Person: ENVER, NECATİ
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ENVER
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NECATİ
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Publication Metadata only A Very Rare Complication of Hyaluronic Acid Injection for Medialization Laryngoplasty: A Case With Laryngeal Abscess(MOSBY-ELSEVIER, 2020) ENVER, NECATİ; Enver, Necati; Asya, Orhan; Abuzaid, Ghazi; Gurol, EceHyaluronic acid injection for medialization laryngoplasty is a safe procedure performed on patients with glottic incompetence. Laryngeal abscess formation as a complication of injection laryngoplasty is a very rare complication, and, as we know from the literature, there has been only one case of laryngeal abscess after injection laryngoplasty in a patient with a type-I laryngeal cleft. We document for the first time a laryngeal abscess resulting from hyaluronic acid injection laryngoplasty for unilateral vocal fold paralysis. Prompt evaluation of the patient was necessary. Our patient was treated with antibiotics and corticosteroids without a need for intubation. One year after injection, the patient's Voice Handicap Index-10 score was still good and within the range of normal values.Publication Metadata only YouTube (TM) as an information source for larynx cancer: a systematic review of video content(SPRINGER, 2020) ENVER, NECATİ; Enver, Necati; Doruk, Can; Kara, Hakan; Gurol, Ece; Incaz, Sefa; Mamadova, UlkerPurpose The increasing availability of Internet as a health-care source causes both positive and negative effects on public health. Though reaching to information about diseases is faster and easier, the contents are not always correct and might be misleading. In our study, we aim to investigate the quality of YouTube (TM) videos on larynx cancer. Methods A YouTube (TM) search by using terms throat cancer and larynx cancer was done and, after eliminating the irrelevant videos, the first 200 videos were evaluated by three authors on quality, content and usefulness by using a pre-developed questionnaire. Videos were categorized according to the type and uploader separately to two (testimonial and educational) and five groups (health care, university, individual users, television channel/news and undetermined), respectively. Results Videos that are uploaded by university-affiliated accounts have significantly better audiovisual quality score and have significantly higher accuracy and usefulness score results. Furthermore, the accuracy and usefulness scores of the educational group were found to be statistically higher than those of the testimonial group. Conclusions Videos uploaded by universities and videos that are created for educational purposes are superior to other sources in terms of quality, accuracy and content. Patient information videos discussing common health problems should be prepared and disseminated only by universities or health-care institutionsPublication Metadata only Awareness of Thyroid Surgeons on Voice and Airway Complications: An Attitude Survey in Turkey(MOSBY-ELSEVIER, 2021) ENVER, NECATİ; Enver, Necati; Doruk, Can; Sormaz, Ismail C.; Makay, Ozer; Uludag, MehmetIntroduction. Thyroidectomy is one of the most commonly performed surgical procedures. Preoperative patient education and postoperative management of complications are vital to avoid postoperative medicolegal problems. Objective. The aim of this study was to assess the attitudes of thyroid surgeons about voice and airway complications of the surgery and the approaches used to avoid or handle these complications. Methods. A questionnaire based on surgeons' attitudes and behaviors on thyroidectomy was answered by 177 thyroid surgeons. Questions regarding demographic information, preoperative information methods, preoperative laryngeal examination, intraoperative nerve preservation techniques, and methods to avoid and handle postoperative complications were asked. Surgeons who completed the questionnaire were divided into three groups based on their annual volumes: less than 50 (low volume), 50-100 (middle volume), and more than 100 (high volume) for statistical analysis. The differences between the subgroups were compared using the chi-squared test. Results. During the preoperative disclosure, nearly all surgeons (97.2%) gave information about possible hoarseness; however, this high rate fell to 79.7% for possible voice changes, and to the lowest level of 36.7% for ability to change the voice pitch. Only 53.7% of the surgeons discussed the possibility of postoperative tracheostomy requirement. The surgeons with high annual volumes were found to perform vocal fold examination prior to a second surgery significantly higher than other groups (P=0.015). In the postoperative period, 84.2% of physicians indicated that they perform a laryngoscopic examination only for