Ear, nose, & throat journal最新文献

Objectives: Crooked noses pose significant challenges in rhinoplasty due to their complex anatomy, particularly in the bony vault. Traditional methods focus on osteotomies but often do not equalize the lengths of the nasal bones. This study introduces a novel technique using otologic drills to address this problem by shortening the longer nasal bone and aligning the nasion-rhinion line at the midline. Methods: A Goodman incision was made to access the nasal bones under general anesthesia. Otologic drills were used for lateral and transverse ostectomies to shorten the longer nasal bone and reposition the nasal bone vault. Follow-ups were conducted 3, 6, and 12 months after surgery. Results: Of 48 cases (22 men and 26 women), 47 achieved satisfactory results with a straightened nose. One case showed a slight deviation after surgery, which did not require revision. Discussion: The technique effectively addresses the issue of asymmetric nasal bone lengths, which traditional methods often overlook. Using otologic drills allows precise bone cutting, contributing to long-lasting outcomes. Conclusions: Otologic drill-assisted ostectomies effectively equalize nasal bone lengths, improving nasal symmetry. More research with larger case series and long-term follow-up is needed to confirm the efficacy and safety of this technique, including potential applications in closed rhinoplasty.

Granular cell tumors (GCTs) are uncommon neoplasms, often originating from Schwann cells, with granular cytoplasm being a hallmark feature. Laryngeal GCTs, comprising 3% to 10% of cases, present diagnostic challenges due to their resemblance to squamous cell carcinoma. We present a case of a 46-year-old male with throat pain, diagnosed with a laryngeal GCT. Histopathological examination and immunohistochemistry confirmed the diagnosis. Laryngeal GCTs typically manifest as small, firm submucosal nodules, posing challenges in differentiation from vocal fold polyps. Diagnosis relies on histological examination, with characteristic features including eosinophilic granular cytoplasm and positive staining for specific markers. Malignant transformation, though rare, necessitates vigilant monitoring and accurate diagnosis. Treatment involves complete surgical excision with long-term follow-up to detect recurrence. This case underscores the importance of awareness and accurate diagnosis in managing laryngeal GCTs, ensuring timely intervention and optimal patient outcomes.

Objectives: The use of mobile phone is increasing around the world. Although it is beneficial in terms of communication, the electromagnetic radiations emitted by mobile phones may cause undesirable biological effects on the human body. In practical use, the tissue with which mobile phones come into most and are closest is the parotid gland. This study investigated the effects of the 1800 MHz electromagnetic field created by a generator on the parotid gland in rats. Methods: A total of 21 Sprague-Dawley Albino rats were included in the study. The rats were randomly divided into three equal groups. To simulate a mobile phone in conversation mode, the first study group was exposed to an 1800-MHz electromagnetic field for 6 hours a day for 30 days, and the second study group was exposed to an 1800-MHz electromagnetic field for 12 hours a day for 30 days. After 30 days, rats were sacrificed, and histopathological and immunohistochemical methods were used to evaluate the effects on the parotid gland. The total antioxidant level and the total oxidant level were measured biochemically in homogenized parotid tissue. Results: Histopathological results showed an increase in degeneration in rats exposed to electromagnetic fields for 6 and 12 hours a day, and immunohistochemical analysis showed an increase in the apoptotic index in both study groups (P = .001, P < .001). Intranuclear inclusions was observed during histopathological examination performed by electron microscopy. Conclusions: This study observed that the 1800 MHz electromagnetic field caused undesirable adverse histopathological and biochemical effects on the parotid gland of rats. Histopathological and biochemical findings were detected with increasing contact and exposure time. This study will lead to other studies on this topic and contribute to the literature by completing other studies.

Chronic cough is a common troublesome symptom in otolaryngology head and neck surgery practice. In rare cases, chronic cough may be related to anatomical abnormalities. In this article, we report the history of a 64-year-old female with a chronic course due to a curved superior cornu of the thyroid cartilage and related irritation of the laryngeal superior nerve. The cough was atypical and resolved after the surgical resection of the abnormal cornu. There was no recurrence at 9 months post-surgery. The findings of the present case report highlight the need to explore the laryngeal anatomy in patients with chronic cough to identify potential abnormalities, which may be treated surgically.

Objectives: To review measures for safer functional endoscopic sinus surgery (FESS). Methods: PubMed, EBSCO, UpToDate, Proquest Central at Kırıkkale University, Google, and Google Scholar were used in the literature review. The search was performed using keywords of "functional endoscopic sinus surgery," "FESS," "Safety," "Image-Guided," and "complications" between 2000 and 2024. Results: Inflammatory and infectious sinus illnesses are the most prevalent indications for FESS. The 4 most common methods for FESS are endoscopic uncinectomy, maxillary antral ostomy/ethmoidectomy, anterior ethmoidectomy, and posterior ethmoidectomy. FESS has a complication rate of 0% to 1.5% for significant problems and 1.12% to 20.8% for minor issues. Sinus surgery outcomes can be improved and problems avoided with careful preoperative preparation. Powered instrumentation may enhance the severity of the problems rather than the number of occurrences. Intraoperative detection of cerebrospinal fluid leakage necessitates immediate localization and fixing of the leaking structure. The danger of infection increases and hospital stays are longer when investigation is delayed. In image-guided surgery, surgeons employ preoperative imaging data to pinpoint the exact position of a surgical tool concerning surrounding anatomical structures in real time. Although initially designed for use in neurosurgery, endoscopic sinus surgery has quickly become one of the most popular applications of this technique. Conclusion: Safer FESS can be accomplished with accurate CT scans, good patient preparation, surgical knowledge and training, and by using image guidance for endoscopic sinus surgery.

