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INTRODUCTION: In this study, we aimed to evaluate the patients with obstructive sleep apnea syndrome OUAS for dermatological diseases.METHODS: A total of 475 patients who were diagnosed to have OUAS by polysomnography between November 2011- April 2015 were included in the study. Data of patients, which were collected from patient registry records on hospital computer automation system, were analyzed retrospectively.RESULTS: A total of 557 dermatological diseases diagnosed in OUAS patients were analyzed in 16 groups. The six most frequently encountered diseases were infectious dermatoses 34.29% , eczematous dermatitis 10.05% , benign-premalignant skin tumors 10.05% , kserosis cutis 7.54% , other group that cannot be classified 6.46% and erythematous-scaly dermatoses 5.92% , respectively.DISCUSSION AND CONCLUSION: We do not have enough data about the accompanying dermatological diseases of OUAS patients which show an increasing incidence in the recent years with the effect of obesity. Early diagnosis and treatment which can be achieved through closer dermatologic monitoring of this patient group is important for the quality of life of these patients., GİRİŞ ve AMAÇ: Çalışmada obstruktif uyku apne sendromu OUAS tanısı almış olguların dermatolojik hastalıklar açısından incelenmesi amaçlandı.YÖNTEM ve GEREÇLER: Çalışmamıza, Kasım 2011- Nisan 2015 tarihleri arasında polisomnografi yapılarak OUAS tanısı alan 475 hasta dahil edildi. Hastane otomasyon sistemindeki hasta dosya kayıtlarından elde edilen hastalara ait veriler retrospektif olarak incelendi.BULGULAR: OUAS hastalarında tanı konulan 557 dermatolojik hastalık, 16 grup halinde incelendi. Bu hastalıklardan en sık görülen altı hastalık sırasıyla; infeksiyöz dermatozlar %34.29 , ekzemalar %10.05 , benign-premalign deri tümörleri %10.05 , kserozis kutis %7.54 , sınıflanamayan diğer grup %6.46 ve eritemli-skuamlı dermatozlar % 5.92 idi. TARTIŞMA ve SONUÇ: Son yıllarda artış gösteren obezitenin de etkisiyle görülme sıklığı artan OUAS hastalarında eşlik eden dermatolojik hastalıklar konusunda elimizde yeterli veri yoktur. Bu hasta grubunun dermatolojik açıdan daha yakından izlemiyle sağlanabilecek erken tanı ve tedavi hasta yaşam kalitesi açısından önemlidir

Melkersson-RosenthalSendromu (MRS) tekrarlayan periferik fasiyal paralizi, yüz bölgesinde ödem ve dilde fissürleşme triadı ile görülen nöromukokütanöz, granülomatöz bir hastalıktır. Klasik triadın tüm bulguları seyrek olarak gözlenir, genellikle bir veya iki semptombirlikte görülür. Etyolojisi tam olarak bilinmemekte olup genetik ve edinsel faktörler rol almaktadır. Pediatrik yaş grubunda daha az sıklıkta görülen bu hastalık hayatın 2. ve 3. dekadında görülme sıklığı artar. Hastalık genelde spontan veya medikal tedaviyle geriler fakat bazı hastalarda progresif seyredip fasiyal sinir dekompresyonu gerekebilmektedir. Tedavi semptomatiktir ve medikal tedavide steroid, NSAİİ ve antibiyotik kullanılmaktadır. Tekrarlayan periferik fasiyal paralizi olgularında ayırıcı tanıda düşünülmelidir. Bu yazıda oldukça nadir görülmesi ve klasik triadın bir arada olması nedeniyle cilt biyopsisine gerek kalmadan Melkersen-Rosenthal Sendromu tanısı alan bir hasta sunulmuştur. Melkersson-Rosenthal Syndrome is a neuromucocutaneous granulomatous disease. It is characterized by recurrent facial nevre paralysis, orofacial edema and fissured tongue. Classical triad of this syndrome is very rarely seen, generally only one or two symptoms can be seen. The cause of MelkerssonRosenthall Syndrome is unknown, but genetic and acquired factors may play a role. This syndrome is very rare in childhood, it is more frequently seen in the second and the third decades of life. The disease usually regresses spontaneously or with medical treatment but it can progress and facial nevre decompression may be required in some patients. Treatment is symptomatic and may include medical therapies such as nonsteroid anti-inflamatory drugs, steroids and antibiotics. In differential diagnosis of recurrent facial paralysis Melkersson-Rosenthal Syndrome must be considered. We present a 23 years old man admitted to our hospital because of recurrent facial paralysis and diagnosed as MelkerssonRosenthal Syndrome without scin biopsy.

