Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods.

The aim of functional septorhinoplasty is to create an esthetically elegant nose and harmony in the face by preserving nasal function as well as maintaining or restoring adequate airway. Since nasal complaints are usually subjective, it may be difficult to evaluate the functions objectively. In the present study, we aimed to investigate the alterations in nasal function associated with septorhinoplasty by using both objective and subjective methods. The study population consisted of 40 patients who underwent septorhinoplasty and 40 healthy controls. Before and after the operation, visual analog scale, acoustic rhinometry, rhinomanometry, and Odiosoft-Rhino test were applied to all patients and controls. There were significant differences in all parameters both before and after the operation. While a significant difference was obtained between the patient and control groups in terms of preoperative values, no significant difference was found between postoperative values of these groups. Both objective and subjective methods are important in evaluations.

[Congenital cholesteatoma frequently mistaken for temporal bone dermoid cyst: a case report]. / Siklikla temporal kemik dermoid kisti ile karisan dogustan kolesteatom: Bir olgu sunumu.

Dermoid cysts of the middle ear are very rare and can develop behind an intact tympanic membrane, just like congenital cholesteatoma. The visual and clinical symptoms of congenital cholesteatomas and dermoid cysts are difficult to distinguish from each other. Their treatments are similar, however the correct diagnosis can be obtained histopathologically after removing the lesion. In this article a case of a twenty-seven-year-old male patient, whose diagnosis was presumed to be dermoid cyst in the middle ear according to the preoperative radiologic examination but reported to be congenital cholesteatoma as a result of the postoperative histopathologic examination, was reported.

The effects of phototherapy on quality of life in allergic rhinitis cases.

Phototherapy, using a combination of UV-A (25%), UV-B (5%) and visible light (70%), is known to be affective in suppressing the clinical symptoms of allergic rhinitis significantly. It has also been shown that phototherapy locally reduces the number of inflammatory cells and the level of mediators. We aimed to investigate the efficacy of phototherapy in improving the quality of life of patients with allergic rhinitis using Rhinoconjunctivitis Quality of Life Questionnaire, besides checking the total symptom scores of 100 consecutive cases. When the previous and after treatment data were compared, statistically significant differences were found in all quality of life variables (P < 0.001). These results suggest that phototherapy is an effective method to relieve symptoms of allergic rhinitis and has a positive effect on the quality of life of allergic patients. Further studies are needed to plan an ongoing treatment of phototherapy at certain intervals for continuous relief of symptoms and a better and longstanding quality of life.

[A case of maxillary sinus mucocele with orbital involvement]. / Orbital yayilimli maksiller sinüs mukoseli: Olgu sunumu.

Maxillary sinus mucoceles account for less than 10% of all paranasal sinus mucoceles. They are reported mostly as long-term sequelae of Caldwell-Luc operations. Orbital involvement is an extremely rare condition that might result in orbital complications. A 43-year-old woman presented to the ophthalmology department with progressive ophthalmologic complaints. She was referred to our department for suspicion of a mass in the left maxillary sinus. The patient had undergone a left Caldwell-Luc sinus procedure two years before followed by two maxillary sinus lavages. Findings of computed tomography and magnetic resonance imaging of the paranasal sinuses were suggestive of a maxillary mucocele. Endoscopic sinus surgery and Caldwell-Luc procedure were performed to remove the mucocele that filled the maxillary sinus. Because the eyeball prolapsed through the defect in the inferior orbital wall to the maxillary antrum, a Silastic sheath was placed between the orbital base and the eyeball. No postoperative complication was observed.

[The evaluation of voice quality after near-total laryngectomy]. / Near-total larenjektomiden sonra ses kalitesinin degerlendirilmesi.

OBJECTIVES: It was intended to compare various characteristics of phonation obtained in cases who underwent near-total laryngectomy (NTL) and frontolateral laryngectomy (FLL). STUDY DESIGN: The study included 29 male cases, 9 of whom underwent NTL, 10 of whom underwent FLL and 10 who had normal laryngeal speech. All cases were evaluated and compared statistically according to the fundamental frequency (Fo), intensity and voiceless time measurements, maximal phonation time (MPT), speech rate and speech intelligibility. RESULTS: Fo and Fo range were found significantly high in both patient groups, but MPT and speech rate was meaningfully decreased in these groups relative to the control group. There were not any significant differences between the two patient groups. The speech intelligibilities of the NTL group patients were significantly low relative to other two groups. The voiceless time measurements during phonation were significantly high in two patients groups, but we also found that it was not effective on speech rate and intelligibility. CONCLUSION: The phonation gained after NTL is similar to that of FLL in respect of various features. But owing to differences of the speech intelligibility measurements, we concluded that patients who underwent NTL could be exposed to more problems during communication with their social surroundings.

Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer.

OBJECTIVE: The incidence of thyroid gland invasion in patients with advanced laryngeal cancer was reported to be 0-50%. However there is a controversy in necessity and extent of routine thyroidectomy in these patients due to the difficulty in diagnosis of tumor invasion to thyroid gland and the risk of possible postoperative hypothyroidism and hypocalcemia. METHODS: The medical files of 47 patients who underwent thyroidectomy as part of surgical treatment for advanced laryngeal cancer were reviewed. RESULTS: Fourty-four (93.6%) patients underwent hemithyroidectomy, 3 (6.3%) patients underwent total thyroidectomy. Thyroid gland invasion was found in 2 (4.2%) patients. Hypothyroidism occurred in 15 (31.9%) patients, and their hormone levels were regulated with medical treatment during follow-up. Hypocalcemia was not found in any patients. CONCLUSION: We recommend that at least a hemithyroidectomy should be performed in patients with advanced laryngeal cancer, if they have any predictive factor (subglottic extension more than 1cm, invasion of paraglottic space, thyroid cartilage, cricoid cartilage and prelaryngeal tissue detected by radiological examination) for thyroid gland invasion.

Cochlear implantation in cases with incomplete partition type III (X-linked anomaly).

Incomplete partition-type III anomaly (X-linked deformity) is no common finding in a prospective candidate for cochlear implantation. In this paper, the problems about the cochlear implantation in cases with incomplete partition-type III anomaly (X-linked deformity) and profound sensorineural hearing loss is discussed. High-resolution multidedector computed tomography (MDCT) and magnetic resonance imaging were performed preoperatively in all patients. MDCT revealed that there was bulbous dilatation at the lateral ends of internal auditory canals (IAC) in all patients. There were also enlargements of labyrinthine segments of facial and superior vestibular nerve canals. Patients with the basal turns of cochlea incompletely separated from IAC were also presented. Patients with IP-type III (X-linked deformity) and profound SNHL were implanted. Standard transmastoid-facial recess approach was used and cerebrospinal gusher was encountered after the cochleostomy in all cases. Postoperative performance was very good in all patients. Two patients had complications, which are facial nerve stimulation and device failure. Both patients were reimplanted. Cochlear implantation is a good choice in the patients with IP-type III. However, this anomaly may have special potential risk than the other inner ear abnormalities. Therefore, the surgeon should be aware of them and must be ready to inform the patient and parents.

Near total laryngectomy: the problems influencing functions and their solutions.

We investigated the problems affecting functional outcomes of near-total laryngectomy and their solutions. A retrospective analysis about complications (i.e., aspiration, pharyngocutenous fistula, shunt stenosis, etc.) that affect postoperative functions was made by using the medical records of 23 male patients (mean age: 56.6, range: 35 to 72 years) who underwent near total laryngectomy. Maximal phonation times of 17 patients and fundamental frequencies of 10 patients were measured and compared with control groups consisting of sex- and age-matched normal laryngeal speakers. Pharyngocutenous fistula occurred in five cases and closed by secondary wound healing. The incidence of aspiration was 42%. Shunt stenosis wasn't observed in our cases, but loss of phonation occurred because of tumor recurrence at the neoglottal region in the 1st postoperative year of one patient. All patients were able to produce voice, and communicable speech was achieved by 19 (82.6%). Measurements of maximal phonation time indicated a significant decrease in the NTL group. The increase in fundamental frequency values of the near total laryngectomy group was also found significant in relation to the control group. After careful patient selection, extreme effort should be made to create a dynamic shunt and complete mucosal covering of the inner surface of the shunt in near total laryngectomy, thus not only producing voice without aspiration or shunt stenosis, but also providing oncologic safety in the patients with sufficient vital capacity.