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Bulğurcu S, Baz E, Güleryüz S, Erkul E, Çekin E. Effect of applying head-shaking maneuver before Epley maneuver in BPPV. Braz J Otorhinolaryngol 2021; 88:932-936. [PMID: 33642216 DOI: 10.1016/j.bjorl.2020.12.015] [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: 10/08/2020] [Revised: 11/21/2020] [Accepted: 12/20/2020] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION The Epley maneuver is applied in the treatment of benign paroxysmal positional vertigo, the BPPV. However, dizziness and balance problems do not improve immediately after the treatment. OBJECTIVE In this study, the effectiveness of the head-shaking maneuver before the Epley maneuver was investigated in the treatment of BPPV. METHODS Between March 2020 and August 2020, ninety-six patients with posterior semicircular canal BPPV were analyzed prospectively. The patients were divided into two groups: patients who underwent the Epley maneuver only in the treatment (Group 1) and patients who underwent the Epley maneuver after the head-shaking maneuver (Group 2). The results of the Berg balance scale and dizziness handicap index were evaluated before the treatment and at the first week after the treatment. RESULTS The improvement in functional, emotional, and physical dizziness handicap index and Berg balance scale values after the treatment was found to be statistically significant in both groups. It was determined that the change in functional and physical dizziness handicap index and Berg balance scale values of the patients in Group 2 was statistically higher than those in Group 1. Although, the change in emotional dizziness handicap index values in Group 2 was higher than those in Group 1, no statistical significance was found between the groups. CONCLUSION As a result of our hypothesis, we think that in the treatment of posterior semicircular canal BPPV, the otoliths adhered to the canal can be mobilized by the head-shaking maneuver, and this will contribute to the increase of the effectiveness of the Epley maneuver.
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Affiliation(s)
- Suphi Bulğurcu
- Sultan Abdulhamid Han Training and Research Hospital, Department of Otorhinolaryngology, İstanbul, Turkey.
| | - Eyup Baz
- Sultan Abdulhamid Han Training and Research Hospital, Department of Otorhinolaryngology, İstanbul, Turkey
| | - Selin Güleryüz
- Sultan Abdulhamid Han Training and Research Hospital, Department of Otorhinolaryngology, İstanbul, Turkey
| | - Evren Erkul
- Sultan Abdulhamid Han Training and Research Hospital, Department of Otorhinolaryngology, İstanbul, Turkey
| | - Engin Çekin
- Sultan Abdulhamid Han Training and Research Hospital, Department of Otorhinolaryngology, İstanbul, Turkey
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Issın G, Kucukodacı Z, Yılmaz I, Erkul E, Tural E, Demirel D, Gungor A, Yıldırım S. Evaluation of the mir-126, mir-182, and mir-486-5p Expression Signature of Head and Neck Squamous Cell Carcinomas and Lung Squamous Cell Carcinomas. Turk Patoloji Derg 2021; 37:106-114. [PMID: 33973644 PMCID: PMC10512682 DOI: 10.5146/tjpath.2021.01528] [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: 01/12/2021] [Accepted: 03/14/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Although squamous cell carcinomas (SCCs) originating from different anatomic localizations display a similar histological appearance under light microscopy, they may differ in terms of epigenetic and genetic features. The aim of this study was to analyze mir-126, mir-182, and mir-486-5p expression levels in head and neck SCCs and lung SCCs, and to identify localization-specific miRNA expression profiles. MATERIAL AND METHOD The expression levels of mir-126, mir-182, and mir-486-5p were analyzed in lung, oral cavity, laryngeal, and hypopharyngeal SCCs in 40 patients, using quantitative real-time polymerase chain reaction. RESULTS The findings showed that lung, oral cavity, laryngeal, and hypopharyngeal SCCs have distinct mir-126 and mir-486-5p expression profiles. It was also observed that mir-126 and mir-486-5p expression levels were highly specific to the tumor localization. CONCLUSION These findings highlighted that SCCs originating from different anatomic localizations have different miRNA expression profiles. miRNA expression analysis can be used to predict the primary localizations of those SCCs.
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Affiliation(s)
- Gizem Issın
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Zafer Kucukodacı
- University of Health Sciences, İstanbul Sultan 2. Abdülhamid Han Training Hospital, Istanbul, Turkey
| | - Ismail Yılmaz
- University of Health Sciences, İstanbul Sultan 2. Abdülhamid Han Training Hospital, Istanbul, Turkey
| | - Evren Erkul
- Department of Otorhinolaryngology, Gulhane Medical School, University of Health Sciences, İstanbul Sultan 2. Abdülhamid Han Training Hospital, Istanbul, Turkey
| | - Ersin Tural
- Department of Pediatrics, University of Health Sciences, İstanbul Sultan 2. Abdülhamid Han Training Hospital, Istanbul, Turkey
| | - Dilaver Demirel
- Department of Pathology, University of Health Sciences, Gaziosmanpasa-Taksim Health Application and Research Center, Istanbul, Turkey
| | - Atila Gungor
- Department of Otorhinolaryngology, Medical Park Goztepe Hospital, Istanbul, Turkey
| | - Sukru Yıldırım
- Department of Pathology, Maltepe University, Faculty of Medicine, Istanbul, Turkey
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Erkul E, Yilmaz I. TERT promoter mutation in patients with second primary of tongue squamous cell carcinoma. Oral Oncol 2020; 114:105089. [PMID: 33189577 DOI: 10.1016/j.oraloncology.2020.105089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 12/16/2022]
Abstract
It is well known that head and neck squamous cell carcinomas are characterized by genetic alterations, genomic instability and different immune defects and Telomerase reverse transcriptase promoter mutations have been found with high rates in patients with tongue squamous cell carcinomas. We presented a non-smoker, no alcohol consuming woman who had a second primary tongue SCC after four and a half years later of her first tongue SCC with TERT promoter mutation. The primary tumor and its recurrences in woman with tongue SCC who have never smoked and had no alcohol consumption may need to be differing from other tongue carcinomas. TERT promoter mutations may have a relation in etiopathogenesis of tumor and mutations need to be on mind in future studies.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, Hamidiye Medical School, Sultan II. Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Ismail Yilmaz
- Department of Pathology, Sultan II. Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Singer MC, Marchal F, Angelos P, Bernet V, Boucai L, Buchholzer S, Burkey B, Eisele D, Erkul E, Faure F, Freitag SK, Gillespie MB, Harrell RM, Hartl D, Haymart M, Leffert J, Mandel S, Miller BS, Morris J, Pearce EN, Rahmati R, Ryan WR, Schaitkin B, Schlumberger M, Stack BC, Van Nostrand D, Wong KK, Randolph G. Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology. Head Neck 2020; 42:3446-3459. [PMID: 32812307 DOI: 10.1002/hed.26417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 07/23/2020] [Accepted: 08/03/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Postoperative radioactive iodine (RAI) administration is widely utilized in patients with differentiated thyroid cancer. While beneficial in select patients, it is critical to recognize the potential negative sequelae of this treatment. The prevention, diagnosis, and management of the salivary and lacrimal complications of RAI exposure are addressed in this consensus statement. METHODS A multidisciplinary panel of experts was convened under the auspices of the American Head and Neck Society Endocrine Surgery and Salivary Gland Sections. Following a comprehensive literature review to assess the current best evidence, this group developed six relevant consensus recommendations. RESULTS Consensus recommendations on RAI were made in the areas of patient assessment, optimal utilization, complication prevention, and complication management. CONCLUSION Salivary and lacrimal complications secondary to RAI exposure are common and need to be weighed when considering its use. The recommendations included in this statement provide direction for approaches to minimize and manage these complications.
