An Investigation Into the Degree of Sinus Mucosal Delivery of Inhaled Black Cumin Volatile and Peppermint Essential Oils.

The aim of this study was to investigate the quantity of volatile components reaching the sinus mucosa (SM) by inhalation, which is responsible for the therapeutic effect, as a first step toward targeted drug design. In this study, 18 Wistar-Albino female rats with an average weight between 200 and 250 g were used. The rats to be used in the study were randomized: Black cumin (BC) essential oil group (group 1) (n = 6), Peppermint essential oil (PEO) group (group 2) (n = 6), and Control (group 3) (n = 6). Volatile oils were inhaled in group 1 and 2; in the control group volatile oils were not inhaled. In all groups, SM was removed and essential volatile oil composition was determined. In group 1, α-pinene was identified as the principal component in the gas phase from five different glass bottles containing SM. The data obtained were evaluated using the single sample T-test and results show that the α-pinene component in the group of inhaled BC essential oil reached significance (P < .001) when compared with the control group. The active component of the BC essential oil could not be identified as thymoquinone. In group 2, eucalyptol (1,8-cineole) was identified as the principal component in the gas phase from five different glass bottles containing SM. The data obtained were evaluated using the single sample T-test and it was found that the eucalyptol component in the group which inhaled PEO reached statistical significance (P < .001) compared with the control group. In group 3, no volatile oil compounds were detected. We have demonstrated that both oils (BC and peppermint) are delivered to the SM. There is a need for the optimum dose to be clarified by different methods of measurement than those used in the spectrometric data we have obtained. We are convinced that our work will lead to pharmacological, toxicological, and subsequent clinical trials in this area.

Acoustic Analysis of Soccer Fans in Acute Phonotrauma After the Match.

OBJECTIVES: Acute phonotrauma is the result of sound production by shouting or straining one's voice. In this study, we aimed to investigate the acute changes in the vocal folds and voices of soccer fans who voluntarily applied to our clinic after the soccer match where they engaged in acute phonotrauma. There are no other studies in the literature conducted on a similar sample group. STUDY DESIGN: This is a case-control study. METHODS: Videolaryngostroboscopic (VLS) examination, acoustic voice analysis, and Voice Handicap Index (VHI) questionnaire were performed on 29 voluntary soccer fans included to the study before the match and at the first hour after the match. The values obtained were compared statistically with each other and with 29 control groups without voice pathology. RESULTS: The jitter, shimmer, and normalized noise energy values measured after the match increased significantly statistically compared with the pre-match level, but harmonic noise ratio value decreased significantly (P < 0.05). VHI scores increased significantly after the match according to the pre-match scores (P < 0.05). In the VLS examinations, there was no difference in the images before and after the match. CONCLUSIONS: It has been concluded that people who are using their voices loudly and intensely by shouting during the match are exposed to sound changes after the match, and if this situation becomes persistent, it may cause permanent voice pathologies. It is thought that VHI and acoustic voice analysis should be done together with VLS for diagnosis and follow-up of voice changes for which the VLS examination alone is not sufficient.

Efficacy of Platelet-Rich Plasma on Fat Grafts in the Repair of Tympanic Membrane Perforations: An Experimental Study.

OBJECTIVE: We investigated the use of autologous platelet-rich plasma (PRP) to improve the success rate of fat graft myringoplasty in perforated tympanic membranes of rats. MATERIALS AND METHODS: A total of 20 healthy Wistar albino female rats were divided into two groups. In Group 1, the left tympanic membranes were perforated and grafted with a fat graft that was harvested from the inguinal region. In Group 2, the left tympanic membranes were perforated, and a fat graft was also harvested from the inguinal region. Then, the fat was soaked in 0.5 mL PRP and grafted at the perforation. After the procedure, the rats were examined, and the graft situation was assessed at 3, 5, 7, 10, and 14 days. All of the rats were sacrificed 21 days after perforation, and a histopathological examination was made. RESULTS: We compared fat graft histopathological and otomicroscopic findings between the groups. While we did not observe graft rejections in Group 2, we saw 1 case of graft rejection in Group 1. In the histopathological examination, PRP prevents fat graft resorption by the terms of the adipocyte area, granulation tissue area, and vacuolization area. CONCLUSION: This study demonstrated the efficacy of fat grafts prepared with PRP on rat tympanic membranes. The fat graft with PRP did not statistically improve the success rate compared to the graft without PRP. Histopatologic findings of the study showed that PRP prevents fat graft resorption. Further studies are needed to further examine the advantages of the graft with PRP.

