Incidentally detected asymptomatic metal foreign bodies (two nails) in shoemaker's maxillary sinus.

The diagnosis metal foreign bodies of maxillary sinus cannot be usually made in an acute setting and patients may present with chronic symptoms due to drainage and chronic irritation of the mucosa years later. Metal foreign bodies can be generally displaced to the maxillary sinus at the time of dental intervention. In this article, we report a very interesting case of 23-year-old male shoemaker with two metal foreign bodies (nails) which were non-related with any surgical intervention or trauma and found incidentally in the right maxillary sinus.

[Evaluation of the duration of postoperative pain control obtained with bupivacaine injection into the tonsillar region in children who underwent tonsillectomy]. / Tonsillektomi yapilan çocuklarda tonsiller bölgeye bupivakain enjeksiyonu ile saglanan ameliyat sonrasi agri kontrolü süresinin degerlendirilmesi.

OBJECTIVES: In this study the effectiveness of postoperative pain control and its probable duration, in the group of pediatric tonsillectomy patients after peroperative application of long acting local anesthetic agent bupivacain to tonsillar fossa is searched. PATIENTS AND METHODS: Our study is a prospective, double-blind, case-control study. A total of 80 children consisting of 50 cases (24 girls, 26 boys; mean age 8.4 ± 2.1 years; range 6 to 12 years) and 30 controls (16 girls, 14 boys; mean age 8.1 ± 1.7 years; range 6 to 12 years) undergoing tonsillectomy were included in this study. Before tonsillectomy 2 ml (0.5 mg/ml) adrenaline-free bupivacain (Marcain, AstraZeneca) injected both of tonsillar fossa in study group, and normal saline injected with the same technique to control group. Face scale is used for pain measurement in both groups. Pain scores were measured at 2, 6, and 24 hours, seventh day and during the first oral intake postoperatively in both groups. RESULTS: We found a significant difference in postoperative second and sixth hours value, when compared control and study groups (p<0.001). No significant difference is found in postoperative 24th hours and first week between study and control group (p>0.001). In our study preincisional bupivacain infiltration makes significant reduction in postoperative pain according to placebo at postoperative second and sixth hours. In both groups at postoperative 24th hours and first week we ascertain significant pain reduction according to postoperative second and sixth hours, but no difference is found between study and control group. CONCLUSION: Intraoperative preincisional bupivacain injection is useful in postoperative pain control at early period of time in children undergoing tonsillectomy. But it has no effect in pain reduction after 24 hours.

Arco-palato-uvular flap: a new surgical technique for the treatment of palatal snoring in tonsillectomized patients.

OBJECTIVES: We describe a new surgical technique called "arco-palato-uvular flap (APUF)" which can be used for the surgical management of palatal snoring in previously tonsillectomized patients. PATIENTS AND METHODS: Among patients who were admitted to the Military Hospital of Novi Sad between January 2000 and December 2004, 36 patients (19 males, 17 females; mean age 45.3 years; range 21 to 60 years) who had previously undergone tonsillectomy for various reasons and who were thought to have palatal snoring based on physical and endoscopic examinations were evaluated on the basis of the visual analog scale (VAS), Epworth sleepiness scale (EPSS) and apnea hypopnea index (AHI) scores and underwent APUF surgery after giving informed consent. RESULTS: Twenty-seven patients with a body mass index (BMI) of <30 kg/m2 had socially-bothersome snoring and nine had mild sleep apnea (AHI 5-15/hour, SO2 >90%). The mean visual analog scale scores were 8.6 ± 1.0 preoperatively and 2.3 ± 1.5 postoperatively. The Epworth Sleepiness Scale scores averaged 10.0 ± 3.0 preoperatively and 4.0 ± 1.0 postoperatively. In patients with mild apnea, the average preoperative AHI was 11.58 ± 3.58 and dropped to 4.75 ± 2.92 postoperatively. Statistical analysis revealed significant reductions in all variables (p<0.001). CONCLUSION: The APUF procedure may treat palatal snoring and mild obstructive sleep apnea in previously tonsillectomized patients by widening the oropharyngeal airway, and stabilizing the uvulopalatal segment. Further studies are needed to determine the long-term success rates of the technique and to modify the patient selection and exclusion criteria.

The effect of tumor width and depth on extracapsular lymp node metastases in tongue tumors.

