The Effects of Different Types of Nasal Packing on Odor Function and Mucociliary Function After Septum Surgery.

BACKGROUND: In this study, we evaluated how the Merocel and nasal splint packing placed in the nose after septoplasty surgery affects the olfactory and mucociliary functions of the nose in the early period, and compared the 2 packing with each other. MATERIAL AND METHOD: The study included 60 patients with isolated septal deviation and 30 patients in the control group. The patients were randomly divided into 2 groups. Nasal splint was inserted after septoplasty in group A (n = 30). Merocel was inserted in group B (n = 30). The Sniffin sticks test and saccharin test were applied to the patients before surgery and 15 days after the surgery. The same tests were applied to the control group consisting of 30 patients and the results were compared. RESULTS: No complications, such as postoperative bleeding, submucoperichondrial hematoma, or abscess formation, were found in both groups. Mucociliary function was improved after septoplasty, and it was statistically significant, but there was no statistically significant difference between both packing groups. A statistically significant difference was found for the odor test in patients who used nasal splint packing in comparison with patients who used Merocel in the early period. CONCLUSION: The odor test showed significant differences between the 2 groups and this was statistically significant in the early period. Mucociliary function was better after surgery, but there was no statistical difference in the different nasal packing groups.

An Unusual Cervical Mass in the Hyoid Bone: Intermediate-Grade Chondrosarcoma.

We describe a case of a 31-year-old woman with a chondrosarcoma of the hyoid bone. The patient presented with a mass in the left submandibular region. Fine-needle aspiration cytology suggested chondroma, but further imaging investigation with CT revealed an exophytic tumor originating from the body of the hyoid bone. Histopathology of the surgical specimen confirmed the diagnosis of a intermediate-grade chondrosarcoma. Chondrosarcomas account for 11% of all bone cancers. Primary sites of the head and the neck include the nasal cavity, the skull base, the maxilla, the mandible. Chondrosarcomas of the hyoid bone are very rare, with only 23 cases previously reported in the literature.

Clinical significance of Ki-67, c-erbB-2 and E-cadherin expressions in open partial laryngectomy patients.

OBJECTIVES: This study aims to analyze the correlation between biomarkers and risks of cervical lymph node invasion, recurrence, distant metastasis and survival regarding the clinicopathological variables in laryngeal cancers. PATIENTS AND METHODS: Forty-one patients with laryngeal cancers were examined retrospectively. The correlations evaluated between E-cadherin, Ki-67, c-erbB-2 expressions, tumor site, differentiation, the risk of cervical lymph node metastasis, perineural, perivascular, pericapsular invasion and recurrence as well as survival time. RESULTS: There was significant correlation between T-grade and the survival rates, and between pericapsular invasion and the lowest survival rates. There was no significant correlation between E-cadherin, Ki-67, c-erbB-2 expressions and clinicopathological variables of tumor. Positive correlation between strong stain of E-cadherin and Ki-67 proliferation index was determined. CONCLUSION: These markers are not reliable prognostic and predictive factors for laryngeal cancers. E-cadherin expression was protected in well-differentiated and less invasive cancers, which maintain their cell-cell adhesions whereas it was reduced in undifferentiated cancers. Positive correlation between E-cadherin and Ki-67 proliferation shows that histopathological differentiation of laryngeal cancers is maintained in spite of the high proliferation index.

Cervical necrotizing fasciitis associated with descending necrotizing mediastinitis.

We report a case of potentially fatal cervical necrotizing fasciitis and descending necrotizing mediastinitis due to deep neck infection in a 66-year-old male patient with no history or evidence of immunocompromising disorders. On admission, he had painful neck movements and the skin over his neck was red, hot and tender. A computerized tomography (CT) scan of his neck and chest showed evidence of air collection in soft tissues. He was treated with broad-spectrum intravenous antibiotics and early massive cervical drainage. Prompt diagnosis by CT of the neck and chest enabled an early surgical treatment of cervical necrotizing fasciitis. Although acute mediastinitis is a fatal infection involving the connective tissues that fill the interpleural spaces and surround the median thoracic organs, an extensive cervicotomy combined with appropriate antibiotics can prevent the need for mediastinal drainage.

Genotyping for Cx26 and Cx30 mutations in cases with congenital hearing loss.

