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1.
Rhinology ; 54(1): 32-7, 2016 03.
Artigo em Inglês | MEDLINE | ID: mdl-26713321

RESUMO

INTRODUCTION: Success and satisfactory results in rhinoplasty are established not only with flawless surgery but also with meticulous perioperative care. Pain stays at the centre of these circumstances. Besides, several contributing perioperative factors such as periorbital edema and ecchymosis play key role on the patients' comfort. METHODS: Septorhinoplasty was carried out in 50 patients between February and May 2014 under general anesthesia. Local anesthesia with lidocaine and adrenaline combination was done prior to incision. Following the procedure, silicone gel packs were applied. One periorbital region was cooled after surgery whereas the opposite site was left uncooled. Periorbital edema-ecchmosis and pain intensity were graded and noted 1 hour, 1 day, 3 days, 1 week and 1 month after surgery. RESULTS: Cold application seriously reduced postoperative edema and ecchymosis at the first week (p=0.001 for the first 3 days and p=0.006 at first week). Pain was reduced with cooling not on the first hour (p>0.05), but on the forthcoming days throughout the first week (p<0.005). Operation time revealed that primary cases were carried out quicker than revisional surgery. Moreover, pain scores were found lower in primary cases than revisions, especially in the first 3 days. These finding were approved statistically. CONCLUSION: Cooling of the periorbital region reduces edema and ecchymosis as well as pain; however 3 days of use is enough after rhinoplasty. One hour after surgery, cooling does not affect the pain but reduce edema and ecchymosis.


Assuntos
Dor Ocular/prevenção & controle , Cuidados Pós-Operatórios/métodos , Complicações Pós-Operatórias/prevenção & controle , Rinoplastia/efeitos adversos , Adulto , Temperatura Baixa , Equimose/etiologia , Equimose/prevenção & controle , Edema/etiologia , Edema/prevenção & controle , Dor Ocular/etiologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Géis de Silicone
2.
J Craniofac Surg ; 25(3): 780-2, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24785755

RESUMO

The aim of our study was to investigate the effect of patient-related factors, such as the body mass index (BMI) and tumor size, in selecting the flap type for the reconstruction of pharyngeal defects. This retrospective review included 182 patients with pharyngeal defect reconstructions with free and pedicled flaps at the Ohio State University from January 2005 to December 2008. We conducted a retrospective comparison of variety of different flap reconstruction techniques. We compared different flap reconstruction with BMI and tumor size without functional outcome such as swallowing and speech data. Although there was no statistically significant correlation (P > 0.05) when comparing the free flaps with pedicled flaps according to the BMI and tumor size, there was an obvious tendency to prefer radial forearm free flap over anterolateral thigh free flap in patients who are overweight and those with obesity with a ratio of 32:3. In the same group of patients, a similar tendency was observed to prefer fibular free flap over iliac crest free flap with a ratio of 14:5, whereas the ratio was becoming 3:5 in favor of iliac crest free flap over fibular free flap in patients with BMI of 24 or lower. Despite the fact that surgeons' experience with a certain flap type is one of the most important factors while determining which flap to reconstruct, BMI might have a significant impact while selecting the free flap types for the reconstruction of pharyngeal defects.


Assuntos
Índice de Massa Corporal , Faringe/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos/transplante , Adulto , Idoso , Idoso de 80 Anos ou mais , Transplante Ósseo/métodos , Feminino , Fíbula/cirurgia , Retalhos de Tecido Biológico/transplante , Humanos , Ílio/cirurgia , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/cirurgia , Retalho Miocutâneo/transplante , Obesidade/complicações , Neoplasias Orofaríngeas/cirurgia , Sobrepeso/complicações , Estudos Retrospectivos , Coxa da Perna/cirurgia , Sítio Doador de Transplante/cirurgia
3.
Ann Otol Rhinol Laryngol ; 122(7): 474-9, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23951702

RESUMO

OBJECTIVES: This study was performed to evaluate the biocompatibility and tensile strength of two new polymeric materials--a polyfluoro ether-modified thermoplastic polyurethane urea and a polydimethyl silicone elastomer--in an experimental rabbit model. METHODS: The two polymers were implanted inside separate subperichondrial pockets created over the auricular cartilages of 12 rabbits. A control pocket received no implant. After 3 months, the animals were painlessly sacrificed, and each site was analyzed histologically for vascular congestion, acute and chronic inflammation, and fibrosis in the tissue surrounding the implant materials. RESULTS: There were no statistically significant differences in vascular congestion, fibrosis, or acute or chronic inflammation between the control sites and either implant site. CONCLUSIONS: These results suggest that the polymers are well accepted by the tissue and remain stable during the entire study period, and that they could be very suitable materials for use in nasal reconstruction.


