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Öğe Biocompatibility of vitallium as ossicular reconstruction material in the middle ear: experimental animal study(TAYLOR & FRANCIS AS, 2005) Ulku, CH; Avunduk, MC; Uyar, Y; Arbag, HConclusion. Although long-term data will be necessary for confirmation, the result of this preliminary study indicates that vitallium may be a good alternative material for ossicular replacement prostheses in the middle ear. Objectives. To investigate the biocompatibility of vitallium (Co-Cr-Mo) as ossicular reconstruction material in the rabbit middle ear, and to compare the results with those obtained with titanium, well known as a highly biocompatible material, and non-implanted control groups. Material and methods. Eighteen female New Zealand White rabbits were anesthetized. The tympanomeatal flap was elevated and 12 vitallium and 12 titanium implants were placed in the bulla away from the ossicles in 24 middle ears. Six rabbits were used as non-implanted controls. All animals were sacrificed under general anesthesia on the 180th day after implantation. The temporal bones were removed, fixed in 10% buffered paraformaldehyde and decalcified for a week in EDTA. Tissue samples were then prepared using an Autotechnicon and embedded in paraffin. Sections (30-mum thick) were cut with a microtome, stained with hematoxylin-eosin, von Gieson's stain and fibroblast growth factor (FGF) and examined under a light microscope. The numbers of lymphocytes, collagen fibers and FGF-positive cells were determined in all three groups. Results. There was no significant difference in the numbers of collagen fibers between the groups (P > 0.05). No significant differences were found in the numbers of lymphocytes and FGF-positive cells between the titanium and vitallium groups (p > 0.05). The differences in the numbers of lymphocytes and FGF-positive cells between the control and other groups were found to be significant (p < 0.05).Öğe Frequency of pharyngeal reflux in children with adenoid hyperplasia(ELSEVIER IRELAND LTD, 2005) Keles, B; Ozturk, K; Arbag, H; Gunel, E; Ozer, BObjectives: The purpose of the study is to investigate whether there is any association between pharyngeal reflux and adenoid hyperplasia by using 24-h esophageal pH monitoring with a dual probe in children. Methods: The study group consisted of 30 children with adenoid hyperplasia, and the control group consisted of 12 healthy children, studied prospectively. All children underwent 24-h esophageal pH monitoring with a dual probe (distal and proximal esophageal pH monitoring). The results were evaluated by the Measurement and Analysis Software of Medical Measurement System program (Version: 7.2a). Results: In the study group, the frequency of pharyngeal reflux was 46.7% and the gastroesophageal reflux (GER) was 64.5%, while, in the control group, they were 8.3% and 25%, respectively. There was a significant difference between study and control groups for frequencies of pharyngeal reflux and GER. Mean adenoid nasopharyngeal ratio (ANR) was 0.78 +/- 0.11 in children with adenoid hyperplasia. There was not a significant difference between positive pharyngeal reflux, positive GER and mean ANR (p > 0.05). Conclusions: Children with adenoid hyperplasia had higher frequency of pharyngeal reflux than children at the same age healthy group. These results supported that pharyngeal reflux may play an important rote in the etiology of adenoid hyperplasia. (c) 2005 Elsevier Ireland Ltd. All rights reserved.Öğe Increased expression of epidermal growth factor receptors in the tracheal epithelia after topical mitomycin-C in rabbits(ELSEVIER SCI LTD, 2005) Arbag, H; Avunduk, MC; Ozer, B; Ozturk, K; Ulku, CHThe aim is to examine histopathological changes and expression of epidermal growth factor receptor (EGFR) in tracheal epithelia caused by application of topical mitomycin-C (MMC) in rabbit model after the tracheotomy procedure. The conventional tracheotomy was performed in 16 rabbits. They were randomly divided into two equal groups. The first group was applied MMC at a concentration of 0.4 mg/ml around tracheotomy for 5 min, and the other group was not taken a treatment as a control. The animals were sacrificed at the end of 4 weeks. Their tracheas were evaluated with H&E and Masson's trichrome histochemically, and with antiepidermal growth factor receptor immunohistochemically. Results showed that there was no significant difference between MMC and control group for inflammatory cells (P = 0.09). The numbers of fibroblasts and subepithelial tissue thickness in the group exposed to MMC were significantly lower than the control group (P < 0.05). In contrast, the percentage of EGFR in the application of MMC group was significantly higher than the control croup (P < 0.05). The application of topical MMC on airway epithelia after tracheotomy showed significant elevation in the levels of epithelial EGFR expression compared to controls in a rabbit model. The activation of epithelial EGFR may facilitate epithelial healing, but further studies are needed to assess the effect of topical MMC on respiratory epithelia. (c) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe A modified technique to bypass the maxillary artery to supraclinoid internal carotid artery by using radial artery graft: an anatomical study(HEADLEY BROTHERS LTD, 2005) Arbag, H; Ustun, ME; Buyukmumcu, M; Cicekcibasi, AE; Ulku, CHObjective: This study aims to examine the use of a radial artery graft for bypass of the maxillary artery (MA) to the supraclinoid internal carotid artery (ICA) in treating ICA occlusions. Study design and setting: This method was carried