Ali Rıza Yağmur

Background: Invasive fungal rhinosinusitis (IFRS) is a rare disorder with a high mortality rate. In this study, we reported four rare cases, two of them being the first reports in the literature, in addition, we reviewed retrospectively and discussed the effects of causative fungi, comorbid disorders, and intracranial involvement on mortality rate in 20 IFRS patients treated in the otolaryngology clinic between May 2019 and May 2021. Results: There were 10 (50%) males and 10 females with a median age of 51 years. Seven patients had rhinomaxillary, 11 had rhino-orbito-cerebral IFRS, and two had atypical presentations that could not be classified. The most frequent comorbid condition was diabetes mellitus (DM), and the most frequent causative fungi were Mucormycetes. There was no difference between DM and other comorbidity groups for orbital involvement (p = 0.37), intracranial involvement (p = 0.17), hard palate involvement (p = 1), cranial nerve palsies (p = 0.17), causative fungi (p = 0.14), or mortality (p = 0.35). Mucormycetes and other fungi were similar for orbital involvement (p = 0.34), intracranial involvement (p = 0.16), hard palate involvement (p = 0.64), and mortality rate (p=0.35); however, cranial nerve palsies were significantly more frequent in Mucormycetes group (p = 0.04). Conclusions: Urgent diagnosis and multidisciplinary treatment are mandatory in IFRS. Due to its high mortality rate, IFRS should always be kept in mind in cases with atypical presentation, particularly if the patient is in the risk group. The current gold standard in IFRS management is urgent wide surgical debridement and concomitant administration of antifungals.

The aim of the study was to investigate the relations between anatomical structures that are susceptible to inadvertent injuries during the surgery using preoperative computed tomography (CT) scans. 153 CT scans were reviewed and the distance from the lamina papyracea (LP) to the midline and the distance of the anterior ethmoidal artery (AEA) to the skull base were measured bilaterally. Also, the depth of olfactory fossa was measured and categorized using the Keros classification. The measurements were analyzed to determine whether LP-to-midline distance was correlated with the distance between the AEA and the skull base and Keros classification. Additionally, correlation of Keros classification with the distance from the AEA to the skull base was investigated. In a total of 306 measurements, 26 (%8.49) were classified as Keros type I, 200 (65.35%) as Keros type II and 80 (25.14%) as Keros type III. Statistically, LP-to-midline distances on the right and left sides were significantly associated with the distance from the AEA to the skull base on the same side (R:p < 0.001, L:p = 0.01) and the Keros classification on the same side (R:p < 0.001, L:p = 0.004). Also, a significant association was found between the Keros classification and the distance from the AEA to the skull base (R:p < 0.001, L:p = 0.02). The locations of anatomical structures are defined in relation to each other during the development of maxillofacial bones. CT scans should be examined and anatomical structures and relations among them reviewed very carefully before ESS. Otherwise, some accidental injuries may arise during the surgery while trying to avoid complications.

Background Chronic hypoxia may lead to auditory dysfunction in patients with obstructive sleep apnea (OSA), and this dysfunction may worsen OSA, creating a vicious circle. The aim of this study was to investigate tinnitus and hearing loss in OSA patients. Methods A total of 147 patients were included in the study. After polysomnography (PSG), the patients with an apnea-hypopnea index (AHI) ≥ 5 were included in OSA group, and the ones with an AHI

Günümüz modern eğitim sistemleri sınavlara salt bilgi yerine kazanılmış beceri yada öğrenilmiş bilginin kullanılabilirliğini ölçme görevi yüklemiştir. Sonuçta bireylere sorunları analiz edip çözüm üretebilme yeteneği kazandırmak nihayi hedeftir. Bu kitabın temelinde bu bakış akıcısı gözönünde tutulmuş olup verilen gerçek vaka örneklerinde dikkatle sorgulanması gereken detaylara, atlanmaması gereken fizik muayene yöntemlerine, öncelikli seçilmesi gereken tanı testlerine, ayırıcı tanıda gözönünüde bulundurulması gereken hastalıklara, kesin tanı yöntemlerine, hazırlıklı olunması gereken komplikasyonlara ve hasta takibindeki önemli unsurlara çözümsel yaklaşım aktarılmaya çalışılmıştır.

