Kerem Polat

Evaluation of hearing in patients with familial Mediterranean fever

Familial Mediterranean fever (FMF) is a common and well-understood hereditary periodic fever syndrome. Hereditary periodic fever syndromes include a group of multisystem diseases characterized by recurrent fever attacks with inflammation affecting skin, joints, and some other tissues. These are FMF, tumor necrosis factor receptor, tumor necrosis factor receptor associated periodic syndrome, hyperimmunglobulinemia D syndrome, Muckle–Wells syndrome, and familial cold urticaria. In literature, it is determined that some of these diseases cause hearing loss. In light of the foregoing, we thought that FMF patients may have the same type of subclinical hearing loss and, therefore, the hearing ability of these patients was evaluated with otoacoustic emission and high frequency audiometry tests.

A Giant Juvenile Nasopharyngeal Angiofibroma

AbstractJuvenile nasopharyngeal angiofibromas are locally growing and highly vascular tumors. They are primarily treated through surgical excision ranging from an open approach to an endoscopic approach. We presented a 20-year-old man with a giant juvenile nasopharyngeal angiofibroma that bilaterally obliterated the pterygopalatine fossa, invaded the sphenoid bone, and extended to the left nasal passage. His complaints were epistaxis and nasal obstruction. After embolization, the patient was treated surgically using the endoscopic approach and declared cured and discharged without any complications.

Primary malignant melanoma of the nasal cavity.

Primary malignant melanoma of the nose and paranasal sinus mucosa is a rare disease and seen in less than 1% among all melanomas. Malignant melanomas have 2 origins: cutaneous and mucosal. The mucosal form has a worse prognosis because of its aggressiveness compared with that of the cutaneous form. Mucosal melanomas often occur at a rate of 2% to 3% among all melanomas and are typically found in the nasal cavity and paranasal sinuses. Generally, it is more common in males and in those older than 50 years. In this study, 4 patients were observed at the Cumhuriyet University Faculty of Medicine; 2 of them were a 64-year-old man and an 82-year-old woman who had a malignant melanoma originating from the nasal septal mucosa, 1 patient was a 72-year-old woman whose malignant melanoma originated from the inferior turbinate, and 1 patient was a 77-year-old woman with a sinonasally located melanoma. The conditions of these patients were discussed under the light of literature instructions.

Analysis of ethmoid roof and skull base with coronal section paranasal sinus computed tomography.

Abstract Chronic paranasal sinus disease is one of the most common causes of application to physicians in pediatric and adult patients. In the surgical treatment of these diseases, endoscopic sinus surgery is an application that is often done to increase the quality of the patient’s life. On account of this, the anatomic variations in skull basement must be well known to avoid possible major complications that may occur during the operation. Recent developments in paranasal sinus surgery also enhanced the need for examining exhaustively the anatomy of this region and existing pathology. Superiority of computed tomography (CT) has an unquestionable importance for the evaluation of anatomic structure and pathology compared with conventional radiographs. A likely anatomic knowledge is needed for a safe surgery. Before the surgery, determining the anatomic variations makes the operation safer and increases the prospects, so we can prevent complications that may occur during the surgery. In this study, CT coronal sections of 300 patients who were admitted to the Department of Ear Nose Throat of Medical Faculty of Cumhuriyet University Research and Training Hospital between the dates December 2008 and January 2011 with complaints of nasal flow and postnasal drip were studied. According to coronal section CT examinations, the patients were divided into 2 groups. Group 1, with 156 cases (64%), showed mucosal changes, and in 144 cases (36%), no mucosal changes were established (group 2). In comparison between the sexes, in groups 1 and 2 females, significant difference was determined for other parameters except the average height of the ethmoid roof. In the comparison between the sexes, in groups 1 and 2 males, significant difference was determined for all parameters. The difference between these 2 rates was statistically significant. Keros types 1 and 2 cases were compared with the control group, and there was no statistically significant difference. Notwithstanding, at the comparison of the Keros type 3 with the control group, there was a statistically significant difference for all the parameters (maximum orbital height, the length of the middle concha, and the nasal wall). It seems to be important for us to know the average length of the peripheral anatomic structures to avoid serious complications that may occur during the operation. Careful preoperative review of paranasal sinus CT scans in patients undergoing sinus surgery seems to be the most important to prevent severe intraoperative complications.

Chronic otitis media with multiple complications.

AbstractChronic otitis media (COM) is defined as persistent infection or inflammation of the middle ear and mastoid air cells. The proximity of the middle ear cleft and mastoid air cells to the intratemporal and intracranial compartments places structures located in these areas at increased risk of infectious complications. The complications of COM are divided into intracranial and extracranial complications. The development and appropriate use of antibiotics have led to a decrease in these potentially devastating complications. However, they continue to occur, and clinical vigilance is required for early detection and treatment. We reported a case with multiple complications, both intracranial and extracranial secondary to COM.

Tularemia and the oculoglandular syndrome of Parinaud.

An 18-year-old female came to our clinic with complaints of a tender lump just under her jaw on the left side and another lump in front of her left ear, ecchymosis around the eye and some redness in the eye at the same side. After administering antibiotic therapy for two days we suspected of tularemia and referred the patient to the Infectious Diseases Department. A serum sample was taken and a fine needle aspiration biopsy was performed. The patient was diagnosed with tularemia, the oculoglandular syndrome of Parinaud. Tularemia should also be kept in mind for differential diagnosis in patients with both ocular and glandular symptoms in endemic regions like Turkey and the appropriate therapy should be initiated immediately.

