The Immediate Effect of Cumulative Transverse Strain via Exercise on the Achilles Tendon in Individuals with and Without Flat Feet.

BACKGROUND: Flat feet change lower extremity alignment, and it may change the load distribution on Achilles tendon during exercise. The purpose of the present study was to investigate the immediate effect of cumulative transverse strain via resistive ankle plantarflexion exercise on the Achilles tendon in individuals with flat feet. METHODS: Fourteen individuals with flat feet and 14 age-matched individuals with normal foot posture were enrolled in the present study. Achilles tendon thickness was measured by an ultrasonography device with a linear probe at 3 points: 1 cm (AT-1), 2 cm (AT-2), and 3 cm (AT-3) proximal to the superior aspect of the calcaneus. Ultrasonography measurements were performed before and after participants completed 90 repetitions of double-leg calf raise exercises which included moving the foot from full ankle dorsiflexion to full ankle plantarflexion. RESULTS: Achilles tendon thickness at all points measured was thinner in the flat feet group at both pre- and post-exercise conditions compared with that of the control group (p<0.05). Achilles tendon thickness at AT-1, AT-2, and AT-3 decreased after the exercise in both groups (p<0.001). The differences in Achilles tendon thickness at all points measured between pre- and post-exercise conditions were lower in individuals with flat feet than those of the control group (p<0.05). CONCLUSION: There was a significant decrease in Achilles tendon thickness after exercise in both groups; however, the tendon thickness markedly diminished in individuals with normal foot posture. The results are thought to result from changes in tendon structure and in load distribution on the Achilles tendon.

An Investigation of Hearing (250-20,000 Hz) in Children with Endocrine Diseases and Evaluation of Tinnitus and Vertigo Symptoms

Abstract Introduction Despite much advancement in medicine, endocrine and metabolic diseases remain an important cause of morbidity and even mortality in children. Objective The present study was planned to investigate the evaluation of hearing that also includes high frequencies, and the presence and degree of vertigo and tinnitus symptoms in pediatric patients diagnosed with endocrine diseases such as type 1 diabetes mellitus (DM), growth hormone deficiency (GHD), obesity, idiopathic short stature, and precocious puberty Methods The present study included a patient group of 207 children patients diagnosed with endocrine disease (95 males, 112 females; mean age 9.71 years old [range 6-16 years old]) and a control group including 55 healthy children who do not have any kind of chronic disease (26males, 29 females;mean age 9.33 years old [range 6-16 years old]). The subjects underwent a hearing test with frequencies between 250 and 20,000 Hz. The vestibular and tinnitus symptoms were evaluated with the Pediatric Vestibular Symptom Questionnaire. Results Out of 207 patients in the patient group, 5 (2.4%) had hearing loss in pure tones, 10 (4.8%) had it in high frequencies, 40 (19.3%) had tinnitus symptoms, and 18 (8.7%) had vertigo symptoms. A total of 4 out of 207 patients in the study group (1.9%), 2 out of 59 with type 1 DMpatients (3.4%), 1 out of 46 with GHD (2.2%), and 1 out of 43 obesity patients (2.3%) had hearing loss, vertigo, and tinnitus symptoms. Conclusions Our results suggest that some childhood endocrine diseases can cause some changes in the inner ear, although the exact cause is unknown. Perhaps, a detailed hearing and balance examination should be a routine in a child diagnosed with an endocrine disease.We think it is necessary to work on more comprehensive patient groups and tests in the future.

An Investigation of Hearing (250-20,000 Hz) in Children with Endocrine Diseases and Evaluation of Tinnitus and Vertigo Symptoms.

