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Biomedical subjects

L Sennaroglu

Publications and source records attributed to L Sennaroglu.

At least 19 recordsLinked to original sources

Audiologic findings in children with biotinidase deficiency in Turkey.

OBJECTIVE: Biotinidase deficiency is an autosomal recessively inherited disorder characterized by neurological and cutaneous features, including sensorineural hearing loss. Although many features of the disorder are reversible following treatment with biotin, the hearing loss appears to be irreversible. In the present study, hearing status of patients with biotinidase deficiency is characterized in a Turkish population. METHODS: Subjective and objective audiologic tests were performed on 20 children with profound biotinidase deficiency. RESULTS: Sensorineural hearing loss occurs in approximately 55% of the children with biotinidase deficiency. The hearing loss varies in severity from mild to profound hearing loss. In children diagnosed immediately after birth because they had an older sibling with the disorder, statistically significant differences were found between ABR results and age of diagnosis (p<0.05). Greater prolongation in ABR latencies were observed in the late-diagnosed children compared to that in the early-diagnosed children (p<0.05). CONCLUSION: Early diagnosis is important to prevent peripheral and central hearing loss. Children with biotinidase deficiency who have hearing loss are likely at increased risk for having speech and language problems. If hearing aids do not provide sufficient amplification, cochlear implantation may be indicated in these children. Therefore, it is important to test the hearing thresholds of these children with hearing aids and evaluate their language development.

Adolescent↗

Intratympanic dexamethasone, intratympanic gentamicin, and endolymphatic sac surgery for intractable vertigo in Meniere's disease.

OBJECTIVE: To compare the efficacy of intratympanic dexamethasone (ID), intratympanic gentamicin (IG), and decompression of the endolymphatic sac (ESD) for intractable vertigo in Meniere's disease. STUDY DESIGN AND SETTING: This prospective study was conducted at Hacettepe University Medical Faculty, a tertiary care center. Dexamethasone was applied through a ventilation tube in 24 patients, intratympanic gentamicin (also through a ventilation tube) to 16 patients, and 25 patients underwent ESD. RESULTS: Satisfactory control of vertigo was 72%, 75%, and 52%, respectively for the ID, IG, and ESD. Two patients in the gentamicine group had total hearing loss. In the dexamethasone group, hearing level remained the same in 46% of the patients with 16% increase and 38% decrease (30% 10dB and 8% 20 dB). CONCLUSION: If the vertiginous symptoms still persist after 6 months of medical treatment, ID can be started. If there is no further improvement after 3 months with ID, patients with profound sensorineural hearing loss undergo treatment with IG, ESD is reserved for patients with good hearing. If ESD also fails, patients with good hearing may undergo vestibular nerve section; patients with nonservicable hearing become candidates for labyrinthectomy.

Administration, Topical↗

Accuracy of acoustic rhinometry measurements.

OBJECTIVES: To identify the factors that influence the accuracy of acoustic rhinometry measurements recorded with commercially available equipment. STUDY DESIGN: A simple model was used which consisted of a metal pipe and cylindrical inserts. These inserts comprised various lengths, and aperture dimensions were comparable to, or smaller than, the nasal valve areas of both adults and children. METHODS: Accuracy of the acoustic rhinometry technique was evaluated by comparing the measured and actual cross-sectional areas. The results were discussed in terms of the calculated acoustic transmission, reflection, and attenuation coefficients of the pipe model variations. RESULTS: Reducing the inner diameter of the insert increased the degree of measurement error. As the length of the insert was increased, the measured cross-sectional area gradually decreased, approaching the actual area of the experimental passageway. For larger inserts, level of error was not highly dependent on passageway length compared with the narrower inserts. CONCLUSION: Our results show that both the cross-sectional area and passageway length of the narrow segment are the most significant factors that influence the accuracy in acoustic rhinometry measurements.

Acoustics↗

Benign paroxysmal positional vertigo after stapedectomy.

OBJECTIVE: To determine the incidence of benign paroxysmal positional vertigo (BPPV) following stapedectomy in a patient group and the efficacy of the Epley maneuver in this group. STUDY DESIGN: Prospective study in a university-based tertiary referral system. METHODS: The patient group comprised 63 patients who had undergone stapedectomy; a control group consisted of normal healthy individuals with no otolaryngological complaints. All individuals underwent the Dix-Hallpike maneuver for the diagnosis of BPPV. Patients who exhibited vertigo, torsional nystagmus (which reverses its direction on return to sitting position) preceded by a latent period, and the fatigability of these findings were considered to have BPPV. If the test result was positive, they underwent the Epley therapeutic maneuver. RESULTS: Four of the patients who had undergone a stapedectomy showed characteristic findings of BPPV. No individual in the control group had BPPV. All patients responded well to the Epley maneuver. CONCLUSIONS: Stapedectomy may be regarded as an etiological factor in BPPV. Because the fenestra is located in the posterior part of the stapes footplate, the pathophysiology appears to be related to utricular rather than saccular trauma. Correct measurement of the distance between the incus and stapes footplate is essential in stapedectomy. An Internet survey of the relevant literature in English shows a scarcity of publications on the incidence of BPPV following stapedectomy. In the present study, 63 patients who had undergone a stapedectomy were investigated for the presence of BPPV; all had Dix-Hallpike maneuvers performed for the diagnosis. Sixty-three individuals with no otolaryngological complaints made up the control group. Four of the patients who had undergone stapedectomy showed characteristic findings of BPPV, and no individual in the control group had BPPV; the difference between the two groups was statistically significant. All four of the patients diagnosed with BPPV responded well to the Epley maneuver. The pathophysiology appears to be related to utricular trauma. Correct measurement of the distance between the incus and stapes footplate is essential in stapedectomy.

