Browsing by Author "Mutlu, C"

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    Surgical implications of anatomical landmarks on the lateral surface of the mastoid bone
    Aslan, A; Mutlu, C; Celik, O; Govsa, F; Ozgur, T; Egrilmez, M
    The aim of this study was to examine the relationships of the surgical landmarks on the lateral surface of the mastoid bone with the landmarks in a deeper location. Simple mastoidectomy was carried out without drilling over the linea temporalis inferior (LTI) on 20 adult temporal bones. The suprameatal spine, i.e., Henle spine (HS), variants were noted. Morphometric measurements were performed between these surgical landmarks, and their variations with pneumatization or HS types were evaluated. Three types of HS were identified: triangular, crest, absent. The HS-lateral semicircular canal distance was 15 mm on average and longer in bones with a triangular HS than a crest type HS (16.4 vs. 14.3 mm). The LTI was found to be located on average 4.7 mm inferior to the middle fossa dural plate (MFD). The LTI-MFD distance had a tendency to be longer in bones without an HS than with a crest type of HS (5.9 vs. 3.9 mm). Chorda tympani emerged from the facial nerve at the stylomastoid foramen in five specimens (25%). This anatomical organization was not correlated with the type of HS. Korner's septum (KS) was identified in nine bones (45%). It was present in eight of 16 (50%) bones with good pneumatization. No tendency for the existence of KS was found for any specific type of HS. This study confirms that the mastoid antrum is located 15 mm deep to the lateral surface of the mastoid bone. It should be expected to be longer in bones with a triangular HS. In addition, the MFD is located on average 5 mm above the LTI, which could be useful information for beginners or inexperienced surgeons. The ear surgeon should anticipate that the MFD might be longer in bones without an HS.
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    Organized hematoma of the maxillary sinus mimicking tumor
    Unlu, HH; Mutlu, C; Ayhan, S; Tarhan, S
    The authors present two cases of organized hematoma of the maxillary sinus. Both patients showed no bleeding abnormalities. Clinical symptoms, signs and radiologic appearance of the mass mimicked tumor during the initial diagnosis of the disease. To our knowledge, this is the first article describing organized hematoma in the maxillary sinus mimicking tumor without bleeding history and disorders. A provisional diagnosis of organized hematoma should be considered when a patient with history of epistaxis develops a slow-growing mass of the cheek and/or nasal obstruction. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
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    Radiologic anatomy of the sphenoid sinus for intranasal surgery
    Mutlu, C; Unlu, HH; Goktan, C; Tarhan, S; Egrilmez, M
    Endoscopic surgery of the sphenoid sinus can present the operator with a considerable challenge. The relationship of the sphenoid sinuses, in particular on the lateral wall, to the carotid artery, optic nerve, as well as the other anatomic structures, is of utmost importance. Surgical complications can occur because of a lack of orientation during dissection. To avoid the complications or lessen, somehow, the rate of complications, some described the technique consisting of the opening of the sphenoid sinus ostium medially. Me studied 69 axial high resolution computed tomography (HRCT) of temporal bones to reveal the relationship of sphenoid sinus to the vital structures and to get some measurements in the sphenoid sinus. The lateral distance from the sphenoid ostium revealed that the lateral distance was about the distance between both ostea. We consider that in selected cases the dissection might be carried out laterally from the sphenoid ostium for safe enlargement of the ostium and approaching the sinus.
