[Show abstract][Hide abstract] ABSTRACT: In this retrospective study, we investigated the relationship between paranasal sinus, optic canal, foramen rotundum, and vidian canal measurements.
Computed tomographic (CT) images of 320 adult subjects and 640 sides (right and left) were used. Paranasal sinus dimensions, optic canal (OC), foramen rotundum (FR), vidian canal (VC), bilateral FR (FRFR), bilateral vidian canal (VCVC), VC-foramen rotundum (VCFR), and VC-optic canal (VCOC) distances were measured.
Right VCFR (6.06 mm), and right and left VCOC values (20.34 and 20.31 mm) of the males were significantly higher than those of the females (5.50, 18.91, and 18.80 mm, respectively). Foramen rotundum, OC, and VC values were positively correlated with each other. There was also positive correlation between FR width and maxillary sinus height. Increase of OC width was related to increase in FR width and area, VCVC distance; and decrease in maxillary sinus width. There was positive correlation between FRFR, VCVC, VCFR, and VCOC distance values. There was negative correlation between VC width and area; VCVC, VCFR, and VCOC distance; and maxillary sinus, ethmoid sinus, and sphenoid sinus measurement values. As these sinuses pneumatized more, VC width and area values decreased.
As a conclusion, the paranasal sinus, OC, VC, and FR values showed relationship with each other. Before performing craniofacial and/or skull base surgeries, CT view should be taken to evaluate the localization and the course and dimensions of the OC and vidian nerve. It should be kept in mind that in the presence of more pneumatized paranasal sinuses in CT views, VC dimensions decreased.
The Journal of craniofacial surgery 06/2015; 26(4):1382-8. DOI:10.1097/SCS.0000000000001597 · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We investigated the efficacy of bupivacaine, lidocaine, and saline infiltrations to peritonsillar region and uvula and soft palate regions for pain relief after tonsillectomy and modified cautery-assisted uvulopalatopharyngoplasty (MCAUP) in patients with obstructive sleep apnea.
In this prospective study, 91 patients (32-65 years old) with obstructive sleep apnea underwent tonsillectomy and MCAUP and were divided into 3 groups. In group 1 patients (n = 31), 0.25% bupivacaine HCl + 1/200,000 epinephrine (10 mL); in group 2 patients (n = 31), 1% lidocaine HCl + 1/200,000 epinephrine (10 mL); and in group 3 patients (n = 29), 0.9% saline (10 mL) were injected to peritonsillar region and uvula and soft palate regions. Operation duration, amount of bleeding, and analgesic requirement and visual analog scale for pain at rest and at swallowing were evaluated in all groups.
Mean body mass index values were between 27.0 and 27.3 kg/m in all groups. Their apnea-hypopnea index values were between 15.3 and 16.9 per hour, and there were no significant differences between their body mass index and apnea-hypopnea index values. Duration of operation of patients in the bupivacaine group was significantly lower than that of patients in the lidocaine and saline groups. In addition, in the lidocaine group, operation duration was significantly lower than that in the saline group. Bleeding amount and postoperative analgesic requirement of the saline group were significantly higher than those of the bupivacaine and lidocaine groups. Although both these measures (operation duration and amount of bleeding) were statistically significant, a mean operating time of 44.3 versus 46.0 minutes and 64.4-mL versus 68.4-mL blood loss for the bupivacaine and lidocaine groups were clinically irrelevant and not too important. In terms of visual analog scale for pain at rest and/or swallowing, Bupivacaine provided more relief than lidocaine and saline injections. The lidocaine provides pain relief less than bupivacaine and more than saline at rest and/or swallowing.
We recommend the use of bupivacaine injections in peritonsillar, uvular, and soft palate regions during tonsillectomy + MCAUP operations. It reduces operation duration and provides more pain relief postoperatively. When patients had cardiac problems, lidocaine may also be recommended because of its cardiac depressant and antiarrhythmic effects and positive effects for pain relief compared with saline injections.
