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Summary Objectives Laryngopharyngeal reflux (LPR), a growing issue in ear, nose, and throat (ENT) and pediatric medicine, is the backflow of stomach contents into the laryngopharynx. Patients present with frequent upper and/or lower respiratory tract infections and coughs, associated with acid- and pepsin-mediated injury to the mucosae of the larynx and pharynx. LPR is associated with rhinosinusitis, laryngitis, pneumonia, and asthma. Children with LPR often fail to exhibit classic gastroesophageal reflux disease symptoms, or such symptoms may be intermittent. Only a few studies have sought correlations among symptoms, endoscopic findings, and the results of frequently used diagnostic tests. The aim of our study We sought associations among the Reflux Finding Score (RFS), Reflux Symptom Index (RSI), and the pathological extent of esophagitis. Methods We reviewed data on children who underwent upper gastrointestinal tract endoscopy and showed LPR symptoms, as reported by the ENT department. The RSI was scored by pediatric gastroenterologists and the RFS by ENT doctors, via laryngoscopic examination. The pathological esophageal data were evaluated retrospectively. Results We treated 52 patients (29 boys) with a mean age of 11.4 ± 4.5 years. On pathological evaluation, one patient exhibited normal esophageal findings, while 28 showed mild esophagitis, 16 esophagitis, and 8 severe esophagitis. Thirteen patients showed esophageal pseudopolypoid lesions secondary to gastroesophageal reflux disease on endoscopic examination, but were human papilloma virus-negative. There was no correlation among the RFS, RSI score, and age, but there was a significant correlation between the pathological data and the RFS (P = 0.010; r = 0.461). Conclusions The incidence of LPR/esophagitis in children may differ from that in adults. Therefore, ENT specialists should determine esophagitis status in children and, if necessary, consult pediatric gastroenterologists.

WOS: 000467083900012 PubMed ID: 30585325 Objectives In this study, pirfenidone's role about reducing tracheal stenosis by suppressing fibrosis and inflammation was examined. Methods Tracheotomy was performed on 14 rats, and their cannulas were fixed to tracheotomy area by stoma suture. Two working groups were established. Rats in the first group were given 15 mg/kg/day (1 mL pirfenidone solution) pirfenidone intraperitoneally for 10 days. In the second group as a control group, 1 mL saline solution was applied intraperitoneally. Ten days later, rats were decanulated and kept alive for 3 more weeks. Anesthetized rats were sacrificed on day 30. All rat tracheas were resected between the first and seventh rings. Epithelial damage, inflammation, and fibrosis were determined histopathologically; diameters of intratracheal lumen and their mucosal thickness parameters were determined histomorphometrically; and TGF beta-1 (the growth factor beta), TNF alpha (tumor necrosis factor alpha), and IL-1 beta (Interleukin-1 beta) values were determined immunohistochemically. Results According to the parameters of the control group, fibrosis; diameters of intratracheal lumen; and values of TGF beta-1, TNF alpha, and IL-1 beta were found to be statistically significant. Conclusion In our study, it was found that pirfenidone reduces fibrosis and narrowing of intratracheal lumen diameter significantly. Level of Evidence NA Laryngoscope, 129:E178-E186, 2019

Bu olguda, Orta Anadolu'nun Kuzey-doğu kesiminde bir köyden gelen, yüzünün sağ tarafında asimetrisi bulunan ve sağ kulak ağrısı şikayeti ile Yeditepe Üniversitesi Hastanesi kulak burun boğaz bölümüne başvuran 33 yaşındaki bir erkek hasta sunulmuştur. Hastanın sağ dış kulak yolunda kene gözlenmiş ve kenenin çıkarılması otomikroskopi altında fine cup forceps ile yapılmıştır. Ani başlayan şiddetli kulak ağrısı ve yüz felci ile başvuran endemik bölgeden gelen hastaların, kulak kanalında kene ısırığı olasılığını dışlamak için dikkatlice incelenmesi gerektiği görüşündeyiz. We present the case of a 33 year-old man from a village of the north-eastern part of central Anatolia admitted to the otolaryngology department of Yeditepe University Hospital with right facial asymmetry and pain on the right ear. A tick of the genus Hyalomma was observed in the external auditory canal of the right ear and it was removed with fine cup forceps under otomicroscopy. We are of the opinion that in patients presenting with sudden acute ear pain and facial palsy, the ear canal should be examined to exclude an infestation by ticks.

