Depertmem of Tho rack and Cardio vasc ular Sergery.H ecette pe Unlversny, Facu lly of~ed iti ne. Anka ra. Turkey 95 Su m mary At the Depa rtm ent of Thoracic a nd Card iovascula r Surgery of Itaeeue po University. a total number of822 pedia tric bronchoscopies were performed from 191' 14 through 1990 for suspected foreign body asp iration . Of the children 65 .3 % were boys and 34,7% were girls ran ging in age from one month to 14 years . Deflnuive state ment of foreign-body aspira tion was obtai ned from 394 patients . Unilateral hyper aeration . atelecta sis. and unilateral parenchymal infiltra tion were the most common radlologtcal flndings. In all end oscopic procedures. a pediatric rigid bronchoscope was use-d under gener al anesthesia a nd controlle-d venulauon . Fore ign bodies were found in 77.7 "10 of the 822 patients. In the rest of the children infla mmatory drsordcrs .....e re confirmed. The foreign bodies most com monly found in 639 patien ts were sun-flower seeds 121 .1%1.beans (10. 4"10). water -melon seeds 110"101. and hazelnu ts 19.8 %1.In our presente-d series. the incidence of non-fatal compllcation was 1.8"10. apa rt from these pat ients 5 cr tbe m (0.6"10) die-d afier the bronchoscopic proce-d ures. Kt') ' we r dsIJronchoscopy -Foreign-body as piration -Endosco py Introdu cuonIn spite of the endoscopic tnves ug a uo n of th e res piratory tract in new bo rns a nd c hild re n having some pote ntial ris k. bronc hosco py is a n im po rta nt diagnosti c a nd the rapeutic tool . Many authors haw regarded aspiration of a for eign body into th e respiratory tract as an important cause of mortality in childre n . Especially small c hild ren. whose ai rways a re narrow and in whom th e protective m echanisms a re inadequate. a re victims u. 13. 14 I.The diagnos is offoretgn-body aspiration in in fa nts and child ren is ofte n d ifficu lt ....-ith no n-bronchoscoplc d iagnostic techniq ues. In spite of modern techniques of radiology such as co mputed to mog ra ph y. m agne tic resonance im agin g. xerora diog raphy. o nly a n e ndosco pic techn ique ca n re veal Thorac. csrcrovesc. Surgeon 39 (199 t I95-98

To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p < 0.05). On postoperative day 2, the pain level was lower in the piezosurgery group than in the conventional osteotomy group (p < 0.05). In an endoscopic examination on postoperative day 4, while 24% of the patients in the conventional osteotomy group had mucosal damage, no such damage was observed in the piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.

Twenty-five patients with fracture of the penis were treated surgically between 1968 and 1984. Long-term follow-up was obtained in 17. In no case were there any early post-operative complications. All patients stated that they were achieving normal, painless erections; two patients developed a slight penile curvature but this did not affect their sexual activities. We strongly recommend early surgical intervention because of these encouraging results. Urethral injury associated with the fracture did not occur in this series.

Aims of this study are to analyze the association of the anterior ethmoidal artery's (AEA) visualization with variations in its adjacent structures in coronal, axial, and sagittal CT images, to assess its relation with the ethmoid roof, and, based on this relation, to introduce a new classification for the ethmoid roof. A retrospective, cross-sectional study was performed in a tertiary referral center. In this retrospective, cross-sectional study, the coronal, axial, and sagittal CTs of 184 patients have been surveyed and the AEA canal, the ethmoid roof, and their relations with surrounding structures have been assessed. The Keros classification used to measure the depth of the lateral lamella of the cribriform plate (LLCP) in the ethmoid roof has been modified to include anterior-posterior length of the LLCP. It was shown that the visualization of the AEA canal increases in a statistically significant manner with an increase in the superior-inferior depth and the anterior-posterior length of the LLCP bilaterally. In the presence of supraorbital pneumatization, AEA visualization was shown to increase bilaterally significantly. This study demonstrated a positive correlation between the AEA canal, the LLCP superior-inferior depth, and the anterior-posterior length. It was shown that with the increased depth and length of the LLCP and in the presence of supraorbital pneumatization, the visualization of the artery and hence the injury risks are increased. The LLCP anterior-posterior length is as clinically relevant as is its depth, and a radiologic classification has been defined according to the anterior-posterior length of the LLCP.

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The objective of this study was to investigate the thermal effects of cold light sources and endoscopes on the inner ear. 25 male guinea pigs were assigned equally to five groups (1: Halogen-1 min, 2: Halogen-5 min, 3: Xenon-1 min, 4: Xenon-5 min, 5: Controls). After both bullae of the guinea pigs were opened, light sources and endoscopes were positioned in the middle ears of the first four groups for specific time periods. DPOAE and ABR tests were conducted on all animals at the beginning of the study, at the end of surgery, and 2 h after surgery. The temperatures of cold light sources were measured by a thermocouple thermometer, and the surface temperatures of the endoscopes were measured by an infrared thermometer. DPOAE and ABR measurements performed right after and 2 h after surgery in group 1, 2, 3, and 5 did not reveal any significant difference. In group 4, DPOAE values were significantly lower and ABR threshold values were significantly higher than those in the other groups, right after and 2 h after surgery. Thermocouple thermometer readings showed that, after the first minute, the Xenon light source generated significantly more temperature rise than the Halogen light source. The surface temperatures of all endoscopes returned to normal approximately 1 min after light sources were turned off. Our study demonstrated that when an endoscope using a Xenon light source was applied to the middle ear for a specific time periods, inner ear functions deteriorated, as reflected by audiologic tests.