Orhan Gedikli

Histopathological Changes of Chorda Tympani in Chronic Otitis Media

Objective To investigate whether histopathological changes of chorda tympani might exist in patients with chronic otitis media without facial paralysis.

Pneumatized inferior turbinate

The inferior turbinate is a separate bone that extends from the body of the maxilla to the ethmoidal crest. Its arched central portion overhangs the so-called inferior meatus, which contains the opening of the nasolacrimal duct. The inferior turbinate is part of the nasal valve area, which is the narrowest part of the nose. During inspiration, airflow is directed upward and backward, mainly over the anterior part of the inferior turbinate.l Concha bullosa, pneumatization of the middle turbinate, is a well-recognized entity. It is the most common anatomic variation of the middle turbinate leading to various clinical problems.2 It may be either unilateral or bilateral, with different sizes, and may compromise the anatomy and function of the ostiomeatal complex. Pneumatization of the superior turbinate, which is also called concha bullosa of the superior turbinate by Stammberger,3 is a very rare entity, and only a few cases have been reported. 3,4 Pneumatization of the inferior turbinate has not yet been reported in the world literature. In this article, a patient with inferior turbinate pneumatization is presented.

Pharyngeal packing is a predisposing factor for postoperative aphthous stomatitis in nasal surgery.

Objective: To evaluate whether pharyngeal packing is a predisposing factor for the development of postoperative aphthous stomatitis in nasal surgery. Study Design: A prospective, randomized, controlled trial. Setting: A tertiary referral center. Subjects and Methods: After the study was approved by the local ethics committee, 100 adult patients scheduled for routine nasal surgery were enrolled. The development of postoperative aphthous lesions within three days after surgery was evaluated in patients in whom a pharyngeal pack was (Group 1) or was not (Group 2) applied during nasal surgery. Results: In Group 1, the presence of pharyngeal pack increased the risk for postoperative oral mucosal aphthae development by 4.64 times (P = 0.02, RR = 4.64, 95% CI = 1.22-17.91). No significant associations were found between postoperative oral mucosal aphthae development and sex (P = 1), age (P = 0.69), height (P = 0.73), weight (P = 0.22), or duration of surgery (P = 0.47) in Group 1. Conclusion: Pharyngeal packing during nasal surgery increases postoperative morbidity by leading to the development of painful oral aphthous lesions.

Improvement in bone conduction threshold after tympanoplasty

ABSTRACT OBJECTIVE: To investigate the causes of bone conduction threshold impairment associated with middle ear pathoses and the factors influencing improvement in bone conduction threshold after tympanoplasty. STUDY DESIGN AND SETTING: The records of 98 consecutive patients with unilateral chronic otitis media who underwent tympanoplasty were reviewed. Pre-operatively, 15 dB or more depression of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was considered to be significant. Similarly in the postoperative period, 15 dB or more improvement of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was regarded as significant. RESULTS: Twelve (12.5%) of 98 cases were found to have depressed bone conduction threshold; 6 of 12 cases had improved bone conduction threshold after tympanoplasty. CONCLUSION: In cases with cholesteatoma and extensive middle ear disease, successful results could be achieved after tympanoplasty disregarding the air-bone gap and deteriorated bone conduction threshold. SIGNIFICANCE: Bone conduction threshold may improve after tympanoplasty.

Efficacy of octyl-2-cyanoacrylate in type I tympanoplasty.

Objective: To evaluate the safety and efficacy of octyl-2-cyanoacrylate for type I tympanoplasty. Methods: This study involved 23 patients (14 females and 9 males) with chronic otitis media who underwent type I tympanoplasty. During surgery, the temporal fascia is placed underlying the eardrum remnant, and octyl-2-cyanoacrylate was dropped over the temporal fascia. The mean air-bone gap (ABG) at the 4 frequencies (500, 1000, 2000, and 4000) was calculated for each patient before and after surgery. These data were compared by Student t test. Results: The mean follow-up was 10 months (range, 6-12 mo). Successful tympanic membrane grafting occurred in 21 patients (91.3%). Graft failure was seen in 2 patients. The mean preoperative ABG of the 23 patients was 19.3 (SD, 5.7) dB, and the postoperative ABG improved to a mean value of 8.2 (SD, 5.9) dB (P ≤ 0.0001). Conclusions: Octyl-2-cyanoacrylate is effective and safe in using as a compound on temporalis muscle fascia in type I tympanoplasty and can be used more widely in tympanoplasty.