Amaç:Tinnitus, hastanın yaşam kalitesini bozan ciddi bir problemdir. Etyopatogenezi karmaşık olup halen tam olarak anlaşılamamıştır. Bu çalışmanın amacı tinnitus şikayeti olan hastalarda hastaların tinnitusa bağlı algıladığı handikap derecesi ile anksiyete ve depresyon belirtilerinin şiddetini karşılaştırmaktır. Gereç ve Yöntemler:Abant İzzet Baysal Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Hastalıkları polikliniğine çınlama şikayetiyle başvuran 64 hasta çalışmaya dahil edildi. Hastalara sosyodemografik veri formu, tinnitus handikap ölçeği ve hastane anksiyete depresyon ölçeği verilerek sonuçlar değerlendirildi. Bulgular: Tinnitus hastalarının % 21,8'inde (n:14) psikiyatrik hastalık öyküsü vardı. Hastaların tinnitus handikap ölçeği ortalama skoru 40,71 ± 24,03, hastane anksiyete depresyon ölçeği anksiyete alt ölçeği ortalama skoru 8,14± 5,03, depresyon alt ölçeği ortalama skoru 6,87± 4,42 idi. Hastaların THQ total puanları ile HAD anksiyete ve depresyon puanları pozitif korelasyon gösteriyordu. Sonuç:Çalışmamızın sonuçları tinnitus hastalarında hastanın algıladığı engellilik derecesi ile anksiyete ve depresyon belirtilerinin şiddeti arasında pozitif korelasyon olduğunu göstermektedir. Bununla birlikte nedensellik ilişkisinin kurulabilmesi için geniş örneklemli, prospektif kontrollü çalışmalar gereklidir. Objective:Tinnitus is a serious problem affecting quality of life of patients. The etiopathogenesis is complex and still not fully understood. The aim of this study is compare perseived degree of handicap due to tinnitus and severity of anxiety and depressive symptoms in patients with tinnitus. Material and Methods: 64 patients with complaint of tinnitus admitted to Abant İzzet Baysal University Medical Faculty Otorhinolaryngology outpatient clinic were included in this study. Sociodemographic data form, tinnitus handicap questionnaire and hospital anxiety and depression scale was given to evaluate the patients Results:%21.8 (n:14) of the patients with tinnitus had history of psychiatric disorder. The mean score of tinnitus handicap questionnaire total was 40,71 ± 24,03, hospital anxiety and depression anxiety subscale mean score was 8.14 ± 5.03 and hospital anxiety and depression subscale mean score was 6.87 ± 4.42. There was positive correlation between THQ total score and HAD anxiety and depression scores. Conclusion: Our results showed that there was positive correlation between perseived degree of handicap and severity of anxiety and depression in patients with tinnitus. However, prospective controlled studies with large samples are needed to establish the causality.

Introduction: In this study, we aimed to evaluate the patients with obstructive sleep apnea syndrome (OSAS) for otorhinolaryngological manifestations. Methods: A total of 347 patients who were diagnosed to have OSAS by polysomnography between April 2010 - September 2015 were included in the study. Data of patients, which were collected from patient registry records on hospital computer automation system, were analyzed, retrospectively. Results: A total of 117 otorhinolaryngological manifestations diagnosed in all of the OSAS patients. According to the polysonographic findings, 26 of these patients had simple snoring while 30 had mild OSAS, 20 had moderate OSAS and 41 had severe OSAS. When the OSAS group (mild-moderate-severe) (n=91) was examined, 68 patients had nasal septum deviation, 28 had inferior concha hypertrophy, 23 had tongue base hypertrophy, 20 had tonsillar hypertrophy and 33 had elongated soft palate. When the simple snoring group was examined, 20 patients had nasal septum deviation, 8 had inferior concha hypertrophy, 5 had tongue base hypertrophy, 3 had tonsillar hypertrophy and 4 had elongated soft palate. When both groups were compared, it was seen that the only significant difference was that the OSAS group had higher values in terms of elongated soft palate (p˂ 0.05). When OSAS group was examined, nasal septum deviation and concha hypertrophy were the most commonly coexisting conditions among all otorhinolaryngologic diagnosis (12.09%). Similarly, in OSAS group, nasal septum deviation, tongue base hypertrophy and elongated soft palate were the most commonly coexisting diagnosis (8.79%).There was only 1 patient having all the otorhinolaryngologic diagnosis (1.1%). Conclusion: Obstructive sleep apnea syndrome cause severe morbidity and mortality. Otorhinolaryngological pathologies have an important role in the physiopathology of OSAS and early diagnosis has a great importance in reducing mortality and morbidity.