Assuntos
Materiais Biocompatíveis , Cartilagem da Orelha/cirurgia , Implantes Experimentais , Poliuretanos , Rinoplastia/métodos , Elastômeros de Silicone , Animais , Modelos Animais de Doenças , Coelhos , Reprodutibilidade dos Testes , Transplante Homólogo
4.
Eur Arch Otorhinolaryngol ; 270(2): 469-75, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22456810

RESUMO

Magnetic resonance imaging (MRI) of the internal acoustic canal is the standard diagnostic tool for a wide range of indications in patients. This study aims to investigate the vascular variations and compression of the cranial nerves (CNs) VII and VIII at the cerebellopontine angle in patients with neuro-otologic symptoms using 3D-fast imaging employing steady-state acquisition (FIESTA) MR imaging. One hundred and eighty-seven patients (374 temporal bones) were examined on a 1.5-T MRI. In addition to conventional MR sequences, a 3D-FIESTA MR imaging was acquired. Magnetic resonance images thus obtained were evaluated with special regard to the presence of vascular contact to the CNs VII and VIII, as well as the presence of the vascular variations of the anterior inferior cerebellar artery (AICA) causing the compression of CNs. The Chi-squared test was used for statistical analysis. No statistically significant differences were found between the presence and absence of the AICA loop and/or vascular contact for the clinical symptoms of patients (P > 0.05). The cisternal and canalicular segments of CNs VII and VIII and adjacent vascular variations are well identified using 3D-FIESTA, especially by determining the relationship of the AICA variations between CNs.


Assuntos
Meato Acústico Externo/patologia , Imageamento por Ressonância Magnética , Nervo Facial/patologia , Doenças do Nervo Facial/diagnóstico , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/diagnóstico , Osso Temporal/patologia , Nervo Vestibulococlear/patologia , Doenças do Nervo Vestibulococlear/diagnóstico
5.
Kulak Burun Bogaz Ihtis Derg ; 23(1): 15-20, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23521407

RESUMO

OBJECTIVES: This study aims to evaluate the complications of tracheoesophageal puncture (TEP) for voice restoration and speech valves in patients undergoing total laryngectomy. PATIENTS AND METHODS: Between January 2006 and June 2011, 47 male patients (mean age 62.8±1.2 years; range 41 to 80 years) who underwent TEP and speech valve for voice restoration after total laryngectomy were retrospectively analyzed. Secondary TEP was performed and Provox indwelling voice prosthesis were inserted in all patients. Demographic, disease and treatment characteristics of patients were recorded. Complications related to TEP and speech valves, the management of complications and clinical conditions of complete closure of TEP were also recorded. RESULTS: Tracheoesophageal puncture and speech valve related complications were observed in 20 patients. The majority of complications were minor complications including granulation tissue formation (n=2, 4.2%), deglutition of prosthesis (n=6, 12.7%) and TEP enlargement/leakage around prosthesis (n=9, 19.1%). Major complications were observed in three patients. Two of them were life-threatening complications; a mediastinitis (n=1, 3.1%) and paraesophageal abscess (n=1, 3.1%), and both appeared in the first month of the postoperative period. The overall complication rate was 42.6% during mean follow-up of 15.3 months. Tracheoesophageal fistula enlargement (n=9, 19.1%) was the most common minor complication and the most common cause of complete closure of TEP in this study. CONCLUSION: Tracheoesophageal puncture for voice restoration is not an entirely innocent procedure without any complications. Patients should be monitored for TEP-related complications in the early and late postoperative period.


