Murat Songu

Izmir Katip Celebi Universitesi, Temnos, İzmir, Turkey

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Publications (70)82.23 Total impact

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    ABSTRACT: Objective: Management of the nasolacrimal system is usually recommended during medial maxillectomy via external approach because of reported higher rates of postoperative epiphora. Association of the endoscopic medial maxillectomy (EMM) with epiphora, however, is not clearly stated. In this study, we attempted to evaluate whether patients develop epiphora after simple transection of the nasolacrimal duct during EMM. Patients and methods: Medical records of 26 patients who underwent endoscopic tumor resection for inverted papilloma (IP) were retrospectively reviewed. Patients who underwent EMM with nasolacrimal canal transection were included and recalled for lacrimal system evaluation. Twelve patients were eligible for inclusion and fluorescein dye disappearance test (FDDT) was performed for each patient. Patient demographics, tumor data, surgical procedures, and follow-up time were recorded. Results: Of the 12 patients included in the study, 6 underwent canine fossa transantral approach concurrently with EMM. The mean duration of follow-up was 21.1 months (range, 6-84 months). Eight patients were graded as 0, whereas 4 patients were graded as 1 according to FDDT. All test results were interpreted as negative for epiphora. All patients were completely symptom free of epiphora. Conclusions: Epiphora after EMM with nasolacrimal canal transection among patients with sinonasal tumors appears to be uncommon. Therefore, prophylactic concurrent management of nasolacrimal system including stenting, dacryocystorhinostomy (DCR), or postoperative lacrimal lavage are not mandatory for all patients.
    No preview · Article · Oct 2015 · The Journal of craniofacial surgery
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    ABSTRACT: The aim of our study was to present our retrospective experience in the single-stage surgical reconstruction of 21 tracheal stenosis (TS) patients during the last 17 years, considering the characteristics of the treated stenosis, surgical procedures performed, and postoperative outcomes and complications. All demographic and clinical data were collected retrospectively. Chest and neck computed tomography (CT) scans were performed to assess the stenosis, including length, location, and glottic involvement. The stenotic area was evaluated endoscopically according to an adapted Myer and Cotton grading scale. The aetiology of the (TS) was intubation related in 18 patients and idiopathic in three patients. The duration of intubation was 13.00 ± 6.83 days (range, 1 hour to 27 days). According to the Myers-Cotton classification, mean stage of stenosis for the study group was 3.33 ± 0.66 (range, 2-4). Mean length of the stenosis was 2.05 ± 0.80 (range, 1-3.5) cm. The mean number of stenotic segment involved was 3.67 ± 1.24 (range, 2-6). Mean follow-up for the study group, excluding two patients who died in the postoperative period, was 57 (range, 12-326) months. Of the 19 patients who survived, postoperative decannulation was achieved in 16 patients (76.19%), and decannulation was not achieved in 3 patients (14.29%) who are still on a T-tube. Of the 16 patients who are decannulated successfully, additional procedures were applied in 9 patients. Segmental resection with primary anastomosis is an effective method and can be used as the first option in selected patients of (TS).
    No preview · Article · Aug 2015 · The Journal of craniofacial surgery
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    ABSTRACT: In this case report, we present the clinical findings and therapeutic outcomes of four rhino-orbital mucormycosis patients. The four patients (1 female, 3 male; age range, 55-77 years) all had diabetes mellitus and two also had chronic renal failure. All patients exhibited proptosis, sinusitis, and dark-colored lesions on the nasopharynx and/or hard palate; three patients had ipsilateral peripheral facial paralysis. Visual acuity was no light perception in the two patients with severe orbital involvement and 0.8 in two patients with limited orbital involvement. Histopathological examination of the hard palate, nasopharynx or sinus biopsy revealed typical Mucor hyphae. Systemic liposomal amphotericin B was initiated in all patients. The patients with limited ocular involvement received amphotericin B both intravenously and by local irrigation; both patients had complete recovery. The other two patients underwent orbital exenteration; one patient died after declining systemic treatment postoperatively. Rapid diagnosis and treatment are important for the survival of rhino-orbital mucormycosis patients. With orbital involvement, surgical debridement and systemic and local treatment with antifungal agents may help avoid mutilating surgery like exenteration.
    No preview · Article · Aug 2015
