Occupational safety threats among dental personnel and related risk factors.

Occupational diseases are primarily considered to be important health problems for individuals with occupations in heavy industry fields. Although dentists work in very clean and elegant offices, they are frequently exposed to various chemicals and high-intensity, sound-producing instruments, such as compressors and aerators. In our study, we aimed to investigate the risk for occupational hearing loss of dental personnel, by performing pure-tone audiometry in 40 dentists and comparing the results with those of healthy individuals. We also sampled the nasal mucosa to investigate the effects of occupational chemicals on the nasal mucosa of the dentists. The pure-tone audiometric thresholds at 5 different frequencies (1000, 2000, 4000, 6000, and 8000 Hz) and working time were evaluated as potential risk factors. The pure-tone audiometric results (as decibels) at each frequency and the median values for each side (right and left ears) were significantly higher for dentists than for the control group (P < 0.05). The pure-tone audiometric results did not significantly differ between the women and men in the study group (P > 0.05). The findings in the nasal mucosa (goblet cell hyperplasia, neutrophil/eosinophil/basophil distribution, metaplasia, dysplasia, premalignant or malignant cells) were similar in the study and control groups (P > 0.05). In conclusion, our study indicated that high-intensity, sound-producing equipment is an important occupational threat for dentists, whereas chemical agents have minimal hazardous effects.

Effect of combination of montelukast and levocetirizine on otitis media with effusion: a prospective, placebo-controlled trial.

CONCLUSION: This study demonstrated that treatment with montelukast in combination with levocetirizine may have a beneficial effect on clinical improvement of middle ear fluid in children with otitis media with effusion (OME). OBJECTIVE: To evaluate the effect of the combination of montelukast and levocetirizine on shortening the duration of effusion in successfully treated OME in children. METHODS: This was a randomized, prospective, double-blind, placebo-controlled trial. The study group consisted of 120 children (age range 2-6 years), who were diagnosed with OME of at least 2 months duration. The children were randomized into one of four groups. The treatment packs containing montelukast 4 mg (tablet) and/or levocetirizine 2.5 mg/5 ml as the active drug or placebo were prepared, numbered, and distributed by the second author. RESULTS: The amelioration of bilateral otoscopic sign scores in the combination therapy group was statistically significantly greater than in all the other groups (p < 0.05). Improvement in bilateral tympanometric findings in the combination therapy group and montelukast group was greater than in the other groups. However, this difference was not statistically significant (p > 0.05). When we compared the difference between otoscopic sign scores before and after treatment we found that it was statistically significant in every group (p > 0.05). However, the significant improvement in tympanometric findings occurred in all groups except the levocetirizine group (p > 0.05).

Desloratadine-montelukast combination improves quality of life and decreases nasal obstruction in patients with perennial allergic rhinitis.

BACKGROUND: The effects of desloratadine-montelukast combination on quality of life (QoL) and nasal airflow of patients with perennial allergic rhinitis (PAR) has not been reported. The objective of this work was investigate the efficacy of desloratadine-montelukast combination on nasal obstruction and health-related quality of life (HRQL) of patients with PAR. METHODS: The patients with PAR (n = 40) were assessed using acoustic rhinometry (AcR) and Rhinoconjunctivitis QoL Questionnaire (RQLQ) before therapy. Desloratadine-montelukast fixed-dose combination treatment was applied to every patient once daily. The AcR and RQLQ score were reevaluated at the first and third months; and statistical comparison of pretreatment and posttreatment results was performed. RESULTS: Nasal symptoms and signs such as itching, sneezing, discharge, congestion, and edema, and color change of turbinates have been decreased after treatment. In AcR, minimum cross-sectional area (MCA) measurements and volume results were increased after the treatment. Correlation was found between the volume results and nasal discharge and/or congestion in right nasal passages. In left nasal passages, statistical relation was observed between the MCA and itching and/or change of turbinate color (p < 0.05). A significant decrease in the overall RQLQ score was determined at the first and third months of therapy. The difference between scores at baseline and end of the first and third months for all domains was statically significant (p < 0.001). The treatment difference in change from the first month to the end of the third month was statistically significant (p < 0.05). CONCLUSION: Desloratadine-montelukast combination therapy causes subjective and objective decrease in nasal obstruction, reduces the other symptoms of PAR and improves the disease-specific QoL.

Effects of escitalopram on symptoms and quality of life in patients with allergic rhinitis.