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    Histopathologic findings of acoustic neuromas (from the temporal bone collection at the University of Minnesota)
    Mutlu, C; Mancini, F; da Costa, S; Paparella, MM; Schachern, PA
    Objective: To describe the diverse histopathological findings of acoustic neuroma (AN) cases including: nerve origin, microscopic characteristics of the tumor, status of facial and cochlear nerves, changes of cochlear and vestibular structures, and associated pathologies. Design: From the 1700 temporal bones at the University of Minnesota, we selected temporal bones from patients with AN. Clinical charts were reviewed, and temporal bones which had been previously sectioned and stained with hematoxylin and eosin were examined using light microscopy. Subjects: Of the 1700 temporal bones, 13 temporal bones from 13 patients had histopathologic evidence of AN. The ages of the patients ranged from 44 to 86 years (mean age 69.61). Eleven (84.6%) of the temporal bones were from males and two (15.4%) from females. The left temporal bone was affected in 10 patients and the right in 3. Results: Audiograms were available in 6 cases, four had high frequency sensorineural hearing loss, one had profound sensorineural hearing loss at all frequencies, and one had total hearing loss. The origin of the tumor was the vestibular nerve in ten temporal bones (seven bones from superior vestibular nerve and three bones from inferior vestibular nerve) and the cochlear nerve in two temporal bones. Since one patient was surgically treated, only residual tumor was detected extrameatally. It was therefore not possible to determine the origin of the tumor. Microscopic characteristics of the tumors were Antoni type A in 12 temporal bones, and Antoni type B in one. The intracanalicular tumor length ranged in from 1.00 mm to 14.40 mm and the width from 0.55 mm to 7.00 mm. Although the origin of the tumor was determined as coming from the superior or inferior vestibular nerve, in most cases both nerves were affected; either invaded or compressed by the involved nerve. Cochlear nerves were generally compressed by tumors and had a ribbon-like appearance. In one temporal bone a facial neuroma in the internal auditory meatus was found with AN, and in other temporal bone several differ-ent middle and inner ear pathologies such as cholestatoma, cholestreol granulaoma, otosclerosis, and Scheibe's dysplasia were also detected. Most of the temporal bones showed well-preserved vestibular structures, but the cochlear structures contained artifactual changes from processing and a decrease in spiral ganglion cells in the basal turn. Conclusions: In a patient who presents with sensorineural hearing loss, we should consider the possibility of AN. However, in a patient who presents with facial weakness or paralysis, the possibility of a combination of AN and facial neuroma should be considered. Furthermore because the cochlear nerve can be compressed or deformed special car-e must be taken during the dissection of the tumor.
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    Facial growth after middle turbinate resection: An experimental study in the rabbit
    Egrilmez, M; Mutlu, C; Unlu, HH; Celik, O
    Background: The aim of this study was to determine the effects of total middle turbinate resection on midfacial growth through a morphometric analysis on an animal model. Methods: Twenty eight male New Zealand white rabbits were used. The animals were divided into three groups: group 1, elevation and relocation Of the nasal bone was performed; group 2, concha resection was performed: group 3, control group with no surgical procedure. The surgery was done at 8-10 weeks of age and the skull of each subject was sampled as they reached maturity. The determined distances then were measured by using landmarks identified oil skull. The supplied data were evaluated by using the Mann-Whitney U test. Results: Deviation of the nasal axis to the opposite side of the resected concha and an increase in the width of nasal bone were observed only in group 2. In group 1, all increase nasal bone length and zygomaticonasal distances was determined ill both the operated and the unoperated sides of nasal bones. Conclusion: This animal experiment showed that operations on the nasal bone or concha resection affected the midfacial growth ill rabbits. The effects of middle turbinate resection to midfacial development should be evaluated by additional studies. Vile recommend only limited, conservative surgical procedures 017 the middle turbinate. saving all the vital mucosa, periosteum. and bone.
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    Purulent otitis media in children and adults
    Tekin, M; Schachern, PA; Mutlu, C; Jaisinghani, VJ; Paparella, MM; Le, CT
    This study was designed to compare tympanic membrane (TM) and middle ear (ME) pathologies of temporal bones from children and adults with purulent otitis media (POM). Thirty-four temporal bones were used from 22 subjects ages 2 days to 76 years with histopathologic evidence of POM. There were 55 age-matched controls. Histopathologic findings of the TM and ME in children and adults with POM were compared. Clinical histories and the presence of complications were recorded. The incidence of POM was more common in male children than in females. There was a significant increase in the thickness of the posterosuperior and posteroinferior quadrants in children with POM compared to non-OM children. In adults with POM, there was a significant decrease in the thickness of the posteroinferior and anteroinferior quadrants compared to non-OM adults. Children with POM showed a significant increase in the anterioinferior and posteroinferior quadrants and the umbo compared to adults with POM. Pathology of the TM and ME occurred in adults and children, but severity was greater in children. Residual mesenchyme was frequently observed in temporal bones of children. Serious complications such as labyrinthtis and meningitis were observed more frequently in children. All cases with meningitis had labyrinthitis, previous histories of otitis media and had been treated with antibiotics. Although POM occurs in both children and adults, pathologic changes of the middle ear are more severe, and complications (labyrinthitis and meningitis) occur more often in children. Our findings suggest the need to monitor children carefully under the age of 2 years who have POM.