Impact of smoking on p65 nuclear factor κB, p38 mitogen-activated protein kinase, and inducible nitric oxide synthase expression levels in oral mucosa.

Objectives Smoking plays an important role in oral cancer development; however, the molecular carcinogenesis mechanism in oral mucosa is not well understood. The aim of this study was to examine and compare the levels of p65 nuclear factor &kgr;B (NF-&kgr;B), p38 mitogen-activated protein kinase (MAPK), and inducible nitric oxide synthase (iNOS) expressions between oral mucosa of nonsmoker and smoker volunteers. Methods Oral cheek mucosa was collected from 78 volunteers. Smokers were divided into 2 subgroups: light smokers (<40 pack years) and heavy smokers (≥40 pack years). Paraffinized tissue immunochemistry was carried out for p65 NF-&kgr;B, p38 MAPK, and iNOS expression with specific antibodies. Results were evaluated based on diffuseness and intensity of staining. Results Group 1 composed of 40 nonsmokers: 52.5% were female and 47.5% were male, with a mean age of 46.4 years. Group 2 composed of 38 smokers (20 light smokers, 18 heavy smokers): 39.5% were female and 60.5% were male, with a mean age of 48.9 years. Total immunohistochemical staining scores of smokers were significantly higher compared with those of nonsmokers in p65 NF-&kgr;B, p38 MAPK, and iNOS expression (P < 0.001). The highest p65 NF-&kgr;B, p38 MAPK, and iNOS expression levels were detected in the oral mucosa of heavy smokers. The expression of iNOS and p65 NF-&kgr;B in heavy smokers was significantly higher compared to that in light smokers (P < 0.01 and P < 0.05, respectively). Although p38 MAPK expressions were higher in heavy smokers compared with light smokers, the difference was not statistically significant (P > 0.05). Conclusions Our results show for the first time the significant increase in the expression of p65 NF-&kgr;B and p38 MAPK in the oral mucosa of smokers. Levels of p65 NF-&kgr;B, p38 MAPK, and iNOS expression in the oral mucosa of smokers were related to the number of pack years.

Gürültülü Ortamda Çalışan İşçilerde Magnezyum ve Kortizol Düzeylerinin Karşılaştınlması

SuleymanDemirel Universitesi TIP FAKULTESI DERGISI: 1996 Eylul; 3(3) Gurultulu Ortamda Calisan Iscilerde Magnezyum ve Kortizol Duzeylerinin Karsilastinlmasi Ramazan Ozcankaya Namik Delibas Harun Dogru Orhan Gedikli Fatma Boz Ozet Bu calismanin amaci gurultunun psikolojik ve biyolojik etkilerini arastirmaktir. Bu amacla farkli gurultulu ortamlarda calisan iki grup iscide Hammilton Anksiyete olcegi skorlari, magnezyum ve kortizol duzeyleri calisildi. Iki farkli gurultu seviyesinde calisan iscilerde kan kortizol duzeyleri ve Hamilton anksiyete skorlari farkli bulundu. Ancak kan magnezyum ve anksiyete skorlari arasinda iliski bulunmadi. Sonuclar literatur isigi altinda tartisildi. Anahtar Kelimeler: Anksiyete, Magnezyum, Kortizol. Abstract Comparison of Magnesium and Cortisol Levels in Different Anxiety Degress in Workers At Noisy Environmet The aim ofthis study was to investigate some psychological and biological effects ofnoise. Hamilton Araciety Rating Scale (HARS) s cor es, magnesium and cortisol lwvels were studied in two groups of workers at different noisy compartments. it \vasfound that the blood cortiso, magnesium and HARS levels of two compartments with different noise levles vvere significantly different. Although there was no correlation between blood magnesium levels and HARS acores. Results were discussed under the light of literature. Key words: Amciety, Magnesium, Cortisol.

