Volume: 17 Issue: 2 (2007) | |
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ORIGINAL RESEARCH ARTICLES | |
1. | Evaluation of Ki-67 expression in recurrent cases of cholesteatoma Pages 65 - 69Arif Şanlı, İlter Tezer, Mustafa Paksoy, Sedat Aydın, Ümit Hardal, Nagehan Barşık Özdemir FREE FULL TEXT Objectives: Recurrences are still a challenge despite [Abstract] [Full Text] (Article In Turkish) (1688 accesses)appropriate techniques in cholesteatoma surgery. This study was designed to evaluate the level of Ki-67 expression in recurrent cases of cholesteatoma. Patients and Methods: The study included 32 patients (18 males, 14 females; mean age 34 years; range 12 to 63 years) who underwent surgery for otitis media. Of these, 19 patients had cholesteatoma, and eight patients had recurrent cholesteatoma. Five patients who underwent tympanoplasty for chronic otitis media comprised the control group. All the patients with cholesteatoma underwent radical mastoidectomy. At surgery, tissue samples of cholesteatoma were taken and prepared for immunohistochemical staining. In controls, retroauricular skin samples were used. The two patient groups with cholesteatoma were compared with respect to Ki-67 expression. Results: Increased cellular proliferation was detected in both groups of cholesteatoma. No significant difference was found between two cholesteatoma groups with respect to Ki-67 staining (p>0.05). Compared to the controls, patients with cholesteatoma and those with recurrent cholesteatoma had significantly higher levels of Ki-67 staining (p<0.05 and p<0.01, respectively). Conclusion: Our results suggest that, despite a higher degree of proliferation in recurrent cholesteatoma cases, treatment failures may be mainly associated with the surgical technique, accompanying infections, and the type of cholesteatoma. |
2. | An evaluation of parotid gland masses Pages 70 - 74Hüsamettin Yaşar, Haluk Özkul, Ayşegül Verim, Emre İlhan, Numan Kökten, Gökçe Dereci FREE FULL TEXT Objectives: We retrospectively evaluated patients who [Abstract] [Full Text] (Article In Turkish) (2592 accesses)underwent surgery for parotid gland masses. Patients and Methods: A total of 50 patients (25 females, 25 males; mean age 48.5 years; range 18 to 76 years) who underwent surgery for parotid gland masses were evaluated with regard to age, sex, preoperative diagnostic methods, histopathologic diagnoses, and surgical techniques. Results: Preoperative diagnostic studies included ultrasonography, fine-needle aspiration biopsy, computed tomoghraphy and magnetic resonance imaging. Histopathological diagnoses were benign in 33 patients (66%), malignant in nine patients (18%), and tumor-like pathologies in eight patients (16%), the most common being pleomorphic adenoma (n=28, 56%), Warthin’s tumor (n=4, 8%), and squamous cell carcinoma (n=4, 8%). Superficial and total parotidectomies were performed in 40 (80%) and 10 (20%) patients, respectively. Nine patients with malignant tumors also had neck dissection and postoperative radiotherapy. Mortality occurred in one patient with metastasis to the parotid gland. One patient with lipoma developed recurrence two years after surgery. Follow-up was five years in 28 patients (56%), three years in 12 patients (24%), and two years in five patients (10%). Complete and transient facial paralysis developed in 10 patients and five patients following total and superficial parotidectomy, respectively. Conclusion: Superficial parotidectomy is the minimal surgery for parotid gland masses. If the deep lobe of the gland is involved, total parotidectomy should be performed with preservation of the facial nerve. In malignant tumors neck dissection and postoperative radiotherapy should be added. |
