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Acetazolamide in vestibular migraine prophylaxis: a retrospective study
(Springer, 2016) Celebisoy, Nese; Gokcay, Figen; Karahan, Ceyda; Bilgen, Cem; Kirazli, Tayfun; Karapolat, Hale; Kose, Timur
The aim of this study is to check the efficacy of acetazolamide in the prophylaxis of vestibular migraine (VM). Treatment options in VM are mainly based on migraine guidelines. We tried to assess the efficacy of acetazolamide in these patients depending on clinical similarities with episodic ataxia type 2 and familial hemiplegic migraine responding to the drug. This is a retrospective cohort study. Among 50 patients with VM and prescribed acetazolamide 500 mg/day, 39 patients were studied as five had been lost on follow-up and six had stopped taking the drug due to side effects. Vertigo and headache frequency determined by number of attacks per month, and the severity determined by visual analog scales measured in centimeters from 0 to 10 were collected from the records. Initial reported figures for frequency and severity were compared with the results gathered after 3 months of treatment. The results were compared. Acetazolamide was effective in reducing both the frequency and severity of vertigo and headache attacks and this effect was more prominent for vertigo frequency and severity.
Adherence to continuous positive airway pressure therapy in obstructive sleep apnea syndrome: effect of visual education
(Springer Heidelberg, 2012) Basoglu, Ozen K.; Midilli, Meltem; Midilli, Rasit; Bilgen, Cem
Continuous positive airway pressure (CPAP) therapy is the most effective treatment in obstructive sleep apnea syndrome (OSAS) although it is known that adherence to therapy is limited. The aims of this study were to evaluate the effect of visual education on CPAP adherence and to identify the factors affecting adherence. Out of 133 consecutive newly diagnosed moderate-to-severe OSAS patients, 66 were informed about OSAS and CPAP therapy and received visual education by videotape (video group), whereas only information was given to 67 of them (control group). The patients were followed up in the 1st, 3rd, and 6th months. After 6-month follow-up, adherence rate to CPAP therapy was 71.2% in the video group and 56.7% in the control group (p = 0.08). OSAS symptoms, such as witnessed apnea, morning headache, night sweating, dry mouth, and Epworth sleepiness score (ESS), were ameliorated more significantly in the video group (p < 0.05). In order to assess predictors of adherence, 85 patients using CPAP effectively were compared to 48 nonadherent patients; significant improvement in OSAS symptoms and ESS was observed in the adherent patients (p < 0.05). ESS was negatively correlated with the duration of CPAP use (r = -0.524, p < 0.0001). Adverse effects such as mask intolerance, choking, noise, and nasal congestion were related to poorer adherence (p < 0.01). It is shown that adherence rate to CPAP therapy might be improved by visual education although the difference was not significant. Besides, patients with better adherence to CPAP treatment report the greatest improvement in OSAS symptoms and daytime sleepiness, and adverse effects are significantly related to poorer adherence.
Akut tonsillofarenjit hastalarında rapid strep A testinin güvenilirliği
(2002) Uygur, Murat; Kirazlı, Tayfun; Bilgen, Cem
KBB polikliniklerine başvuran hastaların büyük bir bölümünü üst solunum yolu hastalıkları oluşturmaktadır. Hastalığın etkeninin viral veya bakteriyel olmasının ayrımının yapılması, hem gereksiz yere antibiyotik kullanımını önlemede hem de tedavi maliyetinin düşmesinde faydalıdır. Günümüzde ajan patojenin belirlenmesine yönelik hızlı test teknikleri mevcuttur. Yaptığımız çalışmada viral-bakteriyel tonsillofarenjit ayırımında kullanılan, hızlı testlerden biri olan, Rapid Strep A testinin güvenilirliği araştırılmıştır. Çalışmaya Ege Üniversitesi Tıp Fakültesi KBB Hastalıkları Polikliniği'ne başvuran 31 hasta dahil edildi. Tüm hastaların muayene sonrasında boğaz kültürleri alındı ve Rapid Strep A (RSA) testi uygulandı. RSA testi pozitif olan hastalara, boğaz kültürü sonucu beklenmeden antibiyoterapi başlandı. Antibiyoterapinin başarısız olduğu dört hastada monospot testi ve heterofil antikor testi pozitif bulundu. Elde edilen bulgulara göre RSA testi poliklinik şartlarında diğer serolojik testlerle birlikte kullanıldığında klinik başarıyı arttıracağı ve gereksiz antibiyotik kullanım oranını azaltacağı için faydalı, kolay uygulanabilir, hızlı ve ucuz bir testtir.
