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Introduction: Tularemia is a zoonotic disease caused by the Gram-negative coccobacillus Francisella tularensis. It is frequently overlooked in the differential diagnosis of neck masses because of its rarity. The purpose of this study is to report cases diagnosed with tularemia among patients presenting to our clinic with neck masses and to share our experience. Methodology: Patients presented to our hospital with cervical masses and diagnosed with tularemia were included in this retrospective study. Medical files of all patients were evaluated, and physical examination findings, titration values, date of diagnosis, location of the abscess or mass, place of residence, occupation, drinking water sources, sedimentation (SED), C-reactive protein (CRP), and white blood cell (WBC) values were recorded. Results: Seventy-six patients were included in the study. Forty patients (52.6%) were living in rural villages and 36 (47.4%) in urban areas. Thirty-one (40.8%) were engaged in animal husbandry and 29 (38.2%) in agriculture. In terms of drinking water sources, 59 patients (73.6%) obtained water from the mains, while 10 (13.32%) used well water. The most frequently observed clinical findings were swelling in the neck, sore throat, lethargy, and fever. Neck swelling frequently occurred in levels II and III. Conclusions: Since tularemia is rare and there are no specific clinical findings, diagnosis may be problematic. Ear, nose and throat (ENT) specialists should be familiar with the clinical symptoms of tularemia in the head and neck region and should consider a preliminary diagnosis of tularemia in the differential diagnosis of persistent neck masses.

SUMMARY OBJECTIVE: Noise-induced hearing loss is a preventable form of hearing loss that has serious social and economic impacts. This study aimed to investigate the protective effect of berberine, a potent antioxidant and anti-inflammatory agent, against Noise-induced hearing loss. METHODS: After applying distortion product otoacoustic emission, 28 female Sprague-Dawley rats were randomly divided into four groups. Group 1 was designated as acoustic trauma group, and rats in this group were exposed to white noise for 12 h at an intensity of 4 kHz 110 dB sound pressure level. Group 2 was the control group. Group 3 was designated as the berberine group, and 100 mg/kg of berberine was administered to rats in this group by intragastric lavage for five consecutive days. Group 4 was designated as the acoustic trauma+berberine group. distortion product otoacoustic emission was repeated on the 6th day of the study and cochlear tissues of rats were dissected for histopathological and immunohistochemical analyses after sacrificing rats. RESULTS: The distortion product otoacoustic emission results showed a significant decrease in signal-noise ratio values at higher frequencies in rats of the trauma group compared to those in other groups. Acoustic trauma caused severe histopathological impairment at cochlear structures together with severe 8-hydroxy-2-deoxyguanosine expression. Rats in the acoustic trauma+berberine group showed mild histopathological changes with mild 8-hydroxy-2-deoxyguanosine expression and better signal-noise ratio values. CONCLUSION: The histopathological and audiological findings of this experimental study showed that berberine provides protection in Noise-induced hearing loss and may have the potential for use in acoustic trauma-related hearing losses.

The study aimed to analyse the hearing levels of patients with gout using extended high frequencies (EHFs) audiometry. Thus, we aimed to reveal the early detectability of potential hearing losses.Comparative cross-sectional study.A single centre patient was diagnosed with gout disease.Two groups consisted of 32 patients with gout and 32 healthy volunteers.The primary outcome was hearing thresholds in pure tone (PT) audiometry and EHFs audiometry. Also, the association between audiometric results and haematological and biochemical parameters were evaluated.There was no significant difference between groups in terms of mean hearing thresholds in PT audiometry. But, at all frequencies above 4000 Hz (4000-18 000 Hz), the hearing thresholds were significantly higher in patients with gout. Also, the hearing thresholds above 8000 Hz were positively correlated with serum uric acid levels. Hearing thresholds at higher frequencies were positively correlated with haemoglobin levels and negatively correlated with high-density lipoprotein levels.To our knowledge, this is the first study in the literature demonstrating the high frequency of hearing loss in patients with gout using EHFs audiometry. We consider that using EHFs audiometry should have an important place in the early detection of potential hearing losses in gout patients.

Objective Several studies have looked at systemic immune-inflammation index (SII) (neutrophil x platelet x lymphocyte) values, which have been shown to be useful in determining tumor aggressivity and prognosis, as well as predicting recurrence risk, particularly in cancer cases. The purpose of the current study was to determine SII values in patients with parotid masses and investigate their utility in distinguishing between malignant and benign parotid tumors. Methods This retrospective study included 237 adult patients-112 women and 125 men-who were followed up on and treated for parotid mass between 2015 and 2021. The SII values determined were compared between the groups. Results The difference between the two groups was statistically significant (p = 0.001). In addition, SII values were higher in malignant tumors with perineural and lymphovascular invasion compared to other malignant tumors, although the difference was not statistically significant. Conclusions Although SII values yielded significant results in differentiating malignant from benign parotid tumors, since no significant cut-off value was determined, we do not think that they represent an effective marker capable of being used to distinguish between these tumors in clinical practice.

The purpose of this study was to employ biochemical, histopathological, and immunohistochemical methods to reveal the effectiveness of hesperidin and thymol in preventing radiotherapy-associated submandibular gland injury.A total of 48 female Sprague Dawley rats were randomly assigned into six groups of eight animals each. Group 1 represented the control group. Group 2 was regarded as hesperidin Group, and the rats received only hesperidin. Group 3 was regarded as thymol Group, and the rats received only thymol. Group 4 was regarded as a Radiotherapy Group, and the rats were exposed to radiotherapy at a dose of 15 Gy. Group 5 was regarded as hesperidin + Radiotherapy Group, and rats received hesperidin at a dose of 100 mg/kg daily for 1 week prior to radiotherapy exposition. Group 6 was regarded as thymol + Radiotherapy Group, and rats received thymol at a dose of 100 mg/kg daily for 1 week prior to radiotherapy exposition. Rats were sacrificed after radiotherapy and submandibular glands were dissected for biochemical and immunohistochemical evaluations.We have shown that, thanks to their strong antioxidant and anti-inflammatory properties, hesperidin and thymol minimize the damage caused by radiation toxicity by decreasing oxidant levels and increasing antioxidant enzyme levels in the submandibular gland. We found that thymol showed more protective activity than hesperidin in terms of effectiveness on radiation toxicity.Hesperidin and thymol exhibit histopathological, immunochemical, and biochemical protection against radiation-related submandibular gland injury. To our knowledge, this is the first study in the literature in this field.NA Laryngoscope, 2022.

