Vahit Mutlu

Antioxidant Effects of Nigella Sativa in the Treatment of Experimentally Induced Rhinosinusitis

Antioxidant Effects of Nigella Sativa in the Treatment of Experimentally Induced Rhinosinusitis Aim. The objective of this study was to investigate the effect of Nigella sativa (NS) in experimental bacterial rhinosinusitis. Material and Methods. Bacterial rhinosinusitis was induced with Staphylococcus aureus. Rabbits were divided into control, NS 50, NS 100 and NS 200 mg/kg/d groups. NS was given orally for 7 days. The same volume of normal saline was given as a vehicle to the control group for the same period. At 7 days post-treatment, mucosal samples were excised from the treated and control groups for measurements of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), myeloperoxidase (MPO) and malondialdehyde (MDA). Results. SOD and GSH-Px activities significantly increased in the NS 50, NS 100 and NS 200 mg/kg/d groups when compared with the saline treated group. MPO activity and MDA levels significantly decreased in the NS 50, NS 100 and NS 200 mg/kg/d when compared with the saline treated group. Conclusion. These findings show that administration of NS increased the SOD, GSH-Px activities and decreased the lipid peroxidation and MPO activity in experimental rhinosinusitis in rabbits. NS prevented oxidative stress by scavenging reactive oxygen species generated in rhinosinusitis model in rabbits.

Thymectomy in Myasthenia Gravis

In recent years, thymectomy has become a widespread procedure in the treatment of myasthenia gravis (MG). Likelihood of remission was highest in preoperative mild disease classification (Osserman classification 1, 2A). In absence of thymoma or hyperplasia, there was no relationship between age and gender in remission with thymectomy. In MG treatment, randomized trials that compare conservative treatment with thymectomy have started, recently. As with non-randomized trials, remission with thymectomy in MG treatment was better than conservative treatment with only medication. There are four major methods for the surgical approach: transcervical, minimally invasive, transsternal, and combined transcervical transsternal thymectomy. Transsternal approach with thymectomy is the accepted standard surgical approach for many years. In recent years, the incidence of thymectomy has been increasing with minimally invasive techniques using thoracoscopic and robotic methods. There are not any randomized, controlled studies which are comparing surgical techniques. However, when comparing non-randomized trials, it is seen that minimally invasive thymectomy approaches give similar results to more aggressive approaches.

Angiofibroma from the Tail of the Inferior Turbinate

Nasopharyngeal angiofibromas are benign and vascular neoplasms, which originate characteristically in the posterior lateral wall of the nasopharynx. They account for less than 0.5% of all head and neck tumours. Although angiofibromas extend beyond the nasopharynx usually, they rarely originate outside the nasopharynx. Reports of primary extranasopharyngeal angiofibromas have appeared sporadically in the literature. The maxillary sinus is the most common site involved, while the inferior turbinate represents an extremely rare localization. We report a case of angiofibroma which arising from the tail of the inferior turbinate in the right nasal cavity.

Preoperative Serum Thyroglobulin Level as a Useful Predictive Marker to Differentiate Thyroid Cancer

Introduction: Thyroid cancer is the most common endocrine system cancer. Although fine-needle aspiration biopsy is the most commonly used method for diagnosis, it is not always sufficient. The aim of this study was to investigate the influence of preoperative serum thyroglobulin (Tg) concentration on differentiated thyroid cancer risk. Material and Methods: A total of 133 patients who underwent total thyroidectomy due to various indications at the Ear-Nose-Throat Department, Ataturk University Medical School, between April 2015 and December 2015, were included in this prospective study. Histopathological diagnosis and preoperative Tg levels were compared. Receiver operating characteristic (ROC) analysis was used for detection of the cut-off to discriminate malignant from benign thyroid masses using preoperative Tg as a variable. Results: Malignant pathology (differentiated thyroid carcinoma) was detected in 59 out of 133 patients (44.4%) and benign pathology in 74 (55.6%). A statistically significant difference in preoperative Tg value was detected between malignant and benign cases (p < 0.05). Conclusion: The prevalence of differentiated thyroid carcinoma was higher among patients with a preoperative serum Tg value > 188.5 ng/mL, and this may thus be used as a marker for the diagnosis of this malignancy.