Objectives/Hypothesis: Verbal fluency deteriorates with normal aging, but is much more severe in Alzheimer’s Disease (AD). Verbal functions were analyzed to find differences between normal aging subjects in patients with mild cognitive impairment (MCI), and in patients with early and moderate stages of AD. This study measured the verbal response time in patients with AD, MCI, and in control subjects Study Design: This study measured the verbal response time in patients with AD, MCI, and in control subjects Methods: Fifteen patients with MCI, 15 patients with early AD, 8 patients with moderate AD, and 15 subjects for controls were included in the study. Word length in milliseconds, reaction time to a phoneme, word, or sentence and acoustic analysis of voice quality and speech diadochokinetic rate (DDK) were measured. Results: Reaction time for a phoneme, word, or sentence especially the initiation period for them were longer in patients with early AD compared to patients with MCI (P < .001). The mean DDK rate was lower with increased severity of the disease, and was much more severe in patients with moderate AD. Conclusions: Clinical discrimination of the early stages of AD and MCI is challenging. Unfortunately, there are no laboratory markers present for the diagnosis of preclinical cases of AD. With the results of this study, the assessments of verbal reaction time may helpful for diagnosis of early AD.

Alt konka hipertrofisi özellikle nasal septum deviyasyonu ile birlikte sık görülen bir durumdur. Bazen alt konka hipertrofilerinin nedeni fibro-osseöz lezyonlar olabilir. Ossifiye fibrom gibi benign, nadir ve agresif olmayan fibro-osseöz neoplazmlar paranazal sinüsleri etkileyebilir. Ossifiye fibromda izole alt konka tutulumu son derece nadirdir. Bu makalede septum deviyasyonu ve konka hipertrofisine bağlı burun tıkanıklığı ile başvuran 28 yaşında bayan hasta sunuldu. Ameliyat öncesi ve ameliyat sonrasındaki incelemelerde alt konka hipertrofisinin nedeni ossifiye fibrom olarak tespit edildi. Bizim bilgilerimize göre, bu olgu izole yerleşimi nedeniyle İngilizce literatürde bildirilen ikinci ossifiye fibrom olgusudur. Alt konka hipertrofisi olan hastalar dikkatli bir şekilde muayene edilirse alt konka hipertrofisi için gereksiz medikal ve cerrahi tedaviler uygulanmasını önlemek mümkün olabilir. Hypertrophy of inferior turbinate is a common condition, especially with nasal septum deviation. Sometimes, the cause of hypertrophy of inferior turbinate can be fibro-osseous lesions. Benign, rare, and non-aggressive fibro-osseous neoplasms such as ossifying fibroma can affect paranasal sinuses. Isolated inferior turbinate involvement is extremely rare in ossifying fibroma. In this article, we present a 28-year-old female suffering from nasal obstruction due to septal deviation and hypertrophy of inferior turbinate. Preoperative and postoperative investigation show that cause of hypertrophy of inferior turbinate is ossifying fibroma. To our knowledge, that this is the second case of ossifying fibroma reported in the English-language literature due to its isolated localization. However, if the patients with inferior turbinate hypertrophy are examined carefully, we can prevent unnecessary medical treatment and surgery for inferior turbinate hypertrophy.

Summary Objective: To investigate the possible harmful cytogenetic effects associated with chronic tonsillitis by analyzing the micronucleus frequency and other nuclear abnormalities in exfoliated buccal epithelial cells. Materials and methods: The study consisted of 20 children with chronic tonsillitis, and 20 control subjects with similar age and sex. The ages ranged between 5 and 12 years old (mean age: 7.5). The patients were diagnosed as having chronic tonsillitis on the basis of history, throat culture and clinical examinations. Buccal cell samples were collected with a wooden spatula. The samples were then applied to clean microscope slides. Smears were air dried and fixed in methanol:acetic acid. Then slides were stained by the Feulgen reaction technique. Three slides were prepared for each subject and 1000 cells were evaluated per slide to determine the frequencies of micronucleus and other nuclear abnormalities (binucleats, karyorrhexis and karyolysis). Statistically, Mann–Whitney U -test was used to analyze and compare the data. Results: The mean micronucleus frequencies in patient and control groups were 5.29 ± 1.67 and 1.58 ± 0.33, respectively. In the patient group, mean binucleus, karyorrhexis and karyolysis frequencies were 3.13 ± 1.2, 2.04 ± 0.64, and 1.74 ± 0.47, respectively. However, in the control group, mean binucleus, karyorrhexis and karyolysis frequencies were 1.43 ± 0.47, 1.26 ± 0.45, and 0.88 ± 0.27, respectively. The mean frequencies of all parameters in the patient group were higher than the control values, and the difference was found to be statistically significant ( p Conclusion: Our results revealed that children with chronic tonsillitis could be under risk of significant cytogenetic damage.

