Comparison of innate lymphoid cells from tissue and blood in chronic tonsillitis and tonsillar hypertrophy.

OBJECT: Recurrent tonsillitis and tonsillar hypertrophy are two common diseases in children for which tonsillectomy is the definitive solution. The underlying causes of both diseases are not fully known. The aim of this study was to identify the predominant innate lymphoid cells in both diseases of the palatine tonsils, which are known to play an important role in the immune system. METHODS: Children who underwent tonsillectomy were divided into two groups as recurrent tonsillitis and tonsillar hypertrophy according to the indication for surgery. The proportions of innate lymphoid cell (ILC) groups and IFN-gamma, IL-10 and IL-17 secreting T lymphocyte cells were determined in tonsil and blood samples obtained during surgery. Local and peripheral immune responses were evaluated. Innate immune responses and acquired immune responses were compared. RESULTS: The results of our study showed that the proportions of the innate lymphoid cell 1 group (ILC1) were similar in tonsil tissue in patients with recurrent tonsillitis and tonsil hypertrophy, with no statistically significant difference. It was observed that the innate lymphoid cell 2 group (ILC2) was the predominant group in tonsil hypertrophy, the innate lymphoid cell 3 group (ILC3) was the predominant innate lymphoid cell group in recurrent tonsillitis, and the proportion of IL-17 secreting T lymphocytes in blood and tonsillar mononuclear cells was higher in recurrent tonsillitis patients than in tonsil hypertrophy patients. CONCLUSION: With the results obtained, the predominant innate lymphoid cells in the pathogenesis of both diseases were identified and local and peripheral responses were compared. These findings may be a guide for possible medical treatments for both diseases in the future.

Bone grafting in maxillofacial trauma.

PURPOSE OF REVIEW: The purpose of this article is to review the recent grafting strategies in maxillofacial trauma. RECENT FINDINGS: Recent technological advancements have applications in the management of maxillofacial trauma; advancements in imaging modalities such as 3D imaging can help surgeons in both the preoperative and intraoperative periods. These may be coupled with navigational systems to further facilitate complex reconstructions. 3D printing has been used in reconstruction and 3D, 4D, and 5D bioprinting technologies continue to improve and to find new uses, and stem cells and growth factors in maxillofacial trauma are also among the most studied topics. Maxillofacial traumas have decreased in number during the COVID-19 pandemic, as more conservative approaches have been preferred in COVID pandemic conditions. SUMMARY: Preoperative planning is the most important step in the reconstruction of maxillofacial trauma defects, and early bone and soft tissue reconstructions are recommended in severe maxillofacial traumas. Autogenous grafts are the gold standard in bone grafting. Nonvascularized grafts are planned according to the size, shape, and location of the defect, with vascularized bone flaps preferred in large defects, wide soft tissue defects, and contaminated defects. Alloplastic grafts or xenografts may be used if autogenous grafts are not available.

Management of a glottic squamous cell carcinoma with cutaneous metastasis.

INTRODUCTION: Oral cavity malignancies constitute 30% of head and neck cancers. The most common distant metastatic sites of glottic carcinoma are usually lung, liver and bone. Although the cutaneous metastasis of head and cancers have been reported with an incidence of 0.7-2.4%, skin metastasis of glottic carcinoma is extremely rare. CASE REPORT: A 69-year-old male patient was admitted to the emergency department with hemoptysis, dyspnea, weakness in lower extremities and difficulty in swallowing. There were subcutaneous lesions with a diameter of 2-5 cm in the scalp, posterior chest wall, nose and abdomen. In addition, there was an ulcerating, painful mass on the right lateral part of the tongue. The biopsy of lesions on tongue and skin revealed a glottic squamous cell carcinoma with cutaneous metastasis.Management and outcome: The patient was treated with cisplatin 50 mg/m2 on day 1, cetuximab 500 mg/m2 on day 1 and 5-fluorouracil 1000 mg/m2 daily on days 1 and 2, repeated every two weeks. After the first cycle of chemotherapy, the lesions on the skin regressed and dysphagia improved. DISCUSSION: There are limited data about the incidence, diagnostic measures and treatment modalities of glottic cancer with cutaneous metastasis. Our case could provide an important experience to literature by its atypical presentation and treatment-sensitive nature.

Effect of Folic Acid on Cisplatin-Induced Ototoxicity: A Functional and Morphological Study.

