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    Adenoid hypertrophy and nocturnal enuresis are associated with sleep disturbances
    (Aves, 2020) Cicek, Ayla Uzun; Bora, Adem; Altuntas, Emine Elif
    Objective: Adenoid hypertrophy and nocturnal enuresis, comorbidities that are quite prevalent among children, are both associated with sleep problems. However, limited research has specifically focused on sleep domains and their parameters. In the present study we thus aimed to investigate the impact of adenoid hypertrophy and nocturnal enuresis on sleep, both when the two disorders coexist and when they do not coexist. Methods: We investigated 178 children (mean age: 7.24=1.02 years, range=6-9 years), 50 (28.1%) of whom had only adenoid hypertrophy, 39 (21.9%) of whom had only nocturnal enuresis, 35 (19.7%) of whom had coexistence of adenoid hypertrophy and nocturnal enuresis, and 54 (30.3%) of whom were healthy-control children. Psychiatric disorders were diagnosed by a semi-structured diagnosis interview and the diagnosis of adenoid hypertrophy was confirmed by flexible fiberoptic nasopharyngoscopy. Sleep habits and disturbances were assessed via the Children's Sleep Habits Questionnaire and Modified Epworth Sleepiness Scale. Results: Our results showed that the comorbid condition was the most severe form in terms of both adenoid hypertrophy and enuresis. Regarding sleep difficulties, the Sleep-Disordered Breathing, Night Wakings, Sleep Onset Delay and Sleep Duration parameters were closely associated with adenoid hypertrophy and its severity, while Bedtime Resistance, Parasomnias and Sleep Anxiety domains of sleep were strongly related to nocturnal enuresis. Conclusion: Otorhinolaryngologists, child psychiatrists and pediatricians should be aware of the relationship between enuresis and adenoid hypertrophy, that both diseases are associated with impaired sleep patterns, and that children affected by the comorbidity of the two disorders experience more sleep disturbances.
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    An Examination of Paraoxonase 1 Gene Polymorphism in Cases of Chronic Otitis Media
    (Dergipark Akad, 2020) Durmus, Kasim; Kurtulgan, Hande Kucuk; Bora, Adem; Yildirim, Malik Ejder; Altuntas, Emine Elif
    Objective: Chronic otitis media (COM) is a multifactorial disorder, the pathogenesis of which has yet to be fully elucidated. Numerous aetiological factors, including genetics, eustachian tube dysfunction, autoimmunity, infection, osteoclastic activity, cytokines, endotoxins, and products of lipid peroxidation resulting from oxidative stress, have been proposed to explain the chronic inflammation which lies at the heart of the disorder. The aim of this study is to investigate a possible relationship between the pathogenesis of COM and polymorphism within the paraoxonase 1 (PON1) gene. Methods: We investigated 49 patients admitted to the Otorhinolaryngology Department of Cumhuriyet University and diagnosed with COM between September and November 2017. The control group consisted of 51 healthy individuals. Polymerase chain reaction (PCR) - restriction fragment length polymorphism (RFLP) methods were used to genotype the PON1 Q192R (rs662) polymorphism. Results: When the case and control groups were compared in terms of the existence of PON1 (Q192) polymorphism, there was no statistically significant difference between the groups (p=0.166, p>0.05). When intergroup comparison was performed on the type of PON1 (Q192) polymorphism, there was also no statistically significant difference (p=0.261, p>0.05). Conclusion: The present study is the first known study in which PON1 polymorphism has been examined in cases of COM. The results of our study failed to indicate a statistically significant relationship between PON1 polymorphism and COM. However, it is important to note that the higher rate of 192RR polymorphism within the control group may indicate a protective effect in COM.