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    ABSTRACT: Delivery of a carbon dioxide laser is an effective method and can be used in selected cases of tracheal stenosis. To present retrospective experience in tracheal stenosis of 16 patients treated by bronchoscopic delivery of carbon dioxide laser, considering the characteristics of the treated stenosis, surgical procedures performed, and post-operative outcomes and complications. All demographic and clinical data were collected retrospectively. Chest and neck computed tomography scans were performed to assess the stenosis, including length, location, and glottic involvement. The stenotic area was evaluated endoscopically according to an adapted Meyer and Cotton grading scale. The aetiology of the tracheal stenosis was intubation-related in 14 cases, and idiopathic in two cases. The duration of intubation ranged between 1 hour to 26 days. According to the Myers-Cotton classification, mean stage of stenosis for the study group was 3.3 ± 0.5. Mean length of the stenosis was 23.75 ± 6.95 (range = 15-40) mm. Mean follow-up for the study group was 23.81 ± 7.11 (range = 12-38) months. Postoperative decannulation was achieved in 13 patients (81.3%), and decannulation was not achieved in three patients (18.7%).
    No preview · Article · Jul 2015 · Acta oto-laryngologica
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    ABSTRACT: Echo-planar diffusion-weighted magnetic resonance imaging (DW MRI) is more reliable than high-resolution computed tomography (HRCT) in predicting the presence and localization of cholesteatoma before tympanomastoid surgery. To evaluate the diagnostic accuracy of HRCT and echo-planar DW MRI in the detection and localization of cholesteatoma. Fifty-nine patients were prospectively included in this study. Patients with suspected primary cholesteatoma were evaluated by HRCT and echo-planar DW MRI before tympanomastoid surgery. Radiological findings were correlated with intraoperative findings. HRCT and echo-planar DW MRI accurately predicted the presence or absence of cholesteatoma in 40/59 (67.8%) and 52/59 (88.1%) patients, respectively. The sensitivity, specificity, and positive and negative predictive values of HRCT were 68.97%, 66.67%, 66.67%, and 68.97%, respectively. However, sensitivity, specificity, and positive and negative predictive values of echo-planar DW MRI were 85.71%, 90.32%, 88.89%, and 87.50%, respectively.
    No preview · Article · Mar 2015 · Acta oto-laryngologica
  • H Katilmis · M Songu · H Aslan · Y Ozkul · S Basoglu · E Kulduk · E Eren · H Candan
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    ABSTRACT: To compare the hearing results and graft take rates of the recently developed gold wire prosthesis with those of the hydroxyapatite partial ossicular replacement prosthesis in patients with chronic otitis media. This retrospective study examined patients who underwent type 2 tympanoplasty with a minimum follow up of one year. The study population consisted of 32 patients in the partial ossicular replacement prosthesis group and 26 patients in the gold wire group. The main outcome measures were the graft success rate and level of hearing improvement. Complications and extrusion rates were also noted. The graft take rate was 90.6 per cent for the partial ossicular replacement prosthesis group and 92.3 per cent for the gold wire group (p = 0.848). Pre-operatively, there were no significant differences in the air or bone-conduction thresholds between groups. Post-operatively, the mean hearing gain was 18.5 ± 14.0 dB in the partial ossicular replacement prosthesis group and 16.5 ± 10.6 dB in the gold wire group (p = 0.555). The mean air-conduction thresholds were 26.6 ± 12.4 and 32.6 ± 10.5 dB, respectively (p = 0.027), and the mean bone-conduction thresholds were 9.7 ± 7.0 and 10.4 ± 6.4 dB, respectively (p = 0.687). The success and complication rates provided by the gold wire prosthesis seem comparable to those of the hydroxyapatite partial ossicular replacement prosthesis.
    No preview · Article · Feb 2015 · The Journal of Laryngology & Otology
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    ABSTRACT: The aim of the present study was to compare pre- and post-operative otoacoustic emission examinations of patients who experienced surgery under hypotensive anaesthesia using distortion product otoacoustic emission (DPOAE) and transient evoked otoacoustic emission (TEOAE). Forty-one patients, admitted to our tertiary centre for nasal valve surgery, were prospectively and randomly assigned into two groups. Hypotensive group included 20 patients, while control group included 21 patients. All investigators and patients were blinded to anaesthesia assignment throughout the course of the study. DPOAEs and TEOAEs were performed before surgery and repeated after 15 days in both groups. In control group, DPOAE–DP1 levels per frequency increased significantly in the post-operative period when compared with the pre-operative values in all patients. However, DPOAE–DP1 levels decreased significantly in hypotensive group. Similarly, DPOAE–SNR levels per frequency decreased significantly in hypotensive group. In conclusion, we have observed that under the influence of hypotensive general anaesthesia, the amplitudes of OAEs are affected.
    No preview · Article · Jan 2015 · Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde

