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Among the sensory properties of foods, texture perception is a complex modality due to catastrophic changes during eating. Relating dental conditions and capacity of texture sensation are still paucities in the literature. Different dental areas emphasize the difference in texture sensation. Anterior teeth are responsible for biting, ripping or tearing; while posterior teeth are chewing and grinding. Hence, the absence of any is expected to cause disruptions in mastication functions. The hypothesis of the present study was dental loss or missing is a burden for hardness perception for first-bite and twice chewed for anterior and posterior teeth, respectively. Patient groups were divided according to anterior-posterior tooth deficiencies and hardness sensation was assessed at first bite and twice chewed modal food (white cheese) with various hardness levels obtained with different fat content. The modal food was tested for its physicochemical, textural and sensory properties with dental assessment. Findings suggest that first-bite hardness judgements were not affected by the loss of the anterior. Oppositely, twice chewed hardness has a significant effect on the loss of a posterior tooth. These findings can indicate to future researchers to be tested according to their dental status especially if chewing is necessary for their sensory tests., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Purpose: Radical resections and invasive techniques have been mostly replaced with more conservative techniques. The aim of this study was to assess the objective and the subjective functional and aesthetic outcomes of transcutaneous suture tip plasty., Methods: A total of 20 patients were included in the study. Patients were treated with transcutaneous suture tip plasty. Functional results were assessed with pre- and postoperative 6-month Sino-Nasal Outcome Test (SNOT-22) and acoustic rhinometry. The pre- and postoperative 6-month mean values of first minimal cross-sectional area (MCA1), second minimal cross-sectional area (MCA2), the distance from the tip of the probe to the first minimal cross-sectional area, the distance from the tip of the probe to the second minimal cross sectional area, nasal volume 1, and nasal volume 2 were measured. Facial analysis was made with the Rhinobase software, designed for facial analysis., Results: The mean pre- and postoperative SNOT-22 scores were 25.55 ± 6.64 and 15.70 ± 8.11, respectively ( P < .05). The mean pre- and postoperative nasolabial angles were 82.26º ± 5.69º and 101.47º ± 7.70º, respectively ( P < .05). The mean pre- and postoperative nasofrontal angles were 144.30º ± 3.81º and 138.25º ± 3.26º, respectively ( P < .05). The mean pre- and postoperative nasal length was 54.22 ± 4.62 mm and 49.95 ± 2.75 mm, respectively ( P < .05). The mean pre- and postoperative tip projection was 25.77 ± 3.64 mm and 28.40 ± 2.97 mm, respectively ( P < .05). Only postoperative MCA2 values on the right and left side were significantly different from preoperative MCA2 values ( P < .05). None of the remaining postoperative acoustic rhinometry scores significantly differed from preoperative scores. Two patients (10%) required revision at around 1 month after surgery due to suture loosening and breakage., Conclusions: Especially in the era of minimal invasive surgery, transcutaneous suspension tip plasty is promising, with rapid and reliable functional and cosmetic results. Further studies with longer follow-up durations are needed to assess the long-term outcomes of this technique.

