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Backgroud/Objectives: Transoral laser laryngeal microsurgery (LTLM) has been widely used in the treatment of early-stage glottic laryngeal squamous cell carcinoma (LSCC) for the past few decades. Although T stage, tumor grade, anterior commissure involvement, type of cordectomy, positive surgical margin, and postoperative additional therapies were accused as the prognostic factors for recurrence, there is still controversy about these data in the literature. The purpose of this study was to evaluate the oncological results of our patients with early glottic LSCC treated with LTLM as a single-modality therapy in a single-center study. Methods: Patients with early-stage (Tis-1–2/N0) glottic LSCC who underwent LTLM as a primary treatment from 2011 to 2019 were retrospectively reviewed. The clinicopathological factors and oncologic outcomes were analyzed. Results: One hundred and sixty-one patients were enrolled in this study. The 5-year overall (OS), disease-specific (DSS), disease-free (DFS), and laryngectomy-free survival rates were 84.5%, 97.9%, 79.2%, and 93.5%, respectively. The most common stage, histopathological type, and type of endoscopic cordectomy were T1 stage, well-differentiated cancer, and type 2 cordectomy, respectively. A positive surgical margin was defined in 20 (12.4%) patients. There was a significant relationship between histopathological grade and positive surgical margins (p = 0.038). OS and DSS rates of “wait and see” modality were lower, while DFS of radiotherapy was lower than that of other treatment modalities in patients with positive surgical margins, but the differences were not statistically significant. Nineteen (11.8%) patients had a recurrence. DSS was statistically significantly lower in patients with recurrence (p < 0.001). Conclusion: The results of our study showed that anterior commissure involvement, surgical margin positivity, and higher T stage statistically did not reduce survival rates in early-stage LSCC patients treated with LTLM. As the histopathological grade of the tumor worsens, the risk of surgical margin positivity increases. RT may have a negative effect on recurrence and organ preservation in the additional treatment of patient with positive surgical margins.

Background/aim Because of close relations to important anatomical structures such as cavernous sinus and optic nerve, sphenoid sinus variations must be well trained by the Otolaryngologist who has an interest in endoscopic sinus surgery. Newly defined sphenoseptal cell (SSC) is one of those variations that may lead to insufficient endoscopic sinus surgery outcomes if not defined preoperatively with imaging studies. The present study aimed to present the main characteristics of this special type of nasal cell. Materials and methods In this study 610 paranasal sinus CT scans were analyzed and reviewed retrospectively between May 2018 and December 2019. Also, endoscopic findings of SSC, that cause a surgical catastrophe in identifying skull base and sella are presented during transnasal transsphenoidal pituitary surgery. Results According to its definition and relation to the sphenoid sinus and the skull base, an SSC was seen in 21 scans of 610 patients (3.4%), 11 were women (55%) and 10 were men (45%). Conclusion Although an SCC is a rare variation of nasal air cells, preoperative diagnosis of this cell is of paramount importance in some patients during endoscopic transnasal surgery for the identification of skull base.

Objective: To reveal the incidence and predictive parameters of occult cervical lymph node metastasis (LNM) in patients with cN0 laryngeal squamous cell cancer (LSCC) who underwent surgery as definitive treatment. Methods: Patients with cN0 laryngeal cancer who had undergone elective neck dissection together with partial or total laryngectomy between January 2006 and November 2020 were retrospectively analyzed. Clinical and histopathologic predictors of occult metastasis were also analyzed. Follow-up data were used to obtain recurrence and survival analysis. Results: A total of 86 patients with a mean age of 62.5 years were included in the study. Occult LNM was detected in 15 (17.4%) patients. Tumor grade, pT stage, thyroid cartilage invasion, and extralaryngeal extension were found to predict occult neck metastasis in univariate analysis. The mean follow-up time was 60.7 months and in the survival/recurrence analysis, pT stage, tumor location, tumor grade, presence of occult metastasis, pre-epiglottic space involvement. and extralaryngeal extension were found to predict poorer outcome. Conclusion: Overall occult LNM is low (17.4%) in N0 laryngeal cancer, but the presence of LNM is a poor prognostic factor. Correct determination of the neck status and proper treatment is crucial. The incidence of LNM is very low in T1–T2 stages and well-differentiated tumors. The “wait and see” strategy may be applied in T1–T2 cases as well as selected T3 cases with well-differentiated tumors.

Upregulation of the epidermal growth factor receptor (EGFR) gene has shown an important impact on the development of head and neck cancers due to its important regulation role on multiple cell signaling pathways. The aim of this study was to investigate the methylation pattern of the promoter region of the EGFR gene between head and neck squamous cell carcinoma (HNSCC) patients and a control group. Forty-seven unrelated HNSCC patients, clinically diagnosed at the Department of Otorhinolaryngology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey, and 48 unrelated healthy volunteers from different geographic regions of Turkey, were included in this study. Methylation status of the promoter region of the EGFR gene was detected by methylation-specific-polymerase chain reaction (MS-PCR). The correlation between EGFR gene promoter methylation profiles and clinical characteristics were examined using the χ2 test. Methylation was observed in 79.0% of HNSCC patients, whereas this ratio was 90.0% in healthy individuals. The results show that promoter region methylation of the EGFR gene was not associated with HNSCC development in the studied Turkish patient group. In addition, the methylation status of the EGFR gene promoter was not found to be related to age, gender or tumor stage.

