Lokman Hekim Üniversitesi

Abstract Objective Tinnitus is the perception of sound without an external source, and its pathophysiology—particularly in individuals with normal hearing thresholds—remains unclear. This study evaluates the interaction between tinnitus and outer/inner hair cells, the efferent auditory system, and potential dead regions based on Jastreboff’s 'mismatched damage' theory. Methods The study included 32 healthy individuals aged between 20 and 40 years, matched with 32 individuals with normal and mild hearing loss and tinnitus complaints. Participants were subjected to acoustic impedance, acoustic reflex, pure tone audiometry, high-frequency audiometry, speech reception and discrimination tests, Threshold Equalizing Noise test, Transient Evoked Otoacoustic Emissions, Distortion Product Otoacoustic Emissions, Medial Olivocochlear Reflex tests and tinnitus frequency and intensity matching tests. Results There were frequency-dependent and lateralized differences in pure tone audiometric thresholds between the tinnitus and control groups, with more widespread threshold elevation in the tinnitus-right ear. DPOAE amplitudes were significantly reduced across all tested frequencies in the tinnitus group, whereas TEOAE amplitudes were significantly reduced in the mid-to-high-frequency range (1400–4000 Hz). After correction for multiple comparisons, no significant differences were observed between groups in the TEN test. MOCR measurements revealed significantly reduced suppression in the tinnitus group at 1400, 2000, and 2800 Hz. Conclusion The findings indicate that tinnitus in individuals with normal hearing and mild hearing loss is associated with subtle outer hair cell–related dysfunction and frequency-specific alterations in efferent auditory modulation, in the absence of extensive inner hair cell or neural damage. This pattern is consistent with the concept of afferent–efferent mismatch described in the “mismatched damage” theory. However, given the cross-sectional design of the study, these associations should not be interpreted as causal.

Objective: This study aimed to assess and compare the short-term whitening performance of three over-the-counter (OTC) whitening pens and one home bleaching agent on extracted human teeth using spectrophotometric color evaluation.Materials and Methods: Sixty maxillary incisors were randomly distributed into five groups (n = 12 each): three OTC whitening pens (iSmile, SDI Pola Luminate, CleverCool), one home bleaching gel (SDI Polanight), and a control group. Whitening protocols were applied according to manufacturers’ directions for seven consecutive days. Tooth color was recorded at baseline (T0), after 7 days of treatment (T7), and at day 14 (T14) using a spectrophotometer. Color change (ΔE) was calculated through the CIELab system. Statistical analysis was performed with one-way ANOVA and Tukey’s post-hoc tests (α = 0.05).Results: All experimental groups presented significantly greater ΔE values compared with the control (p < 0.001). The iSmile pen produced the most noticeable change at both T7 and T14. SDI Polanight achieved similar but slightly lower whitening, while Pola Luminate and CleverCool provided moderate improvements with no significant difference between them.Conclusion: OTC whitening pens are capable of delivering visible short-term whitening effects, although their effectiveness varies across products. A higher peroxide concentration was associated with a more pronounced bleaching outcome.

Amaç: Bu çalışmada, adneksiyal kitlesi olan kadınlarda siberkondri düzeylerini Siberkondri Ciddiyet Ölçeği-Kısa Formu (CSS-12) kullanarak değerlendirmeyi amaçladık.Gereç ve Yöntemler: Bu çalışma, tek merkezde yürütülen kesitsel bir araştırma olarak planlandı. Jinekolojik onkoloji kliniğine başvuran ve adneksiyal kitle tanısı alan toplam 134 kadın çalışmaya dahil edildi. Tüm katılımcılara CSS-12 uygulandı. CSS-12 toplam ve alt ölçek skorları; medeni durum, eğitim düzeyi, çocuk sahibi olma durumu, CA-125 düzeyi ve menopoz durumu değişkenlerine göre karşılaştırıldı. Bulgular: Katılımcı grubun median yaşı 38 (18–75), median vücut kütle indeksi (VKİ) 30 (20–42), median parite sayısı 2 (0–8) ve median CA-125 değeri 45 (11–2350) olarak saptandı. Toplam CSS-12 skoru ve dört alt boyut karşılaştırıldığında, genç (≤35 yaş), çocuğu olmayan ve lise ve üzeri eğitim düzeyine sahip kadınlarda toplam CSS-12 skorları anlamlı olarak daha yüksek bulundu (p

