Evaluation of Periorbital Edema and Ecchymosis After Osteotomy in Septorhinoplasty Cases by Measuring Bone Density and Thickness.

PURPOSE: Periorbital edema and ecchymosis that may occur after surgery in septorhinoplasty patients who have undergone lateral osteotomy are common morbidities and are seen as the main limiting factors for the recovery process of the patients. There are many different studies in the literature about the causes of periorbital edema and ecchymosis. In this study, the authors aimed to investigate the possible relationships between the bone density and bone thickness measured in the frontal process of the maxillary bone, and postoperative periorbital edema and ecchymosis, which are suitable for the osteotomy lines that they will detect in computerized tomography. METHODS: Between January 1, 2019 and November 11, 2020, 59 patients whose nasal pathologies were determined by paranasal sinus computed tomography examination due to nasal deformity and nasal deformity and who underwent septorhinoplasty operation were included in this study. Bone density and thickness measurements were performed on the frontal process of the maxillary bone in accordance with the lateral osteotomy lines on the lateral nasal wall in each patient, right and left side. According to the bone density values measured at the point determined on the lateral osteotomy line, 2 groups were formed as "very dense" and "less dense." According to the bone thickness values of the patients, 2 groups were determined as "thick" and "thin." Thus, the authors investigated the relationship between periorbital edema and ecchymosis on the postoperative first, third, and seventh days obtained from the examination files of the patients. FINDINGS: When bone density subgroups are examined, it has been shown that the degree of periorbital edema of the patients in the "very dense" and "less dense" group categories decreased from the first day to the seventh postoperative day. The degrees of periorbital edema on the third postoperative day were statistically higher in the "less dense" group than in the "very dense" group. In the authors' study, no correlation was found between the degrees of postoperative periorbital edema and ecchymosis and bone density subgroups on other days. While an increase was observed in the periorbital ecchymosis grades of the patients in the "less dense" subgroup category from the first day to the third postoperative day, the periorbital ecchymosis grades of the patients in the "very dense" subgroup category decreased from the first day to the third day. In both subgroups, the lowest periorbital ecchymosis levels were observed on the postoperative seventh day.When bone thickness subgroups are examined, it has been shown that the degree of periorbital edema of the patients in the "thick" and "thin" group categories decreases from the first day to the seventh day postoperatively. When the bone thickness subgroups were examined, the periorbital ecchymosis degrees of the patients in the "thick" and "thin" group categories increased on the third postoperative day, while it reached the lowest level on the postoperative seventh day. There was no significant difference between the first, third, and seventh-day periorbital edema and ecchymosis conditions in the "thick" and "thin" groups. CONCLUSION: The authors observed that periorbital edema and ecchymosis that may occur after septorhinoplasty can be affected by the variable features of the lateral nasal wall bone structure. The authors conclude that the changes in the healing process can be affected by different bone density values in particular.

Assessment of functional and aesthetic outcomes in septorhinoplasty.

PURPOSE: The aim of this study is to review the aesthetic and functional outcomes of septorhinoplasty using questionnaires that have never been collectively used, as well as surgeons' evaluation. MATERIALS AND METHODS: Our study was conducted prospectively among 100 patients who underwent septorhinoplasty operation. We evaluated the effects of septorhinoplasty's functional and aesthetic outcomes on patients' emotional status using a combination of NOSE, ROE, DAS-24, and GBI questionnaires as well as surgeons' evaluations. RESULTS: Our study did not detect any significant difference between preoperative and postoperative levels of patient satisfaction with regard to age, sex, and surgery type and the number of surgeries. Our study, on the other hand, revealed significantly higher postoperative GBI scores among patients with higher preoperative DAS-24 and NOSE scores. However, we showed no significant difference between the preoperative ROE score and postoperative GBI score CONCLUSION: This study demonstrated that septorhinoplasty can not only significantly alter a nose's functional and aesthetic appearance, but it can also boost patient satisfaction.

Effect of Pregnancy on Vocal Cord Histology: An Animal Experiment.

