Evren Erkul

Real-time PCR detection of Helicobacter pylori and virulence-associated cagA in nasal polyps and laryngeal disorders:

Objective: To identify Helicobacter pylori and major virulance factor, cagA, in patients with laryngeal diseases and nasal polyps. Study Design: Cross-sectional study with planned data collection. Setting: The study was performed on fresh tissue samples from patients with 32 nasal polyps, 29 normal nasal mucosa, and 27 laryngeal diseases presenting to the Otolaryngology–Head and Neck Surgery department of a major military hospital in Istanbul, Turkey. Subjects and Methods: Tissue specimens were evaluated by in-house polymerase chain reaction (PCR) and real-time PCR for bacterial DNA and by real-time PCR for cagA. The impact of commercial and in-house DNA extraction methods was also evaluated. Results: H pylori DNA was detected only by real-time PCR in 59.4 percent of nasal polyps, 70.4 percent of nasal mucosa samples, and 58.6 percent of larynx samples. cagA was identified in 78.9, 89.5, and 82.4 percent of positive polyp, nasal mucosa, and larynx samples, respectively. No statistically significant differences were observed between groups. DNA purification methods were equally effective. Conclusion: H pylori DNA is present in nasal polyp and larynx tissues as well as normal nasal mucosa, as detected by a sensitive real-time PCR assay. cagA-positive strains dominate in all groups.

Sialendoscopy for non‐stone disorders: The current evidence

Review the current literature on the use of sialendoscopy in the treatment of non‐stone disorders of the major salivary glands.

Comparison of local anesthesia with articaine and lidocaine in septoplasty procedure.

Background Only a few studies have so far compared the use of different local anesthetic agents in septoplasty procedure with regard to reduction in pain, effectiveness, and related complications. The aim of this study was to compare articaine and lidocaine as local anesthetics for septoplasty surgery, in terms of their efficacy and safety. Methods Seventy patients randomized into two groups were included in this study. For local anesthesia, 35 patients received articaine and 35 received lidocaine. All patients were asked to rate their pain levels on a visual analog scale (VAS) at the 1st, 2nd, 4th, 6th, 8th, 12th, 18th, and 24th postoperative hours. In addition, analgesic consumption of each patient as well as postoperative complications was recorded in both groups. Results VAS scores for pain were significantly lower in the articaine group than in the lidocaine group at the 2nd, 6th, 8th, 12th, and 24th postoperative hours (p < 0.05). Comparison of the patients’ usage of analgesics during the first 24 hours postoperatively showed that in the articaine group, the percentage of patients that had not used analgesics was 58.5%, and in the lidocaine group the corresponding figure was 41.5%. Conclusion Articaine is a safe local anesthetic agent with rapid onset of action. When compared with lidocaine, it is associated with improved tissue diffusion, rare postoperative complications, and less postoperative pain, thus, representing a safe and effective local anesthetic agent for septoplasty procedure.

Trail and trail receptors in patients with laryngeal cancer.

Tumor necrosis factor–related associated‐inducing ligand (TRAIL) is a death ligand currently under clinical trials for laryngeal carcinoma.

Interesting association of squamous cell carcinoma of soft palate and tuberculous lymphadenitis

Squamous cell carcinoma is the most common malignancy of the soft palate. In some cases, it mimics mycobacterial infections and in others it can develop against the background of a previous tuberculosis infection. Here we report a case of a 68-year-old male who presented with squamous cell carcinoma of the soft palate. He had metastatic lymphadenopathy on the right side and, simultaneously, two caseating granulomatous lymphadenopathies without metastatic lymph nodes on the left side. The patient was treated with soft palate excision and bilateral functional neck dissection. Standard antitubercular therapy and radiotherapy were added postoperatively. To our knowledge this is the first case in the English-language medical literature of a head and neck cancer in the setting of tuberculosis. Tuberculosis may mimic head and neck cancers and vice versa, and both conditions may have atypical clinical and radiological presentations. Our case points out the need to consider tuberculosis in the differential diagnosis of squamous cell carcinoma of the head and neck.

