Pleomorphic adenoma of the upper lip.

We present a rare case of pleomorphic adenoma in the upper lip region, with erosion of the maxillary bone and distortion of the facial appearance. A 20-year-old man presented with a painless mass on his upper lip, which had gradually increased in size over a period of 2 years. Computed tomography demonstrated a 30 mm × 28 mm enhancing mass in the upper lip region with no invasion to the surrounding tissues. Erosion of the maxillary bone posterior to this lesion was noted. The lesion was excised completely with a wedge of mucosa overlying the tumoral mass, accompanied with abdominal fat grafting to prevent labial asymmetry. Histological examination confirmed the diagnosis of a minor salivary gland pleomorphic adenoma in the upper lip. The pathology, clinical manifestations, and treatment of intraoral pleomorphic adenomas are reviewed.

Fascia lata: for the repairment of post-intubation tracheoesophageal fistula.

Tracheoesophageal fistulas are challenging formations for surgeons which can be treated with various surgical procedures. In an acquired tracheoesophageal fistula, fascia lata grafting can be accepted as a safe, easy accesible and a promising procedure, which can be one of the treatment options. We present a case of post-intubation tracheoesophageal fistula in which fascia lata was used as a reinforcement graft for the repairment in an adult patient.

Extrusion of Alloplastic Septal Silicone Implant: 25 Years After Rhinoplasty.

Multiple techniques and a variety of materials used for grafting have been described and applied over the years. Silicone implants are one of the most widely used alloplastic materials in Asian rhinoplasty, however, there are several complications. The authors report a case of an Asian woman who presented with implant rejection after 25 years later as a late complication of rhinoplasty. The patient was underwent revision augmentation rhinoplasty and stayed uneventful for 6 months as she was satisfied with aesthetic results and nasal airflow. The silicone implants are still going to be the most popular grafts in Asian augmentation rhinoplasty even so the long term complications must be kept in mind.

Comparison of the impact factors of subscription access and open access orthopedics and sports medicine journals in the SCImago database.

OBJECTIVES: This study aims to compare the annual impact factors (IFs) for the period 1999-2017 and the tri-annual IFs in 2011, 2014 and 2017 of the subscription access (SA) and open access (OA) journals published in the field of orthopedics, traumatology and sports medicine according to the SCImago Journal Rank (SJR). MATERIAL AND METHODS: All data for this study were obtained from the SCImago Journal & Country Rank database. We compared the change in the mean annual IFs of 197 SA journals with 52 OA journals in the field of orthopedics and sports medicine for the period between 1999 and 2017. In addition, we determined and compared the changes in the mean tri-annual IFs of these journals in 2011, 2014 and 2017. The mean publication fee values of the OA journals as well as the correlation between the three-year IFs of the year 2017 and the publication fee values were evaluated. RESULTS: From 1999 to 2017, the mean IF of SA journals increased 0.47-fold to 0.69, while the mean IF of the OA journals increased 0.85-fold to 0.63. Significant positive correlation was observed between the tri-annual IF and publication fee of OA journals in 2017 (r=0.458, p=0.001). CONCLUSION: We can predict that the mean IFs of OA journals in the field of orthopedics and sports medicine will reach the mean IFs of SA journals after several years. Choosing OA journals becomes advantageous when the desire for a higher number of citations is the most important factor.

The Perioperative Utilization of Sleep Monitoring Applications on Smart Phones in Habitual Snorers With Isolated Inferior Turbinate Hypertrophy.

The aim of this study is to investigate the novel use of sleep monitoring applications in simple snorers undergoing concha radiofrequency surgery and to compare and correlate the pre- and postoperative symptoms of these patients using the Nasal Obstruction Symptom Evaluation (NOSE) scale. In this retrospective analysis, we have selected 18 consecutive patients with no comorbid sleep or medical disorders suffering from chronic nasal blockage and habitual snoring due to isolated submucous inferior turbinate hyperplasia. After a median follow-up of 8.3 months, the NOSE scale and snoring sound intensity levels monitored by the smart phone application showed statistically significant improvements after the surgical procedure ( P < .05), and we also detected a positive correlation between the levels of snoring percentage and the total NOSE scores ( P < .05). We hypothesize that sleep monitoring applications could be easily used as portable monitors for basic home sleep studies in conjunction with a comprehensive sleep evaluation. Alternatively, such applications may simply be used for objective monitoring of the postoperative success of surgical interventions in the upper respiratory tract region such as concha reduction surgeries as presented herein.

