A Thyroglossal Cyst With Double Duct Seen in an Adult Patient.

Thyroglossal duct cysts (TDCs) are one of the most common congenital cervical masses that develop in children. Double TDCs are reported in very few patients in the literature. However, the authors did not come across any thyroglossal cyst with double duct in the English literature. A 35-year female patient consulted to authors' clinic with complaints of a swelling localized on the left side of the neck and recurrent purulent discharge. A Sistrunk operation was planned and during the operation, 2 fistula tracts, both terminated in the hyoid bone, were exposed.Usually, only one fistulous tract opens onto the skin; however, in the authors' patient, the authors encountered TDC with double ducti. To authors' knowledge, no similar patients were reported in the literature.

The Frequency of Epileptiform Discharges in Celiac Disease.

BACKGROUND: We studied patients with celiac disease to define the frequency of epileptiform discharges on electroencephalography. METHODS: A total of 307 children with a diagnosis of celiac disease (study group) and 197 age- and sex-matched healthy children as controls (control group) were included in this study. The study group was further divided into newly diagnosed celiac disease patients (n = 216) and patients who were on a gluten-free diet (n = 91) for at least 6 months. Medical histories of all children including age, sex, symptoms, weight, height, physical examination findings, and laboratory data were recorded. All patients underwent an electroencephalograph in a pediatric neurology electroencephalograph laboratory with a 32-channel electroencephalograph for 30 minutes. RESULTS: Twenty-five patients were defined to have epileptiform discharges (spike/sharp-wave discharges); 24 (7.8%) of those patients were in the celiac disease group and 1 (0.5%) was in the control group (P = 0.001). Among those 24 patients, 21 (9.7%) were in newly diagnosed celiac disease group and 3 (3.3%) were in the gluten-free diet group (P = 0.03). CONCLUSIONS: Patients diagnosed with celiac disease are prone to epileptiform activities on electroencephalography and should be evaluated carefully. Moreover, strict adherence to a gluten-free diet early should be advised in those patients with epileptiform activities because it may effectively decrease the occurrence of epileptiform activities.

The comparison of histological results of experimentally created facial nerve defects repaired by 2 different anastomosis techniques: classic suture technique or tissue adhesives for nerve anastomosis?

OBJECTIVE: The objective of this study was to compare the histological regeneration characteristics of nerve fibers at the anastomosis lines performed by classic suture technique or a tissue adhesive (N-butyl-2-cyanoacrylate). METHODS: The control group consisted of 7 rabbits. The 21 rabbits were randomly divided into 3 groups based on the harvesting week. In the study group following preparation of facial nerve bilaterally, a 0.5-cm segment of facial dorsal buccal nerve was resected, and the defect was repaired with a nerve graft, which was harvested from sural nerve of the same side by 8-0 nylon suture technique and by application of N-butyl-2-cyanoacrylate on the other side. RESULTS: Electron microscopic examination at consecutive second, fourth, and sixth days (corresponding to 4th, 8th, and 12th week in human subjects) revealed increased nerve degeneration findings in N-butyl-2-cyanoacrylate group when compared with microsuture repair technique. CONCLUSIONS: We conclude that N-butyl-2-cyanoacrylate is not an appropriate material for nerve anastomosis.

A rare sinonasal neoplasm: fibrosarcoma.

Sinonasal fibrosarcoma is an infrequently occurring malignant neoplasm. It usually presents with nasal obstruction and epistaxis, as do other sarcomas in this region. The final diagnosis is based on the histopathologic and immunohistochemical examination. We report a case involving a 47-year-old woman with a 2-year history of left nasal obstruction and proptosis, as well as diplopia for the 2 months preceding her visit. Computed tomography and magnetic resonance imaging showed a neoplasm occupying the left nasal cavity, ethmoid sinuses, and bilateral frontal sinuses. The neoplasm also was eroding the medial wall of the maxillary sinus, the lamina papyracea, the cribriform plate, and the anterior wall of the frontal sinus. Complete removal of the tumor was achieved both endoscopically and through a Lynch incision. Sinonasal fibrosarcoma was found on histopathologic examination.

Association of inferior turbinate enlargement, concha bullosa and nasal valve collapse with the convexity of septal deviation.

CONCLUSION: Inferior turbinate enlargement (ITE), nasal valve collapse (NVC) and concha bullosa (CB) are nasal anatomic problems that may accompany septal deviation (SD). Establishment of a causal relationship between these variations and SD is doubtful. In patients complaining of nasal obstruction, all nasal structures that may contribute to the symptom must be separately and carefully assessed for setting an appropriate treatment plan and thereby minimizing the failure rate of surgery. OBJECTIVE: To investigate if the convexity of SD is associated with the occurences of ITE, CB and NVC. PATIENTS AND METHODS: This retrospective study was performed on 109 patients who had been operated due to anterior C-shaped SDs. ITE, CB and NVC were encountered in 65 (59.6%), 27 (24.8%) and 55 (50.5%) patients, respectively. Patients with other forms of SD, allergic rhinitis, non-allergic rhinitis with eosinophilia, acute and chronic sinusitis, nasal polyposis, antrochoanal polyps, those who had recently used systemic or topical decongestants and patients with a history of previous nasal surgery were excluded from the study group. Assessment of the patients was based on data derived from the history, physical examination findings and paranasal sinus CT imaging records. RESULTS: No significant correlation was found between the convexity of the SD and occurrence of ITE, CB and NVC (p = 0.098, 0.717 and 0.171, respectively).