Evaluation of paradoxical vocal cord motion and differential diagnosis

[No Abstract Available

Obstrüktif tonsil hipertrofisi olan çocuk hastalarda mikrodebrider tonsillotomi

Aim: To compare intracapsular microdebrider tonsillotomy with conventional cold dissection tonsillectomy in the management of tonsillar hypertrophy causing obstructive airway problems in children. Material and Method: 37 children who underwent microdebrider tonsillotomy were compared with other 45 children who had conventional cold dissection tonsillectomy to examine intraoperative blood loss, operation time, duration of oral intake, intake of analgesics, recovery time and post-operative pain. Results: Children who underwent intra-capsular micro-debrider tonsillotomy had significantly less pain throughout their recovery period than those who had conventional tonsillectomy. In the microdebrider tonsillotomy group intraoperative blood loss, operation time, duration of oral intake, intake of analgesics, and postoperative pain score were found to be less than the conventional tonsillectomy group scores(p <0,05). Tonsillar hypertrophy recurred in two patients of micro-debrider tonsillotomy group. Discussion: Intracapsular tonsillotomy is as effective and safe as conventional tonsillectomy to relieve obstructive sleep apnea in pediatric patients. Intracapsular microdebrider tonsillotomy reduces postoperative pain, improves quality of life and shorthens the recovery time. Therefore; this procedure is more tolerable in children with obstructive tonsillar hypertropy in respect to conventional tonsillectomy

Efficacy of platelet-rich fibrin matrix on viability of diced cartilage grafts in a rabbit model

Objectives/Hypothesis: The objective of this study was to compare the viability of cartilage grafts embedded in platelet-rich fibrin matrix (PRFM) wrapped with no material (bare diced cartilage grafts), oxidized methylcellulose (Surgicel), or acellular dermal tissue (AlloDerm). Study Design: Experimental study. Methods: In this study, six New Zealand rabbits were used. Cartilage grafts including perichondrium were excised from each ear and diced into 2-mm-by 2-mm pieces. There were four comparison groups: 1) group A, diced cartilage (not wrapped with any material); 2) group B, diced cartilage wrapped with AlloDerm; 3) group C, diced cartilage grafts wrapped with Surgicel; and 4) group D, diced cartilage wrapped with PRFM. Four cartilage grafts were implanted under the skin at the back of each rabbit. All rabbits were sacrificed at the end of 10 weeks. The cartilages were stained with hematoxylin-eosin, Masson’s Trichrome, and Orcein. After that, they were evaluated for the viability of chondrocytes, collagen content, fibrillar structure of matrix, and changes in peripheral tissues. Results: When the viability of chondrocytes, the content of fiber in matrix, and changes in peripheral tissues were compared, the cartilage embedded in the PRFM group was statistically significantly higher than in the other groups (P<0.05). Conclusion: We concluded that PRFM has significant advantages in ensuring the chondrocyte viability of diced cartilage grafts. It is also biocompatible, with relatively lesser inflammation and fibrosis

Corticosteroid hypersensitivity in allergic rhinitis

Corticosteroid hypersensitivity in allergic rhinitis. Background: intranasal corticosteroid (IC) is the most effective treatment method in allergic rhinitis patients who are unresponsive to antihistamines. The literature reports an approximate 20% treatment failure for instances where IC is used for the treatment allergic rhinitis. Hypersensitivity reaction to corticosteroids may be one of the causes of this treatment failure. Objective: to discover the incidence and confounding factors of corticosteroid hypersensitivity in patients with allergic rhinitis. Methods: after 31 patients were excluded, 150 consecutive patients who were prospectively evaluated in our outpatient clinics with the diagnosis of allergic rhinitis and 50 age- and sex- matched healthy volunteers were included in this study. To diagnose allergic rhinitis, the symptoms of patients and a skin prick test were used. A skin patch test was used to determine corticosteroid hypersensitivity. Total IgE values and total eosinophil count were obtained for all patients. Total symptom scores were calculated for the severity of symptoms and to determine the response to therapy using intranasal corticosteroids. Results: the incidence of corticosteroid hypersensitivity determined via the skin patch test was 14.0% (21 out of 150 patients). A difference was observed for patch test positivity results between the study and control groups (14% vs. 0%, respectively). Serum IgE levels and total eosinophil count were higher among patients who had corticosteroid hypersensitivity (p:0.005 and p:0.004, respectively). Patients unresponsive to intranasal corticosteroids had a higher incidence of corticosteroid hypersensitivity (71.4% vs. 4.4%, p<0.001). Conclusion: our study is the largest to date investigating CH in patients with allergic rhinitis and patients with allergic rhinitis have been found to have a high incidence (14%) of corticosteroid hypersensitivity, which may affect the response of patients to intranasal corticosteroid treatment

Supraclavicular thoracic duct cyst

[No Abstract Available

Boyun karotid üçgende atipik yerleşim gösteren dev tiroid nodülü: bir olgu sunumu