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    Congenital malformations of middle and inner ears of parabiotic twins
    Mutlu, C; Djeric, DR; Paparella, MM; Schachern, PA; Fulton, S
    We describe herein the congenital malformations of the middle and inner ears in temporal bones of parabiotic, monozygotic twins. Temporal bones were removed from twin B, who had no fetal cardiac activity and was born dead at 23-4/7 weeks, and twin A, the donor or pump twin in intrauterine life, who died shortly after birth at 20-6/7 weeks. The temporal bones were processed routinely in celoidin, stained with hematoxylin and eosin, and examined by light microscopy. We found that twin B had Mondini's dysplasia with associated deformities of the middle ear and in general showed more developmental anomalies than twin A, and we conclude that Mondini's dysplasia with anomalies of the middle ear may occur in the parabiotic twin syndrome, and the abnormalities may be explainable as the result of vascular disturbance, which also causes other lesions in these unusual cases.
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    A new diagnostic approach for Turkish speaking populations DAWBA Turkish Version
    Dursun, OB; Guvenir, T; Aras, S; Ergin, C; Mutlu, C; Baydur, H; Ozbek, A; Ozek, H; Alsen, S; Iscanli, L; Karaman, BI; Goodman, R
    Aims. Turkey has the youngest population in Europe with about 25 million people aged below 19 years and Turkish-speaking people comprise the biggest migrant group in Europe with 2.5 million people dispersed in different countries, but conducting epidemiologic surveys on Turkish people is challenging due to the lack of a suitable diagnostic tool. The Development and Well-Being Assessment (DAWBA) is one of the most widely used diagnostic interviews in child and adolescent psychiatry. In this study, we aimed at translating the DAWBA into Turkish and then examined its validity and reliability. Methods. The validity of the Turkish version was examined in clinical (n = 50) and community (n = 104) samples. The interrater reliability was also evaluated on 20 cases. Results. The translation method used in the study achieved semantic, conceptual, content, technical, item and criterion equivalence between the Turkish and original forms. The validity of the Turkish DAWBA was good or excellent for different diagnostic categories (kappa: 0.43-0.84); the interrater reliability was also excellent (kappa: 0.85-1). Conclusions. The Turkish DAWBA may be useful for future prevalence studies in Turkey. European clinicians and researchers who work with Turkish-speaking families can use the online Turkish DAWBA to gather structured information from Turkish-speaking informants and review the answers in their own language.
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    Functional outcome in late adolescence/early adulthood of patients with autism spectrum disorderresand its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study
    Kutuk, MO; Tufan, AE; Kilicaslan, F; Vural, P; Gokcen, C; Guney, SA; Kutuk, B; Ozyurt, G; Inal, N; Multer, T; Acikalin, EY; Ozer, FH; Pamuk, EN; Yesilmese, SC; Karadag, M; Hangul, Z; Bilginer, C; Sahin, N; Bilac, O; Kandemir, H; Ercan, ES; Soylemez, TE; Acikel, SB; Aksu, GG; Dag, P; Toros, F; Mutlu, C; Kardas, O; Kardas, B; Kizildag, S; Demirci, E; Ozmen, S; Sevicin, L; Karagoz, YS; Isik, U; Aktepe, E; Altun, H; Yektas, Ç; Tuysuz, BP; Buber, A; Cansiz, MA; Ogutlu, H; Eray, S; Taner, HA; Altintas, E; Kutuk, O
    The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported good or very good outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/ hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.
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    The variational anatomy of the external aperture of the human vestibular aqueduct
    Mutlu, C; Govsa, F; Unlu, HH; Senyilmaz, Y
    A study was undertaken to demonstrate the variational anatomy of the external aperture of the vestibular aqueduct in 90 human temporal bones obtained from 58 cadavers, Topographic landmarks of the posterior surface of the petrous bone are useful for general orientation and include the external aperture of the vestibular aqueduct, internal auditory meatus, sigmoid sinus, subarcuate fossa, superior petrosal sinus and cochlear canaliculus. We determined the mean distances from the external aperture of vestibular aqueduct to the above structures to be 10.98, 11.21, 9.42, 10.27 and 13.90 mm, respectively. Furthermore, the length of the external aperture of the vestibular aqueduct revealed significant differences between the right and left sides. The distances between the EAVA and certain anatomical structures on the posterior surface of the temporal bone should be taken into consideration during surgery. Knowing the variability of the position of the external aperture of the vestibular aqueduct may help surgeons avoid traumatizing, and thus producing inadvertent lesions to the hearing mechanism.