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Resume Objectif Evaluer, en debut d’experience, la morbidite precoce et plus particulierement l’incontinence urinaire apres enucleation endoscopique de prostate au laser Holmium (HoLEP), en preciser la nature, l’evolution et rechercher des facteurs predictifs de survenue. Patients et methode Nous avons realise une etude observationnelle, analytique, retrospective, monocentrique incluant tous les patients operes d’une hypertrophie benigne de prostate (HBP) par HoLEP entre novembre 2015 et janvier 2017. Les donnees ont ete recueillies en pre-, per- et postoperatoire. Le suivi etait de 6 mois. Resultats Cent soixante et onze patients ont ete inclus. 23 patients (14,6 %) ont eu une complication classee selon Clavien-Dindo [4] : 19 (83 %) Clavien 2, 1 (4 %) Clavien 3b et 3 (13 %) Clavien 4. A 1 mois postoperatoire, 64 (42,7 %) patients presentaient une incontinence urinaire dont 55 (86,1 %) uniquement a l’effort. 18 (32,7 %) etaient incontinent urinaire a 6 mois. L’energie delivree en peroperatoire ainsi que l’IIEF5 preoperatoire etaient statiquement associes a la survenue d’une incontinence urinaire d’effort. Il n’a pas ete mis en evidence de lien entre l’apprentissage et la survenue de l’incontinence. Conclusion Le taux important d’incontinence urinaire post HoLEP en debut d’experience implique une reflexion sur la technique utilisee ainsi que sur l’information delivree aux patients en preoperatoire. Niveau de preuve 4.

Rinolitiazis, burun icerisindeki bir yabanci cisim etrafinda kalsifiye materyal birikimidir. Genellikle burnun on kisminda bulunurlar. Tanisi endoskopik nazal muayene ve goruntuleme yontemlerine dayanir. Rinolitin yerinin belirlenmesi ve operasyon kararinin verilebilmesi icin bilgisayarli tomografi oldukca faydalidir. Bu makalede, sol nazal kavitede obstruksiyon, nefes almada gucluk ve son iki haftadir devam eden purulan nazal akinti sikayetleri ile klinigimize basvuran ve dev bir rinoliti olan 16 yasindaki bir hastayi sunduk. Endoskopik muayenede, nazal kavitedeki kitlenin nares girisinden koanaya kadar uzanim gosterdigi goruldu. Bilgisayarli tomografide sol nazal kaviteyi tama yakin dolduran, yuksek derecede ranyodensiteye sahip, rinolit ile uyumlu gorunum izlendi. Rinolit endoskopik olarak cikarildi. Cikarilan spesmen boyutlari 10x5x4 cm idi. Rinolitler nadir olup, tanisi burunda yabanci cisim oykusu ile birlikte fizik muayene ve nazal endoskopi ile konur. Rinolitlerin olusumu yillar alabilmektedir, bildigimiz kadariyla bu vaka, bu yas grubunda bugune kadar rapor edilmis en buyuk rinolit olgusudur.

Tramadol was found to be more effective than dexamethasone in post-operative pain control, with long-lasting relief of pain.This study aimed to compare the effects of pre-operative local injections of tramadol and dexamethasone on post-operative pain, nausea and vomiting in patients who underwent tonsillectomy.Sixty patients between 3-13 years of age who were planned for tonsillectomy were included in the study. Patients were divided into three groups. Group 1 was the control group. Patients in Group 2 received 0.3 mg/kg Dexamethasone and Group 3 received 0.1 mg/kg Tramadol injection to the peritonsillary space just before the operation. Patients were evaluated for nausea, vomiting, and pain.When the control and the dexamethasone groups were compared; there were statistically significant differences in pain scores at post-operative 15 and 30 min, whereas there was no statistically significant difference in pain scores at other hours. When the control and tramadol groups were compared, there was a statistically significant difference in pain scores at all intervals. When tramadol and dexamethasone groups were compared, there was no statistically significant difference in pain scores at post-operative 15 and 30 min, 1 and 2 h, whereas there was a statistically significant difference in pain scores at post-operative 6 and 24 h.

