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Öğe The intranasal trigeminal system: roles in rhinitis (allergic and non-allergic)(Verduci Publisher, 2022) Ulusoy, S.; Muluk, Nuray Bayar; Scadding, G. K.; Passali, G. S.; Dilber, M.; Gevaert, P.; Passali, D.The aim of this paper is to review intranasal trigeminal system and associated reflexes. The literature survey was performed on PubMed, ProQuest Central database of Kirikkale University and Google Scholar. The intranasal trigeminal system and associated reflexes play an important role in humans in both health and disease, including in rhinitis of non-allergic and mixed type. The intranasal trigeminal nerve provides sensory perception to the lining of the nose, supplying information on how patent the nasal airway is and responding to various chemical signals. The reflexes known to exist within the intranasal trigeminal system are nasobronchial reflex, trigemino-cardiac reflex, nasogastric reflex, and nasal cycle. The intranasal trigeminal system and its reflexes play a vital role in normal human physiology. Alterations in how this system operates may underlie multiple forms of rhinitis and more research is needed to fully understand the mechanisms involved.Öğe The important adjacent structures for anterior ethmoidal artery in FESS: Anterior ethmoidal artery canal angle, supraorbital ethmoid cells and Keros classification(Elsevier Sci Ltd, 2022) Özdemir, Adnan; Muluk, Nuray BayarObjectives: This study investigated the visualization of the anterior ethmoidal artery (AEA) as notch, canal and sulcus, its relationship between supraorbital ethmoid cells (SOECs) and the Keros classification of the olfactory fossa on paranasal sinus computerized tomography (PNSCT). Methods: In this retrospective study, the paranasal sinus computerized tomography (PNsCT) images of 204 patients (103 males and 101 females) were analyzed. AEA canal, notch and sulcus, SOECs, the distance between AEA notch and ethmoid roof, AEA canal angle and Keros classification of the olfactory fossa were evaluated. Results: AEA notch in all patients and AEA canal (37.6 to 45.6%) and AEA sulcus (53.5 to 61.2%) were visualized. In the AEC canal and sulcus visualized patients, the Keros classification revealed higher. AEA notch and ethmoid roof distance increased in patients with higher Keros types. The presence of SOECs was significantly higher in males (41.7%) than females (19.8%) on the left side. There was a positive correlation between SOEC presence and Keros classification. In patients with SOEC, bilateral AEA canal and sulcus visualized more; and bilateral AEA notch and ethmoid roof distance increased. On the right side, the AEA canal angle of the males was significantly higher than that of the females. In patients with SOEC, the left AEA canal angle also increased. Conclusion: When detected SOECs and higher Keros types, the AEA was detected away from the skull base, AEA notch-ethmoid roof distance increased; and the AEA canal angle increased. To avoid intracranial penetrations, PNSCT should be evaluated carefully during the preoperative period.Öğe The Evaluation of the Cochlear Aqueduct and Internal Acoustic Canal in Patients with Unilateral Subjective Tinnitus and Normal Hearing(Aves, 2023) Yılmazsoy, Yunus; Muluk, Nuray Bayar; Özdemir, Adnan; Şencan, ZiyaObjective: We investigated the relationship between idiopathic subjective tinnitus and internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal measurements by temporal magnetic resonance imaging. Methods: In this retrospective study, temporal magnetic resonance imaging sections of 25 patients (8 males and 17 females) with unilateral tinnitus and normal hearing were included. The internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal measurements and internal acoustic canal and cochlear aqueduct shape classification were determined in the ipsilateral tinnitus side and contralateral non-tinnitus side. Results: The cochlear aqueduct length and width and internal acoustic canal opening width, length, width, and area of the ipsilateral tinnitus side were not different from the contralateral side. Similarly, the vestibule area and lateral semicircular canal height and width values were not different between the ipsilateral tinnitus side and the contralateral side. The main cochlear aqueduct type was type 2 in both ipsilateral and contralateral sides. For the internal acoustic canal types, cylindrical and funnel shapes were the most common types for the ipsilateral tinnitus side and contralateral side. There were positive correlations between the internal acoustic canal and vestibule areas; cochlear aqueduct length and internal acoustic canal areas; cochlear aqueduct width and width of the lateral semicircular canal; internal acoustic canal area and length and cochlear aqueduct length; internal acoustic canal opening width and height of the lateral semicircular canal; and width of the lateral semicircular canal dimensions. In older patients, the ipsilateral internal acoustic canal area was found to be smaller. Conclusions: In idiopathic subjective tinnitus, there were no important pathologies detected in the internal acoustic canal, cochlear aqueduct, vestibule area, and lateral semicircular canal. We concluded that there are no statistically significant morphometric differences compared to the healthy side in the internal acoustic canal, cochlear aqueduct, vestibule, and lateral semicircular canal areas detected by temporal magnetic resonance imaging in patients with unilateral subjective tinnitus and normal hearing.