Does intratympanic xylitol administration have ototoxic effects in a mouse ear model?

OBJECTIVE: To research the ototoxicity of xylitol after intratympanic injection in mice ear model. METHODS: 24 female mice Balb/c mice (48 ears) included in the study. The mice were divided into 4 groups as 6 mice were found (12 ears) in each group. Solutions of 0.9% NaCl solution (Group A), 155 mg/ml (Group B), 310 mg/ml (Group C) and 620 mg/ml (Group D) xylitol, were applied into the middle ear cavity. Microscopic ear examination and auditory brainstem response test were done for each mouse before application of xylitol and on the 1st, 3rd and 10th day of injection. RESULTS: There are some statistically significant alterations found in the threshold values at 8000, 12000, 16000, 24000 Hz frequencies when each group were compared in itself on day 0, 1,3 and 10, which were independent from the increasing dosage. CONCLUSION: According to our findings intratympanic xylitol injection does not have any ototoxic effect in the inner ear. To evaluate the effects of xylitol more clinical studies are need to carried out.

An Unusual Case of Headache: Isolated Fungus Ball in Concha Bullosa.

A concha bullosa forms when the middle turbinate becomes pneumatized, which is a common anatomic variation; however, fungus ball in concha bullosa is rather rare. An otherwise healthy 52-year-old man presented to our ear, nose and throat clinic with the complaints of midfacial pressure headache and malodorous postnasal drip. Computed tomography of the paranasal sinuses demonstrated a polypoid hyperdense lesion with slight microcalcifications in the right nasal cavity, accompanied with a complicated fluid collection in the right frontoethmoideal recess seen as hypodensity in contrast to this hyperdensity. The histopathological examination reported a fungal infection. We present an extremely rare case of isolated fungal mass in the right middle concha detected in an early stage without any evidence of fungal infection of the other paranasal sinuses and discuss the importance of reevaluation of the computed tomography scans in suspicion of a fungal sinusitis.

High sensitization to house-dust mites in patients with allergic rhinitis in the eastern Black Sea region of Turkey: A retrospective study.

OBJECTIVES: Identification of the most common aeroallergens to which patients are sensitized in a specific area is important in the diagnosis and treatment of allergic rhinitis (AR). We determined the distribution of aeroallergens, detected by skin-prick tests (SPT), in adult patients with AR in the Eastern Black Sea region of Turkey and compared the results with the other regions of Turkey and in the world. METHODS: The medical records of SPT performed on 1457 patients with symptoms of AR (with regard to the Allergic Rhinitis and its Impact on Asthma 2008 guidelines) between March 2010 and March 2013 were analyzed retrospectively. SPT were carried out with the same panel, which included grass; weeds; trees; mold; epidermal mixtures; and with two house-dust mite (HDM) extracts, Dermatophagoides pteronyssinus and Dermatophagoides farinae. RESULTS: In 1229 of 1457 patients (84.4%), there were positive reactions for at least one aeroallergen on the SPT. The most common aeroallergen was the HDM D. pteronyssinus (84% [n = 1033]) followed by D. farinae (78.2% [n = 962]). Grass pollen sensitivity (70.8% [n = 871]) was higher than tree or weed pollen sensitivity in this region. CONCLUSIONS: The most common aeroallergens in AR are HDMs of D. pteronyssinus and D. farinae in the Eastern Black Sea region in Turkey. Our study may help in developing environmental control strategies for AR.

Prevalence of Otitis Media with Effusion among Primary School Children in Eastern Black Sea, in Turkey and the Effect of Smoking in the Development of Otitis Media with Effusion.

The aim of this study was to determine the prevalence of otitis media with effusion (OME) in primary school children in Rize (Eastern Black Sea Region) and the impact of tobacco smoke exposure in the development of OME in primary school children. This study involved a total of 2960 children who appeal for ENT examination to our department at Rize Training and Research Hospital between November 2007 and April 2009. All children were evaluated with regard to OME and exposure to cigarette smoke. Pure tone audiometry and tympanometry tests and pneumatic otoscopy were performed on the children who were diagnosed with OME by otoscopic examination. The association between the children diagnosed as OME and exposure to cigarette smoke was evaluated. The prevalence of OME in this study was 9.86% (292/2960). Exposure to cigarette smoke was a statistically significant factor in development of OME (P < 0.0001). Environmental factors such as smoking are important in the development of OME. To prevent delayed diagnosis or development of this disease, parents must be informed about the preventable risk factors and symptoms for the development of OME.

