E-ISSN 2602-4837
The Turkish Journal of Ear Nose and Throat - Tr-ENT: 13 (3)
Volume: 13  Issue: 3 - 2004
ORIGINAL ARTICLE
1.Distribution of allergens among allergic rhinitis patients living in Mersin region
Yavuz Selim Pata, Yücel Akbaş, Murat Ünal, Cengiz Özcan, Kemal Görür, Derya Ümit Talas
Pages 112 - 115
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Objectives: To determine the distrubution of allergens
among allergic rhinitis patients living in Mersin region.
Patients and Methods: We investigated 346 allergic
rhinitis patients who had symptoms and positive
prick test.
Results: The history and clinical examination revealed
that 161 patients (46.5%) had seasonal symptoms
and 185 patients (53.5%) had perennial symptoms
(233 females, 113 males; mean age 32.3±14.1).
Common pattern of multiple allergens were mite allergens,
grass mixture, trees mixture cereals mixture,
weed mixture, dog hair, cat fur, (57.8%), (32.1%),
(14.5%), (13.9%), (7.2%), (5.5%), (2.9%) respectively.
According to the prick test results, sensitivity to one
allergen was found in 96 patients (27.7%) and sensitivity
to multiple allergens in 250 patients.
Conclusion: The most common allergens were
mites and pollens in Mersin region. It was concluded
that the distribution allergens is affected from the living
region’s climatic, environmental and socioeconomic
features.

2.The incidence of anatomic variations and sinus opacities in pediatric patients with chronic sinonasal symptoms
Adil Eryılmaz, Celil Göçer, Engin Dursun, Hakan Korkmaz, Halit Akmansu, Süleyman Boynueğri
Pages 116 - 121
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Objectives: In this study our purpose was to determine
the incidence of paranasal sinus anatomic variations and
their relationship with sinus opacities in pediatric patients.
Patients and Methods: A total of 44 children ranged
between 3 and 16 years of age unresponsive to maximum
medical therapy were evaluated with coronal paranasal
sinus computed tomography.
Results: Computed tomographic evaluations revealed
that 70.5% (31/44) of the patients had at least 1 anatomic
variation; the most common one was septal deviation, followed
by concha bullosa and agger nasi cells. Sinus opacities
were found in 81.8% (36/44) of the patients, of whom
9 had single and 27 had multiple involvement of sinus
groups. Most common involved sinuses were anterior ethmoids
and maxillary sinuses, followed by posterior ethmoids,
sphenoid and frontal sinuses. When we look at the
influence of anatomic variations on sinus opacities;
patients with single, multiple and no anatomic variations
had 78.9% (15/19), 83.3% (10/12), and 84.6% (11/13)
opacities, respectively.
Conclusion: Incidence of anatomic variations was found
to be similar to that reported for adults in the literature;
except nasal septal deformity which was found lower than
adults. Our results revealed no correlation between bony
anatomic variations and sinus opacities in children.

3.Epiglottic anteversion’ in the etiology of globus pharyngeus and surgical management
Ahmet Ural, Ahmet Köybaşıoğlu, Sabri Uslu, Alper Ceylan, Korhan Asal, Fikret İleri
Pages 122 - 125
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Objectives: To define the role of epiglottic “anteversion”
in the etiology of globus pharyngeus, and the
to search the effectiveness of laser partial epiglottectomy
in its treatment.
Patients and Methods: Four patients, who had
admitted to our clinic between 2001 and 2003 with the
complaint of GP, had undergone laryngoscopic examination.
They revealed a structurally “anteverted”
epiglottis which was in contact with tongue base and
vallecula. After ruling out the etiologic factors of GP,
these patients were operated under general anesthesia
and laser partial epiglottectomy was carried out. In
this procedure, the part of epiglottis 1 cm from the free
margin which forms the contact points with tongue
base and vallecula, was excised with laser.
Results: Three patients were symptom-free totally,
while one patient reported a partial cure.
Conclusion: “Epiglottic anteversion” should be kept
in mind in the etiology of GP. Laser partial epiglottectomy
may be helpful in the treatment of selected
cases.

