EAR & NOSE & THROAT

EAR & NOSE & THROAT

RHINOLOGY (NOSE SURGERY)

  • Functional nose surgery (Concha and bone operations)
  • Endoscopic sinus surgery (By navigation method)
  • Endoscopic lacrimal sac surgery

SLEEP DISORDERS AND SNORING DURING SLEEP

  • Polysomnography (Sleep test)
  • Snoring and sleep apnea operations (Classic surgery, laser surgery)
  • CPAP titration (Mask therapy)

PEDIATRIC OTOLARENGOLOGY

  • Painless, No Bleeding Tonsillectomy With Thermal Welding Technology
  • Ventilation tube insertion to the ear

OTOLOGY AND NEUROOTOLOGY (EAR DISEASES AND SURGERY)

  • Audiology (Hearing tests)
  • Hearing aid application
  • Ear microsurgery
  • Ear calcification (Otosclerosis) operations using laser technology
  • Cochlear Implant
  • Diagnosis and treatment of tinnitus
  • Diagnosis and treatment of dizziness and balance disorders (Posturography and videonystagmography)
  • Facial paralysis diagnosis and treatment

LARENGOLOGY (VOCAL DISEASES)

  • Diagnosis and treatment of aphonia and hoarseness disorders (with Videostroboscope)
  • Vocal cord surgery (Polyp, Nodule) Vocal thinning surgery (with laser)
  • Throat cancer operations
  • Speech disorders, stuttering diagnosis and treatment

AESTHETIC PLASTIC SURGERY

  • Aesthetic nose surgery (via open and closed method)
  • Prominent ear surgery

HEAD NECK SURGERY

  • Diagnosis and surgery of head and neck tumors
  • Ear, nose and throat cancer surgery
  • Salivary gland surgery

MAXILLOFACIAL SURGERY

  • Surgical treatment of facial fractures

Vertigo (Dizziness)

Some people refer their balance problems as dizziness. This balance problem, in which the environment remains motionless, may sometimes be caused by a disorder related to the inner ear.

What is Vertigo?
Some people, however, explain their difficulties in balancing themselves with the word “vertigo”. These words derive from the Latin verb “to turn”. These patients frequently report that themselves or their environment are revolving around. Vertigo is usually initiated by inner ear disorders.

What are motion sickness and seasickness? 
Some people become nauseous or even vomit when they are inside a car or a plane. This is called carsickness. Many people experience the same problem when they are on a ship, although the factors triggering the problem are the same, this is called seasickness.
Seasickness is only a minor ailment. It is not a symptom of any other medical disorder. However, passengers having seasickness may feel restricted due to this sickness. Rarely, the sickness endures several days after the travel.

Dizziness and Balance Disorder Unit at Ekol ENT

Posturography

postugrafiIt helps to identify which systems are affected by the problem or by the pathology when patients admit to the clinic with balance disorder complaints.

At the end of the analysis of the results of 18 different tests on the patient in standing position;

Posturography produces numerical data showing and comparing the ratio of damage on three systems, the somatosensorial system, the visual system, and the vestibular system, which may cause patient’s balance disorder.

Which systems are damaged and their damage ratios are identified by a method, which compares the patient’s values with the normative data of expected values from healthy people having the same weight, height, and other features, recorded in the system.

Balance rehabilitation is also done by means of the Posturography device. The patient undergoes a treatment protocol, which consists of 5 phases organized according to their level of difficulty.

Before the evaluation, if the patient is undergoing a medical treatment for dizziness and balance disorder, the patient should stop taking medicines two days before the test day for obtaining the most accurate results.

Patients with pre-diagnosis who have been examined by ear, nose, throat doctors, or who have undergone medical or surgical treatment if necessary are evaluated by our unit and taken to medical treatment if they have one of the following disorders:

  • Balance disorders due to somatosensorial system damage,
  • Continuing balance disorders due to vestibular system damage,
  • Loss of function due to ankle and knee injuries, requiring postoperative rehabilitation,
  • Falling problems due to balance disorder.

