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Öğe Coenzyme q10 effectively prevents age-related hearing loss in c57bl/6 mice(Geriatrics Society, 2021) Müderris, Togay; Sevil, Ergun; Yar Sağlam, A.S.; Babademez, M.A.Introduction: Presbycusis is characterized by gradual, progressive sensorineural hearing loss. The aim of this study is to evaluate the effects of coenzyme Q10 in the prevention and treatment of age-related hearing loss. Materials and Method: Thirty-two C57BL/6 mice were assigned into four groups as early treatment, late treatment, control and sham control. Treatment was started at three months of age in the early treatment group and at six months in the late treatment group. The auditory brainstem test was performed once every three months. At the end of the study period, the cochleae of the animals were harvested, and Bcl-2, Bcl-xL, iNOS, COX-2, NF-?B, Bax, and Bak levels were analyzed with real-time polymerase chain reaction. Results: The hearing thresholds of the mice in the early treatment group were better than those of the other groups (p < 0.001). Hearing levels were also better in the late treatment group than control groups, but the difference was not significant (p > 0.05). The threshold shift in the early treatment group was significantly lower than the control groups (p < 0.001). The mRNA expression levels of proapoptotic genes Bax and Bak were lower (p < 0.05), antiapoptotic genes Bcl-2 and Bcl-xL were higher (p < 0.05), and the NF-?B, COX-2, and iNOS genes, which play a role in inflammation, were lower (p < 0.05) in the early treatment group. Conclusion: These results suggest that coenzyme Q10 effectively attenuates the presentation of age-related hearing loss, especially when started before the onset of hearing loss. © 2021, Geriatrics Society. All rights reserved.Öğe Cranial nerve involvement in COVID-19(W.B. Saunders, 2021) Doblan, Ahmet; Kaplama, M.E.; Ak, S.; Basmacı, N.; Tarini, E.Z.; Göktaş, Ş.E.; Müderris, TogayIntroduction: The COVID-19 disease emerged in Wuhan province of China in November 2019 and spread across the world in a short time, resulting in a pandemic. The first case in Turkey was detected on March 11, 2020. The aim of the current study was to reveal the effects of COVID-19 on cranial nerves by monitoring people infected with the disease based on repeated examinations and surveys. Material and method: The data of 356 patients with a positive COVID-19 polymerase chain reaction (PCR) test who received treatment between June 2020 and August 2020 in our hospital were prospectively evaluated after the study was approved by the relevant ethics committee. Results: Of the 356 patients included in the study, 47 under the age of 18 years were excluded due to their unreliable examination and anamnesis findings. In addition, seven patients that died while in hospital were excluded from the study due to the lack of examination and survey records during their hospitalization. The data of the remaining 302 patients were statistically analyzed. Symptoms of cranial nerve involvement were observed in 135 patients. Conclusion: The COVID-19 disease caused by the SARS-CoV2 virus commonly results in cranial nerve symptoms. The fact that these findings are more common and severe in COVID-19 than previous SARS and MERS outbreaks suggests that it has a more neurotrophic and more aggressive neuroinvasion. While the negative effects of the virus on sensory functions resulting from cranial nerve involvement are evident, motor functions are rarely affected. © 2021 Elsevier Inc.