Kulak Burun Boğaz bölgesi kanser olarak yaygın ve geniş bir alan olup multidisipliner yaklaşım ve tedavi gerektirmektedir. Eserimizde Baş boyun bölgesi kanserlerine güncel bir yaklaşım ile sınıflamadan tedaviye düzensel bir yaklaşım içinde oluşturmayı hedefledik. Başta Türk Kulak Burun Boğaz hastalıkları camiasına ve Türk tıp dünyasına bu kitabın kazandırılmasından ve faydalı olmasını umuyoruz. Nazofarenks Kanserine Yaklaşım Gözde ORHAN KUBAT Paranazal Sinüs Malignitelerine Yaklaşım Tuğba TULACI Kamil Gökçe TULACI Nazal Kavite Tümörleri Ozan TÜYSÜZ İnverted Papillom Caner ŞAHİN Olfaktör Nöroblastom (ESTHESIONEUROBLASTOM) Yaklaşım Umur AKINER Jüvenil Anjiofibroma Yaklaşımı Erkan YILDIZ Dudak Kanserleri Yaklaşım Sultan ŞEVİK ELİÇORA Oral Kavite Kanserlerine Yaklaşım Ömer Faruk ÇUFALI Ali Rıza YAĞMUR Orofaringeal Kanserler Ömer Tarık SELÇUK Larenks Bölgesi Tümörlerinin Patolojik Özellikleri Yavuz GÜNDOĞDU Hipofarinks Kanserlerine Yaklaşım Şükrü AYDIN Supraglottik Larenks Kanserleri Yaklaşımı Ergün SEVİL Glottik Kanserlere Yaklaşım Murat KAR Subglottik Larenks Kanserleri ve Tedavi Yaklaşımları Hüseyin GÜNİZİ Özlem Ceren GÜNİZİ Özofagus Kanserleri Duran KARATAŞ Kutanöz Malign Melanoma Yaklaşım Seçkin AYDIN SAVAŞ Mukozal Melanom Caner ŞAHİN Baş Boyun Lenfomalarına Yaklaşım İsmail DEMİR Benign Tükürük Bezi Tümörlerine Yaklaşım Seda ARSLAN Tükrük Bezi Malign Neoplazmları Ethem İLHAN Vestibüler Schwannom Yaklaşım Ahmet Mahmut TEKİN Dış Kulak Tümörleri Meltem TULĞAR Baş Boyun Cildi Melanom Dışı Kanserleri Öznur GÜNDÜZ Şeyda AKBAL ÇUFALI Baş Boyun Paragangliomalarında Tedavi Yaklaşımı Turgut ÇELİK Baş-Boyun Yumuşak Doku Sarkomları Mustafa GÜLLÜEV Baş-Boyun Kemik Sarkomları Yusuf Çağdaş KUMBUL Tiroid Diferansiye Tümörleri Yaklaşımı Bilal SİZER Medüller Tiroid Kanserine Yaklaşım Derya CEBECİ Anaplastik Tiroid Kanseri Elif AKYOL ŞEN Boynun Primeri Bilinmeyen Metastatik Kanserleri Esra KAVAZ UŞTU Parafarengeal Alan Kitleleri Abdullah KINAR Temporal Kemik Tümörlerine Yaklaşım Fatih YÜCEDAĞ Baş Boyun Kanserlerinde Boyuna Yaklaşım Ali Can SUNGUR Baş Boyun Tümörlerinde Genel Radyoterapi İlkeleri ve Güncel Yaklaşımlar Ayşe ÇEÇEN Baş Boyun Tümörlerinde Genel Kemoterapi İlkeleri Asude ÜNAL

Background Olfactory dysfunction (OD) is a significant symptom of COVID-19 and may be the earliest symptom, or it may sometimes be the only manifestation of the disease. Aims To investigate whether OD is correlated with chest computed tomography (CT) findings, blood test parameters, and disease severity in COVID-19 patients. Methods The files of COVID-19 patients were retrospectively reviewed, and the ones who had information about smelling status and CT were taken into consideration. A total of 180 patients were divided into two groups: the OD group consisted of 89 patients with self-reported OD, and the No-OD group consisted of 91 subjects who did not complain of OD. The two groups were compared for the amount of lung consolidation on CT, intensive care unit (ICU) admission, and blood test parameters (complete blood count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, D-dimer, interleukin-6 (IL-6)). Results The amount of lung consolidation and ICU admission were significantly higher in the No-OD group (p < 0.001 for both). White blood cell (p = 0.06), monocyte (p = 0.26), and platelet (p = 0.13) counts and hemoglobin (p = 0.63), ALT (p = 0.89), and D-dimer (p = 0.45) levels of the two groups were similar. Lymphocyte count (p = 0.01), neutrophil count (p = 0.01), and AST (p = 0.03), CK (p = 0.01), LDH (p < 0.001), CRP (p < 0.001), ESR (p < 0.001), ferritin (p < 0.001), and IL-6 (p < 0.001) levels were significantly higher in the No-OD group. Conclusions The patients presenting to the hospital with self-reported OD may have less lung involvement and a milder disease course compared to patients without OD on admission.

