Bilateral Barotraumatic Involvement of the Infraorbital Nerve with Dehiscence and Ectopic Course: A Case Report.

The infraorbital nerve is responsible for the sensory innervation of the lower eyelid, the lateral nose, the cheek, the upper lip, and the maxillary teeth. It passes along the infraorbital canal, which runs superior to the maxillary sinus. Dehiscence of the infraorbital canal and its ectopic course in the maxillary sinus is a rare variation. A nerve with these variations may be affected by pathologies in the maxillary sinus and this may constitute a rare cause of facial pain. In this report, we present the clinical symptoms of a 29-year-old male patient who had an infraorbital nerve with an ectopic course and dehiscence in light of the literature.

Atypical Lipomatous Tumor Originating From the Nasopharynx in a Patient with Chronic Lymphocytic Leukemia.

Atypical lipomatous tumor, also known as well-differentiated liposarcoma, is rare in the head and neck region. The primary and most effective option in the treatment of this malignancy with a good prognosis is excision with clean surgical margins. Therefore, it is important to distinguish this malignancy from lesions that require more aggressive treatment. In this article, we present the case of an atypical lipomatous tumor originating from the nasopharynx and almost completely obstructing the oropharynx in a 38-year-old male patient with chronic lymphocytic leukemia. To the best of our knowledge, this is the first report in the literature of an atypical lipomatous tumor case originating from the nasopharynx.

Coexistence of Adenoid Cystic Carcinoma and Sialolithiasis in Submandibular Gland: Case Report.

Sialolithiasis is the primary cause of swelling in the major salivary glands. The etiopathogenesis is not clear. Adenoid cystic carcinoma is a slow-growing salivary gland malignancy with a poor prognosis. There are only a few cases in the literature reporting the coexistence of sialolithiasis and adenoid cystic carcinoma. In this report, we present a case that was thought to have sialolithiasis in the foreground because of the calcified image on computed tomography, but was diagnosed with adenoid cystic carcinoma after excision, together with a discussion of the relationship between sialolithiasis and carcinogenesis.

A Rare Case of Laryngeal Osteosarcoma Causing Diagnostic Challenges.

Laryngeal osteosarcomas are extremely rare. They cause diagnostic difficulty for the otolaryngologist and pathologist. Differentiation from sarcomatoid carcinoma is challenging but important, as clinical features and treatment strategies are different. Total laryngectomy is generally the preferred surgical approach for laryngeal osteosarcomas. Since lymph node metastasis is not expected, neck dissection is not needed. In this report, we present a case diagnosed with laryngeal osteosarcoma post the examination of the total laryngectomy specimen of a laryngeal tumor that could not be histopathologically differentiated by punch biopsy.

Angiotensin-converting enzyme insertion/deletion gene polymorphism in patients with laryngeal cancer.

Objectives: The aim of this study was to compare the distribution of the angiotensin-converting enzyme (ACE) I/D polymorphism between patients with laryngeal cancer (LC) and a control group and to examine the distribution of this polymorphism with clinical parameters related to LC. Methods: We enrolled 44 LC patients and 61 healthy controls. The ACE I/D polymorphism was genotyped with the PCR-RFLP method. The distribution of ACE genotypes (II, ID, and DD) and alleles (I or D) was evaluated with Pearson's chi-square test, and logistic regression analysis was performed for statistically significant parameters. Results: There was no significant difference in ACE genotypes and alleles between LC patients and controls (p = 0.079 and p = 0.068, respectively). Among clinical parameters related to LC (extension of tumour, node metastasis, tumour stage and tumour location), only the presence of node metastasis was found to be significant in terms of ACE DD genotype (p = 0.137, p = 0.031, p = 0.147, p = 0.321 respectively). In the logistic regression analysis, the ACE DD genotype was increased 8.3 fold in nodal metastases. Conclusions: The findings of the study suggest that ACE genotypes and alleles do not affect the prevalence of LC, but the DD genotype of ACE polymorphism may increase the risk of lymph node metastasis in LC patients.

Evaluation of Cribriform Plate Dimensions and Middle Turbinate Length in Patients With Vomeral Agenesis: A Computed Tomography Study.

The cribriform plate and attachment area of the middle turbinate are anatomical structures that may potentially be injured during septoplasty and/or endoscopic sinus surgery. The purpose of this study is to compare the cribriform plate and middle turbinate length dimensions between patients with vomer agenesis (VA) and the control group using paranasal sinus computed tomography (CT). Paranasal sinus CTs performed in our hospital between January 2011 and January 2021 were evaluated and patients with VA were identified. A control group was created from patients who underwent paranasal sinus CT for various reasons during the same date interval. The cribriform plate and middle turbinate lengths were statistically compared between the groups. A total of 10,095 paranasal sinus CTs were evaluated and 54 patients with VA were identified. Seven patients with VA were excluded from the study because their measurements could not be made accurately. Forty-seven VA patients were included in the study group, while 94 patients were included in the control group. There was no statistical difference in cribriform plate dimensions (medial ethmoid roof plate height, cribriform plate height, cribriform plate lateral lamella height and width) between the groups (for all dimensions P >0.05). The middle turbinate length was significantly higher in the VA group (for right and left P =0.020 and 0.011, respectively). These findings theoretically suggest that the risk of cribriform plate injury during septoplasty and/or endoscopic sinus surgery is similar in patients with or without VA.

Frozen Section Evaluation for Surgical Margins in Laryngeal Squamous Cell Carcinoma: Is it a Reliable Method for Partial and Total Laryngectomies?

BACKGROUND: In this study, we aimed to compare the accuracy of frozen section evaluation in partial and total laryngectomies performed to treat laryngeal squamous cell carcinoma . METHODS: A retrospective study was conducted to evaluate the efficacy and accuracy of frozen section analysis for laryngeal squamous cell carcinoma of 65 patients, operated at a tertiary hospital. Two groups were recruited according to the surgical procedure. RESULTS: The sensitivity and specificity of frozen section diagnosis in laryngeal cancer were 20% and 99.73%, respectively. For partial laryngectomy, the sensitivity was 16.66% and specificity was 100%. For total laryngectomy, sensitivity was 22.2% and specificity 99.13%. Discordances between the initial frozen section diagnosis and the subsequent permanent section diagnosis were found in 13 (3.35%) pairs (3.37% partial laryngectomy and 3.33% total laryngectomy). CONCLUSION: Our study shows that the surgical method applied has no effect on discordances. However, sampling errors are likely to be more common in partial laryngectomy procedures. It should be kept in mind that the sensitivity of frozen section evaluation is low.

A Plastic Torpedo-Shaped Firecracker That Caused Injury to the Parotid Gland: A Case Report.

Penetrating injuries affecting the parotid gland are relatively rare compared to injuries affecting other head and neck structures. Likewise, foreign bodies impacting the parotid gland are extremely rare. These foreign bodies can be secondary to penetrating injury or may reach the parotid gland by retrograde migration through Stensen's duct. Management of parotid gland foreign bodies is a challenging clinical situation for otolaryngologists due to the course of the facial nerve through the gland. In this article, a patient with penetrating parotid injury as a result of the explosion of a torpedo-shaped firecracker is presented. This object's injury to the parotid gland is presented for the first time in the literature. In addition, the importance of detailed physical examination was emphasized, as foreign bodies may embed under the skin in such injuries.

Transoral penetrating upper cervical injury: a case report.

Transoral penetrating foreign body injury of the neck involving the cervical spine is a rare condition. We present an injury caused by transoral penetration of a broken piece of a wooden plank into the neck with injury to the upper cervical spine in a 31-year-old male patient. The foreign body was removed transorally with the patient making a full recovery under close observation and was discharged and followed up with no complications. This paper highlights the types of neck injuries, the key points to be considered in zone III neck injury in light of existing literature and a discussion on the management of these patients.

Evaluation of Anxiety Sensitivity, Anxiety, Depression, and Attention Deficit Hyperactivity Disorder in Patients with Tinnitus.