OBJECTIVES: The aim of our study was to investigate the effects of folic acid on cisplatin-induced ototoxicity. MATERIALS AND METHODS: Thirty Wistar albino rats were divided into five groups. Group I received intraperitoneal cisplatin (IP) 10 mg/kg/day and IP folic acid 10 mg/kg/day; Group II received IP cisplatin 10 mg/kg/day and IP physiological saline; Group III received IP cisplatin 10 mg/kg/day and intratympanic (IT) folic acid 0.15 mL/day; Group IV received IP cisplatin 10 mg/kg/day and IT physiological saline; and Group V received IT folic acid 0.15 mL/day. Before and after drug administration, plasma homocysteine, folic acid levels, and auditory brainstem evoked responses (ABR) were measured. The rats were then sacrificed, and the inner ears were processed for electron microscopy. RESULTS: The differences of ABR thresholds in Group I compared to Group II were significantly smaller at 4 kHz, 8 kHz, and 16 kHz, whereas they were smaller but not statistically significant at 12 kHz in ABR. The differences of ABR thresholds in Group III compared to Group IV were significantly smaller at 12 kHz, and smaller but not statistically significant at 4 kHz, 8 kHz, and 16 kHz. Cisplatin treatment resulted in the degeneration of the cells of the organ of Corti, stria vascularis, and spiral ganglion. The cells of the organ of Corti, stria vascularis, and spiral ganglion showed a partially preserved morphology in both Group I and Group III. CONCLUSION: Our study results suggests that folic acid is a potential agent in preventing cisplatin-induced ototoxicity.

The Rate of Epistaxis Incidence in New-Generation Anticoagulants and Perioperative Approach in Otorhinolaryngological Practices.

Nose bleeding is a common situation seen in otorhinolaryngological practices. One of the greatest risk factors in nose bleeding is the use of anticoagulant medicine. With the medicine developed in recent years, the risk of nose bleeding due to the frequent use of anticoagulant and antiagregant is gradually increasing.The purpose of this study is to determine the effects of especially new-generation anticoagulants on nose bleeding. In addition, the use and complications of new-generation anticoagulants and antiagregants have been compiled in light of information obtained from the literature.Three hundred forty patients whose follow-up is conducted by the cardiology department and who use oral antithrombocytic medicine have been included in the study. It has been determined that 15% of these patients use new-generation oral anticoagulants (Rivaroksaban, apiksaban, dabigatran, danaparoid) and the other patients are treated with conventional antithrombocytic treatment (Aspirin, Warfarin, Enoksaparin sodium). The rate of nose bleeding in patients who use classical anticoagulants has been observed to be 28%. In 30 of these patients who had nose bleeding, while cauterization and buffering by otorhinolaryngology specialists, major intervention has not been necessary for any of the patients. While bleeding has been observed in 26% of the patients who use new-generation anticoagulants, bleeding that required operational intervention has taken place in 2 patients. Bleedings have been stopped surgically through a large number of cauterization and buffering.While the new-generation anticoagulants cause lower rate of bleeding, it has been observed that controlling these bleedings is more difficult.

Microbiological and Histopathological Effects of Nasal Packing Containing Probiotics on Nasal Mucosa.

BACKGROUND: Nasal packing is frequently used after surgical interventions to prevent bleeding and synecchia formation and for the treatment of diseases such as epistaxis. One of the most morbid complications of nasal packing applications is the toxic shock syndrome (TSS). Owing to the microbiological structure of nasal mucosa, antibiotics are administered to all patients who are applied nasal packages for prevention of TSS. AIM: The aim of this study is the evaluation of microbiological and histopathological changes taking place in nasal mucosa with nasal packing containing probiotics. METHODS: Three groups were formed with 6 rats in each group. The nasal packings with the same characteristics were applied to nasal cavities of rats in all 3 groups. In group 1, only nasal packs were used. Probiotics or parenteral antibiotics were not used. In group 2, parenteral antibiotics were used along with nasal packs. In group 3, nasal packs with probiotics containing Lactobacillus strains were applied. No parenteral antibiotics were used. After 3 days packages were removed and nasal cavity was irrigated with saline. Both packages and irrigation materials were analyzed for microbiological content. After scarification, nasal and paranasal structures were examined for histopathological changes. RESULTS: In group 3 statistically the total bacteria load was significantly lower in comparison to the other groups. However, in the histopathological evaluation of the mucosa of rats in group 3, bleeding and inflammation findings were significantly higher statistically. CONCLUSIONS: It has been determined that the total microbiological load significantly decreases with the application of packing containing probiotics. So, the use of probiotics along with nasal packings is promising to prevent unnecessary use of medications.

