The Relationship Between Destruction Sites and Clinical Findings in Diffuse Paranasal Sinus Mucoceles.

Objective: This study aimed to investigate that complicated mucoceles of paranasal sinuses and their clinical presentation, complications of relations with size, destructions areas, extension limits in affected patients. Materials and methods: A retrospective review was performed on patients who were diagnosed and treated as paranasal sinus mucoceles at ENT department from 2002 to 2013 years. Patients' demographic data, mucoceles location, symptoms, surgical approach and complications were evaluated. Results: The study group included 9 male and 10 female patients with a mean age of 45,0 years (range, 12-76 years). This case series include fronto-ethmoidal complex (52,6%), followed by frontal (26,3%), maxillary (15,7%) and sphenoid sinus mucoceles (5,2%). Endoscopic sinus surgery (ESS) was performed on 11 patients (57.8%); endoscopic procedures included marsupialization through an infundibulotomy, associated with an anterior ethmoidectomy and maxillary sinus antrostomy. Four patients (21%) underwent an external surgical procedure. 8 patients (42%) were treated by a combination of both endoscopic and external approaches such as trephination of the anterior wall of the frontal sinus, osteoplastic flap approach, Caldwell-Luc operation, anterior craniotomy and Lynch procedure. Complications occurred only in 2 cases (10.5%). Conclusion: The majority of patients with extensive paranasal sinus mucoceles exhibited ophthalmologic and intracranial symptoms. A satisfactory outcome can be achieved after surgical treatment of both endoscopic and external approaches.

A New Mystery: Phantosmia after COVID-19 Infection.

Coronavirus disease 2019 (COVID-19) has developed as a pandemic and has caused millions of deaths worldwide. Multiple studies have implicated anosmia and ageusia as symptoms associated with COVID-19. In this case report we present the cases who suffer from phantosmia after COVID-19 infection. As the prevalence of the virus increases, the symptomatology profile continues to be updated. More studies are needed to better understand this disease.

A Rare Paranasal Sinus Abnormality: Maxillary Sinus Hypoplasia.

ABSTRACT: Maxillary sinus hypoplasia is a rare condition. The majority of patients are asymptomatic but in some cases, they suffer from headaches and facial pain. Awareness of this condition is important because of misdiagnosis and possible complications during endoscopic sinus surgery. This is a presentation of 24-year-old women with unilateral maxillary sinus hypoplasia who presented with headache and nasal blockage.

A Rare Complication of Tonsillectomy: Glossopharyngeal Neuralgia.

ABSTRACT: Tonsillectomy is one of the most frequently performed surgical operations in otolaryngology clinics. While postoperative pain is frequently encountered, severe pain such as glossopharyngeal neuralgia is extremely rare.

Frontal Mucocele Extended Orbita and Endoscopic Marsupialization Technique.

Mucocele is benign, slow-growing, mucous-filled cystic lesions that arise in the paranasal sinuses. It causes progressive distension of the bony walls and induces compressive symptoms. Surgical treatment of paranasal sinus mucoceles includes endoscopic approach or external approach. The authors report a patient of frontal mucocele who presented with a history of progressive unilateral protrusion. Computed tomography scan revealed a large mucocele of the frontal sinus with orbital extension on the same side. He was successfully treated with endoscopic marsupialization without any serious complications.

Comparison of Cold Technique Tonsillectomy and Thermal Welding Tonsillectomy at Different Age Groups.

The aim of this study is to compare objectively advantages and disadvantages of cold technique tonsillectomy and thermal welding tonsillectomy at the same case. A total of 100 patients, 53 patients younger than 12 years of age and 47 patients elder than 12 years of age, were included in this study. Tonsillectomy was performed by using cold technique on the right side of the palatine tonsils and thermal welding on the left side. Right and left sides were compared regarding perioperative bleeding, surgical dissection time, postoperative pain scale at the 1st and 7th day and postoperative bleeding parameters. Perioperative bleeding was found to be higher in cold technique side in patients younger than 12 years of age (p<0.001). Postoperative pain score on the day 1 was significantly higher in cold technique side, whereas it was found to be higher in thermal welding side at postoperative day 7 (p<0.001). Perioperative bleeding was found to be significantly higher in cold technique side (p<0.001) and surgical dissection time of thermal welding was found to be longer (p<0.001) in patients elder than 12 years of age. Postoperative pain score at the day 1 and day 7 was found to be higher in thermal welding side (p<0.001). Postoperative pain score at the day 1 and day 7 were statistically significantly higher in patients elder than 12 years of age. As a result, both techniques have its unique superior aspects and both can be applied as a routine tonsillectomy technique.

