Levent Sennaroglu

Hacettepe University, Engüri, Ankara, Turkey

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Publications (84)116.44 Total impact

  • Gamze Atay · Bahar Kayahan · Betul Cicek Cinar · Sarp Sarac · Levent Sennaroglu

    No preview · Article · Oct 2015
  • Levent Sennaroglu
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    ABSTRACT: Objective To investigate the histopathology of inner ear malformations (IEMs) in order to explain their pathophysiology. Method Light microscopy was used to study 33 specimens exhibiting various IEMs in the collection of the Otopathology Laboratory at Harvard University's Massachusetts Eye and Ear Infirmary. Results The investigation found 18 incidences of cochlear hypoplasia (CH) (3 CH-I, 10 CH-II, 5 CH-III), 11 incomplete partitions (IPs) (5 IP-I, 6 IP-II), 2 vestibular dilatations, and 2 cases of cochlear nerve aplasia. The IP-I cases had characteristic defective endosteums, while the IP-II cases showed hydropic changes in the scala vestibuli. The CH cases were small in size externally, with normal or defective internal architecture. Conclusion In combination with embryological data, these findings suggest that cases of CH-III and CH-IV are most probably genetically predetermined to be small in size, and that development of the membranous labyrinth stops at a point earlier than normal, so that it is shorter. At the time of complete ossification, this results in a cochlea with small external dimensions and normal internal architecture. In CH-I and CH-II cases, there is arrested development of the internal architecture, in addition to a small cochlea; it is most likely that in these cases, there is a severely defective vascular supply from the internal auditory canal (IAC). IP-I may be the result of a defective vascular supply from the blood vessels of the IAC. In IP-II, an enlarged endolymphatic sac (EES) appears to be the genetic abnormality that causes the other abnormalities, as it allows high pressure to be transmitted into the cochlea and vestibule. In IP-III, the pathophysiology appears to be an abnormal vascular supply from the middle ear mucosa, caused by a genetic abnormality and resulting in a thinner otic capsule and the absence of the modiolus.
    No preview · Article · Jul 2015 · Cochlear implants international
  • Esra Yucel · Filiz Aslan · Hilal Burcu Ozkan · Levent Sennaroglu
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    ABSTRACT: Objective: The aim of this study is to describe the rehabilitative outcomes of pediatric auditory brainstem implant (ABI) users in the Department of Otolaryngology in the Hacettepe University. It was a retrospective study, and all patients' files were reviewed. Materials and methods: The data was collected from 41 children who were fitted with ABI between 2005 and 2013. Inclusion criteria for children in our study are profound, congenital bilateral sensory-neural hearing loss with anomalies (such as cochlear, labyrinthine, and cochlear nerve aplasia) and more than one year of auditory experience with ABI. Post-meningitis patients and neurofibromatosis type 2 (NF2) patients were excluded. Auditory perception was evaluated using the Meaningful Auditory Integration Scale (MAIS), Functioning after Pediatric Cochlear Implantation (FAPCI) instrument, Categories of Auditory Performance (CAP), and Children's Auditory Perception Skills Test in Turkish (CIAT). Speech intelligibility was categorized with speech intelligibility rating (SIR), and language development was assessed using the Test of Early Language Development-Third Edition (TELD-3) and Manchester Spoken Language Development Scale (MSLD). Results: All patients gained basic audiological functions and were able to recognize and discriminate sounds by the third month of ABI surgery. According to the duration of ABI use and learning skills, patients revealed development from word identification to sentence recognition level in a wide spectrum. Conclusion: Preliminary results indicate that all children have gained basic auditory perception skills. On the other hand, language and speech development data were varying among children. Additional handicaps seemed to slow down progression. Secondary improvement was seen at psychosocial areas with respect to behavioral and social adjustment as well as eagerness to start communication.
    No preview · Article · Jun 2015 · Journal of International Advanced Otology
  • L Sennaroglu · V Gungor · G Atay · S Ozer
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    ABSTRACT: This paper reports the authors' technique of manubrio-stapedioplasty using glass ionomer cement for malleus and incus fixation due to tympanosclerosis. A retrospective case review was conducted of five patients with conductive hearing loss (mean pre-operative air-bone gap of 42.75 dB) treated in a tertiary referral centre. The hearing results of a manubrio-stapedial bone cement ossiculoplasty technique, utilised on the five patients, were analysed. All cases were Wielinga and Kerr tympanosclerosis classification type 2 (attic fixation of the malleus-incus complex with a mobile stapes). The incus and head of the malleus were removed in all patients, and the manubrium was directly connected to the head of the mobile stapes using glass ionomer cement. Patients were evaluated in terms of pre- and post-operative audiometric results; hearing gain and post-operative air-bone gap were the main outcome measures. Mean post-operative air-bone gap was 5.25 dB. Four patients had an air-bone gap of less than 10 dB; the remaining patient had an air-bone of 12.50 dB. Manubrio-stapedioplasty is an effective method for ossicular reconstruction in cases of malleus and incus fixation due to tympanosclerosis.
    No preview · Article · Apr 2015 · The Journal of Laryngology & Otology
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    ABSTRACT: Mutations in the POU3F4 gene cause X-linked deafness type 3 (DFN3), which is characterized by inner ear anomalies. Three Turkish, one Ecuadorian, and one Nigerian families were included based on either inner ear anomalies detected in probands or X-linked family histories. Exome sequencing and/or Sanger sequencing were performed in order to identify the causative DNA variants in these families. Four novel, c.707A>C (p.(Glu236Ala)), c.772delG (p.(Glu258ArgfsX30)), c.902C>T (p.(Pro301Leu)), c.987T>C (p.(Ile308Thr)), and one previously reported mutation c.346delG (p.(Ala116ProfsX26)) in POU3F4, were identified. All mutations identified are predicted to affect the POU-specific or POU homeo domains of the protein and co-segregated with deafness in all families. Expanding the spectrum of POU3F4 mutations in different populations along with their associated phenotypes provides better understanding of their clinical importance and will be helpful in clinical evaluation and counseling of the affected individuals.
    Full-text · Article · Feb 2015 · BMC Medical Genetics
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    Deniz Hanci · Tevfik Sozen · Bahar Kayahan · Sarp Sarac · Levent Sennaroglu

