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Öğe Assessment of intracranial pressure with ultrasonographic measurement of optic nerve sheath diameter on patients undergoing suspension direct laryngoscopy(Springer, 2023) Karalı, Elif; Demirhan, Abdullah; Güneş, Akif; Yıldız, İsa; Ural, AhmetPurpose The study aims to examine the effect on intracranial pressure by calculating the optic nerve sheath diameter (ONSD) using ultrasound in patients who underwent suspension direct laryngoscopy. Methods Thirty-three patients who underwent suspension direct laryngoscopy were included in this prospective observational study. ONSD measurement was performed using a high-frequency linear probe. The ONSD basal (T0) value was determined using ultrasound in the supine position before the induction. Ultrasonography was used to record ONSD in the Boyce Jackson position (T1) just before inserting the laryngeal blade, in the Boyce Jackson position just before removing the laryngeal blade (T2), and in the supine position (T3) just before extubation. Results A statistically significant rise (p < 0.001) was seen between the patients' baseline ONSD values and the values at T1, T2, and T3. The optic nerve sheat diameter level recorded prior to withdrawing the laryngeal blade (T2) was considerably greater than the ONSD level calculated instantly before insertion of the laryngeal blade (T1) (p < 0.001). The ONSD value prior to extubation (T3) following the removal of the laryngeal blade was considerably smaller than the ONSD value prior removing the laryngeal blade (T2) (p < 0.001). Conclusions This study found that when the laryngeal blade is mounted during the suspension direct laryngoscopy surgery, there is a significant increase in ultrasonographically measured ONSD and increased the ONSD even further during the time the mouth gag was remained in situ. This is the first research to indicate that measuring ONSD with ultrasonography during suspension direct laryngoscopy raises intracranial pressure.Öğe Changing trends in otorhinolaryngology publishing(Pacini Editore, 2020) Kazıkdaş, Kadir Çagdaş; Tanık, Murat; Ural, AhmetThe aim of this study is to compare the changes in impact factors and citation numbers of Open Access (OA) vs subscription-based (SB) journals between 1999 and 2016 and to explore the changing trends in ORL publishing. All data extracted from SCImago Journal and Country ranking (SJR) website have been used as input for statistical analysis. The chi-square test of independency was applied in order to understand whether the ratio of number of OA journals of ORL category have dramatically changed between years 1999 and 2016. Also, the years and impact factors of journals belonging to the OA and SB journals have been graphed separately and the changes of annual SJR ranks of both journal types have been compared using one-way Z-test. There was a significant difference as the proportion of OA Journals were not equal to the proportion of SB Journals throughout the years 1999 and 2016, and it showed the tendency to increase greater compared to SB Journals (p < 0.01). Although the overall level of impact factors of SB journals was generally high, by comparing two regression models, it was obvious that the level of increase of the impact factors of OA journals were significantly higher (p < 0.01). When choosing where to publish, it is important to consider the journal's visibility, cost of publication, IF or SJR of the journal and speed of publication as well as changing trends in medical publishing nourished by the Web of Science.