Browsing by Author "Yildirim, Nadir"

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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.
Dissecting Firearm Injury To the Head and Neck With Non-Linear Bullet Trajectory: a Case Report
(Elsevier Ireland Ltd, 2010) Can, Muhammet; Yildirim, Nadir; Atac, Gokce Kaan
Firearm injuries to the head and neck have a potential for fatal complications caused by damage to neurovascular structures in the region. We herewith present a case of a missile injury to the face, caused by a bullet from a rifle with high muzzle energy that slackened while penetrating a vehicle before hitting the victim. The bullet advanced through the retrofacial spaces following a non-linear course and was retained within the opposite parapharyngeal region without injuring any vital structure. The resultant damage was a 'low-velocity injury'. However, it is noteworthy that the missile had still retained enough energy to penetrate the tissue and travel in a 'dissecting' fashion. It is likely that the blunting of the missile during vehicle penetration and the compactness of the anatomical structures bordering the head and neck spaces, such as fascia and tendons, forced the projectile to follow a non-linear inter-structural path. This case yet again demonstrates that the magnitude of firearm-related tissue damage may also depend upon the shape of the projectile and confirms that the head and neck spaces have anatomical integrity rather than just being arbitrarily designated topographical areas. It has also been confirmed that non-surgical approach with regular follow-ups is a viable option for uncomplicated head and neck injuries. (C) 2010 Elsevier Ireland Ltd. 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.
Sensorineural Hearing Loss After Ossicular Manipulation and Drill-Generated Acoustic Trauma in Type I Tympanoplasty With and Without Mastoidectomy: a Series of 51 Cases
(vendome Group Llc, 2015) Kazikdas, K. Cagdas; Onal, Kazim; Yildirim, Nadir
Recognized causes of high-frequency sensorineural hearing loss (SNHL) after tympanoplasty with and without mastoidectomy include acoustic trauma from manipulation of the ossicles, the noise generated by suctioning and, in the case of mastoidectomy, the noise generated by temporal bone drilling. We conducted a retrospective study to identify the effects of ossicular manipulation and mastoid drilling on high frequency SNHL. Our study population was made up of 51 patients-20 males and 31 females, aged 10 to 59 years (mean: 28.5). Of this group, 26 patients had undergone a unilateral over-under tympanoplasty only (tympanoplasty group) and 25 had undergone a unilateral tympanoplasty plus additional mastoid surgery (mastoidectomy group). Bone-conduction audiograms were obtained pre- and postoperatively; the latter were obtained within 24 hours after surgery and again at 6 months of follow-up. In the tympanoplasty group, a significant SNHL, primarily at 2 kHz, was seen in 6 patients (23%) at 24 hours, but at 6 months there was no depression of bone-conduction thresholds. In the mastoidectomy group, a significant SNHL, primarily at 2 and 4 kHz, occurred in 12 patients (48%) at 24 hours, and bone-conduction deterioration was still present in 4 patients (16%) 6 months after surgery. The difference between the preoperative audiograms and the 6-month audiograms in both groups was statistically significant (p = 0.034). We conclude that (1) over-under tympanoplasty, which requires significant manipulation of the ossicles, can cause temporary SNHL after surgery, and (2) prolonged exposure to the noise generated by mastoid drilling can result in permanent SNHL.
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.