Otoacariasis: demographic and clinical outcomes of patients with ticks in the ear canal / Otoacaríase: desfechos demográficos e clínicos de pacientes com carrapatos no conduto auditivo externo

ABSTRACT INTRODUCTION: Otoacariasis, the attachment of ticks and mites within the ear canal is a common phenomenon especially in rural areas. OBJECTIVE: To determine the clinical and demographic features of cases with detected ticks in the ear canal, which is a common health problem, and identify tick species. METHODS: Data of patients who had otoacariasis were collected. We also investigated all ticks at the Veterinary Department of Kafkas University. RESULTS: We present the data of patients with otoacariasis. All ticks were identified as otobius. Otobius ticks were found not related with any complications. CONCLUSION: It is very important to detect ticks in the ear canal as they act as vector of some diseases. Identifying species of ticks may help clinicians to prevent further complications associated with vector-borne diseases.

Resumo Introdução: A otoacaríase, fixação de carrapatos duros e moles no interior do conduto auditivo, é fenômeno comum, especialmente em áreas rurais. Objetivo: Determinar as características clínicas e demográficas de casos de carrapatos detectados no conduto auditivo externo, um problema de saúde frequente, e identificar as espécies do ácaro. Método: Coletaram-se dados dos pacientes com otoacaríase, e todos os carrapatos foram investigados no Departamento de Veterinária da Universidade Kafkas. Resultados: Os dados de pacientes com otoacaríase são apresentados. Todos os carrapatos foram identificados como pertencentes ao gênero Otobius e constatou-se não haver relação entre os carrapatos e qualquer tipo de complicação. Conclusão: É muito importante detectar carrapatos no conduto auditivo externo, pois esses ácaros funcionam como vetores para algumas doenças. A identificação da espécie do ácaro pode ajudar o clínico a prevenir complicações associadas às doenças transmitidas por esse vetor.

Maxillofacial Traumas in Farmers Caused by Farm Animals, Agricultural Vehicles, and Materials.

OBJECTIVE: It has been aimed at evaluating the relationship of maxillofacial fractures in farmers, which are caused due to traumas while working in farms, with trauma etiologies, maxillofacial fracture areas, age, sex, and seasonal variables. METHODS: Among the farmers who have come to our emergency service unit as a result of maxillofacial trauma between 2010 and 2012, 146 patients have been analyzed retrospectively. The patients' demographic findings, trauma etiologies, seasonal variables of trauma, and maxillofacial fracture area distribution have been analyzed. RESULTS: Patients' age varies between 12 and 80 and 87 of them are female (59.59%), while 59 are male (40.41%). The subjects' etiological distribution is as follows: 47.5% is traumas caused by cattle among the farm animals; 15.75% is traumas caused by the blows of agricultural tools; 12.33% is traumas caused by tractor accidents; 9.59% is traumas caused by falling from haystacks; 7.53% is traumas caused by falling from agricultural vehicles, and 6.85% is traumas caused by horse kicks. When trauma etiology, age, sex, seasonal distribution, and the maxillofacial fractures were analyzed, statistically significant results have been determined. CONCLUSIONS: Although the number of maxillofacial traumas is considerably high in farmers due to farm animals, agricultural devices, and agricultural tools, while these traumas can cause functional and aesthetically minor fractures on the face, they can cause important and serious fractures as well. While knowing the mechanism of etiological fractures and accidents in different study groups can be guiding in the speedy diagnosis and treatment of possible fractures, it can also be helpful in taking precautions against traumas in these groups as well.

Laryngeal Chondroma: An Unusual Complication Endotracheal Entubation.

INTRODUCTION: Laryngeal cartilaginous framework tumors are very rare. Chondroma and chondrosarcoma are the most common types of these tumors. PATIENT PRESENTATION: A 27-year-old man with a history of intubation presented with exercise-induced dyspnea. A computed tomography scan of larynx showed a rounded and circumscribed mass without infiltration of the adjacent structures which obstructs 75% of airway. Histopathological investigation of the mass revealed the chondroma of the larynx. The patients' history of intubation trauma with the subsequent progressive onset of clinical symptoms demonstrates the relationship between these 2 entities. CONCLUSION: Clinicians should consider laryngeal chondroma in the differential diagnosis of dyspnea after endotracheal intubation.

