Browsing by Author "Hizal, Evren"

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Assessment of Vestibular Function in Adults with Prelingual Hearing Loss Using c/oVEMP Tests
(2020) Tanyeri, Oya; Akdogan, M. Volkan; Hizal, Evren; Buyuklu, A. Fuat; 0000-0001-9710-9974; 0000-0002-9699-6783; 32066551; AAJ-4584-2021; A-5853-2018
OBJECTIVES: The aim of the present study was to compare the vestibular system integrity of individuals with normal hearing with that of prelingual hearing impaired individuals. It is well known that ocular vestibular evoked myogenic potentials (oVEMPs) reflect utricular function, whereas cervical vestibular evoked myogenic potentials (cVEMPs) reflect saccular function.Therefore,oVEMP and cVEMP tests were applied to evaluate the vestibular system integrity of hearing impaired individuals participating in the research. MATERIALS and METHODS: The study group consisted of sensorineural prelingual hearing-loss volunteers aged from 18 to 60 years, whereas the control group consisted of age- and gender-matched healthy volunteers. cVEMP and oVEMP tests were performed to evaluate the integrity of the vestibular system, and the results were compared with those of the control group. RESULTS: The study included 20 (76.9%) women and 6 (23.1%) men in the study group; on the other hand, the control group consisted of 19 (73.196) women and 7 (26.9%) men. There was a difference between the study group and the control group when oVEMP and cVEMP responses were compared, and the response percentage was higher in the control group. The response rates of oVEMP and cVEMP in patients with prelingual hearing loss were 44.2 % and 59.6%, respectively. There was also a statistically significant difference between the groups for oVEMP amplitude and cVEMP P1 latency (p <= 0.05). CONCLUSION: These findings suggest that prelingual hearing loss is related to both utricular and saccular dysfunctions. However, oVEMPs were more often abnormal in prelingual deaf patients than cVEMPs, suggesting that utricular dysfunction may be more common than saccular dysfunction.
Clinical Interpretation of Positional Nystagmus Provoked by both Dix-Hallpike and Supine Head-Roll Tests
(2022) Hizal, Evren; Jafarov, Sabuhi; Erbek, Seyra H.; Ozluoglu, Levent N.; 35894530
BACKGROUND: Both the Dix-Hallpike test and the supine head-roll test can provoke positional nystagmus in a group of benign paroxysmal positional vertigo patients, including but not limited to those with multiple canal involvement. This study aimed to determine the incidence and interpret the clinical significance of positional nystagmus provoked by both the Dix-Hallpike and the supine head-roll tests. METHODS: The results of video-nystagmography sessions recorded in the computer database that included both the Dix-Hallpike and the supine head-roll tests were examined. RESULTS: The records belonging to 2880 video-nystagmography sessions of 2387 patients were examined. Nystagmus was detected in both the Dix-Hallpike and the supine head-roll tests of 131 (5.5%) patients. The video images belonging to 142 session records of 122 patients were accessed and further analyzed. The diagnosis was posterior canal BPPV in 9.0%, and lateral canal BPPV in 62.3%. More than one canal was involved in 3.3%, one rehabilitation maneuver was performed in 75.0%, and recurrence was observed in 7.4% of those patients. CONCLUSION: In both geotropic and apogeotropic variants of lateral canal BPPV, nystagmus can be observed during the Dix-Hallpike test in addition to the supine head-roll test. In patients with posterior canal benign paroxysmal positional vertigo, nystagmus can also be observed in the head-roll test. To reach a correct and comprehensive diagnosis and apply appropriate treatment in benign paroxysmal positional vertigo, the Dix-Hallpike test and the head-roll test should be completely performed on both sides, and the results of those tests must be interpreted concomitantly.
Effect of Suture Type and Suture Distance on Holding Strength in Nasal Septal Laceration Model
(2021) Koycu, Alper; Hizal, Evren; Erol, Ozan; Buyuklu, Adnan Fuat; 0000-0003-1290-3509; 0000-0002-9699-6783; 0000-0002-4209-9403; 33912854; AAF-3650-2021; A-5853-2018
Objective: Septal mucosal-perichondrial flaps can be lacerated during the elevation of the flaps. Appropriate repair of the lacerations is essential to prevent the development of septal perforation during the healing process. We aimed to determine the superior suture type and suture distance to use in repairing the lacerations of nasal septal mucosal-perichondrial flaps. Methods: The study used 128 nasal septal mucosal-perichondrial flaps prepared from sheep heads. Experimentally induced lacerations on the mucosal-perichondrial flaps were sutured with two interrupted sutures using one of four suture materials (4-0/5-0 Polyglactin 910, 4-0/5-0 Polydioxanone) and leaving either 5 mm or 10 mm distance between the sutures. Maximum tissue holding strength (HSmax) was measured for each suture material and suture distance used. Results: Mean HSmax values were higher for Polyglactin 910 sutures (p<0.001) and 10 mm suture distance (p=0.008) when the groups were compared in terms of suture material and suture distance, respectively. There was no statistically significant difference between the mean HSmax values of sutures with 4-0 and 5-0 diameters (p=0.057). Conclusion: Polyglactin 910 suture material with 10 mm space between two adjacent sutures may be more durable than the other suture materials when repairing nasal septal mucosal lacerations.
