Haldun Oguz

DOI 10.1007/s00405-014-3181-5

Objective: Our aim was to better understand the rarely encountered tuberculous parotitis Methods: A case report Results: Parotid gland involvement of tuberculosis is extremely rare, even in endemic region of disease. However, it should be considered in the differential diagnosis of parotid gland mases. Imaging and fine needle aspiration cytology are often inconclusive , and thus most cases require removal of the salivary gland to enable a final diagnosis to be made as in this case. Once the… Show more

Objective: Our aim was to better understand the rarely encountered tuberculous parotitis Methods: A case report Results: Parotid gland involvement of tuberculosis is extremely rare, even in endemic region of disease. However, it should be considered in the differential diagnosis of parotid gland mases. Imaging and fine needle aspiration cytology are often inconclusive , and thus most cases require removal of the salivary gland to enable a final diagnosis to be made as in this case. Once the diagnosis of tbc is made , standard antituberculosis treatment is given with an initial phase lasting 2 months and a further phase that lasts 4-6 months Conclusion: Clinicians should have a high index of suspicion for tuberculosis of the parotid gland in patients with a chronic parotid lump, even if the chest radiographs appear normal. Show less

OBJECTIVE: To compare hearing results in idiopathic sudden hearing loss patients treated with systemic steroids alone or combined intratympanic and steroids.
STUDY DESIGN:
Prospective.
SETTING:
Tertiary referral hospital.
PATIENTS:
Idiopathic sudden sensorineural hearing loss patients.
INTERVENTIONS:
The patients in the systemic therapy group received consecutive administration of 100 mg intravenous methylprednisolone in the first day, 80 mg/day oral prednisolone in 3… Show more

OBJECTIVE: To compare hearing results in idiopathic sudden hearing loss patients treated with systemic steroids alone or combined intratympanic and steroids.
STUDY DESIGN:
Prospective.
SETTING:
Tertiary referral hospital.
PATIENTS:
Idiopathic sudden sensorineural hearing loss patients.
INTERVENTIONS:
The patients in the systemic therapy group received consecutive administration of 100 mg intravenous methylprednisolone in the first day, 80 mg/day oral prednisolone in 3 divided doses for the next 2 days, and continued with oral administration of steroids by tapering the dose 20 mg in every 2 days. The patients in the combined treatment group received intratympanic injection of methylprednisolone (an approximate dose of 0.5 ml of 125 mg/ml). A total of 5 injections on alternate days were performed.
MAIN OUTCOME MEASURES:
The mean and median PTA gains of systemic corticosteroid therapy (SCT) group were 7.5 and 5 dB at 5th day, 12.1 and 7.5 dB at 10th day, and 13.0 and 8.8 dB at 15th day. The mean and median PTA gains for combined treatment (CT) group were 12.5 and 7.5, 17.8 and 13.8, 21.8 and 20.0 dB, respectively.
RESULTS:
Both the mean and the median PTA gains were statistically significantly different between SCT and CT groups. According to improved hearing results (more than 10 dB gain), there was statistically significant difference between SCT and CT groups. None of the patients had an important complication.
CONCLUSION:
The results of this study suggest that adding intratympanic methylprednisolone to systemic therapy increases the probability of hearing recovery in ISSHL patients. Show less

The effectiveness of intratympanic (IT) corticosteroid injection was compared with a control group on patients with SSHL who failed systemic corticosteroid treatment.
19 patients as a retreatment group (RG) and 18 patients as a control group (CG), all failed high-dose intravenous and oral corticosteroid treatments, were included in this study. These patients were invited back, and IT methylprednisolone was injected five times via 3-day intervals in RG and followed-up for a mean period of… Show more

