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Öğe Acoustic parameter changes after bariatric surgery(Taylor & Francis Ltd, 2022) Eravci, Fakih Cihat; Yildiz, Baris Dogu; Ozcan, Kursat Murat; Moran, Munevver; Colak, Mustafa; Karakurt, Suleyman Emre; Karakus, Mehmet FatihObjective To investigate the acoustic parameter changes after weight loss in bariatric surgery patients. Materials and methods This prospective, longitudinal study was conducted with 15 patients with planned bariatric surgery, who were evaluated pre-operatively and at 6 months post-operatively. Fundamental frequency (F0), Formant frequency (F1, F2, F3, and F4), Frequency perturbation (Jitter), Amplitude perturbation (Shimmer) and Noise-to-Harmonics Ratio (NHR) parameters were evaluated for /a/, /e/, /i/, /o/, and /u/ vowels. Changes in the acoustic analysis parameters for each vowel were compared. The study group was separated into two groups according to whether the Mallampati score had not changed (Group 1) or had decreased (Group 2) and changes in the formant frequencies were compared between these groups. Results A total of 15 patients with a median age of 40 +/- 11 years completed the study. The median weight of the patients was 122 +/- 14 kg pre-operatively and 80 +/- 15 kg, post-operatively. BMI declined from 46 +/- 4 to 31 +/- 5 kg/m(2). The Mallampati score decreased by one point in six patients and remained stable in nine. Of the acoustic voice analysis parameters of vowels, in general, fundamental frequency tended to decrease, and shimmer and jitter values tended to increase. Some of the formant frequencies were specifically affected by the weight loss and this showed statistical significance between Group 1 and Group 2. Conclusion The present study reveals that some specific voice characteristics might be affected by successful weight loss after bariatric surgery.Öğe Analysis of the Effect of Weight Loss on Eustachian Tube Function by Transnasal Videoendoscopy(Lippincott Williams & Wilkins, 2022) Eravci, Fakih Cihat; Yildiz, Baris Dogu; Ozcan, Kursat Murat; Moran, Munevver; Colak, Mustafa; Karaku, Mehmet Fatih; Karakurt, Suleyman EmreObjective: To investigate the effect of weight loss after bariatric surgery on eustachian tube (ET) function with video endoscopy. Materials and Methods: The present study was conducted as a prospective cohort and was completed with 19 patients. Three-step tympanometry (basal, Toynbee, Valsalva), dynamic slow-motion video endoscopy, and the Eustachian Tube Dysfunction Questionnaire-7 (ETDA-7) were applied to the patients preoperatively before bariatric surgery and in the postoperative 6th month. Dynamic slow-motion video endoscopy was graded between 0 and 3, or classified as patulous, as indicated in the literature. Results: The mean body mass index of 6 male and 13 female patients decreased from 47.3 +/- 4.6 to 31.2 +/- 5.4. Grade decline (median 2 +/- 1) was experienced in all patients in DSVE, and 1 patient resulted as patulous ET. The ETDA-7 scores decreased in11 patients, remained stable in 7 patients, and increased in 1 patient with patulous ET. The statistical analysis of the preoperative and postoperative DSVE grading and ETDA-7 scores, excluding the patulous ET patient, was found to be significant (P = 0.001 and P = 0.003, respectively). There was no significant change in any of the tympanometry parameters (P > 0.05). Conclusions: Rapid weight loss with bariatric surgery results in an improvement in both the DSVE images and in the complaints of ET dysfunction in the majority of patients, but in some patients it may result in patulous ET. Therefore, preoperative evaluation of the ET with DSVE and questioning the patient's complaints are important in predicting patients who may develop patulous ET.Öğe Comparison of the Hearing Results of Ossicular Chain Reconstruction Using MCBO and TiTORP in Patients with Cholesteatoma(Zamensalamati Publ Co, 2021) Karakus, Mehmet Fatih; Ozcan, Kursat Murat; Karakurt, Suleyman Emre; Colak, Mustafa; Eravci, Fakih Cihat; Yagmur, Ali Riza; Cetin, Mehmet AliBackground: No studies have investigated the results of ossicular chain reconstruction using mastoid cortical bone ossiculoplasty (MCBO) and titanium total ossicular replacement prosthesis (TiTORP) in Austin-Kartush Group D cholesteatoma patients with severe middle ear risk index (MERI). Objectives: The present study aimed to compare the hearing results of MCBO and TiTORP in Austin-Kartush Group D cholesteatoma patients with severe MERI who underwent ossicular chain reconstruction during primary surgery. Methods: The hearing