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    Anterior Rhinomanometry and Determination of Nasal Mucociliary Clearance Time With the Saccharin Test in Children With Crimean-Congo Hemorrhagic Fever
    (LIPPINCOTT WILLIAMS & WILKINS, 2013) Altuntas, Emine Elif; Kaya, Ali; Uysal, Ismail Onder; Cevit, Omer; Icagasioglu, Dilara; Muderris, Suphi
    Objectives: Crimean-Congo hemorrhagic fever (CCHF), like other viral infections, may prolong mucociliary clearance time and increase nasal resistance in children. The aim of the present prospective case-control study was to study, using saccharin and anterior rhinomanometry tests, whether CCHF infections caused any change in nasal physiology. Methods: Overall, 40 subjects, 20 of whom had CCHF (group 1) and 20 of whom were healthy controls (group 2), were enrolled in this study. The definitive diagnosis of CCHF infection was made based on typical clinical and epidemiological findings and detection of CCHF virus-specific IgM by ELISA or of genomic segments of the CCHF virus by reverse transcription-polymerase chain reaction. Anterior rhinomanometry was performed in all participants according to current recommendations of the Committee Report on Standardization of Rhinomanometry. A saccharin test was used to evaluate mucociliary clearance, and nasal mucociliary clearance time was assessed with the saccharin test as described previously. Results: In our patients, the mean time from the application of saccharin crystals to the first feeling of a sweet taste was 6.77 +/- 3.25 minutes (range 2-16 min). In terms of the mean time from the application of saccharin crystals to the first feeling of a sweet taste, there was no difference between two groups. The mean total air flow was 637.60 +/- 76.18 mL/s (range 490-760 mL/s). The mean total nasal airway resistance was 0.24 +/- 0.03 Pa/mL s (range 0.20-0.31 Pa/mL s). In terms of the degree of nasal air flow and nasal airway resistance and the total air flow and total nasal airway resistance of each nostril, there was no difference between the 2 groups. Conclusions: The results obtained in anterior rhinomanometry and saccharin test showed that there was no statistically significant difference between CCHF (+) patients and controls. These results suggest us that CCHF virus infection does not affect nasal physiology. However, this is the first study performed on this issue and further studies on larger series need to be performed.
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    Are the sinonasal outcome test and nasal obstruction symptom evaluation scale questionnaires suitable for assessing the quality of life after septorhinoplasty? A prospective case-control study
    (2023) Bora, Adem; Durmus, Kasim; Cam, Selim; Altuntas, Emine Elif
    In the evaluation after septorhinoplasty (SRP), the surgeon's plan and the patient's expectations may not always be realised. Therefore, in our prospective case- control study, we aimed to investigate whether the Sinonasal Outcome Test (SNOT-22) and Nasal Obstruction Symptom Evaluation Scales (NOSE), which have been validated in different patient populations in Turkish, are appropriate for evaluating SRP cases and their relationship with each other. Preoperative and postoperative data of NOSE and SNOT-22 questionnaires of 125 cases diagnosed with traumatic septum deviation and external nasal deformity and decided to be operated were analyzed. It was calculated that the SNOT-22 score of those with high/low preoperative NOSE scores was also high/low with a 53.6% probability and that the SNOT-22 score of those with high/low postoperative NOSE scores was also high/low with a 69.9% probability, indicating a positive and high-level relationship between postoperative NOSE and SNOT-22 measurements. When the answers given to all questions in SNOT-22 were evaluated separately, it was observed that the most disturbing symptoms of the cases were nasal obstruction at 78.4% and the need to blow the nose at 46.4% in the preoperative period, and nasal obstruction with 64.8% and the need to blow nose with 37.6% in the postoperative period. The most dramatic changes in the answers to SNOT-22 questions were observed in the patient's feelings of frustrated/restless/irritable, sadness, and embrassed. SNOT-22 and NOSE questionnaires can be used interchangeably to evaluate the functional status of patients undergoing SRP surgery.
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    Assessing the Efficiency of Intranasal Steroid Treatment in Cases with Eustachian Dysfunction Via the Turkish Version of Eustachian Tube Dysfunction Questionnaire-7
    (Wolters Kluwer Medknow Publications, 2020) Bora, Adem; Durmus, Kasim; Demirkiran, Berat Baturay; Aslan, Yasin; Altuntas, Emine Elif
    Aim: The aim of this study was to evaluate the efficiency of the treatment in the cases, who were diagnosed with Eustachian tube dysfunction (ETD) via history, physical examination, and tympanometry and for whom intranasal steroid treatment was planned to be used before surgical treatment options, by using Eustachian Tube Dysfunction Questionnaire (ETDQ)-7. Materials and Methods: Fifty-five cases, who applied to the otorhinolaryngology outpatient clinic due to the complaints suggesting Eustachian dysfunction such as aural fullness and pressure sensation and for whom the diagnosis of Eustachian dysfunction was considered due to the results of the examination, history, and physical examination, were included in the study. The 3rd and 6th weeks of intranasal steroid treatment ETDQ-7 scores were recorded. Results: ETDQ-7 mean scores of the cases were 2.72 +/- 0.97 at the time of initial diagnosis (minimum-maximum: 1-4.71), 2.31 +/- 0.85 in the 3rd week of the treatment (minimum-maximum: 1-5), and 2.12 +/- 0.78 (minimum-maximum: 1-4, 14) in the 6th week. A statistically significant difference was observed when statistically assessing the ETDQ-7 scores determined at the time of diagnosis and in the 3rd and 6th weeks of the treatment (P < 0.001). When ETDQ-7 scores were assessed based on gender in assessment time, there was a statistically significant difference in the assessment conducted in the 3rd week (P < 0.05; P = 0.039). Conclusion: It is believed that the current study is the first study that evaluates the efficiency of intranasal corticosteroid treatment, which is frequently used by the doctors in daily practice in pharmacotherapy in the cases with ETD from young adult and adult age groups, on the symptoms via ETDQ-7. In addition, the results of the present study indicated that intranasal steroid treatment in early periods caused a significant recovery in the symptoms, however this recovery also reached a plateau after the treatment.