VIDEONYSTAGMOGRAPHY (VNG)

videonistagmografiIt is the computerized video recording process of nystagmus and eye movements experienced by the patient, which are checked by 10 different tests. For the purpose of inspection, causes of dizziness, whether they are originated from the center or the periphery are researched. Before the evaluation, if the patient is undergoing a medical treatment for dizziness and balance disorder, the patient should stop taking medicines two days before the test day for obtaining the most accurate results.

Having examined by ear nose throat doctors and with a pre-diagnosis, the following groups of patients are admitted to treatment at our unit:

  • The patients whose dizziness should be identified as central or peripheral;
  • The patients whose dizziness should be examined thoroughly;
  • The patients whose eye movements could not be examined properly,
  • The patients who require their nystagmus to be examined without eye fixation.

Anatomy of Balance

Dizziness, vertigo, and carsickness are related to the balance system. Space researchers call this sense “spatial orientation”. The balance system is located inside the inner ear. It informs the brain about the body’s position in space, its direction, its moving course, and about whether the body is turning or motionless.
Your balance sense is a product of complex relationships between various nervous system parts specified below.
A diagnosis must be made before initiating treatment process. This includes a through ear nose throat examination and some potential laboratory, endoscopy, and x-ray works. Bacterial infections are remedied with antibiotics, but they provide a temporary healing. In choric sinusitis, a surgical operation is required for opening sinus inlets.
1. The inner ear (labyrinth) identifies the movement direction such as forward, backward, horizontal, vertical, or turning.
2. Eyes identify the body’s position within space (such as upside down etc.) and movement direction.
3. Pressure receptors located in joints and in the spine identify which parts of the body are below and touching the ground.
4. Perception receptors in muscles and in joints identify which parts of the body are moving.
5. The central nervous system (the brain and the spinal cord) processes the signals transmitted from the previous four systems, and generates a coordinated perception at the end.

Dizziness and the symptoms of carsickness occur when contradicting signals are transmitted to the central nervous system from the other four systems.
For instance, consider that you are on a plane on a stormy day and your plane is shaking due to airstreams. However, your eyes do not perceive this movement of the plane, because all you see is inside of the plane. As a result, your brain can get discordant messages. This may cause your plane sickness.
Or consider reading a book at the backseat of a car. Your inner ear and skin receptors perceive the movement of the car, but your eyes see only the book. This may cause your carsickness.
Scientifically speaking, consider your inner ear on one side of your head is injured due to a blow. The injured inner ear does not signal the same messages with the normal inner ear. This complication may cause sending wrong signals to the brain about the turning movement, and the person experiencing this may complain about dizziness or vertigo. Sometimes nausea is also observed.


Which medical illnesses cause dizziness? 
1. Circulation: Circulation disorder is one the most frequently encountered factors triggering dizziness. If your brain cannot get enough blood, your head starts spinning. Almost everyone has experienced this when suddenly getting up from laying position. However, some people make complaints about dizziness that is happening frequently and chronically. This is due to arteriosclerosis (vessel stiffness). This illness is usually observed with hypertension patients, diabetics, and people having high blood lipids. It is also seen with people having inadequate heart functionality, and anemia complaints. Some medicines, especially nicotine and caffeine, reduce the blood flow to the brain. Excessive salt in diet may also reduce blood flow. Sometimes, circulatory system may suffer from dysfunctions caused by stress, vexation, and agitation. If the inner ear cannot take sufficient blood, vertigo, a special type of dizziness, may occur. The inner ear is very sensitive to changes in blood circulation. Thus, a weak blood circulation may cause disorders for the inner ear, as it does for the brain.

2. Injury: A fracture on the skull, which injures the inner ear, results in an extremely confining vertigo as well as nausea and hearing loss. Dizziness may last for several weeks. In the meantime, the normal side gradually undertakes the functions.

3. Infection: Viruses, for instance the ones causing cold, may affect harmfully on the inner ear, and on the nerves connecting the inner ear with the brain. While this causes a bad vertigo, hearing function usually remains unharmed. Despite this fact, bacterial infections may disrupt both balancing and hearing functions. Severity of dizziness and healing period are the same with skull fractures.

4. Allergy: Some people may experience dizziness and vertigo when they eat allergic foods or become exposed to allergic air particles.

