Mustafa Tüz

The correlation between septal deviation and concha bullosa.

OBJECTIVES To investigate the incidence of concha bullosa (CB) in patients with septal deviation and the correlation between the angle of deviation and degree of pneumatization. Study and design This study was designed as a prospective trial. METHODS Computerized tomography scans of the paranasal sinuses of 100 consecutive patients with the chief complaint of nasal obstruction and the diagnosis of septal deviation were taken. CB, sinus diseases, and septal deviation angles were recorded. RESULTS Angles of deviation ranged between 3 and 25 degrees (mean, 13.0 +/- 4.1 degrees). The mean of angle of deviation in cases with CB and in cases without CB was 13.0 +/- 4.0 and 13.0 +/- 4.2 degrees, respectively. No statistical difference was found between them (P > 0.05). Pneumatization of the contralateral CB was statistically significantly higher than that of ipsilateral CB (P < 0.05). CONCLUSION Septal deviation does not appear to give rise to the formation of CB, but augments the pneumatization of the middle turbinate depending on the degree of deviation angle.

Histopathological Changes of Chorda Tympani in Chronic Otitis Media

Objective To investigate whether histopathological changes of chorda tympani might exist in patients with chronic otitis media without facial paralysis.

Free Radical Damage in Nasal Polyp Tissue

OBJECTIVE: To investigate whether the free radical injury in nasal polyp tissue exists or not. STUDY DESIGN: A prospective study in patients with nasal polyps. METHODS: Polyp specimens were obtained from 19 patients. Control specimens were acquired from 16 patients who underwent partial turbinectomy with concha bullosa free of rhinitis, sinusitis, and allergy, confirmed by endoscopic nasal examination, coronal paranasal sinus CT scan, and prick test. MDA levels of nasal polyps and control specimens were measured by using the method of Knudsen et al. RESULTS: The mean MDA levels of nasal polyps and control specimens were 38.2 ± 5.1 (33.3–52.2) and 33.9 ± 1.6 (32.6–37.4), respectively. MDA levels in NP were significantly higher compared with control specimens (P < 0.01). CONCLUSION: High level of MDA in nasal polyp tissue that represents FR increase supports the existence of cell injury in nasal polyp tissue. FRs should be considered in the development and life cycles of NP which is thought to have multifactorial pathogenesis.

What Is the Relationship Between Chronic Sinus Disease and Isolated Nasal Septal Deviation

Objective The aim of this retrospective study is to examine the role of isolated nasal septal deviation (NSD) in the pathogenesis of chronic rhinosinusitis (CRS). Study Design and Setting The interaction between isolated NSD and chronic sinus disease were retrospectively evaluated in 1452 patients. Out of 1452 patients, 152 patients were included in the study. Patients with anatomical variants other than NSD were excluded from the study. Patients with NSD were enrolled in the study group and patients without NSD were enrolled in the control group. Results There was no statistically significant difference between NSD group and non-NSD group with respect to the CRS. Conclusions The mild to moderate degree of NSD was not a risk factor for chronic sinus disease. Only gross deviation of the nasal septum itself is a risk factor for the development of CRS. Significance Excluding the subjects with ostiomeatal anatomic variations has differentiated this study from the previously reported researches (isolated NSD).

Congenital vomeral bone defect in two thalassemia trait cases

The nasal septum is composed of a perpendicular plate of ethmoid bone, quadrilateral septal cartilage, membraneous septum, crest of palatine and maxillary bone and vomer. Defects of the nasal septum may be due to a variety of causes such as trauma, infection, inhalant irritants and neoplasia. To our knowledge, up until now, congenital defect of the vomer has been presented in six cases without any nasal symptoms. We present two cases of congenital defect of vomer with thalassemia trait, the patients complaining of nasal obstruction.