Evaluation of the Vestibular System and Etiology in Children with Unilateral Sensorineural Hearing Loss.

OBJECTIVE: The aim of this study was to evaluate the vestibular system of children with unilateral sensorineural hearing loss (USNHL), investigate the etiological factors of USNHL and analyze whether a genetic predisposition exists. MATERIALS AND METHODS: Thirty-three children aged less than 18 years with USNHL, who visited the ear, nose, and throat (ENT) department between January 2004 and December 2012, were included in this study. Cases with conductive hearing loss were excluded from the study. The patients were subjected to etiologic, genetic, and ophthalmologic evaluation; radiologic imaging; electronystagmography (ENG); and vestibular evoked myogenic potential (VEMP) tests. The control group, which included 25 healthy children (13 males and 12 females), had undergone audiological assessment and were subjected to ENG and VEMP tests. RESULTS: All of the patients had severe-to-profound hearing loss. Mumps immunoglobulin G was positive in 22 (66.7%) of 33 patients. The 35delG mutation was not found in any of the patients. All of the patients underwent temporal computed tomography (CT) and magnetic resonance imaging (MRI). Inner ear anomaly was present in 51.5% of the patients. Overall, 21 of 31 ENG patients had canal paresis in the affected ear. The VEMP response was absent on the affected side in three patients. The n23 latency average of the patient group was longer than that of the control group. CONCLUSION: Because USNHL causes irreversible problems in children, early diagnosis and auditory rehabilitation are very important. As USNHL is accompanied by inner ear anomaly, children with USNHL should undergo temporal bone CT and MRI. To evaluate the vestibular system, ENG and VEMP are non-invasive and diagnostic tests.

Lingual Osseous Choristoma.

An osseous choristoma is a rare benign lesion consisting of normal bone tissue; it is seen in abnormal locations. It is most often seen in the posterior 1/3 of the tongue in the head. Its etiopatogenesis is controversial, and till date, less than 100 cases have been reported in the literature. Although a lingual osseous choristoma is asymptomatic, in some patients, symptoms such as swelling sensation in the throat, globus pharyngeus, dysphagia, retching, nausea, and sore throat have been reported. In this article, a 41-year-old female patient admitted to our clinic with throat pain and globus pharyngeus who underwent an excision from the region of radix lingua and the result of histopathological examination was reported as "osseous choristoma" was presented and related literature is reviewed.

Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer.

OBJECTIVE: The incidence of thyroid gland invasion in patients with advanced laryngeal cancer was reported to be 0-50%. However there is a controversy in necessity and extent of routine thyroidectomy in these patients due to the difficulty in diagnosis of tumor invasion to thyroid gland and the risk of possible postoperative hypothyroidism and hypocalcemia. METHODS: The medical files of 47 patients who underwent thyroidectomy as part of surgical treatment for advanced laryngeal cancer were reviewed. RESULTS: Fourty-four (93.6%) patients underwent hemithyroidectomy, 3 (6.3%) patients underwent total thyroidectomy. Thyroid gland invasion was found in 2 (4.2%) patients. Hypothyroidism occurred in 15 (31.9%) patients, and their hormone levels were regulated with medical treatment during follow-up. Hypocalcemia was not found in any patients. CONCLUSION: We recommend that at least a hemithyroidectomy should be performed in patients with advanced laryngeal cancer, if they have any predictive factor (subglottic extension more than 1cm, invasion of paraglottic space, thyroid cartilage, cricoid cartilage and prelaryngeal tissue detected by radiological examination) for thyroid gland invasion.

Survival of diced and block cartilage grafts in combination with injectable calcium hydroxylapatite.

