Bilateral sudden sensorineural hearing loss caused by leptomeningeal carcinomatosis: case report and review.

Leptomeningeal carcinomatosis is a rare condition characterized by diffuse infiltration of the meninges after the metastasis of the solid tumors. Bilateral sudden hearing loss is a rare initial symptom. In this article, we report a 44-year-old male patient with bilateral sudden hearing loss and dizziness. Magnetic resonance imaging showed involvement of the bilateral vestibulocochlear nerves. Malignant cells were detected in cerebrospinal fluid cytology. To the best of our knowledge, leptomeningeal carcinomatosis due to duodenum adenocarcinoma has not been reported before in the English literature. Leptomeningeal carcinomatosis should be kept in mind in patients who have bilateral sudden sensorineural hearing loss.

[Conjugate pneumococcal vaccines and influence on the ear, nose and throat area]. / Konjuge pnömokok asilari ve kulak burun bogaz alanindaki etkileri.

The importance of anti-pneumococcal vaccines has increased due to the gradually increasing incidence rate of pneumococcal infections and their antibiotic resistance. Conjugate pneumococcal vaccine began to be used routinely in the USA in 2000. An important property of this conjugate vaccine is the ability to create immunity in infants after two months. Thus, conjugate vaccines allow us to protect children below the age of two years against to invasive and mortal pneumococcal infections. The first pneumococcal conjugate vaccine (PCV7) contains the seven most common pneumococcal serotypes in the USA. Pneumococci are also the most important bacterial agents in acute otitis media (AOM) and recurrent acute otitis media. Acute otitis media is the most common infectious disease in childhood and resistance to treatment has rapidly increased over the last decade. The incidence of AOM and applications of tympanostomy tubes saw statistically significant decreases in the USA after implementation of PCV7 in national immunization programs. PCV7 was implemented in the national immunization program in Turkey in 2008. For this reason, reductions in the incidence of upper respiratory tract infectious diseases and especially AOM should be expected in our country.

Management of lateral sinus thrombosis in chronic otitis media.

OBJECTIVE: To present our experience with the diagnosis and treatment of lateral sinus thrombosis (LST) secondary to otogenic disease. PATIENTS AND METHODS: We have retrospectively reviewed all the cases of LST caused by chronic otitis media in ten years. RESULTS: In our series of five patients, four patients were successfully treated by surgery without opening the sigmoid sinus. On the other hand, one of our patients developed hydrocephalus and ataxia during preoperative antibiotic treatment. CONCLUSION: Most patients with thrombotic/nonabscessed sinuses will have successful outcomes with this approach, but careful observation is needed, given the possibility of advancing disease.

[A review of undergraduate ENT training programs in the light of the Core Education Program]. / Cekirdek Egitim Programi isiginda mezuniyet öncesi KBB egitiminin gözden geçirilmesi.

OBJECTIVES: The aim of this report was to evaluate the Core Education Program (CEP) and to contribute to the establishment of some national standards for undergraduate ENT training programs in medical schools. STUDY DESIGN: The documents of the national CEP for medical schools were reviewed. The lists under the titles of "Diseases-Condition-Symptoms," "Skills," and "Attitude and Behavior" were evaluated from the standpoint of ENT training. RESULTS: Of 396 items listed under the domain of "Disease-Condition-Symptoms," 25 items were found to be related to ENT training. The essential skills to be achieved concerning ENT were ear, nose, throat, and neck examinations, ear lavage, nasal packing, and the Heimlich maneuver. Skills such as tuning fork tests, paracentesis, and measurement of noise were regarded as optional. CONCLUSION: The aim of the CEP is to determine the necessary level of knowledge and skills for a general practitioner. It should be adopted by all disciplines of medical schools and incorporated into education programs. The ENT society, Association, and study groups of education should collect feedback from ENT departments and convey all this to the CEP Study Group, which convenes every four years to re-evaluate the CEP in the light of the feedback received and recent developments in medical sciences.

Parotid gland tumours in Turkish population: analysis of 165 patients.

BACKGROUND: Retrospective data on 165 patients who presented with a parotid mass and underwent surgery in our clinics during 2000-2009 were examined. The obtained data (demographic data, surgical procedures, histopathological diagnoses) were compared to similar studies to make contributions to the literature. MATERIALS AND METHODS: Patients were classified according to their histopathological diagnosis. Surgical procedures and patient follow-up were clarified. The results are presented as means and standard deviations. RESULTS: Of the 165 masses, 134 (81.3%) were benign and 31 (18.7%) were malignant. Pleomorphic adenoma was the most common benign tumour (79 patients, 59%). Lymphoma and adenoid cystic carcinoma were equally common and were the most common malignant parotid gland tumours (both 6 patients, 19.3%). The most frequent surgical procedure was superficial parotidectomy (92 patients, 55.7%), and the most commonly encountered surgical complication was facial paralysis (12 patients, 7.2%). CONCLUSIONS: Our data are generally in line with the literature but lymphoma was more common than in most previous reports. Although the number of cases was low, the high incidence of parotid gland lymphoma was remarkable.