Argon stapedotominin iç kulak üzerindeki etkisinin otoakustik emisyonlar ile incelenmesi
(Ege Üniversitesi, 2014) Bilgen, Cem; Kirazlı, Tayfun
Giriş: Otoskleroz cerrahisi otolojik cerrahinin yüz güldüren ameliyatlarından biridir. Otoskleroz cerrahisinde amaç, hastalığa bağlı kemikçik zincirdeki hareketsizliği gidererek ses iletimini tekrar sağlamaktır. Bu amaçla tarihsel süreç içerisinde birçok teknik kullanılmıştır. Kliniğimizde otoskleroz ön taneli hastalara konvansiyonel teknikle yapılan stapedotomi son yıllarda yerini KTP lazer ile stapedotomiye bırakmıştır. Bu çalişmadaki amacımız KTP lazer güvenilirliğini distorsiyon ürünü otoakustik emisyon ile değerlendirmektir. Materyal ve Metod: Araştırma kliniğimizde Kasım 2012- Eylül 2013 tarihleri arasında otoskleroz ön tanısı ile KTP lazer ile stapes cerrahisi uygulanan 17 vakayı içeren prospektif bir çalışmadır. Her olgu postoperatif dönemde 3 ay boyunca takip edildi. Preoperatif dönemde, postoperatif 6. hafta ve 3. ayda hastalara saf ses odyometri ve DPOAE uygulandı. Tüm hastalar otomikroskopik olarak testler öncesi tetkik edildi ve hepsinin dış kulak yolunun açık olduğu ve timpan zarlannın olağan izlendiği görüldü. Bulgular: Postoperatif 45. gün ve 3. ayda; 4 frekanstaki SNR ortalamaları; preoperatif dönemdeki aynı 4 frekans SNR ortalamalarıyla istatiksel olarak karşılaştırıldığında aralarında hiçbir frekansta fark saptanmadı (p>0.05). SNR'deki değişim istatiksel olarak anlamlı görülmedi. SNR'de eşik değer olarak 6 dB üzerinden kategorize ettiğimiz yanıtlarda Postoperatif 3. ay ile preoperatif dönem arasında istatiksel olarak 500 ve 4000 Hz frekansta anlamlı artış saptandı ( p
Butterfly cartilage tympanoplasty: an alternative new technique instead of conventional surgery method
(Springer, 2017) Kaya, Isa; Benzer, Murat; Gode, Sercan; Bilgen, Cem; Kirazli, Tayfun
Butterfly graft inlay tympanoplasty is a well-established technique for the repair of small- and medium-sized perforations. There are some difficulties with application of conventional butterfly technique and it affects our success rate of graft healing. With some modifications of graft preparation we can make better success rates. The aim of this study was to present the new renovation of conventional method, describe about what kind of changes we made and its technical facilities about the procedure. The study design is a prospective case series. This study was carried out on 18 patients who underwent inlay butterfly cartilage tympanoplasty with the new technique for anterior and inferior perforations at an otolaryngology department of a tertiary medical center between November 2015 and August 2016. Patients were followed with otoscopy and audiometry, and graft healing's success. Anatomic closure at 6th month after tympanoplasty was found in all 18 patients. There was no incidence of cartilage graft rejection or displacement. Preoperative mean PTA was 27.7 dB, which improved 6 months after surgery to 10.5 dB (the average value of hearing thresholds at 0.5, 1, 2 and 4 kHz). Butterfly cartilage tympanoplasty technique is safe and efficient in terms of both anatomical closure of the defect and improvement in hearing. We believe with this new technique, we facilitate this procedure in addition to the improvement of patients' comfort and decrease the morbidity of the procedure.