Background: The authors of this study have developed a novel graft called the 'The Joint Tip Graft' which adds support to the lateral crus, camouflages the tip grafts, supports the facet and adds volume to the nasal tip as a single graft. The aim of this study was to define and introduce the tripod graft., Methods: Thirty patients who underwent primary rhinoplasty at a tertiary academic center were included. Patients were randomly assigned into two groups according to the grafts used: group 1: Joint tip graft was additionally used, and group 2: Joint tip graft was not used. All patients were photographed by a photographer who is familiar with medical photography. Preoperative and postoperative sixth month photographs were taken for analysis. The brightest point of the infratip lobule and the darkest point of the facets were selected and analyzed with computer software. The luminance ratio of facet to infratip lobule was calculated to overcome light and head position differences., Results: Mean infratip luminance scores were 112.20 ± 5.72 and 109.73 ± 7.13 in groups 1 and 2, respectively (p > 0.05). Mean facet luminance scores were 101.33 ± 4.91 and 89.27 ± 5.11 in groups 1 and 2, respectively (p < 0.05). Facet/infratip luminance ratios were calculated for each group. Mean facet/infratip luminance ratios were 0.90 ± 0.01 and 0.82 ± 0.16 for groups 1 and 2, respectively (p < 0.05)., Conclusions: The joint tip graft is a novel graft that is easy to harvest and apply. It spans both of the alar cartilages, supports the facet area and creates a smooth gradual light shadow transition. Additionally, it acts as a camouflage over the tip grafts., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Purpose: The aim of this study was to investigate the neurovascular structures and their relevant anatomy with the endonasal endoscopic transpterygoid approach on fresh human cadavers. In addition, the relationship between the vidian nerve, ICA and surrounding structures were investigated METHODS: This study was carried out at an otolaryngology department of a tertiary medical center between June 2014 and June 2015. Ten fresh human cadavers were included in this study. Pterygopalatine fossa was explored via an endoscopic endonasal transpterygoid approach. Same surgical dissection procedures were performed on all cadavers: maxillary antrostomy, anterior and posterior ethmoidectomy, sphenoidotomy, transpterygoid pterygopalatine fossa and vidian canal dissection., Results: Mean distance between the anterior nasal spine and ethmoidal crest was 60.35 ± 1.31 mm (range 59-64 mm). Mean distance between the sphenopalatine foramen and superior border of choana was 18.30 ± 1.38 mm (range 17-22 mm). Mean distance between the vidian canal and sphenopalatine foramen was 6.30 ± 0.47 mm (range 5.5-7 mm). Mean distance between the vidian canal and anterior nasal spine was 64.6 ± 1.71 mm (range 62-67 mm). Foramen rotundum was located superior lateral to the vidian canal in all specimens. Mean distance between foramen rotundum and vidian canal was 9.45 ± 0.60 mm (range 8.5-10.5 mm). Course of the greater palatine nerve was always medial to the descending palatine artery. The mean length of the vidian nerve from the petrous ICA to the point the nerve exits the vidian canal (vidian canal length) was 17.90 ± 1.59 mm (range 16-20 mm)., Conclusions: The distances between the vidian canal and surrounding neurovascular structures would help the skull base surgeon in this narrow and complex area.

The aim of this study was to investigate the neurovascular structures of the cavernous sinus with the endonasal endoscopic transpterygoid approach on fresh human cadavers. Additionally, the course of internal carotid artery (ICA) and relevant anatomy was thoroughly investigated to refine the anatomical landmarks, exposure difficulties, potential complications, and limitations using the endonasal endoscopic technique. This study was carried out at an otolaryngology department of a tertiary medical center between June 2014 and June 2015. The surgical dissection was performed on 10 fresh human cadaver specimens using paranasal sinus and skull base endoscopic instruments. Cavernous sinuses and parasellar area were explored via an endoscopic endonasal transpterygoid approach. Dehiscence was present in 5 (25%) cavernous ICAs. Projection of the cavernous ICA on the whole lateral sphenoid wall was prominent in 6 (%30) sphenoid sinuses. Anterior curve was prominent in 12 (60%) cavernous ICAs, whereas posterior was prominent in 7 (35%). Mean distance between the lateral wall of eustachian tube orifice and petrous ICA was 19.50 ± 1.05 mm (range 18-22 mm). Cranial nerves of the cavernous sinus showed no variation. Control of the ICA is critical during the endonasal endoscopic approach to the cavernous sinus and skull base. The vidian nerve is a reliable and important landmark to the petrous ICA in the transpterygoid approach. Dissection of the eustachian tube and its relation to the ICA has to be kept in mind during nasopharyngeal surgery.