This study aimed to analyze laboratory and radiological imaging results in the prediction of treatment strategy in patients with deep neck infections. Eighty-three patients (55 (66.3%) men, mean age: 38.2±14.5 years) were included in the study. Patients were divided into three groups according to the treatment strategy: group 1 received only antibiotic treatment, group 2 underwent abscess drainage with needle puncture in addition to antibiotic treatment, and group 3 underwent surgical drainage with antibiotic treatment. Laboratory outcomes, imaging methods, duration of hospital stay, treatment strategy, and clinical outcomes were analyzed.According to the laboratory results, complete blood count values did not vary among the three groups, but C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values were higher in group 3 (p

The aim of this study was to investigate the efficacy of N-acetylcysteine (NAC) on biofilm layers and on the course of disease in chronic otitis media.Twenty-five rats that were induced with chronic otitis media (COM) were separated into three groups. In Group 1 (N = 18), 0.2% ciprofloxacin + 0.1% dexamethasone sodium phosphate + 0.5 mg/ml NAC solution was locally injected to the right ear of the rats; in Group 2, (N=18) 0.2% ciprofloxacin + 0.1% dexamethasone sodium phosphate was locally injected to the left ear of the rats. No treatment was applied to either ear of rats in Group 3 (N = 5). Histopathological and scanning electron microscope (SEM) evaluations were performed in all groups.SEM revealed biofilm formation in all COM induced groups. No significant difference was seen between groups 1 and 2 in terms of suppuration levels, fibrosis, inner ear involvement, infection staging and biofilm formation (p0.05).In this study, while histopathological and SEM evaluation revealed no effect of 0.5 mg/ml NAC on the biofilm layer in COM-induced rats, further studies with NAC at different concentrations are still needed on different types of experimental animals.L’effetto della N-acetil cisteina sullo strato di biofilm in un modello sperimentale di otite media cronica.Lo scopo di questo studio è quello di valutare l’efficacia della N-acetilcisteina (NAC) sullo strato di biofilm e sul decorso della malattia nell’otite media cronica.Venticinque ratti con otite media cronica (COM) sono stati divisi in tre gruppi. Nel gruppo 1 (N = 18) sono stati iniettati 0,2% di ciprofloxacina + 0,1% di desametasone sodio fosfato + 0,5 mg / ml di soluzione NAC all’orecchio destro dei ratti; nel gruppo 2 (N = 18) sono stati iniettati localmente 0,2% di ciprofloxacina + 0,1% di desametasone sodio fosfato all’orecchio sinistro dei ratti. Nessun trattamento è stato applicato alle orecchie inoculate dei ratti nel gruppo 3 (N = 5, entrambe le orecchie). Sono state eseguite valutazioni istopatologiche e valutazioni al microscopio elettronico (SEM) mediante scansione.SEM ha documentato la formazione di biofilm in tutti i gruppi indotti con COM. Nessuna differenza statisticamente significativa è stata osservata tra i gruppi 1 e 2 in termini di livelli di suppurazione, fibrosi, coinvolgimento dell’orecchio interno, stadiazione dell’infezione e formazione di biofilm (p0,05).Anche se in questo studio la valutazione istopatologica e SEM non ha rivelato alcun effetto del 0,5 mg/ml NAC sullo strato di biofilm nei ratti indotti dalla COM, per arrivare a una conclusione migliore è necessario eseguire ulteriori studi con di NAC a diverse concentrazioni su differenti tipi di animali da esperimento.

Background/aim We aimed to revealthe incidence and predictive role of insulin resistance and distorted oral glucose tolerance test in nondiabetic patients withBell’s Palsy (BP). Materials and methods Eighty-sixpatients with BP and 28 control subjects; all with normal blood glucose levels and no history of diabetes, were enrolled in the study. We investigated insulin resistance (IR) in all subjects, in terms of HOMA-IR greater than 2.7. Sixty-two of the patients also underwent an oral glucose tolerance test (OGTT). Results The mean HOMA-IR value was significantly increased in patients, compared to the control group (3.2 vs 1.6; P < 0.01). IR was detected more in BP patients than in controls (P < 0.05). The patients with higher HOMA-IR values had more severe facial dysfunction at the initial presentation and complete recovery time took longer than the patients with normal HOMA-IR value (75 days vs 42 days; P < 0.05). Following a 2h-OGTT, impaired glucose tolerance and newly diagnosed DM were found in 60% of the patients. Recovery time was significantly longer in prediabetics and newly diagnosed diabetic patients than in patients with normal glycemia (68 days, 52 days, and 32 days, respectively; P < 0.01). Conclusion There is a strong linkage between HOMA-IR value and BP prognosis so HOMA-IR value may have a significant role of predicting BP prognosis at presentation.

