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Öğe Adenoidektomi ve adenotonsillektomi operasyonu yapılan çocuklarda preopoperatif ve postoperatif psikosomatik analiz(Dicle Üniversitesi, Tıp Fakültesi, 2018) Sizer, Bilal; Akdağ, MehmetAMAÇ Çalışmamızda adenoidektomi veya adenotonsillektomi endikasyonu alan çocuklarda, ameliyat öncesi ve ameliyat sonrası, çocuklarda ruhsal bozuklukları taramaya yardımcı ölçekler kullanılarak ameliyat endikasyonuna neden olan etkenin çocukların ruh sağlığı üzerine etkilerini araştırmayı amaçladık. GEREÇ VE YÖNTEM Çalışmaya sadece adenoidektomi yapılan 6-12 yaş arası 41 çocuk, adenotonsillketomi yapılan 6-12 yaş arası 41 çocuk ve sağlıklı 6-12 yaş arası 40 çocuk alındı. Adenoidektomi yapılan hastalar, adenotonsillektomi yapılan hastalar ve kontrol grubu olarak üç gruba ayrıldı. Ameliyat öncesi ve sonrası uygulanan anketlerle mevcut etkenin çocukların ruh sağlığı üzerindeki etkisi araştırıldı. Taramada Güçler ve Güçlükler Anketi Ebeveyn Formu, Çocuklarda Anksiyete Tarama Ölçeği Ebeveyn Formu, Çocuklarda Uyku Ölçeği ve Çocuklar İçin Yaşam Kalitesi Ölçeği Ebeveyn Formu kullanıldı. BULGULAR Rekürren enfeksiyon ve adeno/adenotonsiller hipertrofi nedeniyle sleep apne yapan adenoidektomi/adenotonsillektomi uygulanan çocuklarda ameliyat sonrasında; Güçler ve Güçlükler Anketi, Çocuklarda Anksiyete Tarama Ölçeği, Çocuklarda Uyku Ölçeği puanlarında anlamlı düşüme, Çocuklar İçin Yaşam Kalitesi Ölçeği puanlarında ise anlamlı şekilde yükselme olduğu görüldü. SONUÇ Sonuç olarak tekrarlayan enfeksiyon atakları ve adeno/adenotonsiller hipertrofi nedeniyle sleep apne oluşan çocuklarda geç kalınmadan adenoidektomi/adenotonsillektomi uygulanması, çocuklarda ileride daha karmaşık hale gelebilecek nörodavranışsal sorunları engelleyebileceği, uyku sorunlarını azaltabileceği, yaşam kalitesini artırabileceği düşünülmüştür.Öğe Comparison of death and survival cervical necrotizing fasciits cases(Wiley, 2022) Sizer, Bilal; Yilmaz, Umit; Kinis, Vefa; Yorgancilar, Argun EdizBackground Cervical Necrotizing Fasciitis (CNF) is associated with a high mortality rate. The occurrence of mediastinitis with CNF may increase mortality up to 70%. Aims We aimed to identify the differences between surviving and deceased cases. Methods The present study was conducted retrospectively by scanning the files of 16 patients between the ages of 19-71 who were diagnosed with CNF. Patients were divided into two groups as the surviving patient group (SPG) and the deceased patient group (DPG). Both groups were compared in terms of age, gender, Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, duration of symptom onset to hospital admission, use of antibiotherapy prior to admission, duration of hospitalization, presence of diabetes mellitus (DM), presence of dental etiology, mediastinitis, and respiratory distress at the time of admission. Results Diabetes mellitus was the most common comorbid disease. 5 out of 7 deceased patients had DM. Dental events were the most common etiology. Rapid surgical debridement and airway management was the first treatment method. The most frequently isolated species in the culture was Streptococcus. 6 of 11 patients who developed mediastinitis deceased at the end of the process. Conclusion Dental pathologies mostly play a role in the etiology. It is obvious that dentists, another occupational group that frequently encounters this patient group, have a critical role in this process. Therefore, precise attention should be given to dental problems in patients with diabetes, and hospitalization and initiation of broad-spectrum antibiotherapy should be considered in case of suspicion of deep neck infection.