OBJECTIVES This study aims to investigate the effect of primary surgery on the morbidity of reoperative thyroid surgery. PATIENTS AND METHODS Fifty-seven patients (14 male, 43 female; mean age 41 years; range 21 to 70 years), who underwent reoperative thyroid surgery in our clinic between January 2007 and January 2012 were retrospectively analyzed in terms of vocal cord paralysis, temporary or permanent hypoparathyroidism, and other complications. The patients were classified into two groups. The first group consisted of 42 completion thyroidectomy patients that had undergone the primary operation of unilateral total lobectomy + isthmusectomy in our clinic, whereas the second group consisted of 15 patients that had undergone bilateral subtotal or near total thyroidectomy in another center. Complication rates were compared between the groups. RESULTS Complication rates were observed as permanent vocal cord paralysis in one patient (1.7%), permanent hypocalcemia in two patients (3.5%) and temporary hypocalcemia in four patients (7%). None of the patients had temporary vocal cord paralysis. The complications in the second group were significantly higher than the first group (p=0.021). CONCLUSION The minimal operation should be hemithyroidectomy (total lobectomy and isthmusectomy) to minimize the complications. This approach removes the need for the intervention to the previous surgery field during reoperative thyroid surgery.

Septoplasty is a common procedure performed in the treatment of nasal obstruction resulting from septum deviation. Although septoplasty is generally considered a safe surgical procedure, it may result in rare fatal complications such as cerebrospinal fluid (CSF) leakage and related meningitis, encephalitis, and cerebral abscess. Review of the English-language literature showed 4 case reports of this rare complication after septoplasty.

OBJECTIVE:To determine the accuracy of intraoperative assessment of the node-negative N0 neck with frozen-section biopsy. METHODS:In our study, 60 patients 9 women and 51 men who underwent 88 elective neck dissections with head and neck squamous cell carcinoma, in the Department of Otorhinolaryngology Medical Faculty, Cukurova University, Adana, Turkey, from January 2003 to December 2006, were reviewed retrospectively. RESULTS:Of the 88 clinically preoperatively staged N0 necks, 22 necks 25% were shown subsequently to have metastatic disease after final pathological assessment. In 16 out of 22 cases, frozen-section biopsy revealed metastatic disease, and surgery was changed to a modified comprehensive neck dissection. In another 6 cases, the sampled lymph nodes were considered negative at frozen-section analysis, and metastatic disease was found in the final histopathologic reports. There was no false-positive result. The specificity and positive predictive values were both 100%. The sensitivity of intraoperative lymph node assessment was 73%, and the negative predictive value was 91%. CONCLUSION:Intraoperative assessment of the N0 neck with frozen-section biopsy seems to improve the accuracy of staging and may alter the intraoperative treatment strategy.

Objective: Airway foreign bodies present a diagnostic dilemma and has been recognized for many years. Since aspiration of foreign bodies can be a serious and sometimes fatal problem, early intervention and proper management is vital.Method: In this retrospective study, the results of 1887 bronchoscopies, which were performed between the years 1973 and 2004 for the suspicion of foreign body aspiration in children, were presented. Various instruments and techniques were used over 31-year period and rigid bronchoscopy was the preferred method of foreign body exctraction.Results: There were 1106 boys and 781 girls with the median age of 2.3 years. Seventy-four percent of patients were Less than 3 years old. The most common type of foreign body (89.9%) was organic; watermelon seeds (39.7%) were the most frequent organic foreign bodies. Eight hundred and twenty-three patients (43.6%) were referred to our clinic within the first 24 In of the event while 4.5% of the patients were admitted to the hospital with the suspicion of foreign body in the airway Later than one month. At bronchoscopy, a foreign body was identified in 79.1% of patients and no foreign body was seen in 20.9% of patients. Foreign bodies were encountered in 96.3% of the patients with positive history whereas 28.1% of the patients with negative history had foreign body. Of the patients with foreign bodies, 93.2% had positive history. Overall, the positive history was obtained from 85.2% of patients. The incidence of postbronchoscopic tracheotomy, thoracotomy, and overall mortality rate were 0.47, 0.15, and 0.21%, respectively.Conclusion: Otolaryngologists should consider foreign body aspiration in the airway in the differential diagnosis of any patient with the complaints of stridor, dyspnea, sudden onset of cough and intractable and recurrent lower respiratory tract infections. A careful history and physical examination were strong indicators of the diagnosis and raised the index of suspicion of an aspirated foreign body. Timely intervention with the experienced surgical team would decrease the complication rate and mortality rate. However, prevention of aspiration with the education of parents and caregivers is very important. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

