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Warthin tumor (WT) is the second most common benign tumor of the parotid gland with male predominance and is seen in the elderly population in the left mandibular and cervical regions. Extraparotid WT rarely presents as a mass in the right cervical region in middle-aged adults. Here, we present two extraordinary cases of WT seen in middle age, both in the right cervical region. The first is a 50-year-old man with an asymptomatic neck mass, and the second is a 60-year-old woman with a fast-growing mass with enhancement in positron emission tomography-computed tomography (PET-CT) with suspicions of malignancy.

Summary Objectives Laryngopharyngeal reflux (LPR), a growing issue in ear, nose, and throat (ENT) and pediatric medicine, is the backflow of stomach contents into the laryngopharynx. Patients present with frequent upper and/or lower respiratory tract infections and coughs, associated with acid- and pepsin-mediated injury to the mucosae of the larynx and pharynx. LPR is associated with rhinosinusitis, laryngitis, pneumonia, and asthma. Children with LPR often fail to exhibit classic gastroesophageal reflux disease symptoms, or such symptoms may be intermittent. Only a few studies have sought correlations among symptoms, endoscopic findings, and the results of frequently used diagnostic tests. The aim of our study We sought associations among the Reflux Finding Score (RFS), Reflux Symptom Index (RSI), and the pathological extent of esophagitis. Methods We reviewed data on children who underwent upper gastrointestinal tract endoscopy and showed LPR symptoms, as reported by the ENT department. The RSI was scored by pediatric gastroenterologists and the RFS by ENT doctors, via laryngoscopic examination. The pathological esophageal data were evaluated retrospectively. Results We treated 52 patients (29 boys) with a mean age of 11.4 ± 4.5 years. On pathological evaluation, one patient exhibited normal esophageal findings, while 28 showed mild esophagitis, 16 esophagitis, and 8 severe esophagitis. Thirteen patients showed esophageal pseudopolypoid lesions secondary to gastroesophageal reflux disease on endoscopic examination, but were human papilloma virus-negative. There was no correlation among the RFS, RSI score, and age, but there was a significant correlation between the pathological data and the RFS (P = 0.010; r = 0.461). Conclusions The incidence of LPR/esophagitis in children may differ from that in adults. Therefore, ENT specialists should determine esophagitis status in children and, if necessary, consult pediatric gastroenterologists.

Bu olguda, Orta Anadolu'nun Kuzey-doğu kesiminde bir köyden gelen, yüzünün sağ tarafında asimetrisi bulunan ve sağ kulak ağrısı şikayeti ile Yeditepe Üniversitesi Hastanesi kulak burun boğaz bölümüne başvuran 33 yaşındaki bir erkek hasta sunulmuştur. Hastanın sağ dış kulak yolunda kene gözlenmiş ve kenenin çıkarılması otomikroskopi altında fine cup forceps ile yapılmıştır. Ani başlayan şiddetli kulak ağrısı ve yüz felci ile başvuran endemik bölgeden gelen hastaların, kulak kanalında kene ısırığı olasılığını dışlamak için dikkatlice incelenmesi gerektiği görüşündeyiz. We present the case of a 33 year-old man from a village of the north-eastern part of central Anatolia admitted to the otolaryngology department of Yeditepe University Hospital with right facial asymmetry and pain on the right ear. A tick of the genus Hyalomma was observed in the external auditory canal of the right ear and it was removed with fine cup forceps under otomicroscopy. We are of the opinion that in patients presenting with sudden acute ear pain and facial palsy, the ear canal should be examined to exclude an infestation by ticks.