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.
The Genotoxic Effect of Nasal Steroids on Human Nasal Septal Mucosa and Cartilage Cells In Vitro
(2023) Babakurban, Seda Turkoglu; Vural, Omer; Kasap, Yesim Korkmaz; Hizal, Evren; Yurtcu, Erkan; Buyuklu, Adnan Fuat; 0000-0001-5067-4044; 0000-0001-7157-0850; 35695134; AAI-8856-2021; AAJ-1454-2021
Objective: To determine whether budesonide (Bud) and triamcinolone acetate (TA) cause DNA fractures in the nasal mucosa and septal cartilage cells through examinations using the comet assay technique. Study design: Prospective, controlled experimental study. Setting: University hospital. Methods: Septal mucosal epithelial and cartilage tissue samples were taken from 9 patients. Cell cultures were prepared from these samples. Then, budesonide and triamcinolone acetate active ingredients at 2 different doses of 0.2 and 10 mu M were separately applied to the cell cultures formed from both tissues of each patient, except the control cell culture, for 7 days in one group and 14 days in one group. After the applications, genotoxic damage was scored with the comet assay technique and the groups were compared. Results: In both the budesonide and triamcinolone acetate groups, the comet scores at low and high doses, on the 7th and 14th days were found to be significantly higher in both cartilage and epithelial tissue than in the control group. Conclusion: The study results showed that budesonide and triamcinolone acetate lead to a significantly high rate of genotoxic damage in both epithelial tissue and cartilage tissue.
Glycerol Affects Vestibular-Evoked Myogenic Potentials and Pure-Tone Hearing in Patients with Meniere's Disease
(2015) Oz, Isilay; Erbek, Seyra Hatice; Alp, Gulfem; Hizal, Evren; Ozluoglu, Levent Naci; 0000-0002-8453-6069; 0000-0002-7380-4566; 0000-0002-2150-0237; 0000-0002-9699-6783; 25428817; AAJ-2445-2021; AAJ-1452-2021; AAI-8020-2021; A-5853-2018
Conclusion: The pure-tone audiometry results following glycerol administration indicated a positive effect on cochlear endolymphatic hydrops. Glycerol cervical vestibular-evoked myogenic potential (cVEMP) tests are a useful means of diagnosing saccular hydrops. There was no correlation between cVEMP and audiological results. Objective: To document the changes in pure-tone hearing outcomes and cVEMPs in patients with Meniere's disease (MD) and 10 healthy volunteers before and after oral administration of glycerol. Methods: Twenty-nine study group subjects were chosen with complaints of vertigo. cVEMP testing and pure-tone hearing level testing were performed before and at 1, 2, and 3 h after administration of glycerol. Results: The means of the latencies, amplitudes, and difference ratio in 20 normal subject ears were determined. Based on these values, 9/29 MD-affected (MDA) ears (31%) had a unilaterally absent cVEMP. Compared with difference ratio values of the control groups there were significant differences in both latencies and amplitudes in MDA ears after glycerol administration. Before glycerol administration, there were significant differences between control and MDA ears on mean values of pure-tone hearing outcomes. Twenty patients in the MDA group showed significant pure-tone hearing outcomes after glycerol administration.
