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Tam Metin / Full Text ESCI WOS:000686221300004 Steroid therapy is the gold standard in treating sudden sensorineural hearing loss (SSNHL). This study aimed to compare the results of the systemic and intratympanic administration of steroids used to treat patients with SSNHL. Methods: A retrospective analysis was performed with 90 patients treated for SSNHL in our clinic between 2014 and 2017. Intratympanic steroid (ITS) was administered to 44 patients and systemic administration (intravenous or oral) to 46. Pure-tone average (PTA) values were recorded before treatment and at the first and third months post-treatment. Hearing improvement was evaluated according to the Furahashi criteria. Results: The pre-treatment PTA values were 68.9 ± 25.9 dB in the systemic steroidtreated group and 79.0 ± 22.6 dB in the intratympanic steroid-treated group, with no statistically significant difference determined (P = .07). After 1 month of treatment, the PTA median value was 6.0 (from −23.0 to −65.0) dB in the systemic group; and the median was 7.5 dB (from −13.0 to −84.0) in the intratympanic group. No statistically significant difference was determined between the groups in terms of regression in pure-tone median values after treatment (P = .90). According to the Furahashi criteria, in the evaluations between the 2 groups, those with complete improvement and significant improvement were compared together, and those with mild improvement and those without improvement were compared separately. There was no statistically significant difference in the distribution with respect to healing, between the groups (P = .692). Conclusion: Although steroids––which are the only treatment with proven efficacy in sudden idiopathic hearing loss––are effective in the improvement of hearing, the methods of administration showed no differences in terms of effectiveness.

To investigate the effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on acoustic characteristics of voice production in Turkish patients with Parkinson's disease (PD).This study recruited 20 patients diagnosed with PD. Voice samples were recorded under the "stimulation on" and "stimulation off" conditions of STN-DBS. Acoustic recordings of the patients were made during the production of vowels /a/, /o/, and /i/ and repetition of the syllables /pa/-/ta/-/ka/. Acoustic analyses were performed using Praat.A significant difference in the parameters was observed among groups for vowels. A positive significant difference was observed between preoperative med-on and postoperative med-on/stim-on groups for /a/ and the postoperative med-on/ stim-on and postoperative med-on/stim-off groups for /o/ and /i/ for frequency perturbation (jitter) and noise-to-harmonics ratio. No significant difference was noted between the preoperative med-on and postoperative med-on/stim-off groups for any vowels.STN-DBS surgery has an acute positive effect on voice. Studies on formant frequency analysis in STN-DBS may be expanded with both articulation and intelligibility tests to enable us to combine patient abilities in various perspectives and to obtain precise results.

Yildirim, Ugur/0000-0002-2373-6235; kemal, Ozgur/0000-0002-6419-6204; Atmaca, Sinan/0000-0001-6839-0285 WOS: 000518343200005 PubMed: 32144565 Purpose To investigate the effects of submucosal platelet-rich plasma (PRP) injection on nasal mucosal wound healing after endoscopic sinus surgery. Methods 24 New Zealand white rabbits were randomly divided into three groups. To mimic surgery, injury was created using 3-mm punch forceps on ventral turbinate mucosa for all groups. Submucosal PRP was injected to the damaged mucosa in the first group (PRP group, n = 8), where 0.9% saline solution to the second group (saline group, n = 8) and no injection to the third one (control group, n = 8). All the animals were sacrificed 14 days after surgery; histopathological examination and hydroxyproline measurements were performed on the mucosa of all groups. Results Neutrophils, goblet cells, and collagen intensity were found significantly lower (p < 0.05) in PRP group than the control group. Also, the number of ciliary and goblet cells, and collagen intensity were found significantly lower (p < 0.05) in PRP group, than the saline group. In PRP group, hydroxyproline levels were found (p < 0.05) significantly lower than the saline and the control group, and no significant difference was found between the saline group and the control group (p > 0.05). Conclusion There are many studies in literature showing the positive effects of PRP on wound healing. The results of this study also demonstrated positive effects of PRP on the nasal mucosa. According to these results, PRP injection to the injured nasal mucosa showed anti-inflammatory, mucus-softening, and synechia-reducing effects. Therefore, submucosal PRP injection after endonasal surgeries can be considered an effective application for maintaining nasal physiology. Commission of Scientific Research Projects of Ondokuz Mayis UniversityOndokuz Mayis University [TIP.1904.17.016] This study was supported by the Commission of Scientific Research Projects of Ondokuz Mayis University (Project No: PYO. TIP.1904.17.016).

