Impact of Intranasal Splint Removal Time on Postoperative Complications after Septoplasty.

BACKGROUND: Various types of nasal tampons are used for packing after septoplasty. Intranasal splints are widely used as they are more advantageous than other materials regarding the lower complication rates of synechia, and lesser pain during removal. However, there is no consensus on the timing of intranasal splint removal after septoplasty operations. AIM: In this study, we aimed to investigate the effects of removal time of intranasal splints on postoperative complications after septoplasty. METHODS: One hundred patients who had septoplasty were randomly divided into two groups according to splint removal time. In group I, the splints were removed on the third postoperative day and in group II, splints were removed on the seventh postoperative day. Pain during splint removal was evaluated by visual analog scale (VAS). Complications of hemorrhage, septal hematoma, crusting, mucosal injury, and infection were recorded during splint removal and compared. In the first postoperative month, hemorrhage, crusting, mucosal injury, infection, synechia, and in the second postoperative month, synechia and perforation rates were compared between two groups. RESULTS: Mucosal crusting was significantly higher in group II during splint removal. There was no statistically significant difference between the two groups regarding the complication rates and pain scores. Our findings showed no significant difference in pain scores during splint removal and postoperative complications between the two groups except for mucosal crusting. CONCLUSION: Based on our findings, although there is no consensus on the optimal time for splint removal, earlier removal of splints can be considered a favorable option after septoplasty operations.

A 15-year retrospective study of 160 cases of benign lip lesions.

OBJECTIVE: This study aimed to describe the results of a retrospective analysis of a specific cohort of patients with benign lip lesions encountered in the last 15 years in the School of Medicine at Karadeniz Technical University. METHOD: A total of 312 patients were managed for lip lesions during the period 2000-2014. Data from 160 samples of benign lip biopsies were retrieved from the pathology laboratory records. RESULTS: The study group included 20 different histopathological types of lesions, with mucocele being the most frequent lesion (43.13 per cent). The other frequent lesions were chronic inflammatory infiltrate (11.25 per cent), intradermal naevus (5.63 per cent), pyogenic granuloma (5.63 per cent), fibroma (5 per cent) and papilloma (5 per cent). Mucocele was significantly more common in younger patients (p < 0.001). CONCLUSION: Knowledge of the epidemiology and distribution of oral mucosal lesions is essential to promote early diagnosis and treatment. Further epidemiological studies exploring the causal relationships and risk factors for lip lesions are necessary for a better understanding of lip diseases.

Paratubal borderline tumor incidentally found during cesarean section: case report and review of literature.

Diagnosis of a gynecologic malignancy during cesarean section is quite rare. We report a case of a 39-year-old, nulliparous woman who underwent elective cesarean section during which a paratubal cyst was noticed and removed. The pathology revealed serous borderline tumor. Subsequent staging laparotomy was done 23 days after cesarean section. She was diagnosed with stage IC paratubal serous borderline tumor and underwent no further therapy. For the time being 15 months have passed from the staging laparotomy and she is currently free of disease recurrence. This case presented the importance of the evaluation of adnexa during cesarean section together with a short review of the literature on the rare paratubal borderline tumors and the role of fertility-sparing, conservative surgery in their management.

Isolated abducens nerve paresis associated with incomplete Horner's syndrome caused by petrous apex fracture--case report and anatomical study.

A 17-year-old male presented with a wound on the right temporal region, oozing hemorrhagic necrotic brain tissue and cerebrospinal fluid, following a fall. Computed tomography showed temporoparietal and petrous apex fractures on the right. Neurological examination revealed abducens nerve paresis, ptosis, and myosis on the right side. The patient was treated surgically for the removal of the free bony fragments at the fracture site and to close the dural tear. The abducens nerve paresis, ptosis, and myosis persisted at the 3rd monthly postoperative follow-up examination. The anatomy of the abducens nerve at the petroclival region was studied in four cadaveric heads. Two silicone-injected heads were used for microsurgical dissections and two for histological sections. The abducens nerve has three different angulations in the petroclival region, located at the dural entrance porus, the petrous apex, and the lateral wall of the cavernous segment of the internal carotid artery. The abducens nerve had fine anastomoses with the trigeminal nerve and the periarterial sympathetic plexus. There were fibrous connections extending inside the venous space of the petroclival area. The abducens nerve seems to be vulnerable to damage in the petroclival region, either directly by trauma to its dural porus and petrous apex or indirectly by stretching of the nerve through the nervous and/or fibrous connections. Concurrent functional loss of the abducens nerve and the periarterial sympathetic plexus clinically manifested as incomplete Horner's syndrome in our patient.

Increased morbidity after circumcision from a hidden complication.

OBJECTIVE: To describe a late complication of circumcision and to elucidate the role of surgical materials or any foreign body in the development of a subcutaneous mass in circumcised boys. PATIENTS AND METHODS: From May 1998 to March 2001, 646 boys were circumcised and 523 (mean age 6.5 years, range 0-13) re-examined for the possible development of a subcutaneous mass. Twenty-six (5%) of the re-examined patients had such a mass under the penile skin; it was removed in all patients under local anaesthesia and examined histopathologically. RESULTS: The mean (sd, range) delay after circumcision before developing or detecting the mass was 3.2 (0.7, 1-7) months. All patients were asymptomatic but there was purulent discharge in four. On removing the mass, histopathology showed the development of granulation tissue with foreign-body giant cells. CONCLUSION: There may be minor complications after circumcision which cannot be avoided even when the procedure is undertaken by surgeons. Awareness of such complications occurring long after circumcision may aid in the early detection of this asymptomatic mass and prevent a more severe outcome.

Epidermoid cyst of the ovary: a case report.

In the ovary, epidermoid cysts are rare and their origin is controversial. This rare lesion was uniformly an incidental finding in the study of hysterectomy specimens. The patient was a 48-year-old woman. Because of multiple leiomyomas she had a total hysterectomy and bilateral salpingo-oopherectomy operation. A Epidermoid cyst was found incidentally in the right ovary on the microscopic examination.