Importance: Severe dorsal deviations in crooked noses are treated by either in situ septoplasty with asymmetric spreader grafts (ISS) or extracorporeal subtotal septal reconstruction (ECS). To our knowledge, except one retrospective study, there is no other that compares the objective and subjective results of these two treatment modalities., Objective: The aim of this study was to compare the aesthetic and functional outcomes of ECS and ISS in crooked noses., Design, Setting and Participants: This study was carried out on 40 patients (ISS in 20 patients and ECS in 20 patients) who underwent external rhinoplasty surgery due to crooked noses between May 2014 and January 2016. While performing rhinoplasty on the patients, the decision of whether to use the ECS or ISS technique was randomized in a sequential fashion., Main Outcomes and Measures: Surgical outcomes were assessed and compared using the anthropometric measurement of photographs with Rhinobase software. Subjective assessments of nasal obstruction and aesthetic satisfaction were evaluated with a visual analog scale., Results: There was a significant difference between rhinion deviation angle, supratip deviation angle (SDA) and tip deviation angle pre- and postoperatively in the ECS group, whereas in the ISS group, except SDA, all other postoperative angles were significantly improved from preoperative values (p = 0.218). The nasal tip projection in the ECS and ISS groups was 29.48, 31.5 preoperatively and 29.78, 31.26 postoperatively. The mean postoperative nasal tip projection value (p > 0.005) did not change significantly compared to the preoperative value in both groups. The mean postoperative value of nasolabial (p = 0.226) angle did not change significantly compared to the mean preoperative one in the ECS group. However, in the ISS group, the mean postoperative value of nasolabial (p = 0.001) angle significantly improved compared to the mean preoperative value. There was significant improvement in both groups, while improvements in both functional and aesthetic outcomes were much higher in the extracorporeal group. None of the patients had postoperative nasal obstruction that required revision surgery. One patient underwent revision rhinoplasty due to an irregularity on the nasal dorsum in the ECS group., Conclusions and Relevance: This is the first study that compares subjective and objective aesthetic and functional outcomes of crooked nose surgery according to two common septoplasty techniques in a randomized self-controlled fashion. This study was effective in both objectively and subjectively comparing the functional and aesthetic aspect of the patients submitted to two common different techniques of treatment of nasal deviations in crooked nose patients., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Endoscopic endonasal approach has been successfully used for the management of pituitary tumors; however, the loss of septal mucosa especially around sphenoethmoidal recess and posterior nasal septum might be a disadvantage of this technique. The aim of this study is to describe a variation of the endonasal approach, "double nasoseptal flap" technique in endoscopic transsphenoidal pituitary surgery, and to evaluate its outcomes. The technique depends on fully harvested bigger nasoseptal flap on one side and smaller on the other. Thirty patients were included. Functional results were assessed by preoperative and postoperative first month visual analogue scale (VAS), and morphology was evaluated by achieving intact septum from the sphenoid ostium to the columella. Sphenoid sinusitis, the presence of synechia and crusting in the sphenoethmoidal recess was also assessed. Mean VAS was 71 and 67 mm preoperatively and postoperatively, respectively (p > 0.01). There were no septal perforations, synechia, and sphenoid sinusitis postoperatively. Three patients had (10 %) crusts on sphenoethmoidal recess on first month postoperatively. Double nasoseptal flap technique has advantages, such as wider exposure during surgery; prepared flaps could be used if needed, better morphological and functional outcomes postoperatively. The technique is safe without any perforations and minimal crusting.

