Erkan Özüdoğru

Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods

The aim of functional septorhinoplasty is to create an esthetically elegant nose and harmony in the face by preserving nasal function as well as maintaining or restoring adequate airway. Since nasal complaints are usually subjective, it may be difficult to evaluate the functions objectively. In the present study, we aimed to investigate the alterations in nasal function associated with septorhinoplasty by using both objective and subjective methods. The study population consisted of 40 patients who underwent septorhinoplasty and 40 healthy controls. Before and after the operation, visual analog scale, acoustic rhinometry, rhinomanometry, and Odiosoft-Rhino test were applied to all patients and controls. There were significant differences in all parameters both before and after the operation. While a significant difference was obtained between the patient and control groups in terms of preoperative values, no significant difference was found between postoperative values of these groups. Both objective and subjective methods are important in evaluations.

Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer.

OBJECTIVE The incidence of thyroid gland invasion in patients with advanced laryngeal cancer was reported to be 0-50%. However there is a controversy in necessity and extent of routine thyroidectomy in these patients due to the difficulty in diagnosis of tumor invasion to thyroid gland and the risk of possible postoperative hypothyroidism and hypocalcemia. METHODS The medical files of 47 patients who underwent thyroidectomy as part of surgical treatment for advanced laryngeal cancer were reviewed. RESULTS Fourty-four (93.6%) patients underwent hemithyroidectomy, 3 (6.3%) patients underwent total thyroidectomy. Thyroid gland invasion was found in 2 (4.2%) patients. Hypothyroidism occurred in 15 (31.9%) patients, and their hormone levels were regulated with medical treatment during follow-up. Hypocalcemia was not found in any patients. CONCLUSION We recommend that at least a hemithyroidectomy should be performed in patients with advanced laryngeal cancer, if they have any predictive factor (subglottic extension more than 1cm, invasion of paraglottic space, thyroid cartilage, cricoid cartilage and prelaryngeal tissue detected by radiological examination) for thyroid gland invasion.

Survival of diced and block cartilage grafts in combination with injectable calcium hydroxylapatite

Dorsal nasal irregularities after trauma, and various procedures such as excessive nasal hump resection, are major problems for patients who have undergone rhinoplasty. Many grafts have been described for the correction of dorsal nasal irregularities. In this study, we used an injectable implant, in combination with diced or block cartilage grafts, to test the efficacy of injectable calcium hydroxylapatite on the survival of diced or block cartilage grafts.

Vocal fold hyperplastic lesions: an evaluation of surgical outcome with videolaryngostroboscopy.

BACKGROUND Vocal fold hyperplastic lesions are premalignant lesions that can be treated effectively by removal of the lesions surgically. AIMS The aim of this study was to discuss the success of surgery in patients with vocal fold hyperplastic lesions in terms of preserving vibratory function by comparing the preoperative and postoperative videolaryngostroboscopy findings. STUDY DESIGN The medical charts and videolaryngostroboscopic recordings of patients diagnosed with hyperplastic lesions on the vocal folds were reviewed retrospectively. METHODS Twenty seven patients with unilateral lesions who underwent type1 subepithelial cordectomy were enrolled in the study. The videolaryngostroboscopic recordings were evaluated by three raters who were not the operating surgeon and who were blinded to the histology of patients. To evaluate the videolaryngostroboscopic findings, a form, which is a modification of criteria described by Hirano and Bless, was used. Preoperative and 6th month postoperative videolaryngostroboscopic recordings were compared with each other and with recordings of the control group, which included 50 healthy volunteers. RESULTS All videolaryngostroboscopic findings, except false cord vibration, were significantly improved after surgery. CONCLUSION The principle of vocal fold surgery in patients with benign lesions is to preserve the vibratory tissue. This principle also applies to patients with hyperplastic lesions that are premalignant. The hydrodissection technique may be beneficial for this purpose.

Evaluation of the Vestibular System and Etiology in Children with Unilateral Sensorineural Hearing Loss.

