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Yılmaz T. Sequential Wendler Glottoplasty and Laser Reduction Glottoplasty for Voice Feminization. Laryngoscope 2024; 134:1133-1138. [PMID: 37555644 DOI: 10.1002/lary.30958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/03/2023] [Accepted: 07/19/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE Voice feminizing surgery is frequently needed for transgender female patients. Among several surgical options, Wendler glottoplasty (WG) and laser reduction glottoplasty (LRG) are two endoscopic procedures. However, because a single procedure may not produce sufficient benefit, the two surgeries may sometimes be sequentially performed. This study was carried out to present the voice results of such sequential surgeries. METHODS This is an individual retrospective cohort study, performed at a tertiary referral center, that is a university hospital. 18 transgender patients were treated with WG initially and then underwent LRG; 17 had LRG first then WG. All 35 cases were performed during a 15-year period and followed for at least 1 year postoperatively. Voice Handicap Index (VHI-30), transsexual voice questionnaire (TVQ), and acoustic analysis with /a/ and running speech were obtained pre- and postoperatively. RESULTS VHI and TVQ improved significantly postoperatively (p < 0.05). Their preoperative, first, and second postoperative mean sF0 were 146, 175, and 215 Hz, respectively; these differences were statistically significant (p < 0.001). Their postoperative mean jitter percent, shimmer percent, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), and cepstral spectral index of dysphonia (CSID) worsened significantly compared to preop values (p < 0.05); however, mean postoperative acoustic results were still within normal limits. Patients' self-ratings of their postsurgery voices revealed all feminine, leading to a patient gratification score of 100%. CONCLUSION If transgender female patients are unsatisfied with their voice after WG or LRG, the addition of the alternative procedure may significantly feminize their voice. Sequential WG and LRG is a successful surgical option for voice feminization. LEVEL OF EVIDENCE 4 Laryngoscope, 134:1133-1138, 2024.
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Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology-Head & Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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2
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Külekci Ç, Özer S, Önen S, Korkusuz P, Yılmaz T. Topical Intranasal Insulin Enhances Healing of Nasal Mucosa: An Experimental Animal Study. Am J Rhinol Allergy 2023; 37:284-290. [PMID: 36384319 DOI: 10.1177/19458924221139018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Aim of this study was to evaluate the effect of topical intranasal insulin on healing of nasal mucosa in a rat model. METHODS Forty-eight Wistar rats, weighing between 250 and 300 g and aged 10-12 weeks were used and randomized into two equal groups. 1.9 mm curette was introduced through the left nostril and 1.9 mm mucosa from the left nasal septum was curetted. Postoperatively, animals in the control group received 1 mL of physiologic saline, 3 times a day in a nasal irrigation fashion. Animals in the experimental group received 1 mL of 5 IU/mL regular insulin in saline solution. Subjects were sacrificed after 5, 10, and 15 days and macroscopic and histomorphometric evaluations were performed. RESULTS There were no mucosal synechiae and septal perforation macroscopically. Histological examination revealed that the defect size reduction was 21% in the saline group versus 56% in the insulin group on the fifth day (p = 0.006). There was 62% defect reduction in the saline group versus 79% in the insulin group on the 10th day (p = 0.034). On the 15th day, only 67% of saline group animals had complete defect closure, whereas 100% of animals treated with insulin had complete closure (92% vs 100% mucosal defect reduction, p = 0.036). Both edema and inflammation were less in the insulin group on 15th day (p = 0.006; p = 0.023, respectively). CONCLUSION The results from this study support the safety and efficacy of topical insulin on wound healing in the literature. This study could guide further experimental studies that examine human sinonasal wound healing.
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Affiliation(s)
- Çağrı Külekci
- Department of Otorhinolaryngology, 37515Hacettepe University, Ankara, Turkey
| | - Serdar Özer
- Department of Otorhinolaryngology, 37515Hacettepe University, Ankara, Turkey
| | - Selin Önen
- Department of Stem Cell Sciences, Graduate School of Health Sciences, Hacettepe University, Ankara, Turkey
- Department of Medical Biology, 619830Faculty of Medicine, Atilim University, Ankara, Turkey
| | - Petek Korkusuz
- Department of Histology and Embryology, 64005Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Taner Yılmaz
- Department of Otorhinolaryngology, 37515Hacettepe University, Ankara, Turkey
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Yılmaz T. Voice After Cordectomy Type I or Type II or Radiation Therapy for Large T 1a Glottic Cancer. Otolaryngol Head Neck Surg 2023; 168:798-804. [PMID: 35943800 DOI: 10.1177/01945998221117453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE T1a glottic cancer can be treated with transoral laser microsurgery (TLM) or radiation therapy (RT). Dysphonia is the major disadvantage of TLM, and preservation of voice appears to be the best advantage of RT compared to TLM. Studies on voice outcomes of both options gave conflicting results, but there is a tendency toward better voice outcome after TLM compared to the past. STUDY DESIGN Nonrandomized retrospective cohort study. SETTING Tertiary referral center. METHODS In total, 172 patients with a cancer lesion involving more than two-thirds of 1 membranous vocal fold underwent cordectomy type I (n = 56) (C1 group) or type II (n = 59) (C2 group) or RT (n = 57) (RT group). GRBASI (grade, roughness, breathiness, asthenia, strain, instability), videolaryngostroboscopy, Voice Handicap Index-30, acoustic analysis including F0, jitter, shimmer, noise to harmonic ratio, cepstral peak prominence, and cepstral spectral index of dysphonia using running speech, and aerodynamic analysis were performed before treatment and 6 and 24 months after treatment. RESULTS Study groups did not differ significantly on pretreatment voice outcomes (P > .05). The RT group had significantly better voice outcomes at 6 months posttreatment compared to the C1 and C2 groups (P < .05). The C1 group had significantly better voice outcomes at 6 months posttreatment compared to the C2 group (P < .05). The C1 group had significantly better voice outcomes at 24 months posttreatment compared to the RT and C2 groups (P < .05). The RT and C2 groups did not differ significantly at 24 months posttreatment (P > .05). CONCLUSION Voice outcomes after C2 are equal to RT. C1 has better voice outcomes than RT. C1 and C2 can be the treatment of choice for large T1a glottic cancers.
