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Öğe A case with herpes zoster oticus involving multipl cranial nerves(Galenos Publishing, 2012) Yenigün, Alper; Evcimik, Muhammed Fatih; Tansuker, Hasan Deniz; Çalım, Ömer FarukHerpes Zoster Oticus described a virus caused by facial nerve paralysis associated with herpetic eruption of the pinna and suggested that it resulted from a geniculate ganglionitis. However, this condition represents a polycranial neuronitis and not simply a geniculate ganglionitis. We here present a Herpes Zoster Oticus case with multiple cranial nerves involvement and discussed with literature.Öğe Adenoid hypertrophy in children with allergic disease and influential factors(Elsevier Ireland, 2015) Evcimik, Muhammed Fatih; Do?ru, Mahmut; Cirik, Ahmet Adnan; İşeri Nepesov, MerveObjectives: Adenoid hypertrophy (AH) may cause several comorbid conditions including sleep apnea, chronic serous otitis and sinusitis. Such conditions are more common among children with allergic diseases. In our study, we aimed to determine the patient profile associated with higher incidence of adenoid hypertrophy and the related influential factors. Methods: The study included 1322 children being treated and followed up for allergic conditions. 100 children with no allergic diseases presenting during the same period to the clinic were included as the control group. Skin prick test for the same allergens was performed for all patients. Adenoid tissue was analyzed by an ENT specialist and the diagnosis was confirmed based on the patient history, endoscopic physical examination and radiology. Results: Of the patients, 765 (57.9%) were males and 557 (42.1%) were females and their mean age was 5.9 ± 3.3 years. In the control group, 56 (56%) children were males and 44 (44%) were females and their mean age was 6.3 ± 4.1 years. Children with allergic disease and control subjects did not differ significantly by age and gender. Adenoid hypertrophy was identified in 164 (12.4%) of the patients with allergic disease and in 3 (3%) of the controls. Allergic children were divided into two groups, as children with and without AH, respectively. The groups did not differ statistically significantly by gender, age or familial history of atopic disease. However, cigarette smoke exposure at home and presence of allergic rhinitis was significantly more frequent in the group of patients with AH. In the logistic model investigating the effect of variables on AH presence (according to age, gender, cigarette smoke exposure, asthma, AR, AD presence, atopy presence, sensitivity to house dust, pollen, epithelium, Alternaria alternata and cockroach), AR presence and cigarette smoke exposure were statistically significant. Conlusions: AH frequency is higher in children with allergic disease compared to controls. The most common sensitivity to allergens among patients with AH was to house dust. Presence of allergic rhinitis and cigarette smoke exposure are risk factors for developing AH. Children with these risk factors should be questioned for AH during their routine examinations.Öğe Cases of otology malpractice appeals to the Council of Forensic Medicine: An evaluation of the past two decades(Royal Belgian Society for Ear, 2017) Evcimik, Muhammed Fatih; Aslıyüksek, Hızır; Orhan, Zeynel Abidin; Cırık, Ahmet Adnan; Bayazıt, Yıldırım Ahmet; Orhan, Kadir SerkanCases of otology malpractice appeals to the Council of Forensic Medicine: an evaluation of the past two decades. Introduction: The present study aims to demonstrate the profile of clinical malpractice by evaluating otologyrelated cases, which have been subject to legal action, to determine avoidable errors and identify actions necessary for safe clinical practices.Method: Files of otology-related malpractice appeals to the Council of Forensic Medicine between 1995 and 2015 were evaluated retrospectively. Patients' demographics, complications subject to legal action, performed operations and medical practices, medical centres where the practices took place, and whether physician error was involved, as detailed in these files, were studied.Results: A total of 44 otology-related cases was included in the study. Thirty-two (72.7%) of these were due to surgical errors and 12 (27.3%) were due to outpatient clinic services. When examined by year, there was a significant increase during the latter years. Hearing loss was the main reason for complaint with 19 cases (43.2%), followed by facial paralysis with 17 cases (38.6%), and less commonly by late diagnosis, disfigurement and tinnitus. Second-line healthcare institutions were the source of 75% of the cases. Lawsuit rationales involved under-treatment or wrong treatment, rather than wrong or late diagnosis. Three fated cases were subject to lawsuits. According to the evaluation of the files from the Council of Forensic Medicine, there were faults in eight files, while 36 files involved no faults.Conclusion: The most common causes for law suits were hearing loss and facial paralysis. Most of the lawsuits were associated with surgical cases. The retrospective analysis of otology-related malpractice files is an important step in minimizing physician errors.