Introduction Despite much advancement in medicine, endocrine and metabolic diseases remain an important cause of morbidity and even mortality in children. Objective The present study was planned to investigate the evaluation of hearing that also includes high frequencies, and the presence and degree of vertigo and tinnitus symptoms in pediatric patients diagnosed with endocrine diseases such as type 1 diabetes mellitus (DM), growth hormone deficiency (GHD), obesity, idiopathic short stature, and precocious puberty Methods The present study included a patient group of 207 children patients diagnosed with endocrine disease (95 males, 112 females; mean age 9.71 years old [range 6-16 years old]) and a control group including 55 healthy children who do not have any kind of chronic disease (26 males, 29 females; mean age 9.33 years old [range 6-16 years old]). The subjects underwent a hearing test with frequencies between 250 and 20,000 Hz. The vestibular and tinnitus symptoms were evaluated with the Pediatric Vestibular Symptom Questionnaire. Results Out of 207 patients in the patient group, 5 (2.4%) had hearing loss in pure tones, 10 (4.8%) had it in high frequencies, 40 (19.3%) had tinnitus symptoms, and 18 (8.7%) had vertigo symptoms. A total of 4 out of 207 patients in the study group (1.9%), 2 out of 59 with type 1 DM patients (3.4%), 1 out of 46 with GHD (2.2%), and 1 out of 43 obesity patients (2.3%) had hearing loss, vertigo, and tinnitus symptoms. Conclusions Our results suggest that some childhood endocrine diseases can cause some changes in the inner ear, although the exact cause is unknown. Perhaps, a detailed hearing and balance examination should be a routine in a child diagnosed with an endocrine disease. We think it is necessary to work on more comprehensive patient groups and tests in the future.

Evaluation of choroidal thickness measurements in patients with marked nasal septal deviation.

INTRODUCTION: Chronic upper airway obstruction due to marked nasal septal deviation may cause chronic hypoxia. It may change the balance of the sympathetic-parasympathetic system and may affect blood flow in the choroid. OBJECTIVE: To assess choroidal thickness measurements of patients with marked nasal septal deviation. METHODS: The patients who had nasal obstruction symptoms diagnosed with marked nasal septal deviation by anterior rhinoscopy and nasal endoscopy and scheduled for septoplasty were included in the study. The control group consisted of age, sex and body mass index-matched healthy individuals. The choroidal measurements at the central fovea and 1000µm away from the fovea in the nasal and temporal regions were performed using enhanced depth imaging optical coherence tomography. RESULTS: In the study group, 52 eyes of 26 patients with a mean age of 26.34±8.14 years were examined. In the control group, 52 eyes of 28 healthy individuals with a mean age of 26.69±7.84 years were examined. There was no statistically significant difference in terms of choroidal thickness measurements between the groups (p>0.05). CONCLUSION: Our results suggest that marked nasal septal deviation may not lead to significant hypoxia and sympathetic activation, resulting in deterioration of the choroidal blood flow and consequent choroidal thickening.

Why do infants pull their ears?

OBJECTIVE: In this study, we aimed to evaluate the diagnoses of the infants who were admitted to our outpatient clinic with the complaint of pulling on the ear and to identify the related factors which may contribute to the diagnosis. METHODS: This prospective study included a total of 102 infants who were admitted to our hospital with the complaint of tugging and pulling on, touching, and rubbing the ears on the shoulder or pillow and shaking the head between July 2016 and July 2017. The complaints were evaluated throughout the day, and the application seasons, the person referred the patient to the ear, nose, and throat (ENT) specialist, the child development specialist and child psychiatrist, allergy and atopy histories, and the relationship between the results and diagnoses were evaluated. RESULTS: 46.1% of the patients had normal examination findings, while the second most common finding was cerumen in 37.2%, and the third one was otitis media with effusion (OME) in 16.7%. In infants who were directly referred by the family, normal and serological diagnosis were found to be statistically significantly higher than that of OME diagnosis, whereas in the infants referred by the family physicians and pediatrist, the OME was found to be statistically significantly higher than normal and cerumen levels. The presence of additional complaints in the OME group was found to be higher than normal and cerumen group. In those with complaints during the day, the most common finding was OME, while it was cerumen in those with complaints a few times in a day and normal examination finding in those tugging on their ears only, when they were falling asleep, indicating statistical significance. Of 47 infants with normal physical examination findings, 37 were assessed by the child psychiatrist, and depression was found in six of one of the parents during the family interviews. CONCLUSION: In this study, the majority of the infants referred to the ENT outpatient clinic had normal examination findings, while the rate of OME diagnosis was high. Considering the negative consequences of EOM in infants, the diagnosis of the EOM becomes extremely important. If there are no otologic pathologies in the majority of infants who were admitted with ear pulling and tugging, the possibility of different factors in etiology gives rise to thought. Therefore, further studies are required to prove this condition.