Objective: Nasal septum perforation is an anatomical defect located in the nasal septal cartilage/bone and mucosa. The most common cause of nasal septal perforations is septoplasty. Repair of nasal septal perforations is difficult regardless of the surgical technique due to its location and health of the surrounding tissues. Currently, no technique has been defined to be used for closure of all nasal septal perforations. We aimed to present our bipediculated crescent-shaped unilateral slide flap technique, which we designed and used as a novel technique for closure of nasal septal perforations, and its surgical results. Design: Retrospective study. Settings: Single-center patients with nasal septum perforation. Participants: 36 patients who underwent nasal septum perforation repair in our clinic between 2018-2022. All patients underwent surgical procedure with the same technique by the same surgeon. Main Outcome Measures: Nasal septum perforation closure success at 6th month follow-up. Results: Thirty-six patients, including 20 males and 16 females, were included in the study. The mean age of the patients was 35,58±9,6. The most common cause of nasal septal perforation was previous septal surgeries. The septal perforation dimensions of the patients were between 5-23 mm and the mean was 13,86±5,4 mm. Septal perforation closure rate was determined as 94.4% in the 6 months follow-up results after surgery. Conclusion: Bipediculated crescent shaped unilateral sliding flap is an effective, easy and novel technique in the repair of nasal septal perforations.

In this study, we aimed to reveal the effectiveness of Quercetin and Naringenin in preventing radiotherapy-associated submandibular gland injury.The study was conducted using 48 adult female Sprague Dawley rats. The rats were randomly assigned into six groups of eight animals each. Group 1 represented the control group. The rats received only Naringenin was regarded as Group 2, received only Quercetine was regarded as Group 3. The rats exposed to radiotheraphy at a dose of 15 Gy was regarded as Group 4. Rats in group 5 were received Naringenin at a dose of 50 mg/kg daily for one week prior to radiotheraphy exposition while rats in group 6 was received Quercetine at a dose of 50 mg/kg daily for one week prior to radiotheraphy. Rats were sacrificed after radiotheraphy and submandibular glands were dissected for biochemical and immunohistochemical evaluations.Quercetin and Naringenin were found to have protective effect against radiation-induced damage. Naringenin and Quercetin increased the levels of Superoxide dismutase, Catalase, Glutathione Peroxidase, Glutathione and Total antioxidant status while decreasing the levels of Myeloperoxidase and Total oxidant status. Also, these agents inhibited the expression of Tumor Necrosis Factor-α and 8-hydroxy 2-deoxyguanosine immunohistochemically.With their powerful antioxidant and anti-inflammatory effects, Naringenin and Quercetin exhibit histopathological, immunochemical, and biochemical protection against radiation-related submandibular gland injury. In addition, Quercetin was found to be superior to Naringenin in terms of this efficacy.

Introduction: Cisplatin is an antineoplastic agent widely used in the treatment of a variety of cancers. Ototoxicity is one of the main side-effects restricting the use of cisplatin. Objective: The purpose of this study was to investigate the protective efficacy of gallic acid, in biochemical, functional and histopathological terms, against ototoxicity induced by cisplatin. Methods: Twenty-eight female Sprague Dawley rats were included. Rats were randomly assigned into four groups of seven animals each. Cisplatin group received a single intraperitoneal dose of 15 mg/kg cisplatin. Gallic acid group received intraperitoneal gallic acid at 100 mg/kg for five consecutive days. Cisplatin + gallic acid group received intraperitoneal gallic acid at 100 mg/kg for five consecutive days and a single intraperitoneal dose of 15 mg/kg cisplatin at 3rd day. A control group received 1 mL intraperitoneal saline solution for five consecutive days. Prior to drug administration, all rats were exposed to the distortion product otoacoustic emissions test. The test was repeated on the 6th day of the study. All rats were then sacrificed; the cochleas were removed and set aside for biochemical and histopathological analyses. Results: In cisplatin group, Day 6 signal noise ratio values were significantly lower than those of the other groups. Also, malondialdehyde levels in cochlear tissues were significantly higher, superoxide dismutase and glutathione peroxidase activities were significantly lower compared to the control group. Histopathologic evaluation revealed erosion in the stria vascularis, degeneration and edema in the connective tissue layer in endothelial cells, impairment of outer hair cells and a decrease in the number of these calls. In the cisplatin + gallic acid group, this biochemical, histopathological and functional changes were reversed. Conclusion: In the light of our findings, we think that gallic acid may have played a protective role against cisplatin-induced ototoxicity in rats, as indicated by the distortion product otoacoustic emissions test results, biochemical findings and immunohistochemical analyses. Resumo: Introdução: A cisplatina é um agente antineoplásico amplamente usado no tratamento de vários tipos de câncer. A ototoxicidade é um dos principais efeitos colaterais que restringem o uso da cisplatina. Objetivo: O objetivo deste estudo foi investigar a eficácia protetora do ácido gálico, em termos bioquímicos, funcionais e histopatológicos, contra a ototoxicidade induzida por cisplatina. Método: Vinte e oito ratas Sprague-Dawley foram incluídas. As ratas foram distribuídas aleatoriamente em quatro grupos de sete animais cada. O grupo cisplatina recebeu uma única dose intraperitoneal de 15 mg/kg de cisplatina. O grupo ácido gálico recebeu ácido gálico via intraperitoneal a uma dose de 100 mg/kg durante cinco dias consecutivos. O grupo cisplatina + ácido gálico recebeu ácido gálico via intraperitoneal a uma dose de 100 mg/kg durante cinco dias consecutivos e uma única dose intraperitoneal de 15 mg/kg de cisplatina no terceiro dia. O grupo controle recebeu 1 mL de solução salina via intraperitoneal por cinco dias consecutivos. Antes da administração do fármaco, todos os ratos foram expostos ao teste de emissões otoacústicas - produto de distorção. O teste foi repetido no sexto dia do estudo. Todos os ratos foram então sacrificados; as cócleas foram removidas e reservadas para análises bioquímicas e histopatológicas. Resultados: No grupo cisplatina, os valores da relação sinal-ruído do dia 6 foram significativamente mais baixos aos dos outros grupos. Além disso, os níveis de malondialdeído nos tecidos cocleares foram significativamente mais altos, e as atividades de superóxido dismutase e glutatione peroxidase foram significativamente mais baixas em comparação com o grupo controle. A avaliação histopatológica revelou erosão na estria vascular, degeneração e edema na camada de tecido conjuntivo em células endoteliais, comprometimento das células ciliadas externas e diminuição do número dessas células. No grupo cisplatina + ácido gálico, estas alterações bioquímicas, histopatológicas e funcionais foram revertidas. Conclusão: Tendo em vista os nossos achados, consideramos que o ácido gálico pode ter desempenhado um papel protetor contra a ototoxicidade induzida por cisplatina em ratas, conforme indicado pelos resultados do teste emissões otoacústicas - produto de distorção, achados bioquímicos e análises imuno-histoquímicas. Keywords: Cisplatin-induced ototoxicity, Gallic acid, Oxidative stress, DPOAE, Palavras-chave: Ototoxicidade induzida por cisplatina, Ácido gálico, Estresse oxidativo, EOAPD

