Unusual iatrogenic foreign body in a nose: A case report

Foreign bodies in the nose are common in children, but are rarely found in adults. In this case, a 34-year-old male was ad- mitted to our clinic with complaints of nasal obstruction, halitosis and foul-smelling purulent nasal discharge. History of the patient revealed a septoplasty procedure completed about one year ago. Anterior rhinoscopy and nasal endoscopic exami- nation of the patient revealed that both nasal cavities were filled with foreign bodies. After the removal of these materials, the foreign bodies were identified as rhinolith particles with 2x5cm X-ray film cut-out sheets embedded within. We thought the X-ray film sheets were used for nasal packing following the previous septoplasty. The X-ray film sheets had eventually become rhinoliths over time. It is not clear why the packing was retained for such a long duration. As demonstrated by this case report, postoperative follow-up after septoplasty is important, and iatrogenic foreign bodies should be considered in the differential diagnosis of an adult patient with rhinolithiasis. [Arch Clin Exp Surg 2015; 4(3.000): 157-159

Is There Any Effect on Smell and Taste Functions with Levothyroxine Treatment in Subclinical Hypothyroidism?

Subclinical hypothyroidism has been accused for coronary heart disease, lipid metabolism disorders, neuropsychiatric disorders, infertility or pregnancy related problems with various strength of evidence. Currently there is insufficient knowledge about olfaction and taste functions in subclinical hypothyroidism. Aim of the present study is to investigate the degree of smell and taste dysfunction in patients with subclinical hypothyroidism. 28 subclinical hypothyroid patients, and 31 controls enrolled in the prospective study in Istanbul, Turkey. Subclinical hypothyroid patients were treated with L-thyroxine for 3 months. Psychophysiological olfactory testing was performed using odor dispensers similar to felt-tip pens ("Sniffin' Sticks", Burghart, Wedel, Germany). Taste function tests were made using "Taste Strips" (Burghart, Wedel, Germany) which are basically tastant adsorbed filter paper strip. Patients scored lower on psychophysical olfactory tests than controls (odor thresholds:8.1±1.0 vs 8.9±1.1, p = 0.007; odor discrimination:12.4±1.3 vs 13.1±0.9, p = 0.016; odor identification:13.1±0.9 vs 14.0±1.1, p = 0.001; TDI score: 33.8±2.4 vs 36.9±2.1, p = 0.001). In contrast, results from psychophysical gustatory tests showed only a decreased score for "bitter" in patients, but not for other tastes (5.9±1.8 vs 6.6±1.0, p = 0.045). Three month after onset of treatment olfactory test scores already indicated improvement (odor thresholds:8.1±1.0 vs 8.6±0.6, p<0.001; odor discrimination:12.4±1.31 vs 12.9±0.8, p = 0.011; odor identification:13.1±0.9 vs 13.9±0.8, p<0.001; TDI scores:33.8±2.4 vs 35.5±1.7, p<0.001) respectively. Taste functions did not differ between groups for sweet, salty and, sour tastes but bitter taste was improved after 3 months of thyroxin substitution (patients:5.9±1.8 vs 6.6±1.2, p = 0.045). Correlation of changes in smell and taste, with thyroid function test were also evaluated. TSH, fT4 were found have no correlation with smell and taste changes with treatment. However bitter taste found positively correlated with T3 with treatment(r: 0.445, p: 0.018). Subclinical hypothyroid patients exhibited a significantly decreased olfactory sensitivity; in addition, bitter taste was significantly affected. Most importantly, these deficits can be remedied on average within 3 months with adequate treatment

The correlations for differences in the changes of before and after treatment of olfactory-taste functions and thyroid function tests in subclinical hypothyroid patients.

<p>The correlations for differences in the changes of before and after treatment of olfactory-taste functions and thyroid function tests in subclinical hypothyroid patients.</p

Clinical Characteristics and Endocrine Parameters of Patients and Controls.

<p>Clinical Characteristics and Endocrine Parameters of Patients and Controls.</p

Comparison of TDI (Total score of Threshold + Discrimination + Identification) and taste total score in controls and subclinical hypothyroid patients (before and after treatment).

<p>Comparison of TDI (Total score of Threshold + Discrimination + Identification) and taste total score in controls and subclinical hypothyroid patients (before and after treatment).</p

Olfactory and Taste results of Patients (before and after treatment) and Controls.

<p>Olfactory and Taste results of Patients (before and after treatment) and Controls.</p