Browsing by Author "Yücetürk A.V."
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Item The evaluation of eustachian tube function in patients with chronic otitis media(Blackwell Publishing Ltd, 1997) Yücetürk A.V.; Ünlü H.H.; Okumu̧ M.; Yildiz T.; Fïlïz Ü.In this study we evaluated eustachian tube function in patients with chronic otitis media and compared the results with normal subjects. Two different eustachian tube function tests were applied to 60 ears of the chronic otitis media group and 146 ears of the control group. While eustachian tube dysfunction was observed in 71.7% of the chronic suppurative otitis media group, it was only seen in 34.9% of the control group.Item Anatomical guidelines for intranasal surgery of the lacrimal drainage system(1997) Ünlü H.H.; Gövsa F.; Mutlu C.; Yücetürk A.V.; Şenyilmaz Y.To facilitate identification of the nasolacrimal duct during intranasal surgery, we have determined the distances between the lacrimal drainage system and certain anatomical structures on the lateral wall of the nasal cavity. A total of 15 adult cadaver skulls were bisected mid-sagittally and evaluated morphometrically. In our specimens, the average distance from the natural ostium of the maxillary sinus to the nasolacrimal duct (NLD) was only 5.5 min. This rather small distance should be taken into consideration, in order to prevent trauma of the NLD during surgical enlargement of the ostium of the maxillary sinus. The distances from NLD to the anterior surface of the bulla ethmoidalis, the free edge of the uncinate process and the attachment point of the middle turbinate on the lateral nasal wall were found to be 10.2 mm, 8.8 mm and 5.4 mm, respectively. Taking these distances into account, easy identification of the NLD during endonasal dacryocystorhinostomy surgery will be possible.Item Evaluation of intraocular pressure and cataract formation following the long-term use of nasal corticosteroids(Medquest Communications LLC, 1998) Öztürk F.; Yücetürk A.V.; Kurt E.; Ünlü H.H.; Ilker S.S.It is possible that corticosteroids administered via nasal spray might reach ocular structures in levels sufficient to provoke an ocular hypertensive response and cause posterior subcapsular cataracts (PSCs) in susceptible individuals. In the present study, 26 patients who had undergone endoscopic sinus surgery were evaluated prospectively with respect to intraocular pressure and PSC formation following the use of nasal steroids for at least three months. Eighteen patients (69%) self-administered 200 μg/day of budesonide nasal spray twice daily, and eight patients (31%) self- administered 200 μg/day of beclomethasone dipropionate nasal spray twice daily, for a period of three to 19 months (mean 8.8 ± 3.6 months). Ophthalmologic examination, tonometry, visual field testing and biomicroscopic studies revealed no evidence of ocular hypertension or PSCs during postoperative follow-up. We conclude that intranasal corticosteroids can be used safely for prolonged periods without increasing the risk of ocular hypertension or PSCs.Item The management of glottic and supraglottic cancers of the larynx in relation to neck metastasis.(2003) Yücetürk A.V.; Celik O.; Eskiizmir G.OBJECTIVES: We evaluated the management of glottic and supraglottic laryngeal cancers in relation to neck metastasis. PATIENTS AND METHODS: Fifty-two patients (51 males, 1 female; mean age 59.2 years; range 27 to 82 years) underwent surgery for primary laryngeal cancers. Preoperative and postoperative TNM classification and staging were made according to the AJCC 1997 criteria. The mean follow-up period was 39.4 months (range 6 to 74 months). RESULTS: The tumors were glottic in 31 patients and supraglottic in 21 patients. Laryngectomies were partial in 34 patients and total in 18 patients. All the patients with supraglottic tumors and those with glottic T2-4 tumors underwent neck dissection, as well. Radiotherapy was administered to 22 patients with established N2 or N3 tumors. Clinical assessment was in agreement with the pathological result in 63.5%; 13.5% and 23.1% of cases were underdiagnosed and overdiagnosed, respectively. The rates of neck metastasis were 0% in T1, 25% in T2, 75% in T3, and 66.7% in T4 supraglottic tumors. The corresponding rates for glottic cancers were 0%, 16.7%, 28.6%, and 60%, respectively. The overall rate of N+ tumors was 28.9%. Four patients (7.7%) developed local, two patients (3.9%) developed regional recurrences. Mortality occurred in eight patients (15.4%) due to following causes: laryngeal recurrence (T4N2, T4N2, T3N1), regional recurrence (T4N2), a second primary malignancy in one patient, and other causes in three patients. Five- and two-year disease-specific survival rates (Kaplan-Meier analysis) were 90.7%, and overall survival rates were 73.7% and 87.3%, respectively. CONCLUSION: Neck metastasis and advanced stage of the tumor were the most effective prognostic factors.Item Supracricoid laryngectomy: oncological and functional outcome.