A Postpartum Immigrant with Pulmonary, Pleural, and Intestinal Tuberculosis.

Intestinal tuberculosis is a rare extrapulmonary condition and mainly involves the ileocecal region. Most of the patients with tuberculosis during the postpartum period present with extrapulmonary involvement. The postpartum period has a higher risk of the reactivation of tuberculosis due to changes in the immune system. We present the case of a 22-year-old postpartum immigrant patient, with pulmonary, pleural, and intestinal tuberculosis with intestinal perforation. Due to the nonspecific symptoms of intestinal tuberculosis, clinical suspicion is extremely important.

Digital Citizenship: Beyond Big Data, Technical Skills, Industry 4.0, and COVID-19.

Big data and data deluge are topics that are well known in the field of systems science. Digital transformation of big data and omics fields is also underway at present. These changes are impacting life sciences broadly, and high-throughput omics inquiries specifically. On the other hand, digital transformation also calls for rethinking citizenship and moving toward critically informed digital citizenship. Past approaches to digital citizenship have tended to frame the digital health issues narrowly, around technocracy, digital literacy, and technical competence in deployment and use of digital technologies. However, digital citizenship also calls for questioning the means and ends of digital transformation, the frames in which knowledge is produced in the current era. In this context, Industry 4.0 has been one of the innovation frameworks for automation through big data, and embedded sensors connected by wireless communication. Industry 4.0 and the attendant "smart" technologies relate to various automation approaches deployed as part of the public health responses to the COVID-19 pandemic as well. This article argues that there is a growing need to steer digital transformation toward critically informed digital citizenship, so that the provenance of digital data and knowledge is held to account from scientific design to implementation science, whether they concern academic or Industry 4.0 paradigms of innovation. There are enormous potentials and expectations from digital transformation in an era of COVID-19 and digital health. For this potential to materialize in ways that are efficient, democratic, and socially just, critical digital citizenship offers new ways forward. Systems science scholarship stands to benefit from a broadening of the focus on high-throughput omics technologies to a realm of critical digital citizenship, so the digital health innovations are well situated in their societal and political contexts.

The effects of 2100-MHz radiofrequency radiation on nasal mucosa and mucociliary clearance in rats.

BACKGROUND: Nasal mucociliary clearance has an important role in voiding the airways from inhaled foreign substances. This activity could be disturbed by environmental factors such as radiofrequency radiation. The aim of the present study was to investigate short-term and relatively long-term effects of 2100-MHz radiofrequency radiation emitted by a generator, simulating a 3G-mobile phone, on the nasal septal mucosa and mucociliary clearance in rats. METHODS: Thirty Wistar albino rats were divided into 4 groups. There were 6 rats in Group A and Group B, which served as the control groups (10-day and 40-day groups, respectively). Groups C (10-day exposure) and D (40-day exposure) were both composed of 9 rats; they comprised the radiofrequency radiation exposure groups. The rats in groups C and D were exposed to 2100-MHz radiofrequency radiation emitted by a generator, simulating a 3G-mobile phone, 6 hours/day, for 10 or 40 days, respectively. After exposure, nasal mucociliary clearance was measured by rhinoscintigraphy. After euthanization, the nasal septa of the animals were removed, and tissue samples of the nasal mucosa were examined using a transmission electron microscope. RESULTS: The differences in mucociliary clearances between groups A and C, groups B and D, and groups C and D were found to be statistically significant (p = 0.005, p < 0.001, p < 0.001, respectively). Although there were no histopathological abnormalities in the control groups, the exposure groups showed a number of degenerated and apoptotic cells, ciliary disorganization and ciliary loss in the epithelial cells, epithelial metaplasia, alteration of normal chromatin distribution and karyolysis in nuclei, changes in the basal cells, and lymphocytic infiltration. The histopathological changes were more severe in group D. CONCLUSION: Radiofrequency radiation at 2100 MHz damaged the nasal septal mucosa, and disturbed the mucociliary clearance. Ciliary disorganization and ciliary loss in the epithelial cells resulted in deterioration of nasal mucociliary clearance.