Can verapamil be effective in controlling vertigo and headache attacks in vestibular migraine accompanied with Meniere's disease? A preliminary study
(Springer Heidelberg, 2019) Kaya, Isa; Eraslan, Sevinc; Tarhan, Ceyda; Bilgen, Cem; Kirazli, Tayfun; Gokcay, Figen; Karapolat, Hale; Celebisoy, Nese
Cisplatin ototoxicity in children: risk factors and its relationship with polymorphisms of DNA repair genes ERCC1, ERCC2, and XRCC1
(Springer, 2019) Turan, Caner; Kantar, Mehmet; Aktan, Cagdas; Kosova, Buket; Orman, Mehmet; Bilgen, Cem; Kirazli, Tayfun
Purpose We aimed to investigate the cisplatin-related hearing toxicity and its possible relationship with polymorphic variants in DNA repair genes, ERCC1, ERCC2, and XRCC1. Methods Fifty patients treated with cisplatin in the past were included in the study. There were 29 females and 21 males; mean age 13.4 +/- 6.0 years). the polymorphism in DNA repair genes was studied using primer and probes in Light Cycler device after DNA isolation was carried out with PCR technique. the polymorphisms and clinical risk factors were evaluated using Chi square test and logistic regression modelling. Results the patients had hearing loss in 44%. For ERCC1 gene, the patients with hearing loss had 50% of GG (wild type), 40.9% of AG and 9.1% of AA genotypes, while the patients without hearing loss had 28.6% of GG, 53.5% of AG, and 17.9% of AA genotypes. For ERCC2 gene, the patients with hearing loss had 18.2% of GG (wild type), 40.9% of TG, and 40.9% of TT genotypes, while the patients without hearing loss had 10.7% of GG 39.3% of TG, and 50% of TT genotypes. For XRCC1 gene, the patients with hearing loss had 18.2% of CC (wild type), 59.1% of CT, and 22.7% of TT genotypes, while the patients without hearing loss had 35.7% of CC, 50% of CT, and 14.3% of TT genotypes. There was no statistically significant association among the groups (p = 0.24). Conclusion We did not find a relationship between DNA repair gene polymorphisms and hearing toxicity of cisplatin.
Clinical and video head impulse test in the diagnosis of posterior circulation stroke presenting as acute vestibular syndrome in the emergency department
(Ios Press, 2017) Guler, Ayse; Akarca, Funda Karbek; Eraslan, Cenk; Tarhan, Ceyda; Bilgen, Cem; Kirazli, Tayfun; Celebisoy, Nese
INTRODUCTION: Head impulse test (HIT) is the critical bedside examination which differentiates vestibular neuritis (VN) from posterior circulation stroke (PCS) in acute vestibular syndrome (AVS). Video-oculography based HIT (vHIT) may have aadditional strength in making the differentiation. METHODS: Patients admitted to the emergency department of a tertiary-care medical center with AVS were studied. An emergency specialist and a neurologist performed HIT. vHIT was conducted by an neuro-otology research fellow. RESULTS: Forty patients 26 male, 14 female with a mean age of 49 years were included in the analyses. Final diagnoses were VN in 24 and PCS in 16 patients. In the VN group, clinical HIT was assessed as abnormal in 19(80%) cases by the emergency specialist and in 20(83%) by the neurologist. In all PCS patients, HIT was recorded as normal both by the emergency specialist and the neurologist (100%). On vHIT, patients with VN had significantly low gain values for both the ipsilesional and contralesional sides when compared with the healthy controls, with significantly lower figures for the ipsilesional side (p < 0.001). All patients in this group had normal DWI-MRI. PCS patients had bilaterally low gain (p < 0.05) on vHIT. However, gain asymmetry was not significant. Subgroup analyses according to presence of brainstem involvement revealed bilateral low gain (p < 0.05) in patients with brainstem infarction (anterior inferior cerebellar artery-posterior inferior cerebellar artery stroke, AICA-PICA stroke) whereas patients with pure cerebellar infarction (posterior inferior cerebellar artery-superior cerebellar artery stroke, PICA-SCA stroke) had gain values similar to healthy controls. With a gain cut-off <= 0.75 and gain asymmetry cut-off >= 17%, as determined by ROC analysis, 100% of PCS patients and 80% of VN patients were correctly diagnosed. CONCLUSIONS: Clinical HIT, either performed by an emergency specialist or neurologist is equivalent to vHIT gain and gain asymmetry analysis as conducted by neuro-otologist in the diagnosis of PCS, albeit mislabeling about 20% of VN patients. vHIT does not appear to yield additional diagnostic information. These findings indicate the strength of clinical HIT. Pure gain-based vHIT analysis seems limited and needs to be incorporated with saccade analysis.