The Journal of craniofacial surgery 04/2015; 26(3). DOI:10.1097/SCS.0000000000001439 · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We conducted a prospective study to investigate the role of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the pathogenesis of nasal polyps. Our study group consisted of 24 patients-21 men and 3 women, aged 23 to 70 years (mean: 45.97 ± 11.60)-with nasal polyposis who underwent functional endoscopic sinus surgery. For comparison purposes, we assembled a control group of 11 patients-6 men and 5 women, aged 18 to 56 years (mean: 29.90 ± 14.22)-without nasal polyps who underwent septoplasty and/or rhinoplasty. We analyzed 36 polyp specimens obtained from the study group (10 from the nasal cavity, 10 from the maxillary sinus, and 16 from the ethmoid sinus) and 11 tissue specimens from the control group (each control provided 1 specimen from the inferior turbinate). We then calculated the mean number of these cells in the epithelium, subepithelial layer of the lamina propria, and the deep paraglandular layer of the mucosa. In general, we found that MMP-2, MMP-9, and TIMP-1 values were higher in the nasal polyp group. These differences became less so as patients' ages and the duration of polyps increased. We conclude that the most important role that MMP-2 plays in polyp growth may be in terms of perivascular localization and an increase in vascular permeability, which causes inflammatory cell migration and edema in the extracellular matrix. An increase in MMP-2 in glandular tissue may lead to hydrolysis of tissue matrix components. The degraded extracellular matrix may result in fibrosis of the polyps. An increase of MMP-9 in the apical part of the epithelium in the polypoid tissue of the nasal cavity, maxillary sinus, and ethmoid sinus may facilitate the epithelial and endothelial cell migration that is observed during polyp development and growth.
[Show abstract][Hide abstract] ABSTRACT: Primary tumors that originated from the pterygopalatine fossa are seen rarely. In this paper, the case of a 69-year-old woman who complained of a 2-month history of headache, extending to the left part of the face, teeth, and shoulder, is reported. She had undergone right total mastectomy and axillar dissection of a spindle cell-type metaplastic carcinoma of the breast 1 year ago. Computed tomographic and magnetic resonance images showed a mass originating from the pterygopalatine fossa. Pathologic examination of the biopsy specimen of the mass revealed a nasal-type extranodal natural killer/T-cell lymphoma with CD45 and intense CD56 staining. Our case shows that a nasal-type extranodal natural killer/T-cell lymphoma should be thought in mind for the differential diagnosis of primary tumors of the pterygopalatine fossa.
The Journal of craniofacial surgery 03/2010; 21(2):444-7. DOI:10.1097/SCS.0b013e3181cfe9db · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To determine whether trace elements that are essential for neural function play a role in the pathophysiology and etiology of auditory neuropathy (AN).
Patients diagnosed with auditory neuropathy consisted of eight children (two male, six female). The blood tests including the measurement of sodium, potassium, chloride, calcium, phosphorus, iron, copper and magnesium were done in children with AN during their routine care.
Of the eight children with AN, many had serum levels outside the normal range: one had low sodium, two had low potassium, one had low chloride, two had high zinc and three had low zinc, two had low calcium and two had higher than normal phosphorus.
Although some serum trace element levels in our patients were higher or lower than normal values, the mean values were within normal limits. Thus, we were unable to detect a relationship between serum trace element levels and AN-. In the future, larger studies should be conducted to confirm these findings.
Clinical and investigative medicine. Medecine clinique et experimentale 01/2010; 33(3):E155-160. · 1.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In this study, we evaluated the continuous and state anxiety levels of mothers with children with language delay.
The study group consisted of the mothers of 18 children with language delay. The control group consisted of the mothers of 29 healthy children without language delay. To gain data about mothers, a personal information form and Spielberger's State-Trait Anxiety Inventory (STAI) form were applied to determine continuous and state-trait anxiety levels.
State anxiety levels in the study group were significantly higher (by Student t-test) than that of the control group. For continuous anxiety level, no statistically significant difference was determined between two groups. In the study group, higher education levels of mothers and their husbands were associated with lower levels of both continuous and state anxiety.
In the majority of the group of mothers with language delayed children and even mothers of children with normal language development, there were high levels concern. Mothers' concerns and anxiety levels may decrease with increasing levels of their education levels. We recommend providing detailed information regarding language development to the families at all stages of the childs' training programme.
