The aim of this study was to compare anatomic and audiological results of cartilage graft with temporal fascia graft in type 1 tympanoplasty patients with low middle ear risk index (MERI). In this retrospective study, 63 patients that underwent type 1 tympanoplasty with chondroperichondrial island graft between July 2009 and November 2010 were compared with 45 patients in whom temporal muscle fascia was used. Patients in both groups had low MERI values varying between 1 and 3. Five and nine patients underwent masteidectomy in cartilage and fascia group, respectively. Mean duration of follow-up was 11.9 ± 3.7 (5-17) months. Mean value was calculated at pre-operative and post-operative hearing threshold 0.5, 1, 2, 4 kHz, and air bone gap (ABG) gain was compared in both cartilage and fascia groups. when pre-operative and post-operative ABG gain were compared, significant decrease was seen in ABG levels (p < 0.001). However, no significant difference was seen in ABG gain values (p = 0.608), which was 10.1 ± 7.00 dB in cartilage group and 10.8 ± 5.38 dB in fascia group. In both groups, age, sex, and the addition of mastoidectomy procedure had no significant effect on ABG gain and success. Cartilage is a graft material that may be preferred without concern about the effects on hearing results, especially, in patients with low MERI values. The addition of mastoidectomy had no impact on the outcome of operation and audiological results. However, further studies with larger case series may be carried out to further clarify the issue.

Ectopic thyroid gland may be detected at any place between foramen caecaum and normal thyroid localization due to inadequacy of the embryological migration of the thyroid gland. It has a prevalence varying between 1/10.000 and 1/100000 in the community. Usually follow-up without treatment is preferred except for obstructive symptoms, bleeding, and suspicion of malignity. Main symptoms are dysphagia, dysphonia, bleeding, dyspnea, and obstructive sleep apnea. In symptomatic cases, the first described method in surgical treatment is open approach since it is a region difficult to have access to. However, this approach has an increased risk of morbidity and postoperative complications. Transoral robotic surgery, which is a minimally invasive surgical procedure, has advantages such as larger three-dimensional point of view and ease of manipulation due to robotic instruments. In this report, a case at the age of 49 who presented to our clinic with obstructive symptoms increasing within the last year and was found to have lingual thyroid and underwent excision of ectopic thyroid tissue by da Vinci surgical system is presented.

No abstract

The aim of this study was to evaluate changes in nasal and oropharyngeal flora in patients with acne during treatments with tetracycline and isotretinoin. Swab specimens were taken from the right and left nasal cavities and oropharynx of 55 patients with acne and 20 healthy volunteers who were admitted to the dermatology department (Etlik Educational and Research Hospital, Ankara, Turkey) before the administration of treatment and in the third month of treatment. Study participants were divided into four groups as follows: patients with acne on topical treatment only, systemic isotretinoin, and systemic tetracycline, and the control group. Of 55 patients with acne, 18 were male and 37 were female. The mean age of the patients and the control group was 22.21 ± 4.22 and 21.95 ± 7.64, respectively. Staphylococcus aureus was isolated from the nasal flora of five patients, normal flora was suppressed in the oropharyngeal cultures of seven patients, and normal flora grew in the cultures of the other 20 patients who were on tetracycline treatment. On the other hand, normal flora grew in the nasal and oropharyngeal cultures of all the patients who were on isotretinoin treatment. Treatment options and follow-up procedures for acne vulgaris may lead to the development of bacterial resistance and damage to flora. In particular, systemic tetracycline treatment leads to changes in flora of the nose and throat in patients with acne with an increased carriage of S. aureus. Therefore, careful attention should be paid to the duration of tetracycline treatment in order to not increase the risk of disturbance of microbial flora.

These findings suggest that allergic rhinitis decreases the graft success rate of the pathologies occurring in eustachian tube, middle ear and mastoid although statistically significant difference wasn't found. Prospective studies with larger patient groups are required in order to evaluate this pathology.