Orhan Kemal Kahveci

The efficiency of Nose Obstruction Symptom Evaluation (NOSE) scale on patients with nasal septal deviation.

OBJECTIVE The aim in this study was to evaluate the efficiency of Nasal Obstruction Symptom Evaluation (NOSE) scale for septoplasty (without turbinate reduction) in comparison with other examination methods. METHODS Prospective observational study was undertaken in otolaryngology department of university hospital. NOSE scale for quality of life assessment, visual analog scale for examination findings, acoustic rhinometry and coronal computed tomography were performed before and after septoplasty. The efficiency of NOSE scale to assess for septoplasty results and the correlation between NOSE scores and other techniques was analyzed. RESULTS Twenty-seven patients underwent septoplasty; there was a very significant improvement in mean NOSE scores of patients (60.2 versus 11.28, p<0.01). There was no correlation between NOSE scores and acoustic rhinometry. Correlation was found between NOSE scores and examination and computed tomography findings (p<0.05). CONCLUSION NOSE scale that is well correlated with examination findings and computed tomography, is very useful tool to evaluate the effectiveness of pure septoplasty.

Hearing and cochlear function of patients with ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects the spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of the cochlear system in patients with AS. Thirty-seven AS patients and 20 healthy controls were evaluated prospectively. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech discrimination test, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, and hematologic findings (CRP and ESR) were also collected. Pure tone audiometry findings of the patients and controls were significantly different in all frequencies (p < 0.01). Speech discrimination scores were also significantly different (p < 0.01). No significant difference was found between DPOE responses of the patients and controls (p > 0.05). There was no correlation between disease duration, BASDAI scores, hematological findings, and audiometry findings (p > 0.05). This study demonstrated that there is an association between AS and hearing loss, but the cochlea is not the main source of hearing loss.

Patients with osteoporosis have higher incidence of sensorineural hearing loss

Osteoporosis is a common metabolic disorder that causes progressive changes in bone structure. Metabolic changes and possible degeneration of middle ear ossicles or the cochlear capsule may cause hearing loss in patients with osteoporosis. The aim of this study was to evaluate the hearing function and otolaryngologic symptoms of patients with osteoporosis.

Expression and distribution of aquaporin-1 in nasal polyps: does it have any significance in edema formation?

Background The aim of this study was to investigate the expression of Aquaporin 1 (AQP1) and AQP4 in polyp tissue. Methods Nasal polyps were obtained from 34 patients with nasal polyposis during endoscopic sinus surgery. Bullous middle turbinates with normal-appearing mucosa of 10 patients were used as controls. Expression of AQP1 and AQP4 water channels were determined by immunohistochemical methods. Results AQP1 has been found to be expressed in fibroblasts located in polyp tissue, especially in the subepithelial area, periphery of seromucous glands, and endothelial cells of venules. Conclusion We have established a high expression of AQP1 water channels in nasal polyp tissue and have suggested two mechanisms to explain this finding. Increased AQP1 expression may be a cause or a consequence of edema formation. Thus, additional studies are needed to elucidate the true mechanism underlying this relationship.

Facial paralysis and mediastinitis due to odontogenic infection and poor prognosis.

Cervical necrotizing fasciitis (CNF) is a rare, rapidly advancing infection that involves the skin, the subcutaneous fibrofatty tissue, as well as the superficial and deep fascia and can cause life-threatening complications. The most frequent initiating factors in the head and neck region are a primary odontogenic infection, a peritonsillar infection, as well as posttraumatic or iatrogenic skin and mucosal injuries. Necrotizing fasciitis (NF) can expand within hours, and the reported mortality rate is up to 75% with delay interference. If the patients have any risk factors, poor prognosis can be seen. In this study, 1 patient with CNF with a history of peritonsillar infection and 2 patients with CNF who had a history of odontogenic infection with spreading to the temporal region and the mediastinum were described, with information of the literature and a clinical experience that was gained from 5 patients with NF who were seen at our clinic in the recent year, despite the fact that CNF was not seen up to last year. None of the patients had any risk factors. One of them had a worse clinical state with ascending infection to the temporal region, cranial nerve paralysis, and descending necrotizing mediastinitis, but he recovered from NF. After the oral intake began, dyspnea due to aspiration was seen and he died because of sepsis and multiorgan dysfunction. We aimed to attract attention to the importance of dental pathologies and increased mortality in a healthy patient.

Combined medical and surgical therapy improves olfaction in patients with nasal polyposis.

Objective: The aim of the present study was to evaluate the outcomes of combined oral steroid, nasal steroid and surgical therapy in patients with impaired olfaction due to nasal polyposis. Patients and Methods: This prospective observational study was undertaken in the otolaryngology department of a university hospital. During the study, 19 nasal polyposis patients were evaluated three times, i.e. before oral steroid therapy, before surgery (after steroid therapy) and after surgery, with smell identification tests, acoustic rhinometry, subjective smell score, endoscopic grading and a visual analog scale for nasal obstruction. Results: All subjective and objective measures were significantly improved after medical and surgical therapy (p < 0.01). The median smell identification score improved from 2 (interquartile range 0–4) to 5 (interquartile range 4–7) after combined therapy. Smell identification scores were found to be modestly correlated with all other examination findings. Conclusion: Combined therapy seems efficient in improving smell identification scores of nasal polyposis patients.

Damak ve Parafarengeal Bölgeden Kaynaklanan Farklı İki Dev Pleomorfik Adenom Olgusu

Pleomorphic adenoma is the most common of minor salivary gland tumors. Pleomorphic adenoma of minor salivary glands are commonly located on the palate nevertheless rarely may originate from the parapharyngeal region. Pleomorphic adenomas on the palate show slow growth over the years. The tumors that originate from the parapharyngeal region could reach great dimensions. In this case report, an orphan and neglected geriatric patient who had giant pleomorphic adenoma on the palate and a young patient with a giant pleomorphic adenoma that was excised by transcervical approach without additional surgical procedures at the parapharyngeal region, were presented

Investigation of temporal bone asymmetry in cases with unilateral tinnitus: morphometric and multicentric clinical study

The aim of this multicentric study was to compare the anatomical structures of temporal bone in patients with unilateral tinnitus with their healthy ears. We also aimed at evaluating whether age and gender-related asymmetrical changes occur in temporal bones or not. Fifty two ears of 26 patients who had unilateral tinnitus were included into the retrospective study. The patients who had subjective nonpulsatile tinnitus and who previously had temporal computed tomography according to their file records were accepted to study. Temporal CT scans and audiometric results of patients were examined retrospectively. Middle ear volume, diameter of internal acoustic meats and diameter of jugular bulb were evaluated by both anatomist and radiologist, interobserverly. Internal acoustic meats and jugular bulb were found larger in the ears that had tinnitus than healthy ears; however, there was no statistically significance. The stereological morphometrical study of temporal bone asymmetry in humans correlate with sex is of importance for both otolarygologs and anatomists. These results will contribute to data on middle ear volume, internal acustic meats and jugular bulb sizes.

Is Mastoid Pressure Dressing Necessary

Objective: Assess whether mastoid pressure dressing is necessary after ear surgery to prevent complications such as hematoma or protruding ear. Method: Thirty-seven patients were included in the study. Of the 37 patients, 17 were in the mastoid dressing group and 20 were in the no-mastoid dressing group. We measured the distance from mastoid scalp to helix rim at the most posterior level of upper auricular rim in the operated and non-operated ears. Results: For mastoid to helix distance of the operated ears of the patients, there was no statistically significant difference between the mastoid dressing group and the no-mastoid dressing group. We found a significant difference for the measured distance between operated and nonoperated ears of the mastoid dressing group, the mean value of distance in the operated ears being lower than that in the nonoperated ones (P > .05). Conclusion: This study showed that mastoid to helix distance did not change significantly when the mastoid dressing was not applied, while mastoid dressing seemed to decrease the mastoid-to-helix distance. For his reason, the application of a mastoid pressure dressing following ear surgery seems to be unnecessary and may contribute to increased wound morbidity.

Evaluation of Hearing and Cochlear Function in Patients with Ankylosing Spondylitis

Objective: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of cochlear system in patients with AS. Method: We prospectively evaluated 37 AS patients and 20 healthy controls. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech tests, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Basdai scores, and hematolgic findings (CRP, Sedimentation) were also collected. Results: Pure tone audiometry findings and of the patients and controls were significantly different in all frequencies (P > .05). No significant difference was found between DPOE responses of the patients and controls (P > 0.05). Conclusion: This study demonstrated that there is an association between AS and hearing loss. But the cochlea is not the main source of hearing loss.