Objective To analyze the grade of reflux and the behavior of the cricopharyngeal muscle (CPM) in ... more Objective To analyze the grade of reflux and the behavior of the cricopharyngeal muscle (CPM) in patients with gastroesophageal reflux (GER) by means of electromyographic (EMG) analysis of CPM. Study Design Prospective clinical study. Setting Istanbul Training and Research Hospital. Subject and Methods Motor unit potential (MUP) recordings and kinesiological recordings of CPM were performed using a concentric needle electrode during dry material swallowing and 3-, 5-, and 10-mL water swallowing. Twenty-four patients with GER were compared with 21 healthy volunteers. Results GER was mild in 15 patients and moderate-to-severe in 9 patients. MUP recordings were normal in both groups during the preswallowing/postswallowing periods. Kinesiological investigations revealed that the number of patients who did not show a preswallow EMG burst had a positive correlation with the severity of reflux and the amount of liquid swallowed. Rebound bursts were observed in the patient and the control g...
Objective. To describe the frequency of sulcus vocalis in a population and to establish its histo... more Objective. To describe the frequency of sulcus vocalis in a population and to establish its histopathological properties. Study Design. A cadaver study. Setting. Istanbul Training and Research Hospital and Ministry of Justice National Forensic Institute. Subjects and Methods. One hundred (21 women, 79 men) fresh cadaver larynges were examined. Two hundred vocal folds were coronally sectioned and examined by light microscopy. Sulcus types, depths, degree of fibrosis in Reinke space, basement membrane thickness, and perisulcus degeneration were determined. Results. Sulcus vocalis was found in 39 of 100 cases (39%), with a male preponderance of 41.8% compared with women at 28.6%. Twenty-one (54%) cases had unilateral and 18 (46%) cases had bilateral sulcus. Among 200 vocal folds, 57 had sulcus (28%). A total of 21 sulcus cases were type 1 (37%), 18 were type 2 (31.5%), and the remaining 18 cases were type 3 (31.5%). Of the 39 (30.7%) sulcus cases, 12 were confirmed by histopathological...
Cricopharyngeus is the only muscle for which electromyography is used in the differential diagnos... more Cricopharyngeus is the only muscle for which electromyography is used in the differential diagnosis of swallowing disorders. Because of some practical difficulties, electrophysiologic tests for this muscle are not performed routinely. Thus we aimed to describe an alternative topographic way to reach the muscle easily. On 10 cadavers, a spinal needle (20 G) and on 37 patients a concentric needle electrode (26 G) were used. The needle was inserted percutaneous at the level of the superior border of the cricoid cartilage, anterior to the anterior border of the sternocleidomastoid muscle at 60 degrees angle to the frontal plane in the posteromedial direction. We reached the muscle in all cadavers. In all of the patients, the needle entered the muscle on the first attempt; that was confirmed by electromyographic responses. Our results show that this method can be useful for the practical application of cricopharyngeus muscle electromyography.
To study the biomechanical properties of glass ionomer cement used for incudostapedial rebridging... more To study the biomechanical properties of glass ionomer cement used for incudostapedial rebridging. Two groups were established based on the size of the gap between the incus and stapes (1.0 mm in group 1 and 2.0 mm in group 2). Glass ionomer cement was applied to the gaps, and compression tests were performed. Maximum force was measured at the fracture point, and was divided by the cross-sectional area to obtain the maximum compressive strength. No significant difference was found in the maximum force for the two groups (p = 0.312). The glass ionomer cement diameter was significantly higher in group 2 than in group 1 (p = 0.006). The maximum compressive strength was significantly higher in group 1 than in group 2 (p = 0.042). The fragility of bone cement used in this study was 25.5 per cent higher for a 2 mm gap than for a 1 mm gap. We speculate that the use of bone cement may be safer for the repair of smaller incudostapedial defects.
