Browsing by Author "Cam, Osman Halit"

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Audiological and vestibular measurements in Behcet's disease
(2019) Ertugrul, Ozlem; Mutlu, Ahmet; Zindanci, Ilkin; Cam, Osman Halit; Ozluoglu, Levent; 30929056; AAP-1533-2020
IntroductionBehcet's disease (BD) is a vasculitis that involves all small vessels and influences the multiple systems of the human body. This study aimed to evaluate the audio-vestibular system involvement of patients with BD and healthy individuals.Materials and methodsThis study was designed as a prospective case-control blinded study. Thirty-one patients with BD and 31 healthy individuals were included. All the subjects were evaluated via pure tone audiometry (PTA), video head impulse test (vHIT), post head shake nystagmus test (PHSNT) and dizziness handicap inventory (DHI) to check for audio-vestibular system involvement.ResultsPatients with BD showed higher PTA scores in both speech and high frequencies. The vHIT revealed pathological saccades, particularly in horizontal canals (right ear: p=0.002, left ear: p=0.039). The gain values of the patients were slightly lower than those of the control group; however, gain and gain asymmetry differed significantly in a few canals. In the spontaneous nystagmus test and PHSNT, pathological nystagmus was detected to be significantly higher in the patient group than control group (p=0.001); but the saccade presence in vHIT and nystagmus in PHNT did not differ among the patients (p=0.106). In addition, the DHI scores of the patients group were higher than those of the control group (p<0.001). No correlation was found between disease duration and saccade presence.ConclusionThe vHIT was used preliminary for evaluating the vestibular system in BD. This study showed the influence of BD on the audio-vestibular system, in particular isolated horizontal canal involvement was discovered in patients with BD.Level of evidenceLevel III b.
Contralateral Depressor Labii Inferioris Chemodenervation for Congenital Unilateral Lower Lip Palsy
(2020) Cam, Osman Halit; Ozucer, Berke; 32487835
Introduction: Congenital unilateral lower lip palsy - also known as asymmetric crying facies - is isolated asymmetry of the lower lip unilaterally. It is characterized by isolated lower lip asymmetry during smiling and speech. Although etiology is unknown, depressor labii inferioris (DLI) weakness is hold responsible. Aim: Purpose of this study was to evaluate the effectiveness of contralateral depressor labii inferioris botulinum toxin injection on patients' concern levels and patient satisfaction. Ten units of botulinum toxin A injection was carried out to the healthy contralateral side. Methodology: Eleven patients were treated. Patients' pretreatment and posttreatment concern regarding asymmetry during speech and smiling was evaluated with a questionnaire. Patients' perception of treatment satisfaction was also evaluated with a questionnaire. Results: Mean score related to concern about asymmetric appearance during smiling decreased from 1.6 +/- 0.8 to 0.5 +/- 0.5. Mean score related to concern about asymmetric appearance during speech decreased from 1.6 +/- 0.5 to 0.4 +/- 0.5. Eleven out of 11 patients reported improvement with speech whereas 10 out of 11 patients reported improvement with smiling. No weakness about oral competence was reported. Conclusion: Most congenital unilateral lower lip palsy patients are concerned regarding their asymmetric appearance while smiling or speaking. Chemodenervation of the contralateral DLI muscle reduces concern levels and has high patient satisfaction. Chemodenervation of the contralateral healthy DLI muscle is a valid, practical treatment option.
Effect of Distal Masseter to Facial Nerve Transfer in Paralytic Patients with Preserved Facial Nerve Continuity on Improving Scaled Measurement of Improvement in Lip Excursion (SMILE): A Vectoral Analysis
(2020) Ozucer, Berke; Cam, Osman Halit; 33554200
Objective: Distal masseter-to-facial neurorrhaphy is an option to improve smile excursion in facial paralysis patients in the early period without truncating the facial nerve truncus and by ensuring the continuity of the facial nerve. This study aimed to study the effect of distal masseter-to-facial neurorrhaphy on smile excursion. Methods: Charts of eight patients were retrospectively examined. Screenshots showing the best possible smiles were taken from preoperative videos. Screenshots were taken from postoperative videos showing the best combination of a natural smile on the healthy side and a smile with clenched teeth on the paralytic side. Emotrics and Photoshop software were used for computing vertical, horizontal, and overall excursion from facial landmarks. Scaled measurements of improvement in lip excursion and lip angle was evaluated. Symmetry was evaluated by accepting the healthy side as 100 percent, and the paralytic side was calculated as a percentage of the healthy side. Results: Five patients had total facial paralysis and three had facial paresis. Mean postoperative follow-up period was 15.0 +/- 10.2 months. The average interval between facial denervation and nerve repair was 14.0 +/- 4.1 months (range, 11-23). All neurorrhaphies were coapted end-to-end to either the zygomatic or the buccal branch without an interposition graft. Mean postoperative initial movement occurred at 95.5 +/- 20.5 days (range, 72-138). Paralytic side to healthy side horizontal excursion changed from preoperative 72.5 +/- 17.4% to postoperative 93.4 +/- 6.9%. Vertical excursion changed from preoperative 38.4 +/- 24.6% to postoperative 89.3 +/- 11.8%. Overall excursion changed from preoperative 68.4 +/- 19.6% to postoperative 92.9 +/- 10.4%. Paralytic side to healthy side mean lip angle changed from 64.7% preoperative to 95.2% postoperatively. All changes were statistically significant (p<0.05). Conclusion: Facial paralysis patients with an asymmetric smile benefit from distal masseter-to-facial nerve transfer and it improves smile excursion dramatically. This effect was especially prominent in the vertical component of the smiling vector.
