Volume 7 Issue 1 (2017)

Objective: To investigate the histopathological effect of nimodipine and prednisolone treatment on an animal model with peripheral facial nerve paralysis generated by clamping.
Methods: Twenty-eight New Zealand originated rabbits with facial nerve paralysis of the buccal branches generated by clamping were divided into four groups of seven each, administered with nimodipine, methylprednisolone and nimodipine-methylprednisolone combination throughout 21 days. The injured neural tissues were investigated histopathologically after treatment regarding perineural fibrosis, collagen degeneration, axonal degeneration, myelin degeneration, Schwann cell proliferation, normal myelin structure, and edema. The groups were compared with each other and with the control group.
Results: Statistically significant difference was determined between nimodipine and control groups regarding increased number of collagen fibers, myelin degeneration, axonal degeneration and myelin structure; between nimodipine and methylprednisolone groups, and between nimodipine and nimodipine-methylprednisolone combination groups regarding edema (p<0.05). Statistically significant data were also found between methylprednisolone and control groups in terms of increased number of collagen fibers, myelin degeneration, axonal degeneration and edema; between nimodipine-methylprednisolone combination and the control groups in terms of increased number of collagen fibers, myelin degeneration, axonal degeneration, normal myelin structure and edema (p<0.05).
Conclusion: Nimodipine and methylprednisolone both have positive effects on traumatic peripheral nerve paralysis with nerve integrity preserved whereas advantage of nimodipine over methylprednisolone cannot be suggested.

Objective: We evaluated the incidence of psychiatric disorders in patients with allergic rhinitis (AR) and assessed the effects of the use of antidepressants on symptoms when they are included in the treatment regimen of patients with AR who are resistant to AR treatment.
Methods: A total of 49 patients who were resistant to the treatment for AR and who did not accept the option of immunotherapy were included in the study. Thirty-eight of the 40 patients were advised to take the antidepressant sertraline; however, only 21 of them agreed to use the medication while 17 of them refused. The 21 patients who agreed to begin the antidepressant were also advised to undergo AR treatment with desloratadine once per day and intranasal mometasone furoate once per day (Group 1). The patients who refused to use the antidepressant were advised to begin the AR treatment (Group 2). Symptom scoring for AR was again performed for all patients 6 weeks after treatment. The Psychological Symptom Checklist-90 (SCL-90), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI TX I and TX
II) were performed on the patients in the company of a psychiatrist.
Results: The post-treatment nasal and non-nasal symptom scores in Group 1 were significantly better than the pretreatment scores for any of the seven symptoms (p=0.000). No significant correlation was found between the AR symptom scores and the average SCL-90 general symptom score, the SCL-90 subscale scores, the total BDI scores, and the STAI scores (p>0.05).
Conclusion: This study suggests that the use of antidepressants diminishes the allergic symptoms in patients with treatment-resistant AR since psychosomatic factor is of great importance in the patient population of AR.

Objective: To determine the frequency of p16 positivity in oral cavity and oropharyngeal squamous cell carcinoma (OC/OP-SCC) and to reveal whether there is a difference between p16-positive and -negative cases according to clinicopathological parameters.
Methods: p16 antibody was retrospectively analyzed immunohistochemically in biopsies of 60 patients with OC/OP-SCC operated between 2007 to 2015. Comparison was performed for age, sex, smoking habit, alcohol consumption, site of the tumor, the level of keratinization, T stage, lymphovascular invasion, perineural invasion, recurrence of the tumor, and survival.
Results: Of the 60 patients (18 females, 42 males), the median was 58 (range: 27 to 75) years. Seventeen patients were p16-positive, and 43 patients were p16-negative. Comparison of p16-positive and p16-negative groups according to age, sex, T-stage, tumor subsite, tumor profundity, lymphovascular invasion, perineural invasion and survival was not statistically significant (p>0.05). We found statistical difference between two groups according to tumor recurrence, smoking habit, and the degree of keratinization.
Conclusion: In patients who underwent surgical treatment after the diagnosis of zOC/OP-SCC, p16 positivity may have a predictive role in terms of tumor recurrence.

Objective: Speech delay should be considered in a child in case of not demonstrating the stages of language development in accordance with general developmental period or compared to the peers. Speech delay often may be a sign of a variety of mental and somatic diseases rather than a diagnosis. In this study, we aimed to investigate the demographic characteristics, psychiatric diagnoses and factors that play a role in speech delay in patients admitted to a child psychiatry outpatient clinic with a complaint of speech delay.
Methods: Medical records of the patients who were admitted to the child and adolescent psychiatry outpatient clinic with complaints of “not talking”, “speech delay”, “language delay”, “not forming a sentence” between November 1, 2014 and October 31, 2015 were retrospectively evaluated.
Results: Of a total of 127 cases, 22.8% were female and 77.2% were male. The mean age was determined as 3.1±1.1. Average duration of TV, tablet and smart phone exposure was 5.3±3.4 hours per day. Only 14.1% of cases were going to preschool education, primary school or special education. It was found that 38.2% were not presence in an environment where allows peer relationship; bilingualism history was present in 3.1%; 23.6% had a family history of speech delay, and
21.6% of cases had no meaningful words. Developmental language delay (28.18%) as a clinical finding and pervasive developmental disorders (PDD) as a psychiatric disorder (23.64%) were the most frequent diagnoses. There were no statistically significant differences between PDD and other patients when compared in terms of TV and other virtual media exposure duration [t(55)=1.58, p=0.12].
Conclusion: Different diagnoses lie under the complaint of speech delay. We emphasize that it is important to evaluate these patients multidisciplinary and refer to child and adolescent mental health experts for detection of probable psychopathology and establishing the appropriate treatment plan at an early stage.

