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Kussmaul disease is characterized by recurrent pain and swelling in the major salivary glands that arise from obstruction of salivary ducts by mucofibrinous plugs. In this case report, a 15-year-old girl presented with complaints of pain and recurrent swelling in both parotid regions exacerbated by food intake, which had been persisting for 2 years. History revealed allergic asthma and allergic rhinitis. Head and neck examination revealed diffuse swelling and tenderness in the both parotid glands, mucofibrinous plug drainage from the opening of the bilateral Stensen's ducts, diffuse nasal polyposis, and bilateral otitis media with effusion. The serum eosinophil and the serum immunoglobulin E levels were high while the erythrocyte sedimentation rate and C-reactive protein levels were normal. Computed tomography of the head and neck revealed diffuse ductal ectasia with the enlarged Stensen's duct in the parotid gland and diffuse increased density in all the paranasal sinuses. Yellowish mucofibrinous plugs were seen within the Stensen's duct on sialendoscopy. Histopathological examination of the mucofibrinous plugs demonstrated Charcot-Leyden crystals with profuse eosinophils. In conclusion, mucofibrinous plugs and the enlarged salivary ducts on sialendoscopy may be a sign of Kussmaul disease diagnosis. Sialendoscopy may be a useful diagnostic method and therapeutic approach along with other relevant treatment methods for Kussmaul disease. [ABSTRACT FROM AUTHOR]

Objective: To analyze the demographic characteristics and the pathological results of neck dissection in primary parotid gland (PG) cancer patients, and to investigate the effects of histopathological parameters (perineural invasion, lymphovascular invasion, and extracapsular spread), neck metastasis, stage and lymph node ratio (LNR) on survival. Methods: Patients who underwent parotidectomy for malignant PG tumors between 2000 and 2019 years were retrospectively reviewed from the medical records. Thirty patients who were treated with parotidectomy and neck dissection were included in the study. Lymph node ratio was calculated as the ratio of the number of metastatic lymph nodes (LN) to the total number of excised LNs. Tumor stage, regional LN metastasis, LNR, perineural invasion, lymphovascular invasion, and extracapsular spread were reviewed for the effects on survival with the Kaplan-Meier analysis. Results: The study included 17 (57%) male and 13 (43%) female patients. Their mean age was 67.93±16.90 years (range, 50-85 years). The average number of the excised LN was 26.03±11.79 (range, 3-50). Mean LNR was 0.16±0.26. The Kaplan-Meier analysis showed that neck metastasis (p=0.001) and LNR (p<0.001) were associated with shorter survival times compared to perineural invasion (p=0.818), lymphovascular invasion (p=0.154), extracapsular spread (p=0.410) and stage (p=0.294). In multivariate COX regression analysis, only LNR had a statistically significant difference (p=0.027) compared to the other parameters. Conclusion: The present study suggests that LNR and neck metastasis are associated with shorter survival times in PG cancers. Lymph node ratio can be used as a prognostic marker in these patients. [ABSTRACT FROM AUTHOR]

Objective: This study aims to compare the effect on the hearing results of three different materials used in ossiculoplasty for patients with chronic otitis media (COM) and Austin-Kartush type A defect. Materials and Methods: This retrospective study includes 79 patients with the Austin-Kartush type A defect due to COM. The ossiculoplasty had been performed with a glass ionomer cement (GIC), titanium partial ossicular replacement prosthesis (PORP), or incus interposition between 2011-2021. Age, gender, operation side, hearing thresholds, computed tomography images, intraoperative findings, and middle ear risk index (MERI) were obtained from medical records. Air-conduction (AC) and bone-conduction (BC) thresholds were calculated by averaging the threshold values for 500, 1,000, 2,000 and 3,000 Hz, and air-bone gap (ABG) values were calculated by subtracting the BC thresholds from the AC thresholds, preoperatively and postoperatively. Hearing gains were obtained by subtracting ABG values in the first postoperative year from the preoperative ABG values. Results: This study included 32 male and 47 female patients. The GIC group had 28 patients, the incus interposition group had 28, and the PORP group had 23. No statistically significant difference occurred among the groups regarding MERI scores (p = 0.699). The mean preoperative ABG levels were 37.46±9.23dB in the GIC group, 38.96±11.35dB in the incus interposition group, and 37.34±10.16dB in the PORP group, while the mean postoperative ABG levels were 24.42±11.20dB in the GIC group, 23.25±10.09dB in the incus interposition group, and 22.82±13.59dB in the PORP group (p = 0.814). The ABG gains were 13.75±11.66dB in the GIC group, 15.71±11.55dB in the incus interposition group, and 14.52±9.98dB in the PORP group (p = 0.803). Conclusion: The incus long process defect or lack of the incus due to COM may be repaired with GIC, incus interposition, or titanium PORP, all with similar ABG gains. [ABSTRACT FROM AUTHOR]

