Fuat Buyuklu

Value of acoustic rhinometry for measuring nasal valve area

Objective To assess the validity of acoustic rhinometry for measuring nasal valve area in human subjects.

Outfracture of the Inferior Turbinate: A Computed Tomography Study.

Background: Various surgical treatment modalities are available for inferior turbinate hypertrophy. Each is related to well-established complications, but still there is a lack of consensus on the optimal technique. Outfracture of the inferior turbinate is thought to be a minimally destructive procedure among all other reductive turbinate interventions. The authors’ aim was to assess the long-term effects of inferior turbinate outfracture technique in patients with mild or moderate inferior turbinate hypertrophies. Methods: Twenty inferior turbinates in 10 patients were outfractured during a septoplasty procedure. The distance of the inferior turbinate bone to the lateral nasal wall was compared at three different levels of the nasal passage before and after (at 9 months) surgery with computed tomography scans of each patient at (1) the first section in which the inferior turbinate bone could be seen entirely (anterior portion), (2) the level of the maxillary sinus ostium (middle portion), and (3) the last section in which the inferior turbinate bone could be seen entirely (posterior portion). Results: A statistically significant degree of lateralization was observed at all levels in all patients. The mean lateralization rates were 15, 26, and 23 percent for the right side, and 26, 29, and 25 percent for the left side at the first, second, and third levels, respectively. There was no bleeding, edema, or crusting due to the outfracture procedure in any patient. Conclusion: The authors’ results suggest that outfracture of the inferior turbinate is an effective and durable technique, which can be performed easily to enlarge the nasal airway in mild and moderate inferior turbinate hypertrophies with minimal morbidity.

Growth Characteristics and Clinical Manifestations of the Paranasal Sinus Osteomas

Objective. To investigate the clinical features of paranasal sinus osteomas and to estimate the growth rate of these tumors in a large series of patients. Design. Case series with chart review. Setting. University hospital, tertiary referral center. Subjects and Methods. The authors retrospectively reviewed the paranasal sinus tomography scans that were taken between January 1997 and April 2008 to find patients with paranasal sinus osteomas. A questionnaire was performed to evaluate the possible clinical symptoms associated with sinus osteomas, and control paranasal sinus computed tomography was taken for patients in whom paranasal computed tomography examination had been done at least 1 year ago. Results. A total of 17,154 paranasal sinus computed tomographies of 14,137 patients were reviewed, and 243 cases of paranasal sinus osteomas were found. The lesions were located in the frontal sinus in 183, ethmoid sinus in 48, maxillary sinus in 5, and sphenoid sinus in 7 patients. Eighty-nine patients with paranasal sinus osteomas were readmitted. The mean follow-up was 54 months in this group. In 46 of 89 patients, an increase in the size of osteomas was detected. The mean growth rate of osteomas was estimated to be 0.79 mm/y in the cephalocaudal direction and 0.99 mm/y in the mediolateral direction. No significant differences were found in the growth rate according to location and growth directions. Conclusion. Neither a specific growth pattern nor a specific factor affecting the growth rate of these tumors could be demonstrated. Follow-up is necessary because of the potential severe complications.

Vestibular functions in motion sickness susceptible individuals

There exists no functional guide that can serve as a diagnostic tool for individual susceptibility to motion sickness (MS). We evaluated vestibular system functioning via a caloric test (which assesses functioning of the superior vestibular nerve) and the vestibular-evoked myogenic potentials (VEMP) test (which assesses inferior vestibular nerve functioning) in 20 MS susceptible and 20 nonsusceptible individuals. Susceptibility to MS was determined by self-declaration and with MS susceptibility questionnaire and Hamilton Anxiety Scale (HAS). We found statistically significant differences for scores on the MS susceptibility questionnaire and HAS questionnaire; however, we found no correlation between VEMP and caloric test results. We suggest that VEMP and caloric test results are not affected by individuals’ susceptibility to MS. We could not find vestibular system deficits using the VEMP and caloric test combination. Our findings do not support vestibular function asymmetry in MS patients.

Effects of different levels of crushing on the viability of rabbit costal and nasal septal cartilages.

