Anatomic variations associated with antrochoanal polyps.

OBJECTIVE: Although more than a century has passed since antrochoanal polyps (ACPs) were first defined, etiopathogenesis still remains unclear. The aim of this study was to investigate the relationship between ACPs and sinonasal cavity variations. SUBJECTS AND METHODS: One hundred and forty-four patients with ACP on paranasal sinus computed tomography scans (ACP group) and 160 paranasal sinuses without ACP (control group) were included into the study. The study group was evaluated in respect of the presence of retention cyst in the contralateral maxillary sinus and sinus bone wall sclerosis thickening. Both groups were also compared with respect to the frequency of sinonasal anatomic variations, nasal septal deviation, variations of the uncinate process insertion, concha bullosa, paradoxical middle turbinate, and accessory maxillary sinus ostium. In the ACP group, the cases with septal deviation (SD) were also evaluated whether the deviation convexity was towards the polyp side or the opposite side. In addition, the posterior extension of ACPs were evaluated in three groups as middle meatus, nasopharynx, and oropharynx extension. RESULTS: The prevalence of retention cyst, sinus wall sclerosis thickening, SD, and accessory maxillary ostium was significantly higher in the ACP group. A negative directional correlation was determined between the SD side and ACP side. When the ACP extensions were examined, middle meatus extension was seen in 32.6%, nasopharynx in 56.3%, and oropharynx in 11.1%. CONCLUSION: Accessory ostium may be an accelerating factor in the transformation of retention cyst to ACP. Furthermore, the changes in the nasal passage airflow on the opposite side suggest that SD contributes to this process.

Gender and age differences in absolute and relative handgrip strength of the Turkish population aged 8-27 years.

We aimed to investigate the impact of anthropometric variables on absolute and relative hand grip strength (HGS) and associations among them in gender-specific age groups and also to evaluate normative HGS values adjusted to body mass index (BMI), fat free mass (FFM) and fat free mass index (FFMI) in healthy subjects as a function of age group and gender. A total of 567 volunteers (n=271 boys, 10.89±1.16 years, and n=296 girls, 10.86±1.07 years) participated in this study. Three consecutive trials for both hands were performed; the highest value was used as the HGS. There were no significant differences between genders in both anthropometric and strength values except FFM, FFMI and left-side grip strength (LSGS) in the 8-12 age group even though HGS values were normalized. FFM (r=0.80, r=0.86, p<0.01) and FFMI (r=0.57, r=0.76, p<0.01) had strong relationship with HGS in both females and males, respectively. The results of this study show that both age-dependent increases in HGS and gender differences are strongly associated with changes in FFM and FFMI. For this purpose, we suggest using FFM or FFMI-corrected HGS values to compare or constitute standard data as a guide for practitioners when interpreting grip strength measurements.

An adult adrenal neuroblastoma: a case report.

Neuroblastoma of the adrenal gland is an extremely rare tumour in adulthood although it is one of the most common malignancies in childhood. In this report, we present a 52-year-old man who had a left adrenal mass on preoperative imaging. On laboratory, slightly elevated catecholamine metabolites were detected in the urine that was collected over 24 hours. He was operated and the mass was resected in en-block manner along with the regional lymph nodes. The histopathological examination of the specimen revealed the diagnosis of neuroblastoma. He had no metastatic disease at the time of diagnosis and received chemotherapy after the operation. However, the prognosis was poor and he died 10 months after the operation. Although neuroblastoma of adrenal gland is rare in adulthood, it should be considered in the differential diagnosis for patients with adrenal masses.

Possibly new multiple congenital anomaly syndrome: cranio-fronto-nasal dysplasia with Poland anomaly.

We present a possibly new multiple congenital anomaly syndrome of craniosynostosis, Poland anomaly, cranio-fronto-nasal "dysplasia," and genital and breast anomalies. A similar pattern of anomalies was observed in two previous cases from the literature; however, some peculiar findings suggest that these cases might represent a new multiple congenital anomaly syndrome.

Three-dimensional computed tomography in evaluation of ankylosis of the temporomandibular joint.

Ankylosis is an uncommon disease of the temporomandibular joint (TMJ), the effective treatment of which requires detailed preoperative evaluation of the type and extent of the deformity. As well as lateral radiographs and computed tomography (CT), three-dimensional CT has been introduced to improve the preoperative evaluation. We present six patients with ankylosis of the TMJ who were evaluated by three-dimensional CT before and after condylectomy. Preoperative findings were compared with operative findings. Three-dimensional CT provides a detailed three-dimensional image of the TMJ non-invasively and we suggest that it is a valuable tool for evaluation of ankylosis in the TMJ.

Laryngeal tube use in out-of-hospital cardiac arrest by paramedics in Norway.

BACKGROUND: Although there are numerous supraglottic airway alternatives to endotracheal intubation, it remains unclear which airway technique is optimal for use in prehospital cardiac arrests. We evaluated the use of the laryngeal tube (LT) as an airway management tool among adult out-of-hospital cardiac arrest (OHCA) patients treated by our ambulance services in the Haukeland and Innlandet hospital districts. METHODS: Post-resuscitation forms and data concerning airway management in 347 adult OHCA victims were retrospectively assessed with regard to LT insertion success rates, ease and speed of insertion and insertion-related problems. RESULTS: A total of 402 insertions were performed on 347 OHCA patients. Overall, LT insertion was successful in 85.3% of the patients, with a 74.4% first-attempt success rate. In the minority of patients (n = 46, 13.3%), the LT insertion time exceeded 30 seconds. Insertion-related problems were recorded in 52.7% of the patients. Lack of respiratory sounds on auscultation (n = 100, 28.8%), problematic initial tube positioning (n = 85, 24.5%), air leakage (n = 61, 17.6%), vomitus/aspiration (n = 44, 12.7%), and tube dislocation (n = 17, 4.9%) were the most common problems reported. Insertion difficulty was graded and documented for 95.4% of the patients, with the majority of insertions assessed as being "Easy" (62.5%) or "Intermediate" (24.8%). Only 8.1% of the insertions were considered to be "Difficult". CONCLUSIONS: We found a high number of insertion related problems, indicating that supraglottic airway devices offering promising results in manikin studies may be less reliable in real-life resuscitations. Still, we consider the laryngeal tube to be an important alternative for airway management in prehospital cardiac arrest victims.

Bilaterally involved Tessier No. 4 cleft: case report.

Craniofacial clefts are rare among facial anomalies, with an incidence of 1.5 to 5 per 100,000 births, and 1 per 100 cases of cleft lip and palate. The Tessier No. 4 oro-ocular cleft is one of the rarest, with 33 unilateral and bilateral clefts reported in the literature. Among the bilateral clefts only 3 of 9 involved Tessier No. 4 cleft bilaterally. We report a case of bilateral Tessier No. 4 craniofacial cleft and our approach to surgical correction.