Objective: How the presence of olfactory structures in olfactory cleft polyps (OCPs) affect olfaction function outcomes after surgical removal has not yet been investigated. In this study we aimed to assess the presence of olfactory structures in OCPs and correlate these findings with olfactory outcomes after endoscopic sinus surgery (ESS). Methods: Twenty seven patients with OCP underwent preoperative topical and systemic steroid treatment and ESS. Biopsies from the middle meatal polyps (MMPs) and OCPs were immunohistochemically analyzed for olfactory marker protein (OMP). The smell diskettes olfaction test was applied to patients at baseline, after steroid treatment (AST) and after ESS. Results: OCPs exhibited OMP staining more commonly and intensely compared to MMPs (p=0.008), however, there were no correlations between OMP staining scores and any of the olfaction scores (p>0.05). Steroid treatment increased smell function significantly (p<0.001), however, there were no significant differences between AST and after ESS smell scores (p=0.17). There were significant correlations between smell gains AST and final smell gains after ESS (r=0.665, p<0.001). Conclusion: OCPs contain olfactory neuroepithelium more commonly and intensely than MMPs in nasal polyp patients. However, surgical importance of this finding is controversial because removal of these polyps did not decrease smell function postoperatively in our study. Nasal polyp patients who will take steroid treatment pre-operatively must be informed that the success of ESS on olfaction depends on the response of the steroid treatment and ESS AST might not have additional favorable effect on smell function. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of this study was to evaluate the gene polymorphism and expressions of Rho-A, ROCK-1, and ROCK-2 in cholesteatoma. METHODS: In this study, 120 healthy control group patients and 120 cholesteatoma patients were enrolled. Venous blood was taken from all of the cholesteatoma and control group patients. The genotyping of ROCK-1(G/T)rs35996865, ROCK-2(A/C)rs10178332, and Rho-A(A/T)rs2177268 polymorphisms was performed using predesigned TaqMan SNP Genotyping Assays. Assays-on-Demand SNP genotyping kit was used for the realtime polymerase chain reaction. The expression levels of Rho-A(Hs00357608_m1), ROCK-1(Hs01127699_m1), and ROCK-2(Hs00178154_m1) genes were determined. RESULTS: The expression of Rho-A, ROCK-1, and ROCK-2 was lower in cholesteatoma patients than in the control group. There was no difference in Rho-AAT/TT and ROCK-1GT/TT variation in cholesteatoma patients compared to the control. However, ROCK-2 AC/CC variance was lower in cholesteatoma patients. CONCLUSION: The expression of Rho-A, ROCK-1, and ROCK-2 genes may be decreased in cholesteatoma. Furthermore, since ROCK-2 AC/CC genotype is also lower in cholesteatoma, having C allele seems to decrease the risk of developing this disease. [ABSTRACT FROM AUTHOR]

Our aim was to discuss rhino-orbital mucormycosis developing after coronavirus disease-2019 pneumonia treatment. A 45-year-old man presented with visual loss, headache, and numbness in the palate and the left mid-face. The patient had been administered methylprednisolone for coronavirus disease-2019 disease at another hospital. The head and neck examination revealed ophthalmoplegia and chemosis in the left eye and hypoesthesia in the site under the left orbit. Endoscopic nasal examination revealed a black eschar tissue on the left inferior turbinate and the middle meatus. Liposomal amphotericin B was promptly administered with a dose of 5 mg/kg with a preliminary diagnosis of mucormycosis. Urgent endoscopic medial maxillectomy and orbital decompression were performed. Once total visual loss was seen in the patient in the follow-up period, orbital exenteration was performed. The diagnosis of mucormycosis was made based on the histopathological examination, which revealed non-septate hyphae causing invasion in the tissues and the blood vessels. There was no growth of specific fungal microorganisms in the tissue cultures. The patient has been alive during the 2 months follow-up periods and no complications were observed. Patients with coronavirus disease-2019 should be closely monitored in terms of the underlying disease and mucormycosis. Corticosteroids should be administered carefully in coronavirus disease-2019 patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of this study was to compare the differential Ki-67 and p27 staining properties of acquired cholesteatoma in adult patients for prognostic analysis. METHODS: Forty-two adult patients with acquired cholesteatoma were enrolled. The cholesteatoma and matched meatal skin tissues of the patients were immunostained with Ki-67 and p27 antibodies. Canal wall down mastoidectomy was performed in all patients. The differential staining properties--positive staining in the cholesteatoma and negative staining in the skin tissue (C+S-), negative staining in the cholesteatoma and positive staining in the skin tissue(C-S+)--were compared for bone erosion scores (BES), stage, and recurrence rates. RESULTS: Isolated findings in the cholesteatoma tissues, without matching with the skin tissues, demonstrated that stage and recurrence rates were not related to findings in the cholesteatoma tissues (P = .05). However, C+S- for Ki-67 and C-S+ for p27 are risk factors for worse prognosis including advanced stage (P < .001 for Ki-67 and P = .008 for p27), BES values (P < .001 for Ki-67 and P = .001 for p27), and recurrence rates (P < .001 for Ki-67 and P = .037 for p27). CONCLUSION: This is the first paper assessing the cholesteatoma prognosis according to the differential Ki-67 and p27 staining properties of cholesteatoma and healthy skin tissues. Cellular proliferation rate in the cholesteatoma is important but insufficient by itself for predicting the prognosis of cholesteatoma patients. Patients having lower basal levels of cellular proliferation rate and higher cellular activity in the cholesteatoma tissue are prone to worse prognosis with increased stage, recurrence rates, and degree of bone erosion. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the facial nerve function and audiological results of delayed (by at least one month after the insult) transmastoid facial nerve decompression (FND) in traumatic facial nerve paralysis (FNP). METHODS: Medical records of 57 patients with traumatic FNP were reviewed and surgical results of 13 patients (mean age 28.0 ± 17.67, range 3-67) undergoing transmastoid FND were analyzed. Preoperative and postoperative mean hearing thresholds were compared using 0.5, 1, 2, and 3 kHz. Facial nerve function was graded according to the House-Brackmann scale (HB) before and after surgery. HB scale results of grade III or better were accepted as good results postoperatively. RESULTS: Preoperative HB grades were V in 5 and VI in 8 patients. Twelve of 13 patients had good recovery of facial nerve function regardless of the operation timing. When mean preoperative and postoperative air-bone gap (ABG) values were compared (except the patients with total sensorineural hearing loss), the mean preoperative ABG was 33 ± 15.9 dB, and mean postoperative ABG was 17.2 ± 8.68 dB. There was a mean hearing gain of 15.8 dB after transmastoid facial nerve decompression surgery. Surgery and anesthesia-related complications were not seen in any patients. CONCLUSION: The transmastoid route can be used safely and effectively with elimination of the risks of craniotomy and middle fossa surgery for patients with traumatic FNP. Hearing improvement can be achieved by performing ossicular chain reconstruction during decompression surgery for patients with conductive or mixed hearing loss (HL). [ABSTRACT FROM AUTHOR]