Öğe The effect of anteriorly located sigmoid sinus on postoperative hearing gains: A case-control study(Springer India, 2021) Güneş, Akif; Karalı, Elif; Ural, Ahmet; Coşgun, Zeliha; Dağıstan, EmineThere are many studies on the effects of temporal bone anatomical variations on a mastoid pneumatization. Considering the effects of the anatomic variations on mastoid pneumatization, it is considered that many anatomic variations may affect graft success rates and postoperative hearing threshold gains. We aimed to evaluate the effects of various anatomic variations on postoperative hearing gains among patients undergoing tympanoplasty. This retrospective cohort study conducted in a tertiary-care university hospital. This study enrolled 57 patients who underwent primary type 1 tympanoplasty operation using the temporal muscle fascia. The patients were divided into two groups as those with an anteriorly located sigmoid sinus (group 1), and no anatomic variation (group 2). Airway gain values at the frequency range of 250 Hz-8000 Hz and pure tone average (PTA) value were calculated preoperatively and at postoperative sixth month. The gains attained by the patient groups with anatomic variations were compared with group 2. There were significant differences between Group 1 and Group 2 in terms of the airway frequencies of 250, 500, 2000, 4000 Hz, and PTA value. We detected a lesser postoperative hearing gain in patients with an anteriorly located SS. We believe that anatomic variations that may affect middle ear and mastoid cavity may also affect postoperative hearing gain.Öğe Effect of rhinophototherapy on nasal congestion in patients with seasonal allergic rhinitis(Pacini Editore, 2021) Karalı, Elif; Güneş, Akif; Ural, Ahmet; Akın, İsa; Özsarı, Emine; Kalaycıoğlu, OyaObjective. The aim of the present study was to objectively and subjectively evaluate the effects of adding rhinophototherapy to intranasal beclomethasone dipropionate to treat nasal congestion in patients with seasonal allergic rhinitis. Method. Seventy-five seasonal allergic rhinitis patients were randomly divided into two groups. Patients in Group 1 received intranasal beclomethasone dipropionate for two weeks and patients in Group 2 had rhinophototherapy added to the same medical therapy as Group 1. The effectiveness of treatments was evaluated with the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), Nasal Obstruction Symptom Evaluation scale (NOSE) questionnaires and active anterior rhinomanometry. Results. After treatment, significant improvement was observed in Group 2 vs Group 1 in terms of RQLQ (p = 0.011) and NOSE (p = 0.001) scores. In Group 2, significant differences were observed between before and after treatment for inspiratory total nasal resistance (p = 0.004). However, no significant differences vs. baseline were observed in Group 1. Conclusion. Our study shows that adding intranasal phototherapy with a combination of UVA, UVB and visible light therapy to nasal beclomethasone dipropionate treatment objectively improves nasal patency in patients with seasonal allergic rhinitis.Öğe Evaluation of cervical vestibular evoked myogenic potential measures using different stimulus types in patients with posterior canal benign paroxysmal positional vertigo(Taylor & Francis Ltd, 2020) Güneş, Akif; Karalı, Elif; Ural, Ahmet; Rüzgar, FatihBackground: Cervical Vestibular Evoked Myogenic Potential (cVEMP) measurements still do not have standard normative values in posterior canal benign paroxysmal positional vertigo (BPPV). Aim/Objectives: We aimed to compare cVEMP recordings obtained with different stimuli applied in two different intensities in posterior canal BPPV patients. Methods: Thirty-four patients with unilateral posterior canal BPPV were included in the patient group. In cVEMP recordings obtained with different stimulus intensity [95 dB HL and 105 dB HL] and different stimuli[tone-burst cVEMP (T-cVEMP) and click cVEMP (C-cVEMP)]. Results: When the C-cVEMP and T-cVEMP findings were compared in the patient group, differences were observed only in peak-to-peak p1-n1 amplitude values in the measurements performed with 95 dB stimulus. However, T-cVEMP measurements performed with 105 dB stimulus showed that both p1 and n1 latency values were longer and peak-to-peak p1-n1 amplitude values were higher than C-cVEMP measurements.