Y. Tanyeri

Effects of otitis media with effusion on the vestibular system in children

Middle ear effusion has been considered the most common cause of vestibular disturbance in children. However, there have been only a few studies on vestibular disturbance in children with otitis media with effusion. We studied the vestibular systems of 30 children with otitis media with effusion aged 8 to 13 years and compared the results with 15 age- and sex-matched controls. A questionnaire relating to vestibular disturbance was given to patients and their parents. Spontaneous nystagmus and positional nystagmus were recorded by electronystagmography as diagnostic tests of the vestibular system. Rombergs and past-pointing tests were performed on children with otitis media with effusion and controls. After vestibular tests were completed, myringotomy was performed, and a ventilation tube was inserted. The questionnaire and the vestibular tests were repeated after the operation and during the first month after surgery. Our study showed that there was a history of vestibular disturbance in 33% of children with otitis media with effusion. Electronystagmography and Rombergs test findings demonstrated that 33% of the children had vestibular dysfunction (p >0.05). After myringotomy with ventilation tube insertion, vestibular test results returned to normal, and symptoms related to vestibular disturbance improved. These findings confirm the assumption that middle ear effusion may affect the vestibular system, which can be resolved after myringotomy with ventilation tube insertion. (Otolaryngol Head Neck Surg 1999;120:117-21.)

Comparison of computed tomography and magnetic resonance imaging in the diagnosis of parotid tumors

OBJECTIVE: The role of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of parotid tumors was investigated. METHODS: Forty patients with the clinical suspicion of a parotid mass underwent both CT and MRI of the parotid region. Two radiologists independently assessed the CT and MRI results with respect to tumor localization, tumor margin characteristics, and infiltration of surrounding tissue. Histopathologic specimens were obtained in all cases and correlated with the radiologic findings. RESULTS: The sensitivity and specificity of CT and MRI were nearly the same for tumor location, tumor margin, and tumor infiltration. CONCLUSION: The 2 imaging techniques provided the same information with respect to the presurgical planning and contribute to the diagnosis and therapy planning of parotid tumors. (Otolaryngol Head Neck Surg 2003;129:726-32.)

Huge osteoma of the frontoethmoidal sinus with secondary brain abscess

Osteomas of paranasal sinuses are usually asymptomatic. When enlarged, they may cause serious complications. We report a case of huge frontoethmoidal osteoma associated with brain abscess. If an osteoma associated with an intracerebral pathology is detected, it should be remembered that this could have been a complication of the osteoma and a detailed radiological examination should be performed to show the extent of the osteoma and to confirm any defect at the posterior wall of the sinus which may lead intracerebral complications. Such an osteoma should be operated after the abscess was resolved and patient became stable neurologically.

Giant polypoid tumor of the esophagus

Abstract A patient with a giant polypoid tumor of the esophagus, measuring 22 cm in length is described in this report. The patient presented with cough attacks and respiratory distress. Diagnostic and therapeutic intervention required aggressive airway management, radiographic and endoscopic evaluation, and definitive surgical treatment. Benign esophageal tumors are rarely seen and originate from the upper third of esophagus, frequently close to the cricopharyngeus muscle. They may attain giant proportions. A variety of clinical presentations are described, the most serious being asphyxia secondary to laryngeal obstruction [1] . We observed a giant esophageal tumor which was interpreted as angiofibromyolipoma that caused laryngeal obstruction. We present the clinical picture and histopathological findings of the tumor.

The protective effect of Ginkgo biloba extract against experimental cisplatin ototoxicity: animal research using distortion product otoacoustic emissions

BACKGROUND Cisplatin, an effective therapeutic agent for various human cancers, has dose-limiting side effects of ototoxicity and nephrotoxicity. Cisplatin ototoxicity is thought to result from increased amounts of toxic free radicals or cell membrane changes leading to increased intracellular calcium content. Ginkgo biloba extract prevents lipid peroxidation, decreases intracellular free oxygen radical levels, regulates the cell membrane calcium transport mechanism and prevents cell death. This study aimed to investigate the protective effect of Ginkgo biloba extract against cisplatin-induced ototoxicity in rats. METHODS Twenty Wistar albino rats with normal hearing (confirmed by distortion product otoacoustic emission testing prior to cisplatin application) were randomly allocated to two groups. Both groups received a single intraperitoneal dose of cisplatin (12 mg/kg). Group two also received daily intraperitoneal doses of Ginkgo biloba extract (100 mg/kg) for 10 days. Distortion product otoacoustic emission measurements were repeated on days 10 and 17 and signal-to-noise ratios were compared. RESULTS Compared with group one, group two had significantly better distortion product otoacoustic emission results at 3, 4, 6 and 8 kHz on days 10 and 17. CONCLUSION These findings suggest that Ginkgo biloba extract protects the inner ear against cisplatin-induced ototoxicity.

Validity of Acoustic Rhinometry in the Evaluation of Patients With Adenoid Hypertrophy

Abstract Reliability of acoustic rhinometry (AR) for preoperative diagnosis and decision of surgery in children with adenoid hypertrophy were investigated in this study. Fifty-five children who cannot tolerate nasal endoscopic examination were included. The AR was performed preoperatively and postoperatively 1 month later. The volume of distance between the 6th and 10th centimeters in rhinogram curve was calculated for evaluating the adenoid notch (AN) region. The volume of AN region was compared with each patient’s volume of the adenoid tissue removed with adenoidectomy. Whereas the median adenoid specimen volume was 2.0 (1.0–2.0) cm3 in 23 patients with complaint of nasal obstruction, median AN volumes in the rhinogram curve was 2.3 (0.8–5.2) cm3. All children whose preoperative nasopharyngeal volume was 4.2 cm3 or less had increased volume in the area representing the nasopharynx on rhinogram. We found a statistically significant relationship between the AN and the adenoid specimen volume (P = 0.000, r = 0.797). The sensitivity and specificity were found as 61.2% and 95.8%, respectively. We concluded that the children whose preoperative nasopharyngeal volumes were measured as 4.2 cm3 or less by AR could benefit more from adenoidectomy.