OBJECTIVES/HYPOTHESIS: Dorsal nasal irregularities after trauma, and various procedures such as excessive nasal hump resection, are major problems for patients who have undergone rhinoplasty. Many grafts have been described for the correction of dorsal nasal irregularities. In this study, we used an injectable implant, in combination with diced or block cartilage grafts, to test the efficacy of injectable calcium hydroxylapatite on the survival of diced or block cartilage grafts. STUDY DESIGN: Prospective, controlled, parallel group animal study. METHODS: Fourteen New Zealand white rabbits were used. Block cartilage and diced cartilage grafts, alone and in combination with injectable calcium hydroxylapatite, were placed subcutaneously in the rabbits' dorsal thoracolumbar region. On the 90th day following surgery, the graft areas were extracted immediately after the rabbits were sacrificed. Pathological examination was conducted on all specimens. RESULTS: The pathologic and histochemical findings were compared between groups. There was chronic inflammation observed in all of the groups. However, none of the groups had metaplastic bone formation or calcification. The group that received diced cartilage in combination with the injectable implant received the highest scores for peripheral chondrocyte proliferation, matrix collagen, elastic fiber, and proteoglycan content (P < 0.05). A comparison of the block and diced cartilage grafts revealed that peripheral chondrocyte proliferation was more pronounced in the diced cartilage grafts (P < 0.05). CONCLUSION: The use of calcium hydroxylapatite in combination with diced cartilage grafts does not have any long-term negative effects on chondrocyte viability.

Vocal fold hyperplastic lesions: an evaluation of surgical outcome with videolaryngostroboscopy.

BACKGROUND: Vocal fold hyperplastic lesions are premalignant lesions that can be treated effectively by removal of the lesions surgically. AIMS: The aim of this study was to discuss the success of surgery in patients with vocal fold hyperplastic lesions in terms of preserving vibratory function by comparing the preoperative and postoperative videolaryngostroboscopy findings. STUDY DESIGN: The medical charts and videolaryngostroboscopic recordings of patients diagnosed with hyperplastic lesions on the vocal folds were reviewed retrospectively. METHODS: Twenty seven patients with unilateral lesions who underwent type1 subepithelial cordectomy were enrolled in the study. The videolaryngostroboscopic recordings were evaluated by three raters who were not the operating surgeon and who were blinded to the histology of patients. To evaluate the videolaryngostroboscopic findings, a form, which is a modification of criteria described by Hirano and Bless, was used. Preoperative and 6th month postoperative videolaryngostroboscopic recordings were compared with each other and with recordings of the control group, which included 50 healthy volunteers. RESULTS: All videolaryngostroboscopic findings, except false cord vibration, were significantly improved after surgery. CONCLUSION: The principle of vocal fold surgery in patients with benign lesions is to preserve the vibratory tissue. This principle also applies to patients with hyperplastic lesions that are premalignant. The hydrodissection technique may be beneficial for this purpose.

Evaluation of nasal airway alterations associated with septorhinoplasty by both objective and subjective methods.

The aim of functional septorhinoplasty is to create an esthetically elegant nose and harmony in the face by preserving nasal function as well as maintaining or restoring adequate airway. Since nasal complaints are usually subjective, it may be difficult to evaluate the functions objectively. In the present study, we aimed to investigate the alterations in nasal function associated with septorhinoplasty by using both objective and subjective methods. The study population consisted of 40 patients who underwent septorhinoplasty and 40 healthy controls. Before and after the operation, visual analog scale, acoustic rhinometry, rhinomanometry, and Odiosoft-Rhino test were applied to all patients and controls. There were significant differences in all parameters both before and after the operation. While a significant difference was obtained between the patient and control groups in terms of preoperative values, no significant difference was found between postoperative values of these groups. Both objective and subjective methods are important in evaluations.

Prognostic significance of galectin-3 and cyclin D1 expression in undifferentiated nasopharyngeal carcinoma.

Galectin-3 was shown to be involved in various biological events, including cell growth, adhesion, differentiation, angiogenesis, apoptosis, tumorigenesis, and metastasis. The prognostic significance of galectin-3 expression has already been evaluated in several cancers. However, its prognostic role has not been investigated in nasopharyngeal carcinoma. The loss of cell cycle control is one of the critical steps in the development of nasopharyngeal carcinoma. Cyclin D1 is one of the key proteins involved in cell cycle control and is essential for G1/S phase transition. Overexpression of cyclin D1 has been observed in several human cancers. In the present study, the expression of galectin-3 and cyclin D1 was evaluated with immunohistochemical analysis in 45 patients diagnosed as undifferentiated nasopharyngeal carcinoma and expression of these proteins was correlated with clinicopathological parameters and prognosis. Multivariate analysis showed that older age (>50 vs. ≤50) (P = 0.028), distant metastasis at presentation (M(1) vs. M(0)) (P = 0.001), and increased galectin-3 expression (>5% vs. ≤5%) (P = 0.025) were independently correlated with poor overall survival. We found no statistically significant correlation between cyclin D1 immunoexpression and disease outcome. The Spearman's correlation coefficient revealed a significant correlation between galectin-3 and cyclin D1 expression (r = 0.425; P = 0.004). Our findings suggested that the immunohistochemical analysis of galectin-3 might be useful in predicting prognosis in nasopharyngeal carcinoma.