Comparative Cytochrome P450-1A1, -2A6, -2B6, -2C, -2D6, -2E1, -3A5 and -4B1 expressions in human larynx tissue analysed at mRNA level
(John Wiley & Sons Ltd, 2006) Sarikaya, Devrim; Bilgen, Cem; Kamataki, Tetsuya; Topcu, Zeki
The metabolic activation of numerous exogenous and endogenous chemicals is catalysed by cytochrome P450 enzymes (CYPs). The aim of this study was to analyse the expression of the individual forms of CYP at the mRNA level in human larynx and quantitatively to compare their expressions in human liver, the main in organ of CYP expression. Individual forms of CYP mRNAs were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) using specific primers for the CYPs -1A1, -1A2, -2A6,-2B6,-2C, -2D6, -2E1, -3A3/4 ,-3A5, -3A7 and 4B1. An RNA competitor of known copy number, covering the primer sequences necessary to amplify the entire object CYPs within a single molecule, was used as reference. This study reports a consistent detection of mRNAs for the CYPs -1A1, -2A6, -2B6, -2C, -2D6, -2E1, -3A5 and -4B1 in the human larynx tissue. The data indicate that the human larynx highly resembles the lung tissue in CYP content, as a comparable subset of CYP mRNAs was detected in the larynx previously reported for human lung with the exception of CYP1A2. The results are discussed in quantitative ratios of the detected CYP mRNAs in relation to the hepatic CYP expression. Copyright (c) 2006 John Wiley & Sons, Ltd.
Comparison of anterior and posterior tympanomeatal flap elevations in endoscopic transcanal tympanoplasty
(Taylor & Francis Ltd, 2019) Ozturk, Arin; Benzer, Murat; Kaya, Isa; Gode, Sercan; Bilgen, Cem; Kirazli, Tayfun
Background: There is not an ideal tympanomeatal flap incision type for transcanal procedures. Aims/Objectives: Comparing the outcomes and feasibility of posteriorly and anteriorly based tympanomeatal flap incisions for anterior perforations in endoscopic transcanal cartilage tympanoplasty. Material and methods: Twenty-six patients who had anterior TM perforation were included. Patients were divided into two groups with randomization. All of the data were prospectively collected. These included demographic data, date of the surgery, mean surgery time, preoperative and postoperative sixth-month pure-tone audiometry (PTA), type of tympanomeatal flap incision and graft healing success. Results: Mean follow up time was 20.69 +/- 5.03 months. Graft healing rate was 100% in both groups. There was no major complication in both of groups. Mean air bone gap level improvement of (dB HL) at all frequencies was 7.69 +/- 2.83 dB HL in group 1 and 7.98 +/- 3.08 dB HL in group 2 respectively. Regarding pre-and postoperative mean air bone gap levels and mean surgery times, there was no significant difference between groups (p>.05). Conclusions and significance: For non-complicated anterior perforations that are less than 50% of TM, endoscopic transcanal cartilage tympanoplasty using anterior tympanomeatal flap elevation procedure was seemed minimally invasive and feasible to perform with successful audiologic and postoperative outcomes.
