A Rare Laryngeal Foreign Body Case: Postcricoid Total Dental Prosthesis.

In this case report, 60-year-old patient who aspirated total dental prosthesis into the postcricoid region was presented with patient's history, clinical findings, radiologic examinations and surgical treatment with comparison of literature data. To our literature knowledge, this is the first total dental prosthesis detected in postcricoid region. This was unusual because it did not cause any respiratory disorders such as laryngospasm and asphyxia, although it led to mucosal abrasions in a wide area of esophageus. Laryngoscope, 134:2331-2334, 2024.

Effects of nasal septum deviation and concha bullosa surgery on the frequency and financial burden of acute rhinosinusitis.

BACKGROUND: Nasal septum deviation/concha bullosa (DNS)/(CB) are known to be predisposing factors in the pathophysiology of acute rhinosinusitis (ARS). However, the effects of surgical treatment of these pathologies on ARS have not been adequately investigated. AIMS: To reveal the effects of the surgical treatment of DNS and CB on the frequency of the ARS, the use of antibiotics (ABs), and the direct cost incurred. METHODS: Medical records of the patients who had undergone successful surgery for DNS/CB and were diagnosed with ARS in the preoperative and postoperative 3-year period were retrospectively analyzed. The average annual number of ARS examinations of the patients, the number of ABs prescribed, and prescription, examination, and total health system costs were compared. RESULTS: Fifty-three patients (33 men (62%) and 20 women (38%)) were included in the study. There was a statistically significant decrease in the mean annual number of examinations for ARS, the number of ABs prescribed, prescription, examination, and total health system costs (p < 0.05) in the postoperative period compared with the preoperative period. CONCLUSIONS: The present study determined that successful surgeries performed in patients with DNS/CB resulted in a significant decrease in the average annual number of examinations performed for ARS, number of AB prescriptions, and prescription, examination, and total health system costs. With these results, it seems beneficial to direct patients to surgery within the framework of the health policies of countries to reduce the frequency and financial burden of ARS in DNS/CB patients.

Solitary Plasmacytoma in a Patient Presenting with Taste Disturbance.

Solitary plasmacytoma is a disease included in plasma cell dyscrasias, presenting outside of the bone marrow, and with the potential to turn into multiple myeloma. A 66-year male patient was admitted to the hematology clinic with the complaint of impaired taste. Physical examination revealed edema of the left pharynx. After excisional tissue biopsy, serum/urine protein electrophoresis, and immunofixation tests of the patient diagnosed with plasmacytoma were negative. An increase in atypical plasma cells was noted on bone marrow aspiration and biopsy. There was no systemic involvement outside the pharynx on the PET-CT examination. He was referred to the radiotherapy department for further management. Since the affected area is frequently the nasopharynx, sinuses, and larynx in extramedullary solitary plasmacytoma cases, they generally presented to the clinic with difficulty in swallowing, shortness of breath and pain symptoms. This case presented with a non-specific complaint of taste disturbance along with difficulty in swallowing. Key Words: Plasmacytoma, Nasopharynx, Multiple myeloma.

Turkish Guideline for Diagnosis and Treatment of Allergic Rhinitis (ART).

OBJECT: To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients. METHODS: The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. RESULTS: A detailed guideline about all aspects of allergic rhinitis was created. CONCLUSION: The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals.

Evaluation of the intranasal steroid treatment outcomes in adenoid tissue hypertrophy with or without allergic rhinitis.