Background Drainage of pelvic abscesses is interventional procedures that should be well planned due to organ contiguity. There are not enough publications in the literature evaluating the treatment methods of pelvic abscess drainage and comparing success rates. Methods In this study, 15 patients who underwent pelvic abscess drainage in our interventional radiology unit between June 2017 and December 2019 were retrospectively included. Abscess size, abscess characteristics, the method of access to abscess (transrectal, transvaginal, transgluteal), and drainage treatment procedure (needle aspiration, catheter treatment) were evaluated statistically in terms of effects on the success of treatment. Results Of the 15 patients included in the study, 6 (40%) were male and 9 (60%) were female, with a mean age of 31.6 years.In 2 of the patients treated with needle aspiration alone, the abscess collection was repeated and the second procedure was performed. In our study, the technical success was 100% and the complete clinical success was 80%. None of the patients underwent open surgery due to abscess after drainage treatment. Conclusion In conclusion, endocavitary and percutaneous drainage treatments of pelvic abscesses are safe and effective treatment methods. The success of needle aspiration treatment is lower than catheter treatment and it should be considered that the abscess collection may recur.

Amaç: Glomus karotikum, vagale ve jugulare tümörlerinde preoperatif yapılan endovasküler embolizasyon işlem sonuçlarının değerlendirilmesi amaçlandı.Gereç ve Yöntemler: 2012-2017 yılları arasında glomus tümörü nedeniyle 18 hastaya tanısal anjiyografi ve bazılarına da embolizasyon yapıldı. Hastaların demografik bilgileri, tümör tipleri, embolizasyon ve komplikasyon oranları analiz edildi. Tümör embolizasyonunun etkinliğine, girişim öncesi ve sonrası alınan anjiyografiler karşılaştırarak karar verildi. Hastalar girişim sonrası vital bulgular ve olası komplikasyonlar açısından en az 24-48 saat takip edildi.Bulgular: Tanısal anjiyografi yapılan 18 hastadan 10’una eş zamanlı embolizasyon da uygulandı. Altı hastada glomus jugulare, 1 hastada glomus vagale, 10 hastada glomus karotikum ve 1 hastada eş zamanlı glomus jugulare ve vagale mevcuttu. En sık embolize edilen arter %50 oranı ile asendan faringeal arterdi. Embolizasyon yapılan hastalarda tümör kan akımında en az %70 oranında bir azalma meydana geldiği saptandı. Yapılan işlemler ile ilgili herhangi bir komplikasyon oluşmadı. Sonuç: Endovasküler selektif arter embolizasyonu glomus tümörlerinin preoperatif tedavisinde güvenilir ve etkin bir yöntemdir.

To analyze the association between obstructive sleep apnea syndrome (OSAS) and some hematological variables such as mean platelet volume (MPV), platelet distribution width (PDW), and the impact of positive airway pressure (PAP) treatment on these parameters. The participants of the present prospective study consist of 36 OSAS patients diagnosed with polysomnography and recommended PAP treatment and 30 healthy members as the control group. Complete blood analyses were conducted to the patient group twice; before the initiation of the PAP treatment and 1 month after regular PAP use. The control group was administered a complete blood analyses only once. Patient and control group were compared in terms of various parameters such as MPV, PDW, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) values, and platelet counts. MPV value of the patient group was before and after PAP treatment significantly higher than the control group (respectively; Z = 2.246; p = 0.025, and Z = 2.033; p = 0.042). However, there were no statistically significant differences in the values before and after PAP treatment in the patient group (Z = 0.727; p = 0.467). In terms of platelet numbers and PDW values, no significant differences were determined (p > 0.05). MPV value was significantly elevated in OSAS patients. However, the 1 month of PAP treatment was insufficient in decreasing elevated MPV values.

Objectives: This study aimed to investigate the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) and Bell’s palsy in addition to the usability of these markers to predict prognosis. Methods: In this prospective study, the patient group included 24 patients that were diagnosed with Bell’s palsy and 29 healthy volunteers that had similar characteristics to them regarding age and gender with patient group as the control group. The temporal gadolinium-enhanced magnetic resonance imaging (TGd-MRI) was performed to all patients. The complete blood count was also obtained from both the patient and the control groups, and these two groups were compared for NLR and PLR, mean platelet volume (MPV), platelet distribution width (PDW), and platelet count. The relationship between these markers and Bell’s paralysis prognosis was also investigated. Results: The patient and control groups were similar in age and gender (p > 0.05). NLR was significantly higher in the patient group compared with the control group (p = 0.016). There was no correlation between the NLR value and the prognosis of Bell’s Palsy. The PDW and white blood cell count (WBC) were significantly higher in the patient group than the control group (p = 0.023 and p = 0.012, respectively). A comparison of the recovered and unrecovered patients revealed that the PDW value was significantly higher and the platelet count was lower in the recovered patients than the unrecovered patients (p = 0.009 and p = 0.003 respectively). The MPV value was higher in the recovered patients, though not statistically significant (p = 0.063). Based on the cut-off values determined in the receiver operator characteristic (ROC) curve analysis, a comparison of the recovered and unrecovered patients reveals that the likelihood of not healing was significantly higher in those that had normal PDW values (p = 0.036).