Background Obstructive sleep apnea syndrome (OSAS) is characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep, frequently followed by transient hypoxemia. Advanced oxidation protein products (AOPP) are a family of oxidized protein products, and oxidative stress has a substantial role in the morbidity of OSAS. Aims The aim of this study was to investigate the serum levels of advanced oxidation protein products (AOPP) as a marker of oxidative stress, and their correlation with polysomnographic parameters in patients with obstructive sleep apnea syndrome (OSAS). Additionally, we investigated the effect of positive airway pressure (PAP) treatment on serum AOPP values and compared the levels before and after the treatment. Methods The study enrolled a total of 125 subjects including 59 patients with severe OSAS, 34 patients with moderate OSAS, 32 patients with mild OSAS, and 40 healthy controls. Mean AOPP values were compared between OSAS groups and control groups. Correlations between AOPP and polysomnographic parameters were investigated. Mean AOPP values before and after 6-month PAP therapy were compared. Results Significantly elevated AOPP levels were found in severe and moderate OSAS groups in comparison with mild OSAS and control groups. AOPP was directly correlated with apnea-hypopnea index, percentage of total time spent with oxygen saturation below 90%, oxygen desaturation index, maximum obstructive apnea duration, arousal index, and number of obstructive apneas accompanying bradycardia but inversely correlated with average SPO₂ (%), minimum SPO₂, and percentage of non-REM stage 3 sleep. There was no statistically significant difference between AOPP values before and after PAP therapy. Conclusions AOPP, which is an oxidative stress marker, was found to be high in OSAS patients. Especially, high levels in moderate and severe OSAS patients may be an indicator of increased morbidity. After 6 months of PAP treatment, there was no statistically significant change in these levels.

Tanıtım: Mandibula metastazları oldukça nadir görülür ve mandibula malignitelerinin yaklaşık %1’inden daha azını teşkil eder. Mandibulaya metastaz olan olgularda hastalar genellikle çenede şişlik, çene kemiği ile dişlerde ağrı, ve diş kaybı gibi şikayetlerle başvururlar. Metastatik lezyonların belirtilerinin periodontal hastalıklarla karışma olasılığı nedeniyle dikkatli olmak gerekir ve ayırıcı tanıda primer kemik tümörü olan osteosarkom, primer intraosseöz skuamöz karsinom, ameloblastoma, temporomandibuler eklem hastalıkları akılda tutulmalıdır. Tedavi seçenekleri cerrahi ve ilave kemoradyoterapi olmakla birlikte, prognoz kötüdür ve genellikle tedavi palyatif amaçlı yapılmaktadır. Olgu Bildirimi: Rektum adenokarsinomu nedeni ile 3 yıl önce opere olan 51 yaşında kadın hasta kliniğimize çenede şişlik şikayeti ile başvurdu. Hastanın kraniyal manyetik rezonans ve maksillofasiyal bilgisayarlı tomografi görüntüleri incelendiğinde sağ mandibula ramusunda, kondili de tutan kemikte yıkıma yol açan lezyon tanımlandı. Hastaya yapılan insizyonel biyopsi sonrasında histopatolojik tanı kolorektal adenokarsinom ile uyumlu olarak raporlandı. Hasta medikal onkoloji bölümüne yönlendirildi. Sonuç: Mandibula lezyonlarının ayırıcı tanısı çok dikkatli bir şekilde yapılmalı ve metastatik tümörlerin akılda tutulması gerekmektedir. Öyküsünde akciğer, meme, kolorektal kanser ve benzeri tümörü olan hastalarda baş boyun bölgesinde metastatik tümörlerin oluşabileceği düşünülmeli ve dişlerde ağrı, diş kaybı dikkate alınmalı, gerekli radyolojik incelemeler sonrası mutlaka biyopsi yapılmalıdır.