Mehmet Imamoglu

Active Transport Dacryocystography in Evaluating Lacrimal Drainage System After Rhinoplasty

In order to evaluate the effects of lateral osteotomies performed during rhinoplastic surgery on the lacrimal drainage system, a new technique for imaging the lacrimal passages, Active Transport Dacryocystography, was applied in a total of 16 patients. In all cases, free passage of contrast media from the punctum to the inferior meatus was observed. We did not record any pathologic alteration such as mucosal edema or discontinuity of the bony structure that would have resulted in nasolacrimal obstruction.

Association of inferior turbinate enlargement, concha bullosa and nasal valve collapse with the convexity of septal deviation

Abstract Conclusion: Inferior turbinate enlargement (ITE), nasal valve collapse (NVC) and concha bullosa (CB) are nasal anatomic problems that may accompany septal deviation (SD). Establishment of a causal relationship between these variations and SD is doubtful. In patients complaining of nasal obstruction, all nasal structures that may contribute to the symptom must be separately and carefully assessed for setting an appropriate treatment plan and thereby minimizing the failure rate of surgery. Objective: To investigate if the convexity of SD is associated with the occurences of ITE, CB and NVC. Patients and methods: This retrospective study was performed on 109 patients who had been operated due to anterior C-shaped SDs. ITE, CB and NVC were encountered in 65 (59.6%), 27 (24.8%) and 55 (50.5%) patients, respectively. Patients with other forms of SD, allergic rhinitis, non-allergic rhinitis with eosinophilia, acute and chronic sinusitis, nasal polyposis, antrochoanal polyps, those who had recently used systemic or topical decongestants and patients with a history of previous nasal surgery were excluded from the study group. Assessment of the patients was based on data derived from the history, physical examination findings and paranasal sinus CT imaging records. Results: No significant correlation was found between the convexity of the SD and occurrence of ITE, CB and NVC (p = 0.098, 0.717 and 0.171, respectively).

Nasal nitric oxide and its metabolites as potential biomarkers for the diagnosis and follow-up of allergic rhinitis

Objective: This study was conducted to investigate nasal nitric oxide (nNO) and its metabolites nasal nitrite-nitrate (nNOx) in patients with allergic rhinitis (AR), the effects of two different drugs (oral antihistamine and intranasal steroid) on nNOx and the presence of a correlation between nNOx and clinical parameters. Methods: Sixty patients with active symptoms of perennial AR and 25 healthy adults as a control group were enrolled. The patients were randomized into two groups. Half of the patients received fexofenadine 1x120 mg/day orally, and the other half received triamcinolone acetonide 1x2 puff/day intranasally for one month. The amount of nNOx in nasal lavage fluid was measured by using a commercially available kit and the photometric endpoint determination method. Results: Pre-treatment levels of NOx in the nasal lavage fluids (1.92± 1.20 mg/l) of patients with AR were found to be significantly higher when compared with nasal lavage fluid NOx levels of healthy adults (1.38±0.78 mg/l) (p=0.04). The post-treatment nNOx level (1.52±0.85 mg/l) was significantly lower when compared with the pre-treatment value (p=0.028). Conclusion: Nasal nitric oxide metabolites were shown to be good biomarkers for AR, and that oral fexofenadine significantly decreased nNOx levels.

Comparison of Radiofrequency Thermal Ablation and Microdebrider-Assisted Turbinoplasty in Inferior Turbinate Hypertrophy: A Prospective, Randomized, and Clinical Study

Objective To compare the effectiveness of radiofrequency thermal ablation with those of microdebrider-assisted turbinoplasty, we designed a prospective, randomized clinical study. Methods Forty patients suffering from nasal obstruction due to bilateral inferior turbinate hypertrophy were enrolled. Half of the patients were operated by radiofrequency thermal ablation, while the other half underwent microdebrider-assisted turbinoplasty. The outcomes of both techniques were compared in terms of symptomatology, nasal patency, and mucociliary transport. Results A statistically significant difference existed between the two groups with respect to nasal obstruction and the frequency of obstruction at the first post-operative week and first and third post-operative months (p<0.05). Rhinomanometry detected a significant decrease in nasal resistance values in both surgical groups compared to the preoperative values. The mucociliary transport time was significantly prolonged in the first postoperative week and first postoperative month in microdebrider-assisted inferior turbinoplasty group. Conclusion Both radiofrequency thermal ablation and microdebrider-assisted turbinoplasty are effective techniques for treating inferior turbinate hypertrophy. The treatment modality should be individually determined, and parameters such as tissue healing, volume reduction, and mucociliary activity must be taken into account.

A Case of Descending Necrotizing Mediastinitis Following Tooth Cleaning With a Crochet Hook

Acute mediastinitis is a potentially fatal condition that caused by oropharyngeal infections, esophageal perforations or after cardio-thoracic surgery . Early diag - nosis, aggressive surgical debridement and drainage are important for succesful treatment. Here we present a case of DNM that caused by tooth cleaning with a crochet hook. There is no case of DNM in the literature developed after teeth cleaning.