Introduction: We hypothesized that oxidative stress plays a role in the pathogenesis of chronic otitis media, chronic mucosal inflammatory disease. We aimed to investigate a novel oxidative stress marker in this study. Materıals and methods: Thirty patient with chronic otitis media as the patient group and 30 healthy volunteer subjects as the control group were admitted to the study. Blood samples were taken when they admitted to our clinic before surgical intervention. In healthy volunteers, blood samples were taken when they were admitted to our policlinic. Thiol/disulphide levels were analyzed with a newly developed method by Erel and Neselioglu.Results: 30 subjects were included in chronic otitis media group (20 females, 10 males). 30 subjects were included in the control group (8 females and 22 males). Sex distribution within the groups was significantly different (p=0.004). There was no significant difference between groups with respect to the age distribution (p=0.072). Measured native thiol, disulphide and total thiol values of the groups were not significantly different from each other. Conclusion: This study demonstrated that although dynamic thiol/disulphide homeostasis was shifted towards disulphide formation as a result of thiol oxidation in patients with chronic otitis media. But we could not find any significant difference between groups.

11th International Ear Nose Throat Diseases and Head and Neck Surgery Congress -- APR, 2014 -- -- Ankara, TURKEY, WOS: 000458367000031, PubMed: 30761884, Backround/aim: Papillary thyroid carcinomas (PTC) frequently metastasize to regional lymph nodes. Our purpose was to investigate the predictive role of tumor location for lymph node metastasis pattern in PTCs. Materials and methods: Medical records of 110 PTC patients were reviewed retrospectively. Tumor location was determined as upper, middle, and lower pole according to ultrasonography (USG) findings. The effects of age, sex, tumor size, and location on lymph node metastasis were investigated. Results: The series comprised 87% females (n = 96) and 13% males (n = 14). Forty-three patients had central neck metastasis (CNM) and 14 had lateral neck metastasis (LNM). Upper pole tumors (UPT) metastasized to the central neck (CN) at a lower rate (17.6%) than middle (40.0%) or lower (48.5%) poles overall (P = 0.104), while it was at a significantly lower rate (13.3%) in the PTC group (P < 0.05). UPTs (n = 17) metastasized to the lateral neck (LN) almost 2-fold more. It was observed that 3 of 4 UPTs spread directly to the LN without CNM. Conclusion: In our opinion, UPTs have propensity to demonstrate metastasis to LN rather than the CN in PTCs. Therefore, UPTs should be evaluated meticulously in terms of LNM. New studies could suggest that CN dissection is not performed for low-risk PTCs in UPTs.

Idiopathic subjective tinnitus has a complex pathophysiology in which not only cochlear and central classical auditory pathways but also nonclassical auditory pathways of different parts of the brain are involved. Vestibuloocular and vestibulocollic pathways are the central projections of utricle and saccule used in the vestibular evoked myogenic potential (VEMP) test. Aim of this study was to investigate the effects of idiopathic subjective tinnitus on vestibuloocular and vestibulocollic pathways via VEMP. We prospectively analyzed 30 unilateral idiopathic subjective tinnitus patient's cervical, ocular VEMP tests, tinnitus handicap index scores, symptom duration and compared with contralateral ear and 35 healthy volunteers. The latencies and amplitudes of P1 and N1 waves were recorded and pathologic wave criteria was calculated according to healthy volunteer's data. In cervical VEMP there were significant longer latencies of P1 and N1 waves with respect to contralateral ear and control group. In ocular VEMP test, N1 and P1 latencies and amplitudes were not significantly different. The percentages of pathologic wave of the tinnitus side were not significantly higher in both cervical VEMP and ocular VEMP tests with respect to contralateral side. Tinnitus handicap index scores and symptom duration had no relationship with latency and amplitude of VEMP tests. Although cervical VEMP P1 and N1 latencies were significantly longer, subjective tinnitus did not result in pathological alterations in the VEMP test. Presence of subjective tinnitus is not an influencing factor in the VEMP interpretation.

Objectives To use multifrequency multicomponent tympanometry (MF-MCT) for evaluating the middle ear mechano-acoustics of children with a history of ventilation tube (VT) insertion and to determine the effects of tube insertion sequelae on middle ear function. Methods A prospective case-control study in a tertiary referral center involving 26 children (51 ears) aged 3–15 years. The children had undergone VT insertion surgery at least one-year previously and had no other known ear diseases. In addition, 13 age-matched healthy controls (26 ears) with no prior history of ear disease were included. The patients and control subjects underwent an otoscopic examination, standard 226 Hz tympanometry, and MF-MCT. Results In 13.7% of cases, the VT was still in place in the operated ears. Post-operative myringosclerosis and/or eardrum retraction were noticed in 30% of ears with intact tympanic membranes in the patient group. While patients exhibited a great variability of tympanometric types (with standard 226 Hz tympanometry and tympanometric patterns with 1000 Hz MF-MCT), all cases in the control group had type A tympanograms and 3B1G patterns. Conclusion The effects of VT treatment on the mechano-acoustics of the middle ear have been revealed in this study. It has also been determined that VT application may increase the mass effect on the middle ear functions, which can be detected in the tympanometric shape and pattern.