Assuntos
Esôfago/cirurgia , Laringectomia/efeitos adversos , Laringe Artificial/efeitos adversos , Punções/efeitos adversos , Traqueia/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/cirurgia , Neoplasias de Cabeça e Pescoço/secundário , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Voz Esofágica/métodos
6.
J Craniofac Surg ; 23(5): e438-40, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22976697

RESUMO

Nasolabial cysts are rare nonodontogenic cystic lesions in the soft tissue of the midface and usually present with painless asymptomatic swelling in the nasolabial region. Surgical excision via sublabial approach is considered as the standard treatment. However, endonasal endoscopic marsupialization of the cyst is reported as an effective alternative method for nasolabial cysts. Marsupialization of the cyst is believed to integrate the nasolabial cyst into a part of the nasal cavity as an air-containing sinus. In this article, we present an endonasal endoscopic marsupialization technique in case of recurrent nasolabial cyst. To draw attention to this approach, we present our case with current literature.


Assuntos
Cistos/cirurgia , Endoscopia/métodos , Doenças Nasais/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Humanos , Masculino , Recidiva , Adulto Jovem
7.
Kulak Burun Bogaz Ihtis Derg ; 22(1): 1-5, 2012.
Artigo em Turco | MEDLINE | ID: mdl-22339561

RESUMO

OBJECTIVES: This study aims to evaluate the long-term results of endoscopic sinus surgery and combined approach with Caldwell Luc procedure for the treatment of antrochoanal polyps. PATIENTS AND METHODS: Between January 2002 and December 2009, 41 patients (24 males, 17 females; mean age 34.7 years; range 14 to 78 years) were retrospectively analyzed. Patients were divided into two groups according to treatment modality: group 1 included 26 patients who underwent endoscopic sinus surgery alone and group 2 included 15 patients who underwent endoscopic sinus surgery in combination with Caldwell Luc procedure. Both groups were compared for recurrence and complication rate. RESULTS: Seventeen of 41 patients were diagnosed with right-sided lesions, while 24 patients had left-sided lesions. Recurrence was seen in three patients, including two were in the group 1 and one was in the group 2. There was no statistically significantly difference between the groups in terms of recurrence and complication rate (p>0.05). Mean follow-up was 50.5 months (range 15 to 94 months). CONCLUSION: Current approach for the treatment of antrochoanal polyps is endoscopic sinus surgery. However, combined approaches should be performed to avoid recurrences, unless removal of antral part of the antrochoanal polyp completely by endoscopic resection is possible. Selection of the combined techniques depends on the surgeon familiarity with the procedure and whether the patient is pediatric case. Combined approach with Caldwell Luc is a safe procedure in adults.


Assuntos
Pólipos Nasais/cirurgia , Adolescente , Adulto , Idoso , Endoscopia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/complicações , Pólipos Nasais/patologia , Procedimentos Cirúrgicos Nasais , Seios Paranasais , Complicações Pós-Operatórias , Recidiva , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
8.
Ann Otol Rhinol Laryngol ; 120(5): 339-44, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21675591

RESUMO

OBJECTIVES: The aim of the study was to compare the incidences of pharyngocutaneous fistula after total laryngectomy between patients who underwent manual and mechanical suturing for pharyngoesophageal closure. METHODS: In a retrospective and prospective nonrandomized clinical study conducted at a single tertiary medical center between May 2002 and April 2009, we compared the incidence of pharyngocutaneous salivary fistula between two groups of patients after total laryngectomy. Sixty-one consecutive patients who underwent mechanical suturing with a 60-mm linear stapler (group A) were prospectively enrolled, and 121 patients who had undergone manual suturing (group B) were retrospectively reviewed. RESULTS: The groups were similar in terms of age, gender, comorbidities, TNM (tumor, node, metastasis) stage, and laryngeal tumor extension. The incidence of pharyngocutaneous salivary fistula was 4.9% in group A and 19.8% in group B (p = 0.014). CONCLUSIONS: Mechanical stapler closure of the pharynx after total laryngectomy was associated with a significant reduction in the incidence of pharyngocutaneous fistula compared with manual suture in selected cases.


