Mustafa Paksoy

Prevalence of adenoid hypertrophy and nocturnal enuresis in primary school children in Istanbul, Turkey

OBJECTIVE The purpose of this study is to investigate the prevalence of an existing relationship between adenoid hypertrophy and nocturnal enuresis in primary school children. METHODS The study was performed in four primary schools that were chosen randomly in Kartal, Istanbul. The childrens parents were asked to fill out a questionnaire that included questions concerning the associated symptoms of adenoid hypertrophy and nocturnal enuresis. The interrelations between adenoid hypertrophy and nocturnal enuresis items were examined by X2 tests. RESULTS The study population consisted of 1132 (625 girls, 621 boys) primary school children between 5 and 14 years of age (mean 9.59+/-2.60 years). The children were divided into three groups with 5-7 years old children in Group I (n=232), 8-10 years old children in Group II (n=506) and 11-14 years old children in Group III (n=394). Of the 1132 distributed questionnaires, 1090 (87.4%) were filled in adequately and were accepted for evaluation. Prevalence of adenoid hypertrophy in school children was found to be 58 in Group I (27%), 94 in Group II (19.5%) and 78 in Group III (19.9%). Prevalence of nocturnal enuresis in school children was found to be 35 in Group I (15.1%), 51 in Group II (10.1%) and 18 in Group III (4.6%). No statistically significant association was present between adenoid hypertrophy and nocturnal enuresis in either Group I, II or III school children. CONCLUSION In contrast to previous studies, our prevalence study did not find an association between adenoid hypertrophy and nocturnal enuresis. Thus, this prevalence study provides otolaryngologists new and interesting information.

Expression of cathepsin D and E-cadherin in primary laryngeal cancers correlation with neck lymph node involvement

ObjectiveThe aim of this study was to investigate the relation between Cathepsin D (Cath-D) and E-Cadherin (E-Cad) expression levels in tumor tissue and neck lymph node metastasis. This attempt should be made to identify new factors that one could be useful in predicting clinical behavior.Study designIn this study, we investigated rates of dying for E-Cad and Cath-D in paraphin blocks of larynx and neck dissection specimens taken from 56 selected patients. Laryngeal specimens dyed by ECad and Cath-D immunohistochemically. Immunoreactivity classified for E-Cad as positive (75% and above), reduced (25–75%) and negative (below 25%). Immunoreactivity classified for Cath-D:dye absorption rates higher than 50% evaluated positive and absorption rates lower than 50% evaluated negative. We compared the rates of dying for E-Cad and Cath-D groups to with or without neck lymph node metastasis in specimens.ResultsNeck metastasis were found in 41% of patients, in 55.6% of patients, if the E-Cad was negative, 40.6% if it was reduced, 33.3% if it was positive in specimens. The neck metastasis was found in 35.4% of patients with Cath-D expression negative, while 75% of patients was found with Cath-D expression positive.ConclusionNeck metastasis was found higher in E-Cad reduced group than positive group. Neck node metastasis was significantly higher in Cath-D positive group than Cath-D negative group. Cath-D and E-Cad essays may useful in identifying neck lymph node involvement. Cath-D expression levels are more in this predictive factor than E-Cad levels for possibility of neck lymph node metastasis in LSCC.

Our Experience with Carotid Body Paragangliomas

Carotid body paragangliomas (CBP) are rare neoplasms arising from the small chemoreceptor organ in the adventitia of the common carotid bifurcation. The aim of this study is to present the diagnostic process, performed treatment and obtained results in patients with carotid body paragangliomas of the Department of Otolaryngology of Istanbul Education and Research Hospital between March 1997 and November 2008. Retrospective analysis was carried out, based on the medical documentation of 5 patients with carotid body paragangliomas (3 women and 2 men), age range 44 to 68 years with a mean of 59.6 years. Four of the patients were diagnosed and treated with Shamblin type II tumor, one of the patients with type I. Physical examination, radiological evaluation, method of the treatment and post-treatment complications were studied. The most common and single symptom was nonspecific neck mass. Preoperative diagnostic evaluation consisted of a color duplex ultrasonography, computerized tomography with contrast enhancement, magnetic resonance imaging and digital subtraction angiography. In all patients with Shamblin type I and II, blunt dissection of the tumor was conducted smoothly in the subadventitial plane. Postoperative vagus nerve and hypoglossal nerve deficit were reported in one case. Carotid body paraganglioma excision has higher risk of cranial nerve paresis and carotid artery injury, so it requires careful handling and good surgical skills to ensure complete removal.

Rosai–Dorfman disease: sinus histiocytosis with massive lymphadenopathy

A 25-year-old man presented with a 3 month history of a painless mass on the right side of his neck. Physical examination revealed a smooth surfaced, bilobed, 4×3 cm, semimobile mass at the right and 3×2 cm at the left jugulodigastric region. Endoscopic examination of the patient showed a granular tumour in both nasal cavities. After biopsies were taken from the mass from the nasal cavity, a diagnosis of Rosai–Dorfman disease was made. A conservative approach was taken to treatment and after the 6 month follow-up period, the patient was in a stable condition.

Myeloperoxydase Expression in The Pathogenesis of Nasal Polyps

Nasal polyps are benign mucosal protrusions that expand into the nasal cavity. There are no any etiological factors that may explain the pathogenesis of nasal polyps but currently inflammation continues to be the major factor. As a result of inflammation, neutrophils become activated and migrate to the inflammatory area and form their bactericidal effects by producing free oxygen radicals. The objective of our study is to investigate the expression of myeloperoxydase enzyme, which is usually an indicator of leukocyte infiltration and is responsible in the formation of free oxygen radicals in polyp tissues and to determine its role in the pathogenesis of nasal polyps.