Clinical and investigative medicine. Medecine clinique et experimentale 01/2010; 33(1):E30-5. · 1.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Silent sinus syndrome is a clinical entity with the constellation of progressive enophthalmos and hypoglobus due to gradual collapse of the orbital floor with opacification of the maxillary sinus, in the presence of subclinical maxillary sinusitis. It occurs secondary to maxillary sinus hypoventilation due to obstruction of the ostiomeatal unit. In this paper, a 35-year-old woman with a complaint of asymmetry in her left eye and denting of upper eyelid was reported. In the left eye, upper sulcus was deepened and there was 3-mm hypoglobus. There was no diplopia or restriction of eye movements in any gaze positions. Hertel exophthalmometry revealed a 4-mm enophthalmos on the left eye. Computed tomographic scan of the orbita and paranasal sinuses showed left maxillary sinusitis, air-fluid level, and collapse of left maxillary sinus walls. In addition, inferior bulging in the left orbital floor was also reported. The treatment was a 2-stage operation. In the first stage, she underwent endoscopic septoplasty plus left maxillary antrostomy, and in the second stage, she underwent a subciliary orbital floor repair of the iliac bone resulting in the improvement of the enophthalmos and her cosmetic appearance. Regarding this case, the literature is also reviewed in detail.
The Journal of craniofacial surgery 10/2009; 20(6):2156-9. DOI:10.1097/SCS.0b013e3181bf0116 · 0.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We investigated the effects of explosive acoustic trauma on sleep quality and quality of lives (QOLs) of the workers in Ammunition Factory. Forty-one male workers exposed to explosive acoustic trauma in Ammunition Factory 12 years ago constructed the study group (Group 1). Thirty-eight male workers of Ammunition Factory who were not exposed to the explosion, were included into the control group (Group 2). We used the Mini Sleep Questionnaire (MSQ) and SF-36 questionnaire. In workers of the study group who had experienced psychological and sleep problems; hearing loss and acute tinnitus just after explosion; and had higher education levels, some of the sleep and QOL parameters got worse. Workers, adjacent to the explosion site and not used earpluggs during explosion, had more impaired sleep quality results (p < 0.05). We may conclude that acute explosive acoustic trauma may affect negatively some items of sleep quality and quality of the lives of the workers. Workers should be educated to use ear muffs and ear plugs. For post-explosion sleep problems and other psychological problems, psychological support should be given to the workers by the health-team and their families.
Journal of health science 08/2009; 55(4):532-539. DOI:10.1248/jhs.55.532 · 0.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This prospective study investigated the risk of respiratory distress in the patients who were applied nasal packing at the end of nasal surgery; and effects of nasal packing on consciousness level while the patients were awake or asleep, measured by Bispectral Index (BIS).
The study group consisted of 15 adult patients (10 male, 5 female), who were applied nasal packing at the end of nasal surgery. The control group consisted of 15 adult patients (10 male, 5 female), who received general anesthesia for various reasons. In the study and control groups, BIS index, respiratory rate, peripheral oxygen saturation, pulse per minute and blood pressure were measured at seven different times.
There was no statistically significant difference between BIS indexes of the study and control groups. In the fourth hour after sleep (AS-4h), respiratory rate of the study group was significantly lower than that of the control group. In the fourth hour after the anesthesia (AA-4h), oxygen saturation value of the study group was lower than that of the control group.
We conclude that in patients who are applied nasal packing at the end of nasal surgery; at AA-4h and AS-4h times, there may be risk of decrease in the oxygen saturation and respiratory rate parameters, respectively. Therefore, it is necessary to monitor non-invasive respiratory parameters and to give enriched oxygen by an oral catheter.
[Show abstract][Hide abstract] ABSTRACT: We investigated the effect of nasal packing or suturing of the nasal septum after septoplasty on oxidative stress.
The study included 37 patients who underwent septoplasty for isolated septal deviation. At the end of the operation, intranasal packing was used in 18 patients (5 women, 13 men; mean age 30+/-10 years; range 18 to 47 years), and nasal septal suturing was used in 19 patients (5 women, 14 men; mean age 31+/-12 years; range 18 to 54 years). Nasal packs were removed after 48 hours. Plasma levels of malondialdehyde (MDH), total sulphydryl content (SH), and nitric oxide (NO) were measured at four sequential times to evaluate oxidative stress.
There were no significant changes in plasma levels of MDH, SH, and NO in both treatment groups (p>0.05). Levels of MDH and NO did not differ significantly at four sequential times between the two treatment groups, whereas postoperative SH levels were always significantly higher following septal suturing (p<0.05).
High levels of SH observed in the suturing group favor this technique over nasal packing application in terms of antioxidant systems and oxidative stress.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 01/2008; 18(1):35-9.
[Show abstract][Hide abstract] ABSTRACT: This study was aimed at determining the expression of vascular endothelial growth factor (VEGF) in nasal polyps by immunohistochemical technique.