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    Assessment of Hematological Factors Involved in Development and Prognosis of Idiopathic Sudden Sensorineural Hearing Loss
    (LIPPINCOTT WILLIAMS & WILKINS, 2016) Durmus, Kasim; Terzi, Hatice; Karatas, Tuba Dogan; Dogan, Mansur; Uysal, Ismail Onder; Sencan, Mehmet; Altuntas, Emine Elif
    Objective: The aim of this study was to investigate the possible effects of routine hematological parameters on the development and prognosis of idiopathic sudden sensorineural hearing loss in patients applying to our clinic. Study design: A retrospective clinical study. Setting One academic health center from 2008 to 2014. Patients and intervention: One hundred forty patients with sudden hearing loss and 132 healthy controls were included in the present study. Results: Patients having idiopathic sudden sensorineural hearing loss were divided into 2 subgroups based on whether they recovered (complete, partial, and slight recovery) (Group 1; n = 83, 59.3%) or not (Group 2; n = 57, 40.7%) during the follow-up term. Group 1, Group 2, and the controls differed statistically significantly in terms of neutrophil-to-lymphocyte ratio (P = 0.001), platelet-to-lymphocyte ratio (P = 0.001), lymphocytes%(P = 0.001), mean corpuscular hemoglobin (P = 0.019), mean corpuscular hemoglobin concentration (P = 0.015), platelet (P = 0.001), mean platelet volume (P = 0.001), platelet distribution width (P = 0.009), and glucose (P = 0.001). The study groups and the controls did not have any significant difference in terms of other laboratory parameters affecting the prognosis of Idiopathic sudden sensorineural hearing loss. Conclusions: The results the authors obtained showed that laboratory parameters such as lymphocyte, lymphocyte%, platelet, mean platelet volume, platelet distribution width, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration may be indicative for prognosis and treatment success in groups of patients suffering idiopathic sudden sensorineural hearing loss in whose etiology many factors play a role.
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    Assessment of mucociliary clearance as an indicator of nasal function in patients with COVID-19: a cross-sectional study
    (Springer, 2021) Koparal, Mehtap; Kurt, Ercan; Altuntas, Emine Elif; Dogan, Fatih
    Purpose We assessed the effects of COVID-19 infection on nasal mucociliary activity. Methods The study was conducted in the pandemic wards of Adiyaman University Training and Research Hospital during April and May 2020. All patients admitted to the COVID-19 pandemic wards during the study period were invited to participate in the study. The study included 40 adults who agreed to participate and underwent a mucociliary clearance test successfully. The primary outcome was mucociliary clearance time and the secondary variables of interest were age, sex, and sino-nasal outcome test-22 scores. The control group included 40 concomitant healthy patients who visited the outpatient ear, nose and throat clinic with non-nasal symptoms. Results The study included 40 COVID-19-positive patients and 40 healthy controls. The mean mucociliary clearance times of the study (15.53 +/- 5.57 min) and control (9.50 +/- 3.70 min) groups were significantly different (Z = 4.675, p < 0.001). However, the mucociliary clearance time was not significantly different between males and females (t = 0.590, p = 0.558). Conclusions Nasal mucociliary clearance time was prolonged in COVID-19 patients compared to healthy controls. Thus, we conclude that smell and taste are crucial symptoms that should not be overlooked in patients suspected of COVID-19 disease.
