Person: ENVER, NECATİ
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ENVER
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NECATİ
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Publication Open Access Using generative artificial intelligence in the production and dissemination of innovation in otolaryngology—ethical considerations(2023-01-01) ENVER, NECATİ; Khoury C. J., ENVER N., Paderno A., Ratti E., Rameau A.A team of otolaryngologists is studying the efficacy of early detection strategies in patients affected by idiopathic subglottic stenosis. They use an interactive artificial intelligence (AI) chatbot to prompt patients to report symptoms from home to remotely monitor the progression of stenosis. The chatbot prompts patients to provide feedback on their satisfaction with remote monitoring. Primary endpoints include extent of stenosis at evaluation (noted by flexible laryngoscopy in the office), number of unnecessary visits, and frequency of surgical interventions to relieve stenosis, such as CO2‐laser use, balloon dilation, or laryngotracheal resection. Secondary endpoints include oxygen saturation, spirometry score, pulse, and patient‐reported outcomes. Because idiopathic subglottic stenosis is rare, the study did not have as large of a data set as they had hoped. Therefore, the team augments their existing data set via a generative adversarial network (GAN) trained on their existing data. The team reports significant improvement in the measured endpoints, with marked decrease in unnecessary visits and surgeries. The team has become occupied with clinical duties and does not have time to compose the manuscript. Moreover, they have a history of submitting poorly written manuscripts. Therefore, they decide to use generative AI to aid in manuscript production.Publication Open Access Development of an animal model for type II sulcus (sulcus vergeture)(2023-01-01) ENVER, NECATİ; Batıoğlu-Karaaltın A., Ugurlar M., ENVER N., Erdur Z. B., YILMAZ Y. Z., Bozkurt E. R.Objectives: To develop a reproducible experimental animal model for sulcus vergeture in rabbits. Study Design: Experimental animal study. Material Method: We evaluated three methods of inducing sulcus in twelve New Zealand white rabbits to produce a sulcus model. Experimental groups comprised: group 1 (n = 4) underwent submucosal injury following endolaryngeal epithelial incision; group 2 (n = 4) received submucosal injury via thyrotomy; group 3 (n = 4) received submucosal injury via thyrotomy, followed with horizontal mucosal lateralization suture. Right vocal folds of the rabbits underwent surgery to produce sulcus vocalis and left vocal folds were used for the comparison. In the sixth week after the procedure, the rabbits were sacrificed and the larynxes were harvested and analyzed histopathologically. Results: No animals in group 1 or 2 developed sulcus vocalis. Sulcus formation was observed in all rabbits in group 3, under endoscopic examination and microscopic sulcus formation was demonstrated for the first, second, and third rabbits. An epithelial depression area was seen at the glandular ductal opening zone for the fourth rabbit, but it could also be accepted as a sulcus formation. Conclusion: We successfully developed a reproducible survival model for sulcus using a submucosal injury via thyrotomy, followed with a horizontal mucosal lateralization suture. This model provides the groundwork for future research into the applicability of new approaches for sulcus management.Publication Open Access A single-center multidisciplinary study analyzing thyroid nodule risk stratification by comparing the thyroid imaging reporting and data system (TI-RADS) and American thyroid association (ATA) risk of malignancy for thyroid nodules(2022-01-01) ASYA, ORHAN; YUMUŞAKHUYLU, ALİ CEMAL; ENVER, NECATİ; İNCAZ, SEFA; GÜNDOĞMUŞ, CEMAL AYDIN; ERGELEN, RABİA; BAĞCI ÇULÇİ, PELİN; OYSU, ÇAĞATAY; ASYA O., YUMUŞAKHUYLU A. C. , ENVER N., Gündoğdu Y., Abuzaid G., İNCAZ S., GÜNDOĞMUŞ C. A. , ERGELEN R., Bağcı P., OYSU Ç.© 2022 Elsevier LtdObjectives: The thyroid imaging reporting and data system (TI-RADS) and 2015 American Thyroid Association (ATA) guidelines are two well-known risk stratification systems for classifying thyroid nodules based on cancer risk. This study aims to evaluate the diagnostic efficacy of these two systems in predicting malignancy in patients undergoing thyroid surgery. Methods: We studied data on 120 individuals who were scheduled to undergo surgery for benign or malignant nodular diseases of the thyroid gland between October 2017 and October 2019. The TI-RADS category and ultrasound pattern based on ATA guidelines were assigned to dominant thyroid nodule categories by two experienced radiologists blinded to patients’ previous thyroid ultrasonography and fine-needle aspiration biopsy results. A pathologist with experience in thyroid diseases blinded to patients’ sonographic and clinical data reviewed the thyroidectomy specimens. Results: A total of 120 patients, 88 women and 32 men, were included in our study. Final histopathological results were as follows: 50% (n=60) papillary thyroid carcinoma, 36.6% (n=44) benign nodular thyroid diseases, 4.1% (n=5) follicular adenoma, 2.5% (n=3) hurtle cell adenoma, 1.7% (n=2) follicular thyroid carcinoma, 1.7% (n=2) medullary thyroid carcinoma, 1.7% (n=2) hurtle cell carcinoma, and 1.7% (n=2) follicular tumor of uncertain malignancy potential. The sensitivity, specificity, positive predictive value, and negative predictive value for TI-RADS were 80%, 56%, 72%, and 67%, respectively, and that for ATA were 80%, 64%, 76%, and 69%, respectively. Conclusion: The TI-RADS and ATA showed similar rates of sensitivity, specificity, NPV, and PPV. Our observed risk of malignancy was higher than expected for the ACR TI-RADS 3–5 categories and the very low, low, and intermediate suspicion risk strata in the ATA guidelines. We found no difference between observed and expected malignancy risk for the ACR TI-RADS 2’s and ATA\"s high suspicion categories.