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Affiliation(s)
- Taner Yılmaz
- Hacettepe University Faculty of Medicine, Department of Otolaryngology-Head & Neck Surgery, Ankara, Turkey
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Karaş H, Küçükparlak İ, Özbek MG, Yılmaz T. Addictive smartphone use in the elderly: relationship with depression, anxiety and sleep quality. Psychogeriatrics 2023; 23:116-125. [PMID: 36366976 DOI: 10.1111/psyg.12910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the present study was to explore the relationship between addictive smartphone use (ASU) and depressive symptoms, anxiety and sleep quality in elderly adults. METHODS The study sample included smartphone users over the age of 65 years. The research data were obtained from social networking sites via a Google survey link. In addition to filling out a sociodemographic data form, the participants were also assessed with Smartphone Addiction Scale (SAS), Geriatric Depression Scale, Beck Anxiety Inventory and Pittsburgh Sleep Quality Index tools. RESULTS The correlation analysis revealed the SAS score to be positively correlated with depression and anxiety, and negatively correlated with sleep quality. In the regression analysis, depressive symptoms, anxiety level and sleep quality were all found to have an effect on the SAS total score. Furthermore, the SAS score was found to have an effect on depressive symptoms, anxiety and sleep quality. CONCLUSIONS Our findings reveal a bidirectional relationship between ASU and depressive, anxiety symptoms and impaired sleep quality in elderly adults. It is important to question smartphone use patterns in people with sleep problems, symptoms of depression or anxiety.
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Affiliation(s)
- Hakan Karaş
- Psychology Department, Istanbul Gelişim University, Istanbul, Turkey
| | | | | | - Taner Yılmaz
- Psychology Department, Istanbul Bilgi University, Istanbul, Turkey
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Yağcıoğlu D, Aydınlı FE, Aslan G, Kirazlı MÇ, Köse A, Doğan N, Akbulut S, Yılmaz T, Özcebe E. Development, Validation, and Reliability of the Teacher-Reported Pediatric Voice Handicap Index. Lang Speech Hear Serv Sch 2021; 53:69-87. [PMID: 34762816 DOI: 10.1044/2021_lshss-21-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to develop a novel teacher-reported pediatric voice outcome measure and to investigate its psychometric properties. METHOD In the first stage, a new instrument, the Teacher-Reported Pediatric Voice Handicap Index (TRPVHI), was developed. After item generation, a panel of experts evaluated the items to assess the content validity. Subsequently, the final version of the preliminary instrument was applied to teachers of 306 children (57 dysphonic and 249 vocally healthy) between the ages of 4 and 11 years. Eventually, the construct validity, criterion-related validity, test-retest reliability, and internal consistency of the developed instrument were examined. RESULTS The items with a content validity ratio less than .8 were modified or removed, and accordingly, the preliminary version of the index was finalized. After the application of the preliminary version, item reduction was made based on the factor analysis. The index is composed of 27 questions and three subscales: Functional, Physical, and Emotional. A significant difference was observed between the dysphonic and vocally healthy children for the TRPVHI scores (p < .001). A positive moderate correlation was determined between the Pediatric Voice Handicap Index and TRPVHI scores. Correlation coefficients between the test and retest scores of the TRPVHI were in the range of .92-.98. Cronbach's alpha values computed to assess the internal consistency were in the range of .94-.98. CONCLUSIONS The TRPVHI is the only valid and reliable teacher-reported outcome measure of the effects of voice disorders on children. It is anticipated that the deployment of the TRPVHI in conjunction with other subjective tools, both in the initial evaluation and the follow-up of the treatment results, will allow a better understanding of the physical, functional, and emotional effects of voice disorders on children. Furthermore, it can potentially lead further research to enable the use of the TRPVHI for screening purposes.
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Affiliation(s)
- Damlasu Yağcıoğlu
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Fatma Esen Aydınlı
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Gizem Aslan
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Meltem Ç Kirazlı
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Ayşen Köse
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Nuri Doğan
- Department of Education, Hacettepe University, Ankara, Turkey
| | - Sevtap Akbulut
- Department of Otolaryngology, Demiroglu Bilim University, İstanbul, Turkey
| | - Taner Yılmaz
- Department of Ear-Nose-Throat, Hacettepe University, Ankara, Turkey
| | - Esra Özcebe
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
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Dündar G, Günaydın Ö, Yılmaz T, Kurtulan O, Tezel GG. Comparison of the effects of platelet-rich plasma and dexamethasone ınjection on scar formation after vocal fold ınjury in rabbits. Eur Arch Otorhinolaryngol 2021; 279:1405-1411. [PMID: 34718850 DOI: 10.1007/s00405-021-07154-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES In this study, a histopathological comparison was aimed between platelet-rich plasma (PRP) injection and dexamethasone injection in the prevention of scar formation after vocal fold injury. MATERIALS AND METHODS Electrocautery was applied to damage the right and left vocal folds of a total of 12 New Zealand rabbits. PRP obtained from the rabbit's own blood was injected into the right vocal fold, and dexamethasone was injected into the left vocal fold. After 8 weeks, the experimental animals were euthanized, and the levels of inflammatory cell infiltration, vascularization, collagen, elastin, and hyaluronic acid (HA) were compared in histopathological evaluation. RESULTS In statistical comparison of histopathological data obtained; in terms of plasma cell infiltration, vascularization, and edema parameters, statistically significant results were obtained in favor of the PRP group. Although the difference between collagen, elastin and HA, which are critical in vocal fold scar healing, was more positive in favor of PRP, no significant result was revealed in the statistical evaluation. CONCLUSIONS PRP injection in rabbits with vocal fold damage reveals similar characteristics with dexamethasone injection in preventing scar formation. PRP injection has favorable effects on vascularization, prevention of edema, and number of plasma cells.
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Affiliation(s)
- Görkem Dündar
- Department of Otolaryngology, Dr Nafiz Körez Hospital, Sincan, Ankara, Turkey.
| | - Önder Günaydın
- Department of Otolaryngology, Hacettepe University, Sıhhiye, Ankara, Turkey
| | - Taner Yılmaz
- Department of Otolaryngology, Hacettepe University, Sıhhiye, Ankara, Turkey
| | - Olcay Kurtulan
- Department of Pathology, Hacettepe University, Sıhhiye, Ankara, Turkey
| | - Gaye Güler Tezel
- Department of Pathology, Hacettepe University, Sıhhiye, Ankara, Turkey
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Abstract
OBJECTIVES For unilateral vocal fold paralysis (UVFP) with large posterior glottic gap medialization laryngoplasty (ML) + arytenoid adduction (AA), ML + adduction arytenopexy (AApexy), and ML alone using prosthesis with posterior extension are possible solutions. This study was carried out to elucidate the controversy among these solution options. METHODS Retrospective cohort. Tertiary referral center. One hundred forty patients with UVFP with large posterior glottic gap. Group 1 had 30 patients with ML + AA; Group 2 had 25 patients with ML + AApexy; Group 3 had 29 patients with ML using Isshiki prosthesis; Group 4 had 26 patients with ML using Montgomery prosthesis; Group 5 had 30 patients with ML using prosthesis with large posterior extension. Glottic closure using videolaryngostroboscopy, GRBAS, VHI-30, EAT-10, acoustic and aerodynamic analysis was carried out pre- and 1-year-postoperatively. RESULTS Preoperatively there was no significant difference in any parameters studied among all study groups (P > .05). Except F0, speaking F0 and EAT-10, all other parameters in acoustic and aerodynamic analysis, glottic closure, GRBAS, and VHI-30 scores were significantly better postoperatively in Groups 1 and 2 compared to Groups 3 to 5 (P < .05). CONCLUSIONS In patients with UVFP and large posterior glottic gap, ML + AA and ML + AApexy seem to do better subjectively and objectively, acoustically and aerodynamically, when compared to ML using prosthesis with and without large posterior extension. ML alone does not appear to close posterior glottic gap. Therefore, it is a better and more reasonable option to perform arytenoid procedure when there is large posterior glottic gap in UVFP.
