Effect of airway dynamics on the development of larynx cancer.

OBJECTIVES/HYPOTHESIS: This study aimed to investigate and measure airway dynamics in anatomical regions where laryngeal cancer was most common in comparison to other regions of the larynx, thereby determining the effect of airway dynamics on the development of laryngeal cancer. STUDY DESIGN AND METHODS: Pulmonary function test airflow data and larynx anatomy measurement data obtained by three-dimensional computed tomography. A healthy male adult was modeled by simulation using the ANSYS program. Analysis of air flow rates, pressure, and force were also made. RESULTS: The supraglottic region average pressure was higher when compared to the subglottic region and clearly lower when compared to the glottic region. The subglottic had the lowest pressure and force levels. The glottic region was the first ranked location for laryngeal cancer; the supraglottic region was the second; and the frequency of laryngeal cancer was much lower in the subglottic region. Our data suggests that the high pressure and force contribute to an increased amount of contact and interaction between toxic particles and mucosa and to increased diffusion of the particles, leading to an increased carcinogenic effect and frequency of cancer. CONCLUSION: Laryngeal cancer was found more frequently in regions with an increased pressure and force stress and reduced air velocity, with a subsequent increase in penetration of the inhaled toxic agents. These findings demonstrate the importance of basic physical fluid mechanics in cancer pathogenesis. LEVEL OF EVIDENCE: NA. Laryngoscope, 126:1136-1142, 2016.

Effect of caffeic acid phenethyl ester on myringosclerosis development in the tympanic membrane of rat.

Myringosclerosis is hyalinization and calcification of certain areas of the tympanic membrane, especially the fibrous lamina propria layer and appears as white sclerotic lesions. Ventilation tube insertion is one of the most performed operations in the pediatric otorhinolaryngology practice to treat chronic otitis media with effusion. Myringosclerosis is a very common sequela of ventilation tube insertion. In this experimental study, our aim was to show the histopathological effects of caffeic acid phenethyl ester on myringosclerosis development in rat tympanic membrane after myringotomy. The rats were randomly categorized into four experimental groups including the comparison group (n = 4), non-treated group (n = 7), the saline (control) group (n = 7), the caffeic acid phenethyl ester group (n = 7). Non-treated group did not receive any treatment for 15 days. Saline (2.5 mL/kg, intraperitoneal) was administered to the third group once a day for 15 days. Fourth group received caffeic acid phenethyl ester intraperitoneally once a day at a dose of 10 µmol/kg for 15 days. Myringotomy was performed on the right tympanic membrane of all rats except comparison group using a sterile pick with the help of an operating microscope. Histopathological examination of myringosclerosis formation was done by a pathologist under light microscope. In histopathological analysis of groups, the severity of inflammation was milder in caffeic acid phenethyl ester group compared to non-treated and saline groups (p < 0.05). There was less myringosclerotic plaques in caffeic acid phenethyl ester group than in non-treated and saline groups (p < 0.05). TM thickness measurements were very close to each other in non-treated and saline groups. The tympanic membrane thickness of caffeic acid phenethyl ester group was much thinner than the other two groups (p < 0.05). Caffeic acid phenethyl ester decreases inflammation severity and the formation of myringosclerotic plaques. These two effects resulted in thinner tympanic membranes of rats which were treated with caffeic acid phenethyl ester. As a result, caffeic acid phenethyl ester has potential preventive effects on myringosclerosis development after myringotomy and ventilation tube insertion.

A rare sublingual cyst in an infant: oral heterotopic gastrointestinal cyst.

Oral heterotopic gastrointestinal cyst is rarely seen in the oral cavity. The tongue and floor of the mouth are the most commonly affected sites. These cysts may cause feeding and respiration problems, especially in newborns and infants. A benign mass was considered according to the physical examination and ultrasonography findings. We treated the patient with simple excision. We present a three-month-old female infant who was referred to us with a cystic mass in the sublingual region.

[Bilateral choanal atresia in adults]. / Eriskinlerde çift tarafli koanal atrezi.

Bilateral choanal atresia is a congenital anomaly which occurs immediately after birth and requires immediate intervention. Therefore, it is very rare to see a patient who has reached an advanced age. In this article, we report two cases (sisters) who were able to reach advanced ages with bilateral choanal atresia. In the light of these two adult cases, we aimed to review the diagnostic and therapeutic approaches to bilateral choanal atresia with the literature.

