A Novel Technique for Septal Perforation Repair: Fascia Lata Graft.

BACKGROUND: Nasal septal perforation (NSP) is an anatomical defect involving the mucosa, cartilage/bone of the nasal septum, most commonly caused by septoplasty. Spontaneous healing of a perforated septum is rare; instead, it tends to worsen over time. Several surgical approaches have been described for NSP repair. In this study, the authors present a novel technique using only fascia lata graft for repairing NSP of various sizes. METHODS: The authors conducted a retrospective study, including 23 patients who underwent NSP repair between January 2020 and January 2022. Grafts were harvested, and the perforation was accessed through an open rhinoplasty approach, followed by insertion and suturing of the graft. RESULTS: The mean size of the septal perforations was 2.13 mm horizontally and 2.14 mm vertically. The mean follow-up period was 12 months. Complete closure of NSP was achieved in 21 out of 23 patients (91.30%). Among the cases, 17 were males (11.76%), and the age ranged from 20 to 43 years with a mean of 36.5. Eight cases (50%) were smokers. At 12 months postoperatively, 3 medium-sized NSPs were closed successfully, whereas 2 large NSPs did not achieve closure due to smoking. CONCLUSION: The fascia lata technique for NSP closure is a safe and reliable approach with a high success rate, which should be considered for patients with NSP.

Unusual Histopathological Findings in Appendectomy Specimens: A Retrospective Analysis of 2047 Cases.

BACKGROUND: In this study, we retrospectively evaluated cases of patients who had undergone appendectomy in our hospital and aimed to present the efficiency of diagnostic tests and demographic data of cases. Pathological reports were analyzed for the following parameters: age, gender, and pathological diagnosis. In addition, the demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and reanalysis of archived resected appendix specimens was carried out. METHODS: Files of 2047 patients (1329 males, 718 females, sex ratio: 1.85, age range: 1-87 years, mean age: 26, 50 years), who had been operated with a diagnosis of acute appendicitis in the emergency department of Bezmialem Vakif University Medical Faculty from November 2011 to June 2014, were retrospectively evaluated. RESULTS: Cases were separated into 2 groups. Cases with histopathologic examination reported as acute appendicitis constituted group 1 (n = 2013, 98.34%), and cases with pathologic findings other than acute appendicitis constituted group 2 (n = 34, 1.66%). The second group consisted of 8 low-grade mucinous neoplasms, 7 mucoceles, 6 carcinoid, 5 granulomatous inflammation, 4 intraluminal Enterobius vermicularis, 1 endometriosis externa, 1 adenocarcinoma infiltrated to serosa, 1 mesenteric cyst, and 1 low-grade adenocarcinoma formed in mucinous cystic neoplasm background. CONCLUSION: Acute appendicitis is the most common emergency surgical condition. Although most of the resected appendectomy specimens showed typical histopathologic findings, some (1.66%) showed unusual histopathologic findings. Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination.

Development and Validation of Turkish Version of The Female Sexual Distress Scale-Revised.

INTRODUCTION: The sexually related personal distress becomes an obligation for the diagnosis of female sexual dysfunction (FSD). The Female Sexual Distress Scale-Revised (FSDS-R) was developed, extensively validated, and is among the most widely used tools to measure distress associated with impaired sexual function. AIM: This study aims to develop a Turkish version of the FSDS-R, to evaluate its psychometric reliability and validity, and to estimate the optimal cutoff score that corresponds best to the clinical diagnosis of sexual dysfunction. METHODS: Ninety-five participants were diagnosed with female sexual interest and arousal disorder (FSIAD), 25 participants were diagnosed with another FSD, and 128 participants were healthy. Alpha coefficients (α) were used as an indicator of internal consistency. Test-retest reliability over a 2-week period was estimated using intraclass correlation coefficients (ICCs). Correlation analysis conducted between the FSDS-R total score, the Female Sexual Function Index subscale, and total score was examined for convergent validity. Discriminant validity was assessed by comparing mean scores of the FSD and control groups in a between-groups analysis of variance. Receiver operating characteristic analysis was performed to determine optimal cutoff values of the Turkish version of Female Sexual Distress Scale-Revised (Tr-FSDS-R). MAIN OUTCOMES MEASURES: Sexuality-related distress measured by the Turkish version of the FSDS-R. RESULTS: Internal consistencies of the FSDS-R across the two assessments point for the three groups of women ranged from α = 0.87 to α = 0.99. ICCs ranged from 0.92 to 0.94 for baseline and day 15 for FSIAD, other FSD, and no FSD groups. One-factor unidimensional model explained 85.7% of the total variance of the Tr-FSDS-R items. The optimal cutoff score was found to be >11.5 to provide optimal sensitivity (97.9%) and specificity (83.2%). Significant differences in the FSDS-R scores were found between healthy women, women with hypoactive sexual desire disorder, and women with other types of FSD. CONCLUSION: The Turkish version of FSDS-R is a valid, reliable tool with well discriminative and psychometric validity for use in the Turkish female population and can be used as a screening questionnaire for females with sexual interest/arousal disorder. The score of ≥11.5 was proposed as a cutoff to detect the presence of sexually related personal distress in Turkish women with FSD.

Co-existence of acute appendicitis and inflammatory myofibroblastic tumor of the small intestine: A case report.

INTRODUCTION: Inflammatory myofibroblastic tumor as a rare neoplastic lesion is seen most commonly in the pulmonary system. Beside the presence of limited number of inflammatory myofibroblastic tumors of the gastrointestinal tract in the literature, co-existence with acute appendicitis has not been reported before. PRESENTATION OF CASE: A 27-year-old woman admitted to emergency department with acute abdominal pain at the right lower quadrant. The initial diagnosis was as acute appendicitis. Intraoperatively, a mass with a diameter of almost 5 cm originated from the distal ileal segments neighboring the appendix was seen. The patient was managed by segmental resection of the small intestine including the mass with appendectomy. Histologically, there were bundles of spindle cells accompanied by lymphoplasmocytic infiltration. The immunohistochemical studies showed that tumor cells were positive for smooth muscle actin, vimentin, perinuclear activity for anaplastic lymphoma kinase and CD 68. The final pathologic diagnosis was inflammatory myofibroblastic tumor. DISCUSSION: Concomitant resection of tumoral lesions detected in the neighbor intestinal segments during appendectomy should be considered to diagnose and treat. For the diagnosis of inflammatory myofibroblastic tumor, immunohistochemistry pattern including positivity for actin, vimentin, CD 68 and anaplastic lymphoma kinase plays a crucial role. Therefore, detailed immunohistochemistry analysis should be performed in suspicious cases. CONCLUSION: Coexistence of inflammatory myofibroblastic tumor located in the gastrointestinal system with acute appendicitis is a rare event. Complete surgical excision should be regarded as the mainstay of the treatment. Long-term follow up with serial imaging techniques is recommended.