Browsing by Author "Songu M."

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    Inverted papilloma with new bone formation: Report of three cases
    (2007) Unlu H.H.; Songu M.; Ovali G.Y.; Nese N.
    Background: An inverted papilloma (IP) is a benign sinonasal tumor of ectodermal origin, which is locally aggressive and destructive, tends to recur if incompletely removed, and has significant malignant potential. On CT scan, the appearance of an IP is variable and nonspecific but most commonly it appears to have soft tissue density. The association of IPs and new bone formation is extremely rare; to the best of our knowledge, only one case has been reported in the literature to date. Methods: We report three cases with existence of bony mass surrounded by polypoid soft tissue diagnosed as IP histopathologically. Results: The nature, shape, and location of the bony mass were not in concordance with trapped bone, with tumoral calcifications, or with osteoma. Conclusion: We propose that with regard to the three cases presented here, new bone formation may be associated with IP pathologically. We also believe that additional investigations are required to characterize the pathophysiological mechanisms involved in neoplasm-induced osteogenesis. Copyright © 2007, OceanSide Publications, Inc.
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    Intracochlear hemorrhage after gamma knife radiosurgery
    (2007) Franco-Vidal V.; Songu M.; Blanchet H.; Barreau X.; Darrouzet V.
    PURPOSE: To describe an acute complication after gamma knife stereotactic radiosurgery (GKRS) for vestibular schwannoma (VS) in a neurofibromatosis type 2 (NF2) patient. STUDY DESIGN: Case report. SETTING: Tertiary care center. PATIENT: A 20-year-old man, who had bilateral VS and was having right-sided profound deafness, underwent GKRS for a 2-cm left-sided VS in an attempt to preserve his only hearing ear. He received a margin dose of 13 Gy to the 50% isodose line. Twenty-four hours after treatment, he presented with spinning vertigo, left-sided dead ear, and ipsilateral mild facial paralysis (House-Brackmann grade 3). RESULTS: Magnetic resonance imaging demonstrated an intracochlear hemorrhage at the level of the basal turn of the left cochlea. Hearing did not recover, and the patient had to resort to lip reading. The facial paralysis regressed completely after 3 months. CONCLUSION: Many cases of hemorrhage caused by GKRS have previously been reported, but all were related to meningiomas or brain metastases. Because the patient had no coagulation defect, sign of trauma, or any history of infection, the hemorrhage might have been caused by a direct thermal effect on the endothelial cells or to an immediate tumoral swelling, inducing an increase in intravascular outflow resistance and leading to venous obliteration. To our knowledge, this is the first report of acute intracochlear hemorrhage after GKRS for VS. © 2007 Otology & Neurotology, Inc.
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    Orbital exenteration: A dilemma in mucormycosis presented with orbital apex syndrome
    (2008) Songu M.; Unlu H.H.; Gunhan K.; Ilker S.S.; Nese N.
    Background: Mucormycosis is an uncommon, rapidly progressive, commonly fatal, opportunistic, fungal paranasal sinus infection. The most critical decision in the management of rhino-orbital mucormycosis is whether the orbit should be exenterated. The literature fails to provide a broad base of information of how physicians determine the need for exenteration in daily practice. The decision for exenteration often depends on the judgment of the treating otolaryngologist. The authors report their experience and outline that orbital exenteration may not be mandatory in all cases of rhino-orbital mucormycosis. Methods: The medical records from Celal Bayar University Medical Faculty Department of Otorhinolaryngology/Head and Neck Surgery were retrospectively searched from 1995 to 2007 for three cases with rhino-orbital mucormycosis, treated without orbital exenteration. Results: All patients with rhino-orbital mucormycosis who were treated without exenteration survived. Conclusion: The favorable outcome was attributable to rapid correction of the underlying medical condition; wide local excision and debridement of all involved and devitalized sinonasal and periorbital tissue, while establishing adequate sinus and orbital drainage; daily endoscopic assessment with multiple sinus debridement when necessary; daily irrigation of the involved areas; and high-dose i.v. amphotericin B. Copyright © 2008, OceanSide Publications, Inc.
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    Effect of CPAP therapy on catathrenia and OSA: A case report and review of the literature
    (2008) Songu M.; Yilmaz H.; Yuceturk A.V.; Gunhan K.; Ince A.; Bayturan O.
