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Objective: Benign paroxysmal positional vertigo (BPPV) is a disease characterized by typical symptoms and signs that can be diagnosed easily with the Dix–Hallpike maneuver. The aim of our study was to highlight the importance of rapidly diagnosing and treating this situation by referring patients suffering from vertigo and BBPV to an ear-nose-throat (ENT) specialist for appropriate management. Thus, the unnecessary health expenses of our country and increasing expenses worldwide for the diagnosis and treatment of BPPV can be prevented, and further unnecessary investigations conducted on these patients admitted to hospitals will be decreased. Also, health will be restored in a short period.Methods: In this study, 38 patients which applied to Adana Numune Education and Research Hospital ENT clinic between January 2013 and June 2013 with the complaint of vertigo and in which detected posterior semicircular canal pathology by Dix Hallpike maneuver were inculded. The lab tests and imaging analyses performed by other clinics were queried to exhibit the cost of unnecessary studies before applying to an ENT specialist.Results: The type of vertigo, period of vertigo, vertigo with tinnitus, fullness in the ear, hearing loss, vertigo attacks with neurologic deficit (weakness, balance impairment, facial paralysis, headache, syncope attacks... etc), permanent drug use, systemic disease, presence of trauma history were queried in patients history. Neurologic and ear-nose-throat examination were performed to all patients. 38 patients with posterior BBPV according to examination results were included to our study. 26 women (68.4%) and 12 men (31.6%) between the age of 40-72, totally 38 patients, with median age 55.1 were included.Conclusion: The diagnosis of BBPV can be exhibitted according to anamnesis and Dix-Hallpike maneuver. Easily diagnosable and treatable disease of BBPV by ENT specialist which is unknown and is not considered important by other clinics increases 7 times more the unnecessary spendings. For his reason when these patients’s anamnesis are taken and are thought as BBPV, before any examination and imaging studies they should be referred to ENT specialist. Thus according to prevention of unnecessary healt spendings contributes economy of our country.

Objective:Septorhinoplasty (SRP), one of the most commonly performed rhinologic surgery procedures, can affect olfactory function; however, the findings of studies investigating smell following SRP are controversial. We used a culturally adapted modified Brief Smell Identification Test (B-SIT) to investigate the long- and short-term effects of SRP on olfactory function.Methods:We enrolled 59 patients admitted to the Ear- Nose-Throat Clinic, who were complaining of external nasal deformity and nasal obstruction. Functional SRP was performed on all cases. The B-SIT was administered prior to surgery and at 4 and 12 weeks post-surgery. The smell identification score (SIS) reflected the number of correct answers. In addition, we investigated the effects of gender and smoking on olfactory function and whether the SRP procedure changed these associations.Results:The mean preoperative, 4-week, and 12-week postoperative SISs were 10.15±1.30, 10.21±1.52, and 10.92±0.95, respectively. The difference between the preoperative and 4-week postoperative SISs was not statistically significant; however, the 12-week postoperative score was significantly different from the preoperative and 4-week postoperative scores. Furthermore, the repeated measures analysis according to gender and smoking habit revealed a significant difference between the 4- and 12-week postoperative SISs. One patient developed postoperative anosmia; however, the patient recovered in the 12-week postoperative period.Conclusion:SRP surgery is a safe procedure in terms of olfactory function. In addition, olfactory function may increase following surgery as a result of improved nasal airflow.

Relapsing polychondritis is a rare, autoimmune, multisystemic disease that presents with episodic inflammatory process of the cartilages. We report a case of a 48-year-old woman who presented to our otolaryngology clinic with complaints of pain, eritema, edema on both auricules, itching, and desquamation on hairy skin. She had a history of multiple episodes of these complaints for 2 years. Biopsy was performed in both the auricules. The pathological examination revealed that the perichondrial area was infiltrated by inflammatory cells and fibrosis was composed. On the basis of the pathological examination and clinic correlation, relapsing polychondritis was diagnosed. Low-dose corticotherapy was administered and in the first 8 h, significant healing was observed. This case indicated that clinicians consider relapsing polychondritis and the demonstrative therapy by low doses of corticosteroids for differential diagnosis and therapy of relevant cases.

ObjectivesThe aim of this study is to investigate the role of platelet-derived growth factor (PDGF) in the pathogenesis of sinonasal polyps.MethodsStudy group (groups 1-3) consisted of nasal polyp samples of patients with sinonasal polyps and the control group consisted of inferior turbinate samples of patients without nasal polyp. In group 1, 14 specimens from ethmoid sinus; in group 2, 10 specimens from nasal cavity; in group 3, 10 specimens from maxillary sinus; and in group 4 (control), 9 specimens from inferior turbinate were included. By immunohistochemical staining technique, the PDGF positivity index (PI) in mucosal layers and in the inflammatory cells were assessed at the epithelium (EP), subepithelial layer of lamina propria (SE), and deep paraglandular layer of the mucosa (D).ResultsPolymorphonuclear cell (PMNC)-percentage (%) values of ethmoid and maxillary sinus, and the PDGF PI from all cells of ethmoid sinus and nasal cavity were significantly higher than those of the control group. As mononuclear cell-% (MNC-%) increased, the PDGF_EP_basal PI, PDGF_SE_endothelial PI, and PDGF_D_endothelial PI decreased. As PMNC-PDGF PI increased, the PDGF_D_perivascular PI decreased and PDGF_D_endothelial PI increased. As PDGF-MNC PI increased, the PDGF_EP_apical PI, PDGF_SE_endothelial PI, and PDGF_D_endothelial PI decreased. As PDGF-all cells (PMNCs, MNCs, and fibroblasts) PI increased, the PDGF_EP_basal PI and PDGF_D_endothelial PI decreased, and the PDGF_D_perivascular PI increased.ConclusionWe concluded that the PDGF systems play important roles in polyp pathogenesis. Fibroblast-derived PDGF may be more important than MNC-derived PDGF in polyp developing process. Increased perivascular-PDGF-PI in deep layers of the mucosa may result in sinonasal polyp formation by causing an increase in vascular permeability and extracellular edema, and thus promoting migration of inflammatory cells to extracellular area. Tissue oxygenization may be important for the initiation of PDGF release system. Because of this reason, nasal obstruction should be medically treated earlier, and, if necessary, by surgical approaches.

