Hasan Candan

Mastoid osteomas: report of two cases.

Objective: To discuss the differential diagnosis of two cases with mastoid mass. Study Design: Case report and review of the literature. Setting: The study was carried out in Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey. Patient, Intervention, and Results: Both cases were 23-year-old males. They admitted to our clinic with masses behind their left ears that had been progressively enlarging for 5 years. In both cases, coronal and axial computerized tomography scans revealed a wide-based lesion involving temporal bone cortex. The cases were operated on for diagnosis and for correction of the cosmetic deformity. Histopathological examinations were consistent with mixed and spongiotic osteoma. Conclusions: Mastoid osteoma is a rare, benign tumor of bone. It may cause cosmetic deformity such as external mass or an auricular protrusion. Other neoplasms of the mastoid region, such as osteosarcoma and osteoblastic metastasis, should be considered for the differential diagnosis.

Effects of topical application of mitomycin-C and 5-fluorouracil on myringotomy in rats.

OBJECTIVE The effects of topical application of Mitomycin-C (MMC) and 5-fluorouracil (5-FU) for maintaining myringotomy patency were investigated in this experimental study. STUDY DESIGN We performed simple myringotomy with a knife on 140 tympanic membranes of 70 rats. Rats were divided in two study groups and a control group. Each study group had 60 tympanic membranes, and the control group had 20. We applied Mitomycin-C (0.4 mg/ml) in Group A, 5-fluorouracil (50 mg/ml) in Group B topically, and sterile saline in the control group for 10 minutes. Examination was made with otoendoscope on days 1, 3, 5, 7, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, and 70, and patency rates were recorded. RESULTS MMC and 5-FU Groups remained open for a mean of 46.17 days and 14.62 days, respectively. The control ears healed within 10.4 days. Fibrosis of the MMC-treated group was the same as that of 5-FU-treated groups. Fibrosis of both study groups was significantly lower than that of the control group. CONCLUSIONS MMC is more effective than 5-FU, which is more effective than the simple myringotomy procedure in extending the patency of myringotomies in rat tympanic membranes (p < 0.05). Both medications are useful as an adjunct in preventing myringotomy closure.

The effectiveness of hyperbaric oxygen treatment in tracheal reconstruction with auricular cartilage grafts (experimental study).

PURPOSE Tracheal stenosis or neoplastic changes, as well as, traumatic, congenital, or iatrogenic causes may require extensive tracheal resections. Complications like vascularization insufficiency and structural support problems occur nearly in all cases when end-to-end anastomosis of trachea is not feasible. Hyperbaric oxygen (HBO) treatment is a well-known method for the management of grafts and flaps that have vascularization problems. In this study, the effect of hyperbaric oxygen treatment on wound healing after tracheal reconstruction with auricular cartilage graft (ACG) has been evaluated. METHODS Thirty-two rabbits were divided into 2 groups: study group (n = 16) and control group (n = 16). The anterior halves of the six tracheal rings were resected, and the defects were repaired with autogenic auricular grafts. Hyperbaric 100% pure oxygen was administered to the study group at 2.4 atmospheres of absolute pressure 2 times a day for 1 week. The control group did not receive any therapy except proper control of the wound. RESULTS It was observed that in the study group, inflammation, fibrosis, and necrosis were less, whereas epithelialization and maturation were early and neovascularization and neochondrification were more than the control group only at specific weeks. But all tracheas in both groups showed excellent healing without graft rejection and excessive granulation tissue formation. Furthermore, there was no statistically difference between the 2 groups. CONCLUSIONS Auricular cartilage grafts is a valuable management method of tracheal defects, and hyperbaric oxygen treatment is a good supplementary method in healing period of cartilage autografts.

Bilateral Facial Nerve Paralysis Secondary to Acute Myelogenous Leukemia

Bilateral facial paralysis is a rare condition. We present a case of acute myeloblastic leukemia manifesting itself in bilateral hearing loss and bilateral facial paralysis. We suspected systemic disease because of the abnormal blood cell count of the case. The diagnosis of leukemia was made with histological examination of a bone marrow aspirate. Computed tomography and gadolinium-enhanced magnetic resonance imaging scans revealed bilateral infiltration of the mastoid bones, middle ears and facial nerves. One should always remember that bilateral facial paralysis may be the first sign of a life-threatening illness. If infiltration is observed in the air-filled cells of the mastoid bone, before emergency surgery is planned, the possibility of leukemic infiltration should be considered.