Fine needle aspiration biopsy: in the diagnosis of salivary gland neoplasms compared with histopathology.

Fine needle aspiration biopsy is commonly used for pre operative evaluations of salivary gland masses. We would like to focus on this diagnostic tool for the salivary gland lesions by reviewing Ankara Oncology Hospital's case lists. Cytological and postoperatively histological reassessment is done for 115 cases. Fine needle aspiration biopsy's sensitivity was 80.8 %, specificity 95.1 %, positive predictive value was 84 % and negative predictive value was 93.9 %. False positive range was 4.9 % and false negative range was 19.2 %. Salivary gland masses can be assessed by cytology preoperatively.

Incidentally detected asymptomatic metal foreign bodies (two nails) in shoemaker's maxillary sinus.

The diagnosis metal foreign bodies of maxillary sinus cannot be usually made in an acute setting and patients may present with chronic symptoms due to drainage and chronic irritation of the mucosa years later. Metal foreign bodies can be generally displaced to the maxillary sinus at the time of dental intervention. In this article, we report a very interesting case of 23-year-old male shoemaker with two metal foreign bodies (nails) which were non-related with any surgical intervention or trauma and found incidentally in the right maxillary sinus.

A comparison of unilevel and multilevel surgery in obstructive sleep apnea syndrome.

We conducted a retrospective study of 35 adults who had undergone tongue base suspension in addition to other surgery for the treatment of obstructive sleep apnea syndrome (OSAS). Our goal was to determine the most effective surgical approach by comparing these patients' preoperative apnea-hypopnea index (AHI) with their postoperative scores at 6 months. The 35 patients were divided into three groups based on a preoperative assessment of their level of airway obstruction; the assessment included a determination of AHI and endoscopic findings during the MÜller maneuver. Patients in group 1 (n = 9) exhibited unilevel obstruction, and they were treated with lateral pharyngoplasty; patients in group 2 (n = 13) also had unilevel obstruction, and they underwent Z-palatoplasty; patients in group 3 (n = 13) had multilevel obstruction, and they underwent combined surgery. Postoperatively, all three groups exhibited statistically significant improvements in AHI, but we determined that of the three approaches, multilevel surgery was significantly more effective (p < 0.001).

The effects of tumor size, degree of differentiation, and depth of invasion on the risk of neck node metastasis in squamous cell carcinoma of the oral cavity.

Cervical lymph node metastasis is the most important prognostic factor in patients with head and neck carcinoma. We retrospectively analyzed the effects of three different variables-tumor size, degree of differentiation, and depth of invasion-on the risk of neck node metastasis in 50 adults who had been treated with surgery for primary squamous cell carcinoma of the oral cavity. Primary tumor depth and other pathologic features were determined by reviewing the pathology specimens. Preoperatively, 36 of the 50 patients were clinically N0; however, occult lymph node metastasis was found in 13 of these patients (36.1%). The prevalence of neck node metastasis in patients with T1/T2 and T3/T4 category tumors was 51.5 and 58.8%, respectively. The associations between the prevalence of neck node metastasis and both the degree of differentiation and the depth of invasion were statistically significant, but there was no significant association between neck node metastasis and tumor size. We conclude that the prevalence of neck lymph node metastasis in patients with squamous cell carcinoma of the oral cavity increases as the tumor depth increases and as the degree of tumor differentiation decreases from well to poor, as has been shown in previous studies. It is interesting that tumor size, which is the most important component of the TNM system, was not significantly associated with neck node involvement.

Quality of life in allergic rhinitis.

Allergic rhinitis is a global health problem that causes major illness and disability worldwide. Although nasal and nonnasal symptoms are directly attributable to inflammation in the upper respiratory tract, individuals also experience generalized symptoms that include fatigue, mood changes, depression, anxiety and impairments of work and school performance, and cognitive function. Health-related quality of life focuses on patients' perceptions of their disease and measures impairments that have a significant impact on the patient. The burden of disease, as the patient perceives it, forms the basic motivation to seek medical aid or to undergo therapy. Adherence to therapy requires changes in health, perceived by patients as relevant and outweighing eventual disadvantages of intervention. Because so many factors are involved in health-related quality of life, there are multiple ways in which it can be measured. A variety of validated and standardized questionnaires have been developed including assessments of school performance, work performance, productivity, and other parameters that quantify the impact of allergic rhinitis and its treatment on quality of life. The aim of this review is to highlight the impact of allergic rhinitis on the quality of life and to analyze the most commonly used health-related quality of life instruments.

Phytomedicine in otorhinolaryngology and pulmonology: clinical trials with herbal remedies.