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Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Furkan Özer
- Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Başar I, Aydın Öztürk P, Tuncer MC, Turan Y, Yılmaz T. Surgical management of sporadic hemangioblastomas located in the posterior fossa of brain. Arch Ital Biol 2021; 159:51-63. [PMID: 34184238 DOI: 10.12871/00039829202121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Hemangioblastomas (HBs) are highly vascular tumors, constituting 2%-3% of central nervous system (CNS) tumors. Surgery is a treatment option for HBs. The purpose of this study was to evaluate the demographic, clinical, and radiological findings of patients with HBs who were operated on via microsurgical technique at our clinic and to determine the findings specific to HBs and evaluate their pathological findings and confirmation. METHODS We evaluated age, gender, initial complaints and duration of 100 patients (50 female and 50 male patients), presence of cranial nerve deficits, magnetic resonance imaging, data (localization, presence of hydrocephalus, tumor size, enhancement pattern, and cystic and solid component features), resection rates, pathological findings (grade, Ki-67 ratio, and staining results), recurrence, special conditions of patients, and the final status of patients in this study. RESULTS Mean age was 39.08 ± 14.77 years and 66.7% of the patients presented with cerebellar findings. Five of the cases were located in the brainstem, five were located in the cerebellopontine angle, and two were in the cerebellar cortex. In all patients, gross total resection was performed using arteriovenous malformation repair. CONCLUSIONS Surgical intervention of small and cystic tumors can be performed safely with en bloc resection along with preoperative detailed imaging, improved microsurgical techniques, and an extensive understanding of anatomical and vascular structures. On the contrary, patients with a brainstem invasion and solid structure present surgical difficulties due to arteriovenous malformation-like vascularizations; therefore, gross total resection is the optimal treatment in HBs.
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Affiliation(s)
| | | | | | | | - T Yılmaz
- Department of Neurosurgery, Faculty of Medicine, University of Dicle, 21280, Diyarbakır, Turkey -
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Altuntaş OM, Süslü N, Güler Tezel YG, Tatlı Doğan H, Yılmaz T. Lysyl Oxidase Like-4 (LOXL4) as a tumor marker and prognosticator in advanced stage laryngeal cancer. Braz J Otorhinolaryngol 2021; 88:968-974. [PMID: 33757755 PMCID: PMC9615536 DOI: 10.1016/j.bjorl.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/06/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Lysyl oxidase-like 4 is an amine oxidase from the lysyl oxidase family that was previously shown to be overexpressed in head and neck cancer and upregulated in response to hypoxia. The possible role of lysyl oxidase-like 4 as a tumor marker in advanced stage larynx cancer was investigated. Objective To investigate the expression of lysyl Oxidase-Like 4 protein in advanced stage laryngeal cancer and elucidate its possible role as a tumor marker, predictor of treatment response and prognosticator. Methods Diagnostic specimens of 72 patients treated for stage III–IV laryngeal squamous cell carcinoma were evaluated for lysyl oxidase-like 4 expression by immunohistochemistry. Results Lysyl oxidase-like 4 expression was correlated with advanced tumor stage (p = 0.041) and better differentiation (p = 0.025) but was independent of tumor diameter (p = 0.456). Response to induction chemotherapy or the need for salvage laryngectomy were not affected by lysyl oxidase-like 4 expression (p = 0.999, p = 0.070 respectively). Increased lysyl oxidase-like 4 expression was associated with better 2 year overall survival in both univariate (p = 0.036) and multivariate analyses (p = 0.014). Conclusion Lysyl oxidase-like 4 expression emerges with advancing stages, is lost with worsening differentiation, and may have tumor suppressive properties in larynx cancer.
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Affiliation(s)
- Ozan Muzaffer Altuntaş
- Koç University, Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Turkey.
| | - Nilda Süslü
- Hacettepe University, Faculty of Medicine, Department of Otorhinolaryngology, Ankara, Turkey
| | | | | | - Taner Yılmaz
- Hacettepe University, Faculty of Medicine, Department of Otorhinolaryngology, Ankara, Turkey
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Abstract
OBJECTIVES Laser reduction glottoplasty is a relatively new surgical procedure for voice feminization on transgender women. This study aims to determine long-term voice results of glottoplasty on transwomen. METHODS Nonrandomized, retrospective, cohort. Tertiary referral center. Endoscopic laser reduction glottoplasty was performed on 28 transwomen. Voice Handicap Index (VHI-30), Transsexual Voice Questionnaire (TVQ), acoustic analysis with /a/ for F0, jitter, shimmer, noise to harmonic ratio and acoustic analysis for speaking F0 were measured before and after surgery. Patients self-evaluated their postoperative voices and medical students and 2 voice experts scored patients' pre- and postsurgery voice samples as masculine, feminine or neither. RESULTS Mean total VHI and TVQ scores improved significantly postoperatively (P < .001). Pre- and postsurgery mean F0 were 132 and 198 Hz and mean speaking F0 were 123 and 194 Hz, respectively; these variations were found statistically significant (P < .001). Postoperative mean jitter, shimmer and NHR increased significantly compared to preoperative values (P < .05). Nine patients (32%) were not happy with their postsurgery voice result and were offered anterior glottic web formation as secondary procedure. MFT women's self-ratings of their postsurgery voices showed 3 masculine, 19 feminine and 6 neither outcomes, leading to patient gratification score of 68%. Medical students evaluated 79% of postsurgery voice specimens as feminine. Voice experts evaluated 75% of postsurgery voice specimens as feminine. CONCLUSIONS Laser reduction glottoplasty is an accomplished and satisfying operation for feminizing voice of transwomen. Its voice outcome appears to be durable for 5 years. However, secondary operation may be needed to further gratify transwomen.
