Rifat Karli

Mean Platelet Volume: Is It a Predictive Parameter in The Diagnosis of Sudden Sensorineural Hearing Loss?

The mean platelet volume (MPV) is associated with increased platelet reactivity and increased atherothrombosis. High MPV values are a risk factor for thrombotic vascular diseases. Our aim was to investigate whether a relationship exists between sudden sensorineural hearing loss (SSHL) and a high MPV value. The records of 46 patients who were admitted to the ENT (ear nose throat) ward for SSHL and received medical treatment and 46 patients in a control group were retrospectively screened. The correlation among the levels of the MPV, the number of platelets, and SSHL were evaluated in the two groups. The ages, genders, and the platelet count values of the patients showed a normal distribution in both groups. No significant difference was found for the MPV values between the groups. The MPV is not a predictive parameter in the diagnosis of SSHL.

Correlation of symptoms with total IgE and specific IgE levels in patients presenting with allergic rhinitis

Objective: The objective of this study was to investigate the correlation of symptoms in patients with presumed allergic rhinitis on the basis of their medical history and physical examination with the levels of total immunoglobulin E (IgE) and specific IgE, and to question the necessity of these tests in diagnosis. Methods: The records of 295 patients, who had at least two complaints of nasal itching, nasal obstruction, runny discharge and sneezing, and/or presumed as allergic rhinitis on physical examination findings were retrospectively screened. The correlation between the levels of IgE, specific inhalant IgE, and food-specific serum IgE were evaluated in these patients. Results: A total of 70 cases (23.7%) were determined to have a total value of IgE under 20 U/ml, 113 cases (38.3%) with IgE values between 20 U/ml and 100 U/ml, and 100 cases with IgE values above 100 U/ml. Results of total IgE could not be obtained in 12 (4.06%) patients. Dermatophagoides farinae was the most common allergy in this group with 74 (68.5%) cases. Conclusions: The determination of IgE in allergic rhinitis is a supportive method. However, it cannot be recommended for routine use because of the time loss and high cost.

A Possible Cause of Nasolacrimal Duct Obstruction: Narrow Angle Between Inferior Turbinate and Upper Part of the Medial Wall of the Maxillary Sinus

Abstract Background: To search the relationships between the primary nasolacrimal duct obstruction and the angle between the bony inferior turbinate and upper part of the medial wall of the maxillary sinus. Design: Retrospective study. Participants and methods: Computed tomography findings of 35 patients with primary nasolacrimal duct obstruction and 100 sides of 50 individuals were reviewed. While the study group was composed of patients who had external dacryocystorhinostomy surgery, the control group was composed of patients who had CT scans due to headache, sinusitis and smell dysfunction. Epiphora complaint was evaluated with the lacrimal syringing. The exclusion criteria were: age less than 20 years, previous nose, sinus, turbinate or lacrimal surgery, prior history of maxillofacial fracture, nasopharyngeal malignancy, reflex hypersecretion, and associated pathology of the lacrimal canaliculi. Main outcome measures: The angle of inferior turbinate. Results: The mean angles were 53.2° (range, 37.9–82.9°) for affected side of the study group, 58.6° (range, 32–85.3°) for the unaffected side of the study group and 56.8° (range, 41.2–76.9°) in the control group. The difference between the angles was statistically significant between the study and the control groups (p < 0.05). The difference between the operated and non-operated sides of the study group was also statistically significant (p < 0.05). Conclusion: Although this study was performed in a small group, we thought that the narrow angle between the bony inferior turbinate and upper part of the medial wall of the maxillary sinus might be a possible causative factor in primary acquired nasolacrimal duct obstructions.

The relationships between the clinical and polysomnographic findings and the olfactory function in patients with obstructive sleep apnea syndrome

PurposeThis study aimed to investigate the relationships between the clinical and polysomnographic findings and the olfactory test results in patients with obstructive sleep apnea syndrome (OSAS).MethodsFour groups were established: non-snoring controls (group 1), non-apneic snorers (group 2), mild–moderate OSAS (group 3), and severe OSAS (group 4). The polysomnographic findings, otorhinolaryngologic findings, Epworth Sleepiness Scale (ESS), and Sniffin’ Sticks olfactory test results of the four groups were compared. The relationships between the clinical data and the olfactory parameters were evaluated.ResultsGroup 4 had the worst odor identification and discrimination scores. Non-apneic snorers also had worse odor parameters compared with the non-snorer controls. A significant negative correlation was found among the ESS, apnea–hypopnea index (AHI), mean arterial oxygen saturation, and odor identification and discrimination. Significant negative correlations were found between the tongue and tongue base sizes and among all olfactory parameters.ConclusionOur study revealed olfactory dysfunction in patients with OSAS. A strong negative correlation between the olfactory parameters and the severity of sleep apnea was also found. Olfactory tests may be used to predict the presence and severity of OSAS in the future.

Evaluation of olfactory function in adults with primary hypothyroidism

Sufficient clinical data are not available on the effect of hypothyroidism on olfactory function in adults. In this study, we aimed to evaluate the olfactory function of adult patients diagnosed with primary hypothyroidism.

Peripheral Osteoma of Mandibular Angulus: Analysis of the Literature and Report of a New Case

Osteoma is a benign osteogenic neoplasm originating from the continuous proliferation of compact and/or cancellous mature bone. The tumor can be classified as peripheral, central or extra-skeletal regarding location and it commonly seen in the cranio-facial region especially at the skull and paranasal sinuses. The exact etiology of the tumor is still controversial; however, it is considered that infection, trauma, muscle activity contributes the occurrence of the tumor. Due to the slow growing nature of osteoma, it is coincidentally detected on radiographs or when the tumor reaches a large size enough to trigger symptoms and cause facial disfigurement. Although mainly detected in the craniofacial bones, osteomas are rarely located in the jaw bones. The purpose of this review, is to present the diagnosis and treatment plan of a peripheral osteoma in the mandibular angulus region of an 8-year-old boy together with a review of published cases of peripheral osteomas of mandibular angulus.

Treatment-failure tularemia in children

Purpose Tularemia is an infection caused by Francisella tularensis. Its diagnosis and treatment may be difficult in many cases. The aim of this study was to evaluate treatment modalities for pediatric tularemia patients who do not respond to medical treatment. Methods A single-center, retrospective study was performed. A total of 19 children with oropharyngeal tularemia were included. Results Before diagnosis, the duration of symptoms in patients was 32.15±17.8 days. The most common lymph node localization was the cervical chain. All patients received medical treatment (e.g., streptomycin, gentamicin, ciprofloxacin, and doxycycline). Patients who had been given streptomycin, gentamicin, or doxycycline as initial therapy for 10–14 days showed no response to treatment, and recovery was only achieved after administration of oral ciprofloxacin. Response to treatment was delayed in 5 patients who had been given ciprofloxacin as initial therapy. Surgical incision and drainage were performed in 9 patients (47.5%) who were unresponsive to medical treatment and were experiencing abcess formation and suppuration. Five patients (26.3%) underwent total mass excision, and 2 patients (10.5%) underwent fine-needle aspiration to reach a conclusive differential diagnosis and inform treatment. Conclusion The causes of treatment failure in tularemia include delay in effective treatment and the development of suppurating lymph nodes.

Coincidentally Identified Case of Minor Salivary Gland Adenoid Cystic Carcinoma

Submit Manuscript | http://medcraveonline.com sinuses, pharynx and larynx. Adenoid Cystic Carcinoma (ACC) (or Cylindroma) is the most common cancer of the minor salivary glands [1]. The typical localisation of the tumor is palate, particularly the junction of the soft and hard palate [2]. It consist of 1-2% of all head and neck malignant neoplasms and 10-15% of all salivary gland tumors [3]. It is commonly seen in women at 5th6th decades [4]. Typical features of ACC’s are indolance , slow growth, local recurrence, perineural invasion and potential of distant metastases [5,6]. Due to these features, diagnosis and treatment of ACC can be difficult. Surgery, radiotherapy, chemotherapy or combined therapy can be used for ACC treatment [7]. Surgical resection with wide margins and post operative radiotherapy is the most preferred method for treatment [8]. Different ratios are reported for tumor recurrence and can be up to 42% [8]. In this study, we present a 50 years old female patient who was diagnosed with ACC in her hard palate. We discussed the preferred treatment method of the tumor in the lights of current literature.

Persistent lingual paresthesia caused by a displaced tooth fragment: a case report and literature review

Accidental displacement of the third molar tooth or its fragment into the anatomical spaces is a rare but potentially serious complication. The most common sites of mandibular third molar displacement are the sublingual, submandibular, and pterygomandibular spaces. Removal of a displaced tooth or its fragments from these spaces may be difficult due to poor access and the vital structures involved in these spaces; therefore, removal may result in permanent damage. This article is intended to provide a concise update of the reported cases of submandibular displacement and to present a case of intraoral management of mandibular third molar root fragments that were displaced into the submandibular space.

Pediatric Intranasal Lobular Capillary Hemangioma: A Rare Clinical Entity

Address for Correspondence: Dr. Uğur Yıldırım, Department of Otolaryngology and Head and Neck Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey Phone: +90 505 631 39 11 e-mail: uguryildirimkbb@gmail.com Received: 10 May 2017 Accepted: 25 June 2017 • DOI: 10.4274/balkanmedj.2017.0496 Available at www.balkanmedicaljournal.org Cite this article as: Yıldırım U, Karlı R, Gün S. Pediatric Intranasal Lobular Capillary Hemangioma: A Rare Clinical Entity. Balkan Med J 2017;34:586-7 ©Copyright 2017 by Trakya University Faculty of Medicine / The Balkan Medical Journal published by Galenos Publishing House. A 9-year-old male presented to our clinic with symptoms of a right-sided intermittent epistaxis for the past one year. There was no headache, fever, trauma, nasal packing or history of foreign body. Besides there was no similar symptoms or illness in the family. On physical examination, both nasal cavities were normal in anterior rhinoscopy. The patient and her parents were informed about endoscopic nasal examination and after thier permittion, endoscopic nasal examination was performed. Endoscopic nasal examination revealed that a violescent mass which located between inferior turbinate and nasal septum at the posterior one-third of the right nasal cavity. The origin of the mass couldn’t be identified. The ear and throat examination was normal. Furthermore complete blood count and routine biochemical analysis were normal. Axial and coronal nasal and paranasal sinus computed tomography was performed. computed tomography revealed a right-sided soft tissue mass arising from posterior part of the inferior turbinate, and maxillary and ethmoid sinusitis (Figure 1). Informed consent was taken from the patient’s parents. Endoscopic intranasal excision was performed under general anesthesia. In the right nasal cavity, there was a pedunculated, purplish, irregular necrotic mass which bleeds on touch originating from a region near the base at the posterior one-third of the nasal septum (Figure 1b). The lesion and the septal mucousa which was source of the mass was completely excised using cold dissection (Figure 1c). The patient was discharged without any complication two days after the operation. Histopathologic examination revealed lobular capillary hemangioma (Figure 1d). No recurrence was observed in the 3-month after the surgery. Lobular capillary hemangioma which is also known as pyogenic granuloma typically occurs on the skin and in the oral cavity. Nasal cavity is an uncommon area for lobular capillary 1Department of Otolaryngology and Head and Neck Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey 2Department of Pathology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey Uğur Yıldırım1, Rıfat Karlı1, Seda Gün2