E-ISSN 2602-4837
The Turkish Journal of Ear Nose and Throat - Tr-ENT: 12 (2)
Volume: 12  Issue: 2 - 2004
1.The efficacy of CO2 laser myringotomy in serous otitis media
Mete Kaan Bozkurt, Mustafa Çalgüner
Pages 55 - 59
Objectives: We evaluated the efficacy of CO2 laser
myringotomy combined with adenoidectomy in children
with serous otitis media (SOM) unresponsive to
medical therapy and compared the recurrences in
the follow-up period with the control group who
underwent adenoidectomy and ventilation tube (VT)
Patients and Methods: The CO2 laser myringotomy
group included 25 children with a mean age of 5.6
years and there were 10 children with a mean age of
6.3 years in the VT control group. The laser used
was a Sharplan 1030 CO2 laser, attached to Zeiss
Universal S3 operation microscope with a 300 mm
objective, using a Microspot optical delivery system.
Results: Mean (±SD) healing time was 13 (±2.16)
days in 4 ears with myringotomies less than 2 mm
diameters, and 25 (±2.34) days in 46 ears with
myringotomies with 2 mm diameters. During the 6
months follow-up period there were 11 recurrences
(22%) in CO2 laser group and 4 recurrences (20%)
in the control group, which was not statistically significant
Conclusion: We prefer laser myringotomy in SOM
cases who do not need long time middle ear ventilation;
we use the ventilation tubes in cases with thick
mucoid effusion and recurrent effusion after laser

2.The levels of vitamins A, E, B 12 and folic acid in noise induced hearing loss
Üzeyir Gök, İhsan Halifeoğlu, Mücahit Yıldız
Pages 60 - 64
Objectives: To investigate the levels of vitamin A, E,
B 12, folic acid in employees with hearing loss due
to noise.
Patients and Methods: Employees in a local hydroelectric
powerhouse who suffer from hearing loss due
to noise were included in the study. Study and control
groups were composed of 28 (mean age 37±5) and 30
voluntary subjects (mean age 36±4), respectively. All of
the subjects in patient and control groups were male.
Blood samples were obtained from all subjects and vitamin
A, E, B12 and folic acid levels were measured.
Results: Level of vitamin B12 was found low in
patient group and normal in control group and these
were found statisticaly significant (p<0.005). There
were no significant differences between vitamin A, E
and folic acid.
Conclusion: We think that measurement of vitamin
B12 in routine control of the people who are working
in noisy environment may be useful.

3.A microdissection study of facial nerve at the labyrinthine and tympanic segments in adults
Hünkar Gökçe, Mustafa Zafer Uğuz, Seçil Arslanoğlu, Kazım Önal
Pages 65 - 70
Objectives: To determine the relationship in detail
between the tympanic and the labyrinthine segments
of the facial nerve and the relationship between the
bony structures and the neighboring nerve.
Material and Methods: Measurement of the length
of the segment of the facial nerve within the internal
auditory canal and the lengths of the labyrinthine and
tympanic segments were made on fourteen temporals
bones collected from eight fresh cadavers.
Results: The minimum distance between the point
where the facial nerve leaves the internal auditory
canal and the tympanic segment was measured
4.71±0.54 mm. The angle between the labyrinthine
and the tympanic segments at the geniculate ganglion
was measured 73°85´±10°.89´. The angle
between the labyrinthine and the superior vestibular
nerve are measured 34°35´±5°51´.
Conclusion: We believe that the results of our measurements
will help the surgeons to minimize the complications
who works in this particular anatomic area.

4.The evaluation of voice quality after near-total laryngectomy
Erkan Özüdoğru, Hamdi Çaklı, Handan Sekili, Emre Cingi, Cem Keçik, M. Kezban Gürbüz, Cengiz Bal
Pages 71 - 77
Objectives: It was intended to compare the various characteristics
of the phonation obtained in the cases who
underwent near total laryngectomy (NTL) and frontolateral
laryngectomy (FLL) In this study.
Study Desing: The study washeld in 29 male cases, 9 of
whom underwent NTL, 10 of whom underwent FLL and 10
who had normal laryngeal speech. All cases were evaluated
and compared statistically according to the fundamental
frequency (Fo), intensity and voiceless time measurements,
maximal phonation time (MPT), speech rate
and speech intelligiblity.
Results: Fo and Fo range were found significantly high in
both patients groups but MPT and speech rate was meaningfully
decreased in these groups relative to control group.
There weren’t any significant differences between two patient
groups. The speech intelligibilities of the NTL group patients
were significantly low relative to other two groups. The voiceless
time measurements during phonation were significantly
high in two patients groups but we also found that it was not
effective on speech rate and intelligibility.
Conclusion: The phonation gained after NTL is similar to
that of FLL in respect of various features. But owing to differences
of the speech intelligibility measurements we
concluded that the patients underwent NTL could be
exposed to more problem during the communication with
their social surroundings.

