Rhinoplasty is a common surgical procedure that is requested and accepted by patients for cosmeti... more Rhinoplasty is a common surgical procedure that is requested and accepted by patients for cosmetic and functional reasons. Osteotomies are performed on nasal bone, maxillary crest, or vomer to fix the deviations of the nasal dorsum or septum. During the percussion of the osteotomes with the surgical mallet, the vibration energy diffuses to the cranium. Auditory and vestibular systems may be affected by these vibrations. To assess the effects of rhinoplasty, in which osteotomies were performed using a hammer, on the audiovestibular system. Thirty adults who underwent rhinoplasty were included in the study group. Ten age and gender matched adults who had nasal surgery without surgical mallet or osteotome served as the control group. The patients in both groups were assessed using pure tone audiometry, tympanometry, distortion product otoacoustic emission testing, and vestibular evoked myogenic potential, as well as video head impulse tests (vHIT) before the operation and one week afte...
To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, per... more To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (p<0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells.
The journal of international advanced otology, 2017
We reported the recovery of sensorineural hearing loss and tinnitus in a 22-year-old man after co... more We reported the recovery of sensorineural hearing loss and tinnitus in a 22-year-old man after complete removal of intracranial portion of jugular foramen schwannoma via the retrosigmoid approach. The aim of this case report was to present the excision of a large jugular foramen schwannoma via the retrosigmoid approach and to describe the improvement of sensorineural hearing loss related to arachnoid inflammations due to chronic arachnoiditis after suboccipital craniectomy. The recovery of sensorineural hearing loss and tinnitus after release of arachnoid adhesions may indicate the clinical significance of these adhesions or arachnoiditis, which should also be considered and investigated in the etiology of other neurotological diseases.
Otology Neurotology Official Publication of the American Otological Society American Neurotology Society and European Academy of Otology and Neurotology, May 1, 2005
Journal of Otolaryngology Head Neck Surgery Le Journal D Oto Rhino Laryngologie Et De Chirurgie Cervico Faciale, Dec 1, 2008
Objectives: The aim of this study was to determine safety, pain perception, and the factors that ... more Objectives: The aim of this study was to determine safety, pain perception, and the factors that may affect pain perception in patients undergoing certain otorhinolaryngologic procedures under local anesthesia with sedation. Design: Prospective clinical study. Setting: Tertiary care academic medical centre. Methods: Two hundred thirteen patients operated on under local anesthesia with sedation were included in the study. A visual analogue scale (VAS) and a questionnaire were employed to measure pain perception during surgery and evaluate possible pain-related variables. Results: The mean VAS values were 2.86 (+/-1.84) for the myringoplasty group, 2.54 (+/-1.76) for the otosclerosis surgery group, 1.70 (+/-1.25) for the somnoplasty group, 1.00 (+/-0.94) for the oral biopsy group, 2.15 (+/-1.49) for the inferior turbinate radiofrequency reduction (ITRR) group, 3.47 (+/-2.18) for the septoplasty plus ITRR group, 5.56 (+/-2.01) for the septorhinoplasty group, 4.94 (+/-2.16) for the open technique septoplasty group, and 3.30 (+/-1.87) for the septoplasty group. No variable was shown to affect pain perception when all patients were evaluated in common. When surgical procedures were evaluated individually, the level of acquaintance of patients in the myringoplasty group (p=.007) and operative time for the septoplasty group (p<.001) were found to independently affect pain perception. Conclusions: Given that septorhinoplasty and open technique septoplasty are found to be more painful, it is advisable to perform these procedures under general anesthesia. To increase the level of acquaintance of patients and to shorten operative time as possible may be helpful for minimizing pain perception.
Kulak Burun Bogaz Ihtisas Dergisi Kbb Journal of Ear Nose and Throat, 2008
Schwannomas may rarely arise from the facial nerve and most commonly occur in the intratemporal p... more Schwannomas may rarely arise from the facial nerve and most commonly occur in the intratemporal part of the nerve. Extratemporal facial nerve schwannomas are extremely rare. Intraparotid schwannomas usually develop in adults and only one pediatric case has hitherto been reported. Herein, we reported the second case of facial nerve schwannoma in a 7-year-old boy who presented with a slow growing, painless preauricular mass of three-year history. Superficial parotid ultrasonography revealed a solid mass with homogenous echogenicity originating from the superficial parotid lobe. There was no facial nerve dysfunction. Superficial parotidectomy was performed. The main truncus and main branches of the facial nerve were found intact. The mass, nearly 3x3 cm in size, was originating from a communicating nerve between the marginal mandibular and buccal branches of the facial nerve. The tumor was removed together with this communicating branch. Histopathologic examination revealed schwannoma. Facial nerve functions were normal after the operation, and no recurrence was encountered in a six-month follow-up.
