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Biomedical subjects

Muzaffer Kanlikama

Publications and source records attributed to Muzaffer Kanlikama.

At least 19 recordsLinked to original sources

Audiovestibular disturbance in patients with systemic lupus erythematosus.

OBJECTIVE: The aim of this study was to evaluate the audiovestibular disturbance in patients with systemic lupus erythematosus (SLE). STUDY DESIGN AND SETTING: Twenty-eight patients with SLE and 28 healthy control subjects were included. Pure-tone audiometry, impedance audiometry, and electronystagmography (ENG) were used for baseline evaluation. Laboratory tests were carried out. Cranial and brain stem magnetic resonance imagings (MRI) were undertaken. RESULTS: Nineteen (67%) patients reported audiovestibular symptoms. Sensorineural hearing loss was found in 6 (21%) patients. Abnormal results on ENG were significantly higher (50%) (P < 0.01). Abnormal laboratory data were available from 26 patients (P < 0.05). MRI did not show any pathosis. CONCLUSION: The audiovestibular disturbances in SLE are more prevalent than previously recognized. Although no cause and effect relationship can be established by this type of study, it appears that a relationship exists. SIGNIFICANCE: Audiologic research should be directed toward routine, pure tone audiometry, and ENG assessment for patients with SLE to enable crucial treatment.

Adolescent↗

Medialization laryngoplasty with gore-tex: an animal study.

Vocal cord paralysis is a disease that can cause voice disability and aspiration problems. Expanded polytetrafluoroethylene (ePTFE; Gore-Tex) has been widely used in cardiovascular and plastic surgery; however, its biocompatibility and safety have not been established precisely in the larynx. In this study, the biocompatibility and safety of ePTFE used in vocal cord medialization in the rabbit larynx were assessed. Type 1 thyroplasty with Gore-Tex was performed on one side of the larynx in eight rabbits. A sham procedure was applied on the contralateral side of their larynx. The rabbits were sacrificed after 6 months, and macroscopic and microscopic evaluations and comparisons were performed. No significant inflammatory response to Gore-Tex or displacement of the implant was seen. There was only a tiny fibrotic capsule surrounding the material in each specimen. Intense eosinophilic cell infiltration was seen surrounding one rabbit specimen. Gore-Tex seems to be a biocompatible, stable, and reversible material that can be safely used in laryngeal framework surgery.

Animals↗

Evaluation of hearing loss after spinal anesthesia with otoacoustic emissions.

The aim of this study was to determine the degree and reversibility of hearing loss (HL) following spinal anesthesia with an objective audiometric test: otoacoustic emissions (OAE). Eleven patients (22 ears) who were undergoing surgery under spinal anesthesia were included in this study. Transient-evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) were evaluated 1 day before the operation and postoperative day 1, 2, and 15. DPOAE were recorded as DPgram and input/output functions (I/O). The emission amplitudes of the TEOAE and DPOAE of right and left ears were found to be affected immediately after the surgery and progressive improvement detected with full recovery within postoperative 15 days. These changes were mainly at around 1,500-3,000 Hz. None of the patients had permanent OAE amplitude deterioration. Transient HL may occur more often than it is generally assumed, and the symptoms might not be recognized. OAE is an effective and objective way of evaluating the HL in this particular group of patients. We suggest informing patients about this transient HL for medicolegal issues.

Adolescent↗

Auditory functions in children at schools for the deaf.

OBJECTIVE: To evaluate auditory functions in children at schools for the deaf in Turkey. DESIGN: A total of 218 children who were attending the school for deaf children were involved in the study. Familial and medical histories were obtained, and otoscopic examinations were performed. Immittance audiometry, acoustic reflex testing, pure tone audiometry, otoacoustic emission and auditory brain stem response tests were performed. RESULTS: The mean age of identification of hearing loss was 48 months. Impacted wax was the most common otoscopic finding that was seen in 49 (22.47%) of children. Nontype-A tympanograms were found in 18 (8.25%) of children. One-hundred-eighty-nine (86.69%) children had profound hearing loss, and 29 (10.3%) had severe hearing loss on pure tone audiometry. On auditory brain stem response testing, 192 (88.07%) children had profound hearing loss, and 26 (11.41%) had severe hearing loss. Only one child had auditory neuropathy/dys-synchrony, as his otoacoustic emission results were normal without synchronous auditory brain stem responses. The hearing threshold levels were found >105 dB in 28 children only with pure tone audiometry. CONCLUSION: Early auditory screening is necessary to identify the children at risk. All hearing disorders cannot be detected by subjective or objective audiometric tests only. Pure tone audiometry still has a role in determining hearing threshold levels. The audiological research directions should be directed towards routine pure tone audiometry, otoacoustic emission and auditory brain stem response assessment for all hearing impaired children to enable an successful treatment.