Objective: To evaluate the predictive role of complete blood count (CBC) parameters in thyroid cytological diagnosis in patients with the diagnosis of undetermined significance (AUS) and suspicious for malignancy (SM) in hematological inflammatory parameters.
Methods: The preoperative CBC of 127 patients who underwent total thyroidectomy were retrospectively evaluated. While 52 patients were defined as AUS (Group 1), 75 patients were defined as SM (Group 2) in thyroid fine-needle aspiration cytology. Both groups were divided into benign and malignant sub-groups according to histopathological diagnosis of thyroidectomy specimens. In each group, the preoperative hematologic parameters (leukocyte, neutrophil, lymphocyte, platelet, neutrophil/lymphocyte ratio ‘NLR’, platelet/lymphocyte ratio, ‘PLR’) were compared with respect to malignancy, tumor size, stage and multicentericity of cancer.
Results: The statistical analysis showed that there was no significant difference in comparison of hematological parameters in benign and malignant groups.
Conclusion: Our study showed that there was no role of NLR and PLR in the cytological diagnosis of AUS and SM to predict malignancy. There was also no correlation of hematological parameters to tumor size, multicentricity, and central lymph node metastasis.

Objective: The purpose of the present study was to investigate whether high platelet distribution width (PDW) levels correlated with nasal polyps or not.
Methods: The study was performed retrospectively in 99 patients who underwent endoscopic sinus surgery for nasal polyposis. Data were collected from the routine preoperative hemograms of the patients. The study group was compared with an age- and sex-matched control group including 150 healthy subjects. The Mann-Whitney U test was used to compare the results of the two groups.
Results: The PDW level for the study group was 14.49±2.08, while for the control group it was 13.76±2.14. The PDW levels of the study group were higher than those of the control group, and this difference was statistically significant (p<0.05).
Conclusion: The rise of the PDW levels in patients with nasal polyposis should be investigated for the diagnostic value, and the rise of PDW levels in patients with nasal polyposis may be used for its diagnostic evaluation.

Objective: To evaluate the pattern and incidence of orbital complications due to sinusitis in children in Komfo Anokye Teaching Hospital.
Methods: Ninety-two children aged between 2 and 14 years who presented with various orbital complications as a result of sinusitis among 1627 children in a 5-year period were evaluated to analyze the pattern and the incidence of the various stages and forms.
Results: Of the 1627 children evaluated, 92 (5.7%) had orbital complications. Among those with complications, 52.2% presented with orbital cellulitis, 22.8% presented with subperiosteal abscess, 14.1% presented with periorbital cellulitis, 8.7% presented with orbital abscess, and 2.2% presented with cavernous sinus thrombosis.
Conclusion: Despite the low incidence of sinogenic orbital complications, this study showed that orbital cellulitis is the most common among all orbital complications as a result of sinusitis in children.

Objective: In this study, we aimed to conduct a retrospective analysis of head and neck masses initially presenting with fistulas.
 

Methods: A total of 23 patients with head and neck fistulas who admitted to the otorhinolaryngology department of our tertiary care center between January 2011 and May 2012 were retrospectively reviewed. Age, sex, and duration of symptoms were noted from the case records. The side and site of the lesion and the opening of fistula were noted. Co-morbidities, post-operative complications and histopathological diagnosis were classified.

Results: Of the 23 patients with head and neck fistulas, (12 males, 11 females) the average age was 26.52±14.1 (range: 9 to 74) years. Of the 23 lesions, the most prevalent lesion was branchial fistulas (n=13, 56.52%) followed by thyroglossal fistulas (n=7, 30.43%), dermoid fistulas (n=2, 8.7%) and tuberculosis (n=1, 4.4%). Drainage (n=23, 100%) was consistently observed as the initial symptom in all patients while swelling (n=22, 95.6%) was the second most common presenting symptom.
 

Conclusion: Correct diagnosis is essential to avoid inadequate surgery and multiple procedures for head and neck fistulas of congenital or infectious etiology.

Allergic respiratory diseases are common public health problem. Although several treatment options, some of patients cannot manage to get satisfactory recovery. High altitude (HA) is shown as a natural additive and/or salvage therapy option for this patient group. We aimed to present the effect of HA on allergic rhinitis and bronchial hyperreactivity in company with literature.

Choanal polyps (CPs) can be defined as histologically benign, solitary, soft tissue lesions extending towards the junction between the nasal cavity and the nasopharynx through the choana. They usually originate from the maxillary sinus. In this report, we present an unusual case of a giant angiomatous CP arising from the inferior part of the middle turbinate that completely filled the nasopharynx. A 24-year-old man presented with five-year history of left-sided nasal obstruction, nasal discharge and mildto-moderate epistaxis. The diagnosis was supported by contrastenhanced computed tomography scan of the paranasal sinuses with angiography and confirmed by histopathological examination. The lesion was removed by combined endoscopic and transoral approach. In addition, we discuss the pathogenesis, clinical, radiological and pathological characteristics of angiomatous CPs, and their differential diagnosis.