Free flaps based on static slings principles cannot provide esthetic and functional outcomes at a desired level in total or close to total lip loss. Therefore, dynamic methods have become a current issue in recent years and especially the idea of functional gracilis free muscle flap has been suggested. In this study, we present a case of a successful total lower lip repair with this flap.In a 78-year-old female patient who was diagnosed with squamous cell carcinoma involving the entire lower lip, bilateral modified radical neck dissection and full-thickness total resection with 1 cm surgical margin so as to include both commissures of the tumor were performed and then a free gracilis muscle flap was transferred from the same side. After microvascular anastomoses, the motor nerve of the flap was coapted to the marginal mandibular branch of the fascial nerve. The entire intra- and extraoral surfaces of the flap were covered with a partial-thickness skin graft which was taken from the right thigh. There was no any intra- or early postoperative complication. The skin graft and flap survived without any problem.In the controls of the patient who was followed-up for 8 postoperative months, it was observed that the gracilis muscle flap was well-adapted to its place, gained a very good tonus, its volume reduced over time and reached to ideal dimensions, and the overlying skin graft provided a good color and texture match with the surrounding tissues. The motor activity of the muscle was monitored with the Tinel's test. The speech and facial expressions of the patient were very clear. Despite the patient has an edentulous mandible and was not using prosthesis, her feeding with fluid and solid foods was free of problems, oral competence was highly sufficient, and there was no any drooling. Esthetic appearance was very good and intraoral vestibular depth was sufficient. The mouth opening was 3 cm. When comparing with upper orbicularis oculi muscle on the electroneuromyography (ENMG) ordered at the 8th month, a similar nerve conduction time (3.3 versus 3.8 ms) and contraction amplitude (0.5 versus 0.4 mV) values were obtained from the gracilis muscle. Follow-up of the patient is still continued with no tumor recurrence observed during this period.Being the real dynamic flap and its tonus of the functional gracillis free muscle flap in opposite to the static methods provides a significant superiority over the other options in terms of oral functions; moreover, the overlying skin graft presents a very good color and texture harmony aesthetically. This method is a candidate to be an exclusive surgical technique in the repair of total or close to total lip losses in the future.

Objective Tonsillectomy is one of the most common surgical procedures performed at ear, nose, and throat clinics. Chronic recurrent tonsillitis, obstructive tonsillitis, and halitosis are among the most common indications for surgery. Determining whether the infection is chronic and the patient's annual number of infections are important in estimating the necessity for surgery to be performed due to infectious causes. Red blood cell distribution width (RDW) is a numerical value present in normal complete blood count that provides information about erythrocytes and their dimensions. Studies in recent years have shown that RDW increases in chronic infections, hypoxia, and oxidative stress. This study investigated the changes in RDW in patients with chronic tonsillitis and the effect tonsillectomy has on this value by comparing RDW between patients scheduled for tonsillectomy and normal population and examining preoperative and postoperative changes in RDW. Materials and Methods Sixty-three patients scheduled for tonsillectomy due to recurrent tonsillitis aged 4-14 years were included in the study. The control group consisted of 60 subjects comparable in terms of age and sex. Hemoglobin level and RDW were recorded by collecting 2 mlof blood before surgery and at 4 months postoperatively from all patients. Results Preoperative RDW was significantly higher in the patient group than in the control group. Comparison of patients' preoperative and postoperative RDW revealed a significant decrease in RDW after surgery. Conclusion As a biomarker showing chronic infection in patients with tonsillitis, RDW can provide support to the clinician in deciding on surgery. However, this has to be confirmed in further studies with greater participation.

