Objectives: To compare the amounts of nasal secretions aspirated into the lower airway by patient... more Objectives: To compare the amounts of nasal secretions aspirated into the lower airway by patients with acute sinonasal infection with that aspirated by healthy adults during sleep.Study Design: Sixteen patients who had received a diagnosis of acute sinonasal infections by accurate history, anterior rhinoscopic examination, and radiological assessment and 13 healthy volunteers, aged 14 to 45 years.Methods: A 10-mCi dose of technetium 99m-labeled macroaggregated albumin (Tc-99m MAA) with a concentration of 1 mCi/mL was prepared at midnight, just before sleep. Each subject was administered two puffs of this spray. At 8 AM the next morning transmission and emission views of the thorax were taken with a gamma camera.Results: No significant difference between the two groups was observed in the amounts of nasal secretions aspirated into the lungs.Conclusions: The amount of nasal secretions aspirated does not increase during acute sinonasal infection. However, by irritating the mucosa of the lower respiratory tracts, bacteria, toxins, and inflammatory products existing in purulent secretions may play a major role in the pathophysiology of asthma and sinusitis.
Objective: This study aimed to evaluate the presence of reactive oxygen species in laryngeal canc... more Objective: This study aimed to evaluate the presence of reactive oxygen species in laryngeal cancer tissue, using a luminol-amplified chemiluminescence method.Materials and methods: Fourteen patients with histopathologically diagnosed laryngeal squamous cell carcinoma were enrolled. Patients with recurrent tumours or a history of prior chemotherapy or radiotherapy were excluded. Tissue specimens were harvested both from the tumour itself and from the neighbouring, apparently normal mucosa (immediately after tumour removal). Tissue specimens were washed with ice-cold saline solution and processed immediately, without storage. The level of reactive oxygen species was measured quantitatively by a luminol-amplified chemiluminescence method.Results: The mean luminol-amplified chemiluminescence values for tumour and control tissue were 140.52 (standard error of the mean 40.21) and 121.36 (standard error of the mean 35.33) relative light units/mg tissue, respectively. Furthermore, mean tumour and control luminol chemiluminescence values were compared for stage one and two tumours versus stage three and four tumours. Both the tumour and the control luminol chemiluminescence values for the latter tumour group were significantly higher than those for the former tumour group.Conclusion: This study measured directly the levels of reactive oxygen species in samples of laryngeal cancer tissue and normal mucosa. Higher levels of reactive oxygen species were found in laryngeal cancer tissue, suggesting a relationship between reactive oxygen species and laryngeal cancer.(Accepted February 04 2010)(Online publication May 20 2010)
Objective: The aim of this study was to investigate the value of dynamic contrast-enhanced magnet... more Objective: The aim of this study was to investigate the value of dynamic contrast-enhanced magnetic resonance imaging (MRI) in the differentiation of posttreatment fibrosis from recurrent carcinoma, by comparing the dynamic contrast -enhancement characteristics of the lesions. Materials and methods: Twenty -six patients with previously treated carcinoma of the head and neck are studied by conventional and dynamic contrast -enhanced MRI at least 6 months after treatment by radiotherapy and/or surgery. Patients are divided into tumor-positive or -negative groups according to the radiological and clinical follow-up and biopsy. Lesion enhancement ratios at each dynamic sequence are calculated. Results: The tumor-positive group consisted of 11 patients, while the tumor -negative group included 15 patients. Between the two groups, lesion enhancement ratios are found to be significantly different ( P b.05). Conclusion: Dynamic contrast-enhanced MRI may be a valuable modality in the differentiation of recurrent tumor from posttreatment fibrotic changes of the head and neck. D
In recent years, microsurgical transplant of the gracilis muscle has been the most widely used te... more In recent years, microsurgical transplant of the gracilis muscle has been the most widely used technique in the dynamic rehabilitation of the smile. The most frequently used donor nerve is the seventh cranial nerve, as it allows for the most physiological rehabilitation, including the rehabilitation of spontaneous smile. An exception to this is the case of bilateral facial paralyses, in which there is no contralateral nerve to be used as a donor. In these cases, it is necessary to use other nerves such as the hypoglossal, the accessory nerve, or the masseter branch of the trigeminal nerve. In this article, we describe a case of dynamic bilateral facial rehabilitation with a bilateral transplant of the gracilis muscle neurotized to the masseter nerve to achieve a strong, symmetrical smile, which is properly controlled by the patient.
