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Kum R.O.,Ankara Numune Education and Research Hospital ENT Clinic | Ozcan M.,Ankara Numune Education and Research Hospital ENT Clinic | Baklaci D.,Ankara Numune Education and Research Hospital ENT Clinic | Yurtsever Kum N.,Ankara Numune Education and Research Hospital ENT Clinic | And 3 more authors.
Brazilian Journal of Otorhinolaryngology | Year: 2015

Introduction: Several theories attempt to explain the pathophysiology of sudden hearing loss. Objective: The objective of this study was to investigate the possible role of inflammation and atherothrombosis in sudden hearing loss patients through the neutrophil-to-lymphocyte ratio and mean platelet volume. Methods: Study design - retrospective cross-sectional historical cohort. This study was conducted on two groups: one with 59 individuals diagnosed with sudden hearing loss, and other with 59 healthy individuals with the same characteristics of gender and age distribution, neutrophil-to-lymphocyte ratio and mean platelet volume levels were measured in patients diagnosed with sudden hearing loss as well as in the control group, and it was verified whether these results interfered for a better or worse prognosis with treatment of sudden deafness. Results: Neutrophil-to-lymphocyte ratio levels are much higher in patients diagnosed with sudden hearing loss compared to the control group. Similarly, mean levels of neutrophil-to-lymphocyte ratio are higher in non-recovered versus recovered patients (p= 0.001). However, we could not find a correlation with mean platelet volume levels (p>. 0.05). Conclusion: Neutrophil-to-lymphocyte ratio is a quick and reliable indicator regarding diagnosis and prognosis of sudden hearing loss; on the other hand, mean platelet volume may be considered a less important indicator in this aspect. © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.


Kum R.O.,Ankara Numune Education and Research Hospital ENT Clinic | Ozcan M.,Ankara Numune Education and Research Hospital ENT Clinic | Yurtsever Kum N.,Ankara Numune Education and Research Hospital ENT Clinic | Ylmaz Y.F.,Ankara Numune Education and Research Hospital ENT Clinic | And 3 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2015

The aim of this study was to suggest a new cutoff score for the Turkish version of Epworth Sleepiness Scale (ESS) in the patients with obstructive sleep apnea. In this study, the data of 483 patients who were admitted to our clinic with the complaints of daytime sleepiness and witnessed sleep apnea were reviewed retrospectively. The correlation between ESS and polysomnography (PSG) findings were assessed, and cutoff score of the Turkish version of the ESS was investigated. The mean apnea-hypopnea index (AHI) was 27.71 ± 26.69 eV/h, the mean ESS score was 8.42 ± 4.88. According to AHI, a statistically significant difference between ESS scores was detected (p = 0.001; p < 0.01). According to AHI (AHI ≥ 5, AHI ≥ 15 and AHI ≥ 30) the best cutoff score for ESS score was found as 8. The answers that were given to the ESS questions differ according to their sociocultural and economic condition. These results indicate that a score of 8 or higher on the ESS would seem a more appropriate cutoff score to suspect clinically relevant sleepiness in the Turkish population. © 2014, Springer-Verlag Berlin Heidelberg.


Yilmaz Y.F.,Ankara Numune Education and Research Hospital ENT Clinic | Kum R.O.,Ankara Numune Education and Research Hospital ENT Clinic | Ozcan M.,Ankara Numune Education and Research Hospital ENT Clinic | Gungor V.,Ankara Numune Education and Research Hospital ENT Clinic | And 2 more authors.
Laryngoscope | Year: 2015

Objective/Hypothesis This study aimed to compare application of the Müller maneuver (MM) and application of drug-induced sleep endoscopy (DISE) prior to surgery, in addition to MM, to further ascertain the location of an obstruction in the upper airway and whether the location would change the surgical treatment plan in patients with retropalatal obstruction. Study Design Prospective, clinical trial at a tertiary referral hospital. Methods This study included 39 obstructive sleep apnea patients who were recommended for surgical treatment. Patients were randomly divided into two groups: The first group (DISE plus MM) underwent a DISE (19 patients), in addition to the planned procedure according to MM. Meanwhile, the second group (MM only) underwent surgery based only on their MM evaluation (20 patients). Patients with retrolingual-localized obstructions were excluded, whereas patients with≥third-degree obstructions at the retropalatal level, according to DISE and/or MM, were included in the study. Results There was a significant improvement between pre- and postoperative polysomnography findings in both groups. However, the postoperative improvements between the groups were not statistically different. Because there was a significant change in the planned surgical procedures in the first group, there were significantly more combined surgeries followed by the DISE procedure. Conclusions Although the DISE resulted in more changes in the surgical treatment plan and higher rate of combined treatment compared to MM, we determined that this difference did not result in a significant difference in treatment success. Level of Evidence 4. Laryngoscope, 125:2220-2225, 2015 © 2015 The American Laryngological, Rhinological and Otological Society, Inc.