Assuntos
Fístula Cutânea/cirurgia , Laringectomia/efeitos adversos , Procedimentos Cirúrgicos Otorrinolaringológicos/instrumentação , Doenças Faríngeas/cirurgia , Fístula do Sistema Respiratório/cirurgia , Grampeadores Cirúrgicos , Técnicas de Sutura/instrumentação , Carcinoma de Células Escamosas/cirurgia , Fístula Cutânea/etiologia , Desenho de Equipamento , Feminino , Humanos , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Doenças Faríngeas/etiologia , Fístula do Sistema Respiratório/etiologia , Resultado do Tratamento
9.
Kulak Burun Bogaz Ihtis Derg ; 21(2): 91-4, 2011.
Artigo em Turco | MEDLINE | ID: mdl-21417972

RESUMO

OBJECTIVES: We evaluated the technique of laryngofissure cordectomy without tracheotomy in patients with T1a laryngeal carcinoma. PATIENTS AND METHODS: Twelve male patients (mean age 55 years; range 47 to 68 years) who were diagnosed with T1a laryngeal carcinoma and treated with cordectomy without tracheotomy between January 2005 and March 2008 in our clinic were evaluated with retrospective review of medical charts. They were all treated with laryngofissure and cordectomy. The cord with carcinoma was excised with the inner perichondrium of thyroid cartilage and surgical margins were examined hystopatologically with frozen section. Postoperative oncologic and functional results were evaluated. RESULTS: None of the patients were treated with preoperative or postoperative tracheotomy. Oral nutrition was initiated on the 3rd postoperative day and the patients were discharged. No tumor recurrences were seen in the postoperative follow-ups. CONCLUSION: Although the surgical area is slightly restricted due to the use of entubation tube, cordectomy without tracheotomy had better functional results and the oncological results were unchanged compared to cordectomy with tracheotomy. Since the procedure is without tracheotomy, psychological adaptation period of the patients was shorter compared to the patients treated cordectomies with tracheotomy.


Assuntos
Neoplasias Laríngeas/cirurgia , Prega Vocal/cirurgia , Idoso , Humanos , Intubação Intratraqueal , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Prega Vocal/patologia
10.
Eur Arch Otorhinolaryngol ; 266(5): 699-703, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-18985370

RESUMO

We investigated general and physical predictors of difficult laryngeal exposure in patients undergoing suspension laryngoscopy; 93 patients were included in this prospective study. The patients were classified as difficult laryngeal exposure group or non-difficult laryngeal exposure group based on the laryngeal view in suspension laryngoscopy. Twelve parameters (age, sex, body mass index, neck circumference, full mouth opening, modified mallampati index, hyoid-mental, thyroid-mental, horizontal thyroid-mental, vertical thyroid-mental, sternum-mental distance) that could predict difficult laryngeal exposure were evaluated. Of 93 patients, 22 had difficult laryngeal exposure. Cormack-Lehane score, neck circumference, body mass index, modified mallampati index, hyoid-mental, thyroid-mental, vertical thyroid-mental, and sternum-mental distance showed significant correlation with difficult laryngeal exposure. Based on the multivariate analysis, neck circumference superior to 40 cm, hyoid-mental and sternum-mental distance with respectively a value less than 6.05 and 13.9 cm were independently associated with difficult laryngeal exposure. Muscular neck, hyoid-mental and sterno-mental distance should be considered clinical predictors of difficult laryngeal exposure. Measurements of physical variables at full extension position of the neck are more useful and reliable predictors than neutral position for the risk of difficult laryngeal exposure.


Assuntos
Intubação Intratraqueal/instrumentação , Doenças da Laringe/diagnóstico , Doenças da Laringe/cirurgia , Laringoscopia/métodos , Cuidados Pré-Operatórios , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Masculino , Microcirurgia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos
11.
Kulak Burun Bogaz Ihtis Derg ; 19(2): 77-81, 2009.
Artigo em Turco | MEDLINE | ID: mdl-19796004

