Search

Endoscopic sinus surgery (ESS)-associated risks mainly depend on the proximity of the sinuses to the orbit and anterior skull base. Skull base injuries are usually associated with dural tears and cerebrospinal fuidleaks, which are the leading causes of ascending meningitis and even brain abscesses. A 40-year-old man has a headache that came on suddenly and is an extremely painful, continuous headache accompanied by intermittent fatigue and blurred vision. The patient underwent ESS for chronic sinusitis 2 weeks ago at another hospital. Magnetic resonance examination of the brain depicted abnormal hyperintensity within the left frontal lobe. These fndings suggested the diagnosis of brain abscesses. The patient received an antibacterial treatment for 2 months. Finally, the patient recovered well. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to evaluate the effects of demographic data and comorbid diseases on the prognosis and treatment diagnosed with laryngeal squamous cell cancer (LSCC). Methods: Medical records of LSCC patients treated and followed up in a single referral center between 2008 and 2019 were retrospectively reviewed. In addition to the demographic data, the results of overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), locoregional-free survival (LRFS), and factors affecting recurrence were analyzed. Results: We included 573 patients with a mean age of 60.1±9.8 years. Of the 573 patients, 94.2% (540) were men, 93.7% (537) were smokers, 40.1% had at least one comorbid disease, and 69.8% (400) presented with glottic LSCC. The five-year OS, DSS, DFS, and LRFS rates for all cases were 65.7%, 79.9%, 67%, and 74.7%, respectively. In early-stage LSCC treatment, the rates of OS (p=0.008), DFS (p=0.024) and LRFS (p=0.01) were statistically significantly higher in the endolaryngeal laser surgery (ELS) group compared with the radiotherapy (RT) group. In advanced-stage LSCC treatment, total laryngectomy had statistically significantly higher five-year DFS (p=0.003) and LRFS (p=0.002) rates compared to chemoradiotherapy. Conclusion: Our study showed that ELS provided higher rates of OS, DFS, and LRFS compared to RT in the treatment of early-stage LSCC. Recurrence was significantly higher in supraglottic tumors, advanced-stage tumors, and in patients with clinical N positivity. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to classify the degree of edema in patients with Reinke's edema (RE) and examine its impact on their voice parameters using both objective and subjective assessment methods. Methods: Objective and subjective voice data of 104 patients diagnosed with RE between 2018 and 2021 were evaluated retrospectively. RE is classified into 4 groups (types 1, 2, 3, and 4). The evaluation included videolaryngostroboscopic examination, acoustic voice analysis, and aerodynamic measurements, GRBAS, Voice Handicap Index-10 (VHI-10), Voice-Related Quality of Life Scale (V-RQOL), and Reflux Septum Index (RSI). Results: Patients with type 1 RE had a significantly lower mean age than those with types 3-- Although there were no significant differences in acoustic and aerodynamic parameters between the groups, it was observed that F0 and the maximum phonation time decreased as the degree of edema increased. The GRBASTotal, G, and R scores of types 1 and 2 were significantly lower than those of types 3 and 4, as were the scores of type 1 S. There were no statistically significant differences between the RE groups in terms of VHI-10, V-RQOL, and RSI scores. Conclusion: It has been observed that as the severity of RE increases, voice perception and quality (especially types 3 and 4) are negatively affected. Determining the degree of edema will guide the clinician in both the planning of the intervention phase and the follow-up phase. [ABSTRACT FROM AUTHOR]

To analyze protective/regenerative effects of adipose tissue-derived mesenchymal stem cells (ADMSC) on 131I-Radioiodine (RAI)-induced salivary gland damage in rats.

Objective: The purpose of this study is to determine the efficacy of voice therapy in the treatment of patients with mutational falsetto and which parameters should be used as a more specific criterion for assessing the effectiveness of this treatment. Methods: The objective and subjective voice evaluation data from the files of patients diagnosed with mutational falsetto between 2014 and 2019 were retrospectively evaluated in the study. Fundamental frequency, jitter (%), shimmer (%), noise-to-harmonics ratio, voice turbulence index, soft phonation index, voice handicap index-10, and Grade, Roughness, Breathiness, Asthenia, and Strain scale are all used in the evaluation of voice. The acoustic and perceptual analysis findings of the patients before and after therapy were compared. Results: A total of 31 participants were enrolled in the study. After therapy, the Grade, Roughness, Breathiness, Asthenia, and Strain scale and voice handicap index-10 scores were statistically substantially lower than before therapy (P < .05). The mean fundamental frequency of the patients before therapy was 230.65 ± 69.16 Hz, whereas after therapy, it was 126.32 ± 16.86 Hz. After therapy, there was a statistically significant difference in fundamental frequency, jitter (%), and soft phonation index values when compared to before therapy (P < .05). All patients received an average of 4 sessions of voice therapy. Conclusions: Voice therapy has been identified as a significant treatment approach among the treatment choices for individuals with mutational falsetto. Although fundamental frequency is the most prominent parameter among the acoustic analysis results for determining the efficacy of this therapy, the jitter and soft phonation index parameters were also found to be significant. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prognostic value of the magnetic resonance imaging in Bell's palsy patients. Methods: Patients who were diagnosed and treated with Bell's palsy between October 2013 and March 2016 retrospectively selected. House-Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell's palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data. Results: No significant correlation was observed between pretreatment House-Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell's palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement. Conclusion: The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell's palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell's palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression. [ABSTRACT FROM AUTHOR]

