Researcher:
Altuntaş, Muzaffer Ozan

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Teaching Faculty

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Muzaffer Ozan

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Altuntaş

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Altuntaş, Muzaffer Ozan

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2018 - 201912020 - 20229

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    Does submandibular gland sacrificing neck dissection decrease salivary output and quality of life?
    (Karger, 2021) Ozer, Furkan; Kuscu, Oguz; Suslu, Nilda; Altuntaş, Muzaffer Ozan; Teaching Faculty; School of Medicine; 169795
    Purpose: Our study aimed to quantify the impact of submandibular gland (SMG) resection during Level I neck dissection (ND) on stimulated salivary output (SSO) and xerostomia-related quality of life in patients with head and neck cancer (HNC). Methods: A retrospective cohort was formed from 32 patients that underwent unilateral or bilateral Level I ND and a control group of 23 patients that had level II-IV ND. SSO (Saxon test) and University of Washington Quality of Life survey results for both groups were compared. Results: Mean SSO was 3.41 g in the SMG resection group and 3.86 g in the control group, with no significant statistical difference. There was no difference in mean SSO between patients with 2 SMGs, a single remaining SMG, or no glands. The mean SSO of SMG resection cases with a history of adjuvant RT was 2.61 g which was below the xerostomia threshold for the Saxon test (2.75 g) and control group patients with RT had a significantly higher mean SSO (4.07 g). The lowest UW-QoL saliva domain score average (53.8) was in the SMG-resected, RT-positive group. Conclusion: Results indicate unilateral or bilateral resection of SMG does not reduce SSO to a significant extent. Adjuvant radiotherapy and SMG resection are additive risk factors for xerostomia and the related loss in quality of life. SMG sparing may be necessary in HNC patients with higher risk for the need of adjuvant radiation.
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    Subglottic cysts in preterm infants: superficially located cysts versus deeply buried cysts in the mucosa
    (Springer, 2022) Ünsaler, Selin; Gökler, Ozan; Altuntaş, Muzaffer Ozan; Hafız, Ayşenur Meriç; Ünal, Ömer Faruk; Teaching Faculty; Teaching Faculty; Teaching Faculty; Faculty Member; Other; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 167909; 311179; 169795; 53676; 199800
    Purpose: To analyze the reason for the diversity of the clinical course of subglottic cysts and discuss their pre- and coexistence with subglottic stenosis. Methods: The medical records of patients who were treated for subglottic cysts between 2003 and 2020 were retrospectively reviewed and direct laryngoscopy videos were analyzed to assess the healing patterns of their disease. Results: Of the 15 patients, 10 had a history of intubation in the neonatal period. In 11 patients, the cysts were transparent and well defined, and no recurrence of subglottic cysts occurred after the initial surgery. In four patients, the cysts were located deep in the mucosa and did not have the typical appearance of a cyst, but rather of a stenotic segment; all of them had a history of intubation and three of them required laryngotracheal reconstruction. Conclusion: Transparent, thin-walled superficial subglottic cysts with healthy surrounding mucosa can easily be treated with endoscopic marsupialization; however, the treatment of deep subglottic cysts can be challenging. The coexistence of subglottic cysts and subglottic stenosis is not rare. We point out the need for considering the possibility of a missed deep submucosal cyst in a seemingly refractory case of pediatric subglottic stenosis with atypical endoscopic findings and with a background history of prior intubation.
