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    Are nasal steroids effective in children with adenoid hypertrophy?
    (2019) Solmaz, Fevzi; Aşcıoğlu, Mustafa Erhan; Durgut, Osman; Dikici, Oğuzhan; Haksever, Mehmet; Akduman, Davut
    Objectives: Chronic nasal obstruction is a common disease of childhood. Adenotonsillar hypertrophy playsan important role in obstructive sleep apnea. The topical use of the aerosolized forms of corticosteroids thereforeseems the most appropriate route to decrease systemic side effects. The aim of our study is to demonstrate theeffect of topical mometasone furoate especially on the adenoid volume in patients without any allergic story.Methods: The study group consisting of 30 males and 25 females was administered topical nasal mometasonefuroate steroid treatment. The 20 patients were in the control group where saline solution (0.9% NaCl) treatmentwas administered consisted of 12 males and 8 females. Nasopharyngeal X-rays before treatment revealed that25 patients were Grade 2 and 30 patients were Grade 3 according to the Fujioka method.Results: Flexible endoscopy performed before the treatment revealed that 20 patients were Grade 2, 11 patientswere Grade 3 and 24 patients were Grade 4. Nasal endoscopies performed after 6 weeks of intranasal topicalsteroid therapy revealed that 45 patients were Grade 1 and 10 patients were Grade 2. A statistically significantdifference was present between endoscopic grades before and after treatment (p < 0.0001). Nasal endoscopiesperformed after 6 weeks in control group receiving saline solution treatment revealed Grade 2 in 7 patients,Grade 3 in 10 patients and Grade 4 in 3 patients. There was no statistically significant difference between inthe prior and later grades of the control group (p = 0.3125).Conclusions: We believe that the use of intranasal steroids (mometasone furoate) for 6 weeks in patients withpediatric chronic nasal obstruction due to adenoid hypertrophy may be an effective treatment modality inalleviating symptoms and decreasing adenoid volume without causing systemic side effects.
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    The audiological and take results of perichondrium attached cartilage island graft in tympanoplasty: PACIT
    (Pacini Editore, 2016) Solmaz, Fevzi; Akduman, Davut; Haksever, Mehmet; Gündoğdu, Ercan; Yanılmaz, Muhammed; Mescioğlu, Atilla
    Cartilage is one of the most preferable grafts for tympanoplasty (TPL). The anatomical and audiological results and take rates of perichondrium attached cartilage island graft in tympanoplasty (PACIT) are presented herein. One hundred ninety four ears of 191 patients (108 male, 83 female) were evaluated retrospectively in terms of the type of surgery, graft take rate and hearing results. Type I, II, and III TPL were performed in 127 (65.46%), 45 (23.20%), and 22 (11.34%) ears, respectively. The overall mean preoperative pure tone average-air bone gaps (PTA-ABGs) for TPL types were 33.74 +/- 9.60, 52.58 +/- 9.07, and 56.58 +/- 10.27 dB HL, respectively; postoperative mean values for TPL groups were 18.55 +/- 9.25, 31.21 +/- 4.36, and 44.84 +/- 12.45 dB HL. Postoperative hearing results showed an improvement (>= 10 dB) in 76.81% of ears with a mean gain of 20 dB HL (range 10-40 dB). However, 19.07% of ears showed no change (< 10, >= 0 dB) in hearing, and hearing worsened in 4.12% of ears (< 0 dB) postoperatively. Overall, graft take was 91.24% at least 13 months (mean 68.64) after surgery with a graft failure rate of 8.76%. Graft take was successful in TPL groups. Postoperative PTA-ABG results demonstrated significant improvement. The long-term eligibility of perichondrium attached cartilage island graft in TPL is emphasised with this study.
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    Does amikacin treatment cause subclinical hearing loss in patients with cystic fibrosis?
