Adult tonsillectomy: relationship between indications and postoperative hemorrhage.

OBJECTIVES: In this study, we aimed to determine the possible relationship between the indications for tonsillectomy in adult population and to estimate the incidence of postoperative hemorrhage. PATIENTS AND METHODS: Medical records of 200 adult patients who underwent tonsillectomy between January 2003 and October 2008 were retrospectively analyzed. RESULTS: The indications for adult tonsillectomy were chronic infection in 153 patients (76.5%); upper airway obstruction secondary to tonsillar hypertrophy in 37 patients (18.5%) and suspected neoplasms in 10 patients (5%). Sixteen patients (8%) had postoperative hemorrhage. Fourteen patients of 153 patients (9.2%) who underwent surgery with the indication of chronic infection and two of 37 patients (5.4%) who underwent surgery with the indication of upper airway obstruction secondary to tonsillar hypertrophy had also postoperative hemorrhage. None of the 10 patients who operated with the indication of suspected neoplasm had postoperative hemorrhage. Although the incidence of postoperative hemorrhage according to the indications of adult tonsillectomy in descending order was chronic infection (9.2%), upper airway obstruction secondary to tonsillar hypertrophy (5.4%) and suspected neoplasms (0%), it was found that the incidence of postoperative hemorrhage was not statistically significantly related to the indications for tonsillectomy. CONCLUSION: The incidence of postoperative hemorrhage was not statistically significantly related to the indications for tonsillectomy. In addition, we believe that surgery is a more common cause of postoperative hemorrhage rather than chronic infections.

A comparison of incidence of Frey's syndrome diagnosed based on clinical signs and Minor's test after parotis surgery.

OBJECTIVES: This study aims to investigate whether postoperative follow-up period, clinical signs or Minor test is effective to determine the incidence of Frey's syndrome following superficial parotidectomy. PATIENTS AND METHODS: Between January 2005 and December 2008, 30 patients, (16 males, 14 females; mean age 47.7±15.3 years, range 17 to 76 years) who underwent superficial parotidectomy in the Ear, Nose, Throat Clinic, were retrospectively analyzed. All patients were administered a questionnaire on clinical signs of Frey's syndrome and disease period, and Minor's test. RESULTS: The postoperative pathological examination showed pleomorphic adenoma, Whartin's tumor, basal cell adenoma and oncocytoma. The Minor's test result was positive in 50% of the patients. While 10% of the patients complained about excessive sweating requiring no treatment, none of them complained about the bad body odor. The disease was considered moderate based on the severity of the disease in all patients. CONCLUSION: The incidence of Frey's syndrome may vary according to the postoperative follow-up period and the diagnostic method applied, including assessment of clinical signs and Minor's test.

Clinical evaluation of inner ear changes as result of chronic otitis media and its surgery.

OBJECTIVES: This study aims to evaluate whether chronic otitis media (COM) may cause inner ear damages or middle ear surgery may improve this damage with regard to sensorineural hearing loss (SNHL) and tinnitus and dizziness-related disability. PATIENTS AND METHODS: An observational prospective study was performed on a series of 65 patients (41 males, 24 females; mean age 26.4±12.6; range 11 to 62 years) who were diagnosed with COM and were scheduled for surgical intervention at the Department of Otorhinolaryngology of the Haydarpasa Numune Education and Research Hospital. Patients were divided into two subgroups as tympanoplasty and mastoidectomy group according to the surgical procedure. Standard patient work-up included otomicroscopy, pure tone audiometry and completion of the Turkish translation of Dizziness Handicap Inventory (DHI) and Tinnitus Handicap Inventory (THI) before surgery and eight weeks after surgery. RESULTS: We found higher bone conduction thresholds in the group of patients with mastoidectomy preoperatively. There was a statistically significant difference in the mean preoperative and postoperative THI and DHI scores between the groups (p<0.05). CONCLUSION: Our study results suggest that a successful surgery results in improved tinnitus and vertigo symptoms in patients with COM.

