Biomedical subjects

Tamer Erdem

Publications and source records attributed to Tamer Erdem.

At least 19 recordsLinked to original sources

PubMed2006

Contralateral normal ear after mastoid surgery: evaluation by otoacoustic emissions (mastoid drilling and hearing loss).

Mastoid drilling can cause transient hearing loss in the contralateral normal hearing ear. A study was designed to evaluate hearing in the contralateral normal ear before and after the mastoid surgery in a longitudinal manner and find out the duration of this temporary hearing loss. Twenty-two patients requiring mastoid surgery in their diseased ears, having contralateral normal ear were included. Pure tone audiometry and otoacoustic emissions (OAEs) were utilized for baseline evaluation. OAEs were repeated during the immediate postoperative period and daily up to the 6th postoperative day. The amplitudes of the OAEs of contralateral normal ears were found affected immediately after surgery and progressive improvement was detected with full recovery at 72-96 h. None of the patients had permanent deterioration in OAE amplitudes. The burs used during mastoid surgery can cause temporary hearing threshold changes in the contralateral ears. This adverse effect recovers spontaneously within 72-96 h postoperatively.

Adolescent↗

PubMed2005

Objective evaluation of the effects of intravenous lidocaine on tinnitus.

OBJECTIVE: Tinnitus is one of the most common and distressing otological symptoms. Although numerous therapeutic modalities have been tried, there is no consensus regarding effective therapeutic agents up to now. The effects of lidocaine on tinnitus have been reported in literature using either subjective or audiologic tests. Nevertheless, the otoacoustic emissions (OAEs) have not been utilized to demonstrate lidocaine's effect on the cochlea in the English literature. The aim of this study was to evaluate the effect of lidocaine on tinnitus by considering the alterations with tinnitus, it induces on OAEs and subjective symptoms. METHODS: This study was performed in 30 patients with tinnitus. Twenty-eight of the patients had normal hearing and two of them evidenced mild sensorineural hearing loss. To determine the severity of tinnitus, the patients were required to fill out a tinnitus scoring scale before lidocaine infusion on the same day. Then, lidocaine was administered intravenously to each patient at a dose of 1.5 mg/kg body weight over a period of 30 min. Spontaneous otoacoustic emissions (SOAEs) and distortion product otoacoustic emissions (DPOAEs) were measured three times; namely before lidocaine injection, at 25 min after injection and on the next day. The severity of tinnitus was scored again 1 d, 1 wk and 1 mo after lidocaine administration. RESULTS: Immediately after infusion, four patients (13.3%) declared total suppression of tinnitus, whereas three patients (10%) reported only partial relief in tinnitus subjectively. The patients, who had a subjective improved response (group 1) were compared with the patients, who had no response (group 2). Statistically significant changes (p<0.05) in DPOAE response/growth or input/output (I/O) functions were observed at 1, 2, 3, 4 and 6 kHz frequencies in lidocaine responders and at 1, 2, 3, 4 and 5 kHz frequencies in no responders at different primary stimulus levels. Statistically significant changes (p<0.05) were seen at 2 kHz for 53 dB and at 3 kHz for 62 dB SPL primaries in both groups. When the significant results of these two groups were compared with each other, differences were found insignificant. CONCLUSION: Systematic OAE measurements revealed that no changes occurred in SOAE and DPOAE levels in that alterations disappeared the next day. Subjective relief from tinnitus was stated in some of the patients and lasted for 4 wk at longest.

Acoustic Impedance Tests↗

PubMed2005

Radiological evaluation of the styloid process in young adults resident in Turkey's Yeditepe University faculty of dentistry.

OBJECTIVES: This study evaluated and classified the radiographic appearance of the styloid process (SP) patterns of calcification according to subject gender. The relationship between SP length and the limits of mandibular protrusion was studied. STUDY DESIGN: The panoramic radiographs of 55 young adults were analyzed. Elongated SPs were classified with the radiographic appearance based on length, morphology, and calcification pattern. The data were analyzed by using chi-squared and 1-way ANOVA with significance set at P < .05. RESULTS: "Elongated" (Type I) SP with "calcified outline" was the most frequent SP type and calcification pattern. No correlation was found between SP type and calcification pattern and subject gender. No differences were proven based on laterality of the SP. A relationship between mandibular protrusive movement and SP calcified length was not proven. CONCLUSION: Elongation of calcification of SP in young adults is common with no correlation to gender, laterality, or mandibular protrusive limitation. "Type I" with "calcified outline" of the SP was observed most frequently in the population studied.