Öğe The efficacy of adenotonsillectomy on oxidative stress evaluated by thiol/disulfide balance(Wiley, 2021) Tursun, Serkan; Şimşek, Gökçe; Muluk, Nuray Bayar; Taş, Mustafa Burak; Erel, ÖzcanBackground Oxidative stress plays a role in the pathogenesis of many chronic diseases. Upper airway obstruction has been identified as a risk factor for increased oxidative stress-related disorders such as obstructive sleep apnea. The effect of adenotonsillar hypertrophy, which may result in a narrowing of the upper airways, on oxidative stress can be a valuable subject of research. This study aimed to investigate the efficacy of adenotonsillectomy on oxidative stress evaluated using the thiol / disulfide balance. Methods Thirty children who underwent adenotonsillectomy and 30 healthy controls, all aged from 3 to 18 years, were included in the study. Blood samples were taken preoperatively and 3 months postoperatively in the study group; in the control group, baseline blood samples were taken and samples were again taken 3 months later. Thiol / disulfide homeostasis items were analyzed. Antioxidant markers were native thiol, total thiol, and native / total thiol. Oxidative stress markers were disulfide, disulfide / native thiol, and disulfide / total thiol. Results At the preoperative period, oxidative stress parameters of thiol / disulfide homeostasis were higher in the study group than in the control group (P < 0.05) and antioxidant activity parameters were lower than in the control group (P < 0.05). Three months postoperatively, oxidative stress parameters were lower than in the control group (P < 0.05), and antioxidant parameters were no different from those in the control group (P > 0.05). In the adenotonsillectomy group considered separately, oxidative stress markers of disulfide and disulfide / native thiol decreased (P < 0.05) and antioxidant markers of native thiol and total thiol increased in the postoperative measurements (P < 0.05). Conclusions Oxidative stress related to adenotonsillar hypertrophy decreased after adenotonsillectomy. The antioxidant parameters of the thiol homeostasis increased after adenotonsillectomy. We concluded that adenotonsillectomy operations should be planned and applied timeously to prevent the adverse effects of adenotonsillar hypertrophies on thiol homeostasis.Öğe Temporal CT Evaluation of the Relationships between Basic Anatomical Structures and the Round Window: Importance for the Cochlear Implant Surgery(Thieme Medical Publ Inc, 2024) Asal, Nese; Muluk, Nuray Bayar; Sarıkaya, Pelin Zeynep BekinObjectives In the present study, we investigated the round window (RW) and neighboring anatomical structures using temporal computed tomography (CT) which are important for cochlear implant (CI) electrodes. Methods In this retrospective study, the temporal CT images of 112 adult patients (45 males and 67 females) were evaluated. We classified mastoid pneumatization, and measured RW diameter, RW-carotid canal (CC) distance, RW-facial nerve mastoid segment (FNMS) distance, RW-pyramidal eminence distance, RW-jugular bulb (JB) distance, and RW-internal acoustic canal (IAC) distance. Additionally, RW-cochlea angle and RW-facial nerve angle were also measured. Results RW diameters in males were significantly higher than those in females bilaterally ( p < 0.05). RW-CC distance and RW-JB distance were both smaller than 10mm. RW-IAC distance was 2.54 to 2.68mm, and RW-FNMS distance was 4.20 to 4.40mm. RW-cochlea angle ranged from 39.62 to 41.91degrees and RW-FN angle ranged from 17.28 to 18.40degrees. Males showed better mastoid pneumatization values ( p < 0.05). In higher RW diameters, RW-JB distance decreased, and in pneumatized mastoids, RW-JB distance increased. RW-JB distance and RW-CC distance were detected to increase together ( p < 0.05). Conclusion RW is crucial anatomic structure for CI surgeries. RW diameters are between 1.21 and 1.35mm and lower in the females. Males exhibited better mastoid pneumatization values than the females, and CC and JB distances from RW were farther in well-pneumatized mastoids. Future studies should include comprehensive clinical and surgical findings.