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Sinonasal system malignancies are rare, constituting only 1% of all malignancies and less than 5% of head and neck malignancies. The common form of plasma cell dyscrasias is called multiple myeloma (MM), and the localized forms are called solitary bone plasmacytoma and extramedullary plasmacytoma (EMP). EMP constitutes 3-4% of malignant plasma cell dyscrasias and 1% of all head and neck tumors. 90% of EMP cases occur in the head and neck region, because the nasal and paranasal sinus regions are rich in plasma cells at around 75%. This study aims to present two different cases of plasma cell tumors presenting in the paranasal region. Based on the imaging studies, the first case is seen to have been diagnosed as MM due to bone marrow involvement and to have received systemic chemotherapy treatment, whereas the second case is seen to have undergone endoscopic total excision of the lesion due to the absence of systemic involvement. In the first case, MM was considered to have gone into remission in the sixth month after chemotherapy; however, the patient died one year after diagnosis. In the second case, no recurrence was detected during the fifth year postoperative follow-up. As a result, patients who show sinonasal symptoms should be examined in detail. [ABSTRACT FROM AUTHOR]

Anosmia is a common symptom of COVID-19 infection. In our study, we aimed to investigate the relationship between allergic rhinitis and eosinophil levels in patients who developed anosmia after COVID-19 infection. Patients who had experienced COVID-19 infection and subsequently developed anosmia were included in the study group, while those who had experienced COVID-19 infection but did not develop anosmia were included in the control group. The patients' allergy histories and eosinophil levels were retrospectively analyzed. Our study revealed a significant difference in eosinophil levels between patients with and without anosmia (p<0.05). Additionally, among 55 patients with pre-existing allergic rhinitis, 43 (78.2%) had normal or high eosinophil levels. There was no significant relationship found between age, gender, the most common presenting symptom, hospitalization status, presence of allergic rhinitis and asthma before COVID-19 and increase in allergic symptoms after COVID-19 infection, in patients with and without anosmia. While we did not find a relationship between the presence of allergic rhinitis and the development of anosmia, our study did show that eosinopenia is more pronounced in patients with anosmia. Furthermore, it has been suggested that eosinopenia may not be a suitable marker for patients with allergic symptoms before COVID-19, as these patients may have normal or high eosinophil levels. [ABSTRACT FROM AUTHOR]

Luxation of the temporomandibular joint (TMJ) is an acute condition associated with translocation of the condylar joint out of its functional position. Traumatic causes are more common in childhood, while non-traumatic causes are very rare. A 6-month-old patient was brought to a rural hospital emergency department with the inability to close her mouth. The patient was diagnosed with anterior TMJ luxation after the examination, and no additional imaging was requested. Reduction was performed with gas sedation accompanied by paracetamol for pain. In rare cases, non-traumatic TMJ luxation may be observed after excessive crying or vomiting in infants. Examination findings are generally sufficient for diagnosis. Reduction is performed with the classical manual method, especially in childhood. One issue that should not be ignored is the possibility of recurrence after dislocation. [ABSTRACT FROM AUTHOR]

Objective: Vitamin B12 deficiency-induced hyperhomocysteinemia has been associated with impaired microarterial flow, demyelization, and neuronal damage, resulting in cochlear damage and auditory dysfunction. Therefore, we aimed to evaluate the possible vestibular-evoked myogenic potential (VEMP) abnormalities in patients with vitamin B12 deficiency. Material and Method: In this prospective study, 37 patients diagnosed with vitamin B12 deficiency (<220 pg/mL) were compared with 31 audiologically healthy participants with normal B12 levels. Burst-evoked cervical VEMP (cVEMP) measurements were performed on all participants. Additionally, cVEMP responses were analyzed for P1-N1 latency, interpeak amplitude, and amplitude asymmetry ratio. The results of audiometric examination and VEMP records as well as absent responses were evaluated and compared between groups. Results: The rate of absent VEMP responses was twice as high in the patient group than in the healthy control group (12 vs 6 cases, respectively). Moreover, the mean values of interpeak amplitude in both right and left ears were statistically shorter in the patient group than the control group (P values =.024 and.007, respectively). Similarly, the mean amplitude asymmetry ratio was statistically higher in the patient group than the control group (P =.050). There were no statistically significant differences in latency responses between groups. Furthermore, positive, statistically significant correlation was detected between values of the left P1-N1 interpeak amplitude and vitamin B12 levels (r = 0.287, P =.037). Conclusions: Increased rates of absent VEMPs and decreased amplitudes with normal latencies are attributed to peripheral vestibular hypofunction in patients with vitamin B12 deficiency. [ABSTRACT FROM AUTHOR]

