Inadvertent Injection of Sodium Hypochlorite to Oral Mucosa

It is important to carefully use sodium hypochloride(NaOCI) in its clinical applications. Non-careful use of cytotoxic agents(NaOCI,etg) may cause serious complications. In this case report, a treatment approach to paresthesia and tissue necrosis after inadvertent injection of 1% NaOCl solution into oral mucosa is presented.. Pain, edema, loss of sensation, redness on the cheek, and difficulty in swallowing was seemed during the patient’s clinical examination. The patient was experiencing severe pain and a burning sensation during injection. The patient was administered intraoral drugs,such as antibiotics (amoxicillin 1000 mg two times per a day for two week),alpha lipoic acid (300 mg one times per a day for one mounth), and debridement of oral mucousa .Consequently, re-epithelialization of necrotic tissue was observed in the 3rd month. All symptoms disappeared completely in the 6th month

GEÇMİŞİ YAŞATMAK: YENİKAPI BATIKLARI-KEEPING THE PAST ALIVE: THE YENİKAPI SHIPWRECKS

The salvage excavations carried out in the Yenikapı quarter of İstanbul by the İstanbul Archaeological Museums between 2004 and 2013 have yielded the Theodosius Harbor which was known to have been located on the shore of Marmara Sea in Constantinople during the Byzantine Period. The 37 shipwrecks found during the excavations dating from the 5th to the 11th centuries AD, represent the largest collection of medieval ships unearthed from a single excavation site. The present paper discusses the excavation, documentation, removal, and conservation processes of the 31 shipwrecks excavated under the responsibility of the İstanbul University’s Department of Conservation of Marine Archaeological Objects. We used maximum water content measurements, and FT-IR, SEM, SEM-EDX, XRF, XRD analyses to determine the degree of degradation of waterlogged timbers and the conditions leading to this degradation. Both chemical and mechanical methods were applied to remove iron corrosion products from the wood following desalination. For conservation of these waterlogged timbers, we mainly use PEG (polyethylene glycol) and melamine-formaldehyde resin when appropriate. The melamine-formaldehyde method was preferred when the water content in the ship’s wood was high and the wood density was low. The timbers which were relatively in a better condition and more likely to be displayed in the future were first impregnated with PEG with a molecular weight of 400, 2000, 3350 and 4000 based on the density and the maximum water content of the wood, followed by vacuum freeze drying

Histopathological Results of Functional Endoscopic Sinus Surgery

Giriş: Kliniğimizde Temmuz 2012 ile Ağustos 2015 tarihleri arasında fonksiyonel endoskopik sinüs cerrahisi uygulanan hastaların histopatolojik ve klinik verilerinin sunulması ve dağılım yüzdelerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışma Kırıkkale Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Anabilim Dalında Temmuz 2012 ile Temmuz 2015 tarihleri arasında fonksiyonel endoskopik sinüs cerrahisi yapılan hasta dosyalarının retrospektif olarak değerlendirilmesi ile gerçekleştirilmiştir. Bulgular: Ortalama yaşları 43.4 olan toplam 135 hastanın verileri incelendi. Hastaların 30'u (%22) kadın 105'i (%78) erkek idi. Hastaların 93'ünde (%68.8) bilateral, 42'sinde (%31.1) tek taraflı Fonksiyonel endoskopik sinüs cerrahisi uygulanmıştı. Hastaların histopatoloji sonuçları 92 (%68.1) nazal polip, 20 (%14.8) kronik sinüzit, 10 (%7.4) antrokonal polip, 6 (%4.4) inverted papillom, 2 (%1.4) osteom, 2 (%1.4) hemanjiom, 2 (%1.4) hipofiz adenomu ve 1 (%0.7) yabancı cisim (saçma) olarak kaydedildi. Sonuç: Fonksiyonel endoskopik sinüs cerrahisi uygulanan hastaların histopatoloji sonuçlarında en sık non-neoplastik lezyonlarla karşılaşılmaktadır. Non-neoplastik lezyonlar içinde ise nazal polipler en sık olarak görülen lezyonlardır. Her kliniğin fonksiyonel değerlendirilmesi ile ülkemizdeki fonksiyonel endoskopik sinüs cerrahisi histopatoloji sonuçlarının dağılımı ile ilgili veriler oluşturulabilir.Introduction: Our aim is to display pathological and clinical data and to interpret the distribution of the percentages of the patients to whom we performed functional endoscopic sinus surgery between July 2015 and August 2015 in our clinic. Material and Methods: The present study was performed with the files of the patients who got functional endoscopic sinus surgery in Otorinolaryngology Department at Kirikkale University Faculty of Medicine between July 2015 and August 2015. Results: We examined data from 135 patients whose mean age is 43.4. Thirty patients (22%) were female and 105 patients (78%) were male. Bilateral functional endoscopic sinus surgery was performed in 93 patients (68.8%) and unilateral functional endoscopic sinus surgery was performed in 42 patients (31.2%). According to the histopathological results of the patients the numbe of nasal polyps were 92 (68.1%), chronic sinusitis was 20 (14.8%), anthracoanal polyps were 10 (7.4%), inverted papilloma was 6 (4.4%), osteoma was 2 (1.4%), hemangioma was 2 (1.4%), hypophisis adenoma were 2 (1.4%) and foreign body (gun bullet) were 1 (0.7%). Conclusion: According to the histopathological results of the patients, to whom functional endoscopic sinus surgery was performed, the most commonly seen lesion was non-neoplastic lesions. The nasal polyps were the most commonly seen lesions in the non-neoplastic lesions. Data from different clinics in which functional endoscopic surgery was performed may be helpful to interpret the distribution of the histopathological results of the surgery