Presentation of the cerebellar abscess and sigmoid sinus septic thrombosis secondary to chronic otitis media: Case presentation and literature review

Cerebellar abscess is a serious complication of ear disease. In the present report, a case of cerebellar abscess and thrombosis of the sigmoid sinus, secondary to chronic otitis media is described. A 25-year-old male presented with clinical features suggestive of chronic suppurative otitis media. The patient hospitalized for operation. In postoperative third day the patient began to complain about headache. The patient suddenly began to lose his balance while walking and had difficulty in talking. MRI revealed that there was a cerebellar abscess and operated him for the cerebellar abscess. After 6 weeks antibiotherapy the patient discharged from the hospital as cured. As seen in the literature review; most of the patients having thrombosis of the sigmoid sinus and cerebellar abscess together have showed the symptoms of cerebellar abscess. However, the symptoms of thrombosis of the sigmoid sinus were more prominent than cerebellar abscess in our case unlike many others in the literature.

Dumb-bell Pleomorfik Adenom

Pleomorphic adenoma is a benign tumor, mostly originating from parotid gland. It can also be originated from minor salivary glands. Rarely the mass extends from posterior part of ramus mandibula through stylomandibular ligament towards the parapharyngeal space, called as dumb-bell pleomorphic adenoma and pleomorphic adenomas can be seen in any localization in the neck. We wanted to report a case with dumb-bell pleomorphic adenoma which has repoted before but has seen very rarely

PEDiATRiK TRAKEOSTOMi: 25 VAKANIN ENDiKASYON VE KOMPLiKASYON ANALiZi

Amac: Bu calismada daha onceden farkli nedenlerle trakeotomi uygulanmis 25 pediatrik hasta ele alindi. Endikasyonlar, komplikasyonlar ve elde edilen sonuclar degerlendirildi. Cocuklarda trakeotomi uygulamasi hakkinda deneyimlerimizi paylasmayi ve ozellikle kulak burun bogaz ve pediatri kliniklerinde gorev yapan he- kimlere bu konu ile ilgili fikir vermeyi amacladik. Gerec ve Yontemler: 2006 ve 2015 yillari arasinda trakeotomi uygulanan 25 cocuk hasta (n=17, 68% erkek; n=8, 32% kiz) retrospektif olarak degerlendirildi. Trakeotomi endikasyonlari, erken ve gec komplikasyonlar, dekanulasyon suresi ve trakeotomi sonrasi akibetleri kaydedildi. Bulgular: En sik trakeotomi endikasyonu uzun entubasyon suresi idi (n=19, 76%). Solunum yetmezligi (n=9, 36%), noromuskuler hastaliklar (n=4, 16%), buyuk cerrahi sonrasi surec (n=3, 12%) ve enfeksiyon / sepsis iliskili hastaliklar (n=2, 3.8%) uzun entubasyona neden olan durumlardi. Trakeotomi 6 (%24) cocuk hastada ust hava yolu obstruksiyonu nedeni ile uygulandi. Ortalama entubasyon suresi 18.7±15 gun idi. Erken ve gec komplikas- yon oranlari her ikisi de %8 idi. Dekanulasyon basarisina 8 (%32) cocukta ulasildi. Trakeotomi sonrasi ortalama dekanulasyon suresi 29.4±20.8 gun idi. Trakeotomi sonrasi hayatini kaybeden hasta sayisi 12 (48%) idi. Sonuc: Biz cocuklarda trakeotomi endikasyonlari, komplikasyonlari ve sonuclarini ele alarak bu konuda guncel bir bilgi sunmayi hedefledik. Anahtar kelimeler: Trakeotomi; Cocuk; Endikasyonlar; Komplikasyonlar; Dekanulasyon ABSTRACT Aim: In this study 25 pediatric patients that underwent tracheotomy due to different reasons were evaluated and the indications, complications due to tracheotomy and the results after the procedure were detected. We wanted to share our experience about the use of tracheotomy in children and aimed to give an idea to clinicians especially those working in Otolaryngology and Pediatric departments. Material and Methods: Twenty five children (n=17, 68% boys; n=8, 32% girls) applied tracheotomy between 2006 and 2015 were analyzed retrospectively. The indications of tracheotomy, early and late complications, the time of decannulation and results after tracheotomy were recorded. Results: Prolonged intubation was the most common indication (n=19, 76%) for tracheotomy. Respiratory failure (n=9, 36%), neuromuscular diseases (n=4, 16%), postoperative period following major surgery (n=3, 12%) and infection/sepsis related diseases (n=2, 3.8%) were the causes of prolonged intubation. Tracheotomy was performed for upper airway obstruction in 6 (24%) children. The mean intubation time was 18.7±15 days. Early and late complication rates were 8% respectively. Decannulation success was observed in 8 children (32%). Mean decannulation time after tracheotomy was 29.4±20.8 days in the patients. The number of patients died after tracheotomy was 12 (48%). Conclusion: We evaluated the indications, the complications due to tracheotomy and the results after the procedure in children and aimed to give an up-to-date information. Key words: Tracheotomy; Child; lndications; Complications; Decannulation

The Comparison of Bacteremia and Amount of Bleeding During Tympanomastoidectomy

Objective: The aim of this study was to investigate the relationship between the amount of bleeding and bacteremia during tympanomastoidectomy surgery. Material and methods: A total of fifty-seven patients undergoing tympanomastoidectomy were evaluated in the present study. The amount of bleeding was measured and recorded for each patient. Preoperative and intraoperative blood cultures were collected immediately after the induction of anesthesia and 45th min intraoperatively. Results: Blood cultures taken preoperatively were negative, however the cultures obtained intraoperatively were positive in 7 (12.3%) of 57 patients who underwent tympanomastoidectomy, and bacteremia was more frequent among those with a greater amount of bleeding during the surgery. Conclusion: The results of this study suggest that although bacteremia had no clinical consequences for patients, patients with more bleeding have an increased risk of developing bacteremia which may cause complications in higher risk individuals.