Penile prosthesis implantation: A single center 25 years of experience.

OBJECTIVES: We analyzed the long-term results of malleable and inflatable penile prosthesis: the rates of complications, revision surgery and patient satisfaction. MATERIALS AND METHODS: Between January 1996 and December 2020, a total of 138 patients underwent implantation of a malleable or inflatable types penile prosthesis. The data of the patients were derived from the patient files and digital recording system. The patients were contacted face-to-face interaction if possible. If it is not possible, phone connection was made. RESULTS: The median age of patients was 56 (21-83) years. Fourteen (10.2%) 1-piece, 46 (33.3%) 2-piece and 78 (56.5%) 3-piece penile prosthesis were implanted. The mostly used perioperative antibiotic was teicoplanin+amikacin in 107 patients. Total complication rate was 30% (n=42). Prosthesis infection constituted 9% (n=13) of these complications. The total satisfaction rate was 89.1%. There was no correlation between the complications and antibiotic regimen or prosthesis type (P=0.488, P=0.454, respectively). The rate of infection showed a slight increase in 3-piece penile prosthesis without any statistically significance (P=0.633). The patients with complications expressed more dissatisfaction compared to those without complications (P=0.001). CONCLUSIONS: In our series, penile prosthesis implantation seems to be a recommended treatment method with high patient satisfaction in the treatment of refractory erectile dysfunction. LEVEL OF EVIDENCE: 4.

Satisfaction outcomes in open functional septorhinoplasty: prospective analysis.

This study aimed to prospectively evaluate patient satisfaction by means of the Rhinoplasty Outcome Evaluation (ROE) questionnaire before and after functional septorhinoplasty. We carefully selected 62 patients (mean age, 31.8 years; 28 men, 34 women) who underwent open functional septorhinoplasty in the Otorhinolaryngology and Head Neck Surgery Department of Susehri State Hospital. Satisfaction analyses were carried out by means of the ROE questionnaire both before the surgery and at least 4 weeks after the surgery. Patients were divided according to age (≤ 25 vs >25 years) and follow-up duration (≤ 6 vs >6 months). In addition, patients were grouped according to their satisfaction scores: 0 to less than 50, bad outcome (group B); 50 to less than 75, good outcome (group G); and 75 or greater, perfect outcome (group P). The mean satisfaction score in all the patients significantly increased after functional septorhinoplasty (from 24.8 ± 14.6 to 70.1 ± 17.3; P < 0.001). Moreover, the increment in mean satisfaction scores did not differ with age or follow-up duration. We conclude that the ROE questionnaire can help surgeons select suitable candidates for functional septorhinoplasty who will most benefit from the surgery.

Use of peak nasal inspiratory flowmetry and nasal decongestant to evaluate outcome of septoplasty with radiofrequency coblation of the inferior turbinate.

BACKGROUND: To investigate the role of peak nasal inspiratory flowmetry (PNIF) in evaluating inspiratory improvements in patients who underwent both septoplasty and inferior turbinate coblation by radiofrequency (ITC-RF). METHODS: One hundred and eight patients underwent both Cottle's septoplasty and ITC-RF. PNIF measurements were performed in all patients in the preoperative period and 6 months postoperatively. All measurements were made both before and after decongestion of the nasal cavity with oxymetazoline spray. RESULTS: Mean preoperative PNIF measurements differed significantly: 104.3 ± 33.6 L/min vs 136.1 ± 27.7 L/min before and after oxymetazoline decongestion, respectively. Mean postoperative PNIF measurements were 139.2 ± 30.8 L/min and 151.2 ± 32.3 L/min before and after decongestion, respectively. Preoperatively the mean difference between before and after decongestion was 32.1 ± 16.3 L/min. Postoperatively the mean difference was 11.8 ± 11.1 L/min. CONCLUSION: PNIF can be used in the assessment of ITC-RF outcomes with the aid of nasal decongestants, even in patients who also underwent septoplasty.

Impedance-controlled radiofrequency vs. cold dissection tonsillectomy.

