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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 Determination of hearing levels in gout patients and factors affecting hearing levels such as the dislipidemia, hemoglobin levels and hyperuricemia(W B Saunders Co-Elsevier Inc, 2020) Yucel, Abitter; Yucel, Hilal; Aydemir, Fuat; Cure, Erkan; Eryilmaz, Mehmet Akif; Cizmecioglu, Hilal Akay; Kucuk, Adem[Abstract Not Availabe]Öğe Dysphagia and Airway Obstruction Due to Large Cervical Osteophyte in a Patient With Ankylosing Spondylitis(Lippincott Williams & Wilkins, 2014) Varsak, Yasin Kursad; Eryilmaz, Mehmet Akif; Arbag, HamdiAnterior cervical osteophytes are excessive bony formation of cervical vertebra bodies. They are common but rarely symptomatic lesions mostly seen in geriatric population. Large anterior cervical osteophytes may cause symptoms such as dysphagia, dyspnea, dysphonia, and odynophagia. They have been attributed to multiple etiologies including diffuse idiopathic skeletal hyperostosis, following trauma, cervical spondylitis, and infectious spondylitis. However, symptomatic large anterior cervical osteophyte with ankylosing spondylitis is extremely rare. Surgical excision is the main treatment for symptomatic cases. We report a case of a 53-year-old man with airway obstruction and dysphagia due to large cervical osteophyte who has a history of ankylosing spondylitis, and we also addressed the etiological factors and management of large symptomatic cervical osteophytes.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 The effects of local and intraperitoneal zinc treatments on maxillofacial fracture healing in rabbits(Churchill Livingstone, 2020) Azgin, Isa; Arbag, Hamdi; Eryilmaz, Mehmet Akif; Celik, Zeliha EsinObjective: This study aimed to determine whether administration of topical and intraperitoneal zinc for maxillofacial fractures has any impact on the bone healing process. Material and method: Thirty-two New Zealand rabbits were randomly assigned to four groups of eight each. The first group was the control group; fracture lines were fixed using titanium microplates and no medication was administered. The second group received fixations using zinc-coated titanium microplates. A single dose of 3 mg/kg zinc was administered intraperitoneally to the third group following fixations with titanium microplates. A single dose of 3 mg/kg zinc was administered intraperitoneally to the fourth group following fixations with zinc-coated titanium microplates. Zinc coating on to the titanium microplates was achieved using the physical vapor deposition technique. A fracture line was created in the nasal bones of all subjects and fixed with five-hole flat microplates and three 5-mm micro screws. All work groups were sacrificed at the end of the sixth week. Results: Histological examination showed that the number of osteoblasts were significantly higher in zinc-coated group (Group 2) than zinc uncoated, control group (Group 1), (415.6 +/- 46.7 vs 366.3 +/- 11.8) (p < 0.001). It was observed that intraperitoneal zinc treatment alone (Group 3) did not significantly increase in the osteoblast count compared to zinc un-coated group (Group 1), (390.6 +/- 83.2 vs 366.3 +/- 11.8), (p = 0.341). The immunoreactivity scores for IGF-1 were significantly higher in the zinccoated group compared to control group (Group 2 vs 1), (9.3 +/- 2.8 vs 3.7 +/- 1.9) (p < 0.05). It was observed that intraperitoneal zinc treatment did not cause a significant difference in the aspect of IGF-1 for zinc-coated groups (Group 2 vs 4) (9.3 +/- 2.8 vs 9.6 +/- 2.2) (p = 0.791). The difference in the immunoreactivity score among whole groups for TGF-beta was not statistically significant (Group 1 vs 2, 3.2 +/- 1.7 vs 4.4 2.3, p = 0.256; Group 1 vs 3, 3.2 1.7 vs 3.8 2.8, p = 0.524; Group 1 vs 4, 3.2 1.7 vs 2.8 1.3, p = 0.717; Group 2 vs 3, 4.4 2.3, vs 3.8 2.8, p = 0.610; Group 2 vs 4, 4.4 2.3, vs 2.8 + 1.3, p = 0.124; Group 3 vs 4, 3.8 2.8, vs 2.8 + 1.3, p = 0.311). Conclusion: The local use of titanium microplates coated with zinc by PVD technique was found effective for fracture healing. Zinc coating of titanium microplates used in fracture treatment can accelerate fracture healing. It may be concluded that clinical studies should be performed now in order to explore if comparable results can be achieved in humans. (C) 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Öğe The evaluation of cochlear functions in Familial Mediterranean Fever(Springer, 2016) Eryilmaz, Mehmet