A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?

OBJECTIVES: This study aims to compare pain, bleeding, nasal obstruction, crust and synechia formation, and anesthesia-related morbidity in patients with and without use of nasal packs after septoplasty. PATIENTS AND METHODS: A total of 66 patients (32 women, 34 men; mean age 24 years; range 18 to 48 years) who underwent Cottle's septoplasty under general anesthesia were randomly allocated to three groups in this prospective cohort. Telfa nasal packs were used in sutures + telfa group (n=22) and Merocell nasal packs in merocel alone group (n=22). No packs were administered in sutures alone group (n=22). Three groups were compared in terms of nasal obstruction, bleeding, pain, crust and synechia formation, as well as the amount of secretion, the need for oropharyngeal airway, the presence of laryngospasm, and effort for nasal breathing after anesthesia. RESULTS: The amount of bleeding was higher with lower degree of nasal obstruction in sutures alone group. Pain and secretion were more remarkable in merocel alone group. After the first week, these differences were unable to be differentiated among the groups. There were no differences between three groups with respect to crust and synechia formation two weeks after septal surgery. CONCLUSION: Nasal packs can be more useful in patients who suffer from bleeding-related morbidity, while septoplasty applied without nasal packs can be more suitable in patients with obstructive sleep apnea. The use of nasal packs in septoplasty should be determined on an individualized basis with respect to the characteristics of each patient.

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.

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.

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.