Comparison of the effect of the lidocaine, tetracaine, and articaine application into nasal packs on pain and hemorrhage after septoplasty

ObjectiveWe purposed to compare the effects of certain local anesthetics soaked Merocel nasal packs on hemorrhage and pain after septoplasty.Materials and methodsThis study is a prospective double-blind study that was done in patients undergoing septoplasty. The study was created with 90 patients. All patients were divided into four groups. The each group was applied 2% lidocaine plus adrenaline, 2% tetracaine, 4% articaine plus adrenaline as study groups or 0.9% sodium chloride (NaCl) as control group in their Merocel packs after septoplasty. Verbal analog scale (VAS) was applied to all patients and the amount of postoperative hemorrhage was noted during postoperative period. The statistical analysis was performed using Student’s t test and Chi-square test on each patient group at each time point.ResultsThe study groups (2% lidocaine plus adrenaline, 2% tetracaine and 4% articaine plus adrenaline groups) had significantly better pain scores versus control group in the 1st, 4th, 8th, 16th and 24th postoperative hours (p < 0.05). The articaine plus adrenaline group had better pain scores than the lidocaine plus adrenaline group, and the lidocaine plus adrenaline group had better pain scores than the tetracaine group in the postoperative first day. Also articaine plus adrenaline group had less postoperative bleeding rate than the lidocaine plus adrenaline, tetracaine and control groups (p < 0.05). There was no statistically significant difference between the lidocaine plus adrenaline, tetracaine and control groups in terms of postoperative hemorrhage (p > 0.05).ConclusionTopical articaine plus adrenaline application in the nasal packs can be safely used for less pain and bleeding following septoplasty.

A novel surgical technique: Crushed septal cartilage graft application in endonasal septoplasty

OBJECTIVE Nowadays, different septoplasty procedures are applied for therapy of nasal septum deviation. However, various complications of the septoplasty procedures have been described. Several techniques have been developed to decrease the incidence of these complications by surgeons. We aimed to present the effectiveness of the crushed septal cartilage graft, which is a novel septoplasty technique. METHODS Patients: Patients The study was performed based on the parameters of 500 patients who underwent surgery with crushed cartilage graft technique in our clinic between the dates 2013 and 2016. TECHNIQUE This novel operation technique was performed under general anestesia. The NOSE (Nasal obstruction symptom evaluation) scale was applied to all patients in both the preoperative period and the 2nd month of the postoperative period, and then the both values were statistically compared. Additionally, all the patients were followed up for complications that may occur after the operation for a year. RESULTS The study included 140 (28%) female and 360 (72%) male patients, which totally makes 500 patients. The average age of the participants was 35±12.5. When compared to the preoperative NOSE scale values (P˂0.001), the postoperative NOSE scale values were found to be significant. We watched intranasal infection and incrustation in 7(1.4%) patients in early postoperative period and the epistaxis in 3(0.6%) patients in late postoperative period. We did not see any postoperative complications apart from these two minor and insignificant complications during the follow-up along a year. CONCLUSION The crushed cartilage technique is a feasible, safe and effective alternative surgery technique to traditional septoplasty. What is more, complications of septoplasty can be prevented with the help of this novel surgical technique.

Coincidence of Eagle Syndrome and Diffuse Idiopathic Skeletal Hyperostosis Presenting With Dysphagia as a Result of Compression of the Hypopharynx.

Coincidence of the Eagle syndrome and diffuse idiopathic skeletal hyperostosis can very rarely result with compression of the hypopharynx. The authors here described a very rare case of hypopharyngeal airway compression secondary to cervical osteophytes in a patient with coincidence of Eagle syndrome and diffuse idiopathic skeletal hyperostosis. Multidetector computed tomography accuracy showed compression to the hypopharyngeal air column by the Eagle syndrome and diffuse idiopathic skeletal hyperostosis.

Magnetic Resonance Imaging and Magnetic Resonance Angiography Findings of External Carotid Artery Aneurysm and Coexisting Carotid Body Tumor

AbstractCarotid body tumors originate from paraganglionic tissue in the bifurcation of the common carotid artery. Magnetic resonance imaging is a frequently used diagnostic method in the preoperative diagnosis of these tumors and provides appropriate information for surgical planning. In this study, the authors emphasize magnetic resonance imaging and magnetic resonance angiography findings of the external carotid artery aneurysm associated with carotid body tumor. This highlights that the diagnosis of carotid artery aneurysms is essential to avoid accidental injury to the vessel during tumor surgery.

Kronik Otitli Hastalarda Antibiogram Duyarlılık Sonuçları

Introduction and Aim: This study was conducted to generate microorganisms isolated from cultures of ears taken from the patients diagnosed to have chronic otitis media and determine and compare the in vitro effects of different antibiyotics and topical ear solutions on these microorganisms. Material and Methods: Between June 2009 and October 2010, 127 ear cultures were taken from 100 patients who applied to the Department of Otolaryngology of Ataturk University Faculty of Medicine Training and Research Hospital diagnosed to have chronic otitis media in the otolaryngological investigation. Antimicrobial susceptibility of isolated strains was determined by the disc diffusion method according to the CLSI criteria. Descriptive statistical analysis was performed. The effectiveness of various drugs by species of pathogen was examined using cross tables. Chi square analysis was performed. One-way ANOVA was used to compare numerical variables in multiple groups. Post hoc analysis was performed using Tamhane’s test. Results: From the cultures investigated, 277 (6 ferment and 16 fungus) microorganisms were generated. In 14 cultures, two or more pathogens multiplied. Among the isolated pathogen microorganisms, pseudomonas spp. (24,91%), staphylococcus spp (13,00%), proteus spp. (5,05%) were the three most frequently isolated pathogen agents. 4 Peptococcus spp. (1,44%) and 3 Peptostreptecoccus spp. (1,08%) multiplied and it was observed that there was 2,52%anaerobic reproduction among all microorganisms. It was also seen that Pseudomonas spp. strains were more susceptible to gentamicin (97,1%), imipenem (94,2%), amikacin (84,1%) and ciprofloxacine (78,3%). In the study, vancomycine, teicoplanin, telithromycin and linozolidin were found to be the most effective antibiotics for all staphylococcus. It was seen that proteus spp. strains were more susceptible to gentamicin (92, 9%), ciprofloxacin (%92, 9) and piperacillin (%92, 9). Conclusion: In the antimicrobial treatment required to reach effective outcomes in the treatment of patients with chronic otitis media, it is important to monitor the frequency of effective microorganisms and their rates of resistance to antimicrobial agents

Cervical limbus vertebra presenting as a hypopharyngeal mass

A 59-year-old female patient was referred to our radiology department with the complaints of cervical bolus sensation and dysphagia for 10 years. She had no history of significant medical problems. Endoscopic examination revealed a protrusion located through the posterior wall of the hypopharynx (Fig. 1). The initial diagnosis was a hypopharyngeal neoplasm, and magnetic resonance imaging and plain radiography were performed. Magnetic resonance imaging of neck showed a triangular smooth bone fragment at the superior end plate of C4 vertebrae and bulging of the posterior hypopharyngeal wall (Fig. 2). Lateral plain radiography of the cervical spine showed a triangular-shaped, well-corticated ossicle at the superior end plate of C4 vertebra (Fig. 3). This was consistent with the limbus vertebra.