E-ISSN 2602-4837
The Turkish Journal of Ear Nose and Throat - Tr-ENT: 10 (2)
Volume: 10  Issue: 2 - 2003
ORIGINAL ARTICLE
1.Factors that affect the outcome of open-technique procedures performed in the treatment of cholesteatoma
O. Nuri Özgirgin, Erdinç Aydın, Tuncay Özçelik, Levent Naci Özlüoğlu
Pages 47 - 50
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Objectives: We evaluated the factors that have considerable
significance on the outcome of open cavity
procedures in the treatment of cholesteatoma.
Patients and Methods: The study included 66
patients (43 males, 23 females; mean age 47 years;
range 21 to 69 years) who underwent surgery for
cholesteatoma. Of these, 56 patients completed at
least a five-year follow-up.
Results: Mucosal infections and granulation tissue
formation occurred in seven patients (10%) in the
early postoperative period. Retraction pockets developed
in three patients (4%); of these, only one patient
required excision because of deep localization. Drum
perforations that occurred in two patients (3%) were
repaired by myringoplasty. Revision surgery was performed
in four patients (7.1%) due to residual
cholesteatoma within a five-year follow-up.
Conclusion: The height of the facial ridge was
found as the most important factor related to a successful
outcome of open-technique procedures.
Other factors included the creation of a smooth mastoid
cavity with round edges, removal of all diseased
mastoid cells, and an extensive conchameatoplasty.

2.A histologic study on the temporal bone of guinea pigs
Fatma Tülin Kayhan, Zeynep Algün
Pages 51 - 57
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Objectives: We examined histopathologic and anatomical
features of the guinea pig temporal bone and evaluated the differences
and similarities with respect to the human ear.
Study Design: Seventeen adult guinea pigs were deeply
anesthetized with pentobarbital and then decapitated. Each
temporal bone was removed and fixed in 10% formaldehyde
for a week, then decalcified in 10% formic acid for three
weeks. Paraffin-embedded specimens were serially and horizontally
sectioned at 7-micron thickness. One of every five
sections was stained with hematoxylin and eosin and studied
under light microscopy.
Results: The temporal bone consisted of a mastoid-like
process, a tympanic bulla, a tympanic ring, a petrosal segment,
and a poorly developed squamosal bone. The tympanic
bulla was a semispherical cavity surrounded by the
tympanic ring. The head of the malleus and the body of the
incus were fused, forming a malleoincudal complex. The
diameters of the tympanic sulcus and the tympanic membrane
were much greater than that of the tympanic ring,
resulting in protrusion of the external ear-canal into the
bulla. The Eustachian tube was J-shaped, lying in a bony
hiatus at the anteromedial aspect of the bulla. The inner ear
consisted of the cochlea, semicircular canals, and the
vestibule. The cochlea made 3.5 turns and projected into
the bulla. No internal auditory meatus was observed.
Conclusion: The guinea pig temporal bone was found to
have histological similarities to that of humans, making it a
good model for selected experimental studies in otology.

3.The beneficial effect of septoplasty on snoring
Murat Yarıktaş, Fehmi Döner, Harun Doğru, Mustafa Tüz
Pages 58 - 60
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Objectives: This study sought to determine whether
septoplasty played a favorable role on snoring complaints
as well.
Patients and Methods: The study included 56 patients
(40 males, 16 females; mean age 40 years; range 21 to
60 years) who underwent septoplasty operation for
causes other than snoring. The patients’ snoring complaints
were evaluated and rated before and three
months after surgery.
Results: Before surgery, 22 patients were found to
have complaints of snoring. The snoring complaints
improved after septoplasty in 16 patients (72.7%).
The decrease in snoring complaints was found statistically
significant (p<0.01).
Conclusion: Improvement in snoring complaints in
patients undergoing septoplasty operation emphasizes
the need for investigating and treating septum
deviations which are a primary cause of upper respiratory
tract obstruction.