OBJECTIVES: In this study, we investigate the relationship between the effects of tumor width and depth with the extracapsular nodal spread (ECS) in oral tumors. PATIENTS AND METHODS: In this study we investigate retrospectively data of 107 patients (69 males, 38 females; mean age 45 years; range 25 to 79 years) with tongue tumors, who had undergone surgery in our clinic, between 1994 and 2004. Twenty-one of them had ECS. The effects of tumor width and depth on various parameters such as nodal metastases, survival, grade and ECS are investigated. RESULTS: It was found that tumor width and depth were the most important factors that affect ECS and logistic regression analysis point out tumor width influence more than tumor depth. Receiver operating characteristic (ROC) curve analysis shows us when tumor width exceeds 3.7 cm or tumor depth exceeds 2.4 cm, rate of ECS reaches the maximum sensitivity and specificity. CONCLUSION: Tumor width and depth has affects on survival and prognosis but also they have significant relation with ECS.

Modified sling snoreplasty: double triangle shaped suture uvulopalatopexy.

Following the uvulopalatopharyngoplasty and laser assisted uvulopalatoplasty as treatments for mild obstructive sleep apnea syndrome (OSAS) originating from the soft palate, palatal stiffening operations began to be described as causing less morbidity, interfering less with velopharyngeal and mucosal functions, and being applicable in outpatient settings. We present modified uvulopalatopexy procedure which can be used in mild OSAS patients is a simple, minimally invasive and effective new method. In this article, we present a modified form of sling snoreplasty method and two cases in whom this method was used.

Can the Müller maneuver detect multilevel obstruction of the upper airway in patients with obstructive sleep apnea syndrome?

OBJECTIVES: Our aim is to figure out the role of Müller maneuver (MM) to detect the level of upper airway obstruction and the severity of obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHODS: In this study, polysomnographies were made after the routine otorhinolaryngological examination including MM in patients admitted with OSAS suspicion in Ankara Oncology Training and Research Hospital's Department of Otorhinolaryngology, Sleep Medicine Policlinic. Two-hundred and twenty-one OSAS patients (142 males, 179 females; mean age 47.63 years; range 18 to 82 years) were included to the study. RESULTS: There weren't any significant correlation among apnea hypopnea index (AHI) results and body mass index (BMI), tonsil size and obstruction severity due to MM (p>0.05). Müller maneuver scores are positively correlated to the Epworth sleepiness scale (EPSS) scores (r=0.213 and p<0.001). Epworth sleepiness scale scores are found to be correlated to BMI and neck circumference (p<0.05). Level of the airway obstruction doesn't affects the EPSS scores (p=0.235). Also EPSS scores are not affected from uni or multilevel obstruction (p=0.088). CONCLUSION: The severity of the MM score is not correlated to the severity of OSAS according to AHI results, but it is found to be correlated to EPSS. Vibrating tissues caused local and systemic inflammation in OSAS patients. The correlation between EPSS and MM scores can be explained by this inflammatory process. Further prospective studies have to be done in this field. Müller maneuver in an awake patient might reflect the levels of the obstruction in sleep conditions even though insufficient for figuring out the severity of OSAS.

Preventing cisplatin induced ototoxicity by N-acetylcysteine and salicylate.

OBJECTIVES: In this study we investigated if CP induced ototoxicity could be prevented or reduced by the use of salicylate and N-acetylcysteine. PATIENTS AND METHODS: Fifty-four patients (28 females, 26 males; mean age 37+/-9.5 years; range 29 to 71 years) who had cisplatin chemotherapy due to solid organ tumors were enrolled in the study. The patients were randomized into three groups, with 18 patients in each group. The first group (control group) received cisplatin, second group received N-acetylcysteine (NAC; 600 mg/day) with cisplatin and the third group received salicylate (300 mg/day) with cisplatin. All patients evaluated audiologically including high frequency audiometry and auditory brainstem response. RESULTS: The cisplatin-induced ototoxic damage could be reduced in 10,000 and 12,000 Hz frequencies when N-acetylcysteine was added to the cisplatin therapy protocol. There was no decrease in the hearing loss levels of the patients who were receiving cisplatin with salicylate. CONCLUSION: According to auditory brainstem response testing results, there was no difference detected between N-acetylcysteine or salicylate for the amelioration of cisplatin induced ototoxicity.

[Management of recurrent lower lip carcinomas]. / Nüks alt dudak kanserlerine yaklasim.

OBJECTIVES: In this study patients who had locoregional recurrence of lower lip carcinomas after therapies such as surgery, electrocoagulation, cryotherapy or traditional local therapies are discussed. PATIENTS AND METHODS: The records of 16 cases (1 female, 15 males; mean age 58 years; range 30 to 83 years) with recurrent lower lip carcinoma admitted between March 2002 and September 2007 to Dr. Abdurrahman Yurtarslan Oncology Training and Research Hospital, Ear, Nose and Throat Department were retrospectively reviewed. RESULTS: Fourteen patients had been treated in other institutions, while two had been treated in our center. Four of the patients had recurrence in the lip, four patients had recurrence only in the neck, and the remaining eight patients had both lip and neck recurrence. Ten patients received modified radical or radical neck dissection because of their palpable lymphadenopathies, three patients received supraomohyoid neck dissection due to non palpable lymphadenopathies, and the remaining three patients did not have neck dissection because of co-morbid diseases. Seven patients (43%) died in the first postoperative year because of lower lip carcinomas and three patients died because of other reasons. Six patients survived for the first two years without any evidence of disease. CONCLUSION: Patient survival will be affected by the applied treatment. For patients with primary lower lip cancers, otolaryngologists experienced in oncology must plan surgery rather than local treatments. In case of locoregional recurrence, immediate treatment should be planned.

