Murat Turhan

Background: This study aimed to evaluate the effects of obstructive sleep apnea syndrome (OSAS) surgery on oxidative stress, antioxidant capacity, and oxidative protein modifications. Changes in Total Oxidant Status (TOS), Total Antioxidant Status (TAS), Advanced Oxidation Protein Products (AOPP), Ischemia-Modified Albumin (IMA), and Total Thiol (TT) levels were analyzed in the preoperative and postoperative periods. Methods: Sixty-seven patients aged 18–65 years with an Apnea–Hypopnea Index (AHI) > 5 who underwent OSAS surgery were included. Demographic characteristics were recorded. Venous blood samples were collected at four time points: before anesthesia induction (T1), at the end of surgery (T2), on postoperative day 3 (T3), and at postoperative month 3 (T4). TOS, TAS, AOPP, IMA, and TT levels were measured and statistically evaluated. Results: Of the patients, 13.4% (n = 9) were female and 86.6% (n = 58) were male. No significant changes were observed in TOS, TAS, AOPP, or IMA levels between time points. However, TT levels at postoperative month 3 were significantly higher than those at earlier measurements (p < 0.05). Positive correlations were found between AHI and TOS, AOPP, and IMA levels, while TAS and TT showed no significant correlation with AHI. Conclusions: Surgery for OSAS did not produce significant postoperative improvements in oxidative stress parameters except for TT elevation. These results indicate that surgical intervention alone may be insufficient for biochemical recovery in OSAS and should be complemented by lifestyle and supportive therapies.

Purpose This study aimed to investigate the effects of surgical correction of nasal obstruction on aerobic performance parameters in athletes with nasal obstruction. Specifically, we examined changes in running economy (RE), oxygen uptake (VO₂), and ventilatory responses following nasal surgery. Although previous studies have explored the effects of nasal airflow on exercise, this is the first to directly assess the impact of surgical intervention on physiological determinants of athletic performance. Methods Eleven male athletes diagnosed with nasal obstruction (experimental group, EG) and 11 matched athletes without nasal issues (control group, CG) participated. Nasal patency was evaluated using acoustic rhinometry, while subjective symptoms were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale and Epworth Sleepiness Scale (ESS). All participants performed an incremental treadmill test to assess running economy, gas exchange, and ventilatory parameters both before and 2–3 months after surgery. Results Post-surgery, the EG showed significant improvements in nasal patency and sleep quality, with NOSE scores decreasing from 61.36 ± 15.83 to 8.64 ± 10.27 and ESS scores from 5.09 ± 2.12 to 3.09 ± 1.76. Additionally, oxygen consumption decreased, and ventilation volume increased during the submaximal treadmill stages in the EG. A statistically significant Group × Time interaction was found for RE (p = .005), indicating greater improvements in oxygen cost in the surgical group. Conclusion Surgical correction of nasal obstruction significantly improves running economy and ventilatory efficiency by reducing upper airway resistance and respiratory muscle workload. These adaptations may enhance aerobic performance in athletes with nasal obstruction.

Purpose To evaluate the feasibility, morbidity, and efficacy of transoral robotic surgery (TORS) tongue base resection (TBR) combined with upper airway airflow-facilitating surgeries in patients with obstructive sleep apnoea (OSA) characterized by tongue base hypertrophy and collapse, and to identify anatomical and nonanatomical predictors of surgical success. Methods This single-center, prospective observational cohort study included 110 adult patients with moderate to severe OSA (AHI ≥ 15) or positional OSA, who failed or refused conservative therapies. Retrolingual/hypopharyngeal obstruction and tongue base collapse were confirmed via drug-induced sleep endoscopy or flexible nasopharyngoscopy. Patients with contraindications for surgery, inadequate mouth opening, absence of postoperative polysomnography, or under 18 years of age were excluded. Demographic, polysomnographic, and perioperative data were collected and statistically analyzed. Results The mean patient age was 47.4 ± 10.8 years, and mean BMI was 30.2 ± 4.0 kg/m²; 93.6% were male. All patients underwent TORS-TBR without the need for tracheostomy. The mean hospitalization period was 8.5 ± 4.3 days. Statistically significant differences between surgical success and failure groups included AHIREM, obstructive apnoea counts in REM and NREM, mean obstructive apnoea duration, total apnoea duration, lowest oxygen saturation, mean desaturation percentages, and sleep time with oxygen saturation below 90% (ST₉₀). Postoperative polysomnography demonstrated significant improvements across almost all parameters. Based on surgical success criteria, 73.6% of patients achieved a successful outcome. Conclusion Transoral robotic tongue base surgery, combined with individualized multilevel airway interventions, provides an effective, feasible early treatment option for OSA. This approach supports personalized management strategies and significantly improves polysomnographic outcomes, contributing to the reduction of OSA-related morbidity and mortality.

