Piezoelectric Drilling Hole Technique in Septal Fixation.

OBJECTIVES: The act of securing the septum to the midline is very important for the success of the operation during septoplasty and septorhinoplasty operations. The authors' aim in this study is to open a hole in the anterior nasal spine with the Piezoelectric drilling hole technique so as to fix the septum to the midline with a suture passing through that hole. METHODS: Patients with anterior segmental deviation on whom we performed septoplasty or closed technique septorhinoplasty were included in the study. The patients were divided into 2 groups, as the Classic and Piezo Groups. A total of 63 patients were included in the study; in the Classic Group, we performed septum fixation with suture of the nasal spine to the mucoperiosteum in 27 patients; whereas in the Piezo Group, fixation was performed on 36 patients using the piezo-surgical suture through a nasal spinal opening. Patients were assessed preoperatively and postoperatively by VAS and NOSE scores, and also by postoperative examinations. RESULTS: Preoperative and postoperative VAS-NOSE scores were found to be statistically significantly different in both groups (P < 0.0001, P < 0.0001). Redeviation with no need for revision surgery was reported to develop in 1 patient of the classical group (3.7%). CONCLUSION: Piezoelectric drilling hole technique provides stronger fixation in the midline and prevents postoperative redeviation. Its most important superiority over the other methods used in fixing the septum to the nasal spine is its ability to provide adequate stabilization without damaging soft tissue.

Is Piezoelectric Surgery Really Harmless to Soft Tissue?

AIM: The aim of this study was to investigate the effect of piezoelectric surgery (piezosurgery) on soft tissue in open septorhinoplasty. METHODS: A total of 30 patients (21 females, 9 males; mean age 29.16 ±â€Š8.17 years; range, 18-43 years) who underwent open septorhinoplasty between January 2019 and February 2019 were randomly divided into 2 groups. After the nasal dorsum was opened in all groups, 1 mm tissue under the skin in radix region was taken as punch biopsy. In the first group (classical group, n =  15), the cartilage hump was resected with number 15 scalpel and the bone hump with the help of a chisel. Lateral and median osteotomies were conducted using 4 mm sharp osteotomes. Rasping was performed to dorsum to correct bone deformities. Then, 1 mm punch biopsy was taken from under the skin tissue of the nose back near the radix. In the second group (piezo group, n = 15) hump excision, osteotomies and rasping were performed by piezoelectric surgery. Then, 1 mm punch biopsy was taken from the subcutaneous tissue of the nose back near the radix. Biopsies were examined histopathologically in the light microscope for edema, necrosis, and inflammation. RESULTS: Of the 30 patients presented in this series, 21 were female and 9 were male. In the classical group, edema in the soft tissue was seen in 86.7% of the cases after osteotomy, while this rate was 26.7% in the piezosurgery group. The difference was statistically significant (P < 0.05). Although necrosis was not seen prior to the osteotomy in both groups, the rate of necrosis in the classical group was 13.3% and in the piezo group it was 66.7%. Necrosis was significantly different in the piezosurgery group compared with the classical osteotomy group (P < 0.05). CONCLUSION: Piezosurgery is not completely harmless to soft tissue. A statistically significant increase in subcutaneous necrosis compared with the classical group can be explained by long-term soft tissue trauma caused by piezoelectric vibrations. We think that developing necrosis may cause problems in late period, especially in patients with thin skin.

Significance of Medial Osteotomy on the Olfactory Function in Patients Who Underwent Septorhinoplasty.

OBJECTIVE: This study was designed to explore the impact of medial osteotomy on olfactory function. METHODS: This nonrandomized, prospective study included 60 adult patients who underwent open technique septoplasty (group 1), rhinoplasty with only lateral osteotomy (group 2), and septorhinoplasty with medial and lateral osteotomies (group 3). Olfactory functions were evaluated by using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test. The CCCRC test includes the butanol threshold test and smell identification test using common smells. The butanol threshold test and smell identification test scores of each group were recorded preoperatively and at 1st and 4th months and compared. RESULTS: Each group is consisted of 20 patients. The preoperative smell identification test and butanol threshold test scores were similar in each group. The smell identification test, butanol threshold test, and CCCRC olfactory test scores of the 1st month were statistically significantly low in group 3. There was no statistically significant difference between the groups at 4th month postoperatively. CONCLUSION: The present study is the first analysis of the effect of medial osteotomy on olfactory function. Medial osteotomy may decrease the olfactory function in early time, but afterwards olfaction could recover at preoperative levels.