Objective: Recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease of oral mucosa characterized by recurrent painful ulcers. Despite it is a condition seen frequently, its etiology and pathogenesis are not known fully. Its etiology is reportedly idiopathic or multifactorial. Mean platelet volume (MPV) indicates thrombocytic activation, while neutrophil/lymphocyte rate (NLR) is an indicator of chronic inflammation, and both of them can be measured during routine whole blood analysis. The aim of this study is to investigate MPV and NLR values in patients with RAS and the controlgroup.Methods: A total of 39 patients with RAS and 34 control subjects were included in the study.Results: When the patient and the control groups were compared, MPV, ESR, CRP and vitamin B12 values were significantly higher in the patient group while NLR, WBC, hemoglobin, neutrophil and lymphocyte values were not significantly different between both groups.Conclusion: It was shown that MPV can be used as a diagnostic indicator in patients with RAS.

Amaç: Tinnitus, hastanın yaşam kalitesini bozan ciddi bir problemdir. Etyopatogenezi karmaşık olup halen tam olarak anlaşılamamıştır. Bu çalışmanın amacı tinnitus şikayeti olan hastalarda hastaların tinnitusa bağlı algıladı- ğı handikap derecesi ile anksiyete ve depresyon belirtilerinin şiddetini karşılaştırmaktır.Gereç ve Yöntemler: Abant İzzet Baysal Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Hastalıkları polikliniğineçınlama şikayetiyle başvuran 64 hasta çalışmaya dahil edildi. Hastalara sosyodemografik veri formu, tinnitus handikap ölçeği ve hastane anksiyete depresyon ölçeği verilerek sonuçlar değerlendirildi.Bulgular: Tinnitus hastalarının % 21,8'inde (n:14) psikiyatrik hastalık öyküsü vardı. Hastaların tinnitus han-dikap ölçeği ortalama skoru 40,71 ± 24,03, hastane anksiyete depresyon ölçeği anksiyete alt ölçeği ortalama skoru 8,14± 5,03, depresyon alt ölçeği ortalama skoru 6,87± 4,42 idi. Hastaların THQ total puanları ile HAD anksiyete ve depresyon puanları pozitif korelasyon gösteriyordu.Sonuç: Çalışmamızın sonuçları tinnitus hastalarında hastanın algıladığı engellilik derecesi ile anksiyete ve dep-resyon belirtilerinin şiddeti arasında pozitif korelasyon olduğunu göstermektedir. Bununla birlikte nedensellik ilişkisinin kurulabilmesi için geniş örneklemli, prospektif kontrollü çalışmalar gereklidir.Anahtar kelimeler: Tinnitus; Anksiyete; Depresyon; HandikapABSTRACTObjective: Tinnitus is a serious problem affecting quality of life of patients. The etiopathogenesis is complex and still not fully understood. The aim of this study is compare perseived degree of handicap due to tinnitus and severity of anxiety and depressive symptoms in patients with tinnitus.Material and Methods: 64 patients with complaint of tinnitus admitted to Abant İzzet Baysal UniversityMedical Faculty Otorhinolaryngology outpatient clinic were included in this study. Sociodemographic data form, tinnitus handicap questionnaire and hospital anxiety and depression scale was given to evaluate the patientsResults: %21.8 (n:14) of the patients with tinnitus had history of psychiatric disorder. The mean score oftinnitus handicap questionnaire total was 40,71 ± 24,03, hospital anxiety and depression anxiety subscale mean score was 8.14 ± 5.03 and hospital anxiety and depression subscale mean score was 6.87 ± 4.42. There was positive correlation between THQ total score and HAD anxiety and depression scores.Conclusion: Our results showed that there was positive correlation between perseived degree of handicapand severity of anxiety and depression in patients with tinnitus. However, prospective controlled studies with large samples are needed to establish the causality.Key words: Tinnitus; Anxiety; Depression; Handicap.

