ENT Updates

Volume 14 Issue 1 (2024)

Case Report

Pierre Robin Syndrome and a Subglottic Mass in a Patient with Bruck Syndrome: An Unusual Presentation of an Extremely Rare Condition

The phenotypic spectrum of Bruck syndrome has broadened since its first description. Besides its orthopedic manifestations, other findings such as myopathy or cardiac disease have been reported in previous studies. A case is presented with Pierre Robin syndrome and subglottic mass. Because of the clinical picture of congenital high airway obstruction syndrome, emergency tracheotomy was performed upon delivery. An excisional biopsy under direct laryngoscopy was done later. The patient died of congestive heart failure when 8 months old. In conclusion, Bruck syndrome types 1 and 2 may not be phenotypically equivalent and there may be unexpected upper respiratory system findings.

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Case Report

Injury with a Metal Cutting Wheel Involving Three Anatomical Regions of the Neck

Penetrating head and neck injuries are rare but life-threatening injuries. These injuries are classified into 3 regions in the neck. Injuries involving all 3 regions are almost absent in the literature. Appropriate personal protective equipment must be used to protect from such injuries. In this case report, a case remarkable for a foreign body causing injury is presented.

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Original Article

Effects of Nasal Topical Corticosteroids on Nasal Secretory Immunoglobulin A in Allergic Rhinitis Patients

Background: Recently, there has been interest in the immunoregulatory and preventative effects of immunoglobulin A (IgA) in individuals with allergic rhinitis (AR). Topical corticosteroids are one of the main treatment options for AR. The purpose of this study was to investigate the secretory IgA (sIgA) levels in the nasal fuid of healthy people and people who had received intranasal beclomethasone dipropionate (BD) and triamcinolone acetonide (TA) treatment.

Methods: There were 29 newly diagnosed AR patients and 29 healthy control individuals in the study. Group 1 (n=13) treated with BD and group 2 (n=16) treated with TA were included. Blood samples were collected to measure IgE levels. Nasal secretions were collected through nasal packing and evaluated by enzyme-linked immunosorbent assay.

Results: The mean nasal fuid sIgA level was 573.7±192.2 μg/mL in group 1, 564.8±270.8 μg/mL in group 2, and 559.7±241.9 μg/mL in the control group. The difference in baseline sIgA levels between groups was not statistically signifcant. After 1 month of nasal steroid treatment, sIgA levels in groups 1 and 2 increased signifcantly.

Conclusion: It was found that adult AR patients who were being treated with 2 types of intranasal corticosteroids (BD and TA) have signifcantly higher levels of sIgA in their nasal secretions.

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Original Article

Evaluation the effect of the Cartilaginous Columellar Strut Graft on Nasal Breathing Satisfaction after Septoplasty

Background: Septoplasty is one of the most common operations in adults in order to improve qualitative and quantitative scores in nasal obstruction. Using Columellar strut graft in septoplasty is not a routine technique but helps not only to correct septal deviation but also provides a better breathing status. The aim of this study was to compare the outcome of routine septoplasty with septoplasty with Columellar strut graft in nasal breathing satisfaction.

Methods: Forty patients with deviated nasal septum who scheduled for septoplasty, were randomly assigned into 2 equal groups. In first group routine septoplasty and in second group septoplasty with columellar strut graft were performed. Visual Analog Scale (VAS) was used to evaluate nasal breathing satisfaction, and Nasal Obstruction Symptom Evaluation (NOSE) score was used for the assessment of nasal obstruction.

Results: According to VAS and NOSE score, nasal breathing satisfaction and nasal obstruction improved significantly in septoplasty with columellar strut graft group in comparison with the routine septoplasty group (P < .001).

Conclusion: Using cartilaginous columellar strut graft in septoplasty is effective in improving nasal breathing satisfaction in patients after septoplasty. Therefore it should be recommended in septoplasties.

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