Murat Yariktas

Background: Allergic rhinitis is the most common chronic disease in the upper respiratory tract, requiring better diagnostic methodology to counteract its onslaught. The purpose of this study was to investigate the association between Toxocara seropositivity and allergic rhinitis. Methods: Sixty-four consecutive patients with allergic rhinitis and 61 healthy volunteers in the control group were included in this study. The diagnosis of allergic rhinitis was defined by positive epicutaneous prick test. The diagnosis of toxocariasis was established by IgG and specific IgE antibodies against Toxocara by ELISA method. All cases were examined for intestinal parasites also. The seropositive cases with Toxocara were reevaluated for symptoms and signs of toxocariasis. Results: Higher toxocariasis seropositivity (ELISA IgG; 28.1%) rate was determined in the patients with allergic rhinitis and compared with the control groups (11.5%; p < 0.05). Specific IgE seropositivity (17.2%) was high for the patients with allergic rhinitis compared with the control group (3.3%; p < 0.05). Conclusion: Our results show that there was a possible causal relationship between Toxocara infection and allergic rhinitis. Patients with allergic rhinitis from a region with high prevalence for this parasitic infection should be evaluated for Toxocara infection.

Although choanal polyps frequently arise from the maxillary sinus, a choanal polyp originating from the inferior turbinate is a rare entity. A 14-year-old girl who had a history of bilateral nasal obstruction with snoring, mouth breathing and nasal discharge for 10 years was presented. On endoscopic examination, a polypoid mass completely obliterated the right nasal cavity. The left choana was also totally occluded by the polypoid mass. Endoscopic polypectomy was performed and it was observed that the polyp originated from the right inferior turbinate. Choanal polyps arising from the inferior turbinate should be kept in mind in the differential diagnosis of unilateral nasal polypoid masses.

The purpose of this study was to examine the changes in nitric oxide (NO) level in the nasal and paranasal sinus mucosa after exposure radiofrequency electromagnetic fields (EMF). Thirty male Sprague-Dawley rats were randomly grouped as follows: EMF group (group I; n, 10), EMF group in which melatonin received (group II; n, 10) and the control (sham operated) group (group III; n, 10). Groups I and II were exposed to a 900 MHz. Oral melatonin was given in group II. Control rats (group III) were also placed in the tube as the exposure groups, but without exposure to EMF. At the end of 2 weeks, the rats were sacrificed, and the nasal and paranasal sinus mucosa dissected. NO was measured in nasal and paranasal mucosa. The nasal and paranasal sinus mucosa NO levels of group I were significantly higher than those of the control group (group III) ( P < 0.05). However, there was no statistically significant difference between group II and the control group (group III) regarding NO output ( P > 0.05). Exposure to EMF released by mobile phones (900 MHz) increase NO levels in the sinus and nasal mucosa. Increased NO levels may act as a defense mechanism and presumably related to tissue damage. In addition, melatonin may have beneficial effect to prevent these changes in the mucosa.

Eczematous external otitis, because of its basic allergic nature, tends to be chronic or recurrent. The purpose of our study was to investigate the association between allergic contact dermatitis and chronic eczematous external otitis. Sixty-six patients with eczematous external otitis and 48 healthy volunteers were included in this study. All the patients were tested with an epicutaneous patch test. In the study group, the average recurrent attack rate was 6.1+/-1.5 (between 4-9 times during the last year) in the patch test positive eczematous external otitis patients, and 4.9+/-1.3 (between 4-8 times during the last year) in the patch test negative patients (p = 0.002). The epicutaneous patch test was positive in 19 (28.8%) out of 66 cases with chronic eczematous external otitis, and in 3 (6.3%) out of 48 cases in the control group. The difference between the two groups was statistically significant (p = 0.003). The most common reactions were due to neomycin sulfate and potassium dichromate in this study. These results suggest that, in some cases eczematous external otitis may be considered as a form of delayed type hypersensitivity to allergen stimuli. Patients suffering from eczematous external otitis symptoms should be investigated for allergens.

To investigate the incidence of toxoplasmosis in patients with lymphoid hyperplasia of the head and neck. In this study, 53 patients (32 males, 21 females; mean age 11.2+/-4.3 years, range 5 to 22) were investigated. There were hypertrophic tonsillitis in 13 patients, hypertrophic tonsillitis and adenoid hyperplasia in 22 patients, adenoid hyperplasia in 10 patients, and lymphadenopathy of the neck in eight patients. In venous blood samples, IgM and IgG antibodies for Toxoplasma gondii were investigated with the enzyme-linked immunoabsorbent assay (Axsym, Abbott). Positive IgG was determined in 23 patients (48%) with hypertrophic tonsillitis (n=6), hypertrophic tonsillitis and adenoid hyperplasia (n=10), adenoid hyperplasia (n=3), and lymphadenopathy of the neck (n=4). Positive IgM was determined in 5 patients (9.4%) with hypertrophic tonsillitis (n=1), hypertrophic tonsillitis and adenoid hyperplasia (n=1), and lymphadenopathy of the neck (n=3). Toxoplasmosis, which is known to cause lymphadenopathy, may be a reason for lymphadenopathy of the neck. Toxoplasmosis should be considered in the differential diagnosis of untreated patients with tonsillitis, adenoid hyperplasia, and chronic neck lymphadenopathy.

Identification of the pathogen is crucial for the selection of an appropriate antibiotic in the management of sinusitis. We describe an original instrument that provides contamination-free culture from the sinus in endoscopic sinus surgery.