Hale Aslan

Ankara Atatürk Training and Research Hospital, Engüri, Ankara, Turkey

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Publications (15)11.99 Total impact

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    ABSTRACT: To present the results of the traumatic intratemporal facial nerve injury that have undergone facial nerve decompression by using middle cranial fossa (MCF) approach.
    The Journal of craniofacial surgery. 07/2014; 25(4):1305-1308.
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    ABSTRACT: Objective We investigated the relationship between facial canal dehiscence and intraoperative middle ear and mastoid findings in patients operated on for cholesteatoma. Methods We examined retrospectively 334 patients who had been operated on for cholesteatoma in Izmir Katip Celebi University, Ataturk Research and Training Hospital, ENT Clinic, between April 1997 and April 2010. The patients were examined for facial canal dehiscence according to age, gender, side of the ear , surgery type, first or revision surgery, localization of the facial canal dehiscence, spread of the cholesteatoma, with the presence of lateral semi-circular canal (LSCC) fistula and any defect in the ossicle chain, and destruction in the posterior wall of the external auditory canal(EAC). Results Of the patients, 23.6% had facial canal dehiscence and detected most commonly in the right ear 28,9% and tympanic segment, 83.5% . Facial canal dehiscence was found to be 24.2-fold more common in patients with LSCC fistula and 4.1-fold more common in patients with destruction in the posterior wall of the (EAC). In patients located cholesteatoma in tympanic cavity + antrum and the tympanic cavity + all mastoid cells and with incus and stapes defect, increased incidence of dehiscence. Age, first or revision operation and canal wall down tympanoplasty (CWDT) or canal wall up tympanoplasty(CWUT) did not affect the incidence of dehiscence. Conclusions That the likelihood of facial canal dehiscence occurrence is increased in patients with LSSC fistulas, destruction in the posterior wall of the EAC, or a stapes defect is important information for surgeons.
    American Journal of Otolaryngology 04/2014; · 1.23 Impact Factor
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    ABSTRACT: Abstract Conclusions: Vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique is an effective and durable procedure for the management of patients with bilateral vocal fold immobility. Objectives: To review the long-term results of bilateral vocal fold immobility in 26 patients treated with vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique over a 6-year period. Methods: This retrospective study examined patients with a minimum follow-up of 1 year. The main outcome measures used were the modified Medical Research Council (MRC) dyspnoea scale and the assessment of voice quality pre- and postoperatively using the Likert method. Results: The mean follow-up period was 23.77 ± 12.01 months. All patients reported marked symptomatic improvement in dyspnoea (p = 0.0001). The voice quality worsened as expected; however, this difference did not reach a significant level (p = 0.642). Transient microaspiration was noted in seven of the patients and resolved in 1 or 2 days. The procedure was performed for the contralateral vocal fold in one case, due to the loss of suture tension. No patient showed aspiration postoperatively or during follow-up. All patients were regularly followed up for the beginning of movement of the lateralized or contralateral vocal folds in our outpatient clinic.
    Acta oto-laryngologica 11/2013; 133(11):1201-1206. · 0.98 Impact Factor
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    ABSTRACT: This study evaluated the outcome in adult patients with laryngotracheal stenosis (LTS) and assessed the effect of procedures on their quality-of-life scores. The study included 15 adult patients with LTS (11 males [73.3%], 4 females [26.7%]; mean age, 32 years [range, 10-52 years]) treated at the Department of Otolaryngology Head and Surgery Clinic, İzmir Atatürk Research Hospital, Turkey, from 1997 to 2008. Success of the surgery is evaluated by decanullation rate, Short form-36 (SF-36), and the Medical Research Council dyspnea scale. The etiology of the LTS was intubation related in 14 cases (93.3%) and idiopathic in 1 case. According to the Myers-Cotton classification, 2 (13%), 8 (54%), and 5 (33%) patients were at stages 2 to 4, respectively. Fourteen patients had a mean follow-up of 57 months (range, 24-256 months). The stenotic segment involved 1 to 3 cm (mean, 1.7 cm) of trachea, and 2 to 5 tracheal rings (mean, 3.1) were resected. Postoperative decannulation was achieved in 13 patients (86.6%). In the short form-36 questionnaire, all of the parameters except for "role-emotional" were found to be significant (P < 0.01). The Medical Research Council dyspnea scale assessment revealed a significant (P < 0.001) decrease postoperatively. Segmental resection with primary anastomosis is an effective method and can be used as the first option in selected cases of advanced stenosis.
    The Journal of craniofacial surgery 09/2013; 24(5):1716-9. · 0.81 Impact Factor