OBJECTIVE The aim of this study was to investigate the effects of 3 Tesla (3T) magnetic resonance imaging (MRI) noise on cochlear functions. METHODS The distortion product otoacoustic emission (DPOAE) test was applied to patients who were scheduled to have 3T MRI in the tertiary care center. Patients who revealed emission amplitudes at all frequencies (1, 1.5, 2, 3, 4, 6, and 8 kHz) in the DPOAE test before MRI were included in the study. After MRI, the DPOAE test was performed twice on 17 patients (33 ears) (immediately after MRI and 30 minutes after MRI). The changes in the results of the tests taken before MRI (pre-MRI), immediately after MRI (post-MRI 1), and at 30 minutes after MRI (post-MRI 2) in the DPOAE amplitudes at all frequencies were compared statistically. RESULTS There was a significant difference between pre-MRI, post-MRI 1, and post-MRI 2 measurements at 3, 6, and 8 kHz. In pairwise comparisons; post-MRI 1 was statistically lower than post-MRI 2 at 3 kHz, and post-MRI 1 was statistically lower than pre-MRI and post-MRI 2 at 6 and 8 kHz. In addition, post-MRI 2 was significantly lower than pre-MRI at 8 kHz. CONCLUSION According to these results, 3T MRI noise does not have any permanent negative impact on hearing functions. It can only cause DPOAE amplitude changes at high frequencies. This is a clinically negligible effect. Therefore, it can be considered that the 3T MRI examination with protective headphones does not cause any adverse side effects in terms of hearing functions.

Purpose The objective of this study is to evaluate smell and taste dysfunction (STD) in coronavirus disease 2019 (COVID-19) positive and negative patients, and to assess the factors associated with STD in COVID-19 positive patients. Methods Patients who had been tested with the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for COVID-19 were identified, and according to the RT-PCR test results, patients were separated into Positive and Negative Groups. A telephone-based assessment was applied to both groups using the American Academy of Otolaryngology–Head and Neck Surgery Anosmia Reporting Tool. Patients in Positive Group were also asked to rate STD, nasal breathing, and anxiety in three different time periods (pre-/during-/post-COVID) using the visual analog scale (VAS). Results A total of 53 COVID-19 positive and 51 negative patients completed the surveys. STD was eightfold more frequent (OR 8.19; CI 95% 3.22–20.84) in the Positive Group. Of the 53 COVID-19 positive patients, 32 reported STD and 21 did not. ‘Ground-glass appearance’ on chest-computed tomography was more frequent and median lymphocyte count was significantly lower in COVID-19 positive patients with STD. During-COVID STD and nasal breathing VAS scores were significantly lower than the pre- and post-COVID scores. During-COVID STD scores were significantly correlated with anxiety scores (Spearman’s rho-0.404, p = 0.022) but not correlated with nasal breathing scores. Conclusion STD may be related to increased inflammatory response as well as damage of olfactory neuronal pathway or non-neuronal olfactory mucosa. Understanding the exact cause of chemosensory impairment in COVID-19 can be helpful in explaining the pathophysiology of the disease. Electronic supplementary material The online version of this article (10.1007/s00405-020-06503-9) contains supplementary material, which is available to authorized users.

Dysphagia is a life-threating symptom in patients with multiple sclerosis (MS) because aspiration pneumonia develops as a consequence of swallowing disorders. Dysphagia can be detected by using patient-reported outcome measures in order to prevent complications.To identify the dysphagia prevalence, severity, and swallowing related quality of life (QoL), by using two validated dysphagia questionnaires.Dysphagia in Multiple Sclerosis (DYMUS) and Swallowing Quality of Life (SWALQoL) questionnaires were collected from 64 patients with MS.The mean total SWALQoL score was 67.9 (±11.2) and the mean DYMUS score was 2.02 (±1.3). The highest mean SWALQoL subdomain score belonged to communication (76.7 ± 15.8), and the lowest score belonged to sleep (54.2 ± 12.2). There was a significant correlation between age and DYMUS and SWALQoL scores (r: 0.539 and r: -0.610 respectively, P .001). Additionally, there was a significant moderate correlation between disease duration and DYMUS and SWALQoL scores (r: 0.693 and r: -0.697 respectively, P .001). DYMUS and SWALQoL scores did not vary between males and females (P.05). Patients with secondary progressive MS had higher DYMUS and lower SWALQoL scores (more dysphagia) than in primary progressive or relapsing-type MS. There was a strong, negative and statistically significant correlation between DYMUS and total SWALQoL scores (Spearman's rho: -0.862, p.001).MS causes dysphagia and reduces QoL. Age, disease duration, and MS type are major factors that influence SWALQoL. DYMUS and SWALQoL are well correlated. DYMUS is an easy to answer tool that may advised for screening dysphagia in patients with MS.

