Epithelioid Hemangioendothelioma in the Tongue: A Rare Case Report.

Epithelioid hemangioendothelioma is a rare malignant vascular neoplasm caused by the proliferation of neoplastic endothelial cells. Epithelioid hemangioendothelioma may develop in any organ, but it is commonly observed in the extremities. The tongue is a very unusual location for epithelioid hemangioendothelioma. A 55-year-old male patient presented to the outpatient head and neck clinic with lumps in the tongue, pain, and limitation of motion. The polypoid mass detected in the anterior midline of the tongue was excised. Microscopically, the tumor cells included slightly pleomorphic oval or round vesicular nuclei with an eosinophilic cytoplasm that variably contained vacuoles. There were 4 mitoses per 10 high power fields and there was no necrosis. In immunohistochemical study, the tumor cells were positively stained with CD31 and CD34 whereas they were negatively stained with TFE3, SMA, S-100, HHV-8 and EMA. The patient was diagnosed with "epitheloid hemangioendothelioma". Only ten cases have been reported in the tongue in the literature. Our case was the eleventh case, and we aimed to report this case as a rare entity with an unusual location.

Impairment of nasal mucociliary clearance time in wood industry workers.

PURPOSE: The aim of this study is to investigate the effect of wood dust on nasal mucociliary clearance time in wood industry workers. Moreover, the correlation between duration of exposure to wood dust and nasal mucociliary clearance time will be evaluated. METHODS: A total of 50 male subjects were included in the study. All of the subjects were non-smokers. Nasal mucociliary clearance time of 25 wood industry workers was measured with saccharine method and compared with the results of 25 age-matched control group. Also, the correlation between nasal mucociliary clearance time and duration of exposure to wood dust in woodworkers was evaluated. RESULTS: The mean mucociliary clearance time in control group and wood industry workers was 12.28 ± 1.98 and 16.72 ± 2.71, respectively. The mean mucociliary clearance time in wood industry workers was significantly longer than control group (p < 0.0001). Also,there was positive correlation between duration of exposure to wood dust and nasal mucociliary clearance time in wood industry workers (r = 0.879, p < 0.0001). CONCLUSION: The clinicians must remember that mucociliary clearance time in wood industry workers is prolonged. So the wood industry workers must be followed up more closely for sinonasal infections and respiratory tract diseases.

Is the location of a septal deviation associated with the degree of postoperative pain after septoplasty?

The author conducted a prospective study of patients who underwent septoplasty for nasal obstruction secondary to a septal deviation to determine if the location of the deviation had any association with the degree of postoperative pain. Patients with an anteroposterior deviation were not included in this study, nor were patients with vasomotor rhinitis, allergic rhinitis, nasal polyposis, turbinate pathologies, or a systemic disease; also excluded were patients who were taking any medication and those who had undergone any previous nasal surgery. The final study population included 140 patients, who were divided into two groups on the basis of the location of their deviation. A total of 64 patients (35 men and 29 women; mean age: 29.8 yr) had an anterior deviation, and 76 patients (35 men and 41 women; mean age: 30.3 yr) had a posterior deviation; there were no statistically significant differences between the two groups in terms of sex (p = 0.309) or age (p = 0.848). During the postoperative period, pain intensity in both groups was self-evaluated on a visual analog scale on days 1, 3, and 7 and again at 3 and 6 months. The mean postoperative pain scores on days 1, 3, and 7 were significantly higher in the posterior deviation group than in the anterior group; scores in the two groups were similar at 3 and 6 months.

Why do geriatric patients visit otorhinolaryngology?

The number and proportion of people more than 65 years old in the population are increasing with the rise in life expectancy. This study was designed to investigate the otolarygologic needs and visits of geriatric patients. We conducted a retrospective study that included all patients ≥65 years of age who visited the otolaryngology department between 8 a.m. and 4 p.m. during 1 year. Age, gender, main complaint, and clinical diagnosis were noted on a chart and analyzed. In 2012, a total of 19,875 patients attended the otolaryngology department between 8 a.m. and 4 p.m., of whom 418 (2.1%) were aged ≥65 years. The most common complaints were ear and hearing disorders (24.2%), epistaxis(15.3%), balance disorders (15.1%), pharyngotonsillar pathologies (14.8%), and head and facial trauma (9.6%). This study shows that the changing patient population will change the type and frequencies of pathologies seen in general otolaryngology practices. Geriatric patients need a targeted approach to their diseases because they have special issues unique to their population.

The effect of width of facial canal in patients with idiopathic peripheral facial paralysis on the development of paralysis.