PURPOSE: To compare the intranasal steroid (INS) treatment outcomes in patients with adenoid tissue hypertrophy (ATH) with or without allergic rhinitis (AR). MATERIALS AND METHODS: Medical records of 96 children diagnosed with ATH were retrospectively examined. The pediatric version of the Score for Allergic Rhinitis (SFAR) questionnaire was used to determine the AR status of the patients and classify them. The children were divided into two groups based on the questionnaire: Group 1, low probability of AR (SFAR<9); and Group 2, high probability of AR (SFAR≥9). Intranasal mometasone furoate (100 µg/mL) was used to treat ATH for at least 3 months. The severity of nasal obstruction and snoring was evaluated using the visual analog scale (VAS) score, the adenoid/choana (A/C) ratios before and after treatment were compared, and the rate of patient referral to surgery was recorded among groups. RESULTS: The change in the A/C ratio within the group between before and after treatment was significant (both P < 0.001). However, the reduction in the adenoid size was more significant in Group 1 than in Group 2 (P = 0.025). A significant improvement in the VAS scores was observed between before and after treatment in both groups (P < 0.001). Furthermore, the rate of surgical referral of Group 1 was significantly lower than that of Group 2 (P = 0.035). CONCLUSIONS: INS treatment was found more successful for reducing A/C ratio in ATH without AR. Related with this, when considering the INS treatment for ATH, AR status should be kept in mind for predicting the treatment success.

Q192R polymorphism in the PON1 gene and nasal polyp in a Turkish population.

The pathogenesis of nasal polyps is not completely understood. Oxidative damage contributes to polyp formation in the nasal mucosa. The paraoxonase 1 (PON1) enzyme is an important liver enzyme with high antioxidant activity. In this study, we investigated the correlation between Q192R genotypic polymorphism of the PON1 enzyme and nasal-polyp disease. The study examined 62 nasal-polyp patients and 88 controls. PON1 Q192R polymorphism was determined using polymerase chain reaction-restriction fragment length polymorphism. The genotype distribution of the PON1 gene was significantly different between nasal-polyp patients (QQ = 69.35%, QR = 25.81%, RR = 4.83%) and healthy controls (QQ = 52.27%, QR = 44.31%, RR = 3.40%). Our results suggest that the PON1 QQ genotype (odds ratio [OR] = 2.066, P = .036) is associated with a higher risk of developing the nasal-polyp disease while QR genotype (OR = 0.437, P = .021) showed a lower risk.

Comparison of effects of baby shampoo vs. saline irrigation on endoscopic sinus surgery outcomes and quality of life.

OBJECTIVE: Nasal irrigation is an important step of functional endoscopic sinus surgery (FESS) postoperative care. This study was performed to compare the effects of diluted baby shampoo (BS) and normal saline solution (NSS) irrigation on patients' quality of life (QoL) and surgical outcomes after FESS. METHODS: This study included 77 patients who underwent FESS to treat chronic rhinosinusitis with nasal polyps. Lund-Mackay score, Lund-Kennedy endoscopic score (LKES), synechia score and QoL (using the Sinonasal Outcome Test (SNOT-22)) were evaluated. RESULTS: LKES was significantly better in the BS group (p=0.001), especially in terms of nasal discharge and crust formation (p=0.024 and p=0.030, respectively) at 1 month postoperatively. However, no significant difference was found at 3, 6 or 12 months postoperatively (p=0.833, p=0.263, and p=0.346, respectively). The reduction of SNOT-22 score (between preoperative assessment and 1 month postoperatively) was significantly better in the BS than in the NSS group (p=0.025). However, no statistically significant differences were found between groups at 3, 6, or 12 months postoperatively (p=0.312, p=0.280, and p=0.285, respectively). In the evaluation of SNOT-22 subdomains, changes in psychological, rhinological and extranasal rhinological subdomains were significantly better in the BS group at 1 month postoperatively (p=0.019, p=0.010 and p=0.002, respectively). CONCLUSION: Compared to irrigation with NSS, BS usage following FESS led to reductions of crusting, nasal discharge and synechia formation; moreover, it was associated with improved SNOT-22 scores, especially in psychological, rhinological and extranasal rhinological subdomains.

Comparison of transnasal and transoral routes of microdebrider combined curettage adenoidectomy and assessment of endoscopy for residue: a randomized prospective study.

