Relationship between chronic otitis media with effusion and overweight or obesity in children.

OBJECTIVES: Otitis media with effusion and obesity are both common in childhood and might share some immunological alterations. This study aimed to investigate the relationship between chronic otitis media with effusion and childhood overweight or obesity, including the potential effects of adenoid or tonsillar hypertrophy on that relationship. METHODS: This study included 60 children with chronic otitis media with effusion and 86 healthy children aged from 2 to 10 years. Measures of height and weight were used to calculate the body mass index, weight for height and weight z score. RESULTS: The prevalence of overweight or obesity was higher in children with chronic otitis media with effusion, according to the weight for height percentiles (p = 0.012). However, neither the presence of adenoid or tonsillar hypertrophy nor the degree of adenoid hypertrophy was associated with overweight or obesity. CONCLUSION: Overweight and obesity might be risk factors for developing chronic otitis media with effusion, or vice versa.

The aetiopathologies of Ménière's disease: a contemporary review.

Ménière's disease, a condition first described in the 1800's, has been an advancing area of clinical interest and scientific research in recent decades. Guidelines published by the American Academy of Otolaryngology - Head and Neck Surgery remained nearly static for almost 20 years, although we have certainly expanded our knowledge of the aetiology of the disease since that time. This review of the literature highlights the breadth and detail of the current theories in understanding the pathophysiology of this enigmatic disease. Histopathological specimens providing evidence of many of the aetiologies are presented as well. We aim to provide a centralised and updated resource regarding current and emerging theories for Ménière's disease.

The surgical challenge of carotid artery and Fallopian canal dehiscence in chronic ear disease: a pitfall for endoscopic approach.

OBJECTIVE: Endoscopic procedures are becoming common in middle ear surgery. Inflammation due to chronic ear disease can cause bony erosion of the carotid artery and Fallopian canals, making them more vulnerable during surgery. The objective of this study was to determine whether or not chronic ear disease increases dehiscence of the carotid artery and Fallopian canals. DESIGN: Comparative human temporal bone study. SETTING: Otopathology laboratory. PARTICIPANTS: We selected 78 temporal bones from 55 deceased donors with chronic otitis media or cholesteatoma and then compared those two groups with a control group of 27 temporal bones from 19 deceased donors with no middle ear disease. MAIN OUTCOME MEASURES: We analysed the middle ear, carotid artery canal and Fallopian canal, looking for signs of dehiscence of its bony coverage, using light microscopy. RESULTS: We found an increased incidence in dehiscence of the carotid artery and Fallopian canals in temporal bones with chronic middle ear disease. The size of the carotid artery canal dehiscence was larger in the middle ear-diseased groups, and its bony coverage, when present, was also thinner compared to the control group. Dehiscence of the carotid artery canal was more frequently located closer to the promontory. The incidence of Fallopian canal dehiscence was significantly higher in temporal bones from donors older than 18 years with chronic middle ear disease. CONCLUSION: The increased incidence of the carotid artery and Fallopian canal dehiscence in temporal bones with chronic middle ear disease elevates the risk of adverse events during middle ear surgery.

Castleman's disease (giant lymph node hyperplasia) of the neck: a case report.

Castleman's disease (giant lymph node hyperplasia) is an uncommon cause of neck mass. Its cause and pathogenesis are still unknown. Giant lymph node hyperplasia (GLH) usually presents as an asymptomatic solitary mass and can occur anywhere in the head and neck. Diagnostic test results are always inconclusive. Excision and histopathological evaluation are the only ways to make a definitive diagnosis. The disease is curable by surgical excision. A case of GLH presenting as a solitary neck mass in a 68-year-old man is reported. There has been no recurrence during about 7 months.

Normal configuration of the anterior commissure of the glottis on magnetic resonance imaging.

The purpose of this study was to evaluate the normal width of the anterior commissure of the glottis by measuring its dimensions in patients who had no laryngeal disease on magnetic resonance imaging (MRI), but had unrelated cervical pathology. In all, 27 patients were studied. Axial images through the arytenoid commissure at the level of the vocalis muscle and/or vocal process of the arytenoid cartilage were magnified on MRI. The anteroposterior width of the anterior commissure was measured by using an electronic ruler having 1-mm marks. The average width of the anterior commissure was 1.59 +/- 0.6 mm, varying from a minimum width of 1 mm to a maximum width of 3 mm. The width was less than or equal to 2 mm in 25 patients (92.5%). Our results showed that all of the patients studied had measurable mucosal thicknesses at the level of anterior commissure > or = 1.0 mm.

Chondrosarcoma of the nasal septum.