RESUMO

OBJECTIVES: The aim of the study was to investigate the presence of superior semicircular canal dehiscence (SSC) in patients with unknown etilogy of vertigo/tinnitus. PATIENTS AND METHODS: This study was performed prospectively between December 2007 and March 2008. Fifty five patients (23 males, 32 females; mean age 44.5; range 36 to 74 year) with complaints of vertigo and/or tinnitus, of which we couldn,t establish the etiologies, were included in the study. Control group was consisted of 15 patients who didn,t have complaints of vertigo and/or tinnitus. A high resolution temporal bone computed tomograpy (CT) scan (1 mm slice thickness) was performed in all study groups (patients and controls). RESULTS: Thirty nine subjects (72%) had normal odiometric findings. Mild conductive hearing loss was present in 12 (22%) subjects. Two (3%) of the patients had moderate conductive hearing loss and the other two subjects (3%) had mixed type hearing loss. High resolution temporal bone CT scan revealed that 35 (65%) subjects had dehissence around SSC otic capsule whereas 20 (35%) remaining patients yielded no dehissence. Twenty one of 35 patients (60%) with dehissence at SSC had minimum defect and 14 patients (40%) had significant defect. Bilateral defect was present in nine (64%) of 14 patients with significant defect but none of the subjects with minimum defect showed bilateral involvement. None of the control subjects exhibited SSC dehissence with CT imaging. CONCLUSION: Semicircular canal dehissence was found in 65% of the patients with unknown etiology of the vertigo and tinnitus. Physicians should evaluate the SSC dehissence in patients with vertigo and tinnitus as an etiologic factor.


Assuntos
Zumbido/diagnóstico por imagem , Vertigem/diagnóstico por imagem , Adulto , Idoso , Feminino , Perda Auditiva/diagnóstico por imagem , Perda Auditiva/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Canais Semicirculares/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Zumbido/etiologia , Tomografia Computadorizada por Raios X , Vertigem/complicações , Vertigem/etiologia
12.
Kulak Burun Bogaz Ihtis Derg ; 19(4): 173-8, 2009.
Artigo em Turco | MEDLINE | ID: mdl-19860630

RESUMO

OBJECTIVES: Our purpose was to investigate cervical lymphadenopathies by using color Doppler spectral analysis and power Doppler ultrasonography methods as well as B-mode ultrasound and to classify them as malignant or benign lesions and to compare the results with the histopathological findings. PATIENTS AND METHODS: Sixty-nine lymph nodes of 69 patients were evaluated with color and power Doppler ultrasonography as well as B-mode ultrasonography. The shape and dimensions of the lymph nodes were assessed with B-mode ultrasonography; their vascularization pattern with power Doppler sonography and with color Doppler spectral analysis. Vascular pattern was evaluated according to the vascularization of the lymph node. Vascular resistive index and pulsatility index were assessed by at least three flow samplings. We measured resistive index, pulsatility index, peak systolic velocity, and end diastolic velocity. Results of Doppler analysis were compared with clinical findings and histopathologic results. Nodes were grouped as metastasis, lymphoma, tuberculosis, and reactive benign lymphadenopathies with respect to ultrasonographic results. RESULTS: Forty-four of 69 lymph nodes were found to be malignant histopathologically. In color Doppler analysis, most malign metastatic lymphadenopathies showed peripheral (76.4%), and the rest of them (23.6%) showed peripheral and hilar (mix) vascularization. Most benign lymphadenopathies (88%) and lymphomatous lymphadenopathies (85%) had hilar vascularization. In tuberculous lymphadenopathies, 50% of them showed avascular pattern and the rest of them had variable type of vascularization. A resistive index = or > 0.7 indicated a malignant metastatic lymphadenopathy and a resistive index <0.5 was consistent with benign lesions. In lymphomatous and tuberculous lymphadenopathies resistive index values were between 0.6-0.7. The sensitivity of the resistive index for distinguishing inflammatory from neoplastic lymphadenopathies was 84.6%, the specificity 100% and the diagnostic accuracy 95.7% (p<0.001). CONCLUSION: In addition to B-mode ultrasonography findings, vascularity pattern assessment and spectral analytical measurements with color and power Doppler ultrasonography has an important contribution for the differential diagnosis of cervical lympadenopathies.


Assuntos
Linfonodos/irrigação sanguínea , Linfonodos/diagnóstico por imagem , Doenças Linfáticas/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Resistência Vascular , Adulto Jovem
13.
Kulak Burun Bogaz Ihtis Derg ; 19(3): 146-50, 2009.
Artigo em Turco | MEDLINE | ID: mdl-19857193

RESUMO

OBJECTIVES: The aim of this study is to evaluate risk factors for stomal recurrence and to state and emphasize the importance of these factors. PATIENTS AND METHODS: This study was carried out retrospectively on 119 patients (116 males, 3 females; mean age 56.8 years; range 31 to 86 years) with larynx cancer who underwent total laryngectomy. All patients were examined for T-stage and location of primary tumor, tracheotomy (preoperative or postoperative) opening time, modality of applied treatment, presence of pharyngeal stoma fistula and presence of cervical lymph node metastasis in the postoperative period. RESULTS: Five patients (4.2%) out of 119 had stomal recurrence. Development period of stomal recurrence after laryngectomy was found to be between six months and three years (mean: 16.6 months). CONCLUSION: The treatment of this fatal complication is very difficult, and it has a poor prognostic nature. As a result, presence of subglottic involvement and advanced tumors in our cases are considered as main risk factors.


