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    Cochlear Implant Surgery Experiences of a Tertiary Health Center in the Thrace Region
    (Galenos Publ House, 2022) Guven, Selis Gulseven; Uzun, Cem; Tas, Memduha; Demir, Erbay
    Aim: Cochlear implants (CIs) aid in language and speech development through improved hearing in patients with bilateral severe or profound hearing loss. In this study, we evaluated the outcomes of our patients undergoing CI surgery. Materials and Methods: Preoperative, perioperative and postoperative clinical and audiological findings, hearing loss etiology, surgical approach techniques, and complications were evaluated retrospectively in 31 patients (35 ears) undergoing CI surgery. Results: Thirty one patients (13 adults and 18 children) were included in the study. After posterior tympanotomy following cortical mastoidectomy, electrodes were introduced through the round window in 21 ears and via cochleostomy in 14 ears. CIs with different number of electrodes (22, 16, 12) from 3 different companies were used. No postoperative complications were observed in any of the patients. The mean free field audiogram (FFA) was 95.2 +/- 19.13 dB preoperatively and 37.8 +/- 8.46 dB postoperatively in 24 patients who attended the control visits. Postoperative hearing gains were significantly different from the preoperative values (p<0.001). There was no significant difference between different devices (p=0.340). Electrodes were introduced through the round window or by cochleostomy, and comparison of these two groups revealed no statistically significant difference in terms of postoperative FFA values (p=0.425) or speech awareness threshold and speech reception threshold values (p=0.132). Conclusion: The significant hearing gains in the postoperative period without any complications indicate the success of the surgical technique utilized in this study. It can be said that the difference in electrode insertion location and numbers does not affect the postoperative results.
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    Does noise exposure during pregnancy affect neonatal hearing screening results?
    (Wolters Kluwer Medknow Publications, 2019) Guven, Selis Gulseven; Tas, Memduha; Bulut, Erdogan; Tokuc, Burcu; Uzun, Cem; Karasalihoglu, Ahmet Karasalihoglu
    Objective: The aim is to investigate whether noise is effective on hearing screening tests of neonates born to mothers exposed to noise during pregnancy. Material and Method: Screening results of 2653 infants from the period of January 2013-May 2017 were evaluated. Transient Evoked Otoacoustic Emissions (TEOAE) and Auditory Brainstem Response (ABR) were used. Infants of 65 mothers exposed to noise (LAeq 80-85 dBA/8 hours/day) during pregnancy (Week +/- SD; 32.58 +/- 2.71) comprised the study group while the control group consisted of infants of 2588 mothers without noise exposure. Results: Among the 65 infants, 23 (35.4%) passed screening at the first emission test (OAE1); 34 (52.3%) at the second emission test (OAE2); 7 (10.8%) at the ABR stage, 1 (1.5%) infant was referred to a tertiary center. In the control group, 458 (17.7%) infants passed at OAE1; 1822 (70.4%) at OAE2; 289 (11.2%) at ABR stages, 19 (0.7%) infants were referred to a tertiary center. The rate of infants that passed screening at OAE1 in the study group was high (P = 0.00001). Sixty-four (98.46%) infants in the study group and 2569 (99.26%) infants in the control group passed the tests. The difference between the two groups was not significant, indicating that exposure to noise during pregnancy had no unfavorable effects on auditory functions (P = 0.392). Conclusion: Unfavorable effect of noise exposure during pregnancy was not observed on auditory functions of the infants. The higher rate of infants that passed the screening test at OAE1 stage in the study group raised the question, Does the exposure of the noise at exposure action levels (80-85 dB A) during pregnancy contribute to auditory maturation of fetus?
