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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 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.Öğe Video head impulse test in children with otitis media with effusion and dizziness(ELSEVIER IRELAND LTD, 2020) Tozar, Mesut; Comert, Ela; Sencan, Ziya; Simsek, Gokce; Muluk, Nuray Bayar; Kilic, RahmiObjective: The objectives of the study were to evaluate the vestibular impairment in children with otitis media with effusion (OME) and dizziness by using vHIT test, and to compare their results with healthy children. Methods: The study population consisted of 30 pediatric patients with OME and dizziness and 30 healthy children, age between 4 and 15. Otoscopic and tympanometric examination and vHIT testing were performed to all subjects. vHIT test parameters were compared between pediatric patients with OME and dizziness and healthy children. Additionally, the differences of the mean vHIT gains between tympanogram types, otoscopic findings and the presence of saccades were analyzed. Results: The mean vHIT gains and gain asymmetry values of patients with OME and dizziness and healthy children were comparable. No significant difference was observed between the mean vHIT gains of patients with type B and type C2 tympanogram. Covert saccades were observed in 57% of the patients with OME and dizziness. None of the patients had over saccades and none of the healthy children had saccades. Conclusion: Our study is a preliminary study analyzing the vestibular impairment in children with OME and dizziness using vHIT test. Based on our results, it can be assumed that the children with OME and dizziness usually don't have a great vestibular impairment that can be detected with vHIT test. The covert saccades detected in this patient group are accepted as a sign of slight vestibular impairment.Öğe Expansion sphincter pharyngoplasty: analyzing the technique based on anatomy(SPRINGER, 2021) Comert, Ela; Comert, Ayhan; Sencan, ZiyaPurpose The purpose of this study is to evaluate the effect of the different surgical techniques of expansion sphincter pharyngoplasty (ESP) on the dimensions of the oropharyngeal airway. Methods The techniques that were evaluated included the preservation and transection of the palatopharyngeus (PP) and superior pharyngeal constrictor (SPC) muscle attachment and transposition of the PP muscle to the hamulus of the medial pterygoid plate and the palatal musculature. Surgical techniques were applied in twenty half heads. Results The preservation of the PP-SPC attachment inhibited the transposition of the PP muscle to the hamulus and resulted in comparable enlargement in the medial-lateral dimension in the oropharyngeal airway when the PP muscle was transposed to the palatal musculature. After transection of the PP-SPC attachment, significant enlargement was observed in anterior-posterior and medial-lateral directions in the oropharyngeal airway when the PP muscle was transposed both to the hamulus and the palatal musculature. The distances measured after both the transposition techniques were similar. Conclusion The present study is a basic study demonstrating how different techniques of ESP affect the position of the soft palate. The PP-SPC attachment can be transected in the patients with anterior-posterior palatal and lateral wall collapse to pull the soft palate anteriorly in addition to prevent the lateral wall collapse. The PP-SPC attachment can be preserved in the patients with only lateral wall collapse. Nevertheless, the clinical consequences of these static changes need to be evaluated in clinical studies.Öğe Does Mastoid Pneumatization Affect Facial Canal Dimensions and Distances of Facial Tympanic Segment-Scutum and Lateral Semicircular Canal-Scutum?(LIPPINCOTT WILLIAMS & WILKINS, 2020) Inal, Mikail; Muluk, Nuray Bayar; Asal, Nese; Sahan, Mehmet Hamdi; Simsek, Gokce; Arikan, Osman KursatObjectives In the present study, we investigated whether mastoid pneumatization affects facial canal dimensions and distances of facial tympanic segment and scutum, and lateral semicircular (LSS) canal and scutum. Methods One hundred sixty-one temporal multidetector computed tomography scans were reviewed. Patients with unilateral sclerotic mastoid pneumatization (no aeration) (group 1, n = 81) and unilateral total mastoid pneumatization (100.0% aeration) (group 2, n = 80) were included. Facial canal dimensions at the labrythine, tympanic, and mastoid segments; facial canal dehiscence and length; and facial tympanic segment-scutum and LSS canal-scutum distances were evaluated. Results In the present study, facial canal dimensions of labyrinthine, tympanic, and mastoid segments in total pneumatized mastoid group were significantly lower than