results of 28 adult cholesteatoma patients who underwent tympanomastoidectomy and ossicular chain reconstruction with MCBO (n=15) or TiTORP (n=13) were analyzed in the current study. The postoperative hearing was tested 12 months after the surgery. The hearing-related functional success rate was determined in accordance with the American Academy of Otolaryngology-Head and Neck Surgery Foundation criteria. Results: When all patients were taken into account, the mean preoperative and postoperative air-bone gaps (ABG) were reported as 32.2 decibel (dB) and 17.6 dB, respectively, (P<0.001). In 57.1% of the patients, the mean postoperative ABG was <= 20 dB. The mean preoperative and postoperative ABGs of the MCBO group were obtained at 29.9 and 16.2 dB, while these values were reported as 35.0 and 19.3 dB in the TiTORP group (P=0.001 and P<0.001, respectively). Hearing-related functional success rates were calculated at 60.0% and 53.8% in MCBO and TiTORP groups, respectively, without any significant difference between the groups (P= 0.743). Conclusion: As evidenced by the obtained results, MCBO and TiTORP can provide similar and successful hearing results in Austin-Kartush Group D patients with cholesteatoma; nonetheless, MCBO is a more cost-effective option in this regard.Öğe Computed Tomography Analysis of Nasal Anatomy in Dorsal Preservation Rhinoplasty(Oxford Univ Press Inc, 2022) Eravci, Fakih Cihat; Ozer, Halil; Arbag, Hamdi; Eryilmaz, Mehmet Akif; Aricigil, Mitat; Dundar, Mehmet AkifBackground Subdorsal septal resection and radix osteotomy are distinctive surgical steps in preservation rhinoplasty. Objectives The aim of this study was to evaluate the nasal bone thickness, the level of the septal bony-cartilaginous junction (K area), and the distances of the frontal sinus and skull base from the transverse osteotomy line in the Turkish population by means of conventional computed tomography (CT). Methods A retrospective evaluation was made of 203 consecutive preoperative paranasal CT scans of patients (classified in terms of age and gender) who had undergone rhinoplasty surgery between January 2020 and June 2021. The nasal bone thickness at the medial canthus level, and the distances between the transverse osteotomy line and the K area, the frontal sinus, and the cribriform plate were measured. Results The mean measurements were similar in terms of age groups (P = 0.402, P = 0.542, P = 0.134 and P = 0.276 for ages 18-30, 30-40, 40-50, and >50 years, respectively). The mean nasal bone thickness and the distance between the transverse osteotomy line and the K area showed statistical significance (P = 0.001 and P = 0.001, respectively). In both genders, the mean distances between the transverse osteotomy line and the frontal sinus and the cribriform plate were similar (P = 0.921 and P = 0.280, respectively). The nasal bone was thinner and the K area position more cephalic in females. Conclusions CT plays an important role in preoperative planning. The need for resection of the ethmoid perpendicular bone may be greater in males when lowering the dorsal hump, and hence they may be more prone to skull base complications. It is therefore necessary to be more careful in the surgical stage of subdorsal septal excision in males.Öğe The effect of chemotherapy on olfactory function and mucociliary clearance(Springer, 2021) Eravci, Fakih Cihat; Ucar, Gokhan; Ozcan, Kursat Murat; Colak, Mustafa; Ergun, Yakup; Acikgoz, Yusuf; Ikinciogullari, AykutObjectives Olfactory sensory neurons and the olfactory mucosa are both important for optimal olfactory function. The potential nasal mucosal toxicity of chemotherapy regimens has not been assessed yet. The aim of this study was to objectively investigate the effect of chemotherapy on mucociliary clearance and olfactory function and to evaluate whether this effect differs between different chemotherapy regimens and age groups. Patients and methods The study included consecutive patients admitted for the treatment of a variety of primary tumors (except head and neck and brain malignancies). Patients were evaluated for olfaction and mucociliary clearance before and immediately after completing the last session of chemotherapy cycles, according to the therapeutic protocol. For objective evaluation, the saccharine test was used for mucociliary clearance and the Sniffin' Sticks test for olfactory function. Of the 46 initial patients, 30 completed the study. Groups were formed according to the chemotherapy regimen (four groups: CA (doxorubicin + cyclophosphamide), Folfox (oxaliplatin +5-FU + folinic