The aim of this study was to investigate the relationship between differentiated thyroid carcinomas (DTCs), histopathological findings and systemic immune-inflammation index (SII) [neutrophil (N) x platelet (P) / lymphocyte (L)] values.93 patients with DTC were included. N, P and L levels were measured, and the relationship between the SII and histopathological findings was determined. The results were compared with the values of 33 healthy controls.SII values were significantly higher in the patient group than in the control group (p = 0.000). Tumour pathology diagnosis had no significant effect on SII (p = 0.90). Perineural lymphovascular and capsule invasion and extrathyroidal extension also had no significant effect on SII values. SII was significantly higher in patients with more than one tumour focus (p = 0.01). No significant relationship was determined between tumour diameter and SII.SII is higher in patients with DTC compared to the healthy population. High SII values may be associated with multifocality. According to the results of this study, SII does not affect the histological type, perineural, lymphovascular and capsule invasion, or extrathyroidal extension of DTC.L’indice infiammatorio immunitario sistemico nei carcinomi differenziati della tiroide.Lo scopo di questo studio è quello di indagare la relazione tra i carcinomi differenziati della tiroide (DTC), i risultati istopatologici e i valori dell’indice infiammatorio immunitario sistemico (SII) (neutrofili (N) x piastrine (P) / linfociti (L)).In questo studio sono stati inclusi 93 pazienti con DTC. Sono stati misurati i livelli di N, P e L ed è stata determinata la relazione tra il SII e i risultati istopatologici. I risultati sono stati confrontati con i valori di un gruppo di controllo sano di 33 membri.I valori di SII erano significativamente più alti nel gruppo di pazienti rispetto al gruppo di controllo (p = 0.000). La patologia tumorale non ha avuto effetti significativi su SII (p = 0.90). Anche l’invasione linfovascolare perineurale e della capsula e l’estensione extratiroidea non hanno avuto effetti significativi sui valori di SII. Il SII era significativamente più alto nei pazienti con più di un focolaio tumorale (p = 0.01). Nessuna relazione significativa è stata determinata tra diametro del tumore e SII.SII è più alto nei pazienti con DTC rispetto alla popolazione sana. Valori elevati di SII possono essere associati alla multifocalità. Secondo i risultati di questo studio, la SII non influenza il tipo istologico, l’invasione perineurale, linfovascolare e capsulare o l’estensione extratiroidea del DTC.

Allergic rhinitis (AR) is a ubiquitous chronic disease with a growing incidence. We aimed to investigate the protective effect of naringenin against AR induced in rats. Thirty-two Sprague Dawley rats were divided into four groups of eight animals each. Group 1 represented the control group. The other 24 rats were sensitized with intraperitoneal 0.3 mg ovalbumin (OVA) and 30 mg aluminum hydroxide every other day for 14 days to induce AR. Ten microliters OVA was administered to both nostrils by inhalation for the following seven days to provoke AR. Group 2 represented the AR group and received no treatment. Group 3 was treated as the reference group and received 5 mg/kg desloratadine every day between days 15 and 21. Group 4 received 100 mg/kg naringenin orally between days 15 and 21. All animal’s sneezing and nasal itching scores were recorded on day 22. The rats were then sacrificed. Serum total IgE, IL4 and IL5 values were studied, and nasal structures were extracted ‘en bloc’ for histopathological examination. Significant clinical recovery was achieved in the group treated with naringenin. Serum total IgE, IL4 and IL5 values in the naringenin group were significantly lower than in the AR group, and significant histopathological improvement was observed compared to the AR group. Naringenin produced significant clinical, biochemical and histopathological benefits in rats with induced AR. These effects suggest that naringenin is a promising agent for the treatment of AR.

Septorhinoplasty is a surgical procedure widely employed by otolaryngologists and plastic surgeons. The purpose of this study was to investigate the effects of a single pre-emptive dose of iv ibuprofen on postoperative pain and opioid consumption in patients undergoing septorhinoplasty.50 patients scheduled for septorhinoplasty were included in this prospective, randomized, double-blinded study. Control group (n = 25) was administered 100 mL iv saline solution 30 min preoperatively, while Ibuprofen group (n = 26) received 800 mg ibuprofen iv. in 100 mL saline solution. Intravenous fentanyl was administered with a Patient Controlled Analgesia device after surgery for postoperative pain management. Postoperative pain was evaluated using a Visual Analogue Scale (VAS) with 0 representing no pain and 10 the worst pain possible.VAS scores at 10, 20, and 30 min and at 1, 2, 4, 8, 12 and 24 h were lower in the ibuprofen group than in the control group (p 0.05). Total fentanyl consumption was lower in the ibuprofen group compared to the placebo group (148.8 ± 86.4 mcq vs 338.00 ± 81.00 mcq), respectively.We suggest that the pre-emptive use of iv ibuprofen at a dosage of 800 mg 30 min before septorhinoplasty will be beneficial in reducing opioid consumption and pain scores.

To investigate the efficacy of perfusion magnetic resonance imaging (MRI) in benign-malignant differentiation of thyroid nodules. Images from 24 patients with thyroid masses were obtained using dynamic contrast enhanced MRI (DCE-MRI) at 3-T MR. DCE-MRI images were evaluated by post-processing of selected regions of interest (ROIs) on software, thus eliciting quantitative data for each voxel within the ROI. Ktrans, Ve, Kep, iAUC and chi(2) were calculated automatically. The DCE-MRI values of benign and malignant lesions were then compared. Mean Ktrans and iAUC values in malignant lesions were significantly lower than those in benign lesions (p = 0.028 and 0.049). Ktrans, Kep, and iAUC values in malignant lesions were statistically significantly lower than normal parenchyma values. In contrast to other tissues, the perfusion MRI findings of thyroid masses exhibit a decrease in Ktrans and iAUC values as malignancy increases. Perfusion MRI may be useful in differentiating benign and malignant thyroid nodules once a cut-off value has been determined by other studies.