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat, 2006
Primary involvement of the middle ear and mastoid mucosa by malignant melanoma (MM) has been rare... more Primary involvement of the middle ear and mastoid mucosa by malignant melanoma (MM) has been rarely reported. We report an 81-year-old Caucasian woman presenting with otalgia, left-sided aural fullness, and hearing loss. Otoscopic examination revealed a purple-colored polyp that appeared to be vascular, occupy left external auditory canal (EAC). The computed tomography scanning showed a mass in soft tissue density, filling the tympanic and mastoid cavities, eroding the mastoid cortex, and invading medial and central parts of the EAC. A biopsy was performed with the diagnosis of MM. The patient underwent subtotal temporal bone resection with radical neck dissection. Dacarbazine was given postoperatively. The case presented herein emphasizes the need to be aware that MMs can arise in the middle ear and mastoid cavity. An index of suspicion in the differential diagnosis of temporal bone tumors is necessary for early recognition.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2002
Atherosclerosis and tympanosclerosis are disorders that affect different organs in the body. When... more Atherosclerosis and tympanosclerosis are disorders that affect different organs in the body. When tissue samples taken from atherosclerotic and tympanosclerotic lesions are compared under light and electron microscopes, common pathological characteristics become apparent in both tissues. These similarities indicate that genetic predisposition to atherosclerosis is also seen in the middle ear. For the purpose of evaluating this genetic predisposition, the incidence of tympanosclerosis in atherosclerotic patients was examined and compared with the normal population. Otoscopic examination of 1,024 atherosclerotic patients was performed, and myringosclerosis was revealed in 66.6%. Myringosclerosis was found in 36 out of 300 non-atherosclerotic patients (12%). In the group of atherosclerotic patients, 174 individuals had past histories of previous ear infections. Myringosclerosis was detected in 147 of these patients (84.5%) during ear examinations. In 637 non-atherosclerotic patients with histories of ear infections, this figure was 114 (17.7%). The high rate of tympanosclerosis observed in atherosclerotic patients in comparison to the normal population was found to be statistically significant. These findings indicate that there must be a genetic predisposition for sclerotic degeneration in some individuals.
This study has been performed between December 1990-March 1991 in the Microsurgery laboratory of ... more This study has been performed between December 1990-March 1991 in the Microsurgery laboratory of the Marmara University Hospital. Twelve healthy albino guinea pigs were used as a study group while the control group consists of three animals. The potentials for cholesteatoma formation of the squamous epithelium, namely the squamous epithelium of the posterior superior part of the external ear canal skin and normal skin, were investigated. Among 24 subjects who were implanted by canal skin, cholesteatoma was formed in 21 of them. Likewise, 19 of 24 animals implanted by normal skin came out with cholesteatoma formation. Between these two types of epithelium, there is no statistical difference in cholesteatoma formation (p > 0.5).
Résumé/Abstract Our study documents the anatomy of the middle ear of the guinea pig. The relative... more Résumé/Abstract Our study documents the anatomy of the middle ear of the guinea pig. The relative similarities to and differences from the human middle ear are noted. The guinea pig's ossicular chain, which involves two ossicles, the projection of the cochlea into the middle ear cleft, and the relatively greater space of the inferior chamber, are essential differences. Many similarities were found, such as the relationship of the facial nerve to the oval window
We report a case of Merkel cell carcinoma with parotid lymph node metastasis. The pathology, clin... more We report a case of Merkel cell carcinoma with parotid lymph node metastasis. The pathology, clinical appearance and management of this rare tumor are discussed.
ORL; journal for oto-rhino-laryngology and its related specialties, 1990
Collet-Sicard syndrome is one of the jugular foramen syndromes in which the last four cranial ner... more Collet-Sicard syndrome is one of the jugular foramen syndromes in which the last four cranial nerves are involved whereas the sympathetic plexus is spared. It is very uncommon to find facial paralysis associated to this syndrome and most interestingly, a hemangiopericytoma at this location to cause all these paralyses. We have not been able to find a similar case in the literature, and thus present our case.