Phytomedicine has become an important alternative treatment option for patients in the Western world, as they seek to be treated in a holistic and natural way after an unsatisfactory response to conventional drugs. Ever since herbal remedies have been introduced in the Western world, clinicians have raised concerns over their efficacy and possible side-effects. A PubMed (Medline) search was performed covering the last five years (01/07-04/12) and including 55 prospective clinical randomized control trials in the medical specialities Otorhinolaryngology and Pulmonology. In this review, we present evidence-based clinical data with herbal remedies and try to enlighten the question of efficacy and reliability of phytomedicine.

[Management of recurrent lower lip carcinomas]. / Nüks alt dudak kanserlerine yaklasim.

OBJECTIVES: In this study patients who had locoregional recurrence of lower lip carcinomas after therapies such as surgery, electrocoagulation, cryotherapy or traditional local therapies are discussed. PATIENTS AND METHODS: The records of 16 cases (1 female, 15 males; mean age 58 years; range 30 to 83 years) with recurrent lower lip carcinoma admitted between March 2002 and September 2007 to Dr. Abdurrahman Yurtarslan Oncology Training and Research Hospital, Ear, Nose and Throat Department were retrospectively reviewed. RESULTS: Fourteen patients had been treated in other institutions, while two had been treated in our center. Four of the patients had recurrence in the lip, four patients had recurrence only in the neck, and the remaining eight patients had both lip and neck recurrence. Ten patients received modified radical or radical neck dissection because of their palpable lymphadenopathies, three patients received supraomohyoid neck dissection due to non palpable lymphadenopathies, and the remaining three patients did not have neck dissection because of co-morbid diseases. Seven patients (43%) died in the first postoperative year because of lower lip carcinomas and three patients died because of other reasons. Six patients survived for the first two years without any evidence of disease. CONCLUSION: Patient survival will be affected by the applied treatment. For patients with primary lower lip cancers, otolaryngologists experienced in oncology must plan surgery rather than local treatments. In case of locoregional recurrence, immediate treatment should be planned.

Preventing cisplatin induced ototoxicity by N-acetylcysteine and salicylate.

OBJECTIVES: In this study we investigated if CP induced ototoxicity could be prevented or reduced by the use of salicylate and N-acetylcysteine. PATIENTS AND METHODS: Fifty-four patients (28 females, 26 males; mean age 37+/-9.5 years; range 29 to 71 years) who had cisplatin chemotherapy due to solid organ tumors were enrolled in the study. The patients were randomized into three groups, with 18 patients in each group. The first group (control group) received cisplatin, second group received N-acetylcysteine (NAC; 600 mg/day) with cisplatin and the third group received salicylate (300 mg/day) with cisplatin. All patients evaluated audiologically including high frequency audiometry and auditory brainstem response. RESULTS: The cisplatin-induced ototoxic damage could be reduced in 10,000 and 12,000 Hz frequencies when N-acetylcysteine was added to the cisplatin therapy protocol. There was no decrease in the hearing loss levels of the patients who were receiving cisplatin with salicylate. CONCLUSION: According to auditory brainstem response testing results, there was no difference detected between N-acetylcysteine or salicylate for the amelioration of cisplatin induced ototoxicity.

Measurement of tympanic cavity volume by the Cavalieri principle in Turkish population.

OBJECTIVES: The aim of this study is to measure the tympanic cavity (TC) volumes with Cavalieri principle using computed tomography (CT) scanning of temporal bones, to investigate the difference between the right and the left ears with respect to sexes and to exemplify the TC volume measurements. PATIENTS AND METHODS: Clinical records of 91 patients (46 females 45 males; mean age 48.1 years; range 15 to 60 years) whose TCs were measured at ear nose throat clinic of Ankara Oncology Education and Research Hospital between January 2007 and March 2008, were retrospectively investigated. The CT scans which were obtained from two sides with a slice thickness of 1 mm were evaluated. Measurements of TC volumes were made with using the Cavalieri method. RESULTS: The mean TC volume in male subjects was 0.4721+/-0.0406 cm(3) on the left ears and 0.4883+/-0.0352 cm(3) on the right ears. In females the mean cavity volume was 0.4943+/-0.0501 cm(3) on the left ears and 0.4881+/-0.0485 cm(3) on the right ears. CONCLUSION: There was no statistically difference in between of the both sexes for the TC volume measurements and between both sites of the same individuals.

Can the Müller maneuver detect multilevel obstruction of the upper airway in patients with obstructive sleep apnea syndrome?

