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    Bilateral Sudden Sensorineural Hearing Loss after Treatment of Aneurysmal Subarachnoid Hemorrhage by Angiographic Embolization: A Case Report
    (Galenos Yayincilik, 2014) Ulku, Cagatay Han; Yucel, Abitter
    Bilateral sudden sensorineural hearing loss is a rare otologic emergency and constitutes 0.44%-4.9% of overall sudden sensorineural hearing loss cases. Microvascular dysfunction secondary to systemic cardiovascular diseases, such as embolism, vasospasm, and hypercoagulability, is the main cause of non-idiopathic bilateral sudden sensorineural hearing loss. In this study, a case of bilateral sudden sensorineural hearing that occurred after angiographic embolization for treatment of aneurysmal subarachnoid hemorrhage was presented as a rare clinical condition.
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    Comparisons of the mechanics of partial and total ossicular replacement prostheses with cartilage in a cadaveric temporal bone preparation
    (Informa Healthcare, 2014) Ulku, Cagatay Han; Cheng, Jeffrey Tao; Guignard, Jeremie; Rosowski, John J.
    Conclusions: Reconstruction of the ossicular chain differentially affects the motion of the tympanic membrane (TM) and the stapes. Objectives: To determine the effect of different ossicular replacement procedures on the sound-induced motion of the TM and stapes. Methods: A combination of digital stroboscopic holography and laser Doppler vibrometry was used to determine the sound-induced motion of the TM and stapes in cadaveric temporal bones in which the ossicular chain was reconstructed using 12 varied standard techniques. The variations included the use of total or partial ossicular prosthesis, size of cartilage interposed between the TM and the prosthesis, and the length or fit of the prosthesis between the TM and stapes. The measurements were carried out in repeated measures format, so that each manipulation was performed in each temporal bone. Results: The volume displacement of the TM was in general reduced by reconstruction, with the largest reductions occurring with high-frequency stimulation in the reconstructions with a 'large' cartilage oval interposed between the TM and the prosthesis. Larger stapes motions in response to low-frequency sound were observed with either 'loose' or 'best' fit TORP with a 'small' cartilage plate between the TM and the prosthesis.
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    Endoscopy-Assisted Ear Surgery for Treatment of Chronic Otitis Media With Cholesteatoma, Adhesion, or Retraction Pockets
    (Lippincott Williams & Wilkins, 2017) Ulku, Cagatay Han
    The objective of this study was to analyze the results of endoscopy-assisted ear surgery for the treatment of chronic otitis media with cholesteatoma, adhesion, or retraction pockets. Fifty-one patients who underwent oto-endoscopy-assisted canal wall up tympanomastoid surgery and/or limited anterior atticotomy with tympanoplasty for chronic otitis media with cholesteatoma, adhesion, or retraction pocket from 2006 to 2013 have been included in this study. Eradication of the disease from the middle ear and mastoid air cells was achieved by combination of the oto-microscobic and oto-endoscopic approaches. Second look surgery was performed 18 months later from the initial surgery in selected patients. Age, gender, pre-/postoperative otoscopy findings/audiograms, type of the used prostheses, and follow-up time were obtained from the patient's file. Anatomic integrity rates of the tympanic membrane, the mean gains of air bone gap, on pure-tone audiogram at 4 frequencies and existence of the residual disease were reviewed parameters. Functional evaluation was made in patients with intact tympanic membrane. Of the 51 patients, the ratios of the chronic otitis media with cholesteatoma and isolated adhesive otitis or retraction pocket cases were 74.5% (38/51) and 25.5% (13/51), respectively. Ossicular chain reconstruction was made with PORP in 27 patients and TORP in 20 patients, whereas the ossicular chain was intact in 4 patients. Anatomic integrity rates of the tympanic membrane were 90.2%(46/51). The overall (n = 46) pre-/postoperative mean ABG obtained at 4 frequencies were 28.3 +/- 12.26 and 9.18 +/- 5.68 dB (P<0.0001) respectively. Residual cholesteatoma rate was 10.5% (34/38) for chronic otitis media with cholesteatoma patients. However, there was no recurrence or new cholesteatoma formation in isolated retraction pockets or adhesive otitis patients. Oto-endoscopic eradication of the cholesteatoma or epithelial tissue from hidden area after the all visible cholesteatoma removal by oto-microscope improves the quality of surgery, significantly decreases the frequency of the canal wall-down procedure and posterior tympanotomy requirements with acceptable residual cholesteatoma rates.
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    High-Grade Basal Cell Adenocarcinoma Arising from the Parotid Gland: A Case Report and Review of the Literature
    (Galenos Yayincilik, 2017) Ulku, Cagatay Han; Oltulu, Pembe; Avunduk, Mustafa Cihat
    Basal cell adenocarcinomas are exceptionally rare and were first included in the histopathological classification of salivary gland tumors by the World Health Organization in 1991. These tumors are generally described as a low-grade malignancy with rare regional or distant metastasis. However, 48 basal cell adenocarcinoma cases arising from the major salivary glands have been described as high-grade malignancy in the English literature. Surgical excision and possible postoperative radiotherapy is the treatment of choice. Close follow up is mandatory for early detection of possible local recurrence. A 66-year-old female with high-grade basal cell adenocarcinoma of the parotid gland was presented in this study. Total parotidectomy with protection of the facial nerve integrity and postoperative radiotherapy were performed. At the most recent follow-up examination, 24 months after the surgery, the patient had no complaints and there was no sign of disease recurrence.!