Voice Assessment After Treatment of Subacute and Chronic Cough With Inhaled Steroids.

INTRODUCTION: Inhaled steroids are widely used for persistent cough treatment. Although the side effects of long-term inhaled steroids have been well described in the literature, their laryngeal side effects after short-term use have not yet been defined. The aim of this study was to evaluate the effect of 1 month application of inhaled steroid treatment on voice parameters in patients with subacute or chronic cough. Furthermore, the efficacy of inhaled steroids on cough was investigated, as well. MATERIAL AND METHODS: This study included 46 patients (27 females and 19 males) with a persistent cough lasting at least 3 weeks and treated with inhaled steroids. All patients were examined by a pulmonologist and lung auscultation where a posteroanterior chest X-ray and spirometry were performed. The patients were also examined by an otolaryngologist. Anterior rhinoscopy, flexible fiberoptic nasopharyngoscopy, and laryngostroboscopy were performed. Also, the patients' acoustic voice analyses were performed and recorded using a multidimensional voice program. Cough symptom index (CSI) scores were used to evaluate the response to treatment. Patients with an underlying disease that was unresponsive to inhaled steroids were excluded from study. The 46 patients were administered inhaled budesonide 400 mcg twice a day, for 1 month, and their acoustic voice analyses were performed again at the end of the treatment. In addition, CSI scores were determined after stopping medication. RESULTS: When pretreatment and posttreatment acoustic voice analysis parameters (Fo, Jita, Jitt, Shim, APQ, vAm, and NHR) were compared, statistically significant differences were detected for vAm (P = 0.001) and F0 (P0.003). After treatment with inhaled steroids, the CSI score reduced from 3 to 1 (median), and the difference was statistically significant. CONCLUSIONS: Inhaled budesonide treatment in the proper dose seems to be an effective treatment for persistent cough, in the selected patient group. In addition, short-term budesonide application did not cause any negative effects on the voice parameters in these patients. These findings may be related to the steroid formulation used, the application method, and the duration of treatment. Further studies are needed on a larger group of patients with different formulations of inhaled steroids to clarify aforementioned issues.

The effect of 2100 MHz radiofrequency radiation of a 3G mobile phone on the parotid gland of rats.

PURPOSE: We aimed to evaluate the effect of 2100 MHz radiofrequency radiation on the parotid gland of rats in short and relatively long terms. MATERIAL AND METHODS: Thirty Wistar albino rats were divided into four groups. Groups A and B served as the control groups (for 10 days and 40 days, respectively), and each group included six rats. Groups C and D were composed of nine rats each, and they were the exposure groups. The rats were exposed to 2100 MHz radiofrequency radiation emitted by a generator, simulating a third generation mobile phone for 6 hours/day, 5 days/week, for 10 or 40 days. Following exposure, the rats were sacrificed and parotid glands were removed. Histopathological and biochemical examinations were performed. RESULTS: Although there were no histopathological changes in the control groups except for two animals in group A and three animals in group B, the exposure groups C (10 days) and D (40 days) showed numerous histopathological changes regarding salivary gland damage including acinar epithelial cells, interstitial space, ductal system, vascular system, nucleus, amount of cytoplasm and variations in cell size. The histopathological changes were more prominent in group D compared to group C. There was statistically significant different parameter regarding variation in cell size between the groups B and D (p=0.036). CONCLUSION: The parotid gland of rats showed numerous histopathological changes after exposure to 2100 MHz radiofrequency radiation, both in the short and relatively long terms. Increased exposure duration led to an increase in the histopathological changes.

[Importance of laryngologic examination in chronic cough]. / Kronik öksürükte larengolojik muayenenin önemi.