PURPOSE:The purpose of this study was to investigate the relationship between adenoid microbiology, adenoid size, and maxillary sinus microbiology in children with both chronic rhinosinusitis and adenoid hypertrophy. METHODS:The children with both chronic rhinosinusitis and adenoid hypertrophy were admitted to this prospective study. The study included 30 children. The diagnosis of chronic rhinosinusitis was based on clinical and radiologic examinations. Adenoid hypertrophy was classified as medium and large based on the preoperative flexible fiberoptic endoscopy and nasal endoscopy during surgery. Maxillary sinus aspiration and adenoidectomy was performed in all patients. Sinus aspirate and adenoid tissue specimens were cultured. The correlation of culture results was investigated. The relationship between adenoid size and maxillary sinus culture results was analyzed by using chi-square test. RESULTS:Adenoid sizes were medium in 12 (40%) and large in 18 (60%) cases. Bacterial growth was found on 14 of 30 (47%) sinus aspirate, and all adenoid specimen cultures showed bacterial growth (100%). There was no statistical correlation between cultures obtained from the adenoid tissue with those from the maxillary sinus. The relationship between adenoid size and maxillary sinus culture results was not found statistically significant (chi(2) = 0.96, P = 1.0). CONCLUSION:The reason that there was no correlation between cultures obtained from the adenoid tissue with those from the maxillary sinus is that it seems possible that the adenoids act as a barrier causing mechanical obstruction rather than a nidus for chronic sinus infection. However, there is no relationship between adenoid size and maxillary sinus culture positivity. Medium adenoids causing partial obstruction may lead to changes in the microenvironment and may start bacterial growth in children with positive maxillary culture. Further investigation is needed to explain the association between adenoid hypertrophy and rhinosinusitis. Adenoidectomy helps to resolve the symptoms of chronic rhinosinusitis in the children with both chronic rhinosinusitis and adenoid hypertrophy.

Purpose: To evaluate the efficacy of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction. Methods: Twenty-six patients (29 eyes) with congenital nasolacrimal duct obstruction, who ranged in age from 2 to 12 years (mean, 4.85 ± 2.9 years), underwent silicone intubation with the Ritleng lacrimal intubation system. The Ritleng lacrimal intubation system is composed of a Ritleng probe, a monofilament guide thread and a silicone tube. The prolene tip was removed from the inferior meatus with nasal endoscopy in 26 eyes, whereas this was done by using a Ritleng hook in 3. Clinical success was defined by the relief from symptoms and signs of obstruction. The tubes were left in place for an average of 6 months. The patients were followed up between 6 and 25 months (mean, 8.3 months). Results: All cases were successfully intubated with the Ritleng system. Two cases underwent reintubation because of tube dislocation during the first week. Granuloma developed at the edge of the inferior punctum in 1 case. We observed relief from symptoms in all cases. Conclusion: The Ritleng lacrimal intubation system is an easy, effective and nontraumatizing procedure for the treatment of congenital nasolacrimal duct obstruction.

Objective: Fine needle aspiration (FNA) cytology aims to assist the clinician in the management of patients with salivary gland (SG) masses. We aimed to present our twelve -year experience concerning FNA in SG lesions to address the importance of this procedure. Study Design: Aspirates of 221 cases from SG lesions were reviewed retrospectively. In 151 cases, the FNA diagnosis was consistent with histologic findings. Results: FNA diagnoses were benign in 72.8 %, and malignant in 19.2% of the cases. Eleven cases were reported as suspicious for malignancy. The diagnostic sensitivity was 94% and specificity was 100%. Eight of 43 malignant cases were clinically referred with no evidence for a malignant tumor initially, but FNA was reported as malignant or suspicious for malignancy. Conclusions: Our study documents that FNA is a highly sensitive and specific procedure. It provides preoperative recognition of benign and malignant tumors. Besides that, it helps to prevent unnecessary surgery in SG swellings. To our knowledge, this article is the largest series in Turkish literature concerning FNA of SG. We think that our results are suggestive for FNA to be a primary diagnostic tool in SG lesions.