Objective: This study compared the graft outcomes and complications of endoscopic cartilage inlay myringoplasty with preservation of anterior margins (IPAM) and the cartilage underlay technique with raising the tympanomeatal flap (CUTF) for repairing large anterior perforations. Materials and Methods: In total, 55 patients with large anterior perforations were recruited and allocated to the IPAM (n = 28) or the CUTF (n = 27) group. The graft success rate, hearing gain, operation time, and postoperative complications were compared between the groups at 12 months. Results: The mean operation times were 29.3 ± 2.7 minutes and 46.4 ± 3.9 minutes in the IPAM and CUTF groups, respectively (P < .001). The residual perforation rate was 0.0% in the IPAM group and 11.1% in the CUTF group (P = .222). All patients completed the 12-month follow-up. The overall graft success rate was 96.4% in the IPAM group and 88.9% in the CUTF group (P = .577). No significant differences were observed between the groups in terms of postoperative pure-tone averages for air conduction and bone conduction, air-bone gaps (ABGs), or ABG changes. In the CUTF group, 22.2% of the patients reported altered taste perception, 3.7% experienced bony external auditory canal (EAC) stenosis, and 3.7% developed EAC cholesteatoma. By contrast, the IPAM group did not have any cases of altered taste perception, EAC stenosis, or cholesteatoma. Conclusions: Endoscopic cartilage myringoplasty with IPAM and anterior perichondrium folding is a simple, effective, and minimally invasive technique for repairing large anterior perforations. It offers a high graft success rate and better hearing improvement compared to CUTF.

Objectives: Of all the face surgeries, rhinoplasty is known to be the most difficult. The aim of this paper is to review open-roof deformity. Methods: PubMed, EBSCO, UpToDate, Proquest Central at Kırıkkale University, and Google and Google Scholar were used in the literature review. The search was performed with the keywords "open roof deformity," "rhinoplasty," "fillers" between 2024 and 1980. Results: Rhinoplasty is a surgery that requires a combination of art and science, unlike other procedures that may have challenging anatomic access, requiring an excessive amount of physical strength, or a long operating period that causes surgeon fatigue. It is common for people undergoing primary rhinoplasty to have their hump removed, which can lead to open-roof deformity. Lateral osteotomies and the use of grafts are crucial in the prevention of open-roof abnormalities. It is common practice to perform lateral osteotomies to seal this space. However, lateral osteotomy becomes tricky when the patient's bony vault is small. Another well-known option is to shape and replace the hump or to use a spreader graft, flap, sliced cartilage, or some combination of these. HA filler can also be administered to achieve the same effect as a spreader graft. Along the length of the dorsum on both sides, HA is injected retrogradely. Conclusion: If there are dorsal irregularities after surgery or if there is a need to fix the look of nasal bridge, this therapy can help.

Lipomas are benign and slow-growing neoplasms that typically develop in the subcutaneous tissue. They rarely occur in the upper aerodigestive tract. Oropharyngeal lipomas are rare. They represent 0.5% of all neoplasms of the head and neck. We present a case of a 43-year-old female with a polypoid mass in the base of the left palatine tonsil. The patient underwent a left tonsillectomy and a resection of the mass. The pathological diagnosis was tonsillar lipoma. We describe the clinical characteristics and the management of this rare case. Palatine tonsillar lipoma is a rare benign tumor with an unusual recurrence rate, and an excellent prognosis.

Preservation of residual hearing and vestibular function is a crucial factor in cochlear implantation (CI), especially in patients with residual low-frequency hearing thresholds. We report a case of a patient who underwent unilateral endoscope-assisted CI with a challenging surgical view following rigorous posterior tympanotomy. A 53-year-old male presented with left-sided intractable tinnitus due to sudden sensorineural hearing loss that had occurred 10 years prior. Due to the abnormal location of the round window (RW), which was far more posterior and inferior than usual and impeded insertion of the electrode using the conventional RW approach, endoscope-assisted CI was performed. Pure-tone audiometry at 3 months after CI revealed satisfactory hearing thresholds. Furthermore, there was alleviation of the left-sided tinnitus, which was indicated by a marked decrease in both the subjective visual analog scale loudness and Tinnitus Handicap Inventory scores. With proper indications, we strongly recommend applying the RW approach with endoscopic assistance over conventional bony cochleostomy for the preservation of low-frequency hearing thresholds in cases where RW visualization is insufficient following posterior tympanotomy.