Adult↗

Relationship of vestibular aqueduct and inner ear pressure in Ménière's disease and the normal population.

OBJECTIVE: Etiopathogenesis of Ménière's disease has not been resolved. The principal histopathologic finding in this disease is endolymphatic hydrops. The majority of radiologic and histopathologic studies demonstrated a narrow vestibular aqueduct in Ménière's disease. There is no study in the literature investigating the relationship between inner ear pressure and vestibular aqueduct dimensions. Static acoustic compliance is a noninvasive procedure that is thought to measure perilymphatic pressure at the footplate. An increase in mechanical fluid pressure in the inner ear is transmitted to the footplate of the stapes. This causes a reduction in the compliance at the drum. The aim of this study is to investigate the relationship between vestibular aqueduct dimensions and static acoustic compliance in Ménière's disease and the normal population. STUDY DESIGN: Prospective study. METHODS: Forty patients with Ménière's disease and 40 healthy individuals with no otolaryngologic disorders were the subjects of this study. Each group was further divided into two according to static compliance value (normal and low static compliance). In these four groups dimensions of vestibular aqueduct were determined radiologically by high-resolution computerized tomography and correlated with normal and low static acoustic compliance values (normal and high perilymphatic pressure). RESULTS: The results demonstrated that vestibular aqueduct is narrower in patients with Ménière's disease than the normal population. However, there is no relationship between vestibular aqueduct dimensions and inner ear pressure obtained by static acoustic compliance measurements.

Acoustic Impedance Tests↗

Relationship of the cochlear aqueduct and inner ear pressure in Ménière's disease and in a normal population.

OBJECTIVE: The aim of this study was to determine the dimensions of cochlear aqueduct radiologically in patients with Ménière's disease and in normal subjects, and to correlate these findings with normal and low static acoustic compliance (SAC) (high and normal perilymphatic pressure) to see whether the dimensions of the cochlear aqueduct play any role in the perilymphatic pressure in normal individuals and patients with Ménière's disease. STUDY DESIGN: Prospective double-blind study. SETTING: The study was conducted at Hacettepe University Medical Faculty, a tertiary care center. PATIENTS: Forty patients with Ménière's disease with bilateral involvement, diagnosed by vertigo attacks, fluctuating hearing loss, tinnitus, fullness in the ear, and cochlear sensitivity constituted the patient group. Forty healthy individuals with no otolaryngologic symptoms constituted the control group. INTERVENTIONS: All individuals underwent SAC measurement in terms of equivalent volume in milliliters, based on two volume measurements. To measure the dimensions of the cochlear aqueduct, high-resolution computed tomography of the temporal bone in the axial plane was performed. RESULTS: There was no statistically significant difference in the width of the cochlear aqueduct between patients with Ménière's disease and normal subjects. When SAC measurements were also taken into account, there was no difference in cochlear aqueduct dimensions between individuals with normal and low SAC values in the two groups. CONCLUSION: The dimensions of cochlear aqueduct are not significantly different in Méniére's disease patients and normal individuals. Also, the cochlear aqueduct does not appear to play a significant role in normal and low SAC values in the two groups of individuals.

Adolescent↗

Cochlear implants: is there any relationship between stimulation rates and adaptation?

OBJECTIVE: To determine the relationship between stimulation rate and adaptation in cochlear implant users. STUDY DESIGN: A prospective clinical study. SETTING: This study was conducted at Hacettepe University Medical Faculty, which is a tertiary care and cochlear implant center in Ankara, Turkey. PATIENTS: Seven patients (three women, four men) who were using Nucleus CI 24 M cochlear implants (Cochlear Corp., Lane Cove, NSW, Australia). Two of them had become deaf after developing language skills, and five had congenitally deafness. RESULTS: Six patients demonstrated no tone decay. Only one patient, who had congenital hearing loss, demonstrated tone decay at stimulation rates of 250, 500, 720, 900 pulses per second. There is no statistically significant relationship between the stimulation rate and the selected electrode. CONCLUSION: The majority of the cochlear implant patients sustained the perception of a continuous electrical signal for 1 minute at 5 to 10 current levels above threshold.

Adaptation, Physiological↗

Otogenic brain abscess: review of 41 cases.

