AMAÇMaksillofasiyal kırığı bulunan hastalar, bu travmaya eşlik eden kafa travması geçirme konusunda yüksek risk altın-dadırlar. Bu hastalarda kafa travmasının erken anlaşılma-sı hastanın sağkalımı ve iyileşmesi için kritik öneme sahiptir. GEREÇ VE YÖNTEMOcak 2006 ile Eylül 2009 tarihleri arasında hastanemizin acil servisine maksillofasiyal kırık nedeniyle gönderilen 246 hastanın kayıtları geriye dönük olarak tarandı. Hastaların yaş, cinsiyet, maksillofasiyal travmanın nedeni, tipi, yerleşimi ve kafa travması analiz edildi. BULGULARHastaların yaşlarının ortalaması 23,61±16,75 idi (%83,3 erkek, %16,7 kadın). Kraniyal yaralanma maksillofasiyal travmalı 38 hastada gözlendi. Hastalar arasında tek yüz kemiği kırığı bulunanlarda kafa travması riski çoklu kırıklı hastalara göre 3,44 kat daha az gözlenirken (p<0,001), yüz kemiği çoklu kırılan hastalarda kafa travması geçirme riski anlamlı derecede artmıştı (p<0,001). İçinde nazal kemik, maksiller kemik, mandibular kemik ve frontal bölge kırığı bulunan hastalarda kafa travması riski önemli derecede artmıştı (p<0,05 her bir grupta). SONUÇÇoklu yüz kemik kırığı bulunan hastalarda klinik bulguları olmasa dahi kafa travması yönünden araştırılmaları gerekir.Anahtar Sözcükler: Maksillofasiyal travma; kafa travması; yüz kemik kırığı.

Review of the literature was performed to define the optimal treatment of patients with juvenile nasopharyngeal angiofibroma (JNA

It has been suggested that oxidative stress may play an important role in the pathogenesis of chronic otitis media (COM), but the role of oxidative stress in the pathogenesis of COM has not yet been fully explored. Therefore, the aim of this study was to investigate serum myeloperoxidase (MPO) activity, 4-hydroxynonenal (4-HNE), malondialdehyde (MDA), total antioxidant capacity (TAC) and nitric oxide (NO) in patients with COM. Sixty-one patients with COM and 30 controls were enrolled in the present study. Patients were divided into two groups according to the presence (n = 21) or absence (n = 40) of cholesteatoma. Serum MPO activity and 4-HNE, MDA and NO levels were significantly higher in patients with COM than controls (for all, p < 0.001), while TAC levels were significantly lower (for all, p < 0.001). Serum MPO activity and MDA, 4-HNE and NO levels were significantly higher in patients with cholesteatoma than in those without cholesteatoma, while TAC levels were significantly lower; but the difference between groups was not statistically significant (p > 0.05). Increased oxidative stress seems to be associated with decreased antioxidant levels in patients with COM. Thus, increased oxidative stress may play a role in the pathogenesis of COM. It is believed that the administration of antioxidant vitamins such as A, C and E may be useful in preventing and treating COM.

ObjectivesTo underline the effect of oxidative stress in chronic otitis media with and without cholesteatoma and to compare the oxidative stress values in the serum and tissue specimens in these two forms.MethodsThe study included a total of 75 individuals, 35 cases with chronic otitis media (COM; 16 females and 19 males) and a healthy control group of 40 cases (20 females and 20 males). The COM patient group was comprised of 18 patients with cholesteatoma and 17 patients without cholesteatoma. All patients underwent mastoidectomy. Serum specimens were taken prior to surgery and diseased tissue specimens from the ear were obtained during surgery from all patients. Only serum specimens were taken from the healthy control cases. The malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GHPx) were measured in the serum and tissue samples of the patient group and in the serum specimens of the control group.ResultsThe age ranged from 14 to 48 years in the patient group (mean age, 20.4±12.2 years) and from 19 to 40 years in the control group (mean age, 26.4±4.64 years). When the serum values of all COM patients were compared with those of the control group, in the patient group MDA, which reflects lipid peroxidation, was found to be significantly higher (P<0.01) whereas the antioxidant enzymes SOD, CAT, and GHPx were found to be significantly lower (P<0.01). When the serum and tissue MDA, SOD, CAT, and GHPx values in patients with and without cholesteatoma were compared, no significant difference was found these parameters (P>0.01).ConclusionAlthough oxidative stress plays a role in the pathogenesis of COM with or without cholesteatoma, it may not reflect the severity of the disease. In patients with COM, the evaluation of only serum oxidative stress values without tissue evaluation may be sufficient for assessing oxidative stress.

Intraoral synechia is a rarely seen intraoral anomaly. As a result of intraoral synechiae, fusion of the palatal shelves may be prevented because of the abnormal interposition of the tongue. Hence, cleft palate anomaly accompanies intraoral synechiae in many patients. The main problem for these patients is the inadequate oral opening for feeding. Flexible nasopharyngeal examination before intubation may help the anesthetist for simple excision of synechiae in the newborn period. In this article, a newborn who had a congenital synechia between the mandible and the maxilla has been presented, and the etiopathogenesis of intraoral synechia and the importance of flexible nasal endoscopy before endotracheal intubation are discussed.