Introduction: Tegmen defect (TD) has a potential of intracranial spread of middle ear infection, meningoencephalic herniation (MEH), and cerebrospinal fluid leakage (CSFL). Especially the defects >1 cm with MEH or CSFL are generally repaired via the classical middle fossa or minicraniotomy technique. The aim of this study was to show the efficiency of the intracranial, extradural placement of the septal cartilage graft in the closure of the TD larger than 1 cm via the transmastoid (TM) approach. Methods: The demographic, preoperative, intraoperative, and postoperative data of 11 patients with chronic otitis media (COM) who had TD larger than 1 cm were reviewed retrospectively. Hospitalization time and hearing preservation with respect to MEH or CSFL were analyzed. Results: The most common etiology of TD was cholesteatoma (82%), and 91% of the patients had multiple COM surgery history. The mean TD size was 15.4 (10–25) mm. Fifty-five percent of the patients presented with either MEH or CSFL. The mean follow-up of the patients was 22.5 (8–42) months. There was no significant difference between preoperative and postoperative mean bone conduction thresholds. Mean hospitalization time was 5.2 (3–10) days. There was no significant difference in the hospitalization time between patients with MEH or CSFL and without MEH or CSFL. Neither recurrence nor graft infection was encountered. Conclusion: Extradural grafting with the septal cartilage in the large TD up to 25 mm can be repaired efficiently via the TM approach without application of a lumbar drainage.

Background/aim To evaluate the clinical and histopathological effects of fetal brain tissue derived mesenchymal stem cells (FBTMSC) and fibrin glue (FG) on the facial nerve (FN) regeneration in rats with traumatic FN injury. Materials and methods Twenty-eight Sprague Dawley rats were included in the study and divided into 4 groups. Traumatic FN injury (FP) was created by a surgical clamp compression to the main trunk of left FN in all groups. In the control group (group 1) no treatment was applied, in group 2 (FBTMSC group) 2 × 106 FBTMSC was injected, in group 3 (FG group) only FG was applied, in group 4 (FBTMSC and FG groups) both FBTMSC and FG were applied to the injured section of the nerve. The FN functions were evaluated clinically, immediately after the procedure and at 3rd, 5th, and 8th weeks postoperatively. The FNs of all subjects were excised after the 8th week; then the rats were sacrificed. The presence of stem cells in the injured zone was assessed using bromo-deoxyuridine (BrdU), and apoptosis was determined by the TUNEL method. Results After the damage, total FP was observed in all subjects. Statistically significant functional improvement was observed in group 4 compared to all other groups (P < 0.005). TUNEL-positive cell count was statistically significantly higher in the control group than the other groups (P < 0.001). TUNEL-positive cell count was statistically significantly lower in group 4 than the other groups. The proportion of BrdU-stained cells in group 4 (5%) was higher than group 2 (2%). Conclusion Clinically and histopathologically FBTMSC applied with FG may play a promising role as a regenerative treatment in posttraumatic FP.

Background/aim This study aims to determine the therapeutic superiority of the addition of intratympanic steroid or hyperbaric oxygen therapy to systemic steroid treatment in idiopathic sudden sensorineural hearing loss as initial treatment, and evaluate the long- term results of salvage treatment. Materials and methods This study was a retrospective clinical trial with a total of 96 patients with idiopathic sudden sensorineural hearing loss. Patients were divided into 3 groups. Group 1 (n: 32) received systemic steroid treatment. Group 2 (n: 32) received the Group 1 protocol plus intratympanic steroid treatment. Group 3 (n: 32) received the Group 1 protocol plus hyperbaric oxygen treatment. Pretreatment and postinitial audiologic evaluations were performed, and the hearing outcome was analyzed with Furuhashi criteria. All patients, except those who experienced total recovery after initial treatment, were directed to salvage treatment. Audiologic assessment was performed again after salvage treatment and a mean follow-up period of 36.5 months. Results Each group was homogenous according to demographics, audiologic data, and prognostic factors. There was no statistically significant difference in recovery and success rate within the 3 groups after initial treatment. (P: 0.66, P: 0.248, respectively). Successful results were obtained after salvage treatment in only 3 patients (5%). These patients received follow-up treatment at a mean of 36.5 months, but there was no spontaneous recovery after the end of salvage treatment. Conclusion The addition of intratympanic steroids or hyperbaric oxygen to systemic steroids caused no significant hearing improvement as the initial treatment of idiopathic sudden sensorineural hearing loss. The efficacy of salvage treatment was limited, and there was no spontaneous hearing improvement after the long-term follow-up.

