Senol Polat

Temperature-controlled radiofrequency tonsil ablation for the treatment of halitosis

The objective of the study was to evaluate the efficacy and safety of temperature-controlled radiofrequency (RF) tonsil ablation in the treatment of halitosis caused by chronic tonsillitis with caseum. The study method was retrospective. The medical records of 58 patients undergoing temperature-controlled RF tonsil ablation due to chronic tonsillitis with caseum between November 1, 2005 and November 30, 2008 were reviewed. Forty-nine (84.4%) of 58 patients reported complete disappearance of bad breath after the first treatment; five patients (8.6%) reported as having insufficient improvement and four (6.9%) patients had no change. Two patients from “insufficient group” and all four patients from “no change” group agreed to a repeat treatment. After the second session, four (6.9%) patients reported complete disappearance of halitosis with the disappearance of caseum formation. But two patients still suffered from halitosis. One of these patients underwent tonsillectomy, other patient is under our follow-up. Overall, complete elimination of halitosis was accomplished with one session in 49 (84.4%) patients, two sessions in four (6.9%) patients, making a total of 53 (91.3%) patients. Postoperative morbidities included one transient mild bleeding, one secondary bleeding and one mild edema. Temperature-controlled RF tonsil ablation is an effective method for treating halitosis which derived from chronic tonsillitis with caseum. This well-tolerated technique avoids the post-procedure morbidities and discomfort of more invasive surgical modalities currently used.

Incidental diagnosis of mastoiditis on MRI

The aim of this study was to document patients with clinical mastoiditis who were reported to have mastoiditis by radiologists due to increased fluid signal intensity in the mastoid air cells on magnetic resonance imaging (MRI). Brain and temporal bone MRI reports between January 2004 and November 2009 were obtained from the radiology units of four different hospitals of the same Health Care Group. MRI reports for keyword mastoiditis and 406 patients were reported to have radiological mastoiditis on MRI due to increased fluid signal intensity. Otoscopic examination findings of 275 of these 406 radiological mastoiditis patients were documented and compared with MRI reports for clinical infectious otological disease. Forty-eight (17, 45%) (48/275) patients were found to have clinical otological disease on examination. The remainder of the patients (227/275, 82%) did not show any evidence of clinical otologic infectious disease. Of these 48 patients, 18 patients (37, 5%) had eustachian tube dysfunction, 13 patients (27%) had serous otitis media, nine patients (9%) had chronic otitis media, five patients (10%) had tympanosclerosis, and three patients (6%) had acute otitis media. The results of this study showed that MRI is not an effective diagnostic tool for mastoiditis. 82% of the MRI mastoiditis did not show clinical mastoiditis contradicting MRI reports. Fluid signal in the mastoid on MRI should not always be interpreted as mastoiditis by radiologists. Radiological mastoiditis does not necessarily point out to clinical mastoiditis.

Will a crushed concha bullosa form again

This study endoscopically and radiologically evaluated whether a surgically crushed concha bullosa (CB) can form again.

Ossicular Reconstruction for Incus Long-Process Defects: Bone Cement or Partial Ossicular Replacement Prosthesis

Objective The objective of this study was to compare hearing results in patients undergoing ossiculoplasty with bone cement (BC) vs partial ossicular replacement prosthesis (PORP) in cases of incudostapedial discontinuity during tympanoplasty surgeries. Study Design Case series with chart review. Setting Tertiary referral center. Subjects A total of 44 patients with incudostapedial discontinuity, 21 operated on with BC and 23 operated on with PORP, were enrolled in this study. Methods Preoperative and postoperative audiograms at 12 months were evaluated. Pure-tone averages and air-bone gaps (ABGs) were calculated according to the guidelines. Results The ABG was 26.61 dB preoperatively and 9.76 dB postoperatively in the BC group. The hearing gain in ABG was statistically significant (P = .0001). The preoperative and postoperative ABGs in the PORP group were 29.48 and 8.89 dB, respectively. The hearing gain in ABG was statistically significant (P = .0001). When the groups were compared for mean gains in the ABG, the difference was not statistically significant (P = .192). The postoperative ABG of less than 20 dB was achieved by 90.4% in the BC group and 86.9% in the PORP group. This difference was not statistically significant (P = .745). No adverse reactions or complications were observed. Conclusions Both BC and PORP are reliable and efficient methods for the repair of incudostapedial joint defects. There is no difference between these 2 methods, based on the hearing results. Additional research is necessary to determine the maximum incudostapedial defect length suitable for bone cement repair.

The Morphology of Nasopharyngeal Inlet in Obstructive Sleep Apnea

Objective: Routine flexible optic laryngoscopy (FOL) displays obstructive sleep apnea (OSA) related airway passages from nasopharynx to hypopharynx. Tip of the flexible endoscope awaiting at the nasopharyngeal inlet allows us to visualize the morphology of this area. We wanted to evaluate the impact of nasopharyngeal inlet (NPI) morphology on OSA severity. Method: The videos obtained during FOL examinations of NPI were examined in 83 patients (10 women, 73 men). Two main morphologies, wide and narrow, were depicted. The narrow NPI group was further divided into kidney-shaped, elliptical, and circumferential. The wide NPI group was divided into circumferential and kidney-shaped. Results: Forty-five patients had narrow NPI morphology, and 38 had wide NPI morphology. The wide NPI group had 20 circumferential and 18 kidney-shaped morphologies. The narrow NPI group had 34 kidney-shaped, 6 circumferential, and 5 elliptical morphologies. Mean RDI of the narrow group was 30.378 ± 22.358, and the wide group was 14.511 ± 13.901. Mean RDI of the narrow circumferential group was 45.317 ± 30.56, the narrow elliptical group was 23.74 ± 10.787, and the narrow kidney-shaped group was 28.718 ± 21.47. Mean RDI of the wide circumferential group was 11.3 ± 13.203, and the mean RDI of the wide kidney-shaped group was 17.772 ± 14.586. The wide morphology groups had lower RDI levels compared to the narrow morphology groups (P < .0005). Conclusion: Morphology of nasopharyngeal inlet may be evidence of OSA during routine FOL examinations. Further analysis of the subgroups supported evidence of narrowing by means of increased RDI levels.

Quantification of Retropalatal Region in Sleep Apnea

Objective: Fiberoptic nasopharyngolaryngoscopy (FNPL) allows us to visualize the obstructive sleep apnea (OSA) related airway passages. However, objective data presenting evidence of OSA through this perspective is lacking. The aim of this study was to quantify the surface area of the retropalatal region in normal and OSA patients utilizing FNLP images. Method: Fifty-two OSA patients in group 1 and 68 patients with no complaints of OSA in group 2 were retrospectively evaluated. Retropalatal region photos were captured at the base of uvula through endoscopic images. Retropalatal surface area (RPSA) was measured using AutoCad. Results were analyzed using unpaired t test. Results: The RPSA measurements in group 1 were between 20 and 143 [mean (sd) 64.13 (27.4)]. The RPSA measurements in group 2 were between 51 and 202 [mean (sd) 121.9 (32.4)]. The mean difference was 57.761. RPSA values of group 2 were significantly higher than group 1. Conclusion: The RPSA is significantly higher in OSA group 2, implicating prediction of OSA. Therefore, RPSA can be used as a sign of OSA during FNLP.