Chondrosarcoma of the nasal septum is a rather uncommon tumour. Therefore, only limited numbers of cases have been described in the literature. This paper reveals one more case observed at the ORL department of Dicle University. In the present case, by using a transnasal and transpalatal approach, total resection of the tumour was performed in conjunction with postoperative radiotherapy.

The complications of chronic otitis media: report of 93 cases.

The aim of this study was to investigate the incidence, mortality and morbidity of complications due to chronic otitis media (COM). During the nine-year period 1990-1999, 2890 cases of COM were reviewed, 93 (3.22 per cent) having 57 (1.97 per cent) intracranial complications (IC) and 39 (1.35 per cent) extracranial complications (EC). In three patients more than one complication was observed. Meningitis and brain abscess were common in the IC group. Subperiosteal abscess (mastoid and Bezold's abscess) was a common complication in the EC group. Cholesteatoma and granulation/polyp in the middle ear/mastoid were the major findings in both groups. Fifteen patients died from IC. Overall, the mortality rate was 16.1 per cent in all patients having complications, and in patients with IC it was 26.3 per cent. In all of the patients with complications, the morbidity rate was 11.8 per cent. Our study supports the finding that meningitis and brain abscess are the common complications of COM and the main reason for mortality.

Schwannoma of the larynx: case report.

Neurogenous tumours of the larynx are extremely uncommon. We present a rare case of schwannoma of the larynx. Clinical findings are presented together with computed tomography (CT) and magnetic resonance images. The tumour was located in the right aryepiglottic fold of the larynx. CT showed a well defined and hypodense mass extending from the right aryepiglottic fold to the right vocal cord. The patient underwent an excision of the mass through a lateral thyrotomy and the tumour was completely removed. The diagnosis and treatment of this tumour are discussed.

The results of septal button insertion in the management of nasal septal perforation.

Nasal septal perforation may present with various symptoms. Perforations may be surgically closed or managed by obturation, inserting a prosthesis. We used a silicon septal button in the management of nasal septal perforation. In the follow-up period, although the insertion of the nasal septal button alleviated epistaxis, whistling during inspiration, and nasal obstruction, it could not control the production of crusting around the margin of the button.

Evaluation of hearing loss with auditory brainstem responses in the early and late period of bacterial meningitis in children.

The hearing function of 50 children with bacterial meningitis was evaluated at the second and 10th days, and eight weeks after admission with auditory brain system responses (ABR) to investigate whether meningitis causes hearing loss. Normal values were obtained in all tests from both ears of 24 patients (48 per cent). Twelve patients (24 per cent) had temporary, and seven (14 per cent) patients had persistent mild degree hearing loss. Severe hearing loss was detected bilaterally in five (10 per cent) patients and unilaterally in two (four per cent) patients. Patients, with other complications such as subdural effusion, convulsion, brain oedema and paralysis were found to have a higher incidence of hearing loss. We observed that patients treated with dexamethasone had 7.7 per cent persistent hearing loss, 11.6 per cent mild hearing loss, 34.6 per cent transient hearing loss, but in the group who did not receive dexamethasone there was 19.2 per cent persistent hearing loss, 15.3 per cent mild hearing loss and 11.6 per cent transient hearing loss. There were other significant differences between the two groups in restoration of normal body temperature, the CSF/plasma glucose concentration ratio was elevated, CSF (cerebro-spinal fluid) protein concentration was decreased and the cell count in the CSF was decreased in the dexamethasone group, significantly more than the group who were not receiving dexamethasone. The hearing loss tended to be more frequent among younger children.

Comparison of topical silver nitrate and flunisolide treatment in patients with idiopathic non-allergic rhinitis.

In this study, 90 patients with idiopathic non-allergic rhinitis were divided into three groups. Silver nitrate was given to Group I, flunisolide to Group II, and placebo to Group III. Healing results according to symptoms, physical findings, nasal smear findings and biopsy findings were compared. Improvement ws noticed in symptoms (rhinorrhea 93%, sneezing 89%, nasal congestion 80%), physical findings (color of mucosa 89%, concha hypertrophy 87%, rhinorrhea 82%), nasal smear findings (94%) and biopsy findings (epithelium 76%, basal membrane 80%, edema 84%, eosinophilia 95%, inflammation 87%) in Group I. Recurrence was observed in symptoms and physical findings of 30% of the patients in Group I during the 6 months-follow-up period. In Group II, improvement was noticed in symptoms (rhinorrhea 73%, sneezing 70%, nasal congestion 61%), physical findings (color of mucosa 72%, concha hypertrophy 69%, rhinorrhea 62%), nasal smear findings (87%) and biopsy findings (epithelium 67%, basal membrane 63%, edema 70%, eosinophilia 77%, inflammation 70%). But symptoms recurred in all patients in approximately 1-3 months after competition of treatment. There was a statistically significant difference between silver treatment and flunisolide or placebo treatment.