Diagnostic value of repeated Dix-Hallpike and roll maneuvers in benign paroxysmal positional vertigo / Valor diagnóstico da repetição das manobras de Dix-Hallpike e roll-test na vertigemposicional paroxística benigna

Abstract Introduction: Benign Paroxysmal Positional Vertigo (BPPV) is the most common peripheral vestibular disorder. The Dix-Hallpike and Roll maneuvers are used to diagnose BPPV. Objective: This study aims to investigate the diagnostic value of repeated Dix-Hallpike and Roll maneuvers in BPPV. Methods: We performed Dix-Hallpike and roll maneuvers in patients who admitted with peripheral vertigo anamnesis and met our criteria. The present study consists of 207 patients ranging in age from 16 to 70 (52.67 ± 10.67). We conducted the same maneuvers sequentially one more time in patients with negative results. We detected patients who had negative results in first maneuver and later developed symptom and nystagmus. We evaluated post-treatment success and patient satisfaction by performing Dizziness Handicap Inventory (DHI) at first admittance and two weeks after treatment in all patients with BPPV. Results: Of a total of 207 patients, we diagnosed 139 in first maneuver. We diagnosed 28 more patients in sequentially performed maneuvers. The remaining 40 patients were referred to imaging. There was a significant difference between pre- and post-treatment DHI scores in patients with BPPV (p < 0.001). Conclusion: Performing the diagnostic maneuvers only one more time in vertigo patients in the first clinical evaluation increases the diagnosis success in BPPV. Canalith repositioning maneuvers are effective and satisfactory treatment methods in BPPV.

Resumo Introdução: Vertigem posicional paroxística benigna (VPPB) é a disfunção vestibular periférica mais comum. As manobras de Dix-Hallpike e roll-test são usadas para diagnosticar a VPPB. Objetivo: Este estudo teve como objetivo investigar o valor diagnóstico da repetição das manobras de Dix-Hallpike e roll-test na VPPB. Método: Manobras de Dix-Hallpike e Roll-test foram realizadas nos pacientes que foram internados com história de vertigem periférica e eram adequados aos nossos critérios. O presente estudo contou com 207 pacientes na faixa etária de 16-70 anos (52,67 ± 10,67). Fizemos uma vez mais as mesmas manobras sequencialmente nos pacientes com resultados negativos. Detectamos os pacientes que tiveram resultados negativos na primeira manobra e que posteriormente desenvolveram sintomas e nistagmo. Avaliamos o sucesso pós-tratamento e a satisfação do paciente mediante o Inventário da Deficiência Física na Vertigem (Dizziness Handicap Inventory - DHI) na primeira admissão e duas semanas após o tratamento em todos os pacientes com VPPB. Resultados: De 207 pacientes, 139 foram diagnosticados na primeira manobra. Diagnosticamos mais 28 pacientes nas manobras feitas consecutivamente. Os 40 pacientes restantes foram encaminhados para exames de imagem. Houve diferença significativa entre os escores do DHI pré- e pós-tratamento nos pacientes com VPPB (p < 0,001). Conclusão: A realização das manobras diagnósticas apenas mais uma vez nos pacientes com vertigem na primeira avaliação clínica aumentou o sucesso do diagnóstico em VPPB. As manobras de reposicionamento canalicular são métodos eficazes e satisfatórios de tratamento na VPPB.

Diagnostic value of repeated Dix-Hallpike and roll maneuvers in benign paroxysmal positional vertigo.

INTRODUCTION: Benign Paroxysmal Positional Vertigo (BPPV) is the most common peripheral vestibular disorder. The Dix-Hallpike and Roll maneuvers are used to diagnose BPPV. OBJECTIVE: This study aims to investigate the diagnostic value of repeated Dix-Hallpike and Roll maneuvers in BPPV. METHODS: We performed Dix-Hallpike and roll maneuvers in patients who admitted with peripheral vertigo anamnesis and met our criteria. The present study consists of 207 patients ranging in age from 16 to 70 (52.67±10.67). We conducted the same maneuvers sequentially one more time in patients with negative results. We detected patients who had negative results in first maneuver and later developed symptom and nystagmus. We evaluated post-treatment success and patient satisfaction by performing Dizziness Handicap Inventory (DHI) at first admittance and two weeks after treatment in all patients with BPPV. RESULTS: Of a total of 207 patients, we diagnosed 139 in first maneuver. We diagnosed 28 more patients in sequentially performed maneuvers. The remaining 40 patients were referred to imaging. There was a significant difference between pre- and post-treatment DHI scores in patients with BPPV (p<0.001). CONCLUSION: Performing the diagnostic maneuvers only one more time in vertigo patients in the first clinical evaluation increases the diagnosis success in BPPV. Canalith repositioning maneuvers are effective and satisfactory treatment methods in BPPV.