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Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Furkan Özer
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fatma Esen Aydınlı
- Department of Speech & Language Pathology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Elmas L, Akdogan N, Yılmaz T. Successful treatment of a patient with linear IgA bullous dermatosis limited to oral, hypopharyngeal, and laryngeal mucosa with dapsone. Dermatol Ther 2020; 33:e14127. [PMID: 32761780 DOI: 10.1111/dth.14127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Leyla Elmas
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
| | - Neslihan Akdogan
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
| | - Taner Yılmaz
- School of Medicine, Department of Ear, Nose & Throat, Hacettepe University, Ankara, Turkey
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Yılmaz T. Endoscopic Z-plasty for Treatment of Supraglottic Stenosis: Experience on Nine Patients. Laryngoscope 2020; 131:E534-E539. [PMID: 32533778 DOI: 10.1002/lary.28787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/09/2020] [Accepted: 05/14/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Supraglottic stenosis is a rare type of laryngeal stenosis that is caused by congenital laryngotracheal anomalies, iatrogenic instrumentation injuries, autoimmune disorders, infection, irradiation, chemical or thermal burns, and external blunt or penetrating trauma. The author presents his experience on nine patients using this new endoscopic surgical technique for treatment of supraglottic stenosis. STUDY DESIGN Individual retrospective cohort study, tertiary referral center, university hospital. METHODS All cases of supraglottic laryngeal stenosis treated during a 10-year period at a tertiary academic medical center were reviewed. Nine patients with supraglottic stenosis treated with endoscopic uni- or bilateral z-plasty technique were determined and presented. The etiology of stenosis was iatrogenic surgical trauma in seven patients, laryngeal fracture in one patient, and systemic lupus erythematosus in the other patient. Main outcome measures were respiratory function test results, absence of dyspnea on exertion, and decannulation if tracheotomy was present preoperatively. RESULTS Seven patients with tracheotomy were decannulated 1 month after surgery. All nine patients had adequate airway and were dyspnea-free. Their preop respiratory function test results improved significantly postoperatively (P < .05). CONCLUSION For supraglottic stenosis endoscopic surgery using mucosal flaps in the form of z-plasty should be considered within the available surgical techniques. Although this type of surgery is highly successful, it is technically difficult to apply. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E534-E539, 2021.
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Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology-Head & Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology-Head & Neck Surgery, 37515Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Oğuz Kuşcu
- Department of Otolaryngology-Head & Neck Surgery, 37515Hacettepe University Faculty of Medicine, Ankara, Turkey
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Önay Ö, Süslü AE, Yılmaz T. Huge Dentigerous Cyst in the Maxillary Sinus: A Rare Case in Childhood. Turk Arch Otorhinolaryngol 2019; 57:54-56. [PMID: 31049256 DOI: 10.5152/tao.2019.1920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/17/2018] [Indexed: 11/22/2022] Open
Abstract
Dentigerous cyst (DC) is the second most common type of odontogenic cyst. It is thought to have a developmental origin, arising from an anomaly in the reduced dental epithelium. Rarely seen in early childhood, DC is mostly prevalent among people aged between 20 and 40. The most common location of DC is the mandibular third molar, more rarely occurring in the maxillary sinus. Enucleation is the standard treatment. Herein, we report an 11-year-old boy with DC that developed into the maxillary sinus, measuring 5×2.5×1.7 cm. We also present an evaluation of the diagnosis and treatment of this type of DC.
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Affiliation(s)
- Övsen Önay
- Department of Otorhinolarynogology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ahmet Emre Süslü
- Department of Otorhinolarynogology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Taner Yılmaz
- Department of Otorhinolarynogology, Hacettepe University School of Medicine, Ankara, Turkey
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Yılmaz T. Surgical treatment of glottic web using butterfly mucosal flap technique: Experience on 12 patients. Laryngoscope 2018; 129:1423-1427. [DOI: 10.1002/lary.27531] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology–Head and Neck SurgeryHacettepe University Faculty of Medicine Ankara Turkey
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Yılmaz T, Kuşçu O, Sözen T, Süslü AE. Anterior Glottic Web Formation for Voice Feminization: Experience of 27 Patients. J Voice 2017; 31:757-762. [DOI: 10.1016/j.jvoice.2017.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/11/2017] [Accepted: 03/13/2017] [Indexed: 11/24/2022]
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Karaş H, Yılmaz T. Fluoxetine-related ecchymosis treated with venlafaxine: a case report. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1367556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Hakan Karaş
- Department of Psychology, Beykent University, Istanbul, Turkey
| | - Taner Yılmaz
- Department of Guidance and Psychological Counseling, Middle East Technical University Northern Cyprus Campus, Kalkanlı, Northern Cyprus
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Ermutlu G, Süslü N, Yılmaz T, Saraç S. Sudden hearing loss: an effectivity comparison of intratympanic and systemic steroid treatments. Eur Arch Otorhinolaryngol 2017; 274:3585-3591. [PMID: 28756569 DOI: 10.1007/s00405-017-4691-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/25/2017] [Indexed: 12/01/2022]
Abstract
Corticosteroid treatment has been considered the most effective treatment modality for sudden sensorineural hearing loss so far. Application route of corticosteroids may vary. We have designed a prospective randomized case-controlled clinical trial to evaluate the effectivenesses of the different application routes of steroids in the treatment of SSHL. Thirty-five patients were distributed randomly to two groups which were treated with either 'oral' or 'intratympanic' corticosteroids. Intratympanic steroid administration was performed three times every other day transtympanically. At the end of third month, recovery rate in the 'intratympanic' group was 84.2%, whereas in the 'oral' group, it was 87.5%. The difference between the recovery rates was not statistically significant. There were no major complications related to transtympanic steroid administration. These findings support that intratympanic steroid therapy is an alternative to systemic steroid therapy in the initial treatment of sudden hearing loss. In addition, transtympanic technique is an easy to perform and safe method for delivering steroids into the inner ear.