The effect of melatonin on experimentally-induced myringosclerosis in rats.

OBJECTIVES: This study determined the preventive effect of melatonin on the occurrence of experimentally-induced myringosclerosis of the tympanic membrane (TM). MATERIALS AND METHODS: Twenty Wistar albino-type rats weighing approximately 300 g each were randomly separated into two groups and myringotomized on the left TMs: group 1 rats (n=6) received intraperitoneal melatonin injections 10 mg/kg/day whereas group 2 rats (n=12) were treated with physiological serum only. The remaining two rats were served as the control group for histological comparison and standardization. After 15 days of treatment, myringotomized membranes were examined by otomicroscopy and harvested for histopathological evaluation. The functional effect of myringosclerotic plaques in the TMs of the two groups were compared with tympanometric measurements. RESULTS: Tympanic membranes in group 2 revealed extensive myringosclerotic plaques, on the other hand, TMs in group 1 showed faint or no existence of myringosclerosis. The mean magnitude of the maximum admittance from group 2 measured by tympanometry reduced to about 40% of the values obtained from group 1 (Z=-2,067, p=0.041). The mean magnitude of the maximum admittance from melatonin group was very close to the mean tympanometric value of non-myringotomized Wistar albino rats, demonstrating a functional outcome. CONCLUSION: The occurrence of myringosclerosis following experimental myringotomy can be hindered by systemic melatonin treatment.

Viability of crushed and diced cartilage grafts wrapped in oxidized regenerated cellulose and esterified hyaluronic acid: an experimental study.

OBJECTIVES: The objective of this study was to investigate the viability of diced/crushed cartilage grafts wrapped in esterified hyaluronic acid (HYAFF) and oxidized regenerated cellulose (Surgicel) with respect to macroscopic and microscopic parameters. STUDY DESIGN: Experimental study. METHODS: A total of 10 New Zealand rabbits were acquired for the study. Cartilage grafts were harvested from both ears, with the ventral and dorsal perichondrial layers dissected off. There were six comparison groups in this experimental study: 1) bare, diced cartilage, 2) diced cartilage wrapped in Surgicel, 3) diced cartilage wrapped in HYAFF, 4) bare, crushed cartilage, 5) crushed cartilage wrapped in Surgicel, 6) crushed cartilage wrapped in HYAFF. Six cartilage grafts were inserted into the six subcutaneous pockets of the same animal. All the rabbits were sacrificed at the end of 2 months, the samples were collected, and the total specimen was examined histopathologically. The sections were stained with hematoxylin-eosin and Masson trichrome stain and examined under light microscopy. RESULTS: There was a significant difference among the bare, diced cartilage, the Surgicel, and the HYAFF groups with respect to fibrosis, chronic inflammation, cartilage mass, and vascularization. A significant difference was observed among the bare, crushed cartilage, Surgicel, and HYAFF groups with respect to fibrosis, chronic inflammation, and cartilage mass. There was no significant difference among the three groups regarding vascularization. CONCLUSIONS: This study suggests that wrapping cartilage grafts with Surgicel grossly reduces cartilage viability and the regeneration potential of the chondrocytes, leading to fibrosis formation. On the other hand, hyaluronic acid promotes cartilage integrity and survival, thus increasing clinical predictability and avoiding the need for overcorrection.

Ghrelin may attenuate proinflammatory cytokine-mediated neuropathic pain.

Nerve damage that affects peripheral or central nerve systems leads to abnormal pain states referred to as neuropathic pain. The precise mechanisms in neuropathic pain are very complex, since they are thought to originate through multiple pathophysiological processes. There is quite evidence implicating the proinflammatory cytokines in the induction and facilitation of neuropathic pain. This pain syndrome is usually poorly controlled by available medications. Ghrelin, a peptide hormone predominantly secreted from the stomach, is an endogenous ligand to the growth hormone secretagogue receptor. Previous studies showed that ghrelin has potent anti-inflammatory effect; inhibiting proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and interleukin-6 (IL-6). Furthermore, there are recent studies which prove the interaction between ghrelin and the systems that play role in pain modulation. Therefore, we hypothesize that ghrelin might ameliorate neuropathic pain by diminishing the proinflammatory cytokines and also regulating pain system.