Object: To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients who treat allergic rhinitis patients. Methods: The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. Results: A detailed guideline about all aspects of allergic rhinitis was created. Conclusion: The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals. [ABSTRACT FROM AUTHOR]

COVID-19 is highly transmissible and spreads rapidly in the population. This increases the occupational risk for health care workers. In otolaryngology clinic practice, patients with upper respiratory tract infection symptoms are common. Also, routine head and neck examinations such as oral cavity examination, nasal/nasopharyngeal examination, or video laryngostroboscopic evaluation are highly risky because of the aerosol formation. To emphasize this issue, two leading otolaryngology organizations in Turkey; 'Voice Speech and Swallowing Disorders Society', and 'Professional Voice Society' gathered a task force. This task force aimed to prepare a consensus report that would provide practical recommendations of the safety measurements during routine clinical care of laryngology patients. To fulfill this, universal aim, on the 2nd and 9th of May 2020, two web-based meetings were conducted by 20 expert physicians. This eighteen items list was prepared as an output. [ABSTRACT FROM AUTHOR]

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 longterm 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. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Archives of Otolaryngology / Türk Otolarengoloji Arsivi is the property of Turkish Otorhinolaryngology & Head & Neck Surgery Foundation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Understanding the molecular mechanisms and gene expression in laryngeal squamous cell carcinoma (LSCC) may explain its aggressive biological behavior and regional metastasis pathways. In the present study, patients with locally advanced LSCC tumors were examined for differential gene expression in the normal mucosa (non-tumoral mucosa), tumors and lymph node tissues. The aim was to identify possible predictive genes for lymph node metastasis. A total of 16 patients who had undergone total laryngectomy with neck dissection for advanced LSCC were randomly selected from a hospital database: Eight of the patients had lymph node metastasis (Group 1) and the other eight patients did not have metastasis (Group 2). Overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS) were analyzed. For each patient, paraffin-embedded tissue samples were collected from non-tumoral mucosa, tumoral lesions and lymph node tissues. RNA was extracted from the tissue samples and used for complementary DNA synthesis, and microarray analysis was subsequently performed on each sample. Gene expression levels were determined in each specimen, and Groups 1 and 2 were compared and statistically analyzed. The microarray results for lymph node metastasis-positive and -negative groups, indicated the differential expression of 312 genes in the lymph nodes, 691 genes in the normal mucosal tissue and 93 genes in the tumor tissue. Transgelin (TAGLN) and cofilin 1 (CFL1) were identified as possible target genes and validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The RT-qPCR results for TAGLN and CFL1 supported the microarray data. OS, DFS and DSS times were longer in Group 2 than in Group 1 (P=0.002, 0.015 and 0.009, respectively). In addition, TAGLN and CFL1 were associated with DFS and DSS. On the basis of these results, it is suggested that TAGLN and CFL1 expression may play an important role in the pathogenesis of regional metastasis and poor prognosis in advanced LSCC. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Archives of Otolaryngology / Türk Otolarengoloji Arsivi is the property of Turkish Otorhinolaryngology & Head & Neck Surgery Foundation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the correlation of inşammatory process, endothelial dysfunction and oxidative stress with obstructive sleep apnea (OSA). Methods: In our prospective cross-sectional clinical study in a tertiary referral hospital, we evaluated 63 patients with newly diagnosed OSA and 9 simple snorers. Each patient was evaluated in terms of additional systemic diseases and laboratory tests. In addition to routine blood analysis; oxidative stress markers (leptine, RBP), vascular endothelial markers (ICAM-I, VCAM-I) and inşammatory markers (Crp, IL-6, TNF-alpha, isoprostane) were analyzed. Polysomnography test was performed and study population was divided into four groups depending on their AHI values. The levels of markers were analyzed and compared between the four groups. Results: There was a weak correlation between the isoprostane levels and mean apnea duration and also a mild correlation to the maximum apnea duration. A weak correlation was detected between leptine and VCAM levels to age and also a weak negative correlation was detected between CRP levels to age. The leptin levels were found to be mildly correlated to BMI and abdominal circumference. The ICAM levels were found to have a weak correlation to BMI and abdominal circumference. Conclusion: Our results indicate a correlation between sleep apnea and oxidative stress. These results may help to explain the association of comorbid diseases with OSAS. Further investigators should aim to explain key steps of inşammatory response in sleep apnea. [ABSTRACT FROM AUTHOR]

