Effects of oral isotretinoin on normal and wounded nasal mucosa: an experimental study.

BACKGROUND: We aimed to investigate the effect of systemic isotretinoin therapy on normal and wounded nasal septal mucosa histopathologically in an experimental rabbit model. METHODS: Circular mucosal defect with a 7 mm diameter was made in the left septum of 12 New Zealand white rabbits. The rabbits were divided into two groups (six rabbits in each group) oral isotretinoin was given with olive oil at the operation day to the first group. The control group was only oil given group. The harvested septum mucosas were divided into four groups (1-wounded-drug given side, 2-unwounded and drug-given side, 3-wounded-control and 4-unwounded-control side). The diameter of the defect, mucosal thickness, epithelial thickness, ciliated cell level, goblet cell level and inflammation were evaluated every week for 4 weeks. RESULTS: At both wounded and normal side, thinning of normal respiratory ciliated epithelium was observed in the postoperative period. In study group at the wounded side; mean mucosal thickness was measured 139.66 µ (± 26.24), and in the control group, mean mucosal thickness was 238.33 µ (± 39.7) at the wounded side. (p < 0.001). The difference between the groups in thickness of normal septal mucosa was also statistically significant (p = 0.016) [190 µ (± 14.6) and 256.66 µ (± 44.66)]. The average cilia level was observed 1.16 in the wounded study group, while the average level was 2.33 in the wounded control group (p = 0.012). Average score measurements of the regenerated mucosa suggested that isotretinoin-given wounded animals have reduced goblet cell recovery, compared to the control both on the regenerated and unwounded mucosas (p = 0.007, p = 0.002, respectively). Inflammation was significantly higher in the wounded isotretinoin group (p = 0.018). CONCLUSION: Oral isotretinoin has negative effects on epithelial and ciliary regeneration, significantly reduces mucosal thickness and goblet cell counts of the normal and regenerated mucosa, causes severe inflammation and significant reactive changes.

Histopathological comparison of bone healing effects of endonasal and percutaneous lateral osteotomy methods in rabbit rhinoplasty model / Comparação histopatológica dos efeitos da cicatrização óssea entre as técnicas de osteotomia lateral endonasal e percutânea em modelo de rinoplastia em coelhos

Abstract Introduction: Lateral osteotomy is mainly performed either endonasally or percutaneously in rhinoplasty which is a frequently performed operation for the correction of nasal deformities. Both techniques have both advantages and disadvantages relative to each other. Objective: The aim of this study was to compare the histopathological effects of endonasal and percutaneous osteotomy techniques performed in rhinoplasty on bone healing and nasal stability in an experimental animal model. Methods: Eight one year-old New Zealand white rabbits were included. Xylazine hydrocloride and intramuscular ketamine anesthesia were administered to the rabbits. Endonasal osteotomy (8 bones) was performed in Group 1 (n = 4), and percutaneous osteotomy (8 bones) in Group 2 (n = 4). One month later the rabbits were sacrificed. Bone healing of the rabbits was staged according to the bone healing score of Huddleston et al. In both groups, nasal bone integrity was assessed subjectively. Results: In the percutaneous osteotomy group, Grade 1 bone healing was observed in two samples (25%), Grade 2 bone healing in two samples (25%), Grade 3 bone healing in four samples (50%). In the endonasal osteotomy group, Grade 1 bone healing was observed in 6 samples (75%) and Grade 2 bone healing was observed in 2 samples (25%). In the percutaneous group, fibrous tissue was observed in 2, predominantly fibrous tissue and a lesser amount of cartilage was observed in 2 and an equal amount of fibrous tissue and cartilage was observed in 4 samples. In the endonasal group, fibrous tissue was observed in 6 samples, and predominantly fibrous tissue with a lesser amount of cartilage was observed in 2 samples. In both groups, when manual force was applied to the nasal bones, subjectively the same resistance was observed. Conclusion: Percutaneous lateral osteotomy technique was found to result in less bone and periost trauma and better bone healing compared to the endonasal osteotomy technique.