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    Nasopharyngeal glial heterotopia with intracranial extension: a case report
    (Galenos Yayincilik, 2018) N/A; N/A; N/A; N/A; N/A; Gökler, Ozan; Karanfil, Işıl; Koçak, İlker; Altuntaş, Muzaffer Ozan; Armutlu, Ayşe; Ünal, Ömer Faruk; Teaching Faculty; Undergraduate Student; Doctor; Teaching Faculty; Teaching Faculty; Other; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 311179; N/A; N/A; N/A; 133567; 199800
    Nasopharyngeal glial heterotopia is a mass composed of mature neural tissue occurring outside the central nervous system and is extremely rare. the preoperative diagnosis of such a mass in the head and neck region is challenging. in this study, we report a case of a 16-month-old patient presenting with respiratory distress and snoring caused by nasopharyngeal glial heterotopia. Radiologic imaging and histopathology are obligatory for the definitive diagnosis of glial heterotopia. Preoperative evaluation of an intracranial connection is one of the most essential issues in the presence of pediatric nasopharyngeal masses. the gold standard of treatment is surgical excision. Early recognition and early surgical excision by endoscopic or external approach are crucial to relieve respiratory distress and to maintain healthy growth and development.
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    Lysyl oxidase-4-like protein (LOXL4) as a tumor marker and prognosis in advanced laryngeal cancer
    (Association Brasileira Otorrinolaringologia and Cirurgia Cervicofacial, 2022) Suslu, Nilda; Tezel, Yesim Gaye Guler; Dogan, Hayriye Tatli; Yilmaz, Taner; N/A; Altuntaş, Muzaffer Ozan; Teaching Faculty; School of Medicine; 169795
    Introduction: Lysyl oxidase-like 4 is an amine oxidase from the lysyl oxidase family that was previously shown to be overexpressed in head and neck cancer and upregulated in response to hypoxia. The possible role of lysyl oxidase-like 4 as a tumor marker in advanced stage larynx cancer was investigated. Objective: To investigate the expression of lysyl Oxidase-Like 4 protein in advanced stage laryngeal cancer and elucidate its possible role as a tumor marker, predictor of treatment response and prognosticator. Methods: Diagnostic specimens of 72 patients treated for stage III-IV laryngeal squamous cell carcinoma were evaluated for lysyl oxidase-like 4 expression by immunohistochemistry. Results: Lysyl oxidase-like 4 expression was correlated with advanced tumor stage (p = 0.041) and better differentiation (p = 0.025) but was independent of tumor diameter (p = 0.456). Response to induction chemotherapy or the need for salvage laryngectomy were not affected by lysyl oxidase-like 4 expression (p = 0.999, p = 0.070 respectively). Increased lysyl oxidase-like 4 expression was associated with better 2 year overall survival in both univariate (p = 0.036) and multivariate analyses (p = 0.014). Conclusion: Lysyl oxidase-like 4 expression emerges with advancing stages, is lost with worsening differentiation, and may have tumor suppressive properties in larynx cancer. / Resumo Introdução: A proteína tipo-lisil oxidase-4 é uma amina oxidase da família lisil oxidase cuja superexpressão em câncer de cabeça e pescoço e up-regulação em resposta à hipóxia foram previamente demonstradas. O possível papel da proteína tipo-lisil oxidase-4 como um marcador tumoral no câncer de laringe em estágio avançado foi investigado. Objetivos: Investigar a expressão da proteína tipo-lisil oxidase-4 no câncer de laringe em estágio avançado e elucidar seu possível papel como marcador tumoral, preditor da resposta ao tratamento e do prognóstico. Método: Amostras diagnósticas de 72 pacientes tratados para carcinoma espinocelular da laringe em estágio III-IV foram avaliadas quanto à expressão da proteína tipo-lisil oxidase-4 por imuno-histoquímica. Resultados: A expressão de proteína tipo-lisil oxidase-4 foi correlacionada com o estágio avançado do tumor (p = 0,041) e melhor diferenciação (p = 0,025), mas foi independente do diâmetro do tumor (p = 0,456). A resposta à quimioterapia de indução ou a necessidade de laringectomia de resgate não foram afetadas pela expressão da proteína tipo-lisil oxidase-4 (p = 0,999, p = 0,070 respectivamente). O aumento da expressão da proteína tipo-lisil oxidase-4 foi associado a melhor sobrevida global de 2 anos nas análises univariada (p = 0,036) e multivariada (p = 0,014). Conclusão: A expressão da proteína tipo-lisil oxidase-4 surge com o avanço dos estágios e desaparece com pioria da diferenciação e pode ter propriedades supressoras de tumor no câncer de laringe.