Alt konka hipertrofisi özellikle nasal septum deviyasyonu ile birlikte sık görülen bir durumdur. Bazen alt konka hipertrofilerinin nedeni fibro-osseöz lezyonlar olabilir. Ossifiye fibrom gibi benign, nadir ve agresif olmayan fibro-osseöz neoplazmlar paranazal sinüsleri etkileyebilir. Ossifiye fibromda izole alt konka tutulumu son derece nadirdir. Bu makalede septum deviyasyonu ve konka hipertrofisine bağlı burun tıkanıklığı ile başvuran 28 yaşında bayan hasta sunuldu. Ameliyat öncesi ve ameliyat sonrasındaki incelemelerde alt konka hipertrofisinin nedeni ossifiye fibrom olarak tespit edildi. Bizim bilgilerimize göre, bu olgu izole yerleşimi nedeniyle İngilizce literatürde bildirilen ikinci ossifiye fibrom olgusudur. Alt konka hipertrofisi olan hastalar dikkatli bir şekilde muayene edilirse alt konka hipertrofisi için gereksiz medikal ve cerrahi tedaviler uygulanmasını önlemek mümkün olabilir. Hypertrophy of inferior turbinate is a common condition, especially with nasal septum deviation. Sometimes, the cause of hypertrophy of inferior turbinate can be fibro-osseous lesions. Benign, rare, and non-aggressive fibro-osseous neoplasms such as ossifying fibroma can affect paranasal sinuses. Isolated inferior turbinate involvement is extremely rare in ossifying fibroma. In this article, we present a 28-year-old female suffering from nasal obstruction due to septal deviation and hypertrophy of inferior turbinate. Preoperative and postoperative investigation show that cause of hypertrophy of inferior turbinate is ossifying fibroma. To our knowledge, that this is the second case of ossifying fibroma reported in the English-language literature due to its isolated localization. However, if the patients with inferior turbinate hypertrophy are examined carefully, we can prevent unnecessary medical treatment and surgery for inferior turbinate hypertrophy.

Summary Tinnitus is an irritating symptom which affects approximately 10% of the population. In Latin tinnire means, "to ring." Tinnitus is described as any sound deriving from the head, which does not originate from an external source. There may be hissing, buzzing, squealing, whining, clicking, or popping noises. Tinnitus may be unilateral, bilateral, transient or continuous. The purpose of the assessment is to reveal the cause of tinnitus. In tinnitus with a history of exposure to noise or ototoxic drugs with symmetrical hearing loss, and if vascular or neurological symptoms do not lead to another etiology, there may not be a need for further evaluation. An accurate hearing test should be performed. If the equipment is not available in the primary care setting, the audiometric assessment should be made at hospital or a special office. Tinnitus may occur due to central causes, and in this case, sometimes, tinnitus might be the first symptom.

Laryngopharyngeal reflux (LPR) is defined as the movement of gastric content towards the larynx and the pharynx and it may cause respiratory symptoms or difficulty in their control. We aimed to find the frequency of LPR in chronic obstructive pulmonary disease (COPD) patients and to investigate its effect on COPD symptoms and the results of its treatment. At baseline 30 (20 male, 10 female, mean age: 65 ± 10 years) COPD patients completed LPR and COPD symptom questionnaires and 13 (44%) were diagnosed with LPR based on laryngeal examination. Patients with LPR were given 2 months of PPI treatment, after which LPR and COPD symptom questionnaires, laryngeal examinations and pulmonary function tests were repeated. Following the treatment, significant improvements in COPD symptom index, LPR symptom index and laryngeal examination findings were observed in patients with LPR (P < 0.01, P < 0.01, P < 0.0001, respectively). Treatment of LPR resulted in a significant improvement in the symptoms of COPD. © 2009 Springer-Verlag.

Drop evaporation experiments were performed in still air for 11 liquid drops, and the results were expressed by using the drop half-life time method. This method was found to be useful to judge the...

Change in the surface free energy of poly(glycidyl azide) (PGA) networks prepared with different reactive systems was investigated using the van Oss-Good contact-angle evaluation methodology in order to estimate their wettability properties. The apolar Lifshitz-van der Waals (LW) component of the surface f ree energy of these energetic PGA networks was found to differ only ina minor amount and an average gamma(S)(LW) = 32.2 mJ m(-2) was calculated. The network surface was found to be monopolar and basic (electron donor) in varying degrees in accordance with change of the network bulk structure, mainly due to the presence of oxygen atoms in the PGA chain. The set of the network containing only PG;A and Desmodur N-100 components showed the highest gamma(S)(-) values compared to the other two sets. The main gamma(S)(-) contribution was found to come hom the PGA polymer. A slight decrease of the gamma(S)(-) component was seen when the Desmodur N-100 component was substituted with hexamethylene diisocyanate (HMDI); however a large decrease was seen when Desmodur N-100 was substituted with the isophorone diisocyanate (IPDI) component. This large reduction in the surface basicity of the network was due to increase of the apolar IPDI groups at the surface having low surface tension and also due to decrease of the oxygen atoms belonging to the main chain of PGA at the surface, which resulted in the minimization of the network's basic surface free-energy component. (C) 1999 John Wiley & Sons, Inc.