İşitsel nöropati, işitsel beyin cevabı alınamamasına karşın dış tüylü hücre fonksiyonlarının korunduğu işitme bozukluğudur. Günümüzdeki mevcut yöntemlerle patolojinin tam olarak hangi seviyede olduğunu saptamak mümkün değildir. İşitsel nöropati hem çocuk hem de erişkin yaş grubunda, çeşitli işitme seviyeleri ile görülebilmektedir. Bu nedenle Kulak Burun Boğaz Hastalıkları ve Çocuk Hastalıkları hekimlerinin bu hastalığın klinik özelliklerini akılda tutması ve gözden kaçırmaması önemlidir. Çünkü doğru tanı konulup doğru tedavi yöntemi uygulanmadığında işitmenin daha da kötüleşip hastanın psikososyal gelişiminin de kötü yönde etkilenmesine neden olabilir. Bu çalışmada, 17 yaşında işitsel nöropati tanısı koyduğumuz bir hastayı ve bu hastaya klinik yaklaşımımızı sunduk. Hastaya işitme cihazı uygulamadık, konuşma ve dil gelişimi için rehabilitasyon eğitimine yönlendirdik. Bu olgu ile işitsel nöropatinin klinik ve odyolojik tetkik özelliklerini, fizyopatolojisini ve tedavi yaklaşımını gözden geçirmeyi amaçladık., Auditory neuropathy is a hearing disorder characterized by the preservation of outer hair cell function despite the absence of auditory brainstem evoked responses. The exact site of the pathological lesion in auditory neuropathy hasn’t been demonstrated, yet. Auditory neuropathy in both adults and children may be seen with various levels of hearing loss. Therefore, ENT doctors should keep in mind the clinical features of this disease in order not to overlook the disease. Because under diagnosis and/or inappropriate treatment of the disease may worsen hearing loss and also may negatively effect the psychosocial development of the patient. In this case, we presented a 17 years old patient with auditory neuropathy. We didn’t implement ear aid but we only suggested auditory rehabilitation. We aimed to review the clinical features, audiometric findings, psychopathologic and treatment approaches to patients with auditory neuropathy.

WOS:000307083900008 Objective: In this study we aimed to investigate the psychological status of tinnitus patients as well as the sleep quality and their relation to handicap caused by tinnitus using various scales. Additionally, serum melatonin levels and the effectiveness of melatonin treatment were studied. Study Design: Prospective, double blind, randomized controlled trial Materials and Methods: Patients were divided randomly into two groups as study (melatonin, n=13) and placebo (control, n=11) groups. Tinnitus Handicap Inventory (THI), Symptom Check List (SCL), Hospital Anxiety and Depression Scale (HAD), Beck Depression Inventory (BDI), Pittsburg Sleep Qualty Index (PSQI) were applied. After filling the scales and giving the venous blood sample for melatonin measurements the patients were instructed to take one tablet (placebo or 3 mg melatonin) before sleep every night. After 8 weeks, second order scales were filled and melatonin measurements were repeated. Results: Serum melatonin levels were between 1-260 pg/ml; the mean was 38,7 pg/ml. The correlation of melatonin levels with THI and tinnitus duration was not significant. THI was found to correlate with different measures of the PSQI, HAD, and BDI in both groups. Statistical analysis failed to show any significant difference within and between groups in respect of anxiety, depressive symptoms and sleep as well as melatonin and handicap levels. When the groups were assessed according to the THI severity (mild/moderate to severe;THI2); in the control group there was significant differences in PSQI(1) and PSQI(1) (p=0.0008, p=0.18), NAD(1), HAD(2) (0.002, 0.03), HAD Depression(1-2) (0.0, 0.006) BDI (p=0.007) PSQI(2 sleep) (disturbance) (P=0.018) parameters. However, in the melatonin group it was found that there were significant differences in SCL2 (sleep) (latency), PSQI(2) (sleep) (duration) and total PSQI(2) parameters. (p=0.022, 0.027, 0.006 respectively) Conclusion: Patients with higher handicap may benefit melatonin in respect of sleep latency and duration as well as sleep quality comparing with the patients taking placebo. Moreover, melatonin efficiency may be related to its antidepressive effect.