Background: Acute invasive fungal rhinosinusitis (AIFR) is a highly mortal, progressive fungal infection of the paranasal sinuses and surrounding structures that is almost always seen in patients who are immunocompromised. Despite the use of newer antifungal treatments and early diagnosis, the prognosis of AIFR does not improve significantly. Due to the higher incidence of patients who are immunocompromised and have more complex disease, AIFR is a growing medical issue in tertiary medical centers., Objective: The aim of this study was to present the outcomes and analyze the prognostic indicators of patients with AIFR who underwent surgery., Methods: Between October 2009 and November 2014, 37 patients who underwent surgery for AIFR at a tertiary care university hospital were included in the study. Overall survival and disease-specific mortality and survival rates were calculated to estimate survival function. The impact of age, sex, underlying disease, extent of AIFR, applied medical treatment, and causative species (mucormycosis, aspergillosis) were also taken into consideration. Also, the effect of a variety of laboratory parameters, such as hemoglobin, leukocyte, neutrophil, lymphocyte, platelet, and C-reactive protein (CRP) levels, to survival were evaluated., Results: The median follow-up time was 58 days (interquartile range = 304). Overall and disease-specific mortality rates were 64.9 and 51.4%, respectively. Fever was the most common symptom (86.5%), along with nasal obstruction and/or fullness (48.6%) and epistaxis (48.6%). Age and sex did not have a significant impact on survival (p > 0.05). Palate involvement was significantly associated with mortality (p < 0.05). According to the results of Cox, regression analysis for disease-specific mortality rate, leukocyte and neutrophil counts as well as CRP levels had a significant effect on survival function (p < 0.05)., Conclusions: Palatal involvement was associated with a higher mortality in our study. Also, leukocyte counts, neutrophile counts, and CRP values had a significant impact on survival function. The reversal of the underlying disease and immunosuppression is as important as the medical and surgical treatment.

Primary thyroid-like papillary adenocarcinomas are extremely rare neoplasms that generally originate in the nasopharynx. We report the case of a 24-year-old woman who was diagnosed with a thyroid-like papillary adenocarcinoma that originated in the nasal septum. The tumor was surgically removed, and the patient showed no evidence of local recurrence during 4 years of follow-up.

The objective of the study was to evaluate the efficacy and the safety of the novel cauterization procedure of the inferior turbinate artery, which may be performed with any kind of inferior turbinate procedures in reducing the intra and the post-operative bleeding in partial inferior turbinectomy. A prospective controlled study was conducted in a referral center. Sixty patients (38M, 22F) who underwent partial turbinectomy were included. In 20 patients, partial turbinectomy was performed with the cauterization in one nasal cavity and the other one without it. The remaining 40 patients were divided into two groups which comprised cauterization positive and negative patients and are assessed in terms of post-operative bleeding. The area of the cauterization was 1 cm(2) field which is 1 cm anterior to the posterior attachment of the inferior turbinate on the lateral nasal wall, very close to the inferior turbinate, where the pulsating vessel is most commonly seen. Mean operation time, mean intra-operative blood loss and post-operative bleeding incidence are the main outcome measures. Post-operative bleeding was seen in three patients (15%) in the cauterization negative group. No patient had post-operative bleeding in the cauterization positive group. Mean operation time and mean intra-operative bleeding amount were significantly lower in the cauterization positive side. Cauterization of the inferior turbinate artery on the lateral nasal wall is a safe and effective method which may also be performed with any kind of inferior turbinate procedures to reduce both the operation time and intra and post-operative bleeding.

One of the most effective treatments of inferior turbinate (IT) hypertrophy is surgical reduction. Bleeding from the IT branch of the posterior lateral nasal artery (ITB) may interfere with the outcome of IT surgery. The aim of this study is to define the anatomic localization of the ITB and its variations and to investigate its clinical importance. Anatomic relations of the ITB were determined by microdissecting 20 adult, sagittally cross-sectioned head specimens. Branching characteristics of the ITB and its anatomical relations were evaluated. The most consistent two markers to define the ITB on the lateral nasal wall were the posterior attachment of the IT (PAIT) and the posterior attachment of the middle turbinate (PAMT). Mean horizontal distances of the ITB from the PAIT and the PAMT were 7.2 mm ± 2.8 mm (2.5-11.8 mm) and 8.2 mm ± 2.8 mm (4-14.6 mm), respectively. ITB was the only major artery that supplied the IT in 85% of the specimens, and, in 15%, there was more than one artery. ITB was located lateral to the IT in 95% and medial to the IT in 5%. The ITB coursed on the lateral nasal wall, vertically between the middle and ITs and always anterior to the PAIT. All the variations of blood supply to the IT were within a one square centimeter area, ∼1-cm anterior to the PAIT. Successful cauterization of this particular area may be an alternative cauterization site in IT surgery., (Copyright © 2010 Wiley-Liss, Inc.)

