[Effect of radiofrequency thermal ablation treatment on nasal mucociliary clearance in patients with isolated inferior turbinate hypertrophy]. / Izole alt konka hipertrofisi olan hastalarda radyofrekans termal ablasyon tedavisinin nazal mukosilier klirens üzerine etkisi.

OBJECTIVES: This study aims to evaluate the effect of the radiofrequency thermal ablation on nasal mucociliary clearance in patients with isolated inferior concha hypertrophy. PATIENTS AND METHODS: Thirty patients (10 females, 20 males; mean age 31.0±12.0 years; range 18 to 61 years) who were admitted to our clinic with a complaint of chronic nasal obstruction and diagnosed with isolated inferior concha submucosal hypertrophy between May 2009 and December 2009 were included. Radiofrequency thermal ablation was applied to the inferior concha at three separate points with 350 joule at 75 °C as a treatment. Nasal mucociliary clearance was evaluated through saccharin clearance test in pre- and postoperative (at eight weeks) period. RESULTS: The mean pre- and postoperative saccharin clearance tests were 565.4±253.9 sec and 558.7±257.7 sec, respectively. However, there was no significant difference in two measurements (p>0.05). CONCLUSION: Our study results show that radiofrequency thermal ablation application for the treatment of isolated inferior concha hypertrophy has no effect on nasal mucociliary clearance.

[Evaluation of efficacy of radiofrequency thermal ablation technique by computed tomography and visual analog scale in treatment of isolated inferior turbinate hypertrophy]. / Izole alt konka hipertrofisi tedavisinde radyofrekans termal ablasyon teknigi etkinliginin bilgisayarli tomografi ve görsel analog ölçegi ile degerlendirilmesi.

OBJECTIVES: This study aims to evaluate the efficacy of radiofrequency thermal ablation (RFTA) technique by computed tomography (CT) and visual analog scale (VAS) in patients with isolated inferior turbinate hypertrophy. PATIENTS AND METHODS: Between May 2009 and December 2009, 30 patients (10 females, 20 males; mean age 31.0±12.0 years; range 18 to 61 years) who were diagnosed with an isolated inferior turbinate hypertrophy were included in this study. As a treatment, RFTA was applied to the inferior turbinate on three separate points. Evaluation of turbinate dimensions was performed by CT in pre- and postoperative period. Also, the evaluation of turbinate dimension by another otorhinolaryngologist and of the nasal obstruction by the patients in pre- and postoperative period through VAS were asked. RESULTS: The mean dimensions of the left and right inferior turbinate on CT in pre- and postoperative period were 112.42±28.41 / 81.53±22.57 and 117.72±27.85 / 86.53±23.66 mm2, respectively. The mean VAS values of the left and right turbinate dimensions were determined by another otorhinolaryngologist in pre- and postoperative period as 6.60±2.48 / 4.30±1.47 and 7.60±1.67 / 4.63±1.40, respectively. The mean VAS values of nasal obstruction in pre- and postoperative period were 6.77±1.19 and 3.57±1.46, respectively. CONCLUSION: Radiofrequency thermal ablation technique used for the treatment of the inferior turbinate hypertrophy is an effective procedure in the light of the CT and VAS evaluation results.

Cervical thymic cyst mimicking laryngocele.

Cervical thymic cysts are nearly 0.3% of all congenital cervical cysts. Thymic cysts are asymptomatic, but they rarely complain of dysphagia or tracheal obstruction symptoms. A soft, mobile, and painless mass increasing with valsalva maneuver directs the diagnosis of laryngocele. There has not been any study in the literature in which thymic cyst presenting like laryngocele. We hereby present a case of thymic cyst mimicking laryngocele that has not been reported so far.

Is the use of topical fluorescein helpful for management of CSF leakage?

