Absence of both stapedius tendon and muscle

During surgery for otosclerosis, it is common for the surgeon to cut the stapedius tendon. The absence of the stapedius muscle with its tendon is uncommon. In this study, we present a case of the absence of the unilateral stapedius tendon and muscle. During dissections of adult temporal bones, the absence of the stapedius tendon and muscle was found in one case. The tympanic cavity was explored with the help of a surgical microscope. The pyramidal process was not developed. A possible ontogenetic explanation was provided. In the presented case, the cause of the anomaly may be failure of the embryological development of the muscle. Awareness of the variations or anomalies of the stapedius muscle and tendon are important for surgeons who operate upon the tympanic cavity, especially during surgery for otosclerosis.     

Reversal of vision metamorphopsia: a manifestation of focal seizure due to cortical dysplasia

Upside-down reversal of vision has rarely been reported in the literature. The reported causes are diverse, including posterior circulation stroke, tumors, trauma, and multiple sclerosis. The term seizure has been used in only two cases in the literature, the cause of which was stroke. To our knowledge, this is the first reported case of cortical dysplasia in the posterior parietal cortex as the cause of complex partial seizures beginning with upside-down reversal of vision. As the pathophysiological characteristics of this phenomenon remain unclear, this case implies that the posterior parietal cortex is a possible anatomical localization of the central integrator of visual extra-personal orientation.     

Reference ranges for sonographic dimensions of the liver and spleen in preterm infants

Background

Preterm infants usually have multiple comorbidities that affect spleen and liver. Ultrasonographic measurement of organ sizes is an important and reliable parameter in evaluation of spleen and liver pathology in preterm newborns.

Objective

The purpose of this study was to determine reference values of ultrasonographic measurements of the liver and spleen in preterm newborns.

Materials and methods

We prospectively performed sonography on 498 preterm newborns in the first week of life. We measured spleen and liver dimensions and statistically analyzed relationships between the dimensions and gender, gestational age (based on mother’s last menstrual period), height and weight. Reference ranges of dimensions were defined.

Results

Longitudinal and anteroposterior dimensions of the liver and spleen were statistically significantly different between the boys and girls (P?<?0.05) and showed high correlation with the gestational age, weight and height. Weight was the parameter best correlated with the dimensions.

Conclusion

Nomograms from these data are useful for sonographic evaluation of the liver and spleen in preterm newborns.     

A rare location of sucking blister in newborn: the lips

A male baby was presented with sucking blisters on the upper and lower lips developed immediately after the birth. Although sucking blister which develops on the lips during the postnatal period is known, its prenatal form has not been described previously. We reported a case of sucking blister on the lips which developed during the intrauterine life. In the present case, these lesions resolved spontaneously after 1 day.     

Malaria Epidemiology in Mersin Province,Turkey from 2002 to 2011

Background

Malaria is an infectious disease caused by Plasmodium spp. with high morbidity and mortality in human in tropical and subtropical regions. In recent years, number of malaria cases has been significantly reduced because of fight with the disease in Turkey. This study intended to investigate the malaria epidemiology in Mersin Province from 2002 to 2011 using data from the provincial Public Health Directorate.

Methods

Over ten years, 303573 blood samples were taken from the people by active and passive surveillance methods and blood smears were prepared. Smears were stained with Giemsa and examined under the microscope.

Results

Totally, 73 people including 44 male and 29 female were positive in terms of Plasmodium spp. It was determined that P. vivax observed in 67 cases while P. falciparum in 6 cases. Cases were mainly observed in 15 to 44 years old range, showed an increase between June-September periods and a significant decrease after 2006. Out of the 73 malaria cases, 54 cases were from Mersin Province and 13 cases were imported from another province of Turkey. Six cases were transmitted from abroad.

Conclusion

These results provide information about malaria epidemiology in an endemic area in Turkey and contribute its prevention in Mersin Province.     

Effect of glass fiber reinforcement on the flexural strength of different denture base resins.

OBJECTIVE: Different types of fibers have been added to polymer materials to improve their mechanical properties. Glass fibers have been used in either continuous or woven form as a strengthening material. The aim of this study was to investigate the effect of a new glass fiber reinforcement system on the flexural strength of three different denture base resins (heat polymerized, autopolymerized, and photopolymerized). METHOD AND MATERIALS: Ninety specimens were formed in a specially designed mold to produce identical specimens in accordance with each manufacturer's recommendations. RESULTS: The fibers of Stick and Stick Net were well impregnated with the resin of polymer matrix. Stick and Stick Net reinforcement significantly enhanced the flexural strength of the tested specimens. In all groups, specimens reinforced with Stick glass fibers exhibited the highest flexural strength, followed by Stick Net glass fibers. The control group specimens without fiber exhibited the lowest values. CONCLUSION: The process of reinforcement of denture base resins with glass fiber may be a useful means of strengthening denture bases beyond their normal limits.     

