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Murat Cem Miman

Publications and source records attributed to Murat Cem Miman.

26 records · Page 2Linked to original sources

Autoclaving the ossicles provides safe autografts in cholesteatoma.

OBJECTIVE: The choice of the graft in ossicular chain reconstruction during middle ear surgery for cholesteatoma is a subject still discussed on. In order to clarify the discussion of reuse of the autologous ossicles obtained during middle ear surgery for cholesteatoma, we evaluated the probability of residual disease histologically and the safety of the ossicles after autoclavization, the most promoting alternative method to eradicate residual cholesteatoma and infection on them. METHODS: The specimens used in this study were eroded twenty-seven ossicles (22 incuses, 5 malleoli) which were removed from the 27 consecutive patients operated because of cholesteatomatous middle ear disease. They were grouped as follows: Group 1, Fifteen ossicles examined histopathologically directly. Group 2, Five ossicles autoclaved for 20 min at 134 degrees C and then examined histopathologically. Group 3, Five ossicles autoclaved for 20 min at 134 degrees C after mechanical surface cleaning by a fine diamond drill, examined histopathologically. Group 4, Two ossicles removed from two different patients were placed in their mastoid cavities in order to be examined after access in the second-look operation. While one ossicle was only autoclaved, the other was mechanically cleaned by a drill before autoclavization (for 20 min at 134 degrees C). The ossicles were examined histopathologically after the removal at the second stage operation performed 12 months later. RESULTS: In Group 1, all ossicles showed evidence of periosteal thickening. Additional findings were surface cholesteatoma or epithelia in 13 ossicles, surface inflammation in 12 ossicles, granulation tissue in 10 ossicles, osteitis in six ossicles. In Group 2, all five ossicles had preserved their lamellar structure but, no vital cells were seen. The lacunes that had the osteocytes was almost completely empty. The inflammatory cells were eliminated from the ossicles. In Group 3, ossicles were found well preserved with their lamellar structures and contours, with empty lacunes and eliminated inflammatory cells. In Group 4, in two ossicles of this group the lacunes were replaced by the new migrated viable osteocytes with evidence of new bone formation and neovascularisation. No new inflammatory focus or epithelia were found on the surfaces of the ossicles. The shape and the contour of the ossicles remained unchanged. CONCLUSION: In cholesteatoma surgery, ossicles with minimal erosion and adequate thickness can be used after autoclavization. In this study, it was observed histopathologically that the autoclaving autologous ossicles before ossiculoplasty in cholesteatomatous middle ear is a safe and reliable method.

Cholesteatoma, Middle Ear↗

Glomus jugulare.

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Angiography↗

Effects of the electromagnetic field of mobile telephones on hearing.

The widespread use of mobile telephones has given rise to concern about the potential influences of electromagnetic fields (EMFs) on human health. Anatomically, the ear is in close proximity to the mobile telephone during use. Hearing loss due to mobile telephone use has not been described in the medical literature; however, if there is a subtle cochlear involvement, it might be detected by means of changes in evoked otoacoustic emissions (OAEs). Thirty volunteers with normal hearing were exposed to mobile telephone EMFs for 10 min and evoked OAEs were measured before and after exposure. No measurable change in evoked OAEs was detected and none of the subjects reported a deterioration in hearing level. To the best of our knowledge, this is the first study on the effects of EMFs emitted by mobile telephones on hearing. It was concluded that a 10-min exposure to the EMF emitted from a mobile telephone had no effect on hearing, at least at outer ear, middle ear and cochlear levels.

Adult↗

Maxillary sinus hypoplasia.

Maxillary sinus hypoplasia (MSH) is an uncommonly encountered condition by otolaryngologists. The computerized tomography (CT) scans provide valuable data about the anatomic details of the paranasal sinuses. MSH may be misdiagnosed as an infection or a neoplasm of the maxillary sinuses. Variations of the other paranasal structures, especially the uncinate process associated with MSH were defined. MSH shows three distinct hypoplasia patterns. Type I MSH characteristics are mild hypoplasia of the maxillary sinus, normal uncinate process and a well-developed infundibular passage. Significant hypoplasia of the maxillary sinus, hypoplastic or absent uncinate process and absent or pathologic infundibular passage are seen in Type II MSH. Type III MSH is characterized by the absence of an uncinate process and cleft-like maxillary sinus hypoplasia. In this study a series of 18 patients with MSH were presented. Twelve cases of unilateral and 6 cases of bilateral maxillary antrum hypoplasia were evaluated and 13 MSH type I, 7 MSH type II and 4 MSH type III were detected. Three ethmomaxillary sinuses, an overpneumatized posterior ethmoid cell into the orbit and the maxillary sinus were determined. Our series showed that the uncinate process anomalies related to MSH may lead to inadvertent orbital complications and therefore should be kept in mind.

Adult↗

Bending of the upper lateral cartilages for nasal valve collapse.