Adolescent↗

PubMed2005

The levels of plasma and salivary antioxidants in the patient with recurrent aphthous stomatitis.

BACKGROUND: Despite plenty of research, the cause of recurrent aphthous stomatitis (RAS) remains obscure. It has been proposed that, the aetiological factors such as local trauma, smoking, vitamin deficiencies and viral infections lead to aphthae formation via final common pathway based on increased oxidative stress. The aim of this investigation was to evaluate the antioxidant enzyme superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSHPx) alterations in plasma and saliva, and in addition uric acid (UA) in saliva, in patients with RAS and healthy controls. METHODS: Thirty-two patients with RAS and 30 healthy controls were included into the study. The SOD, CAT, GSHPx and UA levels were measured in plasma and saliva in study and control groups. RESULTS: In the RAS group, although the mean SOD (P<0.001) and CAT (P<0.05) levels of plasma were lower, GSHPx (P<0.001) levels were higher than control group. The salivary concentrations of the SOD (P<0.001), CAT (P<0.05) and GSHPx (P<0.001) in RAS group were entirely opposite to plasma concentrations. UA were not significant between RAS group and controls. CONCLUSION: Since we found salivary SOD and CAT levels were high whereas plasma levels were low, it has been thought that, salivary defence mechanisms via antioxidant agents may be stimulated against to the ulcerous lesion. We consider that the organism might mobilize the antioxidant potential to the sites where they were needed. At this point, decrease of SOD and CAT levels in the plasma may be related to this shift. It is also thought that GSHPx secretion in the saliva may also be increased but the increase in its turnover may be responsible for the diminished activity.

Adolescent↗

PubMed2005

[Laser assisted eustachian tuboplasty: a case report].

Surgical treatment of eustachian tube dysfunction is still challenging. Placement of a transtympanic ventilation tube may not be successful and may require multiple applications. We presented a 47-year-old male patient with chronic recurrent otitis media with effusion and retraction due to eustachian tube dysfunction, in whom the number of previous transtympanic tube insertions amounted to 18. He underwent laser assisted eustachian tuboplasty in both ears with endoscopic guidance under general anesthesia. The mucosal, submucosal, and partially the cartilaginous tissues in the posterior pillow of the nasopharyngeal orifice of the eustachian tube were ablated by Nd:YAG and holmium:YAG laser. Following surgery, air conduction thresholds decreased from 37 dB to 22 dB, and from 38 dB to 33 dB for the right and left ears, respectively. The preoperative tympanogram curve, which was of type B for both ears was found as type C-1 on the right side, and type C-2 on the left. Limited improvement seen in the left ear was ascribed to insufficient ablation of the posterior pillow of the eustachian tube. No complications were encountered within a follow-up of 12 months.

Diagnosis, Differential↗

PubMed2004

Dose-dependent dual effect of melatonin on ototoxicity induced by amikacin in adult rats.

The aim of this animal study was to reveal the dose-dependent effects of melatonin on aminoglycoside ototoxicity by utilizing distortion product otoacoustic emissions (DPOAEs). Forty-four adult (aged 12 months) rats were divided into five groups. Rats of the control group (group C) were injected with vehicle, while the melatonin group (group M) received melatonin (4 mg/kg per day); there were four rats in each of these groups. The study groups consisted of 12 rats per group, and they were treated as follows: 600 mg/kg per day amikacin (group A), amikacin plus a low dose (0.4 mg/kg per day) melatonin (group AML) and amikacin plus high dose (4 mg/kg per day) melatonin (group AMH) for 14 days. During the serial measurements on days 0, 5, 10 and 15, the DPOAE results of groups C,M and AML were not significantly changed. Amikacin ototoxicity findings for input/output (I/O) functions were detected on the 3rd measurement of the study in group A. High-dose melatonin clearly enhanced and accelerated amikacin-induced ototoxicity. The DP-gram amplitudes and I/O amplitudes were reduced, and I/O thresholds were increased in group AMH. Group AMH was the group that was affected the most and earliest by amikacin. Our study results showed that while low-dose melatonin protected the inner ear from ototoxicity, high dose melatonin facilitated amikacin-induced ototoxicity, possibly via the vasodilatory effect, leading to an increased accumulation of amikacin in the inner ear. Probably, the protective effect of the melatonin at a dose of 0.4 mg/kg per day is related to its antioxidant properties. Apparently, the vasodilatory effect of melatonin seems to be more prominent than its antioxidant effect in high doses.

Amikacin↗

PubMed2004

A radiological anatomic study of the cribriform plate compared with constant structures.