BACKGROUND: Voice may be affected during the period of pregnancy, especially in the third trimester. However, the exact mechanisms leading to the phonatory changes have not yet uncovered. AIMS: The aim of this study is to investigate the possible histological changes in the vocal cords of the pregnant rats in three separate trimesters. STUDY DESIGN: Animal experiment. METHODS: Twenty-five Wistar-Albino female rats were divided into four groups: control group, pregnancy day 7 (Group 1), pregnancy day 14 (Group 2) and pregnancy day 20 (Group 3). The laryngeal specimens were obtained under general anesthesia. Histological assessment was performed using Hematoxylin-eosin and toluidine blue. A stereological analysis of vocal cord tissue was performed using a NIS-Elements D32 Imaging Software. RESULTS: Lamina propria was observed to be edematous, and the lamina propria area was thickened starting from the second trimester. Glycosaminoglycans were observed to increase in the second trimester. Although none was encountered in the control, mast cells were observed in the lamina propria layer of the vocal cord starting in the muscular layer in the first trimester proceed to the subepithelial region as degranulated just before term. The covering epithelium remained unchanged throughout pregnancy. CONCLUSION: Lamina propria thickening may be attributed to both edema and increased glycosaminoglycans. The presence of mast cells in the cordal tissue may induce edema during pregnancy in rats.

Malignant eccrine spiradenoma of the external ear.

Eccrine spiradenoma is a benign tumor of sweat gland origin. Malignant eccrine spiradenoma is a rare neoplasm which almost always arises from a pre-existing spiradenoma lesion. In this article, we present a patient with malignant eccrine spiradenoma of the auricula with a prior diagnosis as benign eccrine spiradenoma. Although malignant transformation is usually associated with aggressive behavior, we did not detect recurrence or metastasis in four years of follow-up after performing wide excision.

Effect of heparin on inflammation: an animal model of tracheal stents.

OBJECTIVES/HYPOTHESIS: The objective of this study was to investigate the effect of systemic heparin on tracheal and wound healing. STUDY DESIGN: An animal experiment using a tracheal stent model. METHODS: Twenty Wistar albino rats were divided into two groups; a heparin group (n = 10) that received 210 U/kg/d heparin sodium, and a saline group (n = 10) that received 0.1 mL of 9% NaCl. Stents of 1 cm in length made of 8F feeding tube were placed into the tracheas of rats in both groups and stayed in place for 10 days. Ten days after removal of the stents, the rats were sacrificed and the tracheas were harvested. Histological evaluations of the tracheas were performed with respect to inflammatory parameters. RESULTS: We observed significantly milder inflammation in the heparin group compared to the saline group in terms of inflammatory cell count, fibroblastic proliferation, edema, and vascularity at the site where the tracheal incision was made (P < .05). Inflammation tended to be of a lesser extent in the stent site in the heparin group (P > .05). CONCLUSIONS: We could demonstrate that heparin does inhibit fibroblast proliferation, inflammatory cell count, edema, and angiogenesis in this animal model. We believe that future studies can elucidate on laryngotracheal wound healing as well as their molecular mechanisms.

Facial, cervical, and mediastinal emphysema of the clarinet player: case report.

BACKGROUND: Cervicofacial emphysema may arise due to the leakage of air from a defect in the aerodigestive tract to the fascial layers of neck and face. Rarely, it may be caused by insufflation of air through the Stensen's duct. CASE REPORT: We present a case with diffuse facial, cervical and mediastinal emphysema due to playing a wind instrument immediately after a facial trauma. There was no mucosal defect or laceration noticed by examination which could explain the origin of the emphysema. Despite the widespread cervicofacial emphysema with mediastinal involvement, the patient significantly improved within 48 hours without any intervention. CONCLUSION: Even though cervicofacial emphysema ameliorates spontaneously, increased care must be taken, especially when there is pneumomediastinum and/or pneumothorax.

Submandibular gland pleomorphic adenoma in a seven-year-old child: a case report.

Salivary gland neoplasms are rare in the pediatric age group. Pleomorphic adenomas in the submandibular gland are rarer. In this article, we present a seven-year-old female with a slowly growing mass in her right submandibular area. The firm, mobile and painless mass was about 2x3 cm in size and with bimanual palpation it was indiscriminated from the submandibular gland. Magnetic resonance imaging with contrast revealed a heterogeneous and minimally lobulated mass within the submandibular gland with clearly defined borders. Fine needle aspiration biopsy revealed a diagnosis of pleomorphic adenoma and we performed right submandibular gland excision under general anesthesia. The histopathological diagnosis was pleomorphic adenoma with sparse mitotic figures that may be interpreted as having a potential of malignant transformation. This patient who was followed up for one year without any complication is to our knowledge the youngest case cited in the English-language literature.