Effects of caffeic acid phenethyl ester on wound healing of nasal mucosa in the rat: an experimental study.

PURPOSE: Wound healing of the nasal mucosa is a highly complex process that restores the anatomical and functional integrity of tissue that has been exposed to trauma. In this experimental study, our aim was to use histopathological examination to investigate the effects of caffeic acid phenethyl ester on the wound healing of rat nasal mucosa after mechanical trauma. MATERIALS AND METHODS: The rats were randomly divided into 3 experimental groups: a non-treated group (n=7), a control saline group (n=7) and a caffeic acid phenethyl ester group (n=7). The non-treated group received no treatment for 15 days. The second group was administered saline (2.5 mL/kg, intraperitoneal) once a day for 15 days. The third group received caffeic acid phenethyl ester intraperitoneally at a dose of 10 µmol/kg once a day for 15 days. At the beginning of the study, unilateral mechanical nasal trauma was induced on the right nasal mucosa of all rats in the three groups using a brushing technique. Samples were stained using hematoxylin and eosin solution and were examined by a pathologist using a light microscope. RESULTS: The severity of inflammation was milder in the caffeic acid phenethyl ester group compared with that in the non-treated and saline groups (P<0.05). The subepithelial thickness index was lower in the experimental group (P<0.05). Goblet cell and ciliated cell loss was substantially reduced in the experimental group compared with the non-treated and saline groups (P<0.05). CONCLUSIONS: Caffeic acid phenethyl ester decreases inflammation and the loss of goblet cells and ciliated cells. Therefore, caffeic acid phenethyl ester has potential beneficial effects on the wound healing of nasal mucosa in the rat.

Patients with congenital choanal atresia treated by transnasal endoscopic surgery.

Congenital choanal atresia (CCA) is defined as a congenital failure in the development of communication between the nasal cavity and nasopharynx in newborns. It is the most common congenital anomaly of nose. Most of the patients presented with unilateral CCA. Neonates with bilateral CCA have severe respiratory distress after birth. Airway control with orotracheal intubation should be done immediately to save the life of neonate with bilateral CCA. After airway control, surgery should be performed as soon as possible. The aim of surgery is to create a patent nasal passage and to prevent restenosis with minimal morbidity. Transnasal endoscopic surgery of CCA has become the most popular treatment method. The retrospective review of 33 patients with CCA was presented in this study. The patients who were diagnosed at the neonate period and operated on in 6 months after birth were grouped as I (neonate). The patients who were diagnosed 6 months after birth were grouped as II (child-young adult). All patients were treated by transnasal endoscopic surgery. Stent were put in all patients to prevent restenosis. Although the restenosis rate was higher in group I (53.8%) than in group II (23.1%), it did not cause a statistically significant difference. Overall success rate of our surgical approach was 61.5%. Despite the surgical developments and many treatment modalities, restenosis is still the most challenging problem in CCA.

The reconstruction of full-thickness ear defects including the helix using the superior pedicle postauricular chondrocutaneous flap.

The ear is a complex structure with specific anatomical landmarks and different surface contour properties. In this article, we present the results that we obtained after reconstruction of full-thickness defects of the upper and middle third of the ear including the helix using a superior auricular artery (SAA) pedicled chondrocutaneous flap.In this study, 8 patients underwent reconstructions with postauricular SAA pedicled chondrocutaneous flaps between March 2009 and May 2011. Seven patients were male (88%), and 1 patient was female (12%). The age range was between 27 and 78 years, with a mean age of 57 years. The causes of the defects were tumor excisions in 6 patients and trauma in 2 patients. No serious postoperative complications such as wound infection, wound dehiscence, or partial or total flap loss were observed in any of the patients. A good cosmetic result was obtained with this technique with maximum preservation of the anatomical landmarks and without an effect on the vertical height or projection of the ear.In our experience, the postauricular SAA pedicled chondrocutaneous flap can be used as an appropriate alternative for the treatment of full-thickness defects of the upper and middle thirds of the ear including the helix.

An unusual foreign body in frontal sinus: silicone tube.

