Harun Doğru

The correlation between septal deviation and concha bullosa.

OBJECTIVESnTo investigate the incidence of concha bullosa (CB) in patients with septal deviation and the correlation between the angle of deviation and degree of pneumatization. Study and design This study was designed as a prospective trial.nnnMETHODSnComputerized tomography scans of the paranasal sinuses of 100 consecutive patients with the chief complaint of nasal obstruction and the diagnosis of septal deviation were taken. CB, sinus diseases, and septal deviation angles were recorded.nnnRESULTSnAngles of deviation ranged between 3 and 25 degrees (mean, 13.0 +/- 4.1 degrees). The mean of angle of deviation in cases with CB and in cases without CB was 13.0 +/- 4.0 and 13.0 +/- 4.2 degrees, respectively. No statistical difference was found between them (P > 0.05). Pneumatization of the contralateral CB was statistically significantly higher than that of ipsilateral CB (P < 0.05).nnnCONCLUSIONnSeptal deviation does not appear to give rise to the formation of CB, but augments the pneumatization of the middle turbinate depending on the degree of deviation angle.

Histopathological Changes of Chorda Tympani in Chronic Otitis Media

Objective To investigate whether histopathological changes of chorda tympani might exist in patients with chronic otitis media without facial paralysis.

Removal of a laryngeal leech: A safe and effective method.

This article presents a case of hoarseness, dysphagia, and hemoptysis caused by the laryngeal localization of a leech. This pathological condition is extremely rare in urban areas but is frequent in endemic rural areas. Laryngoscopic evaluation of our patient has shown a leech lodged on the left arytenoid region hanging down to larynx. We present a patient living in an urban area with laryngeal leech that was removed under general induction anesthesia of sevoflurane via a face mask without endotracheal intubation.

Free Radical Damage in Nasal Polyp Tissue

OBJECTIVE: To investigate whether the free radical injury in nasal polyp tissue exists or not. STUDY DESIGN: A prospective study in patients with nasal polyps. METHODS: Polyp specimens were obtained from 19 patients. Control specimens were acquired from 16 patients who underwent partial turbinectomy with concha bullosa free of rhinitis, sinusitis, and allergy, confirmed by endoscopic nasal examination, coronal paranasal sinus CT scan, and prick test. MDA levels of nasal polyps and control specimens were measured by using the method of Knudsen et al. RESULTS: The mean MDA levels of nasal polyps and control specimens were 38.2 ± 5.1 (33.3–52.2) and 33.9 ± 1.6 (32.6–37.4), respectively. MDA levels in NP were significantly higher compared with control specimens (P < 0.01). CONCLUSION: High level of MDA in nasal polyp tissue that represents FR increase supports the existence of cell injury in nasal polyp tissue. FRs should be considered in the development and life cycles of NP which is thought to have multifactorial pathogenesis.

Pneumatized inferior turbinate

The inferior turbinate is a separate bone that extends from the body of the maxilla to the ethmoidal crest. Its arched central portion overhangs the so-called inferior meatus, which contains the opening of the nasolacrimal duct. The inferior turbinate is part of the nasal valve area, which is the narrowest part of the nose. During inspiration, airflow is directed upward and backward, mainly over the anterior part of the inferior turbinate.l Concha bullosa, pneumatization of the middle turbinate, is a well-recognized entity. It is the most common anatomic variation of the middle turbinate leading to various clinical problems.2 It may be either unilateral or bilateral, with different sizes, and may compromise the anatomy and function of the ostiomeatal complex. Pneumatization of the superior turbinate, which is also called concha bullosa of the superior turbinate by Stammberger,3 is a very rare entity, and only a few cases have been reported. 3,4 Pneumatization of the inferior turbinate has not yet been reported in the world literature. In this article, a patient with inferior turbinate pneumatization is presented.

Malondialdehyde levels and superoxide dismutase activity in experimental maxillary sinusitis

OBJECTIVEnAcute maxillary sinusitis is one of the most common diseases in human. Reactive oxygen metabolites (ROMs) produced also physiologically in the body, are normally neutralised by antioxidative enzymes such as superoxide dismutase (SOD). Infection is one of the causes of increased ROMs production. The most important mechanism of tissue damage produced by ROMs is the peroxidation of lipids found in cell membranes and it may be estimated by malondialdehyde (MDA) levels. The purpose of this study, is to investigate tissue damage caused by ROMs in maxillary sinusitis in 24 rabbits.nnnMETHODSnExperimental sinusitis was induced by blocking the right nose and inoculating Staphylococcus aureus into the right maxillary sinuses. Left maxillary sinuses were the control group. Animals were divided into three groups and killed at 3, 5 and 7 days. Mucosas of each maxillary sinus were examined histopathologically and MDA levels were determined. Blood samples were obtained preoperatively (control blood) and on killing days (experimental blood). Serum MDA levels and erythrocyte SOD activities were determined.nnnRESULTSnAll the infected sinuses displayed signs of the inflammation. MDA levels and SOD activities in the experimental blood samples were significantly higher than those of the control group (P < 0.05). Mucosal MDA levels in the experimental group were significantly higher than the controls (P < 0.01).nnnCONCLUSIONSnIn maxillary sinusitis caused by S. aureus an increased ROMs production was observed and it may contribute to tissue damage of sinusitis.

