Malignant myoepithelioma of the palate: a case report with review of the clinicopathological characteristics.

A malignant myoepithelioma is one of the rarest salivary gland neoplasms which may either arise de novo or develop within a preexisting pleomorphic adenoma or benign myoepithelioma. The parotid gland is the most common primary site and the palate the most common intra-oral site of occurrence. Herein is present a case of a malignant myoepithelioma arising in the hard palate of a 79-year-old woman. The lesion had been examined by biopsy at another hospital, and diagnosed as a poorly differentiated squamous cell carcinoma. The patient underwent a wide local tumor resection. Examination of the resection specimen showed the characteristic histopathological and immunohistochemical features of a malignant myoepithelioma. Five months after the operation, the patient was well without evidence of recurrence or metastasis.

Skin prick test reactivity in allergic rhinitis patients to airborne pollens.

The aim was to investigate the impact of atmospheric pollen in determining allergic rhinitis. It was conducted with 130 patients with allergic rhinitis in three different sites in Eskisehir, Turkey, in 2000-2001, using a gravimetric method with a Durham sampler. Skin prick test results, the symptoms of patients and their findings all confirmed the presence of allergic reactions to pollen allergens in the patients observed. During the period, a total of 47,082 pollen grains/cm(2) belonging to 45 taxa were recorded. Of the total pollen grains, 81.0% were arboreal and 18% non-arboreal. The majority of the investigated pollen grains were from Pinaceae, Salix spp., Chenopodiaceae/Amaranthaceae, Cupressaceae and Poaceae. Pollen concentrations reached the highest level in May (54.36%). The pollen allergens provoking severe sensitization were grasscereal mixtures (58.5%), followed by arboreals (33.8%). All patients (100.0%) were sensitive to grass. This study emphasizes the significance of determining the types and concentrations of pollen with a view to comparing changes in highly concentrated allergens.

The neocartilaginous formation with hydroxyl-apatite in injection laryngoplasty: an experimental study on rabbit model.

Adductor paralysis or the pathologies occurring after laryngeal surgery such as scarring or atrophy of the vocal cords cause glottic insufficiency during phonation. Injection laryngoplasty has been a widely accepted technique due to lower morbidity of the procedure and the applicability via endoscope in the treatment of these pathologies. Various materials have been used in injection laryngoplasty. The primary expectations in these techniques are the persistence of injected material long enough, without resorbtion or any cause of serious tissue response and having beneficial effects in reinforcing the glottic tissue. In the present study, we used large molecular-sized calcium hydroxyl-apatite (CaHA) particles in injection laryngoplasty to observe the effects of the material in the laryngeal tissues under the light microscopic examination. The study was performed on 12 rabbits in four groups. After injecting Ca10 (PO4)6(OH)2 (Coaptite) into their vocal folds, the rabbits were killed at certain intervals, in the 1st week (group 1) in the 1st month (group 2) in the 3rd month (group 3) and in the 6th month (group 4). Larynges were removed and processed for light microscopic observations. Our observations revealed that this material induced the new cartilage formation without a serious tissue response in the larynges. Formation of a new cartilage tissue was the most significant, but an unexpected outcome of the study. The injected material inducing a neocartilage formation without any tissue reaction persisted long enough in the laryngeal tissues. Although neocartilage formation may interfere the vocal fold vibrations, providing glottic closure in the phonation with a durable material will be an important gain.

Scintigraphic evaluation of nasal mucociliary activity in unilateral chronic otitis media.

Mucociliary clearance is a key defence mechanism in human upper and lower airways. Although mucociliary activity is present in both ears of the patients, most cases of chronic otitis media are unilateral. In this study, we aim to evaluate the difference between nasal mucociliary activity of the affected and non-affected sides in patients with unilateral chronic otitis media. Both nasal transport times of 36 patients with unilateral chronic otitis media were compared statistically with each other and with the control group by independent samples t-test. The nasal mucociliary transport times of the nasal cavity at the same side as the affected ear and as the non-affected ear are significantly different, in the same patients. Our study shows that impaired or decreased nasal mucociliary activity may result in dysfunction of the eustachian tube and middle-ear ciliary activity, which plays an important role in the aetiopathogenesis of chronic otitis media.

Near total laryngectomy: the problems influencing functions and their solutions.

We investigated the problems affecting functional outcomes of near-total laryngectomy and their solutions. A retrospective analysis about complications (i.e., aspiration, pharyngocutenous fistula, shunt stenosis, etc.) that affect postoperative functions was made by using the medical records of 23 male patients (mean age: 56.6, range: 35 to 72 years) who underwent near total laryngectomy. Maximal phonation times of 17 patients and fundamental frequencies of 10 patients were measured and compared with control groups consisting of sex- and age-matched normal laryngeal speakers. Pharyngocutenous fistula occurred in five cases and closed by secondary wound healing. The incidence of aspiration was 42%. Shunt stenosis wasn't observed in our cases, but loss of phonation occurred because of tumor recurrence at the neoglottal region in the 1st postoperative year of one patient. All patients were able to produce voice, and communicable speech was achieved by 19 (82.6%). Measurements of maximal phonation time indicated a significant decrease in the NTL group. The increase in fundamental frequency values of the near total laryngectomy group was also found significant in relation to the control group. After careful patient selection, extreme effort should be made to create a dynamic shunt and complete mucosal covering of the inner surface of the shunt in near total laryngectomy, thus not only producing voice without aspiration or shunt stenosis, but also providing oncologic safety in the patients with sufficient vital capacity.