Background320-row volume computed tomography (CT) allows CT dose to be reduced while maintaining image quality.PurposeTo evaluate image quality of low-dose non-contrast temporal bone CT using singl...

Rinolitiazis, burun icerisindeki bir yabanci cisim etrafinda kalsifiye materyal birikimidir. Genellikle burnun on kisminda bulunurlar. Tanisi endoskopik nazal muayene ve goruntuleme yontemlerine dayanir. Rinolitin yerinin belirlenmesi ve operasyon kararinin verilebilmesi icin bilgisayarli tomografi oldukca faydalidir. Bu makalede, sol nazal kavitede obstruksiyon, nefes almada gucluk ve son iki haftadir devam eden purulan nazal akinti sikayetleri ile klinigimize basvuran ve dev bir rinoliti olan 16 yasindaki bir hastayi sunduk. Endoskopik muayenede, nazal kavitedeki kitlenin nares girisinden koanaya kadar uzanim gosterdigi goruldu. Bilgisayarli tomografide sol nazal kaviteyi tama yakin dolduran, yuksek derecede ranyodensiteye sahip, rinolit ile uyumlu gorunum izlendi. Rinolit endoskopik olarak cikarildi. Cikarilan spesmen boyutlari 10x5x4 cm idi. Rinolitler nadir olup, tanisi burunda yabanci cisim oykusu ile birlikte fizik muayene ve nazal endoskopi ile konur. Rinolitlerin olusumu yillar alabilmektedir, bildigimiz kadariyla bu vaka, bu yas grubunda bugune kadar rapor edilmis en buyuk rinolit olgusudur.

Tramadol was found to be more effective than dexamethasone in post-operative pain control, with long-lasting relief of pain.This study aimed to compare the effects of pre-operative local injections of tramadol and dexamethasone on post-operative pain, nausea and vomiting in patients who underwent tonsillectomy.Sixty patients between 3-13 years of age who were planned for tonsillectomy were included in the study. Patients were divided into three groups. Group 1 was the control group. Patients in Group 2 received 0.3 mg/kg Dexamethasone and Group 3 received 0.1 mg/kg Tramadol injection to the peritonsillary space just before the operation. Patients were evaluated for nausea, vomiting, and pain.When the control and the dexamethasone groups were compared; there were statistically significant differences in pain scores at post-operative 15 and 30 min, whereas there was no statistically significant difference in pain scores at other hours. When the control and tramadol groups were compared, there was a statistically significant difference in pain scores at all intervals. When tramadol and dexamethasone groups were compared, there was no statistically significant difference in pain scores at post-operative 15 and 30 min, 1 and 2 h, whereas there was a statistically significant difference in pain scores at post-operative 6 and 24 h.

Free flaps based on static slings principles cannot provide esthetic and functional outcomes at a desired level in total or close to total lip loss. Therefore, dynamic methods have become a current issue in recent years and especially the idea of functional gracilis free muscle flap has been suggested. In this study, we present a case of a successful total lower lip repair with this flap.In a 78-year-old female patient who was diagnosed with squamous cell carcinoma involving the entire lower lip, bilateral modified radical neck dissection and full-thickness total resection with 1 cm surgical margin so as to include both commissures of the tumor were performed and then a free gracilis muscle flap was transferred from the same side. After microvascular anastomoses, the motor nerve of the flap was coapted to the marginal mandibular branch of the fascial nerve. The entire intra- and extraoral surfaces of the flap were covered with a partial-thickness skin graft which was taken from the right thigh. There was no any intra- or early postoperative complication. The skin graft and flap survived without any problem.In the controls of the patient who was followed-up for 8 postoperative months, it was observed that the gracilis muscle flap was well-adapted to its place, gained a very good tonus, its volume reduced over time and reached to ideal dimensions, and the overlying skin graft provided a good color and texture match with the surrounding tissues. The motor activity of the muscle was monitored with the Tinel's test. The speech and facial expressions of the patient were very clear. Despite the patient has an edentulous mandible and was not using prosthesis, her feeding with fluid and solid foods was free of problems, oral competence was highly sufficient, and there was no any drooling. Esthetic appearance was very good and intraoral vestibular depth was sufficient. The mouth opening was 3 cm. When comparing with upper orbicularis oculi muscle on the electroneuromyography (ENMG) ordered at the 8th month, a similar nerve conduction time (3.3 versus 3.8 ms) and contraction amplitude (0.5 versus 0.4 mV) values were obtained from the gracilis muscle. Follow-up of the patient is still continued with no tumor recurrence observed during this period.Being the real dynamic flap and its tonus of the functional gracillis free muscle flap in opposite to the static methods provides a significant superiority over the other options in terms of oral functions; moreover, the overlying skin graft presents a very good color and texture harmony aesthetically. This method is a candidate to be an exclusive surgical technique in the repair of total or close to total lip losses in the future.

Objective Tonsillectomy is one of the most common surgical procedures performed at ear, nose, and throat clinics. Chronic recurrent tonsillitis, obstructive tonsillitis, and halitosis are among the most common indications for surgery. Determining whether the infection is chronic and the patient's annual number of infections are important in estimating the necessity for surgery to be performed due to infectious causes. Red blood cell distribution width (RDW) is a numerical value present in normal complete blood count that provides information about erythrocytes and their dimensions. Studies in recent years have shown that RDW increases in chronic infections, hypoxia, and oxidative stress. This study investigated the changes in RDW in patients with chronic tonsillitis and the effect tonsillectomy has on this value by comparing RDW between patients scheduled for tonsillectomy and normal population and examining preoperative and postoperative changes in RDW. Materials and Methods Sixty-three patients scheduled for tonsillectomy due to recurrent tonsillitis aged 4-14 years were included in the study. The control group consisted of 60 subjects comparable in terms of age and sex. Hemoglobin level and RDW were recorded by collecting 2 mlof blood before surgery and at 4 months postoperatively from all patients. Results Preoperative RDW was significantly higher in the patient group than in the control group. Comparison of patients' preoperative and postoperative RDW revealed a significant decrease in RDW after surgery. Conclusion As a biomarker showing chronic infection in patients with tonsillitis, RDW can provide support to the clinician in deciding on surgery. However, this has to be confirmed in further studies with greater participation.