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    ABSTRACT: To investigate the ototoxic effect of boric acid solution prepared with different degree of alcohol. This study was performed on 28 young albino guinea pigs. After the animals divided four groups prior to the application of the solution an auditory brainstem response (ABR) test was applied to the each animal under general anesthesia. Their tympanic membranes perforated and test solutions were administrated to the middle ear through the perforation. On 15th day, ABR measurements were carried out and comparison was made with preadministration values. The degrees of hearing loss occurring as a result of the administration of 4% boric alcohol solutions prepared with 60° and 40° alcohol differed significantly (p<0.001). It was established that 4% boric acid solution prepared with 60 alcohol affected hearing in guinea pigs more negatively and an increase in degree of alcohol also increased the ototoxicity of the boric acid solution.
    International journal of pediatric otorhinolaryngology 07/2013; · 0.85 Impact Factor
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    ABSTRACT: Objective: We present two cases with no evidence of local or systemic disease in which the defective long arm of the incus was replaced with fibrotic tissue connected to the stapes. Case reports: A 13-year-old girl with a unilateral hearing impairment in the left ear and a 26-year-old female patient presented with hearing loss in her right ear which had been present since childhood, without ear discharge, systemic disease, trauma, or familial history was found to have intact bilateral tympanic membranes during otoscopy. The air-bone gap (ABG) was found to be 58 db in two cases. The long arm of the incus was found to be defective up to the body, and a bridge to the stapes had formed intraoperatively. The stapes was intact and mobile. Conclusion: Placing a gold-wire prosthesis between the malleus and the stapes. At 2 months post-operatively, the ABG was 10 db in two cases.
    International Journal of Pediatric Otorhinolaryngology Extra 01/2013; 8(1):e9–e11.
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    ABSTRACT: To evaluate the effectiveness of micronized flavonoid fraction in preventing cisplatin ototoxicity in a guinea pig model. This study was conducted on 23 guinea pigs in the Animal Laboratory of Izmir Atatürk Training and Research Hospital. Animals were divided into three groups: Group 1 consisted of eight animals receiving cisplatin only; Group 2 contained eight animals receiving cisplatin+micronized flavonoid fraction; and Group 3 contained seven animals that received micronized flavonoid fraction only. Their cochlear reserve was evaluated by measuring the distortion product otoacoustic emission on days 0 and 7. In Groups 1 and 2, the intragroup signal-noise ratios were statistically different at all frequencies tested (based on negative ranks, p<0.05). In Group 3, the intragroup signal-noise ratios did not differ significantly at the frequencies tested (p>0.05). Comparison of the three groups showed statistically significant differences among the groups (p<0.05). The post hoc Bonferroni correction showed statistically significant differences among all three groups (p<0.016). The median signal-noise ratio of the three groups tended to increase (z-value was positive for all the frequencies tested; p<0.01). Micronized flavonoid fraction (Daflon) is effective against cisplatin-induced ototoxicity in guinea pigs.
    International journal of pediatric otorhinolaryngology 07/2012; 76(9):1343-6. · 0.85 Impact Factor
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    ABSTRACT: Objective To describe 2 subapproaches of the middle fossa approach: the transillumination method and transection of lines using the foramen spinosum, greater superficial petrosal nerve, and trigeminal impression to locate the malleus head for safe identification and decompression of the geniculate ganglion and facial nerve. Study Design Cadaver study. Setting A tertiary university hospital anatomy laboratory. Subjects and Methods The present study was conducted using 7 formalin-fixed cadaver heads (14 sides). A 0° endoscope was introduced into the external ear canal toward the posterosuperior quadrant of the tympanic membrane, after which transillumination was used to locate the malleus head. The brightest point indicated the convergence of the greater superficial petrosal nerve and a line drawn along the superior semicircular canal. An additional line was drawn parallel to the petrous ridge from the foramen spinosum and along the pathway of the greater superficial petrosal nerve. A third line connected the trigeminal impression to the zygomatic root. The area posterior to the intersection of these 2 lines separately with the third line was considered the zone of location of the malleus head. Among 17 patients undergoing surgery for facial paralysis between 1993 and 2011, transillumination was used in 6 patients to identify the malleus head to locate the geniculate ganglion. Results These techniques were proven to be reliable in locating the malleus head to find the geniculate ganglion in 14 dissected cadaveric temporal bones. Conclusion Two methods of locating the malleus head for facial decompression were defined.
    Otolaryngology Head and Neck Surgery 06/2012; 147(5):907-11. · 1.73 Impact Factor
