Ahmet Emre Süslü

Nasal Pepsin Assay and pH Monitoring in Chronic Rhinosinusitis

Objectives/Hypothesis: The primary objective of this study was to determine the relationship between chronic rhinosinusitis (CRS) and laryngopharyngeal reflux (LPR). We also investigated the diagnostic value of pepsin in nasal lavage by means of fluorometric assay as compared with 24‐hour dual‐probe pH monitoring.

Body fat composition: a predictive factor for obstructive sleep apnea.

Objective: To investigate body fat composition, measured by bioelectrical impedance assay (BIA), for predicting the presence and severity of obstructive sleep apnea‐hypopnea syndrome (OSAHS). Body fat composition was also compared with other well‐known OSAHS predictors such as body mass index (BMI), neck circumference, and abdominal visceral fat.

Treatment of oroantral fistula:experience with 27 cases

PURPOSE To review patients with chronic oroantral and oronasal fistula who underwent surgical correction. MATERIAL AND METHODS Twenty-seven patients with chronic oroantral and oral fistula who underwent surgical correction in the Hacettepe University Faculty of Medicine Department of Otorhinolaryngology Head and Neck Surgery between 1968 and 2001 were reviewed retrospectively. RESULTS Local mucosal flaps were used for surgical correction. The underlying factors were tooth extraction in 13 patients (48%), tumor in 5 (18.5%), osteomyelitis in 3 (11%), Caldwell-Luc procedure in 2 (7.5%), trauma in 2 (7.5%), dentiginous cyst in 1(3.7%), and correction of septal perforation in 1 (3.7%). Among the fistulas, 23 were oroantral, 3 were oroantronasal, and 1 was oronasal, respectively. Two patients required revisional repairment. The surgical procedure failed in 1 diabetic patient and 3 patients with prior history of external radiotherapy. CONCLUSION Tooth extraction was the most common etiologic factor, and malignancy should be excluded in all patients. The outcome may not be satisfactory in patients with systemic disease and in patients with history of radiotherapy. Multiple surgical interventions may be necessary only on rare occasions.

Sole effect of genioglossus advancement on apnea hypopnea index of patients with obstructive sleep apnea

Abstract Conclusion: Selected patients might have benefited from genioglossus advancement (GA), even it was applied solely. GA provided significant reduction on the apnea hypopnea index (AHI), with a 53% surgical success. Objectives: The aim of this study was to evaluate the impact of GA on AHI of patients with obstructive sleep apnea (OSA). Method: From January 2008 to April 2014 patients who underwent a genioglossus advancement procedure alone were included into the study and records of these cases were analyzed retrospectively. Pre-operative and post-operative values of body mass index (BMI), Epworth Sleepiness Scale (ESS), nocturnal polysomnographic data including AHI, mean, and minimum oxygen saturation were compared. Results: There were 16 males and one female patient with the mean age of 46 years. The AHI showed a significant reduction from 27.5 ± 8 pre-operatively to 17.3 ± 12.6 post-operatively. The pre-operative and post-operative mean O2 saturation value improved from 92.1 ± 2.4% to 93.4 ± 1.7%. Pre-operative ESS scores decreased significantly from 7.7 ± 1.6 to 4.8 ± 1.9. There were no significant difference between pre- and post-operative values of BMI and minimum O2 saturation. The success rate was found to be 53%, which was based on success criteria as an AHI of <20 with at least 50% reduction.

Effect of heparin on inflammation: An animal model of tracheal stents

The objective of this study was to investigate the effect of systemic heparin on tracheal and wound healing.

Minimally invasive endoscope-assisted surgery for bilateral branchial cleft fistula

INTRODUCTION Branchial cleft anomalies are the second most common head and neck congenital lesions seen in children. They present as cysts, fistulas, sinuses, or cartilaginous remnants. Bilateral anomalies occur in 2% to 3% of all cases; the rate of bilateralism is higher in familial cases. Fistulas of the second branchial cleft are the most common branchial anomalies, accounting for as many as 90% of all branchial cleft fistulas. They are typically seen at a site along the anterior border of the sternocleidomastoid muscle. These lesions do not regress spontaneously and have a high rate of recurrent infections. Surgical excision is the definitive treatment for branchial anomalies. Their excisions can be difficult and complicated because the tract follows a long way in the neck and usually travels to the carotid bifurcation and opens into the pharyngeal pouch, or goes high and opens to tonsillary fossa. This report describes a technique in which a complete excision of fistula of the second branchial arch is facilitated by using endoscopes.

Endoscopic Z-plasty for Treatment of Supraglottic Stenosis: A New Technique.

Endoscopic Z-plasty for Treatment of Supraglottic Stenosis: A New Technique Otolaryngology– Head and Neck Surgery 2015, Vol. 153(6) 1064–1066 American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599815607201 http://otojournal.org Taner Yılmaz, MD, Shamkhal Jafarov, MD, Oğuz Kus xcxu, MD, Tevfik Sözen, MD, and Ahmet Emre Süslü, MD

The serum leptin level in non-obese patients with obstructive sleep apnea

OBJECTIVE This study aimed to determine the association between the severity of obstructive sleep apnea (OSA) and the serum leptin level in non-obese OSA patients. METHODS This prospective case-control study included non-obese OSA patients that presented with sleep-related disturbances and underwent polysomnography (PSG) between April 2015 and June 2016. The serum leptin level was measured and its relationship to PSG parameters was investigated. RESULTS The study included 73 OSA patients (20 female and 53 male) with a mean age of 41.1±11.5 years and mean body-mass index (BMI) of 26.4±2.7kgm-2. The serum leptin level in 44 patients with moderate/severe OSA (AHI ≥15) was 3.4±2.6ngmL-1, versus 4.5±3.8ngmL-1 in 29 patients with snoring/mild OSA (AHI <15) (P=0.20). There were not any correlations between any of the PSG parameters and the serum leptin level, but there was a significant correlation between the leptin level and BMI (r=0.345, P<0.01). CONCLUSION The serum leptin level does not differ significantly between non-obese OSA patients with moderate/severe and snoring/mild OSA. Obesity is the primary factor associated with the serum leptin level.

Parapharyngeal giant ganglioneuroma with multifocal bone involvement in a pediatric female patient

Ganglioneuroma is a rare benign tumor that originates from neural crest. Tumor tends to be slow growing, asymptomatic but can cause symptoms because of pressure to neighboring structures. In the head and neck region they are relatively rarely seen. We hereby present a rare case of multiple ganglioneuromas that were located in parapharyngeal space, iliac bone and other bones in a 13-year-old girl. Patient underwent surgery for the excision of a large mass, extending from parapharyngeal space to neck, with transparotid and transcervical combined approach. After operation, MIBG (iodine-123-meta-iodobenzylguanidine) scintigraphy was performed and involvement of parietooccipital bone, lumbal vertebra, right iliac wing medial cortex and left humerus were detected. No adjuvant therapy was given to the patient. There is no evidence of recurrence in the head and neck region in the following 12 months. In conclusion, complete surgical excision of the tumor, if possible, is the treatment of choice with high success rate. Close clinical and radiological follow-up for these tumors after surgery should be made.

Case report: malignant teratoma of the sinonasal tract

Malignant teratoma of the sinonasal tract is a very rare malignant neoplasm occurring in adults that consists of epithelial and mesenchymal elements. Histological heterogeneity may cause misdiagnosis, and the definite diagnosis is not easily made unless the tumor is completely excised. The authors present a case of malignant teratoma in a 35-year-old male who was treated with surgery and radiotherapy. The short duration of survival emphasizes the aggressiveness of this uncommon tumor.