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    Assessment of Bone Conduction Thresholds After Surgical Treatment in Patients with Labyrinthine Fistula
    (Galenos Yayincilik, 2018) Baylan, Muzeyyen Yildirim; Yilmaz, Umit; Akkus, Zeki; Topcu, Ismail
    Objective: This study aimed to analyze the bone conduction thresholds before and after surgery in chronic otitis media patients with cholesteatoma who had labyrinthine fistula and whose cholesteatoma matrix had been completely cleaned. Methods: The study was performed between 2013 to 2017 with 23 chronic otitis media patients who had labyrinthine fistula with cholesteatoma and who were operated at the Department of Otorhinolaryngology of Dicle University School of Medicine. Patients were assessed by anamnesis and examination and when necessary, by temporal computerized tomography and diffusion magnetic resonance imaging. Bone conduction thresholds at frequencies of 500, 1000, 2000, and 4000 Hz were determined by audiometric examination and they were compared before and after surgery. Results: Of the 23 patients, 12 were female and 11 were male; their age range was 10-55 (26.04 +/- 14.13) years. In the post-operative period, it was possible to conduct audiological follow-up on 20 patients. In these follow-ups, 16 patients showed no change in bone conduction thresholds, two patients showed worsening, and two showed improvement. When pre-and post-operative bone conduction thresholds at each frequency were compared separately, no significant difference was found (p=0.937). No statistically significant difference was found between the pre-and post-operative means at the four frequencies (p=0.712). Conclusion: In this study, we found that to reduce complications relating to cholesteatoma, it might be necessary to completely remove the matrix especially in the case of type 1 and 2 labyrinthine fistulas.
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    Audiological Findings in Acromegaly Patients
    (Mediterranean Soc Otology & Audiology, 2011) Baylan, Muzeyyen Yildirim; Gokalp, Deniz; Celik, Yusuf; Tuzcu, Alpaslan; Meric, Faruk; Topcu, Ismail
    Objective: The aim of this study was to evaluate otologic problems in patients with acromegaly. Materials and Methods: This retrospective study was performed on 26 patients with acromegaly and 27 age-matched healthy controls. Otoscopic examination, pure tone odiometry, tympanometry, otoacoustic emissions, and stapes reflex were performed in all cases. Hearing thresholds of air and bone conduction (AC and BC), middle ear function, cochlear function, tympanic membrane compliance, gradient, peak pressure, and external ear canal volume were researched in patients with acromegaly. Results: The hearing thresholds for all frequencies except Right-AC 4000 frequencies were found to be significantly higher in patients with acromegaly as compared to the control group (p<0.05). Also significant correlation coefficients were calculated among disease duration, hearing thresholds, and tympanometric variables (p<0.05). There was a significant difference in tympanometry results between the two groups in regard to external ear canal volumes of the right and left ears (p <= 0.05). No differences were observed between the two groups in their type of tympanometry, stapes reflex, and otoacoustic emissions (OAE) (p>0.05). Conclusions: We have determined that patients with acromegaly have lower levels of hearing in both bone and air conduction compared with the normal population. This may be ascribed to deformation of hearing physiology related to hypertrophy in the temporal bone.
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    Evaluation of Hyperactivity, Attention Deficit, and Impulsivity Before and After Adenoidectomy/Adenotonsillectomy Surgery
    (Lippincott Williams & Wilkins, 2013) Ayral, Muhammed; Baylan, Muzeyyen Yildirim; Kinis, Vefa; Bez, Yasin; Bakir, Salih; Ozbay, Musa; Yorgancilar, Ediz
    Objective: The objective of this study was to determine the severity of attention deficit, hyperactivity, and impulsivity symptoms in patients with obstructive airway problems scheduled to undergo adenoidectomy or adenotonsillectomy operation. The effects of the surgical treatment on these symptoms will also be investigated in a case-control design. Methods: This prospective study included 63 patients (29 girls, 34 boys) who were operated on at the Department of Otorhinolaryngology, Dicle University Medical School, between January 2010 and May 2011 because of obstructive symptoms caused by adenoid or adenotonsillar hypertrophy. The age range of the patients was between 4 and 13 years. The control group consisted of 33 (17 girls, 16 boys) healthy children. Results: Among the patients, 15 children underwent adenoidectomy because of adenoid hypertrophy; 13 patients had adenotonsillectomy because of adenotonsillar hypertrophy, and the remaining patients underwent adenotonsillectomy related with chronic or recurrent tonsillitis with adenoid hypertrophy. Based on the preoperative data, statistically significant difference was observed between the patient and control groups. The patients' attention deficit, hyperactivity, and impulsivity symptoms preoperatively and postoperatively have shown statistically significant differences. Conclusions: Attention deficit, hyperactivity, and impulsivity symptoms were common among the children who show signs of airway obstruction due to adenotonsillar hypertrophy. Adenoidectomy or adenotonsillectomy operations were both observed to be associated with improvement in these symptoms.