3. | Screening of the mitochondrial 12S rRNA (MTRNR1) gene in probands with sensorineural hearing loss Pages 75 - 80Yaprak E. Çırçır, Armağan İncesulu, Mustafa Tekin Objectives: We investigated mitochondrial DNA [Abstract] [Full Text] (Article In Turkish) (1684 accesses)12S rRNA (MTRNR1) gene mutations as a cause of hearing loss in probands with or without a history of aminoglycoside use. Patients and Methods: The study included 70 patients (40 females, 30 males; age range 3 to 42 years) with nonsyndromic sensorineural hearing loss. Eleven probands had a history of aminoglycoside use before the onset of hearing loss. All cases were first screened and found to be negative for the GJB2 (connexin 26) gene mutations. The m.1555A>G mutation was screened using the PCRRFLP technique. The entire 12S rRNA gene was later screened with the PCR-TTGE technique followed by direct sequencing. Results: Of 11 patients with a history of aminoglycoside use, one patient was found to have the m.1555A>G mutation. Two probands with no history of aminoglycoside use exhibited the m.750A>G polymorphism. No pathogenic base substitutions were detected in the remaining patients. Conclusion: Apart from the common aminoglycoside ototoxicity-related DNA change, m.1555A>G, we could not identify a common mitochondrial 12S rRNA mutation associated with hearing loss in Turkey. Screening of larger series may document rare alterations. |
4. | Lipid peroxidation and antioxidant levels in patients with laryngeal carcinoma Pages 81 - 84Yavuz Fuat Yılmaz, Filiz Akbıyık, Ümit Tuncel, Adnan Ünal FREE FULL TEXT Objectives: Reactive oxygen species (ROS) play [Abstract] [Full Text] (Article In Turkish) (1454 accesses)an important role in the pathogenesis of cancer. The aim of this study was to investigate the extent of lipid peroxidation and ROS in laryngeal cancer tissues. Patients and Methods: We determined glutathione (GSH) and malondialdehyde (MDA) activities as markers of lipid peroxidation in laryngeal tumor specimens and tumor-free adjacent tissues of 30 patients with squamous cell carcinoma. Results: Compared to the tumor-free specimens, the level of GSH was significantly low (p<0.001) whereas MDA, a lipid peroxidation product, showed a significant increase (p<0.01) in cancer tissues. No significant differences were found in MDA and GSH levels between patients with early (n=14) and advanced (n=16) tumor stages (p>0.05). Conclusions: Decreased antioxidant capacity of laryngeal cancer tissues results in elevation of free oxygen radicals and increased lipid peroxidation. Free radical metabolism may be involved in the pathogenesis of laryngeal cancers. |
5. | Transnasal endoscopic repair of choanal atresia Pages 85 - 89Semih Mumbuç, Erkan Karataş, Cengiz Durucu, Enver Özer, Muzaffer Kanlıkama FREE FULL TEXT Objectives: We evaluated the results of endoscopic [Abstract] [Full Text] (Article In Turkish) (5664 accesses)repair for choanal atresia. Patients and Methods: Ten patients (2 males, 8 females) underwent transnasal endoscopic repair for choanal atresia. Involvement was unilateral in five cases and bilateral in five cases. Unilateral patients were treated at a mean age of 22.6 years (range 1 to 44 years), while bilateral cases were treated within the first six days of life. Two patients with bilateral involvement had associated polydactyl and tracheoesophageal fistula, respectively. The mean follow-up period was 26 months (range 8 to 56 months). Results: No postoperative complications such as significant hemorrhage, injury to the skull base, cerebrospinal fluid fistula, septal perforation, or granulation tissue formation were encountered. All the patients had choanal patency at the end of six months. Conclusion: Endoscopic repair of choanal atresia is effective in both unilateral and bilateral cases. |
6. | Endoscopic transnasal sphenoidotomy with or without ethmoidectomy Pages 90 - 95Adil Eryılmaz, Engin Dursun, Güleser Saylam, Celil Göçer, Muharrem Dağlı, Hakan Korkmaz FREE FULL TEXT Objectives: We evaluated endoscopic transnasal [Abstract] [Full Text] (Article In English) (2139 accesses)sphenoidotomy (ETNS) with or without ethmoidectomy in patients with inflammatory sphenoid sinus disease (ISSD). Patients and Methods: A retrospective review was conducted in 42 patients (17 males, 25 females; mean age 41 years; range 17 to 67 years) who underwent ETNS with (n=37) or without (n=5) ethmoidectomy for ISSD. The disase was staged according to our staging system based on computed tomography findings. Results: Postnasal drainage was the most common symptom (n=37, 