The Hemostatic Efficacy of Hydrogen Peroxide Irrigation to Control Intraoperative Bleeding in Adenoidectomy

Objective:Although adenoidectomy is generally accepted as a safe procedure, intraoperative hemorrhage is still the most common and potentially life- threating complication, especially in pediatric patients. We evaluated the clinical effect of intraoperative hydrogen peroxide irrigation with respect to hemostasis and operation times in pediatric adenoidectomy.Methods:This was a prospective, randomized, double- blind study to investigate hydrogen peroxide solution in hemostasis in pediatric patients undergoing adenoidectomy. The patient, the surgeon, and the study nurse were blinded to the surgical technique used.Results:One hundred seventeen (56 males and 61 females) consecutive pediatric patients with a mean age of 5.46±1.19 years were included in the study. There were 58 patients in the hydrogen peroxide group (median age: 6 years, mean age: 5.62±1.28 years) and 59 patients in the control group (median age: 5 years, mean age: 5.31±1.07 years). No significant difference was observed between the two groups with respect to age (p=0.151), gender (p=0.646), or adenoid size (p=0.767). On the other hand, the difference between the groups with respect to operation and hemostasis times was found to be statistically significant (p<0.001 for both). The average operation times were 8.67±0.48 min in the hydrogen peroxide group and 12.30±0.69 min in the control group. The average hemostasis times were 3.67±0.27 min in the hydrogen peroxide group and 5.73±0.31 min in the control group.Conclusion:Hydrogen peroxide solution can be effectively used in adenoidectomy for reducing intraoperative blood loss and for economic benefits

Cepstral Peak Point Analyses of Patients Recovering from Supraglottic Laryngectomy

Objective:The aim of this study is to evaluate smoothed cepstral peak point and laryngostrobosopic results in patients who underwent supraglottic laryngectomy.Method:Ten patients who underwent transcervical supraglottic laryngectomy with bilateral modified radical neck dissection, and who completed at least 12 months of follow-up, were included. All patients underwent laryngostroboscopic evaluation at study commencement; glottal closure and mucosal wave pattern were examined. Voice records were taken at fundamental frequency and smoothed cepstral peak point were analysed. Voice handicap index-10 was requested to be completed. Ten healthy individual constituted control group. Results were compared.Results:The mean smoothed cepstral peak points were 1.53-5.91 in the supraglottic laryngectomy group and 4.6-6.06 in controls, a significant difference. The fundamental frequency ranged from 174.49 to 197.25 Hz in the supraglottic laryngectomy group and from 118.57 to 197.61 Hz in the control group, also a significant difference. Laryngostroboscopic evaluation revealed no significant between-group differences in closure, but the mucosal waves differed significantly. Voice handicap index was significantly lower in supraglottic laryngectomy patients.Conclusion:Supraglottic laryngectomy reduces smoothed cepstral peak point and affects the mucosal wave, reducing voice quality

Sphenochoanal Polyps and the Optic Nerve

Isolated sphenoid pathology is uncommon. Nasal polyps that originate from the anterior wall of the sphenoid sinus and reach the nasopharynx are called sphenochoanal polyps. The atypical location of sphenochoanal polyps leads to misdiagnosis, and surgery risks injuring the surrounding structures, such as the optic nerve, carotid artery, and brain. For the differential diagnosis of sphenochoanal polyps, nasal endoscopy and computed tomography are very important. We present the clinical and radiological features of a sphenochoanal polyp and review the status of the optic nerve during endoscopic surgery for a sphenochoanal polyp

Diagnosis of Pediatric Nasopharynx Carcinoma after Recurrent Adenoidectomy

Nasopharyngeal soft tissue is most commonly adenoid hypertrophy in children. Although rare, nasopharyngeal carcinoma (NPC) does occur in children. Nasal obstruction, serous otitis media, hearing problems, and tinnitus are common signs and symptoms of all nasal diseases. For this reason, the majority of NPC presents with advanced disease at the time of the diagnosis. This paper reported 7-year-old boy who was admitted to the hospital for adenoidectomy. He had recurrent adenoidectomy operation due to nasal obstruction. NPC had been diagnosed suspecting the hard mass in the nasopharynx during the operation. Adenoidectomy is the most commonly performed surgical procedure in ENT practice and NPC is unlikely to be considered in the differential diagnosis. Surgeon should be careful about signs and symptoms that alert suspicion

Arteriovenous malformation of auricula: Case report

Arteriovenous malformation is the existence of a directcommunication between an artery and vein without capillaryconnections. Although arteriovenous malformations(AVMs) are frequent in head and neck region, it is rare inear, especially in auricula. A thirty three year old femalepatient presented with hemorrhagic mass in her auricula.Radiological and histopatological examinations revealedan AVM that was limited to auricula. The mass is excisedand reconstructed with a local pediculated flap. This casewas presented together with a literature review