Deep neck infection (DNI) refers to infections in spaces created by superficial and deep cervical fascia around the muscles and organs in the neck. Vitamin D is highly important for an effective immune system. Vitamin D receptors (VDR) have been identified in immune system cells, and particularly in T and B lymphocytes, macrophages, and dendritic cells. Vitamin D deficiency is thought to result in impaired immune response, decreased leukocyte chemotaxis, and an increased disposition to infection. The purpose of this study was to investigate whether vitamin D deficiency is an underlying occult factor in the development of DNI. Sixty-five patients aged 6 to 90, diagnosed with DNI, and 70 healthy age- and sex-compatible cases were included in the study. Serum levels of calcium, phosphorus, parathyroid hormone, and 25-hydroxy vitamin D (25(OH)D) were determined in each case. 25-hydroxy vitamin D levels above 20 ng/mL were regarded as normal, 12 to 20 ng/mL as insufficient, 5 to 12 ng/mL as deficient, and less than 5 ng/mL as severely deficient. Mean serum 25(OH)D levels were 10.4 (6.2) ng/mL in the patient group and 15.5 (6.4) ng/mL in the control group ( P < .01). This difference was statistically significant ( P < .01). Vitamin D was within normal limits in 9.2% (n = 6) of cases in the study group, insufficient in 29.2% (n = 19), deficient in 35.3% (n = 23), and severely deficient in 26.2% (n = 17). The equivalent values in the control group were 21.4% (n = 15), 48.5% (n = 34), 30% (n = 21), and 0% (n = 0). Serum 25(OH)D levels were significantly lower in patients with DNI compared to the healthy cases; 25(OH)D levels may be a factor in the development of DNI.

The aim of this randomized prospective study was to investigate the postoperative analgesic effectiveness of bupivacaine versus bupivacaine plus dexamethasone-soaked nasal packing in patients scheduled for endoscopic nasal surgery.Sixty American Society of Anesthesiologists groups I and II patients aged 18 to 65 years and scheduled for endoscopic nasal surgery were assigned into 2 groups. Group B received 8 mL 0.5% bupivacaine and 2 mL saline, and group BD received 8 mL 0.5% bupivacaine and 8 mg (2 mL) dexamethasone-soaked nasal packing. In the postoperative period, 1000 mg paracetamol was administered and repeated every 6 hours. Postoperative pain scores, additional analgesia requirements and nausea-vomiting were recorded.Postoperative pain scores were significantly lower in group BD than in group B at 1, 2, 4, 8, and 12 hours, and during tampon removal (P 0.05), but there was no difference between the groups' 24-hour visual analog scale scores (P = 0.115). Postoperative additional analgesia use was statistically significantly higher in group B than in group BD (25/30 versus 13/30 respectively, P = 0.001). Postoperative nausea and vomiting was statistically higher in group B than in group BD (11/30 versus 4/30 respectively, P = 0.037).The addition of dexamethasone to bupivacaine via soaked nasal packing in endoscopic nasal surgery reduced postoperative pain scores, additional analgesia requirements, and PONV. The authors recommended a combination of bupivacaine plus dexamethasone-soaked nasal packing after endoscopic nasal surgery.

Aim: Aminoglycoside group drugs are widely used due to their broad spectrum and low cost. Clinical or subclinical nephrotoxicity and ototoxicity may frequently be seen as side-effects. The purpose of the present study was to investigate the protective efficacy of thymol and coenzyme Q10 in a gentamycin-induced ototoxicity model in rats.Materials and Methods: Thirty-six female Sprague-Dawley rats were divided into six groups of six animals each. The first group represented the control animals. The second group was exposed to ototoxicity induced by intraperitoneal (i.p.) gentamycin administration at 80 mg/kg for seven days. The third group received oral thymol at 10 mg/kg simultaneously with 80 mg/kg gentamycin. The fourth group received 20 mg/kg oral thymol simultaneously with i.p. 80 mg/kg gentamycin. The fifth group received 10 mg/kg coenzyme Q10 simultaneously with i.p. 80 mg/kg gentamycin, and the sixth group received 20 mg/kg coenzyme Q10 simultaneously with i.p. 80 mg/kg gentamycin. All animals were sacrificed by decapitation under anesthesia at the end of the seventh day. The temporal region was extracted en bloc, and cochlear structures were subjected to histopathological and immunohistochemical examination.Results: Immunohistochemical and histopathological analyses showed that thymol and coenzyme Q10 administered at dosages of 10 mg/kg and 20 mg/kg reduced such effects as hyperemia in the stria vascularis, decreases in inner hair cell numbers, and degeneration in spinal ganglion cells, and produced a decrease in caspase-3 activity. Significantly better results were obtained with high-dose treatments compared to the low-dose groups. The protective efficacy of coenzyme Q10 applied at a dose of 20 mg/kg was particularly marked compared with the ototoxicity group.Conclusion: Coenzyme Q10 and thymol exhibited marked protective effects against ototoxicity induced in rats. Coenzyme Q10 and thymol are two important antioxidant substances with the potential for use in preventing side-effects that may develop in association with gentamycin use.

Aim: The primary treatment of primary hyperparathyroidism (PHPT) is parathyroidectomy. With its shorter operative time and healing period, lesser general anesthesia duration, lesser hypoparathyroidism risk and better cosmetic results minimally invasive parathyroidectomy is the most commonly performed contemporary surgical procedure. However, in order for this procedure to be successful, it is important to know the location of the parathyroid adenoma. The purpose of this study was to determine the diagnostic value of Ultrasonography (USG) and technetium methoxyisobutylisonitrile scintigraphy (99mTc-MIBI) in the preoperative localization of parathyroid adenoma. Materials and Methods: Fifty-two patients diagnosed with parathyroid adenoma were included in the study. Preoperative parathyroid USG and 99mTc-MIBI were performed on all patients. All patients’ preoperative serum calcium, phosphorus, parathormone and Vitamin D levels, parathyroid USG and 99mTc-MIBI, intraoperative parathyroid lesion location and histopathological examination results were recorded. Results: Patients aged between 22 and 81 (51.7±15.6) were eventually enrolled. When USG was used alone, the site of the adenoma was correctly determined in 26 of the 52 patients with a sensitivity of 52% and a positive predictive value of 92.8%. When scintigraphy was performed alone, the site of the adenoma was correctly identified in 39 of the 52 patients. Sensitivity was thus 76.4% and positive predictive value 97.5%. When USG and scintigraphy were assessed together, adenoma location was correctly identified in 45 of the 52 patients. Sensitivity for the two tests employed together was 88.2% and positive predictive value was 97.8%. Conclusions: Due to the high sensitivity of combined use of USG and 99mTc-MIBI, we recommend the two tests to be assessed together before parathyroid surgery.

Purpose We aimed to determine the effect of a cartilage shoe graft placed between the foot of the TORP and the stapes footplate on hearing improvement and long-term displacement rates. Materials and methods Patients who underwent TORP ossiculoplasty were divided into two groups. The TORP-alone group consisted of 32 patients who underwent TORP placement without cartilage shoe graft and served as the control group. The study group consisted of 56 patients who underwent placement of cartilage shoe graft together with TORP. Pure-tone audiometry was administered to all patients before and 3, 6 and 12 months after surgery. Indications for surgery, surgical technique used, postoperative complications, and air and bone conduction thresholds at 500, 1000, 2000 and 4000 Hz were recorded for all patients. Results No significant difference in postoperative air–bone gaps was observed between the groups. The number of patients with air–bone gaps less than 20 dB was 14 (25%) in the study group and 8 (25%) in the control group. There was no significant difference in changes in air–bone gaps between the groups. Dislocation of the prosthesis was observed in 3 patients in the study group (5.3%) and 4 in the control group (12.5%). There was less dislocation of the prosthesis in the study group, but the difference was not statistically significant. Conclusion Placement of a cartilage graft between the footplate of the stapes and the foot of the prosthesis may have positive effects on long-term hearing improvement and rates of prosthesis displacement. Further research with larger patient numbers is needed to identify the advantages of shoe graft.

Noise is a stress factor that causes auditory, psychological and physiological effects. The realization that sudden loud noises or chronic exposure to noise in social and working environments can cause hearing loss has led to increased interest in noise-induced hearing loss (NIHL). The best means of preventing primary damage is protection against noise. Since this protection is not always possible for various reasons, the use of pharmacological agents to prevent or treat NIHL should also be considered. The purpose of this study is to discuss current pharmacological protection and treatment options in the light of the literature, since no such extensive reviews have been performed to date, including agents used for protection against and treatment of NIHL. We reviewed both animal and clinical studies, and these are discussed separately for ease of comprehension. For each agent, first animal studies, then clinical studies, if available, are discussed. We also performed a two-step search of the literature. In the first step, we searched the terms "noise induced hearing loss", "treatment" and "protection" in Pubmed. Based on the results obtained, we identified the agents used for the treatment of and protection against NIHL. In the second step, we searched the names of the agents identified in the first step, together with the term "noise induced hearing loss," and reviewed the results.

Berberine and coenzyme Q10 (CoQ10) are agents with anti-inflammatory and antioxidant characteristics. The purpose of this study was to investigate the effectiveness of berberine and CoQ10 on allergic rhinitis. This study involved 30 Sprague–Dawley rats, and allergic rhinitis model was established with induction of ovalbumin. Rats were randomized into five groups. The first represented the control group, in which no allergy was established. The second represented the allergy group, in which allergy was induced but no treatment was given. In the remaining three groups, following induction of allergy, desloratadine at a dose of 10 mg/kg was given to Group 3, 100 mg/kg dose of berberine to Group 4, and 20 mg/kg dose of CoQ10 to Group 5. Nasal symptom scores, and plasma immunoglobulin-E, interleukin (IL)-4, IL-13, malondialdehyde (MDA) and nitric oxide (NO) levels were examined at the end of the study. Rats’ nasal tissues were also subjected to histopathological immunohistochemical examination. Nasal symptom scores, and plasma immunoglobulin-E, IL-4, IL-13, MDA and NO levels increased significantly in rats with induced allergic rhinitis. Berberine and CoQ10 significantly reduced these elevated levels. CoQ10 was also found as effective as desloratadin in terms of nasal symptom scores and biochemical parameters. At histopathological examination, severe allergic inflammation was observed in rats from allergic rhinitis group. At all treatment groups, the histopathological changes were significantly improved and only a mild inflammation was determined. Also, immunochemistry showed a significant improvement in all three treatment groups. Coenzyme Q10 and berberine were both effective in suppressing allergy symptoms. We think that berberine and coenzyme Q10 can usefully be employed as therapy due to their antioxidant and anti-inflammatory effects in an experimentally induced allergic rhinitis model.

BackgroundOtitis media with effusion is a clinical manifestation characterised by inflammation of middle-ear mucosa. This study investigated the therapeutic effect of erythromycin, clarithromycin, azithromycin and roxithromycin on a histamine-induced animal model of otitis media with effusion.MethodsThe animals were divided into five groups, receiving erythromycin, clarithromycin, azithromycin, roxithromycin or saline solution. The guinea pigs in the study groups received erythromycin (40 mg/kg/day), clarithromycin (15 mg/kg/day), azithromycin (10 mg/kg/day) or roxithromycin (10 mg/kg/day) for 3 days by gastric tube. Four hours after the end of the administration, histamine solution was injected into the right middle ear.ResultsThe lowest neutrophil density value obtained using stereological techniques was in the azithromycin group (0.86 ± 0.25 × 10−5/μm3), while the highest value was observed in the control group (6.68 ± 3.12 × 10−5/μm3). The anti-inflammatory properties of clarithromycin, azithromycin and roxithromycin were similar to one another, but better than that of erythromycin.ConclusionThe use of macrolide antibiotics is recommended, as they show antibacterial and anti-inflammatory efficacy in otitis media with effusion.

Introduction: Ototoxicity refers to cellular damage or function impairment developing in the inner ear in association with any therapeutic agent or chemical substance, and still represents the principal side-effect restricting the use of cisplatin. Objective: The aim of this study was to perform a biochemical, functional and histopathological investigation of the potential protective effect of eugenol against cisplatin-induced ototoxicity. Methods: The study was performed with 24 female Sprague Dawley rats. Distortion product otoacoustic emissions tests were performed on all animals, which were randomized into four equal groups. A single intraperitoneal dose of 15 mg/kg cisplatin was administered to cisplatin group, while the eugenol group received 100 mg/kg eugenol intraperitoneal for five consecutive days. 100 mg/kg eugenol was administered to cisplatin + eugenol group for 5 days. On the third day, these rats were received a single dose of 15 mg/kg cisplatin. The control group was given 8 mL/kg/day intraperitoneal saline solution for five days. The distortion product otoacoustic emissions test was repeated 24 h after the final drug administration. All animals were sacrificed, and the cochleas were subsequently used for biochemical and histopathological examinations. Results: Cisplatin caused oxidative stress in the cochlea, impaired the cochlear structure and significantly reduced signal noise ratio levels. Administration of eugenol together with cisplatin reversed these effects and provided functional, biochemical and histopathological protection. Conclusion: The study findings represent the first indication in the literature that eugenol may protect against ototoxicity by raising levels of antioxidant enzymes and lowering those of oxidant parameters. © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, This study was performed in accordance with the PHS Policy on Humane Care and Use of Laboratory Animals, the NIH Guide for the Care and Use of Laboratory Animals, and the Animal Welfare Act (7 U.S.C. et seq.); the animal use protocol was approved by the Institutional Animal Care and Use Committee (IACUC) of Ataturk University.