Olfactory dysfunction in spondyloarthritis.

OBJECTIVE: Spondyloarthritis (SpA) is a group of disorders characterized by inflammatory arthritis including ankylosing spondylitis, psoriatic arthritis, reactive arthritis and arthritis-related inflammatory bowel diseases. Recently it has been shown that arthritic disorders are accompanied by olfactory dysfunction. We aimed to specifically investigate the association between spondyloarthritis and olfactory impairment. MATERIALS AND METHODS: Fifty individuals with SpA and 50 healthy volunteers were included in the study. Olfactory function was evaluated using the "Sniffin' Sticks" test battery. Additionally, effects of age, gender, activity of the disease, HLA-B27 status, medications, and the duration of disease were included in the analysis. RESULTS: SpA patients showed significantly lower scores for odor threshold (T), odor discrimination (D) and odor identification (I) than healthy controls (all p < 0.001). In addition, olfactory loss was negatively correlated with the presence of HLA-B27 (Human Leukocyte Antigen), but not with the current activity of the disease (Bath Ankylosing Spondylitis Activity Index). Neither medication nor duration of the disease had a significant effect on the results. CONCLUSION: SpA is associated with olfactory loss. Future studies will show whether olfactory function relates to the prognosis of SpA.

The Effects of Experimental Intratympanic Steroid Administration on Organ of Corti Type 1 Spiral Ganglion.

Introduction It is unclear how effective is the intratympanic (IT) steroid treatment on organ of Corti type 1 spiral ganglion, its optimal dosage and frequency of administration. The effect of dexamethasone on cochlear functions in individuals with a normal hearing ability is also unknown. Objective The aim of this study was to evaluate, at the electrophysiological and ultrastructural levels, the effect of IT dexamethasone administration in guinea pigs with normal hearing on organ of Corti type 1 spiral ganglion. Methods A total of 20 guinea pigs ( n = 40 ears) whose hearing was detected to be normal by electrophysiological tests were included in the study and randomly divided into 6 groups. Four groups were considered study groups, while 2 groups were considered control groups. Dexamethasone was administered intratympanically in doses of 2 mg/mL and 4 mg/mL in the guinea pigs in the study groups. The animals in the control groups received physiological saline in equal doses as the study groups. All interventions were performed under general anesthesia, and the electrophysiological tests were repeated following the IT injections. Results No statistically significant differences were found among the groups when the IT injections were evaluated in terms of the electrophysiological measurements ( p > 0.05). The ultrastructural evaluation showed a cellular mitochondrial increase in the spiral ganglions of the cochlea in the groups in which dexamethasone was administered in a dose of 4 mg/mL. Conclusion According to the findings of this study, it can be suggested that the IT injection of dexamethasone is safe, and when applied in a dose of 4 mg/mL, it increases metabolic activity at the cellular level.

Evaluation of choroidal thickness in children with adenoid hypertrophy.

OBJECTIVE: To assess choroidal thickness in children with adenoid hypertrophy versus normal controls using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: Twenty-six children (left and right eyes, total 52 eyes), which were scheduled to adenoidectomy with severe adenoid hypertrophy and 26 age, sex and body mass index-matched healthy subjects (left and right eyes, total 52 eyes) were included in the study. Choroidal thicknesses (CT) were evaluated using enhanced depth imaging optical coherence tomography. The CT measurement was taken at the fovea and 1000 µ away from the fovea in the nasal and temporal regions. The macular retinal thickness was also measured. RESULTS: There was no statistically significant difference in the CT of all regions between the groups (p > 0.05). No statistically significant difference was found between two groups in terms of macular choroidal thickness (p > 0.05). CONCLUSION: These results revealed that severe adenoid hypertrophy did not cause a significant effect on choroidal thickness. Short-term exposure to obstructive symptoms in children and preserved sympathetic-parasympathetic balance may explain this result.

