The affect of increasing radiofrequency surgery application regions to the medical treatment success of snoring

AMAÇ: Ciddi medikal sonuçları olan Obstrürüktif UykuApnesi Sendromu (OUAS)'nun en önemli belirtisi olan horlama sosyal ve medikal bir problem oldugundan titizlikle değerlendirilmesi gerekir. GEREÇ VE YÖNTEMLER: Cumhuriyet Üniversitesi Tıp Fakültesi, KBB Anabilim Dalı, horlama polikliniğine 1999-2002'de horlama şikâyeti ile başvuran, obstrüktif uyku apnesi öyküsü bulunmayan ve yumuşak damak ile uvulası normalden uzun olup değişen oranlarda vibrasyon gösteren 46 olguda yapıldı. Bu 46 olgu grup 1 (iki noktaya radyo frekans uygulaması yapılacak olgular) ve grup 2 (üç noktaya radyo frekans uygulaması yapılacak olgular) olmak üzere rastgele iki gruba ayrıldılar. BULGULAR: Preoperatif yumuşak damak vibrasyon dereceleri postoperatif 12. haftadaki vibrasyon dereceleri ile karşılaştırıldığında anlamlı düzeyde azaldığı görüldü (p<0,05). Subjektif olarak ilk 4 haftada horlama şikâyetinde belirgin artış gözlendi. PreoperatifVizüelAnalog Skala (VAS) değerlerinin ortalaması 7.76±0,25; postoperatif 12. haftadaki VAS değerlerinin ortalaması ise 4,41±0,18 olup aralarındaki fark istatistiksel olarak anlamlıdır (p<0,001). Iki grubun 4. haftadaki VAS değerlerindeki artıs preoperatif VAS değerleri ile karşılaştırıldığında istatistiksel olarak anlamlıdır (p<0,001). Yapılan istatistiksel değerlendirmede preoperatif VAS değerlerine göre postoperatif 12. haftadaki VAS değerlerinde anlamlı azalma saptandı (p<0,001). Subjektif sikâyetlerin de azalma olmaması nedeniyle grup1'de 8 (%40), grup 2'de 2 (%11,8) olguya ikinci seans radyo frekans uygulaması yapılması gerekti. Ikinci seans uygulaması gerekmesi açısından 2 grup karşılaştırıldığında istatistiksel olarak anlamlı bir fark tespit edilmedi. Bununla birlikte rölatif risk %95 güvenlik aralığında hesaplandığında grup1'de grup 2'deki olgulara göre ikinci seans radyo frekans uygulamasına 3,4 kez daha fazla gereksinim gösterdikleri saptandı. SONUÇ: Uygulama yeri sayısı arttıgında ikinci seans radyo frekans uygulaması daha az gerekir. Sonuç olarak uygulama yeri sayısı tedavi başarısında etkilidir.OBJECTIVE: Snoring is a social and medical problem because of the prime sign of OSAS this pathology must be scrupulously evaluate. MATERIALand METHODS: During 3 years period (from 1999 to 2002), the 46 patients with chief complaint of snoring without obstructive sleep apnea history and soft plate elongation was found who applied to snoring policlinic of Cumhuriyet University Faculty of Medicine Department of Otorhinolaryngology was included in this study. RESULTS: There were a prominent decrease preoperative vibrations degree and postoperative 12 week vibrations degree statistically meaningfully differences was found (p<0, 05) in this study participant In the first 4 weeks of treatment, it was observed increasing of snoring subjectively. Patients average-value of VAS were preoperative 7.76±0, 25 and postoperative 12 weeks 4, 41±0, 18 which differences statistically meaningfully was found (p<0,001). Both of 2 group's 4 weeks VAS degree were compare preoperative VAS degree which increase were found statistically meaningfully(p<0,001). Both of 2 group's postoperative 12. weeks VAS degree were compare preoperative VAS degree which decrease were found statistically meaningfully (p<0,001). Second treatment application of radio frequency was needed in 8 patients in group I (%40) and 2 patients of group II (%11.8) due to decrease of subjective complaints. There were no statistically meaningfully differences when the necessity of second treatment application of radio frequency in both groups included in the study compared. In addition, when the relative risk with %95 safe interval was calculated, the necessity of second treatment application of radio-frequency in group I was found 3.4 times more then the necessity of second treatment application of radio-frequency in group II. CONCLUSION: In this study shows second treatment requisiteness was decreased when the increasing number of radiofrequency application regions. Therefore, the treatment success of snoring number of radiofrequency application regions was very important