Surgical Technigues And Results İn Cholesteatoma Surgery

§/ A review of 349 patients with cholesteatoma operated between 1980 and 1995 was done. Of 349 patients, 272 cases had documented follow-up for 1 year or longer and were included in the study which consists of the incidence of residual and recurrent cholesteatoma. The most appropriate surgical technique was performed for each individual case. The surgical techniques were placed in two groups. Open cavity technique: 120 radical mastoidectomy, 26 modified radical mastoidectomy; closed technique: 113 intact canal wall tympanoplasty with mastoidectomy, 13 planned two stage procedure. Recurrence rates were 7.5% with open technique and 11.1% with closed technique. Residive rates were 9.6% with open technique and 5.5% with closed technique. Total failure rate was 17% with open technique and 16.6% with closed technique. The mean follow-up period was 30 months. In our series, there was no significant difference in the incidence and total failure rate of recurrent and residual cholesteatoma between open cavity and closed cavity techniques (p> 0.05). Cerrahi Teknikler ve Sonuclarimiz 1980-1995 yillari arasinda kolesteatoma tanisiyla opere edilen 349 hasta incelendi. 349 hastadan 272si bir yildan fazla takip edilmisti. Bu hastalar calismaya alinarak rezidiv ve rekurrens yonunden degerlendirildi. Her hasta icin en uygun cerrahi yontem secildi. Cerrahi teknikler iki gruba ayrildi. Acik teknik: 120 radikal mastoidektomi, 20 modifiye radikal mastoidektomi; kapali teknik, 113 in takt kanal wall timpanoplasti ve mastoidektomi, 13 iki asamali timpanoplasti idi. Rekurrens oranlan acik teknik icin %7.5 ve kapali teknik icin % 11.1 olarak bulundu. Rezidiv oranlari acik teknik icin %9.6 ve kapali teknik icin %5.5 bulundu. Toplam basarisizlik orani acik teknik icin %17, kapali teknik icin %16.6 bulundu. Ortalama takip suresi 30 ay idi. Bu seride iki grup arasinda rekurrens ve rezidiv yonunden anlamli fark bulunamamistir.

Giant Polypoid Tumor Of The Esophagus

A patient with a giant polypoid tumor of the esophagus, measuring 22 cm in length is described in this report. The patient presented with cough attacks and respiratory distress. Diagnostic and therapeutic intervention required aggressive airway management, radiographic and endoscopic evaluation, and definitive surgical treatment. Benign esophageal tumors are rarely seen and originate from the upper third of esophagus, frequently close to the cricopharyngeus muscle. They may attain giant proportions. A variety of clinical presentations are described, the most serious being asphyxia secondary to laryngeal obstruction. We observed a giant esophageal tumor which was interpreted as angiofibromyolipoma that caused laryngeal obstruction. We present the clinical picture and histopathological findings of the tumor.

Asetil Salisilik Asitin Flep Beslenmesi Üzerine Etkileri

THE EFFECTS OF ACETYL SALICYLIC ACID ON THE FLAP NUTRITION The influence of acetyl salisylic acid on the nutrition of flap was investigated in the 50 rats which divided in two groups. We planned the flap dimension 1x4 cm. in first group and 2x7 cm. in second group. We gave acetyl salicylic acid 10 mg. per oral to the rats. We elevated the flaps on the rats and than sutured the original place immediately. Post operatif 7. day; we noted the necrotic area on the flaps and medium length of flap and the re¬sults compared with the literature. Calismamizdaki iki gruba ayrilan toplam 50 ratda asetil salisilik asitin flep beslenmesi uzerine etkileri arastirilmistir. 1. gruptaki ratlarda flep boyutlari 1x4 cm. 2. gruptaki ratlarda ise 2x7 cm. olarak planlandi. Butun radarda flep kaldirildiktan hemen sonra orijinal yatagina 4/0 ipek kullanilarak ve 0.5 cm. aralikli konulan suturlerle yeniden yerlestiril¬mistir. Deney grubu radara operasyon oncesinde asetil salisilik asid 30 mg/kg olarak uy¬gulandi. Postoperatif 7. gunde fleplerdeki nekroz alanlari ve ortalama uzunluk degerleri kaydedilerek sonuclar istatistiksel olarak karsilastinlmistir.

Maksiller Sinüs Mukozal Kistlerinde Mikrobiyolojik Araştırma

MICROBIOLOGICAL RESEARCH IN MAXILLARY SINUS MUCOSAL CYSTS. ✓ There exist general infectious symptoms of maxillary sinus mucosal cysts besides their local symptoms. In 20 maxillary mucosal cyst cases, bacterologic analysis were performed in cyst flu¬ids and compared with the culture results obtained from the sinuses. While 60% cases of sinus cultures found to be positive, positive ucultures found in 30% of the cyst fluids were assessed to be significant contrary to the literature. Maksiller sinus mukozal kistlerinin lokal belirtileri yaninda genel enfeksiyoz belirtileri de bu¬lunmaktadir. 20 maksiller mukozal kist ve vakasinda kist sivisinda mikrobiyolojik arastirma yapilmis ve sinusten alinan kultur sonuclariyla karsilastirilmistir. Sinusten alinan kulturlerde % 60 vakada ureme gozlenirken % 30 vakanin kist sivisinda gozlenen ureme literaturden farklilik gostermesi yonunden anlamlidir.