"The effects of family-centered physiotherapy on the cognitive and motor performance in premature infants".

OBJECTIVE: The aim of this study is to investigate the effects of family centered physiotherapy according to the neurodevelopmental treatment (NDT) principles on mental and motor performance in premature infants. METHODS: A total of 156 infant, ≥24/36 week+6days gestational age included in the study. All the infants were diagnosed by a child neurologist and referred to psychology and physiotherapy department for their neurodevelopmental assessment and treatment. Bayley Scale of Infant II (BSI-II) was used for neurodevelopmental assessment and Alberta Infant Motor Scale (AIMS) was used for assessing their motor performance. Seventy-eight of the infants were in the study group and 76 were recruited as age matched controls according to the classification of their gestational age. Family centered physiotherapy according to the neurodevelopmental treatment principles was used as an intervention and all the mothers are trained accordingly. RESULTS: Cognitive Development Scores and Motor Development Scores of Bayley II were recorded for the 3., 6., 9., and 12 months respectively. Between the 3. and 12. month of gestational age, within-groups measurements in both Cognitive Development Scores (p<0.001) and Motor Development Scores (p<0.001) were significantly increased. However, the improvements in both Cognitive Development Scores (p=0.059) and Motor Development Scores (p=0.334) between the groups was not different. CONCLUSION: Family centered physiotherapy with NDT principles may not be enough to improve motor and cognitive performance in preterm infants at the first year of age. For supporting the motor and cognitive development of the preterm infants other intervention modalities also should be considered.

Late-term Effects of Surgery on Nasal Functions in Patients who Underwent Total Laryngectomy Surgery

Abstract Introduction There is a common opinion that losing airway functions in total laryngectomy patients cause changes in nasal physiological rates. Studies conducted to review the subject present gaps, especially in terms of objective measurements. Objective We evaluated late-term effects of surgery on nasal functions in patients who underwent total laryngectomy surgery more than two years ago. Methods We included in the study 22 patients who had undergone total laryngectomy, as well as 24 healthy subjects with similar demographic characteristics as the control group. We performed acoustic rhinometry for intranasal volume and cross-sectional area measurements, saccharin test formeasurement of nasalmucociliary clearance, and smell identification test for evaluation of olfactory function in the patient and control groups. We compared and statistically analyzed the data obtained from the groups. Results In our study, although late-term (>2 years) measurements were not statistically significant, we detected more nasal passage patency in the patient group than in the control group. In smell identification test, lower scores were obtained in the patient group. The difference between measurements in both groups was statistically significant. Conclusion We believe that since the upper respiratory tract is disabled due to tracheostomy in patients with total laryngectomy, atrophy occurs in the late term and, consequently, nasal mucociliary clearance is impaired. We also see diminished olfactory function in total laryngectomy patients.

Late-term Effects of Surgery on Nasal Functions in Patients who Underwent Total Laryngectomy Surgery.

Introduction There is a common opinion that losing airway functions in total laryngectomy patients cause changes in nasal physiological rates. Studies conducted to review the subject present gaps, especially in terms of objective measurements. Objective We evaluated late-term effects of surgery on nasal functions in patients who underwent total laryngectomy surgery more than two years ago. Methods We included in the study 22 patients who had undergone total laryngectomy, as well as 24 healthy subjects with similar demographic characteristics as the control group. We performed acoustic rhinometry for intranasal volume and cross-sectional area measurements, saccharin test for measurement of nasal mucociliary clearance, and smell identification test for evaluation of olfactory function in the patient and control groups. We compared and statistically analyzed the data obtained from the groups. Results In our study, although late-term (>2 years) measurements were not statistically significant, we detected more nasal passage patency in the patient group than in the control group. In smell identification test, lower scores were obtained in the patient group. The difference between measurements in both groups was statistically significant. Conclusion We believe that since the upper respiratory tract is disabled due to tracheostomy in patients with total laryngectomy, atrophy occurs in the late term and, consequently, nasal mucociliary clearance is impaired. We also see diminished olfactory function in total laryngectomy patients.

