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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 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 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.
