The basic aim of our study is to compare the results of the conventional and piezoelectric osteotomy in rhinoplasty by complete subperiosteal degloving of nasal bone to minimize soft-tissue injury. The study was designed as a prospective, double-blind, randomized, and controlled study. Setting is a tertiary referral hospital in Turkey. Ninety patients who underwent primary open rhinoplasty with osteotomy, performed by either the conventional instruments or the piezoelectric device. The complete subperiosteal degloving of the entire nasal bone was done up to the nasal maxillary sulcus, medial canthus, and nasion in all patients, independent of the type of osteotomy device used. Patients subsequently underwent median-oblique and lateral osteotomy, either with an ultrasonic device or a conventional 2-mm guarded, straight osteotome. The postoperative edema and ecchymosis were evaluated by another surgeon who was blinded to the osteotomy procedure on postoperative days 2 and 7. The edema scores were significantly increased on the second day compared with the seventh day in both groups 1 and 2. However, there was no significant difference between groups. The ecchymosis scores were slightly higher in postoperative day 2, compared with day 7, in both groups 1 and 2, but statistically not significant. This study showed that the main reason edema and ecchymosis are seen post-rhinoplasty is related to soft-tissue injury during osteotomy.

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Background: Epistaxis is a common problem in childhood. It has been shown that children with recurrent epistaxis are more likely to have nasal colonization with Staphylococcus aureus. It has been suggested that lowgrade inflammation, crusting and increased vascularity due to bacterial colonization contributes to the development of epistaxis in children. Aims: This study aimed to investigate the nasal colonization and treatment outcome in pediatric epistaxis patients. Study Design: Retrospective cross-sectional study. Methods: Charts of the pediatric patients referred to our university hospital otolaryngology outpatient clinics for the evaluation of epistaxis were reviewed. The patients whose nasal cultures had been taken at the first clinical visit comprised the study group. Results: Staphylococcus aureus was the most common bacteria grown. The presence of crusting and hypervascularity was not dependent on the type of bacterial growth and there was no relation between hypervascularity and crusting of the nasal mucosa. Thirty-six patients were evaluated for the outcome analysis. Resolution of bleeding was not dependent on nasal colonization; in patients with colonization, there was no difference between topical antibacterial and non-antibacterial treatments. Conclusion: Despite the high colonization rates, topical antibacterial treatment was not found superior to nonantibacterial treatment. Our study does not support the belief that bacterial colonization results in hypervascularity of the septal mucosa causing epistaxis since no relation was found between nasal colonization, hypervascularity and crusting. The role of bacterial colonization in pediatric epistaxis need to be further investigated and treatment protocols must be determined accordingly.

Tiroglossal duktus kistleri, tiroglossal duktusun kısmi veya tam obliterasyon eksikliği ve içindeki epitelin sekretuvar özelliği sonucunda gelişen iyi huylu kistik oluşumlardır. Bu lezyonlar cilde fistülize olabilirler ve tiroglossal kist fistülü olarak adlandırılırlar. Doğuştan boyun kitleleri içinde en sık görülen tiroglossal duktus kistleridir. Foramen çekum ile tiroid bez arasında orta hatta herhangi bir yerde rastlanabilir. Çoğunlukla boyun orta hattında, yutkunma sırasında vertikal doğrultuda hareketli ve ağrısız bir şişlik olarak ortaya çıkarlar. Ultrasonografi, klinik olarak tiroglossal duktus kisti düşünülen hastalarda ameliyat öncesi dönemde yapılacak ilk tetkiktir. Tiroglossal duktus kistlerinin genel olarak kabul görmüş tedavisi cerrahidir. Sistrunk ameliyatı en az nüks oranıyla güvenli ve komplikasyon riski düşük bir cerrahi prosedürdür. Normal anatomik yapıdaki tiroglossal duktus kistleri yanı sıra yazımızda da bir örneği görülen nadir yapıda çift traktlı tiroglossal duktus kistleri görülebilir. Bu yazıda, çift duktus traktlı çift fistül ağızlı bir tiroglossal duktus kistli olgu sunuldu.