Öğe Does adenoid hypertrophy affect disease severity in children with allergic rhinitis?(Springer, 2017) Doğru, Mahmut; Evcimik, Muhammed Fatih; Çalım, Ömer FarukOur study aims to evaluate the presence of adenoid hypertrophy (AH) in children with allergic rhinitis (AR) and the association of AH disease severity and clinical laboratory finding from retrospective, cross-sectional, and nonrandomized trial. The study included 566 children being treated and followed up for allergic rhinitis. Skin prick test for the same allergens was performed for all patients. Adenoid tissue was analyzed by an ENT specialist and the diagnosis was confirmed based on the patient history, endoscopic physical examination and radiology. Adenoid hypertrophy was detected in 118 (21.2 %) of the children with AR. Children with and without AH did not differ statistically and significantly by gender, age, presence of atopy in the family, exposure to smoke (p > 0.05). Comparison of the groups for AR duration demonstrated significantly higher frequency of persistent rhinitis in patients with AH (p < 0.05). Of the AR patients with AH, 90 (76.3 %) had moderate-severe rhinitis and 274 (62.6 %) AR patients without AH had moderate-severe rhinitis (p = 0.005). Itchy nose was more frequent in AR patients without AH, and nasal congestion was more common in AR patients with AH (p = 0.017 and p = 0.001, respectively). The presence of asthma was more common among AR patients without AH (p = 0.037). Intergroup comparisons for presence of atopic dermatitis, the percentage of eosinophil, serum IgE levels, the number of positive sensitivity, polysensitization, sensitivity to house dust mite, cockroach, pollens and dander yielded no significant difference (p > 0.05). On the other hand, sensitivity to Alternaria alternata was significantly more frequent in AR patients with AH (p = 0.032). The presence of AH increased the severity of the disease and prolongs disease duration. There was a negative relationship between AH and asthma in children with AR. AH is more common among children with mold sensitivity. AH should be considered and investigated particularly in non-asthmatic children with pronounced nasal congestion and A. alternata sensitivity.Öğe Is neutrophil-lymphocyte ratio associated with the severity of allergic rhinitis in children?(Springer, 2016) Doğru, Mahmut; Evcimik, Muhammed Fatih; Cırık, Ahmet AdnanNeutrophil lymphocyte ratio (NLR) could be an important measure of systemic inflammation. There is a lack of knowledge about the neutrophil-lymphocyte ratio in rhinitis. We aimed to determine the relationship between the clinical parameters of allergic rhinitis and NLR in children. 438 children who were diagnosed with allergic rhinitis and followed up in our hospital were included in the study. The control group included 180 control children with no evidence of allergic disease. The immunoglobulin E levels, skin prick tests and complete blood count were measured. Mean NLR was 1.77 +/- A 1.67 in the study group and 1.70 +/- A 1.65 in the control group. Mean NLR was significantly higher in children with allergic rhinitis compared to controls (p < 0.05). The patients with allergic rhinitis were grouped according to the severity of AR as Group I (mild group) and Group II (moderate/severe group). No statistically significant difference was present between groups in terms of gender, age, familial atopy, exposure to smoke, the presence of asthma and/or eczema, the percentage of eosinophil, serum IgE levels, number of positive sensitivity, and sensitivity to allergens (p > 0.05). However, NLR was significantly higher in the moderate/severe AR compared to mild AR (p < 0.05). Mean NLR was statistically higher in children with allergic rhinitis compared to the control group. In addition, elevated ratio is associated with the severity of allergic rhinitis in children. Neutrophil-lymphocyte can be used as an indicator of inflammation in allergic rhinitis. But further studies are needed in this issue.