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    Comparison of Different Treatment Methods for Idiopathic Sudden Sensorineural Hearing Loss
    (Galenos Publ House, 2018) Toroslu, Tolgahan; Erdogan, Halil; Caglar, Ozge; Guclu, Oguz; Derekoy, Fevzi Sefa
    Objective: To evaluate the effectiveness of different therapies for idiopathic sudden sensorineural hearing loss and prognostic factors, and determine the most successful treatment according to the audiogram type and time from onset to treatment. Methods: A total of 90 cases from February 2009 to January 2015 were classified under Group I oral treatment (methylprednisolone, acyclovir, betahistine-dihydrochloride, and vitamin B12); Group II oral treatment + intratympanic steroids (ITS); Group III oral treatment + hyperbaric oxygen; and Group IV only ITS. A pure tone average (PTA) improvement of less than 10 dB was assessed as noimprovement, a PTA of 10 dB or more or a 10% or more increase in the speech discrimination score (SDS) as partial improvement, and a hearing threshold within 10 dB and SDS within 5%-10% of the unaffected ear as full improvement. Results: Overall, 32.2% patients showed full and 28.9% showed partial improvement, whereas 38.9% showed no improvement. There was no significant difference in terms of mean hearing gain between the different treatment methods. As the degree of hearing loss and time from onset to treatment increased, improvement worsened (p<0.05). Descending audiogram had lower mean hearing gains compared to other groups (p=0.014). There was no significant effect of age, sex, tinnitus and/or vertigo, and systemic disease on treatment success (p>0.05). Conclusion: The most important factors affecting prognosis were the time from onset to treatment, hearing loss severity, and audiogram type. Only ITS avoided side effects and reduced hospitalization. ITS in the first two weeks, followed by hyperbaric oxygen were considered as the treatment priority.
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    Does the maxillary sinus have a triggering role in nasal nitric oxide synthesis?
    (Int Rhinologic Soc, 2012) Guclu, Oguz; Uludag, Ahmet; Akcali, Alper; Tekin, Kazim; Erdogan, Halil; Silan, Fatma; Derekoy, Fevzi Sefa
    Objectives: We investigated whether the maxillary sinus plays a stimulatory role in nasal nitric oxide (NO) synthesis. Research on sinusitis and nasal polyps has found low NO levels in exhaled air and linked this to obstruction of the ostium. However, the major source of NO in exhaled air is thought to be the nasal mucosa. In this study, Streptococcus pneumoniae was applied to the maxillary sinus to investigate changes in NO synthesis of the nasal mucosa. Methods: An experimental study was performed with New Zealand white rabbits. Three groups, pneumococcus, control and sham, were created. The maxillary sinus of the pneumococcal group was exposed to Streptococcus pneumoniae suspension. Before and after the exposure, bilateral biopsy specimens were taken from the inferior turbinate. Specimens were examined by RT-PCR for expressions of endothelial nitric oxide synthase (e-NOS) and inducible nitric oxide synthase (i-NOS). Physiological saline solution was administered to the maxillary sinus in the control group and biopsies were obtained. The sham group underwent only biopsy. Results: A significant increase in i-NOS expression of tissue samples from the pneumococcal group on the same and opposite sides were detected. There was no increase in e-NOS expression in this group. The control and sham groups had no significant change in i-NOS or e-NOS expression. Conclusion: In the acute period after the maxillary sinus is exposed to a pathogen, i-NOS expression increases in the nasal mucosa, but endothelial NOS expression is not affected. Consequently, a combined response in the maxillary sinus and the nasal mucosa for nitric oxide synthesis is shown in the present study.
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    Evaluation of Sleep Quality in Patients With Nasal Septal Deviation via the Pittsburgh Sleep Quality Index
    (Lippincott Williams & Wilkins, 2016) Kara, Medine; Erdogan, Halil; Guclu, Oguz; Sahin, Hasan; Derekoy, Fevzi Sefa
    Objective:To investigate the effect of nasal septum deviation, without obstructive sleep apnea, on sleep quality.Methods:The present case-controlled study enrolled patients older than 16 years with nasal septum deviation who attended the Otorhinolaryngology Clinic between December 2013 and July 2014. The control group was selected from patients attending the clinic for another complaint. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, and differences between the groups were compared using the Mann-Whitney U test.Results:During the study period, 55 patients with nasal septum deviation were included in the study group, and the control group consisted of 51 patients with no complaints of nasal obstruction. Compared with the control group, patients with nasal septum deviation were found to be significantly higher (P<0.05) in all parameters of Pittsburgh Sleep Quality Index.Conclusion:The presence of nasal septum deviation with nasal obstruction should be investigated in patients with sleep disorders. If any pathology is present, opening the nasal passages should be ensured and sleep disorders reevaluated.