acid), DCF (docetaxel + cisplatin +5-FU), and GC (gemcitabine + cisplatin)) and according to age (two groups: < 55 years and > 55 years). Results In the overall analyses, significant deterioration was noted in both mucociliary clearance time and smell scores (olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and the composite threshold-discrimination-identification (TDI) score). The changes in these scores showed no significant differences between chemotherapy groups. The decrease in OT and global TDI scores was more severe in the younger age group. Conclusions Chemotherapy impairs both the mucociliary clearance and olfactory function in cancer patients. This might reflect the collective negative effect of chemotherapy on olfactory function, not only through the neurocytotoxic effect but also the cytotoxic effect on the nasal mucosa. In addition, the reduction in olfactory threshold and total olfactory function scores was seen to be more profound in younger patients, which could have been due to higher initial scores.Öğe The Effect of Rhinoplasty Dissection Planes (Sub-SMAS, Subperichondrial, and Subperiosteal) on the Viability of Diced Cartilage Grafts in a Rabbit Model(Oxford Univ Press Inc, 2023) Eravci, Fakih Cihat; Kaplan, Omer; Oltulu, Pembe; Arbag, Hamdi; Eryilmaz, Mehmet Akif; Aricigil, Mithat; Dundar, Mehmet AkifBackground Dorsal preservation surgeries in which the subperichondral and subperiosteal planes are used to elevate the soft tissue envelope of the nose have become increasingly widespread because they can reduce postoperative edema and promote faster healing. However, the effects of surgical dissection planes on the viability of cartilage grafts are not known. Objective The aim of this study was to determine, in a rabbit model, the viability of diced cartilage grafts in different rhinoplasty dissection planes (sub-superficial musculoaponeurotic system [SMAS], subperichondral, subperiosteal). Methods Diced cartilage samples were placed in the sub-SMAS, subperichondrial, and subperiosteal planes, and after 90 days, histopathologic analysis was performed. Cartilage graft viability was evaluated based on the loss of chondrocyte nuclei in the lacuna, the presence of peripheral chondrocyte proliferation, and the loss of matrix metachromasia in the chondroid matrix. Results The median [interquartile range] percentages of live chondrocyte nucleus viability in the sub-SMAS, subperichondrial, and subperiosteal groups were 67.5% [18.75%] (range, 60%-80%), 35% [17.5%] (range, 20%-45%), and 20% [30.0%] (range, 10%-45%), respectively; and the percentages of peripheral chondrocyte proliferation were 80.0% [22.5%] (range, 60%-90%), 30% [28.75%] (range, 15%-60%), and 20% [28.75%] (range, 5%-60%), respectively. There was strong statistical significance in both parameters (P = .001). Intergroup examination revealed a difference between the sub-SMAS and the other surgical planes (P = .001 for both parameters). A smaller loss of chondrocyte matrix was observed in the sub-SMAS group compared with the other 2 groups, which supports the findings of cartilage viability (P = .006). Conclusions Elevating the soft tissue envelope of the nose in the sub-SMAS surgical plane preserves the viability of cartilage grafts better than subperichondrial and subperiosteal elevation.Öğe Evaluation of retinal vessel density and foveal avascular zone measurements in patients with obstructive sleep apnea syndrome(Springer, 2021) Colak, Mustafa; Ozek, Dilay; Ozcan, Kursat Murat; Eravci, Fakih Cihat; Karakurt, Suleyman Emre; Karakus, Mehmet Fatih; Evren Kemer, OzlemPurpose To compare retinal capillary plexus vessel densities, choroidal thickness, optic disc vessel densities and foveal avascular zone measurements between normal subjects and subjects with obstructive sleep apnea syndrome (OSAS) using spectral-domain OCT angiography (OCTA). Methods Forty eyes of patients with overall OSAS, 20 eyes of patients with mild-moderate OSAS, 20 eyes of patients with severe OSAS on polysomnography and 21 controls were evaluated with the RTVue-XR Avanti OCTA (Optovue, Inc., Fremont, CA). Superficial and deep retinal capillary plexus vessel densities, choroidal thickness and foveal avascular zone (FAZ) parameters (area, diameter, acircularity index of the FAZ, foveal density-300) were measured for all subjects. Results Superficial capillary plexus vessel densities of the groups were similar. Deep capillary plexus (DCP) vessel densities of all three OSAS groups decreased in the parafoveal region (< 0.001). In the perifoveal region, DCP vessel densities were decreased in the Overall OSAS group (p = 0.023) and in the Severe OSAS group (p = 0.021), whereas it was similar in the Mild-moderate OSAS group. Choroidal thickness decreased in all three OSAS groups (p < 0.001). All FAZ measurements and foveal density-300 measurements were similar compared to the control group. Conclusion Our findings indicate that in severe OSAS patients, deep parafoveal, perifoveal vascular densities decrease and the choroid layer becomes thinner. When evaluating a patient with OSAS, it should be kept in mind that there may be eye involvement due to the disease.