The relationship between alexithymia and clinical features in rhinoplasty patients.

OBJECTIVE: The present study aimed to investigate the incidence of alexithymia in rhinoplasty patients before and after surgery, and to increase the value of alexithymia analysis. The study also aimed to evaluate self-esteem and rhinoplasty outcome scores together. MATERIAL AND METHODS: Patients who had undergone rhinoplasty were enrolled in the study, and they were grouped according to gender, marital status, working status, indication (functional or aesthetic), and type of surgery (primary or revision). Toronto Alexithymia Scale-20 (TAS-20), Rosenberg Self-Esteem Scale (RSES), Rhinoplasty Outcome Evaluation (ROE), and Nasal Obstruction Symptom Evaluation (NOSE) surveys were used to assess their relationship with alexithymia. RESULTS: We observed significantly higher alexithymia and lower self-esteem scores in females, widows, those with aesthetic indication, those who required revision surgery, and those who had never worked, and a significant correlation was observed except for marital status (p<0.05). After the surgery, significant improvement was found in TAS-20 and RSES according to preoperative scores (p<0.05). There was a significant inverse correlation between TAS-20 and ROE scores, while a positive correlation was observed between RSES and ROE scores (p<0.05). CONCLUSION: This is the first study to investigate alexithymia changes in rhinoplasty candidates. TAS-20 can be considered as a useful survey to assess psychological distress in rhinoplasty candidates.

Extramedullary plasmacytoma of maxillary sinus.

Solitary extramedullary plasmacytomas are rare tumors that often affect the head and neck region. Diagnosis of solitary extramedullary plasmocytoma can be confirmed only when the presence of systemic disease is excluded by performing clinical, biological, and radiological investigations. Radiotherapy is considered the treatment of choice, surgery being limited to biopsy and to excision of residual disease. We report herein the case of a 62-year-old man with an extramedullary plasmacytoma arising in the left maxillary sinus who was referred for chemoradiotherapy.

[The comparison of preoperative examination, computed tomography and peroperative macroscopic inspection in the determination of anterior commissural involvement in laryngeal cancer]. / Larenks kanserinde anteriyor komissür tutulumunun belirlenmesinde ameliyat öncesi muayene, bilgisayarli tomografi ve ameliyat sirasi makroskopik incelemenin karsilastirilmasi

OBJECTIVES: In this study preoperative examination, computed tomography and the peroperative macroscopic examination of the specimen were compared in the determination of anterior commissural involvement in laryngeal cancer. PATIENTS AND METHODS: Twenty-two male patients (mean age 59.6 ± 9.9 years; range 46 to 78 years) who underwent total laryngectomy for laryngeal cancer between January 2007 and May 2010 in our clinic were enrolled into this study. The anterior commissures were evaluated in all patients by preoperative examination, computed tomography and peroperative macroscopic examination of the specimens. For the preoperative evaluation, examination with a 70-degree rigid endoscope and microscopic examination under general anesthesia using suspension laryngoscopy were used. The tomographic sections of the neck and the comments were analyzed and the status of the anterior commissure was evaluated. After the removal of the laryngectomy sample, the larynx was vertically incised on its posterior aspect and anterior commissure was examined peroperatively. All the data obtained were statistically interpreted on the basis of the histopathological results of the anterior commissure. RESULTS: According to the histopathological assessments, the rate of invasion of the anterior commissure by the tumor was determined to be 72.7%. In the preoperative examination, the anterior commissure was found to be invaded by the tumor in 56.3% of the patients. This ratio was 50% with neck computed tomography and 93.8% by the peroperative examination of the samples. CONCLUSION: In laryngeal cancer, anterior commissure involvement is a very important factor in selecting the surgical technique and in predicting the behavior of the tumor. Preoperative examination and classical axial computed tomography have limited a role in the detection of the anterior commissural involvement. Computed tomography reconstructed by a highly experienced radiologist may be more helpful for us in the evaluation of the anterior commissure.

Anomaly of the internal carotid artery detected during tonsillectomy.

The blood vessel anomalies of the head-neck area may result in death with massive hemorrhage during head and neck surgery. Although anomalies of internal carotid artery (ICA) are observed particularly on the posterior pharyngeal wall, we may confront them in various localizations. Because of these anomalies, the surgeon must always be aware of this risk during tonsillectomy, adenoidectomy, and uvulopalatopharyngoplasty operations. In our case, an S curling-type anomaly of the ICA has been discovered in the distance of 1 cm to the left tonsil during tonsillectomy. Protecting the ICA, a careful tonsillectomy has been performed by using thermal welding and cold dissection method. Then, anomaly has been confirmed radiologically by angiography. This document emphasizes the fact that the surgeon must provide against vascular anomalies that may be confronted during head-neck surgery and that the preoperative examinations should be assessed within this frame.

[Incudostapedial bridging ossiculoplasty with bone cement hearing results]. / Kemik çimentosu ile inkudostapedial köprüleme ossiküloplasti isitme sonuçlari.

OBJECTIVES: This study describes the hearing results of patients whose ossicles were reconstruction using bone cement. PATIENTS AND METHODS: The medical records of 19 patients (11 males, 8 females; mean age 35,6 years; range 12 to 64 years) who underwent surgery for chronic otitis media at Istanbul Education and Research Hospital Otorhinolaryngology Department between January 2006 and December 2009 were evaluated. Bone cement reconstruction of the ossicular chain was performed from incus to stapes in the absence of a long arm or lenticular process of the incus. The clinical data of the patients were evaluated by otoscopic examination and audiometry. RESULTS: After incudostapedial rebridging ossiculoplasty we performed; out of 19 patients, 10 had 20 dB gain while two patients had 15-20 dB gain another two patients had 10-15 dB gain. The remaining five patients didn't have any significant gain. The mean pre- and postoperative air-bone gaps of all the patients were 36.5 and 20.4 dB respectively. CONCLUSION: Incudostapedial rebridging ossiculoplasty with bone cement is a cost-effective and safe procedure that yields good hearing results in selected patients.

[Lipoid proteinosis in the mouth and laryngeal structures: a case report]. / Agiz ve larenkste lipoid proteinozis: Olgu sunumu.

Lipoidproteinosis is an uncommon autosomal recessive disorder characterized by accumulation of hyaline material in the skin, oral and laryngeal mucosa. A 23-year-old woman presented with complaints of hoarseness and dryness of the mouth. Yellowish papular deposits were noted in the oral and laryngeal mucosa on physical examination, and in vocal cords and laryngeal structures during laryngoscopy. The lesions were removed and histopathologic diagnosis was made as lipoidproteinosis. A slight improvement was obtained in hoarseness. A control examination after two years showed an increase in the extent of hoarseness and new deposits in the vocal cords. The lesions were removed by microlaryngeal surgery.