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    ABSTRACT: To investigate the histopathological changes and the expression of vascular endothelial growth factor (VEGF), inducible NO-synthase (iNOS), endothelial NO-synthase (eNOS), interleukin (IL)-1β, and IL-17 in the rabbit middle ear mucosa after direct gastric content exposure. Exploratory controlled study in which histological and immunochemical features were studied after gastric content-induced inflammation was established in rabbits. Sixteen healthy rabbits were divided into two equal groups. Gastric contents of an animal were injected into the middle ear of the same animal for 20 days. Saline was injected into the middle ear of the animals in the control group. The rabbits were humanely killed on day 27. Inflammation was assayed by light microscopy. Immunochemical staining was performed for VEGF, iNOS, eNOS, IL-1β, and IL-17 expression. Experimental and control animals were examined using the same protocol. The expression levels of VEGF, iNOS, IL-1β, and IL-17 differed significantly between the experimental and control groups (p=0.018, p=0.010, p=0.002, and p=0.002, respectively). The expression level of eNOS was not significantly different between the two groups (p=0.132). This study demonstrates that gastroesophagial reflux induced middle ear inflammation is associated with increased expression of VEGF, IL-1β, IL-17, and iNOS.
    International journal of pediatric otorhinolaryngology 01/2012; 76(1):64-9. · 0.85 Impact Factor
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    ABSTRACT: Head and neck squamous cell carcinomas readily metastasize to adjacent cervical lymph nodes. This is seen frequently in laryngeal squamous cell carcinoma (LSCC), and neck dissection may be performed in addition to excision of the primary lesion. The aim of this study was to define the frequency of level IIb metastasis to the lymph nodes in patients who underwent selective neck dissection because of LSCC. Cross-sectional study with planned data collection in a tertiary referral hospital. Eighty-one patients diagnosed with LSCC were accepted into the study. One hundred forty-eight neck dissection specimens were examined histopathologically, and those with level IIb metastasis were identified. The frequency of level IIb metastasis was evaluated in accordance with the primary tumor site, clinical N stage, central tumor presence, and T stage. Forty-seven of 81 patients were clinically N-, and 34 patients were clinically N+. Level IIb metastasis was seen in 5 (6%) of 81 patients, representing 5 of 148 neck dissection specimens. Two of these 5 patients were clinically N+ (6%), and 3 were clinically N- (6%). The relationship between level IIb metastasis and clinical N stage was not statistically significant (P ≥ .05). Likewise, no statistically significant relationships between the other parameters and level IIb involvement were found. Level IIb nodal involvement is very rare in LSCC. Therefore, the area can generally be preserved in elective neck dissection to lessen morbidity and, specifically, to avoid damaging the function of the spinal accessory nerve.
    Otolaryngology Head and Neck Surgery 12/2011; 146(3):390-4. · 1.73 Impact Factor
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    ABSTRACT: All patients treated with this new lateralization technique had a good quality of life and no dyspnea at rest or upon exertion. We believe that this technique is an important addition to the many surgical techniques for the treatment of bilateral vocal cord paralysis (BVCP). Most techniques used in the treatment of BVCP result in a prolapse of the laryngeal soft tissues into the endolarynx owing to Bernoulli's principle. We have developed a new lateralization technique to more effectively prevent this prolapse. The lateralization was initially tested on six cadaver larynges before being performed in five clinical cases with BVCP, who suffered from dyspnea at rest. Average follow-up was 17.6 months. As in type 1 thyroplasty, a rectangular piece of cartilage was excised horizontally from the thyroid lamina and placed on the defect in the vertical plane. Then, the vocal and ventricular folds were lateralized with crossing sutures, particularly in the posterior region. Dyspnea was eliminated postoperatively. All patients were successfully decannulated. Postoperative voice quality was socially acceptable. Airways were improved postoperatively, as evaluated via fiberoptic laryngoscopy and CT. The mean preoperative and postoperative rima openings were 1.3 mm (range 0.5-2.6) and 6.4 mm (range 3.4-8.1), respectively.
    Acta oto-laryngologica 03/2011; 131(3):303-9. · 0.98 Impact Factor