OBJECTIVES/HYPOTHESIS: We aimed to evaluate the effectiveness of topical intranasal fluorescence application together with high-resolution computed tomography and magnetic resonance imaging and/or magnetic resonance cisternography for the preoperative diagnosis of cerebrospinal fluid (CSF) leakage and for intraoperative localization of CSF fistulas. We also assessed postoperative recurrence. STUDY DESIGN: Descriptive study. METHODS: Twenty-four cases underwent endonasal endoscopic repair for CSF leakage. Following intranasal topical application of fluorescein 10% to the middle turbinate-cribriform plate region and anterior wall of the sphenoid sinus, a color change of the fluorescein from yellow-brown to green was accepted as evidence of CSF leakage. A nasoseptal flap, collagen matrix, or fascia lata and septal cartilage graft were used for reconstruction of the CSF fistula. RESULTS: The use of topical fluorescein application was helpful in diagnosing CSF rhinorrhea preoperatively and locating the CSF fistula intraoperatively. One case had both ethmoid roof and sphenoid sinus defects, and this case underwent a second operation for closure of the sphenoid defect. All CSF leakages were successfully repaired by endoscopic endonasal surgery using a nasoseptal flap. CONCLUSIONS: Cases with traumatic CSF leakage pose a higher risk of meningitis than the cases with spontaneous CSF leakage. Topical application of fluorescein is highly specific and sensitive in identifying preoperative, intraoperative, and postoperative CSF leakage. It is a simple, quick, and sensitive technique. The surgeon should be vigilant for multiple defects.

[Frontal sinus obliteration with pericranial-subgaleal flap]. / Perikraniyal-subgaleal flep ile frontal sinüs obliterasyonu.

OBJECTIVES: We evaluated the results of patients who underwent frontal sinus obliteration with vascularized pericranial-subgaleal flap. PATIENTS AND METHODS: Charts of patients (7 males 1 female; mean age 40.5+/-17.1 years; range 9 to 61 years) who underwent frontal sinus obliteration with pericranial-subgaleal flap between June 2001 and January 2008 were retrospectively reviewed. Demographics, indications for frontal sinus obliteration, immediate and late postoperative complications were recorded. All patients were invited to the clinic and underwent control examinations and computed tomography. The indications for frontal sinus obliteration were fracture of frontal sinus anterior and posterior walls in four cases, frontal sinus mucoceles in two cases, mucopyoceles in one case and fracture of frontal sinus anterior wall in one case. Bicoronal incision was used in all patients and then they underwent frontal sinus obliteration with lateraly based pericranial-subgaleal flap. RESULTS: In the postoperative period rhinorrhea and meningitis, which lasted for two days, developed in one patient with fracture of frontal sinus anterior-posterior walls and hypoestesia developed in the frontal skin area in one patient with fracture of frontal sinus anterior wall. No complications were observed in the other cases. CONCLUSION: Pericranial-subgaleal flap is a well vascularized, close to surgical area, inexpensive, safe and effective tissue that can be used for frontal sinus obliteration.

Juvenile ossifying fibroma of the mandible: a case report.

BACKGROUND: Fibro-osseous lesions of the jaws, including juvenile ossifying fibroma, pose diagnostic and therapeutic difficulties due to their clinical, radiological and histological variability. The aim of this study was to report the outcome of a 9 years old girl with diagnosed juvenile ossifying fibroma treatment. METHODS: A 9 years old girl presented with a 6 x 8 cm sized hard fixed tumour on right ramus and corpus of the mandible. On the radiological examination tumour showed an irregular but well bordered, unilocular and expansive lesion on the right corpus and ramus of the mandible. There was no teeth displacement or teeth root resorbtion. Microscopically, the tumour had trabeculae, fibrillary osteoid and woven bone. After the clinical, radiological (panoramic radiography, computed tomography and magnetic resonance imaging) and histologic analysis it was diagnosed juvenile ossifying fibroma. In the history of the patient there has been an acute lymphocytic leukaemia in the remission for 3 years. RESULTS: Because of large size of mandibular tumour, resultant expansion and destruction of mandibular cortex, the patient underwent right hemimandibulectomy using transmandibular approach. There was no recurrence or complications for two years follow-up. CONCLUSIONS: Although juvenile ossifying fibroma is an uncommon clinical entity, its aggressive local behaviour and high recurrence rate means that it is important to make an early diagnosis, apply the appropriate treatment and, especially, follow-up the patient over the long-term.