IMPORTANCE: The risk stratification of adrenocortical carcinoma (ACC) based on tumor proliferation index and stage is limited. Adjuvant therapy after surgery is recommended for most patients. Pan-genomic studies have identified distinct molecular groups closely associated with outcome. OBJECTIVE: To compare the molecular classification for prognostic assessment of ACC with other known prognostic factors. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective biomarker analysis, ACC tumor samples from 368 patients who had undergone surgical tumor removal were collected from March 1, 2005, to September 30, 2015 (144 in the training cohort and 224 in the validation cohort) at 21 referral centers with a median follow-up of 35 months (interquartile range, 18-74 months). Data were analyzed from March 2016 to March 2018. EXPOSURES: Meta-analysis of pan-genomic studies (transcriptome, methylome, chromosome alteration, and mutational profiles) was performed on the training cohort. Targeted biomarker analysis, including targeted gene expression (BUB1B and PINK1), targeted methylation (PAX5, GSTP1, PYCARD, and PAX6), and targeted next-generation sequencing, was performed on the training and validation cohorts. MAIN OUTCOMES AND MEASURES: Disease-free survival. Cox proportional hazards regression and C indexes were used to assess the prognostic value of each model. RESULTS: Of the 368 patients (mean [SD] age, 49 [16] years), 144 were in the training cohort (100 [69.4%] female) and 224 were in the validation cohort (142 [63.4%] female). In the training cohort, pan-genomic measures classified ACC into 3 molecular groups (A1, A2, and A3-B), with 5-year survival of 9% for group A1, 45% for group A2, and 82% for group A3-B (log-rank P

Deep neck infection (DNI) refers to infections in spaces created by superficial and deep cervical fascia around the muscles and organs in the neck. Vitamin D is highly important for an effective immune system. Vitamin D receptors (VDR) have been identified in immune system cells, and particularly in T and B lymphocytes, macrophages, and dendritic cells. Vitamin D deficiency is thought to result in impaired immune response, decreased leukocyte chemotaxis, and an increased disposition to infection. The purpose of this study was to investigate whether vitamin D deficiency is an underlying occult factor in the development of DNI. Sixty-five patients aged 6 to 90, diagnosed with DNI, and 70 healthy age- and sex-compatible cases were included in the study. Serum levels of calcium, phosphorus, parathyroid hormone, and 25-hydroxy vitamin D (25(OH)D) were determined in each case. 25-hydroxy vitamin D levels above 20 ng/mL were regarded as normal, 12 to 20 ng/mL as insufficient, 5 to 12 ng/mL as deficient, and less than 5 ng/mL as severely deficient. Mean serum 25(OH)D levels were 10.4 (6.2) ng/mL in the patient group and 15.5 (6.4) ng/mL in the control group ( P < .01). This difference was statistically significant ( P < .01). Vitamin D was within normal limits in 9.2% (n = 6) of cases in the study group, insufficient in 29.2% (n = 19), deficient in 35.3% (n = 23), and severely deficient in 26.2% (n = 17). The equivalent values in the control group were 21.4% (n = 15), 48.5% (n = 34), 30% (n = 21), and 0% (n = 0). Serum 25(OH)D levels were significantly lower in patients with DNI compared to the healthy cases; 25(OH)D levels may be a factor in the development of DNI.

Aim: The primary treatment of primary hyperparathyroidism (PHPT) is parathyroidectomy. With its shorter operative time and healing period, lesser general anesthesia duration, lesser hypoparathyroidism risk and better cosmetic results minimally invasive parathyroidectomy is the most commonly performed contemporary surgical procedure. However, in order for this procedure to be successful, it is important to know the location of the parathyroid adenoma. The purpose of this study was to determine the diagnostic value of Ultrasonography (USG) and technetium methoxyisobutylisonitrile scintigraphy (99mTc-MIBI) in the preoperative localization of parathyroid adenoma. Materials and Methods: Fifty-two patients diagnosed with parathyroid adenoma were included in the study. Preoperative parathyroid USG and 99mTc-MIBI were performed on all patients. All patients’ preoperative serum calcium, phosphorus, parathormone and Vitamin D levels, parathyroid USG and 99mTc-MIBI, intraoperative parathyroid lesion location and histopathological examination results were recorded. Results: Patients aged between 22 and 81 (51.7±15.6) were eventually enrolled. When USG was used alone, the site of the adenoma was correctly determined in 26 of the 52 patients with a sensitivity of 52% and a positive predictive value of 92.8%. When scintigraphy was performed alone, the site of the adenoma was correctly identified in 39 of the 52 patients. Sensitivity was thus 76.4% and positive predictive value 97.5%. When USG and scintigraphy were assessed together, adenoma location was correctly identified in 45 of the 52 patients. Sensitivity for the two tests employed together was 88.2% and positive predictive value was 97.8%. Conclusions: Due to the high sensitivity of combined use of USG and 99mTc-MIBI, we recommend the two tests to be assessed together before parathyroid surgery.