Assuntos
Laringectomia/efeitos adversos , Recidiva Local de Neoplasia/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/cirurgia , Prognóstico , Fatores de Risco
14.
Otolaryngol Head Neck Surg ; 139(3): 386-90, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18722218

RESUMO

OBJECTIVE: The aim of this study was to examine the role of the prognostic factors and middle ear risk index on the success of tympanoplasty. STUDY DESIGN: Case series. SUBJECTS AND METHODS: The charts of 231 patients who underwent tympanoplasty operations between 2002 and 2007 were reviewed. Prognostic factors such as age, sex, presence of systemic diseases, location and size of perforation, duration of dry period, presence of myringosclerosis, presence of septal and conchal pathology, operation type, and status of the opposite ear and middle ear risk index were investigated. RESULTS: The overall success rate was 74.4%. Multivariate analysis was carried out on significant prognostic factors to obtain independent variables and yielded the following results (95% CI): size of the perforation (<50%) (OR:8.11), healthy opposite ear (OR:5.64), more than 3 months dry period (OR:2.21), absence of myringosclerosis (OR:4.01) and low middle ear risk index (OR:87.1). CONCLUSION: Size of the perforation(<50%), healthy opposite ear, absence of myringosclerosis, more than 3 months dry period, and low middle ear risk index were found to be significant independent prognostic factors.


Assuntos
Perfuração da Membrana Timpânica/cirurgia , Timpanoplastia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Perfuração da Membrana Timpânica/epidemiologia
15.
Auris Nasus Larynx ; 35(1): 61-6, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17826020

RESUMO

OBJECTIVE: Topical corticosteroids are recommended as initial therapy in allergic rhinitis (AR) patients. We investigated clinical efficacy of monotherapy with topical steroid and combined therapy in AR patients. METHODS: Ninety-five AR patients sensitive to grass pollens according to skin prick test results were enrolled in this placebo-controlled and open study. Patients were divided to four groups. Group-1 received only intranasal mometasone furoate (MF) 200microg (n=25), group-2 received intranasal MF and oral desloratadine (DLR) 5mg (n=25), group-3 received intranasal MF and oral montelukast (MSK) 10mg (n=25), group-4 received only placebo (n=20). Efficacy was assessed on the basis of total nasal symptom scores, rhinoconjunctivitis quality of life questionnaire scores and nasal inspiratory peak flow rates. RESULTS: All groups that received treatment had better results when compared to the placebo group. Significant improvement in total nasal symptom scores was first evident at the end of the 2nd week in group-2. Group-3 had better results than those of the other groups at the end of the 1st month (p<0.05). Quality of life scores were significantly better in group-2 and -3 when compared to those in group-1 (p<0.05). CONCLUSION: Although corticosteroids are the mainstay of treatment in allergic rhinitis, montelukast may be considered as an additional agent especially in treatment of patients with impaired quality of life and it may be used to reduce nasal symptom scores.


Assuntos
Acetatos/administração & dosagem , Antialérgicos/administração & dosagem , Antagonistas não Sedativos dos Receptores H1 da Histamina/administração & dosagem , Antagonistas de Leucotrienos/administração & dosagem , Loratadina/análogos & derivados , Pregnadienodiois/administração & dosagem , Quinolinas/administração & dosagem , Rinite Alérgica Sazonal/tratamento farmacológico , Acetatos/efeitos adversos , Administração Intranasal , Administração Oral , Adolescente , Adulto , Ciclopropanos , Quimioterapia Combinada , Feminino , Antagonistas não Sedativos dos Receptores H1 da Histamina/efeitos adversos , Humanos , Testes Intradérmicos , Antagonistas de Leucotrienos/efeitos adversos , Loratadina/administração & dosagem , Loratadina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Furoato de Mometasona , Pregnadienodiois/efeitos adversos , Ventilação Pulmonar/efeitos dos fármacos , Qualidade de Vida , Quinolinas/efeitos adversos , Sulfetos
16.
Kulak Burun Bogaz Ihtis Derg ; 18(3): 185-7, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18985003

