The managament of rare nasal mass-nasal dermoid sinus cysts: open rhinoplasty

The differential diagnosis of midline nasal masses includes inflammatory lesions, post-traumatic deformities, benign neoplasms, malignant neoplasms, congenital and vascular masses. Midline congenital lesions of the nose are rare congenital anomalies. Their incidence is estimated at 1 per 20,000 to 40,000 births consisting of gliomas, encephaloceles, and nasal dermoid sinus cysts. Nasal dermoid sinus cysts account for 1–3% of dermoid cysts overall and 11–12% of head and neck dermoids. Most lesions are diagnosed within the first three years of life but in some cases the diagnosis can be prolonged. We present an 18-year old and a two and a half-year old male patients who are concerned about drainage from the tip of the nose with recurrent infection and operated with a diagnosis of nasal dermoid sinus cyst

Effects of Rhinophototherapy on Quality of Life in Persistant Allergic Rhinitis

ObjectivesTo investigate the effect of rhinophototherapy with medical therapy on quality of life in persistent allergic rhinitis.MethodsA prospective, randomized study was being performed between December 2009 and March 2010. The study included 65 patients with persistent allergic rhinitis. The diagnosis was confirmed with positive skin tests. All of the patients had house dust mite allergies. We divided the patients into two groups. First group (n=33) was given topical mometasone furoate 200 mcg/day and levocetirizine 5 mg/day for a month. Rhinophototherapy was applied with the same medical therapy to the second group (n=32), twice a week for three weeks continuously. Rhinophototherapy included visible light, ultraviolet A and ultraviolet B. We evaluated patients before the treatment, at the first month and at the third month after treatment with rhinoconjunctivitis quality of life questionnaire, nasal symptom scores and visual analogue scale (VAS) scores.ResultsImprovements of all variables of the quality of life questionnaire, nasal symptom scores and VAS were statistically significant in the second group both on the first and the third months when compared with the first group.ConclusionAllergic rhinitis is a social problem and impairs quality of life. Rhinophototherapy with medical therapy improves the quality of life in allergic rhinitis

Comparing Traditional Cold Knife Tonsillectomy with a New Technique Plasma Knife Tonsillectomy

Objective:The aim of this study is to compare traditional cold knife tonsillectomy and plasma knife tonsillectomy.Methods:In this study, 15 patients underwent cold knife tonsillectomy, 15 patients underwent plasma knife tonsillectomy. The patients were then followed up in the postoperative days.Results:The operation time and intraoperative blood loss in cold knife tonsillectomy group was significantly greater than the plasma knife group (p0.05). Postoperative complications were similar for both groups (p=0.224). There was no significant correlation of complications and age (p=0.921). Operation time of the patients who had complications was not different from the patients who did not have complications (p=0.086). Pain scores in every follow up time for both groups was not significantly different (p>0.005).Conclusion:According to this data, plasma knife tonsillectomy was not found superior to cold knife tonsillectomy in the postoperative pain and complications but had positive effects on operation time and blood loss

Coincidental Killian-Jamieson Diverticulum During Thyroid Surgery: A Rare Cause of Dysphagia

The aim of this case report is to demonstrate a very rare coincidental existence and management of the Killian- Jamieson diverticulum during thyroid surgery in a patient with dysphagia. An 18-year-old female patient with the complaints of progressive dysphagia and a rapidly growing mass at the anterior cervical region was undergone thyroid lobectomy. Coincidentally, a 2×2 cm Killian-Jamieson diverticulum was observed and simultaneously excised with the thyroid lobe, preserving the recurrent laryngeal nerve. Dysphagia is a frequent symptom, especially in patients with a rapidly growing thyroid mass. Thyroid surgeons should keep in mind that hypopharyngeal and upper esophageal pathologies can mimic the symptoms of a thyroid mass; therefore, detailed imaging techniques should be used for the differential diagnosis

Importance of Sonoelastography in Assessing Non-Thyroid Neck Masses

Objective: To evaluate the feasibility and value of sonoelastography in assessing non-thyroid neck masses.Methods: Non-thyroid neck masses requiring surgical interventions were evaluated using conventional B-mode ultrasonography (US) (size, short/long axis rate, shape, hilum, echogenity, calcification, necrosis, and peripheral edema) and sonoelastograpy (SE) with strain ratio (SR) and elasticity score (ES) before surgery. These parameters were compared with the histopathological examination.Results: In total, 116 non-thyroid neck masses (66 lymph node, 35 parotid gland, eight submandibular gland, and seven cervical mass) of 89 patients (51 men, 38 women) with a mean age of 50.3±15.1 (19-79) years were evaluated. Thirty-seven malignant lymph nodes (23 metastatic and 14 lymphoma), seven malignant parotid tumors, two malignant submandibular tumors, 29 benign lymph nodes, 28 benign parotid lesions, and six benign submandibular lesions were evaluated. Mean SR and ES values of malignant masses were 6.3/3.2 for lymph nodes, 5.5/3.3for the parotid gland, and 4.2/3 for the submandibular gland. Mean SR and ES values of benign lesions were 2.0/2.1 for lymph nodes, 4.4/3.2 for the parotid gland, and 3.2/3 for the submandibular gland. SR and ES were significantly higher for malignant masses compared with those for benign ones. SR was more predictive than ES in evaluating malignant lymph nodes. The area under the curve was 0.917(0.827-1.00) (p<0.05) for SR in differentiating benign-malignant lymph nodes, and the upper cut-off value was two. SR and ES were higher in the malign parotid and submandibular gland lesions than the benign ones, but the difference was not statistically significant.Conclusion: Strain ratio value could be a useful parameter in differentiating benign-malignant lymph nodes. More studies are necessary for differentiating benign-malignant parotid and submandibular lesions using SE