OBJECTIVE: To compare the efficacy and safety of radiofrequency (RF) and cold dissection (CD) tonsillectomy. STUDY DESIGN: Prospective, double-blind, controlled clinical study. PATIENTS AND METHODS: One hundred and fourteen patients underwent tonsillectomy. The RF and CD techniques were used for the right and left tonsils, respectively; the patients and examining physicians were blinded to this information to avoid bias. We compared operation times, intraoperative bleeding, and postoperative pain associated with the respective techniques. RESULTS: The RF and CD techniques required similar operation times. Intraoperative bleeding was lower after RF dissection than after CD. The severity of pain did not differ between the two techniques on postoperative day 1, but was significantly lower for the CD technique than the RF technique on postoperative days 5 and 10. CONCLUSION: The RF technique is superior to CD regarding intraoperative bleeding, but not regarding operation time or time to return to a painless dietary regimen.

The effect of intratympanic vitamin C administration on cisplatin-induced ototoxicity.

The objective of this study is to investigate the effect of intratympanic injection of vitamin C on cisplatin-induced ototoxicity. The study included 24 albino adult female rats (48 ears). The study animals were divided into four groups each of which was composed of six animals including a control (intraperitoneal cisplatin), a cisplatin-saline (saline intratympanic + intraperitoneal cisplatin), a C vit (intratympanic vitamin C) and a cisplatin-C vit group (intraperitoneal cisplatin + intratympanic vitamin C). As two animals had died due to cisplatin-induced ototoxicity (one in the control and one in the cisplatin-saline group) they were excluded from the study. The experiment was terminated, performing distortion product otoacoustic emission (DPOAE) measurement prior to procedures and at the end of the experiment. The results of the statistical analysis were evaluated. In the cisplatin-C vit group, there were no significant decreases in DPOAE amplitudes at 2 kHz (p > 0.05). Although a decrease was observed in DPOAE amplitudes at 2.8, 4, 6, and 8 kHz frequencies, these amplitude reductions were significantly lower than the control group (p < 0.05). Intratympanic vit C infusion provided a protective effect against cisplatin-induced ototoxicity primarily at 2 kHz and at other frequencies (2.8, 4, 6, and 8 kHz), and it did not produce a toxic effect in the cochlea.

Antrochoanal polyposis: analysis of 34 cases.

An antrochoanal polyp (ACP) is a benign polypoid lesion originating from the maxillary sinus and extending to the choana. The objective of our study is to assess etiological and associated features of ACPs, and outcome following surgical treatment. Thirty-four patients who had received surgical treatment for ACPs were followed for 35 ± 17.7 months. Factors including patient age, gender, history of allergic rhinitis, chronic sinusitis, nasal septal deviation, turbinate hypertrophy, concha bullosa, accessory ostia, as well as the origin of the polyp, the surgical technique used and any recurrence, were evaluated. Overall, there were 12 females and 22 males. Mean age was 24.94 ± 8.08. Septal deviation was present in 50 %, turbinate hypertrophy in 32.3 %, concha bullosa in 17.6 %, mucous retention cyst in 32.3 %, allergic rhinitis in 44.11 %, and chronic sinusitis in 20.5 %. An accessory ostia was observed in 97.05 %. The functional endoscopic sinus surgery (FESS) approach was used in 31 cases, and three cases had combined FESS and Caldwell Luc procedures. The mean follow-up time was 35.8 ± 17.7 months. Two cases, who had been treated with FESS alone, experienced a recurrence. In conclusion, the commonest predisposing factors for ACPs are chronic inflammatory pathologies such as chronic sinusitis and allergic rhinitis. ACP left the maxillary sinus via an accessory ostium in 97.5 % of the cases. The FESS procedure is a safe and reliable method, and can be combined with the Caldwell Luc procedure when the origin of the maxillary component cannot be properly cleaned. In order to prevent recurrence, total extirpation of the maxillary component is essential.

Neck masses: diagnostic analysis of 630 cases in Turkish population.