Newborn Hearing Screening Results

Amaç: Bilateral işitme kaybı, erken teşhis edildiğinde birey için önemli bir morbidite nedeni olmaktan çıkan bir durumdur. Günümüzde yenidoğan işitme taraması protokollerinin yaygınlaşması; daha çok işitme kaybı tanısının koyulmasına ve erken tedavi uygulamalarına olanak sağlamıştır. Bu yazıda Aralık 2013 ile Aralık 2015 tarihleri arasındaki yenidoğan işitme taraması sonuçlarımızı sunmayı amaçladık.Gereç ve Yöntemler: Çalışmamızda Aralık 2013 ile Aralık 2015 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi Kulak Burun Boğaz Anabilim Dalı Odyoloji Ünitesinde yenidoğan işitme taraması sonuçları retrospektif olarak incelendi. Ek olarak işitme kaybına neden olabilecek risk faktörleri araştırıldı. Risk faktörü olan bebekler direk olarak işitsel beyin sapı cevabı (ABR) ile tarandı. Risk faktörü bulunmayan yenidoğanlar geçici uyarılmış otoakustik emisyon (TEOAE) ile tarandı. Bulgular: Toplam 2700 yenidoğan işitme taraması yapıldı. Direk ABR testi uygulanan bebek sayısı 762 (%28.22) idi. Bu bebeklerin 37'sinde (%4.85) sensorinöral işitme kaybı tespit edildi. Risk faktörü bulunmayan 1938 yenidoğan arasından birinci TEOAE ve ABR testinden 1107 (%57.12) bebek kalırken, ikinci TEOAE ve ABR testinden 496 (%25.59) bebek kaldı. Bir aylık süre sonunda risk faktörü bulunmayan 1938 bebeğin hepsi taramadan geçti. Ailede işitme kaybı öyküsü, %38.23 oran ile en sık rastlanan risk faktörü olarak bulundu.Sonuç: Doğumdan sonraki ilk üç gün içinde TEOAE testi ile tarama programı başlamalıdır. İşitme kaybı açısından riskli bebeklerin anamnez ile tespit edilip, direk ABR testine tabi tutulması gereklidir. Bu konuda ailelerin bilgilendirilmesi ve testten kalan bebeklerin doğru merkezlere yönlendirilmesinin önemli olduğunu düşünmekteyizAim: Bilateral hearing loss is not a major cause of morbidity for individuals when it is diagnosed early. Today, the expansion of newborn hearing screening protocols enabled more hearing loss diagnosis and early treatment. In this article we aim to offer our hearing screening results of newborns between December 2013 and December 2015. Material and methods:In our study between December 2013 and December 2015, newborn hearing screening results of Kirikkale University Faculty of Medicine Hospital, Department of Otolaryngology, Audiology Unit were analyzed retrospectively. In addition, risk factors that may cause hearing loss were investigated. Infants with risk factors was directly screened with Auditory Brainstem Response (ABR). Newborns without risk factors were screened with Transient Evoked Otoacoustic Emissions (TEOAE).Results: A total of 2700 newborn hearing screening was performed. The number of babies underwent ABR test directly was 762 (28.22%). In 37 of these infants (4.85%) sensorineural hearing loss was detected. Among 1938 newborn without any risk factors, 1107 (57.12%) infants did not pass the first TEOAE and ABR test and 496 (25.29%) of them did not pass the second TEOAE and ABR test. At the end of one month, all 1938 infants without risk factors passed the screening. Family history of hearing loss was found to be the most common risk factors with a rate of 38.23%.Conclusion: Screening program should start with TEOAE within the first three days after birth. Infants at risk for hearing loss must be determined by history and are required to be subjected to ABR test directly. We believe that it is important to inform the family and send the babies who do not pass the test to the correct center

The effect of packing and suture technique on systemic oxygen saturation and patient comfort after septoplasty

