Ceruminous gland carcinoma of the external auditory canal presenting as chronic otitis media.

OBJECTIVE: Ceruminous neoplasms of the external ear canal are rare. Classification, clinical behavior, and management of these tumours are controversial. We report a case of carcinoma originating from the ceruminous glands of the external ear canal (EAC), operated based on a diagnosis of chronic otitis media with polyp. CASE REPORT: A 48-year-old man presented with left ear discharge and hearing loss. Clinical examination showed a well-circumscribed polypoid mass limited to the EAC. There was no history of bloody ear discharge or radiological findings of bony erosion suggestive of malignancy. Our preliminary diagnosis was chronic otitis media with polyp formation. Tympanoplasty was performed. Histopathology revealed a ceruminous carcinoma, and an additional operation involving lateral temporal bone dissection was performed, followed by 60 Gy radiation therapy. CONCLUSION: Ceruminous carcinomas should be considered in the differentialdiagnosis of middle and external ear pathologies in cases of soft tissue mass in the EAC.

Kinetics of L-lysine fermentation: a continuous culture model incorporating oxygen uptake rate.

For process design and optimization, it is essential to have a mathematical model that represents the system well. Many past studies do not go beyond empirically fitting experimental data. In the present study, an unstructured model incorporating oxygen uptake and dissolved oxygen concentration was developed for a continuous culture of L-lysine. Specific rate expressions of cell growth, substrate consumption, product formation, and oxygen uptake were developed and incorporated in the model. The model predicts very well the effects of operational parameters, such as the dilution rate and the feed substrate concentration. It is also able to predict the unsteady-state dynamics of continuous L-lysine fermentation.

Pneumatization in otosclerosis.

In this study, degrees of mastoid pneumatization in otosclerotic and normal patients were compared on CT scan and plain X-rays. This study was prospective, conducted on inpatients and outpatients at a large community hospital. Patients were consecutively evaluated with no sex or age predilection. Each patient had a CT scan and a Schuller graph. Temporal bone volumetric and planimetric measurements were done respectively on CT scans and Schuller graphs. Statistically no significant variations were observed between groups. No correlation could be established between the degree of pneumatization and otosclerosis. Neither imaging technique is superior to the other when they are compared.

Postoperative hypertension effect of carotid sinus denervation.

Postoperative arterial blood pressures were monitored in 43 patients who had undergone bilateral neck dissection during a 6-week period at Ankara Numune Hospital's IInd Otorhinolaryngology Department. During the first operations, all cases received carotid sinus denervation, whereas no denervation was done for the opposite side dissections held 6 weeks later. Study and control groups were composed of the same patients to achieve an objective outcome for the risk of postoperative hypertension. Hypertension was observed in 10 (23%) of 43 patients after the first operations and 12 (28%) of 43 patients after the opposite side dissections, for which no carotid denervation was done. The difference between the rates was insignificant statistically.

Postoperative hypertension after radical neck dissection.

Postoperative hypertension after radical neck dissection was detected in 20.2% of 109 neck dissections in our department between 1989 and 1993. It was probably caused by carotid sinus denervation and appeared after the vasodilation generated by anesthesia had subsided. If postoperative hypertension was encountered after the first operation, the risk of such hypertension after surgery on the contralateral side significantly increased.

Correction of saddle nose deformities by coral implantation.

The coral or Madrepororia is a sea invertebrate with a skeleton morphologically and chemically very similar to mineral bone. In 1990 we implanted coral blocks, sterilized by gamma irradiation, into the nasal dorsa of ten dogs. Resorption and substitution with bone or fibrous tissue were observed within 6 months. Between 1991 and 1994 biocoral was used in 20 patients with saddle nose deformities in order to augment the nasal pyramid and dome. Two extrusions were observed in the early postoperative period during follow-up. One of these extrusions was related to trauma and necessitated removal of the implant. Our findings show that coral is a suitable alloplastic material that can be used in the correction of saddle nose deformities.

The use of molded tympanic heterograft (lamb peritoneum).

The molded heterograft tympanic membrane was applied to twenty-five ears during tympanoplasty. The advantages and disadvantages of the graft material are discussed. Although autograft use is the principal choice, we strongly believe that this heterograft technique may be an alternative for tympanic membrane grafting; especially in revision cases in which temporalis fascia has already been used.