Giriş: Ulusal çekirdek Eğitim programı 2020 tarihinde yenilenmiş (UÇEP-2020) ve Yüksek Öğretim Kurumu tarafından kabul edilerek ülkemizdeki tüm tıp fakültelerine 2021-2022 eğitim döneminden itibaren uygulanması kararı verilmiştir. Çalışmanın amacı UÇEP-2020 doğrultusunda Akdeniz Üniversitesi Tıp Fakültesi, program çıktılarının revizyon sürecinin tanıtılmasıdır. Yöntem: UÇEP 2020’nin yayınlanması ile birlikte, Akdeniz Üniversitesi Tıp Fakültesi Program çalışmalarının güncellenmesi işlemi 2020-2021 eğitim döneminde iç paydaşların geniş katılımı ile başlatılmıştır Bulgular: UÇEP 20202’ye göre programın yeterlikleri ve kazanımları yeniden düzenlenmiş, dönem, ders kurulu/staj ve derslerin çıktıları gözden geçirildi. Bazı eksik yeterlikler ve kazanımlar Fakülte yeterlik listesine eklendi. Hazırlanan yeterlik listeleri soru bankasına girildi. Tartışma: Akdeniz Üniversitesi tıp fakültesi mezuniyet çıktıları iç paydaşların geniş katılımı ile gözden geçirilmiştir. Bu sürecin eğitimde hesap verilebilirlik ve kalite güvencesi sürecine katkı sağlayacağı düşünülmektedir. Deneyimlerimiz, benzer süreci kurumlarında başlatmak isteyen diğer tıp fakülteleri için yol gösterici olabilir.

Aim: To evaluate the coincidence of obstructive sleep apnea syndrome (OSAS) and systemic diseases in elderly patients presenting to our sleep disorders center. Patients and Methods: Ninety-seven patients with ages older than 65 years, who had at least one of snoring, witnessed apnea, and excessive daytime sleepiness symptoms, and whose systemic diseases were under evaluation, were included in the study. The patients were divided into 4 groups according to their apnea-hypopnea indexes (AHI) and body mass index (BMI) values. The association of BMI and the polysomnography parameters such as AHI, arousal index, lowest oxygen saturation and mean oxygen desaturation in patients with and without systemic illnesses ,were evaluated. Results: Seventy-one (73.2%) of the patients comprised the group with systemic illnesses, and 26 (26.80%) patients comprised the group without systemic illnesses. AHI value was found to be higher in patients with systemic diseases compared to patients without systemic illnesses, and this was statistically significant (p25) (p<0.05). A statistically significant association was not detected between the arousal index, lowest oxygen saturation, mean oxygen saturation, and presence of systemic illness. No difference in the rates of presence of systemic illnesses was found among male and female patients. Conclusion: Patients in the geriatric age group with increased BMI and OSAS should be evaluated for the presence of systemic illnesses.

Background/Aims: Celiac disease (CD) is an autoimmune and genetic disease that is triggered by gluten intolerance. We aimed to investigate whether Celiac disease have any effect on Auditory Brainstem Response (ABR) waves compare to a healthy control group, and present its association with sensorineural hearing loss (SNHL). Materials and Methods: Thirty-eight patients aged 2 to 16 years old were included in the study. The patients had confirmed diagnosis of Celiac disease through duodenal biopsies and transglutaminase Antibody (Ab) (+). The control group consisted of 18 children aged 3 to 17 years old who were all admitted to the pediatric gastroenterology department due to complaints of constipation and transglutaminase Ab (-).All children underwent Auditory-Brain-Stem-Evoked Responses (ABR). The data were gathered using click stimulus at 10/s frequency 90dB HL. Results: The results of ABR examination did not show any difference between the patient group and control group as regards the latency of the waves I, III, V. No difference was observed between the two groups in the interpeak latecies I-III, I-V and III-V. None of the patients was observed to have clinical hearing loss. Discussion: The exact pathogenesis of neurological damages observed in Celiac disease is still unknown. Humoral immune mechanisms are the most frequently attributed cause. Conclusion: Although no significant difference was found in hearing values between the study group and healthy control group, there is a need for further research on this subject.

In the present study, we investigated the potential application of elastic light single-scattering spectroscopy (ELSSS) as a noninvasive, adjunctive tool to differentiate between malignant and benign oral lesions in vivo.

Hyalinizing clear cell carcinoma (HCCC) is a rare low-grade salivary gland tumor with distinctive clear cell morphology, accounting for < 1% of all salivary gland tumors. In the majority of cases, the tumor originates typically from the minor salivary glands in the oral cavity. A total of 155 cases of HCCCs from head and neck region have been reported in the literature until 2017, of which only 16 are of maxillary origin. Due to its low incidence, there is no clear consensus on prognostic factors and optimal treatment strategies yet. In this paper, a new case of HCCC of the maxilla is presented and its clinical and histopathological features are discussed.

AIM: We aimed to compare the clinical, epidemiological, and polysomnographic features of rapid eye movement (REM)-dependent obstructive sleep apnea syndrome (OSAS) and positional OSAS which are two separate clinical entities. METHODS: Between January 2014 and December 2015, at the Akdeniz University Medical Faculty Hospital, patients who were diagnosed REM-dependent and positional OSAS with polysomnography were retrospectively studied. RESULTS: In this study, 1727 patients were screened consecutively. Five hundred and eighty-four patients were included in the study. Of the patients, 24.6% (140) were diagnosed with REM-dependent OSAS and 75.4% (444) were diagnosed as positional OSAS. Female predominance was found in REM-dependent OSAS (P < 0.001). The mean total apnea–hypopnea index (AHI), non-REM AHI, and supine AHI in REM-dependent OSAS were 14.73, 9.24, and 17.73, respectively, and these values were significantly lower when compared with positional OSAS (P < 0.001). Patients diagnosed with REM-dependent OSAS had a statistically significant tendency to be overweight (P < 0.001). For REM-dependent OSAS, total pulse rate, supine pulse rate, and REM pulse rate were statistically higher than positional OSAS (P < 0.001). CONCLUSION: Positional OSAS is a clinical entity that is more common than REM-dependent OSAS. OSAS severity is higher in positional OSAS than REM-dependent OSAS. REM-dependent OSAS is observed more commonly in women.