH group, type 3 carotid canal was detected in 21.1% of the patients (left) and 18.4% of the patients (right). ACP pneumatization was present in 13.2% of the patients in the CH group bilaterally. There were positive correlations between optic canal classifications and ACP pneumatization (P<0.05). There were also positive correlations between the right and left carotid canal classifications and ACP pneumatization (P<0.05). Conclusion To avoid complications, CT should be evaluated carefully in patients with CH before surgical interventions in sphenoid sinuses and surgeons should work carefully in the sphenoid sinus or adjacent structures. The protrusion possibility of the optic canal or carotid canal to the sphenoid sinus may be higher in pneumatized ACP patients.