patients with voice problems. There was no statistically important difference between subgroups. Conclusions. Our study is unique to provide information from the surgeons' perspective by evaluating preoperative patient information, and intraoperative and postoperative protective and curative methods. The training of residents and fellows who are expected to perform thyroidectomies can be revised to compromise all aspects of complications.Publication Metadata only Readibility, Understandability, and Quality of Online Education Materials for Vocal Fold Nodules(MOSBY-ELSEVIER, 2020) ENVER, NECATİ; Doruk, Can; Enver, Necati; Caytemel, Berkay; Azezli, Elad; Basaran, BoraObjective. Vocal fold nodules are benign vocal fold lesions that can adversely affect quality of life. Differential diagnosis and treatment modalities of this disease are variable and patients often tend to use online materials to learn the insights. Access to knowledge via Internet is very easy; however, it is important to choose wisely because false and biased information might lead the patient to an inappropriate decision. In this study, we have evaluated the quality, readability, and understandability of online materials for vocal fold nodules. Methods. An Internet search was performed for Vocal fold nodule, vocal fold nodule treatment, and voice therapy for vocal fold nodule by using Google search engine. Readability of each website was evaluated by using v readable Understandability and actionability of pages were measured by using the Patient Education Materials Assessment Tool (PEMAT). In the end, DISCERN instrument was used to measure the quality of information presented. Results. After exclusion, total of 26 web pages were evaluated during the study. Four web pages graded as A level, 5 as B level, 11 as C level, and 5 as D level for language use. Average grade level for all of the web pages is 11.14 +/- 1.75. Overall understandability score was found 59.0+ 12.1 (26.7-77.1), and overall quality score was measured 34.95 + 6.58 (53.75-26.5). Conclusion. The quality, readability, and understandability of the written materials are very low and in order for patients to read and learn from the online sources, contents of the written materials should be revised.Publication Metadata only The Role of Vocal Fold Bowing on Cough and Swallowing Dysfunction in Progressive Supranuclear Palsy(WILEY, 2021) ENVER, NECATİ; Enver, Necati; Borders, James C.; Curtis, James A.; Sevitz, Jordanna S.; Vanegas-Arroyave, Nora; Troche, Michelle S.Objectives: Progressive supranuclear palsy (PSP) is a neurodegenerative disease which results in cough and swallowing dysfunction and aspiration pneumonia. Relationships among vocal fold atrophy, cough, and swallowing have been identified in related diseases, but remain unknown in PSP. This study examined: 1) the prevalence of vocal fold bowing in PSP, and 2) the influence of vocal fold bowing on cough and swallowing in PSP. Study Design: Prospective Cohort Study. Methods: Twenty-three participants with PSP completed instrumental assessments of cough and swallowing. Vocal fold bowing (BI) and swallowing safety (PAS) was assessed using flexible laryngoscopy. Measures of cough effectiveness were obtained using spirometry. Statistical analyses were used to determine the frequency of mild-moderate (BI > 0) and severe (BI > 12.2) bowing, and to assess the influence of BI on PAS and cough effectiveness in PSP. Results: Fifty-two percent (n = 12) of participants exhibited severe bowing while 48% (n = 11) exhibited mild-to-moderate bowing. Voluntary cough peak expiratory flow rate (P= .01), as well as reflex (P= .02) and voluntary (P= .005) cough volume acceleration were lower for participants with severe BI when compared to mild-to-moderate BI. However, BI did not influence PAS (P> .05). Conclusions: Findings from this study suggest that vocal fold bowing is highly prevalent in PSP and associated with reduced reflex and voluntary cough effectiveness. These findings provide insight into the pathophysiology of compromised airway protection in this patient population. Future studies should examine vocal fold atrophy as a treatment target for behavioral and medical intervention in PSP.Publication Metadata only Does Size Matter in Laryngology? Relation Between Body Height and Laryngeal Morphometry(MOSBY-ELSEVIER, 2021) ENVER, NECATİ; Enver, Necati; Doruk, Can; Kara, Erdogan; Kasali, Kamber; Asliyuksek, Hizir; Basaran, BoraObjective. Laryngeal framework surgery has been a topic of interest since last decades. To succeed with least morbidity, the most important step is mastering the anatomy of larynx. In this study, we aim to show the relation between body height and laryngeal morphometrics that are important during laryngeal framework surgeries. Data Sources. Larynges of 187 fresh cadavers were