Objective The frequency of metabolic syndrome is increasing in both children and adults. In addition to metabolic complications such as obesity, hypertension, cardiovascular diseases, insulin resistance, and type 2 diabetes, metabolic syndrome may affect all systems of the body. The aim of the present study was to investigate the effect of metabolic syndrome on hearing in childhood. Methods A prospective, controlled study was performed on 38 obese children diagnosed with metabolic syndrome and 34 healthy children. Anthropometric measurements and biochemical studies were performed. All individuals underwent pure-tone audiometry, tympanogram, and transient evoked otoacoustic emission (TEOAE) tests. The hearing thresholds of the patients were compared with healthy volunteers. Results There was no significant difference in terms of age and gender between the groups (p>0.05). There was no significant difference in mean hearing levels between the groups. When frequencies were compared, significantly increased hearing threshold levels were determined at low frequencies in children with metabolic syndrome. Analysis of the TEOAE results elicited no statistically significant variation in terms of signal-to-noise ratio values, signal amplitudes, or test reproducibility values between the study groups. Conclusion Identification of the potential hearing losses early by means of detailed hearing examinations in children with metabolic syndrome is important. To the best of our knowledge, this is the first study to examine the effect of metabolic syndrome on hearing in this age group.

OBJECTIVES The objective of this study was to evaluate image quality of low dose in noncontrast paranasal sinus computed tomography (CT) using single volumetric 320-row multidetector CT technique. METHODS The low-dose protocol including tube voltage of 135 kV and tube current of 5 mAs was chosen based on results of the present phantom study. Forty-six patients were assigned to control group with factory standard settings (120 kVp, 75 mAs), and 46 patients were assigned to study group and underwent noncontrast CT of paranasal sinus with low-dose protocol using single volumetric 320-row multidetector CT device. Objective and subjective image qualities were performed. RESULTS Effective radiation dose calculated for control group scans was 0.45 (SD, 0.39) mSv. It was 0.038 (SD, 0.004) mSv for study group scans. The effective radiation dose of study group was statistically significant lower than control group (P < 0.001). CONCLUSIONS Noncontrast paranasal sinus CT imaging can be performed at very low radiation exposure maintaining high image quality with 135 kVp and 5 mAs.

Choanal atresia is the unilateral or bilateral obstruction of the passage between nasal cavity and nasopharynx. Transnasal surgery of choanal atresia in a patient with unilateral choanal atresia diagnosed accidentally during operation of septorinoplasti for septal deviation and external nasal deformity in Plastic Surgery Clinic is presented. A 25-year-old female referred to plastic surgery clinic with external nasal deformity and difficulty in breathing through nose. Although concha bullosa at middle concha and polipoid degeneration at lower concha are observed in computerized tomography of paranasal sinus, the patient referred to our clinic. In physical examination, due to advanced septal deviation, endoscopic examination of left nasal cavity could not be established. It was planned to examine the left nasal cavity in operating room after septoplasty. In the endoscopic examination after septoplasty, choanal atresia at left nasal cavity observed. Atresia was repaired with transnasal approach. At follow-up period, the choanal opening was intact. Unilateral choanal atresia is a disorder which can reach at the adolesant ages without diagnosis. Although the symptoms of the disease can be interfere in lots of diseases, the diagnosis is simple with nasal endoscopic examination. If nasal endoscopic examination is difficult because of nasal septal deviation, it must be performed in operating room before ending the operation to reveal the additional disorders. [Med-Science 2015; 4(1.000): 2073-9]

Papillary thyroid carcinoma (PTC) is the most differentiated malignant thyroid neoplasm. Local metastases of PTC commonly occur in the regional lymph nodes, while distant metastases are mainly to the lung and bone. The case of a patient with PTC who presented with swelling of the parotid gland and neck, mimicking a primary parotid neoplasm, is presented herein. This case is unique due to the unexpected initial presentation of PTC with no signs of disease in the thyroid gland.

Frontal sinus fractures (FSF) are relatively uncommon maxillofacial injuries. The most common cause of FSF is motor vehicle accidents with 62% percentage. Management of FSF depends on type of fracture, associated injuries, and involvement of naso-frontal duct. In this report, the authors presented a patient with comminuted fracture of anterior wall of frontal sinus reconstructed with titanium mesh. A 40-year-old man presented with depression of the frontal bone, facial pain, and epistaxis consisting of a motor vehicle accident. Computerized tomography scan revealed multiple comminuted fractures of anterior wall of frontal sinus and fractures of left orbital medial and superior walls. Titanium mesh was used for reconstruction. Postoperative course was uneventful. The titanium mesh, which is easy to handle with no complications, may provide excellent frontal contour after comminuted anterior wall fractures.

INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is characterized by episodes of upper respiratory tract obstruction, decreased oxygen saturation, and sleep fragmentation during sleep, as well as excessive daytime somnolence. Cephalometric analysis offers distance, angle, area, and volume measurements between separate reference points belonging to bony and soft tissues on a film. Cephalometric measurements made with multislice computed tomography (CT) are quite helpful for standardization of measurements and obtaining highly reliable results. The aim of the current study was to make cephalometric measurements with multislice CT in OSAS patients and compare their results with those of a healthy control population. The authors also aimed to determine, which cephalometric parameters might be more valuable for diagnosis of OSAS. MATERIALS AND METHOD This study included 30 patients who were diagnosed with severe OSAS (apnea-hypopnea index >30) by an overnight polysomnography study, performed for suspected OSAS and 10 healthy controls without snoring or apnea who underwent three-dimensional head & neck multislice CT for any indication. All patients underwent a three-dimensional head & neck multislice CT to make cephalometric measurements and compare them across the groups. RESULTS ANS-PNS (anterior and posterior nasal spine), Go-Gn, and UP-PhW distances, as well as sella-nasion-A and sella-nasion-B angles, were significantly lower in the OSAS group compared with the controls (P < 0.05). Mandibulas plane -H, UD, TT-EA, ANS-B, PNS-TB, TT-TB, B-N, and PNS-PhW distances were significantly higher in the patient group compared with the controls (P < 0.05). CONCLUSIONS Our study reached the conclusion that some cephalometric measurements showed significant differences in patients with obstructive sleep apnea compared with the control group, and hence may lead to a susceptibility to having OSAS. Cephalometric measurements performed with multislice CT have come to the forefront as one of the most important tools for diagnosis of OSAS. An inferiorly located hyoid bone may be most commonly responsible for apnea episodes. It was also concluded that an inferiorly located hyoid bone might have been the result of maxillomandibular underdevelopment.