What Is the Relationship Between Chronic Sinus Disease and Isolated Nasal Septal Deviation

Objective The aim of this retrospective study is to examine the role of isolated nasal septal deviation (NSD) in the pathogenesis of chronic rhinosinusitis (CRS). Study Design and Setting The interaction between isolated NSD and chronic sinus disease were retrospectively evaluated in 1452 patients. Out of 1452 patients, 152 patients were included in the study. Patients with anatomical variants other than NSD were excluded from the study. Patients with NSD were enrolled in the study group and patients without NSD were enrolled in the control group. Results There was no statistically significant difference between NSD group and non-NSD group with respect to the CRS. Conclusions The mild to moderate degree of NSD was not a risk factor for chronic sinus disease. Only gross deviation of the nasal septum itself is a risk factor for the development of CRS. Significance Excluding the subjects with ostiomeatal anatomic variations has differentiated this study from the previously reported researches (isolated NSD).

The role of free oxygen radicals in experimental otitis media.

Free oxygen radicals (FORs); have been implicated as important pathologic mediators in many diseases. Under physiological conditions FORs are part of normal regulatory circuits and neutralized by antioxidants, but an increased flux of FORs can cause tissue damage. Infections are one cause of increased FORs production. An important mechanism of tissue damage produced by FORs is the peroxidation of membrane lipids, which can be estimated by malondialdehyte (MDA) levels. The purpose of this study was to determine in 24 albino rabbits whether FORs play a role in the pathogenesis of otitis media experimentally induced by inoculating Streptococcus pneumonia into the right ear, with the left ear serving as a control. We examined the mucosa of each middle ear histopathologically and measured MDA levels in mucosa and serum. Serum MDA levels in infected rabbits were significantly higher than those in preoperative blood specimens (p<0.05). The MDA levels in mucosa were significantly higher in infected ears than in control ears (p<0.01). In the experimentally infected group, a correlation was found between MDA levels in serum and mucosa (p<0.05). In conclusion, serum and mucosa MDA indicating FORs production increased significantly in experimental otitis media. We considered that FORs might play a role in tissue damage caused by otitis media.

Nitric oxide level in the nasal and sinus mucosa after exposure to electromagnetic field

OBJECTIVE: The purpose of this study was to examine the changes in nitric oxide (NO) level in the nasal and paranasal sinus mucosa after exposure radiofrequency electromagnetic fields (EMF). STUDY DESIGN AND SETTING: Thirty male Spraque-Dawley rats were randomly grouped as follows: EMF group (group I; n, 10), EMF group in which melatonin received (group II; n, 10) and the control (sham operated) group (group III; n, 10). Groups I and II were exposed to a 900 MHz. Oral melatonin was given in group II. Control rats (group III) were also placed in the tube as the exposure groups, but without exposure to EMF. At the end of 2 weeks, the rats were sacrificed, and the nasal and paranasal sinus mucosa dissected. NO was measured in nasal and paranasal mucosa. RESULTS: The nasal and paranasal sinus mucosa NO levels of group I were significantly higher than those of the control group (group III) (P < 0.05). However, there was no statistically significant difference between group II and the control group (group III) regarding NO output (P > 0.05). CONCLUSION: Exposure to EMF released by mobile phones (900 MHz) increase NO levels in the sinus and nasal mucosa. SIGNIFICANCE: Increased NO levels may act as a defense mechanism and presumably related to tissue damage. In addition, melatonin may have beneficial effect to prevent these changes in the mucosa. (Otolaryngol Head Neck Surg 2005; 132: 713-6.)

Multiple huge osteomas of the mandible causing disfigurement related with Gardner's syndrome: case report

As osteomas of the bones including the jaws may be the initial symptom or clinical finding in the Gardners syndrome, this entity should always be included in the differential diagnosis. A 20-year-old boy was referred to our clinic from another medical center. Extra-oral examination of the patient revealed an obvious asymmetry and disfigurement of the left mandibular corpus, angle and ramus. A panoramic radiograph revealed two huge osteomas at the angle, ramus and two smaller osteomas at the inferior border of the mandible. At the same time, there were an impacted canine and premolar. Diffuse sclerosis of the whole mandible was also seen. Upon the suspicion of Gardners syndrome, barium passage radiographs of the intestine were requested and multiple polyps were observed. All of these findings led us to the diagnosis of Gardners syndrome. The oral and maxillofacial surgeon and the dentist needs to be aware of the components of this entity because manifestations in the head and neck including epidermoid cysts, osteomas, odontomas, exostoses, supernumerary and impacted teeth are common. At the same time, osteomas causing disfigurement on the face related with Gardners syndrome with increased uptake in scintigraphic examination should be treated by surgical excision of the lesions.