Objectives The majority of thyroid nodules are discovered incidentally, and the management may be a challenge if the fine needle aspiration specimen yields indeterminate findings. Our aim was to develop an individualized risk prediction model to provide an accurate estimate of cancer risk in patients with cytologically indeterminate thyroid nodules. Materials and methods Clinical records, ultrasound images, and cytopathology reports of patients who underwent thyroidectomy were retrospectively reviewed. Logistic regression analysis was used to identify the predictive ability of each variable for malignancy, and a nomogram was built by integrating patients' age, multiplicity of nodules, cytology results, and suspicious ultrasound features, such as microcalcifications and irregular margins. Results For the 233 indeterminate nodules according to the Bethesda System for Reporting Thyroid Cytopathology, the malignancy rates of the subgroups "atypia of undetermined significance," "suspicious follicular neoplasia," and "suspicious for malignancy" were 44.3, 47.7, and 88.0%, respectively. It was found that the Bethesda category "suspicious for malignancy," microcalcifications, and irregular margins were independent risk factors for malignancy. The area under the receiver operating characteristics curve was 0.784, which suggested that the presented nomogram had considerable discriminative performance. Conclusions The nomogram developed in our study accurately predicts the malignancy risk of thyroid nodules with indeterminate cytology by using clinical, cytological, and ultrasonographic features.

Background To analyze protective/regenerative effects of adipose tissue-derived mesenchymal stem cells (ADMSC) on 131I-Radioiodine (RAI)-induced salivary gland damage in rats. Materials and Methods Study population consisted of controls (n:6) and study groups (n:54): RAI (Group 1), ADMSC (Group 2), amifostine (Group 3), RAI+amifostine (Group 4), concomitant RAI+ADMSC (Group 5) and RAI+ADMSC after 48 h (Group 6). We used light microscopy (LM), transmission electron microscopy (TEM), and salivary gland scintigraphy (SGS), and analyzed data statistically. Results We observed the homing of ADMSC in salivary glands at 1st month on LM. RAI exposure affected necrosis, periductal fibrosis, periductal sclerosis, vascular sclerosis and the total sum score were in a statistically significant manner (P < 0.05). Intragroup comparisons with LM at 1st and 6th months revealed statistically significant improvements in Group 6 (P < 0.05) but not in Groups 4 and 5. Intergroup comparisons of the total score showed that Groups 4 and 5 in 1st month and Group 6 in 6th month had the lowest values. TEM showed vacuolization, edema, and fibrosis at 1st month, and an improvement in damage in 6th month in Groups 5 and 6. SGSs revealed significant differences for the maximum secretion ratio (Smax) (P = 0.01) and the gland-to-background ratio at a maximum count (G/BGmax) (P = 0. 01) at 1st month, for G/BGmax (P = 0.01), Smax (P = 0.01) and the time to reach the maximum count ratio over the time to reach the minimum count (Tmax/Tmin) (P = 0.03) at 6th month. 1st and 6th month scans showed differences for Smax and G/BGmax (P = 0.04), but not for Tmax/Tmin (p > 0.05). We observed a significant deterioration in gland function in group 1, whereas, mild to moderate deteriorations were seen in protective treatment groups. Conclusions Our results indicated that ADMSC might play a promising role as a protective/regenerative agent against RAI-induced salivary gland dysfunction.

Defects in mucosal healing after sinonasal surgery cause infection, scar formation causing obstruction, relapse of the disease within a shorter period and revision surgery. The present study aimed to create a functional ciliated epithelium using a stem cell and stem cell sheet of adipose tissue origin and to show such regeneration ultra-structurally on experimentally injured rabbit nasal epithelium. This was an experimental animal study and basic research. A total of 18 white New Zealand rabbits were divided into three groups. The medial wall of the maxillary sinus of the subjects was peeled off bilaterally. No additional procedure was applied to the subjects in Group 1. In Group 2, adipose tissue-derived mesenchymal stem cell was implanted on the wound edges of the subjects. In Group 3, a stem cell sheet of three layers was laid onto the defect area. All subjects were killed after 3 weeks. The presence of the stem cell stained with bromo-deoxyuridine was assessed with a light microscope, whereas cilia density, ciliated orientation and cilia structure were evaluated with a scanning electron microscope. Ciliary densities in Group 2 and Group 3 were statistically superior compared to the control group (p

The objective of this study was to evaluate the volume of paranasal sinuses (PNS) and turbinate in patients with unilateral choanal atresia (CA). Computed tomography images of PNS in 11 individuals with unilateral CA were evaluated retrospectively. Mucosal thickness and volume of the maxillary, frontal and sphenoidal sinuses were determined, in addition to the volume of the middle and inferior turbinate. The unaffected nasal side of patients was used as a control group for the measurements. The results comprised the measurements of the atresic side compared to those of the healthy side. There was no significant difference between the atresic and healthy side of the nose in patients with CA with respect to mucosal thickness and volume of the PNS (the maxillary, frontal and sphenoidal sinuses) and the middle and inferior turbinate (p > 0.050). The complete absence of nasal unilateral airflow had no effect on the development of the PNS and the middle and inferior turbinate. Moreover, mucosal thickness in the sinuses was similar to that in the control group.