Neck masses can be classified into three main categories: congenital, inflammatory and neoplastic. Our aim was to determine the distribution of diagnosis in patients who were followed-up for a neck mass and had undergone surgery for diagnostic indications. Six hundred and thirty cases referred to the Otorhinolaryngology and Head Neck Surgery Department of Haseki Research and Training Hospital between January 2005 and February 2012 with a neck mass who underwent excisional or incisional biopsy to establish a histopathologic diagnosis were retrospectively evaluated. Patients with a diagnosis of upper aerodigestive tract malignancy were excluded from the study. As well as the patients with thyroid masses were excluded. Only unknown primary neck masses were included in the study. The neck masses were categorized as inflammatory (33.49 %), congenital (18.9 %) or neoplastic (47.6 %). Neoplastic masses were either benign (51 %) or malignant (49 %) tumors. The most common causes were tuberculous lymphadenitis (40.28 %) among inflammatory masses, thyroglossal duct cysts (32.77 %) among congenital masses, pleomorphic adenoma (22.33 %) among benign neoplastic masses, and lymphoma (20 %) among malignant neoplastic masses. The most common types of mass were congenital in the 0-20 year age group, benign neoplastic in 21-40-year-old and malignant neoplastic in the >40-year group. Any neck mass, especially in an elderly patient, should be managed with caution as a considerable proportion may be malignant. In children and adolescents, a neck mass requiring surgery is most likely to be congenital. Tuberculosis should be considered as a cause of a neck mass due to a long-term inflammatory process in a developing country.

[Peak nasal inspiratory flowmeter in evaluation of nasal obstruction]. / Nazal tikanikligin degerlendirilmesinde tepe nazal inspiratuvar akimmetre.

Nasal obstruction is one of the major reasons for patients with nasal pathology to visit physicians. Since nasal obstruction is a subjective complaint, objective methods may be used for diagnosis in addition to the history and physical examination. At present, acoustic rhinometry and rhinomanometry are the frequently preferred objective diagnostic modality. So far, no single diagnostic method is sufficient by itself for the evaluation of nasal obstruction. Peak nasal inspiratory flowmetry is a physiologic method for the measurement of peak flow in response to deep nasal inspiration. It is very economic, portable and easy to measure compared to other objective methods, and is getting routinely used more and more in European countries. Although its effectivity and wide usage are supported by a number of studies in the literature, it has not been used sufficiently in our country.

Anti-cancer efficiency of natural killer cells differentiated from human adipose tissue-derived mesenchymal stem cells and transfected with miRNA150.

AIM: The aim of this study is to investigate the effects of miR150 transfection on NK-like cells differentiated from adipose tissue derived mesenchymal stem cells (AD-MSCs). METHODS: NK-like cells were differentiated from AD-MSCs and activated by miR150 transfection. Transfected/non-transfected NK-like cells were characterized by immunohistochemical and RT-PCR analyzes. Apoptotic efficiency of the transfected/non-transfected NK-like cells on pancreatic cancer cells PANC1 were determined by TUNEL and RT-PCR. RESULTS: In miR150-transfected cells, the increased expression of NK cell-specific genes such as GKMB, KIR2DL2, CD16, CD56, NKG2D, NKp46 and increased immunoreactivity of NK cell-specific surface marker CD314 (NKG2D) were evident. TUNEL assays showed that NK-like cells with/without transfection induced apoptosis in PANC1 cells in the same manner. The decrease in oncogene expression and the increase in the tumor suppressor gene expression in PANC1 cells upon co-culture with NK-like cells differentiated from AD-MSCs were more prominent following miRNA150 transfection. CONCLUSION: It was shown in vitro that NK-like cells could be obtained by differentiation from AD-MSCs and their efficiency could be increased via miR150 transfection. The results are encouraging for further clinical studies in improvement of immunotherapeutic approaches for cancer therapy.

Relationships among concha bullosa, nasal septal deviation, and sinusitis: Retrospective analysis of 296 cases.