4.Factors that affect in situ lifetime of Provox voice prosthesis
Deniz Demir, Yusufhan Süoğlu, Haluk Emin, Mehmet Güven, Erkan Kıyak
Pages 126 - 131
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Objectives: We evaluated the effects of age, radiotherapy,
insertion time of prosthesis, the period between radiotherapy
and insertion time on in situ lifetime of Provox,
voice quality and complications.
Patients and Methods: The study included 50 total laryngectomy
patients (46 males, 4 females; mean age 61
years; range 43 to 77 years) using 62 Provox voice prosthesis.
Patients visited our clinic regularly every 3 months
for the first year after insertion and every 6 months in subsequently
years. The ease of use and complication of
prothesis and voice quality of patients were evaluated.
Results: The mean in situ lifetime was 24 months. (Range
one to 49 months) Age, radiotherapy, inserting time of
prosthesis, the period between radiotherapy and insertion
time had no influence on the in situ lifetime of Provox.
These variables were not determined to relate to complication
of prosthesis. Statistically significant good vocal
quality was found in nonirradiated group and patient group
in whom prosthesis inserted between 6 and 24 months
after laryngectomy. Provox was used easier by nonirradiated
group than irradiated group (p<0.001).
Conclusion: In situ lifetime of Provox was not influenced
by factors as age, radiotherapy, insertion time, the period
between radiotherapy and insertion time of prosthesis. We
believe that patient factor is the most important factor
which affect the in situ lifetime of Provox.

5.Toxoplasmosis in the patients with lymphoid hyperplasia of head and neck
Murat Yarıktaş, Mustafa Demirci, Fehmi Döner, Selçuk Kaya, Harun Doğru
Pages 132 - 134
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Objectives: To investigate toxoplasmosis in patients
with lymphoid hyperplasia of head and neck.
Patients and Methods: In this study, 53 patients (32
males, 21 females; mean age 11.2±4.3, range 5 to 22)
were investigated. There were hypertrophic tonsillitis in
13 patients, hypertrophic tonsillitis and adenoid hyperplasia
in 22 patients, adenoid hyperplasia in 10 patients
and lymphadenopathy of the neck in 8 patients. In
venous blood samples of patients, IgM and IgG antibody
of Toxoplasma gondii were investigated with
Enzyme Lynked Immuno Absorbent Assay (Axsym-
Abbott) method.
Results: Positive IgG was determined in 23 patients
(48%). There was hypertrophic tonsillitis in 6, hypertrophic
tonsillitis and adenoid hyperplasia in 10, adenoid hyperplasia
in 3 and lymphadenopathy of the neck in 4 of these
patients. Positive IgM was determined in 5 patients
(9.4%). There were hypertrophic tonsillitis in one, hypertrophic
tonsillitis and adenoid hyperplasia in one and lymphadenopathy
of the neck in 3 patients.
Conclusion: Toxoplasmosis, which is known to cause of
lymphadenopathy, may be reason of lymphadenopathy
of the neck. Toxoplasmosis should be considered in differential
diagnosis of untreated patients with tonsillitis,
adenoid hyperplasia and chronic neck lymphadenopathy.

CASE REPORTS
6.Clinical value of the vestibular evoked myogenic potentials in saccular dysfunction in Meniere’s disease: a case report
Abdullah Erkan Tarhan, Levent Naci Özlüoğlu
Pages 135 - 139
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Sound induced vestibular evoked myogenic potentials
(VEMP) on the surface of the sternocleidomastoid
muscle constitute the basis of the saccular function
test. In order to assess the saccular function
VEMP test was performed in presenting case with
unilateral Meniere’s disease having profound sensorineural
hearing loss at the contralateral ear. The
saccular response was absent on the affected side
with normal caloric response. However VEMP
response was normal on the profound sensorineural
hearing loss with canal paresis. There may be saccular
dysfunction in Meniere’s disease.

7.Subdural hygroma after cerebellopontine angle tumor surgery: a case report
Ahmet Ural, Nebil Göksu, Metin Yılmaz, Memduh Kaymaz, Gökhan Kurt
Pages 140 - 142
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The primary treatment modality for cerebellopontine
angle (CPA) tumors is surgery. In the postoperative
period, collection of subdural hygroma (SDH), is a
rarely encountered complication. This paper presents
a 58-year-old male patient who underwent surgery for
right acoustic neuroma and developed a SDH postoperatively.
SDH, even though rarely seen, is a serious
CPA tumor surgery complication calling for early
diagnosis and treatment. Definition, diagnosis, clinical
aspects and treatment of SDH are discussed.

8.An erosive mass involving the nasal cavity and maxillary sinus: rhinosporidiosis
Gürkan Keskin, Emre Üstündağ, Sevgiye Kaçarözkara, Sinem Keskin
Pages 143 - 147
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Rhinosporidiosis is a chronic granulomatous inflammatory
disease of the mucous membranes caused by
Rhinosporidium seeberi. The disease is endemic in
India but is very rare in other countries. A review of the
literature shows that our patient is the second documented
case from Turkey. The involvement and erosion
of the anterior wall of maxillary sinus as in this
case is very rare. In this article we describe the clinicopathological
features of a case presenting in 47-yearold-
male and discuss transmission of the disease.

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