CT imaging of superior semicircular canal dehiscence: Added value of reformatted images
(Taylor & Francis Ltd, 2010) Ceylan, Naim; Bayraktaroglu, Selen; Alper, Hudaver; Savas, Recep; Bilgen, Cem; Kirazli, Tayfun; Guzelmansur, Ismail; Erturk, Sukru Mehmet
Conclusion: Superior semicircular canal dehiscence (SSCD) syndrome may present with various symptoms. CT scans previously interpreted as normal may show SSCD, especially if special reconstructions tailored for superior canal evaluation are added. Objectives: The purpose of this study was to investigate prevalence of SSCD, its length and its correlation with symptoms in patients who had previously undergone temporal bone CT examination that was reported normal and to demonstrate the importance of reformatted images in the diagnosis of SSCD. Methods: We retrospectively reviewed 108 patients who had undergone temporal bone CT examination for various symptoms and were reported as normal. High-resolution temporal bone CT imaging was performed with 1 mm slice thickness in the transverse plane. Each of the superior semicircular canals was evaluated in the plane of Poschl and Stenver reformatted images together with axial images. Results: Ninety-three patients were included in the study. Nineteen patients with semicircular canal dehiscence were detected. The mean age of the study group was 45 years. Radiologic evidence of SSCD occurred in 23 of 186 temporal bones with a radiologic prevalence of 12%. The most common symptoms in dehiscent patients were vertigo, hearing loss and tinnitus. Defect lengths varied between 1 mm and 6.5 mm.
Does betahistine treatment have additional benefits to vestibular rehabilitation?
(Springer, 2010) Karapolat, Hale; Celebisoy, Nese; Kirazli, Yesim; Bilgen, Cem; Eyigor, Sibel; Gode, Sercan; Akyuz, Aycan; Kirazli, Tayfun
The aim of this study was to investigate the effect of high-dose betahistine treatment added to vestibular rehabilitation (VR) on the disability, balance and postural stability in patients with unilateral vestibular disorder. The VR group (group 1, n = 24) and the VR + betahistine group (group 2, n = 23) were analyzed retrospectively. All patients were evaluated before and after an 8-week customized VR in terms of disability (Dizziness Handicap Inventory, DHI), dynamic balance [Dynamic Gait Index (DGI)] and postural stability (static posturography). In group 1 and group 2, differences between DHI, DGI and falling index score on static posturography before and after the exercise program were significant (p < 0.05). In addition, a significant difference was detected only in group 2 in the variables evaluated in static posturography-Fourier 4 analysis (p < 0.05). Both VR and betahistine + VR have a positive effect on disability and balance in patients with unilateral vestibular disorder. Betahistine treatment added to VR was effective in increasing postural stability.
The Effect of a Mandibular Advancement Splint on Electromyographic Activity of the Submental and Masseter Muscles in Patients with Obstructive Sleep Apnea
(Quintessence Publishing Co Inc, 2009) Kurtulmus, Huseyin; Cotert, Serdar; Bilgen, Cem; On, Arzu Yagiz; Boyacioglu, Hayal
Purpose: The effectiveness of an appliance for the treatment of obstructive sleep apnea (OSA) shows inordinate interindividual differences. Also, its therapeutic effects still remain unresolved. This study examined and compared the effects of a mandibular advancement splint (MAS) on the masseter and submental muscles of patients with mild and moderate OSA. Materials and Methods: Twenty OSA patients (10 mild and 10 moderate) who refused or did not tolerate nasal continuous positive airway pressure were randomly selected among individuals whose apnea-hypopnea indices (AHIs) were determined at the sleep laboratory of the Department of Chest Diseases, Ege University, before the study. Two polysomnography (PSG) sessions were performed and evaluated: the first without an MAS for the first half of the night to determine baseline muscle activity and the second with an MAS for the other half of the night to follow the condition of muscle activity. Electromyograms (EMGs) of the sum of the submental musculature and masseter muscle were measured with PSGs. The highest EMG amplitudes of the muscles and their AHIs were recorded before and after use of the appliance. Data were analyzed statistically using a t test. Results: After insertion of the MAS device, EMG amplitudes increased significantly in the submental (P < .05) and masseter muscles (P < .05) of both mild and moderate OSA patients. However, the increase in muscle activity in the mild OSA group was significantly different from the moderate OSA group (P < .05). Accordingly, the mean EMG amplitude during moderate apnea episodes was lower than mild both with and without the appliance. After insertion of the MAS, the mean AHI in both mild and moderate OSA patients decreased significantly from baseline recordings (P < .05). Patients reported a favorable sleeping pattern and no dislodgement of the appliance during sleep. Conclusion: The MAS activated the masseter and submental muscles during sleep and prevented the upper airway from collapsing. The prosthetic appliance was useful in the treatment of both mild and moderate OSA syndrome. Int J Prosthodont 2009; 22: 586-593.
