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    Does the maxillary sinus have a triggering role in nasal nitric oxide synthesis?
    (Int Rhinologic Soc, 2012) Guclu, Oguz; Uludağ, Ahmet; Alper Akçalı; Tekin, Kazim; Erdogan, Halil; Sılan, 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 nasal airways by objective methods in chronic otitis media
    (Springer, 2013) Guclu, Oguz; Şahin, Erkan Melih; Tekin, Kazim; Derekoy, Fevzi Sefa
    Otitis media (OM) is a common health problem. Nasal airways play an important role in etiopathogenesis of OM. The aim of this study is to evaluate nasal airways by objective methods in chronic otitis media (COM) cases. The relationship between the course of the disease and nasal parameters is also investigated. Fifty-six patients who had chosen an operation for chronic otitis media were included in the study. The control group was composed of 30 healthy patients. Patients were subjected to acoustic rhinometry and rhinomanometry. Nasal airway resistance and cross-sectional area measurements were taken. The results of the COM group and the control group were compared. Cases were classified by the course of the disease such as suppurative/progressive/active and non-suppurative/inactive and the nasal parameters of these sub-groups were compared. In cases with unilateral COM, nasal cavity results from both sides were compared. The nasal airway resistance of the COM group was statistically significantly higher than the control group (p < 0.05). However, there was no difference in cross-sectional area measurements. There was no significant difference between the suppurative/progressive/active and non-suppurative/inactive groups. However, the suppurative group had higher nasal resistance (p > 0.05). There was no statistical difference between the measurements of each side in unilateral COM cases. This study found that COM cases have greater nasal airway resistance. No significant difference was found in cross-sectional area measurements so the increase in resistance may be linked to mucosal rather than structural changes. There was no evidence for a relationship between the course of the OM and nasal airway parameters.
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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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    Relationship between Helicobacter pylori Adenotonsillar Colonization and Frequency of Adenotonsillitis in Children
    (Galenos Publ House, 2013) Guclu, Oguz; Alper Akçalı; Şahin, Erkan Melih; Tekin, Kazim; Barutcu, Ozan; Otkun, Muserref Tatman; Derekoy, Fevzi Sefa
    Background: There are insufficient data in the literature on the presence of Helicobacter pylori in tonsil and adenoid tissue of patients with only airway obstruction. This study examined the presence of H. pylori in surgical cases with airway obstruction or recurrent infection. Aims: To investigate the relationship between H. pylori adenotonsillar colonisation and the frequency of adenotonsillitis and to compare paediatric and adult patients according to H. pylori tonsillar colonisation. Study Design: Prospective clinical trial. Methods: Patients scheduled for adenoidectomy or tonsillectomy were classified into three groups based on indications: paediatric infection (n=29), paediatric obstruction (n=29) and adult infection (n=12). Tissue samples obtained from patients were examined for the presence of H. pylori by culture, rapid urease test and polymerase chain reaction. Results: Forty-nine tonsil tissues were examined. Positive results were found in two specimens with the rapid urease test (4.1%) and three with polymerase chain reaction examination (6.1%). Only three positive polymerase chain reaction results (5.8%) were identified in 52 adenoid tissue samples. There were no statistically significant differences in the presence of H. pylori between paediatric infection and obstruction groups or between paediatric infection and adult infection groups. Conclusion: In our study, there was a low incidence of H. pylori colonisation in tonsil and adenoid tissues. Regarding H. pylori colonisation, there was no significant difference between paediatric infection and obstruction groups. Also, no significant difference was found between adult and paediatric cases.
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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.