88.1%). Chronic rhinosinusitis was accompanied by sinonasal polyps in 25 patients (59.5%). Five patients (11.9%) had isolated sphenoid disease and 16 patients (38.1%) had unilateral disease. Five patients (11.9%) had stage 1, 15 patients (35.7%) had stage 2, and 22 patients (52.4%) had stage 3 disease. Surgery involved 68 sides. Ethmoidectomy was used in 63 sides of 37 patients, eight of whom required a supplementary procedure. At least one complication was seen in eight patients (19%), including severe perioperative hemorrhage (n=2), early postoperative hemorrhage (n=2), minor injuries to the lamina papyracea (n=4), and synechiae (n=5). Conclusion: In patients with isolated ISSD, the direct approach to the sphenoid sinus by ETNS without ethmoidectomy is a favorable technique, whereas ETNS with ethmoidectomy is necessary for patients with concurrent disease in other paranasal sinuses. |
7. | Sensitivity and specificity of fine needle aspiration biopsy in parotid masses Pages 96 - 99M. Zafer Uğuz, H. Kazım Önal, Özlem Özger Eroğlu, Demet Etit FREE FULL TEXT Objectives: We aimed to determine the sensitivity [Abstract] [Full Text] (Article In Turkish) (1587 accesses)and specificity of fine needle aspiration biopsy (FNAB) in patients with parotid masses. Patients and Methods: The study included 29 patients (15 males, 14 females; mean age 52 years; range 20 to 83 years) who underwent FNAB and parotidectomy for parotid masses. After a detailed history taking, otorhinolaryngologic and systemic examinations were performed. Neck ultrasonography and, when needed, neck computed tomography were used. Superficial parotidectomy was performed in 20 patients and total parotidectomy in nine patients. Results: The results of FNAB were reported as benign in 21 patients (72.4%), malignant in six patients (20.7%), and suspicious in two patients (6.9%). Postoperative histopathologic diagnoses were reported as benign in 17 patients (58.6%) and malignant in 12 patients (41.4%). The sensitivity and specificity rates for FNAB were 54.6% and 100%, respectively. The most common histopathological diagnosis was pleomorphic adenoma (n=7, 24.1%), followed by mucoepidermoid carcinoma (n=4, 13.8%), and Warthin’s tumor (n=3, 10.3%). Conclusion: Preoperative FNAB for parotid masses plays an important role in planning surgery. |
8. | The effect of topical mitomycin-C application before or after incisional myringotomy on patency times of guinea pig tympanic membrane perforations Pages 100 - 104Cenk Evren, Mehmet Eken, Günay Ateş, Ziya Bozkurt, Arif Şanlı FREE FULL TEXT Objectives: The aim of this study was to investigate [Abstract] [Full Text] (Article In Turkish) (1732 accesses)the effect of topical mitomycin-C application before or after incisional myringotomy on patency times and to asess its use as an alternative to ventilation tube insertion. Materials and Methods: Nineteen guinea pigs were divided into two groups. In the study group (n=11), mitomycin-C was applied in a concentration of 0.4 mg/ml over the perforation for five minutes before (n=6) or after (n=5) incisional myringotomies in both ears. Control animals (n=8) received 0.1 ml 0.09% NaCl for the same duration. Evaluations were made on days 1, 3, 5, 7, 10, 14, and 21. The patency times, otorrhea, and other complications were recorded. Results: Compared to controls (7.0±1.5 days), the mean patency times of perforations were significantly longer in mitomycin-C treated groups before (11.6±5.2 days) and after (14.2±4.7 days) incisional myringotomies (p<0.05). Patency times did not differ significantly between the two mitomycin-C groups. None of the ears exhibited permanent perforation. Conclusion: The length of patency provided by mitomycin- C is not sufficient for optimal ventilation in otitis media with effusion. However, in cases requiring shorter patency times mitomycin-C application before or after myringotomy may be an alternative to ventilation tube insertion. |
CASE REPORTS | |
9. | Lipoid proteinosis in the mouth and laryngeal structures: a case report Pages 105 - 107Gökhan Güvener, Cumali Kocabay, Gülben Erdem Huq, Şerife Karagülle, Fatih Bora FREE FULL TEXT Lipoidproteinosis is an uncommon autosomal recessive [Abstract] [Full Text] (Article In Turkish) (1636 accesses)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. |
