Elevated serum calprotectin as an inflammatory marker in obstructive sleep apnea

OBJECTIVE To investigate the serum calprotectin (SCal) levels and neutrophil/lymphocyte ratio (NLR) values in patients with obstructive sleep apnea (OSA). METHODS Sixty-seven OSA patients and 46 healthy volunteers without any sleep disorders were included in the study. The patient group was divided into three subgroups according to the severity of OSA. The SCal levels and NLR values were compared among subgroups and between the experimental and control groups. RESULTS The mean SCal level and NLR value were higher in the study group than in the control group (p = 0.002 and p = 0.001, respectively). The SCal levels were significantly higher in patients with severe OSA than in those with moderate and mild OSA (p = 0.004 and p = 0.001, respectively). DISCUSSION Unlike NLR, the SCal level may inform the severity of OSA and could be used as an indicator for OSA

Does the Change in the Indications of Endoscopic Sinonasal Surgery Continue? Data between 1994-2018

Objective: Endoscopic sinonasal surgery (ESS) has changing over the years in parallel with the developments in endoscopy devices, video-imaging techniques, and surgical instruments. In the present study we investigated whether the indications of patients who underwent surgery over a period of 25 years have accommodated to these changes.Methods: We retrospectively evaluated 1173 patients who underwent surgery in our clinic from 1994 through 2007, and 954 patients who underwent surgery from 2008 through 2018. The patients were divided into three groups as follows: chronic rhinosinusitis with polyps (CRSwNP), chronic rhinosinusitis without polyps (CRSsNP), and others. The changes in the indications during the first 14 years and the following 11 years were compared, and the results were statistically evaluated.Results: A significant decrease was observed in the number of patients who underwent surgery following the diagnosis of CRSsNP (p<0.001). In addition, a statistically significant increase was found in CRSwNP (p<0.001) and other (p<0.001) indications.Conclusion: When ESS indications identified in our clinic were reviewed, it was observed that the increasing trend in CRSwNP rate in the first 14 years continued, there was a significant increase in non-CRS indications in the last 11 years, and there has been an increase in patients with fungal sinusitis, especially in this group

Conventional and Diffusion-Weighted MR Imaging Findings of Parotid Gland Tumors

Objective: To investigate diffusion-weighted magnetic resonance imaging (MRI) findings of parotid gland lesions in addition to conventional MRI findings and demographic data.Methods: A retrospective evaluation was made of the demographic data, histopathologic data, preoperative conventional and diffusion-weighted MRI of 74 patients who underwent parotidectomy. The patients were categorized according to the histopathology (pleomorphic adenoma [PA], Warthin’s Tumor [WT] and malignant Tumor [MT]).Results: Histologically, 30 patients had PA, 27 patients had WT, and the remaining 17 patients had MT. The mean age of the PA, WT and MT groups were 44±21 (20-72), 55±10 (41-71) and 62±20 (21-76) years, respectively. The WT (81%) and MT (70%) groups were male dominant, while the PA group showed female dominance (55%). The PA group showed statistically significant difference in terms of age (p<0.05) and gender (p=0.009) compared to the other two groups. The median apparent diffusion coefficient (ADC) values for the PA, WT and MT groups were 1.99±0.94 (1.10-2.41) x 10-3 mm2/s, 0.92±0.35 (0.21-1.79) x 10-3 mm2/s and 1.20±0.34 (0.78-1.47) x 10-3 mm2/s, respectively. PA was differentiated from the other two groups (p=0.001). The sensitivity and specificity for distinguishing PAs from WT was 97% and 85%, respectively, when the ADC cutoff value was 1.25; and for distinguishing PAs from MT was 77% and 83%, respectively, when the ADC cutoff value was 1.35.Conclusion: ADC measurements are useful for the differentiation of PA from both WT and MT; and can be used as a complementary tool to predict the histopathology in the preoperative planning of parotid tumors

New Predictive Parameters of Bell"s Palsy: Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio

Background: Bell’s palsy is the most frequent cause of unilateral facial paralysis. Inflammation is thought to play an important role in the pathogenesis of Bell’s palsy. Aims: Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are simple and inexpensive tests which are indicative of inflammation and can be calculated by all physicians. The aim of this study was to reveal correlations of Bell’s palsy and degree of paralysis with NLR and PLR. Study Design: Case-control study. Methods: The retrospective study was performed January 2010 and December 2013. Ninety-nine patients diagnosed as Bell’s palsy were included in the Bell’s palsy group and ninety-nine healthy individuals with the same demographic characteristics as the Bell’s palsy group were included in the control group. As a result of analyses, NLR and PLR were calculated. Results: The mean NLR was 4.37 in the Bell’s palsy group and 1.89 in the control group with a statistically significant difference (p<0.001). The mean PLR was 137.5 in the Bell’s palsy group and 113.75 in the control group with a statistically significant difference (p=0.008). No statistically significant relation was detected between the degree of facial paralysis and NLR and PLR. Conclusion: The NLR and the PLR were significantly higher in patients with Bell’s palsy. This is the first study to reveal a relation between Bell’s palsy and PLR. NLR and PLR can be used as auxiliary parameters in the diagnosis of Bell’s palsy