RESUMO

Cemento-ossifying fibroma is a benign fibroosseous lesion that contains fibrous tissue and calcified tissue resembling bone, cementum or both. It is frequently seen in the mandibula and maxilla, but it may rarely affect the ethmoid sinus. In this report, we presented computed tomography findings of an ossifying fibroma of the ethmoid sinus associated with exophthalmos. A 25-year-old woman presented with complaints of exophthalmos, headache, and nasal congestion of six-month history. Physical examination showed a firm mass on the right side of the nasal septum and right-sided exophthalmos. Eye movements, vision, and the fundus were normal. Axial and coronal computed tomography scans showed a well-delineated, round mass, 4x4.5x3 cm in size, in the right ethmoid sinus, extending from the right orbital rim to the right nasal cavity. Near-total excision of the mass was performed by a lateral rhinotomy and medial maxillotomy approach. Based on histologic and radiological findings, the diagnosis was made as ossifying fibroma.


Assuntos
Exoftalmia/etiologia , Fibroma Ossificante/complicações , Neoplasias dos Seios Paranasais/complicações , Adulto , Seio Etmoidal/diagnóstico por imagem , Seio Etmoidal/patologia , Seio Etmoidal/cirurgia , Exoftalmia/diagnóstico , Feminino , Fibroma Ossificante/diagnóstico , Fibroma Ossificante/cirurgia , Humanos , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/cirurgia , Radiografia , Fatores de Risco
17.
Kulak Burun Bogaz Ihtis Derg ; 18(5): 284-8, 2008.
Artigo em Turco | MEDLINE | ID: mdl-19155673

RESUMO

OBJECTIVES: We investigated the relationship between tumor localization and depth of tumor invasion and tumor diameter. PATIENTS AND METHODS: Neck dissection specimens of 70 patients (mean age 61+/-10 years, range 38 to 77 years) who underwent laryngectomy for squamous cell carcinoma of the larynx were histopathologically re-examined with regard to the number and localization of metastatic lymph nodes, depth of tumor invasion, and tumor diameter. Three tumor groups (supraglottic, glottic, and transglottic) were compared with respect to depth of tumor invasion, tumor diameter, metastatic lymph nodes, and T-stage. RESULTS: The overall mean depth of tumor invasion was 7.06 mm, being 7.76 mm, 7.05 mm, and 4.06 mm in supraglottic, transglottic, and glottic tumors, respectively. Compared to glottic tumors, depth of tumor invasion and tumor diameter were significantly higher in supraglottic and transglottic tumors (p<0.05). Depth of invasion showed a significant correlation with tumor diameter (p<0.05), whereas there was no correlation between depth of invasion and lymph node metastasis (p>0.05). In supraglottic tumors, depth of invasion significantly increased in parallel with T-stage (p<0.05). In transglottic and glottic tumors, however, there was no correlation between T-stage and depth of invasion (p>0.05). CONCLUSION: Our data show that depth of tumor invasion is related with tumor location and diameter in laryngeal cancers.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Laríngeas/patologia , Laringectomia , Adulto , Idoso , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Neoplasias Laríngeas/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Invasividade Neoplásica
18.
Kulak Burun Bogaz Ihtis Derg ; 17(5): 260-4, 2007.
Artigo em Turco | MEDLINE | ID: mdl-18187984

RESUMO

OBJECTIVES: We evaluated the incidence and predisposing risk factors of pharyngocutaneous fistulas that develop after total laryngectomy. PATIENTS AND METHODS: The records of 210 patients (19 females, 191 males; mean age 60+/-9 years; range 39 to 77 years) who underwent total laryngectomy were retrospectively reviewed. Thirteen predisposing risk factors were evaluated (age, sex, pre-and postoperative anemia and hypoalbuminemia, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, hypertension, preoperative tracheotomy, tumor stage and localization). RESULTS: Pharyngocutaneous fistulas were found in 41 patients (19.5%). The mean duration for fistula formation was 7.7 days (range 2 to 16 days). Coronary artery disease (p=0.00), postoperative hemoglobin (p=0.000) and albumin (p<0.005) levels lower than 10.7+/-1.2 g/dl and 3.0+/-0.5 g/dl, respectively, were found to be significant risk factors for fistula formation. CONCLUSION: Fistula formation is the most frequent complication in laryngectomy patients. To prevent fistula formation, special attention should be paid to surgical technique and postoperative care especially in patients who have coronary artery disease, anemia, and hypoalbuminemia.