Öğe The efficiency of polyglycolic acid felt in the prevention of pharyngocutaneous fistula after total laryngectomy(W B Saunders Co-Elsevier Inc, 2021) Tokat, Taşkın; Müderris, Togay; Ayşel, Abdulhalim; Sarı, Elif; Erol, Ferda[No Abstract Available]Öğe Efficiency of resveratrol in the prevention and treatment of age-related hearing loss(Spandidos Publ Ltd, 2022) Müderris, Togay; Sağlam, Atiye; Ünsal, Döndü; Mulazimoğlu, Selçuk; Sevil, Ergun; Kayhan, HandanAge-related hearing loss (ARHL) is a major public health concern, which is characterized by gradual, progressive sensorineural hearing loss and deterioration of sound localization, with no effective treatment available to date. The aim of the present study was to evaluate the efficacy of resveratrol to prevent and treat ARHL. For this purpose, 32 male C57BL/6 mice were assigned to four groups: Early treatment, late treatment, control and sham control. The experiment lasted for 15 months. Treatment was started at three months of age in the early treatment group and at sixth months in the late treatment group. The auditory brainstem response test was performed once every three months. At the end of the study period, inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2, NF-kappa B, Bcl-2, Bcl-xL, Bax, Bcl-2 homologous antagonist/killer (Bak), caspase-3 and caspase-9 levels in the cochlear tissues of the animals were analyzed by reverse transcription-quantitative PCR. Hearing thresholds of the mice in the early treatment group were better than those in the other groups (P<0.001) at the end of the study. However, hearing levels in the late treatment group were not significantly different from those in the control groups (P>0.05), although mean thresholds were lower. The threshold shift in the early treatment group was significantly lower at all frequencies when compared with those in the control groups (P<0.001). The mRNA expression levels of pro-apoptotic genes Bax and Bak were lower (P<0.05), anti-apoptotic genes Bcl-2 and Bcl-xL were higher (P<0.05), NF-kappa B, COX-2 and iNOS as genes that have a role in inflammation and caspase-3 and caspase-9 as genes with a vital role in apoptosis were lower (P<0.05) in the early treatment group when compared with the late treatment and control groups. These results suggested that resveratrol is effective in the prevention of ARHL, particularly when started prior to the beginning of hearing loss.Öğe Impact of magnetic resonance on the decision of conservative surgery in advanced larynx cancer(W B Saunders Co-Elsevier Inc, 2021) Tokat, Taşkın; Adıbelli, Zehra Hilal; Koç, Ali Murat; Müderris, Togay; Atsal, Görkem; Özkök, GülizObjective: To evaluate the utility of magnetic resonance images (MRI) in the selection of treatment procedures for intermediate-advanced laryngeal cancers. Material and method: This study included patients with histologically proven laryngeal squamous cell carcinoma defined as cT3 and T4a at our tertiary academic care hospital. All scans were evaluated by two radiologists experienced in head and neck cross-sectional studies. Signal patterns in MRI sections of laryngeal compartment subsites were delineated as T1 w, T2w hyperintensity, and T2w intermediate signals, and were compared with the postoperative pathological results. Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were calculated. Results: The study included 51 patients with a mean age of 62.55 +/- 9.14 (range, 45-80) years. Tumor was glottic in 12 (23.5%) patients, supraglottic in 19 (31.4%) patients, glottic-supraglottic in 11 (21.6%) patients, transglottic in 9 (27%) patients. The posterior paraglottic space had the strongest specificity of MRI according to tumor infiltration in the histologic analysis (specificity 96.9% and sensitivity 78.6%). The specificity of MRI was poor for tumor infiltration in thyroid cartilage (specificity 70.0%). Spearman's test demonstrated that there was a statistically significant correlation between the MRI-based prediction scores of all subunites and the findings of histopathologic analyses (mean +/- SD: 4.96 +/- 4.46-5.53 +/- 4.38, respectively, R-2: 0.711, p<0.001). Conclusion: The high specificity values of the predictions, which were MRI-based in all subsites, indicated that MRI could provide an important contribution for defining tumor infiltration and the presurgical assessment of patients with tumors of the larynx.