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    ABSTRACT: To investigate levels of matrix metalloproteinases 2 and 9, and of their tissue inhibitor (i.e. tissue inhibitor matrix metalloproteinase 1), in the serum of patients with tympanosclerosis. We included 40 patients (age range 13-63 years) who had undergone surgery in the ENT department of Izmir Atatürk Training and Research Hospital between 2002 and 2007. Twenty had uncomplicated chronic otitis media and 20 had tympanosclerosis. We also included as the control group 20 individuals with no history of previous otic complaints or systemic or infectious disease. Serum levels of serum matrix metalloproteinases 2 and 9 and of tissue inhibitor matrix metalloproteinase 1 were measured in all subjects and compared. Significantly higher levels of serum matrix metalloproteinases 2 and 9 were found in the tympanosclerosis group, compared with the chronic otitis media and control groups. There was no statistically significant difference in tissue inhibitor matrix metalloproteinase 1 level between the three groups. Tympanosclerosis surgery has poor success rates, since the pathological process is still active. We suggest that high levels of matrix metalloproteinases may play a role in the continuation of the disease process.
    The Journal of Laryngology & Otology 10/2010; 125(2):142-6. · 0.68 Impact Factor
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    ABSTRACT: Tympanosclerosis is a sequel of chronic otitis media characterized by the deposition of calcareous plaques following hyaline degeneration in the fibrous layer of the tympanic membrane and inside middle ear mucosa. It usually results from prior middle ear infections. In this study, results of treatment and clinical findings of the patients with tympanosclerosis are presented. Our objective is to determine the changes in middle ear caused by tympanosclerosis and intervene in the more problematic zone and find out the more useful treatment protocol for patients. Preoperative features, middle ear findings detected during surgery and postoperative hearing levels of the patients who were operated in our clinic between January 1996 and June 2006 due to tympanosclerosis were evaluated. Surgical treatment was performed on a total of 37 patients including 25 females and 12 males between ages of 11 and 71. Preoperative tympanic membranes perforations were presented at a rate of 91% and average airway bone gap was 37.8 dB. Bilateral involvement was present in 59%. Conductive-type hearing loss was present at a rate of 81%, whereas mixed-type hearing existed at a rate of 19%. Sclerotic plaques were most commonly localized in the attic with a rate of 72%. Post-op outcome was found to be 27% in the patients with air bone gap between 0-20 dB. The best hearing result belonged to type 1 patients. Cases in which stapes footplate was fixated had the worst result in terms of hearing. Teflon piston was only applied in one patient. Our tympanoplasty success was found to be 67%. The most common treatment method of tympanosclerosis is surgery. Stapedectomy is recommended in surgery instead of mobilization techniques. However, there is often recurrence and there is no curative treatment. Therefore rehabilitation with hearing device can be preferred as an adjunct. In the recent experimental studies, good results with topical or systemic agents have also been promising.
    Archives of Oto-Rhino-Laryngology 09/2009; 267(5):673-7. · 1.29 Impact Factor
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    ABSTRACT: Synovial sarcomas (SS) account for 7-8% of soft-tissue cancers and 3-5% of all cases with head and neck involvement. Synovial sarcoma of the infratemporal fossa is very rare In this article, we report the fourth case of SS of infratemporal fossa and the first case with intracranial extension via the foramen ovale. A 31-year-old man admitted with a one-year history of intense pain in his right jaw. On physical examination, there was only hyperesthesia over the right mandible side. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a mass in the infratemporal fossa and intracranial extension from the foramen ovale. The mass was surgically removed en bloc. Postoperative pathological examination reported the mass as a biphasic-type synovial sarcoma. The patient who received postoperative chemoradiotherapy had no recurrent disease for one year. The patient is still being followed in our clinic.
    Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 22(6):348-53.
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    ABSTRACT: The aim of this study is to evaluate risk factors for stomal recurrence and to state and emphasize the importance of these factors. This study was carried out retrospectively on 119 patients (116 males, 3 females; mean age 56.8 years; range 31 to 86 years) with larynx cancer who underwent total laryngectomy. All patients were examined for T-stage and location of primary tumor, tracheotomy (preoperative or postoperative) opening time, modality of applied treatment, presence of pharyngeal stoma fistula and presence of cervical lymph node metastasis in the postoperative period. Five patients (4.2%) out of 119 had stomal recurrence. Development period of stomal recurrence after laryngectomy was found to be between six months and three years (mean: 16.6 months). The treatment of this fatal complication is very difficult, and it has a poor prognostic nature. As a result, presence of subglottic involvement and advanced tumors in our cases are considered as main risk factors.
    Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 19(3):146-50.

Publication Stats

13 Citations
11.99 Total Impact Points

Institutions

  • 2009–2013
    • Ankara Atatürk Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2012
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia