Co-occurrence and possible role of sinonasal anomalies in primary acquired nasolacrimal duct obstruction.

OBJECTIVE: Our objective was to determine the co-occurrence of sinonasal anomalies and primary acquired nasolacrimal duct obstruction. METHODS: A total of 41 patients were enrolled in the study, of which 41 had primary unilateral acquired nasolacrimal duct (NLD) obstruction. All patients included in the study were evaluated by anterior rhinoscopy, endoscopic nasal examination, and paranasal sinus computed tomography (CT) in order to reveal significant nasal and paranasal pathology. RESULTS: A significant increase was noted in the rate of concha bullosa, inferior turbinate hypertrophy, osteomeatal complex disease, and maxillary sinusitis in favor of the study group (P < 0.05). Nasal septal deviation, irregularity of middle turbinate, paradoxical middle turbinate, ethmoidal sinusitis, and Onodi cell and agger nasi cell incidence were found to be high in the study group. However, none of this increase was statistically significant (P > 0.05). CONCLUSIONS: Although primary acquired NLD obstruction seems to be an ophthalmologic problem, rhinologic problems have great importance in etiology. Detailed endoscopic examination and preoperative paranasal sinus computed tomography will reveal the possible role of nasal and paranasal structures adjacent to lacrimal sac in etiology of NLD obstruction. This will be effective both on conservative treatment and postoperative success in patients scheduled for surgery.

Effects of polycystic ovary syndrome and menopause on rat soft palate and base of tongue.

OBJECTIVE: To investigate the histopathologic changes in rat soft palate and base of tongue by performing experimental polycystic ovary syndrome (PCOS) and menopause models. STUDY DESIGN: Experimental study. SETTING: The study was conducted at the animal care facility of Haydarpasa Numune Education and Research Hospital. SUBJECT AND METHODS: Thirty healthy female Albino Wistar rats were divided into 4 groups (PCOS study group [n = 10], per oral letrozole given; PCOS control group [n = 6], per oral saline given; menopause study group [n = 8], ovariectomized; menopause control group [n = 6], sham operated). At the end of the follow-up periods, all animals were euthanized, and soft palates and base of tongues of all groups were removed to observe the histopathologic changes. RESULTS: When we compared the PCOS study group with the PCOS control group, submucous gland hypertrophy, mast cell infiltration, vascular engorgement, and acanthosis were significantly different in the soft palate (P < .05), and in addition to these findings, lymphocyte infiltration, subepithelial edema, and dilated glandular excretory duct were significantly different in base of tongue (P < .05). When we compared the menopause study group with the menopause control group, only vascular engorgement was significantly different in the soft palate (P < .05), and in addition to this finding, submucous gland hypertrophy, lymphocyte infiltration, polymorphonuclear leukocyte infiltration, and subepithelial edema were significantly different in base of tongue (P < .05). CONCLUSION: Our findings suggest that PCOS and menopause induce significant histopathologic changes in the soft palate and base of tongue that are similar to the histopathologic changes seen in the soft palate and base of tongue of patients with obstructive sleep apnea syndrome.

Role of allergy in primary acquired nasolacrimal duct obstruction.

OBJECTIVE: Our objective was to determine the role of allergy in primary acquired nasolacrimal duct obstruction. METHODS: A total of 41 patients were enrolled in the study, 41 of whom had primary unilateral acquired nasolacrimal duct obstruction. All patients included in the study were evaluated by anterior rhinoscopy, endoscopic nasal examination, and multiprick skin test to reveal allergic rhinitis. RESULTS: Allergy incidence was found to be high in study group. This was statistically significant (P < 0.05). CONCLUSIONS: Although primary acquired nasolacrimal duct obstruction seems to be an ophthalmologic problem, rhinologic problems have great importance in etiology. Detailed endoscopic examination and multiprick skin test will reveal the possible role of allergic rhinitis. This may increase the success rate both of the conservative treatment options and of the surgical treatment.

Histological evaluation of rat larynx in experimental polycystic ovary syndrome model.

This study aimed at studying the histopathological effects of hyperandrogenemia and estrogen deficiency on larynx mucosa in experimentally designed polycystic ovary syndrome of female rats. Two groups of experimental polycystic ovary syndrome model were composed in healthy female rats by per oral letrozole administration of for 21 and 42 days. Also a control group which only took vehicle (saline) for 42 days was designed. Laryngeal mucosa and ovaries of all animals were examined histopathologically by light microscopy and the serum hormone levels were analyzed using a solid-phase, two-site chemiluminescent enzyme immunometric assay. Statistically significant edema, vascular engorgement, inflammation, cilia loss and differentiation of goblet cell distribution were observed when the control group and study groups were compared (p < 0.01). In serum hormonal analysis there was a significant increase in levels of androgens and decrease in levels of estrogens. In addition, polycystic appearance of ovaries in letrozole-administered groups and normal appearance of ovaries in control group have been proven histopathologically. Polycystic ovary syndrome which causes estrogen deficiency and hyperandrogenemia in fertile ages resulted in histopathological changes in laryngeal mucosa.

Histopathological effects of estrogen deficiency on larynx mucosa in ovariectomised rats.