Öğe Is adenotonsillectomy safe in Covid-19 era? Investigation of SARS-CoV2 in adenoid and tonsil tissues(W B Saunders Co-Elsevier Inc, 2022) Müderris, Togay; Aysel, Abduelhalim; Yiş, Reyhan; Muderris, Tuba; Oketem, Ibrahim Mehmet Ali; corakci, OnurObjectives: COVID-19 has seriously altered physicians' approach to patients and diseases, with a tendency to postpone elective procedures. Tonsillectomy, alone or with adenoidectomy, is one of the most common surgeries performed by otolaryngologists. Although they are generally accepted as elective surgeries, they significantly improve the quality of life, and postponing these surgeries for a long time can have deteriorative effects on the patients. We aimed to investigate the presence of SARS CoV-2 in the adenotonsillectomy materials to find out if performing adenotonsillectomy is safe during the COVID-19 pandemic. Methods: Forty-eight tissue samples from 32 patients that underwent tonsillectomy with or without adenoidectomy were investigated whose SARS-CoV-2 RT-PCR test in the samples obtained from nasopharyngeal (NP) and oropharyngeal (OP) swabs were negative within 24 h before the operation. While 16 patients underwent only tonsillectomy and one of their tonsils was investigated, 16 of the patients underwent adenotonsillectomy and their adenoid tissues were sent along with one of their tonsils. SARS-CoV-2 viral RNA was investigated with Real-Time PCR in tissue samples. Results: Two (4.2%) tissue samples had positive PCR tests for SARS-CoV-2, while 46 of them were negative. One of the positive patients had undergone tonsillectomy with the indication of chronic recurrent tonsillitis, and the other patient had undergone adenotonsillectomy for obstructive adenotonsillar hypertrophy. PCR test was positive in the adenoidectomy specimen and negative in the tonsillectomy specimen in this patient. Conclusions: Adenotonsillectomy can be done safely in asymptomatic patients without a history of Covid-19, with a negative PCR test result obtained within the last 24 h.Öğe Letter to the Editor(W.B. Saunders, 2021) Doblan, Ahmet; Ak, S.; Kaplama, M.E.; Müderris, Togay[No abstract available]Öğe Metastatic salivary gland mammary analogue secretory carcinoma (MASC) of parotid gland - A rare case report in the literature review(Taylor & Francis Ltd, 2023) Aliyeva, Aynur; Karimov, Ziya; Müderris, TogayWe present a patient diagnosed with a parotid tumor whose histopathology was MASC. A 58-year-old female presented with a 5-month history of an enlarging right parotid mass. Ultrasonography showed a 48 x 30 mm heterogeneous solid lesion with a lobulated contour in the right parotid gland. A neck computed tomography (CT) with intravenous (IV) contrast showed a 28 x 34 mm pathological mass in the right parotid gland. After FNA, parotidectomy, and modified radical neck dissection, pathology showed that the surgical margin was positive for tumor, and one lymph node was metastatic in the right neck. This case was classified as T2N1M1 staged MASC of the salivary gland. She completed seven weeks of radiation therapy (RT) after surgery, and no recurrence or metastasis was observed at the 32nd-month follow-up. We aimed to report a rare parotid gland tumor with this case and inspire new research on diagnosing and treating rare salivary gland tumorsÖğe Our septoplasty results: Evaluation with the nose scale(Lippincott Williams & Wilkins, 2022) Karamese, Ozgur; Bercin, Ali Sami; Müderris, Togay; Kiris, MuzafferObjective: The aim of this study was to evaluate the effectiveness of septoplasty and septoplasty + bilateral radio frequency ablation of inferior turbinate (b-RFAIT) according to the type of operation, age groups, gender of patients, and the duration of control period by using Nasal Obstruction Symptom Evaluation (NOSE) Scale. Materials and