OBJECTIVES: This study aims to investigate the distribution of etiologic factors related to otorhinolaryngology in chronic cough patients with normal lung examination and spirometric findings, and also highlight the importance of videolaryngostroboscopic (VLS) examination with these patients. PATIENTS AND METHODS: Seventy-six patients (31 males, 45 females; mean age 48.0±15.5 years; range 18 to 83 year) who applied to pulmonology outpatient clinic with cough complaint for more than two months were included in the study. After being evaluated by a pulmonologist, patients were referred to otolaryngology outpatient clinic. To detect the underlying cause of cough, patients' detailed histories, and flexible fiberoptic endoscopy and VLS findings were reviewed. Reflux symptom index (RSI) was used for the diagnosis of gastroesophageal reflux. RESULTS: In RSI ≥13 group, posterior commissure edema was detected in 12 patients (42.9%), and posterior commissure hyperemia was detected in four patients (14.3%). These findings were statistically significantly higher than RSI <13 group (p=0.006 and p=0.016, respectively). No significant difference was present between the group of patients with allergic rhinitis and the group of patients without allergic rhinitis in terms of VLS findings. Mucopurulent secretion rate in posterior commissure in patients with acute sinusitis findings was statistically higher than patients without acute sinusitis findings (p<0.001). CONCLUSION: Chronic cough is a common symptom of many different diseases. Therefore, a multidisciplinary approach is important for diagnosis. Videolaryngostroboscopy is a valuable examination tool in the differential diagnosis of gastroesophageal reflux and acute sinusitis.

[The same nasal tip deformity in three siblings]. / Üç kardesteki ayni nazal tip deformitesi.

Similar to all other system anomalies, congenital nasal anomalies are caused by the defects during embriyogenesis and organogenesis. Nasal tip anomalies are usually accompanied by other systemic pathologies and syndromes. In this article, we report a nose anomaly with the same nasal tip appearance in three siblings.

[An evaluation of the radioprotective effect of vitamin E on the salivary glands of radioactive iodine in rats]. / Radyoaktif iyot verilen siçanlarda tükürük bezleri üzerinde E vitaminin radyasyondan koruyucu etkisinin degerlendirilmesi.

OBJECTIVES: This study aims to examine the acute effect of vitamin E on salivary gland of radioactive iodine (RAI; 131I)-induced rats and to evaluate whether vitamin E have a radioprotective effect. MATERIALS AND METHODS: Sixteen Wistar albino rats were used in the study. The rats were divided into two groups. The first group was administered (131)I orally and 1 ml physiological saline. The second group was administered (131)I and 1 ml vitamin E intraperitoneally. Vitamin E was started two days before the RAI therapy and continued for seven days. On the eighth day, salivary glands were removed and evaluated histopathologically. RESULTS: There was no statistically significant difference between the groups. The changes in the interstitial space of all glands and in acinar epithelial cells of parotid and sublingual glands were observed in a lower number of the rats of vitamin E group, compared to the controls. Except panacinar inflammation, histopathological changes in acinar epithelial cells of the submandibular gland were noticed in a lower number of the rats of vitamin E group. CONCLUSION: Considering the changes in the interstitial space and acinar epithelial cells in a lower number of the rats of vitamin E group, we conclude that vitamin E may have protective effects for interstitial space of all glands and acinar epithelial cells of the parotid and sublingual glands during the acute period.

The effects of nasal base stabilization techniques on nasal tip rigidity.