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Affiliation(s)
- Michael C Singer
- Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
| | - Francis Marchal
- Department of Otolaryngology - Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Peter Angelos
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Vic Bernet
- Department of Endocrinology, Mayo Clinic Jacksonville, Jacksonville, Florida, USA
| | - Laura Boucai
- Department of Endocrinology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Samanta Buchholzer
- Maxillofacial Surgery and Oral Medicine and Pathology, Geneva University Hospital, Geneva, Switzerland
| | - Brian Burkey
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - David Eisele
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evren Erkul
- Department of Otorhinolaryngology, Gulhane Medical School, University of Health Sciences, Istanbul, Turkey
| | - Frederic Faure
- Department of Otolaryngology - Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Suzanne K Freitag
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Marion Boyd Gillespie
- Department of Otolaryngology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Richard Mack Harrell
- Memorial Center for Integrative Endocrine Surgery, Memorial Healthcare System, Hollywood, Florida, USA
| | - Dana Hartl
- Department of Head and Neck Oncology, Institut de Cancerologie Gustave Roussy, Villejuif, France
| | - Megan Haymart
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Susan Mandel
- Department of Endocrinology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barbra S Miller
- Division of Endocrine Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - John Morris
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth N Pearce
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition & Weight Management, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Rahmatullah Rahmati
- Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA
| | - William R Ryan
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Barry Schaitkin
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Martin Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and University Paris-Saclay, Villejuif, France
| | - Brendan C Stack
- Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Doug Van Nostrand
- Division of Nuclear Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Ka Kit Wong
- Department of Radiology, Division of Nuclear Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Gregory Randolph
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
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Demirel D, Erkul E, Erkılıç S, Narlı Issın G, Ramzy I. Primary Synovial Sarcoma of the Thyroid: Challenges in Cytologic Diagnosis and Review of the Literature. Acta Cytol 2020; 64:498-506. [PMID: 32454502 DOI: 10.1159/000507312] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/17/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Primary synovial sarcoma (SS) of the thyroid (PSST) is extremely rare. Its differential diagnosis from other neoplasms is essential since it has different management protocols and prognosis. CASE A 26-year-old man with a 4.5-cm solid lobulated mass was seen at an outside hospital. Fine needle aspiration (FNA) was interpreted as a papillary carcinoma, and a total thyroidectomy was performed. The final histologic diagnosis was spindle epithelial tumor with thymus-like differentiation (SETTLE). No metastases were detected at that time, and the patient received radioactive iodine treatment. Two years post-surgery, he was seen at our hospital with a local recurrence, and FNA was considered as consistent with SETTLE. The mass was resected, and a left modified radical neck dissection was performed. The tumor revealed necrosis and a high mitotic index. Following histologic, immunohistochemical, and molecular studies, the tumor was classified as a PSST. The patient received chemotherapy and targeted immunotherapy, but he died 41 months after the initial presentation. CONCLUSION The main diagnostic pitfall of PSST is SETTLE. The presence of mitotic figures and basal lamina material, negative staining for smooth muscle actin, and positive staining for transducer-like enhancer of split 1 antibody favor SS over SETTLE. SYT gene rearrangement is essential to establish the definitive diagnosis of PSST.
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Affiliation(s)
- Dilaver Demirel
- Department of Pathology, University of Health Sciences, Medical School, Gaziosmanpasa Health Application and Research Center, Istanbul, Turkey,
| | - Evren Erkul
- Department of Otorhinolaryngology, University of Health Sciences, Gulhane Medical School, Sultan Abdulhamid Han Health Application and Research Center, Istanbul, Turkey
| | - Suna Erkılıç
- Department of Pathology, Gaziantep University, Medical School, Gaziantep, Turkey
| | - Gizem Narlı Issın
- Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey
| | - Ibrahim Ramzy
- Department of Pathology and Laboratory Medicine, University of California, Irvine, California, USA
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Abstract
The use of hearing aid (HA) may improve the hearing performance and ease the perceived negative consequences of hearing difficulties in elderly individuals. The aim of this study was to determine the problems experienced by elderly individuals with HA and to investigate the factors that could increase the use of HA. A total of 122 female and 127 male patients with a mean age of 76.79 ± 6.91 years who were recommended HA were evaluated. The following details were taken from the patients: age, gender, duration of hearing complaint, whether or not they received HA, number of family members, number of hours they used HA in a day, type of device, number of ears with HA, educational status, whether they continued to work, whether they were tested before taking the device, the reasons for not taking HA, and the reasons that reduce their use of HA. A total of 18 patients did not receive HA for the following reasons: 9 considered HA too expensive, 8 thought it would be difficult to use HA, and 1 did not like it because of its appearance. No significant difference was found in the patients' daily HA use duration, age, sex, number of immediate family members, education level, type of device, test before taking the device, and use of HA in single ear or bilateral ears. There was a significant difference in the daily HA use duration and whether the patients continued to work. We need to help reduce the problems associated with the use of HA to help older individuals have a more active role in society and help them in their health problems.
