Görkem Eskiizmir

Is there a vicious cycle between obstructive sleep apnea and laryngopharyngeal reflux disease

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder which is mainly characterized by the repetitive episodes of obstructive apneas and/or hypopneas. It is associated with daytime sleepiness, decrements in quality of life, cardiovascular and cerebrovascular diseases and endocrine disturbances. In addition, there is a high prevalence of gastric reflux (including both gastroesophageal reflux and laryngopharyngeal reflux diseases) in patients with OSA. However, the mechanism underlying this association has not been completely established. Herein, we hypothesize that there is a vicious cycle between OSA and laryngopharyngeal reflux disease. Increased respiratory efforts in OSA generate more-negative intrathoracic pressure, contributing to reflux of gastric contents, which in turn creates inflammation and sensory deficits in the laryngeal and pharyngeal tissues that contributes to progression of OSA through both inflammatory and neuromuscular pathways.

Pleomorphic adenoma originated from the inferior nasal turbinate

Although pleomorphic adenoma is the most common benign neoplasm of the salivary glands, it has also been reported to be present in the neck, ear, mediastinum, external nose and nasal cavity. Intranasal localization of this lesion is very rare and mainly originates from the nasal septum. From wherever the lesion originates, the main treatment modality should be surgical. We presented a very rare case of intranasal pleomorphic adenoma originated from the inferior nasal turbinate. Due to the expansile nature of the lesion, a midfacial degloving approach was preferred.

Inferior concha bullosa.

Inferior concha bullosa is defined as the pneumatization of inferior intranasal turbinate and is a rare clinical condition. In this article, a 37-year-old female patient complaining from unilateral nasal stuffiness and intermittent headache is presented. Symptomatology, diagnostic and therapeutic measures for inferior concha bullosa is discussed. In the differential diagnosis of inferior turbinate hypertrophy, inferior concha bullosa should be kept in mind.

Comparative analysis of primary and secondary rhinoplasties according to surgeon's perspective, patient satisfaction, and quality of life.

Objectives: We sought to analyze and compare the problems and technical difficulties related to surgical intervention, patient satisfaction, and quality of life after primary and secondary rhinoplasties. Methods: A total of 168 cases of rhinoplasty were grouped as primary or secondary according to the patients history of rhinoplasty. The type of nasal deformity, the surgical approach, and the difficulty of the surgery were recorded. The levels of patient satisfaction and the quality of life were assessed before and after the operation with the Rhinoplasty Outcomes Evaluation (ROE) and European Quality of Life–5 Dimension (EQ-5D) questionnaires. A quantitative and statistical analysis was performed. Results: Thirty-three patients had secondary rhinoplasty, and 135 patients had primary rhinoplasty. Relatively high rates of saddle nose deformity, crooked nose, and tip asymmetry were observed in the secondary rhinoplasty group. The preoperative and postoperative scores on the ROE and EQ-5D questionnaires demonstrated statistically significant differences in both the primary and secondary rhinoplasty groups. The comparison of postoperative change between the primary and secondary rhinoplasty groups did not demonstrate a statistically significant difference. Conclusions: The surgical difficulty of secondary rhinoplasty is approximately twice that of primary rhinoplasty because of the high rate of major deformities. However, the levels of patient satisfaction and improvements in quality of life are similar after primary and secondary rhinoplasties.

Effect of thermal energy produced by drilling on the facial nerve: histopathologic evaluation in guinea pigs

The effect of thermal energy due to drilling around the facial nerve canal on the facial nerve was histopathologically evaluated in four guinea pigs. The bony canal of the facial nerve was drilled using a 3 mm diamond burr for one minute. The temperature changes on the facial nerve canal were noted before and after dissection. The temporal bones of the animals were histopathologically examined under light microscopy using haematoxylin & eosin (H&E) and solochrome cyanine staining for myelin, and immunohistochemical staining for neuronal nitric oxide synthase (nNOS). Compared to the control group, it was observed with H&E staining that there was oedema among the axonal fibres and with solochrome cyanine staining that the thickness of the myelin fibres was decreased, and that the severity and extent of nNOS activity was decreased in the axonal fibres. It was concluded that a temperature increase on the facial canal may potentially lead to inflammation of the nerve, and may also cause deterioration of nerve conduction to some extent.