Hearing loss is the most frequent sensory defect in human being. The 13q11-q12 region contains the GJB2 and GJB6 genes, which code connexin 26 (CX26) and connexin 30 (CX30) proteins, respectively. The 35delG, 167delT, and 235delC mutations in the Cx26 gene are the main cause for sporadic nonsyndromic hearing loss (NSHL) in many populations. The 342-kb deletion [del(GJB6-D13S1830)] of the Cx30 gene is the second most common connexin mutation after the 35delG mutation in some NSHL populations. In our study 47 hearing-impaired students were included. The Cx26 gene and the Cx30 gene were analyzed for presence of the 35delG, 167delT, and 342-kb deletion [del(GJB6-D13S1830)]. Genotyping were performed for detecting 35delG, 167delT, and del(GJB6-D13S1830) mutations using the PCR-ELISA techniques. According to the results obtained from 47 cases, the 35delG mutation was detected in 7 cases ( approximately 14.9%). Four of these mutations were determined as homozygote mutant ( approximately 8.5%), and three were determined as heterozygote mutant ( approximately 6.4%). However, 167delT and del(GJB6-D13S1830) mutations were not detected in the study group. These results support the overwhelming majority of 35delG in our study group from deafness school in our study. In conclusion, the 35delG mutation was determined as the most frequently shown mutation that leads to congenital hearing loss as in previous studies from Turkey.

Is pseudoexfoliation associated with sensorineural hearing loss?

OBJECTIVE: To determine the possible relation between pseudoexfoliation (PSX) and sensorineural hearing loss. METHODS: This study was carried out in Afyon Kocatepe University, Afyon, Turkey between July 2002 and June 2005. Sixty-three patients who were found to have ocular PSX on routine biomicroscopic examination, and 38 age-matched control subjects were evaluated for evidence of audiometric abnormality. The sum of pure-tone hearing threshold measured at 250-2000 Hz, 2000-6000 Hz, and 250-6000 Hz in each ear was compared with controls for the same frequencies. RESULTS: The mean age of the patients was 68.4+/-10.3 years. All patients had PSX affecting at least one eye. Fifty (79.4%) patients with PSX, and 10 (26.3%) control subjects were found to have hearing loss (p=0.00, chi-square). From the 50 patients with PSX who had hearing loss, 34 patients had bilateral PSX, and 16 patients had unilateral PSX. Twenty-nine patients had high frequency hearing loss, while 20 patients had hearing loss in all frequencies. Forty-eight patients with PSX and 7 controls had bilateral sensorineural hearing loss (p=0.030). CONCLUSION: Sensorineural hearing loss was seen more frequently in patients with PSX in comparison with age-matched control subjects.

Immunohistochemical assesment of heat shock protein 70 in adenoid tissue.

OBJECTIVES: To evaluate the expression of heat shock protein 70 (HSP70) and its relation to histopathologic parameters in adenoid hypertrophy and hyperplasia. In addition, HSP70 expression in adenoid tissue was compared with in adult and childhood. METHODS: Paraffin-embedded adenoid tissue sections were obtained from 19 childhood and 15 adult patients. Expression of HSP70 was evaluated by immunohistochemical staining using anti-HSP70 monoclonal antibody and correlated with histopathologic parameters. RESULTS: Positive HSP70 expression was observed mainly in the mucosal epithelium, lymphocytes in germinal centers, interfollicular lymphocytes, subepithelial plasma cells and vascular endothelium. HSP70 immunoreactivity in the mucosal epithelium with severe intraepithelial lymphocytic infiltration in childhood patients was higher than in adult patients. Although, the immunoreactivity of HSP70 was detected strongly in whole layer of metaplastic squamous epithelium, it was stained only in basal layers in respiratuary epithelium, Lymphocytes stained with HSP70 in germinal center and interfollicular areas of adenoid tissues was higher in childhood patients than in adults. CONCLUSIONS: These data suggest that HSP70 expression may have an important role in pathogenesis of adenoid hyperplasia, especially, in childhood.

Expression and distribution of aquaporin-1 in nasal polyps: does it have any significance in edema formation?

