Evaluation of clinical parameters in patients with obstructive sleep apnea and possible correlation with the severity of the disease

Obstructive sleep apnea (OSA) is a complex disease whose etiology is multifactorial and incompletely understood. This article focuses on upper airway anatomy evaluation and the standardization of different physical findings in patients with OSA and on the possible correlation of these physical findings with the severity of the disease. All patients underwent a physical examination and polysomnography. The physical examination included tonsil size, modified Mallampati grade, neck circumference, lateral clinical craniofacial assessment and body mass index (BMI). The study group consisted of 85 patients. A statistically significant correlation between tonsil size and BMI and with the respiratory disturbance index (RDI) was detected (P = 0.004 and 0.03 respectively). Also patients with a craniofacial anomaly have a higher RDI level than the patients without this anomaly (P = 0.03). This study has identified some standardized physical findings for predicting the severity of OSA. We aim to benefit from these findings in the selection of a rational treatment modality selection for patients with OSA.

Basaloid squamous cell carcinoma of the supraglottic larynx

Basaloid squamous cell carcinoma (BSC) is regarded as a variant of squamous cell carcinoma, but displays distinct morphological and biological features as well as a different clinical course. The tumor is frequently seen in the head and neck and is preferentially located in the larynx, especially in supraglottic sites. Ten patients with BSC of the supraglottic larynx were treated from 1991 to 1995 at the Medical Faculty of the University of Istanbul. Results of treatment were compared retrospectively with a control group consisting of 44 patients with well-differentiated squamous cell carcinomas. Ages, localizations, stages and treatment procedures were similar. In both groups mean survival, nodal involvement and distant metastases were comparable although the local (laryngeal) recurrence rate in patients with early supraglottic (T2) disease in the BSC group after conservative partial surgery was distinct compared to the control group (P < 0.05). These results indicate that conservative surgery should be assessed with caution in patients with BSC, and postoperative irradiation be taken into consideration.

Sudden total bilateral deafness due to asymptomatic mumps infection

Mumps is the most common cause of unilateral acquired sensorineural hearing loss in children. Although it usually affects the salivary glands. the inner ear may be involved. Deafness is usually unilateral, sudden in onset, profound and permanent. Bilateral total sensorineural hearing loss had been rarely reported in English literature. We present a case of total deafness due to asymptomatic mumps infection.

Tuberculosis of the parotid gland

The presentation of tuberculosis as an isolated parotid lump is rare. In this paper, six cases with tuberculous parotitis are reported which were evaluated as a benign parotid neoplasm in 216 specimens pre-operatively. All but one of them had no previous history of tuberculosis and all had a parotid lump as a sole symptom for at least one year. The diagnosis of tuberculosis was made, after superficial parotidectomy, by histopathology. Parenchymal involvement and intraparotid lymph node involvement with tuberculosis were seen in five and three patients, respectively. Two of the patients had lymph node involvement outside the parotid area. One of six patients had a coincidental Warthin tumour. A surgical approach is not only therapeutic but also diagnostic when other diagnostic tools fail.