Amaç: Septoplasti sonrası konulan intranazal tampon veya tampon konulmaksızın sadece septuma dikiş atılmasının, sistemik oksijen satürasyonu ve hasta konforu üzerine olan etkileri araştırıldı. Hastalar ve Yöntemler: Çalışmaya, izole septum deviyasyonu tanısıyla septoplasti ameliyatı yapılan 37 hasta alındı. On sekiz hastaya (5 kadın, 13 erkek; ort. yaş 3010; dağılım 18-47) intranazal tampon konulurken, 19 hastada (5 kadın 14 erkek; ort. yaş 3112; dağılım 18-54) septuma dikiş atıldı. Sistemik oksijen satürasyonunu değerlendirmek için, ameliyat öncesi ve sonrası dönemlerde puls oksimetri cihazı ile parsiyel oksijen satürasyonu ölçüldü. İki yöntemin hasta konforuna etkisi, ameliyattan önce, 48 saat sonra, tampon alındıktan beş gün sonra ve ameliyattan 30 gün sonra görsel analog skala ile değerlendirildi. Bulgular: İstatistiksel olarak anlamlı olmasa da, sistemik oksijen satürasyonu dikiş grubunda tampon grubuna göre daha yüksek bulundu (p0.05). Tampon grubunda anlamlı derecede daha fazla burun tıkanıklığı izlendi (p0.05). Genel olarak, baş ağrısı ve fasiyal ağrı tampon grubunda daha fazla izlenirken, dikiş grubunda burunda kabuklanma, geniz akıntısı ve koku alma duyarlılığında azalma daha fazlaydı.(p0.05). Sonuç: Septoplasti ameliyatı sonrası kullanılan intranazal tamponun sistemik oksijen satürasyonunu anlamlı derecede olmasa da, dikiş kullanımından daha fazla düşürmesi ve hasta konforunu olumsuz etkilemesi nedeniyle, özellikle kronik sistemik rahatsızlıkları olan yaşlı hastalarda septuma dikiş atılması daha uygun olabilir.Objectives: We investigated the effect of intranasal packing placed after septoplasty or alternatively suturing the septum without inserting a packing on systemic oxygen saturation and patient comfort. Patients and Methods: The study involved 37 patients who underwent septoplasty for isolated septum deviation. Intranasal packing was used in 18 patients (5 women, 13 men; mean age 30±10 years; range 18 to 47 years), while 19 patients (5 women, 14 men; mean age 31 ±12 years; range 18 to 54 years) underwent nasal septal suturing. To evaluate systemic oxygen saturations, partial oxygen saturations were measured pre- and postoperatively by pulse oximetry. The effect of intranasal packing and suturing on patient comfort was assessed by a visual analog scale before and 48 hours after surgery, five days after removal of nasal packing, and 30 days after surgery. Results: Postoperative systemic oxygen saturations exhibited higher levels in the sutured group, but this did not reach significance (p>0.05). The incidence of nasal obstruction was significantly higher with nasal packing (p0.05). Conclusion: Considering that, albeit not significantly, intranasal packing used after septoplasty decreases systemic oxygen saturation more than suturing and thus, has more adverse effects on patient comfort, suturing the septum may be a better alternative, particularly in elderly patients with chronic systemic diseases

Inadvertent Injection of Sodium Hypochlorite to Oral Mucosa

It is important to carefully use sodium hypochloride(NaOCI) in its clinical applications. Non-careful use of cytotoxic agents(NaOCI,etg) may cause serious complications. In this case report, a treatment approach to paresthesia and tissue necrosis after inadvertent injection of 1% NaOCl solution into oral mucosa is presented.. Pain, edema, loss of sensation, redness on the cheek, and difficulty in swallowing was seemed during the patient’s clinical examination. The patient was experiencing severe pain and a burning sensation during injection. The patient was administered intraoral drugs,such as antibiotics (amoxicillin 1000 mg two times per a day for two week),alpha lipoic acid (300 mg one times per a day for one mounth), and debridement of oral mucousa .Consequently, re-epithelialization of necrotic tissue was observed in the 3rd month. All symptoms disappeared completely in the 6th month

