Correlations between objective and subjective tests of nasal patency in patients undergoing septoplasty.

OBJECTIVE: This study assessed correlations between pre- and post-operative objective and subjective nasal patency test results in patients undergoing septoplasty to treat nasal septum deviation. METHOD: Eighty nasal septum deviation patients who underwent septoplasty were prospectively enrolled. Nasal Obstruction Symptom Evaluation questionnaire scores, anterior rhinomanometry and acoustic rhinometry data were compared pre-operatively and three months after surgery. The left, right and total volume and left, right and total minimum cross-sectional area acoustic rhinometry values were compared. RESULTS: The left volume, total volume, left minimum cross-sectional area and total minimum cross-sectional area differed significantly between the two time-points (all p < 0.05). The total resistance, inspiratory total airflow, expiratory total resistance and expiratory total airflow rhinomanometric data did not differ between the two timepoints (all p > 0.05). CONCLUSION: This study suggested that subjective tests such as the Nasal Obstruction Symptom Evaluation questionnaire are optimal to identify complaints and assess post-operative satisfaction.

Performance of ozone and peroxone on the removal of endocrine disrupting chemicals (EDCs) coupled with cost analysis.

Micropollutants such as endocrine disruptors are one of the most important groups of chemicals polluting water resources. Conventional treatment systems may not be effective for the removal of endocrine disrupting chemicals (EDCs), and the fate of these chemicals should be carefully monitored in the effluent of wastewater treatment plants (WWTPs). Additional treatment methods such as advanced oxidation processes can be used for the removal of endocrine disruptors. This study presents the existence of endocrine disruptors in 4 different effluents: (i) municipal WWTP effluent, (ii) textile industry WWTP effluent, (iii) organized industrial zone (OIZ) WWTP effluent and (iv) pharmaceutical industry discharge and also presents their removal efficiencies by ozonation and peroxone oxidation. A broad spectrum of removal efficiencies was observed for the EDCs present in the samples since the oxidation efficiency of wastewaters containing EDCs mainly depends on the wastewater matrix and on the type of the EDCs. Ozonation was found to be a lower-cost option than peroxone oxidation at the investigated conditions.

Effects of subcutaneous melatonin implants and short-term intravaginal progestagen treatments on estrus induction and fertility of Kivircik ewes on seasonal anestrus.

The aim of this study was to compare the efficacy of estrus induction and fertility by using subcutaneous melatonin (MEL, T1) and short-term intravaginal medroxyprogesteronacetate plus pregnant mare serum gonadotropin treatments (sMAP+eCG, T2) in ewes on seasonaly anestrus. In this study, 105 mature clinically healthy Kivircik ewes in anestrus season and 4 rams were used. After synchronization applications, ewes exhibiting estrus signs were hand-mated with rams known to be fertile. Blood samples were collected at different times in order to determine progesterone (P4) concentrations. Results showed that estrus manipulation protocols induced significant improvement in pregnancy rate. All the fertility results obtained with the sMAP+eCG or MEL groups were similar, in seasonal anestrus. The efficacy duration of P4 in the MEL group was longer than that in short-term progestagen group. Plasma P4 concentrations was significantly different between the first (I) and last (III) measurement days (p0.01). Increase in P4 concentration in T2 group was faster than that in T1 group, and blood P4 concentrations at higher levels could successfully be achieved by using any of the protocols in this study during the seasonal anestrus. In conclusion, according to the results obtained, the hormone application groups received very high estrus response. In addition, the twin ratio was found to be higher in T1 group compared to those determined in the other groups (T2 and Control group). Furthermore, plasma P4 concentrations and high birth rates were obtained in ewes in T1 and T2 groups. These procedures can be considered a good alternative to traditional procedures due to its flexibility under field conditions.

Effects of melatonin implantation on the fertility potentials of Kivircik and Charollais ewes and rams during the non-breeding season.