BACKGROUND: Insufficient response to treatment and declining quality of life illustrate the continuing need to find new treatment modalities for allergic rhinitis (AR). The purpose of this study was to assess how escitalopram affects symptoms and quality of life among AR patients. METHODS: This study included 120 patients with AR, who were divided into four treatment groups of 30 patients each. Patients were assessed before treatment and at the end of the 3rd month based on nasal symptom scores, otorhinolaryngological examination, the Rhinoconjunctivitis Quality of Life Questionnaire, and the Beck Depression and Anxiety Inventory. All patients received standardized treatments. Group A patients with positive Beck Depression and Anxiety Inventory scores received escitalopram, and group B patients with positive Beck Depression and Anxiety Inventory scores received placebo. Group C patients with negative Beck Depression and Anxiety Inventory scores received escitalopram, and group D patients with negative Beck Depression and Anxiety Inventory scores received placebo. RESULTS: Anxiety scores pre- and posttreatment revealed a statistically significant reduction in groups A, C, and D. All four groups exhibited reduced posttreatment scores for sleep, nonnasal and noneye symptoms, eye symptoms, and emotions. A statistically significant difference appeared between groups A and B in terms of general complaints and nasal symptom scores. CONCLUSION: The positive effects of escitalopram on posttreatment quality of life in the Beck-positive patient group were a predictable outcome. Otolaryngologists should pay more attention to the moods of their patients with AR while they evaluate treatment during clinical follow-up visits.

A benign teratoma presenting as an obstruction of the nasal cavity: a case report.

INTRODUCTION: Teratoma refers to a neoplasm that recapitulates all three germ layers. Teratomas may be histologically mature and oncologically benign. Teratomas may also be histologically immature while being oncologically benign, or they may harbor malignant components and have the potential to exhibit an aggressive biological behavior. Teratomas of the head and neck are extremely rare and usually present in the neonatal period. As a general rule, pediatric teratomas of the head and neck tend to be oncologically benign, whereas adult teratomas tend to be histologically and oncologically malignant. Most of these teratomas are found in the cervical region and nasopharynx. Calcification within the mass is often evident. CASE PRESENTATION: A 27-year-old Caucasian man complaining of a nasal obstruction was admitted to our clinic in January 2006. A transnasal endoscopic examination revealed a mass arising from the nasal septum which was completely removed using an endoscopic approach. Histologically, it was determined to be a benign teratoma. CONCLUSION: Herein, we present a rare case, along with a review of the related literature, in order to emphasize that a benign teratoma of the nasal septum should not be ignored.

A patient presenting with concha bullosa in another concha bullosa: a case report.

INTRODUCTION: Anatomic variations of the paranasal sinuses are very common. The paranasal sinus anatomy should be carefully examined prior to performing endoscopic sinus surgery in terms of both existent pathologies and anatomic variations. The anatomy of the paranasal sinuses and its variations have gained importance, along with advances in coronal paranasal sinus computed tomography and extensive use of endoscopic sinus surgery. CASE PRESENTATION: A 53-year-old Caucasian woman was admitted to our clinic with complaints of nasal breathing difficulties and headache persisting for a long time. Another concha bullosa was detected in the middle concha bullosa on preoperative paranasal computed tomography examination. It is known that the paranasal sinuses have a number of anatomical variations. CONCLUSION: Herein we report a rare case, along with a review of the literature, to emphasize that a concha bullosa inside another concha bullosa should not be ignored.

[Incidental thyroid carcinoma found during surgery for laryngeal carcinoma: a case report]. / Larenks karsinomu nedeniyle boyun diseksiyonu yapilan olgularda rastlantisal tiroid karsinomu: Olgu sunumu.

At the histopathologic examination of neck dissection specimens of the patients who underwent surgical treatment with the diagnosis of laryngeal cancer, thyroid cancer metastases may also be detected in addition to laryngeal cancer metastases. Were retrospectively reviewed the files of 74 patients who were diagnosed with laryngeal cancer and underwent total or partial laryngectomy and neck dissection in our clinic between January 2008 and July 2010. Thyroid papillary carcinoma was found in neck dissection specimen of two patients who underwent partial laryngectomy and neck dissection. Total thyroidectomy was performed to complete the treatment. No recurrence or metastasis was found during the postoperative follow-up for an average of 9.5 months (range 5 to 14 months). Although it is a rare condition, the possibility of coexisting thyroid carcinoma in laryngeal cancer patients and the possible need for completion surgery when required should always be kept in mind.

[Fungus ball in middle concha bullosa: a case report]. / Büllöz orta konka içerisinde fungus topu: Olgu sunumu.

The enlargement of the middle concha as a pneumatized cavity is defined as concha bullosa. Concha bullosa is one of the most frequently encountered anatomic variations inside the nose. The histopathological changes caused by the infections that occur following the impairment of aeration of the conchal cavity filled with air are frequently found. Polyps, submucous cysts, cholesteatomas, ossifying fibromas and pyoceles have been found in concha bullosa. However, in our literature search, we have found only one case published up to date where presence of mycosis in concha bullosa was reported. In this article we presented a 19-year-old female patient. The patient was admitted to our clinic with the complaints of headache, left ocular pain, and nasal obstruction in July 2009. In her nasal endoscopy and paranasal computed tomographic examination, nasal septum deviation and concha bullosa were detected, calcified areas inside her left middle concha bullosa were noted. In the magnetic resonance imaging examination performed thereon, we found findings confirming the presence of mycosis. The patient was endoscopically operated. The histopathological examination of the removed material was reported as aspergilloma. This case was found worth presenting due to the location of concha bullosa and its rare occurrence in this location.

