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Objectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P <.001). The mean total symptom score fell following treatment (P <.001): whilst the score was 11.09 ± 3.41 before administering Rhinapi; after administration, the average score was 6.23 ± 2.41. The mean QoL scores also altered after medication (P <.001), improving from a mean value of 6.44 ± 1.55 to a mean of 7.31 ± 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P <.001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical and pathologic parameters associated with level IIb metastasis in transglottic laryngeal carcinoma. Methods: A total of 238 laryngeal squamous cell carcinoma patients admitted to our tertiary center and surgically treated between January 2006 and January 2014. Of these 238 patients, 134 patients with transglottic laryngeal SCC were enrolled in the study. The type of neck dissection, the location of histopathologically proven metastatic lymph nodes, clinical N and T stages were reviewed. Palpable lymph nodes were accepted clinically cN(+) and the opposite as cN(-). were as cN(+). Level IIb metastasis was diagnosed in 12 patients in the cN(+) group, and in two patients in the cN(-) group. Histopathological level IIb metastasis was shown in 14 of 134 patients, representing 16 of 268 neck dissection specimens. Level IIb metastasis was shown in the ipsilateral specimens in 12 patients and contralateral specimens in two patients. Forty-one of 134 patients presented cartilage invasion, and nine of them were diagnosed with level IIb metastasis. Conclusion: Thyroid cartilage invasion, the presence of level IIa invasion and advanced stage disease are the risk factors for level IIb metastasis. Therefore, level IIb should not be neglected during neck dissection in transglotticlaryngeal carcinoma. [ABSTRACT FROM AUTHOR]

Objective: To evaluate success of tympanoplasty type 1 in the treatment of patients with sclerotic mastoid bone. Methods: A retrospective study where 92 patients with noncholesteatomatous chronic suppurative otitis media were recruited during the period of 2010 to 2012. Patients were managed medically and after dryness of their perforations they were operated upon. Ninety-two patients underwent type 1 tympanoplasty alone without cortical mastoidectomy. Underlay technique with chondroperichondrial graft was performed for all patients. Results: Mean air-bone gap values were estimated and compared. In pre- and postoperative audiograms, air-bone gap values at 500, 1000, 2000 and 4000 Hz frequencies were determined. Pre- and postoperative mean air-bone gap values of the patients were 23.47±4.95 and 11.58±4.77 dB, respectively. Conclusion: Our study emphasizes the fact that overall satisfactory hearing outcome with adequate air-bone closure can be achieved irrespective of cortical mastoidectomy in the surgical treatment of noncomplicated chronic ear diseases. [ABSTRACT FROM AUTHOR]

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Objective: In the present study, thresholds of airway tone-burst auditory brainstem response (ABR), and pure-tone audiometry were compared, and correlations between threshold values obtained with classical audiometric methods, and pure-tone airway hearing in individuals with advanced, and very advanced sensorineural (S/N) hearing loss were investigated. Methods: Eighty patients with advanced and very advanced S/N hearing loss were included in the study. Pure-tone air conduction thresholds of advanced, and very advanced S/N hearing loss patients detected at 500, 2000 and 4000 Hz frequencies were compared with tone-burst ABR threshold values. Results: Our study population consisted of males with a mean age of 21.8±3.45. Mean differences between thresholds of tone-burst, and pure-tone audiometry were detected to be 4.75 dB, 6.25 dB, and 4.87 dB at stimulus frequencies of 500 Hz, 2000 Hz, and 4000 Hz, respectively. Conclusion: In conclusion, in patients with S/N hearing loss, a strong correlation is found between pure-tone audiometry thresholds, and electrophysiological thresholds obtained at 500, 2000, and 4000 Hz with tone-evoked ABR wave-V. Tone-ABR can be used as a reliable test in the diagnosis of patients with hearing loss in conditions where pure-audiometry cannot be performed. [ABSTRACT FROM AUTHOR]

