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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., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (©Copyright 2023 by Turkish Otorhinolaryngology-Head and Neck Surgery Society / Turkish Archives of Otorhinolaryngology is published by Galenos Publishing House.)

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., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (©Copyright 2022 by Official Journal of the Turkish Society of Otorhinolaryngology and Head and Neck Surgery.)

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., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (© Copyright 2019 by Official Journal of the Turkish Society of Otorhinolaryngology and Head and Neck Surgery.)

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., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare.

Objective: Nasal Polyp (NP) is a benign mass of the paranasal sinuses that protrudes into the nasal cavity. The exact underlying pathogenesis is not known. In this study we aimed to determine the genetic susceptibility of NP formation in relation to TNF-α-308 and IL-1β-511 promoter region gene polymorphisms., Methods: A total of 71 patients with NP with asthma (n=21) or without asthma (n=50) were taken as the study group, and 91 healthy volunteers were taken as the control group. Blood was gathered into EDTA-containing tubes, and patient DNA was extracted. The polymorphisms of the IL-β and TNF-α cytokine genes were analyzed using real time polymerase chain reaction., Results: The GG genotype in the TNF-α-308 region and the CC genotype in the IL-1β-511 region were found to be risk factors for NP formation (OR: 9.2, p=0.007 and OR: 33.3, p=0.001, respectively). Regarding allelic frequencies, the G allele at the TNF-α-308 promoter region was a risk factor for NP formation (OR: 6.06, p<0.001)., Conclusion: TNF-α GG genotype in the -308 promoter region and the IL-1β CC genotype in the -511 region are genetic risk factors for NP formation., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

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.

Objective: Although posterior epistaxis is rarely seen, it is an important medical problem that both decreases the quality of life of the patient and causes difficulties in the management for otorhinolaryngologists. In this study, we aimed to present the results of 30 patients who underwent transnasal endoscopic sphenopalatine artery ligation (TESPAL) for posterior epistaxis in our department., Methods: The records of 30 patients who underwent TESPAL from January 2014 to April 2016 were analyzed retrospectively, and the relationship between perioperative factors and need for revision surgery was assessed., Results: The success rate of TESPAL in posterior epistaxis was 90%. There was no relationship between surgical failure and antiaggregant use (p=0.224), anticoagulant use (p=0.534), hypertension (p=0.564), previous nasal surgery (p=0.279), and bilateral TESPAL application (p=0.279). TESPAL was seen to be effective in cases with Osler-Weber-Rendu disease, pregnancy, and uncontrollable epistaxis after rhinoplasty surgery. Mortality was seen in one of our patients not related to endoscopic ligation in the follow-up period., Conclusion: TESPAL is an effective method in the treatment of posterior epistaxis. Hypertension, antiaggregant or anticoagulant use, bilateral sphenopalatine artery ligation, and previous nasal surgery do not seem to be factors leading to surgical failure., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Physiological changes of the thyroid gland encountered during pregnancy can cause previously diagnosed thyroid nodules to grow or new nodules to form. Surgery of the slowly growing, localized, non-metastatic, well-differentiated, thyroid cancers diagnosed during pregnancy can be delayed to after delivery, whereas rapidly growing and metastatic cancers with compressive symptoms may be a candidate for surgery during pregnancy. In this case report, we present a case of cervical metastatic papillary thyroid cancer diagnosed and treated by total thyroidectomy and right functional neck dissection during pregnancy in a 22-year-old pregnant woman at 23-week pregnancy. In this case report, the optimal treatment for papillary thyroid cancer diagnosed during pregnancy is discussed under the light of current endocrine guidelines and previous case reports and series., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Inhaled or ingested foreign bodies are relatively common causes of airway obstructions. They can be associated with significant morbidity and even mortality. Although various foreign bodies are aspirated or ingested, live leeches are rarely encountered. We reported a case of a live leech at the base of the tongue in an 18-year-old female patient with a history of unfiltered spring water drinking. We discussed the surgical technique and importance of anesthesia with this brief study., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Background: Allergic rhinitis is a common inflammatory nasal mucosal disease characterized by sneezing, watery nasal discharge, nasal obstruction and itching. Although allergen-specific antibodies play a main role in the allergic airway inflammation, neuronal inflammation may also contribute to the symptoms of allergic rhinitis. Neuronal inflammation is primarily caused by the stimulation of sensory nerve endings with histamine. It has been shown that neurotrophins may also have a role in allergic reactions and neuronal inflammation. Nerve growth factor, neurotrophin 3 (NT-3), neurotrophin 4/5 and brain-derived neurotrophic factor are members of the neurotrophin family. Although nerve growth factor and brain-derived neurotrophic factor are well studied in allergic rhinitis patients, the exact role of Neurotrophin-3 is not known., Aims: To investigate the possible roles of neurotrophin-3 in allergic rhinitis patients., Study Design: Case-control study., Methods: Neurotrophin-3 levels were studied in the inferior turbinate and serum samples of 20 allergic rhinitis and 13 control patients. Neurotrophin-3 staining of nasal tissues was evaluated by immunohistochemistry and ELISA was used for the determination of serum Neurotrophin-3 levels., Results: Neurotrophin-3 staining scores were statistically higher in the study group than in the control patients (p=0.001). Regarding serum Neurotrophin-3 levels, no statistically significant difference could be determined between allergic rhinitis and control patients (p=0.156). When comparing the serum NT-3 levels with tissue staining scores, there were no statistically significant differences in the allergic rhinitis and control groups (p=0.254 for allergic rhinitis and p=0.624 for control groups)., Conclusion: We suggest that Neurotrophin-3 might affect the nasal mucosa locally without being released into the systemic circulation in allergic rhinitis patients.