    Introduction: Catathrenia is a rare, idiopathic, sleep-related respiratory condition characterized by irregular groans, which occur during prolonged expiration in sleep. The origins of catathrenia remain inexplicable, the long-term prognosis unexplained. Moreover, empirical treatment with neither pharmacological nor non-pharmacological approaches was satisfactory. Case report: We report a case of catathrenia with concurrent obstructive sleep apnea complicated with pulmonary hypertension and reviewed the literature. Discussion: Treatment with nasal continuous positive airway pressure resulted in marked improvement of catathrenia, obstructive sleep apnea, daytime dyspnea, and pulmonary hypertension for our patient. We think that nasal continuous positive airway pressure can be an option for the treatment of this infrequent but sometimes very disturbing sleep disorder. © Springer-Verlag 2008.
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    Neural control of Eustachian tube function
    (2009) Songu M.; Aslan A.; Unlu H.H.; Celik O.
    Objectives/Hypothesis: It has been hypothesized that middle ear pressure can be controlled by the Eustachian tube through a neuronal reflex arc in animal models. We aimed to define the role of the neuronal control mechanisms in regulating middle ear pressure in humans. Study Design: Prospective study. Methods: The study population consisted of 95 ears of 95 volunteers. The mechanoreceptors on the tympanic membrane and the baroreceptors in the middle ear, which are assumed to form the afferent plexus of the neuronal reflex arc, were blocked by topical administration of lidocaine hydrochloride, in various patient groups. The Eustachian tube functions forming the efferent plexus of the neuronal reflex arc were evaluated by manometric tests both before and after blocking the possible afferent plexus in each study group. Results: The baroreceptors established in the tympanic plexus might possibly have an effective role in this mechanism where the mechanoreceptors on the tympanic membrane seem to have a minor effect. Conclusions: Neuronal control mechanism could play an important role in regulating Eustachian tube function in humans. © 2009 The American Laryngological, Rhinological and Otological Society, Inc.
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    Long-term results in endoscopic dacryocystorhinostomy: Is intubation really required?
    (2009) Unlu H.H.; Gunhan K.; Baser E.F.; Songu M.
    Objective: The long-term (median follow-up eight years) results of endoscopic dacryocystorhinostomy approach and silicone intubation were evaluated by various aspects. Study Design: Case series with planned data collection of 38 procedures for postsaccal stenosis were analyzed. Subjects and Methods: Silicone intubation was not used in 19 of the randomly selected procedures. Anatomical and functional surgical success was evaluated subjectively and objectively. Results: The patients' complaints improved in 84.2 percent of eyes in the intubation group, and in 94.7 percent of the group without intubation, with a mean follow-up of 112 and 96 months after surgery, respectively. Postoperative endoscopic examinations revealed that the rhinostomy opening was visible in 17 sides with intubation (89.5%) and 18 sides without intubation (94.7%). Conclusions: Considering the similar surgical success rates, and disadvantageous factors such as granulation formation, patient discomfort, and cost related to intubation, we recommend endoscopic dacryocystorhinostomy without intubation as the treatment of choice in cases of chronic epiphora due to postsaccal stenosis of the lacrimal drainage system. © 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation.
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    Seawater gel in allergic rhinitis: Entrapment effect and mucociliary clearance compared with saline
    (2010) Cingi C.; Halis Unlu H.; Songu M.; Yalcin S.; Topcu I.; Cakli H.; Bal C.
    Objective: We performed a prospective study to investigate the the efficacy of seawater gel in reducing symptoms in patients with mild allergic rhinitis. We also aimed to investigate the impact of nasal irrigation on mucociliary clearance with seawater gel compared with saline in this patient group. Methods: The study was performed in 100 consecutive adult individuals with a history of allergic rhinitis that was not controlled by anti-allergic drugs. Patients were assigned to receive seawater gel nasal spray for 10 days. The efficacy of treatment was assessed by means of total nasal symptom score and clinical findings. Results: A statistically significant difference was found between scores of ‘nasal discharge, nasal obstruction, sneezing, nasal itching—before and after treatment (p < 0.001). Clinical findings evaluation revealed a statistically significant decrease in lower turbinate colour rating and turbinate congestion at the end of treatment (p< 0.001). Saccharin transit time decreased from baseline in the seawater trials by 12% compared with a 4% decrease for saline. The difference between the percent changes was statistically significant (t = 2.177; p < 0.05). Conclusions: The present study provides evidence that a four times daily regimen of seawater gel can be an adjunctive therapy in the patient with allergic rhinitis. © 2010, SAGE Publications. All rights reserved.
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    Intranasal steroids or radiofrequency turbinoplasty in persistent allergic rhinitis: Effects on quality of life and objective parameters
    (2011) Gunhan K.; Unlu H.; Yuceturk A.V.; Songu M.