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    Prognostic Value of Acoustic Rhinometry and Rhinomanometry in Tympanoplasty Surgery
    (Aves, 2016) Tekin, Kazim; Kara, Medine; Guclu, Oguz; Erdogan, Halil; Derekoy, Fevzi Sefa
    OBJECTIVE: Chronic otitis media (COM) is a disorder characterized by perforation of the eardrum and hearing loss following chronic inflammation of the middle ear cavity, ossicules, and mastoid cells. Eustachian dysfunction plays an important role in COM etiopathogenesis and postoperative prognosis. The determinants of postoperative prognosis are still being researched. This study aimed to research the prognostic value of acoustic rhinometry (ARM) and rhinomanometry (RMM) in COM surgery in terms of eradication of the infection after operation, graft success, and hearing gain in operated cases. MATERIALS and METHODS: This study included 58 patients who underwent surgery with a diagnosis of COM. Patients were assessed in terms of age, gender, COM type, treatment methods used, eradication of infection, graft success, and hearing gain. ARM and RMM measurements were performed in the preoperative period. ARM and RMM values were statistically compared in terms of the existence of postoperative infection, graft success, and hearing gain. RESULTS: In terms of ARM and RMM measurements, there was no statistically significant difference between cases where postoperative infection control was assured and cases with ongoing infection; successful and failed cases in terms of grafting; or successful and failed cases in terms of postoperative hearing. When preoperative and postoperative air-bone gap averages were compared, statistically significant differences were observed. CONCLUSION: In the presence of a nasal obstruction in cases with chronic otitis, elimination of this situation is the first line of treatment. Infection control, graft success, and improvement of hearing will be possible to a greater extent in the postoperative period for patients with the nasal pathology remedied.
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    Sclerotic effect of bleomycin on the submandibular gland: An experimental model
    (Elsevier Ireland Ltd, 2013) Guclu, Oguz; Muratli, Asli; Arik, Deniz; Tekin, Kazim; Erdogan, Halil; Derekoy, Fevzi Sefa
    Objectives: To evaluate the sclerotic effect of bleomycin on the submandibular gland histopathologically and assess it as a possible alternative therapy for sialorrhea. Methods: An experimental model was designed and 18 New Zealand white rabbits were used. The rabbits were divided into two groups: a bleomycin group (n = 9) and a sham group (n = 9). The submandibular glands of the bleomycin group were injected with 0.3 ml bleomycin (3 mg/ml) while the sham group received 0.3 ml saline. Four weeks after the procedure, the glands were removed. Histopathological studies including hematoxylin-eosin and Masson's trichrome stain were carried out. The glands were evaluated for tissue inflammation, fibrosis, edema, lipomatosis, atrophy and congestion. To investigate apoptosis, terminal deoxynucleotidyl transferase (TdT)-mediated digoxigenin-11-dUTP nick-end labeling (TUNEL) immunohistochemical staining was used. Results: In the group injected with bleomycin, inflammation (n = 8), edema (n = 4), fibrosis (n = 3), congestion (n = 4) and lipomatosis (n = 7) were observed. In the sham group, only lipomatosis was observed. The TUNEL assay results were 5.06 +/- 1.18 (p < 0.05) for acinar cells and 8.46 +/- 0.82 (p < 0.05) for ductal cells in the bleomycin group. This was significantly different from the results in the sham group. Conclusions: Apoptosis, inflammation, fibrosis, edema, lipomatosis and congestion were observed in the ductal and acinar cells of the bleomycin group. Bleomycin may be an alternative treatment for sialorrhea cases. However, more research is needed. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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    Sclerotic effect of oxytetracycline on the submandibular gland: An experimental model
    (Vendome Group Llc, 2016) Guclu, Oguz; Muratli, Asli; Arik, Deniz; Tekin, Kazim; Erdogan, Halil; Derekoy, Fevzi Sefa
    Oxytetracycline has been suggested as an alternate therapy for chronic recurrent sialadenitis and sialorrhea. We conducted an experimental study to investigate the sclerotic effect of this drug on the submandibular gland by histopathologic methods. Our subjects were 20 New Zealand white rabbits, which were divided into two groups of 10. The right submandibular gland of the rabbits in the active treatment group was injected with 0.3 ml of oxytetracycline (100 mg/ml), and that of the controls was injected with saline. Four weeks after the injections, all the glands were removed. Histopathologic studies, including hematoxylin and eosin and Masson trichrome staining, were carried out. The glands were evaluated for tissue inflammation, congestion, fibrosis, edema, lipomatosis, and atrophy. To investigate apoptosis, terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL) immunohistochemical staining was used. In the study group, inflammation (n = 9), congestion (n = 9), fibrosis (n = 6), edema (n = 6), and lipomatosis (n = 4) were observed; in the sham group, only lipomatosis was seen (n = 5). The TUNEL assay results for acinar cells were 4.51 +/- 1.41% in the oxytetracycline group and 2.08 +/- 1.76% in the control group (p = 0.006); the corresponding figures for the duct cells were 7.05 +/- 0.87% and 3.10 +/- 2.26% (p = 0.001). Based on our findings, we conclude that oxytetracycline might be a viable alternative for the treatment of chronic recurrent sialadenitis and sialorrhea. However, more research in this area is needed.