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    Histopathological Evaluation of the Polyps with and without the Presence Cholesteatoma
    (Aves, 2010) Baylan, Muzeyyen Yildirim; Koc, Ersar Evren; Kilic, Nihal; Meric, Faruk
    Objective: To determine if there were any differences between the histopathological structures of the polyps with or without cholesteatoma Materials and Methods: In our study, 41 patients underwent operation with complaints of chronic otitis media with polyp. The patients were divided into those who had cholesteatoma and those who did not, so that discriminatory features were identified. Chronic otitis media with polyp was associated with cholesteatoma in 21 patients. Cholesteatoma was not found in 20 patients with chronic otitis media with polyp. Specimens removed from the both of patients groups were evaluated and compared between the groups in according to histopathologic features. Results: We observed that specimens of polyps with cholesteatoma were comprised of keratinized masses, keratinized tissue layers, and abundant immature granulation tissue, whereas, specimens of the polyps without cholesteatoma consisted of copious glandular stroma bordered by smooth epithelium (p<0,05). Conclusion: Our study showed that histopathologic features of the polyps suggest the presence or absence of cholesteatoma.
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    Is Preeclampsia a New Risk Factor for Cochlear Damage and Hearing Loss?
    (Lippincott Williams & Wilkins, 2010) Baylan, Muzeyyen Yildirim; Kuyumcuoglu, Umur; Kale, Ahmet; Celik, Yusuf; Topcu, Ismail
    Objective: We investigated whether preeclampsia is a risk factor for cochlear damage and permanent hearing loss. Study Design: Prospective case-control study design. Setting: Academic tertiary medical center. Patients: Subjects included 40 patients with preeclampsia and 30 healthy pregnant women. Interventions: Otoscopic examinations and pure-tone audiometry, tympanometry, otoacoustic emissions (OAEs), and stapedial reflex tests were conducted for all subjects. Negative audiologic tests were reevaluated after the postpartum period. Statistical analyses were performed using chi(2) and binary logistic regression testing. Main Outcome Measures: We searched for signs of middle ear ventilation, damage of cochlea, and sensorineural hearing loss. Results: Eight patients from the preeclampsia group had 1 or more otological problems. Two patients from the control group were determined as having otological problems. Otoacoustic emissions of the right and left ears (p = 0.029, p = 0.044), hearing levels of right and left ear bone conduction (BC) at the 500-Hz frequency (right and left-BC 500), and left ear at the 2,000-Hz frequency (left-BC 2000) differed significantly between the preeclampsia and control groups (p = 0.040, p = 0.003, and p = 0.003). There was no significant difference in the OAEs between the right and left ears in the preeclampsia group (p < 0.05). The variables BC 500-left, BC 500-right, OAE-right, and OAE-left differed significantly between groups based on binary logistic testing. The odds ratio and 95% confidence intervals (95% CI) for these 4 risk variables were as follows: BC 500-left, 1.167 (1.044-1.306); BC 500-right, 1.117 (1.002-1.244); OAE-right, 0.642 (0.505-0.815); and OAE-left, 0.576 (0.475-0.698), respectively. Conclusion: Preeclampsia is a risk factor for cochlear damage and permanent hearing loss. Even if preeclampsia resolves after delivery, cochlear damage and permanent hearing loss remain unchanged in patients with preeclampsia.
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    Mutations in MINAR2 encoding membrane integral NOTCH2-associated receptor 2 cause deafness in humans and mice
    (Natl Acad Sciences, 2022) Bademci, Guney; Lachgar-Ruiz, Maria; Deokar, Mangesh; Zafeer, Mohammad Faraz; Abad, Clemer; Baylan, Muzeyyen Yildirim; Ingham, Neil J.
    Discovery of deafness genes and elucidating their functions have substantially contributed to our understanding of hearing physiology and its pathologies. Here we report on DNA variants in MINAR2, encoding membrane integral NOTCH2-associated receptor 2, in four families underlying autosomal recessive nonsyndromic deafness. Neurologic evaluation of affected individuals at ages ranging from 4 to 80 y old does not show additional abnormalities. MINAR2 is a recently annotated gene with limited functional understanding. We detected three MINAR2 variants, c.144G > A (p.Trp48*), c.412_419de1CGGTTTTG (p.Arg138Valfs*10), and c.393G > T, in 13 individuals with congenital- or prelingual-onset severe-to-profound sensorineural hearing loss (HL). The c.393G > T variant is shown to disrupt a splice donor site. We show that Minar2 is expressed in the mouse inner ear, with the protein localizing mainly in the hair cells, spiral ganglia, the spiral limbus, and the stria vascularis. Mice with loss of function of the Minar2 protein (Minar2(tm1b/tm1b)) present with rapidly progressive sensorineural HL associated with a reduction in outer hair cell stereocilia in the shortest row and degeneration of hair cells at a later age. We conclude that MINAR2 is essential for hearing in humans and mice and its disruption leads to sensorineural HL. Progressive HL observed in mice and in some affected individuals and as well as relative preservation of hair cells provides an opportunity to interfere with HL using genetic therapies.