This study examined the effect of melatonin implantation during the non-breeding season on the reproductive performance of ewes and the testicular dimensions of rams. In seasonally anestrus Kivircik and Charollais ewes and rams were subjected to melatonin. Estrus response was significantly higher in treated than control ewes of both breeds (p<0.001). The pregnancy rate was significantly lower (p<0.001) in the control than in the treated animals. The twinning rate was significantly lower in melatonin implanted Kivircik than Charollais ewes (p<0.05). The testicular dimensions after 42 days of melatonin treatment increased in both breeds. Scrotal length (SL) increased in Kivircik and Charollais rams (p<0.01). The increase in scrotal circumference (SC) was more marked in the Charollais (P<0.01) than in the Kivircik rams. There was a large increase in testicular volume (TV) in both Kivircik (p<0.01) and Charollais (p<0.001) rams. This study shows that melatonin implants can be applied to induce estrus in ewes approximately four months earlier than breeding season. Melatonin implantation in the non-breeding season significantly increased testicular dimensions in Kivircik and Charollais rams thus increasing their reproductive potential.

Comparison of sexual performance and testicular characteristics of melatonin treated Kivircik and Charollais rams during the non-breeding season / Comparação de desempenho reprodutivo e características testiculares de carneiros Kivircik e Charollais tratados com melatonina durante a estação não reprodutiva

This study was conducted to investigate the effects of melatonin implantation on basic testicular characteristics and reproductive performance of Kivircik and Charollais rams and ewes during the non-breeding season. In this study, 8 Kivircik and 6 Charollais rams were used. Rams were implanted with 54 mg melatonin according to the manufacturer's instructions. At melatonin implantation and at ram introduction the reproductive performance and testicular characteristics were evaluated. Throughout the experimental period, rams were permanently kept outdoors under conditions of natural day length and at ambient temperature. The effects of exogenous melatonin treatments on the reproductive performances of rams and ewes, estrus response, pregnancy rate, litter size and twinning rate of ewes were evaluated in all groups. Libido values were significantly higher in Charollais rams compared to Kivircik rams (P<0.001). Testicular volume (TV) was increased in both ram breeds. Scrotal length (SL) was also increased in both Kivircik and Charollais rams (P<0.01). In conclusion, we showed that the treatment of rams with slow release melatonin implants increased scrotal diameters and testicular volumes in both Kivircik and Charollais rams. Furthermore, melatonin implantation improved the reproductive performances of ewes naturally mated with these melatonin implanted rams during non-breeding season.(AU)

Esse estudo foi conduzido para investigar os efeitos de implantação de melatonina em características testiculares básicas e desempenho reprodutivo de carneiros Kivircik e Charollais durante a estação não reprodutiva. Nesse estudo, oito carneiros Kivircik e 6 Charollais foram utilizados. Foi implantado 54 mg de melatonina nos cordeiros de acordo com as instruções do produtor. Ao implantar a melatonina e à introdução do carneiro, foram avaliados o desempenho reprodutivo e as características testiculares. Ao longo do período experimenta, os cordeiros foram mantidos em ambiente externo sob condições de luz e ritmo circadiano naturais e à temperatura ambiente. O efeito de tratamento com melatonina exógena no desempenho reprodutivo de carneiros e ovelhas, resposta estral, taxa de prenhez, tamanho de ninhada e taxa de gemelaridade foram avaliados em todos os grupos. Valores de libido foram significativamente maiores em Charollais comparados a Kivircik (P<0.001). Volume testicular (VT) estava aumentado em ambas as raças. Comprimento escrotal (CE) também estava aumentado tanto em Kivircik quanto em Charollais (P<0.01). Conclui-se que o tratamento de carneiros com implantes de liberação lenta de melatonina aumentou diâmetro e volume testiculares tanto em carneiros Kivircik quanto em Charollais. Ademais, implantação de melatonina melhorou o desempenho reprodutivo de ovelhas naturalmente cruzadas com esses carneiros implantados com melatonina durante o período não reprodutivo.(AU)

Bicanalicular silicone tubes versus otologic T-tubes in endonasal dacryocystorhinostomy.