    (Elsevier Science Bv, 2016) Solmaz, Fevzi; Gündoğdu, Ercan; Akduman, Davut; Haksever, Mehmet; Dikici, Oğuzhan; Ünal, Fatih
    Introduction: Aminoglycosides (AGs) have been widely used for potential life-threatening bacterial infections. Although AGs are well known for their ototoxic side effects, some AGs such as amikacin are considered less harmful to auditory functions; thus, auditory monitoring is mostly neglected during treatment with these drugs. Objective: To reflect the potential auditory hazards of repeated amikacin use on the patients with cystic fibrosis (CF). Method: 32CF patients with prior exposure to at least 3 courses of amikacin (the CF group) and 35 non CF patients visiting the outpatient clinic with any complaint other than hearing loss and no history of treatment with any AG( the control, or C group) were compared with pure-tone audiometry(PTA). The diagnosis of CF was made by Nanoduck sweat test. Results: The average age of the participants were 8.25 +/- 2.76 years in the CF group and 8.58 +/- 2.00 years in the C group (ranging from 5 to 13 years). 29 (43.28%) of the cases were female and 38 (56.71%) were male. Clinical SNHL(sensorineural hearing loss) was detected in 4 of the 32 subjects in the CF group. None of the subjects in the C group exhibited clinical SNHL. There was no statistically significant difference between the groups with regard to presence or absence of clinical SNHL (p > 0.05). However, hearing levels of the CF group were around 20 dB(decibel) HL(hearing loss), whereas hearing levels of the C group were around 5 dB. This difference was statistically significant for the pure tone averages of both all frequencies and speech frequencies (p < 0.05). Conclusion: Repetitive exposure to AGs can cause permanent, although mild, sensorineural hearing loss. For prevention, hearing status of the patient should be closely monitored and treatment of choice should be precisely tailored according to the audiological evaluation. This is especially important in patients with CF who frequently experience medical conditions necessitating AGs use. (C) 2016 Published by Elsevier Ireland Ltd.
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    The effect of Enterobius vermicularis infection (oxyuriasis) on eosinophil and IgE levels in allergic rhinitis
    (2018) Solmaz, Fevzi; Dikici, Oğuzhan; Akduman, Davut; Haksever, Mehmet; Hakyemez, İsmail Necati; Yanılmaz, Muhammed
    Objectives: Elevated levels of serum IgE and eosinophilia are the indicators of atopy and intestinal parasiticinfections. We evaluated the effect of Enterobius vermicularis infection (enterobiasis) on blood eosinophilcount and IgE levels in allergic rhinitis.Methods: A total of 110 patients diagnosed with allergic rhinitis (with symptoms of rhinorrhea, itchy nose andnasal congestion) consisting of 41 (37.27%) males and 69 (62.73%) females were examined. Forty-one(37.27%) patients with enterobiasis were selected as the study group. The remaining 69 (62.73%) patientsaccepted as the control group.Results: In the study group the mean serum total IgE level and mean serum eosinophil count were 393.10 159.83 IU/mL and 0.56 0.04 103/mL, respectively. In the control group the mean serum total IgE level andmean serum eosinophil count were 236.91 63.55 IU/mL and 0.37 0.12 103/mL, respectively. The differencebetween the two groups was statistically significant for serum total IgE levels (p 0.05) but not for serumeosinophil count (p 0.05). The correlation coefficients between serum total IgE level and eosinophil countwere statistically insignificant (p 0.05).Conclusions: More comprehensive and long-term placebo-controlled studies should be performed in order tofind the answer to the question of whether helminth infections play a role in allergic disease.