Purpose: The main aim of this retrospective computed tomography (CT) study was to examine the morphometric development of the geniculate ganglion (GG) in children aged between 1 and 18 years for surgical approaches. Methods: This study was placed on 41 patients (20 females and 21 males) including cochlear implantation cases aged from one to 18 (at mean, 6.44 ± 5.79) years. All the measurements belonging to the length, width and area of GG were performed with a CT scanner. Results: The morphometric values of GG were not different in terms of sex or side, statistically (p > 0.05). The length (p = 0.155) of GG was not correlated with the increasing ages from one to 18 years; however, its area (p < 0.001) and width (p = 0.003) were found to be increased in the childhood period. Linear functions for the length, width and area of GG were calculated as y = 2.028 + 0.011 × age (years), y = 1.496 + 0.014 × age (years), and y = 3.239 + 0.035 × Age (years), respectively. The dehiscence of GG was found in 22 (26.8%) out of 82 temporal bones. Conclusion: Our data suggested that the area and width of GG were progressively increasing with age in the childhood period. The calculated formula representing the growth dynamic of GG in children and the incidence of the presence of the dehiscent GG can be useful for radiologists and otologists to estimate its size and to avoid iatrogenic injury during early childhood surgeries. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of paper patch closure of tympanic membrane perforation in patients with otomycosis and tympanic membrane perforation. Methods: Fifty-six otomycosis patients with central tympanic membrane perforations were included in the study. Patients were randomized into two groups as patched (PG) and non-patched (NPG) groups. In both groups, Castellani's solution was applied to the external auditory canal. In PG patients, the perforated tympanic membrane was covered with carbon paper patch soaked in Castellani's solution to reduce ear canal humidity and to prevent fungi from passing from the ear canal to the middle ear mucosa. Paper patch was not used in NPG patients. Results: There were statistically significant differences between the two groups in terms of severity scores in the first, second, third, fourth and sixth weeks of admission (p=0.004, p=0.018, p=0.001, p=0.009, and p<0.001, respectively). Time to complete recovery was statistically shorter in PG patients (p<0.001). Disease recurrence was statistically less among PG patients compared to NPG patients (p=0.025). Conclusion: Closing of perforation with paper patch and topical application of Castellani's solution was found to be an effective and safe method. The method eliminated otomycosis in a shorter period and reduced recurrence rate in patients with eardrum perforation. [ABSTRACT FROM AUTHOR]

Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy and it can cause cystic metastasis to the neck region. Branchial cleft cysts (BCCs) are among the most commonly encountered congenital cystic neck masses. PTC metastasis into BCC has been rarely reported in the literature. In this case report we report a patient presenting with a cystic neck mass for which fine needle aspiration biopsy was reported as benign cytology and eventually was diagnosed as PTC metastasis to the BCC. The importance of investigating the thyroglobulin levels in fine needle aspiration materials of cystic neck masses for early diagnosis of possible PTC metastasis is specifically emphasized. [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.)

Background: Deep neck infections are important otolaryngologic emergencies due to serious complications and the risk of airway compromise, which can lead to mortality. Although the most common causes among pediatric patients are tonsillitis and pharyngeal infections, odontogenic infections are an important cause in adults. Case Report: We present three patients with multiple deep neck space abscess formation due to odontogenic infection. Two of them required tracheotomy due to airway compromise, and one had mediastinitis. Conclusion: An underestimated tooth infection can cause hazardous complications such as mediastinitis and respiratory distress requiring tracheotomy. [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.)