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Affiliation(s)
- Gülce Ermutlu
- Department of Otorhinolaryngology and Head and Neck Surgery, Hacettepe University, Ankara, Turkey. .,Kağıthane Devlet Hastanesi, Sanayi Mahallesi Sultan Selim Caddesi, Şahinler Sokak No:23 Kağıthane, İstanbul, Turkey.
| | - Nilda Süslü
- Department of Otorhinolaryngology and Head and Neck Surgery, Hacettepe University, Ankara, Turkey
| | - Taner Yılmaz
- Department of Otorhinolaryngology and Head and Neck Surgery, Hacettepe University, Ankara, Turkey
| | - Sarp Saraç
- Department of Otorhinolaryngology and Head and Neck Surgery, Koc University Hospital, İstanbul, Turkey
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Yılmaz T, Süslü N, Günaydın RÖ, Kuşçu O, Sözen T, Atay G, Bajin MD. Microtrapdoor Flap Technique for Treatment of Glottic Laryngeal Stenosis: Experience With 34 Cases. J Voice 2016; 30:751-754. [DOI: 10.1016/j.jvoice.2015.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
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Kuşcu O, Önay Ö, Kayahan B, Süslü N, Yılmaz T. The rising incidence of papillary thyroid microcarcinoma and is completion surgery necessary or not? Otolaryngol Pol 2016; 70:14-18. [PMID: 27383733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Papillary thyroid microcarcinoma (PTMC) is defined as a papillary cancer that is 1 cm or less in its maximal diameter. The incidence of thyroid cancer has increased during the past 30 years. The aim of this study is to evaluate the rising incidence of PTMC (papillary thyroid microcarcinoma) and whether is lobectomy enough or not. The data of 462 consecutive patients who underwent thyroidectomy (hemithyroidectomy and total thyroidectomy) at the Hacettepe University Hospitals Department of ENT from 2000 to 2015 were analyzed. Surgical procedure, histopathologic examinations, postoperative complications, follow-up time and mortality were recorded. USG and FNAC were performed on all cases. Of the 344 patients with thyroid malignancy and 118 patients underwent total laryngectomy with thyroidectomy. 364 patients with TT and 98 patients with HT. The first group included 204 patients (Surgery time 2000-2007), 91 of them ( 44.6%) had PTMC. The second group included 258 patients, 192of them (74,4%) had PTMC (p&lt;0.001). 22 Patients with PTMC underwent completion surgery and 40 of them just followed by hemithyroidectomy. There was no recurrence. PTMC has been rising incidence because of ,pathological and radiological, increased awareness and completion surgery is not necessary for all PTMC cases especially incidental PTMC.
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Affiliation(s)
- Oğuz Kuşcu
- Hacettepe University Faculty of Medicine Department of Otorhinolaryngology
| | - Övsen Önay
- Hacettepe University Deparment of Otorinolaryngology, Head and Neck Surgery
| | - Bahar Kayahan
- Hacettepe University Deparment of Otorinolaryngology, Head and Neck Surgery
| | - Nilda Süslü
- Hacettepe University Deparment of Otorinolaryngology, Head and Neck Surgery
| | - Taner Yılmaz
- Hacettepe University Deparment of Otorinolaryngology, Head and Neck Surgery
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Kuşcu O, Önay Ö, Kayahan B, Süslü N, Yılmaz T. The rising incidence of papillary thyroid microcarcinoma and is completion surgery necessary or not? Otolaryngol Pol 2016; 70:15-9. [PMID: 27386928 DOI: 10.5604/00306657.1199990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Papillary thyroid microcarcinoma (PTMC) is defined as a papillary cancer that is 1 cm or less in its maximal diameter. The incidence of thyroid cancer has increased during the past 30 years. The aim of this study is to evaluate the rising incidence of PTMC (papillary thyroid microcarcinoma) and whether is lobectomy enough or not. The data of 462 consecutive patients who underwent thyroidectomy (hemithyroidectomy and total thyroidectomy) at the Hacettepe University Hospitals Department of ENT from 2000 to 2015 were analyzed. Surgical procedure, histopathologic examinations, postoperative complications, follow-up time and mortality were recorded. USG and FNAC were performed on all cases. Of the 344 patients with thyroid malignancy and 118 patients underwent total laryngectomy with thyroidectomy. 364 patients with TT and 98 patients with HT. The first group included 204 patients (Surgery time 2000-2007), 91 of them ( 44.6%) had PTMC. The second group included 258 patients, 192of them (74,4%) had PTMC (p<0.001). 22 Patients with PTMC underwent completion surgery and 40 of them just followed by hemithyroidectomy. There was no recurrence. PTMC has been rising incidence because of ,pathological and radiological, increased awareness and completion surgery is not necessary for all PTMC cases especially incidental PTMC.
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Affiliation(s)
- Oğuz Kuşcu
- Hacettepe University Faculty of Medicine Department of Otorhinolaryngology
| | - Övsen Önay
- Hacettepe University Deparment of Otorinolaryngology, Head and Neck Surgery
| | - Bahar Kayahan
- Hacettepe University Deparment of Otorinolaryngology, Head and Neck Surgery
| | - Nilda Süslü
- Hacettepe University Deparment of Otorinolaryngology, Head and Neck Surgery
| | - Taner Yılmaz
- Hacettepe University Deparment of Otorinolaryngology, Head and Neck Surgery
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Kuşcu O, Günaydın RÖ, İcen M, Ergün O, Kulak Kayikci ME, Yılmaz T, Özgür FF, Akyol MU. The effect of early routine grommet insertion on management of otitis media with effusion in children with cleft palate. J Craniomaxillofac Surg 2015; 43:2112-5. [PMID: 26545930 DOI: 10.1016/j.jcms.2015.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/07/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The aim of the study is to compare long term otoscopic and audiological findings of cleft palate patients with or without early grommet insertion. METHODS Cleft palate patients followed-up in Hacettepe University between 2008 and 2013 were included in the study. Age, gender, cleft types and palate surgery data, grommet tube insertion history and otological - audiological evaluations of the patients were recorded. Patients were evaluated in three groups according to grommet insertion history: A-early routine grommet insertion, B-grommet insertion during follow-up, C-no grommet insertion. Otological and audiological findings were compared. RESULTS There were 154 patients in the study, with a median age of 7.7 years. There were 67 patients in group A (43.5%), 22 patients in group B (14.3%) and 65 patients in group C (42.2%). OME was identified significantly higher in group A and normal otoscopic examination findings were higher in group C. Complications showed a higher rate than other otoscopic findings in group B patients. There was no significant difference for any frequencies in between the groups in terms of mean air-bone gap (ABG) values. There were 20 grade I, 25 grade II, 77 grade III and 32 grade IV patients in the study according to the Veau classification. CONCLUSION Prophylactic grommet insertion may not be applied as some cleft palate patients with no OME. Wait and see protocol can be recommended for these patients, and they should be followed-up up closely to avoid complications. If the effusion does not recover or tympanic membrane changes occur in follow-up, grommet insertion should be considered.
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Affiliation(s)
- Oğuz Kuşcu
- Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey.
| | | | - Mehtap İcen
- Hacettepe University, Department of Otorhinolaryngology, Audiology and Speech Pathology Unit, Ankara, Turkey.
| | - Onur Ergün
- Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey.
| | - Mavis Emel Kulak Kayikci
- Hacettepe University, Department of Otorhinolaryngology, Audiology and Speech Pathology Unit, Ankara, Turkey.
| | - Taner Yılmaz
- Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey.
| | - Fatma Figen Özgür
- Department of Plastic and Reconstructive Surgery, Hacettepe University Medical School, Ankara, Turkey.
| | - Mehmet Umut Akyol
- Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey.