5. Neurologic Illnesses: Illnesses harming the nervous system such as multiple sclerosis,syphilis, and tumor may disrupt the balance. Although they are rarely seen factors, your doctor considers these possibilities as well during your examination.

What can I do to avoid carsickness? 
1. Try to sit on places where you’re your ears and your eyes perceive your body movements in the same way. For instance, you could on the front seat of a car and stare directly ahead, or you could watch the horizon standing on the shipboard, or you could view outside sitting on the window-side seat of a plane. During a flight, choose the seats close to the wings of the plane.

2. If you have carsickness, do not read books in the car, and do not sit on reverse seats.

3. Do not talk to the people having carsickness and do not look at them.
4. Stay away from strong odors, spicy and fatty foods before and during travel. Scientific researches do not show that folk remedies are effective.
5. Take one of the medicines suggested by your doctor before the travel. Some of these medicines can be purchased without prescriptions. For tranquillizers and nervous system depressants, proscriptions from your doctor are required. Some of them are pills or bougies, and some of them (scopolamine) are strips that can be applied on the backside of ears.
Remember: Dizziness and carsickness are mostly minor illnesses and can be treated by self-efforts of the patient. However, a specialist on ear, nose, throat, balance, and nervous system subjects should check major and deteriorating cases.

What does a doctor do for treating dizziness?
Your doctor would ask you to describe your dizziness. She asks you whether it is a blackout or a sense of movement, how long it lasts, and if you have hearing loss, nausea, or vomiting. She may also ask under what conditions you experience dizziness. You may be required to answer many questions regarding your overall health condition, medicine use, head trauma, recent infections, and your ears and nervous system. After examining your ear, nose, and throat, your doctor performs tests about your nervous system. Since the inner ear takes role in both hearing and balancing functions, a balance disorder affects hearing function and vice versa. Thus, your doctor may require a hearing test (audiogram) In some cases, your doctor may ask for your skull’s x-ray, its tomography, and its view generated by magnetic resonance, or a test (electronystagmography=ENG), which monitors your eye movements after stimulating your ears by applying hot and cold water. She may sometimes recommend an examination of your heart and some blood tests.
Not every patient requires all of the aforementioned tests.
Your doctor’s decision will determine which tests are necessary. Similarly, the recommended treatment will be related to the diagnosis.
What can I do to ameliorate dizziness? 
1. Avoid sudden position changes. For instance, do not stand up suddenly when you are in laying position, or do not rapidly return from one side to another.
2. Avoid drastic or rapid head movements (especially staring up).
3. Reduce consumption of substances that may disrupt circulation (such as nicotine, caffeine, and salt).
4. Try to avoid stress, temper, and exposition to allergic substances.
5. Avoid activities that may be hazardous to your health when you are feeling dizzy such as driving cars, using dangerous instruments, or climbing ladders.

EAR & NOSE & THROAT

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Our Doctors

In 1980, he completed his medical studies at the University of Hacettepe. He did his training at the ENT Medical Training Centre of Ankara Numune Education and Research Hospital where he worked as a clinical assistant between 2000 and 2012. He became a lecturer in 2000 and a professor in 2011. Professor Adnan Ünal was an observer at the Methodist Hospital in Houston in 1995. He participated in Cocle Implantation in Switzerland and Belgium in 2009. He has published over 150 articles in Germany and about 35 articles in other countries. Professor Dr. Adnan Ünal speaks English. He is specialized in Head and Neck cancer surgery, thyroid surgery, ENT and cochlear implant surgery, endoscopic sinus surgery, thermo-welding with adenoid and tonsil surgery, voice disorders treatment, aesthetic nose in surgery, and snoring surgery. Prof. Dr. Adnan Ünal is married and has 2 children.

Graduated from Hacettepe Medical Faculty in 1969, Dr. İnal specialized in ENT in Ankara Medical Faculty between 1970 -1973. After his military service, he worked intensely on Head and Neck Cancers in Ankara Oncology Hospital for nine years. In 1984, he continued his career as a lecturer at Gazi University Faculty of Medicine, Department of ENT and then as a Faculty Member working on academic studies for 30 years. He was the Head of the Department of this clinic for 9 years. During that period, he had been in Japan, England, France, the Netherlands and the United States for different times and worked in cancer treatment centres. Throughout the same period, he made around 160 domestic and 25 international broadcasts. He has been the chairman and speaker of numerous sessions in national congresses. 350 internal citations and readings were made to those internal and external broadcasts. Today, he is a member of the Turkish ENT Association and ENT and Head and Neck Surgery Associations. Professor Dr. Erdogan İnal is married and has 2 children. He is fluent in English.

