Assessment of Stroop Color Word Interference Test-TBAG form performance in subjects with tinnitus.

PURPOSE: To evaluate ordinary behavioral pattern suppression performance of individuals with tinnitus under disruptive effect using Stroop Color Word Interference Test-TBAG Form (SCWT), and to determine the impact of acoustic stimulus on this performance. METHODS: 40 individuals with subjective tinnitus at Slight and higher severity according to Tinnitus Handicap Inventory (THI) (16 females, 24 males; mean age: 42.02 ± 10.00) (Study group), and 40 healthy individuals (Control group) (18 females, 22 males; mean age: 38.85 ± 10.25) were included in this study. All individuals were subjected to audiological evaluation. SCWT was applied with and without acoustic stimulus (NB noise), and test completion durations were recorded. RESULTS: It was determined that the duration for completion of 5 sections of SCWT, both in the presence of and without acoustic stimulus, was longer in the Study group than the control group. In the presence of acoustic stimulus, it took longer for the individuals with tinnitus to complete sections 4 and 5, and the control group to complete sections 3, 4 and 5 in SCWT in comparison with the lack of acoustic stimulus. CONCLUSION: It was determined that SCWT performance of the individuals with tinnitus was worse than the individuals without tinnitus, both in the presence of and without acoustic stimulus. It was found that SCWT performances of both groups with acoustic stimulus were better than their test performances without acoustic stimulus.

Allergic rhinitis and its impact on asthma classification correlations.

OBJECTIVE: Allergic rhinitis is inflammation of the nasal mucosa following exposure to allergens. A few studies have investigated how the Allergic Rhinitis and its Impact on Asthma classification correlates with symptom severity and skin prick test results in allergic rhinitis patients. Our objective was to evaluate such a correlation. MATERIALS AND METHODS: The study population consisted of 268 patients who had allergic symptoms and were diagnosed with allergic rhinitis. RESULTS: Analysis of the Allergic Rhinitis and its Impact on Asthma classification with regard to symptom severity revealed that there were statistically significant differences between the groups for nasal symptoms, wheezing, eye itching/watering and eye redness. Symptom frequency and severity increased gradually towards the moderate to severe persistent allergic group. There was a statistically significant difference between the groups for grass pollen and house dust mite allergy. CONCLUSION: The Allergic Rhinitis and its Impact on Asthma classification, which takes symptoms and quality of life into consideration in addition to allergen exposure, is a useful classification system for allergic rhinitis.

A misdiagnosis: duplication of the external auditory canal.

We present imaging and clinical findings of a case with a duplicated external auditory canal, which led to misdiagnosis secondary to lipomatous content on imaging studies prior to surgery. It is a very rare congenital anomaly. This entity is usually misdiagnosed not only clinically but also radiologically. This leads to a delay and failure in diagnosis and treatment. To the best of our knowledge, herein is the first case report of the duplication of the external auditory canal presenting with dominant lipomatous imaging features. In this report, we aim to draw attention to the atypical presentation.

Traumatic nasal abscess concomitant with sinusitis: a case report.

PROBLEMS/OBJECTIVES: Nasal septal abscesses are usually formed following nasal trauma or haematoma. A nasal septal abscess is defined as a collection of purulent material (pus) between the cartilage or bony septum and the mucoperichondrium or mucoperiosteum. Sinusitis and periorbital cellulites have been reported among the etiological factors and the complications. METHODOLOGY: A case of posttraumatic nasal septal abscess is reported in a 35-year-old male patient. RESULTS: Frontal, ethmoid, and sphenoid sinusitis, as well as periorbital cellulites were seen to accompany the septal abscess. The abscess was surgically drained and intravenous antibiotherapy was instituted. CONCLUSION: Nasal trauma patients should be carefully assessed for posttraumatic haematoma and abscess formation, so that possible complications can be avoided by taking appropriate therapeutic measures.

Temporomandibular joint involvement in rheumatoid arthritis: correlation of clinical, laboratory and magnetic resonance imaging findings.

OBJECTIVE: Rheumatoid arthritis is a systemic autoimmune disorder that involves many body joints including the temporomandibular joint. The frequency of temporomandibular joint involvement based on clinical and radiological findings is rather diverse and involvement may manifest as pain, restricted range of movement and locking of the joint. The aim of this study is to investigate and correlate the clinical, laboratory and magnetic resonance imaging findings in patients with rheumatoid arthritis. METHODOLOGY: The temporomandibular joint involvement in 43 patients with rheumatoid arthritis, whose diagnoses were based on the revised 1987 criteria of the American College of Rheumatology, were evaluated using clinical examination, laboratory findings and magnetic resonance imaging. RESULTS: Temporomandibular joint involvement was clinically observed in 28 patients (65.1%), and radiologically in 33 patients (76.7%). The most frequent physical examination finding, a "click" in the joint upon opening of the mouth, was found in 21 (48.8%) patients. The most frequently observed radiological finding was synovial proliferation seen in 22 (51.1%) patients. A statistically significant correlation was observed between erythrocyte sedimentation rate and the findings on magnetic resonance imaging; between the rheumatoid factor results and physical examination findings; and between the findings of the physical examination and magnetic resonance imaging. CONCLUSION: The erythrocyte sedimentation rate, the rheumatoid factor results, and the findings on magnetic resonance imaging were found to be important in indicating temporomandibular joint involvement in rheumatoid arthritis. Further studies are necessary to specify the risk factors in more detail.