BACKGROUND: Understanding of the anterior skull base anatomy is crucial to avoid intracranial violations during endoscopic surgery. The aims of this study were to define the normative data about cribriform plate depth and the relationship between this dimension and the measurements of the adjacent anatomical structures such as middle turbinate length, maximal vertical orbital height and distance between the ethmoid roof and the nasal floor. PATIENTS AND METHODS: Paranasal computerized tomographic scans of 136 healthy adults were included into the study. The cribriform plate depth compared to the ethmoid roof and the adjacent anatomical structures mentioned above were measured bilaterally. RESULTS: The maximal vertical orbital height was detected as the most constant anatomic measurement. We found the mean level difference between the ethmoid roof and the cribriform plate as 6.1 +/- 2.3 (range 1-12 mm) on the left side and 6.1 +/- 2.2 (1-15 mm) on the right side. The middle turbinate was significantly longer in the Keros Type I group than in the other groups (p<0.05). Furthermore, the distance between the ethmoid roof and the nasal floor was lowest in the Keros Type I group (p<0.01). The distance between the ethmoid roof and the nasal floor was statistically higher in Keros group 3 among all groups (p<0.01). The deeper the cribriform plate, the higher the nasal cavity. CONCLUSION: To the best of our knowledge, our study has a unique feature by including the data of the constant anatomical structures comparing with the cribriform plate depth. Since in the group with excessive cribriform plate depth, the middle turbinate was short, care should be taken especially during middle turbinate resections.

Adolescent↗

PubMed2003

The effects of the chorda tympani damage on submandibular glands: biometric changes.

OBJECTIVE: It was aimed to analyze the biometric changes in ipsilateral submandibular glands of patients with unilateral chorda tympani (ChT) section during otological operations, compared with change in size of the contralateral glands and with those of healthy subjects. METHODS: 29 patients with unilateral complete ChT section and 29 healthy subjects with identical ages, genders, and weights to the patient group were examined ultrasonographically. The patients having a mean duration to follow-up examination of 32 months (2-84 months) were subdivided into two groups by their time to follow-up as short-term patient group (2-12 months, 14 patients) and long-term patient group (13-84 months, 15 patients). The ultrasonographic dimensions and volumes of submandibular glands were compared statistically between the groups. RESULTS: In the patient group, the glands on the contralateral, non-operated side were found to be greater than the ipsilateral, denervated glands in terms of both paramandibular depth dimension (P<0.05) and volume (P<0.01). The differences could be determined only in long-term patient group. When comparing the submandibular glands of the patient group with those of the control group, it was found that paramandibular depth dimension and volume of the submandibular glands on the contralateral, non-operated side were statistically greater (P<0.01). There was no difference between submandibular glands on the operated side of the patient group and those of the control group (P>0.05). CONCLUSION: The late (13-84 months) biometric results of ChT damage on submandibular gland were significant for increase in the size of the contralateral, non-denervated submandibular gland. An atrophying effect was not ascertained in the submandibular glands denervated parasympathetically due to the section of the ChT.

Adolescent↗

PubMed2003

Effects of chronic exposure of electromagnetic fields from mobile phones on hearing in rats.

OBJECTIVE: Little attention has been paid to the effects of electromagnetic field (EMF) of mobile phones on hearing. The aim of this study is to investigate the effects of chronic exposure to EMF emitting from mobile phones on the inner ear of adult and developing rats using distortion product otoacoustic emissions (DPOAEs). METHODS: EMF of mobile phones exposure was scheduled according to a sham-exposure controlled experimental design. Every day seven of 14 adult and four newborn rats were exposed to 1-h mobile phone EMF for 30 days, while the other seven adult rats were assigned to control group. DPOAEs were measured in both groups before and after the chronic exposure to EMF. The newborn rats were tested following similar exposure beginning on the 2nd day after birth. RESULTS: No measurable EMF associated changes in DPOAEs either in adult or developing rat inner ears were determined (P>0.05). CONCLUSION: It was concluded that chronic exposure of EMF, as long as 30 days 1 h per day, emitting from a mobile phone did not cause any hearing deterioration in adult and developing rats, at least at outer and middle ear and cochlear levels.

Animals↗

PubMed2003

[Landau-Kleffner syndrome (acquired epileptic aphasia)].