Relationship between smoking and otorhinolaryngological symptoms.

OBJECTIVES: This study aims to investigate the possible relationship between smoking and otorhinolaryngological symptoms in smokers, non-smokers and ex-smokers. PATIENTS AND METHODS: Between March 01st, 2014 and March 31st, 2014, a total of 1,840 patients (823 males, 1,017 females) over 25 years of age who were admitted to the ear nose, and throat (ENT) outpatient clinic were included in the study. The patients who were smoking at least 10 cigarettes daily for at least five years were included in the smokers group (n=514). The patients who did not smoke for at least one year following at least five years of smoking were included in the ex-smokers group (n=268). The patients who never smoked were included in the non-smokers group (n=1,058). A form containing all ENT symptoms was given to all patients and the patients were asked to fill the form with their complaints following being informed by the same doctor. RESULTS: Cough, shortness of breath, reflux, dryness of throat, irritation, taste disorder, bad breath, toothache, nasal congestion, smell disorders, snoring, and nasal discharge were found to be significantly higher in the smokers group, compared to the non-smokers group. Cough, sputum, hoarseness, dysphagia, reflux, sore throat, dryness of throat, irritation, stinging, oral aphthae, taste disorder, toothache, bleeding gums, and bad breath were significantly lower in the ex-smokers group. Nasal congestion, nosebleeds, sneezing, nasal discharge, smell disorders, headache, feeling of facial fullness, ear discharge, hearing loss, pain, fullness, dizziness, and tinnitus were statistically significantly lower in the ex-smokers group. CONCLUSION: Our study results show that smoking causes symptoms particularly associated with upper respiratory tract and these symptoms may persist in ex-smokers.

The Evaluation of Relationship Between Body Mass Index and Nasal Geometry Using Objective and Subjective Methods.

INTRODUCTION: It is known that obesity causes obstructive sleep apnea syndrome by increasing upper airway resistance. Also, obese patients are admitted to the ear, nose, and throat clinic very often because of nasal obstruction complaint. The aim of this study is to identify the change and relation among body mass index (BMI), nasal resistance, reduction in nasal ariflow, nasal anatomy, and patients' subjective complaints. MATERIAL AND METHOD: A total of 67 patients admitted to our clinic between August 2013 and January 2014 were included in the study.The study group comprised 33 patients who had a chief complaint-nasal obstruction and the other group consisted of 34 patients who had no complaint and nasal pathology. Both the groups were checked with acoustic rhinometry (AR), active anterior rhinomanometer, nasal obstruction symptom evaluation (NOSE), and visual analog study (VAS) questionnaire. RESULTS: There is a significant statistical correlation between the body mass increase and VAS and NOSE score increase (P < 0.05). But the authors did not find any statistically significant relation between BMI and total inspiratory and expiratory MR and MF measured by anterior active rhinomanometer and left and right nasal cavity MCA, and volume measured by acoustic rhinometery (P > 0.05). CONCLUSIONS: Contrary to belief, obesity does not change the nasal resistance, airflow, and anatomy but it can cause subjective nasal complaints.

Is There a Relationship Between Bell's Palsy and Internal Auditory Canal?

In the present study, we evaluated the diameter of internal acoustic canal in patients with Bells palsy to investigate the role of anatomical differences of the temporal bone in etiology of Bell's palsy. Sixty-four patients who were diagnosed as Bells Palsy and temporal bone computed tomography imagings of them were included into the study group (Group 1). The control group (Group 2) was consisted of 35 healthy subjects without Bell's Palsy. All patients had temporal bone computed tomography imaging. The internal auditory canal inlet, mid-canal, outlet and canal lengths were measured at the most distinctive cross-section of the seventh and eighth cranial nerves bifurcation. In the study group, Bells palsy was on the right side in 26 patients (40.6 %) and on the left side in 38 patients (59.4 %). Initial House-Brackmann (HB) score was HB-2 in 29 patients (45.3 %), HB-3 in 18 patients (28.1 %), HB-4 in 13 patients (20.3 %) and HB-5 in 4 patients (6.2 %). At 6-month evaluation, HB-score of the patients were HB-1 in 37 patients (57.8 %), HB-2 in 25 patients (39.1 %) and HB-3 in 2 patients (3.1 %). Internal auditory canal (IAC) measurements of the groups showed that there were no significant differences between the measurements of right-mid canal, right canal length; and left canal outlet and left canal length of the study and control groups. Right inlet and outlet; and left inlet and mid-canal values of the study group (Bell's palsy) were significantly lower than those of the control group. In Bell's palsy group, left inlet, outlet and canal length values were significantly higher than those of the right ones. Correlation analysis showed that there were no significant correlation between paralysis side; initial HB stage; and IAC measurement results. In patients with higher initial HB score, their 6-month later HB-score was also higher. In patients with higher 6-month HB score; R canal inlet, R mid-canal, L-canal inlet, and L-mid canal values were lower. Lower IAC inlet and mid-canal values were detected in patients with Bell's palsy. Therefore narrow IAC inlet and mid-canal values may be one of the risk factors for Bell's palsy.