The Analysis of Patients Operated for Frontal Sinus Osteomas

Objective:Paranasal sinus osteomas are benign tumors that are smooth-walled, slow-growing, and induced by bone tissue. Although their most common localization is the frontal sinus, some osteomas are seen in the ethmoid, maxillary, and sphenoid sinuses. Frontal sinus osteomas are often asymptomatic; however, when they become symptomatic, headache is the most common complaint. In this study, we aimed to analyze the postoperative results of patients who were diagnosed with frontal sinus osteoma and were operated with appropriate surgical techniques.Methods:We retrospectively evaluated 14 patients who were diagnosed with frontal sinus osteoma and were operated in our department between March 2009 and July 2014. The following parameters were analyzed: patients’ age and gender, complaints at the time of admission to our clinic, pathological findings from physically examination, tumor features observed in preoperative paranasal sinus computed tomography (size and localization), surgical methods applied, intra- and postoperative complications, and recurrence rates. All patients preoperatively provided informed consent.Results:Of the 14 patients, 7 were males and 7 were females, with a mean age of 40.57 years. A total of 11 (79%) osteomas were located within the frontal sinus and 3 (21%) within the frontal recess. External surgical approach was performed to 11 patients, endoscopic approach was performed to 2 patients and external and endoscopic approach was performed to 1 patient together.Conclusion:Although the preferred surgical method in frontal sinus osteoma depends depended on size and localization of tumors, experience of surgeon is also important. Although the external surgical approach is appropriate for large and laterally localized osteomas, the endoscopic approach is appropriate for small and inferomedially localized osteomas. In both surgical approaches the site of origin should be drilled

Malignant Myoepithelioma of the Palate: A Case Report with Review of the Clinicopathological Characteristics

A malignant myoepithelioma is one of the rarest salivary gland neoplasms which may either arise de novo or develop within a preexisting pleomorphic adenoma or benign myoepithelioma. The parotid gland is the most common primary site and the palate the most common intra-oral site of occurrence. Herein is present a case of a malignant myoepithelioma arising in the hard palate of a 79-year-old woman. The lesion had been examined by biopsy at another hospital, and diagnosed as a poorly differentiated squamous cell carcinoma. The patient underwent a wide local tumor resection. Examination of the resection specimen showed the characteristic histopathological and immunohistochemical features of a malignant myoepithelioma. Five months after the operation, the patient was well without evidence of recurrence or metastasis

In vitro study on immune response modifiers as novel medical treatment options for cholesteatoma

Objectives: To investigate cytokine profile of cholesteatoma and to collect information about important intercellular signaling pathways by establishing two different cell culture models, to block important intercellular signaling pathways in cholesteatoma by applying immune system modifier drugs to develop alternative medical therapy options for cholesteatoma. Methods: To observe the pathogenesis of cholesteatoma and to apply the immunomodulatory drugs, cholesteatoma tissue culture models were constituted with HEKa cells and cholesteatoma keratinocytes, which were obtained from 3 patients who underwent operations for cholesteatoma. Medicines including 5-fluorourasil, imiquimod, cyclosporine, and tacrolimus were applied on both cholesteatoma keratinocytes and HEKa cells. After 48 h of incubation, IL-1, IL-6, IL-8, IL-10, TNF-alpha, and Ki67 levels were measured to determine cell viability rates. Results: In the cholesteatoma control group, IL-6 and TNF-alpha levels were found higher than in the HEKa control group. All repurposed drugs in the study demonstrated anti-inflammatory, anti-proliferative, and cytotoxic effects on cholesteatoma. Imiquimod and tacrolimus in particular are potential treatment prospects for cholesteatoma due to their strong anti-inflammatory and cytotoxic effects. Conclusion: Medical therapy options for cholesteatoma are still missing and surgery is not the ultimate solution. We have focused on intercellular inflammatory processes, which play significant roles in the pathogenesis of cholesteatoma in our paper. Inflammation and proliferation of cholesteatoma decreased after all repurposed drug applications in our study. Anti-inflammatory and anti-proliferative effects of tacrolimus and imiquimod was more significant than other drugs in the study. For this reason, tacrolimus and imiquimod should be examined in depth with in vivo studies in terms of efficacy and safety for medical treatment of cholesteatoma.Eskisehir Osmangazi University BAP FundEskisehir Osmangazi UniversityThis study has been funded by Eskisehir Osmangazi University BAP Fund