Occupational safety threats among dental personnel and related risk factors.

Occupational diseases are primarily considered to be important health problems for individuals with occupations in heavy industry fields. Although dentists work in very clean and elegant offices, they are frequently exposed to various chemicals and high-intensity, sound-producing instruments, such as compressors and aerators. In our study, we aimed to investigate the risk for occupational hearing loss of dental personnel, by performing pure-tone audiometry in 40 dentists and comparing the results with those of healthy individuals. We also sampled the nasal mucosa to investigate the effects of occupational chemicals on the nasal mucosa of the dentists. The pure-tone audiometric thresholds at 5 different frequencies (1000, 2000, 4000, 6000, and 8000 Hz) and working time were evaluated as potential risk factors. The pure-tone audiometric results (as decibels) at each frequency and the median values for each side (right and left ears) were significantly higher for dentists than for the control group (P < 0.05). The pure-tone audiometric results did not significantly differ between the women and men in the study group (P > 0.05). The findings in the nasal mucosa (goblet cell hyperplasia, neutrophil/eosinophil/basophil distribution, metaplasia, dysplasia, premalignant or malignant cells) were similar in the study and control groups (P > 0.05). In conclusion, our study indicated that high-intensity, sound-producing equipment is an important occupational threat for dentists, whereas chemical agents have minimal hazardous effects.

Does desloratadine alter the serum levels of montelukast when administered in a fixed-dose combination?

OBJECTIVES/HYPOTHESIS: The aim of this study was to investigate the serum levels of montelukast when administered alone or in combination with desloratadine. STUDY DESIGN: A prospective crossover study. METHODS: Twenty-three healthy volunteers were investigated in two sessions. Volunteers were given 10 mg of montelukast orally with 250 mL water in the first session. The same subjects were given 10 mg of montelukast in fixed combination with 5 mg desloratadine 10 days after first session. Blood samples were collected 2, 3, and 4 hours after drug administration, and kept at -80°C after both applications. Plasma samples were analyzed for montelukast concentration. RESULTS: Mean concentration values of both groups were not statistically different (P > .05), but the differences were statistically significant according to time (P < .05). Statistically significant difference was not found between the groups according to the area under curve on the basis of both marginal and cumulative values for all different time intervals (P > .05). CONCLUSIONS: The absorption rate of montelukast was not altered when administered with desloratadine. This study suggested that desloratadine does not influence the bioavailability of montelukast, and their combination therapy can be used safely.

[A case of maxillary sinus mucocele with orbital involvement]. / Orbital yayilimli maksiller sinüs mukoseli: Olgu sunumu.

Maxillary sinus mucoceles account for less than 10% of all paranasal sinus mucoceles. They are reported mostly as long-term sequelae of Caldwell-Luc operations. Orbital involvement is an extremely rare condition that might result in orbital complications. A 43-year-old woman presented to the ophthalmology department with progressive ophthalmologic complaints. She was referred to our department for suspicion of a mass in the left maxillary sinus. The patient had undergone a left Caldwell-Luc sinus procedure two years before followed by two maxillary sinus lavages. Findings of computed tomography and magnetic resonance imaging of the paranasal sinuses were suggestive of a maxillary mucocele. Endoscopic sinus surgery and Caldwell-Luc procedure were performed to remove the mucocele that filled the maxillary sinus. Because the eyeball prolapsed through the defect in the inferior orbital wall to the maxillary antrum, a Silastic sheath was placed between the orbital base and the eyeball. No postoperative complication was observed.

Peripheral seventh nerve palsy due to transorbital intracranial penetrating pontine injury.

The case of a child injured by a knitting needle penetrating transorbitally and intracranially, resulting in carotid cavernous fistula and pontine injury, is reported. After receiving medical and endovascular treatment, the only remaining abnormal neurological manifestation was right peripheral facial nerve palsy. The clinical sequences of events and the demonstration of a pontine lesion leading to peripheral facial palsy are presented. Facial nuclear injury with a penetrating trauma is an extremely rare condition. It is important to identify the anatomical regions injured in penetrating traumas. The lesions must be identified by computerized tomography, magnetic resonance imaging, clinical and laboratory investigation.

[Detection of primary carcinoma by positron emission tomography in an unknown primary tumor with cervical metastasis: a case report]. / Primeri bilinmeyen boyun metastazinda pozitron emisyon tomografisi ile primer kanserin saptanmasi: olgu sunumu.