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Affiliation(s)
- Suphi Bulğurcu
- Department of Otorhinolaryngology, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Irmak Uçak
- Department of Otorhinolaryngology, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Ayşegül Yönem
- Department of Otorhinolaryngology, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Evren Erkul
- Department of Otorhinolaryngology, University of Health Sciences, Gülhane Medical School, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Engin Çekin
- Department of Otorhinolaryngology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
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Demirel D, Erkul E, Güngör A, Çekin E, Ramzy I. Laryngeal cytology: A cytological, histological, P16 and human papillomavirus study. Cytopathology 2019; 31:26-34. [PMID: 31630464 DOI: 10.1111/cyt.12779] [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: 12/24/2018] [Revised: 09/29/2019] [Accepted: 10/10/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Invasive diagnostic methods, such as punch biopsies, have a potential to produce undesirable side effects in the larynx, such as scarring and vocal dysfunction. This study is an attempt to assess the diagnostic potential of cytology to efficiently diagnose premalignant and malignant laryngeal lesions, while sparing patients the risk of complications of punch biopsies. METHODS Laryngeal smears, using endocervical-type brushes, and punch biopsies were procured from each patient. Smears were prepared and the brush was cut and put in Surepath preservative solution for cytological analysis and human papillomavirus (HPV) DNA testing. A Real-TM Quant kit that detects 14 HPV types was used for genotyping. Immunohistochemical staining for p16 was performed on cytological and histological specimens. RESULTS Cytological diagnosis was correct in 84.6%, 100% and 100% of cases with a histological diagnosis of squamous cell carcinomas, high-grade squamous intraepithelial lesions and benign lesions, respectively. However, cytological interpretation was correct only in 25% of low-grade squamous intraepithelial lesions. HPV DNA test was positive in only one case, which was a laryngeal polyp. Testing for p16 was negative in all the cytological and histological material. CONCLUSION Laryngeal cytology is a useful diagnostic tool in establishing the diagnosis of high-grade squamous epithelial cell abnormalities. Recognition of low-grade lesions, however, is challenging. HPV genotyping and p16 staining do not seem to be helpful ancillary techniques in cytological material procured from the larynx.
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Affiliation(s)
- Dilaver Demirel
- Department of Pathology, University of Health Sciences, Gaziosmanpasa Health Application and Research Center, Istanbul, Turkey
| | - Evren Erkul
- Department of Otorhinolaryngology, University of Health Sciences, Gulhane School of Medicine, Sultan Abdulhamid Han Health Application and Research Center, Istanbul, Turkey
| | - Atila Güngör
- Department of Otorhinolaryngology, Medical Park Hospital, Istanbul, Turkey
| | - Engin Çekin
- Department of Otorhinolaryngology, University of Health Sciences, Sultan Abdulhamid Han Health Application and Research Center, Istanbul, Turkey
| | - Ibrahim Ramzy
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA, USA
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Erkul E, Çekin E, Güngör A. Long-Term Outcomes of Sialendoscopy in the Management of Sialolithiasis and Idiopathic Chronic Sialadenitis with Ductal Scars. Turk Arch Otorhinolaryngol 2019; 57:75-80. [PMID: 31360924 DOI: 10.5152/tao.2019.4290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 03/21/2019] [Accepted: 05/28/2019] [Indexed: 12/15/2022] Open
Abstract
Objective We aimed to present the long-term outcomes and sialendoscopic findings in only patients with sialolithiasis and ductal scars in idiopathic chronic recurrent sialadenitis who experienced unsuccessful results with conservative treatment and were treated with sialendoscopy. Methods We retrospectively analyzed the patients with a diagnosis of only sialolithiasis and ductal scars in chronic recurrent sialadenitis who underwent sialendoscopy between January 2011 and June 2016. We collected clinical and intraoperative data including patient age, sex, date of the procedure, the involved gland, operative findings and complications. Follow-up data included whether the symptoms were resolved or recurred and whether any further procedures were performed. Results Of a total of 38 patients, 16 were excluded from the study due to missing clinical or follow-up data, and analysis was conducted on 22 patients. Twelve were diagnosed with sialolithiasis, while the remaining 10 were diagnosed with idiopathic chronic sialadenitis and had ductal scars. Stone sizes ranged from 2 mm to 10 mm. Mean follow-up time was 39.5 months. The final success rate was 100%. Of the 10 patients with ductal scarring, five had scar in the parotid gland duct, and five in the submandibular gland duct. The mean follow-up time of all ductal scar patients was 47.1 months. The final success rate was 70%. Conclusion Sialendoscopy is a minimally invasive method for the diagnosis and treatment of sialolithiasis and ductal scars of the salivary glands after failure of conservative treatments in adults.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, University of Health Sciences, Gülhane Medical School, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Engin Çekin
- Department of Otorhinolaryngology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Atila Güngör
- Department of Otorhinolaryngology, Medical Park Hospital Göztepe, İstanbul, Turkey
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Scherl C, Kato MG, Erkul E, Graboyes EM, Nguyen SA, Chi AC, Morgan PF, Day TA. Outcomes and prognostic factors for parotid acinic cell Carcinoma: A National Cancer Database study of 2362 cases. Oral Oncol 2018; 82:53-60. [PMID: 29909902 DOI: 10.1016/j.oraloncology.2018.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 02/14/2018] [Accepted: 05/04/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the demographics, clinical features, survival outcomes, and prognostic indicators of patients with acinic cell carcinoma (ACC) of the parotid gland with emphasis on the roles of grade, tumor size, and nodal status in survival. MATERIALS AND METHODS A retrospective analysis of cases diagnosed between 2004 and 2012 from the National Cancer Database was performed. Multivariable logistic regression was used to determine factors associated with survival. RESULTS 2362 cases were identified. Most patients were females (61.3%) and Caucasian (85.4%) with a median age of 54 years (range, 18-90 years). Most tumors were <3 cm in size (75.8%). Regional metastases and high-grade histology were rare (8.2%, 5.1%). All patients received surgery as primary treatment with 42.7% of patients receiving adjuvant radiation therapy or chemoradiotherapy. 5 year overall survival was 88.6%. On multivariable analysis, age >70 years (hazard ratio [HR]: 10.05, 95% confidence interval [CI]: 5.64-17.91), high-grade (HR: 5.30, 95% CI: 3.39-8.29), tumor size of 3 to 6 cm (HR: 1.53, 95% CI: 1.10-2.12), tumor size >6 cm (HR: 2.98, 95% CI: 1.681-5.289), pN2+ (HR: 3.14, 95% CI: 2.10-4.69), T4 (HR: 2.89, 95% CI: 1.74-4.80) were significant prognosticators. CONCLUSION Although patients with ACC generally are considered to have a favorable prognosis, an aggressive subgroup with poor outcomes was identified. This group is characterized by high-grade, advanced T classification, tumors larger than 3 cm, with regional metastases and age greater than 70 years. Histologic grade is a substantially stronger predictor of survival than T and N classifications.
