What is the cause of hypertrophia in asymmetric tonsils?.

OBJECTIVES: Asymmetric tonsillar hypertrophy is a condition, confirmed by physical examination, that can be found in every age group. The aim of this study was to compare each tonsil through macroscopic and microscopic assessment of specimens and reveal the reasons that cause one tonsil to grow more than the other. METHODOLOGY: The study was carried out with 93 patients who wereindicated for tonsillectomy in the authors' Clinic. Of these 93 patients, seven cases who had clinically asymmetric but pathologically symmetric tonsils were excluded from the study. The presence of microscopicintraepithelial abscess, Helicobacter pylori with Giemsa stain, Coccobacillus, fungus, Actinomyces with Pas-Grocott stain, dysplasia or hyperplasia, malignancy and reactive changes in the epithelium were evaluated. RESULTS: The study was conducted with 86 patients aged between two and 35, of whom 32 were women (37.2%) and 54 were men (62.8%). The mean age of cases was 8.37 ± 5.95. The mean difference between two tonsils ranged from 1 to 12 mm, mean 3.67 ± 2.56 mm. When the findings were examined, the presence of H. pylori, Coccobacillus, fungus and Actinomyces, reactive changes in the epithelium, pattern of hyperplasia, intraepithelial abscess and macroscopic presence of pus did not reveal any statistically significant changes. CONCLUSION: The reasons behind asymmetric tonsil hypertrophies and how they are related to malignancies have not yet been clarified. There is no statistically significant difference between the evaluated parameters in the present study. This study has brought a new point of view to the subject by comparing different-sized tonsils in the same person, thus paving the way for future studies with a broader scope.

Epithelioid hemangioendothelioma of the nasal septum.

Epithelioid hemangioendothelioma of the nasal septum. BACKGROUND: Epithelioid hemangioendothelioma is a tumour of vascular origin and unknown aetiology, which occurs in all age groups. The most common locations are the liver, bone, lungs, and brain, with less common occurrence in head and neck regions, and no prior reports of origination from nasal septum. CASE REPORT: Here we report a case of epithelioid hemangioendothelioma of the nasal septum. A 62-year-old male patient attended our clinic with epistaxis and congestion in his left nasal cavity. Endoscopic examination revealed a mass within the left nasal passage. Clinical and histopathological examinations showed that the mass was a septum-originated epithelioid hemangioendothelioma. The mass was removed endoscopically using a transnasal approach. CONCLUSIONS: No recurrence was observed over 36 months of follow-up. Here we discussed this uncommon case along with a literature review.

Chronic otitis media surgery in the only hearing ear.

OBJECTIVES: The present study aimed to investigate how quality of life was impacted in patients who underwent surgery for chronic otitis media in their only remaining hearing ear (OHE). Such surgical treatment is controversial, and avoided by many surgeons due to the high risk of hearing loss due to surgery. However, if the patient is left untreated, hearing may further deteriorate over time, decreasing the patient's quality of life to an undesirable level. METHOD: We performed a retrospective single-institution study of a prospectively collected database in a tertiary university hospital. Twenty-three patients with OHE who underwent surgical treatment were retrospectively analyzed. The patients' age, sex, treated ear, indications, and preoperative and postoperative hearing levels were recorded. The data were statistically analyzed. RESULTS: Of the 23 patients with OHE, 15 regularly attended follow-up for at least two years. In all cases, the tympanic membrane perforations were closed and the ear drum became dry. An air-bone gap gain of ≥ 20 dB was measured in five patients, ≥ 10 dB in seven, and two patients showed no significant change (4-10 dB). One patient showed minimal hearing deterioration of -2 dB. CONCLUSION: Patients with OHE can be treated surgically to improve hearing levels and quality of life. Modern surgical techniques and instruments--especially in experienced hands--may reduce the possible surgical risks. If hearing deteriorates due to surgery, it may be improved, for example, with cochlear implantation surgery.

Does cerumen have a risk for transmission of HIV?

Human immunodeficiency virus (HIV) is mainly transmitted via sexual activity, mother-to-child transmission, and contact with body fluids, such as saliva and semen. Cerumen, however, has not been investigated for its capability to transmit HIV. The purpose of this study was to evaluate the potential of cerumen for transmission of HIV infection. This study was conducted among 42 treatment-naive HIV-infected patients with positive HIV RNA and 27 HIV-infected patients with negative HIV RNA receiving antiviral treatment. Simultaneous blood samples were studied as positive controls. Sixty-nine prospectively collected cerumen specimens were analyzed for the presence of HIV RNA by real-time polymerase chain reaction (PCR). None of the 69 cerumen specimens were positive for HIV RNA. These results conclude that cerumen in HIV-positive patients with or without antiretroviral therapy (ART) carry only an insignificant risk of transmission. However, standard infection control precautions should be applied carefully in all examinations and surgical operations of the ears.