PURPOSE: The aim of this study is to investigate the frequency and locations of residual adenoid tissue in conventional curettage adenoidectomy (CA) via transnasal endoscopic examination at the end of the operation and to determine the most appropriate technique for residual adenoid tissue removal by transoral or transnasal microdebrider usage. METHODS: Sixty-three patients aged 4-12 years who were scheduled for CA were included in this randomized prospective study in a tertiary reference center. Patients who underwent CA had the endoscopic residual tissue exploration at the end of surgery. The amount and locations of residual tissue were recorded. Patients with > 20% residual tissue were divided into two groups according to randomization list for removing the residual tissue, depending on the use of transoral microdebrider (TOMD) and transnasal microdebrider (TNMD). Two procedures were compared in terms of duration, bleeding, pain, post-anesthesia care unit (PACU) transfer time, and complications. RESULTS: Residual tissue was detected in 38 patients (60.2%). The most common location of residual tissue was peritubal area (41.3%). The TOMD group had lower surgical duration, blood loss, pain scores and shorter PACU transfer time (p = 0.001, p = 0.002, p˂0.001, and p = 0.006, respectively). CONCLUSION: Endoscopic exploration at the end of CA should be considered to avoid residual tissue retention. Furthermore, if residual tissue is present, the use of TOMD is easier, faster, and associated with lower morbidity than the use of TNMD.

The novel relationship between polycystic ovary syndrome and temporomandibular joint disorders.

INTRODUCTION: Studies investigating the relationship between sex hormones, inflammatory mediators and joint disorders have reported that sex hormones affect the pathogenesis of joint disorders. We aimed to investigate temporomandibular joint disorder (TJD) in polycystic ovary syndrome (PCOS) and the possible role of systemic mediators and sex hormones in TJD pathogenesis. MATERIAL AND METHODS: PCOS patients (n = 45) and controls (n = 30) aged 20-40 years, were enrolled in this case-control study. TJD diagnosis was performed by the specialist and blood samples were tested in the early follicular phase and on the 21 st (midluteal) day to investigate the levels of estrogen, progesterone, matrix metalloproteinase (MMP) 1-8-9, interleukin (IL)-1ß and Tumor necrosis factor (TNF)-α. RESULTS: TJD incidence was significantly higher in PCOS than the control group (51.1% and 6.9% respectively, p < 0.01). Midluteal progesterone (p < 0.01) was lower in PCOS group than the controls (p < 0.01). TNF-α (p < 0.01), MMP 1 (p < 0.01) and MMP 8 (p = 0.02) levels were found significantly higher in PCOS than the control group. Further, Progesterone levels were found significantly lower in TJD (+) PCOS patients than TJD (-) PCOS patients. However, significant difference was not found between the PCOS TJD (+) and PCOS TJD (-) patients for estrogen, MMP 1, MMP 8, MMP 9, TNF-α and IL-1ß. CONCLUSIONS: TJD frequency was found significantly increased in PCOS patients. Related with this, TJD co-occurrence should be kept in mind in the diagnosing and treatment process of PCOS due to hormonal alteration.

Which one is favorable in the elderly? Transoral rigid laryngoscopy or transnasal flexible fiberoptic laryngoscopy.

PURPOSE: To determine whether transoral rigid laryngeal endoscopy (TORLE) or transnasal flexible fiberoptic laryngoscopy (TNFFL) is more favorable for laryngeal endoscopic examination in the elderly population. METHODS: This randomized prospective study carried out in a tertiary reference center. TORLE or TNFFL were performed to patients who were over 65 years at their first visit according to randomization list. At their second visit, other method was performed. Patients' physiological parameters (Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and oxygen (O2) saturation before and immediately after laryngeal examination were recorded. Patients' pain-irritation, gag reflex, and dyspnea status were evaluated using visual analog scale after first and second endoscopic examinations. Further patient preferences for TORLE and TNFFL were recorded. RESULTS: Of 96 patients included in the study, 69.8% (n = 67) preferred TORLE while 30.2% (n = 29) preferred TNFFL. Major factor influencing patient preferences was pain-irritation in TNFFL. Pain-irritation scores were significantly higher in TNFFL than those in TORLE (p < 0.001). However, no significant difference was found between two methods with respect to gag reflex and dyspnea scores (p = 0.194, p = 0.327, respectively). In TORLE, there was no statistically significant difference between the values measured before and after examination in terms of SBP, DBP, HR, and O2 saturation (p = 0.641, p = 0.134, p = 0.119, p = 0.414, respectively). However, in TNFFL, statistically significant decrease was observed after examination in HR and O2 saturation (p < 0.001, p < 0.001, respectively). CONCLUSION: TORLE is more suitable for laryngeal examination in elderly patients since it is more comfortable for patient and does not change physiological parameters.