Forty-one patients in whom otogenic brain abscess was diagnosed and has been treated since 1968 are presented. Sixty-five percent of the patients were between 5 and 15 years of age. All patients had chronic otitis media, and 95% had cholesteatoma. Abscess was located in the temporal lobe in 54%, in the cerebellum in 44%, and in both locations in 2% of the cases. Most patients had radical mastoidectomy and evacuation of the abscess through the mastoidectomy (61%). In addition to mastoidectomy, burr hole drainage was used in 20% and craniotomy in 15%. The most common micro-organism involved was Proteus. Overall mortality in this series is 29%, but after 1976, when CT became available for the diagnosis and follow-up, the mortality rate was reduced to 10%.

Adolescent↗

Myositis ossificans in the neck.

Myositis ossificans is a non-neoplastic heterotopic bone formation within muscle or soft tissues. The most commonly involved muscles are the muscles of the upper arm and thigh. Occurrence in the head and neck is rarely encountered clinically. A 53-year-old Turkish man (farmer) was operated on for traumatic myositis ossificans circumscripta in his neck. During the operation the mass was found to originate from the scalenus medius muscle and was readily and completely dissected from surrounding tissues. The histologic examination of the specimen revealed focal cartilage and mature bone tissue, which was compatible with the late stage of myositis ossificans. In 5 years of follow-up, the patient has remained asymptomatic and no signs of recurrence have been noted.

Humans↗

Effect of intratympanic steroid application on the development of experimental cholesteatoma.

By introducing certain irritants into the middle ear it is possible to produce cholesteatoma. Propylene glycol, the main agent used for this purpose, produces a long-standing inflammation that causes hyperplasia and migration of the epithelium through an intact tympanic membrane. In the present investigation topical prednisolone was used in order to inhibit the production of cholesteatoma. The results indicate that there is a marked decrease in inflammation and hence experimental cholesteatoma production when prednisolone is administered into the middle ear.

Animals↗

MR imaging in squamous cell carcinoma of the head and neck with no palpable lymph nodes.

PURPOSE: To assess the efficacy of MR imaging in the detection of lymph node metastasis in patients with no palpable lymph nodes ("N0 neck") who have squamous cell carcinoma of the head and neck region. MATERIAL AND METHODS: MR neck imagings in 18 patients who underwent neck dissection (bilaterally in 2) for squamous cell carcinoma of the head and neck region were examined preoperatively for the purpose of detecting lymph node metastases. The imaging features taken into consideration were: size (cutoff point 10 mm), grouping, presence of central necrosis, and appearance of extracapsular spread. The MR examinations comprised spin-echo T1- and T2-weighted sequences. The MR findings were compared with those of surgery and histopathological examination. RESULTS: MR suggested metastatic lymph node involvement in 5 necks. In 2 of these, central necrosis was seen in the enlarged lymph nodes. In a third, a grouping of the lymph nodes was noted. Extracapsular spread was not present. Histopathological examination revealed metastatic lymph nodes in 7 of the 20 necks, the rate of clinically occult disease being 35%, and 4 of them had been accurately graded by MR. There was one false-positive MR examination. The MR sensitivity was 57.1% and specificity 92.3%. CONCLUSION: MR may reveal metastatic lymph nodes in patients with no clinical evidence of metastasis. However, conventional MR techniques are not always sufficient for decision-making on surgery in cases of "N0 neck".

Adult↗

Audiological findings in kernicteric patients.

Audiological findings in kernicteric patients. Thirty patients followed up because of kernicterus sequelae and 15 normal children serving as control group were examined to determine their hearing status and evoked response audiometry (ERA) results. Seventeen out of the 30 patients (57%) had high frequency sensorineural hearing loss. Sixteen of them had bilateral hearing loss. Ten had no response or prolonged bilateral latencies. The results showed that high neonatal serum bilirubin levels affect the hearing adversely.

Adolescent↗

[Primary cholesteatoma of the petrous bone apex].

BACKGROUND: Primary cholesteatoma of the temporal bone is a very rare disease. Initially, the tympanic membrane is intact, and often facial palsy may be the presenting symptom. The authors present a case of primary cholesteatoma which was surgically treated using a transmastoid-translabyrinthine approach. Other surgical approaches to the petrous apex are discussed.

Adult↗

Evaluation of leukocyte chemotactic function in patients with chronic sinusitis.

In this study the chemotactic activities of neutrophils and monocytes were evaluated in patients with chronic sinusitis as compared to a control group. Leukocyte chemotaxis was measured with a micropore filter method in blood samples taken from 26 patients with chronic sinusitis and 10 volunteers. A statistically significant impairment of leukocyte chemotaxis capacity in patients with chronic sinusitis was found. It is concluded that a functional disorder of leukocytes may play a role in the progression of the disease into a chronic state.

Adolescent↗

Infratemporal hydatid cyst--unusual location of echinococcosis.

Hydatid disease is an important medical problem in countries of the temperate zones. Only occasional cases are reported in the head and neck region. An unusual location for hydatid disease in the infratemporal fossa is presented. Characteristics of this rare disease together with treatment modalities are discussed.

Adult↗