Context: There may be a connection between tinnitus, a common disease in society, and psychiatric disorders. When the literature is reviewed, it has been realized that more data are needed to elucidate this issue. Aims: The aim of this study is to compare the symptoms of anxiety sensitivity, anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD) symptoms in patients with tinnitus with healthy individuals and to investigate the relationship between tinnitus and psychiatric disorder symptoms. Settings and design: This study was designed as a case-control study. Materials and methods: Fifty-one patients with tinnitus and 51 healthy controls were enrolled in this study. Clinical severity of the psychiatric variables were evaluated by Beck depression inventory, Beck anxiety inventory (BAI), anxiety sensitivity index-3, and adult ADHD self-report scale (ASRS) in patient and control groups. Statistical analysis used: Variables are presented as either a number, a percentage, a mean ± standard deviation, or frequency. Chi-squared, Student t tests, and logistic regression analysis were used to examine the relationship between variables. Results: Logistic regression analysis results indicated that a significant predictive power of BAI for the presence of tinnitus. Based on a backward-elimination regression analysis, ASRSs (inattention subscale scores) were considered to predict a higher tinnitus handicap inventory score. Conclusion: These findings provide additional evidence that anxiety and attention-deficit (inattentive) symptoms could contribute to the pathophysiology of tinnitus.

Surprise Egg in the Nasopharynx: Basal Cell Adenocarcinoma.

Basal cell adenocarcinoma is a rare salivary gland neoplasm. It is most commonly seen in the parotid gland, and its involvement in the minor salivary glands or upper respiratory tract is very rare. Surgical excision and/or radiotherapy are the mainstay treatment modalities. The nasopharynx is an unusual location for salivary gland basal cell adenocarcinoma. In this case report, the nasopharyngeal punch biopsy of a 60-year-old male patient was reported as salivary gland adenoma, but the final pathological diagnosis was changed to basal cell adenocarcinoma after endoscopic nasopharyngectomy. The clinical, radiological, and histopathological features of the case are presented in light of the literature. In addition, diagnostic clues are emphasized in cases of suspected non-epithelial tumors of the nasopharynx.

Oral Lipoma Resembling Popeye's Pipe: A Case Report.

Lipomas are benign neoplasms of mesenchymal origin. Although they are frequently seen in other parts of the body, they are rare in the oral cavity. In the oral cavity, they most often develop from buccal mucosa. They tend to grow slowly, so they may remain asymptomatic for a long time and go unnoticed. Lipomas in the oral cavity may cause deterioration in chewing-speaking and esthetic problems over time, depending on the increase in their size. The most reliable imaging method for differential diagnosis is magnetic resonance imaging. Complete excision of the lipoma is essential for treatment. In this study, a case of an unusual oral lipoma, causing nutrition-speaking difficulties in a geriatric male patient is presented.

The role of raftlin in the pathogenesis of chronic rhinosinusitis with nasal polyps.

PURPOSE: The aim of this study was to investigate the possible role of raftlin (RFTN) in chronic rhinosinusitis with nasal polyps (CRSwNP). There is no study in the literature investigating the role of RFTN in the pathogenesis of CRSwNP. METHODS: The present study was designed as a case-control study and conducted between 25.09.2020 and 01.01.2022. CRSwNP and control groups were formed in the study. Serum and tissue samples were taken from each patient in the study and their RFTN levels were measured. While nasal polyps were used for tissue samples in the CRSwNP group, middle meatus mucosa obtained during concha bullosa surgery was used in the control group. RESULTS: The control group included 31 patients (8 female, 23 male) and the CRSwNP group included 49 patients (14 female, 35 male). The mean age of the control group was 40.42 ± 9.99 years, while the mean age of the CRSwNP group was 43.47 ± 10.19 years. When the groups are compared in terms of gender and age, there were no statistically significant differences (p = 0.78, p = 0.19, respectively). The serum RFTN levels in the control and CRSwNP groups were 7.85 ± 10.87 ng/ml, and 7.02 ± 8.59 ng/ml, respectively (p = 0.45). The tissue RFTN levels in the control group and CRSwNP group were 87.15 ± 69.91 ng/ml, and 66.50 ± 17.10 ng/ml, respectively (p = 0.04, statistically significant). CONCLUSION: RFTN deficiency in nasal polyp tissue may be one of the reasons for the development of CRSwNP. Further studies are needed to elucidate the role of RFTN in CRSwNP.

A Rare Incidental Diagnosis After Adenoidectomy: Sarcoidosis.