OBJECTIVE The aim of this study was to evaluate the vestibular system of children with unilateral sensorineural hearing loss (USNHL), investigate the etiological factors of USNHL and analyze whether a genetic predisposition exists. MATERIALS AND METHODS Thirty-three children aged less than 18 years with USNHL, who visited the ear, nose, and throat (ENT) department between January 2004 and December 2012, were included in this study. Cases with conductive hearing loss were excluded from the study. The patients were subjected to etiologic, genetic, and ophthalmologic evaluation; radiologic imaging; electronystagmography (ENG); and vestibular evoked myogenic potential (VEMP) tests. The control group, which included 25 healthy children (13 males and 12 females), had undergone audiological assessment and were subjected to ENG and VEMP tests. RESULTS All of the patients had severe-to-profound hearing loss. Mumps immunoglobulin G was positive in 22 (66.7%) of 33 patients. The 35delG mutation was not found in any of the patients. All of the patients underwent temporal computed tomography (CT) and magnetic resonance imaging (MRI). Inner ear anomaly was present in 51.5% of the patients. Overall, 21 of 31 ENG patients had canal paresis in the affected ear. The VEMP response was absent on the affected side in three patients. The n23 latency average of the patient group was longer than that of the control group. CONCLUSION Because USNHL causes irreversible problems in children, early diagnosis and auditory rehabilitation are very important. As USNHL is accompanied by inner ear anomaly, children with USNHL should undergo temporal bone CT and MRI. To evaluate the vestibular system, ENG and VEMP are non-invasive and diagnostic tests.

Larenks kanserli hastalarda sağlıkta yaşam kalitesi

Health-related quality of life (QOL) is increasingly being recognized as an important issue in oncology. It is a multidimensional concept which comprises four core domains: physical functioning, psychological functioning, social interaction and diseaseand treatment-related symptoms. Quality of life is an important indicator of treatment outcome and is used increasingly as an end point in clinical trials. Patients with head and neck cancer not only have to face a life-threatening disease, they also have to deal with the impact of both the disease and its treatment on physical, psychological and social functioning. They are prone to psychosocial problems, because social interaction and emotional expression depend to a great extent upon the structural and functional integrity of the head and neck region. Clinical Research / Klinik Araflt›rma

Acoustic Analysis of Soccer Fans in Acute Phonotrauma After the Match

OBJECTIVES Acute phonotrauma is the result of sound production by shouting or straining ones voice. In this study, we aimed to investigate the acute changes in the vocal folds and voices of soccer fans who voluntarily applied to our clinic after the soccer match where they engaged in acute phonotrauma. There are no other studies in the literature conducted on a similar sample group. STUDY DESIGN This is a case-control study. METHODS Videolaryngostroboscopic (VLS) examination, acoustic voice analysis, and Voice Handicap Index (VHI) questionnaire were performed on 29 voluntary soccer fans included to the study before the match and at the first hour after the match. The values obtained were compared statistically with each other and with 29 control groups without voice pathology. RESULTS The jitter, shimmer, and normalized noise energy values measured after the match increased significantly statistically compared with the pre-match level, but harmonic noise ratio value decreased significantly (P < 0.05). VHI scores increased significantly after the match according to the pre-match scores (P < 0.05). In the VLS examinations, there was no difference in the images before and after the match. CONCLUSIONS It has been concluded that people who are using their voices loudly and intensely by shouting during the match are exposed to sound changes after the match, and if this situation becomes persistent, it may cause permanent voice pathologies. It is thought that VHI and acoustic voice analysis should be done together with VLS for diagnosis and follow-up of voice changes for which the VLS examination alone is not sufficient.