Purpose We aimed to determine the effect of a cartilage shoe graft placed between the foot of the TORP and the stapes footplate on hearing improvement and long-term displacement rates. Materials and methods Patients who underwent TORP ossiculoplasty were divided into two groups. The TORP-alone group consisted of 32 patients who underwent TORP placement without cartilage shoe graft and served as the control group. The study group consisted of 56 patients who underwent placement of cartilage shoe graft together with TORP. Pure-tone audiometry was administered to all patients before and 3, 6 and 12 months after surgery. Indications for surgery, surgical technique used, postoperative complications, and air and bone conduction thresholds at 500, 1000, 2000 and 4000 Hz were recorded for all patients. Results No significant difference in postoperative air–bone gaps was observed between the groups. The number of patients with air–bone gaps less than 20 dB was 14 (25%) in the study group and 8 (25%) in the control group. There was no significant difference in changes in air–bone gaps between the groups. Dislocation of the prosthesis was observed in 3 patients in the study group (5.3%) and 4 in the control group (12.5%). There was less dislocation of the prosthesis in the study group, but the difference was not statistically significant. Conclusion Placement of a cartilage graft between the footplate of the stapes and the foot of the prosthesis may have positive effects on long-term hearing improvement and rates of prosthesis displacement. Further research with larger patient numbers is needed to identify the advantages of shoe graft.

Noise is a stress factor that causes auditory, psychological and physiological effects. The realization that sudden loud noises or chronic exposure to noise in social and working environments can cause hearing loss has led to increased interest in noise-induced hearing loss (NIHL). The best means of preventing primary damage is protection against noise. Since this protection is not always possible for various reasons, the use of pharmacological agents to prevent or treat NIHL should also be considered. The purpose of this study is to discuss current pharmacological protection and treatment options in the light of the literature, since no such extensive reviews have been performed to date, including agents used for protection against and treatment of NIHL. We reviewed both animal and clinical studies, and these are discussed separately for ease of comprehension. For each agent, first animal studies, then clinical studies, if available, are discussed. We also performed a two-step search of the literature. In the first step, we searched the terms "noise induced hearing loss", "treatment" and "protection" in Pubmed. Based on the results obtained, we identified the agents used for the treatment of and protection against NIHL. In the second step, we searched the names of the agents identified in the first step, together with the term "noise induced hearing loss," and reviewed the results.

BackgroundOtitis media with effusion is a clinical manifestation characterised by inflammation of middle-ear mucosa. This study investigated the therapeutic effect of erythromycin, clarithromycin, azithromycin and roxithromycin on a histamine-induced animal model of otitis media with effusion.MethodsThe animals were divided into five groups, receiving erythromycin, clarithromycin, azithromycin, roxithromycin or saline solution. The guinea pigs in the study groups received erythromycin (40 mg/kg/day), clarithromycin (15 mg/kg/day), azithromycin (10 mg/kg/day) or roxithromycin (10 mg/kg/day) for 3 days by gastric tube. Four hours after the end of the administration, histamine solution was injected into the right middle ear.ResultsThe lowest neutrophil density value obtained using stereological techniques was in the azithromycin group (0.86 ± 0.25 × 10−5/μm3), while the highest value was observed in the control group (6.68 ± 3.12 × 10−5/μm3). The anti-inflammatory properties of clarithromycin, azithromycin and roxithromycin were similar to one another, but better than that of erythromycin.ConclusionThe use of macrolide antibiotics is recommended, as they show antibacterial and anti-inflammatory efficacy in otitis media with effusion.