Öğe Ischemia-modified albumin levels in patients with bell's palsy(Wolters Kluwer Medknow Publications, 2022) Cırık, Ahmet Adnan; Evcimik, Muhammed Fatih; Ülfer, Gözde; Yigitbaşı, Türkan; Aktaş, ÖztürkBackground: Although several causes have been regarded as possible including viral, autoimmune, inflammatory, and vascular ischemia, the accurate etiology and pathophysiology of Bell's palsy (BP) remain unclear. The aim of the present article was to determine whether serum levels of ischemia-modified albumin (IMA) are associated with BP and if there is a posttreatment change in IMA levels. Materials and Methods: This was a prospective study enrolling 23 patients (10 males and 13 females; mean age: 44.71 +/- 16.72 years; and range, 20-57 years) and 23 healthy individuals (12 males and 11 females; mean age: 37.91 +/- 9.16 years; and range, 9-73 years) as the control group. Blood samples were obtained from the antecubital vein from all of the volunteers. Albumin cobalt binding test was used to obtain the IMA levels. Results: The mean IMA level was 0.38 +/- 0.06 absorbance units in the study group at the time of diagnosis, 0.35 +/- 0.07 absorbance units at the posttreatment period, and 0.35 +/- 0.06 absorbance units in the control group. IMA levels of patients in posttreatment period were lower than the onset of illness. The result was statistically significant (P = 0.01). Conclusion: The data demonstrate that IMA decreased in BP with treatment. This is a preliminary study and we could not obtain results that clearly support the ischemic hypothesis of pathogenesis of BP; we think it gives an idea for further studies.Öğe Ischemia-modified albumin levels in patients with idiopathic sudden sensorineural hearing loss(2019) Cırık, Ahmet Adnan; Evcimik, Muhammed Fatih; Ülfer, Gözde; Yiğitbaşı, Türkan; Aktaş, ÖztürkObjectives: This study aims to investigate whether serum levels of ischemia-modified albumin (IMA) are associated with idiopathic sudden sensorineural hearing loss (ISSNHL). Patients and Methods: Between December 2015 and June 2017, a total of 17 patients (9 males, 8 females; mean age 49.4±18.0 years; range, 24 to 88 years) with ISSNHL and 24 age- and sex-matched healthy individuals (12 males, 12 females; mean age 44.5±13.3 years; range, 30 to 81 years) as the control group were included in the study. All patients underwent audiometric examination at the time of admission immediately before the beginning of the treatment and weekly after treatment initiation until one month using the Interacoustics AC40 audiometer. Serum IMA levels were evaluated using blood samples from the antecubital vein of both patient and control groups. The samples were centrifuged to separate the serum from the cells. Albumin cobalt binding test was used for IMA measurement. Results: The mean IMA level was 0.374±0.081 absorbance units (ABSU) (range, 0.205 to 0.536) in the study group at the time of diagnosis, 0.358±0.051 ABSU (range, 0.297 to 0.466) in the post-treatment period, at least four weeks after onset, and 0.358±0.053 ABSU (range, 0.281 to 0.434) in the control group. There was no statistically significant difference between the patient and control groups. The IMA levels of the patients with ISSNHL in the post-treatment period were lower than the onset of illness, although this difference was not statically significant (0.440). Conclusion: Our study results demonstrated that serum IMA levels in the patients with ISSNHL did not differ from the control group.Öğe Long term effects of palatal implant method in adult patients with simple snoring and obstructive sleep-apnea syndrome(Societa Editrice Universo, 2015) Evcimik, Muhammed Fatih; Özkurt, Fazıl Emre; Bozkurt, Ziya; Gürsel, Ali Okan; Şapçi, TarıkObjective. To investigate the long term effect and reliability of palatal implant surgery, which is a minimally invasive technique, used in simple snoring and obstructive sleep-apnea syndrome types based on objective and subjective data. Materials and Methods. Seventy-eight patients were included prospectively in this study. It has been possible to obtain preoperative and postoperative polysomnography results in 59 patients. The cases were followed-up for 8 months on average. Considering the apnea index and AHI values, the patients were divided into 5 groups, namely simple snoring (n=13), mild OSAS (n=21), moderate OSAS (n=17), severe OSAS (n=8), and the group on which polysomnography could not be performed, the no-polysomnography group (n=19). The cases were evaluated based on polysomnography and the Epworth Sleepiness Scale and visual analog scale filled by relatives or friends of the patients. Results. The AHI of 46 patients diagnosed with OSAS decreased from 14.9 to 10.14 (31% decline) (p=0.279). The AHI of 13 patients with simple snoring diagnosis reduced from 3.09 to 2.02 (p=0.033). A 40% improvement was observed in VAS of all cases. Implant rejection occurred in 7 of our cases and 3 patients experienced ecchymosis. Conclusion. It is concluded that palatal implant procedure is a good option for appropriate cases, it is equivalent to other methods in terms of treatment efficacy and that is more advantageous than other techniques in that it can be applied in office settings with low morbidity, is minimally invasive and brings about higher patient compliance.