A rare tumor of nasal cavity: glomangiopericytoma.

Glomangiopericytoma is a rare vascular neoplasm characterized by a pattern of prominent perivascular growth. A 72-year-old woman was admitted to our clinic complaining of nasal obstruction, frequent epistaxis, and facial pain. A reddish tumor filling the left nasal cavity was observed on endoscopy and treated with endoscopic excision. Microscopically, closely packed cells interspersed with numerous thin-walled, branching staghorn vessels were seen. Glomangiopericytoma is categorized as a borderline low malignancy tumor by WHO classification. Long-term follow-up with systemic examination is necessary due to high risk of recurrence.

Amniotic membrane covering for facial nerve repair.

Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3(rd) and 8(th) weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair.

Analysis and comparison of changing in thyroid hormones after percutaneous and surgical tracheotomy.

OBJECTIVES: To evaluate the effect of the surgical and percutaneous tracheotomy on the thyroid hormones and their comparisons. MATERIALS AND METHODS: Between January and May 2010, the surgical and percutaneous tracheotomy had been performed on 40 patients with respiration problems. The thyroid hormone levels were measured just before, after one and three hour of the operation and than these measurements were compared statistically. RESULTS: The effect of the surgical and percutaneous tracheotomy on serum thyroglobulin (TG), free thyroxine (fT4), free triiodothyronine (fT3) and thyroid stimulating hormone (TSH) levels was found statistically significant. CONCLUSIONS: The surgeons should not forget the possible increase of the serum thyroid hormone levels after the surgical and percutaneous tracheotomy because of the systemic effects of thyroid hormones. The patients, especially who have cardiac rhythm problems, should be monitored for a while after these processes because the increase of serum thyroid hormones may cause undesired cardiovascular effects.

Functional capacity of the thyroid autograft and heterograft: An experimental study.

BACKGROUND: The aim of this study was to investigate the functional capacity of thyroid autografts/heterografts in a guinea pig model. METHODS: A total of 24 guinea pigs were divided into 4 groups. Group A had only a thyroidectomy incision, and group B had total thyroidectomy. We performed autotransplantation in group C and heterotransplantation in group D. We monitored the guinea pigs for an 8-week period, with weekly measurements of free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH). At the final stage, the autografts/heterografts were histologically examined. RESULTS: In group B, fT3/fT4 showed a gradual decrease; however, an increase of TSH was noted. In groups C and D, fT3/fT4 showed a gradual decrease, followed by a gradual increase until euthyroid levels; an exact opposite was noted for TSH. In histologic examination, there were functional thyroid follicles in all animals of groups C and D. CONCLUSIONS: The autotransplanted/heterotransplanted guinea pig's thyroid tissue provides adequate thyroid function.

How does childhood otitis media change the radiological findings of the temporal bone?

CONCLUSION: Inflammatory changes in the middle ear mucosa since childhood may affect mastoid pneumatization without a change in the position of the sigmoid sinus. Also, despite the fact that recurrences of inflammatory middle ear disease lead to bone destruction, we did not see any relationship between the childhood otitis media and bone destruction. OBJECTIVE: To assess radiological findings in temporal bone in both healthy ears and diseased ears in patients with unilateral chronic otitis media since their childhood. METHODS: Twenty-five patients who had unilateral otological symptoms, such as recurrent otalgia, purulent otorrhea or hearing loss since their childhood were included in the study. Assessment of radiological parameters was performed using a quantitative digital image processing computed tomography program. RESULTS: Mastoid volume values in the chronic otitis media group were significantly smaller when compared with those of a healthy group (p < 0.05). In healthy and diseased mastoid groups, there were no significant differences between groups when we assessed Henle spine-sigmoid sinus (HS-SS) distances. There was a significant correlation (p = 0.001) in both the groups when we compared mastoid volume values with HS-SS distances. There was ossicular discontinuity in two cases and in one patient tegmen tympani was not intact in diseased ears.