The Journal of Laryngology and Otology, Apr 1, 2000
The objectives of this study were to investigate the typical clinical presentation, diagnosis and... more The objectives of this study were to investigate the typical clinical presentation, diagnosis and treatment of mycobacterial cervical lymphadenitis (MCL).Medical records of 87 patients who were treated for MCL were retrospectively reviewed. Definitive diagnosis of MCL was made when a neck mass persisted for several weeks or months and one or more of the following was obtained: (1) positive mycobacterial cultures from biopsy material; (2) Positive mycobacterial staining of biopsy material; (3) Granulomatous inflammation and caseating necrosis on histopathological examination of biopsy material.Clinical findings were reviewed prior to treatment. The treatment included standard antituberculous medications followed by surgery in which either total excision or selective nodal dissection of the cervical lump was made. Follow-up results are presented.The chief complaint was a cervical mass that was localized mostly to the posterior cervical or submandibular regions. A fistula formation was encountered in 11.5 per cent. All patients recovered from MCL by combined antituberculous drug and surgical treatments.Clinical presentation of the disease and histopathological assessment are important in the diagnosis of MCL as well as in the differential diagnosis of tuberculous and nontuberculous MCL. Utilizing the combined medical and surgical treatment options, both tuberculous and non-tuberculous cervical adenitis can be treated successfully.
Minimal invasive approaches have been described for cochlear implantation. However, the number of... more Minimal invasive approaches have been described for cochlear implantation. However, the number of reports about minimal invasive approaches for MED-EL devices is sparse. In this technical note, we describe our pediatric cochlear implantation and incision techniques for MED-EL devices. Among 92 cochlear implantations performed between November 2002 and November 2006, there were 32 consecutive pediatric cochlear implantations with MED-EL devices which were performed between July 2005 and October 2006. In our technique, standard posterior tympanotomy and cochleostomy were performed after 4- to 5-cm mini-incisions in the postauricular region. However, suture fixations were not used for the implant receiver nor its electrode. There were 14 girls and 18 boys with a mean age of 3.9 years. The mean follow-up duration was 5.8 months. No flap necrosis, hematoma or infection, nor implant migration, extrusion or breakdown were encountered. Revision surgery was performed in 3 patients due to cochlear ossification, perilymph leakage and extracochlear implantation. MED-EL implantation can be performed using small incisions without suture fixation of the receiver and its electrode.
Rhinoplasty is a common surgical procedure that is requested and accepted by patients for cosmeti... more Rhinoplasty is a common surgical procedure that is requested and accepted by patients for cosmetic and functional reasons. Osteotomies are performed on nasal bone, maxillary crest, or vomer to fix the deviations of the nasal dorsum or septum. During the percussion of the osteotomes with the surgical mallet, the vibration energy diffuses to the cranium. Auditory and vestibular systems may be affected by these vibrations. To assess the effects of rhinoplasty, in which osteotomies were performed using a hammer, on the audiovestibular system. Thirty adults who underwent rhinoplasty were included in the study group. Ten age and gender matched adults who had nasal surgery without surgical mallet or osteotome served as the control group. The patients in both groups were assessed using pure tone audiometry, tympanometry, distortion product otoacoustic emission testing, and vestibular evoked myogenic potential, as well as video head impulse tests (vHIT) before the operation and one week afte...
To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, per... more To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (p&lt;0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p&gt;0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells.
The journal of international advanced otology, 2017
We reported the recovery of sensorineural hearing loss and tinnitus in a 22-year-old man after co... more We reported the recovery of sensorineural hearing loss and tinnitus in a 22-year-old man after complete removal of intracranial portion of jugular foramen schwannoma via the retrosigmoid approach. The aim of this case report was to present the excision of a large jugular foramen schwannoma via the retrosigmoid approach and to describe the improvement of sensorineural hearing loss related to arachnoid inflammations due to chronic arachnoiditis after suboccipital craniectomy. The recovery of sensorineural hearing loss and tinnitus after release of arachnoid adhesions may indicate the clinical significance of these adhesions or arachnoiditis, which should also be considered and investigated in the etiology of other neurotological diseases.