Laryngeal carcinomas are the most common upper respiratory tract cancers and most commonly involve the glottic region. The aim of this study is to evaluate the voice quality after radiotherapy (RT) and microsurgical cordectomy (MC) treatments using Voice Handicap Index (VHI) and Grade, Roughness, Breathiness, Astenicity, and Strain (GRBAS) perceptual evaluation scale in patients with early-stage glottic carcinoma. A total of 37 patients with early-stage glottic carcinomas, 19 patients had RT and 18 patients with MC, were included in our study. The patients were evaluated in terms of their sound quality by using VHI-10 and GRBAS perceptual assessment scale 3 months after the treatment was completed. Although the findings were better in favor of RT according to GRBAS perceptual assessment scale of patients who received RT (n = 19) and MC (n = 18), no statistically significant difference was found between the 2 groups (P =.613). Patients in both groups were evaluated with VHI-10, emotional (P =.036) and physiological (P =.038) scores were significantly higher in MC group and no significant difference was found in functional scores (P =.192). However, there was no statistically significant difference between the 2 groups in terms of voice quality (P =.185). In early-stage (Tis, T1a, T1b) glottic carcinoma, there was no significant difference between RT and MC in terms of voice quality. Therefore, the choice of treatment modality in patients with early-stage glottic carcinoma should be taken into account in terms of the patient's occupation, comorbid diseases, cost of treatment, hospital stay, and, most importantly, patient preference. [ABSTRACT FROM AUTHOR]

Primary tumors of the nasal cavity can be classified as benign or malignant. Patients with tumors of the nose and paranasal sinuses are usually diagnosed in the advanced stages of the disease. The aim of this study was to evaluate the data of patients who were operated for sinonasal masses in our clinic in light of the literature. Between January 2016 and December 2018, 357 cases of sinonasal masses presenting to the Otorhinolaryngology Department of the Health Science University at the Samsun Training and Research Hospital were retrospectively screened and included in the study. Of the 357 patients included in the study, 256 (72%) were male, and 101 (28%) were female. The most common symptom was nasal obstruction (90%). Most of the benign cases were nasal polyps (90.2%), while the next most frequent diagnosis was inverted papilloma (4.7%). Malign neoplasms were found in 11 cases, and five were found to be squamous cell carcinomas (SCC). All benign cases were treated surgically, and the malignant cases were treated according to the diagnosis. In conclusion, although the symptoms of the 357 patients with sinonasal mass were similar, histopathological evaluation revealed 96.9% benign and 3.1% malign pathologies. The malign/benign ratio was 3.08. Malignancy should therefore be considered as a possibility in patients with nasal bleeding and facial swelling. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the current status and the future of pediatric otolaryngology in Turkey by evaluating the opinions of young otolaryngologists on pediatric otolaryngology. Methods: The study included 224 otolaryngology physicians who were senior residents registered with the Turkish Otolaryngology and Head-Neck Surgery Association (TORL-HNS). The physicians were in their last two years of otolaryngology training (154 physicians) or had completed their residency training and were in their first year of otolaryngology practice (70 physicians). They were approached via e-mail and Short Message Service (SMS) in October through December 2019 with a descriptive letter and asked to voluntarily complete an online questionnaire consisting of total 25 questions in five sections. Results: The online questionnaire was sent to 224 physicians, and 109 (49%) participated in the survey. All 109 participants answered all the questions. Overall, 71 participants (65.1%) were in training for residency and 38 (34.9%) were in their first year of expertise. According to their professional interests, the participants listed rhinology (45 participants, 41.3%), head and neck surgery (27 participants, 24.8%), facial plastic surgery (19 participants, 17%), otology-neurotology (16 participants, 14.7%), and laryngology-phoniatry (2 participants, 1.8%) as their first preference for subspecialty. Pediatric otolaryngology was never a first choice among the participants, although four (3.7%) listed pediatric otolaryngology as their second preference. Conclusion: The aim of this study was to shed light on the current and future status of pediatric otolaryngology in Turkey. We believe the establishment of exclusive pediatric otolaryngology clinics under the umbrella of general ear, nose and throat (ENT) clinics and the foundation of officially approved fellowship programs would bring this subspecialty field to its deserved and desired level in our country. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the clinical characteristics of children with tracheotomy, dependent to mechanical ventilator, taking home care service, their families' socioeconomic status and attitudes about disease process in Samsun. Methods: A total of 32 pediatric patients with tracheotomy dependent to mechanical ventilation who were enrolled in the Home Health Services Unit of Samsun Training and Research Hospital between June 2015 and June 2019 were included in the study. After the families of the pediatric patients were informed, verbal and written consent was obtained. The questionnaire consisting of 19 questions was filled by asking the parents during the home visit by the researcher. Demographic and medical data of children, socio-demographic and economic characteristics of the families, their education about the disease process and their psychological status were evaluated by the questionnaire. Statistical evaluation was made by giving percentage rates. Results: In our study group, there were 19 male and 13 female patients aged between 1 and 16 years. While 28 of the pediatric patients were followed up due to mechanical ventilation, 4 pediatric patients were followed up only by tracheotomy. During the 48-month followup period, 5 ventilator-dependent pediatric patients died and the tracheotomy of 2 pediatric patients was closed. When the primary diseases of our pediatric patients were grouped, 16 (50%) were neurological, 6 (18.7%) were respiratory diseases, 5 (15.6%) were muscle diseases and 5 (15.6%) were metabolic diseases. Thirty-one (96.8%) families with tracheotomy and/or ventilator-dependent pediatric patients who continued their care at home reported that their work and social lives were affected; while one family reported as not affected. It was found that the mothers took care of all the patients and 31 (96.8%) of the mothers stated that their education related to the disease process and the maintenance and use of medical devices were sufficient. The fathers stated that they could not go to work and even they were at work they had to come home in unexpected situations of children. Mothers, on the other hand, stated that they could not leave their child alone in any way, because they could not get out of the house, their neighbors did shopping for them. The results showed that all of the pediatric patients were cared by mothers and 31 of the mothers (96.8%) did not consider themselves sufficient, despite being educated on the disease process, the care and use of medical devices, before their discharge. Conclusion: We consider that there is a need for comprehensive studies to reduce the repeated hospitalization of children with tracheotomy and mechanical ventilators, to provide in-service training to the relevant healthcare workers within the home healthcare services; and to provide economic, social and psychological support to the families providing care. [ABSTRACT FROM AUTHOR]