[Quality of life before and after surgery in patients with nasal polyposis]. / Nazal polipli hastalarda ameliyat öncesi ve sonrasi yasam kalitesi.

OBJECTIVES: The postoperative symptoms, paranasal computed tomography (CT) findings and quality of life of the patients who had undergone surgical treatment for nasal polyposis were evaluated. PATIENTS AND METHODS: This study included 32 patients (18 females, 14 males; mean age 43 years; range 14 to 64 years) who applied to our clinic between January 2008 and January 2009 and were operated on with diagnosis of pure nasal polyps. In addition, 36 healthy volunteers were randomized to the control group. The patients were evaluated before and after surgery, on the 3rd week and 3rd month with routine ear nose and throat physical examination and through the Short Form-36 (SF-36) questionnaire as the nasal symptom scores and quality of life. The SF-36 questionnaire was used in the control group as well. In this SF-36 questionnaire the patients were evaluated for eight domains. Control paranasal CT findings at 6th months after surgery were compared with the CT findings before surgery. RESULTS: We determined improvement of nasal symptoms in patients (nasal obstruction, headache, loss of sense of smell, rhinorrhea and posterior rhinorrhea) at the 3rd week and 3rd month after surgery compared to before surgery (p<0.05). We also determined improvement in the domains of SF-36 questionnaire (general healthy, physical functioning, problems of emotional role, social functioning, pain, vitality and mental health) at the 3rd week and 3rd month after surgery compared to before surgery (p<0.05). Control paranasal CT findings of patients at 6th months after surgery was also improved significantly compared to before (p<0.001). CONCLUSION: We determined improvement in all symptoms and quality of life for a short period of time after the surgical treatment performed on patients with nasal polyposis. The paranasal CT has an important place for diagnosis and treatment.

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.

[Detection of primary carcinoma by positron emission tomography in an unknown primary tumor with cervical metastasis: a case report]. / Primeri bilinmeyen boyun metastazinda pozitron emisyon tomografisi ile primer kanserin saptanmasi: olgu sunumu.

Unknown primary tumors with cervical metastasis account for about 1-3% of patients with neck masses. In many cases, the primary site cannot be detected by diagnostic procedures such as endoscopy, computed tomography, or magnetic resonance imaging, affecting the treatment and prognosis of these patients unfavorably. A 43-year-old male patient presented with a painless mass in the neck. He had previously undergone a neck biopsy, the result of which had been reported as metastatic carcinoma. The primary site could not be determined by extensive diagnostic procedures. Investigation with positron emission tomography with 18F-2-fluoro-2-deoxy-D-glucose suggested the base of the tongue as the primary site, which was then confirmed by an endoscopic biopsy from the tongue. It should be borne in mind that positron emission tomography may be helpful in the diagnosis of unknown primary tumors with cervical metastasis.

Near total laryngectomy: the problems influencing functions and their solutions.

We investigated the problems affecting functional outcomes of near-total laryngectomy and their solutions. A retrospective analysis about complications (i.e., aspiration, pharyngocutenous fistula, shunt stenosis, etc.) that affect postoperative functions was made by using the medical records of 23 male patients (mean age: 56.6, range: 35 to 72 years) who underwent near total laryngectomy. Maximal phonation times of 17 patients and fundamental frequencies of 10 patients were measured and compared with control groups consisting of sex- and age-matched normal laryngeal speakers. Pharyngocutenous fistula occurred in five cases and closed by secondary wound healing. The incidence of aspiration was 42%. Shunt stenosis wasn't observed in our cases, but loss of phonation occurred because of tumor recurrence at the neoglottal region in the 1st postoperative year of one patient. All patients were able to produce voice, and communicable speech was achieved by 19 (82.6%). Measurements of maximal phonation time indicated a significant decrease in the NTL group. The increase in fundamental frequency values of the near total laryngectomy group was also found significant in relation to the control group. After careful patient selection, extreme effort should be made to create a dynamic shunt and complete mucosal covering of the inner surface of the shunt in near total laryngectomy, thus not only producing voice without aspiration or shunt stenosis, but also providing oncologic safety in the patients with sufficient vital capacity.