Background Although, lactoferrin (LF) is the second most important antimicrobial and anti-inflamm... more Background Although, lactoferrin (LF) is the second most important antimicrobial and anti-inflammatory peptide after lysozyme in upper respiratory tract, little is known about its role in chronic rhinosinusitis (CRS). Recent studies pronounced that LF levels were significantly reduced in CRS with nasal polyposis (NP) compared with other subgroups. However, effects of systemic corticosteroid (CS) treatment, which is currently the main NP treatment modality, and subsequent surgical intervention on LF levels are still not known. This study was designed to evaluate the effects of CS treatment and surgical intervention on LF levels in patients with NP. Methods Patients with inflammatory NP who were scheduled to undergo CS treatment and a control group were included in this study. LF levels were determined from mucosal samples taken from both groups, before and after CS treatment, and also 1 month after surgical intervention. Results Twenty-seven patients with NP and 14 patients who under...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2011
Impairment of laryngotracheal movement is a possible complication after total thyroidectomy. Here... more Impairment of laryngotracheal movement is a possible complication after total thyroidectomy. Here, we aimed to investigate the frequency and extent of impairment of laryngotracheal movement after total thyroidectomy and the effect of anti-adhesive barrier hyaluronic acid-carboxymethylcellulose membrane positioning between strap muscles and laryngotracheal complex on deglutition. The study design is prospective clinical study. Istanbul Training and Research Hospital, Laboratory of Electrophysiology, Istanbul Training and Research Hospital. The patients who underwent total thyroidectomy were selected and dichotomized according to use of seprafilm. Each group consisted of 8 female patients. All patients were assessed clinically and electrophysiologically in the pre/postop period. Electrophysiological investigations included cricopharyngeal muscle (CPM) electromyography (EMG), submental EMG, single bolus analysis [foreburst, reburst, swallowing (pause) patterns], laryngotracheal movement analysis and results were compared between two groups. CPM EMG was normal in both groups. Duration of submental muscle activity during dry and 15 cc water swallowing was similar between two groups (P = 0.751). Pause duration was shorter in group with seprafilm (P < 0.01). Dysphagia limit was 15 cc in both groups. The fore/rebound bursts duration, the time of laryngeal elevation, closure and suspension were similar (P = 0.954). We concluded that use of seprafilm between larynx and strap muscles during total thyroidectomy does not have any adverse effects on swallowing. Anti-adhesive barrier can be used safely during thyroid surgery.
Due to scheduled maintenance access to the Wiley Online Library may be disrupted as follows: Satu... more Due to scheduled maintenance access to the Wiley Online Library may be disrupted as follows: Saturday, 2 October - New York 0500 EDT to 0700 EDT; London 1000 BST to 1200 BST; Singapore 1700 SGT to 1900 SGT. ... Department of Neurology, Ege University ...
Objective To analyze the grade of reflux and the behavior of the cricopharyngeal muscle (CPM) in ... more Objective To analyze the grade of reflux and the behavior of the cricopharyngeal muscle (CPM) in patients with gastroesophageal reflux (GER) by means of electromyographic (EMG) analysis of CPM. Study Design Prospective clinical study. Setting Istanbul Training and Research Hospital. Subject and Methods Motor unit potential (MUP) recordings and kinesiological recordings of CPM were performed using a concentric needle electrode during dry material swallowing and 3-, 5-, and 10-mL water swallowing. Twenty-four patients with GER were compared with 21 healthy volunteers. Results GER was mild in 15 patients and moderate-to-severe in 9 patients. MUP recordings were normal in both groups during the preswallowing/postswallowing periods. Kinesiological investigations revealed that the number of patients who did not show a preswallow EMG burst had a positive correlation with the severity of reflux and the amount of liquid swallowed. Rebound bursts were observed in the patient and the control g...
Objective. To describe the frequency of sulcus vocalis in a population and to establish its histo... more Objective. To describe the frequency of sulcus vocalis in a population and to establish its histopathological properties. Study Design. A cadaver study. Setting. Istanbul Training and Research Hospital and Ministry of Justice National Forensic Institute. Subjects and Methods. One hundred (21 women, 79 men) fresh cadaver larynges were examined. Two hundred vocal folds were coronally sectioned and examined by light microscopy. Sulcus types, depths, degree of fibrosis in Reinke space, basement membrane thickness, and perisulcus degeneration were determined. Results. Sulcus vocalis was found in 39 of 100 cases (39%), with a male preponderance of 41.8% compared with women at 28.6%. Twenty-one (54%) cases had unilateral and 18 (46%) cases had bilateral sulcus. Among 200 vocal folds, 57 had sulcus (28%). A total of 21 sulcus cases were type 1 (37%), 18 were type 2 (31.5%), and the remaining 18 cases were type 3 (31.5%). Of the 39 (30.7%) sulcus cases, 12 were confirmed by histopathological...