Öğe Comparison of patients with malignant or benign laryngeal lesions and healthy indivduals in terms of haematological inflammatory parameters(Wiley-Hindawi, 2021) Sizer, Bilal; Yılmaz, Ümit; Kınış, VefaBackground The aim of this study is to compare neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) values, which are inflammatory parameters, in precancerous and cancerous lesions and to determine whether there is a parameter that can be used in the early diagnosis of laryngeal squamous cell carcinoma. Methods In this retrospective study, 174 patients who were benign as a result of pathology, 122 patients who were malignant, 39 patients who were premalignant (335 patients in total) and 117 normal individuals were included. Data groups were divided into 4 groups as benign laryngeal lesion(BLL), precancerous laryngeal lesion (PLL), malignant laryngeal Lesion (MLL) and control group (CG). In addition, the PLL group was subdivided into mild dysplasia (MiD), Moderate Dysplasia (MoD) and severe dysplasia-carcinoma in situ (SeD/CIS). NLR, PLR and other parameters were calculated. Results NLR and PLR values were significantly different between the groups. (P = .000, P = .002) The mean NLR was higher in the MLL and PLL groups, and was lower in the BLL and control groups. The mean PLR was also higher in the MLL and PLL groups. When the groups were compared in pairs, there was a significant difference between BLL and MLL (P = .001) and MLL and CG (P = .006). The PLL group was subdivided into MiD, MoD and SeD/CIS. There was a significant difference in NLR when CG and other subgroups were compared (P = .027). Significant differences were found between CG and SeD when the groups were compared in pairs (P = .007). There was no significant difference between the groups in terms of PLR and dysplasia (P = .516). Conclusion As revealed in this study, these rates were low in the CG and BLL groups and high in the MLL group, so they could be used as markers to differentiate malignant lesions.Öğe Culturally modified olfactory test adapted to East-Turkey: A comparison with Sniffin' Sticks(Wiley, 2021) Demir, Songul; Sizer, Bilal; Gul, Aylin; Topcu, IsmailBackground Although the Sniffin' Sticks test (SST) is a widely used odor test, aplicability of odor tests is limited because of the high cost of the test and the regional-cultural differentiation of odor recognition. We aimed to evaluate our regional odor norms by applying the SST with a Modified odor test (MOT) we created for this study, and to develop a test similar to the SST, which was less expensive and probably had a higher odor definition for our region. Methods This study includes 201 healthy volunteers: 91 men and 110 women over the age of 18 were included in the study. Tests were compared by applying the SST and MOT to all volunteers. Results In all subjects, for the SST: the mean Threshold score (TS), Discrimination score (DS), and Identification score (IS) were, respectively, 10.73 +/- 2.35, 11.11 +/- 11.94 and 11.32 +/- 2.15. TheTDI mean score was found to be 33.11 +/- 5.9. In the TDI score, the 10th percentile value was found to be 26. For the MOT, the mean TS(mTS), DS(mDS), and IS(mIS) were 10.88 +/- 2.31, 12 +/- 2.06, and 11.95 +/- 2.07, respectively, the modified test TDI(mTDI) mean was 34.68 +/- 6.47. The mTDI 10th percentile value was found to be 26. In all volunteers, there was no statistically significant difference between the two tests for the mean threshold score, while the difference in the mean discrimination score, the average identification score, and the average TDI (thresold, discrimination, sum of identification scores) score was statistically significant (P < .01). Conclusion This study is the first study to compare the SST and the MOT in our region. Making low-cost modifications by adding more probable smells to the smell tests and using them in studies involving more participants will be more meaningful in evaluating normative odor scores and will result in more widespread use.