This study aims at predicting Carbon monoxide (CO) emission rate as well as carboxyhaemoglobin (HbCO) levelsin Al-Ain City, United Arab Emirates (UAE). Also, several mathematical models are proposed for estimating both CO emission and HbCO levels. These models yield excellent agreements between observed and predicted data and can be easily coupled with atmospheric models. Carbon monoxide exposure from motor vehicles were measured over a 3-month period from September to December 1995 at three locations in the UAE. The study is based on a sample of 148 cars. The data revealed that the major characteristics of the cars surveyed were as follows: 69.5% of the cars were Japanese, 74.3% of the cars were 5 years old; 41% of the car was range rover or four-wheel-drive car, which indicates a higher proportion of powerful cars; 58.8% was used special fuel; 51.4% had regular maintenance for their cars and 52% of the cars had 4 cylinder engine capacity. Carboxyhaemoglobin (HbCO) levels in the UAE were predicted for 1-hour (1.720 ppm) and 8-hour (8.106 ppm) exposure times. Also, on an average driving of 80 km hr−1 per day, the CO emission rate was found to be 8.729 ppm. These findings indicate that the mean 1-hour and 8-hour Carboxyhaemoglobin (HbCO) levels do not exceed the permissible standards recommended by the WHO. Additionally, the results of stepwise multiple regression analyses revealed that the factors, such as, type of car, size of cylinder, size of car, and maintaining service of the car exerted the greatest influence on the amount and concentration of pollutant emission produced by car exhaust.

This paper reports on the prevalence of respiratory symptoms, skin disorders, status of spirometric lung functions, and amino acid profiles among sewage workers. The data showed that sewage workers had a higher prevalence of respiratory symptoms than manual workers, being significantly greater for chronic cough (p

The epidemiological features of occult papillary thyroid carcinoma (OPTC) at autopsy have not previously been reported in Turkish people. This study provides data on the prevalence of OPTC in people from the Marmara region in Turkey. The study includes thyroid glands from 93 male and 15 female cadavers between 18 and 80 years of age. The thyroid glands were removed, fixed and sectioned at 2-mm intervals. The sections were stained with hematoxylin and eosin, and were examined by a single pathologist. A total of 108 thyroid glands were examined. Macroscopic lesions were found in 36 (33.3%) glands (95% confidence interval = 24-42). OPTC was found in four (3.7%) cases (95% confidence interval = 1.0-7.5). It was concluded that in the Turkish people from the Marmara region, the prevalence of OPTC found at autopsy was relatively low. No age or sex predilection was detected. European Journal of Cancer Prevention 20:308-312.

Vocal fold bridges are rare pathologies and mostly coincidentally discovered in direct laryngoscopy. Although the pathophysiology of formation is not well established, it is attributed as a primary pathology that accompanies sulcus and related vocal fold disorders. This paper presents a vocal fold bridge formation in a professional singer after surgical removal of a sulcus cyst formed as a sequela with typical histologic findings resembling the primary bridges. This case report addresses a very rare unpublished complication of a phonomicrosurgical procedure and implicates the evidence of trauma in the etiology. © 2010 The Voice Foundation.

Objective. To treat androphonic voice quality after failed cricothyroid approximation (CTA) surgery. Study Design. Prospective case series. Methods. The voices of three male-to-female transsexuals, two constitutional androphonic females, and one patient with ambiguous genitalia assigned to the female phenotype were deemed to be unimproved after CTA. The patients underwent laser reduction glottoplasty (LRG) surgery tailored to each case between 2001 and 2005. Vocal outcomes were evaluated according to fundamental frequency (FF), satisfaction status, voice-related quality of life (V-RQOL) measures, and ratings of recorded voices by 10 blinded listeners after 12 months postoperatively. Results. The LRG provided an additional mean gain of 45.17 +/- 8.47 Hz (mean +/- standard deviation) in the FF, equal to 4.36 +/- 0.84 semitones. The mean FF increased significantly (P < 0.05) from 158.33 +/- 12.14 Hz preoperatively to 203.50 +/- 13.34 Hz postoperatively. All patients reported satisfactory female quality in their voices and greetings with female salutations in nonvisual communications. Their voice-related quality of life (V-RQOL) measures were high and significantly elevated (P < 0.05) after LRG. The masculine voice-quality ratings significantly shifted to feminine in the listeners' assessment. No major complications were observed during follow-up, with the exception of mild vocal fold edema that disappeared by 8 weeks postoperatively. Conclusions. LRG can be used in androphonic cases that fail to obtain a high-pitched feminine voice after CTA.

