The Importance and Place of Adenotonsillectomy in Syndromic Children

Objective: Upper airway obstruction and sleeping disorders are important issues in syndromic children, including mouth, lower-upper jaw, or all facial abnormalities. Tonsillectomy and/or adenoidectomy is required because of systemic problems and upper airway obstruction that increase the existing systemic problems, except those anomalies. However, tonsillectomy and/or adenoidectomy are mostly avoided because of the tendency to cause both intubation/perioperative systemic problems and respiratory complications in the postoperative period and in delays in the oral intake. However, these surgeries are sometimes required. In this context, we present our experience related with performing tonsillectomy and/or adenoidectomy in syndromic children admitted to our hospital. Methods: We retrospectively examined the data on tonsillectomy and/or adenoidectomy performed in syndromic patients in our clinic between 2001 and 2011. Results: We did not observe any postoperative complications in adenoidectomy and/or tonsillectomy performed by the same surgeon in 14 syndromic cases. Conclusion: It should be noted that respiratory problems may arise from many different anatomical regions in syndromic patients. Therefore, surgery should be performed taking into consideration all of these factors in these patients. These patients must be hospitalized in the postoperative period

Evaluation of Hearing Loss in Pilots

Objective: High-intensity noise sources with an increase in air traffic and sudden changes in atmospheric pressure can cause hearing loss in pilots. The main goal of this research is to examine hearing loss due to age, the total flight hours and aircraft types and to evaluate the effects of personal conditions that can influence the hearing level. Methods: We examined the data of 234 Turkish pilots aged between 25 and 54 years who were examined due to the aviation Law for annual control from January 2005 to January 2014 at Baskent University Medical Faculty, Ankara Hospital. The audiometric results of the pilots were used. While 1, 2, 3, 4, 6, and 8 KHz were used for the airway threshold, 1, 2, and 4 KHz were used for the bone conduction threshold. Results: According to the data of the 234 pilots, there was a significant correlation between high-frequency hearing loss and the total flight hours and pilots' ages. The average hearing loss was higher, particularly in the left ear, in pilots using helicopters than in those using other aircraft types. There was no statistically significant correlation between hearing loss and diabetes, hypercholesterolemia, high blood pressure, anemia, obesity, and smoking. Conclusion: A significant cor-relation was observed between high frequency hearing loss and the total flight hours, pilots' age, and aircraft types in our study

Recurrent Pleomorphic Adenoma of the Submandibular Gland

Pleomorphic adenoma (PA) is the most common benign tumor of salivary glands. Most PAs occur in the parotid (80%), followed by the submandibular gland (10%) and minor salivary and sublingual glands (10%). Submandibular gland PAs usually manifest in the submandibular area as a painless hard mass. Although several recurrent parotid gland PA cases have been reported in the literature, recurrent submandibular gland PA is quite rare. Complete surgical removal of tumor of the submandibular gland and keeping the capsule intact are important to prevent recurrence. Here we present a rare case of submandibular gland PA recurrence that occurred 5 years after the first surgery and methods to prevent recurrence

Effect of mometasone furoate nasal spray on the DNA of nasal mucosal cells

Background/aim: Allergic rhinitis (AR) is a respiratory disease caused by inflammation of the nasal mucosa. Intranasal corticosteroids (ICs) are an effective treatment for AR; however, their use has been associated with atrophy in nasal mucosae. Because DNA damage has been linked to several chronic diseases, we hypothesize that use of ICs could cause DNA damage in nasal mucosa cells, leading to mucosal atrophy and septal perforation. Materials and methods: Sixty patients with moderate or severe AR were divided randomly into two groups. Mometasone furoate (MF) and antihistamine tablets (desloratadine) were given to the study (IC) group. Physiologic saline and desloratadine were given to the control ((serum physiologic (SP)) group. Nasal irrigation fluid was taken from patients before study commencement and after 4 weeks of treatment. The comet assay was applied to detect DNA damage in nasal mucosa cells. Results: Nineteen patients were excluded, leaving a study population of 41 patients (IC group: 17 patients; SP group: 24 patients). Genotoxic damage was evaluated by comet assay. Conclusion: Treatment with MF spray for 4 weeks does not cause DNA breaks within cells in the nasal mucosa. These results could form the basis of clinical trials involving treatment with different ICs over longer treatment periods

Pediatric Mass Lesions of the Head and Neck Region and Fine-Needle Aspiration Biopsy Results

Objective: 1. To provide a classification of pediatric mass of the head and neck region and evaluate their frequency. 2. To examine the findings of fine-needle aspiration biopsy (FNAB) in pediatric patients along with its contribution to diagnosis. Methods: Totally, 233 pediatric patients (125 boys and 108 girls) operated at Baskent University for head and neck mass were included. Clinical, radiological, and histopathological data were retrieved from medical records. Results: The mean age was 119 +/- 65 months, and the mean duration of follow-up was 75 +/- 49 months. Localization of the masses was as follows: 208 (89%) in the neck, 21 (9%) in the oral cavity, 2 (1%) in the neck and nasopharynx, and two (1%) in the larynx. The most common surgical procedure was open excisional biopsy (n=105, 45%) followed by cystic mass excision (n=72, 31%) and salivary gland excision (n=33, 14%). Basedon histopathological findings, benign cystic lesions were the most common disease group (n=77, 33.1%), whereas reactive lymphadenopathy was the most common condition (n=36, 15%) when a single disease was considered. Infectious/inflammatory diseases, malignancies, and benign salivary glands were present in 49 (21%), 24 (10.3%), and 22 (9.4%) patients, respectively. FNAB was performed in 29.8% of the patients with an accuracy of 90.3% (95% CI, 80.1-96.4). Conclusion: The differential diagnosis of head and neck masses during childhood includes a wide spectrum with the different conditions being benign cystic diseases of congenital origin and reactive lymphadenopathies. Owing to its high predictive value, FNAB represents a rapid and reliable method that can be commonly used in both adult and pediatric patients