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    Does Oral Monosodium Glutamate Have a Cochleotoxic Effect? An Experimental Study
    (Karger, 2022) Guven, Selis Gulseven; Ersoy, Onur; Topuz, Ruhan Deniz; Bulut, Erdogan; Kizilay, Gulnur; Uzun, Cem
    Introduction: The effect of orally consumed monosodium glutamate (MSG), which is a common additive in the food industry, on the cochlea has not been investigated. The present study aimed to investigate the possible cochleotoxic effects of oral MSG in guinea pigs using electrophysiological, biochemical, and histopathological methods. Methods: Thirty guinea pigs were equally divided into control and intervention groups (MSG 100 mg/kg/day; MSG 300 mg/kg/day). At 1 month, 5 guinea pigs from each group were sacrificed; the rest were observed for another month. Electrophysiological measurements (distortion product otoacoustic emission [DPOAE] and auditory brainstem response [ABR]), glutamate levels in the perilymph and blood samples, and histopathological examinations were evaluated at 1 and 2 months. Results: Change in signal-to-noise ratio at 2 months was significantly different in the MSG 300 group at 0.75 kHz and 2 kHz (p = 0.013 and p = 0.044, respectively). There was no statistically significant difference in ABR wave latencies of the guinea pigs given MSG compared to the control group after 1 and 2 months; an increase was noted in ABR thresholds, although the difference was not statistically significant. In the MSG groups, moderate-to-severe degeneration and cell loss in outer hair cells, support cells, and spiral ganglia, lateral surface junction irregularities, adhesions in stereocilia, and partial loss of outer hair cell stereocilia were noted. Conclusion: MSG, administered in guinea pigs at a commonly utilized quantity and route of administration in humans, may be cochleotoxic.
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    The Effect of Mode of Delivery on Newborn Hearing Screening Results
    (Galenos Yayincilik, 2019) Guven, Selis Gulseven
    Objective: Congenital hearing loss is one of the most important public health problems with a frequency of about 1-6 per 1000 live births all over the world. Although neonatal hearing screening tests are important for the timely detection and rehabilitation of hearing loss, determining the factors that may affect the screening results will contribute greatly to the development of screening programs. In this study, the effects of the modes of delivery on the results of tests in the screening program was investigated. Methods: In this study, the results of 10.575 newborns who were screened according to the National Neonatal Hearing Screening Protocol between January 2013 and May 2017 were evaluated. The screening test results of 2.653 newborns were examined retrospectively according to the type of delivery after candidates were excluded according to the exclusion criteria and risk factors for hearing loss. Of these newborns, 1.571 (59.2%) were born by normal deliery and 1.082 (40.8%) by cesarean section. Screening test results were analyzed using Pearson's Chi-square test. Results: No statistically significant difference was observed among the 2.653 neonatal hearing screening test results in terms of mode of delivery (p>0.05). In both delivery modes, the rate of false positive was found to be high (81.9%) in the first hearing screening test of newborns, and this rate decreased in the second screening test (14.5%). Conclusion: The mode of delivery has no significant effect on the neonatal hearing screening results; however, the observation that neonates had been more successful in the second screening test in both groups suggests that the test protocol should be re-evaluated in terms of timing.
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    Evaluation of the Olivocochlear Efferent System Activation After Exposure to Music in Young Individuals
    (Aves, 2019) Bulut, Erdogan; Nurcin, Elcin; Yilmaz, Sule; Guven, Selis Gulseven; Tas, Memduha
    Objective: In this study, a protective role of the olivocochlear efferent system activation on the hearing system in young individuals after music exposure (ME) was investigated. Methods: Twenty two young adults aged 19-22 years (mean age +/- standard deviation, 19.63 +/- 0.83) with normal hearing participated in the study. All participants listened to music at 85.4 dBA for 30 minutes. An audiological evaluation including pure tone audiometry, immittance measurements, Distortion Product Otoacoustic Emissions (DPOAEs), and Transient Evoked Otoacoustic Emissions (TEOAEs) with and without contralateral acoustic stimuli (CAS) was done before ME, immediately after ME, and after a rest period. Results: No significant differences in pure tone audiometry and the DPOAE signal-to-noise ratio (S/N-R) results were found among the three measurement sessions (before ME, immediately after ME, and after the rest period) in all measured frequencies (p>0.05). There was a significant increase in the contralateral stapes reflex threshold at 0.5 kHz, measured immediately after ME (p=0.02), while no significant difference was found in the measured frequency after resting (p>0.05). In the TEOAE S/N-R responses, a statistically significant decrease was found at 1 kHz (p=0.016) and 1.4 kHz (p=0.009) immediately after ME, whereas no significant difference was found between the TEOAE S/N-R responses measured before ME and after resting (p>0.05). Compared to the conditions before the exposure, there was a statistically significant decrease (p<0.001) in all center frequencies measured immediately after ME and after resting conditions in the TEOAE amplitudes obtained in the presence of CAS. Conclusion: The contralateral stapes reflex thresholds increase after ME, and a significant suppression effect of the TEOAE amplitudes in the presence of CAS suggests that the olivocochlear efferent system plays a role in protecting the auditory system from acoustic trauma.