Alt konka hipertrofilerine bağlı burun tıkanıklığı, kulak burun boğaz pratiğinde en sık karşılaşılan şikayetlerden biridir. Tedavide medikal ve cerrahi yöntemler kullanılmaktadır. Medikal tedavinin yeterli olmadığı durumlarda cerrahi tedaviye gerek duyulur. Alt konka cerrahi tedavisinde kullanılan yöntemler arasında; parsiyel/total konka rezeksiyonu, lateralizasyon, lazer cerrahisi, elektrokoter, kriyoterapi, submukozal rezeksiyon, türbinoplasti, submukozal diyatermi, radyofrekans termal ablasyon, argon plazma koagülasyonu bulunmaktadır. Radyofrekans Termal Ablasyon (RFTA) tekniği son yıllarda kullanımı artan, etkinliği kanıtlanmış, uygulanması kolay, minimal invaziv ve düşük yan etki riski nedeniyle sık tercih edilen bir tedavi yöntemi haline gelmiştir. Bu çalışmanın amacı; akustik rinometri ölçümüyle konjesyon öncesi, konjesyon sonrası ve dekonjesyon sonrası minimal kesitsel alan (MCA2)' deki değişim oranlarına bakarak RFTA tedavisi sonrası konkaların konjesyon ve dekonjesyona verdiği yanıtı RFTA öncesi verdiği yanıtla karşılaştırıp, bu sonuçları histolojik çalışmada RFTA ile tedavi edilmiş ve edilmemiş gruplarda konka spesimenlerinde bakılan venöz sinüzoid çaplarındaki değişimle korelasyonunu değerlendirmektir. Çalışmaya, bilateral alt konka hipertrofisi olan ve RFTA planlanan 30 hasta ve ayrıca bilateral alt konka hipertrofisi olup parsiyel konka rezeksiyonu önerilen yedi hasta, toplamda 37 hasta dahil edilmiştir. Tüm hastalara RFTA uygulanmış olup RFTA öncesi, RFTA sonrası 1. ay ve 3. ayda hastalara Vizüel Analog Skala (VAS) doldurmaları istenmiş, ayrıca akustik rinometrik ölçümleri yapılmıştır. Akustik rinometri ölçümünde, konjesyon öncesi, konjesyon sonrası ve dekonjesyon sonrası MCA2 ve total nazal volüm (V) değerleri kaydedilmiştir. Konjesyon 2 mg/ml ve 8 mg/ml histaminle hazırlanmış spreylerle iki defa artan dozlarda verilerek, dekonjesyon ise % 0,1 adrenalinle emdirilmiş pamuk şeritller her iki nazal pasaja yerleştirilerek sağlanmıştır. Elde edilen verilerde, MCA2 ve V değişim oranları RFTA sonrası RFTA öncesine göre anlamlı derecede düzelme göstermiş olup RFTA sonrası 1. ay ve 3. ay arasında aynı oranlar arasında anlamlı fark görülmemiştir. Ayrıca histolojik çalışmada da; RFTA ile tedavi edilmiş grupla tedavi edilmemiş hipertrofik konka grubundaki venöz sinüzoid çapları karşılaştırıldığında RFTA uygulanmış hastaların venöz sinüzoid çaplarında anlamlı derecede fark olduğu saptanmıştır. Tüm bu sonuçlar RFTA tedavisinin konka küçültme işleminde etkin bir yöntem olduğunu göstermektedir. Ayrıca RFTA tedavisi planlanan hastalara preoperatif akustik rinometrik ölçümlerle MCA2 değişim oranlarına bakılarak konkaların konjeste ve dekonjeste olabilme kapasitelerini değerlendirip, hastanın radyofrekans tedavisinden fayda görüp görmeyeceğini öngörmede kullanılabilecek veriler olabileceği düşünülmektedir . Nasal congestion due to inferior conchal hypertropy is one of the the most encountered complaint in ear nose throat practise. There are medical and surgical treatment options. Surgical treatment is indicated if medical treatment is not effective. Surgical options include; partial/total turbinate resection, lateralization, laser surgery, electrocautery, cryotherapy, submucosal resection, turbinoplasty, submucosal diathermy, radiofrequency thermal ablation, argon plasma coagulation. Radiofrequency Thermal Ablation (RFTA) has become preffered treatment of choice because this method is effective, easy to perform, minimally invasive and has rare side effects. Aim of this study is; to compare pre-congestion, post-congestion and post-decongestion MCA2 levels before and after RFTA, which are measured with acoustic rhinometry, and with using these results, to evalute correlation between untreated patients and treated patients? venous sinusoidal calibrate changes histologically. 