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Yılmaz T, Jafarov S, Kuşçu O, Sözen T, Süslü AE. Endoscopic Z-plasty for Treatment of Supraglottic Stenosis. Otolaryngol Head Neck Surg 2015; 153:1064-6. [DOI: 10.1177/0194599815607201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 08/31/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology–Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Shamkhal Jafarov
- Department of Otolaryngology–Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Oğuz Kuşçu
- Department of Otolaryngology–Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tevfik Sözen
- Department of Otolaryngology–Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Emre Süslü
- Department of Otolaryngology–Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Önal M, Yılmaz T, Bilgiç E, Müftüoğlu S, Sözen T, Bajin MD. Possible role of apoptosis in pathogenesis of adenoid hypertrophy and chronic adenoiditis: Prospective case-control study. Auris Nasus Larynx 2015; 42:449-52. [PMID: 26003878 DOI: 10.1016/j.anl.2015.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/15/2015] [Accepted: 04/27/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Apoptosis is a programmed cell death; it provides an important balance between lymphocytes in adenoid tissue. The aim of this study is to investigate the role of apoptosis in chronic adenoiditis and adenoid hypertrophy. This is the first study in the literature about apoptosis in adenoid hypertrophy and chronic adenoiditis. METHODS Prospective case-control study in a tertiary referral university hospital was conducted. 46 patients who had chronic adenoiditis and adenoid hypertrophy underwent adenoidectomy. Adenoids were evaluated for apoptosis and assembled into groups according to their size. Apoptotic cells were counted in three different microscopic fields and their average was taken for every microcompartment. As a result of immunohistochemical staining, specimens were compared for their apoptotic cell rate. RESULTS The difference in apoptosis of chronic adenoiditis and adenoid hypertrophy groups is statistically significant (p<0.05). The age 6 was used as a cut-off to compare apoptosis in adenoid tissue. The difference was not statistically significant for patients at and below 6 years of age; however, the difference was statistically significant for patients above 6 years of age. The comparison of apoptosis in microcompartments of adenoid tissue (intrafollicular, interfollicular, subepithelial and intraepithelial) between chronic adenoiditis and adenoid hypertrophy groups revealed significant differences for intrafollicular and intraepithelial areas, and insignificant differences for interfollicular and subepithelial areas. CONCLUSION Although apoptosis could not totally explain the pathogenesis of chronic adenoiditis and adenoid hypertrophy, it appeared to play an important role in it. Apoptosis functions to limit adenoid hypertrophy. Adenoid apoptosis appears to be age-dependent.
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Affiliation(s)
- Merih Önal
- Hacettepe University Faculty of Medicine, Department of Otolaryngology-Head & Neck Surgery, Ankara, Turkey
| | - Taner Yılmaz
- Hacettepe University Faculty of Medicine, Department of Otolaryngology-Head & Neck Surgery, Ankara, Turkey.
| | - Elif Bilgiç
- Hacettepe University Faculty of Medicine, Department of Histology and Embryology, Ankara, Turkey
| | - Sevda Müftüoğlu
- Hacettepe University Faculty of Medicine, Department of Histology and Embryology, Ankara, Turkey
| | - Tevfik Sözen
- Hacettepe University Faculty of Medicine, Department of Otolaryngology-Head & Neck Surgery, Ankara, Turkey
| | - Münir Demir Bajin
- Hacettepe University Faculty of Medicine, Department of Otolaryngology-Head & Neck Surgery, Ankara, Turkey
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Yılmaz T, Süslü N, Atay G, Günaydın RÖ, Bajin MD, Özer S. The effect of midline crossing of lateral supraglottic cancer on contralateral cervical lymph node metastasis. Acta Otolaryngol 2015; 135:484-8. [PMID: 25677524 DOI: 10.3109/00016489.2014.986759] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The degree of midline crossing of lateral supraglottic cancer does not significantly change its rate of contralateral cervical metastasis. The rate of occult metastasis is too high to take the risk of contralateral regional recurrence. We support routine bilateral neck dissection even in lateral supraglottic cancers with no or minimal midline crossing. OBJECTIVES Data on the rate of contralateral cervical metastasis of laterally located supraglottic cancer, the effect of its degree of midline crossing on contralateral cervical metastasis, and its treatment are still controversial. METHODS This was a retrospective cohort, chart review involving 305 surgically treated patients with T1-3 squamous cell carcinoma of the supraglottic larynx. In all, 184 patients had bilateral neck dissection; 86 N0 contralateral necks were followed up. Thirty-five patients who needed postoperative radiation therapy because of the primary tumor or ipsilateral neck dissection specimen also received radiation therapy to the contralateral neck. The degree of midline crossing at the epiglottis was measured on a laryngectomy specimen with a ruler and expressed as 'no,' '<5 mm' or '≥5 mm.' RESULTS The rates of occult and overall contralateral metastasis in our series were 16% and 28%, respectively. There was no statistically significant difference between contralateral neck metastasis and recurrence rates in the neck dissection, follow-up, and irradiation groups according to the degree of midline crossing.
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Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology-Head & Neck Surgery, Hacettepe University Faculty of Medicine , Ankara , Turkey
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26
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Önal M, Yılmaz T, Bilgiç E, Müftüoğlu SF, Kuşçu O, Günaydın RÖ. Apoptosis in chronic tonsillitis and tonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2015; 79:191-5. [PMID: 25555639 DOI: 10.1016/j.ijporl.2014.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/06/2014] [Accepted: 12/08/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Chronic tonsillitis is the persistent inflammation of the tonsillar tissue that occurs due to recurrent, acute or subclinical infection. The recurrent and chronic inflammation of palatine tonsils sometimes results in hypertrophy. Apoptosis provides an important balance between lymphocytes in tonsillar lymphoid tissue. The aim of this study is to investigate the apoptosis in tonsillar diseases. METHODS 43 patients with chronic tonsilitis and tonsillar hypertrophy underwent tonsillectomy. The specimens were examined immunohistochemically for apoptosis. Tonsils were assembled into groups according to their size. Specimens were compared for their apoptotic cell count. RESULTS The apoptosis difference between the tonsil size groups is not statistically significant (p>0.05). However, when the study group was divided into two at age 6, the difference was not statistically significant for patients at and below 6 years of age; but, the difference was statistically significant for patients above 6 years of age (p<0.05). The comparison of apoptosis in microcompartments of tonsil tissue (intrafollicular, interfollicular, subepithelial and intraepithelial) between tonsil size stages and between chronic tonsillitis and tonsillar hypertrophy groups revealed no statistical significance (p>0.05). There was a statistically significant positive correlation between intrafollicular and interfollicular, interfollicular and intraepithelial & subepithelial and intraepithelial areas (p<0.05). CONCLUSIONS In the light of these findings, it was concluded that apoptosis played a role in the tonsillar hypertrophy and atrophy. Apoptosis functioned to balance lymphocyte proliferation in tonsil tissue. The association of apoptosis with tonsillar hypertrophy seemed to be age-dependent.