Relation Between the Type of Hospitals and the Decision of Adenotonsillectomy Indication.

OBJECTIVE: This study aims to apply tonsillectomy criteria, symptoms and outcomes proposed in earlier studies to investigate patients who were given tonsillectomy indications at different clinical centers but were treated in our clinical center. METHODS: The prospective sample of patients at the ear, nose, and throat clinic within our hospital consisted of 855 male patients and 684 female patients (1539 in total) with ages between 3 and 16 years old who had been given a tonsillectomy or adenotonsillectomy indication. The patients were allocated to 1 of 3 groups, depending on whether they had been treated in a public hospital, a private hospital, or a university/training research hospital. RESULTS: Of the total of 1539 patients, tonsillectomy indication criteria were exhibited by 966 of them (62.8%) but were absent in the rest of 573 patients (37.2%). Most of the 966 patients with tonsillectomy indication criteria had been treated in private hospitals (n = 546; 56.5%), while the others were treated in public hospitals (n = 309; 31.9%) or in university/training research hospitals (n = 111; 15.9%). Furthermore, the majority of the 966 patients (84.1%) received the tonsillectomy indication in just 1 examination, while some of them (n = 154; 15.9%) received it after follow-up appointments. CONCLUSION: Tonsillectomy decisions can pose difficulties for ear, nose, and throat specialists. Therefore, such decisions should be made based on assessment of clinical evaluation and follow-up, information from patients' parents, and the results of examination against the criteria outlined in the literature.

Association of Helicobacter pylori infection with olfactory function using smell identification screening test.

The aim of the present study is to investigate the role of Helicobacter pylori in olfactory function. Thirty-six patients (mean age 38.5) aged between 18 and 55 years who were diagnosed with H. pylori by gastric biopsies and age- and sex-matched 30 healthy adults (mean age 33.6) were included in the study. All participants underwent a detailed ear-nose-throat examination including endoscopic examination of the nasal cavity and laryngeal area, and olfactory tests were performed using the Sniffin' Sticks, a 12-item screening test (Sniffin'Sticks; Burghart, Wedel, Germany) and odor scores were recorded. The mean odor score was 7.9 ± 1.7 (range 2-10) in the patient group and 10.3 ± 1.4 (range 6-12) in the control group. There were significant lower scores in the patient group compared to the control group (p < 0.05). In conclusion, it is apparent that there is an association of H. pylori infection with olfactory dysfunction. H. pylori infection should be considered as possible etiological factors in patients with olfactory dysfunction.

Frequency of Serous Otitis Media in Children without Otolaryngological Symptoms

Abstract Introduction Otitis media with effusion is the fluid in the middle ear with no signs or symptoms of acute ear infection. Objective This study aims to research the frequency of serous otitis media in patients referred to the pediatric clinic between 3-16 years of age without any active ear, nose, and throat complaints. Methods This study included 589 children patients (280 boys, 309 girls; mean age: 9.42; range 3-16) who were administered to the pediatric clinic without otolaryngologic complaints. Patients underwent examination with flexible nasopharyngoscopy for adenoid hypertrophy. An otorhinolaryngologist examined all children on both ears using an otoscope and tested with tympanometry. We used tympanometry results to diagnose SOM. Results The study included 589 patients that underwent fiber optic examination of the nasopharynx with an endoscope. Adenoid vegetation was present in 58 patients (9.8%) and was not detected in 531 patients (90.2%). We found serous otitis media in 94 (15.9%) patients. We obtained Type A tympanogram in 47 (81%) of 58 patients with adenoid vegetation, 6 (10.3%) Type B, and 5 (8.6%) Type C.When comparing 58 patients with adenoid vegetation with 538 patients without adenoid vegetation for serous otitis media, the frequency was not statistically significant (p > 0.05). Conclusion We believe that in children without any ear, nose, and throat complaints, it is possible to detect serous otitis media with adenoid vegetation. Thus, pediatric patients should undergo screening at regular intervals.