Measurement of tympanic cavity volume by the Cavalieri principle in Turkish population.

OBJECTIVES: The aim of this study is to measure the tympanic cavity (TC) volumes with Cavalieri principle using computed tomography (CT) scanning of temporal bones, to investigate the difference between the right and the left ears with respect to sexes and to exemplify the TC volume measurements. PATIENTS AND METHODS: Clinical records of 91 patients (46 females 45 males; mean age 48.1 years; range 15 to 60 years) whose TCs were measured at ear nose throat clinic of Ankara Oncology Education and Research Hospital between January 2007 and March 2008, were retrospectively investigated. The CT scans which were obtained from two sides with a slice thickness of 1 mm were evaluated. Measurements of TC volumes were made with using the Cavalieri method. RESULTS: The mean TC volume in male subjects was 0.4721+/-0.0406 cm(3) on the left ears and 0.4883+/-0.0352 cm(3) on the right ears. In females the mean cavity volume was 0.4943+/-0.0501 cm(3) on the left ears and 0.4881+/-0.0485 cm(3) on the right ears. CONCLUSION: There was no statistically difference in between of the both sexes for the TC volume measurements and between both sites of the same individuals.

[The health problems which can brougth by 3G cell phones to our country]. / 3G cep telefonlarinin saglik açisindan ülkemize getirebilecegi sorunlar.

At present, we are being exposed to electromagnetic pollution which is steadily increasing parallel to the technological advancements and which is invisible and unnoticeable in the short run. Electromagnetic waves which were previously used for therapeutic reasons have recently been uncontrollably used in daily life. By widespread use of 3rd generation (3G) cellular phones, the electromagnetic pollution has multiplied and brought us a huge amount of health dangers in our country. In this article, electromagnetic pollution, which is a comprehensive topic, and problems related with this kind of pollution which is rapidly increasing due to recent wide use of 3G cell phones are summarized in the light of the literature.

[The incidence of group A beta haemolytic streptococci in upper respiratory tract infections in Erzurum]. / Erzurum'da üst solunum yolu enfeksiyonlarinda A grubu beta hemolitik streptokok insidansi.

OBJECTIVES: The incidence of group A beta hemolytic streptococci (GABHS) in upper respiratory tract infections in Erzurum was investigated. PATIENTS AND METHODS: In this descriptive study throat swabs were obtained from 4112 patients (1989 males, 2123 females; mean age 21+/-1.5 years; range 14 to 46 years) with upper respiratory tract infections in Erzurum, Turkey between January 2006 and December 2006 and they were cultured for isolation of GABHS. RESULTS: In this study GABHS were isolated in 268 (6.51%) of patients. Group A beta hemolytic streptococci were isolated in 51 of 941 patients (5.42%) in the spring, in 23 of 592 patients (3.88%) in the summer, in 69 of 968 patients (7.13%) in the autumn, and in 125 of 1611 patients in the winter. Of those patients in whom GABHS were isolated, 128 (6.43%) were male and 140 (6.59%) were female. At Chi square test, (Range for alpha value, p=0.01 and p=0.05) there was a significant difference in the frequency of infection between the seasons (p<0.01). There was no significant difference between men and women with respect to carrier rate (p>0.05). CONCLUSION: The incidence of GABHS detected in Erzurum was lower than that in other countries. There were statistically significant differences in frequency between the seasons (p<0.01). The highest incidence was in the winter. Low incidence of GABHS in this region may be due to prevention of the colonization because of geographic features, nutritional habits and other factors.

Effects of nasal pathologies on obstructive sleep apnea.

Increased airway resistance can induce snoring and sleep apnea, and nasal obstruction is a common problem in snoring and obstructive sleep apnea (OSA) patients. Many snoring and OSA patients breathe via the mouth during sleep. Mouth breathing may contribute to increased collapsibility of the upper airways due to decreased contractile efficiency of the upper airway muscles as a result of mouth opening. Increased nasal airway resistance produces turbulent flow in the nasal cavity, induces oral breathing, promotes oscillation of the pharyngeal airway and can cause snoring.

The incidence of group a beta hemolytic streptococci in throat specimens from upper respiratory infections.