    Preview · Article · Dec 2014
  • 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.
    No preview · Article · Aug 2014 · Auris, nasus, larynx
  • 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.
    No preview · Article · Jul 2014 · Cochlear Implants International
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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.
    No preview · Article · Feb 2014 · International journal of pediatric otorhinolaryngology
  • Ozge Cağlar · Figen Bülbül · Levent Sennaroğlu
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    ABSTRACT: This study aims to investigate the incidence of otitis media with effusion and to report long-term clinical findings in children with cleft lip and palate types. Between March 2000 - October 2010, medical data of 175 patients (84 females, 95 males; mean age 8 years; range, 4 to 20 years) who were operated due to otitis media with effusion with long-term follow-up data were retrospectively analyzed. A total of 105 patients had a complete cleft lip and palate. In the first examination, 134 patients had ear effusion, the eustachian tube were not patent in 146 patients, and middle ear pressure was measured as -200 and below in 121 patients. After the operations, the eardrums had ear effusion in 89 patients, in 93 patients middle ear pressure was lower than -200, and 11 patients had chronic otitis media in the final examination. Our study results suggested that there was a statistically significant relationship among the middle ear disease, function of eustachian tube, treatment outcomes, middle ear pressure, cleft palate type and bilaterality of the disease. We believe that it is of utmost importance as it may affect the treatment process and the patient follow-up in such patients.
    No preview · Article · Sep 2013 · Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat
  • 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.
    No preview · Article · Sep 2013 · Otolaryngologia polska. The Polish otolaryngology
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    Levent Sennaroglu · Gonca Sennaroglu · Gamze Atay
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    ABSTRACT: Until last decade, use of auditory brainstem implant (ABI) was restricted to adults and children with severe inner ear malformations and cochlear nerve aplasia did not have any option for hearing rehabilitation. Use of ABI opened a new era for this group of patients. In this review article, definite and probable indications of ABI for children are stated. Among probable indications, children with hypoplastic nerves constitute the most challenging group in decision making between cochlear implant (CI) and ABI. In these patients, radiological findings should be utilized together with preoperative and intraoperative audiological evaluation. However, none of these assessment methods offer enough data to enable correct choice between CI and ABI. Intracochlear electrical ABR (eABR) seems to a better indicator compared to preoperative electrophysiological tests. Commonly, CI is the first choice in these patients; if benefit with CI is not satisfactory during follow up, then ABI is utilized. Further definitive diagnostic tools are require in order to overcome this uncertainty. The ABI team must be experienced on pediatric CI patients, also an experienced pediatric neurosurgeon is indispensable to achieve success and to avoid complications. Age limit for ABI is similar to CI candidate children. Better language outcome is expected at younger ages, i.e., between 1 and 2 years. Preoperative radiological work up involves both high resolution computed tomography and magnetic resonance imaging. The side with less severe inner ear malformation or with more developed neural structures can be preferred. In preoperative audiological evaluation, subjective tests should always be included in test battery as well as objective ones. Rehabilitative assessment is focused on auditory perception skills, language and speech skills and learning abilities. Surgical method of choice is retrosigmoid approach in children. Intraoperative eABR measurements are important to determine correct position of electrode. Interindividual variability in language development and audiological outcome is prominent. Overall complication rate is in an acceptable range when surgery is performed with an experienced team. In conclusion, ABI can provide satisfactory audiological outcomes and language development to a certain extent is possible when every aspect of whole process is applied properly.
    Full-text · Article · Jun 2013
  • Münir Demir Bajin · Burçe Ozgen Mocan · Sarp Saraç · Levent Sennaroğlu
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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.
    No preview · Article · May 2013 · Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • Article: Response.
    Levent Sennaroglu · Ibrahim Ziyal