Öğe A different perspective on the treatment of branchial cleft cysts, which are very rarely located in the nasopharynx: a case series(Kuwait Medical Assoc, 2024) Sizer, Bilal; Ergen, Pinar; Yorgancilar, Argun EdizNasopharyngeal branchial cleft cysts are very rare. There is no consensus about the approach to these pathologies. The problem that makes surgery difficult is its possible proximity to vital vascular structures such as internal carotid in the deep plane and located laterally. We aimed to present our series of three patients who were diagnosed with nasopharyngeal branchial cyst and operated by transnasal endoscopic method by determining the safe surgical margin with the help of Doppler ultrasonography. Three male patients, who had various complaints such as difficulty breathing through the nose and sleep problems, were operated on with a transnasal endoscopic approach supported by 20MHz Doppler ultrasonography due to cystic formation in the nasopharynx. Histopathological evaluations were reported as a nasopharyngeal branchial cleft cyst. Doppler ultrasonography assisted transnasal endoscopic approach can be applied in the treatment. This approach both shortens the duration of surgery and minimizes the risk of neurovascular injury.Öğe DOES THE HOUNSFIELD UNIT MEASURED IN MULTIPLE FOCUS IN HIGH RESOLUTION TEMPORAL BONE TOMOGRAPHY CONTRIBUTE TO THE DIAGNOSIS OF OTOSCLEROSIS?(2022) Sizer, Bilal; Yılmaz, Ümit; Baylan, Müzeyyen Yıldırım; Çelik, AhmetPurpose: In this study, it was aimed to investigate the function of high-resolution computed tomography (HRCT) densitometry in the diagnosis of otosclerosis by performing densitometric measurements on the foci around the cochlea. Methods: The HRCT images of 0.5 mm thin-slice axial sections were obtained from 30 patients with otosclerosis, who had been surgically confirmed and performed computed tomography of the temporal bone before the surgery, and 30 patients, who had undergone cochlear implant surgery and had been identified as the control group were examined. Densitometric measurements obtained from 7 different points of the otic capsule were recorded as the mean Hounsfield unit (HU) for each patient. Results: When we compared the patient and the control groups, a statistically significant difference was found in densitometric measurements in 6 of the 7 different regions (p<0.05). There was no statistically significant difference only in the HU 4 region (p>0.05). There was also a statistically significant difference between these two groups in the mean HU value obtained by measurements performed in 7 regions (p<0.05). In addition, no significant difference was found between both ears in all regions in the densitometric measurements at 7 different points of the otic capsule between the operated and non-operated ears of these patients (p> 0.05). Conclusion: In our study, it was found that the density around the otic capsule was lower in patients with otosclerosis compared to normal patients.Öğe THE EFFECT OF ABDOMINAL (DIAPHRAGM) RESPIRATORY TRAINING ON AERODYNAMIC PARAMETERS IN PATIENTS WITH MUSCLE TENSION DYSPHONIA(2020) Gül, Aylin; Özalp, Sevcan; Sizer, Bilal; Demir, MelikeObjective: In this study, the effectiveness of abdominal (diaphragm) respiratory training on muscle tension dysphonia was investigated using aerodynamic parameters. Material-Method: 60 patients between the ages of 18-65 who were diagnosed with muscle tension dysphonia were included in the study. 60 healthy individuals were included in the control group. Maximum phonation time (/ a /), maximum (/ s /)duration, maximum (/ z /) duration, s / z ratio, vital capacity and phonification quotient were measured before respiratory training for all participants. Abdominal (diaphragm) respiratory training was given to the group with muscle tension dysphonia, and aerodynamic parameters were measured again after 4 weeks of respiratory training. The data of the control group were compared with the data of the patient group before abdominal (diaphragm) respiratory training. Then, the patient group"s aerodynamic parameters