Levent Sennaroglu

Hacettepe University, Engüri, Ankara, Turkey

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Publications (76)95.77 Total impact

  • Cavid Cabbarzade, Levent Sennaroglu, Nilda Süslü
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    ABSTRACT: Intraoperative cerebrospinal fluid (CSF) leakages from the cochleostomy site - known as gushers - are a serious complication of cochlear implantation surgery in cases of congenital deafness. They occur as the result of abnormal communication between CSF in the internal auditory canal and perilymph in the cochlea. Gushers are well recognized as occurring in a proportion of cases in which there is a clearly visible congenital malformation of the cochlea. In this report, we describe two cases in which pre-operative computed tomography (CT) scanning of the cochlea was initially reported as normal but gushers occurred during cochlear implant surgery. In both cases, more detailed review of the CT scans (peroperatively in the first case, pre-operatively in the second case) showed a defect at the cochlear base, in the absence of any other cochlear malformation. The aim of this paper is to draw attention to the risk of missing this abnormality and to encourage careful inspection of the cochlear base on CT scans in all cases, even when the rest of the cochlear appears normal.
    Cochlear implants international. 07/2014;
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    ABSTRACT: The facial nerve usually occupies the oval window area in patients with oval window atresia. During exploration, if the facial nerve is discovered to lie in the oval window area, this is usually regarded as a contraindication for further surgical intervention. The aim of the present paper is to demonstrate the preoperative pathognomonic radiological sign and describe a new surgical approach for this difficult situation. 3 patients and 4 ears were operated due to conductive hearing loss by the same surgeon in a tertiary referral center. Their clinical presentation, radiological findings, surgical findings and final outcomes were evaluated and correlated. Surgical findings were identical in all 4 ears: facial nerve was running over the oval window and tympanic portion was completely dehiscent. Incus long arm was medially displaced due to abnormal development of the stapes suprastructure. In each ear a successful vestibulotomy and teflon piston placement was achieved. Preoperative mean air-bone gap of 47.5dB was improved to 21.5dB. There were no complications. Oval window atresia is a rare middle ear anomaly usually regarded as a contraindication for surgical intervention. In this study we present a novel surgical approach with succesful results. However the best approach is to inform the family by showing the nerve on tomography, showing the operation video, informing the family about the sensorineural hearing loss and letting the family choose the treatment option.
    International journal of pediatric otorhinolaryngology 02/2014; · 0.85 Impact Factor
  • Levent Sennaroğlu, Gamze Atay, Münir Demir Bajin
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    ABSTRACT: Objective Gusher in inner ear malformations is common in patients with incomplete partition type I and type III. It is also common in less severe form as oozing in incomplete partition type II and large vestibular aqueduct. It is important to prevent cerebrospinal fluid (CSF) escape around the electrode to prevent meningitis. Methods The custom-made device was produced by Med-El Company. It has a “cork”-like stopper instead of the usual silicon ring to prevent gusher. There are two types of electrodes of different lengths. The standard one is 25 mm (contact space 1.7 mm) and the short one is 20 mm (contact space 1.3 mm). It was used in 50 patients with different inner ear malformations. Results Thirteen patients had gusher, and 11 patients oozing during cochleostomy. One patient with initial prototype of the cork electrode had to be revised because of persistent oozing around the electrode. Another patient had slow extrusion of the electrode most probably due to CSF pulsation and had to be revised. Both patients had no more CSF fistula. Conclusion CSF fistula in inner ear malformations is a serious situation which may lead to recurrent meningitis. The new electrode with “cork” stopper looks promising in preventing the postoperative CSF leak around the electrode.
    Auris, nasus, larynx 01/2014; · 0.58 Impact Factor
  • Cavid Cabbarzade, Burçe Özgen, Levent Sennaroglu
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    ABSTRACT: Objective: A case with sudden sensorineural hearing loss (SSNHL) owing to multiple sclerosis (MS) who had clinical and dramatic radiological improvement just after medical therapy was reported in this article. Method: Case report and review of related literature. Results: A 22-year-old female patient with MS related SSNHL was presented in this article. Magnetic resonance imaging (MRI) revealed an MS plaque localized at pons extending from right cochlear nucleus to proximal part of the right cochlear nerve. Most dramatic recovery was present in the 5th day control MRI, where the plaque located on pons disappeared completely. On the 10th day control audiogram hearing recovery was observed and pure tone audiogram levels were almost normal. Conclusion: Sudden sensorineural hearing loss owing to MS is seen more common than expected. It has good prognosis. Magnetic resonance imaging is also thought to have an important role in diagnosis and treatment efficacy of SSNHL owing to MS.
    Otolaryngologia polska. The Polish otolaryngology 09/2013;