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    Mulberry hypertrophy and accompanying sinonasal pathologies: A review of 68 cases
    (Medquest Communications LLC, 2016) Akduman, Davut; Haksever, Mehmet; Yanılmaz, Muhammed; Solmaz, Fevzi
    Mulberry hypertrophy occasionally coexists with sinonasal pathologies. There are very few reports in the literature on this clinical entity. We conducted a retrospective study to draw attention to this condition in the context of accompanying sinonasal pathologies. Our study group was made up of 68 patients-51 males and 17 females, aged 13 to 57 years (mean: 34.9)-who had been diagnosed with mulberry hypertrophy and at least one accompanying sinonasal pathology. All patients had a long-standing chronic discharge. Forty-nine of these patients (72.1%) had unilateral mulberry hypertrophy. The most common concomitant pathologies were chronic rhinosinusitis and ostiomeatal complex disease; others included septal deviation, nasal polyposis, allergic rhinitis, and concha bullosa. Thirty-six patients (52.9%) with varying degrees of choanal/nasal obstruction were operated on with endoscopic excision to treat the mulberry hypertrophy. In all, most patients underwent some sort of surgery to treat either the mulberry hypertrophy or the accompanying sinonasal pathology. Based on our findings, we suggest a clinical staging system to serve as a way to standardize management and guide future basic and clinical research. © 2016 Vendome Group, LLC All rights reserved.
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    Semi-wrapping lateral cartilage to a square edged strut perpendicularly to prevent collapse in external nasal valve dysfunction: pseudodome technique
    (2019) Yanılmaz, Muhammed; Akduman, Davut
    Objectives: During inhalation through the nose, the weakness of lateral cartilage may cause the collapse ofnasal vestibule and sidewall, causing the complaint of difficult breathing through the nose. We aimed to supportthe lateral cartilage with a square edged strut to resolve this problem.Methods: We described a technique in 8 cases (5 males, 3 females). In this technique the lateral cartilage issemi wrapped from the underside to a square edged strut, and arched to outside with an open approachrhinoplasty. As it was only a physical support and did not create a new canting up through the skin, we namedthis maneuver as pseudodome technique.Results: All patients experienced relief of symptoms and no complications observed. The reinforcement effectof the strut was effective in preventing collapse of the nasal alar sidewall as well as did not cause contourirregularities.Conclusions: Pseudodome technique can be performed for acquired or congenital nasal sidewall collapsecaused by lower lateral cartilage structural weaknesses successfully.
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    Tri-layer tympanoplasty as a new technique in high-risk tympanic membrane perforations
    (Mashhad University of Medical Sciences, 2019) Solmaz, Fevzi; Akduman, Davut; Haksever, Mehmet
    Introduction: The eradication of the middle ear disease is mentioned as the fundamental principle of tympanoplasty. The presence of some factors related to patient or disease itself forces the physician to classify the chronic ear disease as high-risk perforations. The aim of this study was to present a tri-layer tympanoplasty technique and its otological and audiological outcomes in the ears with high-risk perforations. Materials and Methods: This retrospective study was carried out on a total of 46 eligible ears that had chronic otitis media with high-risk perforations. Preoperatively, 17, 15, and 14 ears were reported with Sade classification grade 4 pars tensa retraction (Group 1), total or near-total tympanic membrane perforation (Group 2), and a history of ear surgery (Group 3), respectively. All the cases had tympanoplasty using the tri-layer technique at a tertiary center during 2008 and 2014. A review of the patients' chart showed that 46 patients underwent tri-layer tympanoplasty. Regarding the audiological outcomes, the comparison of pre- and post-operative results revealed mean air conduction level and mean air-bone gap (ABG) of 4 different frequencies in dB according to a new standardized format for reporting hearing outcome in clinical trials. Results: The mean value of the follow-up period was reported as 29.22±3.23 months. Graft take rate was 93.4 % in all the cases, as well as 94.1%, 100%, and 85.7% in Group 1, Group 2, and Group 3, respectively. The mean values of ABG were improved from 35.17±6.64 to 23.52±10.4, 30.46±5.89 to 17.20±8.04, and 29.14±8.37 to 16.14±5.02 dB in Group 1, Group 2, and Group 3, respectively (P<0.05). Conclusion: Tri-layer tympanoplasty is a reliable procedure in the surgical treatment of the chronic otitis media with high-risk re-perforations. © 2019 Mashhad University of Medical Sciences. All rights reserved.