10. | Multiple osteomas in the frontal and ethmoid sinuses: a case report Pages 108 - 111Seda Türkoğlu, Erdinç Aydın FREE FULL TEXT Osteomas are the most common benign tumors of the [Abstract] [Full Text] (Article In Turkish) (2215 accesses)paranasal sinuses. They may be seen at all ages and show a male preponderance. A 54-year-old male patient presented with a complaint of nasal obstruction. Computed tomography of the paranasal sinuses showed three osteomas, nearly 5 mm in size, in both ethmoid sinuses and the right frontal sinus. Inquiry into the Gardner’s syndrome was negative. No surgical treatment was performed at the patient’s discretion. To our knowledge, the presence of multiple osteomas in the frontal and ethmoid sinuses has not been reported in the English literature. |
11. | Hemangiopericytoma of the parotid gland: a case report Pages 112 - 115Fatih Öktem, Emin Karaman, Aydın Mamak, Süleyman Yılmaz, Sibel Erdamar FREE FULL TEXT Hemangiopericytomas are uncommon neoplasms of [Abstract] [Full Text] (Article In English) (1361 accesses)vascular origin that mostly arise from extremities, retroperitoneum, and pelvic fossa. They are rarely found in the parotid gland. A 35-year-old female patient presented with a swelling in the right preauricular region. Fine-needle aspiration biopsy performed twice yielded an extraordinary amount of blood. A cytological diagnosis could not be made. Computed tomography showed a homogenous, well-shaped mass in the parotid gland. Superficial parotidectomy was performed. Histopathological diagnosis was made as hemangiopericytoma. No evidence for local recurrence or distant metastasis was seen within a follow-up of 36 months. |
12. | Classic Kaposi’s sarcoma of the tongue: a case report Pages 116 - 119Erdinç Aydın, Volkan Akdoğan, Beyhan Demirhan, Levent N. Özlüoğlu FREE FULL TEXT An 81-year-old male patient presented with a painful [Abstract] [Full Text] (Article In Turkish) (2555 accesses)mass in the tongue that showed a progressive growth within the past two months. Examination revealed a polypoid mass in the midline of the tongue, purple in color, and 1.5x1.5 cm in size. There was no palpable lymph node on neck examination. An excisional biopsy was performed with adequate surgical margins. The histopathological diagnosis was Kaposi’s sarcoma. Clinical and radiological evaluations did not show any systemic involvement. An HIV test was negative. He was referred to the medical oncology department. No recurrence was detected during a year follow up. |
13. | Sudden hearing loss in a patient with a 3-mm acoustic tumor Pages 120 - 125İsmail Yılmaz, Seyra Erbek, Selim Erbek, Özlem Ulusoy, Tarkan Çalışaneller FREE FULL TEXT Sudden sensorineural hearing loss (SNHL) accounts [Abstract] [Full Text] (Article In Turkish) (2191 accesses)for 1% of all SNHL cases. It has been reported that acoustic neuroma may be present up to 47.5% of patients with sudden SNHL. A 55-year-old man presented with sudden hearing loss in his left ear of 45-day history. Audiologic and transient evoked otoacoustic emission tests showed near-total hearing loss and absence of emissions in the left ear, respectively. Electronystagmography showed left canal paralysis and lack of response to the Kobrak test. The interpeak interval I-V latency and interaural amplitude differences in wave V latency were prolonged in auditory brainstem response. Computed tomography showed an increase in the diameter of the left internal acoustic canal, and magnetic resonance imaging (MRI) revealed an intracanalicular mass, 3 mm in size, originating from the left cochlear nerve. Another mass (18x17 mm) was detected that filled the right pontocerebellar cistern, suggesting a meningioma, but this was not thought to exert an obvious shift effect contributing to the development of left-sided hearing loss. Despite treatment with a tapered course of fluocortolone for 18 days the patient’s hearing level did not change. He was included in a follow-up with MRI at six-month intervals. |