Herpes zoster oticus associated with varicella zoster virus encephalitis

Ramsay‐Hunt syndrome, herpes zoster oticus (HZO), derived its name from James Ramsay Hunt, who first described it in 1907. It is classically characterized by acute peripheral facial paralysis, herpetic eruptions on the auricle, and vestibulocochlear dysfunction due to the reactivation of varicella zoster virus (VZV). In this Case Report, the authors describe an HZO patient with simultaneous VZV encephalitis. To date, only eight cases of HZO associated with VZV encephalitis have been reported in the English literature. Therefore, the authors discuss all the aspects of this rare entity, including clinical examination, radiological evaluation, laboratory evaluation, and treatment options. Laryngoscope, 2009

A comparative analysis of the decongestive effect of oxymetazoline and xylometazoline in healthy subjects

BackgroundOxymetazoline and xylometazoline are locally effective and direct acting drugs that relieve nasal congestion. The aim of this study was to objectively determine and compare the decongestive effects of oxymetazoline and xylometazoline in healthy subjects.MethodsThe study population comprised thirty healthy adults. All subjects underwent active anterior rhinomanometry (AARhm) and acoustic rhinometry (AR) tests following the application of oxymetazoline, xylometazoline, or placebo (physiological saline). The change in nasal resistance, nasal airflow, and different cross-sectional areas (CSAs) of the nasal cavity in the subjects were examined for each solution separately. The measurements were obtained over a 1-h period (baseline and 1, 15, 30, and 60 min post-dosing). All results were analyzed using the Kruskal–Wallis test and the Mann–Whitney U test.ResultsA total of 6,300 measurements of AARhm and AR were obtained. The application of placebo did not cause a statistically significant change in nasal resistance, nasal airflow, and CSAs (CSA1, 2, and 3, respectively) of the nasal cavity. In contrast, statistically significant changes in nasal resistance (inspiration p = 0.000 and p = 0.004; expiration p = 0.000 and p = 0.000), nasal airflow (inspiration p = 0.000 and p = 0.004; expiration p = 0.000 and p = 0.000), and CSAs of the nasal cavity (CSA2 p = 0.000 and p = 0.000, CSA3 p = 0.000 and p = 0.00), with the exception of CSA1 (p = 0.982 and p = 0.994), were obtained after the application of oxymetazoline and xylometazoline. A comparison of oxymetazoline and xylometazoline based on nasal resistance, nasal airflow, and CSAs of the nasal cavity demonstrated no statistically significant difference, except for CSA3.ConclusionOxymetazoline and xylometazoline are fast-acting and potent topical decongestants that have similar decongestive effects.

Nonmelanoma Skin Cancer of the Head and Neck: Reconstruction

Reconstruction of facial defects formed after resection of skin cancers is a challenging procedure. Achieving the best functional and aesthetic outcome depends on accurate preoperative planning. Reconstructive surgeons should perform a detailed analysis of the facial defect based on location, size, and depth and choose the most appropriate technique according to their experiences and patient preferences and expectations. This article reviews the preoperative analysis of facial defects, and the major principles and techniques of facial reconstruction. Discussed are reconstruction of the nose, lip, cheek, forehead, and eyelid, presenting for each technique the goals of the reconstruction, types of flaps and grafts, and surgical technique.

The histopathological effect of thymoquinone on experimentally induced rhinosinusitis in rats.

Background Rhinosinusitis is a common disorder and its treatment includes a variety of topical and systemic drugs. This study was designed to determine the histopathological effect of thymoquinone on experimentally induced rhinosinusitis in rats. Methods Sixty rats were randomly allocated into 3 test and 2 control groups, each of which consisted of 12 animals. The rhinosinusitis model was induced using intranasal application of platelet-activating factor. In test groups, the animals were separated into groups: (1) rhinosinusitis-antibiotherapy, (2) rhinosinusitis-thymoquinone, (3) rhinosinusitis-combination therapy. The positive and negative control groups were defined: rhinosinusitis group without any treatment and the group without rhinosinusitis, respectively. The histopathological features (vascular congestion, inflammation, and epithelial injury) in nasal respiratory and olfactory mucosa of animals were examined and graded according to their severity. A quantitative and statistical analysis of histopathological features was performed. Results All histopathological features showed statistically significant differences between negative and positive control groups, respectively. Conversely, neither the group with rhinosinusitis-antibiotherapy nor the group with rhinosinusitis-thymoquinone had a statistically significant difference with the negative control group. Moreover, none of the histopathological features showed a statistically significant difference, when the group with rhinosinusitis-antibiotherapy and the group with rhinosinusitis-thymoquinone were compared. A statistically significant difference was not determined when the group with rhinosinusitis-combination therapy was compared with the group with rhinosinusitis-thymoquinone. The histopathological features did not show a statistically significant difference between the group with combination therapy and the negative control Conclusion Thymoquinone is a promising bioactive agent for the treatment of rhinosinusitis, and its histopathological effect is as equivalent as an antibiotic.

Desloratadine‐montelukast combination improves quality of life and decreases nasal obstruction in patients with perennial allergic rhinitis

The effects of desloratadine‐montelukast combination on quality of life (QoL) and nasal airflow of patients with perennial allergic rhinitis (PAR) has not been reported. The objective of this work was investigate the efficacy of desloratadine‐montelukast combination on nasal obstruction and health‐related quality of life (HRQL) of patients with PAR.