Fatih Bingöl

Combined Occurrence of Alström Syndrome and Bronchiectasis

Alström syndrome (Online Mendelian Inheritance in Man ALMS #203800) is a rare hereditary disorder caused by mutations in the gene ALMS1. This rare disorder’s characteristics are cone-rod dystrophy resulting in blindness in childhood, insulin-resistant type 2 diabetes mellitus, truncal obesity, progressive sensorineural hearing loss, dilated cardiomyopathy, craniofacial features, hypothyroidism, elevation in liver transaminases, renal insufficiency, gonadal dysfunction, and menstrual irregularities. A 13.5-year-old girl was admitted to the hospital for complaints of excessive water consumption and urination over the previous 2 years. The patient’s parents were third-degree relatives. At physical examination, hyperpigmentation was present over the areola and acanthosis nigricans under the arms and on the neck. Audiologic examination revealed bilateral sensorineural hearing loss, and bilateral cataract was determined at ocular examination. The patient was monitored by the chest diseases department due to bronchiectasis. HbA1c was 13.1%. In mutation screening study, 2 novel mutations c.5586T>G; p.Tyr1862* and c.2905insT; p.L968fs*4 were detected in the ALMS1 gene. Saccharin test was positive. We emphasize that Alström syndrome may be complicated by bronchiectasis.

Lymphoepithelial Cyst in the Palatine Tonsil

Lymphoepithelial cyst (LEC) is the most commonly encountered congenital neck pathology in the lateral part of the neck. A 66-year-old woman presented to the ENT clinic due to difficulty in swallowing persisting for approximately 1 year. Magnetic resonance imaging revealed a cystic mass at right tonsil. Surgery was performed due to this unilateral tonsillar mass, which was excised together with the right tonsil. LEC was diagnosed at histopathological examination. LEC in the palatine tonsil is rare, and only a few cases have been reported in the literature. We report a rare case of LEC in the palatine tonsil.

Estimation of the efficacy of chemo-radiotherapy on tumor regression in the patients with laryngeal cancer via computerized tomography using the Cavalieri method

Abstract Conclusion: Calculating tumor volume using the Cavalieri method in laryngeal tumors before and after treatment may be useful to optimize the treatment and to minimize the side-effects of radiotherapy. Purpose: This study aimed to estimate the pre-treatment and post-treatment tumor volumes of the patients to whom radiotherapy or radio-chemotherapy was applied as a treatment using Cavalieri’s Principle as a stereological method and to assess tumor regression rates in the patients with Laryngeal Squamous Cell Carcinoma (LSCC) statistically. Materials and method: Sixteen patients (eight patients with stage T3 and eight patients with stage T4) diagnosed with LCCC bearing the appropriate characteristics to criteria in the otorhinolaryngology clinic were included. Patients had computerized tomography (CT) scans in the axial plane before treatment and 2 months after the treatment. Pre-treatment and post-treatment tumor volumes on CT images were calculated using Cavalieri’s principle as a stereological method and then compared. Findings: Average tumor volumes in patients with stage T3 before and after treatment were 10.12 ± 3.58 cm3 and 1.33 ± 1.74 cm3, respectively (p = 0.008). These volumes were 11.92 ± 4.61 cm3 and 2.17 ± 2.34 cm3 (p = 0.008) for patients with stage T4, respectively. Post-treatment tumor volumes were statistically reduced compared to pre-treatment volumes in all stages.

The importance of endoscopy in the diagnosis and treatment of rhinolithiasis: A case report

Abstract Rhinolithiasis is a rare condition involving a mineralized mass located in the nasal cavity. It may be endogenous or exogenous in origin. The fact that it appears with different symptoms can make diagnosis difficult. Rhinolithiasis was diagnosed as a result of endoscopic examination in two patients previously diagnosed with sinusitis and with no lessening of symptoms despite numerous applications of medical treatment. Rhinolithiasis should be considered in long-term fetid nasal discharges and unilateral nasal obstructions, and the patient should be referred to an ear, nose and throat specialist for endoscopic examination.

Comparison of Early-period Results of Nasal Splint and Merocel Nasal Packs in Septoplasty

Objective Several types of nasal packs are used postoperatively in septoplasty. In this study, we compared two commonly used nasal packing materials, the intranasal septal splint with airway and Merocel tampon, in terms of pain, bleeding, nasal obstruction, eating difficulties, discomfort in sleep, and pain and bleeding during removal of packing in the early period. Methods The study group included 60 patients undergoing septoplasty. Patients were divided into two groups (n=30 in each group). An intranasal splint with airway was used for the patients in the first group after septoplasty, while Merocel nasal packing was used for the second group. Patients were investigated in terms of seven different factors - pain, bleeding while the tampon was in place, nasal obstruction, eating difficulties, night sleep, pain during removal of the nasal packing, and bleeding after removal of packing. Results There was no statistically significant difference between the groups in terms of pain 24 hours after operation (p=0.05), while visual analog scale (VAS) scores for nasal obstruction, night sleep, eating difficulties, and pain during packing removal were lower in the nasal splint group with a statistically significant difference (p<0.05). There was no statistically significant difference between the groups in terms of postoperative bleeding (p=0.23). Significantly less bleeding occurred during removal of the packing in the nasal splint group (p<0.05). Conclusion Our study indicates that the nasal splint was more comfortable and effective in terms of causing lesser bleeding and pain during removal of packing.