Domain Knowledge: Ear, nose, and throat diseases, especially in Tonsil and Adenoid diseases; Children Ear, nose, throat diseases & surgeries; Intranasal surgery; Septum surgery; Nasal turbinate surgery; Reduction of the turbinate by radiofrequency; Radiofrequency applications for allergic flu; Sinus tumours surgery; Approach to nasal area tumours; Snoring treatment with radiofrequency applications and soft palate surgery; Intraoral tongue and jaw tumours surgical approaches; Surgical and laser treatment of larynx (larynx) diseases vocal cord polyps; All kinds of surgeries regarding laryngeal cancers, partial or full laryngeal operations, chemotherapy radiotherapy and combined use of surgery separately or complementary to each other in the treatment of throat cancers; Approach to tumours on the neck area, surgical radiotherapy, and chemotherapy applications; Neck area upper oesophagus surgery.

Associate Prof. Çağlar ÇALLI graduated from Izmir Atatürk High School. He is a graduate of Ege University Faculty of Medicine. He was granted Thyroid Surgery and Diseases Scholarship from the Turkish Ear Nose Throat Association in 2009. With this scholarship, he studied Head-neck tumours and thyroid surgery at Ohio State University in the USA. After being granted the Turkish Ear Nose Throat Foundation Scholarship in 2011, he studied facial plastic surgery, snoring surgery, and endoscopic sinus surgery at New York St. Lukes-Roosevelt Hospital in the USA. He became an Associate Professor in 2012. He has conducted oral presentations abroad, and published book chapters and more than 80 articles in international and national journals. Associate Professor Dr. Çağlar ÇALLI’s surgical research interests include Head-Neck tumours, Goiter and Thyroid surgery, Rhinoplasty and Endoscopic sinus surgery, ear microsurgery, and otosclerosis operations.

He was born in Ankara in 1976.  He graduated from Hacettepe University Faculty of Medicine in 2000. He did his specialization in Ankara Gazi University in 2006. He conducted studies in Central Manchester and Manchester Children’s University Hospitals in Otology & Neuro Otology. He also worked in Bülent Ecevit University ENT Department from 2012 to 2018 during which time he was elected as the Head of Department twice. He became an associate professor in 2017. He has over 70 studies including presentations given at international & national meetings and essays published in national & international journals. He is an active member of the Turkish ENT Head and Neck Surgery Society.

Areas of Interest: Ear Microsurgery and Otosclerosis, Aesthetic Nose operations, endoscopic sinusitis surgery, tonsillectomy and adenoid surgeries, functional nose surgery, otoplasty, sleep apnea, snoring surgeries, vocal cords surgeries, polyp and nodule surgeries, salivary gland diseases, endoscopic hypophysis surgeries. He speaks English well, and is married with 2 children.

He was born in 1965. He graduated from İzmir Atatürk Highschool in 1982 and from Dokuz Eylül University Faculty of Medicine in 1989. He completed his specialization in İzmir Atatürk Research Hospital in 1996. He is a member of TKBB (Turkish Society of ENT), Turkish Society of Rhinology & Facial Plastic. He had various studies in Turkey and abroad. His special areas of interest are Rhinoplasty, Tonsillectomy and Adenoids, Conchae and Nasal Septum operations, Endoscopic Sinusitis Surgeries, Sleep Apnea surgery, ear surgeries, vocal cord surgeries. He speaks English well and is married with 2 children.

He was born in 1969. He graduated from Ege University Faculty of Medicine in 1987 and completed his specialization in Trakya University Faculty of Medicine, Department of ENT. He is an active member of TKBB (Turkish Society of ENT) and Society of Facial Plastics. His areas of interest are adenoid & tonsil surgeries, conchae and nasal septum surgeries, rhinoplasty, velum, sleep apnea & snore surgery. Dr. Ayhan Yıldırım is married with 2 children.