Öğe Evaluation of the effect of Boyle-Davis mouth gag on intracranial pressure in patients undergoing adenotonsillectomy by using ultrasonographic optic nerve sheath diameter measurement(Elsevier Ireland Ltd, 2020) Karalı, Elif; Demirhan, Abdullah; Güneş, Akif; Ural, AhmetObjective: We aimed to evaluate the effect of an increase in intracranial pressure (ICP) due to sympatho-adrenergic response caused by mouth gag and tongue depressor during adenotonsillectomy by measuring the optic nerve sheath diameter (ONSD) by ultrasonographic method. Methods: Forty patients (age range 3-12 years) who underwent adenotonsillectomy were included in the study. All patients underwent surgery under general anesthesia with endotracheal intubation. Boyle-Davis mouth gag was used during the procedure. ONSD measurement was performed and a high-frequency linear probe. All ONSD measurements were performed by a single investigator experienced in the use of ultrasound. Ultrasonographically measured ONSD before induction was accepted as baseline (T0) value. Immediately after insertion of the mouth gag (T1), just before removal of the mouth gag (T2), and just before extubation (T3), ultrasonographic measurements of ONSD were recorded. Results: When patients' baseline ONSD values were compared with the values obtained in T1, T2, T3, and a statistically significant increase was detected. The ONSD value measured before removing the mouth gag (T2) was significantly higher than the ONSD value measured immediately after the insertion of the mouth gag (T1). The ONSD value measured just before extubation (T3) and after removal of the mouth gag was significantly lower than the ONSD value (T2) measured just before removal of the mouth gag. When heart rate, mean arterial pressure (MAP), peripheral oxygen saturation (SpO(2)) values of T0, T1, T2, T3 were compared, any statistically significant difference was not observed. When end-tidal carbon dioxide level (etCO(2)) and peak inspiratory pressure (PIP) values of T1, T2, T3 were compared, any statistically significant difference was not observed. Conclusion: This study showed that the Boyle-Davis mouth gag used during the adenotonsillectomy operation resulted in a significant increase in the diameter of the optic nerve sheath measured ultrasonographically and increased the ONSD even further during the time the mouth gag was remained in situ. In children with intracranial pathologies who will undergo adenotonsillectomy or those with increased ICP-related risk factors, the risks that may arise from the effect of the Boyle-Davis mouth gag on ICP should be considered.Öğe External ear anatomy and variations in neonates(Wiley, 2022) Erdem, Saadet; Fazlıoğulları, Zeliha; Ural, Ahmet; Karabulut, Ahmet Kağan; Doğan, Nadire ÜnverIt is aesthetically important that the auricle has a natural and beautiful shape. The sizes, position and symmetry of normal auricle are used for different purposes in different disciplines. A deformation in the auricle of neonates and its size or location on the face may indicate a possible anomaly. The aim of this study is to investigate the normal sizes, anomaly types, anomaly rates and the relationship between hearing screening test results and auricular anomaly of the neonatal auricle. The length, width, angle, and distance measurements of the auricle were made in neonates (n = 550). Anomaly types of auricle were observed. Goniometer was used to measure angles; digital caliper and ruler were used to measure lengths. Anomalies were detected by the method of observation. In the morphometric data of the neonatal auricle, differences were determined in length and width values in terms of gender. Various types of anomalies were observed in the right ear of 96 participants and in the left ear of 103 participants. Normal auricle size, position and symmetry are important for surgical reconstructions, hearing aid design, producing data banks on gender, age and ethnicity, and providing reference information for multiple diagnostic and forensic procedures. Recognition and early detection of auricular anomalies play an essential role in clinical diagnosis and their correction with special devices.