OBJECTIVE: We compared the efficacy of T-tubes and bicanalicular silicone tubes in endonasal dacryocystorhinostomy (DCR). METHOD: We retrospectively reviewed 54 eyes of 49 patients who had experienced nasolacrimal duct obstruction and undergone endoscopic DCR. Group one had bicanalicular silicone tube stents implanted (24 eyes), and group two consisted of patients who had otologic T-tubes (30 eyes). The duration of stent placement, follow-up time, and the subjective and objective success of the procedures were evaluated. Cases were grouped as failure or success according to improvement in epiphora complaint. RESULTS: An endoscopic DCR procedure was successful in 19 (79.2%) cases in the silicone group and in 23 (76.7%) cases in the T-tube group. The success rate did not differ significantly between the groups (p = 0.83). The most common cause of failure was granuloma formation in the bicanalicular silicone tube group and spontaneous tube loss in the otologic T-tube group. CONCLUSIONS: The findings revealed that both the otologic T-tube and the bicanalicular silicone tube had similar success rates (76.7% and 79.2%, respectively). We believe that otologic T-tubes, which are less expensive and more easily acquired, might be offered as an alternative to bicanalicular silicone tubes in patients with nasolacrimal duct obstruction.

Retropharyngeal submucosal dissection due to nasotracheal intubation.

PROBLEM: Nasal intubation is used often by anaesthetists because it offers many advantages; however, rare complications do arise. A 67-year-old man was admitted to our otorhinolaryngology clinic for uvulopalatopharyngoplasty. Nasotracheal intubation was performed without difficulty. At the beginning of surgery, the surgeon noticed that the nasotracheal tube had penetrated the oropharyngeal mucosa through a channel in the retropharyngeal space. METHODOLOGY: The tube was left in place during surgery to prevent bleeding. After surgery, a vertical incision was made through the mucosa surrounding the tube from the inferior pouch up to the nasopharynx to prevent hematoma. RESULT: The patient was extubated without complication and discharged on the second day postoperative. The oropharyngeal mucosa was healed by the 15th day postoperative. CONCLUSION: Nasal intubation tubes should be lubricated and inserted without force; the oropharynx should be examined carefully after intubation to rule out complications.

Surgical approaches for antrochoanal polyp: a comparative analysis.

OBJECTIVE: The aim of this study was to evaluate the clinical and histopathological characteristics of antrochoanal polyps (ACPs) and to perform a comparative analysis of surgical techniques in terms of recurrence. METHODS: The clinical, radiological and histopathological features of 42 patients with a diagnosis of ACP who underwent surgery in a period of 6 years (January 2000 - January 2006) were investigated retrospectively. Histopathological examinations were present for all patients and were re-examined for histological analysis. RESULTS: Endoscopic sinus surgery (ESS) was performed in all patients. Transcanine sinoscopy (TS) and the Caldwell-Luc approach (CL) were used in addition to ESS in 14 and 13 patients respectively. The attachment site was detected in 21 patients (50%) and the most frequent site was found to be the lateral wall in 15 patients (71.4%). There was no relationship between the choice of surgery, the attachment site or accessory ostium, or any sinusitis with ACP. Histological examination showed prominent eosinophilia in 29 patients (69%). The follow-up time was a minimum of 12 months with a mean of 28.9 months. Three recurrences were seen after ESS. However, there was no recurrence after ESS+TS and ESS+CL. CONCLUSION: Our study showed that the most important factors affecting the choice of surgical approaches are the preference of the surgeon, the age of the patient and the presence of recurrent disease. Combined approaches with either TS or CL should be considered, particularly when the attachment site of the antral part of ACP is undetected, in order to prevent incomplete excision and recurrences.

Patient-controlled analgesia with lornoxicam vs. dipyrone for acute postoperative pain relief after septorhinoplasty: a prospective, randomized, double-blind, placebo-controlled study.

BACKGROUND AND OBJECTIVE: We compared the efficacy of intravenous lornoxicam vs. dipyrone in patient-controlled analgesia for postoperative analgesia. METHODS: The study included 105 patients who had undergone elective septorhinoplasty after receiving general anaesthesia. Patients were divided into three groups to receive lornoxicam (24 mg day(-1)), dipyrone (5 g day(-1)) or placebo. Pain was evaluated using a 0-100 mm visual analogue scale at 2, 4, 6, 8, 12, 16, 20 and 24 h postoperatively. Pethidine (1 mg kg(-1)) was administered intramuscularly to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24 h postoperatively, and treatment-related adverse effects were noted. RESULTS: Postoperative pain scores were significantly lower with lornoxicam compared with dipyrone at 8 h (P = 0.016). No significant differences regarding pain scores at 2, 4, 6, 12, 16, 20 and 24 h were found. Significantly fewer patients in the lornoxicam group required rescue analgesics (vs. dipyrone, P = 0.046; vs. placebo, P = 0.001); fewer patients in the dipyrone group required rescue analgesics compared with placebo (P = 0.008). Significantly fewer patients in the lornoxicam group had nausea (vs. dipyrone, P = 0.022; vs. placebo, P = 0.006); no significant differences were found between the other two groups. Antiemetic use was significantly lower in the lornoxicam group (vs. dipyrone, P = 0.002; vs. placebo, P = 0.001). CONCLUSIONS: Lornoxicam has better tolerability and is a more effective analgesic than dipyrone when administered by patient-controlled analgesia for postoperative analgesia after septorhinoplasty.