Background: Cartilage grafts are frequently used in nasal surgery for structural and/or aesthetic purposes. The literature holds contradictory reports concerning the effect of crushing on the viability of cartilage grafts. Methods: Nasal septal and costal cartilage grafts were harvested from 12 New Zealand rabbits. Each nasal septal and costal cartilage was divided into five equal pieces. One of the pieces was left intact and the remaining four were prepared as slightly, moderately, severely, or significantly crushed. The cartilage pieces were then autoimplanted into the paravertebral skin of the rabbits. The animals were euthanized 4 months later and the effect of crushing on cartilage grafts was assessed pathologically. Results: The viability of the chondrocytes was found to be decreased as the level of crushing increased. The mean chondrocyte viability rates for the intact, slightly crushed, moderately crushed, severely crushed, and significantly crushed cartilages were 88, 75, 51, 41, and 13 percent for the septal cartilages and 94, 83, 62, 32, and 26 percent for the costal cartilages, respectively. The differences between the mean viability rates of septal and costal cartilage groups were statistically not significant. Conclusions: The level of crushing determines the rate of viability for the crushed cartilage. Viability rates and the clinical properties of the slightly crushed cartilage grafts at long-term follow-up may be similar to those of the intact cartilage grafts. However, severe or significant crushing leads to a decrement in the viability of the chondrocytes and may cause unpredictable degrees of volume loss at long-term follow-up.

Eosinophilic ulcer of the tongue

A 76‐year‐old woman presented with a 1‐month history of a rapidly expanding painful ulcerated nodule on her tongue following tooth extraction. Triamcinolone acetonide ointment was applied twice daily for 1 month without any benefit. The histopathology of the excision specimen was consistent with an eosinophilic ulcer of the oral mucosa. There has been no recurrence 12 months later.

Endoscopic Modified Medial Maxillectomy for Treatment of Inverted Papilloma Originating From the Maxillary Sinus

AbstractEndoscopic approaches have become an alternative to external approaches in the treatment of sinonasal inverted papillomas (IPs) in recent years. The aim of this study was to analyze the outcomes of endoscopic modified medial maxillectomy preserving the nasolacrimal duct and the inferior turbinate in selected IP cases. Medical charts of patients diagnosed with IP originating from the maxillary sinus between July 2008 and August 2013 were reviewed. Eight patients who had undergone endoscopic modified medial maxillectomy were included in the study. Attachment of IP was located on the medial wall of the maxillary sinus in all cases. The nasolacrimal duct was preserved in all of the patients. The inferior turbinate was completely preserved in 5 patients, and the anterior part of the inferior turbinate was preserved in 3 patients. The mean follow-up period of the patients was 30.8 months (12–60 mo). None of the patients had recurrence or major complications. The postoperative complaints were minor hemorrhagic discharge and crusting for the first few weeks. Endoscopic modified medial maxillectomy preserving the nasolacrimal duct and the inferior turbinate provides good surgical and functional outcomes in selected IP cases.

Long-term inflammatory response to liquid injectable silicone, cartilage, and silicone sheet

To show and compare the long‐term inflammatory responses to subdermal microdroplet injections of 1,000 centistoke (cS) and 5,000 cS liquid injectable silicone (LIS), and to assess the applicability of insulin pen as an alternative LIS delivery device in an animal model.

Skin problems following septorhinoplasty.

Septorhinoplasty is one of the most commonly performed plastic surgery procedures in the world. Studies on septorhinoplasty in the literature mainly focus on the surgical procedures and their outcomes, but the general appearance of the nose and nasal skin following surgery is also very important.

Viability of crushed human auricular and costal cartilage chondrocytes in cell culture.

The amount or quality of available septal cartilage may be inadequate for grafting in some rhinoplasty patients. In such cases, auricular or costal cartilage may provide an additional source of cartilage. Crushed septal cartilage has been shown to be useful for dorsal onlay grafts. We aimed to investigate the effect of different degrees of crushing on the viability of human auricular and costal cartilage. Ten auricular and 10 costal cartilage grafts were obtained from 20 patients during secondary rhinoplasty. Each graft was sectioned into five pieces. One of the pieces was left intact and the remaining four were prepared as slightly, moderately, significantly, and severely crushed. Viability and proliferation rates of chondrocytes in cell cultures were evaluated. Mean viability rates on day 1 for intact, slightly crushed, moderately crushed, significantly crushed, and severely crushed auricular cartilages were 70%, 67%, 65%, 58%, and 45%; while those for costal cartilages were 65%, 63%, 59%, 55%, and 53%, respectively. There was no statistically significant difference between the viability rates of the similarly crushed auricular and costal cartilage groups on days 1, 2, 3 and 10. The viability of crushed human auricular and costal cartilage grafts depends on the degree of crushing applied.