30 patients with bilateral inferior conchal hypertrophy who are proposed to have RFTA and seven patients who are proposed to have inferior turbinate resection due to choncal hypertrophy were included in the study. All of the patients who are treated with RFTA, filled Visual Analog Scale (VAS) and acoustic rhinometric measurements of these patients were done before RFTA and after RFTA at the 1st and 3rd months. In acoustic measurement, pre-congestion, post-congestion and post-decongestion MCA2 and total nasal volumes (V) were recorded. Congestion was provided by histamin spray applied in 2 mg/ml and 8 mg/ml doses, decongestion was provided by % 0,1 adrenalin soaked cotton placed into both nasal passages. Reduced ratios in MCA2 and V level changes before and after RFTA were statistically significant. There was no statistical significance in the level of changes between the 1st and 3rd months after RFTA. There was a statistically significant difference in the caliber of the venous sinusoidals between the untreated and treated patients with RFTA. All these results show that RFTA is a effective method in conchal reduction. In addition, we thought that, with the preoperative acoustic measurement of MCA2, congestion and decongestion capacity can be observed and this can predict which patients will have benefit from RFTA. 94

WOS:000357533000014 PubMed: 26223721 OBJECTIVE: To investigate the effects of different types of nasal packings on middle ear pressure in patients undergoing septoplasty. MATERIALS and METHODS: Sixty patients who were suffering from nasal obstruction and who had to undergo septoplasty because of nasal septal deviation were included in the study. After the septoplasty, Merocel packings and internal nasal splints were intraoperatively applied in thirty patients each. Middle ear pressure was evaluated by tympanometry. Tympanometric peak pressures were used for this aim. Acoustic impedance measurements were performed in both ears, and the average values of the two ears were calculated. Tympanometric measurements were performed for patients during the preoperative period and on the 2nd and 5th postoperative days. RESULTS: There were 30 (5 females, 25 males; average age 23 years) patients in the internal nasal splint group and 30 (8 females, 22 males; average age 26 years) patients in the anterior Merocel packing group. When the values obtained by acoustic impedancemetry before the operation and on the postoperative 5th day were compared, there was no statistically significant difference between the groups. The middle ear pressure significantly decreased in the anterior Merocel packing group compared with that in the internal nasal splint group. The intragroup comparison of the acoustic impedance measurements of the internal nasal splint group revealed no significant difference between the preoperative acoustic impedance values and the values obtained on the postoperative 2nd day. CONCLUSION: Cannulated silicone intranasal splints are better in terms of patient comfort after an intranasal surgery without effecting eustachian tube function.

Pilomatrixoma is a benign appendageal tumor derived from hair matrix cells which is also known as calcifying epithelioma of Malharbe. It usually appears as a solitary, asymptomatic, firm nodule. It is most common on the face and neck, but is occasionally found somewhere else on the body. It is mostly seen in children and young adults up to 20 years of age. The definite diagnosis is made histopathologically. A 19-year-old female was referred to dermatology clinic with a two year history of painless subcutaneous nodule in front of her right ear. On examination with otorhinolaryngology deparment a firm subcutaneous nodule was seen and palpated over the right angulus mandibula. The computed tomography imaging study demonstrated 8.5x12 mm subcutaneous mass lesion with calcification. Histopathological examination of the excised material showed the presence of basaloid cells associated with phantom cells, with areas of multinucleated giant cells, pigmented macrophages and widespread dystrophic calcification compatible with pilomatrixoma. In this case, we wished to present a patient who underwent excisional biopsy as a result of computed tomography imaging and whose pathological result was reported to be pilomatrixoma. Pilomatrixoma has long been supposed to be an infrequent tumor, but it may be more common than previously realized, so the clinicians must keep in mind the diagnosis of pilomatrixoma for subcutaneous nodules on the head and neck.