The updated fourth edition of the Color Atlas of ENT Diagnosis is an illustrated first introduction examination, diagnosis and therapy of the most frequent ear, nose and throat diseases. The more than 500 good-to-excellent color pictures are of great help to the beginner to become familiar with the conditions typically seen in the ENT field. The text is divided into five main sections: examination; ear; nose and face; pharynx and larynx; head and neck. As the stated purpose of this small pocket book is not to be a textbook but a pictorial survey, the majority of the book is reserved for the excellent pictures. Although most of the color photographs are self-explanatory every illustration is accompanied by a short descriptive text. Moreover, small paragraphs introduce special issues like laryngectomy or audiologic examination. I suggest a reference list for additional reading. All in all this small pocket atlas will be of great help to medical students, ENT trainees and general practitioners seeking a quick reference during daily practice. Elmar Oestreicher, Munich Maria Sanna, Hiroshi Sunose, Fernando Mancini, Alessandra Russo, Abdelkader Taibeh

Otolaryngology–Head and Neck SurgeryVolume 129, Issue 2 p. P141-P141 Article International Symposia: Surgical Management of Advanced Cancer of the Larynx Eugene N Myers MD (moderator), Eugene N Myers MD (moderator) Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorErnest A Weymuller Jr MD, Ernest A Weymuller Jr MD Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorSteiner Wolfgang Professor, Steiner Wolfgang Professor Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorM Levent Erisen MD, M Levent Erisen MD Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorLevent Soylu MD, Levent Soylu MD Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorMark L Urken MD, Mark L Urken MD Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorAlp Demireller MD, Alp Demireller MDSearch for more papers by this author Eugene N Myers MD (moderator), Eugene N Myers MD (moderator) Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorErnest A Weymuller Jr MD, Ernest A Weymuller Jr MD Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorSteiner Wolfgang Professor, Steiner Wolfgang Professor Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorM Levent Erisen MD, M Levent Erisen MD Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorLevent Soylu MD, Levent Soylu MD Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorMark L Urken MD, Mark L Urken MD Pittsburgh, PA Seattle, WA Gottingen, Germany Bursa, Turkey Adana, Turkey New York, NY Ankara, TurkeySearch for more papers by this authorAlp Demireller MD, Alp Demireller MDSearch for more papers by this author First published: 17 May 2016 https://doi.org/10.1016/S0194-59980301302-0Read the full textAboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume129, Issue2August 2003Pages P141-P141 RelatedInformation

Objective: The objectives of the management of nasal polyposis are to eliminate or reduce the size of polyps, reestablish nasal breathing, reduce symptoms of rhinitis, restore the sense of smell, and prevent the recurrence of nasal polyps. Local or systemic steroids have been used in the treatment of nasal polyps, but efficacy of combined (local and systemic) steroids in nasal polyposis has been little investigated. The aim of this study was to evaluate the influence of combined steroid therapy on the symptoms and extent of the disease in patients with nasal polyposis. Methods: Seventeen patients with nasal polyps were treated with combined steroids. Before and after the therapy, polyp size, nasal symptoms, sense of smell, and headache or facial pain were assessed by an established scoring system. Results: After the therapy, symptom scores of all the patients improved. Of the patients, 12% showed a polyp-free nasal cavity, 76% a clear involution of polyps, and 12% no response to the therapy. There were statistically significant differences (P<0.001) for symptom scores and polyp size. Medical ablation of polyps using steroids was not achieved in 88% patients. Conclusion: Steroids can reduce polyp sizes and improve the symptoms, but are inadequate to eradicate the polyps. Surgery still plays a major part in the treatment of the nasal polyposis, but steroids can delay the necessity for surgical intervention.