Auditory evoked potentials in a newborn Wistar rat model of hyperbilirubinemia / Potenciais evocados auditivos em um modelo de rato Wistar neonato com hiperbilirrubinemia

ABSTRACT INTRODUCTION: Hyperbilirubinemia is a common health problem in newborns. Its effects can be different according to the level and duration of the hyperbilirubinemia. The toxic effect of bilirubin on the auditory system can be seen as a sensory neural hearing loss or auditory neuropathy spectrum disorder (ANSD). OBJECTIVE: The purpose of our study was to determine the effects of toxic bilirubin level on the auditory system by using Auditory Brainstem Response audiometry. METHODS: Rats are used as animal models due to their low cost and easy attainability. Auditory Brainstem Response was used for auditory assessment. In this study, three groups were established: experimental, control and placebo groups. RESULTS: In the experimental group, which consists of rats with hyperbilirubinemia, sensory neural hearing loss was found bilaterally in 4 rats (66.67%) and unilaterally in 2 rats (16.67%) and auditory neuropathy spectrum disorder was found unilaterally in 1 rat (8.33%). Auditory Brainstem Response thresholds were significantly elevated compared to control and placebo groups (p < 0.05). CONCLUSION: Hyperbilirubinemia of newborn rats may result both in sensory neural hearing loss and auditory neuropathy spectrum disorder.

RESUMO INTRODUÇÃO: A hiperbilirrubinemia é um problema de saúde comum em neonatos. Seus efeitos podem variar, dependendo do nível e da duração da hiperbilirrubinemia. O efeito tóxico da bilirrubina no sistema auditivo pode ser observado na forma de deficiência auditiva sensorioneural ou de distúrbio do espectro da neuropatia auditiva. OBJETIVO: A finalidade de nosso estudo foi determinar os efeitos de nível tóxico de bilirrubina no sistema auditivo, com o uso da audiometria da resposta auditiva evocada de tronco cerebral. MÉTODO: Os ratos são empregados como modelos animais graças a seu baixo custo e fácil obtenção. Utilizamos a resposta auditiva evocada de tronco cerebral para avaliação da audição. No estudo, foram estabelecidos três grupos: experimental, controle e placebo. RESULTADOS: No grupo experimental, constituído de ratos com hiperbilirrubinemia, disacusia auditiva neurosensorial foi diagnosticada bilateralmente em quatro ratos (66,67%), e unilateralmente em dois (16,67%); e distúrbio do espectro da neuropatia auditiva foi observado unilateralmente em um rato (8,33%). Os limiares da resposta evocada de tronco cerebral estavam significantemente elevados, em comparação com os grupos controle e placebo (p < 0,05). CONCLUSÃO: A hiperbilirrubinemia de ratos neonatos pode resultar tanto em disacusia auditiva neurosensorial como em distúrbio do espectro da neuropatia auditiva.

Audiologic evaluations of children with mucopolysaccharidosis.

INTRODUCTION: Mucopolysaccharidosis is a hereditary lysosomal storage disease, which develops due to a deficiency in the enzymes that play a role in the metabolism of glycosaminoglycans (GAG). The incidence of mucopolysaccharidosis is 1/25,000, with autosomal recessive inheritance (except for MPS II). Mucopolysaccharidosis occurs in seven different types, each with a different congenital deficiency of lysosomal enzymes. In mucopolysaccharidosis patients, even though progression of clinical findings is not prominent, the disease advances and causes death at early ages. Facial dysmorphism, growth retardation, mental retardation, and skeletal or joint dysplasia are the most frequently found symptoms in these patients. OBJECTIVE: The purpose of our study is to present the types of hearing loss types and tympanometric findings of patients with mucopolysaccharidosis referred to our clinic with suspicion of hearing loss. METHODS: After otorhinolaryngological examination, 9 patients with different types of mucopolysaccharidosis, underwent to immittance and audiometric evaluations, performed according to their physical and mental abilities, and ages, in order to determine their hearing thresholds. RESULTS: The audiometric findings of the 9 patients followed with mucopolysaccharidosis were reported separately for each case. CONCLUSION: Based on the high frequency of hearing loss in mucopolysaccharidosis patients, early and detailed audiological evaluations are highly desirable. Therefore, regular and systematic multidisciplinary evaluations are very important.

