Enver Altas

A case of a large dentigerous cyst containing a canine tooth in the maxillary antrum leading to epiphora

A case of a large dentigerous cyst containing a canine tooth in the maxillary antrum is presented. This case is of interest due because of its extensiveness and the presence of a canine tooth in the roof of the maxillary sinus. In addition, this caused a right-sided epiphora. Enucleation of the cyst containing the ectopic tooth was made.

Subhypnotic propofol infusion plus dexamethasone is more effective than dexamethasone alone for the prevention of vomiting in children after tonsillectomy

Background:  Postoperative vomiting (POV) is a common complication after tonsillectomy. Dexamethasone is known to decrease postsurgical vomiting. In this study, we compared the effects of dexamethasone alone to dexamethasone plus propofol on postoperative vomiting in children undergoing tonsillectomy.

Antioxidant Effects of Nigella Sativa in the Treatment of Experimentally Induced Rhinosinusitis

Antioxidant Effects of Nigella Sativa in the Treatment of Experimentally Induced Rhinosinusitis Aim. The objective of this study was to investigate the effect of Nigella sativa (NS) in experimental bacterial rhinosinusitis. Material and Methods. Bacterial rhinosinusitis was induced with Staphylococcus aureus. Rabbits were divided into control, NS 50, NS 100 and NS 200 mg/kg/d groups. NS was given orally for 7 days. The same volume of normal saline was given as a vehicle to the control group for the same period. At 7 days post-treatment, mucosal samples were excised from the treated and control groups for measurements of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), myeloperoxidase (MPO) and malondialdehyde (MDA). Results. SOD and GSH-Px activities significantly increased in the NS 50, NS 100 and NS 200 mg/kg/d groups when compared with the saline treated group. MPO activity and MDA levels significantly decreased in the NS 50, NS 100 and NS 200 mg/kg/d when compared with the saline treated group. Conclusion. These findings show that administration of NS increased the SOD, GSH-Px activities and decreased the lipid peroxidation and MPO activity in experimental rhinosinusitis in rabbits. NS prevented oxidative stress by scavenging reactive oxygen species generated in rhinosinusitis model in rabbits.

Comminuted Frontal Sinus Fracture Reconstructed With Titanium Mesh.

Frontal sinus fractures (FSF) are relatively uncommon maxillofacial injuries. The most common cause of FSF is motor vehicle accidents with 62% percentage. Management of FSF depends on type of fracture, associated injuries, and involvement of naso-frontal duct. In this report, the authors presented a patient with comminuted fracture of anterior wall of frontal sinus reconstructed with titanium mesh. A 40-year-old man presented with depression of the frontal bone, facial pain, and epistaxis consisting of a motor vehicle accident. Computerized tomography scan revealed multiple comminuted fractures of anterior wall of frontal sinus and fractures of left orbital medial and superior walls. Titanium mesh was used for reconstruction. Postoperative course was uneventful. The titanium mesh, which is easy to handle with no complications, may provide excellent frontal contour after comminuted anterior wall fractures.

The effect of piracetam in preventing combined cisplatin and gentamicin-induced ototoxicity in a guinea pig model

Abstract Aim. To investigate the protective effect of piracetam in preventing combined cisplatin and gentamicin-induced ototoxicity in a guinea pig model. Methods. Thirty-two male albino adult guinea pigs were used in this study. The animals were separated into three groups: Group I (control group; n = 10) received saline, Group II (CG group; n = 12) received combined cisplatin (3.5 mg/kg = 3.5 ml/kg) and gentamicin (100 mg/kg = 2.5 ml/kg), and Group III (PCG group; n = 10) received piracetam (350 mg/kg = 1.75 ml/kg) plus the combined cisplatin (3.5 mg/kg = 3.5 ml/kg) and gentamicin (100 mg/kg = 2.5 ml/kg) as a single dose/day for 5 consecutive days, intraperitoneally. Auditory brainstem response (ABR), wave absolute latencies (ALs) and interpeak latencies (IPLs) for each ear (n = 64) of all animals (n = 32) were monitored. Results. Significant differences were found between CG and PCG groups in terms of ABR wave II AL (p < 0.01), III AL (p < 0.001), IV AL (p < 0.001), I-III IPL (p < 0.001), III-IV IPL (p...

Preventive Role of Hilar Parasympathetic Ganglia on Pulmonary Artery Vasospasm in Subarachnoid Hemorrhage: An Experimental Study.

AIM Pulmonary arteries are mainly innervated by sympathetic vasoconstrictor and parasympathetic vasodilatory fibers. We examined whether there is a relationship between the neuron densities of hilar parasympathetic ganglia and pulmonary vasospasm in subarachnoid hemorrhage (SAH). MATERIAL AND METHODS Twenty-four rabbits were divided into two groups: control (n=8) and SAH (n=16). The animals were observed for 20 days following experimental SAH. The number of hilar parasympathetic ganglia and their neuron densities were determined. Proportion of pulmonary artery ring surface to lumen surface values was accepted as vasospasm index (VSI). Neuron densities of the hilar ganglia and VSI values were compared statistically. RESULTS Animals in the SAH group experienced either mild (n=6) or severe (n=10) pulmonary artery vasospasm. In the control group, the mean VSI of pulmonary arteries was 0.777±0.048 and the hilar ganglion neuron density was estimated as 12.100±2.010/mm < sup > 3 < /sup > . In SAH animals with mild vasospasm, VSI=1.148±0.090 and neuron density was estimated as 10.110±1.430/mm < sup > 3 < /sup > ; in animals with severe vasospasm, VSI=1.500±0.120 and neuron density was estimated as 7.340±990/mm < sup > 3 < /sup > . CONCLUSION There was an inverse correlation between quantity and neuron density of hilar ganglia and vasospasm index value. The low numbers and low density of hilar parasympathetic ganglia may be responsible for the more severe artery vasospasm in SAH.