  • No preview · Article · Jan 2015 · Turkiye Klinikleri Journal of Medical Sciences
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    ABSTRACT: The aim of the present study was to evaluate the relationship between obstructive sleep apnea syndrome (OSAS) severity and the hippocampal sulcus width in a cohort of subjects with OSAS and controls. A total of 149 OSAS patients and 60 nonapneic controls were included in the study. Overnight polysomnograpy was performed in all patients. Hippocampal sulcus width of the patients was measured by a radiologist blinded to the diagnosis of the patients. Other variables noted for each patient were as follows: gender, age, body mass index, apnea hypopnea index, Epworth sleepiness scale, sleep efficacy, mean saturation, lowest O2 saturation, longest apnea duration, neck circumference, waist circumference, hip circumference. A total of 149 OSAS patients were divided into three groups: mild OSAS (n = 54), moderate OSAS (n = 40), severe OSAS (n = 55) groups. The control group consisted of patients with AHI n = 60). Hippocampal sulcus width was 1.6 ± 0.83 mm in the control group; while 1.9 ± 0.81 mm in mild OSAS, 2.1 ± 0.60 mm in moderate OSAS, and 2.9 ± 0.58 mm in severe OSAS groups (p p OSAS might be associated with various pathologic mechanisms including increased hippocampal sulcus width.
    No preview · Article · Dec 2014 · Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde
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    ABSTRACT: Aim: The aims of this study were to compare radiofrequency tissue reduction (RFTR) and electrocautery (EC) techniques by assessing preoperatively and 8 weeks postoperatively the visual analog scale (VAS), inspiratory peak flowmetry (IPF), and magnetic resonance imaging (MRI) volume measurement of the inferior turbinate and to see whether EC still stands as a valid treatment of inferior turbinate hypertrophy. Methods: A total of 36 patients were included in the study. An equal number of patients were chosen randomly from 2 groups. Inferior turbinate volumes measured by MRI, IPF, the VAS, and the Sinonasal Outcome Test-20 were used to determine the efficacy of treatment and to compare the 2 groups. Results: Postoperative IPF increase, VAS score decrease, and Sinonasal Outcome Test-20 score decrease were statistically more significant in the EC group, compared with the RFTR group. Although statistically not significant, postoperative inferior turbinate MRI volume decrease was more evident in the EC group when compared with the RFTR group. Conclusions: Both RFTR and EC techniques could be used as an effective treatment of choice for inferior turbinate hypertrophy, and EC technique is superior to RFTR technique to achieve high efficiency.
    No preview · Article · Nov 2014 · Journal of Craniofacial Surgery
  • M Songu · A Kutlu
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    ABSTRACT: Objectives: To investigate the psychosocial impact of prominent ears on children, and evaluate the outcomes of otoplasty two years after surgery, using the Child Behavior Checklist to comparatively evaluate patients' psychosocial profiles. Method and results: A total of 198 otoplasty procedures were performed in 107 patients (85 per cent bilateral procedures). Otoplasty was performed solely in 86 patients and concurrently with other procedures in 21 patients. All children who underwent surgery obtained good post-operative results, with satisfactory correction of the deformity reported by the patients and their parents or guardians. There were statistically significant decreases in Child Behavior Checklist scores in the domains of: anxiety and depression (p = 0.028), social problems (p = 0.018), difficulties in thinking (p = 0.012), total behavioural problems (p = 0.012), internalising problems (p = 0.020) and externalising problems (p = 0.044), and near-significant decreases in scores for attention problems (p = 0.055) and aggressive behaviour (p = 0.078). There was a statistically significant increase in the score for total social competence (p = 0.031). Conclusion: Psychological problems associated with anatomical deformities such as prominent ears can be reduced by means of appropriate corrective surgery. Psychological support is necessary for the patient.
    No preview · Article · Aug 2014 · The Journal of Laryngology & Otology