Adolescent↗

Nasal angiomyolipoma.

Angiomyolipomas (AMLs) are hamartomatous lesions containing smooth muscle, vasculature and mature adipose tissue. AML occurs most frequently in the kidneys, with the liver being the second commonest site of involvement. Other localizations for AML are extremely rare and, to our knowledge, only six cases of AML of the nasal cavity have been reported to date. Our case involved a 52-year-old male who presented with a history of snoring and obstruction of the left nasal cavity. Physical examination revealed a 3-cm polypoid mass in the left nasal cavity, which was excised surgically. Histopathologic examination revealed that the lesion was composed of smooth muscle bundles, mature adipose tissue and blood vessels of different sizes. No epitheloid smooth muscle cells were observed and HMB-45 staining was negative. In conclusion, although nasal AML is a rare lesion, it should be considered in the differential diagnosis of polypoid nasal masses, especially when the mass occurs unilaterally.

Actins↗

Bone cement ossiculoplasty: incus to stapes versus malleus to stapes cement bridge.

OBJECTIVE: In this study, our purpose was to evaluate results of our experience with bone cement repair of ossicular discontinuity between the incus and stapes and between the malleus and stapes. METHODS: Medical records of patients who underwent surgery for chronic otitis media between March 2000 and December 2002 were evaluated retrospectively. Fifty-seven patients who underwent bone cement ossiculoplasty and had appropriate follow-up data were included in the study. Bone cement reconstruction of the ossicular chain was performed 1) from incus to stapes (I-S) in the absence of long arm or lenticular process of the incus and 2) from malleus to stapes (M-S) in the absence of the incus. The clinical data of the patients were evaluated by otoscopic examination and audiometry. RESULTS: The graft take rate was 84.1%. I-S procedure was performed in 42 and M-S in 8 patients. Pre- and postoperative PTAs of all patients were compared, which showed a significant improvement in air PTA (p < 0.001) while bone PTA did not change (p > 0.05). In I-S and M-S groups, successful hearing restoration could be achieved in 78.6.1% and 87.5% of the patients, respectively. Hearing results of different aural pathologies (chronic otitis media and conductive hearing loss) and surgeries (tympanotomy and tympanoplasty with or without mastoidectomy) were not significantly different (p > 0.05). CONCLUSION: Bone cement ossiculoplasty offers cost effective and significant improvement in conductive hearing loss.

Adult↗

Tuberculous deep neck infection in a soldier, preceding miliary tuberculosis: a diagnostic dilemma.

Tuberculosis can affect every organ, most importantly the lungs, and worldwide it is the leading cause of death attributable to a single infectious agent. Tuberculous involvement of the neck is also possible. Patients mostly present with masses or draining fistulas in the neck, which are mostly located in the posterior cervical, submandibular, and supraclavicular regions. We report on a soldier who presented with a tuberculous deep neck infection, followed by miliary tuberculosis. The clinical presentation and diagnostic dilemmas are discussed.

Adult↗

An analysis of the single-stage tympanoplasty with over-underlay grafting in tympanosclerosis.

OBJECTIVES: Our objective was to analyze the results of tympanosclerosis surgery using over-underlay tympanoplasty and to find out the effect of single-stage surgery on hearing results. MATERIALS AND METHODS: Forty-two patients who were operated on for tympanosclerosis between July 1998 and February 2002 were included in the study. These were one-stage tympanoplasties, because second-stage operations and revisions were not included. Operative records and audiograms of the patients were obtained. Of the patients, 48% had bilateral tympanosclerosis. In three (7.1%) of the patients, tympanosclerosis and cholesteatoma occurred concomitantly. The cog was present in eight (20%) of 40 mastoidectomies. Körner's septum was present in nine (22.5%) patients. The graft take rate was 95.2%. RESULTS: The pre- and postoperative air-bone gap values of the patients were not significantly different (p > 0.05). Thirty-three percent of the patients met the successful hearing criteria (air-bone gap <20 dB). However, 47% had an air-bone gap closure between 20 dB and 30 dB, whereas 20% had a gap of more than 30 dB. CONCLUSION: Single-stage surgery does not result in a satisfactory hearing improvement in most of the patients with tympanosclerosis. Only one third of the patients, most of whom had a mobile stapes, had satisfactory hearing results. Mobilization of a fixed stapes is not an effective option for hearing restoration in tympanosclerosis. Second-stage surgery for stapedectomy and placement of a prosthesis-like piston or total ossicular replacement prosthesis should be considered to obtain better hearing results in tympanosclerosis.