Öğe Radiological Evaluation of the Effect of Laryngopharyngeal Reflux on the Thickness of Inferior Turbinate, Maxillary Sinus Mucosa and Nasal Septal Body(Springer India, 2024) Taş, Burak Mustafa; Sarıkaya, Pelin Zeynep Bekin; Şencan, Ziya; Cömert, Ela; Muluk, Nuray BayarBackground We investigated the relationship between Laryngopharyngeal Reflux (LPR) and maxillary sinus mucosal thickness (MSMT), inferior turbinate mucosal thickness (ITMT), inferior turbinate width (ITW) and nasal septal body thickness (NSBT), which can be signs of chronic rhinosinusitis and allergic rhinitis.Methods The study, which included 87 patients, was designed as two groups. While 42 of the patients were included in the Laryngopharyngeal Reflux group, 45 were included in the control group. Age and gender information of the patients were noted. MSMT, ITMT, ITW and NSBT values were measured in patients who had Paranasal Sinus Computed Tomography. MSMT, ITMT and ITW were measured as right and left. Both groups were evaluated in terms of these values.Results Right ITMT, bilateral ITW and MSMT values were found to be significantly higher in the LPR group than in the control group (p < 0.05). MSMT values were higher in males (p < 0.05). The left-ITT and NSBT values were not significantly different between the LPR group and the control group, but both values were higher in the LPR group than in the control group (p > 0.05). In the LPR group, there were positive correlations between ITMT and ITW values of the right side; and left side separately (p < 0.05).Conclusion It has been shown that Laryngopharyngeal Reflux increases maxillary sinus mucosal thickness, inferior turbinate thickness and width, and nasal septal body thickness, which can be signs of chronic rhinosinusitis and allergic rhinitis. The negative effects of LPR on nasal and paranasal mucosa and structures were demonstrated in this study.Öğe Pronator quadratus musculo-osseous free flap for wide hard palatal defect reconstruction: An anatomical study(Elsevier Sci Ltd, 2023) Iğde, Murat; Salman, Necati; Güngör, Yiğit; Yılmaz, Mehmet; Cömert, Ela; Sağlam, Murat Enes; Baykara, YiğitWide hard palate defects include congenital and acquired defects that are six square centimeters or larger in size. Obturator prostheses and autologous soft tissue transfers have been used to reconstruct palatal defects. This study aims to repair wide, hard palatal defects by using a pronator quadratus musculo-osseous free flap to achieve subtotal reconstruction. Seventeen formalin-fixed cadavers were dissected. Free musculo-osseous pronator quadratus flaps were prepared after a 12 cm curvilinear volar skin incision. Standard 30 x 23 mm (690 & PLUSMN; 52.12 mm2) hard palate defects were made by chisels and saws. A subcutaneous tunnel was created between the mandibular edge cross point of the facial vessels and the retromolar trigone through the subcutaneous to the superficial musculoaponeurotic system by dissection. Area measurements of the pedicle and palate defects were performed by the ImageJ program (National Institutes of Health, Bethesda, MD, USA) on drawings over an acetate layer of materials. Mandibular distances of gonion-facial vessel cross point (a), goniongnathion (m), and facial vessels' cross point-retromolar entrance point (h) were measured. Ratios of h/m and a/m were calculated. The mean pronator quadratus area was 2349.39 & PLUSMN; 444.05 mm2, and the arterial pedicle pronator quadratus diameter was 2.32 & PLUSMN; 0.34 mm. The mean pedicle length of the pronator quadratus was 117.13 & PLUSMN; 8.10 mm. Study results showed that musculo-osseous pronator quadratus flaps' bone and muscle parts perfectly fit on the defects in all cadavers. Pronator quadratus musculo-osseous flap is a feasible surgical option for wide, hard palatal defect reconstruction strategies.& COPY; 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Öğe Preventive Measures for Safer Orthognathic Surgery: Key Points(Sage Publications Inc, 2024) İşçi, Kemal Devrim; Muluk, Nuray Bayar; Güngör, Enes; Cingi, CemalObjectives: The aim of this article is to review safer orthognathic surgery. Methods: The literature survey was performed in PubMed, EBSCO, UpToDate, ProQuest Central databases of K & imath;r & imath;kkale University, and Google and Google Scholar databases. Results: Patients with dentofacial skeletal defects may benefit from orthognathic surgery, which entails surgically modifying parts of the facial skeleton to restore the right anatomic and functional relationship. Careful investigation of the soft tissue via clinical examination and supporting pictures, evaluation of the structure via standardized radiographs, and evaluation of the dental via study dental casts are all necessary to successfully correct maxillofacial abnormalities. Orthognathic surgery can involve either the maxilla, the mandible, or both. Improving the dynamics of nasal airflow may necessitate simultaneous intranasal surgery consisting of septoplasty and reduction of the inferior turbinate. In some patients, a genioplasty and neck liposuction may be recommended to enhance the final result. Le Fort I osteotomy, Le Fort II osteotomy, Le Fort III osteotomy, maxillary segmental osteotomies, sagittal split osteotomy of the mandibular ramus, vertical Ramal osteotomy, inverted L and C osteotomies, and mandibular body segmental osteotomies are all examples of well-established osteotomies that can be used to reposition facial skeletal elements and redefine the face. Conclusion: Preventative strategies for risk-free orthognathic surgery include maintaining blood flow, shielding teeth, bone, and neurovascular systems, and bolstering the patient's diet.