The Effect of a Mandibular Advancement Splint on Electromyographic Activity of the Submental and Masseter Muscles in Patients with Obstructive Sleep Apnea
(Quintessence Publishing Co Inc, 2009) Kurtulmus, Huseyin; Cotert, Serdar; Bilgen, Cem; On, Arzu Yagiz; Boyacioglu, Hayal
Purpose: The effectiveness of an appliance for the treatment of obstructive sleep apnea (OSA) shows inordinate interindividual differences. Also, its therapeutic effects still remain unresolved. This study examined and compared the effects of a mandibular advancement splint (MAS) on the masseter and submental muscles of patients with mild and moderate OSA. Materials and Methods: Twenty OSA patients (10 mild and 10 moderate) who refused or did not tolerate nasal continuous positive airway pressure were randomly selected among individuals whose apnea-hypopnea indices (AHIs) were determined at the sleep laboratory of the Department of Chest Diseases, Ege University, before the study. Two polysomnography (PSG) sessions were performed and evaluated: the first without an MAS for the first half of the night to determine baseline muscle activity and the second with an MAS for the other half of the night to follow the condition of muscle activity. Electromyograms (EMGs) of the sum of the submental musculature and masseter muscle were measured with PSGs. The highest EMG amplitudes of the muscles and their AHIs were recorded before and after use of the appliance. Data were analyzed statistically using a t test. Results: After insertion of the MAS device, EMG amplitudes increased significantly in the submental (P < .05) and masseter muscles (P < .05) of both mild and moderate OSA patients. However, the increase in muscle activity in the mild OSA group was significantly different from the moderate OSA group (P < .05). Accordingly, the mean EMG amplitude during moderate apnea episodes was lower than mild both with and without the appliance. After insertion of the MAS, the mean AHI in both mild and moderate OSA patients decreased significantly from baseline recordings (P < .05). Patients reported a favorable sleeping pattern and no dislodgement of the appliance during sleep. Conclusion: The MAS activated the masseter and submental muscles during sleep and prevented the upper airway from collapsing. The prosthetic appliance was useful in the treatment of both mild and moderate OSA syndrome. Int J Prosthodont 2009; 22: 586-593.
The Effect of Endoscopic Tympanoplasty on Cochlear Function
(Korean Soc Otorhinolaryngol, 2018) Kaya, Isa; Turhal, Goksel; Ozturk, Arin; Gode, Sercan; Bilgen, Cem; Kirazli, Tayfun
Objectives. The aim of this prospective clinical study was to measure the audiologic outcomes of the patients that underwent endoscopic transcanal cartilage tympanoplasty, and to investigate the effects on cochlear function. Methods. Thirty-three patients (33 ears) who were diagnosed with noncomplicated chronic otitis media and underwent endoscopic transcanal cartilage tympanoplasty technique were included. Pre- and postoperative first month distortion product otoacoustic emission (DPOAE) signal-to-noise ratio (SNR), bone conduction hearing levels and air bone gap (ABG) values were measured and total endoscope usage time was noted. Results. Preoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (1-11; interquartile range [IQR], 1), 6 dB (4-20; IQR, 1), 7 dB (3-26; IQR, 5) and 5.50 dB (0-9; IQR, 3), respectively. Postoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (3-9; IQR, 1), 6 dB (2-21; IQR, 3), 7 dB (2-20; IQR, 3), and 6 dB (0-10; IQR, 7), respectively. Regarding the DPOAE measurements, there was no statistically significant difference between the SNR values of all given frequencies (P>0.05). Regarding the pure tone audiometry (PTA) measurements, bone conduction was significantly better at 0.5 and 1 kHz, postoperatively (P<0.05) and there was statistically significant difference at 2 and 4 kHz (P>0.05). Additionally, no statistically significant correlation was found between the SNR and PTA measurements and the endoscope usage time (P>0.05). Conclusion. We suggested that cochlear functions and sensorineural hearing remained stable after endoscopic transcanal cartilage tympanoplasty and cold light source doesn't cause significant adverse effects cochlear functions.