Cricopharyngeus is the only muscle for which electromyography is used in the differential diagnos... more Cricopharyngeus is the only muscle for which electromyography is used in the differential diagnosis of swallowing disorders. Because of some practical difficulties, electrophysiologic tests for this muscle are not performed routinely. Thus we aimed to describe an alternative topographic way to reach the muscle easily. On 10 cadavers, a spinal needle (20 G) and on 37 patients a concentric needle electrode (26 G) were used. The needle was inserted percutaneous at the level of the superior border of the cricoid cartilage, anterior to the anterior border of the sternocleidomastoid muscle at 60 degrees angle to the frontal plane in the posteromedial direction. We reached the muscle in all cadavers. In all of the patients, the needle entered the muscle on the first attempt; that was confirmed by electromyographic responses. Our results show that this method can be useful for the practical application of cricopharyngeus muscle electromyography.
To study the biomechanical properties of glass ionomer cement used for incudostapedial rebridging... more To study the biomechanical properties of glass ionomer cement used for incudostapedial rebridging. Two groups were established based on the size of the gap between the incus and stapes (1.0 mm in group 1 and 2.0 mm in group 2). Glass ionomer cement was applied to the gaps, and compression tests were performed. Maximum force was measured at the fracture point, and was divided by the cross-sectional area to obtain the maximum compressive strength. No significant difference was found in the maximum force for the two groups (p = 0.312). The glass ionomer cement diameter was significantly higher in group 2 than in group 1 (p = 0.006). The maximum compressive strength was significantly higher in group 1 than in group 2 (p = 0.042). The fragility of bone cement used in this study was 25.5 per cent higher for a 2 mm gap than for a 1 mm gap. We speculate that the use of bone cement may be safer for the repair of smaller incudostapedial defects.
Background Although, lactoferrin (LF) is the second most important antimicrobial and anti-inflamm... more Background Although, lactoferrin (LF) is the second most important antimicrobial and anti-inflammatory peptide after lysozyme in upper respiratory tract, little is known about its role in chronic rhinosinusitis (CRS). Recent studies pronounced that LF levels were significantly reduced in CRS with nasal polyposis (NP) compared with other subgroups. However, effects of systemic corticosteroid (CS) treatment, which is currently the main NP treatment modality, and subsequent surgical intervention on LF levels are still not known. This study was designed to evaluate the effects of CS treatment and surgical intervention on LF levels in patients with NP. Methods Patients with inflammatory NP who were scheduled to undergo CS treatment and a control group were included in this study. LF levels were determined from mucosal samples taken from both groups, before and after CS treatment, and also 1 month after surgical intervention. Results Twenty-seven patients with NP and 14 patients who under...
Indian Journal of Otolaryngology and Head & Neck Surgery, 2011
Impairment of laryngotracheal movement is a possible complication after total thyroidectomy. Here... more Impairment of laryngotracheal movement is a possible complication after total thyroidectomy. Here, we aimed to investigate the frequency and extent of impairment of laryngotracheal movement after total thyroidectomy and the effect of anti-adhesive barrier hyaluronic acid-carboxymethylcellulose membrane positioning between strap muscles and laryngotracheal complex on deglutition. The study design is prospective clinical study. Istanbul Training and Research Hospital, Laboratory of Electrophysiology, Istanbul Training and Research Hospital. The patients who underwent total thyroidectomy were selected and dichotomized according to use of seprafilm. Each group consisted of 8 female patients. All patients were assessed clinically and electrophysiologically in the pre/postop period. Electrophysiological investigations included cricopharyngeal muscle (CPM) electromyography (EMG), submental EMG, single bolus analysis [foreburst, reburst, swallowing (pause) patterns], laryngotracheal movement analysis and results were compared between two groups. CPM EMG was normal in both groups. Duration of submental muscle activity during dry and 15 cc water swallowing was similar between two groups (P = 0.751). Pause duration was shorter in group with seprafilm (P < 0.01). Dysphagia limit was 15 cc in both groups. The fore/rebound bursts duration, the time of laryngeal elevation, closure and suspension were similar (P = 0.954). We concluded that use of seprafilm between larynx and strap muscles during total thyroidectomy does not have any adverse effects on swallowing. Anti-adhesive barrier can be used safely during thyroid surgery.
Due to scheduled maintenance access to the Wiley Online Library may be disrupted as follows: Satu... more Due to scheduled maintenance access to the Wiley Online Library may be disrupted as follows: Saturday, 2 October - New York 0500 EDT to 0700 EDT; London 1000 BST to 1200 BST; Singapore 1700 SGT to 1900 SGT. ... Department of Neurology, Ege University ...
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