Angiolipoleiomyoma Inside The Nasal Cavity: A Rare Case

Amaç: Anjiolipoleiomiyoma, çoğunlukla kas dokusundankaynaklanan solid bir tümördür. Genellikletuberozskleroz kompleks hastalarının böbreklerindebulunur. Böbrekler dışındakiler çok nadirdir. Buçalışmada daha önce burun içinde hiç görülmemişanjiolipoleiomiyoma olgusunu sunmayı amaçladık.Olgunun Özellikleri: Sol nazal kavitede 5 yıldır nefesalmayı zorlaştıran şişlik şikayeti ile başvuran erkekhastanın muayenesinde sol alt konka ön kısmındabulunan morumsu nodüler lezyon, genel anestezi altındaüstten ve alttan insizyon sonrası periost da eleve edilerektotal olarak çıkarıldı. Eksizyonel biyopsi örneğininanalizi, bir fibromiksoid stroma içinde çoğunlukla kalınduvarlı damarlardan oluşan bir nodüler formasyon ortayaçıkardı; pürüzsüz kas dokusu ve yağ lobülleri yer yergözlemlendi. Histolojik olarak lezyon iyi sınırlıydı ve üçbileşen içeriyordu. Yağ dokusu, kas dokusu ve fibrözkapsülle çevrili damar karışımından oluşan tümöralproliferasyon içinde atipi gözlenmedi.İmmunohistokimyasal incelemede SMA, Desmin, S-100ve CD34 kullanıldı. M. Trikrom ile kas liflerindeboyanma izlendi. SMA ve Desmin ile kas dokudareaksiyon izlendi. CD34 ile vasküler endotelde reaksiyongözlendi. S-100 ile adipozitlerde reaksiyon görüldü.Lezyon burun içi anjiolipoleiomiyoma olarak teşhisedildi. Takipteki hastada nüks gözlenmedi. Sonuç: Nadirgörülen anjiolipoleiomiyoma olgularının burun içinde deortaya çıkabileceği göz önünde bulundurulmalı vehistopatolojik inceleme sonucuna göre cerrahi olarak tameksizyon yapılması yeterli olmaktadır.Purpose: Angiolipoleiomyoma is a solid tumor, usuallyoriginated from muscle tissue. It is usually found in thekidneys of patients with tuberozosclerosis complex.Extrarenal origins are quite rare. In this study, weaimed to present angiolipoleiomyoma case never seenin nasal cavity so far. Case: Under general anaesthesia,we excised a purplish lesion located in anterior portionof left lower concha from a man with a compliant of aswelling in the left nazal cavity, causing breathingdifficulty for 5 years. Analysis of the excisional biopsyspecimen revealed a nodular formation of mostly thickwalled vessels in a fibromyxoid stroma includingsmooth muscle tissue and fat lobules Histologically,the lesion was well-circumscribed and contained threecomponents. No atypia was observed in tumoralproliferation consisting of admixture of adipose tissue,muscle tissue and vein. SMA, Desmin, S-100 andCD34 were used for immunohistochemicalexamination. M. Trichrome showed muscle tissuestaining. Muscle tissue reaction was observed withSMA and Desmin. CD34 showed a reaction in thevascular endothelium. Adipocytes were reacted withS-100. The diagnosed was intranasalangiolipoleiomyoma. No recurrence was observed.Conclusion: Rare cases of angiolipoleiomyoma canalso occur in nazal cavity and surgical excision issufficient after the histopathological examination

Relationship Between Human Papilloma Virus and Benignand Malign Lesions of Oral Cavity and Oropharynx,Current Approach