Öğe A HUGE LESION IN THE MAXILLARY POSTERIOR REGION DIAGNOSED HIGH GRADE MUCOEPIDERMOID CARCINOMA OF MINOR SALIVARY GLANDS: A CASE REPORT(Dokuz Eylul Univ Inst Health Sciences, 2022) Magat, Guldane; Ozcan, Sevgi; Yuce, Fatma; Cetin, Mine; Guven, Mehmet Esad; Eravci, Fakih Cihat; Orhan, KaanMucoepidermoid carcinoma (MEC) is the most common malignant tumor of the salivary glands. These tumors occur commonly in the major salivary glands, especially the parotid, and they are the most frequently located in the palate intraorally. The similarity between MEC and other odontogenic cysts in the mouth is a critical situation that needs attention in clinical examination. Early diagnosis is very important in the diagnosis of asymptomatic growth, reaching very large sizes easily, its recurrence potential, and malignant character. The treatment and prosthetic rehabilitation of MEC are specified according to histopathological grade, location, and invasion pattern of the tumors. The purpose of this case is to present a 19-years-old female with high-grade MEC of minor salivary glands at the palate.Öğe Long-term electrophysiological assessment after hypoglossal-facial anastomosis(Springer, 2020) Tutar, Hakan; Eravci, Fakih Cihat; Mercan, Metin; Karalogu, Furkan; Tutar, Vildan Basturk; Yildirim, Irem; Karamert, RecepPurpose To investigate and provide objective documentation of the possible differences in the axonal reinnervation process of facial muscles after hypoglossal-facial nerve anastomosis. Then, to search for the presence of the trigemino-hypoglossal reflex and determine whether it indicates better peripheral recovery. Methods Electrophysiological examination performed on 20 patients who had undergone VII-XII anastomosis, with follow-up periods of more than 2 years. Results The mean follow-up time after surgery was 4.1 +/- 1.3 years (range 2-8 years). The degrees of axonal reinnervation for the orbicularis oculi (OOc) and orbicularis oris (OOr) were 46.91 +/- 19.77 and 32.65 +/- 14.85, respectively. And the difference between these muscles was statistically significant (p = 0.018) in favor of the OOc. In addition, R1 blink reflexes that were not followed by R2 components were observed in 30% of the patients. However, these 6 patients with short-latency potential did not differ from the others in terms of latency, the amplitude of compound muscle action potential (CMAP), and degree of axonal reinnervation (p > 0.05) at both muscles (OOc and OOr). Conclusion The recoveries of the lower face and upper face are different after VII-XII anastomosis, and in our patients the OOc healed better. In addition, R1 blink reflexes that were not followed by R2 components were observed in 30% of the patients. However, the patients with these blink reflexes did not have better peripheral healing in their neuromuscular units, which suggests that the blink reflex is not an indicator for peripheral recovery.Öğe Symptomatic Solid Ectopic Cervical Thymus in a 2-Month-Old Infant: Case Report(Galenos Yayincilik, 2021) Abakir, Nursultan; Eravci, Fakih Cihat; Emlik, Ganime DilekEctopic cervical thymus (ECT) is a rare pediatric pathology usually with an asymptomatic course. In fewer cases, the patient may present with dyspnea, hoarseness, stridor, dysphagia and pain. The mass may present in cystic or solid forms. Solid forms are rare, constituting only 10% of all ECT cases and these are mostly symptomatic. We aimed to present the case of an infant with ECT in the submandibular region that led to shortness of breath. ECTs in the submandibular region are mostly solid and larger in size, and therefore, likely to result in compressive symptoms. In this case report, we tried to cover the important aspects of the diagnosis of ECT, its treatment, and discussed the results with a literature review. We additionally aimed to emphasize the importance of considering pediatric ECT in the differential diagnosis of pediatric neck mass as well as considering surgical excision to prevent serious consequences.