OBJECTIVE: The aim of the study is researching the incidence of group A beta hemolytic streptococci (GABHS) in upper respiratory tract infections in Turkey. STUDY DESIGN: This is a descriptive study. SUBJECT AND METHODS: Totally, 3964 throat swabs obtained from patients with upper respiratory tract infections were cultured for isolation of GABHS in Corlu Military Hospital, Department of Microbiology, between April 2002 and April 2004. Standard microbiological techniques were used in the screening. RESULTS: In this study, GABHS were isolated from 230 (5.80%) of 3964 patients. The rate of isolation was 79 (5.65%)/914 in 2002 year, 103 (5.55%)/1857 in 2003 year, and 48 (6.77%)/709 in 2004 year. The rate of isolation was 50 (5.47%)/914 in the spring, 21 (3.21%)/642 in the summer, 49 (5.81%)/844 in the autumn, and 110 (7.03%)/1564 in the winter. CONCLUSION: We found that the overall incidence of GABHS in respiratory tract infections (5.80%) was lower than other studies and the incidence was the highest in the winter.

Abrikossoff tumor of the larynx.

Case report about laryngeal localization of a granular cell tumor in a 38 years old female without recurrence over an observation period of two years.

[Scientific stealing (Plagiarism) in medical journals]. / Tip dergilerinde bilimsel çalma (Plagiarizm).

The obligation to publish academic papers in order to get academic rank has made medical doctors more ambitious to publish faster and more papers. According to the ethical and legal rules in our country and in the world, if an idea or technical methods of another person is used in a medical journal, the owner of the method or idea and its publication has to be cited. If an idea, information or a technical method of another scientist is published without citation as if it was one's own idea it's called "Plagiarism". Despite the prohibitive laws and rules, this scientific stealing has become an increasing problem for medical journals worldwide.

Salivary gland choristoma of the middle ear.

Choristoma is a mass of tissue histologically normal for an organ or part of the body other than the site at which it is located. A rare case of ectopic salivary gland choristoma in the middle ear is described in a 14-year-old girl whose only symptom was a 55 dB conductive hearing loss. The left middle ear mass appeared whitish and was located behind the intact tympanic membrane. We first suspected it to be congenital middle ear cholesteatoma. Exploratory tympanotomy, however, revealed a salivary gland choristoma that adhered tightly to the facial nerve. Differential diagnosis and treatment of this rare condition are discussed.

Upper respiratory tract involvement of sarcoidosis in the Turkish population.

PRINCIPLES AND METHODS: Upper respiratory tract (URT) involvement is rare in sarcoidosis. In this descriptive study, we retrospectively evaluated the clinical and demographic features of 12 (2.19%) patients with URT involvement out of the 546 sarcoidosis patients with follow-up visits at our center within the last 40-year period. RESULTS: Out of the 546 patients, 12 (2.19%) had upper respiratory tract involvement, 5 (0.91%) had laryngeal involvement, 4 (0.73%) had sinonasal tract involvement, 2 (0.36) patients had salivary gland involvement, and 1 patient had tonsillary involvement. The number of stage 0 subjects among other sarcoidosis patients was significantly lower than that among those with URT involvement. CONCLUSIONS: URT involvement is rarely diagnosed in patients with systemic sarcoidosis. The most common site for URT involvement among the Turkish population is the larynx, followed by the sinonasal tract. EBM RATING: C-4.

[Long-term results of intracordal or neocordal autologous fat injection in patients with unilateral vocal cord paralysis and cordectomy]. / Tek tarafli vokal kord paralizili ve kordektomili olgularda intrakordal veya neokordal otolog yag enjeksiyonunun uzun dönem sonuçlari

OBJECTIVES: We investigated the long-term results of autologous fat injections for unilateral vocal cord paralysis and laryngofissure and cordectomy defects. PATIENTS AND METHODS: We evaluated the efficacy of autologous fat injections in 21 patients (16 males, 5 females; mean age 57 years; range 24 to 72 years) with unilateral vocal cord paralysis (n=11) and cordectomy defects (n=10) in the light of computed acoustic analysis, phonatory functions, and videolaryngostroboscopic findings and the effect of injections on swallowing. The mean follow-up was 14 months (range 10 to 22 months). RESULTS: Voice quality improved in 14 patients. Glottic insufficiency recurred in three patients in the early period, and in two patients in the late period. Phonatory functions showed significant improvement in all parameters except for jitter and functional interference (p<0.05). Videolaryngostroboscopy showed significant improvement in glottic closure, but mucosal waves remained unchanged. Of 18 patients with swallowing disorders, aspiration symptoms improved in 15 patients. Patients with unilateral vocal cord paralysis had better results compared to those with cordectomy defects. CONCLUSION: Autologous fat injections may be considered effective in patients with cordectomy defects or unilateral vocal cord paralysis.