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Affiliation(s)
- Claudia Scherl
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA.
| | - Masanari G Kato
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Evren Erkul
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Angela C Chi
- College of Dental Medicine, Medical University of South Carolina, 29 Bee Street, Charleston, SC 29425, USA
| | - Patrick F Morgan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
| | - Terry A Day
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA
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Kato MG, Erkul E, Nguyen SA, Day TA, Hornig JD, Lentsch EJ, Gillespie MB. Extracapsular Dissection vs Superficial Parotidectomy of Benign Parotid Lesions: Surgical Outcomes and Cost-effectiveness Analysis. JAMA Otolaryngol Head Neck Surg 2017; 143:1092-1097. [PMID: 28975191 DOI: 10.1001/jamaoto.2017.1618] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance The clinical implications of extracapsular dissection over superficial parotidectomy are controversial and limited in data on cost-effectiveness. Objective To compare extracapsular dissection with superficial parotidectomy for benign parotid tumors with respect to surgical outcomes and cost-effectiveness. Design, Setting, and Participants This was a retrospective medical record review and cost-effectiveness analysis performed from August 2012 to November 2015 at a tertiary care institution. Adult patients (age ≥18 years) who underwent parotidectomy for benign parotid lesions were included. Exposures Treatment by extracapsular dissection or superficial parotidectomy. Main Outcomes and Measures Differences in postoperative complication rates and health services outcomes, including procedure time, anesthesia time, length of stay, and charges for surgeon, anesthesia, operating room, and hospital. Results A total of 46 parotidectomies consisting of 26 extracapsular dissections and 20 superficial parotidectomies met criteria. Of the 46 patients, 33 were women. Patient ages ranged from 18 to 83 years. Lesion features were similar between groups with most being pleomorphic adenoma. Procedure time (effect size, -1.31; 95% CI, -1.93 to -0.65), anesthesia time (effect size, -1.37; 95% CI, -1.99 to -0.70), and length of stay (effect size, -0.66; 95% CI, -1.25 to -0.05) were significantly shorter for extracapsular dissection compared with superficial parotidectomy. Moreover, anesthesia (effect size, -1.55; 95% CI, -2.19 to -0.86), operating room (effect size, -1.09; 95% CI, -1.69 to -0.45), and total hospital charges (effect size, -1.13; 95% CI, -1.74 to -0.49) were significantly less for extracapsular dissection while remaining charges, including surgeon, showed no difference. Finally, facial nerve weakness, great auricular nerve dysesthesia, and other relevant postoperative complications were comparable between groups. Conclusions and Relevance In the hands of an experienced surgeon, extracapsular dissection is a shorter, less costly, and equally safe alternative to traditional superficial parotidectomy when treating benign parotid lesions. Further follow-up is needed to ensure these perceived advantages are maintained over time.
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Affiliation(s)
- Masanari G Kato
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston.,Stony Brook University School of Medicine, Stony Brook, New York
| | - Evren Erkul
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Terry A Day
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Joshua D Hornig
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Eric J Lentsch
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - M Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston.,Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis
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Erkul E, Yilmaz I, Narli G, Babayigit MA, Gungor A, Demirel D. The presence and prognostic significance of human papillomavirus in squamous cell carcinoma of the larynx. Eur Arch Otorhinolaryngol 2017; 274:2921-2926. [PMID: 28439692 DOI: 10.1007/s00405-017-4573-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 02/01/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
Abstract
The aim of the present study was to evaluate the role of HPV in laryngeal squamous cell carcinoma and correlate it with patients' clinicopathological data. In total, 78 laryngeal squamous cell carcinoma patients enrolled in this study. The presence of genotype-specific HPV DNA was evaluated using Genotyping Assay in formalin-fixed paraffin-embedded tissue which was diagnosed between 2005 and 2015. All samples were also evaluated for p16 immunohistochemical staining. HPV DNA and p16 status were assessed in terms of location, smoking, alcohol consumption, lymph node status, tumor stage, overall survival, disease-free survival, perineural invasion, and vascular invasion retrospectively. Five test samples were excluded from the study due to inadequate deoxyribonucleic acid purity. HPV DNA was detected in 19 of 73 (26.02%) in patients with laryngeal squamous cell carcinoma. Human papilloma virus genotyping revealed double human papilloma virus in one case (types 16 and 59) and HPV 16 in the remaining cases. Although HPV-positive cases showed slightly better 3 years survival than HPV-negative ones, this finding was not statistically significant (overall survival p = 0.417, HPV positive: 92.3%, HPV negative: 81.4%, and disease-free survival p = 0.526, HPV positive: 93.8%, HPV negative: 80.9%). The presence of HPV DNA was not significantly associated with any clinicopathological features (p > 0.05). Among 73 patients, only 4 had an immunohistochemical staining of p16 and these patients were also HPV DNA 16 positive. Although our study results revealed a slightly better survival in patients with HPV DNA positivity for HPV 16 compared to the negative ones, the difference was not statistically significant. However, an increasing rate in especially high-risk-type HPV-16 prevalence in laryngeal squamous cell carcinoma by RT-PCR method was observed compared to our previous study. Although the presence of HPV in laryngeal SCCs seems to be associated with slightly better prognosis, additional studies may be needed, since our results were not statistically significant. We believed that HPV is not an adequate biomarker for diagnostic and prognostic purposes in laryngeal squamous cell carcinoma.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, Gulhane School of Medicine, University of Health Sciences, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey.