Background: Sphenopalatine artery (SPA) ligation or cauterization stands to be one of the most common management options of refractory epistaxis. Ramification pattern of SPA as it passes through sphenopalatine foramen (SPF) has not been clearly established. The aim of this study is to investigate situations in which middle meatal approach may fail due to anatomic variations of SPA and to define a minimally invasive surgical cauterization procedure. Anatomic variations of SPA were determined by microdissection of 20 adult sagittally cross-sectioned head specimens., Methods: Branching characteristics of SPA and its anatomic relations were evaluated and anatomic variations were noted., Results: SPA was generally (80%) forming branches within SPF before entering into the nasal cavity. In 20% of the specimens, SPF was located superior to the horizontal lamella of the middle turbinate, and accessory foramen was present in 10%. In 10% of the cases, the posterior lateral nasal branch was situated as two branches in a deep sulcus in the middle meatus., Conclusion: The ramification pattern of SPA can not be fully exposed without resection of the posterior part of the middle turbinate via the middle meatal approach. Two-step procedures are advocated in reducing failure rates. Previously defined two-step procedures are relatively invasive. A less invasive procedure is defined based on the variations of SPA and SPF.

Objective: The effect of Sjögren syndrome (SS) on perceptual ratings of the laryngeal findings using the Reflux Finding Score (RFS) and the Reflux Symptom Index (RSI) and the objective voice quality using Jitter (JITT), Pitch Period Perturbation Quotient (PPQ), Shimmer (Shim), Amplitude Perturbation Quotient (APQ) and Noise-to-Harmonic Ratio (NHR) was examined., Methods: Seventy-seven patients with SS and seventy-seven healthy individuals for the control group were studied. The Reflux Symptom Index (RSI); nine-item outcomes instrument for assessment of symptoms in patients and the Reflux Finding Score (RFS), eight-item laryngoscopic-based scale for evaluation of laryngeal findings in patients were realised. The Multi Dimensional Voice Program (MDVP) was used for capturing and analysis of the voice samples. For comparison of all parameters of patients and control group subjects, the independent sample t-test was used., Results: The difference of RSI and RFS between patients with SS and control subjects was statistically significant. The difference of voice quality parameters between patients with SS and control subjects expect NHR were statistically significant., Conclusion: There is a significant association between SS and a variety of laryngeal pathologies. The SS patients with reflux symptoms and voice problems must be examined by an ENT specialist and local laryngeal manifestations of SS can be treated symptomatically.

Objectives: In this study, we evaluated anatomic variations detected by computed tomography (CT) of the paranasal sinuses and their relationship with sex., Patients and Methods: Computed tomography scans of the paranasal sinuses of 464 patients (206 males, 258 females; mean age 37.5 years; range 4-87 years) were retrospectively analyzed. In cases requiring further investigation, axial and sagittal views were obtained using multiplanar reformatted images. Bone window images were also obtained particularly to evaluate dehiscence variations. Paranasal sinus variations were classified into eight subgroups according to their origins (nasal septum, ethmoid cells, maxillary sinus, uncinate process, frontal and sphenoid sinuses, orbit, and nasal concha). The frequency of variations was compared between male and females., Results: The most common anatomic variation was agger nasi cells (80.4%) followed by pneumatization of the middle concha (37%). The least encountered variations were pneumatization of the inferior turbinate, bony dehiscence of the ethmoidal roof, and duplication of the middle and superior turbinates. The frequency of variations did not differ significantly with respect to gender (p>0.05) except for frontal hypoplasia, which was more often in females (p<0.05)., Conclusion: Axial and sagittal views using multiplanar reformatted images can be helpful in eliminating artefacts and in identifying variations of the paranasal sinuses. Utilization of soft tissue and bone windows, when necessary, may facilitate evaluation of dehiscence abnormalities.