He was born in Bolu - Göynük in 1974. He completed his secondary and high school education in Istanbul Kadıköy Anatolian High School. He started his medical education at Marmara University, Faculty of Medicine (in English language) in 1992.  He graduated from Faculty of Medicine in June 1999 and was granted the title of Consultant Otorhinolaryngologist after completing his specialization in the field of Otorhinolaryngology at Kartal Training and Research Hospital, department of Otorhinolaryngology Clinic in 2003. He worked on sinuses from cadavers at Marmara University, Anatomy Clinic. He attended many cadaver courses in Izmir and Ankara. He served as a clinical observer along with Dr. Shah and Dr. Shaha at U.S. New York Memorial Sloan Kattering Hospital, which is rated as one of the world's top head and neck surgery clinics, for a period of 6 months in 2005. He attended Erlangen/Germany Facial Plastic Surgery Workshop and Practical Cadaver Course, Bern/ Switzerland Facial Plastic Surgery Workshop and Practical Cadaver Course, Zagreb Endoscopic Sinus Surgery Practical Cadaver Course. He kept abreast of current developments in his occupation and attended a number of facial plastic surgery congresses held in Malta, the Netherlands, the USA (Chicago and Miami) and given oral presentations in the field of facial plastic surgery in Nice-France congress. He completed his practical training in the field of sleep disorders, one of his special interests, and received the certificate of Sleep Medicine and established sleep laboratories in the hospitals where he served as the responsible staff. He has ongoing studies in the fields of snoring, sleep apnea and mask treatment. He was granted the title "Member of Turkish Otorhinolaryngology Competence Board" by succeeding in the Otorhinolaryngology Competence Exam in 2007. He also earned the Certificate of European Otorhinolaryngology Competence by being successful in the exam held by the European ORL Board (European Board Examination in Otorhinolaryngology) in 2013. (Fellow of the European Board of ORL-HNS). He gave lectures on Otorhinolaryngology for the students of Yeditepe Faculty of Medicine. He has performed as many as 16000 operations and over 1500 aesthetic nose operations up to today. He has about 30 printed articles that have been published in domestic and foreign literature. He is a member of European Facial Association, Fellow of the European Board of ORL, Turkish Sleep Medicine Society, U.S. Head and Neck Surgery Association, Turkish Otorhinolaryngology Association, Facial Plastic Surgery Association and Turkish Medical Association. His interests are tonsillectomy, adenoidectomy and ear ventilation tube insertion surgeries with the method of Thermal Welding, concha bullosa (deviation) surgery, closed and open technical rhinoplasty (aesthetic and functional nose surgery), otoplasty prominent ears plastic surgery, ear microsurgery (Tympanoplasty surgery and hearing reconstruction surgical operations), endoscopic sinus surgery, endoscopic DSR (lacrimal sac surgery), soft palate, sleep apnea and snoring, radiofrequency surgery, soft palate implantation, vocal cord polyp and nodule microsurgery operations and  salivary gland disease surgeries. Surgeon Dr. Utku Kubilay speaks English very well and is married and has two children. 

He graduated from Hacettepe University Faculty of Medicine (English). He worked at Ege University Faculty of Medicine – Department of ENT Inner Ear & Balance Disorders for 5 years. Ear Microsurgery and Aesthetic Nose Operations are his special areas of interest. He has successful studies in these areas. His areas of interest are also Radio Frequency Non-Bleeding Tonsillectomy and Adenoids, Snoring & Sleep Apnea operations. He is a member of ESRS (European Sleep Research Society), NSS (National Sleep Society), and TUTD (Sleep Society of Turkey). He speaks English and married with two children.

Between 2009 and 2014, Dr. Behçet Şahin completed his training in İzmir Tepecik Research and Development Hospital in ENT Head and Neck Surgery. He conducted a thorough study about the prognostic factors on the therapy in tongue cancer patients in Tepecik Research and Development Hospital, which was accepted as a dissertation. In July 2016, the same study was published in a magazine abroad. In the year 2015, he won the aptitude test for ENT head surgery and received his certificate of quality. Between 2016 and 2017, he started studying otology and neurotology and his studies still continue.
 
