Yusuf Kizil

Effectiveness of Inactivated Influenza Vaccine for Prevention of Otitis Media in Children

Objective: The objective of this study was to evaluate the effectiveness of inactivated influenza vaccine in preventing acute otitis media (AOM) and otitis media with effusion (OME) in children aged 6 to 60 months who attend day care. Study Design: This prospective, single-blind study was conducted in 8 day care centers in Ankara, Turkey. One hundred nineteen (61 vaccinated and 58 unvaccinated against influenza) healthy children were examined at study entry and at 6-week intervals for 6 months by the same 2 otorhinolaryngologists who were blinded about the vaccination status of the children. The frequency of AOM and OME is compared between the 2 groups and the effect of influenza season on frequency of episodes was evaluated. Based on national influenza laboratory data, the influenza season was determined to be the period between December 15, 2003, and January 31, 2004. Result: The frequencies of AOM, OME and total otitis media episodes in vaccinated children were 2.3%, 22.8% and 25.2%, respectively, and these frequencies were 5.2%, 31.1% and 36.3% in the unvaccinated group. The difference was statistically significant (P < 0.01). This difference was especially prominent in the influenza season (P < 0.05). Conclusion: Influenza vaccine is effective in reducing AOM and OME episodes in 6- to 60-month-old day care children, especially during influenza season.

Characteristics and management of intractable neck involvement in tularemia: report of 19 patients

The objective of this study is to determine the clinical characteristics and to evaluate the treatment options of intractable neck involvement in tularemia. The medical records of 19 tularemia patients with neck involvement were reviewed retrospectively. On physical examination, fluctuation indicating an abscess formation was detected in 78.9% of the patients. Bilateral involvement was seen in 15.8% of the patients. The most common clinical form was glandular form (63.1%). The most commonly involved lymph node group was upper jugular nodes (78.6%). Six patients underwent incision and drainage procedure, five patients underwent superselective neck dissection and eight patients had only medical treatment. Complete and immediate cure, and better tissue healing with less scarring could be achieved in all patients who underwent superselective neck dissections. In conclusion, intractable neck masses and an abscess can be the initial finding in tularemia, and a high index of suspicion is needed in the differential diagnosis. Superselective neck dissection is a safe and effective option in the treatment of long lasting cervical tularemia unless it responds to medical treatment.

Mucosal melanoma of the head and neck: recurrence characteristics and survival outcomes

OBJECTIVE The aim of this study was to review oncologic outcomes and recurrence characteristics of head and neck mucosal melanomas (HNMMs) managed at a tertiary referral center. STUDY DESIGN Clinical records of 10 patients who were managed for HNMMs between 2001 and 2013 were retrospectively analyzed. RESULTS The median age was 66 years (range 28-76 years) and male/female (M/F) ratio was 1:5. The 3-year disease-free survival (DFS) rates and overall survival (OS) rates were 11.7% and 35%, respectively; and the 5-year DFS rates and OS rates 11.7% and 23.3%, respectively. The median DFS and OS periods were 12 months (range 2-36 months) and 17 months (range 7-96 months), respectively. The rates of development of local, regional, and systemic recurrences were 20%, 50%, and 80%, respectively. Lungs were involved in all patients who had distant metastasis. CONCLUSIONS This study shows that HNMMs has a very aggressive course and that distant metastases are common. For this reason, systemic control of the disease is an important aim of treatment.

Less known non-infectious and neuromusculoskeletal system-originated anterolateral neck and craniofacial pain disorders

Pain syndromes of neuromusculoskeletal origin are not well-known by most of the clinicians working on head and neck area. As a result, most of the patients with these syndromes are either overlooked without having any treatment or they inappropriately have antibiotic treatments or surgical interventions such as dental extractions and tonsillectomies. Better recognition of the pain syndromes of the neck and face region or entities related to neuromusculoskeletal system may result in more appropriate and effective management of such conditions while avoiding unnecessary medical and surgical treatments. In this review, causes, clinical characteristics, diagnostic and treatment modalities of relatively less known craniofacial and neck pain entities including Eagle syndrome, carotidynia, glossopharyngeal neuralgia, superior laryngeal neuralgia, hyoid bone syndrome, acute calcific retropharyngeal tendinitis, temporal tendinitis, thyroid and cricoid cartilage syndromes, and mastoid process syndrome are summarized.

Sphenopalatine artery pseudoaneurysm: a rare cause of intractable epistaxis after endoscopic sinus surgery.

AbstractEpistaxis is a frequent health problem and the most common cause of emergency in otorhinolaryngology practice. In this report, a case of a 26-year-old patient with intractable epistaxis after endoscopic sinus surgery was presented. The epistaxis began at the fourth postoperative day and was unresponsive to endoscopic cauterization and anterior and posterior nasal packing. On angiographic investigation, a pseudoaneurysm of the sphenopalatine artery was detected and treated with microcatheter embolization. This is the second case of postoperative sphenopalatine pseudoaneurysm as a complication of endoscopic sinus surgery in the literature.