Endoscopic endonasal transsphenoidal surgery (EETS) has become the preferred method for treating pituitary adenomas; however, it entails a significant learning curve. This study aims to evaluate clinical features, surgical outcomes, and complication patterns during the early institutional experience with EETS and to establish a historical benchmark for tracking the progress of endoscopic pituitary surgery. This retrospective, single-center observational study included 46 consecutive patients who underwent EETS for pituitary adenomas between October 2008 and September 2010. Data on demographics, clinical presentation, endocrinological and radiologic findings, surgical techniques, reconstruction methods, perioperative complications, and follow-up outcomes were analyzed. Surgical reconstruction was performed using nonvascularized autologous grafts, as contemporary graded closure strategies were not routinely used during the study period. The cohort included 46 patients, 52.2% of whom were male, with an average age of 44.9 years. Macroadenomas made up 71.7% of cases and were frequently associated with suprasellar extension, cavernous sinus involvement, and sellar floor destruction. The most common initial symptoms were headache (65.2%) and visual impairment (45.7%). Endoscopic duraplasty was performed in 50% of patients. Overall, 23.9% experienced complications, with 15.2% experiencing significant ones. Transient diabetes insipidus occurred in 6.5% of cases. The overall mortality rate was 6.5%. A few cases required additional radiotherapy or radiosurgery. The average follow-up period was 9.9 months. This study offers a detailed overview of early institutional experience with EETS for pituitary adenomas, highlighting how the learning curve, tumor complexity, and reconstructive challenges influence surgical outcomes. Although complication rates were higher than those in recent series, the results emphasize the importance of accumulated surgical experience, multidisciplinary teamwork, and advances in closure techniques in meeting current standards of care. Early experiences like this serve as valuable historical benchmarks for guiding training, patient selection, and future surgical innovations.

IntroductionRecurrent laryngeal nerve (RLN) paralysis is a distressing complication of thyroidectomy, and many methods have been investigated for prevention.ObjectiveThe aim of our study is to investigate to what extent intraoperative neuromonitoring (IONM) predicts postoperative RLN paralysis and what factors may be causing it.MethodsPatients who underwent thyroidectomy in our clinic between January 2014 and December 2020 were included. Patient diagnoses, demographic characteristics, laboratory and imaging results, surgical information, and IONM results were evaluated.ResultsData from 287 patients and 523 RLNs were evaluated. Twenty-two (4.2%) of the RLNs were paralytic. The rate of paralysis was significantly higher in total thyroidectomies than in lobectomies (p = 0.046), permanent paralysis rate was higher in left RLNs. Malignancy was statistically associated with permanent paralysis (p = 0.017). The rate of overall and permanent paralysis was higher in patients with negative results of first, second response, first, and second laryngeal twitch examinations. The means of the first and second responses of the paralyzed RLNs were lower (p = 0.016,p < 0.01, respectively). The sensitivity of the IONM increased when the new thresholds of the first and second responses were determined to be 155 and 170 µv, respectively, by ROC analysis.ConclusionsThis study demonstrates that voltage variation and magnitude obtained from IONM can be predictive and sensitivity can be increased by using a threshold higher than 100 µV and patients in this range may be at risk for RLN paralysis. Our results may guide future studies of IONM and risk scoring systems to be developed for RLN paralysis.

Background: Post–core bonding plays a critical role in restoration longevity, and both the post surface treatment and core composite polymerization mode may influence interfacial performance. Methods: This in vitro study evaluated the effect of the post surface condition (no treatment vs. airborne-particle abrasion combined with an MDP-containing primer) and the composite polymerization mode (dual-, light-, and chemical-cure) on the pull-out bond strength and failure behavior of prefabricated metal post–core systems. A 3 × 2 factorial design was applied to 72 specimens (n = 12). After thermocycling, bond strength and failure modes were analyzed using two-way analysis of variance (ANOVA) and chi-square tests (p &lt; 0.05). Results: The surface treatment significantly increased bond strength (p &lt; 0.001; η2 = 0.49) and shifted failure modes toward predominantly non-adhesive patterns (p = 0.011). Although the core type also showed a significant effect (p &lt; 0.001), its influence was comparatively smaller. The bond strength was ranked as light-cure &gt; chemical-cure &gt; dual-cure under both surface conditions. Conclusions: Within the limitations of this study, post surface treatment was the primary determinant of bond strength and failure behavior. Clinically, effective surface modification appears to be more decisive than core composite selection, while differences among core materials become more apparent after establishing a stable bonding substrate.