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Öğe Comparison of Video Head Impulse Test Results of Pediatric Patients with Dizziness with Healthy Volunteers(İstanbul Üniversitesi, 2022) Yılmaz, Eren; Yağcı, İbrahim; Kesimli, Mustafa Caner; Altundağ, AytuğObjective: The Video Head Impulse Test (V-HIT) is a non-invasive diagnostic test that evaluates the functions of the semicircular canals separately. This test records eye movements in response to head movements, and the vestibulo-ocular reflex gain (VOR-G) is calculated. V-HIT is frequently used in diagnosing adult patients and has been increasingly used in children in recent years. Indeed, V-HIT measurements may be useful in the diagnosis, especially in pediatric patients where vestibular pathologies are difficult to evaluate. In this study, V-HIT findings of pediatric patients with dizziness were examined, and the results were compared with healthy volunteers. Methods: Thirteen pediatric patients who applied to our clinic with dizziness and nine healthy children were included in the study. The necessary evaluations and radiological imaging were performed, and children diagnosed with any pathology were excluded. Each patient underwent GN Otometrics ICS Impulse V-HIT examination, and the results were recorded. The Video Head Impulse Test (v-HIT) results of children with vertigo were compared with those of healthy volunteers and analyzed. Results: The mean age of the patients included in the study was 10.5±3.5 years (range: 5-16). Five of these children were boys, and 8 were girls. In the control group, there were five girls and four boys, and their mean age was 9.3±3.9 years (range: 5-16). None of the children had any additional disease. When the groups were compared, the left anterior canal and left lateral canal VOR-Gs were significantly different between the patients and healthy volunteers (p=0.027 and p=0.007, respectively). No statistically significant difference was observed between the groups in terms of the right anterior canal, right lateral canal, left posterior canal, and right posterior canal VOR-G measurements (p=0.928, p=0.738, p=0.588, and p=0.780,). Conclusion: V-HIT, a non-invasive method for evaluating the etiology of vertigo in children, can be easily applied even in very young children. The use of glasses suitable for children will facilitate the procedure.Öğe Concha Bullosa as a Cause of Rhinological Halitosis(Istanbul University Press, 2024) Yılmaz, Eren; Kesimli, Mustafa Caner; Yağcı, İbrahim; Altundağ, AytuğObjective: Sinonasal diseases are one of the main causes of foul breath. Disruption of mucus drainage leading to bacterial putrefaction is the leading factor of volatile organic compounds (VOCs) production. Concha bullosa (CB) is also one of the factors affecting mucus drainage. Its effect on foul breath was investigated in this study. Materials and Methods: Sixty patients were included in the study. The participants were selected from those complaining of halitosis, who have CB formation on at least one side, and pathologic VOCs, hydrogen sulfide, methylmercaptan, and dimethylsulfide levels in their OralChroma measurements. The patients were divided into two groups. Surgery was applied to 32 patients, and no treatment was given to 28 patients. The VOCs levels were evaluated using OralChroma. Results: Sixty patients with a mean age of 36.5 years were included in the study. Before and after the operation of concha bullosa and also when the surgical group and control groups were compared, the decrease in methylmercaptan values was shown to be statistically significant (p<0.05). Conclusion: Concha bullosa should be considered in the etiology of halitosis in cases with no determined cause and high methylmercaptan values. © 2024, Istanbul University Press. All rights reserved.Öğe Endoscopic Endonasal Approach to a Giant Dentigerous Cyst(İstanbul Üniversitesi, 2022) Yılmaz, Eren; Altundağ, Aytuğ; Karamik, Pelin; Yıldırım, Düzgün; Behzatoğlu, KemalDentigerous cysts constitute 20% of all odontogenic cysts and are often located in the mandible and maxilla. They are often seen at young ages and in men. Patients are usually asymptomatic, and the diagnosis is established by dental radiographs in routine scans. Surgery is recommended for dentigerous cysts because ameloblastoma, intraosseous mucoepidermoid carcinoma, or intraosseous squamous cell carcinoma may develop from them. Generally the transoral route is preferred over the endoscopic route for dentigerous cysts located in the maxilla. In addition to the question of the transnasal versus oral approach to dentigerous cysts, another controversy is the removal or marsupialization of the entire cyst. In our 10-year-old male patient, a cyst that completely filled the right maxillary sinus and eroded the lateral and anterior wall of the maxillary sinus was treated with transnasal endoscopic surgery. The cyst wall and 3 permanent teeth were removed endoscopically. No post-operative complications were observed. The patient’s age and the location and size of the cyst play an important role in the choice of treatment. Furthermore, the most accurate way to choose the appropriate treatment is to make the treatment decision with a multidisciplinary approach.