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    ABSTRACT: Objective: To present the results of the traumatic intratemporal facial nerve injury that have undergone facial nerve decompression by using middle cranial fossa (MCF) approach. Study Design: A retrospective study Setting: Tertiary referral center Patients and Methods: In this study, 13 patients who developed facial paralysis due to temporal bone trauma and undergone decompression by using MCF approach in Department of Otorhinolaryngology of Izmir Katip Celebi University Research and Training Hospital between January 1993 and December 2012 were presented retrospectively. Patients were assessed in terms of side, etiology, fracture type, House-Brackmann (HB) grade, electroneuronography (ENOG), electromyography (EMG), hearing loss, operation time, and the region of the injury. Results: The fracture was at the right side in 7 (53.8%) and at the left side in 6 patients (46.1%). The type of temporal bone fracture was longitudinal in 6 (46.1%), transverse in 2 (15.3%), and mixed in 5 patients (38.4%). Total axonal degeneration in EMG and ENOG were seen in all patients, who were HB grade 6 at preoperative assessment. Mean operation time was 30 days. The lesion in all patients was at the region of geniculate ganglion. There was conductive hearing loss in 7 patients (53.8%), sensorineural in 4 (30.7%), and mixed in 1 patient (7.6%); hearing was normal in 1 patient (7.6%). Seven patients (53.8%) improved to HB grade 2. Conclusion: In the light of the information obtained from HRCT, ENOG, and EMG, we believe that better results can be achieved with facial nerve decompression that is performed before 1 month, and geniculate ganglion region may be better controlled by MCF approach.
    No preview · Article · Jul 2014 · Journal of Craniofacial Surgery
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    ABSTRACT: The aim of our study was to determine the effectiveness of intratympanic α-lipoic acid injection as an otoprotective agent against cisplatin-induced ototoxicity in guinea pigs. Twenty-four adult male albino guinea pigs with normal hearing were divided into 4 groups. The guinea pigs received intraperitoneal cisplatin in group 1, intraperitoneal cisplatin and intratympanic α-lipoic acid in group 2, intratympanic α-lipoic acid in group 3, as well as intraperitoneal cisplatin and intratympanic saline in group 4. Distortion-product otoacoustic emission measurements were obtained for both ears at the following time points: before administration (baseline recording) and on day 3 (72 h later). In group 1 (cisplatin), significant deterioration was observed at all frequencies on day 3 (P < 0.05). In group 2 (cisplatin + α-lipoic acid), deterioration was observed at all frequencies on day 3; however, this deterioration did not reach a statistical significance (P > 0.05). In group 3 (α-lipoic acid), no significant difference was observed between baseline and day 3 (P > 0.05). In group 4 (cisplatin + saline), deterioration was observed at all frequencies on day 3; however, this deterioration did not reach a statistical significance (P > 0.05). Cisplatin-induced hearing loss in the guinea pigs may be limited to some extent by the concomitant use of α-lipoic acid. Dose-dependent changes in the possible effects of α-lipoic acid need further investigation. Future morphologic studies may contribute to expose clearly the protective effect of α-lipoic acid.
    No preview · Article · Jun 2014 · Journal of Craniofacial Surgery
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    ABSTRACT: The aim of our study was to investigate the effect of patient-related factors, such as the body mass index (BMI) and tumor size, in selecting the flap type for the reconstruction of pharyngeal defects. This retrospective review included 182 patients with pharyngeal defect reconstructions with free and pedicled flaps at the Ohio State University from January 2005 to December 2008. We conducted a retrospective comparison of variety of different flap reconstruction techniques. We compared different flap reconstruction with BMI and tumor size without functional outcome such as swallowing and speech data. Although there was no statistically significant correlation (P > 0.05) when comparing the free flaps with pedicled flaps according to the BMI and tumor size, there was an obvious tendency to prefer radial forearm free flap over anterolateral thigh free flap in patients who are overweight and those with obesity with a ratio of 32:3. In the same group of patients, a similar tendency was observed to prefer fibular free flap over iliac crest free flap with a ratio of 14:5, whereas the ratio was becoming 3:5 in favor of iliac crest free flap over fibular free flap in patients with BMI of 24 or lower. Despite the fact that surgeons' experience with a certain flap type is one of the most important factors while determining which flap to reconstruct, BMI might have a significant impact while selecting the free flap types for the reconstruction of pharyngeal defects.
    No preview · Article · Apr 2014 · The Journal of craniofacial surgery
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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.
    No preview · Article · Apr 2014 · American Journal of Otolaryngology
  • Murat Songu · Ayse Kutlu
