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    Autoclaving the ossicles provides safe autografts in cholesteatoma
    (Elsevier Sci Ltd, 2002) Miman, MC; Aydin, NE; Öncel, S; Özturan, O; Erdem, T
    Objective: The choice of the graft in ossicular chain reconstruction during middle ear surgery for cholesteatoma is a subject still discussed on. In order to clarify the discussion of reuse of the autologous ossicles obtained during middle ear surgery for cholesteatoma. we evaluated the probability of residual disease histologically and the safety of the ossicles after autoclavization, the most promoting alternative method to eradicate residual cholesteatoma and infection on them. Methods: The specimens used in this study were eroded twenty-seven ossicles (22 incuses, 5 malleoli) which were removed from the 27 consecutive patients operated because of cholesteatomato us middle ear disease. They were grouped as follows: Group 1, Fifteen ossicles examined histopathologically directly. Group 2, Five ossicles autoclaved for 20 min at 134 C and then examined histopathologically. Group 3, Five ossicles autoclaved for 20 min at 134 C after mechanical surface cleaning by a fine diamond drill, examined histopathologically. Group 4, Two ossicles removed from two different patients were placed in their mastoid cavities in order to be examined after access in the second-look operation. While one ossicle was only autoclaved, the other was mechanically cleaned by a drill before autoclavization (for 20 min at 134 C). The ossicles were examined histopathologically after the removal at the second stage operation performed 12 months later. Results: In Group 1, all ossicles showed evidence of periosteal thickening. Additional findings were surface cholesteatoma or epithelia in 13 ossicles, surface inflammation in 12 ossicles, granulation tissue in 10 ossicles, osteitis in six ossicles. In Group 2, all five ossicles had preserved their lamellar structure but, no vital cells were seen. The lacunes that had the osteocytes was almost completely empty. The inflammatory cells were eliminated from the ossicles. In Group 3, ossicles were found well preserved with their lamellar structures and contours, with empty lacunes and eliminated inflammatory cells. In Group 4, in two ossicles of this group the lacunes were replaced by the new migrated viable osteocytes with evidence of new bone formation and neovascularisation. No new inflammatory focus or epithelia were found on the surfaces of the ossicles. The shape and the contour of the ossicles remained unchanged. Conclusion: In cholesteatoma surgery, ossicles with minimal erosion and adequate thickness can be used after autoclavization. In this study, it was observed histopathologically that the autoclaving autologous ossicles before ossiculoplasty in cholesteatomatous middle ear is a safe and reliable method. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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    Internal nasal valve
    (Mosby, Inc, 2006) Miman, MC; Deliktas, H; Özturan, O; Toplu, Y; Akarçay, M
    OBJECTIVES: Comprehensive examination of the internal nasal valve (INV) using objective methods. STUDY DESIGN AND SETTING: In this prospective study, 248 nasal cavities were examined by nasal endoscopy, acoustic rhinometry (ARM), and rhinomanometry (RMM). RESULTS: Endoscopic examination allowed to suggest a novel classification of INV: convex, concave, sharp angle, blunt angle, twisted caudal border, and angle occupied by the septal body. The INV angle occupied with septal body type was found to have increased nasal resistances compared with the sharp-angled internal nasal valve type (P < 0.05). Convex, concave, and sharp-angle types of INV angles were found different (P < 0.01). CONCLUSIONS: INV should be examined objectively before any INV surgery. A novel description of the INV configurations and their effects on nasal respiration found in this study may increase our understanding and lead surgical approaches more adequately. A surgical attempt to augment INV angle value may impact positively on nasal resistance. EBM rating: C-4 (C) 2006 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. All rights reserved.
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    Nasal carriage of methicillin-resistant Staphylococcus aureus among smokers and cigarette factory workers
    (Luigi Ponzio E Figlio, 2001) Durmaz, R; Tekerekoglu, MS; Kalcioglu, T; Özturan, O
    Effects of smoking and tobacco on nasal carriage and colonisation rates of Staphylococcus aureus were investigated on 368 healthy males aged between 30 and 40 years old. The study group comprised 100 non-smokers (control group), 91 smokers, and 177 cigarette factory workers (42 smokers, 135 non-smokers). Quantitative cultures were done from the nasal swabs of all participants. After identification and determination of colony counts, S. aureus strains were tested for methicillin resistance using the oxacillin disk diffusion method. The rates of nasal carriage of S. aureus were found to be 30% in the control group, 33% in smokers, and 41% in cigarette factory workers. Overall, S. aureus colonisation (greater than or equal to 500 cfu/ml) was detected in 72% of the carriers (55/76). Colonisation rates were 43%, 63%, and 85% in the carriers of the study groups, respectively. An increasing colonisation rate was detected in accordance with the increasing number of cigarettes smoked per day, and smoking period. While methicillin-resistant Staphylococcus aureus was only found in 3% of the 30 S. aureus strains isolated from the control group, its isolation rate was 20% in the 30 S. aureus isolates of the smokers, and 33% in the 72 S, aureus isolates of the cigarette factory workers. These results indicate that cigarette and/or tobacco appear to have noticeable effects on the ecology of the nose.