Hypothesis: Glutathione and glutathione-related antioxidant enzymes are involved in the metabolism and detoxification of cytotoxic and carcinogenic compounds as well as reactive oxygen species. Reactive oxygen species generation occurs in prolonged relative hypoperfusion conditions such as in aging. The etiology of presbycusis is much less certain; however, a complex genetic cause is most likely. The effect of aging shows a wide interindividual range; we aimed to investigate whether profiles of (glutathione S-transferase (GST) M1, T1 and P1 genotypes may be associated with the risk of age-related hearing loss. Patients and Methods: We examined 68 adults with presbycusis and 69 healthy controls. DNA was extracted from whole blood, and the GSTM1, GSTT1 and GSTP1 polymorphisms were determined using a real-time polymerase chain reaction and fluorescence resonance energy transfer with a Light-Cycler Instrument. Associations between specific genotypes and the development of presbycusis were examined by use of logistic regression analyses to calculate odds ratios and 95% confidence intervals. Results: Gene polymorphisms at GSTM1, GSTT1, and GSTP1 in subjects with presbycusis were not significantly different than in the controls (p > 0.05). Also, the combinations of different GSTM1, GSTT1, and GSTP1 genotypes were not an increased risk of presbycusis (p > 0.05). Conclusion: We could not demonstrate any significant association between the GSTM1, GSTT1, and GSTP1 polymorphism and age-related hearing loss in this population. This may be because of our sample size, and further studies need to investigate the exact role of GST gene polymorphisms in the etiopathogenesis of the presbycusis.

Purpose To investigate the influence of the glutathione S-transferase (GST) M1, T1, and P1 genotypes on the laryngeal squamous cell carcinoma risk. Material and methods The study group consisted of 42 white patients with laryngeal squamous cell carcinoma (39 of them were male, mean age: 53, range: 37–67 and 3 of them were female, mean age: 47, range: 32–55) and 89 control subjects (nonsmokers = 47, smokers = 42) (58 male and 31 female, mean age: 51, range: 30–72). DNA samples were isolated from blood samples using high pure polymerase chain reaction (PCR) Template Preparation Kit. The detection of GST T1, GST M1, and P1 polymorphisms were detected by using real-time PCR. Results Gene polymorphisms at GST M1 and P1 were not significantly different in patient and control groups. However, GST T1 null type significantly increased in laryngeal cancer patients when compared with the nonsmoking controls ( P = .04). Conclusions There was a significant association between GST T1 null genotype and laryngeal squamous cell carcinoma. However the potential role of GSTs as markers of susceptibility to laryngeal carcinoma needs further studies in a larger number of patients.

Purpose: We investigated the bactericidal activity of the cerumen in patients with recurrent otitis externa. Materials and methods: Cerumen samples were collected from 2 groups. Group A (n = 20) consisted of patients with recurrent otitis externa (2 or more acute otitis externa attack in the current year) and group B (n = 30) consisted of cerumen from a healthy population. We examined the bactericidal activity against the common microorganisms (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus) that encounter the recurrent otitis externa. Results: A significant decrease in the count of S epidermidis was observed in group A (P < .05) and B (P < .01) was observed. A comparison of decreases and increases in the percentages of microorganisms between the groups A and B showed that there was a significant difference only in the count of E coli (P ≤ .05). The count of E coli decreased in cerumen suspension in group A, but it increased in the normal population. Conclusion: We did not confirm that cerumen from patients with recurrent otitis externa had less bactericidal activity than from a healthy population.

Summary Papillary cystadenocarcinoma is an extremely rare malignant neoplasm characterized by cysts and papillary endophytic projections. It was first defined in 1991 by WHO. We presented a case of papillary cystadenocarinoma arising from the submandibular gland in a 78-year-old male patient, and discussed the clinical, histopathological and treatment features of this rare entity in the light of the current literature.

Cervical cystic masses may be a diagnostic challenge, especially in patients older than 40 years. We present the case of a 62-year-old male patient with a large cystic metastasis of squamous cell carcinoma to the neck and discuss this rare condition regarding diagnostic, pathologic and therapeutic features.

This study investigated the common flora of human cerumen in patients with recurrent otitis externa, and subjects who had been operated on and had an open mastoidectomy cavity from chronic otitis media.Cerumen samples were collected from three groups; group A (n = 20) consisted of patients with recurrent otitis externa, group B (n = 20) consisted of patients with an open cavity and group C (n = 30) consisted of healthy subjects.The mean of the microbial count was 3.4 × 104 in group A, 3.08 × 104 in group B and 2.48 × 104 in group C. The most commonly isolated microorganism from the three groups was Staphylococcus epidermidis. No growth was observed in five cases (25 per cent) in group A and in three cases (10 per cent) in group C. In groupB antimicrobial growth was observed in all samples. In 46 (65 per cent) of the cerumen samples,the isolates were monomicrobial and 24 (35 per cent) of the cerumen samples were polymicrobial. The isolates were polymicrobial in 65 per cent of group A, 20 per cent in group B and 23.3 per cent in group C.In the process of investigating the microbial flora of cerumen in all the three groups, microbial growth was observed from all the samples from patients with an open cavity, unlike the other groups, and it was determined that the group with recurrent external otitis had the most abundant microbial flora.