Sarcoidosis is a systemic disease of unknown etiology. It is characterized by non-caseating granulomatous inflammation. It most commonly affects the pulmonary and intrathoracic lymph nodes. Isolated nasopharyngeal involvement is very rare. Pediatric sarcoidosis and isolated nasopharyngeal involvement are rare entities. Symptoms of nasopharyngeal involvement can mimic adenoid hypertrophy. In this case report, we present a nine-year-old female who was diagnosed coincidentally with sarcoidosis with the adenoidectomy specimen.

A Giant Diving Ranula Extending to the Skull Base in Pediatric Age.

ABSTRACT: Ranula is a retention cyst that develops from the salivary glands. It has 2 subtypes, oral and diving. There are differences in the clinical features of ranula subtypes. In particular, diving ranula is more prone to extend in the neck spaces than oral ranula. The enlargement of the diving ranula is generally downward in the neck. If the opposite occurs, we may encounter very interesting and difficult cases. Diving ranula should be kept in mind in the differential diagnosis of cystic neck masses in the pediatric age group and its treatment should be done surgically.A 15-year-old girl admitted to our clinic with the complaint of swelling in the floor of the mouth and neck. In physical examination of the patient, a mass with cystic content was observed adjacent to the left Wharton canal. In addition, a 4 × 3 cm, soft, fluctuant, nonfixed, painless mass was palpated in the left submandibular area. Magnetic resonance imaging revealed that the neck mass was a diving ranula extending from the parapharyngeal space to the skull base. In the surgery, submandibular and sublingual salivary glands were removed together with the diving ranula. We observed no complications in the postoperative period.Magnetic resonance imaging should be used to confirm the diagnosis of diving ranula. In the treatment of diving ranula, excision of the ranula alone is not enough surgically. We also recommend excision of the submandibular and/or sublingual salivary glands associated with ranula to reduce the recurrence rate.

A Rare Location for Ossifying Fibroma: Temporal Bone Involvement.

Benign fibro-osseous lesions of the craniofacial region are a diverse group of entities with overlapping histologic characteristics. One of these fibro-osseous lesions is ossifying fibroma and it is seen rarely in the head and neck region. Only a few cases of temporal bone involvement were reported in the literature. Patients with ossifying fibroma located in the temporal bone may have the following complaints: conductive hearing loss, swelling, localized pain, headache, and ear discharge. The lesion should be removed surgically and obtaining negative surgical margins is crucial to prevent any recurrence. A 29-year-old female patient who applied to our clinic with the complaint of a mass behind the left ear was treated, and the pathological diagnosis was an ossifying fibroma. In this study, a case of ossifying fibroma is presented.

Can the systemic immune inflammation index preoperatively predict nasal polyp subtypes?

PURPOSE: Chronic rhinosinusitis with nasal polyps can be classified as eosinophilic or neutrophilic based on the major inflammatory cell type in the tissue. There is a need for predictive parameters to enable rhinologists to identify the type of nasal polyp in a patient without surgery. The aim of the present study was to test the predictive value of the markers of inflammation to estimate eosinophilic nasal polyps. METHODS: The study analyzed 299 patients who underwent sinus surgery for nasal polyps from 2012 to 2019. Patients were divided into two groups according to pathology results (eosinophilic polyps = group 1, neutrophilic polyps = group 2). The values of preoperative complete blood count, systemic immune inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were compared. RESULTS: In our series, results of ROC analyses for both mean eosinophil count and systemic immune inflammation index were statistically significant. For the eosinophil count (AUC = 0.681, p < 0.001) and systemic immune inflammation index (AUC = 0.621, p = 0.001). Patients with an eosinophil cut-off value of 0.25 cells × 109/L had ORs of 49.27 (95% CI 11.68-207.81) and sensitivity: 0.69, specificity: 0.64. Patients with a systemic immune inflammation index cut-off value of 332.39 had ORs of 1.003 (95% CI 1.002-1.004) and sensitivity: 0.84, specificity: 0.39. CONCLUSION: The systemic immune inflammation index and absolute blood eosinophil count could be used to predict nasal polyp subtypes before surgery. We believe that systemic immune inflammation index should also be studied to estimate postoperative recurrence.