4.Differences in clinical and histopathologic features between chronic adenotonsillitis and chronic adenotonsillar hypertrophy
Ahmet Kutluhan, Serdar Uğraş, Muzaffer Kırış, Hakan Çankaya, A. Faruk Kıroğlu, Veysel Yurttaş
Pages 61 - 67
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Objectives: This study sought to determine the clinical and
histopathological differences between chronic adenotonsillitis
and chronic adenotonsillar hypertrophy.
Patients and Methods: This prospective study included
286 patients (147 males, 139 females; mean age 16.6
years; range 3 to 45 years) with chronic adenotonsillitis and
197 patients (98 males, 99 females; mean age 9.5 years;
range 2 to 18 years) with adenotonsillar hypertrophy.
Clinical and histopathological findings were compared.
Results: The mean age was significantly higher (p<0.001)
and acute attacks of fever, dysphagia, and sore throat were
more frequent in chronic adenotonsillitis. Patients with adenotonsillar
hypertrophy more commonly manifested snoring,
mouth breathing, and dispnea. Physical examination showed
hyperemia of the anterior plica in 93% and 15% in chronic
adenotonsillitis and adenotonsillar hypertrophy, respectively.
Histopathologically, the former was more commonly associated
with severe lymphocyte infiltration to surface epithelium,
surface epithelial defects, plasma cells, atrophy, and fibrosis.
The sole outweighing difference in favor of chronic adenotonsillar
hypertrophy was increased germinal centers.
Conclusion: Clinical and histopathologic findings suggest
that chronic adenotonsillitis and chronic adenotonsillar
hypertrophy may be diverse diseases requiring different
approaches in treatment.

CASE REPORTS
5.Thyroid hemiagenesis: a case report
Levent Saydam, Mehmet Birol Uğur, Mete Kaan Bozkurt, Tuncay Özçelik
Pages 69 - 71
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Thyroid hemiagenesis is usually diagnosed incidentally
during examination for other thyroid gland diseases.
Iodine-123 thyroid scan of a 25-year-old
woman showed a normal homogeneous right thyroid
lobe, but no uptake in the left lobe.
Ultrasonography of the neck confirmed the absence
of the left thyroid lobe, while the right lobe was
homogeneous and normal. Thyroid hemiagenesis
should be included in the differential diagnosis of
thyroid diseases.

6.A report of Thornwaldt’s cyst in four patients: the effectiveness of endoscopic approach in three symptomatic cases
Mustafa Deniz Yılmaz, Fevzi Sefa Dereköy, Fatma Aktepe, Ali Altuntaş
Pages 74 - 77
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We encountered Thornwaldt cysts in four patients (3
males, 1 female; age range 30 to 46 years). Three
symptomatic patients underwent endoscopic surgery.
No intervention was made in one asymptomatic
patient. Cyst-related complications included bilateral
middle ear effusion in one patient. Postoperatively, no
symptoms or recurrences were observed in a mean
follow-up period of 11 months. In the asymptomatic
patient, the cyst size remained unchanged during
eight-month follow-up.

7.Successful use of botulinum toxin injection in the treatment of salivary fistula following parotidectomy
Ahmet Kızılay, İbrahim Aladağ, Orhan Özturan
Pages 78 - 81
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A twenty-year-old woman underwent right superficial
parotidectomy for pleomorphic adenoma. On the 10th
postoperative day she presented with a salivary fistula,
for which repeated aspirations with pressure
dressings were applied for a month. Despite decreases
in the salivary fluid volume, reaccumulation persisted.
Following aspiration of the salivary fluid, 40
units of botulinum toxin was injected into the pouch.
On the second day of injection, the discharge ceased
and the pouch disappeared. No side effects were
observed and the patient remained symptom-free
during four-month follow-up.

8.Fracture of the thyroid cartilage and fixation with miniplate: a case report
Ozan Seymen Sezen, Şeref Ünver, Mehmet Eken, Ahmet Bozkurt
Pages 82 - 85
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Laryngeal traumas are rarely seen. A tracheostomy
was performed in a 39-year-old male patient who
developed dyspnea following a neck trauma.
Computed tomography examination revealed fracture
of the thyroid cartilage. He was treated successfully
by open reduction and miniplate fixation.
No problems were detected in airway patency and
voice quality on postoperative controls. No complications
were encountered within a follow-up period
of five months.

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