Akif; Yucel, Abitter; Cure, Erkan; Sakiz, Davut; Koder, Ahmet; Kucuk, Adem; Tunc, RecepFamilial Mediterranean Fever (FMF) is a progressive disease characterized by chronic inflammation, which also has negative effects on cochlear functions and hearing levels. We investigated whether the cochlear functions and hearing levels of FMF patients were different than healthy controls and also evaluated the relationship of hearing levels with the age at diagnosis, duration without treatment, and inflammation and lipid parameters in this study. A total of 60 patients diagnosed with FMF and 48 age, gender and body mass index (BMI)-matched healthy controls were included in the study. The hemogram, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and lipid parameters of the subjects were studied and they all underwent pure tone audiometry and Transient evoked otoacoustic emission tests after an otologic examination. The hearing levels of the FMF group were significantly higher than those of the control group. The TEOAE signal/noise (S/N) ratios were similar in both groups. A positive relationship was present between the audiometric test results and the age, BMI, low-density lipoprotein and triglyceride levels and a negative relationship with the high-density lipoprotein levels. A negative relationship was present between the TEOAE S/N ratios and the age of the patients, duration without treatment, lipid parameters, inflammation markers and the creatinine level. FMF patients are exposed to chronic inflammation and this can influence their hearing levels. The age at diagnosis, duration without treatment, chronic inflammation, unfavorable lipid parameters, and obesity can affect hearing tests negatively.Öğe Giant Epignathus (Teratoma of Palatine Tonsil): A Case Report(Galenos Yayincilik, 2021) Aydemir, Fuat; Mutaf, Mert; Eryilmaz, Mehmet AkifTeratomas are benign tumours containing tissues derived from ectoderm, endoderm and mesoderm Epignathus is a rare congenital teratoma and originates from oropharyngeal region. We present a case of giant epignathus arising from tonsillar region in a neonate. A male neonate that was born with a 38-week cesarean section presented with a pedunculated mass from left tonsilla palatina and protruding outside the mouth. The patient did not have any airway problem. Magnetic resonance imaging and computed tomography scan showed no intracranial extension. The patient was operated on the postpartum 3rd day and the mass was excised successfully. After histopathological examination, mature teratoma was diagnosed. During post-operative 6 months control visit, there was no recurrence. Epignathus is a rare congenital oropharyngeal teratoma, it should be diagnosed in the fetus as early as possible. Teratomas of the tonsilla palatina are extremely rare. In such cases, the mass may cause airway obstruction and feeding difficulties so complete resection is curative in most cases during the early neonatal period.Öğe Intramuscular Cavernous Hemangioma of the Temporalis Muscle(Lippincott Williams & Wilkins, 2014) Eryilmaz, Mehmet Akif; Varsak, Yasin Kursad; Gul, Zuhal; Ugur, AysenurHemangiomas are frequent benign hereditary vascular tumors. Intramuscular hemangiomas, a distinctive type of hemangioma occurring within the skeletal muscle, account for less than 1% of all hemangiomas. They occur more often in the trunk and extremity muscles, whereas the involvement of the temporal muscle is extremely rare. A 34-year-old man with a mass in his left temporal fossa was admitted. Computed tomographic scan showed no erosion of the bone, and magnetic resonance imaging revealed an ovoid mass within the temporal muscle. The lesion was surgically excised, and histopathologic examination confirmed the diagnosis of cavernous hemangioma. The patient was not able to lift his left eyebrow right after the surgery. Two months after the surgery, the patient recovered from paralysis, and there was no recurrence of tumor 12 months after the surgery. We report the 27th cavernous hemangioma case of the temporalis muscle. Care must be taken to avoid possible stretch injury to facial nerve branches while resecting these tumors.