Ectopic thyroid tissue is a rare pathology of the thyroid that is formed by the abnormal migration of the thyroid tissue. It is seen once in about every 100.000 to 300.000 births and is generally asymptomatic. Asymptomatic ectopic thyroid tissue may grow larger and become symptomatic in the form of a neck mass due to thyroid tissue hyperplasia. The thyroid gland, apart from its normal localization before the trachea, may lie between the tongue root and the trachea generally on the middle line at any level. A 71-year-old male patient presented to our ear- nose and throat clinic with a mass of 5x4x3 cm located in the right carotid triangle. The thin-needle aspiration biopsy specimen was reported as thyroid tissue and sub-sequently the mass was excised under general anesthesia. The histopathological evaluation of the mass revealed that it was an atypically located ectopic thyroid nodule. No complications were seen within one year follow-up of the patient

PPI kullanımının clostridium difficile serum antijen değerlerine olan etkisi

Aim: To evaluate the effects of proton-pump inhibitor (PPI) use on distrubtion of intestinal flora by measuring serum Clostridium Difficile antigen levels before and at the end of a three- months treatment in patients with Laryngopharyngeal reflux (LFR) treatment. Material and Method: The study covers 32 patients with LFR, out of which 24 were female (75%) and 8 were male (25%). The mean age of the patients was 34.13 +/- 11.59. All patients included in the study were administered Lansoprazole 30 mg tablets perorally before meals and twice a day for treatment. Reflux Symptom Index (RSI), Reflux Finding Score (RFS), white blood cell count, CRP and serum Clostridium Difficile toxin A, B measurement results were comparatively evaluated through the blood serum samples drawn from the patients before and at the end of the three- months treatment. Results: While the mean values of pre-treatment RSI and RFI were 20.81 +/- 4.05 and 13.31 +/- 3.30 respectively, the mean values were measured to be 3.41 +/- 2.37 and 1.50 +/- 1.88 respectively following the three- months treatment (p< 0.05). The pre-treatment mean value of serum Clostridium Difficile Ag was 140.56 +/- 11.74, while it was seen that the same value became 114.94 +/- 10.70 after the three- months treatment (p< 0.05). There was, however, no statistically significant change in the other parameters. Discussion: According to the results obtained, it was seen that the treatment with PPI was not cause to increase Clostridium difficile toxin A, B serum antigen levels. So these drugs could be used in long time therapies confidently.Amaç: Larengofarengeal Reflü (LFR) hastalığının tedavisi amacıyla Proton pompa inhibitörü (PPİ) kullanan hastalarda tedavi öncesi ve üç aylık tedavinin sonunda serum Clostridium Difficile antijen miktarı ölçülerek PPİ kullanımının serum Clostridium Difficile serum antijen miktarı üzerindeki etkisinin değerlendirilmesi. Gereç ve Yöntem: Çalışmaya LFR hatalığı tespit edilen 32 hasta ( 24 ( % 80)’ü kadın, 8 (% 20)’i erkek) dahil edildi. Hastaların yaş ortalaması 34.13 ± 11.59 idi. Çalışmaya dahil edilen tüm hastalara tedavi için günde iki kez yemeklerden önce alınacak şekilde lansoprazol 30 mg tablet peroral olarak başlandı. Tedavi öncesinde ve üç aylık tedavinin sonunda hastaların LFR şiddeti Reflü Semptom İndeksi ( RSI) ve RBS ( Reflü Bulgu Skoru) kullanılarak değerlendirildi. Ayrıca hastalardan tedavi öncesi ve üç aylık tedavinin sonunda alınan kan serum örneklerinde beyaz küre, CRP, sedimantasyon ve serum Clostridium Difficile toxin A, B ölçümleri yapılarak karşılaştırmalı olarak değerlendirildi. Bulgular: Tedavi öncesi RSI ve RBS ortalamaları sırasıyla 20.81±4.05 ve 13.31±3.30 iken, üç aylık tedavi sonrasında bu ortalamalar sırasıyla 3.41±2.37 ve 1.50±1.88 olarak tespit edildi ( p< 0,05). Tedavi öncesi serum Clostridium Difficilie Ag değerlerinin ortalaması 140.56±11.74 iken üç aylık tedavi sonrasında bu ortalamanın 114.56±10.70 olduğu görüldü ( p 0,05). Tartışma: Elde ettiğimiz sonuçlara göre, proton pompa inhibitörü kullanan hastaların Clostridium difficilie toxin A, B serum antijen düzeylerinde istatistiksel olarak anlamlı bir düşüş olduğunu görüldü

The comparison of thermal tissue injuries caused by ultrasonic scalpel and electrocautery use in rabbit tongue tissue