Isolated necrotizing epiglottitis: report of a case in a neutropenic patient and review of the literature.

Isolated necrotizing epiglottitis (INE) is an unusual condition that may develop in immunocompromised patients. Only 3 cases of INE have been reported in the English-language literature; this is the fourth case, one in a 27-year-old woman who had neutropenia due to cytomegalovirus infection. Stenotrophomonas maltophilia and Candida albicans were isolated from the culture of necrotic material. The features of INE are discussed here by reviewing the literature and by examining the characteristics of this case.

Use of polyethylene terephthalate and expanded-polytetrafluoroethylene in medialization laryngoplasty.

Various materials have been used up to the present time in vocal fold augmentation. Although silicon has been the most frequently employed, the surgical difficulties encountered in shaping, positioning and placing this material have led to a search for a more easily applicable material. In our study, we investigated the local tissue reaction to implants in the laryngeal skeleton of 10 New Zealand rabbits in which we performed medialization laryngoplasty employing polyethylene terephthalate (PETP=Dacron) and expanded polytetrafluoroethylene (e-PTFE=Gore-Tex). When the local host tissue reaction to PETP and e-PTFE were compared, PETP was found to cause significant foreign body giant cell and histiocyte infiltration localized around fibres of the implant. The greater irregularity of the fibrous capsule formed in response to PETP and the density of foreign body giant cells around the PETP fibres suggested that resorption of the implant with time would decrease the degree of medialization.

A case of congenital bilateral stapes agenesis.

Congenital absence of the stapes and the oval window is an anomaly reported in only sporadic cases. We present a 17-year-old male patient with congenital bilateral conductive hearing loss. The external auditory canal and the tympanic membrane appeared normal on both sides. An exploratory tympanotomy in the right ear revealed dehiscence of the the horizontal segment of the facial nerve, which was displaced inferiorly, occupying the area of the absent oval window. The stapes was totally absent and a malformed long process of the incus was attached by a fibrous band to the promontory. Manipulation of the facial nerve in association with stapedectomy or vestibulotomy was avoided in order not to injure the nerve. Instead, amplification with hearing aids was recommended to the patient.

The relationship between chronic otitis media with effusion and surface and deep flora of hypertrophic adenoids.

OBJECTIVE: The relationship between bacterial flora of the adenoids and middle ear problems is unclear. In this study, superficial and deep aerobic and anaerobic bacterial flora of adenoid tissues were compared in children with and without chronic otitis media with effusion (cOME). PATIENTS AND METHODS: Between 2004 and 2007, family members of children (ages 1-14 years) who were scheduled to undergo adenoidectomy were approached for participation in the study. Of the 180 patients who gave consent, 107 (59%) did not have cOME (Group I), whereas 73 (41%) had had a tympanostomy tube previously due to cOME (Group II). Prior to adenoidectomy, swabs were taken from the surface of the adenoids, and samples of deep tissue for culture were obtained from curetted tissue. All samples were cultured aerobically and anaerobically. Growth of 10 of the bacteria most commonly cultured were evaluated: 5 classified as normal flora (coagulase-negative staphylococci, α-hemolytic streptococci, Neisseria spp., Prevotella spp. ve Peptostreptococci) and 5 potential pathogens (S. aureus, S. pyogenes, S. pneumoniae, H. influenzae ve Moraxella spp.). RESULTS: Isolation rates of potential pathogens including S. pneumoniae,H. influenzae and Moraxella spp. from surface and deep cultures of adenoids were between 5 and 15% (no significant differences between those with and without cOME). While S. aureus was the most frequently isolated bacteria (26%) in children with cOME (Group II), the incidence of S. pyogenes as a potential pathogen was only 1% (p<0.05) in Group II and the anaerobic Prevotella spp. were significantly less common (p<0.05) in children with cOME (Group II). CONCLUSION: Potential pathogens of middle ear colonized in adenoid tissue may not be significant factor for the etiopathogenesis of cOME. Bacterial interference mechanisms may play an important role in pathogenesis of cOME because of Prevotella spp. showed statistically significant decrease children with cOME.