Landau-Kleffner syndrome is characterized by a complex group of symptoms including deterioration in language skills, seizures, and abnormal electroencephalography findings. A six-year-old male patient had aphasia for three years and generalized tonic-clonic epileptic seizures for two years. Pure-tone audiometry and auditory brain-stem response audiometry findings were normal. He had verbal auditory agnosia rather than true aphasia. Cranial computed tomography and magnetic resonance imaging studies did not show any abnormal findings. Single-photon emission computed tomography showed hypoperfusion in the right hemispheric temporal lobe. Despite treatment with corticosteroids and intravenous immunoglobulins, multiple exacerbations were interspersed in a four-year follow-up period.

Agnosia↗

PubMed2003

[Determination of allergen-specific IgE in patients with atopy or allergy symptoms].

OBJECTIVES: We investigated the role of specific IgE assay in the diagnosis in patients found to be atopic or allergic by history and physical examination. PATIENTS AND METHODS: Serum specific IgE levels were measured by the chemiluminescent assay in 143 adults (58 females, 85 males; mean age 34.3 years; range 16 to 62 years) and in 113 children (62 girls, 51 boys; mean age 10.2 years; range 5 to 16 years) with rhinitis, asthma, or dermatitis. The results were analyzed in six groups depending on the specific IgE level (no specific IgE, very low, low, moderate, high, and very high levels). The specific IgE threshold for a negative or positive result was accepted as 0.70 IU/ml. Allergen-specific IgE antibodies were sought for 35 allergens in adults, and for 19 allergens in children. RESULTS: Specific IgE levels were positive (>0.70 IU/ml) in 92 adults (64.34%) and in 50 children (44.25%). Hypersensitivity to individual allergens ranged between 20.08% and 41.96% in adults, and between 17.70% and 28.32% in children. Fourteen adults and eight children showed sensitivity to a single allergen; the remaining patients were sensitive to at least two allergens. CONCLUSION: Detection of sensitivity to allergens is complementary to findings obtained by history and physical examination and may help to reveal allergic etiology in patients presenting with a similar symptom profile.

Adolescent↗

PubMed2003

A functional and aesthetic solution for saddle nose deformity: the use of the inferior turbinate bone.

The use of a new autologous material, the inferior turbinate bone, for nasal augmentation is presented together with surgical treatment of a 24-year-old male patient with moderately severe saddle nose deformity. In the postoperative period, no complications were observed. Photographs and three-dimensional computed tomography views obtained 13 months after the operation showed that the reconstruction area was highly free of postoperative resorption. The patient's complaints disappeared, and he was satisfied with functional and cosmetic results. Moreover, a histologic evaluation which was made to assess the depth of the glandular component showed that the inferior turbinate bone could be used over the nasal dorsum in a smoother shape, retaining its overlying soft tissue.

Adult↗

PubMed2003

A case of necrotizing sialometaplasia in the upper lip.

Necrotizing sialometaplasia is a benign, reactive, and self-limiting inflammatory disorder with clinical and histologic features resembling carcinoma. A fifty-eight-year-old woman presented with a firm submucosal mass on the right side of the upper lip, measuring 0.5 cm. Histopathologic examination of the incisional biopsy specimen was reported as adenoid cystic carcinoma, resulting in removal of the mass with a large excision and reconstruction of the primary site. However, final histopathologic diagnosis of the excised mass was necrotizing sialometaplasia. No recurrences occurred during a three-year follow-up. This report draws attention to the difficulty in distinguishing between necrotizing sialometaplasia and adenoid cystic carcinoma.

Diagnosis, Differential↗

PubMed2003

Metastatic spread of occult papillary carcinoma of the thyroid to the parapharyngeal space: a case report.

Metastasis from thyroid carcinomas to the parapharyngeal space is very rare. A forty-year-old male presented with progressive dysphagia and enlargement in the right upper neck. Examination showed medial displacement of the right palatine tonsil and the lateral oropharyngeal wall. A firm, submucosal mass measuring 4 x 3 cm was palpated. Computed tomography revealed a hypodense and heterogenic parapharyngeal mass with a calcified border. The mass was totally removed by a transcervical approach. Although frozen-section diagnosis was a benign lesion, histopathologic evaluation showed metastasis of papillary thyroid carcinoma to the parapharyngeal lymph nodes. Total thyroidectomy and bilateral selective neck dissection were performed, after which the tumor turned out to be papillary microcarcinoma (0.8 x 0.8 cm) in the right upper lobe of the thyroid gland. No locoregional recurrences or distant metastasis were observed during a three-year follow-up. The differential diagnosis of parapharyngeal masses should include metastatic thyroid carcinomas, for which a lymphatic route has been suggested between the thyroid gland and the parapharyngeal lymph nodes.