Osteoplastic Flap Approach to Inverted Papilloma of the Frontal Sinus

Inverted papilloma is a locally aggressive benign disease. Patients most commonly present with unilateral nasal obstruction. Isolated frontal sinus inverted papilloma may remain asymptomatic for a long time. Surgical management of frontal sinus inverted papilloma is challenging. Despite advances in endoscopic sinus surgery, open frontal sinus approach may be required. In this case report, we present a 67-year-old female patient who underwent osteoplastic frontal sinus surgery due to frontal sinus inverted papilloma with intracranial extension causing severe cosmetic deformity. The patient had previously experienced two inefficient surgical procedures. The indications for the surgical approach performed in our clinic is presented with the recent literature. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 67-70

Evaluation of Patients with Post-Tonsillectomy Bleeding in a Second-Degree State Hospital Our Patients with Post-Tonsillectomy Bleeding

Aim: Investigation of features of patients with post-tonsillectomy bleeding and evaluation of clinical approach to those patients in a second-degree state hospital. Methods: In this retrospective study we evaluated records of 322 patients who had undergone onsillectomy in the Department of Otolaryngology (ENT) at Babaeski State Hospital, a second-degree state hospital between March 2009 and December 2012. The median age of the subjects was 19.8 (5-45) years. Results: A total of 18 patients (5.5%, 11 female, 7 male) had reported post tonsillectomy bleeding. Two patients had primary (11%), 16 (89%) had secondary bleeding. Admittance days of secondary bleeding patients were recorded (two at the 3rd, two at the 4th, six at the 5th, one at the 6th, four at the 7th and one at the 10th days, post-operatively). Bleeding was controlled in 4 patients using conservative methods. In 14 patients, bleeding was brought under control in the operating room. External carotid artery ligation was not performed in any patient. Conclusion: Tonsillectomy is a common ENT operation. The most important and life-threatening complication of this operation is bleeding. Investigating the clinical features of patients with post-tonsillectomy bleeding may help us in taking appropriate precautions to reduce the incidence of this complication. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 1-4

The effect of dexpanthenol-vitamin A (nazalnem) on silastic splints after nasal septal surgery

Kumral, Tolgar Lutfi/0000-0001-8760-7216WOS: 000415085100098PubMed: 28938325Objective:To investigate the effect of dexpanthenol-vitamin A (Nazalnem) ointment applied to the surface of silastic splints with an airway immediately after nasal septal surgery on postoperative complaints and nasal mucosa function. Materials and Methods:The study enrolled 60 patients undergoing nasal septoplasty surgery. Group 1 (n=30) received silastic splints with ointment containing dexpanthenol-vitamin A (Nazalnem), and Group 2 (n=30), the control group, received silastic splints with vaseline. Of these patients, 2 patients from the Group 1 and 9 from the Group 2 were excluded. A thin layer of ointment was applied to the flat side of a silastic splint with an airway. The splints were removed on the second postoperative day. Patients were evaluated preoperatively and 1 and 2 weeks postoperatively using a visual analog scale and the Sino-Nasal Outcome test (SNOT-22). Mucociliary clearance (MCC) tests were performed at the same times. Results:Visual analog scale for nasal crusting, nasal congestion, and foul odor was better in Group 1 than in Group 2 both at 1 week and at 2 weeks postoperatively (P0.05). Postoperatively, the MCC were insignificant between the groups and within the groups at 1 and 2 weeks (P>0.05). Conclusion:Although Dexpanthenol-Vitamin A ointment had no direct effect on wound healing, it had significant effects on crusting, obstruction, and foul smell. However, silastic splints with dexpanthenol did not improve the MCC of the nose

The Development of Dorsal Nasal Cyst Formation after Rhinoplasty and Its Reconstruction with Conchal Cartilage

The dorsal nasal cyst formation is a rare and late complication of rhinoplasty. It has been rarely reported in the literature and it is usually mucous cysts. Migration and planting to the subcutaneous space during the surgical procedure has been recognized as the formation mechanism. This case report has presented 42-year-old male patient with a destructing dorsal nasal mucous cyst that developed 10 years after the rhinoplasty operation. There was no complication in the primary rhinoplasty and the patient was satisfied with his appearance. There was a swelling of the nasal dorsum over the past year and surgical excision of the cyst was performed. During the surgery, the defect was reconstructed with conchal cartilage. There was no recurrence during follow-up