Amaç: komplikasyonlar sıklıkla görülmektedir. Bu çalışmada, akut pankreatite bağlı gelişen pulmoner komplikasyonlar nedeniyle mekanik ventilasyon uygulanan hastalarda bilgisayarlı tomografi şiddet indeksi (CTSI) ve geleneksel iki farklı skorlama sistemi olan APACHE II ve Ranson skorlama sistemlerinin uygulanabilirliği ve güvenilirliğinin karşılaştırılması amaçlandı. Gereç ve Yöntem: Çalışmaya, akut pankreatit tanısı ile mekanik ventilasyon uygulanan toplam 36 hasta dahil edildi. Mortalite oranlarının öngörülmesi için CTSI, APACHE II ve Ranson skorlama sistemleri kullanıldı. Bulgular: Toplam 36 hasta içinden sağ kalan hasta sayısı dokuz (%25) idi. Mortalite oranları yoğun bakımda %66.6 (n=24), hastanede ise %75 (n=27) olarak bulundu. Mortaliteyi öngörme konusunda 17'nin üzerinde APACHE II skoru en yüksek sensitivite (%64) ve spesifiteye (%66) sahipti. Bu oranları sırasıyla 4'ün üzerinde CTSI skoru (sensitivite %60, spesifite %40) ve 6 'nın üzerinde Ranson skoru (sensitivite %50, spesifite %46) takip etmekteydi. Sonuç: Bu çalışmada, akut pankreatite bağlı gelişen pulmoner komplikasyonlar nedeniyle yoğun bakımda mekanik ventilasyon uygulanan hastalarda mortaliteyi öngörme konusunda yüksek APACHE II, Ranson skoru ve CTSI skorlarının bağımsız birer belirleyici olduğu bulundu. Ancak APACHE II skorunun bu tür hastalarda; mortalite oranlarını öngörmede en güvenilir ve etkili bir skorlama sistemi olduğu belirlendi., Objective: To evaluate the utility of CT severity index (CTSI) and two main scoring systems (Ranson and APACHE II) for patients underwent mechanical ventilation due to pulmonary complications associated with severe pancreatitis. Materials and Methods: Mechanical ventilated patients due to severe acute pancreatitis were enrolled the study. CTSI and two traditional clinical scoring systems including APACHE II and Ranson were used to predict the mortality rates in mechanical ventilated patients due to severe AP. Results: Nine of 36 patients were survived (25%). The ICU (Intensive Care Unit) mortality was 66.6% (n= 24) and hospital mortality was 75% (n=27). Patients had upper then 17 scores for APACHE II score, the sensitivity and specificity were 64% and 66%, respectively to predict the mortality, by CTSI (>4) and Ranson scoring system (>6) with sensitivity and specificity of 60% and 40% and 50% and 46%, respectively. Conclusion: In this study, high scores of CTSI, Ranson and APACHE II were found to be independent predictors in patients underwent mechanical ventilated due to severe pancreatitis in ICU. However, APACHE II was the most reliable and effective scoring system for predicting the mortality rate.

Background: Head and neck paragangliomas are slowly growing benign tumors and they originate from specialized neural crest cells.Aims/objectives: This study aimed to express the safety of paragangl...

Giris: Aterosklerotik hastaliklar dunyada onemli bir morbidite ve mortalite nedenidir. Periferik arterlerde aterosklerotik degisiklikler sik rastlanmaktadir. Biz bu calismada alt ekstremitebilgisaraylitomografianjiografi (BTA) cekilen hastalarda iliak arter bifurkasyon seviyesinde plak dagilimlarini ve plaklarin yapisal ozelliklerini degerlendirmeyi amacladik. Gerec-Yontem: BTA cekilen ve iliakbifurkasyon seviyesinde plak saptanan 37 olgunun 67 alt ekstremitesiretrospektif olarak dahil edildi.Calismada elde edilen verilere ait betimsel degerler hasta sayisi, ortalama, standart sapma seklinde verildi. Kategorik veriler sayim ve yuzde olarak verildi. Bulgular: Ocak 2018-ocak 2019 tarihleri arasinda hastanemizde alt ekstremite BTA cekilen 37 olgunun 67 alt ekstremitesi retrospektif olarak calismaya dahil edildi. Iliak arter bifurkasyonunda en sik plak ana iliak arterlerde saptandi. Kadran olarak plaklar en sik olarak posterior kadran ikinci siklikta ise medial kadranda plak saptandi.Plaklar en sik olarak kalsiye idi. Yapi olarak ikinci siklikta mikst tip plak saptandi. Sonuc: Iliak arter bifurkasyonunda en sik plak ana iliak arterlerdedir. Kadran olarak plaklar en sik olarak posterior kadrandir.Plaklar en sik olarak kalsifiyedir.

Dysphagia and pain are most common problems after soft palate surgery in obstructive sleep apnea (OSA) patients.The aim of this study was to compare the postoperative pain scores and presence of dysphagia in patients who underwent anterior palatoplasty (AP) or uvulopalatal flap (UPF) surgeries.In this prospective study, AP or UPF was performed on the patients with mild or moderate OSA. Daytime sleepiness of all patients was evaluated with Epworth sleepiness scale (ESS). Snoring, pain and dysphagia complaint of the patients was evaluated with visual analog scale (VAS).In both AP and UPF groups, VAS snoring and ESS scores decreased significantly after operation. VAS pain and dysphagia scores were determined to be significantly higher in UPF compared with the AP.Since the success rates of surgical interventions to the soft palate are similar, preferring surgical approaches with a less damage to the life quality of patients after operations is more rational. In this regard, AP, which is technically quite simple with a short operation time and fewer postoperative complaints affecting life quality such as pain or dysphagia may be preferred in selected patients with OSA.

