Scanning electron microscopy of hydroxylated polyvinyl acetal and conventional gauze strip nasal packing materials.

The application of nasal packing is one of the most commonly performed procedures in rhinology. Various materials have been used as nasal packing, including conventional gauze strips and hydroxylated polyvinyl acetal. Complications related to nasal packing may cause problems that lead to increased morbidity. Among those complications, infectious ones range from localized infection in the nasal cavity to toxic shock syndrome. The purpose of this study was to evaluate conventional gauze strips and hydroxylated polyvinyl acetal nasal packing materials by scanning electron microscopy, to reveal their surface characteristics that would promote or prevent the development of infectious complications. The two types of materials were examined before and after application into the nasal cavity. Scanning electron microscopy demonstrated that hydroxylated polyvinyl acetal material had a smooth surface, whereas conventional gauze strips had an irregular surface with fibers projecting, thus increasing the surface area for bacterial adherence and allowing possible evasion of bacteria from the elements of the immune system within this fibrillar structure.

Pleomorphic adenoma of an unusual size in the deep lobe of the parotid gland.

Tumors of the salivary glands in children are not as common as in adults and they are mostly benign. The most common benign epithelial neoplasm seen in children is pleomorphic adenoma. As is usually the case in the adult population, it is usually found in the superficial lobe of the parotid gland. Its localization in the deep lobe is rare. Pleomorphic adenomas of the deep lobe present with a neck mass and when it is large, it may have an intraoral extension as well. It may also assume a dumb-bell shape as it enlarges and may be observed on CT or MRI scans as a prestyloid mass. The choice of treatment depends on the localization and the size of the tumor. The method can be transoral, cervical, transmandibular, transparotid, retromandibular fossa or a combination of these. A child with an unusually large pleomorphic adenoma of the deep lobe of the parotid gland is presented in this study. The deep lobe tumor was totally removed using a combination of cervical and transmandibular approaches.

A variation of the median nerve at the level of brachial plexus.

We report a variation of the median nerve at the level of brachial plexus in a 38 years old male cadaver. The median nerve was formed by the fusion of three branches; two of them coming from the lateral cord, and one from the medial cord. The abnormal root coming from the lateral cord had a very close oblique course over the axillary artery. These kinds of variations are more prone to injury in radical neck dissections and in other surgical operations of the axilla. Secondly, the very close course of the unusual branch with the axillary artery may lessen the blood supply of the upper extremity by compressing the vessel.

An important anatomic variation in head and neck region: anomaly of the anterior belly of the digastric muscle.

Anomalies of the anterior belly of the digastric muscle are not very rare. An anomaly in this region may have clinical significances. In this study, bilateral anomalies of the anterior bellies of both digastric muscles are presented. When an asymmetry in the floor of the mouth is detected during diagnostic procedures like radiologic studies, anomalies of the anterior belly of the digastric muscle should also be considered besides other reasons of asymmetry. Additionally, possible occurrence of this kind of anomalies should be remembered during surgical procedure involving this region.