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Affiliation(s)
- Merih Önal
- Hacettepe University, Faculty of Medicine Department of Otolaryngology-Head & Neck Surgery, 06100 Sıhhiye, Ankara, Turkey.
| | - Taner Yılmaz
- Hacettepe University, Faculty of Medicine Department of Otolaryngology-Head & Neck Surgery, 06100 Sıhhiye, Ankara, Turkey.
| | - Elif Bilgiç
- Hacettepe University, Faculty of Medicine, Department of Histology and Embryology, Ankara, Turkey.
| | - Sevda Fatma Müftüoğlu
- Hacettepe University, Faculty of Medicine, Department of Histology and Embryology, Ankara, Turkey.
| | - Oğuz Kuşçu
- Hacettepe University, Faculty of Medicine Department of Otolaryngology-Head & Neck Surgery, 06100 Sıhhiye, Ankara, Turkey.
| | - Rıza Önder Günaydın
- Hacettepe University, Faculty of Medicine Department of Otolaryngology-Head & Neck Surgery, 06100 Sıhhiye, Ankara, Turkey.
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Önal M, Bajin MD, Yılmaz T. Fibrodysplasia ossificans progressiva: a case report. Turk J Pediatr 2014; 56:561-564. [PMID: 26022598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Fibrodysplasia ossificans progressiva (FOP) is a rare, severely disabling, autosomal dominant disease characterized by recurrent painful episodes of soft tissue swelling and the development of heterotopic ossification. The main target is the axial musculature, but eventually ectopic bone formation occurs in the ligaments, the fascia, the tendons and the joint capsules. Small soft tissue traumas and intramuscular injections exacerbate this extraskeletal bone formation. We present a 16-year-old male patient who has osseous lesions beginning from the left ramus mandible and extending along the sternocleidomastoid muscle, vertebral region and deltoid, with visible restriction in temporomandibuler joint movement. Surgery was not performed due to parental concerns. Unfortunately, no effective medical therapy for FOP is known. These patients may require extra care during some oral surgery and anesthetic procedures. In this report, the importance of the decision to perform surgery has been stressed.
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Affiliation(s)
- Merih Önal
- Department of Otorhinolaryngology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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Günaydın RÖ, Süslü N, Bajin MD, Kuscu O, Yılmaz T, Ünal ÖF, Akyol U. Endolaryngeal dilatation versus laryngotracheal reconstruction in the primary management of subglottic stenosis. Int J Pediatr Otorhinolaryngol 2014; 78:1332-6. [PMID: 24961989 DOI: 10.1016/j.ijporl.2014.05.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/18/2014] [Accepted: 05/20/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The scope of the study is to compare endolaryngeal dilatations (ED) with laryngotracheal reconstruction with cartilage grafting (LTRCG) in terms of restenosis. METHODS Pediatric subglottic stenosis patients treated in Hacettepe University, between 2002 and 2012 were retrospectively evaluated. Patients who had ED or LTRCG as primary management were included in the study. EDs were grouped into bronchoscopic dilatation (BD), laser incision and balloon dilatation (LBD) and cold knife incision and balloon dilatation (CKBD). The groups were evaluated in terms of restenosis and decannulation rates. RESULTS There were 35 patients (9 females, 26 males; mean age 4.42). LTRCG was performed in 16 patients (9 anterior and 7 anterior and posterior grafts). EDs were performed in 19 patients with 6 CKBDs, 7 LBDs and 6 BDs. There were 3 grade II, 13 grade III cases in the LTRCG group while 4 grade I, 6 grade II, 8 grade 3 and 1 grade 4 in the ED group. Overall decannulation rate was 97% (34/35) in all patients. Restenosis was higher in the ED group (63.2%) than the LTRCG group (31.3%) with rates of CKBD 16.7% (1/6), LBD 71.4% (5/7) and BD 100% (6/6). Restenosis rates were found to be increasing with higher grades (grade I-25%, grade II-66%, grade III-85%). CONCLUSION ED may need more repetitive interventions than LTRCG due to restenosis. Less restenosis might be observed when balloon is used for dilatation and cold knife for mucosal incisions.
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Affiliation(s)
- Rıza Önder Günaydın
- Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey.
| | - Nilda Süslü
- Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey.
| | - Münir Demir Bajin
- Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey.
| | - Oguz Kuscu
- Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey.
| | - Taner Yılmaz
- Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey.
| | - Ömer Faruk Ünal
- Acıbadem University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey.
| | - Umut Akyol
- Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey.
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Yılmaz T, Bajin MD, Günaydın R&O, Özer S, Sözen T. Laryngopharyngeal reflux and Helicobacter pylori. World J Gastroenterol 2014; 20:8964-8970. [PMID: 25083069 PMCID: PMC4112879 DOI: 10.3748/wjg.v20.i27.8964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 01/17/2014] [Accepted: 04/03/2014] [Indexed: 02/06/2023] Open
Abstract
Laryngopharyngeal reflux (LPR) occurs when gastric contents pass the upper esophageal sphincter, causing symptoms such as hoarseness, sore throat, coughing, excess throat mucus, and globus. The pattern of reflux is different in LPR and gastroesophageal reflux. LPR usually occurs during the daytime in the upright position whereas gastroesophageal reflux disease more often occurs in the supine position at night-time or during sleep. Ambulatory 24-h double pH-probe monitoring is the gold standard diagnostic tool for LPR. Acid suppression with proton pump inhibitor on a long-term basis is the mainstay of treatment. Helicobacter pylori (H. pylori) is found in many sites including laryngeal mucosa and interarytenoid region. In this paper, we aim to present the relationship between LPR and H. pylori and review the current literature.