sclerotic mastoids on axial and coronal images (P < 0.05). Facial tympanic segment and scutum distance of the sclerotic mastoid group was significantly lower than those of the total pneumatized mastoid group (P < 0.05). However, LSS canal-scutum distance was not different between both groups (P > 0.05). The LSS canal-scutum distance of the females was lower than those of the males (P < 0.05). Facial canal dehiscence ratio was 11.3% and 11.1% in sclerotic and total pneumatized mastoids, respectively. The mean +/- SD length of the dehiscence was 2.46 +/- 1.29 mm in pneumatized mastoids and 1.92 +/- 0.68 mm in sclerotic mastoids. Conclusions In cholesteatoma cases, scutum erosion may occur. Because facial tympanic segment and scutum distance decreased in sclerotic mastoids compared with completely pneumatized ones, maximum care must be taken in the operations for avoiding to damage facial canal and nerve. Revision cases may be more difficult because of distorted anatomy. However, in pneumatized mastoids, the mean length of the facial canal was more than 2 mm, which must be kept in mind during operations.Öğe Important landmarks and distances for posterior fossa surgery measured by temporal MDCT(SPRINGER, 2020) Burulday, Veysel; Bayar Muluk, Nuray; Komurcu Erkmen, Selmin Perihan; Akgul, Mehmet Huseyin; Ozdemir, AdnanIn this retrospective study, we aimed to present important anatomical structures and distances for posterior fossa surgery by temporal multidetector computed tomography (MDCT). The temporal MDCT images of 317 adult patients (158 males and 159 females) were retrieved from the hospital's picture archiving and communication system (PACS). In the coronal temporal MDCT views, the cochlea-carotid canal and jugular bulb-mastoid bone outer surface were measured. In the axial MDCT views, the carotid canal-jugular bulb and carotid canal-posterior fossa distances were measured; the carotid canal and jugular bulb anterior-posterior (AP) and transverse dimensions were also measured. The bilateral cochlea-carotid canal, jugular bulb-mastoid bone outer surface, and right carotid canal-jugular bulb distances were significantly greater in the males than those in the females (p < 0.05). The carotid canal-posterior fossa distance was not different in both genders (p > 0.05). The carotid canal-jugular bulb and the carotid canal-posterior fossa distances were greater on the left side than those on the right side in both genders (p < 0.05). In males, the outer surface distance was greater on the left jugular bulb-mastoid bone than that on the right side of that bone (p < 0.05). The difference between the carotid canal AP dimensions was not significant between males and females (p > 0.05). However, the carotid canal transverse dimension, jugular bulb AP, and transverse dimensions were significantly greater in the males than those in the females, bilaterally (p < 0.05). In each gender separately, the carotid canal AP and transverse dimensions were greater on the left side and the jugular bulb AP and transverse dimensions were greater on the right side than those on the left side (p < 0.05). Positive correlations were found between the cochlea-carotid canal, the jugular bulb-mastoid bone outer surface, and the carotid canal-jugular bulb distances as well as between the jugular bulb-mastoid bone outer surface and the carotid canal-posterior fossa distances (p < 0.05). In older patients, the carotid canal-posterior fossa distances were shorter on the left side (p < 0.05). Vascular and neural localizations should be well understood in the operative area before applying the surgical approach in the posterior fossa. Computed tomography (CT) has a greater role in the evaluation of bone structures and vascular canals in this area.Öğe Evaluation of the vestibular system with video head impulse test in pregnant women with hyperemesis gravidarum(WILEY, 2020) Tulmac, Ozlem B.; Kilic, Rahmi; Yaman, Selen; Aktulum, Fatma; Simsek, Gokce; Erdinc, SevalAim We aimed to evaluate the semicircular canal functions of the vestibular system in pregnant women with hyperemesis gravidarum. Methods This is a prospective case-control study. Among pregnant women in their first trimester (<14. gestational weeks) who presented to our outpatient clinic, 36 patients diagnosed with hyperemesis gravidarum defined as persistent nausea and vomiting requiring intravenous hydration or loss of at least 5% of prepregnancy weight and 34 healthy pregnant without nausea and vomiting were included. Otorhinolaryngologic examination and video head impulse test (vHIT) was performed to all patients. Vestibular-ocular reflex (VOR) gain and gain asymmetry were assessed between groups. Results The VOR gains in each semicircular canal did not differ between hyperemesis and