Assuntos
Fístula Cutânea/epidemiologia , Laringectomia/efeitos adversos , Doenças Faríngeas/epidemiologia , Adulto , Idoso , Fístula Cutânea/etiologia , Fístula Cutânea/patologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doenças Faríngeas/etiologia , Doenças Faríngeas/patologia , Complicações Pós-Operatórias , Fatores de Risco , Turquia/epidemiologia
19.
Kulak Burun Bogaz Ihtis Derg ; 15(1-2): 9-13, 2005.
Artigo em Turco | MEDLINE | ID: mdl-16340285

RESUMO

OBJECTIVES: The aim of this study was to investigate the expression of p53 tumor suppressor gene and Ki-67 antigen in laryngeal squamous cell carcinoma and its relation to conventional prognostic indicators. PATIENTS AND METHODS: p53 and Ki-67 expressions were evaluated in surgical specimens of 37 patients (34 males, 3 females; mean age 57.2 years; range 35 to 75 years) with squamous cell carcinoma of the larynx. Immunohistochemical studies were performed in routinely fixed and paraffin-embedded tissue sections using the immunoperoxidase technique and monoclonal antibodies. RESULTS: The tumors were well-, moderately, and poorly differentiated in 5, 24, and 8 patients, respectively. Ten patients had lymph node metastasis, nine patients had vascular invasion, and 15 patients had neural invasion. Ki-67 and p53 nuclear staining was detected in 31 (83.8%) and 15 (40.5%) tumors, respectively. The incidence of Ki-67 expression was higher in patients with lymph node metastasis, but this did not exhibit significance. Neither p53 nor Ki-67 immunoexpression was in significant association with conventional clinicopathological parameters (p>0.05). CONCLUSION: These data indicate that p53 and Ki-67 are not correlated with conventional prognostic parameters in squamous cell carcinoma of the larynx.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/metabolismo , Neoplasias Laríngeas/metabolismo , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Estudos de Casos e Controles , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Antígeno Ki-67/metabolismo , Neoplasias Laríngeas/patologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Proteína Supressora de Tumor p53/metabolismo
20.
Kulak Burun Bogaz Ihtis Derg ; 14(5-6): 101-5, 2005.
Artigo em Turco | MEDLINE | ID: mdl-16340277

RESUMO

OBJECTIVES: We investigated the relationship between positive skin test results and serum eosinophilic cationic protein (ECP), nasal eosinophilia, and total IgE levels in patients with allergic rhinitis. PATIENTS AND METHODS: The study included 36 patients with allergic rhinitis (26 females, 10 males; mean age 32.8 years; range 17 to 60 years) and with a positive skin test result. Serum ECP, nasal eosinophilia, and serum total IgE levels were assessed and compared with a control group of 18 healthy volunteers (15 females, 3 males; mean age 30.3 years; range 20 to 49 years) and correlation was sought with skin test results. RESULTS: Twenty-five patients were sensitive to only seasonal, four patients to only perennial, and seven patients to both seasonal and perennial allergens. Twelve patients were sensitive to one allergen, seven patients to two, and 17 patients to three or more allergens. Compared to controls, the mean serum ECP, nasal eosinophilia, and serum total IgE values were significantly higher in the patient group (p<0.05). These parameters did not show significant relationship with the type and number of allergens (p>0.05). CONCLUSION: Serum ECP, nasal eosinophilia, and serum total IgE levels increase in patients with allergic rhinitis. These parameters are not affected by sensitivity to seasonal or perennial allergens.


Assuntos
Alérgenos , Proteína Catiônica de Eosinófilo/sangue , Imunoglobulina E/sangue , Mucosa Nasal/citologia , Rinite Alérgica Perene/diagnóstico , Rinite Alérgica Perene/metabolismo , Adolescente , Adulto , Estudos de Casos e Controles , Eosinófilos/citologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rinite Alérgica Perene/sangue , Testes Cutâneos
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