Methods: Prospective observational study was undertaken in the otolaryngology department of a training hospital. Using the NOSE scale, the study prospectively compared the results of septoplasty only and septoplasty with b-RFAIT in the treatment of nasal obstruction caused by the combination of septal deviation and turbinate hypertrophy. Patients were divided into 2 groups. The first group had only septoplasty and the second group had septoplasty with b-RFAIT. General and local anesthesia were applied in both groups. To review clinical success, all patients were controlled at the 1st week, 1st month, and 3rd month. Results: One hundred seventy-eight adult patients (male/female: 127/51) with chronic nasal obstruction complaint were enrolled in this prospective study. Our data demonstrated significant improvement from baseline after 24 months for the NOSE scores in both the septoplasty and septoplasty + b-RFAIT groups. No statistical difference was noted in the amount of postoperative improvement between the 2 treatment groups (P = 0.306). No significant difference was observed between general and local anesthesia with respect to patients'(TM) preop and postop mean scores (P > 0.05). There was a significant difference between the age of patients'(TM) postoperative mean (P < 0.001). There were 4 postoperative means with respect to control time. There was an 82.29% decrease in the complaints of patients at 0 to 6 months, 80.51% decrease at 7 to 12 months, 76.1% decrease at 13 to 18 months, and 59.67% decrease at 19 to 24 months. Only the last group had a significant difference regarding mean change in scores (P < 0.001). Conclusions: This study shows that septoplasty + bilateral turbinate radiofrequency should be applied to patients who suffer from septum deviation with concha hypertrophy. Postoperative NOSE scale shows that the success of operation does not depend on the gender of patients and operation types (general or local anesthesia). We conclude that younger patients (18-40 age) who have obstruction with septal deviation and septum deviation with concha hypertrophy benefit more from operation than older patients do.Öğe Pediatric Bell’s palsy: prognostic factors and treatment outcomes(2020) Ayşel, Abdulhalim; Yılmaz, Mehmet Fatih; Tokat, Taşkın; Aliyeva, Aynur; Altaş, Enver; Müderris, Togay; Şimşek, Özgür ÖzdemirBackground. Idiopathic facial paralysis or Bell’s palsy is the most common type of peripheral facial paralysis. Children with Bell’s palsy is an uneasy situation for the family and physician with questions about the etiology, treatment options and the healing process. Here, we aimed to compare the epidemiologic features and prognostic factors of patients with Bell’s palsy aged <18 years.Methods. Records of patients with Bell’s palsy who were admitted to our clinic between January 2008 and December 2017 were evaluated. Results. Forty-seven patients with Bell’s palsy were included to this study. The patients’ ages varied between 7 and 17 (14.7±2.5) years. At the end of at least 6 months of follow-up, 32 (68.1%) of the patients presented with House Brackmann (HB) grade 1 facial paralysis, while 12 (25.5%) of them had grade 2 and 3 (6.4%) of them had grade 3 facial paralysis. Mean neutrophil-to-lymphocyte ratio (NLR) in patients with advanced grades (grade 4, 5, 6) was higher, compared to that of patients with grade 2 and 3 (4.10 ± 1.06 vs 1.34 ± 1.02 (p <0.001). Conclusions. In our study, the response rate to treatment was high. In differential diagnosis, congenital anomalies, malignancy, trauma, middle ear infection and surgery should be considered. In addition, NLR at admission can be considered as a prognostic factorÖğe Pediatric sudden sensorineural hearing loss: etiology, prognostic factors and treatment(2022) Altaş, Enver; Atsal, Görkem; Aysel, Abdulhalim; Boyacıoğlu, Hayal; Dalgıç, Abdullah; Yılmaz, Fatih; Müderris, TogayAim: Sudden sensorineural hearing