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Article Citation - Scopus: 2The Distribution of Geriatric Problems in Otolaryngology and Their Alteration From Young Adults(Wolters Kluwer Medknow Publications, 2021) Onay, O.; Aydin, C.Background: Many changes occur in human physiology with aging, and as expected complaints of geriatric patients differ from the other age groups in population. Aims: The objective of the study was to investigate the common complaints of geriatric patients attending to an otolaryngology clinic (ENT clinic), and to compare their complaints with the 18-65 years aged patients'. Materials and Methods: A total number of 41888 adult patients who visited the ENT clinic from 2015 to 2018 were retrospectively investigated. Patient complaints were scanned, and subcategorized as five groups (otologic/rhinologic/head and neck/ others/ neoplasias) and all data were evaluated. Results: Forty-one thousand, eight hundred and eighty-eight patients were included in the study, and 3946 of them were geriatric patients. The most frequent problem was otologic problems, followed by rhinologic problems among geriatric patients. However, rhinologic problems were the major complaint among the 18-65-year-old patients. A comparison of all the individual complaints bringing the geriatric patients to the ENT clinic revealed the three most frequent complaints: 1. hearing loss, 2. balance disorders, and 3. common cold. However, the three major complaints beyond nongeriatric adults were 1. tonsillopharyngeal disease, 2. common cold, and 3. inflammatory and infectious diseases of the sinuses, and these differences were statistically significant (P = 0.001*). Conclusion: It was found in this study that the five most frequently reported complaints of geriatric patients when applying to an ENT clinic are hearing loss, loss of balance, common cold, cerumen, and tonsillopharyngeal diseases. Unlike from nongeriatric population, otologic problems (most commonly hearing loss) were the essential ENT clinic complaints of geriatric patients.Article Citation - Scopus: 4Sedation With Propofol and Propofol.ketamine (ketofol) in Flexible Bronchoscopy: a Randomized, Double.blind, Prospective Study(Wolters Kluwer Medknow Publications, 2023) Ulutas,H.; Ucar,M.; Celik,M.R.; Agar,M.; Gulcek,I.Background: The flexible bronchoscopy procedure, which is performed in awake conditions or under local anesthesia, is a difficult and complicated procedure for patients and physicians. Propofol is a fast-acting sedative-hypnotic anesthetic with a rapid return. Ketamine hydrochloride is a fast-acting general anesthetic producing an anesthetic state characterized by deep analgesia, normal pharyngeal, and laryngeal reflexes. Materials and Method: The study was planned in a randomized, prospective, and double-blind design. The drug(s) administered by the anesthesiologist was not known to the bronchoscopist and the patient. A total of 64 cases were included in the study (34/propofol, 30/ketamine-propofol (ketofol) group). Group propofol received 0.1 mL/kg propofol, and group ketofol received 0.1 mL/kg ketofol intravenously over approximately 30 seconds. Vital signs, non-invasive blood pressure, peripheral oxygen saturation, and pulse values of all cases were measured three times and were recorded just before the start of the procedure, after entering the trachea, and after the procedure was terminated. The Visual Analogue Scale (VAS) and The Ramsay scoring were additionally used in the present study. Results: Statistically significant differences were detected between the groups in terms of blood pressure and heart rates. Statistically significant differences were detected between the two groups according to The VAS scoring and additional dose requirement. Conclusion: It must be noted that flexible bronchoscopy procedures, which are performed with local anesthesia by both the patient and the physician with a high degree of difficulty, especially combined drugs to be applied with anesthesia support, are more effective/comfortable/reliable, and have fewer complications and higher tolerability if there are no contraindications. © 2023 Wolters Kluwer Medknow Publications. All rights reserved.Article Citation - WoS: 19Citation - Scopus: 21Psychometric Properties of a Turkish Version of the Oral Health Impact Profile-14(Wolters Kluwer Medknow Publications, 2017) Balci, N.; Alkan, N.; Gurgan, C. A.Objectives: The purpose of this study was to analyze and evaluate a Turkish translation of the oral health impact profile-14 (OHIP-14) in a Turkish population to provide an objective standard for future studies. Methods: This cross-sectional research study consisted of three independent studies. Data were collected utilizing a personal interview and a review of periodontal records. This study was performed on 1205 subjects who were visiting for routine medical check-ups. The OHIP-14 was administered to measure oral health related to the quality of life, along with a questionnaire addressing demographic information, such as age, gender, and education. Results: The reliability coefficient (Cronbach's alpha) of the Turkish version OHIP-14-TR (OHIP-14-TR) was reported to be nearly perfect in all 3 parts of our study (alpha 1: 0.82; alpha 2: 0.76; alpha 3: 0.91); additionally, values were greater than the recommended 0.70 threshold. Spearman's correlation coefficients showed that both OHIP scores significantly correlated with periodontal parameters, serving as proof of convergent validity (P < 0.01, P < 0.001). The principal component analysis with varimax rotation revealed seven factors. The OHIP-14-TR was more than 95% comprehensible. Conclusion: The OHIP-14-TR is a reliable, valid, and comprehensible scale for measuring oral health-related quality of life in the Turkish population.Article Topographic Radioanatomical Analysis of the Singular Canal: Computed Tomography Study(Wolters Kluwer Medknow Publications, 2024) Demir, Berin Tugtag; Koksal, Ali; Cankal, FatihPurpose: The singular canal (SC) is where the singular nerve, a branch of the inferior vestibular nerve, which carries afferent information from the posterior semicircular canal (PSCC), passes and is important in the surgical approach of the presigmoid retrolabyrinthine. This study was carried out to evaluate the visibility of the SC on standard computed tomography (CT) images, its distance to the surrounding structures, and to investigate the variations of its anatomy and its relationship with the meatus acusticus internus.Materials and Methods: The study was carried out retrospectively using images of 194 temporal bones on temporal bone CT scans of 44 men and 53 women aged 18-65. In the study, various measurements were made, especially the presence of the SC, its length, its angle with the internal acoustic canal (IAC), and the distance between the internal acoustic pore (IAP) and the singular foramen. In addition, the presence of the high jugular bulb and PSCC dehiscence images were investigated.Results: The SC was detected in 85.1% of the analyzed images. The mean canal length was 3.93 +/- 1.22 mm, the angle between the SC and the IAC was 22.68 degrees +/- 3.60 degrees, and the distance between the SC and the IAP was 7.70 +/- 0.83 mm. While no difference was found between the sides, it was determined that the length and diameter of the SC did not differ according to gender.Conclusion: Detailed morphometric analysis of the SC and a thorough understanding of its relationship with the IAC, vestibulum, and PSCC will help to accurately define the posterior and lateral borders of the dissection for this region.Article Citation - WoS: 4Citation - Scopus: 3Assessment of Pulmonary Arterial Hemodynamic and Vascular Changes by Pulmonary Pulse Transit Time in Patients With Human Immunodeficiency Virus Infection(Wolters Kluwer Medknow Publications, 2021) Erdol, Mehmet Akif; Acar, Burak; Ertem, Ahmet Goktug; Karanfil, Mustafa; Yayla, Cagri; Demirtas, Koray; Akcay, Adnan BurakIntroduction: Pulmonary arterial hypertension and human immunodeficiency virus (HIV) infection is a well-known association. Pulmonary pulse transit time (pPTT) is a recent echocardiographic marker that might be used for evaluation of pulmonary arterial stiffness (PAS) in patients with HIV infection. We aimed to investigate whether pPTT elevated in patients with HIV infection compared to healthy controls and its association with echocardiographic indices of right ventricular functions. Materials and Methods: Fifty HIV (+) patients from infectious disease outpatient clinics and fifty age- and sex-matched HIV (-) healthy volunteers were enrolled in this study. pPTT was measured from pulmonary vein flow velocity as the time interval between the R-wave in the electrocardiography and corresponding peak late systolic was then calculated