Amaç: Rekürren aftöz stomatit (RAS) oral mukozanın tekrarlayan,ağrılı ülserlerle karakterize, kronik inflamatuar bir hastalığıdır. Sıkgörülen bir durum olmasına karşın etyolojisi ve patogenezi tam olarak bilinmemektedir. Etyolojisinin idiyopatik veya multifaktöryel olduğu belirtilmektedir. Ortalama trombosit hacmi (MPV) trombositaktivasyonunu gösteren, nötrofil lenfosit oranı (NLR) ise kronik inflamasyon göstergesi olan ve her ikisi de rutin tam kan tetkiklerindeölçülebilen değerlerdir. Bu çalışmanın amacı RAS'lı ve kontrol grubuhastalardaki MPV ve NLR değerlerini araştırmaktır. Yöntem:Bu çalışmaya 39 RAS'ı bulunan ve 34 kontrol grubu hastadahil edildi. Bulgular:Hasta ve kontrol grubu karşılaştırıldığında MPV, ESR, CRP,vitamin B12 değerlerinin hasta grubunda kontrol grubuna göre anlamlı derecede yüksek çıktı ve NLR, WBC, hemoglobin, nötrofil, lenfositdeğerleri arasında her iki grup arasında anlamlı fark bulunmadı. Sonuç:Ortalama trombosit hacminin, RAS'lı hastalarda tanısal birgösterge olabileceği ortaya konuldu Objective:Recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease of oral mucosa characterized by recurrent painfululcers. Despite it is a condition seen frequently, its etiology andpathogenesis are not known fully. Its etiology is reportedly idiopathic or multifactorial. Mean platelet volume (MPV) indicates thrombocytic activation, while neutrophil/lymphocyte rate (NLR) is an indicator of chronic inflammation, and both of them can be measuredduring routine whole blood analysis. The aim of this study is to investigate MPV and NLR values in patients with RAS and the controlgroup. Methods:A total of 39 patients with RAS and 34 control subjectswere included in the study. Results: When the patient and the control groups were compared,MPV, ESR, CRP and vitamin B12 values were significantly higher inthe patient group while NLR, WBC, hemoglobin, neutrophil and lymphocyte values were not significantly different between both groups. Conclusion:It was shown that MPV can be used as a diagnostic indicator in patients with RAS

WOS:000246545000001 PubMed: 24678121 Background: Monitored anesthesia care (MAC) may be applied for septoplasty or endoscopic sinus surgery in which an adequate sedation and analgesia without respiratory depression are desired for comfort of both the patient and the surgeon. Several combinations with different agents have been used for this purpose in these patients. However, analgesic properties for these agents have not been reported. Objective: The aim of this study was to investigate the analgesic and sedative effects of dexmedetomidine or midazolam infusion combined with tramadol that was used via patient-controlled analgesia (PCA), and to document the effects of these drugs on early cognitive functions. Methods: This prospective, randomized, double-blind, clinical study enrolled patients undergoing septoplasty or endoscopic sinus surgery at the Abant Izzet Baysal University Hospital, Bolu, Turkey, between February and September 2006. Patients were randomly allocated in a 1: 1 ratio into I of 2 groups: the dexmedetomidine group (group D) patients received IV dexmedetomidine I mu g/kg for 10 minutes followed by continuous infusion of 0.5 mu g/kg center dot h(-1); and the midazolam group (group M) patients were administered a loading dose of IV midazolam 40 mu g/kg for 10 minutes followed by infusion at the rate of 50 mu g/kg center dot h-1. A I-minute bolus dose of IV tramadol (1.5 mg/kg) was administered in both groups 10 minutes after the administration of the primary drug, and continued via infusion using a PCA device. After baseline measurements, systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), oxygen saturation, and rate of respiration were recorded after the loading dose of study drug, after the bolus tramadol dose, at 10-minute intervals during the operation, and twice in the recovery rooms; 5 minutes after arrival and 5 minutes before discharge. Verbal rating score (VRS) and Ramsay sedation score were determined at baseline (after surgery was started), every 10 minutes thereafter until the end of the operation, and 2 times during recovery. All patients were assessed with the Wechsler Memory Scale-Revised at baseline (preoperatively) and 4 hours after the operation. Results: Seventy patients were enrolled in the study and randomly assigned to I of 2 groups: group D (sex, male/fernale, 23/12; mean [SEM] age, 32.53 [2.07] years; mean [SEM] weight, 73.03 [2.41] kg) or group M (sex, male/female, 21/14; mean [SEM] age, 34.43 [1.83] years; mean [SEM] weight, 67.90 [2.32] kg). All hemodynamic parameters (SAP, DAP, MAP, HR) were significantly higher in group M compared with group D from the onset of the surgery to discharge time (P < 0.05). Pain and sedation scores were similar in both groups, but the amount of PCA-administered rescue tramadol was significantly higher in group M (P = 0.001). A higher, though not statistically significant, prevalence of adverse events (ie, hypotension, bradycardia, and perioperative nausea and vomiting) were observed in group D. Postoperative logical verbal memory and digit span values were significantly higher in group D when compared with group M (P < 0.05). Postoperative digit span and visual reproduction scores were significantly higher than preoperative values in group D (P < 0.05). Postoperative personality functioning scores were significantly higher than preoperative values in group M (P < 0.05). Conclusions: Based on VRS, Ramsay sedation scores, and surgeon and anesthesiologist satisfaction scores, dexmedetomidine or midazolam combined with tramadol PCA provided adequate analgesia and sedation in these adult patients undergoing septoplasty or endoscopic sinus surgery with MAC. A significantly larger amount of rescue tramadol was used by group M, suggesting that a better analgesic effect was achieved with dexmedetomidine. (Curr Ther Res Clin Exp. 2007;68:69-81) Copyright (C) 2007 Excerpta Medica, Inc.