Bifid inferior turbinate: a case report.

OBJECTIVES: A bifid inferior turbinate is an extremely rare anatomical variation and has been reported in only two cases to date. Including the present report, the uncinate processes were missing in all three patients reported. It is suggested that, in the reported patient, bifid inferior turbinate coexisted with a developmental anomaly of the uncinate process, and that the bifid inferior turbinate represented two separate turbinates originating from the same site. CASE REPORT: We present the first reported case of bilateral bifid inferior turbinates, with a secondary middle turbinate, in a patient complaining of nasal obstruction. CONCLUSION: We suggest that the superior part of the bifid inferior turbinate may have been formed by severe medial displacement and inferior rotation of the uncinate process, and that the bifid inferior turbinate is an anatomical abnormality of the uncinate process.

Is there a relationship between myringosclerosis and atherosclerosis?

OBJECTIVE: Myringosclerosis and atherosclerosis are two different pathologies seen in different parts of the body. Both of these occur following a similar physiopathological process. However this has not previously been adequately discussed in the literature. Trauma to either the tympanic membrane or to the intimal layer of the arterial wall results in the formation of a sclerotic plaque. The goal of this study was to investigate the relationship between myringosclerosis and atherosclerosis. PATIENTS: A total of 421 patients with the diagnosis of coronary artery disease were included in the study. All of the patients were evaluated for the presence of atherosclerosis by coronary angiography and for myringosclerosis by otoscopic examination. MAIN OUTCOME MEASURES: The presence of myringosclerotic plaques, plaque dimensions and bilateral involvement of tympanic membranes were compared in the groups with and without atherosclerosis. RESULTS: Amongst the 316 patients (75.0%) shown to have atherosclerosis, 65 (20.5%) also had myringosclerosis. Amongst the 105 patients without atherosclerosis, 24 (22.8%) had myringosclerosis. There was no statistically significant relationship between atherosclerosis and myringosclerosis (p > 0.05). Neither plaque dimensions nor bilateral involvement of the ears showed significant difference between the two groups (p >0.05 and p >0.05, respectively). CONCLUSIONS: We conclude that there is no similar genetic tendency between atherosclerosis and myringosclerosis. The significance of the plaque dimensions and the bilateral involvement of tympanic membranes have not been satisfactorily discussed in the literature and this is the first time that they are being addressed. In contrast to the reported articles, there is no relationship between atherosclerosis and myringosclerosis other than being similar pathological processes occurring as a result of endothelial-epithelial damage.

Adenoid cystic carcinoma of the parotid gland presenting as temporal bone neoplasm: a case report.

PROBLEM: Temporal bone tumours are rare head and neck cancers that may involve both the parotid and the neck. In cases with concomitant temporal bone and parotid tissue involvement, tumour origin determination can be challenging. A tumour with parotid and temporal bone involvement is usually of temporal origin. The tumour may also be a rare parotid neoplasm with intratemporal invasion through the facial nerve, such as adenoid cystic carcinoma. These are slow-growing, yet locally aggressive tumours marked by late-stage distant metastases. CASE REPORT: We describe a case of parotid adenoid cystic carcinoma invading the temporal bone via the facial nerve, presenting as primary temporal bone tumour with parotid tissue involvement. We emphasize the significance of intracranial involvement by perineural invasion. CONCLUSION: Tumours mimicking temporal bone neoplasms can originate from the parotid tissue and invade through the facial nerve. Preoperative fine needle biopsy evaluation is indispensable for malignancy type determination and surgical planning.

Derevator: a soft tissue elevator for maxillary sinus in endoscopic sinus surgery.

Removal of the soft tissue lesions from the maxillary sinus is sometimes difficult and time consuming in endoscopic sinus surgery. Failure of endoscopic removal may necessitate combination of canine fossa approach and endoscopic approach. Our new instrument, 'Derevator', is designed for easy removal of the pathological soft tissue lesions from the maxillary sinus through middle meatal antrostomy. Derevators are available for both adults and children. Suction-tipped ones are also available.

Fibrous dysplasia of inferior turbinate, middle turbinate, and frontal sinus.

Fibrous dysplasia (FD) is a non-neoplastic fibro-osseous lesion. Paranasal sinus involvement is infrequent. Involvement of the frontal sinus, sphenoid sinus, and middle turbinate is rare, and only sporadic cases have been reported in the literature. Nasal turbinates and especially the inferior turbinate are the least involved bones of the craniofacial region. To the best of our knowledge, only one case with McCune-Albright syndrome had FD of the inferior turbinate. Here, we report a rare case with FD of inferior and middle turbinates and review literature concerning FD of the craniofacial region.

Ceruminous gland carcinoma of the external auditory canal presenting as chronic otitis media.