Foreign bodies in paranasal sinuses are very rare and more than half of them are encountered in maxillary sinus. Most of the foreign bodies are associated with maxillofacial trauma. Foreign body in the frontal sinus is even a rarer condition. Foreign bodies usually present with chronic symptoms and complications due to the delayed diagnosis. In this article, we report an unusual case of mucocele resulting from silicone nasolacrimal duct tube in right frontal sinus which was left or forgotten in nasal cavity after external dacryocystorhinostomy operation. The patient was treated surgically and her symptoms resolved after surgery.

Management of orbital complications of sinusitis in pediatric patients.

The most common reason of orbital infections is sinusitis. Orbital complications of sinusitis are mostly seen in children. Loss of vision and intracranial infections are among the complications of sinusitis. Prompt diagnosis and treatment is very important in the management of orbital complications. The orbital complication can be in the form of cellulitis or abscess. A retrospective review of 26 pediatric patients with orbital complications due to sinusitis was presented in this study. Of 26 patients, there were 13 cases of preseptal cellulitis, 2 cases of orbital cellulitis, and 11 cases of subperiosteal abscess. We grouped the preseptal and orbital cellulites in one category and the subperiosteal abscess in the other. All patients in the cellulitis group recovered by medical treatment. All the patients were treated by surgical drainage. Early diagnosis and appropriate treatment method are vital for the treatment of orbital complications secondary to sinusitis.

The effect of corticosteroid against streptomycin ototoxicity.

The aim of this experimental study was to determine the possible protective role of corticosteroid in prevention of streptomycin-induced ototoxicity. Twenty-eight adult Wistar albino rats were divided into 4 groups: control (n = 7), streptomycin (n = 7), corticosteroid (n = 7), and streptomycin + corticosteroid (n = 7). Rats were tested with distortion product otoacoustic emissions (DPOAEs) in the beginning and at the end of the study. The animals in all groups were killed under general anesthesia on the 45th day after the last DPOAE measurements. Hearing results were analyzed statistically to determine differences in amplitudes of DPOAE. In addition, the cochleas of each rat were evaluated by histopathologic and immunohistochemical examination. Significant difference was not observed in cochlear hair cells in the control and corticosteroid groups, whereas severe degeneration of hair cells and increased apoptotic cells were observed in the streptomycin group. Moderate degeneration was observed in the streptomycin + corticosteroid group. The hair cells were partially intact. DP-gram of the streptomycin and streptomycin + corticosteroid groups was significantly deteriorated (P < 0.05). The coadministration of steroids with streptomycin, which has a serious ototoxic effect, did not lead to a limitation of this harmful effect.

Solitary plexiform neurofibroma of the buccal region unassociated with neurofibromatosis type 1.

Neurofibroma is a benign neural tumor. Plexiform type of this tumor is rarely seen in oral cavity in solitary form. In this article, we present an 18-year-old male case with an isolated plexiform neurofibroma localized at buccal region without any other manifestation or family history of neurofibromatosis type 1.

Evaluation of hyperactivity, attention deficit, and impulsivity before and after adenoidectomy/adenotonsillectomy surgery.

OBJECTIVE: The objective of this study was to determine the severity of attention deficit, hyperactivity, and impulsivity symptoms in patients with obstructive airway problems scheduled to undergo adenoidectomy or adenotonsillectomy operation. The effects of the surgical treatment on these symptoms will also be investigated in a case-control design. METHODS: This prospective study included 63 patients (29 girls, 34 boys) who were operated on at the Department of Otorhinolaryngology, Dicle University Medical School, between January 2010 and May 2011 because of obstructive symptoms caused by adenoid or adenotonsillar hypertrophy. The age range of the patients was between 4 and 13 years. The control group consisted of 33 (17 girls, 16 boys) healthy children. RESULTS: Among the patients, 15 children underwent adenoidectomy because of adenoid hypertrophy; 13 patients had adenotonsillectomy because of adenotonsillar hypertrophy, and the remaining patients underwent adenotonsillectomy related with chronic or recurrent tonsillitis with adenoid hypertrophy. Based on the preoperative data, statistically significant difference was observed between the patient and control groups. The patients' attention deficit, hyperactivity, and impulsivity symptoms preoperatively and postoperatively have shown statistically significant differences. CONCLUSIONS: Attention deficit, hyperactivity, and impulsivity symptoms were common among the children who show signs of airway obstruction due to adenotonsillar hypertrophy. Adenoidectomy or adenotonsillectomy operations were both observed to be associated with improvement in these symptoms.