Objective The frequency of metabolic syndrome is increasing in both children and adults. In addition to metabolic complications such as obesity, hypertension, cardiovascular diseases, insulin resistance, and type 2 diabetes, metabolic syndrome may affect all systems of the body. The aim of the present study was to investigate the effect of metabolic syndrome on hearing in childhood. Methods A prospective, controlled study was performed on 38 obese children diagnosed with metabolic syndrome and 34 healthy children. Anthropometric measurements and biochemical studies were performed. All individuals underwent pure-tone audiometry, tympanogram, and transient evoked otoacoustic emission (TEOAE) tests. The hearing thresholds of the patients were compared with healthy volunteers. Results There was no significant difference in terms of age and gender between the groups (p>0.05). There was no significant difference in mean hearing levels between the groups. When frequencies were compared, significantly increased hearing threshold levels were determined at low frequencies in children with metabolic syndrome. Analysis of the TEOAE results elicited no statistically significant variation in terms of signal-to-noise ratio values, signal amplitudes, or test reproducibility values between the study groups. Conclusion Identification of the potential hearing losses early by means of detailed hearing examinations in children with metabolic syndrome is important. To the best of our knowledge, this is the first study to examine the effect of metabolic syndrome on hearing in this age group.

Introduction: Thyroid cancer is the most common endocrine system cancer. Although fine-needle aspiration biopsy is the most commonly used method for diagnosis, it is not always sufficient. The aim of this study was to investigate the influence of preoperative serum thyroglobulin (Tg) concentration on differentiated thyroid cancer risk. Material and Methods: A total of 133 patients who underwent total thyroidectomy due to various indications at the Ear-Nose-Throat Department, Ataturk University Medical School, between April 2015 and December 2015, were included in this prospective study. Histopathological diagnosis and preoperative Tg levels were compared. Receiver operating characteristic (ROC) analysis was used for detection of the cut-off to discriminate malignant from benign thyroid masses using preoperative Tg as a variable. Results: Malignant pathology (differentiated thyroid carcinoma) was detected in 59 out of 133 patients (44.4%) and benign pathology in 74 (55.6%). A statistically significant difference in preoperative Tg value was detected between malignant and benign cases (p < 0.05). Conclusion: The prevalence of differentiated thyroid carcinoma was higher among patients with a preoperative serum Tg value > 188.5 ng/mL, and this may thus be used as a marker for the diagnosis of this malignancy.

Choanal atresia is the unilateral or bilateral obstruction of the passage between nasal cavity and nasopharynx. Transnasal surgery of choanal atresia in a patient with unilateral choanal atresia diagnosed accidentally during operation of septorinoplasti for septal deviation and external nasal deformity in Plastic Surgery Clinic is presented. A 25-year-old female referred to plastic surgery clinic with external nasal deformity and difficulty in breathing through nose. Although concha bullosa at middle concha and polipoid degeneration at lower concha are observed in computerized tomography of paranasal sinus, the patient referred to our clinic. In physical examination, due to advanced septal deviation, endoscopic examination of left nasal cavity could not be established. It was planned to examine the left nasal cavity in operating room after septoplasty. In the endoscopic examination after septoplasty, choanal atresia at left nasal cavity observed. Atresia was repaired with transnasal approach. At follow-up period, the choanal opening was intact. Unilateral choanal atresia is a disorder which can reach at the adolesant ages without diagnosis. Although the symptoms of the disease can be interfere in lots of diseases, the diagnosis is simple with nasal endoscopic examination. If nasal endoscopic examination is difficult because of nasal septal deviation, it must be performed in operating room before ending the operation to reveal the additional disorders. [Med-Science 2015; 4(1.000): 2073-9]