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    PublicationOpen Access
    Comparison of nasopharyngeal swab and nasopharyngeal aspiration in adults for SARS-COV-2 identification using reverse transcription-polymerase chain reaction
    (Wiley, 2021) Altuntaş, Muzaffer Ozan; Gökler, Ozan; Hafız, Ayşenur Meriç; Ünsaler, Selin; Okan, Ayşe; Tekin, Süda; Teaching Faculty; Teaching Faculty; Faculty Member; Teaching Faculty; School of Medicine; Koç University Hospital; 169795; 311179; 53676; 167909; N/A; 42146
    We aimed to compare reverse transcription-polymerase chain reaction (RT-PCR) results of nasopharyngeal aspiration (NA) and nasopharyngeal swab (NS) samples in the diagnosis of coronavirus disease 2019. NS was obtained with a dacron swab and NA was performed by aspiration cannula. The sampling was performed by an otolaryngologist to ensure standardized correct sampling from the nasopharynx. RT-PCR was performed for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The level of agreement between the result of NA and NS samples for each patient was analyzed. The Ct values were compared. Thirty-three patients were enrolled in the study with a mean age of 56.3 years. Thirteen subjects resulted negative with both NS and NA; 20 subjects resulted positive with NA and 18 subjects resulted positive with NS. The mean values of Ct for NA samples and NS samples were 24.6 +/- 5.9 and 24 +/- 6.7, respectively. There was no statistical difference between Ct values of NA and NS samples (p = 0.48). RT-PCR for SARS-Cov2 performed with NA sample and NS sample showed a strong correlation regarding the positivity/negativity and the Ct values.
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    PublicationOpen Access
    Long-term outcome of cochlear implantation in post-meningitic deafness
    (Aves, 2021) Özkan, B.; Bajin, D.; Sennaroğlu, G.; Sennaroğlu, L.; Altuntaş, Muzaffer Ozan; Teaching Faculty; School of Medicine; 169795
    Background: this study was planned (1) to evaluate long-term outcome after cochlear implantation in patients with post-meningitic deafness and (2) to compare the outcome measures with patients implanted for deafness due to other causes. Methods: records of 54 patients deafened as a sequel of bacterial meningitis and implanted at the largest university-based cochlear implant program in Turkey were retrospectively reviewed. Fifty-four age-and sex-matched patients with a similar interval of implant use were selected for controls. Surgical and long-term audiological outcome (in terms of categories of auditory performance-II scores) was assessed and compared. Results: twenty-seven (52%) patients had some degree of labyrinthitis ossificans and 19 of them had full electrode insertion via basal turn cochleostomy. Patients with and without labyrinthitis ossificans in the post-meningitic group had no difference in final categories of auditory performance-II score (P =.559). Median categories of auditory performance-II scores were 6 for post-meningitic group and 7 for controls, with a significant statistical difference (P <.001). Partial or full insertions did not differ in outcome (P =.938). Mean time to implantation was not cor-related with the final categories of auditory performance-II score for the post-meningitic group (P =.695). Conclusion: cochlear implant recipients deafened due to meningitis have a worse long-term hearing and speech performance as measured by categories of auditory performance-II than patients implanted for congenital deafness. The presence of labyrinthitis ossificans or the limited extent of electrode insertion produced overall results that were comparable with other cases.