Öğe Preoperative computer imaging before augmentation rhinoplasty(Verduci Publisher, 2023) Cingi, Can Cemal; Muluk, Nuray Bayar; Cingi, Can CemalOBJECTIVE: In the present study, we investigated the efficacy of morphing technology via Adobe PhotoShop program and its liquefy effect in patients planned to undergo augmentation rhinoplasty. PATIENTS AND METHODS: The retrospective data for 100 consecutive augmentation rhinoplasty cases (64 females and 36 males) were enrolled in our study. Preoperative computer imaging (PCI) steps, a stepwise systematic guide for image editing, including (1) augmenting the dorsum, (2) lengthening the nose, (3) adjusting the tip projection, (4) perfection of the nasal dorsum and (5) exaggerating the tip projection and/or the dorsal augmentation were applied to the patients. After performing the PCI before augmentation rhinoplasty, the patients were allowed to see the options for the final appearance of their noses. Therefore, PCI helped them to decide on their operations. RESULTS: After applying CS-PCI before augmentation rhinoplasty, 71 patients (71%) accepted Step-4, and 19 (19%) accepted Step-3. Furthermore, six patients (6%) requested additional changes during their operational planning. In 95% of the cases, the authors achieved the results agreed upon based on the preoperative simulation. CONCLUSIONS: By PCI involving five steps for augmentation rhinoplasty, the patients were allowed to see the options for the final appearance of their noses. Therefore, PCI helped them to decide on their operations. With the help of morphing technology (2D), it is possible to increase interpersonal communication effectively.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 An evaluation of the efficacy of indomethacin in experimentally induced acute sinusitis in rats(Verduci Publisher, 2022) Kurt, Y.; Muluk, Nuray Bayar; Yildirim, C.; Dönmez, D. Burukoğlu; Erol, K.; Cingi, C.OBJECTIVE: We evaluated how efficacious indomethacin, at two different doses, is in the treatment of an experimental model of sinusitis in rats. MATERIALS AND METHODS: Twenty-one Wistar albino rats (all male) were sorted at random into one of three groups: 1(st) group (n=7) was placebo. 2(nd) group (n=7). These rats had sinusitis induced experimentally, following indomethacin 3 mg/kg, 5 days was administered to them. 3(rd) group (n=7). These rats had sinusitis induced experimentally, following indomethacin 6 mg/kg, 5 days was administered to them. The animals' sinonasal mucosae were examined histopathologically by standard light microscopy. RESULTS: Experimental sinusitis was observed in the 2(nd) and 3(rd) groups, but not in the rats administered a placebo. Although the in-flammatory features of sinusitis were found to be significantly decreased in the animals administered indomethacin 3 mg/kg (the 2(nd) group), this anti-inflammatory effect was even greater in the 3(rd) group, where indomethacin 6 mg/kg had been administered. Indomethacin at either dose was superior to placebo in reducing inflammatory features of sinusitis. CONCLUSIONS: Topical use of indomethacin nasal drops decreased the inflammatory features in experimentally induced acute sinusitis. Moreover, a higher dose of indomethacin (6 mg/kg) was more efficacious than a lower dose (3 mg/kg). The present study is valuable as an initial step in showing the need to undertake human trials to see the effect of indomethacin nasal drops on sinusitis in humans. In acute rhinosinusitis, the use of topical anti-inflammatory drops may help to decrease the symptoms and may be used adjunctively with antibiotic treatment.Öğe An evaluation of ketoprofen as an intranasal anti-inflammatory agent(Verduci Publisher, 2022) Altıntaş, M.; Muluk, Nuray Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.OBJECTIVE: The objective of the study was to evaluate the effect of ketoprofen when locally applied to tissue-cultured nasal epithelium. MATERIALS AND METHODS: Healthy primary nasal epithelial cells were grown in a tissue culture medium. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide) assay was used to evaluate cytotoxicity. Markers of cellular injury revealed by the MTT assay include fragmentation of DNA, condensed nuclei, and changes affecting the cellular outer membrane and cytoskeleton. Epithelial cells at body temperature in cell culture were exposed over a 24- hour period to ketoprofen. Following the MTT assay, the confocal microscopic examination was performed. The extent to which epithelial cells remained capable of proliferating was evaluated by inducing a scratch injury, waiting for the repair to occur, and then examining the result with the ordinary light microscope. RESULTS: Topically applied ketoprofen does not affect the viability of tissue-cultured nasal epithelial cells within a 24-hour period. Furthermore, there were no cellular morphological alterations observed which would indicate toxicity from ketoprofen. In the scratch assay, the cells regained a normal confluent appearance within 24 hours. Thus, ketoprofen neither increases nor alters the rate at which nasal epithelial cells proliferate. CONCLUSIONS: Ketoprofen, when applied topically for 24 hours to nasal epithelial cells in cell culture, does not cause any alterations in cellular appearance which would suggest impairment of the ability to proliferate or indicate a cytotoxic effect. Extrapolating from these results, it appears acceptable to use ketoprofen topically within the nose in cases of rhinosinusitis (acute or chronic) or nasal pain since there is minimal risk of local toxic injury.Öğe Agility Skills, Speed, Balance and CMJ Performance in Soccer: A Comparison of Players with and without a Hearing Impairment(Mdpi, 2023) Yapıcı, Hakan; Soylu, Yusuf; Gülü, Mehmet; Kutlu, Mehmet; Ayan, Sinan; Muluk, Nuray Bayar; Aldhahi, Monira, I.This study investigates the differences in agility, speed, jump and balance performance and shooting skills between elite hearing-impaired national team soccer players (HISP) and withouthearing-impairment elite soccer players (woHISP). Players were divided into two groups, the HISP group (n = 13; 23.5 +/- 3.1 years) and the woHISP group (n = 16; 20.6 +/- 1.4 years), and were tested in three sessions, seven apart, for metrics including anthropometrics, speed (10 m, 20 m and 30 m), countermovement jump (CMJ), agility (Illinois, 505, zigzag), T test (agility and shooting skills), and balance. The results showed that 30 m, 20mand 10msprint scores, agility/ skills (sec), shooting skills (goals), zigzag, Illinois, and 505 agility skills, and countermovement jump scores were significantly lower among players with hearing impairments (p < 0.05). There were no significant T test differences between HISP and woHISP (p > 0.05). The HISP showed right posterolateral and posteromedial, and left posterolateral and posteromedial scores that were lower than the woHISP group (p < 0.05). Anterior scores were not significantly different between each leg (p > 0.05). In conclusion, the HISP group showed higher performance scores for speed (10 m, 20 m and 30 m), CMJ, agility (Illinois, 505, zigzag) and T test (sec and goals), but not balance. Hearing-impaired soccer players are determined by their skill, training, and strategy, not their hearing ability.Öğe A safety investigation into topical effects of naproxen sodium on nasal epithelial cells and potential toxicity in local application(W B Saunders Co-Elsevier Inc, 2023) Dündar, Rıza; Muluk, Nuray Bayar; Sezer, Canan Vejselova; Kaya, Furkan; Kutlu, Hatice Mehtap; Cingi, CemalObjectives: We examined how topically-applied naproxen sodium affects human nasal epitheliocytes in culture. Methods: Samples of healthy human primary nasal epithelium (NE) harvested during septoplasty from volunteers without rhinosinusitis were incubated in cell culture. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assays may be utilised when assessing cellular damage (toxicity), as evidenced by DNA fragmentation, nuclear condensation, alteration in the outer plasma membrane and cytoskeletal alteration. This was the method used in the study. Cultured epitheliocytes were incubated with naproxen sodium for 24 h at 37 ???C. The MTT assay was then performed and the cells' morphology was examined by confocal microscopy. Additionally, cellular proliferation was assessed by the artificial scratch method followed by light microscopy. Results: The results indicated that naproxen sodium does not cause any cytotoxic effects upon nasal epithelial cells when applied topically. There was no evidence indicating cytotoxicity on the nasal epitheliocytes in culture for the 24 h period over which the drug was applied. In particular, there was no alteration in cellular morphology, damage to the intracellular organelles structure or the cytoskeleton secondary to naproxen sodium. Furthermore, cellular proliferation occurred normally in these conditions, as on scratch test. Conclusion: Topical naproxen sodium may be used on nasal epithelial cells without inducing toxicity. This agent is therefore suitable, given its known anti-inflammatory effects, for use in patients suffering from diseases involving nasal and paranasal sinusal inflammation, including rhinosinusitis (both chronic and acute) and nasal polyposis which should be investigated. In the future, topical medication forms for nasal usage should be developed.Öğe 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.