Frequency of Serous Otitis Media in Children without Otolaryngological Symptoms.

Introduction Otitis media with effusion is the fluid in the middle ear with no signs or symptoms of acute ear infection. Objective This study aims to research the frequency of serous otitis media in patients referred to the pediatric clinic between 3-16 years of age without any active ear, nose, and throat complaints. Methods This study included 589 children patients (280 boys, 309 girls; mean age: 9.42; range 3-16) who were administered to the pediatric clinic without otolaryngologic complaints. Patients underwent examination with flexible nasopharyngoscopy for adenoid hypertrophy. An otorhinolaryngologist examined all children on both ears using an otoscope and tested with tympanometry. We used tympanometry results to diagnose SOM. Results The study included 589 patients that underwent fiber optic examination of the nasopharynx with an endoscope. Adenoid vegetation was present in 58 patients (9.8%) and was not detected in 531 patients (90.2%). We found serous otitis media in 94 (15.9%) patients. We obtained Type A tympanogram in 47 (81%) of 58 patients with adenoid vegetation, 6 (10.3%) Type B, and 5 (8.6%) Type C. When comparing 58 patients with adenoid vegetation with 538 patients without adenoid vegetation for serous otitis media, the frequency was not statistically significant (p > 0.05). Conclusion We believe that in children without any ear, nose, and throat complaints, it is possible to detect serous otitis media with adenoid vegetation. Thus, pediatric patients should undergo screening at regular intervals.

Association Between Endocrine Diseases and Serous Otitis Media in Children.

OBJECTIVE: Otitis media with effusion (OME) is a condition in which fluid is retained in the middle ear cavity. The association between endocrine disorders and OME has not yet been determined. This study aimed to investigate the presence of OME in children diagnosed with an endocrine disease and the relationship between these two conditions. METHODS: The study was conducted on 918 pediatric patients (440 boys, 478 girls; mean age: 8.40, range 3-15 years) and 158 healthy controls (76 boys, 79 girls; mean age: 8.31, range 3-15 years). All children underwent an ear examination and a tympanometry performed by an otorhinolaryngologist. Tympanometry results were used to diagnose OME. RESULTS: OME was detected in 205 (22.3%) of 918 patients and in 19 (12.0%) of 158 subjects in the control group. The difference in frequency of OME between the two groups was statistically significant (p=0.003). CONCLUSION: The results of the study reveal that there may be a tendency towards the occurrence of OME in pediatric endocrinology patients.

Effect of Topical Dexamethasone for Preventing Experimentally Induced Myringosclerosis.

OBJECTIVE: We aimed to examine the effect of topical dexamethasone by otomicroscopic and histologic examinations for preventing myringosclerosis induced by myringotomy in rat tympanic membranes. METHODS: Twenty-one Sprague Dawley rats (42 ears) were randomly divided into the following three groups after otomicroscopic examinations: experimental surgical group (5 rats), control group (8 rats), and study group (8 rats). The rats of all the groups underwent myringotomy in both tympanic membranes. Other than myringotomy, no additional procedure was performed for the rats in the experimental surgical group. In the control group, 0.9% NaCl was applied to the ears, whereas in the study groups, topical dexamethasone was applied to the ears. These applications in the control and study groups were repeated for nine days. On the 10th day of the study, the rat ears of all groups underwent otomicroscopic and histologic examinations. The prevalence and process of myringosclerosis were evaluated by otomicroscopic examination, whereas inflammation, membrane thickness, and myringosclerosis intensity were evaluated by histologic examination. RESULTS: The growth of myringosclerosis with otomicroscopic examination was lesser in the study group in which topical dexamethasone was applied than the control and the experimental surgical groups. Moreover, it was observed that myringosclerosis effected fewer quadrants in the study group.Histologic examinations revealed that inflammation was significantly lesser in the study group than in the experimental surgical and control groups. The average membrane thickness values were significantly lesser in the study group than in the experimental surgical group. With respect to myringosclerosis growth, no statistically significant difference was observed among all groups, whereas with respect to myringosclerosis intensity, the rat ears in the study group were less severely affected. CONCLUSION: Thus, our study results suggest that applying topical dexamethasone after myringotomy has positive effects on limiting the intensity and prevalence of myringosclerosis.