Background Obstructive sleep apnea (OSA) has been shown to be associated with atrial fibrillation (AF). Prolongation of inter- and intraatrial conduction times during sinus rhythm has also been shown to be related to AF generation. Nasal continuous positive airway pressure (CPAP) is an effective treatment modality of OSA. Methods Twenty-four OSA patients diagnosed through polysomnography and 18 controls were included in the study. The basal inter- and intraatrial electromechanic delays prior to onset of the therapy were measured using tissue Doppler imaging. P-wave dispersion (Pd) was calculated on the basis of 12-lead electrocardiography. Same measurements were performed in OSA patients 6 months after the initiation of the therapy. Results Interatrial (39.2 ± 8 vs. 21.1 ± 2.8 ms, P < 0.001), left intraatrial (20.5 ± 7.2 vs. 11.1 ± 2 ms, P = 0.003), and right intraatrial electromechanical delays (20.7 ± 11 vs. 10 ± 2.6 ms, P < 0.001) prior to CPAP therapy were found to be significantly greater in OSA group as compared with the controls. Pd was also greater in the OSA group as compared with the controls (44 ± 7 vs. 28.5 ± 4 ms, P < 0.001). However, significant improvement has been noted after 6 months of CPAP therapy in interatrial (P < 0.0001), left intraatrial (P = 0.002), and right intraatrial electromechanical delays (P < 0.0001) as well as in Pd (P < 0.0001) as compared to baseline values in patients with OSA. Conclusion Our findings suggested that CPAP therapy provides more homogenous conduction through atria in patients with OSA. This effect may translate into decreased risk for AF associated with OSA. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to investigate the prevalence of biofilms and the effects of medical treatment modalities in chronic rhinosinusitis (CRS) patients without nasal polyps.Study Design. Randomized controlled trial.Settings. Tertiary referral hospital.Subjects and Methods. The authors randomly divided 32 adult patients with CRS without nasal polyps into 2 groups. In the first group (n = 16), oral clarithromycin was administered 500 mg/bid for 2 weeks and then 250 mg/d for the following 6 weeks. In the second group (n = 16), an 8-week course of 200-mcg/d topical mometasone furoate was added to the clarithromycin regimen, identical to the first group. The pre- and posttreatment nasal tissue samples were evaluated by scanning electron microscopy for biofilm prevalence and graded from 0 to 3 according to density and extension.Results. Biofilms were detected in 24 of 32 patients (75%) before the treatment (grades 1-3). Biofilms were detected in 14 of 32 patients (43.8%) after the treatment (grades 1-2). When each group was evaluated independently, there was a significant improvement after the treatment in both groups I and II. When the biofilm grades of group I were compared to those of group II, there was no significant difference both in the pre- and posttreatment evaluation.Conclusion. The prevalence of biofilms in CRS without polyps was 75% in our study. Regression of biofilms to 43% was observed under medical treatment. Adding nasal steroids to macrolides gave no further benefit. [ABSTRACT FROM PUBLISHER]

Objectives: To investigate bacterial biofilm formation on the adenoid surface of pediatric patients undergoing adenoidectomy and to reveal whether this formation is associated with chronic otitis media with effusion (COME). Design: Prospective, single-blinded study with scanning electron microscopy. Setting: Dıs kapı Yıldırım Beyazıt Research and Educational Hospital, Ankara, Turkey. Patients: Thirty-four children between 4 and 15 years of age (mean age, 7.76 years) who had undergone adenoidectomy from June 1 through December 31, 2007, were divided into 2 groups. The first group (17 children) had undergone adenoidectomy alone, whereas the second group (17 children) had undergone adenoidectomy combined with ventilation tube insertion for COME. Main Outcome Measures: Scanning electron microscopy was performed to observe biofilm formation on the surface of adenoid tissues. The biofilm formation was graded according to extension. The roles of adenoid size, age, sex, and duration of COME symptoms were evaluated. Results: Biofilm formation was detected on all samples. Adenoids removed from patients with COME had highergrade biofilm formation than the other group (P=.001). No correlation was found between adenoid size and biofilm formation. Conclusion: In pediatric patients, adenoid surface biofilm formation may be associated with COME etiopathogenesis. [ABSTRACT FROM AUTHOR]