out on five adult cadaver sides. The MA was reached 1-2 cm inferior to the crista infratemporalis, following a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally 2-3 cm lateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4 mm tipped drill. A radial artery graft was passed through the hole to the inside of the dura. Before giving the infraorbital artery branch, the MA was dissected from the surrounding tissue and transected. The proximal end of the graft was anastomosed end-to-end with the MA and the distal end of the graft end-to-side with the supraclinoid ICA. Results: The mean calibre of the MA was 2.6 +/- 0.3 mm. The mean calibre of the proximal end of the radial artery graft was 2.5 +/- 0.25 mm and the distal end was 2.35 +/- 0.2 mm. The mean length of the radial artery graft was 4.0 +/- 0.5cm. Conclusion: This study suggested that the cases with ICA occlusion, which require high blood flow, may be treated as an alternative to current bypass methods requiring long vein grafts.Öğe Pharyngeal reflux in children with chronic otitis media with effusion(TAYLOR & FRANCIS AS, 2004) Keles, B; Ozturk, K; Gunel, E; Arbag, H; Ozer, BObjective - To investigate whether there is an association between chronic otitis media (COM) with effusion and pharyngeal reflux in children by using 24-h pH monitoring with a dual probe. Material and Methods - This was a prospective study. The study group consisted of 25 children with COM with effusion and the control group comprised 12 healthy children. All children underwent 24-h esophageal pH monitoring with a dual probe ( distal and proximal esophageal pH monitoring). Results - In the study group, the frequencies of pharyngeal and gastroesophageal reflux (GER) were 48% and 64%, respectively, and the corresponding values in the control group were 8.3% and 25%. Both of these differences were significant (p< 0.05). In the study group, 28% of patients were positive for at least 1 symptom of GER; 72% of the patients did not have any symptoms but 56% of these patients had silent GER. Conclusions - These findings indicate that pharyngeal reflux may play an important role in the etiology of COM with effusion. If patients have typical symptoms of GER, such as pyrosis, regurgitation, dysphagia and emesis, the presence of GER should be considered. The presence of silent GER and pharyngeal reflux should also be considered.Öğe Postauricular subcutaneous leiomyosarcoma(ELSEVIER SCI LTD, 2004) Ozturk, K; Keles, B; Arbag, H; Yondemli, F; Avunduk, MMSuperficial leiomyosarcomas are rare soft tissue tumors, most frequently involving the lower extremity. Leiomyosarcomas which could be misdiagnosis or delayed are very rare in the head and neck region. In this report, a 46-year-old man with postauricular leiomyosarcoma was presented. The tumor was totally excised with 3 cm margins. Immunohistochemically, the specimen showed reactivity for smooth muscle actin, vimentin, and desmin. No complications developed in the postoperative period and the patient was free of recurrence at the 26 months follow-up. Immunohistopathological examination is essential for an accurate histological diagnosis. The ENT surgeon should pay attention to superficial leiomyosarcoma with its specific behavior and treatment while evaluating the lesions in the head and neck region. (C) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Submandibular gland mucocele: Report of two cases(MOSBY, INC, 2005) Ozturk, K; Yaman, H; Arbag, H; Koroglu, D; Toy, HSubmandibular gland mucocele should be remembered in the differential diagnosis of swelling at the submandibular triangle. In the cystic lesion of the submandibular area, the biochemical analysis of aspirated material for amylase should be performed. The cases with submandibular gland mucocele should be treated by removing the lesion with both the submandibular and the sublingual glands.Öğe Superficial temporal artery graft for bypass of the maxillary to proximal middle cerebral artery using a transantral approach: an anatomical and technical study(TAYLOR & FRANCIS AS, 2005) Arbag, H; Cicekcibasi, AE; Uysal, II; Ustun, ME; Buyukmumcu, MConclusion. Using a transantral approach, we examined a new bypass of the maxillary artery ( MA) to proximal middle cerebral artery ( MCA). The caliber of the MA was suitable to provide sufficient blood flow. The length of the graft was shorter and it had a straighter course in the new technique than in previously described techniques. Objective. To examine a new bypass of the MA to proximal MCA using a transantral approach as an alternative to other forms of anterior circulation bypass surgery. Material and methods. The method was applied to five adult cadavers bilaterally. The MA and its branches were easily found after removal of the posterior sinus wall using a transantral approach. Then, a hole was created in the sphenoid bone 5 - 6 mm lateral to the posteroinferior edge of the superior orbital fissure extradurally. After the carotid and sylvian cisternae had been opened, the M2 segment of the MCA was exposed. The MA was transected just before the origin of the descending palatine artery branch. After opening the dura over the hole, the MA was passed through the hole to reach the intracranial cavity. The proximal side of the superficial temporal artery graft was anastomosed end- to- end with the MA and the distal side was anastomosed end- to- side with the M2 segment of the MCA. Results. The mean caliber of the MA was 2.4 +/- 0.3 mm before the origin of the descending palatine artery branch. The mean caliber of the largest trunk of the M2 segment of the MCA was 2.3 +/- 0.3 mm. The average length of the graft was 24 +/- 3 mm.