Letter to the editor regarding 'Evaluation of vitamin D levels in children with primary epistaxis'
(2017) Akdogan, M. Volkan; Hizal, Evren; 0000-0001-9710-9974; 0000-0002-9699-6783; 28648890; AAJ-4584-2021; A-5853-2018
Long-Term Inflammatory Response to Liquid Injectable Silicone, Cartilage, and Silicone Sheet
(2014) Hizal, Evren; Buyuklu, Fuat; Ozdemir, B. Handan; Erbek, Selim S.; https://orcid.org/0000-0002-9699-6783; https://orcid.org/0000-0003-1528-0036; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0003-4825-3499; 24966072; A-5853-2018; W-5941-2018; X-8540-2019; B-7604-2019
Objectives/HypothesisTo show and compare the long-term inflammatory responses to subdermal microdroplet injections of 1,000 centistoke (cS) and 5,000 cS liquid injectable silicone (LIS), and to assess the applicability of insulin pen as an alternative LIS delivery device in an animal model. Study DesignAnimal study. MethodsEighteen healthy adult Sprague-Dawley rats were used. Two graft recipient sites and four injection sites were prepared on each rat's back for: 1) autogenous auricular cartilage graft; 2) silicone sheet; 3) 1,000 cS LIS injection with insulin syringe; 4) 1,000 cS LIS injection with insulin pen; 5) 5,000 cS LIS injection with insulin syringe; and 6) 5,000 cS LIS injection with insulin pen. The animals were followed up for 6 months, and skin biopsies were examined for the evaluation of LIS microdroplets in situ and the degree of inflammatory tissue response. Immunohistochemistry was used for the examination of macrophages and the density of microvessels. ResultsBiopsies from 17 animals were assessed. There was no statistically significant difference among the groups in terms of the number of lymphocytes (P=0.081), macrophages (P=0.857), and neutrophils (P=0.995), the degree of vascular proliferation (P=0.698), and the mean LIS microdroplet diameter (P=0.540). Grossly, there was no sign of granuloma formation in any of the specimens. ConclusionThere is a low-grade, well-tolerated long-term inflammatory response to microdroplet injections of 1,000 cS and 5,000 cS LIS that is comparable to autogenous cartilage graft in rats. Standard dose delivery devices such as insulin pens can be used for controlled LIS injections. Level of EvidenceN/A. Laryngoscope, 124:E425-E430, 2014
Protective effect of Nigella sativa oil on acoustic trauma induced hearing loss in rats
(2017) Culhaoglu, Belde; Erbek, Selim S.; Erbek, Seyra; Hizal, Evren; 0000-0002-8453-6069; 0000-0003-4825-3499; 0000-0002-9699-6783; 28791082; AAJ-2445-2021; B-7604-2019; A-5853-2018
Acoustic trauma is a common reason for hearing loss. Different agents are used to prevent the harmful effect of acoustic trauma on hearing. The aim of this study was to evaluate the potential preventive effect of Nigella sativa (black cumin) oil in acoustic trauma. Our experimental study was conducted with 20 Sprague Downey female rats (mean age, 12 months; mean weight 250 g). All of the procedures were held under general anesthesia. Following otoscopic examinations, baseline-hearing thresholds were obtained using auditory brainstem responses (ABR). To create acoustic trauma, the rats were then exposed to white band noise of 4 kHz with an intensity level of 107 dB in a soundproof testing room. On Day 1 following acoustic trauma, hearing threshold measurements were repeated. The rats were divided into two groups as the study group (n: 10) and the controls (n: 10). 2 mL/kg/day of Nigella sativa oil was given to the rats in the study group orally. On Day 4 following acoustic trauma, ABR measurements were repeated again. There was no difference between the baseline hearing thresholds of the rats before acoustic trauma (P>0.005). After the acoustic trauma, hearing thresholds were increased and there was no significant statistically difference between the hearing thresholds of the study and control groups (P=0.979). At the 4th day following acoustic trauma, hearing thresholds of the rats in control group were found to be higher than those in the study group (P=0.03). Our results suggest that Nigella sativa oil has a protective effect against acoustic trauma in early period. This finding should be supported with additional experimental and clinical studies, especially to determine the optimal dose, duration and frequency of potential Nigella sativa oil therapy.