Laryngeal manifestations due to estrogen deficiency have been studied in the literature. But to date, the possible histopathological changes of laryngeal mucosa due to estrogen deficiency have not been studied. Therefore, our objective was to determine the histopathological changes of laryngeal mucosa in ovariectomised rats in order to clarify effects of estrogen deficiency on laryngeal tissue. The study is a randomized trial and was conducted at the animal care facility of Haydarpasa Numune Education and Research Hospital. Twenty-one Wistar rats were used throughout the experiment. There were six rats in the sham-operated control group. And others were divided into two groups (4, 8 weeks) according to follow-up time after ovariectomy. We observed significant changes 4 weeks after ovariectomy when we assessed subepithelial edema, inflammation, cilia and goblet cell loss (p < 0.01). It was shown that estrogen deficiency after ovariectomy in rats caused changes in laryngeal tissue when it was studied histopathologically.

How does reflux affect laryngeal tissue quality? An experimental and histopathologic animal study.

OBJECTIVE: To investigate the histopathologic changes in intact laryngeal epithelium and mucosa exposed to endogenous gastric acid and pepsin in an experimental model of reflux. STUDY DESIGN: Randomized trial. SETTING: The study was conducted at the animal care facility of Haydarpasa Numune Education and Research Hospital. SUBJECTS AND METHODS: Eighteen healthy 200- to 220-g, 20-week-old Sprague-Dawley rats were used. The animals were divided into three groups according to exposure time (1-, 4-, and 12-week exposures), and four rats were examined as controls who underwent sham operation. An experimental model of gastroesophageal reflux was induced. After exposure, the animals were euthanized, and their larynges were removed. The histopathologic changes in the larynx were observed under a light microscope. RESULTS: The mean scores for inflammation in the control, one-, four-, and 12-week groups were 0.75 ± 0.50, 1.75 ± 0.50, 2.20 ± 0.45, and 1.94 ± 0.87, respectively. However, mean scores for vascular engorgement in the control, one-, and four-week groups were 0, and in the 12-week group was 2.0 ± 0.70. The mean scores for subepithelial edema in the control, one-, four-, and 12-week groups were 1.00 ± 0, 1.75 ± 0.95, 1.80 ± 0.45, and 2.20 ± 0.84, respectively. However, mean scores for keratinization for the control, one-, and four-week groups were 0, and for the 12-week group was 1.60 ± 0.55. When we compared inflammation, vascular engorgement, subepithelial edema, and keratinization mean scores between the control and study groups, there were statistically significant increases (P = 0.005, P = 0.001, P = 0.043, P = 0.002, respectively). CONCLUSION: Our findings suggest that reflux induces significant histopathologic changes in larynx mucosa.

[Efficacy of clinical examination and computed tomography at T-staging of laryngeal carcinoma]. / Larenks kanseri T-evrelemesinde klinik muayene ve bilgisayarli tomografinin etkinligi.

OBJECTIVES: The purpose of this study is to investigate the accuracy rates of tumor T-staging and the efficacy of methods used at T-staging. PATIENTS AND METHODS: Forty-seven laryngeal carcinoma patients (6 females, 41 males; mean age 57.9+/-9.8 years; range 38 to 81 years) who underwent surgery at Haydarpasa Numune Education and Research Hospital 2nd Ear Nose Throat Clinic between March 2003 and June 2008 were included in the study. T-staging of the tumors were separately determined according to their clinical examination, computed tomography (CT) findings, and their correlation between these methods. Staging according to histopathological examination was accepted as real accurate staging. Rates of accurate staging according to postoperative histopathological examination results were evaluated under guidance of the literature. RESULTS: When their accuracy rates in determining histopathological T-stages of tumors were compared, there were no significant differences between the methods. The rates of accuracy in determining histopathologic T-stage of tumors were 40% by clinical examination; 66% by CT; and 76% when both methods were used together. The most successful results were obtained at the tumors of glottic region. Among the patients whose tumors had been staged inaccurately by clinical examination, 71% were underestimated while 29% were overestimated. Underestimation and overestimation of stagings were found to be 37% and 63%, respectively, with CT examination. CONCLUSION: Success of staging increases when clinical examination is used in together with CT. While there is a tendency towards underestimation of T-stage when staging is done only by means of clinical examination, this tendency is towards overestimation when CT is used alone. Thus, combination of clinical examination findings with CT is necessary for an accurate T-staging of a laryngeal cancer.

Does auditory tube angle really affect childhood otitis media and size of the mastoid?

OBJECTIVE: To assess the cross-sectional area of mastoid air cells and auditory tube angles (ATA), which were defined as the angles between the longitudinal line bisecting the transverse length of the external auditory canal and the longitudinal axis of the auditory tube (AT), both in healthy ears and diseased ears in patients with unilateral chronic otitis media (COM). METHODS: 25 patients who had unilateral COM were included in the study. Assessment was performed using a quantitative digital image processing computer tomography (CT) program. STUDY DESIGN: Prospective study with institutional review board approval including adult patients who had otological symptoms since their childhood period. RESULTS: Mastoid areas were greater on the healthy side than on the diseased side (p<0.05). ATA were not significantly different among groups (p>0.05). When we compared ATA with mastoid area in each group; there were no significant correlations in both healthy group and COM group (p>0.05). Mastoid size in COM group was smaller than in the healthy group. CONCLUSION: We suggest that middle ear inflammations in childhood may affect mastoid size but, the anatomic relationships of the auditory tube, mastoid and middle ear that form a functional unit may not be significantly important in chronic ear disease.