The aim of this study is to determine some parameters such as the structure of foreign body, age of patient etc. in patients with foreign body in their nasal cavity. The patients who referred to our hospital with foreign body in their nasal cavity between November 2013 and November 2014 are included to study. Data were collected retrospectively from patients records. 80 patients had foreign body in their nasal cavity. 45(%56.25) of them have foreign body in right nasal cavity, while 35 have in left one (%43.75). 48 of the patients were male (%60), 32 of them were female (%40). The foreign bodies were more common in early ages. 28 of patients (%35) were between age 0-2, 32 of them (%40) were between age 2-4, 15 of them (%19) were between age 5-8 and 5 of them (%6) were older than 8 years old. The foreign bodies mostly consist of little plastic substances (18 patients, %22.5), beans (16 patients %20), paper particles (12 patients, %12) and sponge (7 patients, %8.75). Only 5 of patients had complication of epistaxis after removal of foreign body. Foreign bodies in nasal cavity are common disorders of pediatric population. Although it is generally easy to remove foreign bodies from nasal cavity, it must be also considered that, all foreign bodies of nasal cavity have potential risk to obstruct the airway. Because of this, the foreign body in the nasal cavity is an emergency situation. Key Words: Foreign bodies, nasal cavity, epistaxis

Papillary thyroid carcinoma (PTC) is the most differentiated malignant thyroid neoplasm. Local metastases of PTC commonly occur in the regional lymph nodes, while distant metastases are mainly to the lung and bone. The case of a patient with PTC who presented with swelling of the parotid gland and neck, mimicking a primary parotid neoplasm, is presented herein. This case is unique due to the unexpected initial presentation of PTC with no signs of disease in the thyroid gland.

INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is characterized by episodes of upper respiratory tract obstruction, decreased oxygen saturation, and sleep fragmentation during sleep, as well as excessive daytime somnolence. Cephalometric analysis offers distance, angle, area, and volume measurements between separate reference points belonging to bony and soft tissues on a film. Cephalometric measurements made with multislice computed tomography (CT) are quite helpful for standardization of measurements and obtaining highly reliable results. The aim of the current study was to make cephalometric measurements with multislice CT in OSAS patients and compare their results with those of a healthy control population. The authors also aimed to determine, which cephalometric parameters might be more valuable for diagnosis of OSAS. MATERIALS AND METHOD This study included 30 patients who were diagnosed with severe OSAS (apnea-hypopnea index >30) by an overnight polysomnography study, performed for suspected OSAS and 10 healthy controls without snoring or apnea who underwent three-dimensional head & neck multislice CT for any indication. All patients underwent a three-dimensional head & neck multislice CT to make cephalometric measurements and compare them across the groups. RESULTS ANS-PNS (anterior and posterior nasal spine), Go-Gn, and UP-PhW distances, as well as sella-nasion-A and sella-nasion-B angles, were significantly lower in the OSAS group compared with the controls (P < 0.05). Mandibulas plane -H, UD, TT-EA, ANS-B, PNS-TB, TT-TB, B-N, and PNS-PhW distances were significantly higher in the patient group compared with the controls (P < 0.05). CONCLUSIONS Our study reached the conclusion that some cephalometric measurements showed significant differences in patients with obstructive sleep apnea compared with the control group, and hence may lead to a susceptibility to having OSAS. Cephalometric measurements performed with multislice CT have come to the forefront as one of the most important tools for diagnosis of OSAS. An inferiorly located hyoid bone may be most commonly responsible for apnea episodes. It was also concluded that an inferiorly located hyoid bone might have been the result of maxillomandibular underdevelopment.

The authors report an isolated echinococcosis in a 17-year-old girl presented with swelling of right neck approximately 12 cm in diameters with no evidence of the disease elsewhere in the body. A thorough search of the literature revealed only a few cases of isolated cervical echinococcosis. Surgical procedure was planned for our case with the guidance of the magnetic resonance imaging, which showed right cystic mass and within a laminar membrane. Histopathologic report confirmed echinococcosis. In summary, this current study shows that in the differential diagnosis of the cystic masses localized in the neck in the endemic regions, echinococcosis should be suggested. In these patients, the careful assessment of the magnetic resonance imaging evaluation before the surgery would extremely facilitate either the diagnosis or the surgery planning.