Analysis of choanal polyps.

AbstractChoanal polyps (CPs) are unilateral benign masses usually originating from paranasal sinuses. Maxillary, ethmoid, and sphenoid sinuses are involved in order of decreasing frequency. In this study, the medical records of patients operated on with a clinical diagnosis of CP between 1998 and 2011 were reviewed. A total of 98 patients with a mean age 24.3 years were analyzed. Histopathologic diagnoses were CP in 94 patients and inverted papilloma in 4 patients. The sites of origin were maxillary sinus in 89 patients (90.8%), sphenoid sinus in 6 patients (6.1%), bulla ethmoidalis, inferior concha, and uncinate process in 1 patient each (1.0%). The most common symptoms were nasal obstruction (98.0%) and postnasal drip (30.6%). The surgical approaches were endoscopic sinus surgery in 63 patients (62.4%) unilaterally and in 12 patients (11.9%) bilaterally and unilateral endoscopic sinus surgery with mini Caldwell in 26 patients (25.7%). All 3 recurrences were in pediatric patients, and the recurrence rates among pediatric patients and overall were 7.7% and 3.1%, respectively.Endoscopic sinus surgery is an effective surgical procedure for treatment of CP; however, addition of a mini-Caldwell approach is safe for antrochoanal polyp resection if the endonasal technique fails. Histopathologic examination is mandatory because inverted papillomas may present as CPs.

An individualised treatment algorithm for tumour stage 1 glottic squamous cell carcinoma

OBJECTIVE To report and discuss the outcome of a treatment algorithm for patients with tumour stage 1 glottic squamous cell carcinoma. METHOD A retrospective outcome analysis study was performed using data from a tertiary referral centre. RESULTS Sixty-nine patients were treated with radiotherapy and 26 with surgery, in accordance with the treatment algorithm. Five-year overall survival rates were the same for both treatment groups (92 per cent). Five-year disease-specific survival rates were 100 per cent for surgery, 98 per cent for radiotherapy and 99 per cent overall. The overall 5-year laryngeal preservation rate was 89.1 per cent, being 95.7 per cent for surgery patients and 86.7 per cent for radiotherapy patients (p = 0.502). There was no significant association between laryngeal preservation rates and age (p = 0.779), anterior commissure involvement (p = 0.081), tumour stage (1a or 1b) (p = 0.266) or treatment modality (surgery or radiotherapy; p = 0.220). There was no significant difference in local recurrence rates between the two treatment groups (19.3 per cent for radiotherapy vs 10.0 per cent for surgery; p = 0.220). The overall 5-year regional recurrence rate was 1.2 per cent. CONCLUSION Tumour stage 1 glottic carcinoma can be managed with different treatment modalities, following an individualised treatment algorithm, with results comparable to published outcomes.

Hyoid bone insertion tendinitis: clinicopathologic correlation

Hyoid bone insertion tendinitis is often not taken into consideration in clinical practice and neglected in the differential diagnosis while evaluating patients with chronic neck pain. One of the main important reasons why physicians do not bear this entity in mind is that it has not been well described histopathologically. Two patients, who had been diagnosed and treated surgically for hyoid bone insertion tendinitis, were presented in this study. Microscopically, degenerative changes in the striated muscle tissue, which are characterized by myocyte necrosis, atrophy along with fibrosis and calcification in some foci, were observed. These findings provide evidence for the clinical picture of hyoid bone insertion tendinitis.

The basaloid variant of squamous cell carcinoma of the larynx.

Introduction Basaloid squamous cell carcinoma (BSCC) is a rare subtype of squamous cell carcinoma (SCC). Because of its rarity, both clinical and prognostic features of this variant are not well known.

An analysis of petrous bone cholesteatomas treated with translabyrinthine transotic petrosectomy

Abstract Conclusion: In cases of petrous apex cholesteatoma, radical removal should be prioritized over an unreasonable sparing of hearing or facial symmetry. Restoration of facial nerve function is achievable by reanimation procedures. Objectives: To analyze clinical manifestations, surgical findings, and postoperative functional results of petrous apex cholesteatoma. Methods: From 1995 to 2012, 34 cases of petrous apex cholesteatoma underwent operations. Clinical and surgical findings and postoperative functional outcomes were analyzed retrospectively. Results: Hearing loss was the most common symptom in 95% of patients, followed by otorrhea in 64% and facial palsy in 59%. Four patients had recurrent facial palsy. In eight (24%) patients petrous apex cholesteatomas were recurrent or iatrogenic in origin. The supralabyrinthine and massive type of petrous bone cholesteatoma were the most common types, followed by, infralabyrinthine-apical, infralabyrinthine, and apical. Among 18 cases with facial nerve paralysis, 8 underwent hypoglossal–facial nerve anastomosis, 4 underwent rerouting and end to end anastomosis, 3 of them did not undergo any treatment because of the duration of facial palsy (> 3 years), and another 3 patients for whom we had recommended facial–hypoglossal anastomosis did not accept the operation. There were no major complications. Recurrence was observed in two (5%) cases.