[The evaluation of voice quality after near-total laryngectomy]. / Near-total larenjektomiden sonra ses kalitesinin degerlendirilmesi.

OBJECTIVES: It was intended to compare various characteristics of phonation obtained in cases who underwent near-total laryngectomy (NTL) and frontolateral laryngectomy (FLL). STUDY DESIGN: The study included 29 male cases, 9 of whom underwent NTL, 10 of whom underwent FLL and 10 who had normal laryngeal speech. All cases were evaluated and compared statistically according to the fundamental frequency (Fo), intensity and voiceless time measurements, maximal phonation time (MPT), speech rate and speech intelligibility. RESULTS: Fo and Fo range were found significantly high in both patient groups, but MPT and speech rate was meaningfully decreased in these groups relative to the control group. There were not any significant differences between the two patient groups. The speech intelligibilities of the NTL group patients were significantly low relative to other two groups. The voiceless time measurements during phonation were significantly high in two patients groups, but we also found that it was not effective on speech rate and intelligibility. CONCLUSION: The phonation gained after NTL is similar to that of FLL in respect of various features. But owing to differences of the speech intelligibility measurements, we concluded that patients who underwent NTL could be exposed to more problems during communication with their social surroundings.

[An evaluation of surgical techniques and oncologic results in early glottic cancers]. / Erken evreli glottik kanserlerde cerrahi tedavi seçimi ve onkolojik sonuçlar.

OBJECTIVES: We evaluated the surgical techniques employed and survival rates in patients who were treated for early glottic cancer. PATIENTS AND METHODS: The study included 29 patients (28 males, 1 female; mean age 59 years; range 47 to 73 years) who underwent surgery for early glottic cancer. Surgical techniques were employed in view of factors such as involvement of the anterior commissure, the extent of sub- or supraglottic invasion, and cord mobility. Two- and five-year survival rates were calculated. TNM classification was made according to the 1992 AJCC staging system. RESULTS: Preoperative tumor stages were TisN0 (n=2, 7%), T1N0 (n=20, 69%), and T2N0 (n=7, 24%). Surgical techniques included laryngofissure and cordectomy (n=9, 31%), frontolateral laryngectomy (n=18, 62%), and vertical hemilaryngectomy (n=2, 7%). Positive surgical margins were reported postoperatively in 10 patients, eight of whom remained tumor-free with (n=4) or without (n=4) radiation therapy during the follow-up period, while two patients underwent total laryngectomy because of local recurrences. Three patients died due to causes other than the primary disease. Two- and five-year survival rates were 88.8% and 80%, respectively. CONCLUSION: Involvement of the anterior commissure, and the extent of invasion to the subglottis, supraglottis, and the laryngeal ventricle seem to play a major role in selecting the most appropriate surgical technique in early glottic cancer.

[Patient selection for near-total laryngectomy and oncologic results]. / Near-total larenjektomi için hasta seçimi ve onkolojik sonuçlar.

OBJECTIVES: We reviewed preoperative, perioperative, and postoperative findings and the survival data to determine which patients may be appropriate for near-total laryngectomy. PATIENTS AND METHODS: We reviewed hospital records of 20 patients (all males; mean age 56.6 years; range 35 to 73 years) who underwent near-total laryngectomy. Indications for patient selection for near-total laryngectomy and survival data were evaluated in comparison with literature reports. RESULTS: The site of the tumor was the sinus pyriformis in two, and the larynx in 18 patients. Thirteen patients had T3, seven patients had T2 tumors. The lesions were localized in the sinus pyriformis in two patients with T2 tumors. The locoregional control rate at the end of two years was 75%; two- and three-year survival rates were 81.2% and 64.2%, respectively. CONCLUSION: Following a detailed and meticulous investigation in the preoperative period, near-total laryngectomy seems to be appropriate in selected patients with advanced laryngeal and hypopharyngeal tumors in which partial laryngectomy procedures are not considered. It may both provide cure and preserve phonation. It may also be considered for functional purposes in patients whose pulmonary functions are insufficient for partial laryngectomy, in those in whom food aspiration is inevitable after partial laryngectomy, and in those suffering from lifelong food aspiration due to neurologic causes, and for oncologic reasons in patients who develop local recurrences after partial laryngectomy.