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    Audio-vestibular evaluation in patients with essential tremor
    (SPRINGER, 2012) Balaban, Hatice; Altuntas, Emine Elif; Uysal, Ismail Onder; Senturk, Ilteris Ahmet; Topaktas, Suat
    The aim of this study was to investigate audio-vestibular function in patients with essential tremor. Twenty-three patients with essential tremor (46 ears) and 21 health control subjects (42 ears) were included in the present study. Patients and comparison subjects were matched for age and gender. All patient and control subjects underwent pure tone audiometric test, tympanogram, transient-evoked otoacoustic emissions and auditory brainstem response. Vestibular system was evaluated by bitermal caloric test. Comparison of variables between the groups was performed. Investigation of the relationship between parameters about ET disease and hearing levels were also studied. Pure tone thresholds significantly differed between patients and controls in 250 and 500 Hz frequencies ( < 0.05). There was no statistically significant difference in 1,000, 2,000, 4,000, and 6,000 Hz frequencies in essential tremor patients in comparison to the control subjects. A correlation between tremor severity and audiometric scores in low frequencies was not found. In addition, statistical analysis did not demonstrate a correlation between audiometric scores and tremor duration. The otoacoustic emission responses were found significantly different in patient and control group. The latencies of waves I, V and I-V inter-peak latencies on the ABR were not different between the groups. Our findings indicated that, abnormalities are due to cochlea rather than the retro cochlear pathology which is responsible for hearing loss associated with essential tremor.
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    Audiological evaluation of hearing levels in patients diagnosed with migraine
    (MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2015) Karadag, Mujde; Altuntas, Emine Elif; Sanli, Serkan; Uysal, Ismail Onder
    Introduction: Based on the hypothesis that neurovascular events involving in the pathophysiology of migraine can cause hearing loss by influencing blood flow of inner ear, it was aimed to determine whether migraine with or without aura in our clinics patients are at risk for hearing loss by assessing hearing levels via a high-frequency audiometry, acoustic reflex and transient otoacoustic emission responses; to discriminate whether hearing loss is cochlear or retrocochlear originated, if present; and to evaluate whether or not migraine treatment affect hearing level in patients received treatment for migraine in this study. Materials and Methods: The study included patients who were diagnosed as migraine between December 2011 and December 2012 at Neurology Department of Cumhuriyet University, Medicine School according to ICD-II classification and accepted to receive medical therapy. In all patients, hearing levels were measured at baseline and after treatment by using high-frequency audiometry, transient otoacoustic emission and acoustic reflex tests. Results: In the present study, hearing thresholds measured in the right ear was normal in migraine patients with or without aura at baseline, while mild hearing loss was detected in right ear at the frequency of 500 Hz after treatment when hearing thresholds at different frequencies were compared. This difference was significant (P < 0, 05). When hearing thresholds in right ear at baseline and after treatment was compared, mild hearing loss was detected at the frequency of 250 Hz in migraine patients with aura. This difference was significant (P < 0, 05). In migraine patients with aura, hearing was normal in all patients at baseline, while in both ears mild hearing loss was detected in 2 patients (8.7%) after treatment. This difference was not significant (P > 0, 05). Conclusion: Differently from literature, hearing loss in our patients developed at lower frequencies and after treatment. The results we obtained from our study also presented that there might be a relationship between migraine disease and sensorineural hearing loss.
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    Biocompatibility evaluation of cigarette and carbon papers used in repair of traumatic tympanic membrane perforations: experimental study
    (SPRINGER, 2013) Altuntas, Emine Elif; Sumer, Zeynep
    The purposes of this study were to investigate the biocompatibility of two different paper patches (carbon and cigarette papers) and compare the adhesion and proliferation features of L929 fibroblast cells by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT Test) test and scanning electron microscopy (SEM). In this study, time-dependent cytotoxic effects of cigarette and carbon papers used in repairing small traumatic TM perforations were investigated in vitro by using MTT test. And also adhesion and spreading of cells over disk surface were observed by SEM. Cytotoxicity test carried out by MTT analysis on leakage products collected from two types of paper patches at the end of 24 and 48 h revealed no cytotoxicity (P > 0.05). In SEM studies, it was observed that cells started to proliferate over disk surface as a result of 48-h incubation, and SEM revealed that the cell proliferation over cigarette paper was more compared to the one over carbon paper. We believe that this is the first study where biocompatibility and adhesion features of carbon and cigarette paper have been studied by using L929 fibroblast cell culture. As a result, biocompatibility of cigarette paper and also whether cigarette paper was superior to carbon paper in cell attachment and biocompatibility were studied. It was found, by MTT test and SEM test, that cigarette paper had a higher biocompatibility and cell attachment, and thus cigarette paper should be the patch to be preferred in cases where TM perforations are repaired by paper-patch method.