Rare Adult Sinonasal Embryonal Rhabdomyosarcoma with OpticInvolvement

Rhabdomyosarcoma of the Paranasal sinus accounts for 10% to 15% of adult head and neck Rhabdomyosarcoma. We presented a 32-year-old man with a month history of the right eye vision loss and had no common symptoms as nasal obstruction or headache. The adult patients, who have nasal symptoms along with eye complaints, should be examined with nasal endoscopy by an otorhinolaryngologist and Rhabdomyosarcoma must be kept on mind in terms of differential diagnosis.

Extrusion of Gore-tex implant after medialization thyroplasty

Various materials such as autogenous cartilage, silicone, hydroxylapatite, Gore-tex (expanded polytetrafluoroethylene), and titanium have been used for medialization laryngoplasty. We report an extrusion of Gore-tex implant after 11 months of medialization laryngoplasty. We believe tha t thought Gore-tex is a safe and easy-to-use implant for medialization laryngoplasty, the possibility of extrusion after the operation must not be ignored.

Mucosal Malignant Melanoma of Inferior Concha and Nasal Septum: A Case Report with Mutation Analysis

Mucosal Malignant Melanoma of Inferior Concha and Nasal Septum: A Case Report with Mutation Analysis Nasal and paranasal Mucosal Malign Melanoma’s occurs 0.5% of all Malign Melanomas. Sinonasal Mucosal Malign Melanoma often arises from lateral nasal wall and septum. We present molecular features (BRAF, NRAS, c-KIT and PDGFRA mutations) of a sixty-three-year-old male patient with primary sinonasal mucosal malignant melanoma with rarely localized synchronously in inferior concha and nasal septum. The patient underwent melanoma resection via endoscopic approach with negative surgical margins, right functional neck dissection and 6000 Gy radiotherapy after surgery. There was no tumor recurrence and metastasis at the ten month follow-up of the patient. Pathological studies revealed no mutations in the KIT gene (exons 9, 11, 13, 17 and 18), NRAS gene (exons 2 and 3), BRAF gene (exon 15) and the PDGFRA gene (exons 12 and 18) in this tumor. Our case is also unique with its concurrent localization in the nasal septum and inferior turbinate and with no mutations in BRAF, NRAS, c-KIT and PDGFRA genes. Primary sinonasal mucosal malignant melanomas are biologically different from cutaneous malignant melanomas and molecular features of these tumors need more investigation.

The Effects of Septoplasty on QTc Dispersion

Objective: Studies have shown that nasopharyngeal airway diseases, such as obstructive sleep apnea, are closely associated with cardiovascular diseases. The purpose of this study was to investigate whether there is any impact of septoplasty operation on QTc dispersion (QTcD) in patients with nasal septum deviation. Method: This study included 28 young deviated nasal septum patients. All patients underwent septoplasty. The QT interval, the heart rate-corrected QT, and the QT dispersion were calculated digitally using computerized electrocardiograms (ECG) by Holter ECG. Heart rates, QT intervals, QTc, and QTcD values were compared preoperatively and one-month postoperatively. Results: QTcD was measured 62.9 ± 7.9 in young patients with nasal septal deviation. While there was no significant change in ECG QT interval periods obtained from the patients taken after the procedure (354.8 ± 25.7 and 360 ± 25.4, P > .05), there was a significant decrease in QTc values (398 ± 22.9 and 383.7 ± 21.2, P = .013 [<0.05]), and there was a significant decrease in QTcD values (62.9 ± 7.9 and 45.7 ± 6.7, P = .000). In addition, heart rates were significantly decreased after surgery (76.5 ± 13.2 and 67.4 ± 10.4, P = .007). Conclusion: In our study, QTcD values were increased in young patients with nasal septal deviation. High QTcD value indicates increased heterogeneity of ventricular repolarization. Septoplasty is important for young people with nasal deviations to provide improvement of QTc dispersion. Nasopharyngeal airway diseases have negative effects on myocardial repolarization.