| | - Ismail Yilmaz
- Department of Pathology, University of Health Sciences, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
| | - Gizem Narli
- Department of Pathology, University of Health Sciences, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
| | | | - Atila Gungor
- Department of Otorhinolaryngology, NB Kadikoy Hospital, Istanbul, Turkey
| | - Dilaver Demirel
- Department of Pathology, University of Health Sciences, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey
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12
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Erkul E, Duvvuri U, Mehta D, Aydil U. Transoral robotic surgery for the pediatric head and neck surgeries. Eur Arch Otorhinolaryngol 2016; 274:1747-1750. [DOI: 10.1007/s00405-016-4425-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/07/2016] [Indexed: 10/20/2022]
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13
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Erkul E, Gillespie MB. Sialendoscopy for non-stone disorders: The current evidence. Laryngoscope Investig Otolaryngol 2016; 1:140-145. [PMID: 28894810 PMCID: PMC5510257 DOI: 10.1002/lio2.33] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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: 07/06/2016] [Accepted: 07/31/2016] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Review the current literature on the use of sialendoscopy in the treatment of non-stone disorders of the major salivary glands. DATA SOURCES Eligible articles that reported on the use of sialendoscopy in the treatment of non-stone disorders were identified using MEDLINE, Embase, and Google Scholar through May 2016. The search used key words sialendoscopy, salivary endoscopy, salivary scope, salivary duct stenosis, salivary duct stricture, Sjogren's disease, radioiodine sialadenitis, salivary duct obstruction, sialadenitis, chronic sialadenitis, juvenile recurrent parotitis, parotitis, and radiation sialadenitis. REVIEW METHODS Full-length prospective and retrospective original articles; systemic reviews; and meta-analysis, including adults and children with adequate data for evaluating the sialendoscopy for non-stone disorders, were included. Individual case reports were excluded. RESULTS There is an increasing trend for the use of sialendoscopy for salivary obstruction caused by a wide variety of non-stone disorders worldwide. The studies of sialendoscopy for non-stone disorders are often retrospective, of smaller sample size, and more subjective in measurement of patient outcome. The most common indications currently for the procedure are scars, juvenile recurrent parotitis, radioiodine sialadenitis, and Sjögren syndrome, respectively. CONCLUSION Although the initial evidence for the use of sialendoscopy for non-stone disorders is not as established as that for stones, it remains a promising gland-preserving tool in the management of non-stone disorders of major salivary glands.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology Gulhane Military Medical Academy, Haydarpasa Training Hospital Istanbul Turkey
| | - M Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery Medical University of South Carolina Charleston South Carolina U.S.A
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14
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Erkul E, Yilmaz I, Gungor A, Kurt O, Babayigit MA. MicroRNA-21 in laryngeal squamous cell carcinoma: Diagnostic and prognostic features. Laryngoscope 2016; 127:E62-E66. [DOI: 10.1002/lary.26226] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 06/17/2016] [Accepted: 07/07/2016] [Indexed: 12/24/2022]
Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology; Gulhane Military Medical Academy Haydarpasa Training Hospital; Istanbul Turkey
- Department of Otolaryngology-Head and Neck Surgery; Medical University of South Carolina; Charleston South Carolina U.S.A
| | - Ismail Yilmaz
- Department of Pathology, Gulhane Military Medical Academy; Haydarpasa Training Hospital; Istanbul Turkey
| | - Atila Gungor
- Department of Otorhinolaryngology; Gulhane Military Medical Academy Haydarpasa Training Hospital; Istanbul Turkey
| | - Onuralp Kurt
- Department of Otorhinolaryngology; Erzincan Military Hospital; Erzincan Turkey
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Pinar D, Cincik H, Erkul E, Gungor A. Investigating the Effects of Smoking on Young Adult Male Voice by Using Multidimensional Methods. J Voice 2015; 30:721-725. [PMID: 26277074 DOI: 10.1016/j.jvoice.2015.07.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 04/16/2015] [Accepted: 07/13/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Smoking is one of the most common harmful habits in the world, especially common among young adult male population in Turkey. The purpose of this study was to evaluate the effect of smoking on the young adults' male voice using multidimensional voice assessment methods. STUDY DESIGN This is a case-control study. METHODS The study included 109 young adult men, 51 nonsmokers and 58 smokers between the ages of 20 and 34 years. The voice evaluation protocol consisted of voice handicap index (VHI), maximum phonation time (MPT), and perceptual, acoustic, and videostroboscopic analyses. RESULTS A statistically significant increase for physical, physiological, and total scores of VHI was found in smokers group (P < 0.05). MPT showed significantly lower values among smokers (P < 0.05). There were no significant changes in perceptual analysis of voice samples between smoker and nonsmoker groups. There were no significant changes in any of the acoustic parameters between smoker and nonsmoker groups. Results of videostroboscopic analysis showed significant relationships between smoking and increased vocal fold erythema (P < 0.05). In addition, significantly asymmetry, amplitude, and periodicity abnormality of vocal fold movements were observed in smoker group during phonation (P < 0.05). CONCLUSIONS The results of this study indicate that observable signs of laryngeal irritation and disturbed phonatory physiology occur even in young adults with relatively brief smoking habits. Subjective symptoms of smoking on voice appear to occur earlier than objective findings.
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Affiliation(s)
- Dogan Pinar
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
| | - Hakan Cincik
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Evren Erkul
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Atila Gungor
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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16
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Erkul E, Kucukodaci Z, Pinar D, Gungor A, Alparslan Babayigit M, Kurt O, Cincik H. TRAIL and TRAIL receptors in patients with laryngeal cancer. Head Neck 2015; 38 Suppl 1:E535-41. [PMID: 25810124 DOI: 10.1002/hed.24035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Tumor necrosis factor-related associated-inducing ligand (TRAIL) is a death ligand currently under clinical trials for laryngeal carcinoma. METHODS Paraffin-embedded tissues from 40 patients with laryngeal carcinoma and 20 patients with benign laryngeal pathologies were retrospectively analyzed using immunohistochemistry in terms of distribution and intensity, and for final analysis of immunoreactivity of receptors, H-score was used. The study group was assessed in terms of localization, lymph node staging, tumor stage, overall survival, disease-free survival, locoregional control, perineural invasion, and vascular invasion. RESULTS The H-score of decoy-R2 (DcR2) staining were increased significantly in tumor tissue (p = .04). A significantly greater increase in terms of H-score of DR5 receptor staining (p = .06) was detected in tumor tissue. CONCLUSION TRAIL-mediated gene therapy may not be effective. Indeed, the findings may indicate treatment resistance. TRAIL and TRAIL receptor levels were not associated with prognosis © 2015 Wiley Periodicals, Inc. Head Neck 38: E535-E541, 2016.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, Gülhane Military Medical Academy Haydarpasa Training Hospital, Istanbul, Turkey
| | - Zafer Kucukodaci
- Department of Pathology, Gülhane Military Medical Academy Haydarpasa Training Hospital, Istanbul, Turkey
| | - Dogan Pinar
- Department of Otorhinolaryngology, Gülhane Military Medical Academy Haydarpasa Training Hospital, Istanbul, Turkey
| | - Atila Gungor
- Department of Otorhinolaryngology, Gülhane Military Medical Academy Haydarpasa Training Hospital, Istanbul, Turkey
| | | | - Onuralp Kurt
- Department of Otorhinolaryngology, Gülhane Military Medical Academy Haydarpasa Training Hospital, Istanbul, Turkey
| | - Hakan Cincik
- Department of Otorhinolaryngology, Gülhane Military Medical Academy Haydarpasa Training Hospital, Istanbul, Turkey
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17
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Yilmaz I, Erkul E, Berber U, Kucukodaci Z, Narli G, Haholu A, Demirel D. The presence of Helicobacter pylori in laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2015; 273:761-5. [PMID: 25721196 DOI: 10.1007/s00405-015-3566-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/21/2014] [Accepted: 02/16/2015] [Indexed: 02/07/2023]
Abstract
A definitive relationship between Helicobacter pylori (HP) and upper respiratory tract disorders has not been established. In this case-control study, we investigated the relationship between HP and laryngeal carcinoma by real-time PCR method in Turkey. 74 subjects were enrolled from patients who were admitted to the Otolaryngology Department. Formalin-fixed-paraffin-embedded tissue samples with laryngeal cancer were used and all samples were evaluated by real-time PCR method. Our study population included 72 males and 2 females with a mean age range of 62.7 years. Helicobacter Pylori was detected in only one case. The positive case was also investigated with histopathologic evaluation and HP immunohistochemistry. However, we could not detect HP in this case with both methods. This study revealed that HP might not contribute to the pathogenesis of laryngeal carcinoma. A definitive relationship between HP and upper respiratory tract disorders has not been established.