before the abdominal respiratory training were compared with the patient group"s aerodynamic parameters after the training. Results: The aerodynamic parameters of patients before abdominal (diaphragm) respiratory training; maximum phonation time, vital capacity, s / z ratio and phonation quotient were found to differ statistically significantly from the control group (p <0.05). When the patient data after four weeks of respiratory training were compared with the patient data before respiratory training, no significant change was observed in the other parameters (p <0.05), except for the s / z ratio (p <0.05). Conclusion: The main source of sound is air in the lungs. Therefore, correct and effective breathing is necessary for the effectiveness and continuity of phonation. Although, in our study, no statistically significant change was observed in relation to aerodynamic parameters, vital capacity, maximum phonation time and phonification quotient after 4 weeks, positive changes were observed in all the parameters mentioned. While it was thought that the four-week period might be short, it was observed that abdominal (diaphragm) respiratory training was effective on the s / z ratio of aerodynamic parameters.Öğe THE EFFECTS OF FACE MASK USE DURING COVID-19 ON SPEECH COMPREHENSION IN GERIATRIC PATIENTS WITH HEARING LOSS WHO USE LIP-READING FOR COMMUNICATION: A PROSPECTIVE CROSS-SECTIONAL STUDY(Gunes Kitabevi Ltd Sti, 2022) Sizer, Bilal; Demir, Songul; Yilmaz, Umit; Yeniceli, Nurelis; Budak, Yakup; Yorgancilar, Argun Ediz; Topcu, IsmailObjective: Communication difficulties are considered the most significant consequence of hearing loss. This study aimed to determine whether surgical face masks, which have been mandatory throughout the COVID-19 pandemic, have an effect on speech comprehension scores in geriatric lip-reading patients with hearing loss and to raise awareness of the need for solutions to this problem. Materials and Method: Patients with moderate and higher sensorineural or mixed bilateral symmetrical hearing loss who stated that they lip-read to better understand during communication were included in the study. The patients' speech comprehension scores were gathered while the audiologist wore a surgical mask and then a transparent mask, respectively. Results: Twelve (33,3%) of the patients were female, and 24 (66.7%) were male. The mean age of the patients was 66.64 +/- 1.53 years. The mean speech comprehension scores of the patients when the audiologist was wearing a surgical mask (38.25 +/- 14.33) and a transparent mask (67.81 +/- 14.30), respectively, were compared. The surgical mask significantly affected speech comprehension scores, and the Cohen d value of the effect size was 2.06. As such, the surgical face mask had a great effect on these patients' speech comprehension scores. Conclusions: In elderly lip-reading patients who suffer from hearing loss, seeing the lip movements of the speaker, especially in hospital applications, promotes more effective communication. Transparent face masks can be considered a solution.Öğe Evaluation of symptoms of preopoperative and postoperative psychosomatic screening in children with adenoidectomy and adenotonsillectomy(Elsevier Ireland Ltd, 2020) Sizer, Bilal; Akdag, Mehmet; Sizer, Esra; Yilmaz, Umit; Demir, SongulIntroduction: Adenoidectomy and adenotonsillectomy are very common operations in childhood. It is important to clarify their effects on this age group; in this study, we aimed to investigate the effects of the causative agent on children's mental health by using scales that help to screen for indications of mental disorders in children, who have had adenoidectomy or adenotonsillectomy, both before and after surgery. In this way, we aimed to investigate the effects of this factor on children's mental health. Materials and methods: The study included 82 children aged 6-12 years with signs of upper respiratory tract obstruction or recurrent adenotonsilitis. Adenotonsillectomy was performed in 41 patients included in the study and adenoidectomy was performed in 41 patients included in the study. 