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    Boron-Doped Nano Hydroxyapatite Grafts for Bone Regeneration in Rat Mandibular Defects
    (Springernature, 2024) Demirkiran, Berat Baturay; Inan, Zeynep Deniz Sahin; Hamutoglu, Rasim; Oksuz, Kerim Emre; Hasbek, Zekiye; Altuntas, Emine Elif
    The aim of this study was to evaluate the potential effects of boron-doped nano hydroxyapatite grafts on craniofacial bone regeneration in critical bone defects in the mandibular corpus of rats, in terms of scintigraphic and histopathological aspects. Forty Wistar albino rats, with an average weight of 200-220 g, aged 16-18 weeks, and all male, were used in the study. The rats were randomly assigned to five groups, each containing 8 rats, as follows: group C1 (no procedure applied to the mandible), group C2 (surgical defect created in the mandible but no treatment applied), group nHA (nano hydroxyapatite applied to the surgical defect area), group nHA + B1 (nano hydroxyapatite + 1% boron applied to the surgical defect area), and group nHA + B2 (nano hydroxyapatite + 2% boron applied to the surgical defect area). A standard 4 x 4 mm full-thickness transosseous bone defect was created in the mandibular corpus of all rats, except for those in group C1. The bone defect in the rats in group C2 was left to heal naturally. Nano hydroxyapatite (nHA), nano hydroxyapatite + 1% boron, and nano hydroxyapatite + 2% boron were applied to the surgical defect areas of the other three groups, respectively. Bone scintigraphy was performed on all rats on days 0 (following the surgical procedure) and 28 of the experimental period. At the end of the 28th day, the animals were sacrificed, and tissue samples were collected for histological examination. A standard grading system was used to evaluate fracture healing. When the groups were compared in terms of bone healing histopathological scores, a statistically significant difference was observed between group C1 and the other groups (p < 0.005). In the statistical evaluation made according to the histopathological mean scores, the least improvement was observed in group C2. No statistically significant difference was observed between group nHA and group nHA + B1 and group C2 and between group nHA and group nHA + B1 in terms of bone healing scores (p > 0.005). A statistically significant difference was found between group nHA + B2 and group C2 (p = 0.026). Although there was no statistically significant difference in histopathological scores, the mean score closest to group C1 was observed in group nHA + B2. A statistically significant difference was observed between the groups in the scintigraphic evaluation performed on the 28th day of the experimental procedure, and the difference was between group C1 and group nHA + B1 and between group nHA and group nHA + B1 (p = 0.004; p = 0.028, p < 0.005). In the comparison of the values obtained on days 0 and 28 within the group, a statistically significant change was observed in group nHA + B1 and group nHA + B2 (p < 0.005). When the results of the present study were evaluated, it was thought that the boron-doped nHA graft biomaterials may have positive effects on bone healing. Providing a different perspective for the development of an alternative new treatment modality that can be locally applied in the treatment of fractures a serious and common health problem can be interpreted as an important outcome of the present study. We believe that this study will serve as a preliminary study for more comprehensive future studies on this subject.
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    Can local administration of humic acid shorten recovery time of mandibular fractures? Experimental study
    (DEOMED PUBL, ISTANBUL, 2017) Durmus, Kasim; Bora, Adem; Dogan, Mehtap; Ozer, Hatice; Tuncer, Ersin; Altuntas, Emine Elif
    Objective: The aim of the present pilot study was to evaluate the effects of a single local dose administration of humic acid on healing of subcondylar mandibular fractures in rats. Methods: In this study, a randomized experimental protocol was used. The study was conducted with 16 male Wistar-albino rats that were 16-18 weeks old. The rats (n=16) were randomly divided into two groups: Group HA received humic acid (0.3 cc/site, n=8) and Group C received no additional medical administration (control group, n=8). A full-thickness surgical osteotomy was performed in the subcondylar area. A single dose of humic acid (0.3 cc/site) was administered locally by spraying on the bone surfaces of the fracture line. Mandible was dissected on postoperative day 21. Then, fractured hemimandibles were obtained for histopathological examination. Results: The median score of bone fracture healing was 7.16 (range: 7 to 8) in the Group HA and 7.50 (range: 7 to 8) in the Group C. When the groups were compared in terms of bone healing scores, there was no statistical difference between the Group HA and the Group C (p>0.05). Conclusion: Results of this study showed that local administration of humic acid was not efficient for healing of bone fractures. However, we are of the opinion that it is required to conduct more comprehensive studies, including humic acid's different concentrations and administration manners, evaluating the effects of humic acid on tissue both histopathologically and in terms of inflammatory and proinflammatory cytokine levels.
