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Objectives: Surgery interventions for thyroid disorders are rare in pediatric population. This study aims to present our institution's 10-year experience regarding the surgical treatment and outcomes of thyroid pathologies in children and review the literature., Methods: All pediatric patients who underwent thyroid surgery at our institution from April 2013 to October 2023 were retrospectively reviewed., Results: The study included 57 patients with a median age of 15 years. 38 patients (66.6 %) were female, and 19 patients (33.3 %) were male. The most common indication for thyroid surgery was a nodule (71.9 %), followed by Graves' disease (10.5 %), multinodular goiter (8.7 %), and familial multiple endocrine neoplasia syndrome (8.7 %). Of the 57 patients, 36 (63.2 %) were diagnosed with thyroid neoplasia, with 28 (77.8 %) having papillary thyroid carcinoma (PTC), three (8.3 %) having medullary thyroid carcinoma (MTC), two (5.6 %) having follicular thyroid carcinoma (FTC). Temporary unilateral vocal cord paralysis and permanent unilateral vocal cord paralysis were seen in three patients (5.3 %) and in two patients (3.5 %) respectively. Persistent hypocalcemia and permanent hypoparathyroidism were noted in two patients (3.5 %), while transient hypocalcemia was observed in 13 patients (22.8 %). The presence of neoplasm did not appear to be associated with the incidence of hypocalcemia or vocal cord paralysis (p=0.115 and 0.652, respectively)., Conclusions: Thyroid pathologies in pediatric patients necessitate a multidisciplinary approach. Surgical management should be carefully evaluated in accordance with pediatric guidelines. Complication rate significantly decreases when surgery is performed by experienced surgeon., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Importance: Otologic disease is common among people with primary ciliary dyskinesia (PCD), yet little is known about its spectrum and severity., Objective: To characterize otologic disease among participants with PCD using data from the Ear-Nose-Throat Prospective International Cohort., Design, Setting, and Participants: This cross-sectional analysis of baseline cohort data from February 2020 through July 2022 included participants from 12 specialized centers in 10 countries. Children and adults with PCD diagnoses; routine ear, nose, and throat examinations; and completed symptom questionnaires at the same visit or within 2 weeks were prospectively included., Exposures: Potential risk factors associated with increased risk of ear disease., Main Outcomes and Measures: The prevalence and characteristics of patient-reported otologic symptoms and findings from otologic examinations, including potential factors associated with increased risk of ear inflammation and hearing impairment., Results: A total of 397 individuals were eligible to participate in this study (median [range] age, 15.2 [0.2-72.4] years; 186 (47%) female). Of the included participants, 204 (51%) reported ear pain, 110 (28%) reported ear discharge, and 183 (46%) reported hearing problems. Adults reported ear pain and hearing problems more frequently when compared with children. Otitis media with effusion-usually bilateral-was the most common otoscopic finding among 121 of 384 (32%) participants. Retracted tympanic membrane and tympanic sclerosis were more commonly seen among adults. Tympanometry was performed for 216 participants and showed pathologic type B results for 114 (53%). Audiometry was performed for 273 participants and showed hearing impairment in at least 1 ear, most commonly mild. Season of visit was the strongest risk factor for problems associated with ear inflammation (autumn vs spring: odds ratio, 2.40; 95% CI, 1.51-3.81) and age 30 years and older for hearing impairment (41-50 years vs ≤10 years: odds ratio, 3.33; 95% CI, 1.12-9.91)., Conclusion and Relevance: In this cross-sectional study, many people with PCD experienced ear problems, yet frequency varied, highlighting disease expression differences and possible clinical phenotypes. Understanding differences in otologic disease expression and progression during lifetime may inform clinical decisions about follow-up and medical care. Multidisciplinary PCD management should be recommended, including regular otologic assessments for all ages, even without specific complaints.

