Sabri Uslu

Accessory Nerve Function After Modified Radical and Lateral Neck Dissections

Objectives: Evaluate preoperative and postoperative electrophysiological changes related to the accessory nerve with reference to dissection technique, modified radical neck dissection, and lateral neck dissection.

Surgical treatment of elongated styloid process: experience of 61 cases.

AIM To describe the management of patients with elongated styloid process syndrome (Eagles syndrome). MATERIALS AND METHODS Sixty-one patients with elongated styloid process were treated between 2000 and 2005. Computed tomography examination defines those whose symptoms suggest the diagnosis. Patients with styloid processes longer than 25 mm were treated by surgical resection. RESULTS Fifty-seven (93.4%) of 61 patients treated for Eagles syndrome became asymptomatic after resection. There were no serious complications. CONCLUSION Patients with clinically and radiologically established elongated styloid process can be managed successfully by surgical resection using an external approach.

Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone

Variations of the vascular structures related with the temporal bone may cause important problems in diagnosis, treatment planning and surgery. High resolution computed tomography (CT) scans of 700 temporal bones of 350 patients were retrospectively examined for the incidence of dehiscent jugular bulb, high jugular bulb, diverticulum of jugular bulb, anteriorly located sigmoid sinus and dehiscent internal carotid artery. Dehiscent jugular bulb was seen in 27 (3.9%), high jugular bulb was seen in 142 (20.3%), jugular bulb diverticulum was seen in 55 cases (7.9%). The average distance between external acoustic canal and sigmoid sinus was found to be 13.3 mm and in 12.4% of the cases this distance was < 10 mm. Of 700 temporal bones, 10 (1.4%) showed dehiscent carotid canal. To aid diagnosis, treatment planning and surgery, CT scanning is currently a very reliable tool in determining these conditions. Special attention should be paid to the position of the vascular structures in the preoperative temporal bone CT scans.

Lymphatic Metastasis to the Supraretrospinal Recess in Laryngeal Squamous Cell Carcinoma

In order to evaluate lymphatic metastasis to the supraretrospinal recess (SRSR) in laryngeal squamous cell carcinoma (SCC), we separately dissected SRSR lymph nodes and submitted them to pathological examination. Fifty-three lateral neck dissections (LNDs), 2 radical neck dissections (RNDs), and 19 modified RNDs were performed in 49 previously untreated patients with laryngeal SCC. The nodal status of the patients was NO in 29 patients, N1 in 17, and N2 in 3. The neck was pathologically positive in both RNDs (100%), in 7 of 19 modified RNDs (37%), and in 7 of 53 LNDs (13%). No SRSR lymph nodes were positive in any of the dissection materials. No metastasis was found in the SRSR lymph nodes in the N0 necks treated with LND, and none was found even in N1 and N2 necks treated with RND or modified RND. We conclude that the SRSR may be left undissected during treatment of an N.0 neck with LND so that accessory nerve dysfunction can be minimized and operative time can be saved.

Accessory nerve function in lateral selective neck dissection with undissected level IIB

Background: To investigate the accessory nerve function in lateral selective neck dissections (LSND) performed in laryngeal squamous cell carcinoma patients without dissection of level IIB. Methods: Fifteen LSND were performed in 11 N0 laryngeal carcinoma patients with preservation of level IIB. Distal latencies, compound muscle action potentials (CMAP), and electromyography findings were investigated before surgery, during the 3rd postoperative week, and 3 months thereafter to compare the effects of the procedure on the accessory nerve. Results: Distal latencies and CMAP values were significantly lower in the early and late postoperative periods when compared with preoperative values. In 8 patients, there was no motor unit potential (MUP) in the early postoperative period. However, in the late postoperative period, there was no MUP loss. Conclusions: Only temporary functional deterioration of the accessory nerve was seen in patients in whom LSND was performed with undissected level IIB.

Clinical presentation of a sphenochoanal polyp.

Abstract Although choanal polyps frequently arise from the maxillary sinus, a choanal polyp originating from the sphenoid sinus is a rare entity. In this report, an unusual case of a large choanal polyp taking origin from the sphenoid sinus is presented. The reasons for its development and methods of management are discussed.

Can Bile Acids Be an Etiological Factor for Laryngeal Carcinoma

Purpose: The objective of this study is to show the accumulation of bile acids in laryngeal tissues of laryngeal carcinoma patients. Materials and Methods: The present study compared the total bile acid level in the hypopharyngeal tissue, tumor tissue, and blood of 21 primary laryngeal carcinoma patients (study group) to that in the hypopharyngeal tissue and blood of 15 patients with benign laryngeal lesions (control group). Results: The total bile acid level was significantly higher in the tumor and hypopharyngeal tissues of the study group than in the hypopharyngeal tissues of the control group; however, the difference in the blood total bile acid level between the 2 groups was not significant. Conclusion: Bile acids in reflux material accumulate in the laryngeal tissue in laryngeal carcinoma patients; therefore, bile acids should be considered a carcinogenic factor in the etiology of laryngeal carcinoma because of their mutagenicity due to DNA breaking, as they cause chronic inflammation due to intracellular accumulation.

Comparison of pharyngoesophageal segment pressure in total laryngectomy patients with and without pharyngeal neurectomy

To compare pharyngoesophageal segment (PES) pressure values in total laryngectomy patients with and without pharyngeal neurectomy (PN) in the early postoperative period.

Submandibular accessory salivary gland causing Warthin's duct obstruction

Submandibular masses are mostly secondary to sialolithiasis. Salivary gland tumors should be considered in the differential diagnosis. In this case report, an unusual cause of Warthins duct obstruction caused by an accessory salivary gland tissue is presented.

Intracerebral tension pneumocephalus complicating endoscopic sinus surgery: case report

BackgroundVarious forms of intracranial air have been described in the literature.AimThis report aims to present clinical, radiological and intraoperative findings of a rare intracranial air entrapment case after endoscopic sinus surgery.