The effects of allergic rhinitis on growth, development and body mass indexes in school children

ObjectiveThe purpose of this study is to determine the frequency of allergic rhinitis (AR) in children and investigate if allergenic rhinitis demonstrated any effects on developmental growth levels and body mass indexes (BMI) in children.Materials and methods651 students, between 3–15 years of age who were randomly selected from four elementary schools located at Kartal, Istanbul were assessed according to symptoms and the presence of AR by nasal examination with the aid of a 0 degree 2.7 mm hand rigid endoscope. Height and weight percentile values of students regarding growth according to age and their BMI were calculated and statically assessed. Results obtained are presented.ResultsFindings obtained from a questionnaire and clinical examination does not allow us to perform a definite differentiation regarding in school children at age 3–5. The prevalence of AR in girls is higher. However, there are no any significant differences regarding BMIs in children with or without AR (p < 0,142). But there are statistically significant differences regarding height and weight percentiles in children with and without AR. Accordingly, there was a tendency in children diagnosed with AR to display low values related with height and weight percentiles. In Pearson chi-square testing, p values of percentile values related with weight (p < 0,032) and p values of percentiles related with height (p < 0,001) were determined.ConclusionAR prevalence was higher in girls independently from BMI values. We determined a strong relationship between BMI values and AR dependant to age and gender.

MAXILLECTOMY FOR CEMENTIFYING OSSEOUS DYSPLASIA OF THE MAXILLA: A CASE REPORT

OBJECTIVES Osseous dysplasias are the most common subtype of fibro-osseous lesions of the maxillofacial bones. They are benign and often present as incidental asymptomatic lesions. Diagnosis can be made with clinical and radiographic examination. CASE REPORT This article reports the case of a 47-year-old man with a huge cementifying osseous dysplasia of the maxilla that presented with secondary infection after teeth extraction and repair of oroantral fistula. A subtotal maxillectomy had to be done after conservative treatment failed to resolve the infection. DISCUSSION/CONCLUSION Biopsy, tooth extraction or surgical trauma to the affected bones of osseous dysplasia could easily lead to severe secondary infection, the treatment of which may be very difficult, and thus should be avoided if possible.

Myeloperoxydase activity in the pathogenesis of cholesteatoma

ObjectiveThe aim of this study was to determine the effect of myeloperoxydase (MPO) in bone destruction in patients of chronic otitis media (COM) with cholesteatoma by immtino-histochemical staining and to conclude the possible relationship between bone destruction in patients with cholesteatoma accompanied with COM and MPO activity.MethodsThe study was conducted on a total number of 81 patients where 51 of the patients were enrolled in the “patient group” and 30 of the patients were enrolled in the “control group” whom were operated due to otitis media. MPO positivism was monitored when a cytoplasmic staining process was performed.ResultsMeanwhile, a significant difference is present at a statistically advanced level between the MPO levels of groups (p = 0.001; p < 0.01). However, MPO activity is absent in patients included in the control group or it can be observed at a very slight level. A moderate level or intense level of activity can be observed in patients enrolled in the study group. Excluding the destruction at the dura, all findings related with the middle ear and the erosion of the mastoid cavity and MPO activity indicated a statistically significant difference (p < 0.05). According to the destruction at the wall of the dura bone, distribution of MPO activity did not display a statistically meaningful difference (p > 0.05).ConclusionIn this study, we investigated the relationship between MPO level and bone destruction and found a significant level of correlation among the fore said. A new era may be opened in the treatment of cholesteatoma when preoperative MPO levels are determined and adequate information is obtained related with bone erosion.

The Evaluation of Relationship Between Body Mass Index and Nasal Geometry Using Objective and Subjective Methods.

Introduction: It is known that obesity causes obstructive sleep apnea syndrome by increasing upper airway resistance. Also, obese patients are admitted to the ear, nose, and throat clinic very often because of nasal obstruction complaint. The aim of this study is to identify the change and relation among body mass index (BMI), nasal resistance, reduction in nasal ariflow, nasal anatomy, and patients’ subjective complaints. Material and Method: A total of 67 patients admitted to our clinic between August 2013 and January 2014 were included in the study. The study group comprised 33 patients who had a chief complaint—nasal obstruction and the other group consisted of 34 patients who had no complaint and nasal pathology. Both the groups were checked with acoustic rhinometry (AR), active anterior rhinomanometer, nasal obstruction symptom evaluation (NOSE), and visual analog study (VAS) questionnaire. Results: There is a significant statistical correlation between the body mass increase and VAS and NOSE score increase (P < 0.05). But the authors did not find any statistically significant relation between BMI and total inspiratory and expiratory MR and MF measured by anterior active rhinomanometer and left and right nasal cavity MCA, and volume measured by acoustic rhinometery (P > 0.05). Conclusions: Contrary to belief, obesity does not change the nasal resistance, airflow, and anatomy but it can cause subjective nasal complaints.

Huge internal carotid artery aneurysm presenting as tonsillar asymmetry.

Abstract Aneurysms of the extracranial portion of the carotid artery are extremely rare. Internal carotid artery aneurysm is an uncommon cause of tonsillary asymmetry. Although internal carotid artery aneurysms usually remain asymptomatic, the clinical manifestation requires the tonsillar enlargement. Asymmetry as a sole determining factor for tonsillectomy may lead to unnecessary operations. We report a patient with a giant internal carotid artery aneurysm presenting as tonsillary asymmetry that might be mistaken for a tonsillar neoplasia. When faced with a tonsillar asymmetry, an otolaryngologist must keep aneurysms in mind.