Öğe Functional and Olfactory Outcomes of Inferior Turbinate Hypertrophy Reduction with Laser, Radiofrequency, and Bipolar(Istanbul University Press, 2023) Kesimli, Mustafa Caner; Yılmaz, Eren; Altundağ, AytuğObjective: This study aims to compare the effects of bipolar cauterization, radiofrequency ablation, and laser reduction methods, which are frequently used for turbinate reduction, on recovery times and olfactory functions in the early postoperative period. Materials and Methods: The olfactory functions of all patients were preoperatively evaluated with the Sniffin’ Sticks test. To assess the effects on olfactory functions, olfactory tests were repeated in the third month after the operation. The patients were examined weekly, and the resolving time of the crusts was recorded. Results: The endoscopic turbinate reduction was performed with bipolar cautery in 50 patients, with radiofrequency ablation in 50 patients, and with laser ablation in 50 patients. There was no statistically significant difference between the techniques used regarding the severity of the olfactory function loss in the third month (p=0.546). It was observed that the resolving time of the crusts was the shortest in the group treated with the Holmium-YAG laser and the longest in the patients who underwent bipolar cautery (p<0.001). Parosmia persisted in only 9 patients in the postoperative third month (BP:7, RF:2, L:0) (p=0.049). In addition, it was determined that nasal dryness and pain (as assessed by visual analog score) were the most in the bipolar group (p=0.001 and p=0.005, respectively), and there was no significant difference between the laser and radiofrequency groups in terms of these symptoms (p=0.53 and P=0.96, respectively). Conclusion: Patients who underwent Holmium laser turbinate ablation had less crusting and less olfactory function loss in the early period compared to those who underwent radiofrequency and bipolar turbinate reduction. © 2023, Istanbul University Press. All rights reserved.Öğe Functional connectivity patterns in parosmia(BMC, CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND, 2023) Thaploo, Divesh; Joshi, Akshita; Yılmaz, Eren; Yıldırım, Düzgün; Altundağ, Aytuğ; Hummel, ThomasObjective Parosmia is a qualitative olfactory dysfunction presenting as“distorted odor perception” in presence of an odor source. Aim of this study was to use resting state functional connectivity to gain more information on the alteration of olfactory processing at the level of the central nervous system level. Methods A cross sectional study was performed in 145 patients with parosmia (age range 20–76 years; 90 women). Presence and degree of parosmia was diagnosed on the basis of standardized questionnaires. Participants also received olfactory testing using the “Snifn’ Sticks”. Then they underwent resting state scans using a 3 T magnetic resonance imaging scanner while fxating on a cross. Results Whole brain analyses revealed reduced functional connectivity in salience as well as executive control networks. Region of interest-based analyses also supported reduced functional connectivity measures between primary and secondary olfactory eloquent areas (temporal pole, supramarginal gyrus and right orbitofrontal cortex; dorsolateral pre-frontal cortex and the right piriform cortex). Conclusions Participants with parosmia exhibited a reduced information fow between memory, decision making centers, and primary and secondary olfactory areas.Öğe Modified Olfactory Training Is an Effective Treatment Method for COVID-19 Induced Parosmia(WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ, 2022) Altundağ, Aytuğ; Yılmaz, Eren; Kesimli, Mustafa CanerObjectives: Coronavirus disease (COVID-19) infection often causes olfactory dysfunction and parosmia may occur in some patients with olfactory dysfunction. In this study, we retrospectively investigated the effectiveness of modified olfactory training (MOT) for the treatment of COVID-19-induced parosmia. Study Design: This study presents results of MOT performed with 12 odors for 36 weeks in patients with olfactory dysfunction following COVID-19 infection. A total of 75 participants were included in the study (mean age 33 years, range 16–60 years). Methods: The patients were separated into two groups: 1) Treatment group consisted of parosmia patients who received MOT with three sets of four different odors sequentially. 2) Control group consisted of parosmia patients who did not perform any olfactory training. Both groups were matched for age and sex distribution of participants. TDI scores were compared at the time of application and at the end of the 9th month by the Sniffin’ Sticks Test. The results of the 0th and 9th months were recorded by applying the parosmia assessment scale to both groups. The results were analyzed statistically, and p < 0.05 was considered significant. Results: When the treatment group and the control group were compared, a significant improvement was observed in both groups at the third, sixth, and ninth month, however the improvement in the treatment group was found to be better than in the control group (P < .001). Extending the treatment from 6 to 9 months in the treatment group was found to be effective in mitigating parosmia complaints and improving discrimination scores (P < .001). Conclusion: This study has shown that modified olfactory training is effective in the treatment of parosmia following COVID-19 infection.