control groups. Using a VOR gain cut-off value of 0.8, the groups were compared in terms of the frequency of low values. In the hyperemesis group, abnormally low gain values of left anterior canal were more frequently observed than in the control group (32 [88.9%], 22 [64.7%], respectively,P= 0.01). In left anterior-right posterior (LARP) plane VOR gain asymmetry was higher in hyperemesis group (13.5 [1.0-71.0], 6.0 [0.0-35.0],P= 0.001). No significant gain asymmetry was detected between the groups in the other planes. Conclusion Semicircular canal functions were not abnormal globally in women with hyperemesis gravidarum. However, higher LARP plane asymmetry and low LA gain in women with hyperemesis suggests need for further research to clarify functional role of vestibular system on hyperemesis gravidarum.Öğe MRI evaluation of distance between tonsillary fossa and internal carotid artery in children(ELSEVIER IRELAND LTD, 2020) Sahan, Mehmet Hamdi; Muluk, Nuray BayarObjectives: The presence of the internal carotid artery (ICA) near tonsils can also cause severe bleeding during a tonsillectomy. We investigated the relationship between tonsil width and volume; and superior, middle and inferior tonsil-ICA distances in 5-9 and 10-15 years of age children. Methods: Cranial MRI images of 200 children between 5 and 15 years of age were evaluated retrospectively. There were 100 children in group 1 (5-9 years of age) and 100 children in group 2 (10-15 years of age). Palatine tonsil width and volume; and superior, middle and inferior tonsil-internal carotid artery (ICA) measurements were performed bilaterally. Results: Our results showed that bilateral tonsil width and volume; and left superior, middle and inferior tonsilICA distance of 5-9 years of age group were lower than those of the 10-15 year-of age group (p < 0.05). The nearest distance between ICA and palatine tonsil is at the inferior tonsil-ICA distance side in both age groups. Especially mean inferior and middle tonsil-ICA distances were lower than 8 mm in 5-9 years of age group and lower than 9 mm in 10-15 years of age group. Minimum middle tonsil-ICA distances were 2.0-2.50 mm in smaller children and 2.0-3.50 mm in older children. Similarly, the minimum inferior tonsil-ICA distances were 2.00 mm in smaller children and 2.20-3.00 mm in older children. There were positive correlations between tonsil width, volume, and superior tonsil-ICA distance; and middle and inferior tonsil-ICA distances (p < 0.05). Conclusion: In younger children, lower tonsil width; and in all children, lower tonsil volume can be a warning sign in terms of lower tonsil superior-ICA distance. During tonsillectomies, working at the middle and inferior tonsillary fossa, maximum attention must be performed for the possibility of the ICA being very closer to the tonsil to avoid unwanted bleedings.Öğe The Role of CD68 (+) Histiocytic Macrophages in Nasal Polyp Development(THIEME MEDICAL PUBL INC, 2020) Bayar Muluk, Nuray; Arikan, Osman Kursat; Atasoy, Pinar; Kilic, Rahmi; Tuna Yalcinozan, EdaObjectives The aim of this study was to investigate the role of CD68 (+) histiocytic macrophages (H-M) in the nasal polyp pathogenesis. Materials and Methods The study group consisted of 24 adult patients with nasal polyposis. The control group consisted of 11 adult patients without nasal polyps. A total of 36 nasal polyp samples (10-nasal cavity, 10-maxillary sinus, and 16-ethmoid sinus) from the study group and 11 inferior turbinate samples from the control group were analyzed by immunohistochemical staining, with monoclonal antibodies against CD68 (+) H-M. Results CD68 positivity was significantly higher than the control group in the subepithelial (SE) layer of the ethmoid sinus, and deep layers of nasal cavity, maxillary, and ethmoid sinuses. In SE and deep layers of ethmoid and maxillary sinuses, CD68 positivity was significantly higher than that of the epithelial layer. In the deep layer, histiocytic macrophages tended to gather around eosinophils. Conclusion The high numbers of CD68 (+) histiocytic macrophages mainly located in deep layer of lamina propria may be responsible for the phagocytosis of eosinophils within the polyp tissue. Therefore, it may be concluded that increased macrophages in nasal polyps do not trigger the growth of nasal polyps. Instead, they may serve to reduce the number of eosinophils in already-developed nasal polyps.