Kum R.O.,Ankara Numune Education and Research Hospital ENT Clinic | Ozcan M.,Ankara Numune Education and Research Hospital ENT Clinic | Baklaci D.,Ankara Numune Education and Research Hospital ENT Clinic | Kum N.Y.,Ankara Numune Education and Research Hospital ENT Clinic | And 3 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2014

Background: Laryngeal carcinogenesis is a multifactorial process that has not been fully elucidated. Despite extensive research, reliable markers with diagnostic and prognostic value are still lacking. It was recently reported that an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) may correlate with an increased risk of recurrence, tumor aggressiveness and poorer prognosis in various malignancies. The aim of this study was to examine whether NLR could be used as an inflammatory marker to differentiate laryngeal squamous cell carcinoma (LSCC) patients from benign laryngeal lesion (BLL) and precancerous laryngeal lesion (PLL) patients. Materials and Methods: This retrospective study was performed on 209 patients admitted to a tertiary referral center with laryngeal lesions and undergoing biopsies to establish their histopathological diagnosis. We reviewed the patient files for their clinical, histopathological and laboratory data. The patients were divided into three groups according to their histopathological findings, as BLL, PLL and LSCC groups. The patients in the PLL group were also divided into three subgroups as mild, moderate and severe dysplasia/ carcinoma in situ (CIS) subgroups. The groups were compared for NLR and the other laboratory data. Results: The mean NLRs of the BLL, PLL and the LSCC groups were 2.12±0.86, 2.32±0.68 and 3.46±1.51, respectively, and the difference was statistically significant (p=0.001). The mean NLRs of the patients with PLL and LSCC were significantly higher than the patients with BLL (p=0.031 and p=0.001, respectively). The mean NLRs were similar among mild dysplasia, moderate dysplasia and severe dysplasia / CIS groups (p>0.05). Conclusions: To our knowledge, this is the first study investigating NLR in BLL, PLL and LSCC. NLR is an inexpensive, reproducible and widely available blood test, and could be a useful inflammatory marker to differentiate LSCC from BLL and PLL.


Uysal G.S.,ENT Clinic Konya | Ozcan I.,ENT Clinic | Ozcan K.M.,Ankara Numune Education and Research Hospital ENT Clinic | Selcuk A.,ENT Clinic | And 3 more authors.
Journal of International Advanced Otology | Year: 2013

Purpose: The purpose of this study is to research the effect of including the hyperbaric oxygen therapy in medical treatment protocol in sudden hearing loss (SHL). Materials and Methods: Seventy-three patients suffering from SHL with a loss of 30 dB and over in three successive frequencies, who were treated in our clinic were put into two groups, were included in the retrospective study. Thirty-four patients in the first group were given papaverine and corticosteroid treatment. Antiviral therapy was added to 12 patients within this group, due to a history of the existence of upper respiratory infection (URI), which had been present over the previous 14 days. Thirty-nine patients in the second group were given papaverine and corticosteroid treatment, and antiviral therapy was added to 18 patients with a history of URI that had been present over the previous 14 days. Between the 6th and 16th days, patients received hyperbaric oxygen therapy (HBOT). An audiological examination of patients was carried out prior to treatment, and at five days, seven days, one month, and three months after the treatment. Patients in both groups were compared in terms of hearing gain. Results: In a comparison of the two groups, it was determined that both groups were correlated with each other in terms of age (p=0.55), gender (p=0.39), seasonal distribution (p=0.39), duration of hearing loss (p=0.51), presence of tinnitus (p=0.48), and vestibular symptom existence (p=0.82), and there was no difference between groups. A statistically significant change was determined in hearing following treatment in the first group, in comparison to the pre-treatment period (p=0.01). A statistically significant change was also determined in hearing following treatment in the second group, in comparison to the pre-treatment period (p=0.01).Following the comparison of hearing gain of both groups, a no statistically significant difference could found (p=0.89) Discussion: It is believed that many factors exist in the etiology of SHL. Among those, vascular, immunologic, and viral factors were discussed in particular in many studies, and the role of these factors in etiology was not elucidated, although they were frequently regarded as responsible for the development of SHL. Therefore, combining the agents directed to vascular, immunologic, and viral etiology in SHL treatment became an acceptable approach. The combined treatment modality based on the principle of simultaneous usage of more than one agent in SHL treatment was also supported with the results of our study, and is thought to be a highly effective practice. Conclusion: It is believed that the treatment protocol including papaverine, corticosteroid, antiviral agents, and HBOT have a significant effect on the results of SHL treatment. Although including HBOT in medical treatment was observed to provide a hearing gain within the group, following the comparison of both groups, it was determined that it did not cause a statistically significant difference on the results, and more comprehensive and prospective studies are required regarding this subject. Copyright 2005 © The Mediterranean Society of Otology and Audiology.

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