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    Frequency of Epstein-Barr virus and human papilloma virus in patients with nasopharyngeal carcinoma
    (Springer, 2020) Altekin, Ilhan; Tas, Abdullah; Yalcin, Omer; Guven, Selis Gulseven; Aslan, Zulkar; Adali, Mustafa Kemal; Karasalihoglu, Ahmet Rifat
    Purpose Nasopharyngeal cancer is a type of malignancy originating from the epithelial cells lining the nasopharynx. In genetic and environmental factors, infection with Epstein-Barr virus is one of the particular factors held accountable for the etiopathogenesis. Human papillomavirus has been associated with cervical, anogenital, and oropharyngeal cancers. The aim of the present study is to demonstrate the presence and incidence of Epstein-Barr virus and human papillomavirus in patients with nasopharyngeal cancer. Methods The information collected for these patients included age at the time of biopsy, gender, alcohol consumption and smoking, and histopathological type of nasopharyngeal cancer. Only patients for whom nasopharyngeal biopsy was performed as punch biopsy were included in the study. In situ hybridization was performed with formalin-fixed, paraffin-embedded tissue sections for Human Papillomavirus and Epstein-Barr virus nucleic acids obtained by means of automated Ventana BenchMark Medical system Results Utilizing in situ hybridization with samples obtained from 56 patients diagnosed with nasopharyngeal cancer. Epstein-Barr virus was positive in 41 out of the 56 (73.2%) patients, while human papillomavirus was positive in 3 (5.4%), and 1 patient (1.8%) had co-infection. Thirty seven (90.2%) of the 41 patients positive for Epstein-Barr virus were Type-2 according to WHO, while 4 (9.8%) were Type-1. All three patients (100%) with Human Papillomavirus positivity were Type-2 according to WHO. Conclusions This study shows the close association between nasopharyngeal cancer and Epstein-Barr virus whereas such an association is not shown for Human Papillomavirus.
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    The impact of preoperative psychological characteristics on postoperative satisfaction and quality of life in patients undergoing septoplasty and inferior turbinate ablation surgery
    (Springer, 2022) Guven, Selis Gulseven; Gorgulu, Yasemin
    Purpose To investigate the effect of preoperative mental state on postoperative satisfaction and quality of life in patients undergoing septoplasty and inferior turbinate ablation surgery. Methods A total of 41 patients who underwent septoplasty and inferior turbinate ablation surgery due to nasal congestion were included in the study. Patients were asked to complete the Mental Symptoms Checklist Revised (SCL-90 R), World Health Organization Quality of Life Scale-Short Form (WHOQoL-BREF-TR), and Visual Analogue Scale (VAS) tests before and after their surgery. The surgical procedure for all patients was performed by a single ear-nose-throat physician. The preoperative and postoperative test results were then compared. Results A significant decrease was noted in the postoperative SCL-90 R somatization (p < 0.001), additional items (p = 0.001), and global severity index (GSI) (p = 0.002) scores; a significant increase was observed in the postoperative WHOQoL-BREF-TR physical health score (p = 0.029); and a significant decrease was seen in the postoperative VAS scores (p < 0.001). The preoperative SCL-90 R GSI showed a negative correlation with the postoperative WHOQoL-BREF-TR total score and a significant positive correlation with the postoperative VAS scores (p < 0.05 for all). There was a significant difference between those with a postoperative VAS score of <= 2 and > 2 in terms of GSI and all preoperative SCL-90 R subscale scores, except for the additional items subscale. Increased preoperative psychological symptoms reported by the patients were associated with a lower perception of postoperative quality of life. Conclusion The preoperative mental state of patients undergoing septoplasty and inferior turbinate ablation surgery affects postoperative satisfaction and quality of life. In addition, the recognition of this parameter may contribute to the treatment management of these patients and the legal protection of physicians.