The aim of this study compares to the increase in tissue temperature and the thermal histological eff ects of ultrasonic scalpel, bipolar and unipolar electrosurgery incisions in the tongue tissue of rabbits. The is study evaluates the histopathological changes related to thermal change and the maximum temperature values in the peripheral tissue brought about by the incisions carried out by the three methods in a comparative way. To assess thermal tissue damage induced by the three instruments, maximum tissue temperatures were measured during the surgical procedure and tongue tissue samples were examined histopathologically following the surgery. The mean maximum temperature values of the groups were 93.93±2.76 Cº for the unipolar electrocautery group, whereas 85.07±5.95 Cº for the bipolar electrocautery group, and 108.23±7.64 Cº for the ultrasonic scalpel group. Th ere was a statistically signifi cant relationship between the increase in maximum temperature values and the separation among tissue layers, edema, congestion, necrosis, hemorrhage, destruction in blood vessel walls and fi brin accumulation, and between the existence of fi brin thrombus and tissue damage depth (p<0.05). It was concluded that the bipolar electrocautery use gives way to less temperature increase in the tissues and less thermal tissue damage in comparison to the other methods

Temporal bone posterior wall defect, a new clinic entity?

OBJECTIVE: To define clinical and audiological findings in patients with temporal bone posterior wall defects (TBPWD) and to investigate possible relationships between these findings and the characteristics of the defect. MATERIALS and METHODS: The computed tomography (CT) views of 1198 patients with vestibulocochlear symptoms between 2007 and 2012 were retrospectively evaluated, and TBPWD and associated anomalies were investigated. Patients who had TBPWD were called back, and clinical and audiological examinations (tympanometry, pure tone audiometry, acoustic reflexes, and otoacoustic emission) were performed. RESULTS: Twenty-eight (2.34%) patients had TBPWD. Twenty-three of them were eligible for the study. Size of the defect was significantly correlated with the presence of tinnitus and/or vertigo (p< 0.005). The cut-off values for the largest size of TBPWD were 1.65 mm [sensitivity: 0.67 and specificity: 0.77 (95% CI: 0.58-0.97); p= 0.04] in case of the presence of tinnitus and 1.85 for vertigo (sensitivity: 0.78 and specificity: 0.86 (95% CI: 0.67-0.99); p= 0.006). In pure tone audiometry tests, mixed-type hearing loss was present in four (17%) patients, sensorineural hearing loss was present in three (13%) patients, and conductive-type hearing loss was present only in one (4%) patient. Otoacoustic emission tests revealed significant differences in signal/noise ratios at frequencies of 500, 750, 1000, and 6000 Hz. CONCLUSION: For the first time in the literature, we defined clinical and audiological findings in patients with TBPWDs. These defects seem to cause more prevalent symptoms of vertigo and tinnitus and disturb the audiological characteristics of patients

Complications of trabeculectomy

Glokom, ilerleyici optik atrofi ve görme alanı kaybı ile karakterize, kronik iskemik optik nöropatidir. Yüksek göz içi basıncı (GİB) en önemli risk faktörlerinden biridir. Tedavide GİB’i düşürmek amaçlanır. GİB’i düşürmeye yönelik tedavi yöntemleri; medikal tedavi, lazer tedavisi ve cerrahi tedavi olarak üç gruba ayrılır. Penetran glokom cerrahisi, maksimum tolere edilebilen medikal tedaviye rağmen kontrolsuz yüksek GİB olması nedeniyle ya da başarısız lazer trabeküloplasti sonrası uygulanmaktadır. Cerrahiyi geciktirmenin ana sebebi özellikle yüksek risk grubunda görülen yüksek başarısızlık oranları ile ilişkili postoperatif komplikasyon riskidir. Buna rağmen yeni gelişmeler ile daha güvenli ve başarılı cerrahiler yapılmaktadır. Trabekülektomi, günümüzde glokomun cerrahi tedavisinde altın standart olma özelliğini korumakta ve GİB’i azaltmak için ülkemizde ve tüm dünyada yaygın olarak uygulanmaktadır. Bu derlemede, trabekülektomi sonrası görülen komplikasyonların, klinik özellikleri ve tedavi seçenekleri güncel literatüre göre tartışılmıştır.Glaucoma is a chronic ischemic optic neuropathy characterized by an optic atrophy and progressive visual field loss. High intraocular pressure (IOP) is one of the most important risk factors. The aim of the treatment is to reduce IOP. IOP lowering therapy methods are divided into three groups as medical therapy, laser therapy and surgical treatment. Penetrating glaucoma surgery is applied against uncontrolled high IOP despite the maximum tolerated medical therapy or after a failed laser trabeculoplasty. The main reason for the delay in conventional trabeculectomy is the risk of postoperative complications associated with high failure rate especially in high risk groups. Nevertheless, more secure and successful surgery is made with new advancements. Today, trabeculectomy remains the gold standard in the surgical treatment of glaucoma and is performed widely in our country and all around the world to decrease IOP in refractory glaucoma. In this review, the clinical characteristics and treatment options for complications after trabeculectomy are discussed according to recent literature