Papillomavirus enfeksiyonu insanlarda çok sık görülen ve esas olarak cinsel yolla bulaşan bir hastalıktır. HPV enfeksiyonunun gelişimi, uterus serviksi, diğer alt genital bölge mukozası ve oral mukozadan başlayabilir. HPV subklinik veya klinik enfeksiyonlara neden olabilir. HPV ile ilişkili klinik enfeksiyonlar, genital papillomlar, cilt papillomları, nükseden solunum yolu papillomatozisi, skuamöz intraepitelyal lezyonlar ve serviks, oral kavite ve orofarinks kanseridir. Oral kanserlerin yaklaşık %20'si ve orofaringeal kanserlerin %60-80'inin HPV enfeksiyonuna bağlı olabileceği düşünülmektedir. 2007'de birçok Avrupa ülkesinde HPV aşısının kullanıma sunulmasından bu yana 40'dan fazla ülke, ulusal bağışıklama programlarında HPV aşılamayı başlattı. Orofarengeal ve Oral kavite kanser tedavisinden sorumlu hekimler, HPV aşısı hakkında bilgi sahibi olmalı ve HPV ile ilişkili enfeksiyon ve kanserleri azaltmak için teknolojideki gelişmeleri takip etmelidir.Papillomavirus infection is a very common and mainly sexually transmitted disease in humans. The development of HPV infection may start from uterine cervix, other lower genital area mucosa and oral mucosa. HPV can cause subclinical or clinical infections. Clinical infections associated with HPV are genital papillomas, skin papillomas, recurrent respiratorial papilomatosis, intraepithelial squamous lesions, cervix, oral cavity and oropharyngeal cancer. Approximately 20% of oral cancers and 60-80% of oropharyngeal cancers are thought to be due to HPV infection. Since the introduction of HPV vaccine in many European countries in 2007, more than 40 countries have launched HPV vaccination in national immunization programs. Physicians responsible for the treatment of oropharyngeal and oral cavity cancer should be knowledgeable about HPV vaccination and should follow developments in technology to reduce HPV-associated infections and cancers

Relationship between human papilloma virus and benign and malign lesions of oral cavity and oropharynx, current approach

Papillomavirus enfeksiyonu insanlarda çok sık görülen ve esas olarak cinsel yolla bulaşan bir hastalıktır. HPV enfeksiyonunun gelişimi, uterus serviksi, diğer alt genital bölge mukozası ve oral mukozadan başlayabilir. HPV subklinik veya klinik enfeksiyonlara neden olabilir. HPV ile ilişkili klinik enfeksiyonlar, genital papillomlar, cilt papillomları, nükseden solunum yolu papillomatozisi, skuamöz intraepitelyal lezyonlar ve serviks, oral kavite ve orofarinks kanseridir. Oral kanserlerin yaklaşık %20'si ve orofaringeal kanserlerin %60-80'inin HPV enfeksiyonuna bağlı olabileceği düşünülmektedir. 2007'de birçok Avrupa ülkesinde HPV aşısının kullanıma sunulmasından bu yana 40'dan fazla ülke, ulusal bağışıklama programlarında HPV aşılamayı başlattı. Orofarengeal ve Oral kavite kanser tedavisinden sorumlu hekimler, HPV aşısı hakkında bilgi sahibi olmalı ve HPV ile ilişkili enfeksiyon ve kanserleri azaltmak için teknolojideki gelişmeleri takip etmelidir.Papillomavirus infection is a very common and mainly sexually transmitted disease in humans. The development of HPV infection may start from uterine cervix, other lower genital area mucosa and oral mucosa. HPV can cause subclinical or clinical infections. Clinical infections associated with HPV are genital papillomas, skin papillomas, recurrent respiratorial papilomatosis, intraepithelial squamous lesions, cervix, oral cavity and oropharyngeal cancer. Approximately 20% of oral cancers and 60-80% of oropharyngeal cancers are thought to be due to HPV infection. Since the introduction of HPV vaccine in many European countries in 2007, more than 40 countries have launched HPV vaccination in national immunization programs. Physicians responsible for the treatment of oropharyngeal and oral cavity cancer should be knowledgeable about HPV vaccination and should follow developments in technology to reduce HPV-associated infections and cancers

Fungus Ball Inside The Concha Bullosa

Fungal rinosinüzitler invaziv ve non-invaziv formlar olarak iki ana grup altında sınıflandırılır. Mantar topu fungalrinosinüzilerdenensıkgörüleniolupnon-invaziv birmantarinfeksiyonudur.Mantartopuensıkmaksiller sinüste görülür. Konka bülloza ise orta konka pnömatizasyonuna verilen isimdir ve en sık görülen sinonazalanatomikvaryasyondur.Diğerpnömatizehücre ve sinüslerde görülen patolojiler konka büllozada da görülebilir. Konka büllozada polip, piyosel ve fibro osseoz lezyonlar görülebilir. Konka büllozada mantar topu çok nadir görülen bir durumdur. Bu çalışmada baş ağrısı şikâyeti ile hastaneye başvuran, konka büllozada mantar topu olan olgu literatür bilgileri eşliğinde sunulmuştur.Fungal rhinosinusitis can be categorized as invasive and non- invasive forms. Fungus ball is the type of fungal rhinosinusitis most commonly seen and it is a non- invaziv fungal infection. The most common localization of the fungus ball is maxillary sinus. Concha bullosa is simply the pneumatization of the middleturbinatesanditisthemostcommonsinonasal anatomic variation. Pathologies seen in other pneumatized cells and in sinuses can also occur inside the concha bullosa. Presence of polyps, pyoceles and fibro- osseous lesions are possible inside the concha bullosa. In this study, we presented a case of fungus ball inside the concha bullosa with a compliant of headache, reviewing the literature