[External auditory canal osteoma resulting in cholesteatoma which is complicated with meningitis]. / Kolestatoma neden olan ve menenjit ile komplike olan dis kulak kanali osteomu.

Osteoma of external auditory canal is a unilateral benign tumor which usually presents with no symptoms. They only cause symptoms when cerumen collection or conduction type hearing loss occurs. They are the most common osseous lesions of the temporal bone. It very rarely presents with cholesteatoma. So far, no osteoma case concomitant with, cholesteatoma and meningitis has not been reported. In this article, we report an interesting case presenting with external auditory canal osteoma, cholestatoma and meningitis concomitantly who was treated successfully using the canal Wall-down mastoidectomy technique.

The protective role of caffeic acid phenethyl ester against streptomycin ototoxicity.

OBJECTIVE: The aim of this experimental study was to investigate the efficacy of caffeic acid phenethyl ester (CAPE) in the prevention of streptomycin-induced ototoxicity. MATERIALS AND METHODS: Thirty-two adult Wistar albino rats were divided into 4 groups: control (n = 8), streptomycin (n = 8), CAPE (n = 8), and streptomycin + CAPE (n = 8). Rats were tested with distortion product otoacoustic emissions (DPOAEs) before drug administration. The animals in all groups were killed under general anesthesia on the 45th day following last DPOAE measurements. Hearing results were analyzed statistically to determine differences in amplitudes of DPOAE. Also, the cochleas of each rat were evaluated by histopathological and immunohistochemical examination. RESULTS: Significant difference was not observed in cochlear hair cells in the control and CAPE groups. In the streptomycin group, severe degeneration of hair cells and increased apoptotic cells were observed. In the streptomycin + CAPE group, although some deteriorations were observed, hair cells were mostly preserved. The DPgram of the streptomycin and streptomycin + CAPE groups was significantly deteriorated (P < .05). The analysis of the DPgram results revealed statistically significant differences between the groups of streptomycin and streptomycin + CAPE (P < .05). CONCLUSIONS: Caffeic acid phenethyl ester treatment attenuated hair cells injury in the inner ear, possibly via its antioxidant effect. Prophylactic administration of CAPE for streptomycin ototoxicity ameliorated hearing deterioration in rats.

Mental health and quality of life in patients with chronic otitis media.

The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p < 0.001), interpersonal sensitivity (p < 0.001), depression (p < 0.001), phobic anxiety (p < 0.001), and other subscores, and also global severity index score (p < 0.001) were significantly high in patient group when compared to the control group. The patients with COM reported significantly lower levels of QoL in terms of physical role difficulty (p < 0.001), general health perception (p < 0.004), social functioning (p < 0.001), and mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests.

[Acinetobacter baumannii: a rare cause of deep neck infection]. / Acinetobacter baumannii: Derin boyun enfeksiyonunun nadir bir nedeni.

Deep neck infections, which are originated from upper respiratory tract, are bacterial infections involving deep structures of the neck. Unless diagnosed and managed appropriately, these infections may progress rapidly, leading to severe morbidity and mortality. Although, Acinetobacter baumannii plays a significant role in several nosocomial infections, ear nose throat physicians are usually unfamiliar with this bacteria and it is rarely isolated in deep neck infections. In this article, we present a serious case of deep neck infection in which Acinetobacter baumannii was cultured from the abscess. The patient was treated successfully with antibiotic and surgical drainage.

Hemangioma arising from external jugular vein mimicking neck mass.

Hemangiomas are common benign tumors which can develop in any part of the body. Despite their common nature, hemangiomas arising from blood vessels are very rare. In this article, we present a very rare case of hemangioma which was originated from external jugular vein. The hemangioma was totally excised after the external jugular vein was ligated from both sides and no complication was observed.

Seborrheic keratosis of the external auditory canal in a 1-year-old boy.

Seborrheic keratosis is a common and benign cutaneous lesion occurring on the trunk, extremities, and head and neck of the elderly. It is rarely seen in the external auditory canal. We present a case of seborrheic keratosis in the external auditory canal of a one-year-old child. The patient was treated successfully with surgical excision.