Effects of Radiofrequency Thermal Ablation on the Nasal Cycle Measured Using Rhinomanometry

Objective: This study was designed to research the effects of radiofrequency thermal ablation (RFTA) surgery on the nasal cycle, with anterior rhinomanometry being used for assessment. Methods: Thirty patients with inferior concha hypertrophy and 13 healthy volunteers were included in this study. An anterior rhinomanometry was performed on each of the patients before surgery and at 1 month and 6 months after surgery, and on the volunteers in the control group, simultaneously. Results: Nineteen of the 30 patients and 8 of the 13 healthy participants showed a distinct type of nasal cycle at different periods of measurement. The mean of the total nasal airflow of the patients was lower before RFTA surgery but increased at a rate of 71.07%, closer to the value of the control group, after RFTA surgery. After RFTA, the unilateral nasal airflow (fmin and fmax) values increased at ratios of 22.36% and 94.44%, respectively. The amplitude (fmax-fmin) showed a statistically significant decrease in the postoperative period (108.43 ± 54.37), when compared with that of the preoperative period (202.80 ± 81.24) (P < .01). Conclusion: We conclude that the RFTA is a useful method for treating inferior concha hypertrophy, because it positively affects the nasal physiology, increasing the total nasal airflow without changing the nasal cycle time.

Excellent Result With the Use of Single-Dose OK-432 in Cervical Macrocystic Lymphangioma.

Though the lymphangioma is a benign neoplasm, it may make an invasion to vital structures by progressively growing. For lymphangioma, which progressed in such a way, surgical treatment has high morbidity and recurrence risk. On these cases, OK-432 is a frequently used sclerotherapy agent. The authors report the result they obtained by the use of single-dose OK-432 on an inoperable pediatric cervical macrocystic lymphangioma case and also their experiences.

Congenital Sialolipoma in an Infant.

Sialolipoma is a newly recognized tumor of the major and minor salivary glands and represents only 0.3% of all salivary gland tumors. Only 3 cases of congenital sialolipoma are available in the literature. In the current case, we performed a total parotidectomy with facial nerve preservation on a 12-week-old infant exhibiting huge mass in the parotid region. Histopathology results showed sialolipoma. There was no recurrence at the 18-month follow-up. Although it is a very rare disease in infants, congenital sialolipoma should be kept in mind in patients with parotid mass. The primary treatment is parotidectomy with facial nerve preservation.

Deep Neck Infection Accompanied by Descending Necrotizing Mediastinitis.

Ethicon). Subsequently bilateral vertical bipedicled cutaneous flaps 6-cm wide were designed making 11-cm lateral incisions. Flaps were advanced medially to overlap the muscular fascia with 6-0 nylon (Ethilon, Ethicon) stitches, and donor sites were closed directly. Hydrocephalus treatment with a ventriculoperitoneal shunt was postponed to the following day and an orthopedic plaster was splinted to correct foot deformities. Left releasing incision required to be resutured. No other surgical complications were observed. In the following months, the child required a new surgery for excision of a hyperostosis at the level of the posterior part of the foramen magnum, which was impinging on the brainstem, and 4 uneventful shunt revisions. At the age of 10 months, the patient was admitted to the hospital for central apnea with asystole, which eventually resulted in cardiac arrest 2 days later (Fig. 1). The presence of multiple risk factors entailed a life-threatening condition to our patient. First, the newborn presented with a severe type III Chiari malformation associated to a thoracic diastematomyelia. Second, the area of the MMC was significantly large (54 cm) extending to a high thoracic level. Early operative repair is mandatory to prevent serious bacterial infections and subsequent permanent neurological sequelae. Our plan was to provide adequate soft-tissue coverage of the neural elements but with minimal morbidity using the less traumatic technique available. Bipedicled skin advancement flaps have been described in the literature to repair defects up to 8.5 cm in diameter and may result in up to 20% risk of skin necrosis resulting from excessive tension at the midline sutures. Although our defect was larger, the patient did not suffer any complication such as skin necrosis, CSF leak, or infection. However, the association of paraspinous fascial turnover flaps was aimed to reinforce the dural closure and increase the distance between the spinal cord and the skin, diminishing the rate of CSF leak and the subsequent risk of meningitis. This procedure provided an additional vascularized layer of soft tissue avoiding the dysfunction of the gluteus or lattisimus dorsi muscles in a neurologically compromised patient. Literature on this type of severe cases is sparse. We consider our patient’s case illustrative for 2 main reasons. First, it outlines how a simple technique like bilateral bipedicled flaps associated with paraspinal fascial turnover flaps can provide adequate coverage for a large MMC, and second, it demonstrates in cases of newborns with severe neural tube defects how an adequate multidisciplinary team should work to offer the best quality of life possible during their lifetime.