Two-level septocolumellar suture technique for correction of septal caudal dislocation / Técnica de sutura septocolumelar em dois níveis para correção de desvio septal caudal

ABSTRACT INTRODUCTION: Caudal septal dislocation is a respiratory and cosmetic problem. The correction of caudal septal dislocation is a challenging issue. Although different modalities have been described for the treatment, it is still controversial. OBJECTIVES: This study aims to describe a two-level suture technique which can be used to correct and stabilize the septum in the columellar pocket. METHODS: The caudal septum was fixed to the nasal spine with suturing, and an anterior columellar pocket was formed. Two septocolumellar sutures including superior and inferior were performed to correct the dislocated caudal septum and to increase the stability of caudal septum in the columellar pocket. RESULTS: Anterior rhinoscopy showed no recurrent deviation or dislocation in our patients. CONCLUSION: Our suture technique is an effective and easy-to-use method to correct the caudal septal dislocation. It can also be used to increase the stability of corrected septum by other techniques. A two-level suture technique increases the success of correction and reduces the risk of postoperative septal caudal luxation, stabilizing the superior portion of the caudal septum, in particular. Therefore, it would reduce the rate of redo surgeries.

Resumo Introdução: O desvio septal caudal é um problema respiratório e estético, e a sua correção é tarefa desafiadora. Embora tenham sido descritas diferentes modalidades para o tratamento, esse é ainda um tópico controverso. Objetivos: O presente estudo objetivou descrever uma técnica de sutura em dois níveis, que pode ser empregada na correção e estabilização do septo na bolsa columelar. Método: O septo caudal foi fixado à espinha nasal com suturas, após a realização de uma bolsa columelar anterior. Duas suturas septocolumelares, superior e inferior, foram aplicadas para a correção do desvio septal caudal e, também, para maior estabilidade do septo caudal na bolsa columelar. Resultados: Rinoscopia anterior não resultou em recorrência do desvio ou luxação em nossos pacientes. Conclusão: Nossa técnica de sutura é um método efetivo e de fácil uso para a correção do desvio septal caudal. A técnica também pode ser utilizada para aumentar a estabilidade de septos corrigidos por outras técnicas. A técnica de sutura em dois níveis aumenta o sucesso da correção e diminui o risco de luxação septal caudal, estabilizando, em particular, a parte superior do septo caudal. Portanto, nossa técnica diminui o percentual de reoperações.

Two-level septocolumellar suture technique for correction of septal caudal dislocation.

INTRODUCTION: Caudal septal dislocation is a respiratory and cosmetic problem. The correction of caudal septal dislocation is a challenging issue. Although different modalities have been described for the treatment, it is still controversial. OBJECTIVES: This study aims to describe a two-level suture technique which can be used to correct and stabilize the septum in the columellar pocket. METHODS: The caudal septum was fixed to the nasal spine with suturing, and an anterior columellar pocket was formed. Two septocolumellar sutures including superior and inferior were performed to correct the dislocated caudal septum and to increase the stability of caudal septum in the columellar pocket. RESULTS: Anterior rhinoscopy showed no recurrent deviation or dislocation in our patients. CONCLUSION: Our suture technique is an effective and easy-to-use method to correct the caudal septal dislocation. It can also be used to increase the stability of corrected septum by other techniques. A two-level suture technique increases the success of correction and reduces the risk of postoperative septal caudal luxation, stabilizing the superior portion of the caudal septum, in particular. Therefore, it would reduce the rate of redo surgeries.

Oncocytoma of the parotid gland complicated by hypercalcemia: a case report.

Salivary gland tumors are rare head and neck tumors. The majority of these tumors are benign and include pleomorphic adenoma, monomorphic adenoma, oncocytoma, and papillary cystadenoma lymphomatosum. Oncocytoma is a rare benign salivary gland tumor. In this article, we report a 69-year-old female case of oncocytoma of the right parotid gland in whom fine needle aspiration cytology result was reported as a Warthin's tumor.