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Affiliation(s)
- Ismail Yilmaz
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - E Erkul
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
| | - U Berber
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Z Kucukodaci
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - G Narli
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - A Haholu
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - D Demirel
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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18
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Erkul E. Thyroid Papillary Microcarcinoma: Diagnostic and Treatment Approaches. Turk Arch Otorhinolaryngol 2014. [DOI: 10.5152/tao.2014.784] [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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19
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Erkul E, Cincik H. Amyloidosis: A Rare Case with Nodular Lesions on the Tongue and Buccal Mucosa. Ear, Nose & Throat Journal 2013. [DOI: 10.1177/0145561313092010-1108] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, GATA Hydyarpasa
Training Hospital, Istanbul, Turkey
| | - Hakan Cincik
- Department of Otorhinolaryngology, GATA Hydyarpasa
Training Hospital, Istanbul, Turkey
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20
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Erkul E, Cincik H. Amyloidosis: a rare case with nodular lesions on the tongue and buccal mucosa. Ear Nose Throat J 2013; 92:502-504. [PMID: 24170461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
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21
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Erkul E, Cekin IE, Kurt O, Gungor A, Babayigit MA. Evaluation of patients with unilateral endoscopic sinus surgery. Turk Arch Otorhinolaryngol 2013. [DOI: 10.5152/tao.2012.13] [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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22
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Erkul E, Cingi C, Özçelik Korkmaz M, Çekiç T, Çukurova I, Yaz A, Erdoğmuş N, Bal C. Effects of escitalopram on symptoms and quality of life in patients with allergic rhinitis. Am J Rhinol Allergy 2013; 26:e142-6. [PMID: 23168146 DOI: 10.2500/ajra.2012.26.3819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Insufficient response to treatment and declining quality of life illustrate the continuing need to find new treatment modalities for allergic rhinitis (AR). The purpose of this study was to assess how escitalopram affects symptoms and quality of life among AR patients. METHODS This study included 120 patients with AR, who were divided into four treatment groups of 30 patients each. Patients were assessed before treatment and at the end of the 3rd month based on nasal symptom scores, otorhinolaryngological examination, the Rhinoconjunctivitis Quality of Life Questionnaire, and the Beck Depression and Anxiety Inventory. All patients received standardized treatments. Group A patients with positive Beck Depression and Anxiety Inventory scores received escitalopram, and group B patients with positive Beck Depression and Anxiety Inventory scores received placebo. Group C patients with negative Beck Depression and Anxiety Inventory scores received escitalopram, and group D patients with negative Beck Depression and Anxiety Inventory scores received placebo. RESULTS Anxiety scores pre- and posttreatment revealed a statistically significant reduction in groups A, C, and D. All four groups exhibited reduced posttreatment scores for sleep, nonnasal and noneye symptoms, eye symptoms, and emotions. A statistically significant difference appeared between groups A and B in terms of general complaints and nasal symptom scores. CONCLUSION The positive effects of escitalopram on posttreatment quality of life in the Beck-positive patient group were a predictable outcome. Otolaryngologists should pay more attention to the moods of their patients with AR while they evaluate treatment during clinical follow-up visits.
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Affiliation(s)
- Evren Erkul
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
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Cincik H, Erkul E, Pinar D, Ipcioglu O, Gungor A, Cekin E, Cakmak A. Evaluation of MMP-9 and TIMP-1 Levels of the Patients with Nasal Polyposis After Corticosteroid Therapies. Indian J Otolaryngol Head Neck Surg 2013; 65:445-9. [PMID: 24427695 DOI: 10.1007/s12070-013-0656-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 10/31/2012] [Accepted: 04/19/2013] [Indexed: 10/26/2022] Open
Abstract
The aim of this study is to evaluate the effects of intrapolyp, systemic and local corticosteroid treatment modalities on MMP-9 and TIMP-1 level in polyp tissues. This study included 71 patients and five groups. Group A treated with oral methylprednisolone, Group B, treated with topical steroid spray, Group C treated with intralesional triamcinolone acetonide, Group D patients with nasal polyposis who has not given any medication, Group E had surgery for concha bullosa without nasal polyp disease. Samples from group A were collected endoscopically 1 day after treatment was stopped. Group B samples were collected at the end of the first month. Video guided sample collection from Group C was also performed on the 7th day after treatment. MMP-9 and TIMP-1 levels were measured by Enzyme-linked immunosorbent assay method. When we compared the MMP-9 levels of all groups, there were no significant differences. There was significant difference of TIMP-1 level between Groups C and E (pC-E = 0.0019), however there was no difference among the level of the other groups. When MMP-9/TIMP1 rates of all groups were compared, there were significant difference between Group A and D (pA-D = 0.005) and between Group A and E, also between Group C and E. Our study is the first study to evaluate the effects of different corticosteroid treatment modalities on MMP-9 and TIMP-1 in nasal polyps and concluded that corticosteroid did not do a significant impact on this pathway.
