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Biomedical subjects

Kemal Uygur

Publications and source records attributed to Kemal Uygur.

15 recordsLinked to original sources
PubMed2006

Surgical exposure in retrosigmoid approach: do we need cerebellar retractors?

BACKGROUND: The aim of this study was to present our technique of posterior fossa surgery and to evaluate whether cerebellar retractors are needed. METHODS: Since March 1989, more than 500 surgeries were performed through retrosigmoid approach, and our surgical technique was described. The data were evaluated whether or not cerebellar retractors were used in the operations. RESULTS: The surgeries were vestibular neurectomy, acoustic neuroma removal, and neurovascular decompression in 351, 135, and 14 patients, respectively. Cerebellar retractors have not been used in vestibular neurectomies and in most acoustic neuroma surgeries. The cerebellar retractors have been used in all of the neurovascular decompression surgeries where better exposure of the root entry zones of the cranial nerves is needed, and intracranial endoscopy is applied for further exposure and decompression of the vascular loop. CONCLUSION: There is no need for cerebellar retractors when adequate conditions such as patient positioning, adequate anesthesia techniques, and surgical manipulations are applied in posterior fossa approach except for neurovascular decompression and some of the acoustic neuroma surgeries.

Anesthesia, General↗
PubMed2005

Ultrastructural analysis of the chorda tympani nerve in chronic suppurative otitis media.

OBJECTIVE: To compare ultrastructure of the chorda tympani nerve by light and electron microscopy in patients with otosclerosis and chronic suppurative otitis media. STUDY DESIGN: Comparative prospective study. SETTING: Tertiary care, referral medical center. PATIENTS: The tympanic segments of chorda tympani nerves were collected for ultrastructural investigation in 20 cases with chronic suppurative otitis media and 10 cases with otosclerosis that underwent middle ear surgery. RESULTS: Histopathologic examinations of the suppurative group showed that unmyelinated fibers were almost totally lost and replaced by collagen fibers. The thickness of the myelin sheaths was very slender, whereas some of them were atrophic. A substantial increase was encountered in the endoneural collagen substance and connective tissue, whereas inflammatory elements and edema were present occasionally. Degenerative alterations of the myelinated fibers mainly occurred in the form of adaxonal vacuoles. There was disorganization and separation of parallel lamellae of Schmidt-Lanterman clefts. CONCLUSION: The chorda tympani nerve should be preserved in otologic surgery. However, inadvertent dissection of the chorda tympani nerve in chronic suppurative otitis media surgery will not possibly cause a postoperative disturbance in light of ultrastructural changes that occur in the nerve.

Axons↗
PubMed2003

Otitis media with effusion and histopathologic properties of adenoid tissue.

OBJECTIVE: Adenoidectomy is being generally used for the treatment of otitis media with effusion (OME). The purpose of current study was to determine objectively the significance of the histopathology of adenoid tissue on the development of otitis media with effusion. METHODS: The records of all the patients operated on with the diagnosis of adenoid enlargement with or without OME were reviewed and pathologic specimen were re-evaluated regarding histopathological properties by one pathologist unfamiliar with the diagnosis. Sixty-one patients with adenoid hyperplasia were enrolled in the study group, 38 males and 23 females. Age ranged between 3 and 13 years (mean age was 7.03+/-3.26 years). All the patients of study group were those operated on due to the adenoid hyperplasia and uni- or bilateral OME. Control group was composed of 39 male and 26 female patients (age range was between 3 and 13 years, and mean age was 7.06+/-3.04 years) with solely adenoid hyperplasia. RESULTS: The squamous metaplasia was present in 47 (77%) and 14 (22%) patients of study and control groups, respectively. The fibrosis of connective tissue interspersed follicles of adenoid was present in 29 (48%) and 6 (9%) patients of study and control groups, respectively. The statistical analysis revealed a significant prevalence of squamous metaplasia (P<0.001) and fibrosis of connective tissue interspersed follicles of adenoid (P<0.001) for a surgical indication of adenoid hyperplasia with OME than for without OME. The prevalence of other parameters was not significantly different between two groups. CONCLUSIONS: Adenoid tissue not only exerts an obstructive influence on the eustachian tube lumen when enlarged, but also impedes (hinders) mucociliary drainage of the middle ear by the way of non-ciliated metaplastic epithelium and fibrosis of connective tissue.

Adenoidectomy↗
PubMed2003

The correlation between septal deviation and concha bullosa.