Objective: To determine septal variations and rates of intrasinusal protrusions of optic nerve and internal carotid artery in sphenoid sinus. Methods: Retrospective analysis of spiral computed tomography scan-ning of paranasal sinuses of 218 patients diagnosed as acute/chronic sinusitis was performed. Bilateral sphenoid sinuses were evaluated as if a single sinus, septa of this sinus were evaluated in terms of number and configuration. Besides rates of optic nerve and internal carotid artery protrusions were determined. Results: A total of 5 types of septal variations were detected. A single complete septum (n=132; 60.5%), a single incomplete septum (n=66; 30.2%), double septum (complete + incomplete, n=6; 2.7%), two complete septa (n=9; 4.1%), and sphenoid sinuses without septum (n=5; 2.2%) were identified. Sixty-four percent of single septum was located in midline, while other types were found immediately right or left side of the midline. Besides, protrusions of optic nerve and inter-nal carotid artery were detected in 39 (17.8%) and 61 (27.9%) cases, respectively. Conclusion: Preoperative evaluation with computed tomography and surgical planning dependent on these findings are very important for endoscopic interventions and these approaches minimize potential major intraoperative complications. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Myringosclerosis (MS) is a pathological condition characterized by hyaline degeneration and calcification of the collagenous structure of the fibrotic layer of the tympanic membrane, which may develop after trauma, infection, or inflammation as myringotomy, insertion of a ventilation tube, or myringoplasty. The aim of our study was to both reveal and evaluate the impact of the factors that might be effective on the post-tympanoplasty development of myringosclerosis in the graft. MATERIALS and METHODS: In line with this objective, a total of 108 patients (44 males and 64 females) aged between 11 and 66 years (mean age, 29.5 years) who had undergone type 1 tympanoplasty (TP) with an intact canal wall technique and type 2 TP, followed up for an average of 38.8 months, were evaluated. In the presence of myringosclerosis, in consideration of the tympanic membrane (TM) quadrants involved, the influential factors were analyzed in our study, together with the development of myringosclerosis, including preoperative factors, such as the presence of myringosclerosis in the residual and also contralateral tympanic membrane, extent and location of the perforation, and perioperative factors, such as tympanosclerosis in the middle ear and mastoid cavity, cholesteatoma, granulation tissue, and type of the operation performed. For statistical analysis of data, independent samples t-test was used. RESULTS: Our study comprised 44 male and 64 female patients. Median postoperative follow-up period was estimated as 38.8 months. The rate of postoperative development of myringosclerosis in grafts was significantly higher in patients with already existing sclerotic foci in TM (p=0.001). The location of the perforation had no effect on the postoperative development of MS in the graft (p=0.521). No statistically significant difference was detected between the size of the perforation and formation of MS (p=0.581). Statistical analysis of both groups could not discern any significant intergroup difference as to the impact of the presence or absence of cholesteatoma on the development and extent of MS (p=0.604). Impact of tympanosclerosis on the postoperative development and extent of MS in the graft was significant (p=0.001). Presence or absence of granulation tissue on the development or extent of myringosclerosis was not detected (p=0.697). Myringosclerotic foci in the contralateral ears had a statistically significant effect on the postoperative development and extent of MS in the grafts (p=0.001). Type of surgery performed did not exert any significant effect on the development or extent of myringosclerosis (p=0.765). CONCLUSION: We have determined that the presence of myringosclerosis in the residual membrane and in the contralateral tympanic membrane and tympanosclerosis in the middle ear have a significant role in the development of postoperative myringosclerosis in the tympanic membrane, contrary to the type of the surgical intervention, location and extent of perforation, presence of cholesteatoma, and granulation tissue. [ABSTRACT FROM AUTHOR]

