Zahide Mine Yazici

Histologic Changes in Eustachian Tube Mucosa of Rats After Exposure to Gastric Reflux

Objective: Reflux is thought to be a risk factor for middle ear disease, but the mechanism underlying this relationship is unclear. In this study, we evaluated the effects of reflux on the eustachian tube (ET) mucosa.

Clear cell odontogenic carcinoma of the maxilla.

Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis and low survival. We report a case of CCOC affecting the maxilla of 62 year-old woman. It was first described as a clinicopathological entity in 1985 and to date only 67 cases were described in the English literature. We are understanding of the behavior of this carcinomas was depend on limited case reports. For these reason we found important to report this case of CCOC in the maxilla.

Castelman disease of the parotid gland: An unusual entity.

Castleman disease (CD) is a benign lymphoepithelial disorder characterised by abnormal growth of a lymph node. This disease may be seen anywhere along the lymphatic chain but it usually occurs in the mediastinum. Two clinical types (localised and generalised) and three histopathological types (hyaline vascular, plasma cell, and mixed) have been described. We present a case of a 35-year-old female patient with parotid CD of the hyaline-vascular type as an extremely rare entity. We also discuss recent updates on this disease.

Intratympanic steroid injection and hyperbaric oxygen therapy for the treatment of refractory sudden hearing loss.

INTRODUCTION Controversy surrounds the use of salvage therapies to treat sudden sensorineural hearing loss (SSNHL), with no consensus on recommendations. While several studies have demonstrated the effectiveness of intratympanic administration of steroids (ITS) and hyperbaric oxygen (HBO) treatment, few have compared the efficacy of ITS and HBO therapy in patients with refractory SSNHL. OBJECTIVE We evaluated the efficiency of ITS and HBO therapy in patients with refractory SSNHL. METHODS Patients who did not adequately benefit from systemic treatment were evaluated retrospectively. Refractory patients were defined as those who gained less than 20dB in hearing after initial treatment. All refractory patients were informed about salvage therapy options: ITS or HBO therapy, the advantages and disadvantages of which were explained briefly. ITS involved 4mg/mL dexamethasone administered through a 25 gauge needle. Patients underwent HBO therapy in a hyperbaric chamber where they breathed 100% oxygen for 120min at 2.5 atmospheric pressure. The hearing levels of both groups were evaluated before the salvage therapy and at 3 months after treatment. Improvements in hearing were evaluated according to the Furahashi criteria. We also compared the two therapies in terms of speech discrimination scores (SDSs) and the recovery of all frequencies. RESULTS The salvage therapies generated similar results. Changes in pure tone averages and SDSs were similar for ITS and HBO therapy (p=0.364 and p=0.113). Comparison of SDSs and hearing thresholds at all frequencies showed similar levels of improvement. CONCLUSION ITS and HBO therapy produced similar improvements in SSNHL patients, but the sample size was too small to draw definitive conclusions. Further randomized controlled studies are needed to identify the best therapy for patients with refractory sudden hearing loss.

Glanzmann's thrombasthenia: a rare case of spontaneous bilateral hemotympanum

O hemotimpano pode ocorrer em decorrencia de varias con -dicoes, incluindo fratura do osso temporal, tamponamento nasal, epistaxe, terapia anticoagulante e doencas hemato-logicas. A trombastenia de Glanzmann, uma doenca hemor-ragica congenita rara, representa uma causa pouco frequente de hemotimpano. Apresentamos aqui um caso de hemotimpano bilateral espontâneo em trombastenia de Glanzmann.

The Ignored Parameter in the Diagnosis of Obstructive Sleep Apnea Syndrome The Oxygen Desaturation Index

Objective The apnea-hypopnea index (AHI) does not provide information about the apnea depth and length. We aimed to evaluate the correlation of the oxygen desaturation index (ODI) with AHI and the subjective symptoms because it is known that hypoxia plays an important role in morbidity and complications of obstructive sleep apnea syndrome (OSAS). Methods We reviewed the data of patients who applied to our clinic between 2010 and 2014 and underwent polysomnography (PSG) with a diagnosis of suspected sleep apnea. The demographic and anthropometric data of the patients were recorded. Epworth sleepiness scale (ESS) and values of AHI and ODI were analyzed in PSG. Results A total of 321 patients were divided into four groups, according to AHI as follows: 82 (25.5%) common snoring, 77 (24%) mild obstructive sleep apnea (OSA), 71 (22.1%) moderate OSA, and 91 (28.3%) severe OSA. A strong correlation was detected between AHI and ODI (p<0.005 and r=0.904) in all patient groups. There was a positive correlation between AHI and ESS (p<0.05 and r=0.435), but the correlation of ESS with ODI was stronger than that with AHI (p<0.05 and r=0.504). Conclusion The subjective symptoms of sleep apnea syndrome seem to be closely related to oxygen desaturations. Hypoxia during apnea periods of OSA is important; therefore, we suggest that ODI is as valuable as AHI in diagnosing and grading the OSAS.

