Shall We Resect the Tip of Manubrium Mallei in Tympanoplasty?

ObjectivesIn tympanoplasty operations if perforation is related with malleus handle, malleus handle is desepithelised. We planned this research to investigate whether the epithelial remnants remain as a result of this desepithelisation or not.MethodsThe 35 patients who were performed tympanoplasty operation were divided into two groups. In the first group which included 13 patients the tip portion of manubrium mallei were cut off without desepithelisation. In the second group which included 22 patients the tip portions of manubrium mallei were cut off after the meticulous desepithelisation. The presence of squamous epithelium was examined histopathologically on the specimens.ResultsSquamous epithelium was observed in 9 of the 13 non-desepithelised specimens and in 6 of 22 desepithelised specimens.ConclusionIn tympanoplasty operations despite careful desepithelisation, squamous epithelial remnants may remain on the malleus handle. So the tip of manubrium mallei could be resected to prevent the future development of cholesteatoma

The Evaluation of The Relation Between Nasal Polyp Etiopathogenesis and the Amount of Biofilm

Objective: To evaluate the effect of biofilm layer on polyp formation in nasal polyposis by comparing the amount of biofilm layer on polyp tissue and the normal mucosa. Material and Methods: This study is a prospective study. 14 patients who underwent functional endoscopic sinus surgery (FESS) for nasal polyposis were evaluated. Patients were had no history of previous FESS. Tissue samples were obtained from lower turbinate (Group 1 n:14) and from nasal polyp (Group 2, n:14) of the same nasal cavity. Biofilm presence was identified using scanning electron microscopic (SEM) morphological findings. In biofilm positive samples, the presence of biofilm in less than 25% of the surface area was classified as (+), between 25-50% as (++) , and over 50% as (+++). Results: In Group 2, with SEM imaging, (+++) biofilm presence was detected in 9 patients and (++) biofilm was detected in 5 patients. In Group 1, no biofilm was detected 8 patients, while; (+++), (++), and (+) biofilm presence was detected in 1, 2, and 3 patients respectively. Significant difference was found between group 1 and group 2 with respect to the amount of biofilm according to SEM (p =0.000). Conclusion: In samples, statistically significant difference was found between polyp tissue and normal mucosa in terms of the amount of biofilm. However, further studies with larger patient series are required in order to reach a definitive conclusion on the effect of biofilm on pathogenesis of polyp

Ocular Manifestations of Bilateral Ethmoidal Sinus Mucopyocele: Case Report

Mucoceles of the paranasal sinuses are slowly growing, epithelium-lined cystic lesions with sterile content. When the mucocele content becomes infected with a bacterial super-infection, the lesion is defined as mucopyocele. Mucoceles or mucopyoceles are commonly located in the frontal and anterior ethmoidal sinuses and can manifest with ocular signs and symptoms, mostly proptosis. In this report, we demonstrate a case of bilateral ethmoidal mucopyocele in a 53-year-old female who presented with reduced vision, diplopia, and proptosis. Computed tomography (CT) scanning of the paranasal sinuses revealed cystic lesions filling the maxillary sinuses and anterior ethmoidal cells bilaterally and causing erosion in the walls of the sinuses. After marsupialization of the mucopyoceles was performed by endoscopic sinus surgery, the symptoms of the patient recovered rapidly. (Turk J Ophthalmol 2011; 41: 354-6

Preparation and placement of cartilage island graft in tympanoplasty

Introduction: Cartilage graft tympanoplasty has a better success rate in the treatment of chronic otitis media if regularly prepared and placed. Objective: To prepare cartilage island material and evaluate its effect on the success rate of tympanoplasty. Methods: The medical records of 87 patients (48 males and 39 females; mean age, 27.3 ±11.2 years; range, 14–43 years) with chronic otitis media without cholesteatoma who underwent intact canal-wall-up tympanoplasty and revision surgery between December of 2007 and October of 2011 were retrospectively evaluated. Surgery was performed under general anesthesia via a retroauricular approach. Results: The overall success rate of this technique was 93% in terms of perforation closure. No graft lateralization or displacement into the middle ear occurred. The overall average preoperative air bone gap was 37.27 ± 12.35 dB, and the postoperative air bone gap was 27.58 ± 9.84 dB. The mean postoperative follow-up period was 15.3 months (range: 7–21 months). Conclusion: If cartilage graft is properly prepared and placed, cartilage graft tympanoplasty appears to provide better success rates and hearing results

Value of thallium-201 scintigraphy for primary tumour detection in patients with malignant neck masses

The aim of this study was to assess the contribution of thallium-201 scintigraphy to primary tumour detection in patients with malignant neck masses and to evaluate its sensitivity and specificity. A total of 30 patients with histopathologically proven malignant tumours were included in the study. The sensitivity, specificity and accuracy of Tl-201 scintigraphy were found to be 54%, 75% and 57% respectively. These results suggest that Tl-201 scintigraphy has a limited value in the detection of the primary tumour in patients with malignant masses of the neck