Öğe Isotretinoin's action against cisplatin-induced ototoxicity in rats(Univ Karachi, 2018) Alan, Mehmet Akif; Eryilmaz, Mehmet Akif; Kaymaz, Figen; Suzer, Aysegul; Aricigil, MitatCurrent data do not support the routine use of any agent to prevent cisplatin ototoxicity. Although there are various diseases in which derivatives of vitamin A are used due to their antioxidant effects, there is no study for prevention from ototoxicity. In this study, the protective effect of isotretinoin was investigated on cisplatin ototoxicity in rats. 21 Wistar Albino rats were divided randomly into 3 groups. Group I: cisplatin, Group II: cisplatin + isotretinoin and Group III was the control group. Hearing assessment of all rats was done with ABR and DPOAE tests before and after the procedure. After the procedure, cochleas were resected and transmission electron microscopic examination was performed. Our DPOAE and ABR findings showed that isotretinoin has protective effects on cisplatin ototoxicity. According to transmission electron microscopic findings, isotretinoin has protective effects on cell integrity. We think that new experimental and clinical studies to be carried out in this regard may give us a new option on prevention of cochlea from ototoxicity.Öğe Mean Platelet Volume as a Potential Predictor of Cholesteatoma in Children(Lippincott Williams & Wilkins, 2016) Eryilmaz, Mehmet Akif; Derin, SerhanObjectives:Cholesteatoma is a chronic inflammatory clinical disorder, and it may cause hearing loss and various complications due to its destructive nature. Mean platelet volume (MPV) is a prothrombotic and proinflammatory marker. The aim of this study is to investigate predictive values of MPV, neutrophil-to-lymphocyte ratio, erythrocyte distribution width, and platelet lymphocyte ratio in cholesteatomatous or noncholesteatomatous pediatric chronic otitis media.Methods:In this study, the authors retrospectively analyzed 24 patients with cholesteatomatous chronic otitis media, 9 patients with noncholesteatomatous chronic otitis media, and 36 age- and sex-matched healthy controls. Cholesteatomatous and noncholesteatomatous chronic otitis media groups were compared with each other, and with controls for WBC, MPV, erythrocyte distribution width, neutrophil-to-lymphocyte ratio, and platelet lymphocyte ratio.Results:Mean platelet volume was significantly lower in patients with cholesteatoma (8.171.22 fL) compared with the control group (10.42 +/- 0.87 fL) (P<0.001). Region of conversion curve analysis showed that the cutoff level of 9.5 fL for MPV was an independent predictor for cholesteatoma with a high sensitivity (86%) and specificity (84%). Cholesteatomatous and noncholesteatomous chronic otitis media patients were similar for other parameters studied.Conclusion:Mean platelet volume may be used as a fast-to-obtain, reliable, and inexpensive marker with a high predictive level to indicate cholesteatoma in children.Öğe Melatonin prevents possible radiotherapy-induced thyroid injury(Taylor & Francis Ltd, 2017) Aricigil, Mitat; Dundar, Mehmet Akif; Yucel, Abitter; Eryilmaz, Mehmet Akif; Aktan, Meryem; Alan, Mehmet Akif; Findik, SidikaPurpose: We aimed to investigate the protective effect of melatonin in radiotherapy-induced thyroid gland injury in an experimental rat model.Materials and methods: Thirty-two rats were divided into four groups: the control group, melatonin treatment group, radiotherapy group and melatonin plus radiotherapy group. The neck region of each rat was defined by simulation and radiated with 2 Gray (Gy) per min with 6-MV photon beams, for a total dose of 18Gy. Melatonin was administered at a dose of 50mg/kg through intraperitoneal injection, 15min prior to radiation exposure. Thirty days after the beginning of the study, rats were decapitated and analyses of blood and thyroid tissue were performed.Results: Tumor necrosis factor- (TNF-), interleukin-1 beta (IL-1), thiobarbituric acid reactive substances (TBARS) and nitric oxide (NO) levels in the radiotherapy group were significantly higher than those in the melatonin plus radiotherapy group (p<.05), whereas interleukin-10 (IL-10) and glutathione (GSH) values were higher in the melatonin plus radiotherapy group (p<.05). The infiltration of inflammatory cells and percentage of apoptosis in the radiotherapy group were significantly higher than those in the melatonin plus radiotherapy group (p<.05).Conclusions: Melatonin helped protect thyroid gland structure against the undesired cytotoxic effects of radiotherapy in rats.