Öğe Assessment of the effects of menopause on semicircular canal using the video head impulse test(TAYLOR & FRANCIS INC, 2020) Tulmac, Ozlem Banu; Simsek, GokceThis cross-sectional study included early menopausal and late menopausal women aged between 40 and 60 years to evaluate the effects of menopause on semicircular canal function. A video head impulse test (vHIT) was performed for all subjects. Vestibulo-ocular reflex (VOR) mean gains of each semicircular canal and gain asymmetry were compared between groups. Of the 87 subjects, 37(42.5%) were reproductive age 28(32.5%) were early menopausal and 22(25.3%) were late menopausal patients. VOR gain of semicircular canals or gain asymmetry values did not differ between groups. In postmenopausal women, presence of vasomotor symptoms was associated with higher gain asymmetry of the left anterior-right posterior (LARP) plane (p = .01), and presence of balance problems was associated with lower right anterior (RA) VOR gain (p = .01). In conclusion semicircular canal function in postmenopausal women was similar to that in women of reproductive age. IMPACT STATEMENT What is already known on this subject? During menopause, women face potential risks such as dizziness, balance problems, falls and fractures. Postmenopausal patients were tested with dynamic posturography to measure balance before and after oestrogen treatment, and it was shown that balance problems significantly improved with oestrogen treatment. Healthy vestibular system is one of the components for sustaining normal balance. What do the results of this study add? In postmenopausal women the function of the semicircular canals is normal and the balance deficit in postmenopausal women may not be caused by the vestibular system. In this study changes within normal limits were observed in vestibular system of postmenopausal women. What are the implications of these findings for clinical practice and/or further research? Reported balance deficits might have been due to central origin. Further research to differentiate origin of balance deficits are needed. Specific research on symptomatic postmenopausal patients would reveal more information.Öğe Voice and Quality-of-Life Outcomes of Diode Laser for Tis-T1a Glottic Cancer(Sage Publications Inc, 2020) Sencan, Ziya; Comert, Ela; Tuncel, Umit; Kilic, CanerThe aim of this prospective study was to analyze the voice and quality-of-life outcomes of microscopic diode laser surgery (MDLS). The study was conducted on a series of 46 patients with Tis-T1a glottic carcinoma treated with microscopic endolaryngeal diode laser surgery. Patients were asked to complete the Voice Handicap Index and quality-of-life questionnaires of the European Organization for Research and Treatment of Cancer. When comparing the pre- and postoperative scores, there were significant difference on the physical scores (P = .014) of the patients who underwent type III cordectomy and functional (P = .022), emotional (P = .002), and overall scores (P = .005) of the patients who underwent type IV cordectomy, in the direction of better quality of voice after MDLS. The postoperative functional, physical, emotional, and overall scores of groups were significantly increased with the extension of resection.Öğe Morphometric Analysis of the Fronto-maxillary Sinuses in Adult Patients with Traumatic Septal Deviations(Bentham Science Publ Ltd, 2019) Inal, Mikail; Simsek, Gokce; Kaya, Ahmet; Kilic, RahmiObjective: The aim of the current study was to investigate a change in the volume of the frontal and maxillary sinuses in patients with nasal septum deviations due to physical trauma. Materials and Methods: Paranasal sinus computed tomography data of 100 patients admitted to Kirikkale University medical faculty hospital between November 2013 and June 2014 were retrospectively analyzed. The side of the nasal septal deviation, the deviation angle, the severity of the deviation, and bilateral frontal and maxillary sinus volumes were calculated using a computer program. The relationship between sinus volumes and deviated septum characteristics was investigated. Results: The maxillary sinus volumes did not differ between the two genders. However, the female patients had significantly decreased frontal sinus volumes when compared with the male patients (p < 0.05). A right-sided septal deviation was found to be associated with a significantly decreased maxillary sinus volume (p < 0.001), and the severity of the deviation was a significant determinant of the maxillary sinus volume (p < 0.001). The age of the patient at the time of the septal trauma was significantly associated with their maxillary sinus volumes. Patients who had experienced this trauma after 12 years of age had significantly increased maxillary sinus volumes when compared with those who experienced the trauma before the age of 12. Conclusion: A distorted septal anatomy was found to be a significant parameter for developing paranasal sinuses. Right-sided and severe traumatic deviations with an onset before the age of 12 were significantly associated with a decreased maxillary sinus volume.