40 healthy children matched with the patient groups in terms of age and gender were included in the control group. Patients, were divided into three groups, those who underwent adenoidectomy, patients undergoing adenotonsillectomy and those in the control group Preoperative and postoperative questionnaires were used to investigate the effect of tonsillectomy or adenoidectomy on the mental health of children. The Parents' Form for the Strengths and Difficulties Questionnaire, the Parental Form for the Children's Anxiety Screening Scale, the Sleeping Scale for Children and the Quality of Life Scale for Children were used in the screening. Results: In children, who underwent adenoidectomy/adenotonsillectomy due to recurrent infection and adeno/adenotonsillar hypertrophy; it was seen that there was a significant decrease in the scores for the Strengths and Difficulties Questionnaire, the Anxiety Screening Scale in Children, and the Sleep Scale in Children, and a significant increase in Quality of Life Scale for Children scores. Outcome: In conclusion, adenoidectomy/adenotonsillectomy in children with sleep apnea due to recurrent episodes of infection and adeno/adenotonsillar hypertrophy was thought to prevent further neurobehavioral problems, likely to become more complex in the future, and to improve quality of life.Öğe Kulak Burun Boğaz polikliniğine başvuran hastalarda COVID-19 pandemisi farkındalığı: Kesitsel bir çalışma(Ortadoğu Reklam Tanıtım Yayıncılık, 2020) Sizer, Bilal; Yıldız, İsmail; Yılmaz, Ümit; Demir, Songül; Sırma, Enes; Çelik, Ahmet; Topçu, İsmailAmaç: Mayıs 2020 tarihinde Türkiye genelinde yeni vaka sayısı azaldı ve Haziran 2020’de normalleşme sürecine girildikten sonra Diyarbakır ilinde vaka sayıları artmaya başladı. Bu çalışma, pandemi ile mücadelede etkin rol alan kulak-burun-boğaz branşına ait polikliniğe başvuran hastaların COVID-19 farkındalığının sorgulanmasının vaka artışının olası nedenine yönelik bilgi sağlayabileceğinin düşünülmesi nedeni ile planlandı. Gereç ve Yöntemler: Bu kesitsel çalışmaya, 20 Temmuz 2020-24 Temmuz 2020 tarihleri arasında Dicle Üniversitesi Kulak Burun Boğaz Polikliniğine başvuran ve çalışmaya kabul kriterlerini karşılayan 200 hasta alındı. Hastalara, tarafımızca oluşturulmuş sosyodemografik bilgileri sorgulayan (7 soru), polikliniğe başvuru sürecini sorgulayan (2 soru), pandemiye ait temel bilgileri sorgulayan (3 soru) ve 5’li Likert tipi ölçek şeklinde hazırlanmış, bilgi düzeyini karşılaştırmak için kullanılan 21 soru olmak üzere toplam 33 sorudan oluşan anket formu uygulandı. Bulgular: Hastaların en sık boğaz ağrısı, alerjik semptomlar ve kulak ağrısı ile polikliniğe başvurdukları tespit edildi. En sık alerjik rinit, akut farenjit ve otitis eksterna tanılarının konulduğu izlendi. Evde risk grubunda olan bireylerle yaşayanların (p=0,008), gelir düzeyi (p=0,000) ve eğitim düzeyi (p=0,000) yüksek olanların ve salgından Aralık 2019’dan itibaren haberdar olanların (p=0,000) bilgi düzeylerinin daha yüksek olduğu görüldü. Sonuç: Her ne kadar genel pandemi farkındalık düzeyi iyi olsa da düşük eğitim düzeyi ve düşük gelirli bireylerin farkındalık çalışmalarında ana hedef olmaları gerekmektedir. Ayrıca özellikle pandemi sürecinde birinci basamak sağlık hizmetlerinin daha efektif organize edilmesi, ikinci ve üçüncü basamak sağlık kuruluşlarının bu mücadelede daha etkin rol almasını sağlayacaktır.Öğe Management of post-COVID olfactory disorder: is olfactory training effective on recovery of olfactory function?