loss (SSNHL) may have a negative impact on the language and psychological development of children, especially if it is not diagnosed early and treated promptly. This study were aimed to determine and compare the etiological factors, treatment outcomes and prognostic factors in the pediatric patients who were followed up with the diagnosis of SSNHL. Materials and Methods: The files of 28 children were analyzed retrospectively. In pure tone audiometry, the average of pure tone thresholds of 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz were accepted as pure tone averages (PTAV). Patients' recovery status was determined according to Siegel criteria. Audiometric curve types were evaluated as ascending, descending, and flat. Results: The ages of patients with SSNHL was mean ± SD 14.89 ± 3.24 (min-max: 7 and 18). The pre-treatment PTAV was mean ± SD 55.27 ± 12.39 dB HL (min-max: 38.5 and 85.25 dB HL) and the PTAV after treatment was mean ± SD 23.13 ± 18.22 dB HL (min-max: 5 and 72.5 dB HL). Audiometric curve types were detected as descending curve (n: 11, 39.2%), ascending curve (n: 5, 17.9%), flat curve (n: 12, 44.9%). Eighteen (64.3%) patients had complete recovery, 8 (28.6%) patients had partial recovery, and 2 (7.1%) patients had no recovery after the treatment. Conclusion: The response to treatment was found to be high. Descending audiometric curve type was found as a positive prognostic factor. Although the presence of tinnitus was a better prognostic factor than the presence of vertigo.Öğe Sfenoid sinüs ve komşu nörovasküler yapıların anatomik varyasyonları(2021) Müderris, Togay; Zorlu, Mehmet Ekrem; Doblan, Ahmet; Mişe, İbrahimAmaç: Çalışmamızda Endoskopik Endonazal Transsfenoid Yaklaşım (EETY) ile opere edilen hastaların operasyon öncesi bilgisayarlıtomografilerini değerlendirerek sfenoid sinüs pnömatizasyonunu, sfenoid sinüs varyasyonlarını, internal karotid arter (İKA) dehisans veprotruzyonunu, optik sinir ve maksiller sinir dehisans ve protruzyonlarının sfenoid sinusle ilişkisini incelemeyi amaçladık.Materyal-Metod: Hastanemizde 2006-2015 yılları arasında hipofiz adenomu tanısı ile beyin cerrahisi ile birlikte EETY ile opere edilen113 hastanın dosyası retrospektif olarak incelendi.Bulgular: Çalışmaya 64'ü kadın 49'u erkek olmak üzere toplam 113 hasta dahil edildi. Sfenoid sinüs pnömotizasyonu %1.8 konkal,%7.3 presellar, %47.7 sellar ve %43.3 postsellar tip olarak saptandı. Erkeklerde postsellar (%44.8) ve sellar tip (%44.8) eşitken, kadınlardaise sellar tipin (%50) en sık olduğu görüldü. İnternal karotid arter (İKA) protruzyonu %28.3 ve dehisansı %2.65 idi. Erkeklerde İKAprotruzyonu kadınlara oranla daha yüksek bulundu (p = 0.008). Çalışmamızda optik sinir protrüzyonunun %25,6, optik sinir dehisansının ise%1.76 olduğu tespit edildi. Maksiller sinirin protruzyonu genel olarak %25.9 iken maksiller sinirin dehisansı genel olarak %7.4 olaraksaptandı. Klinoid pnömotizasyonu erkeklerde %27 iken, kadınlarda %14.1 olarak izlendi. Aradaki farkın istatiksel olarak anlamlı olduğugörüldü (p<0.005) Sfenoid interseptum 25 hastada (%22) sol internal karotis arterin üzerinde sonlanırken, 13 hastada (%11,5) sağ internalkarotis arterin üzerinde sonlandığı tespit edildi. 54 hastada (% 47,7) sella turcica üzerinde sonlandığı görülürken, 3 hastada (%2.65) septumizlenmedi.Sonuç: Çalışmamızın verileri sfenoid sinüs anatomisinin büyük bir değişiklik gösterdiğini ortaya koymuştur. Kafa tabanına endonazaltranssfenoidal koridor ile yaklaşırken sellaya güvenli bir ulaşım sağlayarak komplikasyonları en aza indirebilmek için rutin preoperatif BTbulgularının cerrahi ekip tarafından ayrıntılı bir şekilde incelenmesi oldukça önemlidir.