WOS: 000506799400001 PubMed: 31928280 Background: Increasing arterial stiffness is associated with atherosclerosis and there is an association between atherosclerosis and tinnitus may occur. Objectives: The aim of this study was to investigate the relationship between arterial stiffness and tinnitus using the central pulse-wave analysis method. Methods: This prospective, single center study included 98 participants, comprising 49 patients diagnosed with subjective idiopathic tinnitus (Group 1) and a control group of 49 healthy subjects (Group 2). The Mobil-O-Graph 24 h Pulse wave analysis (PWA) Monitor (I.E.M. GmbH, Stolberg, Germany) was used to determine the arterial stiffness and cardiovascular hemodynamic parameters. Central pulse pressure (CPP), Augmentation index and pulse wave velocity (PWV) were obtained with the device. Results: No statistically significant difference was determined between Groups in respect of age, smoking and hypertension (p > .05). Statistically significantly higher Central Pulse Pressure (CPP) values and pulse wave velocity were higher in Group 1 compared to the control group (p < .005). No statistical variation was detected in terms of the augmentation index (18.5 +/- 11.3 vs 16.7 +/- 10.3, p = .543). Conclusion: Our results marked that arterial stiffness is associated with tinnitus. The relationship was examined via oscillometric method, which is simple to perform and has been recommended in guidelines for the determination of cardiovascular event risk.

WOS: 000431947600012 PubMed: 29988261 …

Objectives/Hypothesis Mean platelet volume is the measurement of the average size of platelets in the blood, and red blood cell distribution width is the variability of the size of red blood cells in circulation. This study aimed to investigate if there was any relationship between mean platelet volume, red blood cell distribution, and epistaxis. Study Design Prospective controlled trial. Methods The study included 90 patients admitted to Ankara Ataturk Hospital and Samsun Medicana Hospital with complaints of recurrent epistaxis, and a control group of 90 healthy subjects. Blood samples were taken from all patients and control group subjects. Mean platelet volume and red blood cell distribution parameters were examined and compared between the two groups. Results The mean platelet volume levels were determined as 8.86 ± 0.1 in the control group and 8.36 ± 0.1 in the patient group. The difference between the two groups with respect to mean platelet volume was statistically significant (P

Purpose We aimed to attract our college's attention to the Melkersson-Rosenthal syndrome (MRS), which has been an infrequently encountered subject in otolaryngology journals during the last 10 years. Materials and methods A retrospective review of the last 10 years' patient database was performed to find patients with MRS. The medical files, treatment charts, and radiological and histopathological records of these patients were reviewed. Results The study group consisted of 3 MRS patients who had been misdiagnosed for 9, 10, and 16 years. Two of them have had the symptoms since adolescence. All of them presented orofacial edema and fissured tongue, whereas first two also had recurrent facial paralysis. Characteristic histopathological features were noted in 1 patient. Electromyography (EMG) was done in 1 patient who underwent facial decompressiom. All patients responded to either systemic or intralesional corticosteroid treatment. Conclusions In the daily practice of an otolaryngologist, it is not usual to diagnose a patient as having MRS. We consider that this is partly because of misdiagnosis. We therefore believe that this study will supply an additional aspect to otolaryngologists, in the scope of recurrent facial paralysis and orofacial edema in both children and adults.

The purpose of this study was to present our experience with combined use of CO2 laser and cold instrumentation for Reinke's edema surgery and to evaluate 1-year follow-up results of the technique in a series of professional voice users. Fifteen patients with Reinke's edema who underwent microlaryngoscopic surgery were included. Videolaryngostroboscopy, perceptual and acoustic voice analyses were performed before and after surgery. During the 1-year follow-up, no recurrence of Reinke's edema was encountered. Significant postoperative improvement was obtained in the quality of voice, in terms of GRBAS scores, Fo, jitter, shimmer and NHR. No evidence of laryngeal cancer was found on the histological examinations. Combined use of CO2 laser and cold instrumentation provides a reliable and safe method for Reinke's edema surgery, and cessation of smoking, voice rest and control of the laryngopharyngeal reflux contribute to the success of surgery. We consider that the removal of redundant mucosa of the vocal fold reduces the risk of the recurrence of Reinke's edema and provides better quality of voice. However, it does not imply that our method is superior to others', but this procedure constitutes an effective treatment of choice for Reinke's edema patients, including professional voice users.