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Kuscu O, Onay O, Gunaydın RO, Yılmaz T. Otoplasty Outcomes and Results: Does Furnas Setback Suture Affect Complication Rates? Turk Arch Otorhinolaryngol 2014. [DOI: 10.5152/tao.2014.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kamani T, Yılmaz T, Sürücü S, Bajin MD, Günaydın RÖ, Kuşçu O. Histopathological changes in nasal mucosa with nasal septum deviation. Eur Arch Otorhinolaryngol 2014; 271:2969-74. [PMID: 24647493 DOI: 10.1007/s00405-014-2990-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 02/27/2014] [Indexed: 11/29/2022]
Abstract
Histopathological changes in septal and nasal mucosa of patients with nasal septum deviation are not well known. Biopsies of septal and lateral nasal mucosae from both sides of nose were obtained from 20 patients undergoing septoplasty and control group of 10 patients undergoing head and neck surgery. Histopathological changes including lymphocytic infiltration and squamous metaplasia were compared. This study determined significantly higher rate of squamous metaplasia and lymphocytic infiltration in septal mucosa opposite the deviation compared to control group. Furthermore, there was a significantly higher rate of lymphocytic infiltration in the lateral nasal wall mucosa opposite the deviation when compared to control group. Increased lymphocytic infiltration and squamous metaplasia are observed on both sides of nasal mucosa; however, they are more severe on the side opposite the deviation. Septal deviation predisposes to chronic mucosal inflammation and squamous metaplasia, both of which may render patients susceptible to chronic rhinosinusitis.
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Affiliation(s)
- Tawakir Kamani
- Department of ENT, Queens Medical Centre, Nottingham, UK
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Yılmaz T, Cabbarzade C, Süslü N, Bajin MD, Günaydın RÖ, Özer S, Atay G. Novel endoscopic treatment of pharyngocele: endoscopic suture pharyngoplasty. Head Neck 2014; 36:E78-80. [PMID: 24170686 DOI: 10.1002/hed.23531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/13/2013] [Accepted: 10/22/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pharyngocele or a lateral pharyngeal diverticulum (LPD) are rare lesions, which are bulgings of the pharyngeal mucosal surface through one of the weak areas of the pharynx. METHODS The external approach has been the primary surgical treatment of pharyngoceles. The purpose of this article was for us to report an endoscopic successful treatment of pharyngocele by suture pharyngoplasty. RESULTS Endoscopic suture pharyngoplasty does not require an external incision and hospitalization. After 3 months of abstinence from trumpet playing, the patient is back to his musical career. CONCLUSION Because of the minimally invasive procedure, endoscopic suture pharyngoplasty can be performed in case of symptomatic pharyngoceles with a good result.
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Affiliation(s)
- Taner Yılmaz
- Department of Otolaryngology - Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Abstract
Testicular carcinoma metastatic to the neck is rare. Even more rare is a finding of choriocarcinoma as a neck mass without any sign of a primary testicular tumor, as only a few cases have been reported in the literature. We describe a new case that occurred in a 29-year-old man who presented with a neck mass. Fine-needle aspiration biopsy identified the tumor as a malignant epithelial neoplasm. Radiologic findings indicated the presence of a systemic metastasis of a tumor to the chest and abdomen, as well as the neck. Findings on an incisional biopsy of the neck mass were consistent with a choriocarcinoma. The testicles were normal on palpation and ultrasonography. The patient was diagnosed with metastatic choriocarcinoma with an unknown primary, and he was started on chemotherapy. On the second day of treatment, which was 25 days after his referral to our clinic, he died of respiratory insufficiency.
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Affiliation(s)
- Hilmi Alper Senkal
- Department of Otorhinolaryngology-Head and Neck Surgery, Hacettepe University Hospital, Gevher Nesibe St., 06230, Sıhhiye, Ankara, Turkey.
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Süslü N, Süslü AE, Akyol U, Yılmaz T. Minimally invasive endoscope-assisted surgery for bilateral branchial cleft fistula. Laryngoscope 2013; 123:2296-9. [DOI: 10.1002/lary.23826] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2012] [Indexed: 11/06/2022]
Affiliation(s)
- Nilda Süslü
- Department of Otorhinolaryngology; Hacettepe University School of Medicine; Ankara; Turkey
| | - Ahmet E. Süslü
- Department of Otolaryngology; TDV 29 Mayıs Hospital; Ankara; Turkey
| | - Umut Akyol
- Department of Otorhinolaryngology; Hacettepe University School of Medicine; Ankara; Turkey
| | - Taner Yılmaz
- Department of Otorhinolaryngology; Hacettepe University School of Medicine; Ankara; Turkey
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Yılmaz T. Recurrent Contact Granuloma Experience With Excision and Botulinum Toxin InjectionRecurrent Contact Granuloma. JAMA Otolaryngol Head Neck Surg 2013; 139:579-83. [DOI: 10.1001/jamaoto.2013.3186] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Yılmaz T. Endoscopic total arytenoidectomy for bilateral abductor vocal fold paralysis: A new flap technique and personal experience with 50 cases. Laryngoscope 2012; 122:2219-26. [DOI: 10.1002/lary.23467] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 03/30/2012] [Accepted: 05/04/2012] [Indexed: 11/11/2022]
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Yılmaz T. Sulcus vocalis: excision, primary suture and medialization laryngoplasty: personal experience with 44 cases. Eur Arch Otorhinolaryngol 2012; 269:2381-9. [DOI: 10.1007/s00405-012-2058-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 05/15/2012] [Indexed: 11/24/2022]
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Zayyan E, Zeyyan E, Bajin MD, Aytemir K, Yılmaz T. The effects on cardiac functions and arterial blood gases of totally occluding nasal packs and nasal packs with airway. Laryngoscope 2011; 120:2325-30. [PMID: 20938948 DOI: 10.1002/lary.21064] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the effects on cardiac functions and blood arterial gases of totally occluding nasal packs and nasal packs with airway. STUDY DESIGN Prospective, randomized trial. METHODS Thirty-nine adults without any comorbidities underwent septoplasty or septorhinoplasty and had nasal packs placed postoperatively; 19 nasal packs with airways and 20 totally occluding nasal packs. Twenty-four-hour Holter monitorization was done pre- and postoperatively. Arterial blood gas analysis was performed both before the operation and after application of nasal packs. RESULTS Application of packs with airway did not cause any significant changes in blood gas parameters. Packing with totally occluding nasal packs caused a significant decrease in HCO(3) and pCO(2), and insignificant changes in pO(2), O(2) saturation, and pH. No serious arrhythmias were observed in any patient. In both groups, nasal packing resulted in a significant increase in minimum heart rates, a significant decrease in maximum heart rates, and insignificant changes in the mean heart rates. Heart rate variability obtained from 24-hour Holter electrocardiography was analyzed by power spectral analysis. An increase in the high-frequency (HF) domain, a decrease in the low-frequency (LF) domain, and a decrease in the LF/HF ratio were observed after packing in both groups. CONCLUSIONS Nasal pack-induced cardiac complications may occur due to increased vagal stimuli secondary to nasal mucosa compression rather than obstruction-related hypoxia. The use of nasal packs in the elderly patients with cardiopulmonary disease warrants close observation. Nasals packs with airways should be preferred in patients susceptible to hypoxia.
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Affiliation(s)
- Ehab Zayyan
- Hacettepe University Department of Otorhinolaryngology, Hacettepe University Hospital, Ankara, Turkey
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