Objective – To evaluate changes in perceptual and several acoustic parameters of voice in patients with Parkinson’s disease (PD) and to find out any relation with these parameters and motor components of Unified Parkinson’s Disease Rating Scale (UPDRS) in this patient group. Materials and methods – Twenty patients with PD (12 male and 8 female) were given objective and subjective voice tests and results were compared with those of 20 age- and sex-matched controls. Patient's perceptual voice analysis was assessed using GRBAS scale including Grade of Dysphonia, Roughness, Breathiness, Asthenia and Strain items. Measurements for objective voice analysis, acoustic assessment tests including frequency perturbation [jitter (jitt)%], intensity perturbation [shimmer (shim)%], noise to harmonic ratio (NHR), fundamental frequency (F0), variability of fundamental frequency (vF0), diadochokinetic rate (DDK) and maximum phonation time (MPT) were used. An assessment of disability caused by voice disorders was scored according to the Voice Handicap Index (VHI) by the patient. All subjects also underwent videolaryngostroboscopic (VLS) examination. Motor components of UPDRS and acoustic parameters of voice were investigated for any correlations. Results – Compared with controls, roughness (P = 0.15), breathiness (P = 0.004) and asthenia (P = 0.031) values of males and breathiness (P = 0.043) and asthenia (P = 0.023) values of females were higher in patients with PD. Mean VHI scores of patients with PD were higher for both male and female patients (P = 0.0001 for male, P = 0.002 for female). The mean values for MPT (P = 0.02) and DDK (P = 0.025) were shorter in patients with PD. Jitt%, shim% and mean F0 values were similar among the two groups. But mean vF0 values were significantly higher in male patients with PD (P = 0.05). On VLS examination, non-closure glottic pattern was found to be more frequent in the PD group. Conclusion – Although it is well known that pathophysiological changes in PD affect the voice, the present study found only few significant correlations between motor component of UPDRS and voice parameters.

Laryngopharyngeal reflux (LPR) is defined as the movement of gastric content toward laryngopharynx and is a common occurrence in patients with asthma. This study aimed (1) to determine the incidence of LPR in patients with asthma by assessment of symptom scores and indirect laryngoscopy and (2) to determine the effect of LPR treatment on asthma symptom scores.A total of 28 patients with mild to moderate asthma (24 women, 4 men, mean age 46 +/- 6 years) were included in the study, and after all patients completed LPR and asthma symptom questionnaires, indirect videolaryngoscopy was performed. In patients with LPR, daily treatment with 40 mg pantoprazole was administered for 3 months. Symptom score assessment and indirect videolaryngoscopic examination were repeated at the end of treatment.A diagnosis of LPR was made in 21 of 28 patients (75%) by indirect laryngoscopy. A statistically significant improvement was observed in asthma and LPR symptoms in patients with LPR after the treatment (p = 0.001 and p0.001, respectively).LPR is a frequent condition in asthma patients. When the LPR symptom questionnaire and indirect laryngoscopy findings are suggestive of LPR, treatment with a proton pump inhibitor provides improvement in both asthma and LPR symptoms.

To evaluate the voice quality in patients with mild-to-moderate asthma by subjective and objective methods.Comparative, controlled, cross-sectional study.Patients with mild-to-moderate asthma (n=40) and age- and sex-matched healthy controls (n=40) were included. Acoustic analyses were performed by the Multi-Dimensional Voice Program (MDVP; Kay Elemetrics Corporation, Lincoln Park, NJ) and the movements of the vocal cords were examined by videolaryngostroboscopy (VLS). In addition, the duration of illness, maximum phonation time, "s/z" values, and vital capacity were evaluated. Voice Handicap Index (VHI) and GRB scales were used for subjective evaluations.Maximum phonation time values were significantly shorter both in male and female asthma patients compared with controls (P0.0001). Also, average shimmer values in MDVP were higher for both sexes in the patient group compared with controls (P=0.002 and P=0.04, respectively). There was a significant difference between female patients and sex-matched controls with regard to mean noise-to-harmonic ratio values (P=0.006). Female patients with asthma had higher average jitter values compared with sex-matched controls (P0.0001). A significant difference was noted between asthma and control groups with regard to GRB scale (P0.0001, P0.001, and P0.0001, respectively). The VHI score was above the normal limit in 16 (40%), and VLS findings were abnormal in 39 (97.5%) asthmatics.In asthmatic patients, maximum phonation time, frequency, and amplitude perturbation parameters were impaired, but the vital capacity and the duration of illness did not correlate with these findings.