e17538 Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common type of cancer worldwide. In Turkey, 5538 new cases and 2340 deaths from head and neck cancer are estimated to occur every year. Tobacco and alcohol are the most important etiological risk factors but in the past three decads tobacco usage is decreased and Human Papilloma Virus (HPV) has changed HNSCC epidemiology. Many new reports suggests that almost 25% of all cases of HNSCC are related to HPV. But its prevelans shows a wide variation among different populations.Today in Turkey HPV positivity in HNSCC is currently not known and this retrospective study aimed to to evaluate the HPV infection in our HNSCC patients. Methods: We included 125 HNSCC patients diagnosed and treated in our hospital beween January 2010 and December 2016. Oral cavity, oropharyngeal, laryngeal and hypopharyngeal cancers were included. Nasopharyngeal and salivary gland cancers were exculuded. Head and neck cancer tissue samples fixed using 10% Neutral Buffered Formalin and embedded blocks were used. From an initial evaluation of 125 patients records 77 of the paients blocks could be adequate for the HPV testing. Detection and genotyping of HPV genotypes were done using a polymerase chain reaction (PCR) protocol. Results: PCR amplification was succesful in 61 of 77 patients. Among the 61 HNSCC patients only 3 patients were HPV positive(4.9 %). HPV 16 subtype was detected in one patient who was 70 years old male, stage III laryngeal cancer with a smoking history. The subtypes detected in other two patients were different from 16 and 18. One of these patients was 42 years old nonsmoker female stage IVa hypopharyngeal cancer and the other one was 56 years old smoker male with stage II oropharyngeal cancer. Conclusions: In Turkey, this is the first study that evaluated HPV positivity in HNSCC. Our results suggest a low prevelance of HPV in Turkish HNSCC patients; large scale population based studies are needed to confirm our findings.

WOS: 000465456800006 Background: Salivary gland tumors are rare, comprising only 6%-8% percent of all head and neck neoplasms. Most are benign and commonly occur in the parotid gland. In the last decade elevated hematological inflammatory parameters, such as neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were identified as predictive and prognostic factors in various malignancies. The aim of this study was to evaluate the differences in preoperative NLR and PLR in benign and malignant salivary gland tumors. Methods: This retrospective study included a total of 133 patients (28 malign, 105 benign) with salivary gland tumors (age range: 17-89 years; 68 male and 65 female) who were treated between January 2006 and May 2016. Preoperative counts and levels of hematological parameters were obtained from the recorded computerized database of benign and malignant tumors. Results: NLR and PLR levels were significantly higher in the malignant salivary gland tumor group than the benign group. (Mean NLR: 2.74 +/- 1.183 vs 2.039 +/- 0.791 [p: 0.001]; Mean PLR: 160361.02 +/- 16200.293 vs 124669.76 +/- 4308.446 [p: 0.014]). According to the receiver operating curve (ROC) analysis of the NLR, the area under the curve (AUC) was 0.705 [(95% CI 0.589-0.821); p : 0.001] with a cutoff value 2.13 with 75% sensitivity; 61% specificity. ROC analyses performed for PLR with a cutoff value of 126794 had 64% sensitivity and 44% specificity and AUC was found to be 0.651 [(95% CI 0.541-0.760); p:0.014]. Conclusions: Results of the current study revealed the potential predictive role of NLR and PLR in patients with salivary gland tumors. These cheap and easily available blood count parameters could be useful biomarkers in the future. Further investigations are needed to confirm these findings.

Kemal Ö, Atmaca S, Bel-Çeçen A, Düzgün B, Aygün HC. The use of nasal trumpet as a non-invasive treatment method in congenital nasal stenosis. Turk J Pediatr 2017; 59: 210-213. Newborns and infants are dependent on nasal respiration and therefore, nasal obstructions may lead to life-threatening outcomes in this age group. Although the most common cause of nasal obstruction in newborns are choanal atresia, soft tissue edema, congenital nasal bone anomalies such as narrowness of the apertura piriformis and midnasal stenosis should be kept in mind. A 5-day-old infant was referred to our clinic with the complaints of respiratory problems. Physical examination revealed nasal bone hypoplasia and saddle nose deformity. In the endoscopic examination, the septum was seen to be deviated in an `S` shape and the nasal passages were almost completely closed. The paranasal CT examination reported significant narrowing of the airway in the central part of the nasal cavity. After application of nasal trumpet to both nasal passages, clinical recovery was determined in the patient and no pathology was determined during the follow-up period.

kemal, Ozgur/0000-0002-6419-6204 WOS: 000359271100040 PubMed: 25351500 There are many causes of septal injury or saddle nose. A variety of materials like autografts or exogenous ones have been used for reconstruction. Cartilage grafts are usually used for reconstruction. The reconstruction material should be strong enough to reshape the nose but also easy to reshape (cut or crop) and the cartilage should be thick enough to allow cosmetic shaping. A new technique for total septal reconstruction is presented in this paper. From the experience of these three cases. The method described here has two significant advantages. This method provides better stability and strength and also allows for easy reshaping or cropping of the cartilage, it seems to be an easier method to reconstruct the septum with good results.