Effects of a sequential cochlear implant of minimum comfort, impedance and electrically evoked compound action potential values of the initial cochlear implant

Purpose To evaluate the impact of sequential second CI on the electrophysiological parameters of the initial CI. Methods Totally, 30 children who received sequential CIs between January and July 2018 were included in the study. All patients received the same brand of CI (Advanced Bionics, HIRES 90K Advantage 1J). Of 16 CI electrodes, 3rd (E3), 7th (E7) and 11th (E11), and 15th (E15) electrodes which were corresponding to the apical, middle, and basal cochlea were used in the measurements. The tNRI, electrode impedance and M levels were recorded as the contralateral CI was switched off and on, respectively. Results As the second CI was switched off, the impedance, tNRI and M values of initial CI 1st, 3rd and 6th months were not significantly different (p > 0.05). There was a significant difference between the impedance, tNRI and M values of initial CI as the second CI was switched on (p < 0.05). Conclusion Activation of the sequential second CI leads to a decrease in the tNRI and M levels of the initial CI. This condition can increase the efficiency obtained by CIs. However, these changes should be remembered during CI programming

Tl-201 imaging for differentiating between malignant and benign neck masses

The aim of this study was to assess the ability of Tl-201 scintigraphy to differentiate between malignant and benign neck masses. Fifty-eight patients with neck masses, whose diagnoses were confirmed by histological examination, were examined. The sensitivity, specificity and accuracy of Tl-201 scintigraphy were 80%, 96% and 88% respectively; when salivary gland masses were excluded, these values were 87%, 95% and 91% respectively. Our results suggest that Tl-201 scintigraphy is highly reliable in determining the malignancy of neck masses, especially when salivary gland masses are excluded. ((C) 1998 Lippincott-Raven Publishers)

Lingual Thyroid Excision with Transoral Robotic Surgery

Ectopic thyroid gland may be detected at any place between foramen caecaum and normal thyroid localization due to inadequacy of the embryological migration of the thyroid gland. It has a prevalence varying between 1/10.000 and 1/100000 in the community. Usually follow-up without treatment is preferred except for obstructive symptoms, bleeding, and suspicion of malignity. Main symptoms are dysphagia, dysphonia, bleeding, dyspnea, and obstructive sleep apnea. In symptomatic cases, the first described method in surgical treatment is open approach since it is a region difficult to have access to. However, this approach has an increased risk of morbidity and postoperative complications. Transoral robotic surgery, which is a minimally invasive surgical procedure, has advantages such as larger three-dimensional point of view and ease of manipulation due to robotic instruments. In this report, a case at the age of 49 who presented to our clinic with obstructive symptoms increasing within the last year and was found to have lingual thyroid and underwent excision of ectopic thyroid tissue by da Vinci surgical system is presented

Thiol-disulphide homeostasis in noncomplicated chronic otitis media

Introduction: We hypothesized that oxidative stress plays a role in the pathogenesis of chronic otitis media, chronic mucosal inflammatory disease. We aimed to investigate a novel oxidative stress marker in this study. Materıals and methods: Thirty patient with chronic otitis media as the patient group and 30 healthy volunteer subjects as the control group were admitted to the study. Blood samples were taken when they admitted to our clinic before surgical intervention. In healthy volunteers, blood samples were taken when they were admitted to our policlinic.    Thiol/disulphide levels were analyzed with a newly developed method by Erel and Neselioglu.Results: 30 subjects were included in chronic otitis media group (20 females, 10 males).  30 subjects were included in the control group (8 females and 22 males). Sex distribution within the groups was significantly different (p=0.004). There was no significant difference between groups with respect to the age distribution (p=0.072). Measured native thiol, disulphide and total thiol values of the groups were not significantly different from each other. Conclusion: This study demonstrated that although dynamic thiol/disulphide homeostasis was shifted towards disulphide formation as a result of thiol oxidation in patients with chronic otitis media. But we could not find any significant difference between groups

Bacteriology of antrum in children with chronic maxillary sinusitis

Swabs from 93 chronically inflamed maxillary sinuses in children mere taken from aerobic and anaerobic bacteria during endoscopy. Bacterial growth was present in 87/93 specimens (93%). Anaerobic bacteria were isolated in 81/87 culture-positive specimens (93%) and mere recovered alone in 61 cases (70%) and mixed with aerobic or faculative bacteria in 20 (23%). Aerobic or facultative bacteria were present alone in six cases (7%). A total of 261 isolates (3/specimen), 19 (2.4/specimen) anaerobes and 69 (2.6/specimen) aerobes or facultatives, were isolated. The predominant anaerobic organisms sere Bacteroides sp. and anaerobic cocci; the predominant aerobes or facultatives mere Streptococcus sp. and Staphylococcus aureus. These findings indicate the important role of anaerobic organisms in chronic sinusitis