dissected within 24 hours after death at the Council of Forensic Medicine. Methods. Age, sex, weight, height, and a total of 12 measurements were taken from each cadaver. Results were subgrouped according to gender, age of 45, body height of 165 millimeters (mm), and thyroid cartilage height of 17 mm. These subgroups were compared for each measurement and ratio. Results. A positive correlation was found between body height and thyroid cartilage height (hTC), thyroid cartilage width, vocal fold length, and distance from projection of anterior commissure (pAC) to inferior border of thyroid cartilage (TIB). Male gender, higher body heights, and higher thyroid cartilage heights significantly higher results were obtained. The ratio between pAC-TIB distance to hTC was found to be 0.54 in males and 0.52 in females, and this ratio was not statistically different in subgroups. Conclusion. Although all of the laryngeal measurements were found to be statistically significant in patients with higher body height, the ratio between pAC-TIB distance to hTC was independent. Thus, especially in patients with body heights longer than average, it should be safer to use the midpoint of the thyroid cartilage as a landmark for anterior commissure.Publication Metadata only Laryngeal Framework Surgical Anatomy: A Radiological Study(Mosby Inc., 2021) GÜNDOĞMUŞ, CEMAL AYDIN; Şahin A., Gündoğmuş C.A., Üçkuyulu E.İ., Oysu Ç., Enver N.Purpose: Awareness of variations in laryngeal anatomy among different age and gender groups is crucial during laryngeal framework surgery. The aim of this study is to demonstrate the relationship between gender and laryngeal radiologic morphometrics among different age groups and the applicability of important anatomical landmarks of laryngeal surgery. Methods: Laryngeal images of 180 adult patients older than 18 years of age were obtained by computed tomography and assessed. A total of 11 measurements of important laryngeal landmarks were taken from the patients’ computed tomography images. Results were subgrouped according to gender and age, and these groups were compared for each measurement. Results: The majority of laryngeal measurements obtained in the study were higher in males than females, with the exception of the interlaminar angle. The mean interlaminar angle value was 88.27°± 14.99 for males and 103.04°± 14.81 for females (P <0.005). The distance from the anterior commissure to the inferior border of the thyroid cartilage was 10.46 ± 2.5 mm for males and 7.72 ± 1.9 mm for females. The anterior commissure locates slightly higher than the midpoint of the distance from the thyroid notch to the thyroid inferior border. The shortest distance between the muscular process of the arytenoid cartilage and the thyroid cartilage was found to be 9.60 ± 3.47 mm for males and 7.72 ± 2.33 mm for females (P <0.001). Conclusion: Observation of obvious diversities in the size and distance of the important laryngeal structures between the gender groups is an important factor to be considered for successful laryngeal framework surgery. Also, using the midpoint of the thyroid cartilage as a landmark for anterior commissure is a practical method during surgery, especially for thyroplasty. © 2021 The Voice FoundationPublication Metadata only Impact of subspecialty training on management of laryngopharyngeal reflux: results of a worldwide survey(SPRINGER, 2021) ENVER, NECATİ; Lechien, Jerome R.; Carroll, Thomas L.; Allen, Jacqueline E.; Ayad, Tareck; Enver, Necati; Eun, Young-Gyu; Perazzo, Paulo S.; Ceccon, Fabio Pupo; Sant'Anna, Geraldo D.; Imamura, Rui; Raghunandhan, Sampath Kumar; Chiesa-Estomba, Carlos M.; Calvo-Henriquez, Christian; Saussez, Sven; Karkos, Petros D.; Remacle, Marc; Akst, Lee M.; Bock, Jonathan M.Objective To study the management of laryngopharyngeal reflux (LPR) among the subspecialties of practicing otolaryngology-head and neck surgeons and their trainees. Methods A survey was sent to over 8000 otolaryngologists (OTOHNS) over 65 countries, utilizing membership lists of participating otolaryngological societies. The outcomes were answers to questions regarding LPR knowledge and practice patterns, and included queries about its definition, prevalence, clinical presentation, diagnosis, and treatment. Results Of the 824 respondents, 658 practiced in one specific otolaryngologic subspecialty. The symptoms and findings thought to be the most related to LPR varied significantly between subspecialists. Extra-laryngeal findings were considered less by laryngologists while more experienced OTOHNS did not often consider digestive complaints. Compared with colleagues, otologists, rhinologists and laryngologists were less aware of the involvement of LPR in otological, rhinological and laryngological disorders, respectively. Irrespective of subspecialty, OTOHNS consider