Öğe Factors that may affect graft success in tympanoplasty with mastoidectomy(2015) Yurttaş, Veysel; Ural, Ahmet; Kutluhan, Ahmet; Bozdemir, KazımAmaç: Çalışmanın amacı mastoidektomili timpanoplastide greft başarısı üzerinde etkisi olabilecek faktörleri araştırmaktır. Yöntem: Bu retrospektif çalışmada Eylül 2004 ile Temmuz 2014 arasında mastoidektomili timpanoplasti ameliyatı geçiren olguların verileri değerlendirildi. Epitimpanik açıklık, kulağın kuru kalış süresi, preoperatif otore olup olmaması, perforasyonun yeri, orta kulak mukozasının ile timpanik membranın durumunun postoperatif greft başarısı üzerindeki etkisi araştırıldı. İstatistiksel analiz için ki-kare ve Fisher exact testleri kullanıldı. Bulgular: Çalışmada toplam 130 hasta (56 kadın, 74 erkek; yaş ortalaması: 35.7, yaş aralığı: 11-56) dahil edildi. Greft başarı oranı %75 olarak belirlendi. Kulağın 3 aydan daha uzun süre kuru kalması, preoperatif olarak kulak akıntısı olmaması, preoperatif normal orta kulak mukozası ve epitimpanik açıklık oluşu postoperatif greft başarısını anlamlı şekilde artırmıştır (p<0.001). Preoperatif otore ve orta kulakta granülasyon dokusu varlığı, preoperatif miringoskleroz varlığı ile epitimpanik açıklığın olmaması mastoidektomili timpanoplasti sonrası greft başarısını anlamlı olarak olumsuz yönde etkileyen faktörler olarak izlendi (p<0.001). Sonuç: Çalışmamızın sonuçlarına göre epitimpanik açıklık, orta kulak enfeksiyonu ve timpanik membran ve orta kulak mukozasının yapısal özellikleri mastoidektomili timpanoplasti yapılacak hastalarda prognostik açıdan önem taşımaktadır.Öğe Investigation of the presence of pregnancy rhinitis in the third trimester with rhinomanometry(2021) Filiz, Rüstem; Ural, Ahmet; Topçuoğlu, Mehmet Ata; Dağli, MuharremAim: Pregnancy rhinitis (PR) is characterized with nasal symptoms during pregnancy without any signs of respiratory infection and it usually disappears within 2 weeks after delivery. We aimed to investigate the relationship between pregnancy rhinitis and findings derived from anterior rhinoscopy (AnR), anterior rhinomanometry (ARM) and subjective nasal obstruction score (SNOS). Methods: This prospective, controlled study was performed in otorhinolaryngology and obstetrics and gynecology departments of our tertiary care center. A total of 30 pregnant women in the third trimester and 30 non-pregnant women were involved. All participants underwent otorhinolaryngology examination, as well as clinical evaluation for AnR, ARM and SNOS. Results: Pregnancy rhinitis was detected in 66.7% of the pregnant women. The mean AnR was 3.60 ± 1.35 in pregnant women and 0.77 ± 0.73 in the control group. Total nasal inspiratory resistance (TNID) was 0.46±0.23 in pregnant women and 0.27±0.06 in the control group. The mean SNOS was 1.37±0.72 in pregnant women and 0.57±0.63 in the control group. AnR, ARM and SNOS findings were significantly higher in pregnant women (p<0.05). There is a low positive and significant correlation between AnR, ARM, and SNOS values in pregnant women (p<0.05). Conclusion: Our data yielded that nasal obstruction and pregnancy rhinitis were common in pregnant women. Nasal symptoms and complaints must be carefully examined during pregnancy. Further prospective, controlled, randomized trials on larger series are warranted to elucidate the clinical and pathophysiological features of pregnancy rhinitis.Öğe Pathophysiology of Chronic Rhinosinusitis with Nasal Polyps(Springer International Publishing, 2019) Boztepe, Fatih; Ural, Ahmet; Paludetti, Gaetano; De Corso, EugenioChronic rhinosinusitis (CRS) is defined the following way in the 2012 EPOS guidelines: nasal and paranasal sinus inflammation lasting a minimum of 12 weeks, plus at least two of the following features: blocked nose, rhinorrhoea, pain or pressure sensation over the face, hyposmia or anosmia. According to this guideline, at a minimum, the nose should be obstructed or there must be nasal drip anteriorly or posteriorly to qualify for the diagnosis. This clinical diagnosis can then be confirmed objectively through CT scanning of the sinuses or nasal endoscopy, which also permits characterisation as chronic rhinosinusitis with or without nasal polyp formation (CRSsNP and CRSwNP, respectively). Polyps characteristically contain elevated levels of IL-5 and IL-13, produced by T-helper 2 cells, as well as histamine. Through the endoscope, polyps take on a translucent, glistening appearance, with a colour between yellowish-grey and white, and are seen to contain abundant