Reconstruction of shallow upper buccal sulcus deformity secondary to cleft lip and palate repair

Shallow upper buccal sulcus deformity, one of the secondary deformities after cleft lip-palate repair, causes both aesthetic and functional problems. This deformity also prevents or makes difficult orthodontic and prosthodontic procedures. An upper buccal sulcus deepening procedure was performed in 14 patients during the last 5 years. In 12 cases, premaxillary-based mucosal flaps were combined with one of the following: lip re-repair, Abbé flap, or bilateral buccal mucosal advancement flaps; in two cases, premaxilla was grafted with buccal mucosal graft together with bilateral buccal mucosal advancement flaps. The follow-up period was 2 to 5 years. Results were satisfactory for the surgeon, orthodontist, prosthodontist, and the patient. Upper buccal sulcus reconstruction with premaxillary thin mucosal flap or full-thickness mucosal graft combined with tissue-sparing techniques provides successful and durable results.     

Temporalis muscle flap for craniofacial reconstruction after tumor resection

Temporalis muscle flap provides a good solution for the reconstruction of craniofacial defects after tumor resection. Nine patients with complicated defects located at the upper two thirds of the face, anterior cranial base, or mastoid region are presented. Five patients had orbital exenteration, two with total maxillectomy and two with anterior craniofacial resection. Temporalis muscle flap provided profuse well-vascularized tissue for the obliteration of orbital exenteration and total maxillectomy cavities and coverage of surface defects. Cranial, oral, and nasal spaces were separated successfully in all patients. Temporalis muscle flap is a very reliable technique with low complication rates and few donor site problems. This safe and technically easy flap can be preferred for the reconstruction of craniofacial defects after ablative tumor surgery, especially in older and debilitated patients.     

Evaluation of osteogenic and chondrogenic activities of prefabricated periallografts

Reconstruction of cartilage and bone defects has always been a challenging problem for the surgeon. Basic elements that are responsible for the repair process of these tissues are periost and perichondrium. Although several methods for the use of periost and perichondrium are proposed in the literature, the osteogenic and chondrogenic capacities of these tissues were shown to be the most important factor for a successful outcome. Bone and cartilage formation in acellular dermal matrix (ADM) prefabricated with periost and perichondrium was studied in 20 New Zealand rabbits. Morphologic and histologic evaluation and comparison of the newly formed tissues were evaluated. Four rabbits were excluded from the study because of infection, and specimens were obtained at 4, 6, 8, and 12 weeks after the study began from the remaining 16 rabbits. A gradual increase in bone and cartilage tissue formation through the 4th to 12th weeks was documented by reason of perichondrium and periost activation infiltrating into acellular dermal allografts. In view of the data obtained, it was concluded that periost or perichondrium prefabricated over ADM may be an alternative technique of cartilage and bone formation that may provide adequate tissue with elastic and osteo- and chondroconductive properties for the reconstruction of challenging defects.     

Fibrous dysplasia of the face: utility of three-dimensional modeling and ex situ malar recontouring

A 20-year-old male with fibrous dysplasia involving the right fronto-orbital and malar regions showed no significant progression of disease by serial computed tomography (CT) scans over 6 years. Two prior attempts to recontour the right maxilla and zygoma in situ and to increase the right orbital volume had been unsatisfactory. To solve the problem of persistent right-sided proptosis and facial asymmetry, a three-dimensional model of the midface and orbits was made on the basis of a pre-operative CT scan. Removable components transformed the model of the affected right side of the midface into a mirror image of the unaffected side, giving a precise indication of where and how much bone needed to be removed. Surgical correction was performed using a right malar osteotomy in which the zygoma was mobilized in continuity with the lateral and inferior orbital rims. This approach gave direct access to the orbit, through which the lateral and medial orbital walls were re-contoured to increase intraorbital volume. The freely mobilized zygoma was then shaped to match the prefabricated model. The zygoma was repositioned, and the affected maxilla was recontoured to blend with the remodeled zygoma. Follow-up CT scan and physical examinations postoperatively demonstrate excellent facial symmetry and correction of right-sided proptosis. When there is no documented progression of fibrous dysplasia in the face over several years, three-dimensional modeling as a guide to ex situ malar recontouring can improve the accuracy of facial reconstruction. This approach also provides direct access to the orbit for the correction of bony orbital volume.