Murat Sari

The Use of Expanded Polytetrafluoroethylene (Gore-Tex) in Rhinoplasty

BackgroundSeptal cartilage still is the most appropriate graft material used in rhinoplasty. In traumatic or revision cases, septal cartilage can be insufficient, and the need for an implant material emerges. In this study, the safety and efficacy of polytetrafluoroethylene (Gore-Tex) used as an implant material in nasal dorsal augmentation were assessed.MethodsThis study retrospectively reviewed 74 patients who underwent nasal dorsal augmentation with Gore-Tex. Of the 74 patients who underwent rhinoplasty with Gore-Tex for dorsal augmentation from February 1999 to January 2006, 46 (62.2%) represented primary cases and 28 (37.8%) represented revision cases. The patients were followed from 5 to 62 months (average, 28 months) and questioned about cosmetic and functional outcomes. The results were assessed according to patients’ charts as well as preoperative and postoperative photographic documentation.ResultsThere were no complications such as infections, foreign body reaction, extrusions, resorption, or migration, and all the patients were satisfied with their results. Only one case of soft tissue reaction was observed, which lasted for 3 weeks postoperatively.ConclusionsBiocompatibility, ease of use, lack of extrusion or resorption, and low rate of infection make Gore-Tex a good alternative to autogenous tissue. However, long-term success and complication rates still are lacking, and large numbers of patients with longer follow-up periods are required.

Protective role of resveratrol against cisplatin induced ototoxicity in guinea pigs

OBJECTIVE The aim of this study was to evaluate the effectiveness of systemic administration of resveratrol against cisplatin-induced ototoxicity in guinea pigs. MATERIALS AND METHODS Healthy guinea pigs (n=24) were randomly divided into four groups. Group 1 (n=6) received resveratrol+cisplatin, group 2 (n=6) received 4% ethanol+cisplatin, group 3 (n=6) received cisplatin, and group 4 (n=6) received saline. Cisplatin was administered at a dose of 10mg/kg/day on days 14 and 15 of the study. Resveratrol (10mg/kg/day), 4% ethanol, and saline were administered throughout the study. Baseline auditory brainstem responses (ABR) (4 kHz, 8 kHz, and click stimulus) were determined for all groups. ABR was repeated 72 h after the last dose of cisplatin in order to record the threshold shifts. The ABR threshold shifts for the click stimulus, 4-kHz- and 8-kHz-frequency stimuli were compared after drug administration. After follow-up ABRs the animals sacrificed under deep sedation and their cochleae were removed. Left cochleae were immediately harvested for measurement of level of reactive oxygen species (ROS). Right cochleae were prepared for histological changes which were observed by scanning electron microscopy (SEM). RESULTS For the all stimulus, there was a significant threshold difference among the groups (p<0.01). Group 3 had a significantly higher threshold shift at all stimuli when compared with groups 1 and 4. There was no significant threshold shifts in all stimuli between groups 2 and 3. The resveratrol-treated group 1 showed preservation of threshold in ABR (p ≤ 0.05). SEM showed that inner and outer hair cells were preserved in the group 1. Level of reactive oxygen species (ROS) were significantly higher in groups 2 and 3 compared with groups 1 and 4 (p ≤ 0.05). CONCLUSION These results indicated that systemic administration of resveratrol afforded statistically significant protection to the cochlea of guinea pigs from cisplatin toxicity. Experimental dose of resveratrol injections may have a protective effect against cisplatin ototoxicity in guinea pigs.

Ototoxic Effect of Burow Solution Applied to the Guinea Pig Middle Ear

Objective: To analyze the ototoxicity of Burow solution as an otologic preparation. Background: Burow solution has been used for years in the treatment of acute or chronic otitis externa and chronic suppurative otitis media. This acidic solution has antibacterial and antiedematous properties. Ototoxic effect of Burow solution has not been known, so the current study was designed to observe the ototoxic effect of Burow solution experimentally. Materials and Methods: Experiments were performed in 32 young, male albino guinea pigs (weight, 450-550 g). Twenty animals in the experimental group were divided into 2 groups of 10 animals each. The first group received 13% Burow solution (13% aluminum subacetate), and the second received 4% Burow solution (4% aluminum subacetate). Twelve animals in the control group were divided into 2 groups of 6 animals each. The first group received gentamicin (40 mg/mL; ototoxic control), and the second received saline solution (negative control). Under general anesthesia, pretreatment auditory brainstem responses (ABRs) from the right ear were obtained from the animals in all groups. The right tympanic membranes were widely perforated, and a small piece of Gelfoam was applied to the middle ear. Ear solutions at concentrations of 0.1 mL were applied through transcanal approach to the middle ear twice a day in 10 days. Under general anesthesia, the Gelfoam was removed from the right middle ear, and posttreatment ABRs were obtained 14 days later after the initial time in all groups. Results: Baseline ABR results were normal in right ears of all animals tested. Animals undergoing placement of Gelfoam with either 13% Burow solution, 4% Burow solution, or saline in the middle ear showed no changes in ABR threshold. The gentamicin group showed significant change in the ABR threshold. Conclusion: Burow solution was considered to be an effective and safe otologic preparation.

Effects of Vitamin E on Cigarette Smoke Induced Oxidative Damage in Larynx and Lung

Objectives: Cigarette smoke (CS) contains a large variety of compounds, including many oxidants and free radicals (also known as reactive oxygen species), that are capable of initiating or promoting oxidative damage, which leads to various degenerative pulmonary and cardiovascular diseases as well as cancer. Recent studies have established a strong relationship between CS and development of reactive oxygen species (ROS). The aim of the present study was to detect ROS levels in laryngeal and lung tissues of rats by measuring luminol‐amplified chemiluminescence and to determine the changes in ROS levels in lung and laryngeal tissues induced by exposure to CS, with and without concurrent treatment with vitamin E.