inflammatory debris of a gelatinous consistency. They arise from the mucosal linings of the nasal sinuses or the nose itself. They are particularly frequent at the ostia of the sinuses. Due to being poorly vascularised, polyps have a greyish-white appearance. It is fairly uncommon to find polyp formation confined unilaterally, despite the occurrence of a sole polyp on occasion at the middle meatus or the posterior recess of the sphenoethmoid. Polyps which form unilaterally may exhibit a difference in appearance and are a suspicious feature for inverting papilloma, fungal infection or a neoplasm. Combining sinusal CT with MRI is often beneficial diagnostically. A confirmation of unilaterality through imaging should make the clinician evaluate other possible diagnoses. Pathophysiology of chronic rhinosinusitis with nasal polyps is presented. © Springer Nature Switzerland AG 2020.Öğe Prognostic factors for graft success in tympanoplasty with mastoidectomy(2015) Yurttaş, Veysel; Ural, Ahmet; Kutluhan, Ahmet; Bozdemir, KazımAmaç: Çalışmanın amacı mastoidektomili timpanoplastide greft başarısı üzerinde etkisi olabilecek faktörleri araştırmaktır.Yöntem: Bu retrospektif çalışma, Eylül 2004 ile Temmuz 2010 arasında mastoidektomili timpanoplasti amliyatı geçiren olguların verileri kullanılarak yürütüldü. Epitimpanik açıklık, kulağın kuru kalış süresi, preoperatif otore olup olmaması, perforasyonun yeri, orta kulak mukozasının ve timpanik membranın durumunun postoperatif greft başarısı üzerindeki etkisi araştırıldı. İstatistiksel analiz için ki-kare ve Fisher exact testleri kullanıldı.Bulgular: Çalışmada toplam 130 hasta (56 kadın, 74 erkek; yaş ortalaması: 35.7, yaş aralığı: 11-56) dahil edildi. Greft başarı oranı %75 olarak belirlendi. Kulağın 3 aydan daha uzun süre kuru kalması, preoperatif olarak kulak akıntısı olmaması, preoperatif normal orta kulak mukozası ve epitimpanik açıklık oluşu postoperatif greft başarısını anlamlı şekilde artırmıştır (p<0.001). Preoperatif otore ve orta kulakta granülasyon dokusu varlığı, preoperatif miringoskleroz oluşu ve epitimpanik açıklığın olmaması mastoidektomili timpanoplasti sonrası ise mastodiektomili timpanoplasti sonrası greft başarısı anlamlı olarak düşüren faktörler olarak izlendi (p<0.001).Sonuç: Çalışmamızın sonuçlarına göre epitimpanik açıklık, orta kulak enfeksiyonu ve timpanik membran ve orta kulak mukozasının yapısal özellikleri mastoidektomili timpanoplasti yapılacak hastalarda prognostik açıdan önem taşımaktadır.Öğe The relationship of high-frequency distortion product otoacoustic emission (DPOAE) values with hematological parameters in tinnitus patients(Springer, 2019) Güneş, Akif; Karalı, Elif; Ural, Ahmet; Rüzgar, Fatih; Bayatkara, TuğbaPurpose In this study, we aimed to investigate whether there is any positive or negative correlation between high-frequency distortion product otoacoustic emission (DPOAE) values and mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) in tinnitus patients. Methods The study was performed with 52 volunteers (27 females, 25 males) aged between 35 and 50 years who presented with tinnitus to the otolaryngology outpatient clinic of a tertiary care center. Pure voice audiometric examination, DPOAE measurement, complete blood count values of the study participants were examined. Results In both ears, a significant and negative correlation was observed between 4000 and 8000 Hz airway and 4000 Hz bone conduction pathways with NLR rates (p < 0.05). A statistically significant relationship was found between the bone conduction pathway PTA and discrimination values for both ears and NLR s (p < 0.05). A positive correlation was detected between NLRs and DPOAE measurements recorded at 4444 Hz, 5000 Hz, 8000 Hz, 8889 Hz, 10,000 Hz and 11,429 Hz frequencies in the right and 4444 Hz, 5000 Hz, 6154 Hz, 8000 Hz, 10,000 Hz and 11,429 Hz frequencies in the left ears, respectively (p < 0.05). Conclusions We concluded that there is a significant correlation between high-frequency pure tone audiometry measurements and high frequency DPOAE measurements and NLR. Further studies are needed to determine the utility of NLR as a marker for the recognition and follow-up of hearing loss in patients with tinnitus.