Evaluation of the Effect of Betahistine on Noise-Induced Hearing Loss Using Distortion Product Otoacoustic Emission and Scanning Electron Microscopy.

OBJECTIVE: To evaluate the protective effect of betahistine on noise-induced hearing loss (NIHL) using scanning electron microscopy (SEM) and distortion product otoacoustic emission (DPOAE). MATERIALS AND METHODS: A total of 8 adult albino guinea pigs were used in this study (study group: n=4 and control group: n=4). DPOAE measurements of both groups were performed before the procedure. Two hours before noise exposure, 0.9% NaCl solution was injected perorally to the control group and betahistine was administered through a peroral catheter to the study group. Both groups were then exposed to 105-dB sound pressure level (SPL) 4-kHz frequency-based narrow-band noise for 2 h per day for 5 days. DPOAE measurements were performed again on the 6th day and cochleae were dissected and examined by SEM on the 7(th) day. RESULTS: Regarding the results of DPOAE, NIHL was observed in both groups on the 6th day (p<0.05). Loss, flattening, and fusion, which are findings of permanent hearing loss, were determined in the stereocilia of the inner and outer hair cells by SEM. These findings were evaluated as signs of permanent increase in the threshold. When DPOAE measurements and SEM results were evaluated in the study group, no significant difference was observed in NIHL compared with the control group (p>0.05). CONCLUSION: In our study, it was observed that simultaneous administration of betahistine during noise had no protective effect on permanent increase in the threshold. However, further studies on noise and long-term use of betahistine can be performed.

Quality of life in patients with persistent allergic rhinitis treated with desloratadine monotherapy or desloratadine plus montelucast combination.

OBJECTIVES: This study aims to compare the effectiveness of desloratadine monotherapy and desloratadine plus montelukast combination therapy on quality of life in patients with persistent allergic rhinitis. PATIENTS AND METHODS: This study consists of 40 patients (28 females, 12 males, mean age 29.8 years; range 17 to 44 years) referred to ear, nose, and throat outpatient clinic between May 2010 and September 2010. A six-week randomized, double-blind, cross-sectional study was performed in two arms: In group 1, 20 patients received desloratadine (5 mg/d) alone; in group 2, 20 patients received desloratadine (5 mg) plus montelukast (10 mg) combination therapy. Quality of life was assessed on the day before starting treatment and on the last day of each treatment period using the Rhinoconjunctivitis Quality of Life Questionnaire and Nighttime Symptom Scores. RESULTS: In group 1, the mean quality of life scores before and after treatment were 3.17 and 2.43, respectively. In group 2, the mean quality of life scores before and after treatment were 2.94 and 1.73, respectively. CONCLUSION: Desloratadine plus montelukast combination therapy may have a positive impact on quality of life, sleep symptoms in particular.

Metastasis of non-muscle-invasive bladder cancer into the thyroid gland: a literature review accompanied by a rare case.

Bladder cancer is the most prevalent malignancy of the urinary tract. About 90% of bladder cancers are urothelial carcinomas. Seventy percent of cases newly diagnosed are superficial diseases; roughly 30% of newly diagnosed cases are muscle-invasive metastatic diseases. Bladder urothelial carcinoma primarily metastasizes into regional lymph nodes and then into liver, lung, mediastinum, bone, and adrenal gland. In our case, non-muscle-invasive bladder cancer metastasized into the bone, mediastinum, iliac lymph node, and adrenal and thyroid glands. This is the first reported case in the current literature in which urothelial carcinoma metastasized into the thyroid gland.

Severe destruction of the upper respiratory structures after brief exposure to a dieffenbachia plant.

Dieffenbachia is a common domestic plant. Oral contact with the plant generally causes slight effects, but when chewed it may result in painful oropharyngeal edema. Even though the mechanism through which this plant causes toxicity is not known, calcium oxalate crystals (rhaphides) and protease in the idioblast of the plant are considered to be the causes. Our aim was to show the lethal effects of a common domestic plant named Dieffenbachia.A 70-year-old male patient applied to our clinic with aphasia, dysphagia, sialorrhea, wounds on the lips and tongue, and swelling on the face. There was edema on his tongue, soft palate, uvula, anterior pharyngeal plica, epiglottis and aryepiglottic fold, and ulceration on the right side of his tongue, the right cheek mucosa, right-lower gingival, soft palate, tongue base, epiglottis anterior surface, and free edge.Dieffenbachia toxicity presents both minimal and serious problems, which can be life threatening, as in our case. Toxic cases resulting in serious clinical pictures due to Dieffenbachia are rare.

Extramedullary plasmacytoma of maxillary sinus.

Solitary extramedullary plasmacytomas are rare tumors that often affect the head and neck region. Diagnosis of solitary extramedullary plasmocytoma can be confirmed only when the presence of systemic disease is excluded by performing clinical, biological, and radiological investigations. Radiotherapy is considered the treatment of choice, surgery being limited to biopsy and to excision of residual disease. We report herein the case of a 62-year-old man with an extramedullary plasmacytoma arising in the left maxillary sinus who was referred for chemoradiotherapy.

Fibromyxoma of the frontal sinus.

Fibromyxomas are uncommonly encountered pathologies in the head and neck region. They are slow growing, which result in expansion of the surrounding bony cortices. In this article, we report an extremely rare case of frontal sinus fibromyxoma which occluded the frontal sinus and expanded anterior ethmoid cells and nasal dorsum. Initially, it was suspected to be a mucocele. Surgical resection with a wide excision was performed and it was diagnosed as fibromyxoma, histopathologically.

Huge internal carotid artery aneurysm presenting as tonsillar asymmetry.

Aneurysms of the extracranial portion of the carotid artery are extremely rare. Internal carotid artery aneurysm is an uncommon cause of tonsillary asymmetry. Although internal carotid artery aneurysms usually remain asymptomatic, the clinical manifestation requires the tonsillar enlargement. Asymmetry as a sole determining factor for tonsillectomy may lead to unnecessary operations. We report a patient with a giant internal carotid artery aneurysm presenting as tonsillary asymmetry that might be mistaken for a tonsillar neoplasia. When faced with a tonsillar asymmetry, an otolaryngologist must keep aneurysms in mind.

[The comparison of preoperative examination, computed tomography and peroperative macroscopic inspection in the determination of anterior commissural involvement in laryngeal cancer]. / Larenks kanserinde anteriyor komissür tutulumunun belirlenmesinde ameliyat öncesi muayene, bilgisayarli tomografi ve ameliyat sirasi makroskopik incelemenin karsilastirilmasi

OBJECTIVES: In this study preoperative examination, computed tomography and the peroperative macroscopic examination of the specimen were compared in the determination of anterior commissural involvement in laryngeal cancer. PATIENTS AND METHODS: Twenty-two male patients (mean age 59.6 ± 9.9 years; range 46 to 78 years) who underwent total laryngectomy for laryngeal cancer between January 2007 and May 2010 in our clinic were enrolled into this study. The anterior commissures were evaluated in all patients by preoperative examination, computed tomography and peroperative macroscopic examination of the specimens. For the preoperative evaluation, examination with a 70-degree rigid endoscope and microscopic examination under general anesthesia using suspension laryngoscopy were used. The tomographic sections of the neck and the comments were analyzed and the status of the anterior commissure was evaluated. After the removal of the laryngectomy sample, the larynx was vertically incised on its posterior aspect and anterior commissure was examined peroperatively. All the data obtained were statistically interpreted on the basis of the histopathological results of the anterior commissure. RESULTS: According to the histopathological assessments, the rate of invasion of the anterior commissure by the tumor was determined to be 72.7%. In the preoperative examination, the anterior commissure was found to be invaded by the tumor in 56.3% of the patients. This ratio was 50% with neck computed tomography and 93.8% by the peroperative examination of the samples. CONCLUSION: In laryngeal cancer, anterior commissure involvement is a very important factor in selecting the surgical technique and in predicting the behavior of the tumor. Preoperative examination and classical axial computed tomography have limited a role in the detection of the anterior commissural involvement. Computed tomography reconstructed by a highly experienced radiologist may be more helpful for us in the evaluation of the anterior commissure.