KBB ve Baş-Boyun Cerrahisinde Lokal Anestezi

SuleymanDemirel Universitesi TIP FAKULTESI DERGISI: 1995 Haziran; 2(2) KBB ve Bas-Boyun Cerrahisinde Lokal Anestezi Orhan Gedikli Harun Dogru Fehmi Doner Ali Dolgun Abdurrahman Arslan Ozet Lokal anestezi KBB ve Bas-Boyun Cerrahisinde oldukca sik kullanilmaktadir. Ancak lokal anestezik ilaclar olgulara, dozuna ve uygulama sekline dikkat edilmedigi takdirde olumle sonuclanabilecek komplikasyonlara neden olabilmektedirler. Bundan dolayi lokal anesteziklerin farmakolojik yapilari, dozajlari, komplikdsyonlari, komplikasyonlan onleyici tedbirleri ve tedavileri etraflica bilinmelidir. Bu makalede siklikla kullanilan lokal anestezikler gozden gecirilmistir. Anahtar Kelimeler: Lokal anestezi, bas-boyun cerrahisi. Abstract Local Anesthesia in ENT and Head and Neck Surgery Local anesthesia is widely used in ENT and head and neck surgery. But these drugs may befatal ifone does not pay attention to individual case, dose of the drug and application route. For this reason, pharmacologic properties, dosages, complications and precautions to avoid complications must be well known. in this paper, widely used local anesthetics ar e reviewed. Key Words: Local anesthesia, head and neck surgery.

Gürültüye Bağlı İşitme Kaybında Serum Lipid Düzeyleri

SuleymanDemirel Universitesi TIP FAKULTESI DERGISI: 1995 Aralik; 2(4) Gurultuye Bagli Isitme Kaybinda Serum Lipid Duzeyleri Namik Delibas Orhan Gedikli Harun Dogru Veysel Tahan Ozet Bu calismada isitme kaybi ile kan lipid duzeylerinin iliskisi arastirildi. Bu amacla bir iplik fabrikasinda 70-94 dB seviyeleri arasinda gurultuye maruz kalan 48 iscinin isitme esikleri odyolojik olarak tespit edildi. Gurultunun neden oldugu isitme kaybi (GNIK) olanlarla, normal isitme duzeylilerden (NID) iki grup olusturuldu. Her iki grupta da serum Trigliserid, Total Kolesterol, HDL-Kolesterol • ve LDL-Kolesterol duzeyleri olculdu ve gruplar karsilastirildi. GNIK grubunda, NID grubuna gore Trigliserid, Total Kolesterol ve LDL-Kolesterol duzeyleri anlamli bir sekilde yuksek (p<0.0l), HDL-Kolesterol duzeyleri ise dusuk (p<0.01) bulundu. Sonuc olarak kan lipid duzeylerinin gurultuye bagli isitme kaybini artirici bir faktor olabilecegi kanisina varildi. Anahtar Kelimeler: Isitme kaybi, gurultu, lipidler. Abstract Serum Lipid Levels of Persons with Noise Induced Hearing Loss in this study it \vas investigated whether the blood lipid levels affected noise induced hearing loss. For this purpose hearing thresholds of 48 workers which were exposed to noise levels between 70 and 94 dB in ayarn factory are established audiometrically. The workers were divided in two groups. Group I included vorkers with noise induced hearing loss (NIHL), group H included \vorkers with normal hearing levels (NHL). Serum Triglycerides, Total Cholesterol, HDL-Cholesterol and LDL-Cholesterol levels vere determined in both groups and compared to each other. Triglycerides, Total Cholesterol and HDL-Cholesterol levels were significantly higher (p<0.01), and LDL-Cholesterol levels \vere significantly lover (p<0.01) in group with NIHL than group with NHL. it ~was considered t hat blood lipid levels may be an important factor that increase noise induced hearing loss. Key Words: Hearing loss, noise, lipids.

Ani İşitme Kayıpları

Suleyman Demirel Universitesi TIP FAKULTESI DERGISI: 1995 Mart; 2(1) Ani Isitme Kayiplari Harun Dogru, Orhan Gedikli, Fehmi Doner, Murat Yariktas Ozet Ani isitme kayiplari cesitli ic kulak patolojilerine bagli olarak oldukca sik gorulen ve etiyopatogenezi tam olarak bilinmeyen bir durumdur. Cesitli tedavi metotlari olmakla beraber henuz tam olarak yerlesmis tedavi sekli yoktur. Bu makalede isitme kayiplari ve ozellikle tedavi metotlari ile ilgili literatur bilgileri sunuldu. Anahtar Kelimeler: Ani isitme kaybi, tedavi. Abstract Sudden Hearing Losses Sudden hearing losses are common disorders due to some inner-ear pathology with ethiopathagenesis which is not well-known. Although various treatment modalities are used, there is not a common concept. in this paper current literature and treatment modalities are presented. Key Words: Sudden hearing loss, treatment.