(Doğu Karadeniz Deri ve Zührevi Hastalıklar Derneği, 2022) Demir, Songül; Sizer, Bilal; Sırma, EnesBackground The number of patients presenting with sudden onset and persistant anosmia and other olfactory disorders, which is a finding related to coronavirus disease has increased considerably. Objective In this study, we aimed to evaluate the efficacy of olfactory training in patients with persistent anosmia after Covid-19 infection. Methods Forty-six patients who applied for a sudden loss of smell after Covid-19 infection and still had olfactory disorders were included in the study. Odor threshold and odor identification tests were performed on the patients before the treatment. As olfactory training, four scent bottles included the following groups: phenyl ethyl alcohol, eucalyptol group, citronellal group and eugenol group were given to patients, and they were instructed to sniff the odors twice a day, for five seconds each, when they woke up in the morning and before they went to sleep and make a daily check that they applied the treatment. Patients who continued the training for 12 weeks were re-evaluated with the odor threshold test and odor identification test. Results The pre-training mean olfactory threshold score of the patients was 1.65±1.74, and the post-training mean olfactory threshold score was 3.89±2.73. It was observed that the olfactory threshold scores increased significantly after the olfactory training (PÖğe Parotis Bezi Kitlelerinin Sistemik İnflamatuvar Parametrelerle İlişkisi(İstanbul Aydın Üniversitesi, 2020) Sizer, Bilal; Yılmaz, Ümit; Topçu, İsmailAmaç: Son yıllarda yapılan çalışmalar kanser ve inflamatuvar yanıt arasında bir ilişki olduğunu göstermiştir. Bu çalışmada inflamatuvar parametrelerden nötrofil/lenfosit oranı, trombosit/ lenfosit oranı ve sistemik immün inflamasyon indeksinin parotise ait kitlelerin ayırıcı tanısında kullanılıp kullanılamayacağını incelemeyi amaçladık. Gereç ve Yöntem: Bu retrospektif çalışmamızda Dicle Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Polikliniği’ne parotiste kitle ile başvurmuş ve opere edilmiş toplam 100 hasta ile 70 sağlıklı birey kontrol grubu olarak çalışmaya alınmıştır. Hastaların 18’inin malign patolojisi varken 82’sinin patolojisi benign idi. Malign hasta grubu, benign hasta grubu ve kontrol grubu hemogram tetkikinden oranlanarak elde edilen nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve sistemik immün inflamatuvar indeks parametreleri açısından karşılaştırıldı. Bulgular: Sistemik immün inflamatuvar indeks ve nötrofil/lenfosit oranı yönünden üç grup arasında anlamlı fark varken (p=0.006, p=0.000) trombosit/lenfosit oranı açısından gruplar arasında anlamlı farklılık gözlenmedi (p=0.285). Gruplar sistemik immün inflamatuvar indeks ve nötrofil/lenfosit oranı açısından ikili olarak karşılaştırıldığında, kontrol grubu ile benign hasta grubu arasında (pÖğe Subclavian steal syndrome with otologic findings(Türkiye Klinikleri Yayınevi, 2020) Sizer, Bilal; Şimşek, Sadullah; Yılmaz, Ümit; Baylan, Müzeyyen YıldırımSubclavian "steal" syndrome is a condition that causes re-verse flow and changes in the flow pattern from the vertebral artery to the subclavian artery on the same side as a result of severe stenosis or ob-struction in the proximal section of the subclavian artery before deliv-ery to the vertebral artery. Subclavian steal syndrome is mostly asymptomatic due to collaterals to the head, neck and shoulders, but as a result of subclavian steal syndrome, neurotological symptoms can sometimes be seen due to vertebrobasias insufficiency as the verte-brobasilar arterial system feeds the peripheral, central auditory and vestibular systems. We found it appropriate to present a patient com-plained of tinnitus and hearing loss in the right ear, and we detected sub-clavian steal syndrome during the differential diagnosis we made based on these complaints. For this reason, patients with dizziness, hearing loss, or tinnitus should undergo a careful neurotological examination, and consideration given to a finding of vertebrobasilar insufficiency due to subclavian steal syndrome, although this is rarely seen.