Carotid Artery Aneurysm: A Rare Cause of Hemotympanum.

Abstract Temporal bone fractures can occur as a result of various head trauma. The most common cause of the hemotympanum is traumatic temporal bone fracture. Facial paralysis and hearing loss can be seen associated with temporal bone fracture. The development of the internal carotid artery aneurysm after temporal bone fracture is extremely rare. In this article, the authors evaluated carotid artery aneurysm that developed after temporal fracture and aneurism compressed by coagulated blood mass which showed itself as a hemotympanum. The internal carotid artery aneurysm that induced by temporal bone fracture and presented as hemotympanum has not been reported yet. This patient is the first case in the literature. Diagnosis, treatment, and follow-up options will be discussed in the light of current literature.

Multilevel Combined Surgery With Transoral Robotic Surgery for Obstructive Sleep Apnea Syndrome.

Objective:To evaluate the results of combined multilevel surgery with transoral robotic surgery (TORS) in patients with obstructive sleep apnea/hypopnea syndrome for multilevel upper airway obstruction. Methods:Subjects who underwent combined sleep surgery via TORS were evaluated. The drug-induced sleep endoscopy was used in diagnosing the presence of level-specific upper airway collapse and to detect the type of surgery. Pre- and postoperative Apnea-hypopnea index, Epworth sleepiness scale lowest oxygen saturation, total operation time, robotic set-up time and robotic surgery time, blood loss value, and complications were recorded. Results:Twenty five subjects were identified. All subjects underwent base of tongue (BOT) + epiglottoplasty. The tracheotomy was not performed for any patient. Overall, 72% of patients met the criteria for cure, 8% met the criteria for cure, and 20% of patients met the criteria for failure. There was a significant decrease between preoperative and postoperative Apnea-hypopnea index scores (28.7 ± 17.8 SD versus 9.4 ± 12.4, P = 0.000) and Epworth sleepiness scale scores (13.5 ± 2.8 versus 3.4 ± 1.6, P = 0.000). There was a significant increase between preoperative and postoperative ED SPO2 levels (80.7 ± 7.6 versus 82.6 ± 18.1, P = 0.001). Conclusion:TORS BOT, epiglottoplasty, and multilevel procedures in patients with obstructive sleep apnea/hypopnea syndrome can be regarded as feasible, safe, and effective technique.

Management of Pleomorphic Adenoma in the Nasopharynx: A Case Report

BACKGROUND Pleomorphic adenomas (PAs) are the most common type of benign salivary gland tumours and usually originate from the major salivary glands. PA originating from the nasopharynx has rarely been reported in the literature. CASE REPORT A 62 year-old male presented with right aural fullness and subjective hearing loss. Otoscopic examination revealed an opaque and bulging tympanic membrane. Nasal endoscopic examination revealed a smooth mass arising from the right wall of the nasopharynx, obstructing the opening of the right Eustachian tube. The MRI showed a 1.3×2×1.3 cm sharply outlined and lobar mass in the right lateral wall of the nasopharynx. The tumour was meticulously detached from its attachment site and excised via the transnasal route under endoscopic visualisation. CONCLUSION We reported pleomorphic adenoma in the nasopharynx in a patient who presented with serous otitis media that successfully resected with transnasal endoscopic surgery and discussed the treatment methods.

A huge cemento-ossifying fibroma of paranasal sinus: a case report.

Cemento-ossifying fibroma is a well-bordered, slow-growing, benign fibro-osseous disease. Although its localization is generally in the mandible, it can be seen in any area of the craniofacial region. Radiology and histopathology help to diagnose the condition. Treatment is based on close observation and/or surgical excision. In this case, we report the case of a 62-year-old male patient who had a large radiological appearance, cemento-ossifying fibroma in the paranasal sinuses.