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    PublicationOpen Access
    Publishing outcomes of abstracts presented at the European Society of Pediatric Otorhinolaryngology Congress in 2018: a web-based analysis
    (Aves, 2022) Gökler, Ozan; Coşkuntürk, Ali; Bayram, Yavuz; Ünsaler, Selin; Altuntaş, Muzaffer Ozan; Çetin, Feyza; Teaching Faculty; Teaching Faculty; School of Medicine; 311179; N/A; N/A; 167909; 169795; N/A
    Background: clinicians and researchers share their projects in congresses, which are collaborative meetings that enhance the dissemination of information among scientists. Furthermore, critical evaluations of their colleagues help the progress of their research. However, the mainfocus of any research is publication. In thisstudy, we assess the effect of the European Society of Pediatric Otorhinolaryngology 2018 meeting on the publication rate of abstracts submitted. The aim of this study was to determine whether attending the ESPO 2018 congress had an impact on the publication rate of oral and poster presentations. Methods: all abstracts submitted to the European Society of Pediatric Otorhinolaryngology 2018 Congress catalog were searched in Google Scholar via corresponding title and author to identify the ones that were published. The date of publication, name, and impactfactor of the journals of published articles was recorded. Results: a total of 785 abstracts (217 oral, 568 posters) were accepted. Of all abstracts, 21.3% (n=167) were published. Out of all publications, 32% (n=53) were oral presentations and 68% (n=114) were poster presentations. There were 62 different journals with an average weighted 3-year impact factor of 2.06 (+/- 1.09 standard deviation). The 3 most common journals were Mt) Pediatr Otorhinolaryngol (n = 49, impact factor: 1.64 ), Laryngoscope (n=12, impact factor: 2.81 ), and Eur Arch Otorhinolaryngol (n=10, impactfactor: 2.16). Conclusion: our publication rate of 21.27% is low when compared to oral-only meetings but is similar to others having both oral and poster presentations. We found out that poster presentations reduced the overall publication rate and were published in journals having lower impactfactors when compared to oral presentations.
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    PublicationOpen Access
    The effect of COVID-19 pandemic on sudden idiopathic sensorineural hearing loss: a cross-sectional study in a single institution
    (Bayçınar Tıbbi Yayıncılık ve Reklam Hizmetleri, 2022) Ünsaler, Selin; Hafız, Ayşenur Meriç; Şahin, Selin Merve; Aydoğan, Esra; Gökler, Ozan; Altuntaş, Muzaffer Ozan; Faculty Member; Undergraduate Student; Teaching Faculty; Teaching Faculty; School of Medicine; Koç University Hospital; 167909; N/A; N/A; N/A; 311179; 169795
    Objectives: this study aimed to evaluate the effects of the coronavirus disease 2019 (COVID-19) pandemic on the incidence, course, and prognosis of sudden idiopathic sensorineural hearing loss (SISNHL). Patients and methods: this retrospective study was conducted with 55 patients (31 males, 24 females; mean age: 44.4±18.5 years; range, 11 to 83 years) treated for SISNHL. The patients were analyzed in two groups: Group 1, which included 35 patients (24 males, 11 females; mean age: 42.5±18.8 years; range, 11 to 72 years) admitted after the onset of the pandemic between March 2020 and March 2021, and Group 2, which consisted of 20 patients (7 males, 13 females; mean age: 47.5±19.0 years; range, 20 to 83 years) admitted before the pandemic between March 2019 and February 2020. Age, the timing of referral to the otolaryngology clinic after the perception of the first otologic symptom, the severity of the hearing loss, and the status of recovery were investigated. The COVID-19 status of Group 1 was investigated. Results: the incidence of SISNHL among all patients admitted to our clinic in the same time duration was found to have increased after the COVID-19 pandemic, and this increase was statistically significant (p=0.04). One patient had SISNHL during acute COVID-19. Three patients had COVID-19 three weeks before SISNHL, six patients had COVID-19 three months before SISNHL, and one patient was diagnosed with COVID-19 six months before SISNHL. Fourteen patients were tested for severe