Objective. Head and neck squamous cell carcinomas readily metastasize to adjacent cervical lymph nodes. This is seen frequently in laryngeal squamous cell carcinoma (LSCC), and neck dissection may be performed in addition to excision of the primary lesion. The aim of this study was to define the frequency of level IIb metastasis to the lymph nodes in patients who underwent selective neck dissection because of LSCC.Study Design and Setting. Cross-sectional study with planned data collection in a tertiary referral hospital.Subjects and Methods. Eighty-one patients diagnosed with LSCC were accepted into the study. One hundred forty-eight neck dissection specimens were examined histopathologically, and those with level IIb metastasis were identified. The frequency of level IIb metastasis was evaluated in accordance with the primary tumor site, clinical N stage, central tumor presence, and T stage.Results. Forty-seven of 81 patients were clinically N−, and 34 patients were clinically N+. Level IIb metastasis was seen in 5 (6%) of 81 patients, representing 5 of 148 neck dissection specimens. Two of these 5 patients were clinically N+ (6%), and 3 were clinically N− (6%). The relationship between level IIb metastasis and clinical N stage was not statistically significant (P ≥ .05). Likewise, no statistically significant relationships between the other parameters and level IIb involvement were found.Conclusion. Level IIb nodal involvement is very rare in LSCC. Therefore, the area can generally be preserved in elective neck dissection to lessen morbidity and, specifically, to avoid damaging the function of the spinal accessory nerve. [ABSTRACT FROM PUBLISHER]

Conclusion: All patients treated with this new lateralization technique had a good quality of life and no dyspnea at rest or upon exertion. We believe that this technique is an important addition to the many surgical techniques for the treatment of bilateral vocal cord paralysis (BVCP). Objectives: Most techniques used in the treatment of BVCP result in a prolapse of the laryngeal soft tissues into the endolarynx owing to Bernoulli's principle. We have developed a new lateralization technique to more effectively prevent this prolapse. Methods: The lateralization was initially tested on six cadaver larynges before being performed in five clinical cases with BVCP, who suffered from dyspnea at rest. Average follow-up was 17.6 months. As in type 1 thyroplasty, a rectangular piece of cartilage was excised horizontally from the thyroid lamina and placed on the defect in the vertical plane. Then, the vocal and ventricular folds were lateralized with crossing sutures, particularly in the posterior region. Results: Dyspnea was eliminated postoperatively. All patients were successfully decannulated. Postoperative voice quality was socially acceptable. Airways were improved postoperatively, as evaluated via fiberoptic laryngoscopy and CT. The mean preoperative and postoperative rima openings were 1.3 mm (range 0.5--2.6) and 6.4 mm (range 3.4--8.1), respectively. [ABSTRACT FROM AUTHOR]

Wegener's granulomatosis is an idiopathic systemic disease characterized by necrotizing vasculitis with the formation of granulomatous lesions that involves the upper respiratory tract, the lungs and the kidneys. Limited forms of Wegener's granulamatosis confined to only head and neck are not rare where as it is unusual that the otologic symptoms are the primary manifestations of the disease. These patients can also be misdiagnosed as otitis media which can cause the deterioration of the disease. We presented here a patient admitted with bilateral otitis media and facial palsy as the first manifestation of Wegener's granulomatosis and was treated with antibiotics for nearly three months before the diagnosis. We conclude that early diagnosis of Wegener's granulomatosis requires a suspicion of the disease in the patients with otologic symptoms and/or facial paralysis if there is otitis media refractory to treatment. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance ( P < .001). The mean total symptom score fell following treatment ( P < .001): whilst the score was 11.09 ± 3.41 before administering Rhinapi; after administration, the average score was 6.23 ± 2.41. The mean QoL scores also altered after medication ( P < .001), improving from a mean value of 6.44 ± 1.55 to a mean of 7.31 ± 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered ( P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Aslı Elif Tanugur Samanci MD is the Scientific Director of Bee&You, the company that developed the product tested in this study. Reşat Kubilay Irkan is the Medical & Marketing Director of Bee&You, the company that developed the product tested in this study. All other authors declare no conflict of interest.