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    ABSTRACT: To investigate health-related quality of life changes that occurred in children with prominent ears applied pre- and postoperatively. A prospective study was performed in 67 consecutive children who underwent otoplasty procedures between April 2008 and July 2010 and followed up for more than 2 years. Evaluations and interviews performed in the pre-and postoperative periods included the patients' history, clinical and routine laboratory examinations. Glasgow children's benefit inventory was the basis of the used inquiry for detecting the changes in health-related quality of life after otoplasty. For the children's cohort, the mean total Glasgow children's benefit inventory score was 23.9 (p < 0.001), indicating a benefit from the operation. All Glasgow children's benefit inventory subscores (emotion, physical health, learning, and vitality) were raised (mean 30.84, 14.98, 18.89, and 23.96, respectively). The health-related quality of life was raised in 63 of 67 children (94.03 %). Negative Glasgow children's benefit inventory scores or subscores were not found in a single case. Otoplasty can significantly increase patients' health-related quality of life and leads to a high rate of patient satisfaction in children with prominent ears.
    No preview · Article · Mar 2014 · Archives of Oto-Rhino-Laryngology
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    ABSTRACT: We have planned to demonstrate histopathologic effects of mid- or long-term oral use of desloratadine and cetirizine HCl molecules on middle ear mucosa of rats. Thirty-six rats were randomized equally into six groups. Desloratadine groups received once daily doses of 1 mg/ml desloratadine for 30 (D30 Group) or 60 (D60 Group) days. The Cetirizine study groups were given once daily doses of 1 mg/ml cetirizine for 30 (S30 Group) or 60 (S60 Group) days. Control groups were given 2 cc physiologic saline using orogastric gavage method through a 12 G gavage catheter for 30 (K30 Group) or 60 (K60) days. At the end of 30 days, D30, S30 and K30 Groups were sacrificed. Tissue samples harvested from groups were evaluated between 1 and 4 Grades for histological characteristics of middle ear canal, eardrum, middle ear epithelium and connective tissue, edema, vascular congestion and inflammatory cells. In the control group no pathological finding was encountered in rats sacrificed on 30 and 60 days. No statistical difference was observed when groups were compared on external ear epithelial tissue, external ear sebaceous gland, middle ear inflammation, and middle ear capillary dilatation both on 30 and 60 days. Tympanic membrane collagen was more evident in D30 and D60 groups when compared with C30 and C60 groups. Comparison of histopathological grading results between 30 and 60 days revealed no significant changes. In conclusion, oral intake of cetirizine and desloratadine preparations has effects of tympanic membrane collagen, degrees of edema and vascular congestion being more prominent with desloratadine molecule.
    No preview · Article · Feb 2014 · Archives of Oto-Rhino-Laryngology
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    ABSTRACT: The objective of this study is to investigate the correlation between inferior turbinate size and paranasal sinus opacification on computerized tomography (CT) scans. Paranasal sinus CT scans of a total of 185 patients (92 males, 93 females) were examined in terms of sinus opacification. Sizes of the inferior turbinates were measured using stereological method and these sizes in normal and opacified paranasal sinuses are compared using one-way analysis of variance. Scans of 185 patients (93 female, 92 male) aged between 12 and 84 (mean 37.85 ± 16.27) years were examined in this study. Sizes of the inferior turbinates were found to be increased significantly in case of opacification of ipsilateral maxillary and anterior ethmoid sinuses (p = 0.000 and p = 0.4, respectively) on both sides. On the other hand, such a relationship could not be demonstrated for sizes of inferior turbinates with opacified or non-opacified posterior ethmoid, frontal and sphenoid sinuses. In conclusion, the combination of CT and the Cavalieri principle can provide an unbiased, direct, and assumption-free estimate of the regions of interest. The presented method can be efficiently applied without any need for special software, additional equipment, or personnel than that required for routine CT in daily use. Paranasal sinus disease, especially the inflammatory diseases of maxillary and anterior ethmoid sinuses, must be carefully investigated in cases with inferior turbinate hypertrophy.
    No preview · Article · Jan 2014 · Archives of Oto-Rhino-Laryngology
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    Murat Songu

    Preview · Article · Dec 2013
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    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.
    No preview · Article · Nov 2013 · Acta oto-laryngologica

Publication Stats

424 Citations
82.23 Total Impact Points

Institutions

  • 2013-2015
    • Izmir Katip Celebi Universitesi
      Temnos, İzmir, Turkey
  • 2012
    • Ankara Atatürk Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2010-2012
    • Izmir Bozkaya Research and Training Hospital
      Ismir, İzmir, Turkey
  • 2008-2012
    • Dr. Behcet Uz Children's Hospital
      Nikfer, Denizli, Turkey
  • 2007-2009
    • Celal Bayar Üniversitesi
      Saruhan, Manisa, Turkey