acute respiratory syndrome coronavirus 2 with real-time polymerase chain reaction at the time of admission, which resulted in negative. Conclusion: as the incidence of SISNHL has increased following the COVID-19 pandemic, a possible relation between hearing loss, presenting as SISNHL, and COVID-19 disease should be investigated. / Amaç: bu çalışmada, koronavirüs hastalığı 2019 (COVID-19) pandemisinin ani idiyopatik sensörinöral işitme kaybının (AİSİK) insidansı, seyri ve prognozu üzerindeki etkileri değerlendirildi. Hastalar ve yöntemler: bu retrospektif çalışma, AİSİK için tedavi edilen 55 hasta (31 erkek, 24 kadın; ort. yaş: 44.4±18.5 yıl; dağılım, 11-83 yıl) ile yürütüldü. Hastalar iki grupta analiz edildi: Mart 2020 ile Mart 2021 arasında pandemi başlangıcından sonra başvuran 35 hastadan (24 erkek, 11 kadın; ort. yaş: 42.5±8.8 yıl; dağılım, 11-72 yıl) oluşan Grup 1 ve Mart 2019 ile Şubat 2020 arasında pandemi öncesi başvuran 20 hastadan (7 erkek, 13 kadın; ort. yaş: 47.5±19.0 yıl; dağılım, 20-83 yıl) oluşan Grup 2. Yaş, ilk otolojik semptomun algılanmasından sonra kulak burun boğaz polikliniğine başvuru zamanlaması, işitme kaybının şiddeti ve iyileşme durumu araştırıldı. Grup 1’in COVID-19 durumu araştırıldı. Bulgular: kliniğimize aynı süre içinde başvuran tüm hastalarda AİSİK insidansının COVID-19 pandemisi sonrası arttığı saptandı ve bu artış istatistiksel olarak anlamlıydı (p=0.04). Bir hastada akut COVID-19 sırasında AİSİK gelişti. Üç hastada AİSİK’den üç hafta önce COVID-19 vardı, altı hastada AİSİK’den üç ay önce COVID-19 vardı ve bir hastada AİSİK’den altı ay önce COVID-19 tanısı konulmuştu. On dört hasta başvuru sırasında şiddetli akut solunum yolu sendromu koronavirüsü 2 için gerçek zamanlı polimeraz zincir reaksiyonu ile test edildi ve sonuç negatif çıktı. Sonuç: COVID-19 pandemisini takiben AİSİK insidansı arttığı için AİSİK olarak ortaya çıkan işitme kaybı ile COVID-19 hastalığı arasındaki olası ilişki araştırılmalıdır.
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    PublicationOpen Access
    Pediatric laryngeal measurements based on computed tomography images
    (Aves, 2022) Ünsaler, Selin; Gökler, Ozan; Aygün, Murat Serhat; Şahin, Selin Merve; Yaycıoğlu, Arda; Altuntaş, Muzaffer Ozan; Ünal, Ömer Faruk; Hafız, Ayşenur Meriç; Teaching Faculty; Teaching Faculty; Undergraduate Student; Other; Faculty Member; School of Medicine; Koç University Hospital; 167909; N/A; N/A; N/A; N/A; N/A; N/A; N/A
    Background: this study aimed to establish average laryngeal measurements in the Turkish pediatric population and measure the narrowest portion of the pediatric airway. Methods: the laryngeal measurements of 88 pediatric patients between the ages 0 and 17 were retrospectively obtained from neck computed tomography scans performed between January 2018 and May 2021. Subjects were divided into 6 age groups. Four following measurements were made: cricoid anteroposterior, cricoid transverse, subglottic anteroposterior, and subglottic transverse. Cross-sectional areas were calculated using these dimensions. Subglottic cross-sectional area/cricoid crosssectional area ratio for each subject was calculated and patients were divided into 2 groups: group 1, subjects with ratio < 1; group 2, subjects with ratio ? 1. Results: mean age was 8.97 ± 5.7. Mean anteroposterior diameters at subglottis and cricoid ring levels were 13.74 ± 4.45 mm and 13.26 ± 4.39 mm; mean transverse diameters were 7.88 ± 2.62 mm and 9.06 ± 3.12 mm, respectively. The subglottic anteroposterior diameter was greater than cricoid (P < .001), but the transverse diameter was smaller than cricoid (P < .001). Subglottic cross-sectional area was 93.24 ± 59.20 mm2 and cricoid cross-sectional area was 103.61 ± 69.15 mm2 . Subglottic cross-sectional area/cricoid cross-sectional area ratio was smaller than 1 in 69 subjects (group 1; mean=0.85) and equal to or greater than 1 in 19 subjects (group 2; mean=1.33). Conclusion: the narrowest portion of the airway was subglottis immediately below the vocal cords, in contrast to the common belief as to the cricoid ring. Subglottic cross-sectional area/cricoid cross-sectional area ratios showed that the pediatric airway was larger at cricoid (69 subjects, 78.4%), and this ratio does not differ based on age.
