Carotid Doppler ultrasound evaluation in patients with pulsatile tinnitus.

A wide range of conditions, including atherosclerosis, may lead to pulsatile tinnitus. The objective of this study was to evaluate the patients with pulsatile tinnitus by means of carotid Doppler ultrasound parameters. Thirty-four patients with pulsatile tinnitus were enrolled in the study. Internal carotid artery intima-media thickness (IMT), blood flow velocities and arterial lumen diameters (LD) were measured and compared with the control group. Mean end diastolic velocity (EDV) (32.29 ± 17.22) and IMT (1.06 ± 0.36) values were significantly higher and mean LD (6.69 ± 1.20) was significantly lower compared to the control group. Peak systolic velocity and EDV values were significantly higher in patients whose IMT were greater than 1 mm. Pulsatile tinnitus may be the first symptom of a severe, life threatening disease. Doppler sonography is a noninvasive, safe and easily applicable diagnostic tool for the evaluation of the vascular structures, in patients with pulsatile tinnitus.

An unusual location for a fungus ball: the concha bullosa.

OBJECTIVE: We report an unusual case of a fungus ball in the concha bullosa, without involvement of the paranasal sinuses. CASE REPORT: A 29-year-old woman presented complaining of nasal obstruction and postnasal discharge. Paranasal computed tomography demonstrated that the concha bullosa in the right middle turbinate was filled with a high-density material. The patient underwent endoscopic resection of the concha bullosa, during which a dark brown, cheese-like material was found. Histopathological examination of the excised specimen revealed a fungus ball. CONCLUSION: Fungus balls are non-invasive accumulations of dense fungal concretions that generally affect healthy individuals. In the sinonasal region, they occur most frequently in the maxillary sinus. Although fungus ball formation in the concha bullosa is unusual, it should be considered in the differential diagnoses of middle turbinate and sinonasal pathology.

Functional results of temporalis fascia versus cartilage tympanoplasty in patients with bilateral chronic otitis media.

OBJECTIVES: To compare the functional results of type I tympanoplasty performed with either temporalis fascia or a perichondrium and cartilage island flap, in patients with bilateral chronic otitis media. METHOD: The study included primary tympanoplasty cases with a subtotal perforation, an intact ossicular chain, a dry ear for at least one month and normal middle-ear mucosa, together with contralateral tympanic membrane perforation. Temporalis fascia tympanoplasty was undertaken in 41 patients, and cartilage tympanoplasty in 39 patients. RESULTS: The graft success rate was 65.9 per cent for the fascia group and 92.3 per cent for the cartilage group. Post-operatively, the mean ± standard deviation air conduction threshold was 28.54 ± 14.20 dB for the fascia group and 22.97 ± 8.37 dB for the cartilage group, while the mean ± standard deviation bone conduction threshold was 11.71 ± 8.50 dB for the fascia group and 7.15 ± 5.56 dB for the cartilage group. CONCLUSION: In patients with bilateral chronic otitis media, cartilage tympanoplasty seems to provide better hearing results and graft success rates.

Bilateral deep neck space infection in the paediatric age group: a case report and review of the literature.

Deep neck space infections can occur at any age but require more intimate management in the paediatric age group because of their rapidly progressive nature. Concurrent abscess in distinct neck spaces has rarely been reported in healthy children. Herewith, a rare case of bilateral neck abscess is reported in a 16-month-old female and the clinical presentation and management are discussed with a review of the literature.

Comparison of nasal cytology and symptom scores in patients with seasonal allergic rhinitis, before and after treatment.

OBJECTIVE: To evaluate symptom scores and nasal smear cytology findings in seasonal allergic rhinitis patients, before and after treatment. METHODS: Twenty-nine consecutive adult patients with seasonal allergic rhinitis were evaluated prospectively. They received mometasone furoate nasal spray and cetirizine for 21 days. Nasal and ocular symptom scores were recorded before and after treatment. Nasal cytology was also assessed as a means of determining treatment. RESULTS: The combined use of an intranasal corticosteroid and an oral antihistamine caused a significant improvement in nasal and ocular symptom scores. Cytological evaluation revealed significant reduction in nasal eosinophil, neutrophil and goblet cell counts after three weeks' treatment. CONCLUSION: Symptom scoring systems are widely used for the evaluation of drug efficacy in allergic rhinitis treatment. When investigating the disease and evaluating treatment efficacy, objective as well as subjective methods are needed. Nasal cytological assessment is a simple, objective method which provides valuable information about the nasal mucosa.