BACKGROUND: The aim of this study was to compare the degree of nasal tip rigidity from different techniques for increasing nasal tip projection. METHODS: Retrospective records of patients who had undergone rhinoplasty were reviewed at the tertiary referral center. 81 patients who had undergone suturing of the medial crura to the extension graft or to the long septum were selected. In group A, fixation was performed at the same level compared to before surgery. In group B, tip grafting was performed to gain 3 mm or more in projection after fixation as done in group A. In group C, the same tip projection was provided by advancing the medial crura on the caudal septum or extension graft. Patients were evaluated with a visual analog scale, based on the rigidity of the nasal tip (0=very flexible, 10=very rigid). RESULTS: When the preoperative and postoperative VAS scores of all groups were compared, postoperative scores were significantly higher than the preoperative scores (p<0.001). The postoperative scores of group C were higher than those of the other groups. These differences were statistically significant (p<0.001). There was no statistically significant difference between groups A and B with regard to the postoperative scores (p=0.389). However, in group C, the increase between preoperative and postoperative scores was significantly higher than in the other groups (p<0.001). CONCLUSION: Advancing the medial crura on the caudal septum and suturing to gain 3 mm or more of tip projection may result in a more rigid nasal tip. Patients should be informed preoperatively of this potential result. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Does helicobacter pylori have a role in the etiology of adenoid hypertrophy?

To investigate whether there is any association between nasopharyngeal reflux and adenoid hypertrophy in children by using 24-h pH monitoring with dual probe and to determine whether Helicobacter pylori simply colonises in adenoid tissue or it is present there temporarily due to extraesophageal reflux. A prospective study at a tertiary referral center. Thirty-two patients who underwent adenoidectomy, aged ranged between 4 and 13 were included. All children with adenoid hypertrophy underwent 24-h pH monitoring with a dual probe. Proximal probe was placed in the nasopharynx. The presence of nasopharyngeal reflux and gastroesophageal reflux were investigated by 24-h pH monitoring. The presence of H. pylori was investigated in adenoidectomy samples by HP-fast test. Of the 32 patients who underwent adenoidectomy, 5 had nasopharyngeal reflux positivity while 27 patients did not show nasopharyngeal reflux positivity with pH monitorisation. Helicobacter pylori could not be detected in 5 nasopharyngeal reflux positive children while 3 of 27 nasopharyngeal reflux negative children showed H. pylori positivity, one of them in the mucosa and others in the core. This study demonstrated the high incidence of nasopharyngeal reflux and gastroesophageal reflux in adenoid hypertrophy and the possible colonisation of H. pylori in the adenoid tissue. This may change the assesment of children with adenotonsillar hypertrophy in near future. However, more placebo controlled and double blind studies and larger series are still needed to support this hypothesis.

The use of glass ionomer cement in the reconstruction of the dorsal L-strut: an experimental study on rabbits.

OBJECTIVES/HYPOTHESIS: This experimental study in a rabbit model aimed to investigate the use of glass ionomer cement as a tissue adhesive on the dorsal L-strut. STUDY DESIGN: Sixteen adult male New Zealand White rabbits were used. The rabbits were equally divided into two groups as the control and the study groups. METHODS: The nasal septum was exposed through a superior approach. A graft was harvested preserving an L-strut cartilage. In the control group, a vertical incision was performed on the dorsal part of the L-strut to divide it into two cut ends, and the graft was sutured to the cut ends with 5-0 polydioxanone suture. In the study group, the reconstruction of the dorsal L-strut was made by fixing the graft to the cut ends with glass ionomer cement as the tissue adhesive. At 2 months, the rabbits were sacrificed. The nasal septum was removed for histopathological examination. RESULTS: No foreign body giant cells or acute inflammation were determined in the rabbits. The study group had less pronounced chronic inflammation. Comparison of the groups revealed that parameters regarding vascularization, cartilage proliferation, and new cartilage cells were statistically significant different between the two groups (P = .010, P = .010, P = .028, respectively). More vascularization, cartilage proliferation, and new cartilage cells were seen in the study group. CONCLUSIONS: Glass ionomer cement was effective for the reconstruction of the dorsal L-strut without any foreign body reaction, cartilage necrosis, or marked inflammation in rabbits, and it may be a potentially beneficial alternative to suture fixation.

Is there any effect of coenzyme Q10 on prevention of myringosclerosis? Experimental study with rats.