Otology Neurotology Official Publication of the American Otological Society American Neurotology Society and European Academy of Otology and Neurotology, May 1, 2005
Journal of Otolaryngology Head Neck Surgery Le Journal D Oto Rhino Laryngologie Et De Chirurgie Cervico Faciale, Dec 1, 2008
Objectives: The aim of this study was to determine safety, pain perception, and the factors that ... more Objectives: The aim of this study was to determine safety, pain perception, and the factors that may affect pain perception in patients undergoing certain otorhinolaryngologic procedures under local anesthesia with sedation. Design: Prospective clinical study. Setting: Tertiary care academic medical centre. Methods: Two hundred thirteen patients operated on under local anesthesia with sedation were included in the study. A visual analogue scale (VAS) and a questionnaire were employed to measure pain perception during surgery and evaluate possible pain-related variables. Results: The mean VAS values were 2.86 (+/-1.84) for the myringoplasty group, 2.54 (+/-1.76) for the otosclerosis surgery group, 1.70 (+/-1.25) for the somnoplasty group, 1.00 (+/-0.94) for the oral biopsy group, 2.15 (+/-1.49) for the inferior turbinate radiofrequency reduction (ITRR) group, 3.47 (+/-2.18) for the septoplasty plus ITRR group, 5.56 (+/-2.01) for the septorhinoplasty group, 4.94 (+/-2.16) for the open technique septoplasty group, and 3.30 (+/-1.87) for the septoplasty group. No variable was shown to affect pain perception when all patients were evaluated in common. When surgical procedures were evaluated individually, the level of acquaintance of patients in the myringoplasty group (p=.007) and operative time for the septoplasty group (p<.001) were found to independently affect pain perception. Conclusions: Given that septorhinoplasty and open technique septoplasty are found to be more painful, it is advisable to perform these procedures under general anesthesia. To increase the level of acquaintance of patients and to shorten operative time as possible may be helpful for minimizing pain perception.
Kulak Burun Bogaz Ihtisas Dergisi Kbb Journal of Ear Nose and Throat, 2008
Schwannomas may rarely arise from the facial nerve and most commonly occur in the intratemporal p... more Schwannomas may rarely arise from the facial nerve and most commonly occur in the intratemporal part of the nerve. Extratemporal facial nerve schwannomas are extremely rare. Intraparotid schwannomas usually develop in adults and only one pediatric case has hitherto been reported. Herein, we reported the second case of facial nerve schwannoma in a 7-year-old boy who presented with a slow growing, painless preauricular mass of three-year history. Superficial parotid ultrasonography revealed a solid mass with homogenous echogenicity originating from the superficial parotid lobe. There was no facial nerve dysfunction. Superficial parotidectomy was performed. The main truncus and main branches of the facial nerve were found intact. The mass, nearly 3x3 cm in size, was originating from a communicating nerve between the marginal mandibular and buccal branches of the facial nerve. The tumor was removed together with this communicating branch. Histopathologic examination revealed schwannoma. Facial nerve functions were normal after the operation, and no recurrence was encountered in a six-month follow-up.
The Journal of Laryngology and Otology, Apr 1, 2000
The objectives of this study were to investigate the typical clinical presentation, diagnosis and... more The objectives of this study were to investigate the typical clinical presentation, diagnosis and treatment of mycobacterial cervical lymphadenitis (MCL).Medical records of 87 patients who were treated for MCL were retrospectively reviewed. Definitive diagnosis of MCL was made when a neck mass persisted for several weeks or months and one or more of the following was obtained: (1) positive mycobacterial cultures from biopsy material; (2) Positive mycobacterial staining of biopsy material; (3) Granulomatous inflammation and caseating necrosis on histopathological examination of biopsy material.Clinical findings were reviewed prior to treatment. The treatment included standard antituberculous medications followed by surgery in which either total excision or selective nodal dissection of the cervical lump was made. Follow-up results are presented.The chief complaint was a cervical mass that was localized mostly to the posterior cervical or submandibular regions. A fistula formation was encountered in 11.5 per cent. All patients recovered from MCL by combined antituberculous drug and surgical treatments.Clinical presentation of the disease and histopathological assessment are important in the diagnosis of MCL as well as in the differential diagnosis of tuberculous and nontuberculous MCL. Utilizing the combined medical and surgical treatment options, both tuberculous and non-tuberculous cervical adenitis can be treated successfully.
Minimal invasive approaches have been described for cochlear implantation. However, the number of... more Minimal invasive approaches have been described for cochlear implantation. However, the number of reports about minimal invasive approaches for MED-EL devices is sparse. In this technical note, we describe our pediatric cochlear implantation and incision techniques for MED-EL devices. Among 92 cochlear implantations performed between November 2002 and November 2006, there were 32 consecutive pediatric cochlear implantations with MED-EL devices which were performed between July 2005 and October 2006. In our technique, standard posterior tympanotomy and cochleostomy were performed after 4- to 5-cm mini-incisions in the postauricular region. However, suture fixations were not used for the implant receiver nor its electrode. There were 14 girls and 18 boys with a mean age of 3.9 years. The mean follow-up duration was 5.8 months. No flap necrosis, hematoma or infection, nor implant migration, extrusion or breakdown were encountered. Revision surgery was performed in 3 patients due to cochlear ossification, perilymph leakage and extracochlear implantation. MED-EL implantation can be performed using small incisions without suture fixation of the receiver and its electrode.
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