Evaluating the Effect of Infraorbital Region Taping Procedure on Patient Anxiety, Satisfaction, Edema, and Ecchymosis Level on Primary Septorhinoplasty.

AIM: This study aims to evaluate the effect of infraorbital region taping on patients' postoperative edema and ecchymosis, satisfaction levels, and anxiety during follow-up. METHODS: A total of 64 patients who underwent septorhinoplasty were included in this randomized controlled prospective study. According to the randomization list, the taping group's (TG) infraorbital region was taped with adhesive strips. Others were included in the control group and were classified as the nontaping group. Two blinded physicians evaluated the degree of edema and ecchymosis according to the photographs of patients taken on the first, second, fifth, and seventh postoperative days. Patient's appearance satisfaction was evaluated for ecchymosis levels. State anxiety inventory (STAI-S) and trait anxiety inventory (STAI-T) were used to measure preoperative and postoperative anxiety levels of patients. RESULTS: The degree of ecchymosis and edema were not significantly different except on the first day in the TG (P = 0.01, P = 0.01, respectively). Significant increment was found in the TG on first, second, and fifth days based on the satisfaction levels of patients for their appearance (P = 0.05, P = 0.03, P = 0.04, respectively). Preoperative STAI-S and STAI-T were similar for the groups (P = 0.78, P = 0.17, respectively). However, postoperative STAI-S of the TG were significantly lower compared with those of the nontaping group except seventh day (P < 0.05). CONCLUSION: Infraorbital taping did not decrease the edema and ecchymosis except on the first postoperative day. However, it had a significant ameliorating effect on patients' anxiety and satisfaction levels.

Effect of prilocaine and its combination with tramadol on anxiety and pain during nasal packing removal.

PURPOSE: To investigate the effect of local usage of prilocaine and its combination with tramadol on the pain and anxiety levels of patients during nasal packing removal. METHODS: A total of 117 patients who were treated with the Merocel nasal packing after septoplasty were included in the study. Patients whose Merocel nasal packings infiltrated with prilocaine (P group), prilocaine combined with tramadol 1 mg/kg (P + T1 group), prilocaine combined with tramadol 2 mg/kg (P + T2 group), or normal saline solution (Control group) before nasal packing removal were compared for their pain, sedation, and anxiety related to this removal procedure. The visual analog scale (VAS), Ramsay sedation scale (RSS), and State-Trait Anxiety Inventory (STAI) scale were assessed to evaluate the pain, sedation, and anxiety levels of the patients. RESULTS: Groups were found similar according to sex, age, and preoperative STAI scores. The VAS score was significantly lower in P, P + T1, and P + T2 than control group during nasal packing removal (p < 0.001, p < 0.001, and p < 0.001, respectively). However, state anxiety inventory (STAI-S) and RSS were found significantly improved only in P + T1 and P + T2 (STAI-S: p = 0.032, RSS: p = 0.002, STAI-S: p = 0.000, RSS: p < 0.001, respectively). In the comparison of P + T1 and P + T2, no significant difference was found in VAS, RSS, and STAI-S (p = 0.604, p = 0.154, and p = 0.264, respectively). CONCLUSION: The combined infiltration of prilocaine and tramadol 1 mg/kg into the nasal packing is effective in reducing the pain and anxiety of patients during nasal packing removal.