Objective: The present study aimed to compare the effects of bacterial cellulose used for closure of pharyngocutaneous fistulae, a complication of total laryngectomy, with those of primary sutures in a rat model., Methods: Thirty female Sprague-Dawley underwent experimental pharyngoesophagotomy and were grouped depending on the material used for pharyngocutaneous fistula closure: group I, which received primary sutures alone, group II, which received bacterial cellulose alone; and group III, which received both. After 7 days, the rats were sacrificed. Pharyngocutaneous fistula development was assessed, the gross wound was inspected, and histological examination was conducted., Results: Pharyngocutaneous fistulae developed in 12 rats (41%) in all: 6 from group I (21%), 4 from group II (14%) and 2 from group III (7%)., Conclusion: Fibroblast density and inflammatory cell infiltration were significantly greater in group III than group I. We concluded that bacterial cellulose may be useful for pharyngocutaneous fistula closure., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objectives/hypothesis: To compare quality of life (QOL) of patients who underwent transoral robotic surgery (TORS) alone, with adjuvant radiation therapy (RT), or adjuvant chemoradiation therapy (CRT) in the treatment of oropharyngeal squamous cell cancer (OPSCCA)., Study Design: Prospective cohort study., Methods: Medical records were reviewed for 111 patients treated for OPSCCA from 2008 to 2015. Patients were administered the Head and Neck Cancer Inventory (HNCI) to evaluate QOL preoperatively, and at 3 weeks, 3 months, 6 months, and 1 year postsurgery. QOL data were compared between 13 patients treated with TORS alone, 31 with adjuvant RT, and 67 with adjuvant CRT by a linear mixed effects model., Results: Mean follow-up was 35 months. The HNCI response rates at 3 weeks and 3, 6, and 12 months were 80%, 60%, 55%, and 46%, respectively. TORS alone reported significantly higher eating scores than adjuvant RT or CRT at 3 and 6 months, and higher speech scores compared to adjuvant CRT at 3 months and adjuvant RT at 6 months. TORS alone and adjuvant RT reported less social disruption compared to adjuvant CRT at 3 months. Adjuvant CRT had consistently lower overall QOL scores until 6 months. No TORS-alone patient required percutaneous endoscopic gastrostomy, and no study patient required tracheostomy during treatment., Conclusions: TORS alone maintained higher QOL than adjuvant RT or CRT in eating, social function, speech, and overall QOL postsurgery. QOL and functional metrics were better for 6 months in TORS-alone patients, and at 12 months, the differences were not significant., Level of Evidence: 4. Laryngoscope, 128:403-411, 2018., (© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)

Background: The purpose of this study was to assess the quality of life (QOL) outcomes in patients who underwent transoral robotic surgery (TORS) for carcinoma of unknown primary (CUP)., Methods: Twenty-nine patients with CUP were administered the Head and Neck Cancer Inventory (HNCI) prospectively to evaluate QOL preoperatively and postoperatively., Results: There was statistically and clinically significant deterioration in 2 of 4 domains (eating and social disruption) in the immediate aftermath of TORS. There was statistically and clinically meaningful deterioration in all 4 domains at 3 months relative to baseline, and there remained statistically and clinically meaningful deterioration in 2 of 4 domains at 6 months compared to baseline. These 2 domains remained statistically and clinically worse than baseline at 12 months. Speech and aesthetics domain scores were comparable at baseline and 12 months., Conclusion: Patients reported difficulties with eating and social disruption over the course of 1 year, but problems with speech and appearance abated., (© 2017 Wiley Periodicals, Inc.)

Calprotectin is an S100 protein and marker of inflammation found in neutrophils and monocytes; S100 proteins are a family of calcium-modulated proteins. The aim of this study was to determine if the serum concentration of calprotectin is higher in patients with laryngeal carcinoma than in patients with benign laryngeal pathologies and controls. The study included 107 participants. The serum calprotectin concentration was analyzed using the calprotectin ELISA (enzyme-linked immunosorbent assay) kit (Calpo AS, Norway). EDTA-serum for analysis was collected prior to surgery from patients with laryngeal carcinoma (n = 41), those with a benign laryngeal pathology (Reinke's edema, vocal nodules, etc.) (n = 32), and healthy controls (n = 34). The median serum calprotectin concentration was significantly higher in the laryngeal carcinoma group (2179.6 μg L -1 ) than in the benign laryngeal pathology group (727.84 μg L -1 ) and control group (733.73 μg L -1 ) (P < 0.05). The median serum calprotectin concentration in patients with advanced-stage laryngeal cancer (5854.,4 μg L -1 ) was significantly higher than in those with early-stage laryngeal cancer (971.84 μg L -1 ) (P < 0.05); however, there was not a significant difference in the median calprotectin concentration between the control and benign laryngeal pathology groups (P > 0.05). Furthermore, the median serum calprotectin concentration in the patients with early-stage laryngeal cancer (n = 21) (971.84 μg L -1 ) was significantly higher than that in the benign laryngeal pathology and control groups (n = 64) (730.6 μg L -1 ) (P < 0.05). The serum calprotectin concentration was strongly correlated with poor survival and advanced-stage laryngeal carcinoma. Malignant laryngeal cancer patients (n = 4) that died during follow-up had a higher median serum calprotectin concentration (9468.4 μg L -1 ) than those that remained alive (n = 37) (857.78 μg L -1 ) (P < 0.05). The serum calprotectin concentration is higher in patients with laryngeal carcinoma than in those with benign laryngeal pathologies and healthy controls. The present findings show that the serum calprotectin concentration might be used as a marker to discriminate between laryngeal carcinoma and benign laryngeal pathologies. Additional research is needed to further assess the value of this parameter as a useful tumor marker for the diagnosis, treatment, and follow-up of laryngeal carcinoma.