Audiometry, Pure-Tone↗

Cyclo-oxygenase 2 expression in laryngeal squamous cell carcinoma and its clinical correlates.

OBJECTIVE: To assess the significance of cyclo-oxygenase 2 (COX-2) in laryngeal squamous cell carcinoma (LSCC). STUDY DESIGN: An immunohistochemical study in which 39 patients with LSCC were included. METHODS: Immunohistochemical staining of the paraffin-embedded tumour tissues was performed using isoform-specific COX-2 polyclonal antisera (Santa Cruz, Calif., USA). COX-2 results were compared with the clinical parameters of the patients. RESULTS: COX-2 was detected in all tumour tissues. In the normal laryngeal tissue around the tumour area, which served as control, there was no COX-2 staining. There was no relationship between the COX-2 results and the location of the primary tumour, T stage and N stage, survival, recurrence or pulmonary metastases. CONCLUSION: The absence of a relation between COX-2 positivity and clinical parameters may suggest an involvement of COX-2 in laryngeal carcinogenesis. Since COX-2 positivity could be detected in all LSCC specimens studied, COX-2 could serve as a therapeutic target in LSCC.

Carcinoma, Squamous Cell↗

[Management of paediatric neck masses].

OBJECTIVES: The present study was designed to demonstrate the regional distribution prevalence and management differences of certain pediatric neck masses in this region of the country. PATIENTS AND METHODS: Fifty-five patients with pediatric neck masses, who were diagnosed and treated surgically were retrospectively analyzed. RESULTS: Analysis of 55 patients showed that congenital neck masses were the most common pathology in pediatric neck masses (47%), followed by infectious and tuberculous lymphadenopathies (24%). CONCLUSION: It can be concluded from the study that besides the age group and the characteristics of the neck mass, life standards of the region is also an important factor to be considered.

Adolescent↗

A giant granular cell tumor of the tongue in a pediatric case.

Granular cell tumor (GCT) is an infrequent and usually benign neoplasm which is found predominantly in the head and neck region. More than half of the head and neck GCTs originate from the tongue. It is most frequently seen in the fourth to sixth decades of life. We presented an interesting case of a giant GCT in a 2.5-year-old patient. It was located under the anterior tongue, filled the floor of the mouth and was resected by the transoral route.

Child, Preschool↗

Ethmomaxillary sinus: a particular anatomic variation of the paranasal sinuses.

We assessed the morphological and radiological characteristics of ethmomaxillary sinus (EMS), which is an enlarged posterior ethmoidal air cell occupying the superior portion of the maxillary sinus while draining into superior meatus. This study is based on 1450 patients submitted to CT examination of the paranasal sinuses between 1998 and 2002. Sequential CT scans were obtained in the coronal plane in all the patients with 2.5- to 5-mm section thickness and were evaluated for EMS. The diagnosis of EMS was made when there was a posterior ethmoidal cell occupying the superior part of the maxillary sinus while draining to the superior meatus. When EMS was diagnosed, the morphology of the septum between the and maxillary sinus, and width of the superior meatus, were noted. The EMS was found in 10 of 1450 (0.7%) patients. The coexisting anatomic variations were concha bullosa (50%), upper concha pneumatization (20%), maxillary sinus hypoplasia (20%), uncinate bulla (10%), hypertrophied inferior concha (10%), paradoxic middle concha (10%), and septate maxillary sinus (10%). There was no relation between EMS and sinus disease. The EMS is a rare anatomic variation and does not appear to be associated with sinusitis. The EMS is not a well-studied anatomic variation, and the literature is lacking adequate information about this anatomic variation. This study performed in a large series of patients will possibly contribute to better understanding of this particular anomaly.

Adolescent↗

A unique case of an epidermoid cyst of the pterygopalatine fossa and its management.