The Role of Meteorologic Factors and Air Pollution on The Frequency of Pediatric Epistaxis
(2018) Akdogan, M. Volkan; Hizal, Evren; Semiz, Mustafa; Topal, Ozgul; Akkas, Hakan; Kabatas, Aydin; Erbek, Selim S.; 0000-0001-9710-9974; 0000-0002-9699-6783; 0000-0001-6305-5023; 0000-0003-4825-3499; 30273433; AAJ-4584-2021; A-5853-2018; ABI-6777-2020; B-7604-2019
Fluctuations in atmospheric temperature, humidity, and air pollution are associated with the incidence of epistaxis. To date, no study in the literature has evaluated the effect of air pollution and meteorologic conditions on the pediatric population. We aimed to evaluate the effect of meteorologic factors and air pollution on the frequency of epistaxis in children. Children presenting to an outpatient clinical setting at a tertiary care hospital during a 5-year period ( July 1, 2009, to June 30, 2014) and diagnosed with epistaxis formed the study population. Daily temperature and humidity parameters and average daily atmospheric water vapor pressure, average daily concentration of particulate matter < 10 mu m in diameter, and sulfur dioxide readings were obtained. The distribution of daily parameters was analyzed. Of the 1,559 children with the primary diagnosis of epistaxis, data from 1,330 children were analyzed after excluding patients with coexisting pathologies. Positive correlations were found between the frequency of epistaxis and both the average daily temperature and the difference between the maximum and minimum daily temperature. There was a negative correlation between the epistaxis frequency and the average daily humidity, the difference between the maximum and minimum daily humidity, the average daily concentration of particulate matter, and the sulfur dioxide levels. Our findings suggest that epistaxis in children is related to high temperatures and low humidity.
Short-Term Results of Neurelec Digisonic SP Cochlear Implantation in Prelingually Deafened Children
(2014) Senkal, Ozgul Akin; Hizal, Evren; Yavuz, Haluk; Yilmaz, Ismail; Ozluoglu, Levent Naci; https://orcid.org/0000-0002-3554-8274; https://orcid.org/0000-0002-9699-6783; https://orcid.org/0000-0003-3320-204X; https://orcid.org/0000-0002-1694-7608; https://orcid.org/0000-0002-2150-0237; 23749057; F-9493-2013; A-5853-2018; F-6315-2015; AAJ-2992-2021; AAI-8020-2021
This paper examines the reports on the selection criteria and the post-operative performance of 25 children implanted with the Neurelec Digisonic SP. This study reported benefits from Neurelec Digisonic SP cochlear implant in auditory and speech perception outcomes. There has been a lack of studies into the additional factors such as level of the mothers' education and bilingualism, which is a factor that may have a significant effect on the success of cochlear implantation. This paper examines the reports on the reasons for the differences in performance and the post-operative performance of 25 children implanted with the Neurelec Digisonic SP. Meaningful Auditory Integration Scale and Meaningful Use of Speech Scale questionnaires were used just before 3, 6, 12, and 18 months following implantation. Electrode array was inserted without difficulty in all cases, with no complications to date. This is a retrospective and cross-sectional study and all the data were collected between March 2010 and December 2012. Auditory performance improved over time for up to 12 months after implantation. Our experience indicates that the Neurelec Digisonic SP cochlear implant system in children under the age of two is relatively safe and reliable. The Neurelec Digisonic SP device surgery can be performed without complications. Auditory performance results support the effectiveness of early implantation. These important findings further support the importance of professionals working very closely with parents or especially mothers and enhancing their involvement in achieving therapy goals to develop auditory skills and speech in young children following cochlear implantation.
Upright positioning-related reverse nystagmus in posterior canal benign paroxysmal positional vertigo and its effect on prognosis
(2020) Jafarov, Sabuhi; Hizal, Evren; Bahcecitapar, Melike; Ozluoglu, Levent N.; 0000-0002-2150-0237; 0000-0002-9699-6783; 0000-0002-7302-4199; 32597824; AAI-8020-2021; A-5853-2018; AAI-8044-2021
BACKGROUND: Positional nystagmus elicited by the Dix-Hallpike maneuver often reverses its direction as the patient is re-seated from the provoking head hanging position. The incidence of reverse nystagmus and its association with prognosis in posterior canal benign paroxysmal positional vertigo (pcBPPV) is not clear. OBJECTIVE: To determine the incidence of upright positioning-related reverse nystagmus and its association with the success of canalith repositioning (Epley) maneuver (CRM) treatment in pcBPPV. METHODS: The records of patients that had been tested with video-nystagmography in a tertiary care center, between October 2016 and March 2019, were reviewed. Data were obtained from detailed analysis of video recordings of 321 patients with typical pcBPPV. RESULTS: Reverse nystagmus was determined in 85% of the patients with pcBPPV. The number of CRMs required for treatment was lower in patients with reverse nystagmus (1.32 +/- 0.68) compared to patients without reverse nystagmus (1.81 +/- 0.98) (p < 0.001). There was not a statistically significant relationship between reverse nystagmus and recurrence (p = 0.623). CONCLUSIONS: The absence of reverse nystagmus on upright positioning during the Dix-Hallpike test predicts poor success for the CRM, as repetitive repositioning maneuvers might be required to achieve successful treatment in pcBPPV.