Impact of Piezo and other Osteotomy Models on Soft Tissue, Blood Oxidative Stress, and Proinflammatory Markers.

BACKGROUND: Rhinoplasty is a common surgical procedure used in nose esthetics and pathologies. Shaping the nasal bones is a crucial step in achieving successful rhinoplasty surgery. However, complications such as excessive bleeding, edema, mucosal damage, and periosteal damage may occur during osteotomy for nose shaping. AIM: To investigate the damage to soft tissue and the effects on oxidative stress and proinflammatory cytokines in the blood caused by osteotomy performed on rabbits, using different osteotomy methods. Methods: Thirty-two albino New Zealand rabbits were divided into four groups. Group A was the sham group (n = 8), Group B the piezoelectric device group (n = 8), Group C the manual saw group (n = 8), and Group D the classical osteotomy group (n = 8). About 3 ml of blood was drawn to compare preoperative and postoperative interleukin-1ß (IL-1ß), thiobarbituric acid-reactive substances (TBARS), tumor necrosis factor-alpha (TNF-alpha), nitric oxide (NO), interleukin-10 (IL-10), and glutathione (GSH) levels. A 1 mm3 piece of soft tissue from the nasal bone of each animal in the study groups was sent for histopathological examination. The Chi-square test was used to analyze the incidence of postoperative necrosis, inflammation, and edema in the groups. RESULTS: Histopathologically, edema was significantly higher in Group C and Group D compared to Group B. Inflammation was increased in all groups. The necrosis was significantly higher in Group B compared to Group C and Group D. Except for two parameters, no significant changes were found in the biochemical markers for all groups. CONCLUSIONS: The piezoelectric device was found to be a better option for reducing edema and inflammation, while manual saws and classical osteotomy may lead to more tissue damage.

Association of age-related macular degeneration with age-related hearing loss.

OBJECTIVE: To assess the association between age-related macular degeneration and age-related hearing loss in Turkish subjects aged 50 years or older. STUDY DESIGN AND SETTING: Prospective, case-control study within a tertiary university hospital. SUBJECTS AND METHODS: Fifty subjects with age-related macular degeneration and 43 healthy subjects underwent ophthalmological and otolaryngological examination. Statistical analyses were conducted for the poorer eye and ear, comparing age-related hearing loss and pure tone average in the macular degeneration group versus controls. RESULTS: Median pure tone average was significantly poorer in the macular degeneration group (35 dBHL) compared with controls (23 dBHL). In the macular degeneration group, hearing loss was significantly greater in dry type (43 dBHL) than wet type (32 dBHL) cases. There was a significant difference between the prevalence of varying degrees of hearing loss in the macular degeneration versus control groups, being respectively: mild, 50 and 35 per cent; moderate, 20 and 5 per cent; and severe, 6 and 0 per cent. There was a weak, but significant correlation between each patient's visual acuity and pure tone average results (r(s) = -0.37, p < 0.001). CONCLUSION: Age-related hearing loss is more common in patients with age-related macular degeneration. Such patients should be questioned regarding hearing difficulty, and referred to an otolaryngologist if appropriate.

The use of adjunctive topical mitomycin in endoscopic congenital choanal atresia repair.

OBJECTIVE: To evaluate the efficacy of topical mitomycin in providing the patency of the neochoanae in children undergoing transnasal endoscopic congenital choanal atresia (CA) repair. METHODS: A retrospective analysis of surgical results in CA patients who were treated in Selcuk University, Meram Medical Faculty, Department of Otolaryngology between November 2002 and November 2009 was performed. All patients underwent transnasal endoscopic approach using nasal telescopes and traditional sinus instrumentation together with a microdebrider. Mitomycin was used according to the senior surgeon's preference, and certainly not in a randomized fashion. After completion of surgery, mitomycin 0.4 mg/ml was applied to the neochoanae for 3 min. Postoperative stenting was performed in all patients. RESULTS: CA was unilateral in 8 subjects (mean age 71.8+/-41.7 months; range 18 months-144 months) and bilateral in 12 subjects (mean age 4.6+/-1.3 days; range 3-7 days). Among the subjects, 75% was female in both groups. Fourteen subjects under endoscopic repair without mitomycin, whereas mitomycin was used in 6 patients (4 bilateral, 2 unilateral). Stents were left at least 3 weeks postoperatively (mean 31+/-10 days; range 21-45 days). The patients were followed-up at least 6 months (range 6-72 months). No symptomatic restenosis requiring further dilatations was seen in patients treated with preoperative mitomycin, whereas restenosis was detected in 6 subjects (42.9%) treated without mitomycin postoperatively within 6 months period (Fisher's Exact Test 2-sided, p=0.12). These subjects underwent revision endoscopic repair with mitomycin and had no need for further dilatations with acceptable control of symptoms during a follow-up period ranging between 14 and 78 months. CONCLUSION: Mitomycin improves the surgical treatment outcome of CA and reduces the rate of restenosis significantly without any complications. However, further prospective randomized studies are needed to fully investigate the benefits of mitomycin therapy in CA surgery.

Management of parapharyngeal space tumors.

In this study, we aimed to investigate the influence of the surgical approaches for the parapharyngeal space tumors. Eighteen patients with parapharyngeal space tumors diagnosed and treated at our clinic between 1992 and 2001 were included in this study. Surgical techniques used included transcervical, transparotid, transcervical-transmandibular, and infratemporal-A approaches depending on tumor size, location, vascularity, and malignant potential. Postoperative radiation therapy was applied in all malignant tumor. Postoperative morbidity, complications, and recurrence were evaluated. We found that 55.6 % of the PPS tumor were of salivary gland origin, 27.8 % were neurogenic, and 16.6% were miscellaneous. Of the four surgical techniques, transcervical approach were used most commonly. Postoperative morbidities were at acceptable levels. Our surgical survival rates were 100% for benign and 40% for malignant PPS tumors after a mean follow-up of 54 months.