Maxillofacial Traumas in Farmers Caused by Farm Animals, Agricultural Vehicles, and Materials.

OBJECTIVE: It has been aimed at evaluating the relationship of maxillofacial fractures in farmers, which are caused due to traumas while working in farms, with trauma etiologies, maxillofacial fracture areas, age, sex, and seasonal variables. METHODS: Among the farmers who have come to our emergency service unit as a result of maxillofacial trauma between 2010 and 2012, 146 patients have been analyzed retrospectively. The patients' demographic findings, trauma etiologies, seasonal variables of trauma, and maxillofacial fracture area distribution have been analyzed. RESULTS: Patients' age varies between 12 and 80 and 87 of them are female (59.59%), while 59 are male (40.41%). The subjects' etiological distribution is as follows: 47.5% is traumas caused by cattle among the farm animals; 15.75% is traumas caused by the blows of agricultural tools; 12.33% is traumas caused by tractor accidents; 9.59% is traumas caused by falling from haystacks; 7.53% is traumas caused by falling from agricultural vehicles, and 6.85% is traumas caused by horse kicks. When trauma etiology, age, sex, seasonal distribution, and the maxillofacial fractures were analyzed, statistically significant results have been determined. CONCLUSIONS: Although the number of maxillofacial traumas is considerably high in farmers due to farm animals, agricultural devices, and agricultural tools, while these traumas can cause functional and aesthetically minor fractures on the face, they can cause important and serious fractures as well. While knowing the mechanism of etiological fractures and accidents in different study groups can be guiding in the speedy diagnosis and treatment of possible fractures, it can also be helpful in taking precautions against traumas in these groups as well.

Human otoacariasis: Demographic and clinical outcomes in patients with ear-canal ticks and a review of literature.

INTRODUCTION: Otoacariasis is a rare infestation of the ear canal, which affects the quality of life especially in rural areas. Different types of ticks and mites may cause otoacariasis. Although treatment of otoacariasis is simple, diseases transmitted through ticks and mites should be considered during diagnosis and treatment. Both local and systemic signs and symptoms of such diseases should be followed up.A literature review was conducted in PubMed using the following terms: "otoacariasis," "ticks," "mites," and "outer ear canal infestations." Demographic, radiologic, and treatment options were discussed. Treatment hints and pitfalls were also discussed with the literature review. CONCLUSION: In this paper, we describe otoacariasis in humans and discuss the appropriate interventions.

Intracranial hemorrhagic infarct after local anesthesia on nasal mucosa: A case report.

INTRODUCTION: Epinephrine containing local anesthetics are used hemostasis in many cases. Otolaryngologists typically selected to decrease bleeding in surgery field for operations such as especially FESS (Functional Endoscopic Sinus Surgery), septoplasty, septorhinoplasty. In addition to known adverse effects of this local anesthetics agents they have rare complications too. PRESENTATION OF CASE: We presented intracranial hemorrhagic infarction in a 41-year-old male patient after using lidocaine with epinephrine for local anesthesia on nasal mucosa. DISCUSSION: There are some publications like this case in the literature. In our case, a hemorrhagic infarction developed after giving the adrenaline/lidocaine infiltration to make up a local anesthesia in the mucosa of the septum. There is not any reported case like this in the literature. CONCLUSION: We want to emphasize that all surgeons especially the ENT surgeons should be careful while using local anesthetic medicines which contains adrenaline for rare complication of intracranial hemorrhagic infarction. Another fact is that the patients must sign an informed consent form including those situations even for all minor surgical procedures to avoid a medicolegal problem.