Öğe Multilayered Closure of Cerebrospinal Fluid Rhinorrhea with Inlay Fascia Lata, Autologous Fat, and Outlay Fascia Lata: Our Experience(Karger, 2016) Eryilmaz, Mehmet Akif; Anagil, Mitat; Alan, Mehnnet AkifBackground/Aims: Since the initial use in 1981 by Wigand, different endoscopic endonasal surgery techniques have been proposed to close ventral skull base defects, all of which include multilayer closure involving vascularized mucoseptal flaps, autologous grafts, and synthetic materials. These methods are used individually or in combination, as required by the operative condition. Methods: In this study we aimed to describe our endoscopic technique using inlay-outlay fascia lata and autologous fat with fibrin sealant to close spontaneous and traumatic cerebrospinal fluid (C5F) rhinorrhea. Results and Conclusion: Twenty-one CSF rhinorrhea patients were operated with this technique in our hospital. Two patients had large skull base defects and 15 patients had high-flow CSF leaks. We reached a 100% success rate in the first attempt without any long-term recurrence. Multilayered endoscopic closure with this technique offers satisfactory results with minimal morbidity even in large defects and high-flow CSF leaks. (C) 2016 S. Karger AG, BaselÖğe Second Primary Malignant Peripheral Nerve Sheath Tumor of the Paranasal Sinuses After Nasopharynx Carcinoma(Lippincott Williams & Wilkins, 2014) Eryilmaz, Mehmet Akif; Varsak, Yasin Kursad; Gul, Zuhal; Etli, OzlemMalignant peripheral nerve sheath tumors are uncommon neoplasms that arise out of Schwann cells from the peripheral nerves, which rarely occur in the paranasal sinuses and nasal cavity. Especially with the increasing long-term survival of patients with nasopharynx carcinoma, second primary cancers can be diagnosed. Second primary cancers are not uncommon in patients with the prior radiation therapy. However, malignant peripheral nerve sheath tumor in the head and neck region after radiation is an exceedingly rare condition. We report the first case of malignant peripheral nerve sheath tumor of the paranasal sinuses as a second primary malignancy in a patient treated with radiation therapy for nasopharyngeal carcinoma 10 years ago.Öğe Single seventh day debridement compared to frequent debridement after endoscopic sinus surgery: a randomized controlled trial(Springer, 2016) Varsak, Yasin Kursad; Yuca, Koksal; Eryilmaz, Mehmet Akif; Arbag, HamdiThe aim of this study was to evaluate the postoperative debridement frequency following endoscopic sinus surgery. Individual randomized controlled trial. Sixty-two adult patients with a diagnosis of chronic rhino sinusitis (CRS) with nasal polyps (NP) and CRS without NP meeting the inclusion criteria were enrolled in this prospective study. The patients were randomized equally to frequent debridement (FD; at postoperative weeks 1, 2 and 4) or to a single debridement (SD; at postoperative week 1) after surgery. The outcomes were assessed with visual analog scale (VAS) for nine main symptoms concerning patient discomfort within the first 4 weeks, with the modified Lund-Kennedy endoscopic score (MLKES) at weeks 4 and 24 and with the sino-nasal outcome test-20 (SNOT-20) at week 24. Thirty-seven of the patients were male, and twenty-five were female. The mean age was 36.1 +/- 13.5 in FD group and 39.2 +/- 14.7 in SD group. In the SD group, the VAS scores at postoperative week four showed significantly less discomfort at visits (p = 0.004) and less negative effects on their work (p = 0.013). There was no statistically significant difference between the two groups in the week 4 and 24 MLKES and in the week 24 SNOT-20 scores (p > 0.05). The endoscopic findings did not show significant differences between the groups. Our data indicate that FD causes more discomfort at the required visits, more facial pain and more negative effects on patients' work; this method is not superior to postoperative single seventh day debridement in terms of the 24-week quality of life and endoscopic scores.Öğe Sudden bilateral hearing loss after organophosphate inhalation(Kare Publ, 2016) Dundar, Mehmet Akif; Derin, Serhan; Aricigil, Mitat; Eryilmaz, Mehmet AkifSudden bilateral hearing loss are seen rarely and the toxic substance exposure constitutes a small part of etiology. A Fifty-eight-year-oldwoman admitted to our clinic with sudden bilateral hearing loss shortly after chlorpyrifos-ethyl exposure. Otolaryngologic examination findings were normal. The patient had 40 dB sensorineural hearing loss (SNHL) on the right ear and 48 dB SNHL on the left ear. Additional diagnostic tests were normal. The conventional treatment for sudden hearing loss was performed. On the second week following organophosphate (OP) exposure the patient's hearing loss almost completely resolved. OP's are heavily used in agriculture and should be taken into consideration as an etiologic factor in sudden hearing loss. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