This paper presents a case with a 4-month history of nasal obstruction and intermittent epistaxis. The cause was found to be a leech in the nasopharynx by means of endoscopic examination. Leech endoparasitism, although rare, may cause serious, even lethal, complications. A high index of suspicion of leech infestation must be entertained when faced with nasal obstruction and intermittent epistaxis in children, and should be investigated surgically as with all other foreign bodies.

The pituitary fossa, sphenoid rostrum, sphenoid sinus, nasopharynx, pterygopalatine fossa and clivus are the components of the central compartment of the middle cranial base. It is a surgical challenge to gain access to this region. This fact has led to the development of a number of surgical procedures reported in the literature. However, none of these techniques can provide a wide and direct exposure to the middle cranial fossa without morbidity on its own. In this report, nasomaxillary osteotomy is described as a satisfactory alternative to reach the middle cranial fossa. With the nasomaxillary osteotomy technique, a wide access can be obtained to the central compartment of the skull base, caudally till the inferior clivus and upper cervical vertebrae (C1, C2). Since bilateral, internal carotid arteries are in sight laterally, the technique provides a secure resection of tumors with marked lateral extensions. Repositioning the translocated bone segment, surrounding the apertura piriformis, results in satisfactory cosmesis postoperatively. The technique is discussed on the basis of eight cases with the histopathological diagnosis of squamous cell carcinoma (1 case), olfactory neuroblastoma (2 cases), chordoma (2 cases) and juvenile nasopharyngeal angiofibroma (3 cases). No vascular complication has been encountered. One chordoma patient died of the disease in the follow-up period. All other cases, including one squamous cell carcinoma patient, are alive and disease-free without cosmetic deformity. In conclusion, nasomaxillary osteotomy provides a wide and direct exposure to the central compartment of the skull base in a relatively short period of time, securing the vascular and neural structures. Besides, it offers the advantage that it can be combined with other techniques in extensive tumors, while cosmesis and nasal functions are preserved.

Fungal infections can be mainly grouped into four types. The invasive forms are acute sinusitis (fulminant), chronic sinusitis (indolent), whereas the non-invasive forms are mycetoma and allergic fungal sinusitis. From December 1993 to December 1997, 27 cases of fungal sinusitis, 22 of which were noninvasive forms, and 5 of which were invasive forms, were treated and are presented in this study. When we classified the patients with fungal sinusitis, 11 were diagnosed as mycetoma, 9 as allergic fungal sinusitis, 3 as acute fulminant sinusitis and 2 as chronic indolent sinusitis, while 2 patients were not included in our four groups of sinusitis. In all mycetoma cases the active agent was Aspergillus. Patients with non invasive forms of sinusitis were all treated with endoscopic sinus surgery. 2 of the patients with invasive forms of sinusitis underwent maxillectomy and they were given Amphotericin-B. With a mean follow up of 20 months, only 3 recurrences were seen. The infection recurred in 2 patients with allergic fungal sinusitis and 1 patient with chronic invasive sinusitis. However, 2 patients with acute fulminant invasive sinusitis died before they were operated on, and 1 patient died postoperatively.

