To describe the clinical presentation and the radiological and surgical findings in patients with spontaneous meningoencephalocele of the temporal bone. Design: Retrospective case series. Setting: Academic, tertiary care medical center. Patients: Fifteen consecutive patients with surgically confirmed meningoencephalocele of the mastoid and middle ear, without a history of trauma, tumor, cholesteatoma, or surgery of the mastoid or cranium, who were treated at our institution between January 1, 1999, and December 31, 2006. Results: Ten of the 15 patients were women. Ages ranged from 31 to 77 years, with 12 patients 50 years or older. The most common presenting complaint was newonset hearing loss in 14 patients, followed by aural fullness and headache. Cerebrospinal fluid formed an effusion in the middle ears of 13 patients and was most commonly identified when myringotomy resulted in continuous clear otorrhea. Four subjects had a history of adult-onset recurrent acute otitis media with intermittent otorrhea, which in 1 case was complicated by brain abscess. At least 1 full-thickness defect of the tegmen associated with cortical thinning of the middle fossa floor was identified in all cases on high-resolution computed tomography. At surgery, herniations of meningeal and cerebral tissue were seen through 1 (7 cases) or 2 (8 cases) defects in the middle fossa floor. Obstruction of antral aeration by the meningoencephalocele was present in all 4 cases associated with otitis media.

The purpose of this study was to determine the role of high-definition computed tomography (CT) in chronic otitis media (COM) patients and to present which parameters were useful or misleading for preoperative evaluation for management. Fifty cases of COM that underwent preoperative CT scanning at a tertiary referral center were retrospectively analyzed. Their CT scan reports were compared with the operative findings. The patients had undergone tympanoplasty with or without mastoidectomy for COM between April 2008 and January 2010. Patient charts were used to obtain the necessary data. In 62% (31/50) of cases, the CT scan showed the presence of cholesteatoma. Operative findings revealed cholesteatoma in 61.8% (19/31) of these cases. However, when a bone eroding soft tissue mass involved the epitympanum on CT, the presence of cholesteatoma was observed in 83.3% (15/18) of cases intraoperatively. Cholesteatoma was present in the mastoid or middle ear intraoperatively in 77.7% (7/9) of patients with an external ear bony canal defect found on CT. Despite 89.7, 85.29, and 90% agreement ratios for dehiscence of facial canal, lateral semicircular canal, and tegmen, respectively, CT could not detect dehiscence of these anatomic structures successfully. Based on these results, CT scanning has limitations but is a useful adjunct for the surgical management of COM patients.

Patients with adenoid and tonsil hypertrophy are at a higher risk for cardiopulmonary complications, poorer quality of life, and more severe UAO symptoms and should have priority for surgical treatment to prevent cardiopulmonary complications.

PDT provides an easy and convenient alternative to open tracheotomy (OT) and should be added to the otolaryngologist's armamentarium of surgical airway procedures. The complication rate of PDT is low and similar to that of open operative tracheotomy. However, with experience and the use of strict protocols in both patient selection and PDT procedure, the complication rate can be significantly reduced further both in frequency and severity, making it even safer than an open operative tracheotomy.

Bacillus thuringiensis (Bt) has a significant impact on biological pest control because of the insecticidal activity through its parasporal inclusion bodies (crystal proteins). Fig is an economically important plant in Turkey; agricultural pests result in a considerable economic loss in fig quality and cultivation. The aim of this work was to isolate, characterize, and determine the lepidopteran toxicity of Bt obtained from fig groves in Aydın Province. A total of 606 colonies (out of 1167) obtained from 380 samples were identified as Bt based on parasporal crystal formation. The highest Bt index of 0.60 was observed in the Kuyucak region. A total of 288 Bt isolates were characterized in terms of cry gene content by PCR analysis. It was found that the cry1 plus cry2 genotype was the most abundant (40%) in our collection. Bioactivity tests indicated that 6 isolates exhibited high mortalities against Cadra cautella and 3 isolates were found to exhibit high toxicity against Carpophilus hemipterus. Moreover, 13 Bt isolates exhibiting toxic activity against fig pests were further characterized based on specific cry gene content, protein profiles, and PCR-RFLP analysis. Among cry1 genes, the cry1Aa, cry1Ab, cry1Ac, cry1B, cry1C, cry1D, and cry1Ea genes were the most frequent (100%). Protein profiles of isolates toxic to C. cautella were different from those of isolates toxic to C. hemipterus. PCR-RFLP analysis indicated that toxic isolates differed from the reference strain with respect to cry1 type gene. Finally, it was concluded that Bt strains isolated from fig groves showed high level of toxicity against fig pests. These strains can serve as potential biopesticides for the control of C. cautella in the region as well as alternative biopesticides in the case of pesticide resistance in insects.