The Effects of Superficial Musculoaponeurotic System Flap on the Development of Frey’s Syndrome and Cosmetic Outcomes After Superficial Parotidectomy

Objective:To investigate the outcomes of superficial musculoaponeurotic system (SMAS) flap and classic techniques in superficial parotidectomy in terms of Frey’s syndrome (FS) and cosmetic satisfaction.Methods:In this study, a retrospective chart review of patients that underwent superficial parotidectomy was performed. These patients were divided into two subgroups: group 1 included patients in which the SMAS flap was harvested and group 2 comprised the remaining patients on whom classic superficial parotidectomy was performed. All the patients were evaluated clinically and with Minor’s starch-iodine test for FS. For the evaluation of the cosmetic results, the patient’s satisfaction was queried according to the incision scar and surgical field skin retraction/facial symmetry. Both groups were compared in terms of complications and numbness of surgical area.Results:Fifty-five patients (31 male and 24 female) with a mean age of 50.19 years were included in the study. Thirty-two patients were in group 1 and 23 in group 2. Thirteen patients (23.7%) described as having FS and six of them were in group 1, while seven were in group 2. Minor’s starch-iodine test was positive in nine patients in group 1 (28.1%) and six patients in group 2 (26.1%) (p=1.000). With regard to cosmetic satisfaction, eight patients (25%) stated mild discomfort from the incision scar and two patients (6.3%) stated cosmetic dissatisfaction for facial asymmetry in group 1. In group 2 for the same factors the number of patients were 11 (47.8%) and 2 two (8.7%), respectively (p=0.027). There were no statistically significant differences in means of complication and numbness (p>0.05).Conclusion:According to our study results, there was no superiority between both the groups in terms of FS and incision scar satisfaction. We determined that there was a significant benefit of SMAS flap application in the prevention of volume loss and surgical area retraction

Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy

Objective:To investigate the prognostic value of the magnetic resonance imaging in Bell’s palsy patients.Methods:Patients who were diagnosed and treated with Bell’s palsy between October 2013 and March 2016 retrospectively selected. House–Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell’s palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data.Results:No significant correlation was observed between pretreatment House–Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell’s palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement.Conclusion:The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell’s palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell’s palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression

Geleneksel soğuk bıçak tonsillektomi ile yeni bir teknik olan plazma knife tonsillektominin karşılaştırılması

Amaç: Geleneksel bir yöntem olan soğuk bıçak tonsil- lektomi ile plazma knife tonsillektomi tekniğinin sonuç- ları karşılaştırıldı. Yöntemler: Onbeş hastaya soğuk bıçak tonsillektomi, 15 hastaya plazma knife ile tonsillektomi uygulandı, hastalar ameliyat sonrası takip edildi. Bulgular: Soğuk bıçak tonsillektomi grubunda operas- yon süresi ve kanama miktarı istatistiksel anlamlı olarak daha fazla bulundu (p0,005). Gruplar arasında komplikasyon görülme oranı açısından istatistiksel olarak anlamlı fark yoktu (p=0,224). Komplikasyon ile yaş arasında istatistiksel olarak anlamlı birliktelik görülmedi (p=0,921). Komp- likasyon görülen ve görülmeyen olgularda operasyon sü- resi açısından istatistiksel olarak anlamlı farklılık yoktu (p=0,086) ve her bir izlem zamanı içerisinde ağrı düzey- leri yönünden istatistiksel olarak anlamlı farklılık yok idi (p>0,005). Sonuç: Plazma knife ile tonsillektomi tekniği soğuk bı- çak tonsillektomiye göre postoperatif ağrı ve komplikas- yonlar açısından çok farklı bir kazanç sağlamazken, daha kısa operasyon süresi ve daha az kan kaybı açısından olumlu etkisi olduğu kanaatine varılmıştır.Objective: Te aim of this study is to compare tradi- tional cold knife tonsillectomy and plasma knife ton- sillectomy. Methods: In this study, 15 patients underwent cold knife tonsillectomy, 15 patients underwent plasma knife tonsillectomy. Te patients were then followed up in the postoperative days. Results: Te operation time and intraoperative blood loss in cold knife tonsillectomy group was signifcantly greater than the plasma knife group (p&lt;0.001). Te mean pain scores in the plasma knife group was signif- cantly higher than the dissection group (p=0.006). Pain scores in each follow up time for each group was not statistically signifcant (p&gt;0.05). Postoperative compli- cations were similar for both groups (p=0.224). Tere was no signifcant correlation of complications and age (p=0.921). Operation time of the patients who had com- plications was not diferent from the patients who did not have complications (p=0.086). Pain scores in every follow up time for both groups was not signifcantly dif- ferent (p&gt;0.005). Conclusion: According to this data, plasma knife ton- sillectomy was not found superior to cold knife tonsil- lectomy in the postoperative pain and complications but had positive efects on operation time and blood loss