Combined Surgical Approach Via Orbitozygomatic Craniotomy and Endoscopic Sinus Surgery for Giant Frontoethmoidal Osteoma Spreading into Orbit and Anterior Cranial Fossa

 

Abstract

Introduction: Osteoma is the most common benign paranasal sinus tumour. In majority of cases, it is asymptomatic and is diagnosed by chance. We report on a case of giant frontoethmoidal osteoma with intraorbital and intracranial spread. Combined surgical approach was chosen for management of this case. Immediate reconstruction of medial orbital wall and anterior skull base was performed.

Case Description: 25 years old man presented to otorhinolaryngology department due to incidental computed tomography finding. Giant osteoma of the right frontoetmoidal region spreading into an orbit and anterior cranial fossa was identified on computed tomography. The patient was absolute candidate for surgical treatment. Magnetic resonance imaging was performed to view possible involvement of adjacent intraorbital and intracranial anatomical structures. Right side orbitozygomatic craniotomy and endonasal endoscopic surgery were performed for removal of osteoma. On control computed tomography 12 months after surgery there were no pathological changes or reccurrence of osteoma.

Conclusion: Surgical approach for osteoma management should be chosen according to its size, localization and involvement of adjacent anatomical structures. For giant osteomas, spreading outside paranasal sinuses, endoscopic approach perspectives are limited. Multidisciplinary approach is of a vital importance to achieve the best treatment outcome.

Keywords:Frontoethmoidal osteoma; giant osteoma; bicoronal incision; orbitozygomatic craniotomy; FESS

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A Systematic Literature Review of Music Induced Hearing loss

 

Abstract

Music induced hearing loss is caused by listening to loud music on Personal Music Players (PMP) or attending discotheques regularly over a period of time. Exposure to loud music causes physiological changes and damage in the Basilar Membrane especially to the Outer Hair Cells, Inner Hair Cells, and the Auditory Nerve. Damage includes loss of sensitivity to soft sounds, presence of recruitment, tinnitus, reduced frequency selectivity and reduced flow of synapses and information to the auditory cortex. This leads to poor auditory discrimination and reduced temporal fine structure of sounds and poor pitch perception. Hearing loss acquired due to exposure to intense loud music, is typically greatest over the frequency range 3–6 kHz, hence the high frequency hearing loss. Numerous studies done on threshold changes, temporary threshold shift and permanent threshold shift using Pure Tone Audiometry and Oto-Acoustic Emission have indicated high frequency hearing loss in young adults after exposure to loud music at discotheques, overuse of Personal Music Players (PMP) in teenagers and children. Pure Tone Audiometry (PTA) changes weren’t noted, however Oto-Acoustic Emissions (OAE) showed changes and indication of high frequency hearing loss and tinnitus was noted as a symptom after loud music exposure.

Keywords:PTA: Pure Tone Audiometry; OAE: Oto-Acoustic Emissions; PMP: Personal Music Players; MIHL: Music Induced Hearing Loss; TM: Tympanic Membrane

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Effectiveness of Current Physiotherapy in Osteoarthritis of the Knee

 

Abstract

Osteoarthritis (OA) of the knee is a multifactorial disease that develops with many causes such as aging, obesity, genetic factors, and mechanical load. The main symptoms of OA are the initial degeneration and destruction of knee articular cartilage, and the mechanical load and accumulation of abnormal bone turnover (bone resorption and formation) that occurs in the subchondral bone. Until now, physiotherapy approaches for knee OA have been focused on as the main pathological conditions of articular cartilage destruction and bone changes around the joints. However, in recent years, it has been perceived as a regression change in all joint components, including the meniscus, joint capsule, ligaments, and muscles. The purpose of this review is to explain current physiotherapy methods applied to knee OA patients and the findings of research on this subject.

Keywords:After knee osteoarthritis; physiotherapy; rehabilitation; conservative therapy; total knee arthroplasty

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Platelet Mass Index as A New Factor in Tinnitus Etiology

 

Abstract

Introduction: Although there are numerous studies on the etiology and treatment of tinnitus, most have not provided a definitive conclusion. Vascular and hematological abnormalities play an important role in the etiology of tinnitus. In this study, we aimed to evaluate the usability of the platelet mass index as a new inflammatory marker in patients with tinnitus.

Material and Method: The detailed medical records (examination notes, drug use, radiological evaluations, audiological evaluations, and previous vascular-cardiac-autological surgical procedures) of 1,079 tinnitus patients presenting to our clinic between January 2019 and May 2020 were examined, and a retrospective hemogram evaluation was performed in 176 patients meeting the inclusion criteria in tinnitus group. As the control group, 190 people were selected from individuals that presented to the outpatient clinic without otologic complaints. Age, gender, erythrocyte (RBC), hemoglobin (HGB), neutrophil (NEU), lymphocyte (LYM), platelet (PLT) and mean platelet volume (MPV) were examined, and the neutrophil-lymphocyte ratio (NLR), plateletlymphocyte ratio (PLR) and platelet mass index (PMI) were calculated, and the results were compared between the tinnitus and control groups.

Statistical analysis and results: There were no statistically significant difference between the control and tinnitus groups in terms of mean age, gender, and RBC, NEU, LYM, PLR and NLR levels (p>0.05 for all). The HGB and MPV levels were significantly higher (p<0.001 for both) and the PLT level was significantly lower (p = 0.033) in the tinnitus group compared to the control group.

In addition, the PMI value of the tinnitus group was statistically significantly higher than that of the control group (p<0.001).

Discussion and conclusion: This study was the first to investigate PMI in tinnitus patients, and this index was found to be higher in this patient population. This supports the idea that PMI can be used as an inflammatory marker in tinnitus. PMI can reveal platelet functions more clearly since it provides the opportunity to simultaneously evaluate the volume and number of platelets. However, since the relationship of PMI with tinnitus severity was not examined in this study, further detailed studies are needed on this subject.

Keywords:Tinnitus; platelet mass index; inflammatory marker; mean platelet volume; platelet

 

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