Importance: Secondary posttonsillectomy bleeding associated with oozing from multiple sites or overcauterized tonsillar bed deserves special evaluation., Objective: To evaluate the use of an absorbable, flowable gelatin-thrombin hemostatic matrix (GTHM) sealant for secondary bleeding after tonsillectomy., Design, Setting, and Participants: This was a retrospective data analysis, with information gathered from medical records of pediatric patients with secondary posttonsillectomy bleeding treated with the GTHM between 2012 and 2016 at a referral center and a local satellite facility. Forty-two pediatric patients admitted with secondary bleeding after tonsillectomy characterized by diffuse bleeding, multiple bleeding sites, or an overcauterized tonsillar bed, were treated with GTHM. Exclusion criteria were a bleeding disorder, genetic syndrome associated with abnormal oropharyngeal anatomy, and hemorrhage from a single site., Exposures: GTHM was used to treat posttonsillectomy secondary bleeding., Main Outcomes and Measures: Patient medical records were reviewed for information relevant to this study: (1) patient history, the tonsillectomy surgical technique used, and whether there were prior bleeding episodes (and if so, methods of treatment); (2) physical examination and laboratories on presentation, operative report details, and results of treatment; (3) hospital course and whether any further bleeding episodes occurred; and (4) hospital follow-up information (range, 3-20 months)., Results: The study population comprised 22 boys (52%) and 20 girls (48%) (a total of 42 patients), and the mean (SD) age was 7 (2.7) years (range, 4-14 years). Two patients had presented with recurrent secondary bleeding necessitating multiple operations, but the others had only 1 episode. The mean day of occurrence of bleeding was on the eighth day (range, day 7-12; median, day 10). Only 2 patients required blood transfusions: they were the same patients who underwent multiple operations for recurrent episodes of secondary bleeding. All patients except for 1 (41 of 42) were discharged without further bleeding following treatment. No adverse effects were reported., Conclusions and Relevance: Results suggest that GTHM is generally simple, safe, and effective for use in the treatment of posttonsillectomy secondary bleeding types not associated with a direct vein or artery source but oozing from multiple sites and/or overcauterized tonsillar bed that cannot be stopped by traditional hemostatic methods.

This retrospective review aims to evaluate the postoperative morbidity and mortality of 30 patients with Down syndrome who underwent adenotonsillectomy between June 2012 and December 2015 in a tertiary referral center. Mean age was 7.8 with a range of 3-12. There were 20 (66.6 %) male and ten (33.3 %) female patients. Mean follow-up was 23 months with a range of 7-43 months. 23 (76.6 %) of 30 patients had been operated due to obstructive tonsillar and adenoid hypertrophy, whereas seven (23.3 %) of them operated for chronic recurrent infections. All of the patients had undergone adenotonsillectomy operation; one patient had also bilateral tympanostomy tube insertion. Hospital stay was noted 1.3 days in average with a range of 1-3 days. Anesthetic complications of persistent bradycardia and postextubation respiratory difficulty occurred in two (6.6) patients. Patient who had intraoperative bradycardia necessitated intensive care unit stay and pacemaker implantation during follow-up. 3 (10 %) patients had late onset hemorrhage between days 7 and 10 and required intraoperative bleeding control. We did not experience any other morbidity and mortality except the abovementioned ones. In conclusion, adenotonsillectomy in patients with Down syndrome is a worthwhile operation with certain risks and these operations should better be performed by the tertiary referral centers which have the capacity to deal with the complications.