Coexistence of frontal sinus hypoplasia with maxillary sinus hypoplasia: a radiological study

Hizli, Omer/0000-0001-6822-2679WOS: 000426758300012PubMed: 29417280The goal of this study was to determine whether frontal sinus hypoplasia coexists with maxillary sinus hypoplasia. Analyzing paranasal CT scans retrospectively, we included 86 patients who had a hypoplastic maxillary sinus at least on one side and 80 patients with bilateral normal maxillary sinuses (control group). We classified hypoplastic maxillary sinuses using the classification system previously defined by Bolger et al. (Otolaryngol Head Neck Surg 103(5):759-765, 1990). We classified the frontal sinuses as aplastic, hypoplastic, medium-sized, and hyperplastic; as previously defined by Guerram et al. (Am J Phys Anthropol 154(4):621-627, 2014). We compared the presence of frontal sinus hypoplasia using Chi-square test between the groups. The mean age of the maxillary sinus group was 43.2 (range 18-84) years. Of 86 patients, 33 (38.4%) had unilateral and 53 (61.6%) had bilateral maxillary sinus hypoplasia. Of 139 maxillary sinuses totally included, 73 (52.5%) were type 1, 51 (36.7%) were type 2 and 15 (10.8%) were type 3 hypoplastic maxillary sinuses. Of 332 frontal sinuses totally included, 25 (7.5%) were aplastic, 32 (9.6%) were hypoplastic, 172 (51.9%) were medium-sized, and 103 (31%) were hyperplastic. Of 86 patients with a hypoplastic maxillary sinus at least on one side, 29 (33.7%) had a hypoplastic and/or aplastic frontal sinus, while 10 (12.5%) had a hypoplastic and/or aplastic frontal sinus at least on one side in control group. Incidence of frontal sinus hypoplasia and/or aplasia was significantly higher in patients with maxillary sinus hypoplasia compared to the patients with bilaterally normal maxillary sinuses (chi (2) = 10.384, P = 0.001). Maxillary sinus hypoplasia has a significantly higher coexistence with frontal sinus hypoplasia. This study may have an implication for anatomical studies about the development of the paranasal sinuses and paranasal sinus surgery as well as further morphological studies

Coexistence Of Ethmoid Sinolithiasis, Nasal Polyposis And Chronic Sinusitis

Nazal kavitede organik veya inorganik maddelerin birikerek organize olması ile ortaya çıkan rinolitiyazis, eğer herhangi bir paranazal sinüs içerisinde görülürse sinolitiyazis adını almaktadır. Taş oluşumunun en sık görüldüğüparanazalsinüsmaksillersinüsolup,budurum ‘antrolit’ olarak da adlandırılabilir. İkinci sıklıkta ise frontal sinüslerde görülmektedir. Sinolitiyazis, sıklıkla ekzojen kaynaklı nadir bir patoloji olup kanal tedavisi uygulanan diş kökünün maksiller sinüse fistülize olması sonucudolgumateryalikaynaklısinolitiyazisnadirdeolsa görülebilir. Ayrıca, sinolitiyazis temelinde oluşan inflamatuar süreç nedeniyle sinüs içerisinde veya nazal kavitede polip de gelişebilir. Diş dolgu materyalinin etmoid sinüse geçmesi ve etrafında sinolit oluşması ise çokdahanadirdir.Buçalışmada,dişdolgumateryalinin maksiller sinüs içine ve daha sonra etmoid sinüse invagine olmasıyla ortaya çıkan sinolitiyazis ve beraberinde görülen inflamatuar sürecin sunulması ve tanısında tomografinin öneminin vurgulanması amaçlanmıştır.Rinolithiasis, a condition due to accumulation of organic and inorganic materials in nasal cavity, is referredtoas‘sinolithiasis’whenlocatedinaparanasal sinus. The maxillary sinus is the most common site of thesinolithsandtheymaybecalledas‘anthrolith’.The secondcommonsiteisthefrontalsinus.Sinolithiasisis ararepathologyofexogenousoriginanditmayrarely originate from dental filling materials, due to fistulization of tooth root to the maxillary sinus. Additionally, inflammatory process based on sinolith may cause polypoid degeneration inside the sinus and the nasal cavity. Invasion of the ethmoid sinus by dental filling material and dependently sinolith formationarerarer.Inthisreport,weaimedtopresent asinolithiasiscaseduetoinvaginationofdentalfilling material into maxillary sinus, then ethmoid sinus, with co-existed inflammatory process and to emphasize the importance of the computerized tomoghraphy for diagnosis