Browsing by Author "Sahan, Murat"

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Carcinoid Tumor of the Middle Ear
(W B Saunders Co-elsevier inc, 2008) Sahan, Murat; Yildirim, Nadir; Arslanoglu, Atilla; Karslioglu, Yidirim; Kazikdass, Kadir Cagdas
Carcinoid tumor of the middle ear is an extremely rare lesion of the middle ear, and thus its diagnosis is frequently delayed. Some authors found it hard to differentiate middle ear carcinoid front the middle car adenoma. However, the balance of opinion is currently oil the side of considering it as a separate clinical entity. Definitive diagnosis is made by identifying neurosecretory tumor cells using immunohistochemistry and electron microscopy. It usually follows a nonaggressive clinical course, rarely metastases, and infrequently recurs after radical excisions. We present a patient with middle ear carcinoid, who is free of disease 2 years after the resection of the tumor mass with canal walldown procedure. The relevant literature is also herewith reviewed. (C) 2008 Elsevier Inc. All rights reserved.
Klippel-Feil Syndrome and Associated Ear Anomalies
(W B Saunders Co-elsevier inc, 2008) Yidirim, Nadir; Arslanoglu, Atilla; Mahirogullari, Mahir; Sahan, Murat; Ozkan, Huseyin
Background and purpose: Klippel-Feil syndrome (KFS) is a congenital segmentation anomaly of the cervical vertebrae that manifests as short neck, low hair line, and limited neck mobility. Various systemic malformations may also accompany the syndrome including wide variety of otopathologies affecting all 3 compartments of the ear (external, middle, and inner ear) as well as internal acoustic canal and vestibular aqueduct. We aimed to investigate these involvements and their clinical correlates in a group of patients with KFS. Materials, methods, and results: We present 20 KFS cases, of which 12 (% 60) displayed most of the reported ear abnormalities such as microtia, external ear canal stenosis, chronic ear inflammations and their sequels, anomalies of the tympanic cavity and ossicles, inner car dysplasies, deformed internal acoustic canal, and wide vestibular aqueduct, which are demonstrated using the methods of otoscopy, audiologic testing, and temporal bone computed tomography. Conclusions: This series represents one of the highest reported rate of ear involvement in KFS. We found no correlation between the identified ear pathologies and the skeletal and extraskeletal malformations. The genetic nature of the syndrome was supported by the existence of affected family members in 4 (20%) of the cases. (C) 2008 Elsevier Inc. All rights reserved.
Primary Cholesteatoma Within the Stenotic Ear Canal: Report of Two Cases, One With Extra-Temporal Complications
(Mediterranean Soc Otology & Audiology, 2009) Yildirim, Nadir; Sahan, Murat; Akkaya, Abdullah
Congenital aural stenosis can be complicated with primary cholesteatomas which may be overlooked until the occurrences of resultant complications or incidentally diagnosed during or before corrective surgeries. In this report, samples of both "complicated" and "occult" types of cholesteatomas associated with aural stenosis are presented with the aim of illustrating their clinical course and shedding light on their possible pathogenesis. We herewith report 2 patients with congenital aural stenosis who developed cholesteatoma related to the external ear canal (EEC) stenosis. One of the cases, had previously undergone craniotomy for intracranial complication of the disease, and also had postauricular fistula, whereas in the second patient it was silent and confined within the relatively enlarged stenotic ear canal in front of a rudimentary tympanic membrane. In the first case cholesteatoma was removed with mastoidectomy in the first phase and then atresioplasty was carried out with tympanoplasty. In both cases, a novel two-stage technique was used for EEC reconstruction with success. Congenital aural stenosis predisposes cholesteatoma most likely due to entrapping of the squamous epithelium within the stenotic EEC or tympanum, and these cases were more prone to the extra-tympanic complications of cholesteatoma than those with the normal EEC. In conclusion, otologists should hold a high grade of suspicion of cholesteatoma in a patient with stenotic EEC, and their presence should be ruled out prior to any definitive corrective surgery.
Rhinolithiasis: Clinical, Radiological, and Mineralogical Features
(Ocean Side Publications inc, 2008) Yidirim, Nadir; Arslanoglu, Atilla; Sahan, Murat; Yidirim, Altan
Background: Rhinolithiasis is a rare and under-diagnosed clinical entity whose etiology and pathogenesis is poorly understood. Objective: The objective of the study is to review the clinical and radiologic features of rhinolithiasis and mineralogical-chemical composition of the rhinoliths with the aim of shedding light on its etiology and pathogenesis. Methods: Our subjects consisted of 8 rhinolithiasis cases. Clinical presentations, signs, and symptoms of the patients with radiologic findings are presented, and X-ray diffraction analyses of the stones were carried out to assess their mineralogical composition. Results: Nasal obstruction appeared to be the chief symptom, followed by nasal discharge and facial pain. Neither exogenous nor endogenous nidi were identified in any of the cases. Mineralogical analyses of the rhinoliths revealed Whitlockite [(Ca,Mg)3 (PO4)2] in one and Dahllite [Ca5 (PO4,CO3)3OH] in 7 cases. Conclusion: We hypothesized that some substances or organic objects form the nidi of the rhinoliths and are disintegrated over the course of mineral precipitation. This hypothesis was supported by radiologic and microscopic findings.
Two-Stage Aural Atresia and Stenosis Surgery With the Use of Synthetic Skin Substitute
(Taylor & Francis Ltd, 2009) Yildirim, Nadir; Sahan, Murat; Kasapoglu, Fikret
Conclusion. With this technique, patency rates achieved in congenital external ear canal (EAC) atresia/stenosis and improvement in hearing were evaluated as 'good' and 'satisfactory', respectively. Objectives. We aimed to test the efficacy of a novel two-stage technique in preventing restenosis following atresioplasty. Patients and methods. Nine patients with congenital EAC atresia/stenosis comprised our cases. We performed 10 atresioplasties using the two-stage technique described below. In the first stage, the ear canal is drilled and its wall is covered with a synthetic skin replacement that induces proliferation of a soft tissue; in the second stage this is lined underneath with split thickness skin graft. Operations were complemented with tympanoplasties in five of the patients. Results. Nine (91%) of 10 operations carried out with the technique were largely successful in terms of patency. The achieved average hearing gain was air conduction/bone conduction (Ac/Bc): 31.33/9.44 dBHL (21.89 in the air-bone gap), while the postoperative air-bone conduction gap was changed to <30 dBHL in eight (88.9%) of the patients.