UNLABELLED: Recent studies have shown that the formation of myringosclerosis could be reduced by the application of antioxidant enzymes and elements. OBJECTIVE: The aim of this study was to investigate the effectiveness of coenzyme Q10 on the prevention of experimentally induced myringosclerosis. METHOD: Forty-eight healthy female wistar albino rats were bilaterally myringotomized and divided into four groups randomly. Group A received no treatment, group B was administered oral coenzyme Q10. Group C was treated with topical saline solution, group D received topically coenzyme Q10. On the 15th day of treatment, tympanic membranes were examined by otomicroscopy. Myringosclerotic lesions were documented semiquantitatively by using 4-point scale. After harvesting tympanic membranes were evaluated histopathologically. RESULTS: In group D (topical coenzyme Q10), we observed otitis within the first four days of the study and this group was excluded from the study. Regarding otomicroscopic examinations, there were no significant differences among groups in myringosclerosis formation (p = 0.241). When group A (non treatment) compared to groups B and C regarding histopathologic examination, the results demonstrated statistical significant differences (p = 0.004; p < 0.001), respectively. There was no statisticaly significant difference between groups B and C (p = 0.160). CONCLUSION: Oral administration of coenzyme Q10 did not reduce myringosclerosis formation in myringotomized rats.

The oblique split method: a novel technique for carving costal cartilage grafts.

IMPORTANCE: Autogenous rib cartilage is widely used in the septorhinoplasty cases with major structural grafting requirements. However, there is a risk of warping over time. OBJECTIVE: To introduce a novel method for carving costal cartilage grafts to obtain straight grafts of varying thicknesses and to eliminate the risk of warping. DESIGN: Between 2007 and 2011, a total of 43 consecutive patients underwent septorhinoplasty using autogenous costal cartilage grafts carved by the oblique split method (OSM). SETTING: The Ankara Training and Research Referral Hospital, Ankara, Turkey. PARTICIPANTS: The study included 43 patients with saddle nose deformity and revisional rhinoplasty with a depleted source. All patients were followed-up for a period ranging from 12 to 37 months (mean, 19.2 months) after surgery. INTERVENTIONS: All patients underwent open or closed septorhinoplasty. Autogenous costal cartilage was carved with the OSM to obtain grafts suitable for use as columellar strut, dorsal onlay, L-strut, lateral crural strut, caudal extension, and tip or speader grafts in selected cases. MAIN OUTCOME MEASURES: Patients were evaluated by inspection, palpation, and photographic documentation before surgery. Inspection, palpation, and photographic documentation were carried out every 6 months and 12 months after surgery and once a year thereafter. RESULTS: Patient satisfaction in terms of form and function was achieved in 41 patients (95%). Two patients required reoperation for further tip projection (n=1) and alar batten graft displacement (n=1). No complication was observed as a result of graft warping, resorption, or fracture. CONCLUSIONS AND RELEVANCE: The OSM provides straight costal cartilage grafts of varying thicknesses without the risk of warping. Because they strictly preserve their straight form, the grafts may safely be modified into rectangular shape or carved asymmetrically and/or have their edges beveled. Current data from this study suggest that the OSM offers a flexible and reliable reconstructive option for the rhinoplasty surgeon. LEVEL OF EVIDENCE: 4.

Antioxidant role of selenium in rats with experimental acute otitis media.