The Impact of Type II Diabetes on Tongue Dysplasia and p16-Related Aging Process: An Experimental Study.

OBJECTIVE: To evaluate the effect of streptozotocin-induced experimental diabetes mellitus on p16, p53, Ki67, and Bcl2 expressions and histopathological changes in the tongue of the rats. MATERIAL AND METHODS: Twenty-two adult female Sprague-Dawley rats were used. The rats were randomly divided into 2 groups (n = 14) as control (C) (n = 8) and diabetic (DM) (n = 6). The rats in the DM group were given streptozotocin as a single intraperitoneal dose for induction of diabetes. Histopathological and immunohistochemical evaluations of formalin-fixed and paraffin-embedded tissue sections of the tongue were used. RESULTS: Significant differences were observed between the DM group and the control group in terms of epithelial thickness, length of filiform papillae, and width of filiform papillae (p = 0.005, p = 0.001, and p = 0.006, respectively). There was no significant difference between the groups in terms of mononuclear inflammatory cell infiltration, capillary proliferation, and dysplasia (p = 0.204, p = 0.244, and p = 0.204, respectively). As a result of immunohistochemical studies, no significant difference was found between the groups in terms of p53, Ki67, and Bcl-2 expressions (p = 0.588, p = 0.662, and p = 0.686, respectively). A significant difference was found between the groups when p16 expression was evaluated (p = 0.006). CONCLUSIONS: In our study, streptozotocin-induced experimental diabetes mellitus induced p16 expression but did not show any difference in p53, Bcl-2, and Ki67 levels. It should be considered in the studies that the pathological changes at the early stages of the relationship between DM and oral cancer may be related to p16 expression; however, it may also be linked with p16-related aging process.

Psammomatoid variant of juvenile ossifying fibroma.

Juvenile ossifying fibroma (JOF) is a rare benign tumor of the craniofacial bones differing from other fibro-osseous lesions in terms of early age of onset, aggressive clinical behavior, and high recurrence rate. Histopathologically, it is divided into two as trabecular JOF (TrJOF) and psammomatoid JOF (PsJOF). In PsJOF, psammoma-like spherical ossicles constitute pathognomonic histopathological images, whereas TrJOF has trabeculae of fibrillary osteoid and woven bone. Despite the histopathologic separation, both lesions have similar clinical behavior, thus the treatment procedure is also the same. Complete surgical resection is preferred for the treatment. We report a rare case of PsJOF involving the maxillary sinus and resultant facial symmetry in a 13-year-old female child.

Transseptal Subperichondrial Endoscopic Hypophysectomy With Preservation of Vital Nasal Structures.

INTRODUCTION: Pituitary surgery involving different techniques is often applied to the excision of benign adenomas. Operative interventions involved various approaches and techniques. Endoscopic transsphenoidal approach is the less traumatic route to the sella turcica, avoiding brain retraction, and also permitting good visualization, with lower rates of morbidity and mortality. Although mortality of pituitary surgery decreased by advances in surgical techniques morbidities such as synechiae formation, anosmia, bleeding, nasal septal perforations, drying, and incrustation due to traumatization of the nasal structures such as septum, nasal mucosa, and middle concha are the current problems in pituitary surgery. Here, the authors described an endoscopic transseptal subpericondrial hypophysectomy with minimal damage to normal anatomy and physiology and discussed advantages of this technique. METHODS: The authors performed endoscopic transseptal subpericondrial hypophysectomy to 2 patients and evaluated intraoperative and postoperative results. RESULTS: No complication was noted during surgery or postoperative period with endoscopic transseptal subpericondrial hypophysectomy technique. CONCLUSIONS: Endoscopic transseptal subpericondrial hypophysectomy is a safe technique and, requires only a short surgery time and does not require the removal of any physiological tissue or cause any bleeding.

Protective Effect of Selenium Against Cisplatin-Induced Ototoxicity in an Experimental Design.