5.Management of padiatric neck masses
Enver Özer, Semih Mumbuç, Cengiz Durucu, Yıldırım A. Bayazıt, Muzaffer Kanlıkama
Pages 78 - 83
Objectives: Present study was designed to demonstrate
the regional distribution prevalence and management
differences of certain pediatric neck masses
in this region of the country.
Patients and Methods: Fifty-five pediatric neck
masses patients who were diagnosed and treated
surgically were retrospectively analyzed.
Results: Analysis of 55 patients showed that congenital
neck masses were the most common pathology in
the pediatric neck masses (47%), and followed by
infectious and tuberculous lymphadenopathies (24%).
Conclusion: It can be concluded from the study that
besides the age group and the characteristics of the
neck mass, life standards of the region is also an
important factor to be considered while these
patients are being evaluated.

6.Assessment of quality of life in patients with laryngeal cancer after surgical treatment
Abdullah Taş, Recep Yağız, Ahmet R. Karasalihoğlu, Muhsin Koten, Mustafa Kemal Adalı, Cem Uzun
Pages 84 - 90
Objectives: To evaluate quality of life of the patients undergone
a surgical treatment for larynx cancer and to compare
quality of life between patients with total laryngectomy and
partial laryngectomy.
Patients and Methods: Thirty-two questions were asked to
patients, who underwent total laryngectomy (22 subjects) or
who underwent partial laryngectomy (24 subjects). These
questions were based on the European Organization for
Research on Treatment of Cancer questionnaires Quality of
Life - C30 (EORTC-QoL-C30) and adapted to our nation.
Patients with total laryngectomy and those with partial lar›ngectomy
were compared according to the answers.
Results: We found significant statistical differences between
total and partial laryngectomy patients in 12 questions. When
functional disorders were evaluated, the most significant was
one associated with communication. However, pain, smell disorders
and increased secretion belonged to morbidity that rised
in relation to psycologic and social life. It was observed that
patients with total laryngectomy were particularly affected psycologically
and economically.
Conclusion: Patients, who underwent total laryngectomy, live
densely physical and psyco-social disadvantages that arise from the
treatment. In order to establish these negative effects and to minimize
them tools of assesment of quality of life should be developed.
This assessment should be appropriate to our nation, providing information
and psycological support for individuals and their families,
who have psyco-social and economical disadvantages that arise
from the disease and the treatment.

7.Intradermal nevus of the external auditory canal: a case report
Can Alper Çağıcı, İsmail Yılmaz, Levent N. Özlüoğlu, Fazilet Kayaselçuk
Pages 91 - 94
The external auditory canal is an uncommon location
for the nevi that are common benign tumors of the skin.
A papillomatous lesion was detected on the external
auditory canal of the patient who was on following-up
for acute otitis externa. The lesion which resembles the
nevus was excised and was diagnosed as an intradermal
nevus in the pathological examination. The clinical
and pathological picture of the intradermal nevus of the
external auditory canal was discussed.

8.Non-Hodgkin’s lymphomas of the nose and paranasal sinuses: a case report
Tolga Kandoğan, Levent Olgun, Levent Aydar, Özlem Sezgin
Pages 95 - 98
Primary Non-Hodgkin Lymphoma (NHL) of the nasal
cavity is a rare neoplasm. They account for about
0.17-2% of all cases of NHL and 5.8% of all malignant
neoplasms of the sinonasal region in the adult.
A 37- year old male patient presented with left sided
nasal obstruction and headache for a couple of
weeks before the admission. Nasal examination
revealed a massive poliposis. After medical therapy
with corticosteroid, neither the polyposis nor his
complaints showed any regression thus he underwent
a nasal polypectomy operation. Biopsy results
indicated an inflammatory nasal polyp. 2 weeks
later, a rapidly progressive facial swelling, especially
in left periorbital area and blurred vision occured.
Second biopsy, which was also taken from left nasal
cavity suggested again an inflammatory nasal polyp.
To rule out any possible malignancy a third biopsy
was conducted on the left maxillary sinus which indicated
“T/NK cell lymphoma” of the sinonasal tract.

9.Treatment of unilateral masseter hypertrophy with botulinum toxin in two cases
Mete İşeri, Pervin Kutluay İşeri
Pages 99 - 102
Botulinum toxin is a new method for treating masseteric
hypertrophy which offers many advantages
over conventional surgical treatment. We describe
the successful outpatient medical management of
two patients with masseteric hypertrophy using botulinum
toxin type A. No significant side effects have
occured and the patients are satisfied cosmetically
six months after the treatment.

10.Skin metastasis: an unusual localization from laryngeal carcinoma
Ömer Aydın, Emre Üstündağ, Zerrin Boyacı, Bahar Müezzinoğlu
Pages 103 - 106
Skin metastasis from laryngeal carcinoma is rare
and indicates a poor prognosis. A case of laryngeal
carcinoma with unusual metastasis to the skin of the
hand is reported. The patient had undergone total
laryngectomy, left radical neck dissection and right
functional neck dissection. After the operation, the
patient received radiotherapy. On the postoperative
18th month, a mass on the left hand was observed.
It was found to be a metastatic tumor from laryngeal
carcinoma, histopathologically as well as immunohistochemically.
Metastatic potential in malignant
neoplasm is generally correlated with reduced cellular
adhesiveness. We investigated the expression of
the vascular endothelial growth factor (VEGF),
matrix metalloproteinase-9 (MMP-9), E-cadherin.
Interestingly the immunohistochemical expression
characteristics of such an aggressive tumor are not

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