Vitamin e-coated tympanostomy tube insertion decreases the quantity of free radicals in tympanic membrane.

Objective: Tympanosclerosis is a common sequela of ventilation tube treatment of otitis media with effusion causing hearing disability. It is associated with an increased production of free radicals (also known as reactive oxygen species) after myringotomy. Vitamin E is a scavenger of different free radicals by working as an antioxidant. The aim of the present study was to evaluate the effect of vitamin E‐coated tympanostomy tube insertion at quantity of free radicals in rat tympanic membrane.

Actinomycosis of the larynx

Actinomycosis is a rare chronic granulomatous disease that involves the upper airway and gastrointestinal tract. Approximately 40–55% of actinomycosis comprises the cervicofacial form. It presents a challenging clinical diagnostic dilemma because of variable presentations in the head and neck. Herein, we report a rare case of actinomycosis presenting as a vocal cord nodule in a healthy 21-year-old man who was not immunocompromised and had no other known medical disease.

Unusual Presentation and Location of Thyroglossal Duct Cyst in a Child

Thyroglossal duct cysts (TDCs) are common congenital neck masses resulting from persisting epithelial tissue of the thyroglossal duct that enlarges because of inflammation, infection, and mucus retention. They can be found anywhere in the midline between the foramen cecum and the thyroid gland. TDCs are most frequently found below the level of the hyoid bone (85%). They may occur above the hyoid (8%), at the base of the tongue (1.2%), or low in the neck (5%). They are the most common nonodontogenic cysts in the neck and present frequently with a painless anterior midline neck mass occurring at the second or third decade of life. Other less common midline neck masses, such as dermoid cysts, branchial cleft cysts, cystic higromas, and teratomas, should be considered in the differential diagnosis. Despite the close proximity of the cyst to laryngeal structures and being mostly infrahyoid, only 10 cases have been reported to extend into the larynx. Although intralaryngeal extension can be seen in cases of malignant transformation of cysts, this condition is extremely rare in normal benign TDCs and clinically causes hoarseness, dysphagia, and dyspnea. Our patient is the 11th case and the only pediatric patient reported in the literature to have a TDC with intralaryngeal extension. A 2-year-old child presented with dyspnea, history of attacks of stridor, and harsh sound with respiration for one year. These complaints had started increasing in the past month before his admission to the hospital. He had no fever, dysphagia, cough, neck mass, or any lung or lung-related diseases. His medical history was indicative of recurrent medical therapy of laryngitis and croup. His family history was unremarkable.

A new consideration of scar formation in open rhinoplasty.

Rhinoplasty is one of the most variable operations in facial plastic surgery because of the various deformities involved and dissimilar methods used to correct them. Although the exposure of the surgical anatomy with an open approach to rhinoplasty is much better than with the endonasal approach, many surgeons focus mainly on the risk of a visible columellar scar. However, despite this unfavorable complication of a midcolumellar incision, a better understanding of the nasal deformities can be gained, and a more detailed reconstruction can be performed. Surgeons have developed various methods to reduce the risk of scar formation. Different incision types include the Z, V, reverse V, and W incisions. In our experience, meticulous inverted V midcolumellar incision closure results in a better scar. There is no convincing reason to reject the transcolumellar incision for external rhinoplasty.

Ototoxic effect of topical ciclopirox as an antimycotic preparation.

To evaluate the ototoxicity of ciclopirox-containing solution as an otologic preparation for the treatment of otomycosis. Background: Ciclopirox is a synthetic antimycotic agent available in a variety of formulations to treat superficial fungal infections. Ciclopirox has demonstrated both fungicidal and fungistatic activity in vitro against a broad spectrum of pathogenic fungi. It also possesses a broad-spectrum antibacterial properties, anti-inflammatory, and antiedema effect. The ototoxic effect of ciclopirox-containing solutions has not been known, so the current study was designed to observe the ototoxic effect of this solution experimentally. Materials and Methods: Experiments were performed in 22 young male albino guinea pigs (weight, 450-550 g). The 10 animals in the experimental group received ciclopirox solution, and the control group was divided into two groups of six animals each. The first group received saline solution (negative control) and the second received gentamicin (40 mg/mL; ototoxic control). Under general anesthesia, pretreatment auditory brainstem responses (ABRs) from the right ears were obtained from the animals in all groups. The right tympanic membranes were totally perforated, and a small piece of Gelfoam was applied to the middle ear directly to the round window membrane. Ear solutions were applied through transcanal approach to the middle ear twice a day in 2 weeks. Twenty-two animals of perforated tympanic membrane were observed during a 2-week period. Posttreatment ABRs were obtained in all groups in a week after the last administration. Results: Baseline ABR results were normal in right ears of all animals tested. Animals undergoing placement of Gelfoam with either ciclopirox solution or saline in the middle ear showed no changes in the ABR threshold. The gentamicin group showed a significant change in the ABR threshold. Conclusion: In the guinea pig, when applied topically to the middle ear, ciclopirox does not cause a reduction in the ABR threshold. Because its safety has not yet been confirmed in patients, caution should be observed when prescribing this agent.

Histologic Changes in Eustachian Tube Mucosa of Rats After Exposure to Gastric Reflux

Objective: Reflux is thought to be a risk factor for middle ear disease, but the mechanism underlying this relationship is unclear. In this study, we evaluated the effects of reflux on the eustachian tube (ET) mucosa.