Cisplatin is an effective chemotherapeutic agent in the treatment of several types of malignant solid tumors but its clinical use is associated with ototoxicity. In the present study, we investigated the effect of selenium administration on lipid peroxidation (malondialdehyde [MDA]) and cisplatin-induced ototoxicity in rats. Healthy wistar albino rats (n = 21) were randomly divided into 3 groups: control (C), cisplatin (Cis), cisplatin and selenium (Cis+Se). Cisplatin was administered for 3 days to Cis and Cis+Se groups. Cis+Se group received selenium 5 days before cisplatin injection and continued for 11 consecutive days. Hearing thresholds and lipid peroxidation (MDA) levels of the rats were recorded before injections and at the end of experimental protocol. The cochleas of animals were harvested for histologic and immunuhistochemical examinations. In biochemichal analyses, pretreatment with selenium prevented the elevation of MDA levels in Cis+Se group rats. Moreover, animals in Cis+Se group had better hearing threshold levels than animals in cis group. Samples obtained from the animals in Cis group revealed extensive loss of the normal microarchitecture of the organ of Corti. On the other hand, animals in Cis+Se group exhibited a preservation of the morphology of the organ of Corti and outer hair cells. In the immunohistochemical examinations of cochlear tissues stained with anti-caspase-3, a higher degree of immunopositivity was found in the Cis group. When Cis+Se group and Cis group were compared, significantly less immunopositivity occurred in the Cis+Se group (P < 0.05). Thus, it appears that pretreatment with selenium may reduce cisplatin-induced ototoxicity in rats.

Ocular blood flow alterations during inferior turbinate radiofrequency reduction under local anesthesia.

BACKGROUND: Ocular blood flow alterations and blindness are uncommon and less-known adverse effects of nasal local anesthetic infiltrations. Our aim was to investigate ocular blood flow alterations during radiofrequency (RF) tissue reduction of inferior turbinates with the patient under local anesthesia by using a noninvasive method with optical coherence tomography. METHODS: A total of 120 patients with inferior turbinate hypertrophy were prospectively randomized into two groups. In group 1, a total of 61 patients underwent RF tissue reduction while under local anesthesia with epinephrine. In group 2, a total of 59 patients underwent RF tissue reduction of inferior turbinates while under local anesthesia without epinephrine. Optical coherence tomography measurements were performed before surgery and at 5, 15, 30, 45, and 60 minutes after local anesthetic infiltration. RESULTS: Choroid thickness measurements decreased gradually after local anesthetic infiltration until 30 minutes and increased to the same plane with the baseline at 60 minutes in group 1 (p < 0.05). In group 2, the choroid thickness measurement was significantly decreased after local anesthetic infiltration at 15 and 45 minutes (p < 0.05). When the choroid thickness measurements were compared between the groups, in group 1 blood flow was significantly lower than in group 2 at 30 minutes (p < 0.05). CONCLUSION: We observed a statistically significant reduction in choroid circulation after local anesthetic with epinephrine infiltration into inferior turbinates. Otolaryngologists should be careful after local anesthetic infiltration, and monitor the vision. Further studies with larger series would be needed to discuss safety of local anesthetics.

Laryngopharyngeal Reflux Has Negative Effects on Taste and Smell Functions.

OBJECTIVE: We evaluated the halimetric, olfactory, and taste functions of patients with laryngopharyngeal reflux (LPR). STUDY DESIGN: Prospective clinical study. SETTING: Multicenter tertiary care hospital. METHODS: Patients who were diagnosed with LPR for the first time on the basis of a Reflux Finding Score (RFS) >11 and a Reflux Symptom Index (RSI) >13 were enrolled in this study. A control group was selected from patients without a complaint of LPR. OralChroma was used for the halimetric measurement; Sniffin' Sticks were used for the smelling test; Taste Strips were used for the taste test; and monosodium L-glutamate was used for the umami test. RESULTS: A total of 110 subjects were included, with a mean age of 36.8 ± 10 years (range, 19-57 years). The differences in odor threshold scores were significant between the groups (P < .001), but no change was detected for the odor identification or discrimination scores between the groups. Bitter taste scores were significantly diminished in the reflux group compared with those in the control group (P = .001), whereas no impairments were found in the other taste scores (sweet, salty, and sour). The reflux group had significantly higher umami taste scores than those of the control group for the posterior tongue and soft palate anatomic sites (P < .001 and P < .001, respectively). Dimethyl sulfite levels were significantly higher in the reflux group than in the control (P = .001). CONCLUSION: Questioning patients who present with halitosis, taste, or smelling disorders is important to diagnose LPR.