Many ENT surgeons are accustomed to perform stapedectomy in a hospital setting. We present our re... more Many ENT surgeons are accustomed to perform stapedectomy in a hospital setting. We present our results with 19 patients on whom stapedectomies were performed in an outpatient setting. In respect of hearing gain and complications, our results are not significantly different from the results of those series of stapedectomies performed in hospital. Thus, we believe that stapedectomy can be performed as an outpatient procedure.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2001
Tympanostomy tube insertion is an accepted treatment for otitis media with effusion in children. ... more Tympanostomy tube insertion is an accepted treatment for otitis media with effusion in children. Several clinical studies have shown that tube insertion may cause myringosclerosis. During the period 1988 to 1997 we treated 533 ears from 311 children who had otitis media with effusion by inserting tympanostomy tubes. Most of these (431 ears from 251 children) were re-examined in 1998 and sex and occurrence of myringosclerosis at the tube insertion site were noted. Myringosclerosis was observed in 31% of ears of girls treated with tubes, whereas in boys 71% of ears showed myringosclerosis. This difference between sexes may indicate a genetic predisposition such as that seen in atherosclerosis.
1. Ear Nose Throat J. 1994 Oct;73(10):782-4. Massive epistaxis due to intracavernous carotid arte... more 1. Ear Nose Throat J. 1994 Oct;73(10):782-4. Massive epistaxis due to intracavernous carotid artery aneurysm: a case report. Batman C, Tutkun A, Koc A, Uneri C, Sehitoglu MA, Pamir N. Department of Otolaryngology Head and Neck Surgery, Marmara University School of Medicine, Istanbul, Turkey. PMID: 7805601 [PubMed - indexed for MEDLINE]. Publication Types: Case Reports. MeSH Terms. Adult; Arteriovenous Fistula/complications*; Arteriovenous ...
Archives of otolaryngology--head & neck surgery, 1995
To determine and compare the therapeutic efficiency of ciprofloxacin hydrochloride and gentamicin... more To determine and compare the therapeutic efficiency of ciprofloxacin hydrochloride and gentamicin sulfate in the treatment of chronic ear disease. Prospective randomized study. Academic tertiary medical center. Consecutive referred sample of 44 patients with chronic suppurative otitis media randomized into two groups. Ciprofloxacin hydrochloride (200 mg/mL) was administered to the first group (composed of 24 patients), while the second group (composed of 20 patients) received gentamicin sulfate (5 mg/mL) locally, five drops three times a day for 10 days. In the ciprofloxacin group, 21 (88%) of the 24 patients with suppurative chronic otitis media were cured. On the other hand, only six (30%) of the patients in the gentamicin group were cured. The rest of the patients showed no clinical or bacteriological improvement. To our knowledge, this is the first study to compare the efficiency of two topical otic preparations in the treatment of chronic ear disease. The results show that topical ciprofloxacin preparation is more efficacious and efficient than topical gentamicin for the treatment of chronic otitis media in the acute stage.
The aim of this study was to observe histopathologic and ultrastructural ciliary changes by SEM a... more The aim of this study was to observe histopathologic and ultrastructural ciliary changes by SEM and TEM in the mucosaof the regenerating sinus and to evaluate mucociliary activity within the nasal cavity at the same time after ESS.
The authors review their 5 years' experience with endonasal endoscopic repair of the anterior sku... more The authors review their 5 years' experience with endonasal endoscopic repair of the anterior skull base fistulas presenting with cerebrospinal fluid (CSF) rhinorrhea. A total of 12 patients were managed endoscopically between 2004 and 2008. Seven patients (58.3%) had nonsurgical posttraumatic CSF rhinorrhea, 2 patients (16.7%) had CSF rhinorrhea due to surgical/iatrogenic trauma, and 3 patients (25%) had spontaneous onset of CSF rhinorrhea. Radiosurgical correlation for CSF fistula identification was positive in all patients. The most common site of leak was the fovea ethmoidalis. The repair method consisted of an extradural underlay closure of a defect with fascia lata. The largest diameter of a defect to be closed was 15 mm. Immediate results were good in all patients, but later in the follow-up, CSF rhinorrhea recurred in 2 patients, and each patient had a revision 2 times. In the first revisions, transcranial approach was used, whereas in the second revisions endonasal endoscopic route was resorted. The primary closure rate was 83.3%, and the overall closure rate was 100%. The average follow-up period thus far is 21 months. Endonasal endoscopic technique well known to otolaryngologists should be considered as the first choice of surgery in the repair of CSF rhinorrhea because of low morbidity and a higher closure rate. The possibility of revision with the same technique makes this approach ideal for the repair of cranionasal osteodural defects.