Öğe Surgical burr-assisted lateral osteotomy technique in septorhinoplasty(Lippincott Williams & Wilkins, 2022) Aysel, Abdulhalim; Karatan, Berrak; Müderris, TogayAchieving aesthetic and functional results in rhinoplasty requires meticulous techniques, and postoperative edema, ecchymosis, and pain can deteriorate the desired outcomes. Different osteotomy techniques are defined to have optimal outcomes while reducing edema, ecchymosis, and pain. In this study, the authors compared conventional and power-assisted surgical burr osteotomy techniques in terms of early postoperative complications. Patients who underwent primary open septorhinoplasty were included in the study and were divided into 2 groups. The first group had lateral endonasal osteotomy with conventional guided osteotomes, and the second group had lateral osteotomy with surgical round burr. Edema and ecchymosis scoring systems were used on the postoperative first, third, and seventh day to evaluate postoperative edema and ecchymosis, and the visual analog scale was used to evaluate pain severity on the postoperative period. Out of 70 patients who had undergone septorhinoplasty, 36 received conventional osteotomy and 34 received surgical round burr osteotomy. Periorbital ecchymosis scores were significantly lower in the second group on the postoperative first, third, and seventh days. The periorbital edema scores were significantly lower in the second group on the first postoperative day but no difference was found between postoperative days 3 and 7. Also, the pain scores were significantly lower in the second group. Osteotomy with surgical round burr yields less ecchymosis, edema, and pain in the early postoperative period than conventional osteotomy in primary septorhinoplasty patients.Öğe Tükürük bezi tümörü tanısında ultrasonografi (USG), mangnetik rezonans görüntüleme (MRG), bilgisayarlı tomografi (BT), ince iğne aspirasyon biyopsisi’nin (İİAB) karşılaştırılması(2020) Doblan, Ahmet; Sevil, Ergun; Müderris, Togay; Kırış, MuzafferGiriş: Tükürük bezleri tümörlerinde benign ve malign neoplazm arasındaki preoperatif farklılıkların belirlenmesi cerrahi operasyonun gerekliliği, aciliyeti ve kapsamını belirlemede önemlidir. Çalışmanın amacı, tükürük bezi kitlesi nedeniyle opere olmuş hastalarda, tükürük bezi tümörlerinin tanımlayıcı özelliklerinin ve tanı yöntemlerinin tanısal değerlerinin belirlenmesidir.Yöntemler: Çalışma, 2008-2016 yılları arasında, tükürük bezinde malign veya benign kitle nedeni ile opere edilen hastaların, tıbbi kayıtlarının retrospektif incelenmesi ile yapılan tanımlayıcı tipte bir araştırmadır. Hastalara preoperatif dönemde yapılan Ultrasonografi (USG), Magnetik Rezonans Görüntüleme (MRG), Bilgisayarlı Tomografi (BT), İnce İğne Aspirasyon Biyopsisi’nin (İİAB) sonuçları ve postoperatif dönemde histopatolojik tetkik sonuçları değerlendirildi. Kullanılan tanı yöntemlerinin sensitivite, spesifite, pozitif prediktif değer (PPD), negatif prediktif değer (NPD), eğri altında kalan alan (AUC±SE) değerlerinin hesaplanması için ROC analizi yapıldı.Bulgular: Çalışma grubu 114 kişiden oluşmakta olup yaş ortalamaları 46.90±14.32 yıl idi. Çalışma grubunun %54.4’ü erkek, %71.9’u 40 yaşın üstündeydi. Tükürük bezi tümörlerinin %71.9’u parotiste idi. Hastaların tanı amaçlı yapılan histopatoloji incelemesinde % 11.4’ünün malign tümöre sahip olduğu bulundu. Hastalarda en sık rastlanan benign tümör çeşidi pleomorfik adenom, en sık rastlanan malign tümör çeşidi mukoepidermoid kanser olarak saptandı. Sensitivite, NPD, AUC±SE değerlerinin en yüksek olduğu yöntem MRG, spesifite ve PPD değerlerinin en yüksek olduğu yöntem İİAB idi.Sonuç ve Öneriler: Sonuç olarak, hastalarda tükürük bezi tümörlerinin en sık parotis bezinde (%11.4’ü malign) görüldüğü, en sık benign tükürük bezi tümörünün pleomorfik adenom, en sık malign tükürük bezi tümörünün mukoepidermoid kanser olduğu bulundu. Sensitivite, NPD, AUC±SE değeri en yüksek olan yöntem MRG ve spesifite ve PPD değeri en yüksek olan yöntem İİAB idi. USG, BT, MRG, İİAB’nin tükürük bezi tümörlerindeki tanısal değerlerini inceleyen, daha geniş örneklemlerde yapılacak klinik araştırmaların faydalı olacağı düşünüldü.