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    Childhood Traumas and Personality Traits' Impact on Rhinoplasty Decision
    (Springer, 2024) Yilmaz, Yavuz; Aksoy, Ahmet; Altuntas, Emine Elif
    ObjectiveAesthetic surgeries are increasingly common procedures today, with rhinoplasty being the most frequently performed. The desire for improved appearance is closely linked to an individual's psychological health. It is known that patients seeking rhinoplasty tend to be more anxious and have experienced more negative childhood experiences. However, the impact of personality traits and adverse childhood experiences on the decision to undergo rhinoplasty remains unclear.MethodsThe study included 256 individuals, consisting of 106 who had undergone rhinoplasty, 46 considering rhinoplasty, and 104 not considering rhinoplasty. All participants completed the Eysenck Personality Questionnaire Revised Short Form and the Childhood Trauma Questionnaire.ResultsNeuroticism increased the likelihood of undergoing rhinoplasty by 16.3%, and this rate rose to 29.3% if a family member had undergone rhinoplasty. Psychoticism increased the likelihood by 15.4%, and the rate increased to 19.1% if no family member had undergone rhinoplasty. Extraversion increased the likelihood by 24.4%, and this rose to 30.9% if a family member had undergone rhinoplasty. Emotional abuse, mediated by neuroticism, increased the likelihood of undergoing rhinoplasty by 5.4%, and this increased to 17.7% if a family member had undergone rhinoplasty. Physical neglect increased the likelihood by 17.9%, and this rate rose to 22% if no family member had undergone rhinoplasty.ConclusionOur findings indicate that both personality traits and childhood traumas influence the decision to undergo rhinoplasty. These results will serve as an important guide for future research.Level of Evidence IIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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    Comprehensive evaluation of deep neck infections: A retrospective analysis of 111 cases
    (Wiley, 2024) Aksoy, Ahmet; Demirkiran, Berat Baturay; Bora, Adem; Dogan, Mansur; Altuntas, Emine Elif
    Purpose: Our study will analyze patients' clinical characteristics, treatment strategies, and complications with deep neck infection (DNI) using their medical records for five years. Methods: The present study included 111 patients diagnosed with DNI in our clinic between January 2018 and March 2023. The patients' complaints at admission, sociodemographic characteristics, season of diagnosis, findings from laboratory tests, radiological imaging performed at the time of first diagnosis, abscess localization, medical and surgical treatment methods used, and complications developing during follow-up were retrospectively examined. Results: The mean age of the patients included in the study was 38.51 +/- 16.92 (6-87 years). There was a significant correlation between chronic disease, smoking behaviours, oral hygiene, and DNI among patients based on their sociodemographic characteristics and medical history (p < .005). DNI development did not differ by season (p > .005). Physical examination findings predominantly revealed neck masses (39.6%) and peritonsillar abscesses (32.4%), and patients with peritonsillar abscesses had a shorter length of hospital stay than those with other localizations. No severe complications occurred during the clinical follow-up. Conclusion: Chronic diseases, smoking, and poor oral hygiene are the primary risk factors for developing DNIs. If an abscess is located in a critical area, it may require extended hospitalization and surgery under general anesthesia. Therefore, addressing these risk factors and encouraging good oral hygiene practices are crucial to preventing DNIs and reducing the need for intensive treatment.
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    Determination of nasal mucociliary clearance time and nasal symptom in patients with Crimean-Congo hemorrhagic fever
    (WILEY, 2017) Durmus, Kasim; Engin, Aynur; Karatas, Tuba Dogan; Gozel, Mustafa Gokhan; Altuntas, Emine Elif
    Crimean-Congo hemorrhagic fever (CCHF) is an important health problem in Turkey. Number of studies on symptoms of ear nose throat system and indicating whether or not the organs are affected in patients with CCHF is limited. The aim of the present study was to investigate whether CCHF infections caused any change in nasal physiology in adult patients or not by using saccharin transit time (STT) and nasal symptom scoring. Twenty subjects with laboratory-confirmed diagnosis of CCHF and 28 healthy control subjects were included in the present study. A saccharin test was used to evaluate nasal mucociliary clearance time (NMCT) and the nasal symptom scoring used in allergic rhinitis was modified and used to examine the symptoms of the patients. The average STT of CCHF and control groups were 472.70 +/- 151.58 and 276.07 +/- 89.65sec, respectively. The difference between them was statistically significant (P=0.00, P<0.05). When those in CCHF group were classified according to timing of the test, STT average of those undergoing the test on the 1st-3rd days (n=10) and 4th-6th (n=10) days was 547.00 +/- 154.37 and 398.40 +/- 111.39sec, respectively. The difference between them was statistically significant (P=0.024; P<0.05). The results of the present study showed that NMCT prolonged in adult patients with CCHF compared to those in the control group despite the fact that it was within normal limits. For these reasons, clinicians should follow-up CCHF patients more closely for respiratory tract diseases and sinonasal and middle ear infections. J. Med. Virol. 89:960-965, 2017. (c) 2016 Wiley Periodicals, Inc.