Objectives: To compare the amounts of nasal secretions aspirated into the lower airway by patient... more Objectives: To compare the amounts of nasal secretions aspirated into the lower airway by patients with acute sinonasal infection with that aspirated by healthy adults during sleep.Study Design: Sixteen patients who had received a diagnosis of acute sinonasal infections by accurate history, anterior rhinoscopic examination, and radiological assessment and 13 healthy volunteers, aged 14 to 45 years.Methods: A 10-mCi dose of technetium 99m-labeled macroaggregated albumin (Tc-99m MAA) with a concentration of 1 mCi/mL was prepared at midnight, just before sleep. Each subject was administered two puffs of this spray. At 8 AM the next morning transmission and emission views of the thorax were taken with a gamma camera.Results: No significant difference between the two groups was observed in the amounts of nasal secretions aspirated into the lungs.Conclusions: The amount of nasal secretions aspirated does not increase during acute sinonasal infection. However, by irritating the mucosa of the lower respiratory tracts, bacteria, toxins, and inflammatory products existing in purulent secretions may play a major role in the pathophysiology of asthma and sinusitis.
Objective: This study aimed to evaluate the presence of reactive oxygen species in laryngeal canc... more Objective: This study aimed to evaluate the presence of reactive oxygen species in laryngeal cancer tissue, using a luminol-amplified chemiluminescence method.Materials and methods: Fourteen patients with histopathologically diagnosed laryngeal squamous cell carcinoma were enrolled. Patients with recurrent tumours or a history of prior chemotherapy or radiotherapy were excluded. Tissue specimens were harvested both from the tumour itself and from the neighbouring, apparently normal mucosa (immediately after tumour removal). Tissue specimens were washed with ice-cold saline solution and processed immediately, without storage. The level of reactive oxygen species was measured quantitatively by a luminol-amplified chemiluminescence method.Results: The mean luminol-amplified chemiluminescence values for tumour and control tissue were 140.52 (standard error of the mean 40.21) and 121.36 (standard error of the mean 35.33) relative light units/mg tissue, respectively. Furthermore, mean tumour and control luminol chemiluminescence values were compared for stage one and two tumours versus stage three and four tumours. Both the tumour and the control luminol chemiluminescence values for the latter tumour group were significantly higher than those for the former tumour group.Conclusion: This study measured directly the levels of reactive oxygen species in samples of laryngeal cancer tissue and normal mucosa. Higher levels of reactive oxygen species were found in laryngeal cancer tissue, suggesting a relationship between reactive oxygen species and laryngeal cancer.(Accepted February 04 2010)(Online publication May 20 2010)
Objective: The aim of this study was to investigate the value of dynamic contrast-enhanced magnet... more Objective: The aim of this study was to investigate the value of dynamic contrast-enhanced magnetic resonance imaging (MRI) in the differentiation of posttreatment fibrosis from recurrent carcinoma, by comparing the dynamic contrast -enhancement characteristics of the lesions. Materials and methods: Twenty -six patients with previously treated carcinoma of the head and neck are studied by conventional and dynamic contrast -enhanced MRI at least 6 months after treatment by radiotherapy and/or surgery. Patients are divided into tumor-positive or -negative groups according to the radiological and clinical follow-up and biopsy. Lesion enhancement ratios at each dynamic sequence are calculated. Results: The tumor-positive group consisted of 11 patients, while the tumor -negative group included 15 patients. Between the two groups, lesion enhancement ratios are found to be significantly different ( P b.05). Conclusion: Dynamic contrast-enhanced MRI may be a valuable modality in the differentiation of recurrent tumor from posttreatment fibrotic changes of the head and neck. D
In recent years, microsurgical transplant of the gracilis muscle has been the most widely used te... more In recent years, microsurgical transplant of the gracilis muscle has been the most widely used technique in the dynamic rehabilitation of the smile. The most frequently used donor nerve is the seventh cranial nerve, as it allows for the most physiological rehabilitation, including the rehabilitation of spontaneous smile. An exception to this is the case of bilateral facial paralyses, in which there is no contralateral nerve to be used as a donor. In these cases, it is necessary to use other nerves such as the hypoglossal, the accessory nerve, or the masseter branch of the trigeminal nerve. In this article, we describe a case of dynamic bilateral facial rehabilitation with a bilateral transplant of the gracilis muscle neurotized to the masseter nerve to achieve a strong, symmetrical smile, which is properly controlled by the patient.