Parotid duct cyst: a case report.

Salivary gland cysts can be benign or malignant. Salivary duct cysts are benign tumours that occur mainly in the parotid gland and represent 10% of all salivary gland cysts. We report the case of a 48-year-old man who presented with a painless preauricular mass on the right side. Superficial parotidectomy was performed based on magnetic resonance imaging (MRI). Histopathologic examination of the specimen revealed a parotid duct cyst. Here we report clinical features, diagnosis, and treatment of the case as well as a review of the literature.

Relationship of vestibular aqueduct and inner ear pressure in Ménière's disease and the normal population.

OBJECTIVE: Etiopathogenesis of Ménière's disease has not been resolved. The principal histopathologic finding in this disease is endolymphatic hydrops. The majority of radiologic and histopathologic studies demonstrated a narrow vestibular aqueduct in Ménière's disease. There is no study in the literature investigating the relationship between inner ear pressure and vestibular aqueduct dimensions. Static acoustic compliance is a noninvasive procedure that is thought to measure perilymphatic pressure at the footplate. An increase in mechanical fluid pressure in the inner ear is transmitted to the footplate of the stapes. This causes a reduction in the compliance at the drum. The aim of this study is to investigate the relationship between vestibular aqueduct dimensions and static acoustic compliance in Ménière's disease and the normal population. STUDY DESIGN: Prospective study. METHODS: Forty patients with Ménière's disease and 40 healthy individuals with no otolaryngologic disorders were the subjects of this study. Each group was further divided into two according to static compliance value (normal and low static compliance). In these four groups dimensions of vestibular aqueduct were determined radiologically by high-resolution computerized tomography and correlated with normal and low static acoustic compliance values (normal and high perilymphatic pressure). RESULTS: The results demonstrated that vestibular aqueduct is narrower in patients with Ménière's disease than the normal population. However, there is no relationship between vestibular aqueduct dimensions and inner ear pressure obtained by static acoustic compliance measurements.

Relationship of the cochlear aqueduct and inner ear pressure in Ménière's disease and in a normal population.

OBJECTIVE: The aim of this study was to determine the dimensions of cochlear aqueduct radiologically in patients with Ménière's disease and in normal subjects, and to correlate these findings with normal and low static acoustic compliance (SAC) (high and normal perilymphatic pressure) to see whether the dimensions of the cochlear aqueduct play any role in the perilymphatic pressure in normal individuals and patients with Ménière's disease. STUDY DESIGN: Prospective double-blind study. SETTING: The study was conducted at Hacettepe University Medical Faculty, a tertiary care center. PATIENTS: Forty patients with Ménière's disease with bilateral involvement, diagnosed by vertigo attacks, fluctuating hearing loss, tinnitus, fullness in the ear, and cochlear sensitivity constituted the patient group. Forty healthy individuals with no otolaryngologic symptoms constituted the control group. INTERVENTIONS: All individuals underwent SAC measurement in terms of equivalent volume in milliliters, based on two volume measurements. To measure the dimensions of the cochlear aqueduct, high-resolution computed tomography of the temporal bone in the axial plane was performed. RESULTS: There was no statistically significant difference in the width of the cochlear aqueduct between patients with Ménière's disease and normal subjects. When SAC measurements were also taken into account, there was no difference in cochlear aqueduct dimensions between individuals with normal and low SAC values in the two groups. CONCLUSION: The dimensions of cochlear aqueduct are not significantly different in Méniére's disease patients and normal individuals. Also, the cochlear aqueduct does not appear to play a significant role in normal and low SAC values in the two groups of individuals.