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    Do Mean Values of the Peak Inspiratory Nasal Flowmeter Vary According to the Severity, Direction and Type of Nasal Septum Deviation?
    (Springer India, 2022) Bora, Adem; Aslan, Yasin; Durmus, Kasim; Demirkiran, Berat Baturay; Altuntas, Emine Elif
    The aim is to investigate the contribution of the PNIF test in daily clinical practices in the objective evaluation of the early postoperative functional results of septoplasty and the effect of the severity, direction, and type of nasal septum deviation on mean PNIF values. Nasal septum deviation (NSDs) of the cases were grouped according to the Mladina classification and the severity of NSDs. An objective evaluation of the nasal airway was conducted via a peak flowmeter device in the preoperative and postoperative first month. When examining the mean PNIF values according to genders, it was observed that the values determined in male cases in the preoperative and postoperative period were higher. In the intragroup evaluation performed according the Mladina classification, a statistically significant increase was observed in the preoperative and postoperative PNIF values of the cases in Types 1-4. In the intragroup evaluation performed according to the severity of NSD, there was a significant increase in the preoperative and postoperative PNIF values of the mild and moderate cases. When comparing the preoperative and postoperative PNIF values of the groups in terms of the severity of NSD, it was observed that there was a significant difference. The PNIF can be used in routine clinical practices to evaluate the septoplasty results objectively. In the evaluation of functional results, the change in the mean PNIF values may also vary according to the direction and severity of septum deviation and the Mladina classification other than age, gender and ethnic origin.
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    Effect of Extracorporeal Shock Waves on Subcondylar Mandibular Fractures
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) Altuntas, Emine Elif; Oztemur, Zekeriya; Ozer, Hatice; Muderris, Suphi
    Objective: The purpose of this pilot study was to evaluate the effects of extracorporeal shock wave therapy on healing of subcondylar mandibular fracture in rats. Methods: Unilateral subcondylar fracture in 20 Wistar albino rats was used as a fracture model. Each rat was anesthetized 1 day after surgery, and extracorporeal shock wave therapy was performed. On the 21st day after surgery, animals were killed. Mandibles were dissected, all soft tissues were removed after sacrifice, and fractured and nonfractured hemimandibles were obtained from each rat. Histologic analyses were performed by a single pathologist blinded to the samples. Results: The specimens' mean score in bone fracture healing was 7 (1.09) (range, 6-9) in group 1 and 2.57 (1.62) (range, 1-6) in group 2. With respect to the specimens' bone fracture healing score, there was a statistically significant difference between the 2 groups. Conclusions: As a result, our study showed that extracorporeal shock wave therapy accelerated the improvement of fractures in experimentally induced subcondylar mandibular fracture in the rat mandible. We believe that reducing the duration of improvement in subcondylar mandibular fractures by intermaxillary fixation along with extracorporeal shock wave theraphy would contribute to preventing complications such as ankylosis, fibrosis, and hypomobility occuring because of prolonged fixation.
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    Effects of acute thyroxine depletion on hearing in differentiated thyroid carcinoma patients
    (Wolters Kluwer Medknow Publications, 2014) Hasbek, Zekiye; Karakus, Canan Filiz; Altuntas, Emine Elif; Kilicli, Fatih
    Introduction: Radioiodine ablation refers to the destruction of functioning remnants of normal thyroid tissue or metastatic foci remaining after thyroidectomy. Effective thyroid ablation requires adequate stimulation of thyroid-stimulating hormone. Our aim in this study was to evaluate the hearing changes of patients before ablation therapy in the iatrogenic hypothyroid period, which has been constituted with the purpose of treatment success and following the ablation therapy in the euthyroid period 1 month after the thyroid hormone (TH) replacement therapy was initiated. Materials and Methods: Patients who were diagnosed with thyroid cancer, treated with total/near-total thyroidectomy and referred for I-131 therapy or low-dose I-131 whole body scan were included in our study. Hearing tests as high-frequency audiometry, autoacoustic emission and tympanometry were made during hypothyroid and euthyroid periods on all the patients included in the study. Results: In the present study were enrolled 75 patients with a mean age of 46.6 +/- 12 years (range: 19-69 years). In hypothyroid period, while there was not any hearing-loss in 124 of 150 (82.7%) ears of 75 patients; mild hearing-loss in 18 (12%) ears, moderate hearing-loss in 7 (4.7%) ears and severe hearing-loss in 1 (0.07%) ear were detected. In euthyroid period, while there was not any hearing-loss in 132 of 150 (88%) ears; there were mild hearing-loss in 11 (7.3%), moderate hearing-loss in 6 (4%), and severe hearing-loss in 1 (0.07%) ear. However, there could not be found any significant difference between hearing levels of patients before and after treatment (P = 0.317). Conclusion: Although THs play an important role in the physiology of hearing, the hypothyroidism made in 4 weeks period causes serious damages on hearing functions of patients. However, with regard to temporary hearing losses that hearing levels could improved with treatment, we believe that hearing should also be questioned in the follow-up of patients with differentiated thyroid cancer.