The authors report an isolated echinococcosis in a 17-year-old girl presented with swelling of right neck approximately 12 cm in diameters with no evidence of the disease elsewhere in the body. A thorough search of the literature revealed only a few cases of isolated cervical echinococcosis. Surgical procedure was planned for our case with the guidance of the magnetic resonance imaging, which showed right cystic mass and within a laminar membrane. Histopathologic report confirmed echinococcosis. In summary, this current study shows that in the differential diagnosis of the cystic masses localized in the neck in the endemic regions, echinococcosis should be suggested. In these patients, the careful assessment of the magnetic resonance imaging evaluation before the surgery would extremely facilitate either the diagnosis or the surgery planning.

To evaluate image quality of protocol including 135 kVp, 5 mAs and 80 kVp, 5 mAs in the paranasal sinus CT examinations using single volumetric 320-row multidetector CT technique.From September to December 2016, both of our control group including 135 kVp and 5 mAs and our study group including 80 kVp and 5 mAs paranasal CT protocols were simultaneously performed on 40 patients using single volumetric 320-row multidetector CT device. Image quality for bony structures, air-filled structures and soft tissues were independently assessed for each group by three blinded observers using a 3-point grading scale (0 = not diagnostic, 1 = partially diagnostic, 2 = diagnostic). Objective image quality was also performed by region of interests were placed on axial soft tissue reconstructions in both eye bulbs, retrobulbar fat and maxillary sinuses to obtain different values for aqueous tissue, soft tissue and air, respectively. Effective dose was calculated from the dose-length product.The effective radiation dose which calculated for the control group scans was 0.037 ± 0.003 mSv. But, it was 0.0099 ± 0.001 mSv for the study group scans. The effective radiation dose of study group was statistically significant lower than control group (p0.001). Despite significant lowering of the radiation doses, image qualities were sufficient for evaluating all the bony structures, air-filled structures and soft tissues except for eye muscle, retrobulbar fat and eye bulb.Our results present that our protocols for study and control group provide significant dose reduction without the loss of diagnostic image quality for paranasal sinus CT. Paranasal sinus CT imaging can be performed at very low radiation exposure maintaining high image quality using a single volume 320-row detector CT device using 135 kVp and 5 mAs.

The results of the study showed that clarithromycin has anti-inflammatory and antioxidant effects and, when it is combined with prednisolone, those effects gain strength.The present study aims to investigate the effects that the antioxidant and anti-inflammatory activities of clarithromycin and/or prednisolone have on experimental otitis media in effusion-induced guinea-pigs.In this study, 35-male guinea pigs were randomly divided into five-groups. For the experimental otitis media, intra-tympanic histamine (0.1 ml) was injected into the guinea pigs in all of the groups except the control group. Then, 24-h after the intra-tympanic injections, clarithromycin (15 mg/kg/day) and/or prednisolone (1 mg/kg/day) were applied intraperitoneally to the guinea-pigs for 7-days. The biochemical analysis showed an increase in antioxidant capacity and a decrease in oxidant status and malondialdehyde (MDA) levels in the clarithromycin group and the prednisolone group and especially in the clarithromycin+prednisolone group, as compared to the experimental group (p0.05). In the cytokine analysis, lower levels of interleukin (IL)-6 and IL-17A and higher IL-10 were found in the clarithromycin, prednisolone, and clarithromycin+prednisolone groups than in the experimental group (p0.05). Furthermore, the histologic analyses showed histopathologic changes in the middle ear mucosa of the experimental group, but comparatively fewer-histopathologic changes were observed in the clarithromycin, prednisolone, and clarithromycin+prednisolone groups.

Pseudoankylosis of temporomandibular joint (TMJ) is characterized by limited mouth opening and impaired mandibular mobility induced by pathologic factors outside the joint itself, usually leading to compromised speech, swallowing, and breath functions. Multiple surgical approaches or reconstructive procedures have been proposed to resolve the joint pseudoankylosis and restore the mandibular movement for these affected patients. Free forearm flap has been widely used in reconstruction for various congenital or acquired defects or deformities; however, this flap has been rarely employed for TMJ pseudoankylosis in the literature. Here, the authors reported that noma-induced TMJ pseudoankylosis was diagnosed and successfully treated by extended free forearm flap with length over 10 cm in a Chinese female patient.

Mucociliary clearance (MC) is one of the main defense mechanisms of the nasal respiratory mucosa. The purpose of this study was to determine changes occurring nasal MC in patients with sinusitis, and how medical treatment affects changes in MC, and to identify an appropriate topical solution with positive effects on MC for use in the treatment of sinusitis by examining the effects of various topical solutions on MC. 60 patients diagnosed with rhinosinusitis at the ear, nose and throat clinic were included in this prospective study. Patients were randomly assigned into groups. Group 1 (n:10) received no topical treatment. Group 2 (n:10) was administered with fluticasone propionate, Group 3 (n:10) received mometasone furoate and Group 4 (n:10) received oxymetazoline. Group 5 (n:10) received isotonic sea water for nasal irrigation, while Group 6 (n:10) received isotonic Ringers solution for nasal irrigation. Group 7 represented the control group (non-sinusitis). The saccharin test was used to determine nasal mucociliary clearance times. The saccharin test was performed before and on the 2nd week of treatment in all groups. Basal MCT and 2nd week MCT values were compared in all groups. When measurements performed 20 min and 14 days after administration of topical agents were compared with basal values, mean MCT values at 20 min. and 14 days were shorter in all groups compared to mean basal MCT values. However, the difference between 20-min, 14th day and basal MCT values was only statistically significant in the oxymetazoline and isotonic Ringers solution groups (p [Med-Science 2018; 7(1.000): 1-4]