Background and Aim: To determine efficacy safety and the cost effectiveness, of the four most commonly prescribed statins (rosuvastatin, atorvastatin, pravastatin, and simvastatin) in the treatment of dyslipidemia among diabetic patients. Materials and Methods: This is a cohort, observational, population-based study conducted at diabetic clinics of the Hamad Medical Hospital and Primary Health Care Centers (PHCC) over a period from January 2007 to September 2012. The study included 1,542 consecutive diabetes patients above 18 years of age diagnosed with dyslipidemia and prescribed any of the indicated statins. Laboratory investigations were taken from the Electronic Medical Records Database (EMR-viewer). The sociodemographic, height, weight, and physical activities were collected from Patient's Medical Records. Information about statin was extracted from the pharmacy drug database. The effective reductions in total cholesterol using rosuvastatin with atorvastatin, simvastatin, and pravastatin in achieving cholesterol goals and improving plasma lipids in dyslipidemic diabetic patients were measured. Serum lipid levels measured a 1 week before the treatment and at the end 2nd year. Results: Rosuvastatin (10 mg) was the most effective in reducing low-density lipoprotein cholesterol (LDL-C; 28.59%), followed by simvastatin 20 mg (16.7%), atorvastatin 20 mg (15.9%), and pravastatin 20 mg (11.59.3%). All statins were safe with respect to muscular and hepatic functions. Atorvastatin was the safest statin as it resulted in the least number of patients with microalbuminuria (10.92%) as compared to other statins. Treatment with rosuvastatin 10 mg was more effective in allowing patients to reach European and Adult Treatment Plan (ATP) III LDL-C goals as compared to other statins (P < 0.0001) and produced greater reductions in LDL-C, total cholesterol, and non-HDL-C, produced similar or greater reductions in triglycerides (TGs) and increased in HDL-C. Conclusion: Rosuvastatin 10 mg was the most effective statin in reducing serum lipids and total cholesterol in dyslipidemic diabetic patients.

Objective: To present the success rate of a less invasive modification of Isshiki type III anterior commissure relaxation laryngoplasty technique in patients with high-pitched voice disorders. Design: Prospective case series. Setting: KBB Major Private Clinic of Istanbul Surgery Hospital and the University of Yeditepe Hospital. Patients: Twenty-one adult patients who believed that their high-pitched voices conflicted with their body image and/or gender identity. Intervention: Type III thyroplasty for pitch alteration. Main Outcome Measures: Comparison of preoperative and postoperative (>6 months) fundamental frequency levels, diplophonia, perception of body image and pitch, and subjective ratings of comfort during vocalization. Results: The patients were mostly male (mean age, 30.5 years). The most frequent cause of high-pitched voice was sulcus vocalis (n=14), followed by constitutional causes (n=5), mutational falsetto (n=1), and severe glottic scarring secondary to childhood diphtheria (n=1). After surgery, the fundamental frequency dropped significantly from a mean of 213.81 Hz to 149.86 Hz (P

Change in the surface free energy of poly(glycidyl azide) (PGA) networks prepared with different reactive systems was investigated using the van Oss-Good contact-angle evaluation methodology in order to estimate their wettability properties. The apolar Lifshitz–van der Waals (LW) component of the surface free energy of these energetic PGA networks was found to differ only in a minor amount and an average γ = 32.2 mJ m−2 was calculated. The network surface was found to be monopolar and basic (electron donor) in varying degrees in accordance with change of the network bulk structure, mainly due to the presence of oxygen atoms in the PGA chain. The set of the network containing only PGA and Desmodur N-100 components showed the highest γ values compared to the other two sets. The main γ contribution was found to come from the PGA polymer. A slight decrease of the γ component was seen when the Desmodur N-100 component was substituted with hexamethylene diisocyanate (HMDI); however a large decrease was seen when Desmodur N-100 was substituted with the isophorone diisocyanate (IPDI) component. This large reduction in the surface basicity of the network was due to increase of the apolar IPDI groups at the surface having low surface tension and also due to decrease of the oxygen atoms belonging to the main chain of PGA at the surface, which resulted in the minimization of the network's basic surface free-energy component. © 1999 John Wiley & Sons, Inc. J Appl Polym Sci 74: 2848–2855, 1999