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    External auditory canal obstruction due to tuberous sclerosis complex angiofibromas: a case report
    (Springer, 2022) İşlek, Akif; Şimşek, Sadullah
    Background: Tuberous sclerosis complex (TSC), an autosomal dominant genetic disorder and auricula and external auditory canal (EAC) involvement, is rare. Surgical excision is rarely recommended for cutaneous lesions. Case presentation: A 31-year-old male patient was admitted with a complaint of left fullness, discharge, and conductive hearing loss. Symmetrical nodular cutaneous lesions on the malar region, tragus, and lateral portion of the EAC bilaterally were noted. The patient had diagnosed with TSC during adolescence clinically and genetically. Surgery was planned to obtain a favorable, self-cleaning EAC rather than total excision of angiofibromas. Angiofibromas on the EAC and tragus were excised. The defect was repaired by sliding a fasciocutaneous island flap inferiorly created in the preauricular area. No EAC stenosis or angiofibroma recurrence was observed during follow-up. Discussion: Surgical excision for this clinical entity provides satisfactory management even if it was not routinely recommended for other skin lesions.
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    A fatal rhino-orbit-cerebral mucormycosis infection aggravated by coronavirus disease-2019
    (Sociedade Brasileira de Medicina Tropical, 2022) İşlek, Akif; Şimşek, Sadullah
    Rhino-orbit-cerebral mucormycosis is an opportunistic infection caused by Rhizopus spp., Mucor spp., and other mucormycosis with high morbidity and mortality1 .The main risk factors for mucormycosis include uncontrolled diabetes mellitus, diabetic ketoacidosis, other forms of metabolic acidosis, corticosteroid treatment, organ or bone marrow transplantation, neutropenia, trauma and burns, malignant hematologic disorders, and iron overload
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    Nasal steroid use and osteitis development in chronic rhinosinusitis with nasal polyps
    (Springer Medizin, 2022) Şimşek, Sadullah; İşlek, Akif
    Objectives: Osteitis and tissue remodeling are infammatory processes associated with the severity of chronic rhinosinusitis with nasal polyps (CRSwNP). Nasal steroids are the mainly recommended therapeutics in the treatment of the disease, and besides their benefcial efects, they may worsen osteitis via osteopenia. This study aimed to search for the coalescence of osteitis in CRSwNP and nasal steroid use (NSU). Methods: A cross-sectional study was designed. Patients who underwent paranasal sinus computed tomography (PNSCT) imaging were queried, and the sino‐nasal outcome test-22 (SNOT-22) was completed. Regular NSU was defned as a continued treatment for 2 months in the last 6 months. The cumulative period of NSU during the last 6 months was determined and classifed as no use or, for 1 to 3 months, or more than 3 months. Lund-MacKay scores (LMS) and Global Osteitis Scores (GOS) were calculated for 10 sinuses via PNSCT. Results: Sixty-two patients were included in the study. The mean GOS score was 5.7±1.7 points higher in patients with regular NSU (p=0.002, 95% CI: 9.2–2.2, t-test). LMS and SNOT-22 scores also were signifcantly higher for patients with regular NSU (p=0.036 and<0.001 consecutively). The mean GOS score showed a signifcant increase according to the cumulative period of NSU (p<0.001, one-way ANOVA test). Similarly, LMS and SNOT-22 scores were also signifcantly associated with the duration of total NSU. GOS score showed a signifcant positive high correlation with LMS and SNOT-22 scores (p<0.001, r=0.608 and r=0.753 consecutively). Conclusions: This association found between the severity of GOS and NSU is probably due to the severity of the disease. However, it may question the value of the NSU efect in the development of osteitis. The presence of NSU should be investigated in future histopathological studies. Level of evidence: IV
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    Radiological examination of cranial, ear-nose-throat, and maxillofacial system findings of Dyke-Davidoff-Masson syndrome in 28 patients
    (Ediciones Doyma, S.L., 2021) Şimşek, Sadullah; İşlek, Akif
    Objectives: It was aimed to detail the intracranial and ear–nose–throat-maxillofacial (ENT-MF) system findings of Dyke–Davidoff–Masson Syndrome (DDMS), and to examine the association in a larger sample according to current literature. Patients and methods: The study was designed retrospectively. Cranial magnetic resonance (MRI) and computed tomography (CT) Imaging records of patients were re-examined. Outcome parameters were identified as patients' demographics, the emergence of the central nervous system (CNS) pathologies, the asymmetric pneumatization of the skull bones, and ENT-MF system presentation. The correlation of the cranial and ENT-MF system findings was evaluated with Spearmen correlation analysis. Results: Radiological images of 28 patients were examined. The number of men was 21 (75.0%) and the number of females was 7 (25.0%). The mean age of the patients was 23.6 ± 10.6 (min. 1, max. 44). DDMS involvement detected on the right side in 15 (53.6%) of the patients. Cerebral atrophy (n = 28, 100%), lateral ventricular dilatation (n = 26, 96.3%) and corpus callosum damage (n = 19, 67.9%) were most frequent findings respectively. Cerebellar atrophy (n = 4, 14.3) and venous sinus dominance (n = 4, 14.3) were the rarest pathologies. Facial asymmetry (n = 15, 53.6%) and frontal sinus hyperpneumatization (n = 15, 53.6%) were the most frequent findings in the ENT-MF system. Increased calvarial thickness showed a high positive correlation with facial asymmetry and frontal sinus hyperpneumatization (p = 0.002, r = 0.571 and 0.024, r = 0.424, respectively). Conclusion: DDMS may occur with different radiological findings depending on the level of cerebral damage. Facial asymmetry often accompanies the disease and it should be considered in clinical practice of facial plastic and maxillofacial surgery.