(2004) Yücetürk A.V.; Günhan K.OBJECTIVES: The aim of this study was to evaluate the oncological outcome and postoperative course, mortality, morbidity, and functional results of supracricoid laryngectomy (SCL). PATIENTS AND METHODS: The study included 15 consecutive patients who underwent SCL for primary laryngeal squamous cell carcinoma and had a follow-up period of more than two years. Unilateral arytenoidectomy was required in seven of the SCLs. All of the patients with supraglottic tumors and the patients with glottic T2-3 tumors underwent neck dissection in the same session with SCL. Adjuvant radiotherapy was applied in two patients with pN2 and pN3, respectively. RESULTS: The mean time for starting oral feeding was 6 days (range 3-10 days) and the time for adequate oral taking was 12.5 days (range 7-25 days). Nasogastric tube was removed between the seventh and 49th postoperative days (mean 15.7 days). All the patients were decannulated successfully in 10 to 38 days (mean 18 days) and had a satisfactory swallowing, a well-understood speech, and an intelligible voice quality. The hospitalization period was 12 to 46 days (mean 23.4 days). The durations of adequate oral feeding, nasogastric tube removal, decannulation, and hospitalization were longer in patients with one arytenoid preserved than those with bilateral arytenoids preserved, but the difference was not statistically significant. Postoperative complications were observed in three patients. Wound infection was found in two patients in the early postoperative period. One patient with a T3 supraglottic tumor that involved the medial wall of the pyriform sinus developed aspiration pneumonia twice in six months after the first operation. This patient underwent total laryngectomy seven months after the first operation. Recurrences and mortality did not occur in the follow-up period. The mean follow-up of the patients was 50.3 months (range 26-80 months). CONCLUSION: Supracricoid laryngectomy has obvious functional advantages over total laryngectomy with similar local control rates.Item Multidimensional assessment of voice and speech after supracricoid laryngectomy with cricohyoidopexy(2004) Yücetürk A.V.; Günhan K.This study was designed: to evaluate the vocal function in the patients with supracricoid laryngectomy (SCL) compared with normal subjects; to determine the factors affecting voice (such as number of arytenoid(s) preserved and movement of larynx and tongue base); and to determine the correlations between videolaryngostroboscopy, acoustic and perceptual parameters. Ten patients who underwent SCL with cricohyoidopexy for primary laryngeal squamous cell carcinoma were included into the study. Vocal function was investigated by means or videolaryngostroboscopy. Voice quality was assessed by means of objective acoustic analysis and subjective perceptual ratings by trained raters. Aberrant, incompetent, and rough mucosal wave was observed in the anterior and superior surfaces of arytenoids(s), the inferior part of tongue base and the lateral walls of the hypopharynx. The acoustic parameters were found to be significantly different from those of normal subjects. The values of perceptual scores were approximately within 50 per cent of normal range. The number of arytenoids spared did not affect acoustic or perceptual measurements. A rough, breathy, unpleasant but intelligible and acceptable voice could be obtained after SCL with cricohyoidopexy.Item Rhinocerebral mucormycosis: Perineural spread via the trigeminal nerve(2005) Orguc S.; Yücetürk A.V.; Demir M.A.; Goktan C.We report a case of rhinocerebral mucormycosis associated with an abscess in the lateral aspect of the pons associated with perineural spread of disease via the trigeminal nerve. Contrast enhanced MRI was useful in depicting the extent of the disease and suggesting perineural spread. A pathological diagnosis of mucormycosis was established by means of rhino-orbital punch biopsy. © 2005 Elsevier Ltd. All rights reserved.Item Videofluoroscopic evaluation of the swallowing function after supracricoid laryngectomy(2005) Yücetürk A.V.; Tarhan S.; Günhan K.; Pabuşçu Y.This study was designed to evaluate the swallowing function in patients with supracricoid laryngectomy (SCL) compared to normal subjects and to search for the factors affecting postoperative aspiration. Ten patients who underwent SCL with cricohyoidopexy (CHP) for primary laryngeal squamous cell carcinoma were included in the study. The control group consisted of 13 normal adult volunteer men with similar ages. The swallowing act of the subjects was evaluated by using videofluoroscopy (VFS) and videolaryngostroboscopy (VLS). The movements of the larynx were measured with regard to the hyoid bone, mandible and vertebral spine. The patients with SCL-CHP, except for two who had slight aspiration, had effective and near normal swallowing regarding the measurements of the movements of the hyoid bone. They could tolerate a near-normal oral diet. We have observed that the preventive precautions for aspiration are preserving the superior laryngeal nerves, suturing and positioning the cricoarytenoid unit as anterosuperiorly as possible, early decannulation and early onset of swallowing rehabilitation; the risk factors for aspiration are advanced stage