Objective This study aimed to investigate the correlation between morphological features of vocal fold polyps (VFPs) and subjective/objective voice parameters. Methods Perceptual evaluations, aerodynamic and acoustic tests were performed on 47 patients with VFPs. Still images were captured from video and the morphological features associated with the size of VFP were quantified. To reveal the correlation between size-related morphological features (length of polyp base, the ratio of polyp base to vocal fold length, glottal gap area) and objective/subjective parameters of voice, Pearson's and Spearman's tests were carried out. Results This cohort was composed of 30 (63.8 %) male and 17 (36.2%) female patients with the mean age of 45.2 years and 41.3 years, respectively. No correlation was found between the morphological features of VFPs and any of perceptual, aerodynamic and acoustic voice parameters. Conclusions Our findings indicated that controversies still exist regarding the role of vocal fold polyp morphology in clinical decision making.

Aim: The aim of this study was to investigate the relationship between tinnitus and the factors that cause the tendency to thrombosis in terms of gender.Material and Methods: Fifty-five consecutive patients who admitted to our clinic with the complaint of idiopathic subjective tinnitus were included in this study. Routine ENT (ear nose throat) examinations and pure tone audiometry test were performed. Prothrombin time (PT), partial thromboplastin time (PTT), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, Triglycerides, antithrombin III (AT III), protein C, protein S, homocysteine, antiphospholipid and anticardiolipin antibodies were examined in blood samples of patients. Temporal bone magnetic resonance imaging (MRI) was performed all patients. The results of the patients were compared in terms of gender and age groups (40 age).Results: The study was completed with 47 patients. Twenty-four of the patients were female and 23 were male. Both genders groups were similar in terms of age and pure tone average. Antiphospholipid and anticardiyolipin antibodies (IgG and IgM) were found as negative in all patients. Homocysteine levels were found to be statistically significantly higher in males than females (p=0.015; respectively 13.38±5.98 µmol/L and 9.87±3.11 µmol/L). AT III and Protein S levels were lower in males than females although this difference was not statistically significant (respectively p=0.07 and p=0.08)Conclusion: In this study, an association was shown between hyperhomocysteinemia and tinnitus, especially in males. Keywords: Tinnitus; tinnitus of vascular origin; thrombosis; gender role.

Small interfering RNA (siRNA)-based gene silencing strategy has high potential on suppressing specific molecular targets, involved in cancer progression. However, the lack of an effective nanocarrier system that safely delivers siRNA to its target still limits the clinical applications of siRNA. This study aimed to develop albumin-sericin nanoparticles (Alb-Ser NPs) as a novel siRNA delivery system for laryngeal cancer treatment. Nanoparticle formulations composed of albumin and sericin at different ratios (1:1, 2:1, 1:2 w/w) were synthesized by desolvation method. The nanoparticles were modified with poly-L-lysine (PLL) for siRNA binding and decorated with hyaluronic acid (HA) to target laryngeal cancer cell line, Hep-2. HA/PLL/Alb-Ser NPs were individually loaded with siRNAs for casein kinase 2 (CK2), Absent, Small, or Homeotic-Like (ASH2L), and Cyclin D1 genes, which are overexpressed in Hep-2 cells. Downregulation of genes was confirmed by real-time PCR (RT-PCR). Size, morphological, and thermogravimetric characterizations revealed that Alb-Ser NPs having 2:1 (w/w) ratio are the most optimized formulation. Between 36.8 and 61.3% of siRNA entrapment efficiencies were achieved. HA/PLL-siRNA/Alb-Ser (2:1) NPs-mediated gene silencing resulted in a significant inhibition of cell growth and induction of apoptosis in cells. Our findings showed that HA/PLL/Alb-Ser (2:1) NPs were promising as a siRNA carrier.

IBCT technique should be preferred owing to its high graft survival rate and ABG gain. While no significant difference was found in middle ear pressures between ears that underwent IBCT and normal ears, compliance values were found to be decreased in patients undergoing IBCT. However, the lack of correlation between ABG gain and compliance values indicated that compliance increase had no effect on post-operative ABG results.The aim of the present study was to compare tympanometric and audiological parameters in patients undergoing inlay butterfly cartilage tympanoplasty (IBCT) with their normal ears and to determine their difference with normal ear tympanometric parameters.Overall, 25 patients that underwent an operation between August 2010-May 2014 were included in the present study. In 13 of these patients, the ear that did not undergo operation was normal. 0.5, 1, 2, 4 kHz pure sound average values, tympanometric measurements and compliance values of normal and operated ears were compared.The graft survival rate in patients was found to be 92%. Mean pre-operative air-bone gap (ABG) was 16.4 ± 5.4 in patients, while mean post-operative ABG was 10.9 ± 5.8, with a statistically significant difference (p = 0.001) While there was no significant difference between operated and normal ears of patients in terms of middle ear pressure (0.441), compliance values were significantly higher in normal ears than those in operated ears (0.032). When post-operative ABG gain was compared with compliance values, no significant correlation was found between ABG gain and compliance measurements (r = -0.025 and p = 0.936).