The effects of dexamethasone vs low doses of propofol infusion on postoperative nausea and vomiting in tympanoplasty surgery: a randomized, placebo-controlled, double-blinded study

Received: 16.03.2017 Accepted: 14.05.2017 1Department of Anaesthesiology, Erzincan University School of Medicine, Mengücekgazi Regional Training and Research Hospital, Erzincan, Turkey 2Department of Otolaryngology Surgery, 3Department of Anaesthesiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey Yazışma adresi: Özgür Özmen, Erzincan University School of Medicine, Mengücekgazi Regional Training and Research Hospital, Department of Anaesthesiology, Erzincan, Turkey e-mail: dr.ozgurozmen@yahoo.com.tr ABsTRACT

Measuring Oxidative DNA Damage With 8-Hydroxy-2’-Deoxyguanosine Levels in Patients With Laryngeal Cancer

Objectives: 8-Hydroxy-2’-deoxyguanosine is a biomolecule associated with DNA damage. We evaluated oxidative stress and DNA damage in patients with laryngeal cancer by measuring 8-hydroxy-2’-deoxyguanosine levels. Methods: This study enrolled 117 subjects, including 64 controls and 53 patients who had benign vocal cord lesions or laryngeal cancer. The benign excised lesions, tumor tissue, noncancerous laryngeal tissue, blood, and urine were subjected to high-performance liquid chromatography, and 8-hydroxy-2’-deoxyguanosine levels were compared between groups. Results: Blood and urine 8-hydroxy-2’-deoxyguanosine levels in patients with laryngeal carcinoma were significantly higher than in the controls (P = .00002, P = .00001). The 8-hydroxy-2’-deoxyguanosine level was significantly higher in tumor tissues than in non-tumor tissue and benign vocal cord lesion tissues (P = .00002, P = .000001). Conclusions: We determined that laryngeal cancer was associated with oxidative stress, which may be quantified by measuring 8-hydroxy-2’-deoxyguanosine. For a patient with a suspicious laryngeal lesion, 8-hydroxy-2’-deoxyguanosine levels in blood and urine can provide advance information about the likely diagnosis.

Kronik Otitli Hastalarda Antibiogram Duyarlılık Sonuçları

Introduction and Aim: This study was conducted to generate microorganisms isolated from cultures of ears taken from the patients diagnosed to have chronic otitis media and determine and compare the in vitro effects of different antibiyotics and topical ear solutions on these microorganisms. Material and Methods: Between June 2009 and October 2010, 127 ear cultures were taken from 100 patients who applied to the Department of Otolaryngology of Ataturk University Faculty of Medicine Training and Research Hospital diagnosed to have chronic otitis media in the otolaryngological investigation. Antimicrobial susceptibility of isolated strains was determined by the disc diffusion method according to the CLSI criteria. Descriptive statistical analysis was performed. The effectiveness of various drugs by species of pathogen was examined using cross tables. Chi square analysis was performed. One-way ANOVA was used to compare numerical variables in multiple groups. Post hoc analysis was performed using Tamhane’s test. Results: From the cultures investigated, 277 (6 ferment and 16 fungus) microorganisms were generated. In 14 cultures, two or more pathogens multiplied. Among the isolated pathogen microorganisms, pseudomonas spp. (24,91%), staphylococcus spp (13,00%), proteus spp. (5,05%) were the three most frequently isolated pathogen agents. 4 Peptococcus spp. (1,44%) and 3 Peptostreptecoccus spp. (1,08%) multiplied and it was observed that there was 2,52%anaerobic reproduction among all microorganisms. It was also seen that Pseudomonas spp. strains were more susceptible to gentamicin (97,1%), imipenem (94,2%), amikacin (84,1%) and ciprofloxacine (78,3%). In the study, vancomycine, teicoplanin, telithromycin and linozolidin were found to be the most effective antibiotics for all staphylococcus. It was seen that proteus spp. strains were more susceptible to gentamicin (92, 9%), ciprofloxacin (%92, 9) and piperacillin (%92, 9). Conclusion: In the antimicrobial treatment required to reach effective outcomes in the treatment of patients with chronic otitis media, it is important to monitor the frequency of effective microorganisms and their rates of resistance to antimicrobial agents

Tick in the outer ear canal: Two case reports

Abstract Serious systemic diseases such as Crimean Congo Hemorrhagic Fever, Lyme Disease, tularemia, typhus and Q fever can be transmitted by ticks. An 8-year-old boy and a 34-year-old woman were brought to our clinic with ear pains. No symptoms such as fever, headache or lethargy to suggest CCHF were present. The patients both lived in rural areas and were engaged in farming. Full blood count, liver and kidney function tests and serum electrolytes were within normal limits at laboratory tests. Prothrombin time, partial thromboplastin time and INR were normal. The tick was grasped with alligator forceps and removed from the outer ear in one piece with the help of 0-degree rigid otoendoscopy.