Mean platelet volume is the measurement of the average size of platelets in the blood, and red blood cell distribution width is the variability of the size of red blood cells in circulation. This study aimed to investigate if there was any relationship between mean platelet volume, red blood cell distribution, and epistaxis.Prospective controlled trial.The study included 90 patients admitted to Ankara Atatürk Hospital and Samsun Medicana Hospital with complaints of recurrent epistaxis, and a control group of 90 healthy subjects. Blood samples were taken from all patients and control group subjects. Mean platelet volume and red blood cell distribution parameters were examined and compared between the two groups.The mean platelet volume levels were determined as 8.86 ± 0.1 in the control group and 8.36 ± 0.1 in the patient group. The difference between the two groups with respect to mean platelet volume was statistically significant (P .05). The mean red blood cell distribution levels were determined as 12.68 ± 0.32 in the control group and 11.90 ± 0.16 in the patient group. The difference between the two groups with respect to red blood cell distribution was also statistically significant (P .05).The results of this study showed a clinical finding of lower mean platelet volume and red blood cell distribution levels in epistaxis. These findings could be beneficial in new investigations into epistaxis mechanisms.

This is a double bind clinical trial which evaluated harmonic scalpel versus bipolar diathermy tonsillectomy The study was conducted at Diyarbakir government hospital, Diyarbakir, Turkey. The study population comprised 144 patients, aged 4–18 years (mean 9 years ± 4.12 SD). All patients underwent tonsillectomy with or without adenoidectomy. The indications for tonsillectomy were obstructive sleep apnea (84 patients [58.3%]) and chronic tonsillitis (60 patients [41.7%]). All 144 patients were randomly divided into two groups: bipolar dissection (81 patients [56.2%] with mean age 8.98 years ± 4.22) and harmonic scalpel (63 patients [43.8%] with mean age 9 years ± 4.02). BD group showed statistically significantly less intraoperative bleeding (< 0.05). There was no statistically significant difference on postoperative day 1 but a statistically significant difference was determined on postoperative days 4, 7 and 14. There was no statistically significant difference between the two techniques with regard to immediate and delayed bleeding. The mean operative time was the same in both the groups. Bipolar dissection group showed statistically significant less intraoperative bleeding than harmonic scalpel group. An analysis of postoperative pain scores showed that the harmonic scalpel group pain scores are lower than the bipolar dissection group on all recorded days, and no statistically significant complications was seen in both groups. The results of this study indicate that the HS technique is associated with lower pain scores with the same complication rates as the BD technique.

To investigate the histopathologic profile and clinical presentation of tonsillar disease in the presence of Actinomycetes in children.A qualitative and quantitative histopathologic analysis of the palatine tonsil was performed.Tonsillectomy specimens from patients who underwent tonsillectomy or adenotonsillectomy were searched for Actinomycetes.Histologic evaluation of the specimens was done on hematoxylin and eosin-stained slides as blinded to patients' clinical category for disease groups.Four histologic compartments of the tonsil, including the surface epithelium, reticulated crypt epithelium (lymphoepithelium), lymphoid tissue, and interfollicular region, were examined.Actinomycetes was more prevalent in patients with obstructive symptoms treated with adenotonsillectomy. The number of subjectively quantitated total lymphoid follicles and small and medium-sized lymphoid follicles of the palatine tonsil were significantly increased in patients demonstrating "sulphur granules" in their crypts. Highly thick squamous metaplasia of the lymphoepithelium and dilatation of crypts were more prevalent in tonsil tissue revealing Actinomycetes.The presence of Actinomycetes in tonsillectomy specimens does not indicate active tissue infection. However, the histopathologic outcome may indicate the possible etiologic role of Actinomycetes in the development of prominent lymphoid hyperplasia and hypertrophy and, in turn, obstructive tonsillar hypertrophy.

Objective:This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume.Methods:This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups.Results:Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm3in the study group and 7.28 ± 0.56 μm3in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p< 0.05).Conclusion:The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear.