Volume 4 Issue 1 (2014)

Actinomyces, a gram-positive, anaerobic-to-microaerophilic species of bacteria, lives as commensal in human body. In this report, actinomycosis in concha bullosa in a 51-year-old woman is presented and it is aimed to add a case to the very rarely reported atypical locations of actinomycosis. Also, diagnostic and therapeutic approaches were discussed. Actinomycosis should also be considered in the differential diagnosis of the patients with effluent at head and neck region and nasal cavity in daily practice of otorhinolaryngology.

Granular cell tumor (GCT) is a rare benign neoplasm that is observed in oral cavity mostly in head-neck part or especially on the tongue. This lesion is generally observed as a solitary nodule with unidentified boundaries and it may reside in different areas of the body. The presented case is a 35-year-old male patient who referred with a problem of indolent lesion on his tongue. Excisional biopsy has been applied to the patient under general anesthesia. There was no complication observed in surgical operation and during post-operative period. There were no symptoms observed on the sixth month of post-operative period. In this paper, a case that has unidentified boundary of tongue placement which includes cystic lesion and identified by a GHT diagnosis has been presented by reviewing the up-to-date studies.

Objective: To compare health-related quality of life (QOL) in laryngeal cancer patients using generic and head and neck cancer-specific questionnaires.

Methods: A total of 52 patients, who were diagnosed as laryngeal cancer between January 2003 and January 2006, were included in the study. The patients were requested to fill up EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaire forms. These questionnaires were responded by the patients before treatment and at 1st, 2nd, 3rd, 6th and 12th months of the treatment.

Results: Patients who received surgical therapy or chemotherapy for laryngeal cancer without any tumor recurrence up to 12th month of the treatment were evaluated. Changes in the mean values of all variables other than the changes in the mean score of diarrhea variable of QLQC30 questionnaire were found to be statistically significant. The questionnaire scores of QLQ-H&N35 were found to be statistically significant in terms of all variables except opening mouth, intake of nutritional supplements and use of feeding tube.

Conclusion: Since quality of life of the patients who had undergone functional surgery is more satisfactory, functional surgery should be preferred to the extent permitted by oncological principles.

Objective: To retrospectively evaluate clinical and radiological characteristics of the patients with paranasal sinus fungus ball.

Methods: The medical files of nine patients who had been operated between April 2010 and November 2013 in Adana Hospital of the Baflkent University with the diagnosis of fungus balls of paranasal sinuses were analyzed. Patients with fungus infection which was showed tissue invasion, allergic mucin, rich of eosinophil and granulomatous tissue in histopathologic examination were excluded in the study. Demographic characteristics, physical examination findings, results of computed tomography, culture and histopathologic examinations were analyzed.

Results: Study population consisted of three men and six women with a mean age of 64.5 (range: 35 to 78) years. In all patients, an intrasinusal hyperdense heterogenous image was detected on paranasal sinus tomograms. Fungus balls were noted in the right maxillary sinus in five (77.7%) and in sphenoid sinus in two (22.3%) patients. Only three (33.3%) patients had not any other systemic disease. All patients underwent functional endoscopic sinus surgery. On histopathological examination, results of all patients were reported as fungus balls.

Conclusion: In cases presenting with a systemic disease associated with non-specific symptoms of sinusitis, the presence of a fungus ball should be considered.

Objective: To show the efficacy of mucopeptid breaking agent N-acetylcysteine on the treatment of otitis media with effusion.

Methods: A total of 64 patients who were admitted to our clinic and diagnosed otitis media with effusion were included in the study. The study group of 33 patients were administered antibiotics, decongestants, and N-acetylcysteine. The control group was treated with only antibiotics and decongestants. Both groups of patients were examined with a low-frequency probe tone (226 Hz) device before, one month, three months and 6 months after the treatment. Tympanometric and pure tone audiometric examination of the patients were performed.

Results: At the end of the first month, recovery rates of the left and right ears in the study and control groups were 66 and 72% vs. 13 and 22%, respectively. At sixth month, recovery rates for the left and right ears in the study group were 91 and 94%, respectively, while the corresponding recovery rates were 48 and 55% in the control group.

Conclusion: N-acetylcysteine can be used in the treatment of otitis media with effusion as a medical agent. However, studies on more patients are needed to evaluate the efficacy and long-term effect of N-acetylcysteine on otitis media with effusion.

Objective: To present our prick test results that would reflect allergens prevalent in the Central Anatolia.