Objectives: In laryngeal cancer, which comprises 25% of head and neck cancer, chemotherapy has come into prominence with the increase in organ-protective treatments. With such treatment, salvage surgery has increased following recurrence; the incidence of pharyngocutaneous fistula has also increased in both respiratory and digestive system surgery. We investigated the effects of recombinant human growth hormone on pharyngocutaneous fistula closure in Sprague-Dawley rats, based on an increase in amino acid uptake and protein synthesis for wound healing, an increase in mitogenesis, and enhancement of collagen formation by recombinant human growth hormone., Methods: This study was experimental animal study. Forty Sprague-Dawley rats were separated into two groups, and pharyngoesophagotomy was performed. The pharyngoesophagotomy was sutured with vicryl in both groups. Rats in group 1 (control group) received no treatment, while those in group 2 were administered a subcutaneous injection of recombinant human growth hormone daily. On day 14, the pharynx, larynx, and upper oesophagus were excised and examined microscopically., Results: Pharyngocutaneous fistula exhibited better closure macroscopically in the recombinant human growth hormone group. There was a significant difference in collagen formation and epithelisation in the recombinant human growth hormone group compared to the control group., Conclusion: This study is believed to be the first in which the effect of recombinant human growth hormone on pharyngocutaneous fistula closure was evaluated, and the findings suggest the potential of use of growth hormone for treatment of pharyngocutaneous fistula.

Objective: The aim of this study was to determine whether the neutrophil-to-lymphocyte ratio (NLR) can be used as a predictor for deep neck space infections (DNSIs) that occur as a complication of acute bacterial tonsillitis in the pediatric population., Materials and Methods: We evaluated the NLR values of 180 pediatric patients diagnosed with acute bacterial tonsillitis with or without DNSI who presented to the Otolaryngology Department of Marmara University Hospital between 2010 and 2013. In cases in which DNSI was suspected, the patients underwent complete otolaryngological examination and radiological imaging including CT and MRI. NLR was calculated in all the subjects and was compared between the patients with acute bacterial tonsillitis without DNSI and those with DNSI., Results: With regard to the tonsillitis-related complications, 17 patients had peritonsillar abscess (9.4%); five, parapharyngeal abscess (2.8%); and two, retropharyngeal abscess (1.1%). The mean NLR was significantly higher in the patients of acute bacterial tonsillitis with DNSI (P<0.05). The optimum cut-off value of NLR was determined to be 5.4., Conclusion: This study is the first to investigate the relationship between NLR and DNSI as a complication of acute bacterial tonsillitis. The results demonstrated that the NLR value could be a potential laboratory parameter for diagnosing DNSIs., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: Fascin is an actin-bundling protein found in cell membrane protrusions and increases cell motility. The expression of fascin in epithelial neoplasms has been described only recently. No data are available concerning the role of this protein in invasive cholesteatoma. Thus, we investigated the expression of fascin in cholesteatoma tissue and the relationship between fascin expression and intraoperative evaluation of the destruction of the ossicular chain and extent of disease., Method: Cholesteatoma specimens of 28 patients and external auditory canal (EAC) skin specimens of the same patients (as the control group) were collected from mastoidectomies. Immunohistochemical technique was used to investigate the fascin expression in all cholesteatoma tissues and EAC skin specimens. Immunohistochemical staining was assessed semiquantitatively based on the thickness of epithelium. SPSS software version 16.0 (SPSS Inc., Chicago, IL, USA) was performed to statistically analyse the relationships between fascin expression and intraoperative evaluation destruction of ossicular chain and extent of the disease., Results: Immunohistochemically, there was no or very low fascin expression observed in normal epithelial cells of EAC skin, while expressed in cholesteatoma tissue. Also, fascin expression in cholesteatoma tissues was significantly correlated with destruction of ossicular chain and extent of the disease., Conclusions: Fascin expression is usually found in cholesteatoma epithelium and is correlated with destruction of the ossicular chain and extent of disease. Considering all of the correlations between the clinical and histopathological findings, 'fascin immunoexpression scoring' may be used for histological grading of cholesteatoma., (© 2015 John Wiley & Sons Ltd.)

