[show abstract][hide abstract] ABSTRACT: Malformation of the inner nose is often found in conjunction with different types of cleft palate or may be seen with severe and complex craniofacial anomalies. Among such malformations, however, isolated vomer aplasia is rarely reported in the literature. This study sets forth our findings that congenital vomeral defect of the nasal septum is an isolated disorder with hereditary characteristics. Between 2001 and 2009, nine cases of isolated congenital vomeral bone defect were detected on endoscopic examination of patients referred to our clinic with nasal and otologic complaints. The files of these patients were reviewed and vomer aplasia was identified as an isolated hereditary condition with concomitant sinonasal symptoms. The defect of the posteroinferior part of the nasal septum was defined as a genetic disease presenting with no significant medical problems. Chromosomal analysis of these patients may help to reveal the relationship of this anomaly with different malformations of the maxillofacial complex.
Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 04/2012; · 1.25 Impact Factor
[show abstract][hide abstract] ABSTRACT: Idiopathic sudden sensorineural hearing loss (ISSNHL) is an otologic emergency with an incidence of about 5-20 per 100,000 of the population per year. There is no universally accepted standard protocol for the treatment of patients with ISSNHL. Hyperbaric oxygen therapy (HBOT), was first reported to improve the outcome following acute inner ear disorders during the late 1960s by both French and German authors. The increase in perilymph oxygenation produced by HBOT provides logical basis for the use of this treatment modality in ISSNHL. We reviewed the records of 97 cases that received HBOT for SSNHL to identify the factors that may affect the treatment outcomes. The effects of age, gender, affected ear, status of the contralateral ear, symptoms associated with hearing loss, presence of a cardiovascular disease, dyslipidemia, history of diabetes mellitus, seasonal factor, smoking, degree of hearing loss, audiogram type, medical treatments provided prior to HBOT, onset time, and number of HBOT sessions were evaluated. The mean hearing gain in all cases after the HBOT was 29.5 dB. The gains were statistically significant in the following cases: early onset of HBOT (p = 0.016), higher number of HBOT sessions (p < 0.01), steroid usage (p = 0.009), low frequency-ascending and total audiogram configuration (p < 0.01) and profound hearing loss (p = 0.011). The success rate was significantly lower in cases with high frequency-descending audiogram configuration (p < 0.001). The most important factor affected the prognosis favorably was found as steroid therapy. This retrospective study and our clinical experience suggest that HBOT has beneficial effects when administered in the early phase of the disease together with steroids. HBOT is a safe practice when used properly by an experienced hyperbaric team. In the treatment of ISSNHL, 20 sessions of HBOT at 2.5 ATA can be tolerated well besides some minor side effects. HBOT should be considered for the cases especially with total or profound hearing loss.
Archives of Oto-Rhino-Laryngology 01/2011; 268(1):41-7. · 1.29 Impact Factor
[show abstract][hide abstract] ABSTRACT: We conducted a retrospective analysis of 18 cases of rhinolithiasis treated in our clinic between 1990 and 2004. Age, sex, locations, diagnostic methods, and surgical technique were analyzed. Diagnosis was made by clinical examination and radiologic methods. Anterior rhinoscopy was performed in all patients and endoscopic evaluation in 14 patients. Plain-film x-rays of the paranasal sinus were taken in all patients, and computed tomography was performed in 5 patients. All rhinoliths were in the inferior meatus-11 right and 7 left. Patients' complaints were unilateral, foul-smelling rhinorrhea and nasal obstruction. Five patients also had headache, and 2 had cleft lip and palate. Rhinoliths were removed under local anesthesia in 12 patients and under general anesthesia in 6. An anterior rhinoscopic approach was used in 4 patients and an endoscopic approach in 14. Four of the patients underwent additional procedures, such as septoplasty, endoscopic sinus surgery, and adenoidectomy. Rhinolithiasis should be suspected in every case with unilateral, foul-smelling rhinorrhea and nasal obstruction. The treatment of choice is surgical removal under local or general anesthesia.
[show abstract][hide abstract] ABSTRACT: We retrospectively evaluated patients who underwent surgery for parotid gland masses.
A total of 50 patients (25 females, 25 males; mean age 48.5 years; range 18 to 76 years) who underwent surgery for parotid gland masses were evaluated with regard to age, sex, preoperative diagnostic methods, histopathologic diagnoses, and surgical techniques.
Preoperative diagnostic studies included ultrasonography, fine-needle aspiration biopsy, computed tomography, and magnetic resonance imaging. Histopathological diagnoses were benign in 33 patients (66%), malignant in nine patients (18%), and tumor-like pathologies in eight patients (16%), the most common being pleomorphic adenoma (n=28, 56%), Warthin's tumor (n=4, 8%), and squamous cell carcinoma (n=4, 8%). Superficial and total parotidectomies were performed in 40 (80%) and 10 (20%) patients, respectively. Nine patients with malignant tumors also had neck dissection and postoperative radiotherapy. Mortality occurred in one patient with metastasis to the parotid gland. One patient with lipoma developed recurrence two years after surgery. Follow-up was five years in 28 patients (56%), three years in 12 patients (24%), and two years in five patients (10%). Complete and transient facial paralysis developed in 10 patients and five patients following total and superficial parotidectomy, respectively.
Superficial parotidectomy is the minimal surgery for parotid gland masses. If the deep lobe of the gland is involved, total parotidectomy should be performed with preservation of the facial nerve. In malignant tumors, neck dissection and postoperative radiotherapy should be added.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 02/2007; 17(2):70-4.
[show abstract][hide abstract] ABSTRACT: We describe a case of bilateral massive conchae bullosa in a 76-year-old woman. She presented with a 2-year history of nasal obstruction and frontal headache. In light of these and other findings on anterior rhinoscopic and endoscopic examinations, we initially suspected nasal tumors. However, after a prebiopsy evaluation by computed tomography, we diagnosed bilateral massive conchae bullosa that did not impair sinus ventilation. Endoscopic surgery was performed, and the patient's symptoms abated.
[show abstract][hide abstract] ABSTRACT: A 32-year-old woman presented to our department with a 10-month history of right-sided intermittant otorrhagia. There was no history of hearing loss or pulsatile tinnitus. Otomicroscopic examination revealed a reddish mass arising from the right antero-superior portion of bony canal wall, which measured about 1 cm in diameter. The tympanic membrane seemed to be uninvolved. A computed tomography scan of the temporal bone showed 0.6 x 0.8 cm diameter soft-tissue mass arising from the right external auditory canal, 0.5 cm away from tympanic membrane. The lesion was excised via a transcanal approach under local anesthesia. The histopathologic assessment indicated a capillary hemangioma. There was no recurrence four years after the surgery. Hemangioma of the external auditory canal is a rare otologic entity. It is commonly classified as capillary or cavernous hemangioma. According to the literature, this case represents the second patient with capillary hemangioma of the external auditory canal.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 19(4):212-5.