Öğe Retraction: Yurttafl V et al. Prognostic factors for graft success in tympanoplasty with mastoidectomy. ENT Updates 2015;5:72-75(2016) Yurttaş, Veysel; Ural, Ahmet; Kutluhan, Ahmet; Bozdemir, Kazım[No Abstract Available]Öğe Role of uric acid and other parameters in sudden sensorineural hearing loss(2020) İlancıoğlu, Meltem; Ural, Ahmet; Çobanoğlu, Bengü; Örem, AsimAim: To investigate the levels of metabolites (predominantly uric acid) effective on biochemical, and coagulation parameters and evaluate their effects on the onset, and course of the disease. Methods: In this retrospective study, files of 92 patients hospitalized between January 2007, and December 2013, in our clinic with established diagnosis of sudden hearing loss were screened. The biochemical (predominantly uric acid), and hematological parameters were compared with those of the control group. In addition, the patient group was divided into two groups according to uric acid levels and the difference between the groups was investigated in terms of the onset or course of the disease. Results: A significant difference was not detected between the patient, and the control groups regarding mean uric acid levels. Among biochemical parameters glucose, creatinine, and international normalized ratio (INR) were significantly higher (p<0.05) while a significant intergroup difference was not detected as for other parameters. A significant intergroup difference was not detected in mean pure- tone averages, and mean hearing gain at admission between two groups formed based on uric acid levels, while post-treatment pure-tone average was significantly better in patients with higher serum uric acid levels. In the patient group, uric acid levels were significantly higher in patients with partial hearing loss relative to those with total loss. Conclusion: In our study, we could not find a significant difference between the patient and the control groups as for uric acid levels. However, we have encountered evidence supporting the possible role of serum uric acid levels in the prognosis of sudden hearing loss.Öğe The score for allergic rhinitis study in Turkey, 2020(DERGIPARK AKAD, 2021) Cingi, Cemal; Muluk, Nuray Bayar; Susaman, Nihat; Küçükcan, Nagehan; Ural, AhmetObjective: This study aimed to determine how prevalent allergic rhinitis (AR) is in Turkey and to compare the current prevalence with the figures obtained 10 years earlier. Methods: This study included 9,017 participants. The minimum number of participants required from each center was determined via a stratified sampling technique according to regional demographic characteristics as ascertained from the last census. For each region, both men and women were administered the score for allergic rhinitis (SFAR) questionnaire and a score for each participant was calculated based on the responses supplied. Results: A total of 9,017 individuals (55.3% men and 44.7% women) took part in this study. Of these, 94.4% were urban residents and 5.6% lived in a rural setting. Of the men, 38.5% self-reported as suffering from AR. The corresponding figure in women was 40.5%. The overall prevalence of AR, as deduced on the basis of the SFAR, was found to be 36.7%. Comparing the prevalence in different regions, we found that AR was the least prevalent in the Black Sea region with a frequency of 35.8%. The highest prevalence was in the Mediterranean region, where the prevalence was 37.7%. There was no statistical significance in the apparent differences in prevalence between different geographical regions. Despite this, however, there was a clear increase in the frequency of AR over the preceding decade. This increase was most pronounced in the South-Eastern Anatolian region, where the frequency rose from 21.0% to 36.9%. Conclusion: Our results indicate that there has been a marked increase in the prevalence of AR in every region in Turkey over the last 10 years. This could be related to living conditions in urban environments. Alterations in lifestyle, urban living, air pollution causing impairments in immune defense mechanisms,