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    ABSTRACT: OBJECTIVE: Pneumolabyrinth resulting from temporal bone trauma and stapes luxation has been associated with sensorineural hearing loss (SNHL). The principal purpose of this study was to determine the incidence and volume of pneumolabyrinth after stapedotomy in which iatrogenic perilymphatic fistula is created and to also correlate this with possible hearing loss and vertigo. STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS AND METHODS: Fifty stapedotomy patients were operated on for otosclerosis, and of those 50, 20 underwent high-resolution computed tomography (CT) on the first day, 10 on the third day, and 20 on the seventh day. The patients followed up regarding SNHL and vertigo that could develop postoperatively, and the correlation of such complications with HRCT findings was examined. RESULTS: The 20 patients who had high-resolution CT (HRCT) on the first day all presented with pneumolabyrinth, and none of the 20 patients who underwent HRCT on the seventh day had pneumolabyrinth. Postoperatively, 92% of the patients had less than 20 dB and 62% had less than 10 dB air-bone gap. None of the patients had SNHL or persistent vertigo. There was no correlation between pneumolabyrinth and hearing loss or vertigo. CONCLUSION: Pneumolabyrinth is a radiological sign of perilymphatic fistula and has no effect on sensorineural hearing loss and vertigo. Observing pneumolabyrinth during the early postoperative stage should not necessarily implicate a complication; however, pneumolabyrinth after the first week supported with the clinical symptoms of perilymphatic fistula would be a meaningful finding.
    Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 05/2013; · 1.44 Impact Factor
  • Article: Response.
    Levent Sennaroglu, Ibrahim Ziyal
    Auris, nasus, larynx 01/2013; · 0.58 Impact Factor
  • Levent Sennaroglu, Ibrahim Ziyal
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    ABSTRACT: The use of cochlear implants for selected individuals with bilateral severe to profound sensorineural hearing loss who derive limited benefit from conventional hearing aids is well established. There are situations where cochlear implantation is contraindicated. Auditory brainstem implantation (ABI) is the only solution to restore hearing when the cochlear nerve is disrupted together with pathologies where the cochlea does not provide a suitable location for cochlear implant. Labyrinthine and cochlear aplasia and cochlear nerve aplasia constitute the congenital indications for ABI. In the present review article history and development of ABI, indications, side selection criteria, surgery and audiological outcome are presented.
    Auris, nasus, larynx 12/2011; 39(5):439-50. · 0.58 Impact Factor
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    ABSTRACT: The aim of the study was to compare results of objective test techniques in cochlear implant users with inner ear malformations and incomplete partition anomalies with types I and II and to show which techniques should be used in the evaluation and fitting of cochlear implant users with inner ear malformations. Retrospective clinical study. The subjects in the control group were selected randomly from cochlear implant users with normal cochlea. Inclusion criteria for patients group were having inner ear malformation for the study group and at least 1 year cochlear implants use for both groups. For each individual subject, electrically evoked compound action potentials (ECAPs), electrically evoked stapedius reflex threshold (ESRT), and electrically evoked auditory brainstem response (EABR) thresholds were determined. These tests were applied after a normal cochlear implant fitting session. There were 20 subjects in inner ear malformation group and 15 subjects in the control group. For each subject, 6 intracochlear electrodes, representing apical, middle, and basal array of intracochlear electrode, were used. In the cochlear malformation group, percentage of acquired ECAP thresholds was 25%. However, in the control group, percentage of ECAP was 74%. Similarly with ECAP, percentage of ESRT in the cochlear malformation group was 17.5%, and that in the control group was 90%. The difference between these percentages was statistically significant. Both current levels and latencies of EABR wave V were significantly different from each other for the inner ear malformation group and the control group. For statistical analysis, Mann-Whitney U test for 2 independent samples, Kruskal-Wallis analysis and Dunn's Z test were used. For the inner ear malformation group, EABR is a more applicable objective test technique when compared with ECAP and ESRT.
    Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 09/2011; 32(7):1065-74. · 1.44 Impact Factor
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    ABSTRACT: Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to third-party sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myESR.org Purpose Congenital inner ear anomalies are complex developmental disorders that are initially assessed with temporal bone CT. It has been reported that only about 5% to 15% of congenitally deaf individuals demonstrate radiographical abnormality and the detected abnormalities have a large spectrum of imaging findings. These anomalies have been classified by Jackler et al. in 1987, a classification that has been revised in 2002 by Sennaroglu and Saatci. The purpose of this study was to evaluate the prevalence of radiologically detectable inner ear abnormalities in patients with congenital sensorineural hearing loss (SNHL) evaluated with high resolution CT of the temporal bone and to assess the relative frequency of different malformations of the inner ear among the detectable anomalies.
    ECR 2011; 03/2011