The study group consisted of 25 adult patients with nasal polyps who underwent functional endoscopic sinus surgery. Polyp tissues were taken from the maxillary and ethmoid sinuseses and the nasal cavity. The control group consisted of three adult patients without nasal polyps who underwent septoplasty operation. Their inferior turbinate biopsies were taken with written approval. VEGF positivity was scored by the Vascular Endothelial Growth Factor Positivity Index (VEGF-PI) in the subepithelial (VEGF-PI-SE) and deep (VEGF-PI-Deep) layers of the mucosa on a 0 to 3 scale, and the percentage of inflammatory cells per 100 cells was found.
VEGF expression was identified as cytoplasmic staining in the vascular endothelium and inflammatory cells. In each of four groups (maxillary and ethmoid sinuses, nasal cavity, and control), no significant difference was present between VEGF-PI-SE and VEGF-PI-Deep scores. For the VEGF-PI-SE and VEGF-PI-Deep groups, nasal cavity scores were significantly higher. For plasma cell count, the nasal cavity value was significantly higher. As the plasma cell count increased, VEGF-PI-SE and VEGF-PI-Deep scores were also increased in all four groups.
In the nasal cavity, VEGF expression is observed more, causing angiogenesis and an increase in the vascular permeability. In the paranasal sinuses, lower VEGF-PI results may show that contact inhibition reduces VEGF expression and thus the polyp growth rate.
The Journal of otolaryngology 01/2008; 36(6):357-66. DOI:10.2310/7070.2007.0056 · 0.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We investigated the effect of intranasal packing placed after septoplasty or alternatively suturing the septum without inserting a packing on systemic oxygen saturation and patient comfort.
The study involved 37 patients who underwent septoplasty for isolated septum deviation. Intranasal packing was used in 18 patients (5 women, 13 men; mean age 30+/-10 years; range 18 to 47 years), while 19 patients (5 women, 14 men; mean age 31+/-12 years; range 18 to 54 years) underwent nasal septal suturing. To evaluate systemic oxygen saturations, partial oxygen saturations were measured pre- and postoperatively by pulse oximetry. The effect of intranasal packing and suturing on patient comfort was assessed by a visual analog scale before and 48 hours after surgery, five days after removal of nasal packing, and 30 days after surgery.
Postoperative systemic oxygen saturations exhibited higher levels in the sutured group, but this did not reach significance (p>0.05). The incidence of nasal obstruction was significantly higher with nasal packing (p<0.05). In general, headache and facial pain were more common with nasal packing, while suturing was associated with a higher frequency of nasal crusting, postnasal discharge, and reduced sense of smell (p>0.05).
Considering that, albeit not significantly, intranasal packing used after septoplasty decreases systemic oxygen saturation more than suturing and thus, has more adverse effects on patient comfort, suturing the septum may be a better alternative, particularly in elderly patients with chronic systemic diseases.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 01/2007; 17(6):318-23.
[Show abstract][Hide abstract] ABSTRACT: Modiolar deficiency has been reported as representing the mildest form of cochlear dysplasia. In this study the authors aimed to determine baseline values of the mid-modiolar area and modiolus volume in normal subjects. In this way they aimed to improve the detection of previously underdiagnosed subtle cochlear dysplasia in patients with sensorineural hearing loss.
The Journal of Laryngology & Otology 08/2004; 118(7):496-9. DOI:10.1258/0022215041615236 · 0.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Chondroid syringoma (mixed tumor of the skin) is a rare benign neoplasm of the sweat glands which often occurs in the head and neck region. We present a 73-year-old white farmer man with a mass in the anterior surface of the upper lip that was histologically diagnosed as a chondroid syringoma after surgical wide excision. There were no signs of recurrence during a follow-up of 14 months.
Kulak burun bogaz ihtisas dergisi: KBB = Journal of ear, nose, and throat 02/2004; 13(1-2):25-7.
[Show abstract][Hide abstract] ABSTRACT: In this report, we describe a 57-year-old woman with oropharyngeal tularemia who presented with tonsillopharyngitis and cervical lymphadenitis. Clinical and radiological manifestations and histopathological characteristics of this disease are discussed with a review of the world literature. The oropharyngeal form of tularemia should be considered in the differential diagnosis of cases involving tonsillopharyngitis and cervical lymphadenitis, particularly in those not responding to penicillin treatment.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 08/2003; 260(6):298-300. DOI:10.1007/s00405-002-0565-8 · 1.55 Impact Factor