The displacement of a dental implant into the maxillary sinus during surgery or after a period of use is a complication defined in the dental implant clinical practice. This complication arises primarily from inadequate bone height and peri-implant infection. Specifically, foreign objects in the maxillary sinus can cause sinusitis via impaired mucociliary flow and foreign body reactions, so they must be removed. Caldwell–Luc, transnasal, and intraoral endoscopic sinus surgeries have all been used to remove such foreign bodies and lesions from maxillary sinuses. In this article, the authors present the case of a patient whose dental implant slipped into the right maxillary sinus after a period of use and describe the endoscopic removal of said implant via an intraoral approach. The endoscopic removal of the dental implant from the maxillary sinus proved to be a safe, reliable, and minimally invasive method.
Abstract Background Numbness of the nasal skin is one of the most common complications following rhinoplasty. Objectives The present study investigated postoperative changes in nasal skin sensation among primary and revision rhinoplasty patients and evaluated the recovery outcomes for both groups. Methods A prospective, randomized blinded study was undertaken involving 100 primary and 34 revision open rhinoplasty patients and 50 volunteers as control group. Semmes-Weinstein monofilament testing was performed on 7 designated nasal points preoperatively and at postoperative months 1, 3, 6, and 12, and the results were evaluated. Results Among the primary rhinoplasty patients, the change in reduced sensation on pressure to the tip and infratip over time was significant (P < 0.001), whereas there was no statistically significant difference for the other points. Among the revision rhinoplasty patients, the change in reduced sensation on pressure to the tip, infratip, and base of columella over time was significant (P < 0.001), whereas there was no statistically significant difference at the other points. In a comparison of the revision and primary rhinoplasty patients at all timepoints, a statistically significant reduction in sensation was noted on the application of pressure to all points in the revision patient group (P < 0.001). Conclusions This study found that the sense of touch on pressure returned to normal, aside from at the tip and infratip, by the end of month 12 in primary rhinoplasty patients. The revision rhinoplasty patients, in turn, were observed to have reduced sensation on pressure by the end of month 12, with the greatest reduction at the tip, infratip, and columellar base. Level of Evidence: 3
Although carotid body tumor (CBT) is a rare neoplasm, it should always be considered in differential diagnosis of lateral neck masses. We shared the 10 years of CBT experience in our clinic and started a discussion on CBT with literature support. A total of 21 patients with CBT diagnosis in Fırat University Hospital, Otorhinolaryngology Clinic, participated in the study. Patients were evaluated based on demographical data and particularities of the tumor. Participant patients were 19 women and 2 men, and their ages were between 21 and 79 (mean age 54.06 ± 12.48). The most frequent reason for the patients to apply to the hospital was painless swelling in the neck (76.2%). Tumor was located in the right side of the neck in 10 patients (47.6%), and in the left side of the neck in 11 (52.4%). Twenty patients (95.2%) had undergone computerized tomography angiography. Surgical treatment was applied to 19 patients (90.5%) and the tumor was totally excised. According to Shamblin classification, 15 of the tumors of these patients were class II (78.9%) and 4 were class III (21.1%). In 1 patient (5.3%), postoperative contusion infection that recovered after medical treatment was observed; in 2 patients (10.5%), n. vagus injury was observed because of tumor's pervasion of n. vagus; and in 1 of these patients vocal cord paralysis was developed and this patient was later taken into thyroplasty surgery. Two patients (10.5%) suffered n. hypoglossus injury, 1 of these recovered within 3 months postoperative and the other developed n. hypoglossus palsy. The size and extension of the tumor should be determined by preoperative imaging for the correct planning of surgical procedure. It should be taken into consideration that despite advanced surgical techniques, the rate of postoperative cranial nerve damage is still high.
To evaluate the efficacy of topical ciprofloxacin and tobramycin with and without topical dexamethasone in the treatment of chronic suppurative otitis media without cholesteatoma.The study included 103 ears of 80 patients (49 males, 31 females; mean age 31 years; range 18 to 60 years) with chronic suppurative otitis media without cholesteatoma. The patients were randomly divided into four groups to receive topical applications of either ciprofloxacin and tobramycin alone, or in combination with dexamethasone. Cultures were obtained from the ears preoperatively and 24 hours after treatment.Aerobic bacteria were isolated in 94.1% of patients before the treatment, the most common being Pseudomonas aeruginosa (38.9%). With dexamethasone, the clinical response for ciprofloxacin and tobramycin increased from 80% to 90% and from 70% to 75%, respectively, but this improvement was not significant (p > 0.03). Addition of dexamethasone to ciprofloxacin decreased the recovery period from 14 days to seven days, whereas no change (7 days) was observed with tobramycin.The efficacy of ciprofloxacin and tobramycin were similar in the treatment of chronic suppurative otitis media. Addition of dexamethasone to ciprofloxacin decreased the treatment period.
To analyze diagnostic and therapeutic methods used in the diagnosis and treatment of foreign body aspiration (FBA) and to determine the impact of technical infrastructure on mortality and morbidity.Hospital records of patients diagnosed with FBA between the years 1987 and 2015 were retrospectively evaluated. The patients were grouped according to the length of time until their admission to the hospital as follows: Group I (0-24 h); Group II (1-7 days); Group III (>7 days). Age, sex, history, existing symptoms, physical examination, endoscopic and radiological findings, time to treatment, type and location of the foreign body, treatment modality, mortality and morbidity rates were recorded. A rigid bronchoscopy procedure was performed between 1987 and 2005 (Phase 1) without the need for an optic telescope, while between 2006 and 2015, it was performed using a rigid bronchoscope equipped with an optical telescope and HD camera (Phase 2).A total of 513 patients [male, n = 328 (63.9%) and female, n = 185 (36%)] who had complaints of FBA were evaluated. The mean age of the patients was 3.7 ± 3.5 years. In order of decreasing frequency, sunflower seeds, peanuts, and hazelnuts (38% of all patients) were extracted. Bronchoscopy could not detect a foreign body in 127 (24.7%) patients. Foreign bodies were mostly observed in the right (43.3%) main bronchus. When the locations of the foreign bodies were analyzed, significant differences were found for subglottic foreign bodies (FBs) between Groups I and III and for FBs located within the bifurcation between Groups II and III. The most prevalent symptom was sudden onset of coughing in 231 (45%) patients. A significant difference was detected between Groups I and II, as well as Groups I and III, for sudden onset of coughing, decrease in breathing sounds, wheezing, and fever. No abnormal radiological signs were detected in 136 (26.5%) patients. Manifestations of emphysema were significantly more frequent in Group I, pneumonia in both Groups II and III, and pleural effusion in Group III. When complications related to bronchoscopy were evaluated, a significant increase was observed in transient complications in Group III compared with Groups I and II. The negative bronchoscopy rate in Phase I was statistically significantly higher than that in Phase II.When the length of time elapsed till admission to a hospital was considered, a decrease in morbidity rates was observed in patients who presented at a hospital within the first 24 hours. In the diagnosis of suspect patients, virtual bronchoscopy seriously decreased the incidence of negative bronchoscopy. The authors determined that for bronchoscopic procedures, the renewal of technical ultrastructure with technological advances strongly contributed to a decrease in mortality and morbidity as a result of FBA in paediatric patients.