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    ABSTRACT: Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to third-party sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myESR.org Purpose Cochlear aqueduct (CA) is a bony canal surrounding the perilymphatic duct, located within the temporal bone, between the basal turn of the cochlea and the posterior cranial fossa. Although its exact function and importance is still unknown, it is thought to maintain the fluid and pressure balance within the inner ear by connecting the perilymph of the scala tympani with the cerebrospinal fluid of the posterior fossa. Previous histopathological studies have demonstrated that in meningitis the CA is the pathway for the spread of infection from the meninges to the labyrinth. However it has not been clarified why most patients who had meningitis have no hearing deficit whereas some develop postmeningitic sensorineural hearing loss (SNHL).
    ECR 2011; 03/2011
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    Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 02/2011; 32(2):187-91. · 1.44 Impact Factor
  • L. Sennaroglu, S. Sarac
    International Journal of Pediatric Otorhinolaryngology - INT J PED OTORHINOLARYNGOL. 01/2011; 75:15-15.
  • Source
    International Journal of Otolaryngology 01/2011; 2011:438696.
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    ABSTRACT: The inclusion criteria for an auditory brain stem implant (ABI) have been extended beyond the traditional, postlingually deafened adult with Neurofibromatosis type 2, to include children who are born deaf due to cochlear nerve aplasia or hypoplasia and for whom a cochlear implant is not an option. Fitting the ABI for these new candidates presents a challenge, and intraoperative electrically evoked auditory brain stem responses (EABRs) may assist in the surgical placement of the electrode array over the dorsal and ventral cochlear nucleus in the brain stem and in the postoperative programming of the device. This study had four objectives: (1) to characterize the EABR by stimulation of the cochlear nucleus in children, (2) to establish whether there are any changes between the EABR recorded intraoperatively and again just before initial behavioral testing with the device, (3) to establish whether there is evidence of morphology changes in the EABR depending on the site of stimulation with the ABI, and (4) to investigate how the EABR relates to behavioral measurements and the presence of auditory and nonauditory sensations perceived with the ABI at initial device activation. Intra- and postoperative EABRs were recorded from six congenitally deaf children with ABIs, four boys and two girls, mean age 4.2 yrs (range 3.2 to 5.0 yrs). The ABI was stimulated at nine different bipolar sites on the array, and the EABRs recorded were analyzed with respect to the morphology and peak latency with site of stimulation for each recording session. The relationship between the EABR waveforms and the presence or absence of auditory electrodes at initial device activation was investigated. The EABR threshold levels were compared with the behavioral threshold (T) and comfortably loud (C) levels of stimulation required at initial device activation. EABRs were elicited from all children on both test occasions. Responses contained a possible combination of one to three peaks from a total of four identifiable peaks with mean latencies of 1.04, 1.81, 2.61, and 3.58 msecs, respectively. The presence of an EABR was a good predictor of an auditory response; however, the absence of the EABR was poor at predicting a site with no auditory response. The morphology of EABRs often varied with site of stimulation and between EABR test occasions. Postoperatively, there was a trend for P1, P3, and P4 to be present at the lateral end of the array and P2 at the medial end of the array. Behavioral T and C levels showed a good correlation with postoperative EABR thresholds but a poor correlation with intraoperative EABR thresholds. The presence of an intraoperative EABR was a good indicator for the location of electrodes on the ABI array that provided auditory sensations. The morphology of the EABR was often variable within and between test sessions. The postoperative EABR thresholds did correlate with the behavioral T and C levels and could be used to assist with initial device fitting.
    Ear and hearing 12/2010; 32(3):300-12. · 2.06 Impact Factor
  • Cochlear implants international 01/2010; 11 Suppl 1:83-7.
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    ABSTRACT: The aim of our study is to present the results of 11 children where auditory brainstem implantation (ABI) was successfully performed to restore hearing. Case presentation. This study was conducted at the departments of Otolaryngology and Neurosurgery at Hacettepe University Ankara, Turkey. Between July 2006 and April 2008, 11 prelingual (30-56 mo) deaf children with several cochlear malformations had ABI. All patients were programmed and were enrolled in auditory verbal therapy sessions and family counseling programs at Hacettepe Auditory Verbal Center. The evaluation was performed at preimplant and again 1, 3, 6, 9, and 12 months post-switch on. The main test components composing this test battery were Ling 6 Sound Detection-Identification Test, Word Identification Test in Turkish, Meaningful Auditory Integration Scale, and Meaningful Use of Speech Scale. Successful brainstem implantations were performed in all patients with retrosigmoid approach. Six children gained basic audiologic functions and were able to recognize and discriminate sounds, and many could identify environmental sounds such as a doorbell and telephone ring by the third month of ABI. Improvement in mean performance on Meaningful Auditory Integration Scale is apparent for all ABI children. Improvement in Meaningful Use of Speech Scale scores in 2 patients, demonstrating that the child using its own voice for speech performance, was observed between the baseline and 12th month. First, 5 children were able to identify Ling's 6 sound by the end of 2 to 6 months, and 2 of them also started to identify words due to their pattern differences and multisyllabic word identification by 6 to 9 months. Two children with Attention Deficit Hyperactivity Disorder have made slower progress than the other children with ABIs. Our preliminary results show that there is adequate contribution of brainstem implants in the development of auditory-verbal skills. Additional handicaps slow the progress of the prelingually deaf children.
    Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 10/2009; 30(6):708-15. · 1.44 Impact Factor
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    ABSTRACT: The aim of this study was to investigate vestibular symptoms and their effect on the balance in otosclerosis patients undergoing stapedotomy operations. Prospective study at an academic tertiary referral centre. Thirty-three patients undergoing stapedotomy were included in the study. Sensory organisation test (SOT) protocol of computerized dynamic posturography was used to analyse the balance in patients preoperatively, in the first postoperative week and the first postoperative month. Postoperative vestibular symptoms were analysed with a grading system. Audiograms were obtained preoperatively and 1 month after the operation. Preoperatively, all patients were asymptomatic when considering the vestibular system; however, eight of them got low SOT scores on vestibular examination. Postoperatively 82% of the patients had vestibular complaints in variable severity. In the first week, all but one patient become asymptomatic. This patient recovered by the end of postoperative second week. However, a significant drop in SOT scores was encountered at the first week testing (Student's T-test, P = 0.001). One month after the operation, all patients were asymptomatic and SOT scores recovered at least to preoperative level. Neither patient characteristics, nor audiological findings were found to be correlated with vestibular changes. Stapedotomy causes a temporary balance loss in a high percentage of patients which then recover to their former levels in the first postoperative month.
    Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 07/2009; 34(3):212-7. · 1.87 Impact Factor
  • Levent Sennaroglu
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    ABSTRACT: Inner ear malformations constitute about 20% of congenital sensorineural hearing loss. In this review article an updated classification of cochlear malformations is provided. Incomplete partition and cochlear hypoplasia cases are each divided further into three groups. There are two main difficulties in the surgery of inner ear malformations; gusher and facial nerve abnormalities. Radiological features of malformations necessary to identify these problems preoperatively are discussed. Facial nerve abnormalities that may occur are described. Two different types of cerebrospinal fluid leakage are defined and necessary measures to prevent leakage are described. Standard and modified surgical approaches to overcome the described problems are described with literature findings. Finally meningitis which may occur with and without cochlear implantation in this special group of patients is emphasized. This is common in incomplete partition type I patients and is usually due to a fistula in one of the windows (usually oval window) which occurs as a result of cerebrospinal fluid pressure. This is a medical emergency leading to potential meningitis and measures that should be taken to stop the leak as soon as possible are described.
    Cochlear implants international 05/2009; 11(1):4-41.
  • Skull Base Surgery 04/2009; 19(01). · 0.72 Impact Factor
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    ABSTRACT: We present a 4-year-old girl with congenital profound sensorineural deafness associated with inner ear malformation (incomplete partition type II, enlarged vestibule, and enlarged vestibular aqueduct). The proposita also had pseudocleft lips, skin defects, auricle abnormalities, and unilateral multicystic dysplastic kidney, leading to the diagnosis of branchio-oculo-facial (BOF) syndrome. Mutation analysis of the TFAP2A gene showed a de novo deletion of 18 and insertion of 6 nucleotides, resulting in deletion of amino acids LPGARR and insertion of RI between amino acids 276 and 281. Altered amino acids are located within the basic DNA binding and dimerization domains of TFAP2A. Previously reported amino acid substitutions in TFAP2A involved only DNA binding domain in four patients with BOF syndrome who were not reported to have profound sensorineural deafness. Our report implies that the localization of mutations in TFAP2A might be responsible with the phenotypic findings in BOF syndrome.
    American Journal of Medical Genetics Part A 03/2009; 149A(3):427-30. · 2.30 Impact Factor

Publication Stats

609 Citations
95.77 Total Impact Points

Institutions

  • 1994–2014
    • Hacettepe University
      • • Faculty of Medicine
      • • Department of Otolaryngology
      • • Department of Radiology
      • • Department of Audiology and Speech Pathology
      Engüri, Ankara, Turkey
  • 2009
    • Ankara University
      • Department of Pediatrics
      Ankara, Ankara, Turkey
  • 2001
    • Baskent University
      • Department of Otorhinolaryngology
      Engüri, Ankara, Turkey
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia