Chemical Composition and Antimicrobial Activity against Phytopathogenic Fungi of Essential Oils Obtained from Echinophora tenuifolia subsp. sibthorpiana Grown in Wild and Cultivated Conditions in Turkey

The hydro-distilled essential oils obtained from aerial parts of the wild and cultivated Echinophora tenuifolia subsp. sibthorpiana have been analyzed by GC-MS and screened for antimicrobial activity. In total, 28 compounds representing more than 99% of the oils were identified. α-phellandrene (13.22% and 55.27%), δ-3-carene (49.29% and 4.03%), and methyl eugenol (22.59-25.69%) were found as the main components for the wild and cultivated oils, respectively. EOs of the wild and cultivated plants differed significantly in both the percentage of the main components and antifungal effect. α-phellandrene was more dominant in cultivated plants (55.27%) than in wild ones (13.22%), while δ-3-carene was more abundant in the wild plants (49.29%). In the antifungal assays, both oils displayed moderate to high activity against three phytopathogenic fungi; Fusarium oxysporum, Rhizoctonia solani, and Alternaria alternata.

An Unusual Location of Osteochondroma: Temporal Bone.

Osteochondromas are the most common benign tumor of the bones which are cartilage-capped exophytic lesions that arises from the bone cortex. They usually seen in the axial skeleton, especially around the metaphysis of long bone but seldom in the head and neck region. The majority of patients in the head and neck region affect the mandibular area. To our knowledge, this is the first reported patient with an osteochondroma of the temporal bone in the English literature. A patient with temporal bone osteochondroma and its surgical treatment are here described.

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.

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.

Sudden hearing loss and vertigo after tooth extraction successfully treated with combined therapy including HBO2: a case report.

Sudden sensorineural hearing loss (SSNHL) is a decrease in hearing of at least 30 dB that occurs within three days and which affects at least three consecutive frequencies in either ear or both ears. This case report describes a woman who had sudden hearing loss and vertigo in the right ear after tooth extraction. As the first-line therapy, systemic and intratympanic steroid injections were used this led to a slight improvement; however, the majority of improvement in hearing was not observed until hyperbaric oxygen (HBO2) therapy was instituted on the 20th day of hearing loss. Sudden hearing loss and vertigo after tooth extraction is an otologic emergency and early evaluation and treatment are effective. HBO2, although employed beyond the Undersea and Hyperbaric Medical Society's recommended initial 14 days of symptom onset, very was effective for this particular case.

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.

[Evaluation of benign vocal cord lesions with laryngeal electromyography]. / Benign vokal kord lezyonlarinin larengeal elektromiyografi ile degerlendirilmesi.

OBJECTIVES: This study aims to identify patients with benign vocal cord lesions using laryngeal electromyography (EMG) and to investigate the presence of accompanying vocal cord paresis. PATIENTS AND METHODS: Twenty-eight patients (18 males and 10 females; mean age 38.6±10.2 years; range 22 to 59 years) who were diagnosed with benign vocal cord lesion using a rigid laryngostroboscopy underwent laryngeal EMG and the presence of neurogenic involvement was investigated. RESULTS: Laryngostroboscopic examination revealed polyp in 85.7% (n=24), Reinke's edema in 10.7% (n=3), submucosal cyst in 10.7% (n=3), and contact granuloma in 3.6% (n=1). Of the patients, 14.2% (n=4) were suspected to have vocal cord paresis. Laryngeal EMG revealed neurogenic involvement in at least one of the larynx muscles in 57.2% (n=16) of the patients. Eight patients (28.6%) had unilateral neurogenic involvement, while three (10.7%) demonstrated isolated recurrent laryngeal nerve paresis two (7.2%) demonstrated isolated superior laryngeal nerve paresis, and three (10.7%) demonstrated combined recurrent and superior laryngeal nerve paresis. Six (21.4%) of eight patients with bilateral neurogenic involvement had paresis in three laryngeal nerves, whereas in two (7.2%) patients four laryngeal nerves were affected. CONCLUSION: Our study shows that vocal cord paresis frequently accompanies benign vocal cord lesions. Laryngeal EMG is useful to identify clinically suspected or unsuspected paresis with physical examination precisely.

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.

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.

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.

Microscopic guide to the middle ear anatomy in guinea pigs.

OBJECTIVES: To reveal microscopic surgical anatomy of the middle ear in guinea pigs (GPs). MATERIALS AND METHODS: Twenty ears of GPs were dissected under dissection microscopy via inferior approach. By using digital equipment, the most suitable photograph was taken for each step. Differences and similarities between the ears of GPs and those of human beings are discussed to show the advantages and disadvantages of the GP ear for experimental studies. RESULTS: Tympanic membrane of the GP merely consists of pars tensa and above this there is a bony segment called as supratympanic crest. There were two spaces called bulla and hypotympanium in the GP,s middle ear. Cochlea, which is normally found in the inner ear in humans, separates these two spaces. Upper part of this space which is called epitympanium is a slit like cavity having a bony complex called malleoincudal complex. Bulla, the largest cavity in the middle ear, is a hemispherical cavity having a smooth surface. It corresponds to hypotympanum and mesotympanum of human middle ear. Cochlea has 3.5 turns from basal turn to apical turn. While the oval window is placed vertically, the round window is placed horizontally. While the stapes is almost identical to that of the humans, there is a bony bridge between the crura of the stapes called crista stapedius. Stapes can not removed unless this bony bridge is taken. CONCLUSION: The middle ear in GP differs from the human middle ear in many aspects. Researchers who are planning to the study with this animal model should be aware of all these differences.

[The comparison of the expansion of polyps according to the Ki-67 and computed tomography scores]. / Polip yayginliginin Ki-67 ve bilgisayarli tomografi skorlarina göre karsilastirilmasi.

OBJECTIVES: The disease extention in nasal polyps was compared by using the mitotic activity rates and the computed tomography scores. PATIENTS AND METHODS: This study was conducted on 19 nasal polyposis patients (8 males, 11 females; mean age 40.0+/-13.7 years; range 20 to 63 years). The preoperative computed tomography records of the patients were evaluated according to the Lund-Mackay grading system. The polyp tissues of the same patients were stained with the Ki-67 antigen for immunohistochemical evaluation. The correlation between the radiologic results and the Ki-67 values was compared by means of the Spearman's correlation test. RESULTS: The mean computed tomography score was observed as 14.3+/-4.7 (range 7-24). The mean Ki-67 score resulting from the immunohistochemical staining was calculated as 24.3+/-18.5 (range 3.3-73.5%). A significant correlation was determined between the Ki-67 values and the computed tomography scores. ("Spearman's" correlation factor: 0.677; p<0.001). CONCLUSION: As the mitotic activity rate of nasal polyps increases, both the volume of the polyps and the computed tomography scores increase as a result of the blockage of the sinus ostiums by the increased polyp volume.

Prevalence of adenoid hypertrophy and nocturnal enuresis in primary school children in Istanbul, Turkey.

OBJECTIVE: The purpose of this study is to investigate the prevalence of an existing relationship between adenoid hypertrophy and nocturnal enuresis in primary school children. METHODS: The study was performed in four primary schools that were chosen randomly in Kartal, Istanbul. The children's parents were asked to fill out a questionnaire that included questions concerning the associated symptoms of adenoid hypertrophy and nocturnal enuresis. The interrelations between adenoid hypertrophy and nocturnal enuresis items were examined by X2 tests. RESULTS: The study population consisted of 1132 (625 girls, 621 boys) primary school children between 5 and 14 years of age (mean 9.59+/-2.60 years). The children were divided into three groups with 5-7 years old children in Group I (n=232), 8-10 years old children in Group II (n=506) and 11-14 years old children in Group III (n=394). Of the 1132 distributed questionnaires, 1090 (87.4%) were filled in adequately and were accepted for evaluation. Prevalence of adenoid hypertrophy in school children was found to be 58 in Group I (27%), 94 in Group II (19.5%) and 78 in Group III (19.9%). Prevalence of nocturnal enuresis in school children was found to be 35 in Group I (15.1%), 51 in Group II (10.1%) and 18 in Group III (4.6%). No statistically significant association was present between adenoid hypertrophy and nocturnal enuresis in either Group I, II or III school children. CONCLUSION: In contrast to previous studies, our prevalence study did not find an association between adenoid hypertrophy and nocturnal enuresis. Thus, this prevalence study provides otolaryngologists new and interesting information.

Role of the 30 degrees telescope in evaluation of laryngeal masses during direct laryngoscopy.

SUMMARY: Visualization of enlarged laryngeal lesions is the most important factor in choosing a surgical technique, especially for partial surgery. For this reason standard microlaryngoscopy, a computed tomography (CT) scan of the larynx, and 30 degrees telescopic microlaryngoscopy were compared during evaluation of the laryngeal ventricul and sub-glottic area. The histopatholgoical findings of the specimens collected under each modality were simultaneously compared. Comparison of the histopathological findings, which corresponded to inspection with the 30 degrees telescopic method, was more significant than with the use of standard microlaryngoscopy or the CT scan. The aim of the current study therefore was to determine the importance of the 30 degrees telescopic microlaryngoscopic method for the evaluation of the laryngeal ventricle and subglottic area.

[Clinical signs and management strategies in thyroid masses]. / Tiroid kitlelerinde klinik bulgular ve uyguladigimiz tedavi yöntemleri.

OBJECTIVES: Patients who underwent surgery for thyroid masses were evaluated with regard to clinical symptoms, diagnostic and treatment methods, and the results of treatment. PATIENTS AND METHODS: The study included 92 patients (72 women, 20 men; mean age 45 years; range 16 to 71 years). Clinical diagnoses were based on findings of ultrasonography, thyroid function tests, thyroid scintigraphy, and fine-needle aspiration biopsy. Operations performed were near-total thyroidectomy (n=40), hemithyroidectomy (n=25), bilateral subtotal thyroidectomy (n=16), and total thyroidectomy (n=11). Patients with carcinoma associated with neck lymph node metastasis also underwent lateral, anterolateral, modified radical, or radical neck dissections. RESULTS: Postoperative histopathologic diagnoses were benign colloid nodule (n=70), papillary carcinoma (n=16), medullary carcinoma (n=2), anaplastic carcinoma (n=2), and Basedow-Graves disease (n=2). Unilateral vocal cord paralysis developed in 11 patients (11.9%), five of which persisted beyond one year follow-up. Two patients (2.2%) had transient hypocalcemia and one patient (1.1%) had postoperative hematoma. CONCLUSION: Preoperative determination of the structure and confines of thyroid masses increases success rates of surgical procedures and minimizes complication rates.

[The role of concha bullosa in nasal pathologies]. / Konka bullozanin nazal patolojilerdeki rolü

OBJECTIVES: We investigated the relationship between the size of concha bullosa (CB) detected by coronal paranasal sinus computed tomography (CT) and the frequency of sinonasal symptoms. PATIENTS AND METHODS: The study included 60 patients (39 females, 21 males; mean age 38.3 years; range 17 to 67 years) who had CB on CT scans and underwent endoscopic sinus surgery for symptoms of chronic sinusitis, nasal obstruction and/or headache. The patients were evaluated in three groups according to the ratio of the cross-section area of CB to that of the nasal cavity (NC); hence, group 1, 0-14%; group 2, 15-29%; and group 3, = or >30%. The relationship of CB/NC with clinical symptoms and nasal pathologies were examined. RESULTS: The presenting complaints were sinusitis in 28 (46.7%), nasal obstruction in 56 (93.3%), and headache in 36 (60%) patients. Concha bullosa was on the right side in 16 (26.7%), on the left side in 13 (21.7%), and bilateral in 31 patients (51.7%). Of 91 CB, 29 (31.9%) were in group 1, 43 (47.3%) were in group 2, and 19 (20.9%) were in group 3. The cross-section area of CB was greater than 1 cm2 in 25.6%, and less than 0.5 cm2 in 53.4%. The most common pathology accompanying CB was nasal septal deviation (n=36, 60%). The distribution of symptoms and accompanying pathologies was similar in the three groups. CONCLUSION: Our findings show that symptoms and accompanying pathologies do not differ in patients with varying sizes of CB.

An alternative surgical approach for sublingual dermoid cysts: a case report.

A 52-year-old woman presented with a painless swelling in the floor of the mouth. She stated that it had existed there for 40 years and had undergone a gradual enlargement within the past year. Examination showed a mass, 5x4 cm in size. An aspiration from the lesion revealed a cyst. The lesion was removed by a U-shaped superior based flap. Histopathological examination showed stratified squamous epithelium lining the cystic lumen. This technique can be an alternative approach in such lesions because it protects the oral mucosa by providing good exposure, and prevents injury to the lingual nerve and submandibular duct.

[The effect of topical mitomycin-C application before or after incisional myringotomy on patency times of guinea pig tympanic membrane perforations]. / Kobay timpan membraninda mitomisin-C uygulamasinin insizyonel miringotominin kapanma süresine etkisi.

OBJECTIVES: The aim of this study was to investigate the effect of topical mitomycin-C application before or after incisional myringotomy on patency times and to asess its use as an alternative to ventilation tube insertion. MATERIALS AND METHODS: Nineteen guinea pigs were divided into two groups. In the study group (n=11), mitomycin-C was applied in a concentration of 0.4 mg/ml over the perforation for five minutes before (n=6) or after (n=5) incisional myringotomies in both ears. Control animals (n=8) received 0.1 ml 0.09% NaCl for the same duration. Evaluations were made on days 1, 3, 5, 7, 10, 14, and 21. The patency times, otorrhea, and other complications were recorded. RESULTS: Compared to controls (7.0+/-1.5 days), the mean patency times of perforations were significantly longer in mitomycin-C treated groups before (11.6+/-5.2 days) and after (14.2+/-4.7 days) incisional myringotomies (p<0.05). Patency times did not differ significantly between the two mitomycin-C groups. None of the ears exhibited permanent perforation. CONCLUSION: The length of patency provided by mitomycin-C is not sufficient for optimal ventilation in otitis media with effusion. However, in cases requiring shorter patency times, mitomycin-C application before or after myringotomy may be an alternative to ventilation tube insertion.

Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?

OBJECTIVES: The effect of topical N-acetylcysteine (NAC) application was investigated on the healing of acute experimental tympanic membrane perforations. MATERIALS AND METHODS: Twenty guinea pigs were used in this study. Under intraperitoneal ketamine anesthesia, incisional myringotomies were performed in the posterosuperior quadrant of the tympanic membranes with a straight otologic hook. The diameter of the perforations was approximately 2 mm. Perforations in both ears were treated with freshly prepared sponges soaked in either 0.1 ml 0.9% NaCl solution (10 control animals) or 0.6 mg/0.1 ml NAC (10 animals) for three consecutive days. All the tympanic membranes were examined by otomicroscopy on the third, fifth, seventh, and ninth days. RESULTS: In the control group, all the perforations were completely closed at the end of nine days. During the same period, only 40% of the perforations were completely closed in the NAC group. The remaining ears exhibited otorrhea by the third day. CONCLUSION: N-acetylcysteine may cause severe otorrhea in the healing process of tympanic membrane perforations. Further studies including histopathological examinations are required to elucidate this condition.

The effects of radiofrequency and incisional myringotomy on the duration of patency.

OBJECTIVES: We investigated whether radiofrequency could prolong the patency of myringotomy. MATERIALS AND METHODS: Eighteen guinea pigs were enrolled in this study. Myringotomies were created by radiofrequency in the right ears in the study group using the ENTec coblator plasma surgery system, while the left ears had incisional myringotomies as the control group. After myringotomies, the tympanic membranes were examined with otomicroscopy on the 5th, 7th, 10th, and 14th days. Closure times of the two groups were compared by the Mann-Whitney U-test. RESULTS: All the myringotomies were closed up to the tenth postoperative day. There was no significant difference between the two groups with respect to closure times. CONCLUSION: Radiofrequency is a safe and minimally destructive method to perform a myringotomy, but it does not provide long-time patency.