Methods: Prick tests of the 1618 patients diagnosed with allergic rhinitis, atopic dermatitis, allergic conjunctivitis between January 2003 and May 2005 were included in the study. In epidermal skin prick test, sensitization to 21 allergens including trees, grasses, weeds, fungus, epithelium-hair, house dust and mites, latex, and food were evaluated.

Results: Positive prick test results were obtained in 565 (34.9%) of 1618 patient. Sensitivity to prick tests were as follows; 372 (66%) were positive for grass pollens, 242 (43%) were positive for house dust and mites, 265 (47%) were positive for tree pollens, 71 (12.6%) were positive for epithelium-hair allergens, 96 (17%) were positive for weed pollens, 37 (6.7%) were positive for foods, 24 (4.3%) were positive for fungus, 26 (4.7%) were positive for latex allergens.

Conclusion: Our data indicates that the most common allergens in Ankara are grass pollens, tree pollens and house dust and mites.

Objective: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by means of objective and subjective data..

Methods: A total of 70 patients were divided into obese (n=38; BMI>35 kg/m2 ) and non-obese patient groups (n=32; BMI<30 kg/m2 ). The Epworth sleepiness scale scores, modified Mallampati index scores, levels of obstruction in the oropharynx and soft palate, neck circumference and polysomnography findings between two groups were compared.

Results: Obese patients had an average Mallampati score of Class III while the non-obese study participants had an average score of Class II, with a statistically significant intergroup difference. In Muller’s maneuver, the levels of obstruction in both the soft palate and oropharynx were higher in the obese patients with a statistically significant difference between two groups. When polysomnography results were examined, the average apnea-hypopnea index (AHI) score was determined to be 22.5 in the obese and 6.4 in the non-obese groups, respectively. Furthermore, average scores of rapid eye movement (REM) AHI in the non-obese and obese patients were 4.6 and 17.2 with a statistically significant difference between the groups. The average lowest oxygen saturation was 75.5% in the obese and 88% in the non-obese group, which represented a statistically significant difference between groups. In the obese group, the number of patients with REM-dependent OSAS was higher than in the nonobese group which attained a level of statistical significance.

Conclusion: Our study indicated that obesity increases the severity of OSAS, in part due to significant narrowing of the airway at the level of the soft palate and oropharynx. Additionally, our study has shown that the risk of supine position-dependent OSAS and especially REM-dependent OSAS were notably higher in obese patients.

Objective: To determine septal variations and rates of intrasinusal protrusions of optic nerve and internal carotid artery in sphenoid sinus.

Methods: Retrospective analysis of spiral computed tomography scanning of paranasal sinuses of 218 patients diagnosed as acute/chronic sinusitis was performed. Bilateral sphenoid sinuses were evaluated as if a single sinus, septa of this sinus were evaluated in terms of number and configuration. Besides rates of optic nerve and internal carotid artery protrusions were determined

Results: A total of 5 types of septal variations were detected. A single complete septum (n=132; 60.5%), a single incomplete septum (n=66; 30.2%), double septum (complete + incomplete, n=6; 2.7%), two complete septa (n=9; 4.1%), and sphenoid sinuses without septum (n=5; 2.2%) were identified. Sixty-four percent of single septum was located in midline, while other types were found immediately right or left side of the midline. Besides, protrusions of optic nerve and internal carotid artery were detected in 39 (17.8%) and 61 (27.9%) cases, respectively.

Conclusion: Conclusion: Preoperative evaluation with computed tomography and surgical planning dependent on these findings are very important for endoscopic interventions and these approaches minimize potential major intraoperative complications.

Objective: Despite the fact that there are many studies about the osmophobia and migraine, we have very little knowledge about the olfactory abilities of migraineurs during the period between the attacks. So, the aim of this study was to evaluate the olfactory function of migraineurs during the period without headaches with odor identification test.

Methods: Two hundred and ninety healthy people aged 16 to 65 years (152 female, 138 male) and 84 migraine patients aged 18 to 55 years (47 female, 37 male) were studied. The participants with migraine were selected from the patients who applied to headache outpatient clinic for assessment. Participants, appropriate to the study, were physically and neurologically examined in detail and then they were taken to the test room in order to be screened with Short Smell Test Battery of GATA Haydarpaşa (GULTEST).

Results: The mean GULTEST score of the migraine group was less than the healthy group and the difference was significant. The effect of gender, cigarette smoking and disease status (migraine) on GULTEST scores was evaluated by linear regression model. It was found that females had higher odor identification scores than males in both migraineurs and controls. On the other hand, cigarette smoking had a significant negative effect on GULTEST scores. Furthermore, migraine had a significant negative effect on GULTEST scores.

Conclusion: Our study showed that even during the headache-free period, migraineurs might have reduced olfactory abilities.