The aim of this prospective study is to investigate whether the possible stenosis due to anatomic variations of labyrinthine segment (LS), tympanic segment (TS) and mastoid segment (MS) of the facial canal in the temporal bone is a predisposing factor in the development of paralysis. 22 patients with idiopathic peripheral facial paralysis (IPFP) were included in the study. Multi-slice computed tomography (MSCT) with 64 detectors was used for temporal bone imaging of the patients. Reconstruction images in axial, coronal and sagittal planes were created in workstation computers from the captured images. The diameters and lengths of LS, TS and MS of the facial canal were measured. The mean values of LD, ND and SL of LS were 1.31 ± 0.39, 0.91 ± 0.27, 4.17 ± 0.48 in patient group and 1.26 ± 0.29, 0.95 ± 0.21, 4.60 ± 1.36 in control group, respectively. The mean values of LD, ND and SL of TS were 1.11 ± 0.22, 0.90 ± 0.14, 12.63 ± 1.47 in patient group and 1.17 ± 0.23, 0.85 ± 0.24, 12.10 ± 1.79 in control group, respectively. The mean values of LD, ND and SL of MS were 1.80 ± 0.30, 1.44 ± 0.29 vs. 14.3 ± 1.90 in patient group 1.74 ± 0.38, 1.40 ± 0.29, 14.15 ± 2.16 in control group, respectively. The measurements of the parameters of all three segments in patient group and control group were similar. Similar results between patient and control group were obtained in this study investigating the effect of stenosis in facial canal in the development of IPFP.

Determination of oxidative stress and effect of erdosteine on rhinitis medicamentosa in a rat model.

We aimed to determine the presence of oxidative stress in rhinitis medicamentosa (RM) and to evaluate the effect of erdosteine (ED) on mucosal changes in a rat model. Twenty-four male rats were used in this experimental study. Three groups were created. Group 1 (n=8) was the control group. Two puffs of 0.05% oxymetazolin were sprayed into the nasal cavities of the remaining rats (n=16) three times daily for eight weeks. One of these 16 rats was scarified at the end of the eight weeks and examined to confirm the presence of RM. Seven of the remaining 16 rats were killed, and venous blood samples were taken (Group 2). Group 3 (n=8) received 10mg/kg of an ED suspension orally for seven days. All rats were put on formalin for light microscopy. The total antioxidant status (TAS) was similar in all groups (p=0.073). The total oxidative status (TOS) of the RM group was significantly higher than that of the control group and RM+ED group (Group 3) (p=0.003 and p=0.011, respectively). The pathological recovery of the nasal mucosa of the rats was similar in the RM+ED and control groups. The TOS was high in this RM rat model, and oxidative stress was associated with RM. ED significantly ameliorated nasal mucosal changes induced by RM, suggesting that oxidative stress may play an important role in the pathophysiology of this condition.

Increased neutrophil-lymphocyte ratio in patients with idiopathic sudden sensorineural hearing loss.

OBJECTIVE: The aim of this study was to determine whether neutrophil-lymphocyte ratio (NLR) levels are elevated in patients with idiopathic sudden sensorineural hearing loss (ISSHL) compared with healthy controls. Moreover, we aimed to find out whether there is a correlation between NLR levels and the severity of hearing loss. MATERIALS AND METHODS: The study group consisted of 40 subjects with ISSHL and 40 control subjects with no evidence of ear pathology. Severity of hearing loss in the ISSHL patients was classified as mild (<40 dB loss for any frequency), moderate (up to 80 dB), and severe (profound, >80 dB). RESULTS: The mean ± SD NLR values were 5.53 ± 1.72 in the ISHHL patients and 2.73 ± 0.81 in the control group. The mean NLR values in the patients with ISHHL were significantly higher than in the control group (P = 0.0001). The mean ± SD NLR values in the patients with mild (group A), moderate (group B), and severe (group C) sensorineural hearing loss were 5.53 ± 1.72, 5.29 ± 1.81, and 5.82 ± 1.72, respectively. The mean NLR values in the patients with severe sensorineural hearing loss were significantly higher than in the other groups (P = 0.0001). Nevertheless, there was no correlation between NLR values and severity of hearing loss. CONCLUSIONS: There is no previous study that investigated the association between NLR and ISSHL in the literature. High NLR values in ISSHL patients may be a predictor of other ishemic conditions such as coronary or cerebral ischemia. Thus, the otorhinolaryngologist would then refer the patient to cardiology and then neurology specialists for the appropriate examinations.

Neutrophil-lymphocyte ratio: a new predictive and prognostic factor in patients with Bell palsy.

OBJECTIVE: The aim of this study was to investigate whether neutrophil-lymphocyte ratio (NLR) levels are elevated in patients with Bell palsy (BP). Moreover, we aimed to find out whether there is a correlation between NLR levels and the severity and prognosis of BP. MATERIALS AND METHODS: The study group consisted of 25 subjects who presented with BP and 25 control subjects with no evidence of facial nerve pathology. The subjects underwent a general physical examination; an assessment of laboratory blood parameters; and a cranial magnetic resonance imaging, using gadolinium as a contrast medium. RESULTS: The mean (SD) NLR values were 2.16 (0.80) in the patients with BP and 1.36 (0.48) in the control group. The mean NLR values in the patients with BP were significantly higher than in the control group (P = 0.0001). There was a positive correlation between NLR values and grade of facial paralysis (r = 0.661, P = 0.0001). The mean (SD) NLR values in the grades III, IV, V, and VI BP groups were 1.40 (0.54), 1.78 (0.44), 3.00 (0.63), and 2.60 (0.54), respectively. The mean NLR values in the grade V BP group were significantly higher than in the other groups (P = 0.0001). In addition, there was a positive correlation between NLR values and prognosis of facial paralysis (r = 0.239, P = 0.251). CONCLUSIONS: There is no previous study that investigated the association between NLR and BP in the literature. Higher NLR values in patients with BP may be a predictor of worse prognosis.