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    Evaluating the frequency of anatomical variations of the sinonasal region in pediatric and adult age groups according to gender: computed tomography findings of 1532 cases
    (Springer, 2021) Bora, Adem; Koc, Merve; Durmus, Kasim; Altuntas, Emine Elif
    Background: The aim of the present study was to evaluate retrospectively the frequency of anatomical variations in sinonasal region, which were frequently seen in our cases, for whom coronal section paranasal computed tomography imaging (CPNCT) was taken, as well as the correlation of these variations with age and gender and correlations of identified anatomical variations with one another. In the study, CBCT scans of a total of 1532 (825 males and 707 females) cases were evaluated in order to determine the prevalence of anatomical variations of the nasal cavity and paranasal sinuses. All the images were taken by a multi-detector CT device (Aquilion, Toshiba medical system, Tokyo, Japan). Results: Most frequently detected three anatomical variations were septum deviation (79.7%), concha bullosa (40.9%), and ethmoid bulla (21.0%) according to the frequency order. When the frequency of anatomical variations was evaluated according to gender, septum deviation, concha bullosa, and anterior clinoid process pneumatization were more frequently observed in males and Onodi cell in females (p < 0.05). When the relationships of the anatomical variations with one another were evaluated, it was found that the possibility of the presence of concha bullosa in the septum deviation cases and the presence of ethmoid bulla in the cases with Haller cell septum were higher (p < 0.05). In terms of the anatomical variations that were evaluated by taking age as the independent variable, a statistically significant difference was observed in pterygoid process pneumatization, Haller cell, pneumatized crista galli, ethmoid bulla, and paradoxical middle concha between the adult and children age groups (p < 0.05). Conclusion: In terms of the frequency of occurrence to various sinonasal region variations, statistically significant differences were observed between both genders and age groups. The correlations of the detected variations with each other were also remarkable. Consequently, it is believed that comprehensive studies and serious objective evaluations evaluating the change of frequency of anatomical variations according to age and gender besides their correlation with each other are required.
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    Evaluation of allergic rhinitis with nasal symptoms and nasal mucociliary clearance in patients with fibromyalgia syndrome
    (IOS PRESS, 2018) Dogan, Sevil Ceyhan; Karadag, Ahmet; Durmus, Kasim; Sahin, Ozlem; Altuntas, Emine Elif
    BACKROUND: The exact etiopathogenesis of fibromyalgia syndrome (FM) is still unclear but the pathogenesis of FM is associated with neurogenic inflammation. Allergic rhinitis (AR) is a common inflammatory and immunological disease of the nasal mucosa. As a result, it is known that neurogenic inflammation has a role in the pathophysiology of both FM and AR. OBJECTIVE: The aim of this study was to evaluate AR and nasal allergic inflammation using nasal mucociliary clearance time (NMC) in FM patients. METHODS: Forty-five FM patients and fifty healthy controls were included in the study. In both groups, AR was evaluated by total nasal symptom scoring (TNSS) and NMC was measured using saccharine transit time test (STT). RESULTS: TNSS was positive in 9 patients (20%) in the FM group and no positivity in the control group. In FM group, the mean value of TNSS was higher than that of the control group (p = 0.0001). The average value of STT of FM patients was statistically significantly longer when compared to the control group (p = 0.0001). CONCLUSION: The results we obtained suggest that there is a high possibility of coexistence of FM and AR. As a result, the coexistence of AR and FM cannot be denied but we believe that comprehensive clinical studies should be conducted on this subject.