OBJECTIVES: To investigate the incidence of concha bullosa (CB) in patients with septal deviation and the correlation between the angle of deviation and degree of pneumatization. Study and design This study was designed as a prospective trial. METHODS: Computerized tomography scans of the paranasal sinuses of 100 consecutive patients with the chief complaint of nasal obstruction and the diagnosis of septal deviation were taken. CB, sinus diseases, and septal deviation angles were recorded. RESULTS: Angles of deviation ranged between 3 and 25 degrees (mean, 13.0 +/- 4.1 degrees). The mean of angle of deviation in cases with CB and in cases without CB was 13.0 +/- 4.0 and 13.0 +/- 4.2 degrees, respectively. No statistical difference was found between them (P > 0.05). Pneumatization of the contralateral CB was statistically significantly higher than that of ipsilateral CB (P < 0.05). CONCLUSION: Septal deviation does not appear to give rise to the formation of CB, but augments the pneumatization of the middle turbinate depending on the degree of deviation angle.

Adolescent↗
PubMed2003

A case of giant cholesteatoma extending to the posterior fossa.

We present a 43-year-old male patient who developed a giant cholesteatoma with lateral sinus obliteration and involvement of the posterior cranial fossa. The only complaints were left-sided aural discharges and total sensorineural hearing loss. Examination revealed a mass lesion consistent with cholesteatoma within the left middle ear. Computed tomography and magnetic resonance imaging showed an extensive acquired cholesteatoma in the left middle ear, invading the posterior cranial fossa and leading to lateral sinus obliteration. The patient underwent left radical mastoidectomy. He had an uneventful postoperative follow-up for 13 months. This case emphasizes the value of preoperative radiologic assessment of giant cholesteatomas that may present with relatively few or limited symptoms.

Adult↗
PubMed2003

Correlation between blood group and noise-induced hearing loss.

OBJECTIVE: To investigate the correlation between blood group and noise-induced hearing loss (NIHL). MATERIAL AND METHODS: The study was conducted in 176 factory workers who had been exposed to a noise level of 85-90 dB for 8 h a day for a period of > or = 10 years. Pure-tone audiometric measurements were performed in a standard silent room. The blood groups of the workers were obtained from the factory files. RESULTS: NIHL was found in 23 (32.0%), 35 (58.3%), 10 (38.5%) and 7 (38.9%) persons with blood groups A, O, B and AB, respectively. NIHL was determined to be significantly more frequent in workers with blood group O. CONCLUSION: We suggest that people with blood group O are more prone to develop NIHL.

ABO Blood-Group System↗
PubMed2003

Asymptomatic IgE mediated food hypersensitivity in patients with nasal polyps.

The aim of this prospective study is to compare the prevalence of atopy in patients afflicted by nasal polyps with the atopy prevalence in healthy volunteers without nasal polyps, since systemic allergy and allergy in the nasal mucosa are still being debated as underlying causes for nasal polyps. Thirty-four cases with nasal polyposis without asthma and history of allergy or atopic disease were enrolled in the study and compared with 20 healthy volunteer controls in respect to asymptomatic food hypersensitivity. Hypersensitivity for 48 kinds of commonly consumed food in Turkey was investigated by an epicutaneuos prick test, Multi-Test II (Lincoln Diagnostic, Inc, USA), using a special applicator. The food allergy test was positive in 25 out of the 34 cases with nasal polyps and in 6 out of the 20 controls. The difference between the two groups was statistically significant (chi2 = 0.000, p < 0.001). The number of skin tests with positive results in patients with nasal polyps ranged from 1 to 37 (mean +/- S.D. = 10.0 +/- 7.9), whereas in the control subjects the range was 1 to 10 (mean +/- S.D. = 4.0 +/- 3.3). The difference in the number of food reactions was also statistically significant. Asymptomatic food hypersensitivity, being immunologically mediated, may be a triggering factor for the pathogenesis of nasal polyps. Therefore, treatment of asymptomatic food allergy in patients with nasal polyps may alleviate symptoms, slow the progress of nasal polyps and prolong the disease-free interval after polypectomy.

Adolescent↗
PubMed2003

[The correlation between computed tomography findings of the paranasal sinuses and the symptoms of acute sinusitis].