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    Inlay Butterfly Cartilage Tympanoplasty: Anatomic and Functional Results
    (Springer India, 2018) Ulku, Cagatay Han
    To evaluate anatomic/functional results of inlay butterfly cartilage tympanoplasty and compare those with the results of over-underlay perichondrium-cartilage island or temporalis fascia tympanoplasties. Patients who operated for primary type 1 tympanoplasty (n = 78) with inlay butterfly cartilage (n = 25), over-underlay perichondrium-cartilage island (n = 36) or over-underlay temporalis fascia (n = 17) graft from January 2005 to January 2015 were included in the study. Age, gender, pre-/postoperative otoscopy findings/audiograms, and follow-up time were obtained from the patient's file. Anatomic integrity rates of the tympanic membrane, the mean gains of air bone gap on pure tone audiogram at four frequencies (0.5, 1, 2, 4 kHz) and complications were reviewed parameters. Functional evaluation was made in patients with intact tympanic membrane. Anatomic integrity rates of the tympanic membrane was 92.00% for inlay butterfly cartilage tympanoplasty, 91.67% over-underlay perichondrium cartilage island tympanoplasty and 88.2% over-underlay fascia tympanoplasty. The mean gains of air bone gap on pure tone audiogram for the inlay butterfly cartilage, over-underlay perichondrium cartilage island and over-underlay fascia graft group were 11.28, 12.84 and 12.66 dB respectively. Inlay butterfly cartilage tympanoplasty is a reliable and simple technique with satisfactory outcomes in selected cases. The anatomic and functional results after inlay butterfly cartilage tympanoplasty are parallel to the results of over-underlay perichondrium-cartilage island or temporalis fascia tympanoplasties.
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    Myxoma Arising from the Middle Ear: A Case Report
    (Aves, 2020) Ulku, Cagatay Han; Aydogdu, Demet; Erdem, Rukiye; Esen, Hasan
    The primary head and neck myxomas are rare, generally arising from the mandible, maxilla, and oral cavity. Other anatomical areas, such as cardiac myxomas, may also have metastases to the head and neck regions. The middle ear is an extremely rare location for myxomas. Myxoma slowly grows and is usually asymptomatic until it affects the surrounding structures. Surgical treatment is performed with a complete en bloc resection where possible. We report a case of a 42-year-old woman with myxoma arising from the right middle ear because of her tumor's rare anatomical region. Her main complaints were progressive fullness and loss of hearing which she felt for approximately 1 year on the right ear. High-resolution computed tomography (HRCT) revealed an isodense soft tissue mass localized in the right mastoid bone and the middle ear. The mass was totally removed by canal wall up tympanomastoidectomy. At the last follow-up examination on 36 months after the surgery, the patient was asymptomatic, and there were no signs of recurrence.
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    Possible Effects of Chronic Otitis Media with and without Cholesteatoma on Bone Conduction Thresholds: An Evaluation of 112 Cases
    (Dergipark Akad, 2019) Ulku, Cagatay Han; Aydogdu, Demet; Yucel, Abitter; Aydemir, Fuat
    Objective: The aim of this study is to evaluate any possible effects of chronic otitis media (COM), with or without accompanying cholesteatoma, on bone conduction thresholds (BCT). Methods: A total of 112 cases who underwent surgery for unilateral COM between 2006 and 2014 were enrolled in the study. Eighty cases had no cholesteatoma (Group 1). Thirty-two cases did have cholesteatoma (Group 2). Prior to surgery, the temporal bone was evaluated radiologically by use of high resolution computed tomography. The presence of a clinically and radiologically normal contralateral ear was the principal selection criterion for the cases. BCT at 0.5, 1, 2, 4 kHz and their averages were evaluated with pure tone audiogram (PTA) and the normal and diseased ears in each group were compared. This comparison was also made between the diseased ears in Groups 1 and 2. Results: There was a statistically significant difference observed between the mean BCT scores obtained by PTA for the normal/diseased ears in Group 1(9.78 +/- 0.98/17.34 +/- 1.71 dB) and in Group 2 (9.10 +/- 0.99/17.58 +/- 2.59 dB). This statistically significant difference was observed for each of the four different frequencies (p<0.0001). However, there was no statistically significant difference observed between the mean BCT scores obtained by PTA for the diseased ears in Groups 1 and 2 (17.34 +/- 1.71/17.58 +/- 2.59 dB). Similarly, in the comparison between the diseased ears, the differences of BCT at all four different frequencies (0.5, 1, 2, 4 kHz) lacked statistical significance (p>0.05). Conclusion: As a result of this study, we can say that COM may lead to sensorineural hearing loss. However, we observed that the presence of cholesteatoma does not exert an additional negative effect on cochlear function.