Adult↗

PubMed2003

A case of Ewing's sarcoma in the mandible and the skull base.

A thirteen-year-old boy with Ewing's sarcoma was presented. The treatment was considerably delayed because of the initial diagnostic difficulties due to its insidious presentation and the unwillingness of the child's parents to further investigations and treatment. During a three-year delay, the tumor turned out to be a gross painful mass from a painless lesion. Cranial computed tomography and magnetic resonance imaging with contrast showed a destructive lesion extensively involving the right mandible and the skull base, with invasion to the intracranial space. Facial and intratemporal portions of the mass were removed totally, but the intracranial extension could not be totally excised because of cavernous sinus involvement. Histologic and immunohistochemical findings were consistent with the diagnosis of Ewing's sarcoma. The patient received systemic chemotherapy and radiotherapy following surgery. A month after radiation therapy, radiologic investigations showed a lung mass suggestive of metastasis. He died two days after hospitalization, from an intracranial hemorrhage associated with the intracranial mass.

Adolescent↗

PubMed2002

Exploration of the early auditory effects of hyperlipoproteinemia and diabetes mellitus using otoacoustic emissions.

Although the relationship between hearing loss and hyperlipoproteinemia (HLP) or diabetes mellitus (DM) has been shown in many clinical investigations, this concept is still controversial. A prospective study was designed to search for the existence of subclinical auditory dysfunction related to HLP and DM by transient-evoked (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) in patients with hearing levels better than 30 dB. Evoked otoacoustic emissions were utilized to investigate subclinical auditory dysfunction. Fifteen hypercholesterolemic patients (28 ears), 21 hypertriglyceridemic patients (42 ears) and 21 DM patients (40 ears) were eligible for investigation. The results of the DPOAEs and TEOAEs of the study groups were compared with the control group composed of individuals with similar ages and with normal blood lipids and glycemia. This group consisted of 22 people (44 ears). There was no difference in the existence of TEOAEs at all frequencies among the groups (P>0.05). No differences were found in the amplitudes of the DPOAES between the groups except at 4 kHz (P>0.05). The difference was caused by the hypertriglyceridemia group (P=0.014) and the non-insulin-dependent diabetes mellitus (NIDDM) group (P=0.012) when compared with the control group. The mean DPOAE amplitudes of the hypertriglyceridemic and NIDDM groups at 4 kHz were higher than those of the control group. The decreased DPOAE amplitudes at 4 kHz in hypertriglyceridemic and diabetic patients without clinical findings are compatible with the sensorineural hearing loss observed with hyperviscosity and increased noise susceptibility, as was shown before in these patients. Longitudinal investigations should be performed with otoacoustic emissions to help with the early prediction of the prospective effects of HLP and DM on the auditory system.

Acoustic Impedance Tests↗

PubMed2002

Amikacin ototoxicity enhanced by Ginkgo biloba extract (EGb 761).

An animal study was realized to investigate the possible beneficial effect of EGb 761 as an antioxidant agent on amikacin ototoxicity by measuring distortion product otoacoustic emissions (DPOAEs). Twenty-eight adult rats were grouped equally as follows. GROUP AMIKACIN: rats received amikacin 600 mg/kg/day intramuscularly between postnatal days (PND) 30 and PND44. Group amikacin/EGb 761: rats received amikacin 600 mg/kg/day intramuscularly between PND30 and PND44 and EGb 761 100 mg/kg/day orally between PND30 and PND50. Group EGb 761: rats received equivolume saline intramuscularly between PND30 and PND44 and EGb 761 100 mg/kg/day orally between PND30 and PND50. NO TREATMENT GROUP: rats received nothing. Group amikacin was found to be affected only on the last measurement day of study (PND57). The frequencies greater than 2002 Hz were significantly reduced compared with the amplitudes of PND30 (P<0.05). Group amikacin/EGb 761 was most and earliest affected by amikacin-induced ototoxicity. DPOAE amplitudes were found in this group to be decreased at 2-6 kHz starting on PND50. The results of Group EGb 761 and No treatment group were not significantly changed. For the DPOAE input/output amplitude thresholds, Group amikacin (P<0.05) and Group amikacin/EGb 761 (P<0.01) had significantly elevated thresholds on PND57, except at 5 kHz for Group amikacin (P=0,06). According to the results of the study, EGb 761 may be regarded as a facilitating drug for the development of amikacin ototoxicity. The results of the present study may warn against concomitant use of aminoglycosides, specifically amikacin, with EGb 761.

Amikacin↗

PubMed2002

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↗