symptoms and signs and a positive response to empirical therapeutic trial to establish a LPR diagnosis. Awareness regarding the usefulness of impedance pH-studies is low in all groups. The therapeutic approach significantly varies between groups, although all were in agreement for the treatment duration. The management of non-responder patients demonstrated significant differences among laryngologists who performed additional examinations. The majority of participants (37.1%) admitted to being less than knowledgeable about LPR management. Conclusions LPR knowledge and management vary significantly across otolaryngology subspecialties. International guidelines on LPR management appear necessary to improve knowledge and management of LPR across all subspecialties of otolaryngology.Publication Metadata only Inflammatory complications of vocal fold injection with hyaluronic acid: a multiinstitutional study(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2021) ENVER, NECATİ; Enver, Necati; Azizli, Elad; Akbulut, Sevtap; Tatar, Emel Cadalli; Yelken, Muhammed Kursad; Ozturk, Kayhan; Coskun, Hakan; Birkent, Ahmet Hakan; Buyukatalay, Zahide Ciler; Ozgursoy, Ozan Bagis; Oguz, HaldunBackground/aim: This study aimed to assess the inflammatory adverse reactions of vocal fold injection laryngoplasty with hyaluronic acid. Materials and methods: This study was a retrospective chart review of patients who underwent vocal fold injection augmentation with HA injection from January 2005 to September 2016 in nine different institutions. Demographic data, indication for injection, injection techniques, types of injection material, settings of procedure, and complications were reviewed. The types of complication, onset time, and management of complications were also noted. Results: In all, 467 patients were identified. The majority of patients had been injected under general anesthesia (n = 382, 84.7%). For injection material, two different types of hyaluronic acid were used: hyaluronic acid alone or hyaluronic acid with dextranomer. Complications occurred in nine patients (1.9%). The majority of complications were inflammatory reactions (n = 7, 1.47%). Main symptoms were dysphonia and/or dyspnea with an onset of 0 h to 3 weeks after the hyaluronic acid injection. Three patients were hospitalized, one of which was also intubated and observed in the intensive care unit for 24 h. Systemic steroids and antibiotics were the main medical treatment in the majority of cases. There was no statistical difference in complication rates between patients who received hyaluronic acid and those who received hyaluronic acid with dextranomer (P = 0.220). Conclusion: Hyaluronic acid can be considered as a safe substance for the injection of vocal folds with a low risk of inflammatory reaction.Publication Metadata only Office-Based Procedure Training in Laryngology Fellowship Programs(WILEY, 2021) ENVER, NECATİ; Enver, Necati; Ramaswamy, Apoorva; Sulica, Lucian; Pitman, Michael J.Objective To assess the current practices and challenges of training office-based procedures to laryngology fellows in the United States. Methods An anonymous web-based survey study was distributed to laryngology fellowship program directors, as listed by the American Laryngological Association. The survey was a 19-item questionnaire with free-text, Likert scale, and multiple-choice answers. Results Twenty-two of 27 program directors (81.4%) replied to the survey. Many programs (8/16) have three or more laryngologists and do more than 10 procedures each week (10/16). Sixty-nine percent (11/16) of directors had not been trained for office procedures in their fellowship. The fellows are allowed to be primary surgeon on 68.75% and 75% of vocal fold augmentation and laser procedures, respectively. The expected competencies for these procedures on graduation are average-moderate and moderate. When program directors asked about the methods used for training, a minority of them use simulators (2/16), procedural checklists (2/16), or structured debriefing (2/16). The most commonly used methods were case-based troubleshooting (13/16) and unstructured debriefing (13/16). Patients being awake and patients' expectations are seen as the most important obstacles. Most of the directors thought office-based procedure training could be improved (14/16). The most common suggestions were using step-wise checklists, simulator-labs, and formal debriefings. Conclusion This is the first study evaluating the training of office-based laryngeal procedures during laryngology fellowship. Given the increasing importance of these procedures in practice and the herein identified barriers and need for improvement, fellowships should investigate the use of systematic training tools to improve fellow competency with office-based procedures.Laryngoscope, 2020