Postadenoidectomy hemorrhage: how we do it?

AIMS: Conventionally, adenoidectomy has been performed using blind curettage. Postoperative hemorrhage is the most common complication of surgery. There is no specific management algorithm in the literature. In this study, we described an endoscopic approach in the management of postadenoidectomy hemorrhage. MATERIAL AND METHODS: Between 1995 and 2014, 7946 patients undergoing adenoidectomy under general anesthesia in our clinic were retrospectively analyzed. All patients had a rest adenoid tissue located in the choanae. Endoscopic excision of the tissue was performed without using a post-nasal pack. RESULTS: All patients (100%) had a rest adenoid tissue located in the choanae. Hemorrhage was completely discontinued with endoscopic excision of the hemorrhagic tissue. CONCLUSION: Based on our study findings, we conclude that an endoscopic approach should be applied in all postoperative patients with hemorrhage who are unresponsive to conservative treatment modalities.

[Subjective assessment of olfactory function]. / Koku fonksiyonunun subjektif degerlendirilmesi.

Of the five senses, the sense of smell is the most complex and unique in structure and organization. As diagnostic and therapeutic modalities are often underdeveloped, the sense of smell has been inadequately studied. Olfactory disorders may result from benign pathologies such as sinusitis as well as several diseases including Parkinson's disease, temporal lobe epilepsy, schizophrenia and Alzheimer disease. In this article, we aim to instruct the otorhinolaryngology specialists and residents regarding the tests which measure odor subjectively.

Unpredicted effects of Ankaferd® on cartilage tissue.

OBJECTIVE: This study aims to investigate the histopathological changes secondary to the administration of Ankaferd Blood Stopper® (ABS) into the auricular cartilage. MATERIALS AND METHODS: Both of the auricular cartilages of thirty New Zealand rabbits were marked with tattoo ink. A 0.2-cc ABS (study group, n: 30) and 0.2 cc physiological saline (control group, n: 30) were subcutaneously infused into the right auricle and left auricle, respectively. All layers were removed at 14 days. RESULTS: The ABS group had significantly higher level of fibrosis, necrosis, foreign body reaction, inflammation, and cartilage degeneration, compared to the controls. CONCLUSION: Our study results showed that ABS administration into a closed cavity led to a significantly increased fibrosis and necrosis in the auricular cartilage.

[Conservative approach to isolated cricoid cartilage fracture]. / Izole krikoid kartilaj kirigina konservatif yaklasim.

Isolated cricoid fracture is encountered rarely during the clinical follow-up. A 71-year-old female patient was referred to emergency service with complaints of fall from height, and urgent tracheotomy was performed due to dyspnea. During the examination, isolated fractures of the cricoid cartilage were identified. With the conservative approach, the patient remained symptom-free and was discharged after decannulation.

Effects of a new hemostatic agent Ankaferd Blood Stopper(®)on the intraocular tissues in rat model.

PURPOSE: To investigate the histopathological changes due to administration of Ankaferd Blood Stopper(®) (ABS) into intraocular tissues by an anterior chamber and intravitreal injections. METHODS: Twenty Wistar albino rats were divided into four equal groups. Group 1 was injected 0.01 mL ABS into anterior chamber. Group 2 was injected intravitreal 0.02 mL ABS. Groups 3 and 4, which were used as controls, were injected into the anterior chamber and intravitreal 0.01 mL and 0.02 mL balanced salt solution (BSS), respectively. At 2, 5, 10, 15 and 20 days after injection, the eyes were examined under an operating microscope and were subsequently enucleated for histopathological examination. RESULTS: Ophthalmic examination of the rats prior to enucleation revealed ocular complications ranging from conjunctival hyperemia to corneal perforation in group 1 and increased conjunctival hyperemia and discharge in group 2. No physical and histopathological anomalies were detected in groups 3 and 4. All eyes in group 1 showed mixed type inflammatory cell reaction, foreign-body reaction, stromal congestion, disintegration of the collagen fibers and loss of the epithelium of the posterior wall in the iris and ciliary body were observed histopathologically. All eyes in group 2 showed disintegration and separation of the retina, brown pigment accumulation and mixed type inflammatory cell reaction. CONCLUSION: Our results indicate that the commercially available form of ABS solution exerts a toxic effect on intraocular tissues. We consider that the intraocular use of different concentrations, rather than multiple time point of ABS should be investigated.

