Asim Kaytaz

Pott's Puffy Tumor

Potts Puffy tumor is a rare clinical entity characterized by subperiosteal abscess associated with osteomyelitis. It is usually seen as a complication of frontal sinusitis or trauma predominantly in the adolescent age group. Potts Puffy tumor can be associated with cortical vein thrombosis, epidural abscess, subdural empyema, and brain abscess. The cause of vein thrombosis is explained by venous derange of the frontal sinus, which occurs through diplopic veins, which communicate with the dural venous plexus; septic thrombi can potentially evolve from foci within the frontal sinus and propagate through this venous system. An apparently healthy 7-year-old girl presented to the emergency service of otolaryngology with complaints of swelling of forehead and periorbital zone, headache, chills, fever, and rhinorrhea. The patient described in this case report had 2 important complications of paranasal sinus disease: the relatively common complication of postseptal cellulites and the less common complication of Potts Puffy tumor.

Evaluation of laryngeal findings in users of inhaled steroids

The objective of the prospective study is to examine the laryngeal changes by laryngeal videostroboscopy and electromyography (EMG) regarding new-onset dysphonia in asthmatic patients taking inhaled corticosteroids (ICS). Laryngeal changes and electrophysiological status of the laryngeal muscles were evaluated by these methods in 12 patients both at the time of presentation of dysphonia and after cessation of therapy. Laryngeal changes of our patients were mucosal edema, erythema, thickening, adduction deficit, nodule and irregularity in videostroboscopy. Significant correlations were found between laryngeal pathology and dosage and duration of ICS therapy. We detected myopathy by EMG in most of the patients. Also, EMG revealed that cricothyroid muscle was much more affected than thyroarytenoid muscle. In conclusion, we consider that steroid myopathy or mucosal inflammatory theory alone is not sufficient to explain the etiopathogenesis of dysphonia in asthmatic patients taking ICS. The laryngeal mucosal changes were detected by laryngeal videostroboscopic examination in some asthmatic patients, with dysphonia using ICS, and/or laryngeal myopathy was found by laryngeal EMG in some of them in this study. Thus, various factors may have role simultaneously in the occurrence of dysphonia.

Carotid-cavernous fistula after functional endoscopic sinus surgery.

Carotid-cavernous fistulas (CCFs) are anomalous communications between the carotid arterial system and the venous cavernous sinus. They can arise because of spontaneous or trauma causes. Most caroticocavernous fistulas are of spontaneous origin and unknown etiology. Spontaneous CCF may also be associated with cavernous sinus pathology such as arteriosclerotic changes of the arterial wall, fibromuscular dysplasia, or Ehler-Danlos syndrome. Traumatic CCFs may occur after either blunt or penetrating head trauma. Their clinical presentation is related to their size and to the type of venous drainage, which can lead to a variety of symptoms, such as visual loss, proptosis, bruit, chemosis, cranial nerve impairment, intracranial hemorrhage (rare), and so on. Treatment by endovascular transarterial embolization with electrolytically detachable coils is a very effective method for CCF with good outcomes. Carotid-cavernous fistulas have been rarely reported after craniofacial surgery and are uncommon pathologies in otolaryngology practice. In this study, we report a 40-year-old woman with CCF secondary to blunt trauma of functional endoscopic sinus surgery.

Cololaryngostomy procedure in caustic esophageal burns

The study presented herein was undertaken to report an original case of cololaryngostomy operation in caustic esophageal burns. Cololaryngostomy application to a chronic caustic esophageal burn case is reported with a detailed literature review of the topic. For the first time in the world, the larynx was used for the integrity of the gastrointestinal system by applying a cololaryngostomy procedure as it was found to be the only intact and reliable tissue in the operation. The patient started to gain weight in a 3-month period. Oral nutrition and speech were also achieved. Caustic injury to the upper aerodigestive system with scarring of the pharynx, hypopharynx and esophagus is an important reconstructive problem. In reconstruction, the aim should be the supplementation of both oral nutrition and speech.

A Rhizopus oryzae strain isolated from resected bone and soft tissue specimens from a sinonasal and palatal mucormycosis case. Report of a case and in vitro experiments of yeastlike cell development

We report a histologically and mycologically proven sinonasal mucormycosis case causing palatal necrosis in a nondiabetic patient with renal failure. Mycological examination of Giemsa stained imprinted tissue preparations revealed abundant yeast-like cells besides the typical mucoraceous hyphae. The fungus was isolated from surgical specimens and identified as Rhizopus oryzae by phenotypic and genotypic tests. Laboratory studies were performed to investigate the association of the yeast-like cells observed in tissue specimens and the fungus recovered in culture. In vitro induced yeast-like cell development of the case isolate was found under certain growth conditions and documented by photomicrographs.

Stridor associated with essential laryngeal myoclonus

An isolated abnormal rhythmic laryngeal movement is a very rare condition. In most cases, this movement is related with palatal movements, of which it is only one component. Usually, abnormal palatolaryngeal movements refer to the well-known concept of palatal myoclonus, recently also designated as palatal tremor. Palatal myoclonus can be symptomatic or essential. Involvement of the larynx, either in its inner or outer part, is possible in both forms, although it is more common in symptomatic cases. Symptomatic palatal or palatolaryngeal myoclonus is due to a brainstem and/or a cerebellar lesion in the olivary-dentatorubro pathways, inducing an inability to inhibit the firing of cranial nerve motor nuclei. There are few reports of abnormal palatolaryngeal movement due to a cortical epileptic process or a peripheral nerve lesion. In more than 80% of cases, the presenting complaints are related to the underlying neurological disease; audible ear clicks are reported in only 8% of the patients. Essential palatal or palatolaryngeal myoclonus is a different entity, as there is no related neurological disease, and longlasting audible ear clicks are the presenting complaint in 90% of the patients. An isolated abnormal rhythmic laryngeal movement is a very unusual condition. In most cases, this movement is a component of palatal movements. Here, we present an unusual case in which the stridor was associated with isolated abnormal laryngeal movements. A 50-year-old man with no specific medical condition was first referred to a hospital in May 1990 because of stridor. The problem had started 1 year earlier, and he was wrongly diagnosed with bilateral vocal cord paralysis. Microlaryngeal surgery was performed, and the left arytenoid cartilage was removed. Afterward the patient was referred to us for evaluation of a persistent stridor. Laryngologic examination revealed bilateral rhythmic contractions of the vocal cords hitting together at a rate varying from 60 to 80 beats per minute. The abnormal movement of the vocal cords was observed during inspiration and it was synchronous with the contraction of extra-laryngeal muscles. There were no simultaneous movements of the soft palate, tym-

Unilateral Blindness After Septoplasty

Abstract Septoplasty is a frequently performed procedure with mostly minor complications. Nevertheless, it may lead to serious complications. The authors present a 29-year-old patient admitted to their hospital 10 days after septoplasty in another institution. He suffered a total loss of vision immediately after the surgery. High-resolution computed tomography and magnetic resonance imaging revealed a direct trauma of the optic canal and an inflamed and edematous optic nerve. Even though a successful endoscopic optic nerve was performed, the patients loss of vision did not improve after the surgery. Blindness after septoplasty is an extremely rare but a devastating complication. There are only few patients that indicates the optic nerve injury caused by a direct trauma.