[Sensitivity and specificity of fine needle aspiration biopsy in parotid masses]. / Parotis kitlelerinde ince igne aspirasyon biyopsisinin duyarlilik ve özgüllügü

OBJECTIVES: We aimed to determine the sensitivity and specificity of fine needle aspiration biopsy (FNAB) in patients with parotid masses. PATIENTS AND METHODS: The study included 29 patients (15 males, 14 females; mean age 52 years; range 20 to 83 years) who underwent FNAB and parotidectomy for parotid masses. After a detailed history taking, otorhinolaryngologic and systemic examinations were performed. Neck ultrasonography and, when needed, neck computed tomography were used. Superficial parotidectomy was performed in 20 patients and total parotidectomy in nine patients. RESULTS: The results of FNAB were reported as benign in 21 patients (72.4%), malignant in six patients (20.7%), and suspicious in two patients (6.9%). Postoperative histopathologic diagnoses were reported as benign in 17 patients (58.6%) and malignant in 12 patients (41.4%). The sensitivity and specificity rates for FNAB were 54.6% and 100%, respectively. The most common histopathological diagnosis was pleomorphic adenoma (n=7, 24.1%), followed by mucoepidermoid carcinoma (n=4, 13.8%), and Warthin's tumor (n=3, 10.3%). CONCLUSION: Preoperative FNAB for parotid masses plays an important role in planning surgery.

The anti-oxidant effect of alpha-tocopherol in the prevention of experimentally induced myringosclerosis.

HYPOTHESIS: The objective of this study was to investigate the possible effect of alpha-tocopherol on the prevention of experimentally induced myringosclerosis. BACKGROUND: Myringosclerosis is a common sequela of ventilation tube treatment of otitis media with effusion. The relationship between oxygen-derived free radicals and occurrence of myringosclerosis has been proven in experimental models, and it was also shown that the formation of myringosclerosis after experimental myringotomy could be reduced by application of various free radical scavengers. METHODS: Eighteen Wistar albino rats were myringotomized on the left side and randomly separated into two groups: group A consisted of rats which received intramuscular alpha-tocopherol injections 100 mg/kg daily and group B which were injected with physiological serum only. The occurrence of myringosclerotic plaques in the tympanic membranes of the two groups was compared by otomicroscopy, histopathology, and tympanometry, which is a novel method of quantification. Blood samples were collected for biochemical evaluation, and the tympanic membranes were harvested on the 15th day of the experiment. RESULTS: In otomicroscopic evaluation, tympanic membranes in group B revealed varying degrees of myringosclerotic plaques; on the other hand, tympanic membranes in group A showed faint or no existence of myringosclerosis. The mean malondialdehyde levels were 1.33 +/- 0.11 micromol/L in group A and 7.49 +/- 1.37 micromol/L in group B (Z = -1.906, p = 0.057). In all ears from group B, the magnitude of the maximum admittance measured by tympanometry reduced to approximately 40% of the values obtained from group A (Z = -2,160, p = 0.031). The mean magnitude of the maximum admittance from group A was very close to the standardization values of Wistar albino rats, which predicts a functional outcome. CONCLUSION: The formation of myringosclerosis after experimental myringotomy can be diminished by intramuscular alpha-tocopherol injections.

Malignant carotid body tumor: a case report.

Malignant carotid body tumors are rare neoplasms which originate from the chemoreceptor cells at the carotid bifurcation. A 61-year-old man presented with a neck mass which was diagnosed as a malignant carotid body tumor. Surgical resection of the mass with accompanying lymph nodes was performed. No evidence for local recurrence or distant metastasis were detected during the follow-up period.

Transglottic laryngeal paraganglioma: a rare location for this tumor.

Laryngeal paragangliomas are rare neoplasms that originate in the neural crest cells of the laryngeal paraganglia. Although the vast majority of these tumors are benign, they exhibit different types of biologic behavior that require different treatment modalities. Therefore, differentiation among these tumors is extremely important. We report a rare case of laryngeal paraganglioma that presented as a transglottic lesion in a 68-year-old man. The atypical location of the tumor led to difficulties in diagnosis and management. To the best of our knowledge, this is only the third such case to be reported in the English-language literature.

The influence of smoking on success of tympanoplasty measured by serum cotinine analysis.

The aim of this study was to evaluate the effects of smoking on surgical outcome and hearing results in tympanoplasty by serum cotinine analysis as an objective method. Furthermore, type of grafting for the smoking patients has been investigated in a prospective cohort in a tertiary medical center. The overall success rate of long-term surgical outcome was 70.1% out of 77 tympanoplasty operations. On the basis of cotinine enzyme immunoassay, 56 patients had a serum cotinine measurement below 17.5 ng/ml and 21 patients above that. While the graft take rate in the non-smoking group was 76.8%, it was 52.4% in the smoking group and this difference was statistically significant (p = 0.037). While mean graft take rate in the temporalis fascia group was 25% for smokers, mean graft take rate in cartilage shield tympanoplasty group it was 88.9%, and for smokers it was 52.4%. Cotinine is a major metabolite of nicotine and is a reliable marker to differentiate smoking patients from non-smokers. Smoking status was found as a significant prognostic factor influencing the success rate of tympanoplasty negatively and the influence of a more stable grafting technique was demonstrated on smoking patients undergoing tympanoplasty procedure.

An unusual foreign body in the floor of the mouth presenting as a gradually growing mass.

Foreign bodies in the upper aerodigestive tract represent one of the most common ENT emergencies, but patients with foreign bodies in the floor of the mouth rarely present to the otolaryngologist. Only a very small number of these foreign bodies are embedded under normal mucosa and can result in lethal complications. In this article, we report the case of a 3-year-old girl with a gradually enlarging mass in the floor of the mouth. On physical examination at admission, there was a 2x3-cm, elastic, tender mass on the left side of the floor of the mouth, with the overlying mucosa intact and normal in color. Taking the palpable lymph nodes into consideration, a congenital lesion or a pediatric malignancy was suspected initially. A blue pen cap with a surrounding pneumatocele was found intraoperatively. After a careful reevaluation of a previous MRI, a check valve mechanism at the possible site of entry was detected, leading to a pneumatocele, thus explaining the constant growth of the mass. This is a unique case of a foreign body in the floor of the mouth, mimicking a congenital lesion or a pediatric malignancy. Thus, the possibility of a foreign body should not be underestimated when evaluating a child with swelling in the floor of the mouth.