    Nasal congestion is a cardinal symptom of allergic rhinitis (AR). It is associated with decreased quality of life and difficult to treat as perceived by the patients. The purpose of this study is to evaluate the mid-term objective and subjective outcomes of management of nasal congestion using intranasal steroid (INS) therapy or radiofrequency turbinoplasty (RFT) in patients with persistent AR who have mucosal hypertrophy of the inferior turbinate. Fifty-five adult patients with AR, who claimed nasal congestion refractory to oral antihistamine (desloratadine) therapy, were randomized to INS (mometasone furoate) or temperature-controlled RFT treatment groups. Outcomes were determined by active anterior rhinomanometry, visual analog scale (VAS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) at least 12 months after treatment. The median total nasal resistance decreased from 0.49 ± 0.17 to 0.39 ± 0.12 Pa/cm3/s (p = 0.42), and from 0.51 ± 0.18 to 0.29 ± 0.07 Pa/cm3/s (p = 0.003) with INS and RFT, respectively. RFT provided a better reduction in the perception of congestion in VAS scores. RQLQ scores improved significantly in both groups 1 year after treatment (mean follow-up 14.2 months) (p < 0.05). No adverse reactions were encountered in either group. Nasal congestion refractory to antihistamine appears to be improved by INS at some point, while reduced significantly by RFT in objective and subjective parameters. Both options are also effective in increasing the quality of life in patients with AR. RFT might be a safe and effective treatment of option in AR compared with INS. © 2010 Springer-Verlag.
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    Spectrum of symptoms in motion sickness
    (2012) Aslan G.G.; Songu M.; Aslan A.
    Objective: To search and report extraordinary symptoms of motion sickness (MS) which have not been classically described. Study Design: Prospective study. Setting: Tertiary referral center + state hospital Patients: Thiry-four MS patients were included in the study. Of these, 32 were female and 2 were male. Intervention(s): No Main Outcome Measures: All patients were asked to fillout a questionaire by face to face conversation for their symptoms. Severity of MS symptoms in general were assessed by visual analog scale. In addition, factors precipitating MS symptoms were also searched. Results: All patients reported to have nausea. In addition to classical knowledge, atypical symptoms decleared by the patients were intolerance to smell, feeling of nausea in the head, intolerance to sound and difficulty in concentrating on conversation. Average VAS score for severity of MS symptoms was found to be 7.3. Relaxing of the symptoms when the eyes were closed was noted as an important feature. Sixteen (47%) reported no symptoms of MS while driving a car. The most important factors leading to the beginning of MS symptoms were curving road, reading, head movements, talking, and the smell of gasoline, respectively. Conclusion: The clinical picture of acute MS may include the symptoms other than the classical symptoms like dizziness, nausea, pallor, cold sweating etc. © 2005 The Mediterranean Society of Otology and Audiology.
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    Effects of oral intake of cetirizine HCl and desloratadine molecules on the middle ear mucosa: An experimental animal study
    (Springer Verlag, 2014) Songu M.; Ozkul Y.; Kirtay S.; Arslanoglu S.; Ozkut M.; Inan S.; Onal K.
    We have planned to demonstrate histopathologic effects of mid- or long-term oral use of desloratadine and cetirizine HCl molecules on middle ear mucosa of rats. Thirty-six rats were randomized equally into six groups. Desloratadine groups received once daily doses of 1 mg/ml desloratadine for 30 (D30 Group) or 60 (D60 Group) days. The Cetirizine study groups were given once daily doses of 1 mg/ml cetirizine for 30 (S30 Group) or 60 (S60 Group) days. Control groups were given 2 cc physiologic saline using orogastric gavage method through a 12 G gavage catheter for 30 (K30 Group) or 60 (K60) days. At the end of 30 days, D30, S30 and K30 Groups were sacrificed. Tissue samples harvested from groups were evaluated between 1 and 4 Grades for histological characteristics of middle ear canal, eardrum, middle ear epithelium and connective tissue, edema, vascular congestion and inflammatory cells. In the control group no pathological finding was encountered in rats sacrificed on 30 and 60 days. No statistical difference was observed when groups were compared on external ear epithelial tissue, external ear sebaceous gland, middle ear inflammation, and middle ear capillary dilatation both on 30 and 60 days. Tympanic membrane collagen was more evident in D30 and D60 groups when compared with C30 and C60 groups. Comparison of histopathological grading results between 30 and 60 days revealed no significant changes. In conclusion, oral intake of cetirizine and desloratadine preparations has effects of tympanic membrane collagen, degrees of edema and vascular congestion being more prominent with desloratadine molecule. © 2014 Springer-Verlag.