Use of a novel haemostatic agent: ankaferd blood stopper in conjunctival incisions.

BACKGROUND: To investigate the haemostatic efficacy and histopathological effects of a new haemostatic agent, ankaferd blood stopper, in a rat conjunctival incision model. METHODS: Twenty Wistar albino rats were divided into two equal groups (A, B). Limbal incisions of 90-120° were performed in both eyes of all rats. In group A, bleeding at the site of incision was controlled by the administration of ankaferd blood stopper to the right eyes and balanced salt solution to the left eyes. In group B, bleeding was controlled by the application of ankaferd blood stopper to the right eyes and cautery to the left eyes. Time to haemostasis was recorded. After a 4-week period, conjunctival vascularity and postoperative adhesion between Tenon's capsule and sclera were assessed. Additionally, eyes were enucleated and evaluated histopathologically. RESULTS: In group A, the mean bleeding times were 15.2 and 66.7 s for right and left eyes, respectively (P = 0.002). In group B, the mean bleeding times were 17.6 and 17.5 s for right and left eyes, respectively (P = 0.939). Cautery was found to cause significantly more adhesion (P = 0.04). Histopathological examination of the conjunctiva and scleral revealed no statistically significant difference between the samples. CONCLUSIONS: Given the ease of use and lack of histopathological side-effects in the conjunctival incision model, ankaferd blood stopper is promising for use in ophthalmic surgery. Ankaferd blood stopper is a potent haemostatic agent. Its use in ophthalmic surgery should be investigated further in a larger cohort of patients and tested in clinical and experimental models.

Effects of the folk medicinal plant extract Ankaferd Blood Stopper® on the ocular surface.

PURPOSE: To investigate the effects of Ankaferd Blood Stopper(®) (ABS) on the ocular surface. METHODS: Twenty adult male Wistar albino rats, weighing 390-530 g, were used in this prospective, controlled trial. One drop of ABS and one drop of balanced salt solution (BSS) were instilled into the lower conjunctival sac of the right and left eyes, respectively. After the rats were anesthetized, the ocular surface was evaluated based on the Draize criteria, and fluorescein tests were performed at 1, 2, 4, 18, 24, and 48 h. Subsequently, the rats were killed and all eyes were enucleated for histopathological examination. RESULTS: The outcome of the Draize and fluorescein tests revealed that ABS caused more irritation of the ocular surface than BSS (P < 0.001). The highest mean ABS score was 4.9 for the Draize test and 0.4 for the fluorescein test, and ABS was considered to be a slight irritant. Histopathological examinations of the cornea and the conjunctiva revealed no significant difference between the eyes instilled with BSS and those instilled with ABS. CONCLUSIONS: ABS is a hemostatic drug that exerts a slight toxic effect on the ocular surface. Given its ease of use and antibacterial activity, as well as its efficiency in stopping bleeding, the use of ABS during ocular surgery should be further investigated in experimental and clinical studies.

[The prevalence of allergic rhinitis in patients with simple snoring and obstructive sleep apnea syndrome]. / Basit horlama ve obstrüktif uyku apnesi sendromu hastalarinda alerjik rinit prevelansi

OBJECTIVES: This study aims to investigate the prevalence of allergic rhinitis and the relation between allergic rhinitis and the development of obstructive sleep apnea syndrome (OSAS) and OSAS severity in patients with simple snoring and OSAS. PATIENTS AND METHODS: A total of 80 patients (51 males, 29 females; mean age 45.4±8.1 years; range 18 to 69 years) who were admitted to our clinic with the complaints of snoring and nocturnal awakening and diagnosed with simple snoring and OSAS were included in the study and divided into four groups according to apnea-hypopnea indexes (AHIs) scores. The patients were interrogated about the presence of allergic rhinitis. Radioallergosorbent test (RAST) and prick tests were performed. RESULTS: We found allergic rhinitis in 18 of the 80 (23%) patients. The house mites were found to be the causative allergen in 13 of the 18 (72%) patients. CONCLUSION: We recommend that the allergy symptoms such as nasal obstruction and sneezing should be added to the questions that are asked to the patients with simple snoring and OSAS and that the investigations should include the skin prick and RAST tests in these patients.

[Foreign body which resembles concha bulloza in the middle meatus: a case report]. / Orta meatusta konka bullozaya benzer yabanci cisim: Olgu sunumu.