Resumo Introdução: Nas rinoplastias, a osteotomia lateral é realizada principalmente por via endonasal ou percutânea para correção de deformidades nasais. Ambas as técnicas apresentam vantagens e desvantagens. Objetivo: Comparar os efeitos histopatológicos sobre a cicatrização óssea e estabilidade nasal entre as técnicas de osteotomia endonasal e percutânea em rinoplastia em um modelo animal experimental. Método: Foram incluídos oito coelhos brancos da Nova Zelândia de um ano de idade. Hidrocloreto de xilazina e cetamina intramuscular foram administrados aos coelhos como agentes anestésicos. Osteotomia endonasal (8 ossos) foi realizada no Grupo 1 (n = 4) e osteotomia percutânea (8 ossos) no Grupo 2 (n = 4). Um mês depois, os coelhos foram sacrificados. A cicatrização óssea dos coelhos foi avaliada de acordo com o escore de cicatrização óssea de Huddleston et al. Em ambos os grupos, a integridade do osso nasal foi avaliada subjetivamente. Resultados: No grupo da osteotomia percutânea, observou-se cicatrização óssea de grau 1 em duas amostras (25%), cicatrização óssea de grau 2 em duas amostras (25%), e cicatrização óssea de grau 3 em quatro amostras (50%). No grupo da osteotomia endonasal, observou-se cicatrização óssea de grau 1 em 6 amostras (75%) e a cicatrização óssea de grau 2 foi observada em 2 amostras (25%). No grupo percutâneo, o tecido fibroso foi observado em 2 amostras, enquanto tecido predominantemente fibroso e uma menor quantidade de cartilagem foi observada em 2 e uma quantidade igual de tecido fibroso e cartilagem foi observada em 4 amostras. No grupo endonasal, observou-se tecido fibroso em 6 amostras e tecido predominantemente fibroso com uma menor quantidade de cartilagem em 2 amostras. Em ambos os grupos, quando força manual foi aplicada aos ossos nasais, a mesma resistência foi observada subjetivamente. Conclusão: A técnica de osteotomia lateral percutânea resultou em menor traumatismo ósseo e periosteal e melhor cicatrização óssea em comparação com a técnica de osteotomia endonasal.

Histopathological comparison of bone healing effects of endonasal and percutaneous lateral osteotomy methods in rabbit rhinoplasty model.

INTRODUCTION: Lateral osteotomy is mainly performed either endonasally or percutaneously in rhinoplasty which is a frequently performed operation for the correction of nasal deformities. Both techniques have both advantages and disadvantages relative to each other. OBJECTIVE: The aim of this study was to compare the histopathological effects of endonasal and percutaneous osteotomy techniques performed in rhinoplasty on bone healing and nasal stability in an experimental animal model. METHODS: Eight one year-old New Zealand white rabbits were included. Xylazine hydrocloride and intramuscular ketamine anesthesia were administered to the rabbits. Endonasal osteotomy (8 bones) was performed in Group 1 (n=4), and percutaneous osteotomy (8 bones) in Group 2 (n=4). One month later the rabbits were sacrificed. Bone healing of the rabbits was staged according to the bone healing score of Huddleston et al. In both groups, nasal bone integrity was assessed subjectively. RESULTS: In the percutaneous osteotomy group, Grade 1 bone healing was observed in two samples (25%), Grade 2 bone healing in two samples (25%), Grade 3 bone healing in four samples (50%). In the endonasal osteotomy group, Grade 1 bone healing was observed in 6 samples (75%) and Grade 2 bone healing was observed in 2 samples (25%). In the percutaneous group, fibrous tissue was observed in 2, predominantly fibrous tissue and a lesser amount of cartilage was observed in 2 and an equal amount of fibrous tissue and cartilage was observed in 4 samples. In the endonasal group, fibrous tissue was observed in 6 samples, and predominantly fibrous tissue with a lesser amount of cartilage was observed in 2 samples. In both groups, when manual force was applied to the nasal bones, subjectively the same resistance was observed. CONCLUSION: Percutaneous lateral osteotomy technique was found to result in less bone and periost trauma and better bone healing compared to the endonasal osteotomy technique.

Comparison of Frey Syndrome Rates Following Superficial Parotidectomy and Partial Superficial Parotidectomy for Pleomorphic Adenoma.

PURPOSE: Comparison of Frey syndrome rates following superficial parotidectomy and partial superficial parotidectomy for pleomorphic adenoma. METHODS: Fifty patients diagnosed with pleomorphic adenoma and received surgical treatment at the Otolaryngology Department of Bagcilar Training and Research Hospital between January 2009 and October 2015 were reviewed retrospectively. The patients were specifically queried for Frey syndrome symptoms. The syndrome was investigated with Minor starch iodine test. The patients who underwent superficial parotidectomy were compared to those who underwent partial superficial parotidectomy in terms of Frey syndrome development and recurrence. RESULTS: In the partial superficial parotidectomy group, Frey syndrome symptoms were edema and increased sweating and burning sensation on the face in 7 patients (21.9%, P = 0.735). In the superficial parotidectomy group, 5 patients exhibited edema (27.8%), 3 exhibited increased sweating (16.7%), and 5 exhibited burning sensation (27.8%). Minor test results were positive for 7 patients in the partial superficial parotidectomy group (21.8%) and 5 patients were positive (27.8%) in the superficial parotidectomy group. No recurrence was found in either group during the 5-year follow-up. No significant difference was found between 2 groups in terms of postoperative complications and recurrence. CONCLUSION: In terms of their effect on Frey syndrome development, there is no significant difference between partial superficial parotidectomy and superficial parotidectomy.