Efficacy of Platelet-Rich Plasma on Fat Grafts in the Repair of Tympanic Membrane Perforations: An Experimental Study

OBJECTIVE We investigated the use of autologous platelet-rich plasma (PRP) to improve the success rate of fat graft myringoplasty in perforated tympanic membranes of rats. MATERIALS AND METHODS A total of 20 healthy Wistar albino female rats were divided into two groups. In Group 1, the left tympanic membranes were perforated and grafted with a fat graft that was harvested from the inguinal region. In Group 2, the left tympanic membranes were perforated, and a fat graft was also harvested from the inguinal region. Then, the fat was soaked in 0.5 mL PRP and grafted at the perforation. After the procedure, the rats were examined, and the graft situation was assessed at 3, 5, 7, 10, and 14 days. All of the rats were sacrificed 21 days after perforation, and a histopathological examination was made. RESULTS We compared fat graft histopathological and otomicroscopic findings between the groups. While we did not observe graft rejections in Group 2, we saw 1 case of graft rejection in Group 1. In the histopathological examination, PRP prevents fat graft resorption by the terms of the adipocyte area, granulation tissue area, and vacuolization area. CONCLUSION This study demonstrated the efficacy of fat grafts prepared with PRP on rat tympanic membranes. The fat graft with PRP did not statistically improve the success rate compared to the graft without PRP. Histopatologic findings of the study showed that PRP prevents fat graft resorption. Further studies are needed to further examine the advantages of the graft with PRP.

FRONTOLATERAL LARENJEKTOMİNİN ONKOLOJİK YÖNDEN EMNİYETİ VE SONUÇLARIMIZ / ONCOLOGIC SAFETY OF FRONTOLATERAL LARYNGECTOMY AND OUR RESULTS

OZET: Frontolateral larenjektomi (FLL) erken evre glottik kanserlerde uygulanan ve bir vokal kordun tamaminin, on komissurun, diger kordun on 1/3’une kadar olan bolumunun ve tiroid kartilajin bir bolumunun rezeksiyonunu iceren konservatif parsiyel larenjektomi cesitidir. Bu calismada tedavi ettigimiz ve duzenli takiplerine gelen 29 olgumuzdaki bulgular retrospektif olarak incelenmistir. Tani asamasinda olgularimizin 25’i(%86.2) T1 evresinde, 4‘u(%14) T2 evresinde saptandi. Olgularimizin 27’si erkek ve 2’si kadin olup, ortalama yas 62.6(49-77) olarak bulunmustur. Ortalama takip suresi 41.8 ay olan olgularimizin postoperatif histopatolojik tetkikleri sonucunda 6 olguda pozitif cerrahi sinir rapor edilmis olup, bunlardan 3 olguya postoperatif radyoterapi uygulanmis, 3 olgu ise takip edilmistir. Bu olgularin hicbirinde lokal nuks gelismemistir. Bir olgu postoperatif 37.ayda kardiyolojik patoloji nedeniyle kaybedilmistir. FLL; uygun endikasyon konmus hastalarda onkolojik yonden emniyetli ve larengeal fonksiyonlarin iyi korundugu bir cerrahi tekniktir. ANAHTAR KELIMELER: Frontolateral, Glottik ca, Larenjektomi ONCOLOGIC SAFETY OF FRONTOLATERAL LARYNGECTOMY AND OUR RESULTS ABSTRACT: Frontolateral laryngectomy (FLL) is a variety of conservative partial laryngectomy applied in early glottic cancer and containing resection all of a vocal cord, anterior commissure, the section up to 1/3 front part of the other cord and one section of the thyroid cartilage. In this study, findings in 29 patients we have treated and come to regular following-up, were analyzed retrospectively. At diagnosis 25(86.2%) of our patients were detected in stage T1, 4(14%) of them were stage T2. 27 of our patients were male and 2 of them were female and mean age was found 62.6(49-77), respectively. In our cases mean follow-up time were 41.8 months, from the results of histopathological examination, positive surgical margin has been reported in 6 cases and postoperative radiotherapy applied to 3 of them, while 3 of cases were followed. In none of these cases developed local recurrence. One patient died because of cardiologic pathology on post surgical 37. month. FLL; is a surgical technic which has oncologic safety and laryngeal functions are well-protected in appropriate indications. KEYWORDS: Frontolateral, Glottic ca, Laryngectomy