Special interests; Ultrasonic nose aesthetic & closed rhinoplasty, Concha and Septum surgeries without splints, Tympanoplasty, Mastoidectomy, Stapedotomy, Ear esthetics, Ventilation Tube procedures, Endoscopic Chronical Sinusitis Surgeries, Endoscopic closed tear gland operation, Soft palate and snoring surgeries, Closed saliva gland procedures, Vocal cord procedures, Every kind of neck & head cancer surgeries, Goiter surgery, adenoidectomy and tonsillectomy surgeries   He speaks very good English, is married and has two children.

Ear, nose and throat specialist. He graduated from the Faculty of Medicine at Dokuz Eylül University in 2008. In 2013, he completed his specialist training at İzmir Tepecik Research and Educational Hospital. He is a member of the Turkish ENT Association, the Turkish Rhinology Association, and the Society of Facial Plastic Surgery. He has also given oral presentations and published articles in national and international journals. Areas of Interest: Tonsil and adenoid surgery, nasal polyp and nasal bone surgery, rhinoplasty (aesthetic nasal surgery), otoplasty (flapped ear surgery), endoscopic otorhinolaryngology, endoscopic middle ear surgery, endoscopic sinus surgery, endoscopic DSR surgery (lacrimal sac surgery) and surgery for snoring, voice surgery, larynx cancer surgery. Op. Dr. Onur Gündoğan is married and has one daughter. He is fluent in English.

He graduated from the Faculty of Medicine at Ankara University in 1999. In 2004, he completed his specialty training in Faculty of Medicine at Ege University, at the Otolaryngology Department. He is a member of European Society of Facial Plastic Surgery, Turkish ENT. Association, Turkish Rhinology Society and Facial Plastic Surgery Association. He has also given verbal presentations and published many articles in national and international journals.  His Areas of Interest: Rhinoplasty, Endoscopic eardrum surgery, Endoscopic middle ear surgery, Microscopic middle ear surgery, Parotid surgery, Tonsil and adenoid surgery, nose, and nasal bone surgery, Otoplasty. His research fields include endoscopic DSR (tear surgery), soft palate and surgery for snoring, vocal cord surgery, laryngeal cancer surgery. He is married and the father of two children. Dr. Baran Aydemir speaks English and German fluently.

He graduated from Marmara University Faculty of Medicine in 2005. He completed his specialization area between 2005 and 2011 in İzmir Bozyaka Research & Educational Hospital. He is an active member of Turkish Society of Ear & Nose & Throat, Turkish Society of Rhinology and Turkish Society of Facial Plastic. He had oral presentations in both national & international meetings, published articles in national and international journals.  He is supported and encouraged by TUBİTAK for the development of a new device in order to be used in sleep apnea and snoring treatments. He has been attending many cadaver courses and national & international meetings in order to keep up with his technical and Professional knowledge.  His areas of interest are: aesthetic nose surgeries, tonsillectomy, septum operations without using tampons, concha operations, chronical otitis media, tympanoplasty, otosclerosis, ventilation tube operations, endoscopic sinus surgeries, and endoscopic DCR, sleep apnea operations, vocal cord operations, vocal cord polyps and nodule microsurgeries.   He speaks fluent English and is married with two children.

He graduated from the Faculty of Medicine in 2001. He completed his specialization degree in İzmir Atatürk Research and Educational Hospital in the branch of ENT. He is an active member of TKBB, Turkish Association of Rhinology and Association of Facial Plastic. He has published articles in national and international journals and has given presentations in international and domestic meetings and congresses.  He speaks fluent English and is married with two children.    His areas of interest are: Nose Aesthetic Surgery, Tonsillectomy and Adenoidectomy, Head & Neck Cancer Surgeries, Allergic Rhinitis Treatment, Nasal Septum Surgeries without Tampons (Septum Deviation), Concha Operations, Chronical Middle Ear Infection Surgeries (Chronical Otitis Media), Tympanoplasty, Otosclerosis Surgery, Ventilation Tube Surgery, Endoscopic Sinus Surgery (Sinusitis Surgery), Endoscopic DSR (Tear Gland and Channel Operations), Snoring and Sleep Apnea Surgery,  Radiofrequency Surgeries, Vocal Cords and Nodule Microsurgery.

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