Retinal Artery Branch Occlusion After Septoplasty

Nazal septum deviasyonu sonrası burundan nefes alamama Kulak Burun Boğaz polikliniklerinde en sık rastlanılan şikâyetler arasındadır. Bu sebeple nazal septoplasti operasyonu da Kulak Burun Boğaz kliniklerinde sıklıkla yapılmaktadır. Geçici ya da kalıcı görme kayıpları septoplasti operasyonu sonrası çok ender görülebilen komplikasyonlar arasındadır. Biz de bu vakamızda septoplasti sonrası retinal arter dal oklüzyonuna bağlı görme kaybını sunmayı amaçladık. Otuz altı yaşında erkek hasta kliniğimize burun tıkanıklığı şikâyetiyle başvurdu. Anamnezde hastanın şikâyetlerinin uzun süredir olduğu ve çocukken burnuna darbe aldığı öğrenildi. Hasta sigara içmiyordu ve ek hastalığı da yoktu. Hastaya kliniğimizde septoplasti operasyonu yapıldı. Hastanın postop 1. saatte sol gözde görme azlığı tespit edildi. Hastanın Göz muayenesinde sol göz alt retinal dalcık trasesi ve alt perifer retinal arter trasesi bölgelerine uyan retinada ödem izlendi. Sıklıkla yapılan Septoplasti operasyonları hastaların burun tıkanıklığını dramatik olarak değiştirdiği için perioperatif dönemde hastalar iyi takip edilmeli ve değerlendirilmelidir. Medikal ve hukuki yaptırımlarla başa çıkabilmek için Göz hekimleri ve Kulak Burun Boğaz hekimleri bu gibi komplikasyonların oluşma ihtimali konusunda dikkatli olmalıdırlar.Difficulty to breath from nose after nasal septum deviation is one of the most common complaints in Ear Nose Throat policlinics. Therefore nasal septoplasti operation is performed commonly in Ear Nose Throat clinics. Temporary or permanent visual loss is a rare complication seen after septoplasty operation. In this case report, we aimed to introduce visual loss due to retinal artery branch occlusion after septoplasty. A 36-year old patient came to our clinic with complaint of difficulty to breath from nose. We learnt that he had this complains for a long time, and had a trauma to his nose in childhood. He was not a smoker and had no co-morbidity. Septoplasty operation was done in clinic. One hour later after surgery, patient had visual loss in his left eye. In ophthalmological examination there was retinal edema-related left inferior retinal branch block and inferior peripheral retinal artery occlusion. Septoplasty operations change nasal functions dramatically. Therefore patiens should be evaluated fastidiously during and after the surgery. Due to the medical and the legal responsibilities, Ear Nose Throat doctors and ophthalmologists should be aware of this kind of complications

Çocukluk çağı hızlı büyüyen boyun kitlesi: Posteriyor servikal bölgede kavernöz lenfanjioma ile birliktelik gösteren Castleman hastalığı

Bu yazıda, iki haftadır boynunun sol arka bölgesinde ağrısız kitlesi olan 12 yaşında bir kız olgu sunuldu. Ameliyat esnasında iki ayrı kitleye rastlandı. Histopatolojik incelemede büyük olan kitlenin hiyalen vasküler tipte Castleman hastalığı ve küçük olan kitlenin ise kavernöz lenfanjiyom olduğu gözlendi. Literatür verileri ışığında bu olgu literatürde çocukluk çağı arka servikal üçgen yerleşimli Castleman hastalığı olan üçüncü olgu ve kavernöz lenfanjiyom birlikteliği nedeniyle de bildirilen ilk olgudur.In this article, we present a 12-year-old girl case with a painless mass in the left posterior region of the neck for two weeks. Two masses were detected during surgery. Histopathologic examination revealed the hyaline vascular type of Castleman‘s disease for the bigger mass and cavernous lymphangioma for the smaller mass. In the light of literature data, our case was the third childhood cervical posterior triangle Castleman‘s disease and was the first case reported due to its concomitance with cavernous lymphangioma

The Efficacy of Gabapentin plus Dexamethasone for Postoperative Analgesia Following Septoplasty: A Prospective Randomized Placebo-Controlled Trial

Aims: This study aimed to compare the efficacy of gabapentin, dexamethasone, and gabapentin + dexamethasone for pain control after septoplasty. Materials and Methods: This prospective randomized trial included 120 patients that underwent septoplasty and were randomly divided into 4 groups: group G (preoperative gabapentin 600 mg p.o.); group D (intraoperative dexamethasone 8 mg i.v.); group GD (preoperative gabapentin 600 mg p.o. + intraoperative dexamethasone 8 mg i.v.); group C (placebo control). Results: The median VAS score was significantly lower in groups G and GD at 1, 2, 4, 6, 12, and 24 hours postsurgery than in group C (P < .008 for all). The median VAS score was significantly lower in group D than in group C at 1, 2, and 4 hours postsurgery (P < .008 for all). There weren't any significant differences in the VAS score between groups D, G, and GD at any time point. Groups G, D, and GD had a significantly lower frequency of rescue analgesic use than group C; however, there were no differences between groups G, GD, and C (P < .001 and P = .108, respectively). Conclusion: Gabapentin, dexamethasone, and gabapentin + dexamethasone are equally more effective analgesics during the first 4 hours postsurgery than placebo. The addition of dexamethasone to gabapentin does not provide extra analgesia. Both gabapentin and gabapentin + dexamethasone have a more prolonged analgesic effect than dexamethasone alone