Otitis media with effusion and histopathologic properties of adenoid tissue

OBJECTIVE Adenoidectomy is being generally used for the treatment of otitis media with effusion (OME). The purpose of current study was to determine objectively the significance of the histopathology of adenoid tissue on the development of otitis media with effusion. METHODS The records of all the patients operated on with the diagnosis of adenoid enlargement with or without OME were reviewed and pathologic specimen were re-evaluated regarding histopathological properties by one pathologist unfamiliar with the diagnosis. Sixty-one patients with adenoid hyperplasia were enrolled in the study group, 38 males and 23 females. Age ranged between 3 and 13 years (mean age was 7.03+/-3.26 years). All the patients of study group were those operated on due to the adenoid hyperplasia and uni- or bilateral OME. Control group was composed of 39 male and 26 female patients (age range was between 3 and 13 years, and mean age was 7.06+/-3.04 years) with solely adenoid hyperplasia. RESULTS The squamous metaplasia was present in 47 (77%) and 14 (22%) patients of study and control groups, respectively. The fibrosis of connective tissue interspersed follicles of adenoid was present in 29 (48%) and 6 (9%) patients of study and control groups, respectively. The statistical analysis revealed a significant prevalence of squamous metaplasia (P<0.001) and fibrosis of connective tissue interspersed follicles of adenoid (P<0.001) for a surgical indication of adenoid hyperplasia with OME than for without OME. The prevalence of other parameters was not significantly different between two groups. CONCLUSIONS Adenoid tissue not only exerts an obstructive influence on the eustachian tube lumen when enlarged, but also impedes (hinders) mucociliary drainage of the middle ear by the way of non-ciliated metaplastic epithelium and fibrosis of connective tissue.

Rapidly growing sublingual dermoid cyst throughout pregnancy

Dermoid cysts (DCs) are subcutaneously located cystic masses that contain epithelium and adnexal structures. They are most commonly located in the ovaries and sacral region. Seven percent of DCs are found in the head and neck. Sublingual DCs may develop above the mylohyoid, presenting in the floor of the mouth or below it, causing a submental or submaxillary mass. We presented a case with a sublingual giant DC enlarged rapidly during pregnancy manifesting deglutition and mild respiratory problems. The growth of a DC of the neck may be accelerated in pregnancy period and may ensue severe symptoms challenging both mother and fetus. We proposed the removal of sublingual DCs before attempting to conceive to eliminate the risk of rapid growth of DC that results in respiratory and deglutition problems.

Polymorphic variants of MnSOD Val16Ala, CAT-262 C < T and GPx1 Pro198Leu genotypes and the risk of laryngeal cancer in a smoking population

OBJECTIVE To investigate the relationship between development of laryngeal cancer and the presence of polymorphisms of the MnSOD Val16Ala, CAT-262 C < T and GPx1 Pro198Leu genes in a smoking population. PATIENTS AND METHODS Single nucleotide polymorphisms were determined in DNA from the peripheral blood erythrocytes of 48 heavy smokers (25 patients with laryngeal cancer and 23 cancer-free controls), using polymerase chain reaction. RESULTS There were no significant differences in age, smoking duration or smoking intensity, comparing the two groups. The homozygous AA genotype of MnSOD Val16Ala was significantly more prevalent in the cancer group than the control group (92 vs 13 per cent, respectively), while the heterozygous AV genotype of MnSOD Val16Ala was more prevalent in the control group than the cancer group (87 vs 8 per cent, respectively) (p < 0.001). There were no significant differences between the cancer and control groups regarding GPx1 Pro198Leu or CAT-262 C < T polymorphisms. CONCLUSION Polymorphism of the MnSOD Val16Ala gene may contribute to susceptibility to laryngeal cancer among smokers.

Subjective pulsatile tinnitus associated with extensive pneumatization of temporal bone.

Pulsatile tinnitus (PT) although an infrequent otologic symptom. PT can be objective (auscaltable) or subjective (non-auscultable). It has been suggested that subjective PT could occasionally be associated with vascular disorders such as arteriovenous malformation, traumatic or spontaneous carotico-cavernous fistula, intracranial aneurysms, vascular tumors of the temporal bone and cerebellopontine angle, fibromuscular dysplasia, cervical venous hums and high jugular bulb. To our literature knowledge, it has not been reported subjective PT due to extensive pneumatization of temporal bone around internal carotid artery (ICA). In this report, we present a case of subjective PT, which was caused by resonance due to extensive pneumatization of temporal bone particularly peripheral to the ICA.

Improvement in bone conduction threshold after tympanoplasty

ABSTRACT OBJECTIVE: To investigate the causes of bone conduction threshold impairment associated with middle ear pathoses and the factors influencing improvement in bone conduction threshold after tympanoplasty. STUDY DESIGN AND SETTING: The records of 98 consecutive patients with unilateral chronic otitis media who underwent tympanoplasty were reviewed. Pre-operatively, 15 dB or more depression of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was considered to be significant. Similarly in the postoperative period, 15 dB or more improvement of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was regarded as significant. RESULTS: Twelve (12.5%) of 98 cases were found to have depressed bone conduction threshold; 6 of 12 cases had improved bone conduction threshold after tympanoplasty. CONCLUSION: In cases with cholesteatoma and extensive middle ear disease, successful results could be achieved after tympanoplasty disregarding the air-bone gap and deteriorated bone conduction threshold. SIGNIFICANCE: Bone conduction threshold may improve after tympanoplasty.