The Effect of Mandibulectomy and Mandibulotomy on Cochlear Function
(Lippincott Williams & Wilkins, 2016) Gode, Sercan; Kaya, Isa; Turhal, Goksel; Kirazli, Tayfun; Bilgen, Cem; Ogut, Mehmet Fatih; Ozturk, Kerem
Mandibulectomy and mandibulotomy procedures are performed with the oscillating saw and the acoustic energy generated during the osteotomies is transferred to the cochlea via temporomandibular joint and air conduction. The aim of this study was to assess the effect of mandibulectomy and mandibulotomy on cochlear function. This study was carried out on 15 patients who underwent at an otolaryngology department of a tertiary medical center between January 2013 and August 2015. The study was designed as a prospective study. All of the data were prospectively collected. These included demographic data, date of the surgery, type of surgery, preoperative pure-tone audiometry, preoperative and postoperative distortion product otoacoustic emission (DPOAE) measurements. Of the DPOAE measurements, there was a statistically significant difference between the signal-to-noise ratio measurement on the right ear measurement at 4kHz (P<0.05). Additionally, there was a statistically significant correlation between the signal-to-noise ratio measurements and the side of the osteotomy (P<0.05). In conclusion, it is found that mandibulectomy and mandibulotomy procedure has a negative effect on cochlear function in the early period. The DPOAEs were diminished on the osteotomy site in day one postoperatively. Results with a longer follow-up time can yield more information on the prognosis of the cochlear damage.
The effect of radiotherapy on propylene glycol-induced cholesteatoma in rats
(Mediterranean Soc Otology & Audiology, 2008) Ersoy, Elif; Kirazli, Tayfun; Esassolak, Mustafa; Bilgen, Cem; Basdemir, Guelcin
OBJECTIVE: Radiotherapy has been an alternative therapy in benign pathologies with epithelial and connective tissue hyperplasia. The aim of this study was to investigate the efficacy of low dose radiotherapy in the inhibition of cholesteatoma in an experimantal cholesteatoma model in rats. MATERIAL AND METHODS: Thirty-five Wistar albino rats were used to form 3 groups: Group I (n=20; bilateral cholesteatoma induction with propylene-glycol), Group 11 (n=10; unilateral cholesteatoma induction with propylene-glycol and unilateral intratympanic saline injection), Group III (n=5, control group without injection). The effect of radiotherapy was evaluated according to the histopathological parameters. RESULTS: The results indicated that low dose radiotherapy was ineffective in the management of cholesteatoma in this histopathological study.
Effects of Vestibular Rehabilitation and Pharmacological Therapy in Patients with Vestibular Migraine
(2020) Aydın, İsa; Kirazlı, Tayfun; Bilgen, Cem; Gökçay, Figen; Çelebisoy, Neşe; Eraslan, Sevinç; Köse, Timur
Objectives: The objectives of this study were to compare the results ofpharmacologic management options and vestibular rehabilitation (VR) programsin the context of dizziness, balance problems, and headache in patients withvestibular migraine. Materials and Methods: Sixty patients with migraine with vestibular symptoms were evaluated in three groups in the neurology, physical medicine, and rehabilitation and otorhinolaryngology clinics of a medical school hospital. The groups were defined as routine pharmacologic therapy (PT), VR, or both. Patients were evaluated with static posturography, the Dizziness Handicap Inventory (DHI), and the Activities?Specific Balance Confidence (ABC) Scale as primary outcome measures and symptom frequency and severity (headaches and vertigo attacks) as secondary outcome measures. In?group and between?group comparisons were made using relevant statistical methods. Results: DHI scores were significantly reduced (P < 0.001) in all treatment groups. ABC scores increased significantly (P < 0.001) in patients taking PT and those on VR + PT. Posturographic examinations revealed that sway velocity values recorded on foam with eyes closed, which targets vestibular assessment, were significantly reduced (P < 0.001) in groups taking VR either alone or with PT. VR benefited patients with migraine in terms of headaches, vertigo attack frequency, intensity, and duration. Conclusion: Patients with predominant vestibular disorders can benefitfrom VR alone, and patients with combined symptoms (headache and vertigo) canbenefit from pharmacologic and rehabilitation therapies.