Clinical Characteristics of Recurrent Juvenile Nasopharyngeal Angiofibroma (JNA) After Radiation Therapy.

Juvenile nasopharyngeal angiofibroma (JNA) is a benign vascular tumor occurring in young males. Treatment of JNA is a complex procedure, especially in advanced cases with a high risk of major complications. We report the clinical, radiological and histological specialties of a rare case of recurrent JNA 3 years after radiation therapy in an 18-year-old boy. The patient underwent endoscopy assisted partial midfacial degloving approach. This treatment has been shown to be effective in advanced JNAs with minor morbidity.

Recurrent Lymphoepithelial Carcinoma of the Parotid Gland.

BACKGROUND: Lymphoepithelial carcinomas (LECs) are rare tumors of parotid gland. Although few cases were reported in literature, there is no reported recurrent case. METHOD: The authors report a case of recurrent LEC after 8 months of primary surgery. Total parotidectomy and selective neck dissection surgery were performed. Radiation therapy after surgery was planned. Patient had partial facial weakness in the early postoperative period that was getting better with follow-up. CONCLUSIONS: In the diagnosis of LECs of parotid region, nasopharyngeal carcinomas must be excluded. If LECs are not treated properly, recurrences may occur.

An unusual mass of nasal cavity: recurrent glomangiopericytoma.

Hemangiopericytomas are rare tumors of sinonasal region. In this article, we described a case of recurrent mass in right nasal cavity which presented with nasal obstruction and intermittent epistaxis. Patient had a surgical history on the same nasal region without any histopathological document. Abnormal bleeding was observed during surgery and mass was partially removed for histopathological investigation. The result was glomangiopericytoma of the sinonasal region. Although extended surgery was recommended to the patient including preoperative and perioperative measures for bleeding problem, patient preferred to follow-up rather than removal. The clinical progress and review of glomangiopericytoma have also been discussed.

Lateral skull base destruction: unusual clinical progress of lymphoma.

Lymphoma is a common tumor especially in pediatric population. It can originate every lymphoid tissue in the head and neck region. Head and neck lymphomas usually present with a slow-growing mass. We encountered a man who had a lymphoma that destroyed all soft tissues of the left lateral skull base. The unusual clinical progress is discussed in the article.

Sphenopalatine artery pseudoaneurysm: a rare cause of intractable epistaxis after endoscopic sinus surgery.

Epistaxis is a frequent health problem and the most common cause of emergency in otorhinolaryngology practice. In this report, a case of a 26-year-old patient with intractable epistaxis after endoscopic sinus surgery was presented. The epistaxis began at the fourth postoperative day and was unresponsive to endoscopic cauterization and anterior and posterior nasal packing. On angiographic investigation, a pseudoaneurysm of the sphenopalatine artery was detected and treated with microcatheter embolization. This is the second case of postoperative sphenopalatine pseudoaneurysm as a complication of endoscopic sinus surgery in the literature.

Quantitative measurement of m-RNA levels to assess expression of cyclooxygenase-II, inducible nitric oxide synthase and 12-lipoxygenase genes in middle ear cholesteatoma.

To assess expression of three main inflammatory genes, COX-II, ALOX-12 and i-NOS, quantitatively at transcriptional level in cholesteatoma matrix tissue. Ten patients who have chronic otitis media with primary acquired cholesteatoma were included in this study. Tissue samples obtained from cholesteatoma matrix and external ear canal skin (control tissue). Expression of the targeted genes (COX-II, i-NOS and LOX-12) was assessed using real-time quantitative polymerase chain reaction (RT-PCR) technique. The amount of COX2 mRNA was significantly higher in cholesteatoma matrix at transcriptional level (p = 0.038). There was no statistically significant difference regarding expression of iNOS and LOX12 mRNA levels (p > 0.05). There is a significant overexpression of the mRNA of COX-II in cholesteatoma matrix, which indicates a difference between the normal skin and cholesteatoma matrix at molecular level. COX-II gene overexpression seems to be associated with pathogenesis of cholesteatoma. This molecular change is similar to the molecular abnormalities observed in some benign and malignant neoplasms. Invasive and locally destructive nature of cholesteatoma may be due to COX-II overexpression. Absence of an increase in the gene expressions of i-NOS and LOX-12 in cholesteatoma matrix suggests that these mediators may not be related with the pathogenesis and evolution of cholesteatoma.