Purpose: To evaluate the beneficial effects of nasal endoscopy on preventing complications during probing and bicanalicular silicone intubation, and to determine the structural nasal abnormalities in congenital nasolacrimal duct obstruction., Methods: Probing and silicone tube intubation under nasal endoscopy were performed in 37 eyes of 26 patients who ranged in age from 7 to 60 months (mean, 18.8 +/- 13.4 months)., Results: By nasal endoscopy, the inferior turbinate and meatus appeared normal in 15 patients (58%), whereas 11 patients (42%) had hypertrophy of the inferior turbinate and/or stricture in the inferior meatus. Twenty-four of 26 eyes (92%) were cured by probing only. We performed silicone tube intubation and cured 11 of 12 eyes (92%) including two failures. Of 14 eyes that had undergone failed probings elsewhere, the success rate was 92.8% (13 of 14 eyes). The overall success rate of probing and silicone tube intubation under nasal endoscopy was 97%., Conclusion: Nasal endoscopy during probing and bicanalicular silicone tube intubation is useful especially in selected cases of failed probings. Nasal endoscopy should assist the inexperienced surgeon in preventing trauma to the nasal base and septal mucosa, hemorrhage, and passage of the probe under the mucosa rather than through the ostium.

Fungal infections of the paranasal sinuses are in four clinical forms. Beside the acute fulminating form, chronic invasive form, allergic fungal sinusitis and fungus ball. Fungus ball is mostly encountered in only one paranasal sinus of an otherwise healthy person. Ten fungus balls of the paranasal sinuses are presented with their management and results.

Allergy has been reported as an important factor in the etiology of nasal polyposis. Asthma, chronic sinusitis and aspirin hypersensitivity are frequently found together with nasal polyposis. Total IgE, RAST for specific IgE and skin prick test were used to investigate the incidence of allergy in 95 patients with nasal polyposis. In addition, histopathologic appearance of polyp tissue was examined in 21 patients after polypectomy and compared in allergic and nonallergic groups. IgG subclass levels were also measured to detect if there were any changes. Mean serum IgE level was found to be higher in the patient group and the skin prick test (SPT) was positive in 66.3% of patients. On the basis of positive SPT and serum RAST results, 45.2% of all patients with nasal polyposis were defined as allergic. Both total IgE and IgG4 were detected at increased levels in the SPT-positive group. These findings suggest that an IgE-mediated mechanism may be present in a subpopulation of patients with nasal polyposis.

Due to 447 cases of sudden deafness followed up and treated during the last ten years in their clinic, the authors report the results of their treatment method composed of normovolemic hemodilution followed by fractional perfusion of vasodilators, corticosteroids and anticoagulants. Presenting overall examination of this population with audiological, vestibular, clinical, hematological and radiological findings, they insist on the need for emergency treatment and discuss the different aspects of this problem. They also present a global evaluation of the investigations performed on some patient groups. The most spectacular recoveries are obtained in cases who present earlier and who have a hearing loss of low frequencies.

This study was done at the ENT Department of the Ege University Medical Faculty on twenty trainee singers. Using the two-channel signal processing method, the electroglottographic (EGG) signals and the voice signals were digitized with an analog-digital converting card during an ascending and descending glissando exercised by the trainee singer. These signals were recorded on the computer's hard disk and the obtained data was analysed. It has been determined that the EGG signals were more irregular the singing formant of the voice signal was very weak or absent and the change of register was more significant in less trained singers. This method can be used to evaluate objectively the change of voice registers in the training of the singers and be easily performed by adding an analog-digital converting card to a PC computer, without the need of expensive modern devices.

The arytenoidopexy operation has been performed in 15 cases of bilateral abductor paralysis of different causes. A tube on n. 6 for women and a tube of n. 6.5 for men has been used for the intratracheal general anesthesia without a tracheotomy. The microdissection of the arytenoid has been realised under the operation microscope. The fixation suture of the arytenoid has been passed with a special needle set prepared by the experimental studies on the laryngectomised pieces. The functional respiration result has been controlled by the pre and postoperative spirometry. The laryngeal spasm disappeared and very good respiratory functional results have been obtained in all cases. After a post-operative phoniatric reeducation, the voice was found to be good in most of the cases.