OBJECTIVE: Ceruminous neoplasms of the external ear canal are rare. Classification, clinical behavior, and management of these tumours are controversial. We report a case of carcinoma originating from the ceruminous glands of the external ear canal (EAC), operated based on a diagnosis of chronic otitis media with polyp. CASE REPORT: A 48-year-old man presented with left ear discharge and hearing loss. Clinical examination showed a well-circumscribed polypoid mass limited to the EAC. There was no history of bloody ear discharge or radiological findings of bony erosion suggestive of malignancy. Our preliminary diagnosis was chronic otitis media with polyp formation. Tympanoplasty was performed. Histopathology revealed a ceruminous carcinoma, and an additional operation involving lateral temporal bone dissection was performed, followed by 60 Gy radiation therapy. CONCLUSION: Ceruminous carcinomas should be considered in the differentialdiagnosis of middle and external ear pathologies in cases of soft tissue mass in the EAC.

The association of laryngoceles with squamous cell carcinoma of the larynx presenting as a deep neck infection.

OBJECTIVES: We present a case of an external laryngocele with laryngeal carcinoma. INTRODUCTION: A laryngocele is a rare benign lesion of the larynx resulting from an abnormal dilation of the laryngeal saccule filled with air. When the neck of the laryngocele is obstructed, it fills with mucus and is called a laryngopyocele. RESULTS: There may be a relationship between laryngoceles and squamous cell carcinomas of the larynx. A review of the literature found a reported association between laryngoceles and carcinomas of the larynx of between 4.9 and 54%. In this report, we present a case of an external laryngocele associated with laryngeal carcinoma. Another important point of this case is that a deep neck infection was the first symptom. CONCLUSION: In the light of the cases presented in the literature, patients with a deep neck infection should undergo CT imaging and patients with laryngoceles must also be examined with direct laryngoscopy.

Castleman's disease of the bilateral parotid gland: a case report.

OBJECTIVE: Castleman's disease (CD) is a benign lymphoproliferative disorder characterized by enlarged hyperplastic lymph nodes. We describe a patient who was found to have Castleman's disease as the cause of a parotid mass. METHODS AND RESULTS: The mass was the hyaline vascular type. After surgical excision of the largest masses on the right side, the patient was followed up for 6 months. Another mass in the left parotid region also became larger and was excised, with the pathological examination demonstrating Castleman's disease. CONCLUSION: Although rare in the head or neck region, Castleman's disease should be considered when investigating head-neck diseases.

An epidermal cyst in the parotid gland following ear surgery: a case report.

PROBLEM/OBJECTIVE: Iatrogenic epidermal cysts have been reported in various locations following otological surgical procedures. Especially after endaural incisions, surgeons may implant squamous epithelium into underlying tissue. An epidermal cyst of the parotid region may appear years after ipsilateral ear surgery. METHODOLOGY: A cystic lesion in the superficial lobe of the parotid gland was identified by computed tomography and ultrasonography in a 30-year-old man with a history of myringoplasty and endaural surgery. A superficial parotidectomy was performed to remove the mass. RESULTS: The mass was histopathologically diagnosed as an epidermal cyst. CONCLUSION: If a cystic lesion is present in the parotid gland in a patient with a history of otologic surgery, it must be considered that the mass is of epidermal origin.

Soft-tissue complications of laser surgery for recurrent respiratory papillomatosis.

Twenty-two patients with recurrent respiratory papillomatosis underwent 105 carbon dioxide (CO2) laser microlaryngoscopic and tracheobronchoscopic operations from July 1986 through February 1990. All soft-tissue complications, whether intraoperative or delayed secondary to laser surgery, were retrospectively analyzed. The intraoperative laser-related soft-tissue complication rate was zero. Two of the 22 patients acquired slight unilateral true vocal cord scar tissue and 1 patient developed a small posterior laryngeal web. The delayed soft-tissue complication rate was 13.6%, which compares favorably with published reports of 28.7% and 45%. This low complication rate has resulted from the selection of appropriate CO2 laser emission parameters and the use of the microspot micromanipulator, which help minimize lateral and/or deep thermal damage at the site of laser impact.

Microsubglottoscopy: an expansion of operative microlaryngoscopy.

The development of the adult subglottiscope has facilitated expansion of the indications for operative microlaryngoscopy to include surgery in the subglottic region of the larynx, as well as in the upper cervical trachea. A set of microlaryngeal instruments with an elongated shaft has been developed to support the use of the subglottiscope in the adult patient population. During the 18-month period from January 1, 1988, through June 30, 1989, sixteen adult patients with subglottic or upper cervical tracheal pathology were operated on a total of twenty-three times, using the adult subglottiscope to facilitate exposure and treatment. The patients' pathologic conditions included subglottic stenosis, subglottic granuloma, subglottic extension of laryngeal hemangioma and papilloma, and suprastomal granuloma. Two selected cases are presented to highlight indications for the use of this instrument. We have found the exposure of these subglottic and upper cervical tracheal lesions, using the binocular, microlaryngeal approach facilitated by the adult subglottiscope, to be improved over that obtained with existing microlaryngoscopes or conventional tracheoscopes.