Epidermoid cysts are rare benign tumors that are derived from the development of abnormally situated ectodermal tissue. Although they may originate from any part of the body head and neck region is occasionally affected. Epidermoid cyst originating from pterygopalatine fossa has not been reported previously in the literature. We report the first case of epidermoid cyst of pterygomaxillary fossa in this study.

Child, Preschool↗

GJB2 gene mutations causing familial hereditary deafness in Turkey.

Mutations in Connexin 26 (Cx26) play an important role in autosomal non-syndromic hereditary hearing loss. In this study, our objective was to find out the significance of Cx26 mutations in Turkish families who had hereditary deafness. Fourteen families who had at least two prelingually deaf children per family were included in the study. One affected child from each of the 14 families was selected for single-stranded conformational polymorphism SSCP analysis. Three PCR reactions were used for each subject to amplify the entire Cx26 coding region with overlap. PCR products were sequenced on an Applied Biosystems (ABI) model 3700 automated sequencer. Six of the 14 representative family members (42.9%) demonstrated shifts on SSCP and were subsequently sequenced for Exons 1 and 2 of GJB2 and were tested for the 432 kb upstream deletion. No mutations were found in Exon 1 and no 432 kb deletions were noted. Three different GJB2 mutations were found in Exon 2 of the probands, which were 35delG, 299-300delAT, and 487G > A (M163V). GJB2 mutations were detected in 21.4% of the families. Two patients were homozygous for 35delG and 299-300delAT mutations, and were given a diagnosis of DFNB1 deafness (14.3%). Two different polymorphisms, 457G > A (V153I) and 380G > AG (R127H) were also found. In conclusion, although GJB2 mutations were detected in 21.4% of the families tested, only 14.3% of subject representatives were homozygous and therefore deafness caused by Cx26 mutation segregated with DFNB1. Thus, contribution of GJB2 mutations appears less significant in familial deafness. This necessitates further assessment for the other known gene regions as well as a search for new genetic factors in familial type of genetic deafness.

Child↗

Otogenic cerebral venous infarction: a rare complication of acute otitis media.

A case of cerebral venous infarction (CVI) as a complication of acute otitis media (AOM) was presented in a 16-month-old male patient. The patient admitted with AOM in the right ear, ipsilateral facial paralysis and contralateral hemiplegia. Computerized tomography of the brain showed low density areas involving both the cortex and subcortical white matter in the right frontoparietal region, and there were patchy and multifocal enhancing areas with intravenous contrast enhancement. These findings disclosed the diagnosis of venous infarctions involving the superficial cortical veins on the right side. Complete recovery was achieved with 2 weeks of sulbactam-ampicilline, amikacin and prednisolone treatment. Although it is rather rare, CVI should also be remembered among the otogenic intracranial complications.

Acute Disease↗

Langerhans cell related inflammatory reaction in laryngeal squamous cell carcinoma.

The major cells involved in cancer cell kill are the T lymphocytes. However, T cells need to be activated upon antigen presentation, which is mediated by the antigen presenting cells, one of which is the Langerhans cell (LC). The purpose of this study was to assess the significance of LC and inflammatory cell infiltration in the laryngeal squamous cell carcinoma (LSCC). Forty-five patients who were operated on for LSCC between 1992 and 1999 were included in the study. The clinical and histopathological features of the patients were reviewed. A semiquantitative estimation of the lymphocyte dominant inflammatory reaction within and around the tumor was performed. Anti S-100 antibodies were used for immunohistochemical detection of LCs. Horseradish peroxidase method was used. LCs were present in almost all of the specimens within and around the tumor tissue. The S-100 results did not associate with grade, T and N stages, tumor stage, laryngeal site of involvement and survival (P>0.05). The S-100 results significantly associated with inflammatory reaction in the tumor tissue (P<0.01). In conclusion, the LC related response is not important to inhibit regional metastasis by cancer cells. The LC is not a reliable tool to determine prognosis of the patients with LSCC in the clinical practice.

Adult↗

Primitive neuroectodermal tumour of the mandible.

Primitive neuroectodermal tumors (PNETs) are relatively rare tumors. Tumors that once would have been diagnosed as Ewing's sarcoma are now often designated as peripheral neuroepithelioma or synonymously PNET. Herein we report the first case of PNET of the mandible in a 6-year-old female who was admitted to the hospital with a two-months history of painless, progressively enlarging lower jaw mass.

Antineoplastic Combined Chemotherapy Protocols↗