Objectives: This study aims to investigate the quality of life of allergic patients with or without asthma during dust storms., Patients and Methods: A total of 148 allergic patients (66 males, 82 females; mean age 35.7±15.5 years; range 18 to 65 years) were classified as those with (group 1, n=80) or without (group 2, n=68) concomitant asthma between January 2012 and January 2013. The quality of life [Short Form-36 (SF-36)] scores, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), nasal symptom and visual analog scale (VAS) scores at the time of diagnosis were obtained. The particulate matter (PM10) and sulfur dioxide (SO2) values of that day from the General Directorate of Meteorology were recorded. The day of dust storm and PM10 and SO2 measurements along with SF-36, RQLQ, nasal symptom and VAS scores were recorded again., Results: The absolute change in the RQLQ subparameters including eye and nasal symptoms, practical problems and global scores was statistically significant (p=0.022, p=0.036, p=0.026 and p=0.032, respectively). There were statistically significant changes in the SF-36 subgroups of general health, physical functioning, vitality, and mental health (p=0.026, p=0.042, p=0.008 and p=0.026, respectively). In the multivariate logistic regression model, specific and general quality of life was 4.6 times worse in RQLQ and 3.8 times in SF-36 after the dust storm in patients with asthma, while 2.1 times worse in RQLQ and 1.9 times in SF-36 in patients with pure allergic rhinitis. The attributable risk of asthma was found to be 2.5 times higher in RQLQ and 1.9 times higher in SF-36., Conclusion: Dust storms may deteriorate the quality of life of patients with allergic rhinitis and asthma and lead to related personal and societal problems.

Objectives: This retrospective study aims to detect the prognostic factors which affect the duration of hospital stay and evaluate the complications which develop in patients with deep neck infection., Patients and Methods: The study included 77 patients (40 males, 37 females; mean age 42.4±20.1 years; range 11 to 88 years) treated with a diagnosis of deep neck infection in our clinic between November 2006 and November 2012. Patients' demographic and clinical features were analyzed to detect their associations with development of complications and hospitalization time., Results: Odontogenic origin and submandibular localization were the most frequently observed clinical appearance. Of eight patients (10.4%) who developed serious complications, two (2.6%) died. Age, comorbidity, presence of anemia alone, Ludwig's angina and retropharyngeal involvement were associated with increased rate of complications (p<0.05); while sex, antibiotic usage prior to admittance and primary location of infection were not related (p>0.05). Submandibular localization and absence of leucopenia reduced the risk of complications (p<0.05). The mean duration of hospital stay was 12.9±8.7 days (range 2-59 days). Age, presence of comorbidity and development of complications extended the hospitalization period (p<0.05)., Conclusion: In spite of the improvements in diagnosis and treatment, deep neck infection may be an important cause of mortality if complications develop. Comorbid anemia, Ludwig's angina and retropharyngeal involvement were identified as the strongest predictors in terms of development of complications. Duration of hospital stay extended in patients who developed complications.

Objectives: This study aims to investigate the efficiency of mastoidectomy during tympanoplasty procedures in patients having sclerotic mastoid bone with dry or dried up tympanic cavity., Patients and Methods: The study included 146 patients (66 males, 80 females; mean age 28.6 years; range 16 to 52 years) having sclerotic mastoid bone who underwent tympanoplasty between March 2010 and March 2013. Patients were divided into two groups: group A (34 males, 58 females; mean age 25.8 years; range 17 to 47 years) underwent only tympanoplasty, while tympanoplasty + mastoidectomy were performed on group B (32 males, 22 females; mean age 29.8 years; range 16 to 52 years). All outcomes were evaluated including the actual state of the tympanic membrane graft and level of hearing., Results: While postoperative perforation and retraction rates were not significantly different between the two groups, results of group A were superior to group B in terms of operation duration and hearing results., Conclusion: Mastoidectomy is not an efficient procedure in chronic otitis media patients having sclerotic mastoid bone with dry or dried up tympanic cavity.