The aim of this prospective experimental animal study was to determine whether selenium had a protective effect on oxidative stress in rats with acute otitis media, by measuring the alterations of antioxidant parameters and lipid peroxidation on days 4 and 10 after inoculation into the middle ear. Streptococcus pneumoniae was inoculated into the middle ear cavities of 32 rats in animal laboratory of a tertiary medical center. Group 1 served as the control group and the animals were administered 1.5 ml/day saline. Group 2 received 0.2 mg/kg/day oral selenium for 10 days. The blood samples of each group were obtained on post-inoculation days 4 and 10. The levels of thiobarbituric acid reactive substances, albumin, total sulphydryl, superoxide dismutase and glutathione peroxidase were investigated. Day 10 level of thiobarbituric acid reactive substance in group 2 was lower than the day 4 level of the same substance in the control group. Although glutathione peroxidase and superoxide dismutase levels significantly decreased starting from 4th day until 10th day in group 1, their levels increased in group 2. Day 10 levels of albumin and total sulphydryl in group 1 were significantly higher than day 4 levels in group 2. We found that selenium supplementation for 10 days decreased thiobarbituric acid reactive substances and increased glutathione peroxidase and superoxide dismutase levels when compared to the control group. We believe that selenium supplementation may be beneficial to prevent the clinical sequelae and recurrence of otitis media.

Is there a relationship between serum levels of vitamin a, vitamin e, copper and zinc and otitis media with effusion in children?

The aim of this study is to determine whether the serum levels of vitamin A, vitamin E, copper and zinc have a role in the development of otitis media with effusion (OME) in childhood. This prospective study was conducted between February 2010 and February 2011 at a tertiary Otorhinolaryngoloy Clinic. There were 113 subjects and subdivided into three groups. Group 1 consisted of 44 patients who underwent adenoidectomy with ventilation tube placement due to OME. Group 2 consisted of 43 patients underwent adenoidectomy alone and group 3,called control group, included 26 healthy children. Serum values of vitamin A, vitamin E, copper and zinc were measured preoperatively. Comparison of the patient groups showed that group 1 patients had significantly lower serum zinc levels than group 2 patients (p = 0.002), although differences between both patients groups and controls were not significant. We found that the differences among the three groups in terms of serum levels of vitamin A, vitamin E and copper were not statistically significant (p > 0.05). The results of this study showed that serum levels of vitamin A, vitamin E and copper may not play a role on development of OME. We postulated that high serum zinc status may have the preventive effect in the predisposition to OME which may related to adenoid hyperplasia.

Are systemic voriconazole and caspofungin ototoxic? An experimental study with rats.

OBJECTIVES: To determine whether systemic administration of voriconazole and caspofungin causes ototoxicity. METHODS: This study was conducted on 32 healthy male Wistar albino rats. The baseline auditory brainstem response (ABR) thresholds of all animals were obtained under general anesthesia. Then, the rats were randomly divided into 4 groups (groups I-IV), each group consisting of 8 rats. Rats in group I were injected intraperitoneally with voriconazole 10 mg/kg/day for 7 days, and the rats in the group II were injected intraperitoneally with caspofungin 5 mg/kg/day for 7 days. Group III received 120 mg/kg/day gentamicin for 7 days. Group IV received saline for 7 days. The animals were then observed for 7 days, and on 14th day of the trial, posttreatment ABRs of both ears were recorded. RESULTS: We did not find any significant differences between pretreatment and posttreatment median ABR thresholds in the voriconazole, caspofungin, or saline groups. In the gentamicin group, there was a statistically significant difference between pretreatment and posttreatment ABR thresholds. CONCLUSION: Caspofungin and voriconazole did not change ABR thresholds in speech frequencies after a 7-day-period of their administration. We believe that further animal studies must be performed after administration of these agents for a longer time period, and these findings must be consolidated with histopathological investigations.

Concurrence of alopecia areata and vitiligo at the same anatomical site.

Both alopecia areata and vitiligo are common skin disorders that are considered to be caused by an autoimmune response targeted to hair follicle and melanocyte antigens, respectively. The association of these two diseases in the same patient is well known, however, coexistence of alopecia areata and vitiligo within the same lesion is very rare. Herein, we report an 8-year-old boy who had colocalization of alopecia areata and vitiligo on the frontal portion of his scalp.

Concurrent assay for four bacterial species including alloiococcus otitidis in middle ear, nasopharynx and tonsils of children with otitis media with effusion: a preliminary report.