The Effectiveness of Asymmetric Dorsal Preservation for Correction of I-Shaped Crooked Nose Deformity in Comparison to Conventional Technique
(2020) Ozucer, Berke; Cam, Osman Halit; 0000-0002-2785-4474; 32392429; AAP-1533-2020
Importance: Using asymmetric dorsal preservation (ADP) (pushdown technique for deviated side and letdown technique to the contralateral nondeviated side) is an alternative surgical method to correct osseocartilaginous deviation in crooked nose deformity. Objective: Aim of this study was to evaluate whether ADP rhinoplasty is a good method to address I-shaped crookedness in comparison with conventional midvault deconstructing/reconstructing rhinoplasty. Design, Setting, and Participants: This study was conducted between June 2017 and August 2019. Twenty-two consecutive patients' I-shaped crookedness was addressed with either ADP (n = 10) or conventional midvault techniques (n = 12). Patients were followed up at least for 6 months. Main Outcomes and Measures: Pre- and postoperative frontal photographs and digital screen protractor was utilized for measurement of crookedness in a single-blinded manner. Surgical success were calculated and compared. Results: In ADP group, mean angle of deviation was 10.2 +/- 3.7 degrees and 0.5 +/- 1.0 degrees pre- and postoperatively, respectively. In control group, mean angle of deviation was 9.5 +/- 1.8 degrees and 0.3 +/- 0.9 degrees pre- and postoperatively, respectively. Change in angle was statistically significant for both groups. Postoperative calculated mean success rate was 96.3 +/- 7.9% and 97.5 +/- 8.5% for dorsal preservation and control group, respectively. Eight out of 10 patients in dorsal preservation group and 11 out of 12 patients in the control group achieved the ideal angle of 0 degrees, hence had 100% postoperative surgical success. Conclusions and Relevance: Utilization of dorsal preservation principles for correction of I-shaped crookedness presents as a promising and practical surgical alternative approach that should be in every rhinoplasty surgeon's armamentarium.
Effects of Glycerol Test on Resonance Frequency in Patients with Meniere's Disease
(2019) Oz, Isilay; Hizal, Evren; Cam, Osman Halit; Ozluoglu, Levent Naci; 31715604
Objective: To evaluate resonance frequency (RF) values via dehydration effects in the inner ear caused by the glycerol test, which is used as a diagnostic method for Meniere's disease (MD). Methods: Twenty adult patients with unilateral MD were included in the study. Before, and then at 1, 2, and 3 h after administration of glycerol (1 g/kg), pure-tone hearing levels (125-8,000 kHz) and multifrequency tympanometry tests were performed. As a control, the RF values of the ears of 25 healthy subjects (i.e., 50 ears) were compared to the affected and unaffected ears in the 20 MD patients. Results: There was a significant difference between the RF values of affected and healthy ears before glycerol administration (p = 0.047). The RF values before and after glycerol administration into affected ears were compared. The average RF values decreased significantly from 748.0 +/- 402.1 to 808.0 +/- 410.1 Hz at 1 h after glycerol intake, and this value increased during the subsequent hours. There were no statistically significant differences between the pure-tone levels before and 1 h after glycerol administration, but a significant decrease was observed at 3 h. Conclusion: We suggest that MD has different inner-ear dynamics and normal RF values when compared to healthy ears. Furthermore, decreased inner ear pressure causes reduction of the mass effect and a stiffening of the annular ligament. We conclude that pre- and post-RF tests should be added to the test battery for diagnosis of MD.
Transient Velopharyngeal Insufficiency After Calcified Stylohyoid Ligament Resection
(2020) Cam, Osman Halit; Kocdor, Pelin; Ozluoglu, Levent N.; 0000-0001-9253-1412; 0000-0002-2150-0237; 32371704; AAP-1533-2020; AAD-7236-2021; AAI-8020-2021
Elongation of the stylohyoid process or calcification of the stylohyoid ligament is known as the Eagle syndrome. Mostly, it is seen incidentally on imaging or with extreme suspicion and usually patients are asymptomatic. Surgery is the preferred method in symptomatic patients. Transcervical or transoral methods may be preferred as surgical route. A 28-year-old female patient who had formerly underwent tonsillectomy presented with throat and ear pain. A neck computed tomography was performed, and the patient was diagnosed as Eagle Syndrome. Surgery was recommended. Patient developed transient velopharyngeal insufficiency on postoperative day 4. Ventilation exercise and follow-up was recommended. Complaints of the patient decreased on the 15th day. It should be kept in mind that stylohyoid ligament may be calcified in young age group and middle age group patients with dysphagia or odynophagia, and differential diagnosis should be performed. Another issue is the condition of velofaringeal insufficiency which may occur due to the damage of the pharynx muscles by deep dissection during surgery.