The Current Management at Diagnosis and Treatment of Allergic Rhinitis

Allergic rhinitis is a common disease with a remarkable social impact. The semptoms of allerjic rhinitis include itching, nasal discharge and sneezing. Similar to lethargy, fatigue, somnolence, decreased cognition, difficulty in concentration and decreased sleep and appetite is commonly seen besides physical symptoms. The treatment of allergic rhinitis consists of allergen avoidance, pharmacotherapy and immunotherapy. [Archives Medical Review Journal 2009; 18(3.000): 156-170

Nasal Glioma: Case report

Nasal gliomas are rare, benign, congenital tumors that are thought to be result of abnormality in embryonic development. Three types of clinical presentations have been recognized; extranasal, intranasal and combined. Clinically, these masses are non-pulsatile, gray or purple lesions that obstruct the nasal cavity and cause deformity extranasaly. Histologically, they are made up of astrocytic cells, fibrous and vascular connective tissue that is covered with nasal respiratory mucosa. Treatment of the nasal glioma requires a multidisciplinary approach including an radiologist, neurosurgeon and otorhinolaryngologist. Radiological investigation should be performed to describe intracranial extension. In this case, a 2 years old boy with nasal mass that was diagnosed as nasal glioma is reported. . [Cukurova Med J 2011; 36(1): 34-36

Otitis media with effusion:diagnosis and treatment

Otitis media with effusion (serous otitis media) is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Serous otitis media is the most common cause of hearing loss in children in the developed world. Hearing loss may be affected speech, cognitive, and psychological development of the childeren. In addition, otitis media with effusion is not only seen in children, this sign may present with signs of nasopharyngeal diseases. For this reason, especially in childhood otitis media with effusion should be treated by early diagnosis. [Archives Medical Review Journal 2013; 22(2.000): 194-208

Effects of Selective Seratonine Re-Uptake Inhibitors on Meniere's Disease

WOS: 000408247500026PubMed ID: 28639557OBJECTIVE: To evaluate the effects of selective serotonin re-uptake inhibitors (SSRIs) on Meniere's disease (MD) on patients who have both MD and generalized anxiety disorder. MATERIALS and METHODS: All patients were evaluated with neurotologic examination, videonystagmography, audiological tests, and inner ear magnetic resonance imaging. Characteristic history and the evaluation of the patients' vertigo attacks during the attacks were the primary criteria for the diagnosis of MD. According to these parameters, 12 patients were diagnosed with definite MD and also symptoms of generalized anxiety disorder. Escitalopram 10 mg was prescribed to the patients. The clinical records of these patients were reviewed. RESULTS: Eight female and 4 male patients with MD and generalized anxiety disorder were included. The average age was found to be 46.25 years (34-63 years). Magnetic resonance imaging of patients was reported as normal. All patients had unilateral MD. The patients were diagnosed with MD for 2-12 years (mean: 5 years). All patients used betahistine and diuretics before escitalopram. Intratympanic gentamicin was also applied to one patient. After escitalopram medication, no vertigo attack was observed in any of the patients. CONCLUSION: SSRIs may have a central balancing effect on vertigo attacks of MD. Escitalopram can control vertigo attacks in MD. Further studies are needed to support this effect

Carbon Dioxide Laser Endoscopic Posterior Cordotomy Technique for Bilateral Abductor Vocal Cord Paralysis A 15-Year Experience

WOS: 000320855300012PubMed ID: 23519722Importance: Treatment of bilateral vocal cord paralysis is a considerable challenge for otolaryngologists. Many surgical techniques have been developed for the management of this entity to eliminate the need for tracheotomy. Objective: To evaluate the success of the unilateral carbon dioxide laser endoscopic posterior cordotomy technique for bilateral abductor vocal cord paralysis. Design: A retrospective study. Setting: A university department of otolaryngology-head and neck surgery. Participants: Sixty-six patients (58 women and 8 men) diagnosed as having bilateral abductor vocal cord paralysis. Intervention: Endoscopic posterior cordotomy with the carbon dioxide laser. Main Outcome Measures: Decannulation and postoperative voice quality and exercise tolerance. Results: The most common etiologic factor was recurrent laryngeal nerve paralysis after thyroidectomy, observed in 61 patients (92%); an unknown cause was observed in 5 (8%). Unilateral cordotomy sufficed in 58 patients (88%). We performed revision procedures for vocal cord granuloma in 4 patients (6%). Bilateral cordotomy was required for 4 patients (6%) with an insufficient airway. Postoperative tracheotomy was needed for only 4 patients owing to the edema in the operation site. These patients underwent decannulation within a mean period of 7 days. No patient had poor postoperative exercise tolerance. We found no statistically significant difference between the preoperative and postoperative voice quality using the 10-item Turkish version of the Voice Handicap Index. Conclusions and Relevance: Carbon dioxide laser endoscopic posterior cordotomy is a safe, minimally invasive, effective technique with a short operation time. A bilateral approach or a revision procedure is rarely required. Bilateral cordotomy should be reserved for patients with insufficient airway passage with unilateral cordotomy