Öğe Reply to the letter to the author concerning: 'Does adenoid hypertrophy affect disease severity in children with allergic rhinitis?'(Springer, 2018) Doğru, Mahmut; Evcimik, Muhammed Fatih; Çalım, Ömer FarukWe would like to thank the author for making valuable comments about our article entitled “Does adenoid hypertrophy affect disease severity in children with allergic rhinitis?” [1]. However, we think that the reviewer has made several mistakes while evaluating the content of our article and the details of the literature. Firstly, as we have already pointed out in our trial, our study aims to evaluate the presence of adenoid hypertrophy (AH) in children with allergic rhinitis (AR) and the connection between AH disease severity and clinical laboratory findings. The aim of the study is not about exploring the effects of adenoidectomy on the patients with AR and AHÖğe Reply to the letter to the editor by satvinder singh bakshi concerning: Is neutrophil-lymphocyte ratio associated with the severity of allergic rhinitis in children?(Springer, 2016) Doğru, Mahmut; Evcimik, Muhammed Fatih; Cırık, Ahmet AdnanWe would like to thank the author of the letter for contributing valuable comments to our article entitled ‘‘Is neutrophil–lymphocyte ratio associated with the severity of allergic rhinitis in children?’’ [1]. However, we think that the author has missed some points. First, all patients with any chronic disease were not enrolled in the trial as specified in the materials-method section of the article. This includes patients with Bell’s palsy, chronic tonsillitis and hearing loss. Second, regarding the relationship between the age, body mass index (BMI) and neutrophil–lymphocyte ratio (NLR), our trial was written in February 2015, submitted to the journal on June 28, 2015 and accepted on October 24. The publication date of the reference source is November 2015 [2]. Moreover, there were no differences in terms of age between groups in our trial. There is no consensus about NLR and BMI relationship within the literature. There are also publications in which no relationship has been detected between BMI and NLR.Öğe Reply to the letter to the editor by Viroj Wiwanitkit concerning: 'Is neutrophil-lymphocyte ratio associated with the severity of allergic rhinitis in children?'(Springer, 2016) Doğru, Mahmut; Evcimik, Muhammed Fatih; Cirik, Ahmet AdnanWe appreciate to receive these constructive and valuable comments regarding our article entitled ‘‘Is neutrophil– lymphocyte ratio associated with the severity of allergic rhinitis in children?’’ [1]. As mentioned by Wiwanitkit, it is more feasible to analyze the blood samples on the same analyzer [2]. However, the results were obtained on two separate analyzers, as the analyzer used to perform complete blood count in our hospital was changed after August 2013. When the blood samples were re-analyzed in terms of the analyzers, neutrophil–lymphocyte ratio (NLR) values in the AR group were found to be higher before August 2013 and the difference was not statistically significant (p = 0.179).Öğe The effect of parotid gland examination and massage on serum amylase levels in patients with acute parotitis(Deomed Publisher, 2016) Evcimik, Muhammed Fatih; Çakır, Burak Ömür; Cırık, Ahmet Adnan; Cevizci, Raşit; Soylu, Erkan; Günay, CelalObjective:Acute infection of the parotid gland is common in the clinical practice of ear-nose-throat medicine. The present study aims todemonstrate the effect of parotid gland massage on serum amylase levels. Methods:The study included 30 patients with acute parotitis presentingto our clinic and 14 healthy volunteers. The correlation between the serumsamples collected before and after parotid gland massage was compared. Results: A significant difference was observed in the amylase levelsbefore and after massage in the acute parotitis group. Amylase levels didnot differ significantly between measurements before and after massagein healthy subjects. Conclusion:Patients should be evaluated with consideration to theeffect of parotid gland massage performed to determine suppurationof parotid gland on amylase levels.