    No preview · Article · Jan 2013 · Auris, nasus, larynx
  • Serdar Ozer · Ozer PA · Cekic Kaya S · Ahmet Atas · Altiparmak UE · Gamze Atay · Levent Sennaroglu
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    ABSTRACT: Background: Idiopathic intracranial hypertension (IIH) is a syndrome characterized by increased intracranial pressure (ICP) without focal signs for neurological dysfunction except for occasional fifth, sixth, and seventh cranial nerve palsies. Presenting symptoms most commonly are headache and visual loss. These patients may also present with complaints about neuro-otological symptoms like hearing loss, and tinnitus. In this study, we investigated the presence and laterality of neuro-otological symptoms, and correlations of these symptoms with the audiological and ophthalmological findings in patients with IIH. Materials and Methods: The study included 28 patients with the diagnosis of IIH and 18 patients as control group. Ears of the patients in the study were grouped as symptomatic ears of IIH patients, non-symptomatic ears of IIH patients and ears of control group patients. We questioned the patients for neuro-otologic symptoms. Audiological and electrophysiological evaluations and ophthalmological examinations were done. Results: The most common presenting symptom was headache. The most commonly seen neuro-otologic symptom was tinnitus, which was present in 21 patients (75%). Tinnitus was in pulsatile pattern in 15 of these patients (71.4%). We observed sensorineural hearing loss (SNHL) in 20 patients (35.7%) when standard pure tone averages (SPTA) and SNHL in 39 patients (69.6%) when low frequency pure tone averages (LFPTA) were evaluated. Complaints were unilateral in 39.3 % of these patients. SPTA and LFPTA's of the symptomatic ears were significantly higher than the non-symptomatic ears of IIH patients (p=0.008, p=0.005 respectively). Conclusion: Neuro-otologic symptoms are commonly seen in patients with IIH. Audiological evaluations of the patients with unilateral symptoms showed different degree of hearing losses could be seen. Since neuro-otological symptoms and findings are commonly seen, audiological evaluations may play a role in the diagnosis and follow up of the patients with IIH. Patient follow up by the ear-noseand throat specialists and the audiologists in association with neuroophthalmologists is thought to be beneficial.
    No preview · Article · Jan 2013 · Journal of International Advanced Otology
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    Full-text · Article · Dec 2011 · International Journal of Otolaryngology
  • 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.
    No preview · Article · Dec 2011 · Auris, nasus, larynx
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    Betul Cicek Cinar · Ahmet Atas · Gonca Sennaroglu · Levent Sennaroglu
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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.
    Full-text · Article · Sep 2011 · Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • L. Sennaroglu · S. Sarac

    No preview · Article · May 2011 · International Journal of Pediatric Otorhinolaryngology
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    B. Ozgen Mocan · E. Sanverdi · N. Orhan · S. Sarac · L. Sennaroglu
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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.
    Full-text · Conference Paper · Mar 2011

Publication Stats

1k Citations
116.44 Total Impact Points


  • 1994-2015
    • Hacettepe University
      • • Faculty of Medicine
      • • Department of Otolaryngology
      • • Department of Audiology and Speech Pathology
      • • Department of Radiology
      Engüri, Ankara, Turkey
  • 2009
    • Ankara University
      Engüri, Ankara, Turkey
  • 2001
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia