Taylan Gün

Giant cell reparative granuloma originating from the ethmoid sinus

Giant cell granuloma is a reactive osseous proliferation and is histologically benign despite its aggressive clinical course. It usually involves the maxilla and the mandible in the region of the head and neck. It is rare in the ethmoid region. In this paper, an aggressive and recurrent giant cell reparative granuloma, which is recurred in a very short time period, originating from the ethmoid sinus is presented and the criteria for the differential diagnosis are noted in the light of the histological, clinical and biochemical parameters and the literature is reviewed.

A novel predictive marker for the viscosity of otitis media with effusion.

OBJECTIVES To evaluate the significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for the prediction of the viscosity of otitis media with effusion. METHODS This retrospective study was performed on 81 patients who were admitted to the otolaryngology clinic.The patients were divided into two groups according to their effusion type, as serous or mucoid, which was defined intraoperatively after myringotomy. The NLR and PLR were calculated as a simple ratio between the absolute neutrophil/platelet and absolute lymphocyte counts.Tympanostomy tube insertion was performed for all cases.Under direct visualization, the effusion was aspirated and classified as serous or mucous. RESULTS We postulated that an NLR value of less than 1.38 may show mucoid effusion and if the PLR value is less than 97.96, the effusion is mucoid. CONCLUSIONS We speculate that a useful predictor of viscosity for a middle ear effusion could prevent unnecessary surgeries and additional costs in the treatment of EMO. Additional studies are needed to confirm our results.

Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study

Abstract Objectives: (1) To evaluate the effects of a platelet-rich fibrin (PRF) membrane in the repair of traumatic tympanic membrane (TM) perforations; and (2) to compare the use of a PRF membrane with the paper patch technique with regard to recovery rates, healing time, and correction of the mean air–bone gap. Methods: A randomized, prospective analysis was performed for 60 patients who were treated for traumatic TM perforations using one of the two methods. Closure rate, speed of healing, and hearing gain were compared between the PRF (Group 1) and paper patch (Group 2) groups. Results: Closure was obtained in 28 (93%) perforations in Group 1 and 25 (83%) perforations in Group 2 (p > 0.05). On day 10, full closure of the TM was observed in 24 (80%) patients in Group 1 and 16 (53%) patients in Group 2 (p < 0.05). The improvement in the mean air–bone gap was 14.1 dB in Group 1 and 12.4 dB in Group 2 on post-operative day 45 (p < 0.05). Conclusions: In comparison with the paper patch method, PRF, a new method, provided more rapid healing with more successful audiological results, and with no requirement for a second procedure.

Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations.

OBJECTIVE To compare the efficacy of three different myringoplasty techniques, namely hyaluronic acid fat graft myringoplasty (HAFGM), fat graft myringoplasty (FGM), and temporal fascia for the closure of different sizes and sites of tympanic membrane perforations. MATERIALS AND METHODS We retrospectively analyzed the medical records of patients who had undergone a type 1 tympanoplasty operation at our clinic between May 2007 and February 2013. The patients were divided into three groups depending on the patients choice of technique as follows: Fat Graft Myringoplasty (FGM) (Group I), Hyaluronic Acid Fat Graft Myringoplasty (HAFGM) (Group II), and Temporalis Fascia (TF) (Group III). A total of 136 patients were included in the study, split in to the FGM (57 patients; 56.1% female; median age: 30 years), HAFGM (31 patients; 54.8 female; median age: 25 years), and TF (48 patients; 58.3% females; median age: 33 years) surgery technique groups. RESULTS The patients were further divided into two groups, depending on the size of the perforation (small and large), and into three groups, depending on its location (anterior, inferior, and central). None of techniques provided a significantly better success rate in terms of perforation location (p>0.05). Also, none of the techniques provided a significantly better success rate in terms of perforation size (p>0.05). CONCLUSION We propose using HAFGM for large perforations and FGM alone for small perforations. The TF technique is a successful and well-defined technique for tympanic membrane perforations; however, in our opinion, its technical difficulties make it a secondary choice, particularly for small-sized perforations.

A Comparison of Cartilage Palisades and Temporal Fascia in Type 1 Tympanoplasty for Bilateral Tympanic Membrane Perforations in Children.

OBJECTIVE To compare the graft success rates and audiological outcomes of bilaterally performed type 1 tympanoplasty using cartilage palisades or temporal fascia in children. MATERIALS AND METHODS We retrospectively analyzed the medical records of patients who underwent type 1 tympanoplasty at Medical Park Hospital between May 2007 and February 2013. 27 patients (54 ears) were enrolled in the study: 15 (30 ears) in the palisade cartilage group and 12 (24 ears) in the fascia group. RESULTS The graft success rate for the fascia group was 79.2%, and that for the cartilage group was 96.7%. The difference was statistically insignificant (p=0.078). Audiological improvements were seen in both groups, and the difference was statistically insignificant. CONCLUSION The use of temporalis fascia grafting has similar outcomes to palisade cartilage tympanoplasty for both success rate and audiological values in children who have bilateral disease.

A very rare case of sphenoid lymphoma presenting as cavernous sinus syndrome

DOI: 10.4328/JCAM.5669 Received: 23.01.2018 Accepted: 20.02.2018 Publihed Online: 22.02.2018 Printed: 01.05.2018 J Clin Anal Med 2018;9(3): 248-50 Corresponding Author: Taylan Gun, Ankara Medical Park Hospital Kentkoop Mah. 1868 Sok. No:15, Batıkent, Ankara, Turkey. Tel: +90 3126668000 GSM: +905323435019 F.: +90 3126668666 E-Mail: taylangun@gmail.com Abstract A 4-year-old boy admitted to our clinic with unilateral ophthalmoplegia, ptosis, and proptosis. He has been suffering the symptoms of a headache, nausea, dyspnea, fatigue, weakness, and loss of appetite for about three months. Complete blood count showed an increased white blood cell count with 77% blast cells, anemia, and thrombocytopenia. Magnetic resonance imaging (MRI) examination revealed the mass was obliterating the sphenoid and cavernous sinuses also causing osseous changes of the sinus walls. We performed endoscopic surgical decompression to relieve the symptoms of cavernous sinus syndrome also to obtain enough tissue samples for pathologic diagnosis. Pathologic examination revealed that the mass was diffuse B cell non-Hodgkin lymphoma and the patient was referred to pediatric oncology department for further treatment.

Is tinnitus an early voice of masked hypertension? High masked hypertension rate in patients with tinnitus

ABSTRACT Objectives: Tinnitus is hearing a sound without any external acoustic stimulus. There are some clues of hypertension can cause tinnitus in different ways. The aim of the study was to evaluate the relationship between tinnitus and masked hypertension including echocardiographic parameters and severity of tinnitus. Methods: This study included 88 patients with tinnitus of at least 3 months duration and 85 age and gender-matched control subjects. Tinnitus severity index was used to classify the patients with tinnitus. After a complete medical history, all subjects underwent routine laboratory examination, office blood pressure measurement, hearing tests and ambulatory blood pressure monitoring. Masked hypertension is defined as normal office blood pressure measurement and high ambulatory blood pressure level. Results: Baseline characteristics in patients and controls were similar. Prevalence of masked hypertension was significantly higher in patients with tinnitus than controls (18.2% vs 3.5%, p = 0.002). Office diastolic BP (76 ± 8.1 vs. 72.74 ± 8.68, p = 0.01), ambulatory 24-H diastolic BP (70.2 ± 9.6 vs. 66.9 ± 6.1, p = 0.07) and ambulatory daytime diastolic BP (73.7 ± 9.5 vs. 71.1 ± 6.2, p = 0.03) was significantly higher in patients with tinnitus than control group. Tinnitus severity index in patients without masked hypertension was 0 and tinnitus severity index in patients with masked hypertension were 2 (1–5). Conclusion: This study demonstrated that masked hypertension must be kept in mind if there is a complaint of tinnitus without any other obvious reason.

Giant antrochoanal polyp presenting as oropharyngeal mass

Antrochoanal polyps are benign mucosal lesions emerging from the maxillary sinus. The primary symptoms are nasal obstruction and rhinorrhea.

Unusual Lip Mass: Schwannoma of the Upper Lip: Case Report

Schwannomas are benign lesions of the peripheral nerve sheath. There are only a few cases of upper lip schwannomas in the literature. A male patient 23 years old, admitted to our clinic with mobile, non-tender, and 2x2 cm sized lip swelling. The mass was excised and the histological diagnosis was consistent with a schwannoma. Multinodular appearance was detected on microscopic evaluation. Most of the lip swellings are treated like a mucocele in outpatient clinics but the specimen should be examined carefully to differentiate the possible diagnosis.

Circulating Vascular Endothelial Growth Factor and Vascular Cell Adhesion Molecule in Laryngeal Squamous Cell Carcinomas

Objective : To assess the relationship between the immunohistochemical expression of vascular endothelial growth factor (VEGF) and vascular cell adhesion molecule (VCAM) with the clinical feature of laryngeal squamous cell carcinoma (LSCC). Study Design and Methods : Twenty-nine patients with LSCC were examined as the LSCC group. Twenty-one healthy people who showed no signs of regional or systemic disorders were used as the control group. The staging system for LSCC was determined using American Joint Committee on Cancer (AJCC) 2010 criteria. A quantitative enzyme-linked immunosorbent assay (ELISA) was performed to measure the concentration of soluble serum VEGF and VCAM-1. Results : VEGF levels were higher in the LSCC group compared to the control group (p = 0.001). VCAM levels were not significantly different (p = 0.617). VEGF levels were not correlated to the T and N stage in the LSCC group (p = 0.402). VCAM levels were significantly correlated with the T and N stage (p < 0.0001). Conclusions : VCAM levels could not be used as a tumor marker for diagnosis but were correlated with the stage and, therefore, the aggressivity of the cancer disease.