as the mean from two separate pw-Doppler measurements. Results: pPTT, tricuspid annular peak systolic excursion (TAPSE) and right ventricle fractional area change (FAC) were significantly lower in patients with HIV than control patients (177.1 +/- 34.9 vs. 215.7 +/- 35.7 msn, P < 0.001; 2.33 +/- 0.28 vs. 2.19 +/- 0.22, P = 0.039; 45 [4.25] vs. 41.1 [4.0], P = 0.032, respectively). pPTT was positively correlated with FAC, TAPSE and cluster of differentiation 4 count (r = 0.210; P = 0.036, r = 0.256; P = 0.041, r = 0.304; P = 0.044, respectively). Conclusion: Our study showed that pPTT, TAPSE, and right ventricle FAC levels were lower in patients with HIV infection. pPTT is an important predictor in patients with HIV expected to develop pulmonary vascular pathology.Article Citation - WoS: 1Citation - Scopus: 1Utilising Uniportal Video-Assisted Thoracoscopic Surgery for Pericardial Window: A 12-Year Single-Centre Experience in the Diagnosis and Treatment of Pericardial Effusion(Wolters Kluwer Medknow Publications, 2025) Agar, Mehmet; Gulcek, Ilham; Kalkan, Muhammed; Ulutas, Hakki; Celik, Muhammet RehaIntroduction:Uniportal video-assisted thoracoscopic surgery (Uni-VATS) is an effective minimally invasive technique for pericardial drainage, biopsy and window creation in cases of pericardial effusion (PE).Patients and Methods:This retrospective study evaluated 73 patients with PE who underwent pericardial window procedures between 2012 and 2024. Intraoperative and post-operative data related to Uni-VATS were assessed.Results:The mean age of the patients was 53.79 +/- 17.79 years (10-82 years), with 34 (46.6%) females and 39 (53.4%) males. The mean volume of pericardial fluid drained after window creation was 446.23 +/- 199.81 cc (75-1100 cc). The mean operation time was 42.87 +/- 12.79 min, and chest drain removal occurred after an average of 1.8 +/- 1.2 days. The mean duration until discharge or referral to the follow-up clinic was 5.98 +/- 2.14 days. In addition to the pericardial window procedure, pleural biopsy was performed in 12 patients, mediastinal mass biopsy in eight patients and wedge resection for parenchymal nodules in six patients. Microbiologic and virologic cultures of the fluids were negative in all cases. Among the 41 patients with benign cytology, pericardial biopsy results indicated tuberculosis in four patients (5.4%), amyloidosis in one patient (1.3%) and chronic or subacute nonspecific pericarditis in the remaining patients.Conclusion:Uni-VATS is a novel and safe technique that may be the preferred choice for pericardial window due to its diagnostic and therapeutic efficacy, ability to perform simultaneous procedures, favourable impact on operation duration/hospital stay, low complication rates and superiority compared to traditional methods.Article Randomised Comparison Between Navigation and Non-Navigation Camera Control Performance in a Surgical Simulation Task Using a Haptic Device Interface(Wolters Kluwer Medknow Publications, 2026) Cagiltay, Nergiz Ercil; Topalli, Damla; Tuner, Emre; Berker, MustafaIntroduction:Navigation skills for controlling the camera in the surgical field are critical for many minimally invasive surgery (MIS) procedures. Currently, endoscopes lack integrated navigation aids, making camera control a challenging task. This experimental study aims to investigate the effect of navigation guidance on the performance of beginners.Patients and Methods:A custom computer-based simulation environment was developed for this study, featuring two conditions - one with navigation guidance and one without - focussed on a camera-cleaning task. Participants (64 beginners) were randomly assigned to one of these groups and used two haptic devices to simulate the endoscope and surgical tools.Results:Participants in the guided condition performed significantly better than those in the unguided condition. Notably, female participants completed the task in significantly less time under the guided condition compared to the unguided one.Conclusion:These findings suggest that incorporating navigation aids into endoscope interfaces could improve user performance, especially for beginners. Medical device manufacturers should consider adding navigation features to enhance usability. In addition, simulation-based instructional systems should integrate navigation aids to better support surgical training.Article Evaluation of Diaphragmatic