OBJECTIVES: To detect the prevalences of Alloiococcus otitidis, as well as Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis in children with chronic otitis media with effusion (OME) and to simultaneously investigate the colonization of these bacteria in the nasopharynx and palatine tonsils of these patients. METHODS: The study included 34 pediatric patients with OME, and 15 controls without OME. In the study group, A. otitidis, H. influenzae, S. pneumoniae, and M. catarrhalis were investigated in the samples obtained from middle ear effusions (MEE), nasopharyngeal swabs (NPS) and tonsillar swabs (TS), using multiplex polymerase chain reaction (PCR) and conventional culture methods. Only the samples obtained from NPS and TS were studied with the same techniques in the control group. RESULTS: A. otitidis was isolated only in MEE and only with multiplex PCR method. A. otitidis, S. pneumoniae, M. catarrhalis, H. influenzae were identified in 35%, 8.8%, 8.8%, and 2.9%, respectively, in 34 MEE. A. otitidis was not isolated in NPS or TS of the study and the control groups. CONCLUSION: The prevalence of A.otitidis is high in children with OME and A.otitidis doesn't colonize in the nasopharynx or tonsil.

Inferior turbinate composite graft for repair of nasal septal perforation.

BACKGROUND: Repair of nasal septal perforations is one of the most challenging procedures in nasal surgery. The aim of this prospective clinical study was to determine the efficacy of using an inferior turbinate composite graft (ITCG) for the repair of nasal septal perforation. METHODS: Between 2009 and 2011, 27 consecutive patients with nasal septal perforation underwent endoscopy-assisted, endonasal septal perforation repair by using an ITCG alone or in combination with bipedicled mucosal advancement flap. RESULTS: Complete closure of the perforation was achieved in 24 of 27 (88.8%) patients, and incomplete closure was observed in 2 patients with medium-sized perforation and 1 patient with large perforation. CONCLUSION: The ITCG technique provides three-layer repair of the defect under no tension in closure of small perforations located anteriorly, posterior perforations with mucosal atrophy, or previous unsuccessful surgical repair. In graft-depleted revision rhinoplasty cases with small-sized septal perforations, this technique provides a simple solution with autogenous grafts. In cases involving larger perforations, the ITCG technique can easily be combined with bipedicled flap and allows for more options to solve a challenging problem. Current data from this prospective study suggest that this surgical technique may be used in the repair of nasal septal perforation.

Is there any relationship between the frontal cell and the Agger nasi cell and the localization of the anterior ethmoid artery?

OBJECTIVES: In this article, we examined the effect of the presence or absence of a frontal cell or an Agger nasi cell on the localization of the anterior ethmoid artery. PATIENTS AND METHODS: Coronal paranasal sinus computed tomography scans on 110 sides of 61 patients (35 males, 26 females; mean age 35.6 ± 12.7 years; range 15 to 72 years) who underwent surgery for septal deviation, concha bullosa, antrochoanal polyp between September 2006 and February 2008 were retrospectively evaluated and the anterior ethmoid foramen localization was measured according to the anterior nasal spine. The correlations of these measurements with the presence and absence of a frontal cell and an Agger nasi cell were investigated. RESULTS: The measurement of the anterior ethmoidal foramen according to anterior nasal spine was 18.2 ± 8.8 mm in the absence of an Agger nasi cell and was 20.3 ± 6.6 mm in the presence of an Agger nasi cell. This distance was measured as 20.0 ± 7.3 mm when the frontal cell was not determined. This measurement was 20.2 ± 6.5 mm in the presence of a frontal cell. According to the frontal cell types the results of the measurements were 20.5 ± 5.9 mm, 18.9 ± 8 mm, 20.6 ± 7.3 mm, for type 1, type 2 and type 3, respectively. Our results revealed that there were no significant relationship between the presence or absence of a frontal cell and an Agger nasi cell and the localization of the anterior ethmoidal foramen. CONCLUSION: The results of this study showed that the presence or absence of these cells does not affect localization of the anterior ethmoid artery.