Effects of vestibular rehabilitation and pharmacological therapy in patients with vestibular migraine
(Wolters Kluwer Medknow Publications, 2020) Aydin, Isa; Gokcay, Figen; Karapolat, Hale; Eraslan, Sevinc; Bilgen, Cem; Kirazli, Tayfun; Celebisoy, Nese
Objectives: the objectives of this study were to compare the results of pharmacologic management options and vestibular rehabilitation (VR) programs in the context of dizziness, balance problems, and headache in patients with vestibular migraine. Materials and Methods: Sixty patients with migraine with vestibular symptoms were evaluated in three groups in the neurology, physical medicine, and rehabilitation and otorhinolaryngology clinics of a medical school hospital. the groups were defined as routine pharmacologic therapy (PT), VR, or both. Patients were evaluated with static posturography, the Dizziness Handicap Inventory (DHI), and the Activities-Specific Balance Confidence (ABC) Scale as primary outcome measures and symptom frequency and severity (headaches and vertigo attacks) as secondary outcome measures. In-group and between-group comparisons were made using relevant statistical methods. Results: DHI scores were significantly reduced (P < 0.001) in all treatment groups. ABC scores increased significantly (P < 0.001) in patients taking PT and those on VR + PT. Posturographic examinations revealed that sway velocity values recorded on foam with eyes closed, which targets vestibular assessment, were significantly reduced (P < 0.001) in groups taking VR either alone or with PT. VR benefited patients with migraine in terms of headaches, vertigo attack frequency, intensity, and duration. Conclusion: Patients with predominant vestibular disorders can benefit from VR alone, and patients with combined symptoms (headache and vertigo) can benefit from pharmacologic and rehabilitation therapies.
Endoscopic versus microscopic type 1 tympanoplasty in the same patients: a prospective randomized controlled trial
(Springer, 2017) Kaya, Isa; Sezgin, Baha; Sergin, Demet; Ozturk, Arin; Eraslan, Sevinc; Gode, Sercan; Bilgen, Cem; Kirazli, Tayfun
The aim of this study was to compare the audiologic outcomes of the patients who underwent endoscopy on one ear and microscopic tympanoplasty on the other, and to investigate the operative time, graft success, postoperative pain and health status. This prospective randomized controlled study was carried out in Ege University ENT Department between February 2015 and September 2016. The patients who had bilateral chronic otitis media, normal middle ear mucosa and a hearing loss difference of 10 dB or less between the two ears randomly underwent microscopic tympanoplasty in one ear and endoscopic tympanoplasty in the contralateral ear, with 6-month intervals. 13 patients were included in the study with a mean age of 36.17 +/- 3.61 years (range 17-53 years, 7 female, 6 male). The improvement in air-bone gap for groups 1 (endoscopic) and 2 (microscopic) was 9.48 +/- 5.23 and 9.89 +/- 2.79 dB, respectively. The duration of the surgery in group 1 was significantly lower than that in group 2 (p < 0.01). VAS scores were 2.15 +/- 0.37 and 3.76 +/- 1.64 cm for groups 1 and 2, respectively (p = 0.006). The endoscopic approach for type 1 tympanoplasty offers shorter surgery time, better health status and lower postoperative pain than microscopic surgery. In addition, endoscopic surgery offers comparable improvement in air-bone gap and similar graft success. The endoscopic approach has comparable audiological and morphological graft outcomes with the microscopic one. The endoscopic approach yielded better health and pain status for the same patients. Level of evidence This is an individual randomized controlled trial. The level of evidence is 1b.

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