Unknown primary tumors with cervical metastasis account for about 1-3% of patients with neck masses. In many cases, the primary site cannot be detected by diagnostic procedures such as endoscopy, computed tomography, or magnetic resonance imaging, affecting the treatment and prognosis of these patients unfavorably. A 43-year-old male patient presented with a painless mass in the neck. He had previously undergone a neck biopsy, the result of which had been reported as metastatic carcinoma. The primary site could not be determined by extensive diagnostic procedures. Investigation with positron emission tomography with 18F-2-fluoro-2-deoxy-D-glucose suggested the base of the tongue as the primary site, which was then confirmed by an endoscopic biopsy from the tongue. It should be borne in mind that positron emission tomography may be helpful in the diagnosis of unknown primary tumors with cervical metastasis.

[The evaluation of voice quality after near-total laryngectomy]. / Near-total larenjektomiden sonra ses kalitesinin degerlendirilmesi.

OBJECTIVES: It was intended to compare various characteristics of phonation obtained in cases who underwent near-total laryngectomy (NTL) and frontolateral laryngectomy (FLL). STUDY DESIGN: The study included 29 male cases, 9 of whom underwent NTL, 10 of whom underwent FLL and 10 who had normal laryngeal speech. All cases were evaluated and compared statistically according to the fundamental frequency (Fo), intensity and voiceless time measurements, maximal phonation time (MPT), speech rate and speech intelligibility. RESULTS: Fo and Fo range were found significantly high in both patient groups, but MPT and speech rate was meaningfully decreased in these groups relative to the control group. There were not any significant differences between the two patient groups. The speech intelligibilities of the NTL group patients were significantly low relative to other two groups. The voiceless time measurements during phonation were significantly high in two patients groups, but we also found that it was not effective on speech rate and intelligibility. CONCLUSION: The phonation gained after NTL is similar to that of FLL in respect of various features. But owing to differences of the speech intelligibility measurements, we concluded that patients who underwent NTL could be exposed to more problems during communication with their social surroundings.

[An evaluation of surgical techniques and oncologic results in early glottic cancers]. / Erken evreli glottik kanserlerde cerrahi tedavi seçimi ve onkolojik sonuçlar.

OBJECTIVES: We evaluated the surgical techniques employed and survival rates in patients who were treated for early glottic cancer. PATIENTS AND METHODS: The study included 29 patients (28 males, 1 female; mean age 59 years; range 47 to 73 years) who underwent surgery for early glottic cancer. Surgical techniques were employed in view of factors such as involvement of the anterior commissure, the extent of sub- or supraglottic invasion, and cord mobility. Two- and five-year survival rates were calculated. TNM classification was made according to the 1992 AJCC staging system. RESULTS: Preoperative tumor stages were TisN0 (n=2, 7%), T1N0 (n=20, 69%), and T2N0 (n=7, 24%). Surgical techniques included laryngofissure and cordectomy (n=9, 31%), frontolateral laryngectomy (n=18, 62%), and vertical hemilaryngectomy (n=2, 7%). Positive surgical margins were reported postoperatively in 10 patients, eight of whom remained tumor-free with (n=4) or without (n=4) radiation therapy during the follow-up period, while two patients underwent total laryngectomy because of local recurrences. Three patients died due to causes other than the primary disease. Two- and five-year survival rates were 88.8% and 80%, respectively. CONCLUSION: Involvement of the anterior commissure, and the extent of invasion to the subglottis, supraglottis, and the laryngeal ventricle seem to play a major role in selecting the most appropriate surgical technique in early glottic cancer.

[Patient selection for near-total laryngectomy and oncologic results]. / Near-total larenjektomi için hasta seçimi ve onkolojik sonuçlar.

OBJECTIVES: We reviewed preoperative, perioperative, and postoperative findings and the survival data to determine which patients may be appropriate for near-total laryngectomy. PATIENTS AND METHODS: We reviewed hospital records of 20 patients (all males; mean age 56.6 years; range 35 to 73 years) who underwent near-total laryngectomy. Indications for patient selection for near-total laryngectomy and survival data were evaluated in comparison with literature reports. RESULTS: The site of the tumor was the sinus pyriformis in two, and the larynx in 18 patients. Thirteen patients had T3, seven patients had T2 tumors. The lesions were localized in the sinus pyriformis in two patients with T2 tumors. The locoregional control rate at the end of two years was 75%; two- and three-year survival rates were 81.2% and 64.2%, respectively. CONCLUSION: Following a detailed and meticulous investigation in the preoperative period, near-total laryngectomy seems to be appropriate in selected patients with advanced laryngeal and hypopharyngeal tumors in which partial laryngectomy procedures are not considered. It may both provide cure and preserve phonation. It may also be considered for functional purposes in patients whose pulmonary functions are insufficient for partial laryngectomy, in those in whom food aspiration is inevitable after partial laryngectomy, and in those suffering from lifelong food aspiration due to neurologic causes, and for oncologic reasons in patients who develop local recurrences after partial laryngectomy.