of cancer, postoperative radiation and shortening of bolus transit time. VFS is useful for the patients with postoperative aspiration, because it is the definitive technique for anatomical and physiological evaluation of swallowing. We consider that the parameters of VLS and VFS, such as tongue base-arytenoid contact, presence of bolus splitting, pseudoepiglottis function, maximal opening of the pharyngoeosophageal sphincter and total movement of hyoid bone are important criteria to evaluate swallowing. © Springer-Verlag 2004.Item Changes in growth pattern, body composition and biochemical markers of growth after adenotonsillectomy in prepubertal children(2005) Ersoy B.; Yücetürk A.V.; Taneli F.; Ürk V.; Uyanik B.S.Objective: Adenotonsillar hypertrophy (ATH) is associated with growth interruption during childhood. The aim of this study was to determine the changes in growth, body composition and biochemical markers associated with growth following adenotonsillectomy (A&T) in prepubertal children. Study design: Twenty-eight children aged 3-10 years (mean age 73.90 ± 20.97 months) with ATH were followed up for 1 year after A&T. During the same period of time, 20 healthy children of similar ages (mean age 73.7 ± 18.2 months) were followed up too. Methods: Height, weight as well as insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) were measured during the preoperative period, 6 months and 1 year after surgery. Results: Height and weight of the patient group significantly increased during the first year after A&T (p < 0.01). Increase in height standard deviation score (SDS) during the first postoperative year reflected a true acceleration of growth (p = 0.04). Height and weight of patients were not significantly below those of their healthy peers at the preoperative measurement. Height velocity of the patients (p = 0.118), which was similar to that of their healthy peers in the first 6 months postoperatively, was significantly higher at the end of the second 6-month period after the operation (p = 0.048). IGF-1 levels of the patient group, which were significantly lower than those of the controls preoperatively (p < 0.001), increased to similar levels 1 year after the operation. IGFBP-3 levels of the patient group increased significantly after postoperative sixth month (p = 0.002). Conclusion: Although children with ATH do not have significant growth retardation, their growth rate is slower. Increase in weight and IGF-1 levels followed by the increase in height leads to an acceleration in growth rate after A&T. These results have led to the conclusion that either the levels or effect of growth hormone (GH) increase following A&T. © 2005 Elsevier Ireland Ltd. All rights reserved.Item A child with cervical Castleman's disease mimicking nasofaringeal carcinoma: Case report; [Nazofarenks karsinomunu taklit eden servikal Castleman hastaliǧi tanili bir çocuk olgu](2010) Neşe N.; Özgüven A.A.; Onaǧ A.; Yücetürk A.V.Castleman's disease (CD) is an uncommon benign disease that causes progressive lymph node enlargement. Most observations of CD have focused on adult patients and it rarely occurs in children. It usually arises as a solitary mass and is commonly found in the mediastinum and abdomen and less commonly in the head, neck and axilla.The diagnosis of CD is histopathological. We report a child of CD in the neck region who also had a mass at the nasopharenx mimicking nasofaringeal carcinoma and review the published child cases with CD that involved neck region. This report emphasizes that CD should be considered in the differential diagnosis of children presented with neck mass. Copyright © 2010 by Türkiye Klinikleri.Item Acute spiral ganglion cell degeneration following acoustic overstimulation: An experimental study(2011) Eskiizmir G.; Yücetürk A.V.; Inan S.; Gürgen S.G.Background: To evaluate acoustic overstimulation-induced spiral ganglion cell (SGC) degeneration, and determine the relationship between the duration of acoustic overstimulation and rate of SGC degeneration. Methods: Fifteen guinea pigs were randomized equally to 4 experimental groups, which were exposed to different durations (7.5, 15, 30 and 60 min) of acoustic overstimulation (120 dB at 4 kHz), and a control group. Every bulla was examined histopathologically and immunohistochemically. A quantitative and statistical analysis of acidophilic and TUNEL-positive SGCs was performed. Results: In the control group, 2.1% of SGCs were acidophilic and no TUNEL-positive SGC was detected. In contrast, a statistically significant number of acidophilic (p = 0.000) and TUNEL-positive SGCs (p = 0.002) was determined in the experimental groups. Moreover, a positive correlation between the duration of acoustic overstimulation and acidophilic SGCs (p = 0.000), and a statistically significant relationship between the duration of acoustic overstimulation and TUNEL-positive SGCs (p = 0.000) were demonstrated. Conclusion: Acoustic overstimulation may induce acute SGC degeneration. A positive correlation was determined between the duration of acoustic overstimulation and rate of degenerated SGCs. Copyright © 2010 S. Karger AG, Basel.