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    PublicationOpen Access
    Is elective cancer surgery feasible during the lock-down period of the COVID-19 pandemic? Analysis of a single institutional experience of 404 consecutive patients
    (Wiley, 2021) Cesur, Ezgi; Kırış, Talat; Giray, Burak; Kulle, Cemil Burak; Azamat, İbrahim Fethi; Ağcaoğlu, Orhan; Dilege, Ece; Erkan, Murat Mert; Balık, Emre; Bilge, Orhan; Buğra, Dursun; Vatansever, Doğan; Taşkıran, Çağatay; Erus, Suat; Yavuz, Ömer; Tanju, Serhan; Dilege, Şükrü; Tarım, Kayhan; Kiremit, Murat Can; Kılıç, Mert; Canda, Abdullah Erdem; Kordan, Yakup; Akyoldaş, Göktuğ; Solaroğlu, İhsan; Sasani, Mehdi; Gökler, Ozan; Ünsaler, Selin; Altuntaş, Muzaffer Ozan; Hafız, Ayşenur Meriç; Şimşek, Sezai Aykın; Deveci, Mehmet Ali; Korkmaz, Murat; Çakar, Nahit; Ergönül, Önder; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Teaching Faculty; Faculty Member; Researcher; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Teaching Faculty; Teaching Faculty; Teaching Faculty; Faculty Member; Faculty Member; Doctor; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; N/A; N/A; 175476; 218050; 214689; 18758; 176833; 1758; 193687; 134190; 175565; N/A; 214690; 122573; 327605; N/A; N/A; 116202; 157552; N/A; 102059; N/A; 311179; 167909; 169795; 53676; N/A; 206311; N/A; 198906; 110398
    Background: we aimed to assess the feasibility and short-term clinical outcomes of surgical procedures for cancer at an institution using a coronavirus disease 2019 (COVID-19)-free surgical pathway during the peak phase of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Materials and methods: this was a single-center study, including cancer patients from all surgical departments, who underwent elective surgical procedures during the first peak phase between March 10 and June 30, 2020. The primary outcomes were the rate of postoperative SARS-CoV-2 infection and 30-day pulmonary or non-pulmonary related morbidity and mortality associated with SARS-CoV-2 disease. Results: four hundred and four cancer patients fulfilling inclusion criteria were analyzed. The rate of patients who underwent open and minimally invasive procedures was 61.9% and 38.1%, respectively. Only one (0.2%) patient died during the study period due to postoperative SARS-CoV2 infection because of acute respiratory distress syndrome. The overall non-SARS-CoV2 related 30-day morbidity and mortality rates were 19.3% and 1.7%, respectively; whereas the overall SARS-CoV2 related 30-day morbidity and mortality rates were 0.2% and 0.2%, respectively. Conclusions: under strict institutional policies and measures to establish a COVID-19-free surgical pathway, elective and emergency cancer operations can be performed with acceptable perioperative and postoperative morbidity and mortality.