We aimed to investigate the relationships among concha bullosa (CB), nasal septal deviation (NSD), and sinus disease. We retrospectively reviewed paranasal sinus computed tomography scans obtained from 296 patients-132 men and 164 women, aged 17 to 76 years (median: 39)-who had been evaluated over a 19-month period. CBs were classified as lamellar, bulbous, and extensive. In cases of bilateral CB, the larger side was designated as dominant. In all, 132 patients (44.6%) exhibited pneumatization of at least one concha, 176 (59.5%) had NSD, and 187 (63.2%) had sinus disease. Some 89 of 106 patients with unilateral or one-side-dominant CB (84.0%) had NSD, 89 of 132 patients with CB (67.4%) had sinus disease, and 109 of the 176 patients with NSD (61.9%) had sinus disease. We found a statistically significant relationship between CB and contralateral NSD, but no significant relationship between CB and sinus disease or NSD and sinus disease. While CB is a common anatomic problem that may accompany NSD, a causal relationship between CB or NSD and sinus disease is dubious.

Malignant mesothelioma of tunica vaginalis testis associated with long-lasting hydrocele: could hydrocele be an etiological factor?

A case of malign mesothelioma of tunica vaginalis testis in a 67 year old man with a 30 year history of hydrocele was reported. The diagnosis was made with an excisional biopsy performed in scrotal exploration and revealed epithelial type mesothelioma. High orchiectomy with hemiscrotectomy was performed. The patient had a local recurrence at the end of two years. As there were no distant metastasis only local excision was performed. In his sixth month after the second surgery he is still tumor free. Related literature reviewed.

The use of polytetrafluoroethylene (Gore-Tex) grafts in reconstruction of the urinary bladder.

The safety and histopathologic effects of polytetrafluoroethylene (Gore-Tex) grafts in reconstruction of the urinary bladder were examined. Following partial excision of the bladder Gore-Tex was placed, and the rats were sacrificed at days 7, 14 and 30. Gore-Tex did not cause urine infection, and there was no peritonitis or sepsis in any of the rats. Inflammation around the Gore-Tex diminished after four weeks. Some mononuclear cells and exudate were observed on the inner surface of the Gore-Tex. There was no inflammation or fibrosis in the mucosa and muscular layers of the remaining bladder. In this study the Gore-Tex graft was found to be an infection resistant, urine impermeable material, with no adverse effects on the urinary bladder. Gore-Tex is suggested as a safe material for the reconstruction of the urinary bladder.

The efficacy of anti-serotoninergic agents in the treatment of erectile dysfunction.

We investigated 3 agents with antiserotoninergic activity (oral trazodone, ketanserin and mianserin) in a double-blind randomized placebo controlled design in terms of the effectiveness in erectile dysfunction. Positive response rates to 30 days of treatment were 65.2% with trazodone, 19.1% with ketanserin, 31.6% with mianserin and 13.6% with placebo. Response to trazodone treatment was significantly better than with placebo (p = 0.0004) and the other 2 agents (p = 0.03 and p = 0.002 for mianserin and ketanserin, respectively). The effectiveness of ketanserin and mianserin seemed to be greater than that of placebo but the differences did not reach statistical significance (p = 0.63 and p = 0.17, respectively).

Value of the echocardiographic findings of arrhythmogenic right ventricular dysplasia with left ventricular involvement in a child.

A 9-year-old girl was admitted because she had had palpitations for 2 years. Her electrocardiogram revealed multifocal ectopic beats with left bundle branch morphology, sinoatrial block, and first- and second-degree atrioventricular blocks. Cross-sectional echocardiography demonstrated an enlarged left ventricle and filling defects and sacculations of the posterior left ventricular wall, apex, and septum. The diagnosis of arrhythmogenic right ventricular dysplasia (ARVD) was confirmed by endomyocardial biopsy and thallium 201 scintigraphy. We present this case because of the rarity of left ventricular involvement associated with ARVD. We also emphasize the value of echocardiography in the early diagnosis of ARVD.