Solitary Cystic Metastasis Of Thyroid Papillary Carcinoma: Two Cases Reports

The appearance of a solitary lateral cervical cystic mass as the only initial presenting symptom of occult thyroid carcinoma is uncommon. Its presence is often related with the more frequently branchial cyst in young adults, but also rarely related with thyroid carcinomas. In most of these cases all such lesions may initially be considered as metastatic foci from a primary thyroid lesion. However, an alternative explanation by means of which ectopic thyroid tissue is associated with a branchial cyst has to be considered, especially if no primary tumour is observed in the histological examination of the thyroid gland. We present two case of solitary cystic lymph node metastasis of occult papillary carcinoma of the thyroid. [Cukurova Med J 2011; 36(1.000): 29-33

Amyloidosis and difficult airway: a case report

Amyloidosis is a disease which can affect any tissue in the body with extracellular deposition of low molecular weight protein fibrils. Amyloid deposition can appear in many organs and tissues. Amyloidosis of tongue occurs most commonly in systemic form as rubbery macroglossia due to extra-deposition of amyloid within the suprahyoid muscle. Anesthesiologist can experience the negative consequences of amyloidosis in many conditions. Difficult airway due to amyloid deposition in tongue is an unexpected condition. We aimed to report a case that had respiratory distress with extremely big tongue due to amyloidosis. We performed a fiberoptic intubation for emergent tracheostomy without any complication [Cukurova Med J 2016; 41(4.000): 804-807

The Effectiveness of Botulinum Toxin Type A Injections in the Management of Sialorrhea

WOS: 000443089700011PubMed ID: 30197810Objective: The aim of this study was to evaluate the effect of Botulinum toxin type A by injecting in the submandibular and parotid glands on the frequency and severity of sialorrhea. Methods: Pediatric patients who were referred to our department with sialorrhea were evaluated using their parents' frequency and severity scores of sialorrhea with visual analog scales before and after 3 months of botulinum toxin type A injections. Bilateral submandibular and parotid glands were injected with Botulinum toxin type A. Results: Twenty-seven pediatric patients who were referred to our department with a complaint of sialorrhea were included in this study. Seventeen patients were female and 10 were male. Severe sialorrhea with cerebral palsy was present in all the patients. There were no complications after the procedure. Conclusion: Botulinum toxin A injected in the major salivary glands in pediatric patients with neurological disorders is a safe and effective method

A Rare Cause Of Unilateral Chronic Nasal Obstruction: Fibrous Dysplasia of The Middle Turbinate

Fibrous dysplasia is a nonneoplastic fibro-osseous lesion characterized by fibroblastic proliferation and progressive replacement of normal bone with fibrotic tissue and disorganised bony trabeculae.Fibrous dysplasia infrequently occurs in the sinonasal tract. Location in the middle turbinate is extremely rare. It is usually asymptomatic but, in the advanced stage, nasal obstruction due to extension of disease and pain due to neural compression, or pathological fractures may occur. It is usually secondary to extension of disease from adjacent bones. In this case report we presented a 54 year old woman with unilateral chronic nasal obstruction [Cukurova Med J 2015; 40(Suppl 1): 106-111

Comparison of the Effects of Intravenous and Peritonsillar Dexamethasone Plus Levopubivacaine in Children

Purpose: We aimed to investigate the effects of intravenous and peritonsillar dexamethasone plus levopubivacaine on postoperative pain, bleeding, nausea and vomiting in children undergoing tonsillectomy or adenotonsillectomy. Methods: After obtaining the approval of Ethics Committee of Cukurova University Medical Faculty Hospital and the patients were given informed consent, 60 patients of ASA (American Society of Anesthesiologist) class I- II between ages 3-12 which were planned to be undergone elective tonsillectomy or adenotonsillectomy were included. All patients were randomised and divided into 3 groups. After anesthesia induction, Group I (n=20) patients received 0.4 mg/kg %0.5 levobupivacaine for each tonsil at the dose of max. 4 ml with peritonsillar infiltration after before tonsillectomy. While Group II (n=20) and Group III (n=20) received levobupivacaine via the same route, Group II received i.v. (intravenous) dexamethasone 0.25 mg/kg and Group III 4 mg dexamethasone with peritonsillar infiltration additionally. All groups were administrated 1mg/kg tramadol iv as postoperative analgesic. Hemodynamic parameters were recorded after drug injections. Frequency of nausea and vomiting and analgesic requirements determined with Visual Analog Scale (VAS) and CHEOPS (Children’s Hospital of Eastern Ontario Pain Scale) at first, 10th, 20th, 30th, 45th minutes and first, 2nd, 4th, 6th and 24th hours were recorded. Postoperative bleeding were recorded at early and late periods. Results: The hemodynamic parameters and demographic data of groups were similar. The insidance of nausea and vomiting was statistically higher in Group I compared to Group II and III. First analgesic administered time was 3.15±0.88 in Group I, 4.85±1.09 in Group II and 5±1.21 in Group III and the difference was found significant. At postoperative period, VAS and CHEOPS scores were lower in group II than the other groups. Bleeding or other complications did not recorded. Conclusion: In concluded that, intravenous and peritonsillary dexamethasone prolonged the first analgesic administered time and decreased pain, nausea and vomiting compared to peritonsillar levobupivacaine alone in children undergoing tonsillectomy or adenotonsillectomy. However, dexamethasone did not increase postoperative bleeding after tonsillectomy. [Cukurova Med J 2012; 37(4.000): 203-210