Backround. Thyroglossal duct cyst (TDC) is a developmental abnormality of the thyroid gland. Due to embryological remnants of thyroid tissue located in the TDC, the same malignant tumors that develop in the thyroid gland can also develop in the TDC. Methods. We present the unique case of a 39-year-old female with simultaneous de novo papillary carcinoma in a TDC and the thyroid gland. Results. With the suspicion of simultaneous papillary carcinoma in the TDC and the thyroid gland, Sistrunk procedure with total thyroidectomy and central neck exploration was performed. Conclusion. The clinician should have a high index of suspicion upon encountering papillary carcinoma of the TDC to differentiate de novo papillary carcinoma in the TDC from those originating from the thyroid gland, because papillary carcinoma in TDC may originate from an occult thyroid papillary carcinoma.

Larynx and adjacent anatomical structures have complicated physiological functions and mechanical features. Traffic accidents, penetrating stab wounds and shot wounds, sports matches, and occupational accidents cause external laryngeal trauma. In the management of laryngeal trauma, maintenance of airway patency has priority. In this case report, we will mention of a 15-year-old male patient with a blunt laryngeal trauma and also the approach to laryngeal traumas.

This study reports a patient having olfactory neuroblastoma complicated by syndrome of inappropriate antidiuretic hormone secretion. Olfactory neuroblastoma is a rare tumor that begins in the olfactory membrane. Only 10 cases have been reported previously. Because of having nonspecific symptoms, most patients manifest at an advanced stage at the time of diagnosis. Olfactory neuroblastoma may show local invasion and/or distant metastasis. We demonstrated preoperatively clinical and biochemical parameters consistent with antidiuretic hormone syndrome turned to normal ranges after the treatment. Surgery, chemotherapy, and radiotherapy are the choices of treatment; among these, surgery is an indispensible treatment.

Hydatid cyst disease is a rare parasitic infestation caused by larvae of Echinococcus granulosus. Although larval stage of this parasite can thrive in any part of the body, especially lungs and liver; head and neck involvement is rare. Pterygopalatine fossa involvement is reported in two cases in the literature. In this report we represent a case with solitary, secondary pterygopalatine fossa hydatid cyst extending in to the maxillary sinus, orbita, sphenoid sinus and skull base., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objective: The aim of this study was to evaluate the effectiveness of systemic administration of resveratrol against cisplatin-induced ototoxicity in guinea pigs., Materials and Methods: Healthy guinea pigs (n=24) were randomly divided into four groups. Group 1 (n=6) received resveratrol+cisplatin, group 2 (n=6) received 4% ethanol+cisplatin, group 3 (n=6) received cisplatin, and group 4 (n=6) received saline. Cisplatin was administered at a dose of 10mg/kg/day on days 14 and 15 of the study. Resveratrol (10mg/kg/day), 4% ethanol, and saline were administered throughout the study. Baseline auditory brainstem responses (ABR) (4 kHz, 8 kHz, and click stimulus) were determined for all groups. ABR was repeated 72 h after the last dose of cisplatin in order to record the threshold shifts. The ABR threshold shifts for the click stimulus, 4-kHz- and 8-kHz-frequency stimuli were compared after drug administration. After follow-up ABRs the animals sacrificed under deep sedation and their cochleae were removed. Left cochleae were immediately harvested for measurement of level of reactive oxygen species (ROS). Right cochleae were prepared for histological changes which were observed by scanning electron microscopy (SEM)., Results: For the all stimulus, there was a significant threshold difference among the groups (p<0.01). Group 3 had a significantly higher threshold shift at all stimuli when compared with groups 1 and 4. There was no significant threshold shifts in all stimuli between groups 2 and 3. The resveratrol-treated group 1 showed preservation of threshold in ABR (p ≤ 0.05). SEM showed that inner and outer hair cells were preserved in the group 1. Level of reactive oxygen species (ROS) were significantly higher in groups 2 and 3 compared with groups 1 and 4 (p ≤ 0.05)., Conclusion: These results indicated that systemic administration of resveratrol afforded statistically significant protection to the cochlea of guinea pigs from cisplatin toxicity. Experimental dose of resveratrol injections may have a protective effect against cisplatin ototoxicity in guinea pigs., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)