This is a case report about a rare oropharyngeal foreign body causing oropharyngeal symptoms such as sore throat, dysphagia and hemoptysis. We reported a 7 year-old boy who had ingested a leech from a bottle which had been fi lled with water and it had attached to the palate within 4 days. The leech was identifi ed as approximately 3 cm in length. Leech was removed under premedication by using monopolar cauterization. Although child infestation by a leech in the upper respiratory tract is very rare, it should be investigated when contaminated liquids are ingested. Electro cauterization should be borne in mind as a therapeutic option in the treatment of leech infestations in the upper respiratory tract under pre-medication in pediatric patients. ( ÖZETBu vakada hemoptizi, disfaji ve boğaz ağrısı gibi semptomlara yol açan bir orofarengeal yabancı cisim tartışılmıştır. İçi su ile dolu ve sülük bulunan şişeden su içen ve 4 gündür şikayetleri bulunan 7 yaşında erkek hastanın, yumuşak damağına yapışık halde bir kitle tespit edilmiştir. Kitle yaklaşık 3 cm uzunluğunda olup, sülük olarak tanımlanmıştır. Premedikasyon altında monopolar koter kullanılarak sülük alınmıştır. Üst solunum yollarında sülük infestasyonu nadir olmasına karşın, sülük ile kontamine su içen kişilerde görülebilmektedir. Çocuk hastalarda üst solunum yollarında sülük tespit edildiğinde, premedikasyon altında elektrokoterizasyonun bir tedavi seçeneği olabileceği unutulmamalıdır.

Silicon rings for modified expanded voice prosthesis seems to be an effective treatment for persistent peri-prosthetic leakage, for both, fistula closure and preserving the patients speech.

The aim of the study was to evaluate the effects of high altitude (HA) on the expiratory nasal sound spectra. The design consisted of a prospective analysis. The study group consisted of 24 otorhinolaryngologists and a student (2 females, 23 males) climber of the mountain of Kackar in Rize, a city located in northeastern Turkey. The elevation of the highest peak of the Kackar Mountain is 3,937 m (12,920 ft) and that of mountain plateaus at about 3,000 m (9,800 ft). Nasal sound spectral analysis was performed on 25 subjects at 700 and 3,937 m, respectively. We found that sound intensity (dB) at high frequency (Hf) was below 18.6 dB in the subjects at low altitude, while the results were found to be above 25.1 dB in the subjects at HA during expiration. A correlation was observed between the degree of HA and 'Odiosoft-rhino' findings at Hf intervals of the subjects. At the top of the mountain, the sound intensities at low and medium frequency were observed to be significantly lower than at low altitude (p < 0.05). We concluded that Hf values of HA were significantly higher than at low altitude because of nasal congestion and also narrowing of the cross-sectional area of the nasal airway. Nasal conchal and mucosal congestion affects airflow through the nasal cavity at HA, transforming it from a laminar pattern to turbulent flow. We found significant increases in the sound intensity level at Hf in the sound spectra at HA. Awareness of the impact of HA in nasal airflow is important in the diagnosis and treatment of nasal obstruction symptoms.

The aim of this study was to investigate the impact of high altitude on nasal and lower airway parameters in a healthy population. This was a prospective study of 61 individuals who climbed to the summit of Mount Kackar, at 3,937 m. Peak nasal inspiratory flow rates were recorded in all participants at sea level and at the summit. In 32 participants who ascended to the summit, sea-level and summit peak expiratory flow rates and olfactory function were evaluated. A rise in altitude significantly decreased peak nasal inspiratory flow by a mean of 27.43%. Mean peak expiratory flow values measured at the summit were 8.94% lower than basal values. Between-value differences were statistically significant (p < 0.001, p < 0.05). At high altitude, there was a significant decrease in olfactory function, as determined by a significant reduction in smell detection (p < 0.05) and smell identification (p < 0.05). The effect of high altitude on nasal function was found to parallel that of the effect on lower airway function, together accounting for an adverse effect on airway flow rates. The nasal mucosa responded to high altitude with an increase in airway resistance and a consequent impaired sense of smell.

The objective of this study is to investigate the effect of topical and systemic enoxaparin sodium on the healing pattern of experimentally induced tympanic membrane perforation and formation of myringosclerosis. A total of 24 Wistar-Albino strain rats were included in the study. Standard myringotomies were performed on each rat. In the first group, isotonic serum physiologic was dropped on external ear canal (control group). Topical enoxaparin was dropped on external ear canal and daily topical doses of enoxaparin were dropped on external ear canal of the rats for 14 days (topical treatment group). Third group received subcutaneous injections of enoxaparin for 14 days (systemic treatment group). Five micrometer thick sections of the bullae of the rats were stained with H&E. Inflammation, edema and sclerotic lesions and neovascularization observed in the lamina propria layer of the tympanic membrane, and total thickness of the tympanic membrane were evaluated. In intergroup comparisons, significant difference in the distribution pattern of severity of inflammation in all three groups was not observed (p = 0.784, p > 0.05). Total TM thickness differed among all three groups (p = 0.028, p < 0.05). A statistically significant difference was observed between the systemic enoxaparin and the control groups (p = 0.022, p < 0.05). A statistically significant difference was observed between the topical enoxaparin and the control groups (p = 0.037, p < 0.05). However, comparison between the topical and systemic treatment groups could not reveal any statistically significant intergroup difference (p = 0.682, p > 0.05). A significant difference was not observed among three groups as for the distribution of myringosclerotic plaques, severity of edema and neovascularization in the lamina propria (p = 0.539, p > 0.05), (p = 0.063, p > 0.05), (p = 0.152, p > 0.05). Topical and systemic enoxaparin treatment did not prevent formation of sclerotic plaques; however, it decreased TM thickness significantly in comparison with the control group.