Phototherapy for allergic rhinitis: a prospective, randomized, single-blind, placebo-controlled study.

BACKGROUND: Phototherapy has a profound immunosuppressive effect, and phototherapeutic methods using both ultraviolet (UV) and visible light are therefore widely used for the therapy of various inflammatory skin diseases. It is also proposed that phototherapy, using a combination of UV-A (25%), UV-B (5%) and visible light (70%), may represent a therapeutic alternative in patients with allergic rhinitis. METHOD: Seventy-nine patients were randomly assigned to receive either a combination of UV-A (25%), UV-B (5%) and visible light (70%), in the phototherapy group, or low-intensity visible light, in the control group. The efficacy of treatment was assessed by means of total nasal symptom score before treatment and 1 month after the end of treatment. RESULTS: Total nasal scores decreased in both groups but the decrease was highly significant in the active treatment group when compared with the placebo (p < 0.001). CONCLUSIONS: This study demonstrates that phototherapy may be an effective modality in the treatment of allergic rhinitis especially in cases of which commonly used drugs either are contraindicated and/or have insufficient efficacy.

Prevalence of allergic rhinitis among the adult population in Turkey.

CONCLUSION: The prevalence of self-reported and physician-diagnosed allergic rhinitis (AR) exhibits significant variability across the seven geographical regions in Turkey. Our findings may contribute to the formulation of public health policy and development of preventive and therapeutic strategies for AR in Turkey. OBJECTIVE: The purpose of this study was to assess the prevalence of AR in the Turkish adult population, with emphasis on descriptive parameters in seven distinct geographical regions in Turkey. METHODS: The volunteers were evaluated with a custom-designed questionnaire for AR. Sample size for the study was calculated by allowing for 2% error in prevalence along with a 95% confidence interval (CI). At the end of the study, we reached 4125 volunteers. The data were analyzed with chi(2), ANOVA, and Tukey (post hoc) tests. RESULTS: A total of 4125 volunteers participated in the study; 2200 were female and 1925 were male. On the basis of self-reporting, 23.1% of the study population was considered to have AR (males 22.3%, females 23.8%). On the other hand, the prevalence of physician-diagnosed AR was 20.1% (males 19.7%, females 20.4%). The prevalence of self-reported AR was 23.8% in the urban and 18.4% in the rural areas.

The effects of phototherapy on quality of life in allergic rhinitis cases.

Phototherapy, using a combination of UV-A (25%), UV-B (5%) and visible light (70%), is known to be affective in suppressing the clinical symptoms of allergic rhinitis significantly. It has also been shown that phototherapy locally reduces the number of inflammatory cells and the level of mediators. We aimed to investigate the efficacy of phototherapy in improving the quality of life of patients with allergic rhinitis using Rhinoconjunctivitis Quality of Life Questionnaire, besides checking the total symptom scores of 100 consecutive cases. When the previous and after treatment data were compared, statistically significant differences were found in all quality of life variables (P < 0.001). These results suggest that phototherapy is an effective method to relieve symptoms of allergic rhinitis and has a positive effect on the quality of life of allergic patients. Further studies are needed to plan an ongoing treatment of phototherapy at certain intervals for continuous relief of symptoms and a better and longstanding quality of life.

The neocartilaginous formation with hydroxyl-apatite in injection laryngoplasty: an experimental study on rabbit model.

Adductor paralysis or the pathologies occurring after laryngeal surgery such as scarring or atrophy of the vocal cords cause glottic insufficiency during phonation. Injection laryngoplasty has been a widely accepted technique due to lower morbidity of the procedure and the applicability via endoscope in the treatment of these pathologies. Various materials have been used in injection laryngoplasty. The primary expectations in these techniques are the persistence of injected material long enough, without resorbtion or any cause of serious tissue response and having beneficial effects in reinforcing the glottic tissue. In the present study, we used large molecular-sized calcium hydroxyl-apatite (CaHA) particles in injection laryngoplasty to observe the effects of the material in the laryngeal tissues under the light microscopic examination. The study was performed on 12 rabbits in four groups. After injecting Ca10 (PO4)6(OH)2 (Coaptite) into their vocal folds, the rabbits were killed at certain intervals, in the 1st week (group 1) in the 1st month (group 2) in the 3rd month (group 3) and in the 6th month (group 4). Larynges were removed and processed for light microscopic observations. Our observations revealed that this material induced the new cartilage formation without a serious tissue response in the larynges. Formation of a new cartilage tissue was the most significant, but an unexpected outcome of the study. The injected material inducing a neocartilage formation without any tissue reaction persisted long enough in the laryngeal tissues. Although neocartilage formation may interfere the vocal fold vibrations, providing glottic closure in the phonation with a durable material will be an important gain.