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Affiliation(s)
- Hakan Cincik
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Uskudar, 34668 Istanbul, Turkey
| | - Evren Erkul
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Uskudar, 34668 Istanbul, Turkey
| | - Dogan Pinar
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Uskudar, 34668 Istanbul, Turkey
| | - Osman Ipcioglu
- Department of Biochemistry, GATA Haydarpasa Training Hospital, Uskudar, Istanbul, Turkey
| | - Atila Gungor
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Uskudar, 34668 Istanbul, Turkey
| | - Engin Cekin
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Uskudar, 34668 Istanbul, Turkey
| | - Adem Cakmak
- Department of Otorhinolaryngology, GATA Haydarpasa Training Hospital, Uskudar, 34668 Istanbul, Turkey
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Erkul E, Babayigit M, Kuduban O. Postoperative cephazolin usage is sufficient for preventing infection after septoplasty procedure. Allergy Rhinol (Providence) 2012; 2:e54-7. [PMID: 22852118 PMCID: PMC3390117 DOI: 10.2500/ar.2011.3.0013] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The use of antibiotics in septoplasty is a common practice among most ear, nose, and throat doctors; however, there are few studies proving the efficacy, which is considered as unnecessary by some authors. The aim of this pilot study was to evaluate the effect of two different kinds of antimicrobial agent on efficacy and safety after septoplasty surgery and to show that use of cephazolin, 1.0 g, postoperatively, might be sufficient for preventing infection after septoplasty procedure. Patients were randomly divided into two groups with a simple randomization method. The first group of 80 patients received cephazolin, 1.0 g i.v., once postoperatively and the second group of 80 patients received amoxicillin–clavulanate orally for 7 days postoperatively (1000 mg). An early and late postoperative questionnaire and nasal endoscopy evaluation was performed and patients were followed up in the outpatient service to investigate the presence of complications. There was no significant difference in postoperative pain between groups A and B, using visual analog scale scores at the 1st postoperative day. There were no differences related to the amount of purulent discharge found at the lower margin of the inferior turbinate through nasal endoscopy performed on the 14th day postoperatively. There were no statistical significances among groups for complications rates and postoperative endoscopic evaluation. Septoplasties are considered potentially contaminated surgeries, and cephazolin, 1.0 g i.v., given once postoperatively is enough to prevent potential complications with its easy and effective use.
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Affiliation(s)
- Evren Erkul
- From the Departments of Otorhinolaryngology and
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25
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Çekin E, Ozyurt M, Erkul E, Ergunay K, Cincik H, Kapucu B, Gungor A. The Association between Helicobacter Pylori and Laryngopharyngeal Reflux in Laryngeal Pathologies. Ear Nose Throat J 2012; 91:E6-9. [DOI: 10.1177/014556131209100314] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We conducted a study to determine the presence or absence of Helicobacter pylori and laryngopharyngeal reflux (LPR) in 43 previously untreated patients who had presented with a laryngeal lesion. Our aim was to determine if there was any association among H pylori, LPR, and laryngeal lesions. H pylori status was determined by real-time polymerase chain reaction (PCR) assays of biopsy tissue obtained during direct laryngoscopy. The presence or absence of LPR was determined on the basis of patients’ reflux symptom index (RSI) and reflux finding score (RFS), which were based on their questionnaire responses and findings on endoscopic examination of the larynx, respectively. Patients with an RSI of 14 or more and/or an RFS of 8 or more were considered to have LPR. H pylori was present in 24 patients (55.8%) and absent in 19 (44.2%)—not a statistically significant difference. The prevalence of LPR was higher than the prevalence of H pylori; it was present in 30 patients (69.8%) and absent in 13 (30.2%). The difference was statistically significant (p = 0.01). We found no association between H pylori status and LPR status. Additionally, we analyzed two subgroups based on whether their lesions were benign or malignant/premalignant and found a significant relationship between LPR positivity and the presence of malignant/premalignant laryngeal lesions (p = 0.03). We found no association between H pylori status and either of the two subgroup categories.
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Affiliation(s)
- Engin Çekin
- Department of Otolaryngology–Head and Neck Surgery, Haydarpasa Training Hospital, Gulhane Military Medical Academy, Istanbul
| | - Mustafa Ozyurt
- Department of Microbiology, Haydarpasa Training Hospital, Gulhane Military Medical Academy, Istanbul
| | - Evren Erkul
- Department of Otolaryngology–Head and Neck Surgery, Haydarpasa Training Hospital, Gulhane Military Medical Academy, Istanbul
| | - Koray Ergunay
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hakan Cincik
- Department of Otolaryngology–Head and Neck Surgery, Haydarpasa Training Hospital, Gulhane Military Medical Academy, Istanbul
| | - Burak Kapucu
- Department of Otolaryngology–Head and Neck Surgery, Haydarpasa Training Hospital, Gulhane Military Medical Academy, Istanbul
| | - Atila Gungor
- Department of Otolaryngology–Head and Neck Surgery, Haydarpasa Training Hospital, Gulhane Military Medical Academy, Istanbul
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Abstract
Objective: Studies have shown that nasopharyngeal airway diseases, such as obstructive sleep apnea, are closely associated with cardiovascular diseases. The purpose of this study was to investigate whether there is any impact of septoplasty operation on QTc dispersion (QTcD) in patients with nasal septum deviation. Method: This study included 28 young deviated nasal septum patients. All patients underwent septoplasty. The QT interval, the heart rate-corrected QT, and the QT dispersion were calculated digitally using computerized electrocardiograms (ECG) by Holter ECG. Heart rates, QT intervals, QTc, and QTcD values were compared preoperatively and one-month postoperatively. Results: QTcD was measured 62.9 ± 7.9 in young patients with nasal septal deviation. While there was no significant change in ECG QT interval periods obtained from the patients taken after the procedure (354.8 ± 25.7 and 360 ± 25.4, P > .05), there was a significant decrease in QTc values (398 ± 22.9 and 383.7 ± 21.2, P = .013 [<0.05]), and there was a significant decrease in QTcD values (62.9 ± 7.9 and 45.7 ± 6.7, P = .000). In addition, heart rates were significantly decreased after surgery (76.5 ± 13.2 and 67.4 ± 10.4, P = .007). Conclusion: In our study, QTcD values were increased in young patients with nasal septal deviation. High QTcD value indicates increased heterogeneity of ventricular repolarization. Septoplasty is important for young people with nasal deviations to provide improvement of QTc dispersion. Nasopharyngeal airway diseases have negative effects on myocardial repolarization.