Omental Hernias by Radiology: a Prevalence Study(Wolters Kluwer Medknow Publications, 2022) Cankal, Fatih; Demir, Berin T.; Koksal, AliINTRODUCTION: This study aimed to describe the radiological features of omental hernias originating from the diaphragm and their localization on the diaphragm, examine their relationship with the thoracic and abdominal organs, and present guiding data to clinicians in operational planning. MATERIALS AND METHODS: This study was obtained as a result of retrospective scanning of the images of 824 patients aged 18-65 who applied for thorax and/or upper abdomen computerized tomography (CT). The patients' thorax and upper abdomen regions were examined in detail and divided into two groups of individuals with and without hernias. Hernia types, content, localization, and effect types of patients with hernia were recorded and analyzed separately. RESULTS: Diaphragmatic hernia was detected in 197 (23.9%) of 824 patients. While 50.8% of these patients were female, 49.2% were male. Of the patients diagnosed with diaphragmatic hernia, 49.2% (n = 97) had Morgagni hernia, 30.5% (n = 60) had Bochdalek hernia, and 17.8% had hiatal hernia. While Morgagni hernia had anterior localization in 82.5%, Bochdalek hernia was generally localized on the left side (75.8%), and hiatal hernias were sliding type with a rate of 84.2%. The highest effect was observed in Bochdalek hernias (71.1%). Omental tissue (59.4%) was observed most frequently in Morgagni hernias, while stomach content (91.9%) was found to be the highest in hiatal hernias (P < 0.05). DISCUSSION-CONCLUSION: Diaphragmatic omental hernias are rare. The rarity, as well as the uncertain and nonspecific presentations, contributes to the retard in diagnosis. Commonly, the presentation in the adult age group is that of recurrent chest infection and rarely with gastroesophageal reflux and esophagitis. Physicians caring for these patients should be aware of this, and a high index of suspicion is recommended to obviate delay in diagnosis with its associated morbidity. We think the radiological features of diaphragmatic hernias should be detailed in determining and applying the optimal treatment approach. In addition, contrary to what was thought, we found that the prevalence of diaphragmatic hernia in our population is higher than that reported in the literature.Article Citation - WoS: 9Citation - Scopus: 11Using Deep Learning Approaches for Coloring Silicone Maxillofacial Prostheses: a Comparison of Two Approaches(Wolters Kluwer Medknow Publications, 2023) Kurt, Meral; Kurt, Zuhal; Isik, SahinAim: This study aimed to compare the performance of two deep learning algorithms, attention-based gated recurrent unit (GRU), and the artificial neural networks (ANNs) algorithm for coloring silicone maxillofacial prostheses. Settings and Design: This was an in vitro study. Materials and Methods: A total of 21 silicone samples in different colors were produced with four pigments (white, yellow, red, and blue). The color of the samples was measured with a spectrophotometer, then the LFNx01, aFNx01, and bFNx01 values were recorded. The relationship between the LFNx01, aFNx01, and bFNx01 values of each sample and the amount of each pigment in the compound of the same sample was used as the training dataset, entered into each algorithm, and the prediction models were obtained. While generating the prediction model for each sample, the data of the corresponding sample assigned as the target color were excluded. LFNx01, aFNx01, and bFNx01 values of each target sample were entered into the obtained models separately, and recipes indicating the ratios for mixing the four pigments were predicted. The mean absolute error (MAE) and root mean square error (RMSE) values between the original recipe used in the production of each silicone and the recipe created by both prediction models for the same silicone were calculated. Statistical Analysis Used: Data were analyzed with the Student t-test (alpha=0.05). Results: The mean RMSE values and MAE values for the ANN algorithm (0.029 & PLUSMN; 0.0152 and 0.045 & PLUSMN; 0.0235, respectively) were found significantly higher than the attention-based GRU model (0.001 & PLUSMN; 0.0005 and 0.002 & PLUSMN; 0.0008, respectively) (P < 0.001). Conclusions: Attention-based GRU model provided better performance than the ANN algorithm with respect to the MAE and RMSE values.