OBJECTIVES: We investigated the relationship between symptoms, coronal paranasal computed tomography (CT) findings and anatomic variations in patients with acute sinusitis. PATIENTS AND METHODS: The study included 44 patients (23 females, 21 males; mean age 35 years; range 21 to 74 years) whose diagnosis was acute sinusitis by history and physical examination. A comprehensive inquiry into the symptoms was made and coronal paranasal CT scans were obtained in all the patients. Correlations were sought between symptom scores, CT scores, and anatomic variations. RESULTS: No correlations were found between anatomic variations and CT scores. Total symptom scores did not correlate with CT scores. A statistically significant correlation existed only between headache and CT scores. The most commonly affected sinuses were maxillary sinuses (73%), followed by posterior ethmoidal sinuses (60%). CONCLUSION: Our data suggest that routine CT evaluations are superfluous in acute sinusitis.

Acute Disease↗
PubMed2003

[The adverse effect of gas formation on prognosis in a patient with deep neck infection].

A seventy-one-year-old woman was hospitalized with a suspicion of deep neck infection and poor general health. She had been receiving treatment for hepatitis, diabetes mellitus, and cardiac failure and had a history of tooth ache and severe neck pain lasting for the past 10 days. She had been admitted to another center where she had received antibiotic treatment for five days for widespread swelling in the neck and lower extremities, fatigue, and difficulty in breathing and swallowing. Upon admission, computed tomography showed gas formation in the neck and facial regions. Prompt abscess drainage was performed and intense treatment with antibiotics was continued. Despite all efforts, the patient died on the second day of hospitalization from cardiopulmonary arrest. This case emphasizes how urgent drainage is when gas formation is detected in deep neck infections, with inevitable poor prognosis with antibiotic treatment alone.

Aged↗
PubMed2002

Nasal septal clip (Ciğdem clip).

We report the use of a nasal septal clip. We believe that this instrument is more easily inserted and removed when compared with the classical nasal packs.

Equipment Design↗
PubMedDate not supplied

Rapidly growing sublingual dermoid cyst throughout pregnancy.

Dermoid cysts (DCs) are subcutaneously located cystic masses that contain epithelium and adnexal structures. They are most commonly located in the ovaries and sacral region. Seven percent of DCs are found in the head and neck. Sublingual DCs may develop above the mylohyoid, presenting in the floor of the mouth or below it, causing a submental or submaxillary mass. We presented a case with a sublingual giant DC enlarged rapidly during pregnancy manifesting deglutition and mild respiratory problems. The growth of a DC of the neck may be accelerated in pregnancy period and may ensue severe symptoms challenging both mother and fetus. We proposed the removal of sublingual DCs before attempting to conceive to eliminate the risk of rapid growth of DC that results in respiratory and deglutition problems.

Adult↗
PubMedDate not supplied

Removal of a laryngeal leech: A safe and effective method.

This article presents a case of hoarseness, dysphagia, and hemoptysis caused by the laryngeal localization of a leech. This pathological condition is extremely rare in urban areas but is frequent in endemic rural areas. Laryngoscopic evaluation of our patient has shown a leech lodged on the left arytenoid region hanging down to larynx. We present a patient living in an urban area with laryngeal leech that was removed under general induction anesthesia of sevoflurane via a face mask without endotracheal intubation.

Adult↗
PubMedDate not supplied

[The incidence of septal deviation in newborns].

OBJECTIVES: To determine the incidence of septum deviation and dislocation in newborns and to investigate relationships between these pathologies and maternal causes and the mode of delivery. PATIENTS AND METHODS: The study included 195 mothers and 200 newborns, of which 10 were twins. Vaginal and cesarean deliveries were performed in 147 (73.5%) and 53 (26.5%) newborns, respectively. All newborns were examined with the use of anterior rhinoscopy. The nasal pyramid, columella, and septum were assessed to detect septal deviation or dislocation. RESULTS: Twenty-three cases (15.6%) of vaginal delivery had septal deviation, while five (3.4%) had septal dislocation. In the newborns delivered by cesarean section, eight (15.1%) had septal deviation, but none had dislocation. Significant correlations were noted between pregnancy, delivery period, the way of delivery and the incidence of septal deviation and columella dislocation (p < 0.05). There was a significant correlation between head circumference and columella dislocation (p < 0.05). CONCLUSION: Since early reconstruction of the potential pathologies may be problem-solving, a careful rhinologic examination should be carried out in the newborns who have prolonged delivery, increased head circumference, and vaginal delivery.

Adolescent↗