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Abstract
BACKGROUND Only a few studies have so far compared the use of different local anesthetic agents in septoplasty procedure with regard to reduction in pain, effectiveness, and related complications. The aim of this study was to compare articaine and lidocaine as local anesthetics for septoplasty surgery, in terms of their efficacy and safety. METHODS Seventy patients randomized into two groups were included in this study. For local anesthesia, 35 patients received articaine and 35 received lidocaine. All patients were asked to rate their pain levels on a visual analog scale (VAS) at the 1st, 2nd, 4th, 6th, 8th, 12th, 18th, and 24th postoperative hours. In addition, analgesic consumption of each patient as well as postoperative complications was recorded in both groups. RESULTS VAS scores for pain were significantly lower in the articaine group than in the lidocaine group at the 2nd, 6th, 8th, 12th, and 24th postoperative hours (p< 0.05). Comparison of the patients' usage of analgesics during the first 24 hours postoperatively showed that in the articaine group, the percentage of patients that had not used analgesics was 58.5%, and in the lidocaine group the corresponding figure was 41.5%. CONCLUSION Articaine is a safe local anesthetic agent with rapid onset of action. When compared with lidocaine, it is associated with improved tissue diffusion, rare postoperative complications, and less postoperative pain, thus, representing a safe and effective local anesthetic agent for septoplasty procedure.
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Affiliation(s)
- Evren Erkul
- Department of Otolaryngology Head and Neck Surgery, Elazig Military Hospital, Istanbul, Turkey.
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Abstract
Our objective was to determine the factors that affect (i) the rectal-axillary temperature measurement difference (RATD) for digital and mercury-in-glass thermometers and (ii) the difference between mercury-in-glass and digital thermometer readings taken by the rectal and axillary routes. Children (between the ages of 2 and 48 months) who were admitted to Hacettepe University Children Hospital and Corum Children's Hospital in 2 months period were included in this study. Two measurements were taken from each patient within 2 days at two different occasions including day/night and sleep/awake by the same physician. A total of 135 patients were enrolled. RATD was 0.61 + 0.54 degrees C in the mercury-in-glass thermometer, and 0.81 +/- 0.57 degrees C in the digital thermometer. The mean differences between digital and mercury-in-glass thermometers were 0.16 degrees C for rectal routes and -0.02 degrees C for axillary routes. Children at older age with hypoalbuminemia and children exposed to higher ambient temperatures had lower values of RATD than others. Temperature recordings from different sites might change with ambient temperature and individual characteristics of children.
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Affiliation(s)
- S S Yalçin
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Ozyurt M, Gungor A, Ergunay K, Cekin E, Erkul E, Haznedaroglu T. Real-time PCR detection of Helicobacter pylori and virulence-associated cagA in nasal polyps and laryngeal disorders. Otolaryngol Head Neck Surg 2009; 141:131-5. [PMID: 19559972 DOI: 10.1016/j.otohns.2009.04.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 03/18/2009] [Accepted: 04/07/2009] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To identify Helicobacter pylori and major virulence factor, cagA, in patients with laryngeal diseases and nasal polyps. STUDY DESIGN Cross-sectional study with planned data collection. SETTING The study was performed on fresh tissue samples from patients with 32 nasal polyps, 29 normal nasal mucosa, and 27 laryngeal diseases presenting to the Otolaryngology-Head and Neck Surgery department of a major military hospital in Istanbul, Turkey. SUBJECTS AND METHODS Tissue specimens were evaluated by in-house polymerase chain reaction (PCR) and real-time PCR for bacterial DNA and by real-time PCR for cagA. The impact of commercial and in-house DNA extraction methods was also evaluated. RESULTS H pylori DNA was detected only by real-time PCR in 59.4 percent of nasal polyps, 70.4 percent of nasal mucosa samples, and 58.6 percent of larynx samples. cagA was identified in 78.9, 89.5, and 82.4 percent of positive polyp, nasal mucosa, and larynx samples, respectively. No statistically significant differences were observed between groups. DNA purification methods were equally effective. CONCLUSION H pylori DNA is present in nasal polyp and larynx tissues as well as normal nasal mucosa, as detected by a sensitive real-time PCR assay. cagA-positive strains dominate in all groups.
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Affiliation(s)
- Mustafa Ozyurt
- Department of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
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Gungor A, Dogru S, Cincik H, Erkul E, Poyrazoglu E. Effectiveness of transmeatal low power laser irradiation for chronic tinnitus. J Laryngol Otol 2007; 122:447-51. [PMID: 17625032 DOI: 10.1017/s0022215107009619] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To evaluate effectiveness of 5 mW laser irradiation in the treatment of chronic tinnitus.Study design:Prospective, randomised, double-blind study.Methods:This investigation included 66 ears in 45 patients with chronic unilateral or bilateral tinnitus. A 5 mW laser with a wavelength of 650 nm, or placebo laser, was applied transmeatally for 15 minutes, once daily for a week. A questionnaire was administered which asked patients to score their symptoms on a five-point scale, before and two weeks after laser irradiation. A decrease of one scale point, regarding the loudness, duration and degree of annoyance of tinnitus, was accepted to represent an improvement.Results:The loudness, duration and degree of annoyance of tinnitus were improved, respectively, in up to 48.8, 57.7 and 55.5 per cent of the patients in the active laser group. No significant improvement was observed in the placebo laser group.Conclusion:Transmeatal, low power (5 mW) laser irradiation was found to be useful for the treatment of chronic tinnitus.
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Affiliation(s)
- A Gungor
- Department of Otolaryngology, Haydarpasa Military Hospital, Istanbul, Turkey
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Erdem G, Ceyhan M, Ecevit Z, Kanra G, Erkul E. Multiple intracranial tuberculomas in a child. Turk J Pediatr 1996; 38:95-9. [PMID: 8819628] [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: 02/02/2023]
Abstract
Intracranial tuberculomas continue to be a serious complication of central nervous system tuberculosis. Tuberculomas are conglomerates of tubercles resulting from hematogenous spread of infection. Modern neuroimaging studies such as magnetic resonance imaging and molecular biologic techniques such as polymerase chain reaction are helpful in the diagnosis of central nervous system tuberculosis and tuberculomas. We report a boy with multiple intracranial tuberculomas diagnosed and treated with the aids of magnetic resonance and polymerase chain reaction techniques.
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Affiliation(s)
- G Erdem
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Affiliation(s)
- T Coskun
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Turkey
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