BACKGROUND: The aim of this study was to investigate the expression of Aquaporin 1 (AQP1) and AQP4 in polyp tissue. METHODS: Nasal polyps were obtained from 34 patients with nasal polyposis during endoscopic sinus surgery. Bullous middle turbinates with normal-appearing mucosa of 10 patients were used as controls. Expression of AQP1 and AQP4 water channels were determined by immunohistochemical methods. RESULTS: AQP1 has been found to be expressed in fibroblasts located in polyp tissue, especially in the subepithelial area, periphery of seromucous glands, and endothelial cells of venules. CONCLUSION: We have established a high expression of AQP1 water channels in nasal polyp tissue and have suggested two mechanisms to explain this finding. Increased AQP1 expression may be a cause or a consequence of edema formation. Thus, additional studies are needed to elucidate the true mechanism underlying this relationship.

The effects of tonsillectomy and adenoidectomy on pulmonary arterial pressure in children.

PURPOSE: It is well known that hypertrophic tonsils and adenoids may cause upper-airway obstruction. The aim of this study is to determine the mean pulmonary arterial pressure (mPAP) in children with hypertrophic tonsils and adenoids and to clarify whether tonsillectomy and adenoidectomy (T&A) has any effect on mean pulmonary arterial pressure of these children. MATERIALS AND METHODS: Fifty-two randomly selected children (36 male, 16 female) aged between 4 and 11 (mean 7.7+/-2.5) a with a diagnosis of upper-airway obstruction resulting from hypertrophied tonsils and adenoids were included in our study. Thirty-three children were assigned as controls with similar age and sex distribution with the study groups. Mean pulmonary arterial pressure was measured by using Doppler echocardiography preoperatively and mean 5.4+/-2.9 months postoperatively in all subjects. RESULTS: When the mean pulmonary arterial pressure values of study and control group compared preoperatively, the mean pulmonary arterial pressure levels of the children in the study group were significantly higher than the mean pulmonary arterial pressure levels of the children in the control group (P<.05) (study group mean PAP=23.13+/-7.68, control group mean PAP=16.11+/-7.24) (Levene's test, P<.05). When the preoperative and postoperative results were compared, it was found that there was a statistically significant decrease in mean pulmonary arterial pressures in these 52 children (preoperative mean PAP=23.13+/-7.68, postoperative mean PAP=17.00+/-6.99) (paired sample t test, P<.05). Twenty-seven of the 52 subjects in the study group were pulmonary hypertensive preoperatively. mPAPs of 18 of these children decreased to normal range yielding 9 subjects, and this was also found ststistically significant (McNemar test, P<.001). CONCLUSION: This study showed that obstructive adenoid and tonsillar hypertrophy causes higher mPAP values in children and revealed that T&A is an effective therapeutic measure in such patients.

Coexistence of choanal atresia and Tessier's facial cleft number 2.

Choanal atresia is one of the most commonly observed congenital abnormalities of the nose. This defect is frequently associated with other congenital anomalies. One of the anomalies, which is rarely encountered is a Tessier's facial cleft 2. In this report, we present a 6-year-old girl who was brought to our department with complaints of nasal obstruction and chronic nasal discharge. On examination, a scar was seen on the left ala of her nose due to the former repair of a congenital defect. We found hypoplastic nasal cavities and bilateral choanal atresia demonstrated by rigid and flexible endoscopy. A CT scan supported these findings. This coexistence of bilateral choanal atresia with a number 2 facial cleft is an addition to a formerly proposed classification of laterofacial clefts. We think that this classification is better for describing the extent and origin of these complex lesions.

Unilateral aplasia of the submandibular gland.

The congenital absence of major salivary glands is an extremely rare disorder. In this case, we report a 32-year-old woman who came to us with right submandibular gland aplasia, which was detected incidentally. The literature on this rare occurrence is reviewed and the significance of the patient is discussed.

[Nasolabial cyst: two cases]. / Nazolabial kist: iki olgu.

Nasolabial cysts are developmental swellings originating from the epithelial remnants of the nasolacrimal ductus. In this report we present two female patients (age 44 and 54 years) with nasolabial cysts. In both cases the leading complaints arose from cosmetic appearance. Surgical excision by sublabial approach was performed. Histopathological diagnoses were in agreement with the clinical diagnoses. The patients had an uneventful postoperative period and no recurrences were seen during a follow-up period of 12 months.