Diagnosis of foreign body in the nasal cavity may be difficult because it has a wide variety of presentations. Concha bullosa is defined as the pneumatization of the middle concha in various degrees. A 43-year-old female patient was admitted to our clinic with the complaint of breathing difficulty through her right nostril which had been going on for the last year. She had had some medical treatments previously in some different medical centers, there wasn't purulent discharge with unpleasant odour, bleeding and halitosis in the nose and there wasn't a history of a blow to the nose or a history of previous facial, nasal or dental surgery. In the computed tomography there was an image resembling concha bullosa. Transnasal endoscopic approach was used, under general anesthesia, in the patient, whose physical examination results, laboratory findings and allergy test results were normal. Endoscopic sinus surgery was performed including polypectomy, right uncinektomy and the foreign body was removed from the middle meatus using a forceps. No complications were observed in the follow-up control one month later.

[The role of concha bullosa in nasal pathologies]. / Konka bullozanin nazal patolojilerdeki rolü

OBJECTIVES: We investigated the relationship between the size of concha bullosa (CB) detected by coronal paranasal sinus computed tomography (CT) and the frequency of sinonasal symptoms. PATIENTS AND METHODS: The study included 60 patients (39 females, 21 males; mean age 38.3 years; range 17 to 67 years) who had CB on CT scans and underwent endoscopic sinus surgery for symptoms of chronic sinusitis, nasal obstruction and/or headache. The patients were evaluated in three groups according to the ratio of the cross-section area of CB to that of the nasal cavity (NC); hence, group 1, 0-14%; group 2, 15-29%; and group 3, = or >30%. The relationship of CB/NC with clinical symptoms and nasal pathologies were examined. RESULTS: The presenting complaints were sinusitis in 28 (46.7%), nasal obstruction in 56 (93.3%), and headache in 36 (60%) patients. Concha bullosa was on the right side in 16 (26.7%), on the left side in 13 (21.7%), and bilateral in 31 patients (51.7%). Of 91 CB, 29 (31.9%) were in group 1, 43 (47.3%) were in group 2, and 19 (20.9%) were in group 3. The cross-section area of CB was greater than 1 cm2 in 25.6%, and less than 0.5 cm2 in 53.4%. The most common pathology accompanying CB was nasal septal deviation (n=36, 60%). The distribution of symptoms and accompanying pathologies was similar in the three groups. CONCLUSION: Our findings show that symptoms and accompanying pathologies do not differ in patients with varying sizes of CB.

An alternative surgical approach for sublingual dermoid cysts: a case report.

A 52-year-old woman presented with a painless swelling in the floor of the mouth. She stated that it had existed there for 40 years and had undergone a gradual enlargement within the past year. Examination showed a mass, 5x4 cm in size. An aspiration from the lesion revealed a cyst. The lesion was removed by a U-shaped superior based flap. Histopathological examination showed stratified squamous epithelium lining the cystic lumen. This technique can be an alternative approach in such lesions because it protects the oral mucosa by providing good exposure, and prevents injury to the lingual nerve and submandibular duct.

[The effect of topical mitomycin-C application before or after incisional myringotomy on patency times of guinea pig tympanic membrane perforations]. / Kobay timpan membraninda mitomisin-C uygulamasinin insizyonel miringotominin kapanma süresine etkisi.

OBJECTIVES: The aim of this study was to investigate the effect of topical mitomycin-C application before or after incisional myringotomy on patency times and to asess its use as an alternative to ventilation tube insertion. MATERIALS AND METHODS: Nineteen guinea pigs were divided into two groups. In the study group (n=11), mitomycin-C was applied in a concentration of 0.4 mg/ml over the perforation for five minutes before (n=6) or after (n=5) incisional myringotomies in both ears. Control animals (n=8) received 0.1 ml 0.09% NaCl for the same duration. Evaluations were made on days 1, 3, 5, 7, 10, 14, and 21. The patency times, otorrhea, and other complications were recorded. RESULTS: Compared to controls (7.0+/-1.5 days), the mean patency times of perforations were significantly longer in mitomycin-C treated groups before (11.6+/-5.2 days) and after (14.2+/-4.7 days) incisional myringotomies (p<0.05). Patency times did not differ significantly between the two mitomycin-C groups. None of the ears exhibited permanent perforation. CONCLUSION: The length of patency provided by mitomycin-C is not sufficient for optimal ventilation in otitis media with effusion. However, in cases requiring shorter patency times, mitomycin-C application before or after myringotomy may be an alternative to ventilation tube insertion.