Septum deviasyonu kulak burun boğaz kliniklerinde en sık karşılaşılan, prevalansı erişkin toplumda yüksek olan bir nazal patolojidir. Septum deviasyonunun da etyolojisinde yer aldığı OUAS gibi komorbiditesi yüksek olan hastalıkların atriyal fibrilasyon gibi subklinik kardiyak patolojilere neden olduğu bilinmektedir. Bu çalışmada nazal septum deviasyonu olan ve başka nazal patolojisi olmayan hastalar, nazal patolojisi olmayan sağlıklı deneklerle karşılaştırıldı. Çalışmamızdaki hasta grubu ve kontrol grubu arasında visüel analog skala(VAS), rinomanometri, ekokardiyografi ve yüzeyel elektrografi uygulandı ve sonuçlar karşılaştırıldı. Hasta grubunda kontrol grubuna göre, VAS ve transnazal basınç anlamlı yüksek bulunurken transnazal akım anlamlı düşük bulundu. Hasta grubunda interatriyal ve intraatriyal iletinin uzadığını gösteren PA septum, PA triküspit, PA lateral-triküspit, PA septum-triküspit değerleri kontrol grubuna göre anlamlı yüksek bulundu. Hasta grubunda sol atriyum boyutunu gösteren, sol atriyum genişliği (LA), sol atriyum hacimlerinden LA volüm maksimum, LA volüm minimum ve LA volüm p değerleri kontrol grubuna göre anlamlı yüksek bulundu. Çalışmamızın sonucunda elde ettiğimiz mevcut veriler ile nazal septum deviasyonunun atriyal fibrilasyona yatkınlık oluşturan subklinik kardiyak patolojilere neden olabileceğini ve bu patolojilerin ekokardiyografi gibi noninvaziv yöntemlerle saptanabileceğini göstermiş olduk. Anahtar kelimeler: Nazal septum deviasyonu, atriyal fibrilasyon, ekokardiyografi, rinomanometri Nasal septum deviation is one of the most frequently encountered nasal pathology in ear nose throat clinics with a high prevelance among the adult population. Diseas with a high comorbidity such as Obstructive Sleep Apnea Syndrome(OSAS), among whose etiology septum deviation takes place, can cause subclinical patologies like atrial fibrilation.In this study, patients who have nasal septum deviation and who do not have other forms of nasal pathologies, are compared with other healthy patients who do not have any nasal pathologies.In the study, the patient and the control group are subjected to visual anologue scale (VAS), rhinomanometry, echocardiography and surface electrocardiography and the results are compared between two groups. In the patient group while the VAS and transnasal pressure were found meaningful higher, the transnasal flow was found meaningful lower than the control group. In the patient group PA septum, PA tricuspide, PA lateral-tricuspide, PA septum-tricuspide values, which domanstrate that interatrial and intraatrial conduction prolonged, were found meningful higher than the control group. In the patient group left atrium width (LA), LA volume maximum, LA volume minimum and LA volume p values, which show the size of left atrium, were found meningful high in comparison to the control group.As a result of the data obtained from this study, the dissertation domanstrates that nasal septumdeviation can cause subclinical cardiac pathologies such as atrial fibrilation and these pathologies can be detected with noninvasive methods such as echocardiography.Keywords: Nasal septum deviation, atrial fibrilation, echocardiography, rhinomanometry. 73