The effectiveness of intratympanic (IT) corticosteroid injection was compared with a control group on patients with SSHL who failed systemic corticosteroid treatment.
19 patients as a retreatment group (RG) and 18 patients as a control group (CG), all failed high-dose intravenous and oral corticosteroid treatments, were included in this study. These patients were invited back, and IT methylprednisolone was injected five times via 3-day intervals in RG and followed-up for a mean period of 24.9 months (range, 7-30 mo). Audiological evaluations were performed initially, a week after the completion of the injections, monthly in the following first 3 months, and at the end of follow-up period in RG. The CG was followed-up for 3 months after the completion of systemic corticosteroid treatment without any additional drug administration.
The mean age was 52.6 years (range, 20-79 yr) in RG and 59.9 years in CG. The mean pure-tone average for speech frequencies (500-4,000 Hz) at baseline audiogram and at the first month, at the third month, and at last controls were 65.2 (range, 43-102 dB), 45.4 (range, 23-77 dB), 43.6 (range, 30-77 dB), and 44.5 (range, 33-77 dB) dB, respectively, in RG. The mean pure-tone averages for speech frequencies (500-4,000 Hz) at the end of systemic treatment and at third-month control were 63.5 (range, 44-98 dB) and 59.0 (range, 40-100 dB) dB, respectively, in CG. The hearing gain that is equal to or more than 10 dB was achieved in 14 patients (73.6%) at the last control in RG. No hearing gain could be detected in the CG. No serious side effect was observed with IT treatment.
We conclude that IT methylprednisolone injection provides more significant hearing improvement for patients that failed with previous high-dose systemic corticosteroid administration than systemic corticosteroid treatment alone. So it may be the first-step medical treatment of idiopathic SSHL alone or at least may be combined with the systemic corticosteroid administration. Show less

Necrotizing fasciitis (NF) is a potentially fatal soft-tissue infection characterized by rapidly progressive necrosis of subcutaneous tissue and superficial fascia. NF of the head and neck is a rare clinical entity, and it must be carefully differentiated from less severe conditions. Factors such as delayed treatment, inappropriate treatment, host debilitation, and polymicrobial infection contribute to the mortality and morbidity of NF. Adequate surgical debridement, urgent antibiotic therapy… Show more

Necrotizing fasciitis (NF) is a potentially fatal soft-tissue infection characterized by rapidly progressive necrosis of subcutaneous tissue and superficial fascia. NF of the head and neck is a rare clinical entity, and it must be carefully differentiated from less severe conditions. Factors such as delayed treatment, inappropriate treatment, host debilitation, and polymicrobial infection contribute to the mortality and morbidity of NF. Adequate surgical debridement, urgent antibiotic therapy, and supportive measures are the keys to decreasing mortality and morbidity. We report 2 new cases and review the literature. Show less

OBJECTIVE/HYPOTHESIS:
The aim of this study was to determine the reliability and feasibility of modified splay graft technique in the surgical correction of internal nasal valve (INV) incompetence and nasal valve collapse.
STUDY DESIGN:
Eleven patients operated with the diagnosis of INV incompetence were followed for 6 to 30 months after operation.
METHODS:
Between 2004 and 2007, 11 patients with the complaint of shortness of breath, and in whom nasal valve incompetence was… Show more

OBJECTIVE/HYPOTHESIS:
The aim of this study was to determine the reliability and feasibility of modified splay graft technique in the surgical correction of internal nasal valve (INV) incompetence and nasal valve collapse.
STUDY DESIGN:
Eleven patients operated with the diagnosis of INV incompetence were followed for 6 to 30 months after operation.
METHODS:
Between 2004 and 2007, 11 patients with the complaint of shortness of breath, and in whom nasal valve incompetence was detected, and who were positive for Cottle and modified Cottle tests were operated. In the operation, splay graft was used endonasally with the technique we describe. Before and at least 6 months after the operation, patients were evaluated with acoustic rhinometry, linear symptom scale, and nasal obstruction symptom evaluation scale in addition to endoscopic examination, and the results were compared.
RESULTS:
In 10 of 11 (90.9%) patients operated with modified splay graft technique, marked improvement was observed in INV region with endoscopic examination and acoustic rhinometry. In the evaluation made with linear symptom scale and nasal obstruction symptom evaluation scale, partial improvement was seen in nasal obstruction in one patient and marked improvement in 10 patients. No complications developed.
CONCLUSIONS:
Modified splay technique is an effective graft method that can be easily applied and has minimal complications and morbidity. Show less