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat, 2006
Primary involvement of the middle ear and mastoid mucosa by malignant melanoma (MM) has been rare... more Primary involvement of the middle ear and mastoid mucosa by malignant melanoma (MM) has been rarely reported. We report an 81-year-old Caucasian woman presenting with otalgia, left-sided aural fullness, and hearing loss. Otoscopic examination revealed a purple-colored polyp that appeared to be vascular, occupy left external auditory canal (EAC). The computed tomography scanning showed a mass in soft tissue density, filling the tympanic and mastoid cavities, eroding the mastoid cortex, and invading medial and central parts of the EAC. A biopsy was performed with the diagnosis of MM. The patient underwent subtotal temporal bone resection with radical neck dissection. Dacarbazine was given postoperatively. The case presented herein emphasizes the need to be aware that MMs can arise in the middle ear and mastoid cavity. An index of suspicion in the differential diagnosis of temporal bone tumors is necessary for early recognition.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2002
Atherosclerosis and tympanosclerosis are disorders that affect different organs in the body. When... more Atherosclerosis and tympanosclerosis are disorders that affect different organs in the body. When tissue samples taken from atherosclerotic and tympanosclerotic lesions are compared under light and electron microscopes, common pathological characteristics become apparent in both tissues. These similarities indicate that genetic predisposition to atherosclerosis is also seen in the middle ear. For the purpose of evaluating this genetic predisposition, the incidence of tympanosclerosis in atherosclerotic patients was examined and compared with the normal population. Otoscopic examination of 1,024 atherosclerotic patients was performed, and myringosclerosis was revealed in 66.6%. Myringosclerosis was found in 36 out of 300 non-atherosclerotic patients (12%). In the group of atherosclerotic patients, 174 individuals had past histories of previous ear infections. Myringosclerosis was detected in 147 of these patients (84.5%) during ear examinations. In 637 non-atherosclerotic patients with histories of ear infections, this figure was 114 (17.7%). The high rate of tympanosclerosis observed in atherosclerotic patients in comparison to the normal population was found to be statistically significant. These findings indicate that there must be a genetic predisposition for sclerotic degeneration in some individuals.
This study has been performed between December 1990-March 1991 in the Microsurgery laboratory of ... more This study has been performed between December 1990-March 1991 in the Microsurgery laboratory of the Marmara University Hospital. Twelve healthy albino guinea pigs were used as a study group while the control group consists of three animals. The potentials for cholesteatoma formation of the squamous epithelium, namely the squamous epithelium of the posterior superior part of the external ear canal skin and normal skin, were investigated. Among 24 subjects who were implanted by canal skin, cholesteatoma was formed in 21 of them. Likewise, 19 of 24 animals implanted by normal skin came out with cholesteatoma formation. Between these two types of epithelium, there is no statistical difference in cholesteatoma formation (p > 0.5).
Résumé/Abstract Our study documents the anatomy of the middle ear of the guinea pig. The relative... more Résumé/Abstract Our study documents the anatomy of the middle ear of the guinea pig. The relative similarities to and differences from the human middle ear are noted. The guinea pig's ossicular chain, which involves two ossicles, the projection of the cochlea into the middle ear cleft, and the relatively greater space of the inferior chamber, are essential differences. Many similarities were found, such as the relationship of the facial nerve to the oval window
We report a case of Merkel cell carcinoma with parotid lymph node metastasis. The pathology, clin... more We report a case of Merkel cell carcinoma with parotid lymph node metastasis. The pathology, clinical appearance and management of this rare tumor are discussed.
ORL; journal for oto-rhino-laryngology and its related specialties, 1990
Collet-Sicard syndrome is one of the jugular foramen syndromes in which the last four cranial ner... more Collet-Sicard syndrome is one of the jugular foramen syndromes in which the last four cranial nerves are involved whereas the sympathetic plexus is spared. It is very uncommon to find facial paralysis associated to this syndrome and most interestingly, a hemangiopericytoma at this location to cause all these paralyses. We have not been able to find a similar case in the literature, and thus present our case.