Background: The pathophysiology of vertigo is not fully known; thus, it is difficult to diagnose vestibular migraine (VM) in some migraine patients with vertigo symptoms. Aims/objectives: We aimed to evaluate the diagnostic value of cervical vestibular evoked myogenic potential (cVEMP) in patients with VM. Materials and Methods: Thirty-two patients diagnosed with migraine and 31 patients with VM were prospectively included in this study. The cVEMP responses were obtained, and P1-N1 latency, interpeak amplitude, amplitude asymmetry ratio were calculated. The patients' demographics, results of physical and audiometric examinations, and VEMP records as well as absence of responses were evaluated and compared between groups. Results: The incidence of ears with absence VEMP responses was found to be numerically higher in the migraine group than in the VM group (p = .106). Additionally, there were no statistically significant differences detected between the groups in terms of the p13 or n23 latency, interpeak amplitude, and amplitude asymmetry ratio measured in both right and left ears (p > .05). Conclusions: The increased rate of absent VEMPs was associated with the hypoperfusion of the sacculo-collic reflex pathway in migraine patients. In addition, it was concluded that VEMP reflex responses appear to be insufficient to differentiate between VM and migraine diagnoses. [ABSTRACT FROM AUTHOR]

Objective: Transcanal endoscopic type 1 tympanoplasty is a minimally invasive procedure that enables better visualization of deep and narrow spaces compared to conventional microscopic methods. In our study, we aimed to evaluate air-bone gap difference, graft success, and hearing gain according to the perforation size and location in pediatric patients who underwent transcanal endoscopic type 1 cartilage tympanoplasty. Methods: Fifty pediatric patients who underwent transcanal endoscopic type 1 cartilage tympanoplasty for chronic otitis media were included in the study. Tragal cartilage grafts were used in all patients. Air conduction pure tone audiometry hearing results (500, 1000, 2000, and 4000 Hz), mean air-bone gap levels, operating times, postoperative gap closure, and graft success rates were evaluated. Results: Mean operating time was 43.34±8.56 minutes. Overall graft success was 94% (47/50). Mean hearing levels at all frequencies (500, 1000, 2000, and 4000 Hz) were found to have significantly improved after the operation (p<0.001). Mean preoperative air conduction pure tone threshold and mean air-bone gap had statistically significantly improved by the 6th postoperative month (p<0.001). Conclusion: Transcanal endoscopic type 1 cartilage tympanoplasty was found to be a minimally traumatic, easy and safe method with a low complication rate. In pediatric patients, this method allows for high rates of anatomic and functional recovery with optimal surgery time regardless of the location and the size of the perforation. [ABSTRACT FROM AUTHOR]

Background: Luxation of the temporomandibular joint (TMJ) is an acute condition associated with translocation of the condylar joint out of its functional position. Traumatic causes are more common in childhood, while non-traumatic causes are very rare., Clinical Presentation: A 6-month-old patient was brought to a rural hospital emergency department with the inability to close her mouth. The patient was diagnosed with anterior TMJ luxation after the examination, and no additional imaging was requested. Reduction was performed with gas sedation accompanied by paracetamol for pain., Conclusion: In rare cases, non-traumatic TMJ luxation may be observed after excessive crying or vomiting in infants. Examination findings are generally sufficient for diagnosis. Reduction is performed with the classical manual method, especially in childhood. One issue that should not be ignored is the possibility of recurrence after dislocation.