BACKGROUND: As a consequence of removal of the nasal hump, the upper lateral cartilages are separated from the septal cartilage in reductive rhinoplasty. A decrease in the nasal airway cross-sectional area and collapse of the internal nasal valve (INV) are inevitable unless additional surgical measures are taken. OBJECTIVE: To determine the efficacy of the horizontal mattress bending suture in treating patients with nasal valve collapse. METHODS: Each upper lateral cartilage was separately bent to a certain degree with a horizontal mattress suture following nasal dorsum reduction in the external septorhinoplasty as a preventive or corrective measure for the INV stenosis. The efficacy of this suture was assessed in 28 patients who presented with tension nose by comparing the INV angles preoperatively and 12 months postoperatively, as determined photographically by means of a rigid nasal endoscope. RESULTS: The mean +/- SD preoperative INV angle was calculated as 9.1 degrees +/- 4.2 degrees (range, 0 degrees -18.3 degrees ). The mean postoperative INV angle was increased to 25.3 degrees +/- 3.8 degrees (range, 18.4 degrees -34.5 degrees ) (P<.001). CONCLUSIONS: This method reconstitutes the normal anatomy of the INV, reestablishes stiffness or resistance of the nasal side walls so that they do not bend inwardly with inspiration, improves the airflow at this area, and avoids postoperative nasal valve stenosis in functional-cosmetic rhinoplasty cases that require considerable nasal hump reduction.

Adolescent↗

[Approaches to twisted noses and results of treatment].

OBJECTIVES: The aim of this study was to address the multiplicity of surgical techniques and pitfalls in the treatment of twisted noses. PATIENTS AND METHODS: Fifty-nine patients (43 males, 16 females; mean age 27 years; range 17 to 47 years) with vertical axis deviation of the nose were surgically treated. Thirty patients had C-type and 29 patients had I-type twisted noses. Deviation angles were measured before nd at least six months after the operation. Correction of deviations was graded according to the ideal angular values and the two groups were compared. RESULTS: Significant correction was achieved in both types of twisted noses (p < 0.01). The results of the I-twisted noses were significantly closer to the ideal angles compared to those of the C-twisted noses (p < 0.05). Three patients underwent revision surgery. CONCLUSION: To correct functional and aesthetic problems in twisted noses, an external approach can be employed to straighten the nose by releasing, mobilizing, aligning and reinforcing the nasal anatomic structures. Cartilage grafts may be used to camouflage persistent deformities. C-twisted noses require more experience in, and familiarization with, a large number of surgical techniques.

Adolescent↗

Laryngotracheal reconstruction of the congenital glotto-subglottic stenosis with autogenous thyroid cartilage interposition: a case report.

Surgical correction of grade III glotto-subglottic stenosis in a two-month-old girl was illustrated in a staged manner. Firstly, a silicone keel was placed via anterior thyrotomy following a tracheotomy. Secondly, laryngotracheal reconstruction was performed by interposing an autogenous thyroid cartilage anteriorly between the edges of the longitudinally divided cricoid cartilage and the upper tracheal rings. A stent was maintained for two months. The glottis and subglottis appeared patent and healed following removal of the stent. A meaningful voice and rather comfortable respiration were observed during a 13-month follow-up. The use of thyroid cartilage autograft offers many advantages in laryngotracheal reconstruction with considerably less technical difficulty.

Female↗

Nasal pyriform aperture stenosis in adults.

BACKGROUND: Congenital nasal pyriform aperture stenosis (CNPAS) leading to respiratory insufficiency in infants has been well documented. Nevertheless, the nasal pyriform aperture stenosis (NPAS) entity in adulthood has not been discussed at all. The normative data of the width of the pyriform aperture, which has not been revealed before, is necessary for evaluation of the adult subjects with nasal bony inlet stenosis. The aim of this study was to define the normative data about the pyriform aperture width measured in 80 adult subjects with paranasal sinus symptoms without nasal obstruction and, additionally, to report the surgical results of two representative cases with NPAS. METHODS: The nasal bony inlet width measurements have been achieved in axial computerized tomographic sections to establish normative data. The maximal distance between the nasal processes of the opposite maxillary bones was measured. Two adult males complaining of nasal obstruction with overt pyriform aperture stenosis were treated surgically via a sublabial approach. RESULTS: The mean widest dimension of the nasal pyriform aperture was 21.6 +/- 2.2 mm (range, 17-27 mm) in 80 adult subjects. This width was 21.9 +/- 2.1 mm (range 18-27 mm) in men and 21 +/- 2.2 mm (range, 17-26 mm) in women. Stenotic pyriform apertures in two patients were widened surgically by drilling via a sublabial approach from 12 and 10 mm to 24 and 21 mm, respectively. CONCLUSION: NPAS should be included in the list of differential diagnosis for nasal obstruction. Surgical enlargement using a sublabial approach was found an effective and adequate treatment in pyriform aperture stenosis.

Adult↗