To evaluate image quality of protocol including 135 kVp, 5 mAs and 80 kVp, 5 mAs in the paranasal sinus CT examinations using single volumetric 320-row multidetector CT technique.From September to December 2016, both of our control group including 135 kVp and 5 mAs and our study group including 80 kVp and 5 mAs paranasal CT protocols were simultaneously performed on 40 patients using single volumetric 320-row multidetector CT device. Image quality for bony structures, air-filled structures and soft tissues were independently assessed for each group by three blinded observers using a 3-point grading scale (0 = not diagnostic, 1 = partially diagnostic, 2 = diagnostic). Objective image quality was also performed by region of interests were placed on axial soft tissue reconstructions in both eye bulbs, retrobulbar fat and maxillary sinuses to obtain different values for aqueous tissue, soft tissue and air, respectively. Effective dose was calculated from the dose-length product.The effective radiation dose which calculated for the control group scans was 0.037 ± 0.003 mSv. But, it was 0.0099 ± 0.001 mSv for the study group scans. The effective radiation dose of study group was statistically significant lower than control group (p0.001). Despite significant lowering of the radiation doses, image qualities were sufficient for evaluating all the bony structures, air-filled structures and soft tissues except for eye muscle, retrobulbar fat and eye bulb.Our results present that our protocols for study and control group provide significant dose reduction without the loss of diagnostic image quality for paranasal sinus CT. Paranasal sinus CT imaging can be performed at very low radiation exposure maintaining high image quality using a single volume 320-row detector CT device using 135 kVp and 5 mAs.

Pseudoankylosis of temporomandibular joint (TMJ) is characterized by limited mouth opening and impaired mandibular mobility induced by pathologic factors outside the joint itself, usually leading to compromised speech, swallowing, and breath functions. Multiple surgical approaches or reconstructive procedures have been proposed to resolve the joint pseudoankylosis and restore the mandibular movement for these affected patients. Free forearm flap has been widely used in reconstruction for various congenital or acquired defects or deformities; however, this flap has been rarely employed for TMJ pseudoankylosis in the literature. Here, the authors reported that noma-induced TMJ pseudoankylosis was diagnosed and successfully treated by extended free forearm flap with length over 10 cm in a Chinese female patient.

European Annals of Otorhinolaryngology, Head and Neck Diseases - Vol. 133 - N° 5 - p. 371-372

Nasal furunculosis is a deep infection of hair follicle within the nasal vestibule. In this report, the authors presented a 49-year-old woman with 4-day history of focal red area and tender swelling on the tip of her nose. On physical examination, together with a swelling at nasal vestibulum, erythema, and edema on the skin of nasal tip were observed, which is called the Rudolph Sign. The patient was treated with intranasal topical mupirocin and oral sodium fusidate. Because nasal furunculosis may lead to serious complications such as ophthalmic vein thrombosis and cavernous sinus thrombosis, early diagnosis and effective treatment is essential.

One of the most common causes of hearing loss depends on noise overexposure. Noise is a stress factor that has auditory, psychological and physiological effects. Noise causes overproduction of stress hormones, sleep disturbances and impairment of cellular immunity. The effect of noise that inflicts organic damage on the human hearing system varies depending on intensity, and duration of the noise and individual susceptibility. There are several anatomical and physiologic abnormalities caused by noise overexposure. These abnormalities vary from the minimal loss of metabolic activities of hair cells and stiffness of stereocilia to total loss of organ of corti and the auditory nerve. The opportunity to treat and prevent noise induced hearing loss may increase with the clarification of the mechanism of cochlear damage in noise. Understanding of these mechanisms is important for development of new agents for treatment or prevention of noise induced hearing loss. In this report, we reviewed the pathological changes of the cochlea in noise induced hearing loss in the light of the literature. Keywords: Hearing loss, noise-induced cochlea, mechanism of action

The objective of the present study was to investigate the antiulcer activity of methanol extract of Oxalis corniculata (whole plant) using pylorus ligation and indomethacin-induced gastric ulceration in Wistar rats. The extract was preliminary evaluated for acute oral toxicity test using Organisation for Economic Co-operation and Development guidelines 423. Further, it was studied for antiulcer potential at the dose levels of 125, 250 and 500 mg/kg. Ranitidine was used as a standard drug (100 mg/kg). Acid secretory parameters like gastric volume, pH, total acidity and free acidity were measured in pylorus ligation model, whereas numbers of ulcers, ulcers score and ulcer index was measured in pylorus ligated and indomethacin treated rats. Pretreatment of test extract significantly (p