No abstract

An antrochoanal polyp (ACP) is a benign polypoid lesion originating from the maxillary sinus and extending to the choana. The objective of our study is to assess etiological and associated features of ACPs, and outcome following surgical treatment. Thirty-four patients who had received surgical treatment for ACPs were followed for 35 ± 17.7 months. Factors including patient age, gender, history of allergic rhinitis, chronic sinusitis, nasal septal deviation, turbinate hypertrophy, concha bullosa, accessory ostia, as well as the origin of the polyp, the surgical technique used and any recurrence, were evaluated. Overall, there were 12 females and 22 males. Mean age was 24.94 ± 8.08. Septal deviation was present in 50 %, turbinate hypertrophy in 32.3 %, concha bullosa in 17.6 %, mucous retention cyst in 32.3 %, allergic rhinitis in 44.11 %, and chronic sinusitis in 20.5 %. An accessory ostia was observed in 97.05 %. The functional endoscopic sinus surgery (FESS) approach was used in 31 cases, and three cases had combined FESS and Caldwell Luc procedures. The mean follow-up time was 35.8 ± 17.7 months. Two cases, who had been treated with FESS alone, experienced a recurrence. In conclusion, the commonest predisposing factors for ACPs are chronic inflammatory pathologies such as chronic sinusitis and allergic rhinitis. ACP left the maxillary sinus via an accessory ostium in 97.5 % of the cases. The FESS procedure is a safe and reliable method, and can be combined with the Caldwell Luc procedure when the origin of the maxillary component cannot be properly cleaned. In order to prevent recurrence, total extirpation of the maxillary component is essential.

Neck masses can be classified into three main categories: congenital, inflammatory and neoplastic. Our aim was to determine the distribution of diagnosis in patients who were followed-up for a neck mass and had undergone surgery for diagnostic indications. Six hundred and thirty cases referred to the Otorhinolaryngology and Head Neck Surgery Department of Haseki Research and Training Hospital between January 2005 and February 2012 with a neck mass who underwent excisional or incisional biopsy to establish a histopathologic diagnosis were retrospectively evaluated. Patients with a diagnosis of upper aerodigestive tract malignancy were excluded from the study. As well as the patients with thyroid masses were excluded. Only unknown primary neck masses were included in the study. The neck masses were categorized as inflammatory (33.49 %), congenital (18.9 %) or neoplastic (47.6 %). Neoplastic masses were either benign (51 %) or malignant (49 %) tumors. The most common causes were tuberculous lymphadenitis (40.28 %) among inflammatory masses, thyroglossal duct cysts (32.77 %) among congenital masses, pleomorphic adenoma (22.33 %) among benign neoplastic masses, and lymphoma (20 %) among malignant neoplastic masses. The most common types of mass were congenital in the 0-20 year age group, benign neoplastic in 21-40-year-old and malignant neoplastic in the >40-year group. Any neck mass, especially in an elderly patient, should be managed with caution as a considerable proportion may be malignant. In children and adolescents, a neck mass requiring surgery is most likely to be congenital. Tuberculosis should be considered as a cause of a neck mass due to a long-term inflammatory process in a developing country.

Thirty subjects with unilateral Ménière's disease (MD) and 18 age-matched controls underwent cervical (cVEMP) and ocular vestibular-evoked myogenic potential (oVEMP) testing using bilateral air-conducted stimulation (ACS) with stimulus frequencies of 500 and 1,000 Hz. The aim of this study is to determine the diagnostic value of frequency-associated responses in MD using oVEMP and cVEMP following 500- and 1,000-Hz ACS. In healthy controls and unaffected ears, responses to 500 Hz were found better than 1,000-Hz ACS in both oVEMP and cVEMP, while ears with MD responded to 1,000-Hz ACS better than to 500-Hz ACS in oVEMP. In cVEMP tests, affected ears responded to 500-Hz and 1,000-Hz ACS equally. Amplitude ratios of 1,000/500 Hz in both oVEMP and cVEMP were successful in differing affected ears from unaffected ears and healthy controls. This study showed frequency alteration of oVEMP and cVEMP can be used as a diagnostic test battery in MD.

According to the English literature, this case represents the oldest patient with bilateral CCA presenting for the first time in adult life.