Schwannomas (neurilemmomas) are solitary neurogenic tumors which are observed rarely and originating from peripheric, cranial or autonomic nerve cells. They grow slowly and frequently manifest themselves as asymptomatic masses in the neck. Imaging methods such as ultrasonography (USG), computed tomography (CT), magnetic resonance imaging (MRI) and angiography are helpful in the diagnosis. Between 1995- 2001 histopathologically confirmed seven benign schwannomas were excised. Lesions were located at lateral of the neck in three patients, at parapharyngeal space in two patients, in nasal cavity in one patient and adjacent to maxillary sinus in one patient. In four patients (66.7%), the neural origins of the masses were cervical sympathetic chain in two, vagal nerve in one, and inferior orbital nerve in another. The functions of the nerves were preserved in surgical excision of these four cases via conservative approaches, thus no nerve grafting was needed. However, one patient developed Horner syndrome postoperatively, it had resolved within four months. In this study diagnosis of head and neck schwannomas, their histopathological features, treatments and prognosis were discussed.

Role of the pre-operative embolization in the treatment of juvenile nasopharyngeal angiofibroma, is controversial. For the purpose of evaluating clinical effectiveness of embolization, ten patients who came to our clinic with histopathological diagnosis of juvenile nasopharyngeal angiofibroma and who are and not administered embolization between 1994 and 2000, have been retrospectively analyzed. In five of the cases, selective embolization method has been administered with polyvinyl alcohol (PVA). In cases where only surgical treatment is administered, it is found that average intra-operative bleeding amount is 2530 cc and transfusion unit administered is 4.4 units. In the cases where pre-operative embolization is administered, intra-operative bleeding amount is 1590 cc and number of transfusion units is 2. Results indicated that embolization with pre-operative polyvinyl alcohol is a reliable and effective method in decreasing the amount of intra-operative bleeding, transfusion need and duration of the surgical operation.

Aim:The aim of this study was to assess the association between apnea-hypopnea index (AHI) with neutrophil lymphocyte ratio (NLO) and platelet lymphocyte ratio (PLO) according to gender in patients with obstructive sleep apnea syndrome (OSAS) and to investigate whether PLO and NLO can be a predictor of disease severity before polysomnography.Material and Method:This study was designed as retrospective and cross-sectional, between March 2018 and April 2018, The patients who underwent PSG who were admitted to the Otorhinolaryngology outpatient clinic of Adana City Training and Research Hospital with the complaint of snoring and sleep apnea were evaluated. The study population was divided in to four groups: (i) first group described as; AHI 0-4.9 (ii) second group described as; 5-14.9 (iii) third group described as; AHI 15-29.9 and (iv) fourth group decribed as AHI ≥30 according to polyspmnography (PSG). Neutrophil, lymphocyte and platelet results were evaluated routinely from the blood count results.Results:Of the patients included in the study, 106 were male and 32 were female. The mean age was 45.3 (43,3 for males and 50,4 for females), the mean body mass index (BMI) was 30.1 (min: 19 - max: 51), the mean AHI was 23.7 (min: 0,3 max: 103), the mean PLO was 113,1 (male:111.2 , female: 119.5) and the mean NLO was 1,93 (male:1.99, female:1.72 ) . In our study, the highest PLO value was found in group 2 and the highest NLO value was found in group 3. The lowest NLO and PLO values were found in group 4, unlike the results from other studies. However, no statistically significant difference was found between the groups.Conclusıons:In OSAS, there is a need for more comprehensive prospective and multi-centered study to better understand AHI and NLO, PLO relationship.

Fibrous dysplasia is a nonneoplastic fibro-osseous lesion characterized by fibroblastic proliferation and progressive replacement of normal bone with fibrotic tissue and disorganised bony trabeculae.Fibrous dysplasia infrequently occurs in the sinonasal tract. Location in the middle turbinate is extremely rare. It is usually asymptomatic but, in the advanced stage, nasal obstruction due to extension of disease and pain due to neural compression, or pathological fractures may occur. It is usually secondary to extension of disease from adjacent bones. In this case report we presented a 54 year old woman with unilateral chronic nasal obstruction [Cukurova Med J 2015; 40(Suppl 1): 106-111]

Fibrovascular polyps occur most commonly in the cervical esophagus and are extremely rare in the hypopharynx. In this paper, we report a case of fibrovascular polyp of a 52-year-old female, who presented with progressive dysphagia and weight loss and regurgitating a mass from her mouth. By the endoscopic examination, a polyp covered by normal mucosa with a wide stalk was detected at the hypopharynx. The pedicle of the mass was identified under general anesthesia and the 13 × 3 × 2 cm mass was completely resected perorally. Histopathological examination of the tumor showed oedematous subepithelial fibrous stroma, surrounded by squamous epithelium and containing many congested vascular structures. No recurrence was detected over one year of follow-up. This case highlights the need for clinicians to be aware of this rare entity and to develop the best approach to patient management.