Evaluation of Lacrimal Gland Dimensions and Volume in Turkish Population with Computed Tomography.

INTRODUCTION: Computed tomography (CT) is a widespread method for evaluating head and neck pathologies. The lacrimal glands (LGs) are usually visible in routine head and neck CT scans. LG pathologies usually manifests with changes in gland sizes, so it is important to know the normal values of the LG dimensions and volume. The LG sizes may change with age, gender and race. The normal values of LG dimensions and volume in Turkish population was not reported before. AIM: The aim of this study was to evaluate the dimensions and volumes of the LGs by CT in a Turkish population. MATERIALS AND METHODS: Two hundred seventeen consecutive paranasal CT scans of subjects evaluated retrospectively. Measurements of LG dimensions were performed in axial and coronal paranasal CT images. The LG volume was calculated with Aquarius software by outlining the gland in all consecutive axial images. RESULTS: Four hundred orbits of 200 subjects were included to the study. The mean axial LG length in right and left orbits were 16.2±2.0 mm and 16.0±2.0 mm and the mean axial width of the right and left orbits were 4.1±0.7 mm and 4.0±0.7 mm. The right and left LG mean values for coronal length and width were equal 18.3 ±2.2 mm and 4.1±0.7mm respectively. The mean LG volume was 0.617±0.210 cm(3) in right and 0.597±0.197 cm(3) in the left orbits. There were statistically significant differences in the axial width and volume of the LG according to sides, however there was no significant difference according to gender. Age and LG measurements were negatively correlated. CONCLUSION: Our study may serve as a guide to determine the average values of the LG measurements in Turkish population and find out the orbital pathologies that involves the LG.

Morphometric Evaluation of Bony Nasolacrimal Canal in a Caucasian Population with Primary Acquired Nasolacrimal Duct Obstruction: A Multidetector Computed Tomography Study.

OBJECTIVE: The bony nasolacrimal duct (BNLD) morphology as a contributory factor in primary acquired nasolacrimal duct obstruction (PANDO) is still controversial. The objectives of this study were to evaluate the morphometric differences of BNLDs in unilateral PANDO patients between PANDO and non-PANDO sides, as compared with the control group using multidetector computed tomography (CT). MATERIALS AND METHODS: Bilateral BNLDs in 39 unilateral PANDO patients and 36 control subjects were retrospectively reviewed. CT images with 0.5-mm thickness were obtained with a 64-slice scanner. The length, volume, coronal orientation type, sagittal orientation angle of BNLD, and relative lacrimal sac-BNLD angle were assessed. The entrance, minimum and distal end transverse diameters (TD) of BNLD was investigated. RESULTS: The mean minimum and distal end BNLD TDs measurements were significantly narrower in PANDO patients, both in PANDO and non-PANDO sides, as compared with the control group (p < 0.001 and p = 0.040, respectively); however, there were no significant differences between PANDO and non-PANDO sides within PANDO patients. The length, entrance TD, volume, coronal orientation type, sagittal orientation angle of BNLD, and relative lacrimal sac-BNLD angle were not significantly different between PANDO patients and control subjects, as well as between PANDO and non-PANDO sides within PANDO patients. CONCLUSION: The narrow mean minimum and distal end BNLD TD in PANDO patients, in both PANDO and non-PANDO sides, may be associated with PANDO development. The lack of difference between PANDO and non-PANDO sides within PANDO patients and some overlap between PANDO patients and control subjects suggest that narrow BNLD is not the sole factor.