OBJECTIVES: Our aim is to figure out the role of Müller maneuver (MM) to detect the level of upper airway obstruction and the severity of obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHODS: In this study, polysomnographies were made after the routine otorhinolaryngological examination including MM in patients admitted with OSAS suspicion in Ankara Oncology Training and Research Hospital's Department of Otorhinolaryngology, Sleep Medicine Policlinic. Two-hundred and twenty-one OSAS patients (142 males, 179 females; mean age 47.63 years; range 18 to 82 years) were included to the study. RESULTS: There weren't any significant correlation among apnea hypopnea index (AHI) results and body mass index (BMI), tonsil size and obstruction severity due to MM (p>0.05). Müller maneuver scores are positively correlated to the Epworth sleepiness scale (EPSS) scores (r=0.213 and p<0.001). Epworth sleepiness scale scores are found to be correlated to BMI and neck circumference (p<0.05). Level of the airway obstruction doesn't affects the EPSS scores (p=0.235). Also EPSS scores are not affected from uni or multilevel obstruction (p=0.088). CONCLUSION: The severity of the MM score is not correlated to the severity of OSAS according to AHI results, but it is found to be correlated to EPSS. Vibrating tissues caused local and systemic inflammation in OSAS patients. The correlation between EPSS and MM scores can be explained by this inflammatory process. Further prospective studies have to be done in this field. Müller maneuver in an awake patient might reflect the levels of the obstruction in sleep conditions even though insufficient for figuring out the severity of OSAS.

Modified sling snoreplasty: double triangle shaped suture uvulopalatopexy.

Following the uvulopalatopharyngoplasty and laser assisted uvulopalatoplasty as treatments for mild obstructive sleep apnea syndrome (OSAS) originating from the soft palate, palatal stiffening operations began to be described as causing less morbidity, interfering less with velopharyngeal and mucosal functions, and being applicable in outpatient settings. We present modified uvulopalatopexy procedure which can be used in mild OSAS patients is a simple, minimally invasive and effective new method. In this article, we present a modified form of sling snoreplasty method and two cases in whom this method was used.

Association of inferior turbinate enlargement, concha bullosa and nasal valve collapse with the convexity of septal deviation.

CONCLUSION: Inferior turbinate enlargement (ITE), nasal valve collapse (NVC) and concha bullosa (CB) are nasal anatomic problems that may accompany septal deviation (SD). Establishment of a causal relationship between these variations and SD is doubtful. In patients complaining of nasal obstruction, all nasal structures that may contribute to the symptom must be separately and carefully assessed for setting an appropriate treatment plan and thereby minimizing the failure rate of surgery. OBJECTIVE: To investigate if the convexity of SD is associated with the occurences of ITE, CB and NVC. PATIENTS AND METHODS: This retrospective study was performed on 109 patients who had been operated due to anterior C-shaped SDs. ITE, CB and NVC were encountered in 65 (59.6%), 27 (24.8%) and 55 (50.5%) patients, respectively. Patients with other forms of SD, allergic rhinitis, non-allergic rhinitis with eosinophilia, acute and chronic sinusitis, nasal polyposis, antrochoanal polyps, those who had recently used systemic or topical decongestants and patients with a history of previous nasal surgery were excluded from the study group. Assessment of the patients was based on data derived from the history, physical examination findings and paranasal sinus CT imaging records. RESULTS: No significant correlation was found between the convexity of the SD and occurrence of ITE, CB and NVC (p = 0.098, 0.717 and 0.171, respectively).

[The incidence of group A beta haemolytic streptococci in upper respiratory tract infections in Erzurum]. / Erzurum'da üst solunum yolu enfeksiyonlarinda A grubu beta hemolitik streptokok insidansi.

OBJECTIVES: The incidence of group A beta hemolytic streptococci (GABHS) in upper respiratory tract infections in Erzurum was investigated. PATIENTS AND METHODS: In this descriptive study throat swabs were obtained from 4112 patients (1989 males, 2123 females; mean age 21+/-1.5 years; range 14 to 46 years) with upper respiratory tract infections in Erzurum, Turkey between January 2006 and December 2006 and they were cultured for isolation of GABHS. RESULTS: In this study GABHS were isolated in 268 (6.51%) of patients. Group A beta hemolytic streptococci were isolated in 51 of 941 patients (5.42%) in the spring, in 23 of 592 patients (3.88%) in the summer, in 69 of 968 patients (7.13%) in the autumn, and in 125 of 1611 patients in the winter. Of those patients in whom GABHS were isolated, 128 (6.43%) were male and 140 (6.59%) were female. At Chi square test, (Range for alpha value, p=0.01 and p=0.05) there was a significant difference in the frequency of infection between the seasons (p<0.01). There was no significant difference between men and women with respect to carrier rate (p>0.05). CONCLUSION: The incidence of GABHS detected in Erzurum was lower than that in other countries. There were statistically significant differences in frequency between the seasons (p<0.01). The highest incidence was in the winter. Low incidence of GABHS in this region may be due to prevention of the colonization because of geographic features, nutritional habits and other factors.