Many ENT surgeons are accustomed to perform stapedectomy in a hospital setting. We present our re... more Many ENT surgeons are accustomed to perform stapedectomy in a hospital setting. We present our results with 19 patients on whom stapedectomies were performed in an outpatient setting. In respect of hearing gain and complications, our results are not significantly different from the results of those series of stapedectomies performed in hospital. Thus, we believe that stapedectomy can be performed as an outpatient procedure.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2001
Tympanostomy tube insertion is an accepted treatment for otitis media with effusion in children. ... more Tympanostomy tube insertion is an accepted treatment for otitis media with effusion in children. Several clinical studies have shown that tube insertion may cause myringosclerosis. During the period 1988 to 1997 we treated 533 ears from 311 children who had otitis media with effusion by inserting tympanostomy tubes. Most of these (431 ears from 251 children) were re-examined in 1998 and sex and occurrence of myringosclerosis at the tube insertion site were noted. Myringosclerosis was observed in 31% of ears of girls treated with tubes, whereas in boys 71% of ears showed myringosclerosis. This difference between sexes may indicate a genetic predisposition such as that seen in atherosclerosis.
1. Ear Nose Throat J. 1994 Oct;73(10):782-4. Massive epistaxis due to intracavernous carotid arte... more 1. Ear Nose Throat J. 1994 Oct;73(10):782-4. Massive epistaxis due to intracavernous carotid artery aneurysm: a case report. Batman C, Tutkun A, Koc A, Uneri C, Sehitoglu MA, Pamir N. Department of Otolaryngology Head and Neck Surgery, Marmara University School of Medicine, Istanbul, Turkey. PMID: 7805601 [PubMed - indexed for MEDLINE]. Publication Types: Case Reports. MeSH Terms. Adult; Arteriovenous Fistula/complications*; Arteriovenous ...
Archives of otolaryngology--head & neck surgery, 1995
To determine and compare the therapeutic efficiency of ciprofloxacin hydrochloride and gentamicin... more To determine and compare the therapeutic efficiency of ciprofloxacin hydrochloride and gentamicin sulfate in the treatment of chronic ear disease. Prospective randomized study. Academic tertiary medical center. Consecutive referred sample of 44 patients with chronic suppurative otitis media randomized into two groups. Ciprofloxacin hydrochloride (200 mg/mL) was administered to the first group (composed of 24 patients), while the second group (composed of 20 patients) received gentamicin sulfate (5 mg/mL) locally, five drops three times a day for 10 days. In the ciprofloxacin group, 21 (88%) of the 24 patients with suppurative chronic otitis media were cured. On the other hand, only six (30%) of the patients in the gentamicin group were cured. The rest of the patients showed no clinical or bacteriological improvement. To our knowledge, this is the first study to compare the efficiency of two topical otic preparations in the treatment of chronic ear disease. The results show that topical ciprofloxacin preparation is more efficacious and efficient than topical gentamicin for the treatment of chronic otitis media in the acute stage.
The aim of this study was to observe histopathologic and ultrastructural ciliary changes by SEM a... more The aim of this study was to observe histopathologic and ultrastructural ciliary changes by SEM and TEM in the mucosaof the regenerating sinus and to evaluate mucociliary activity within the nasal cavity at the same time after ESS.
The authors review their 5 years' experience with endonasal endoscopic repair of the anterior sku... more The authors review their 5 years' experience with endonasal endoscopic repair of the anterior skull base fistulas presenting with cerebrospinal fluid (CSF) rhinorrhea. A total of 12 patients were managed endoscopically between 2004 and 2008. Seven patients (58.3%) had nonsurgical posttraumatic CSF rhinorrhea, 2 patients (16.7%) had CSF rhinorrhea due to surgical/iatrogenic trauma, and 3 patients (25%) had spontaneous onset of CSF rhinorrhea. Radiosurgical correlation for CSF fistula identification was positive in all patients. The most common site of leak was the fovea ethmoidalis. The repair method consisted of an extradural underlay closure of a defect with fascia lata. The largest diameter of a defect to be closed was 15 mm. Immediate results were good in all patients, but later in the follow-up, CSF rhinorrhea recurred in 2 patients, and each patient had a revision 2 times. In the first revisions, transcranial approach was used, whereas in the second revisions endonasal endoscopic route was resorted. The primary closure rate was 83.3%, and the overall closure rate was 100%. The average follow-up period thus far is 21 months. Endonasal endoscopic technique well known to otolaryngologists should be considered as the first choice of surgery in the repair of CSF rhinorrhea because of low morbidity and a higher closure rate. The possibility of revision with the same technique makes this approach ideal for the repair of cranionasal osteodural defects.
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