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    The Effect of Repositioning Maneuver Applied with the TRV Chair on Residual Dizziness after Benign Paroxysmal Positional Vertigo
    (Lippincott Williams & Wilkins, 2023) Soylemez, Emre; Bolat, Kubra Binay; Karakoc, Kursad; Can, Mehmet; Basak, Hazan; Aydogan, Zehra; Tokgoz-Yilmaz, Suna
    ObjectiveThis study aims to investigate the effect of TRV chair on residual dizziness (RD) after idiopathic posterior semicircular canal benign paroxysmal positional vertigo (BPPV) successfully treated with canalith repositioning maneuver (CRM).Study DesignProspective case-control study.SettingHospital.PatientsThirty-three patients with posterior canal BPPV were included in the study. These patients were divided into two identical groups. CRM was applied to the first group with a TRV chair (TRV group) and manually to the second group (manual group).InterventionsDizziness Handicap Inventory (DHI), Beck Anxiety Inventory (BAI), and video head impulse test were applied to the patients. Patients in both groups were asked to report the RD developed after successful CRM daily by visual analog scale (VAS).ResultsThe TRV group's first-day RD rate was 94.1% with VAS, and the RD duration was 2.47 & PLUSMN; 1.77 (0-7) days. The manual group's first-day RD rate was 100%, and the RD duration was 3.38 & PLUSMN; 1.70 (1-7) days. There was no difference between the groups in terms of RD duration (p > 0.05). Mean RD severity and severity in the first 3 days were lower in the TRV group compared with the manual group (p < 0.05). There was no difference between the groups on other days (p > 0.05). In addition, there was a positive correlation between RD and DHI and BPPV duration (p < 0.05).ConclusionRD is a multifactorial symptom associated with how the repositioning maneuver is performed, BPPV duration, and DHI. Performing the repositioning maneuver with the TRV chair can reduce the severity of RD.
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    Endonasal endoscopic management of the craniopharyngeal canal meningoencephalocele using a nasoseptal flap in a 6-month-old infant
    (Springer, 2020) Basak, Hazan; Kahilogullari, Gokmen; Guler, Tugba Morali; Sayaci, Emre Yagiz; Etus, Volkan; Meco, Cem
    Endonasal endoscopic approach (EEA) has become a routine and effective method for the management of large skull base defects in adults and increasingly in older pediatric populations despite their challenging narrow transnasal corridors. To our knowledge, this is the first report in the literature of a large craniopharyngeal canal (CC) meningoencephalocele in a 6-month-old infant managed purely through EEA, also by utilizing a pedicled nasoseptal flap (PNF).
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    Endoscopic Anatomy and a Safe Surgical Corridor to the Anterior Skull Base
    (Elsevier Science Inc, 2021) Kilinc, Mustafa Cemil; Basak, Hazan; Coruh, Aysegul Gursoy; Mutlu, Merve; Guler, Tugba Morali; Beton, Suha; Comert, Ayhan
    OBJECTIVE: We describe the possibility to create precise preoperative planning for endonasal endoscopic approaches to the anterior skull base by overlapping endoscopic and radiologic anatomy. The important anatomic structures were marked. Morphometric measurements between these anatomic landmarks were performed endoscopically and compared with radiologic measurements of the same areas to ensure result compatibility. METHODS: Seven cadaver heads injected intravascularly with colored silicone were used for this study. Thinsection brain and paranasal sinus computed tomography scans were obtained on all cadavers. Using 0-degree rigid endoscopes and endonasal endoscopic surgical instruments, the anterior skull base was examined binostrally in all cadavers. Bilateral middle turbinates were identified and preserved. Next, an inferior uncinectomy and middle meatal antrostomy were performed. After performing a frontal antrostomy, bilateral anterior and posterior ethmoidal cells were opened and the skull base was identified and followed to the posterior wall of the frontal sinus. A transnasal transethmoidal sphenoidotomy was done with full exposure to the entire anterior skull base. RESULTS: The anatomic landmarks for endonasal endoscopic skull base approaches were distinguished and measurements were made. The anterior skull base was divided into 3 compartments: anterior (area between the posterior inferior border of the frontal sinus and the course of anterior ethmoidal artery), middle (area between the course of the anterior ethmoidal artery and that of the posterior ethmoidal artery [PEAR and posterior (area between the course of the PEA and the attachment point of the anterior border of the sphenoid sinus to the skull base) compartments. The distances between important anatomic markers and endoscopic depth measurements of this area were measured. CONCLUSION: During endonasal endoscopic anterior skull base surgery, the area between the anterior border of the sphenoid sinus and PEA artery was safe as the first dissection zone. Preoperative radiologic width and depth measurements facilitate orientation to the endoscopic anatomy during surgery and help predict the endonasal surgical corridor anatomy preoperatively.