Paragangliomas are rare benign neuroendocrine tumors derived from the extra-adrenal paraganglia of the autonomic nervous system. Here, we described a new case of a 75-year-old woman with paraganglioma arising in the middle and posterior cranial fossa with extended destruction of the skull base and clivus. She was admitted to our department with the complaint of severe respiratory distress due to vocal cord paralysis. We discussed its clinical, radiological, histopathological features and treatment modalities in the light of the current literature.

Nitric oxide (NO) plays an important role in the regulation of upper respiratory function. Patients with untreated allergic rhinitis (AR) have an increased level of NO in the nasal cavity compared to normal individuals. We aimed to investigate serum levels of arginase and NO metabolites nitrite/nitrate in patients with AR during the symptomatic period. The patient and control groups consisted of 14 males and 12 females (mean age: 29, range: 20–40 years), and 10 males and 10 females (mean age: 27, range: 22–38 years), respectively. Nitrite/nitrate levels were 0.98 ± 0.33 ng/ml in the patients with AR, and 0.78 ± 0.26 ng/ml in the control group (p = 0.03). Arginase levels were 28.8 ± 14.1 ng/ml in the patients with AR, and 20.8 ± 13.5 ng/ml in the control group. The difference between the groups was statistically insignificant (p = 0.24). Our results support the view that NO plays an important role in the pathogenesis of AR, and NO metabolites may be used as a marker for monitoring the disease activity and therapy.

Background. The purpose of this study was to investigate whether polymorphism of N-acetyltransferase 2 (NAT2) genotypes are associated with the risk of laryngeal squamous cell carcinoma (SCC). Methods. The study group consisted of 45 white patients with laryngeal SCC (42 men, with a mean age of 54 years [range, 37–70 years] and three women, with a mean age of 47 years [range, 32–55 years]) and 104 control subjects (68 men and 36 women; mean age, 50 years; range, 28–73 years). All of the patients were primarily treated with surgical intervention. Blood samples (5 mL) were obtained before surgery or from the patients under follow-up to 5 years after surgery (mean follow-up, 27 months; range, 6–48 months). DNA was extracted from the lymphocytes by high pure template preparation kit. NAT2*5A, NAT2*6A, NAT2*7A/B, and NAT2*14A were detected by use of LightCycler-NAT2 mutation detection kit by real-time polymerase chain reaction with Light Cycler instruments. The association between NAT2 polymorphisms and laryngeal SCC was prospectively modeled through multivariate logistic regression analysis. Results. We found that the risk of laryngeal SCC was 7.3-fold higher in individuals with NAT2*5 mutant allele, 3.8-fold higher in subjects with NAT2*6 heterozygote allele, and 38.3-fold higher in NAT2*6 mutant allele. We also found that individuals with NAT2*7 heterozygote allele had a 0.2-fold less risk for the development of laryngeal SCC (p = .018). Conclusion. In this population, patients with NAT2*5 mutant and *6 heterozygous and mutant genotypes had a significantly higher risk for development of laryngeal SCC. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX–XXX, 2005

Central giant cell reparative granuloma (CGCRG) is an uncommon benign, reactive osseous lesion usually located in the mandible and maxilla. Although it is histologically benign, it may be locally destructive. There is still controversy on its development and growth pattern. Surgery is the treatment traditionally recommended. In this article, we presented a 12 year-old girl CGCRG of the mandible caused by a molar tooth extraction and discussed its histopathological, clinical, radiological and therapeutic features in the light of the current literature. Also we described our additional surgical maneuver 'drilling the surgical field' after the removal of the lesion.

Objective: To investigate the effect of fusafungine spray on pain and healing process after pediatric tonsillectomy. Methods: Sixty children with ages between 4 and 14 years underwent tonsillectomy or adenotonsillectomy. The patients were randomly divided into three groups and each group consisted of 20 patients. Group 1 was treated with antibiotic (amoxicillin–clavulanic acid) plus analgesic (acetaminophen), group 2 was treated with fusafungine plus analgesic (acetaminophen) and group 3 was treated with only fusafungine. The average ages were 7.8+3.4, 6.6+2.9, and 8.2+3.7 for groups 1, 2, and 3, respectively. Clinical evaluations were made after the operation on the 1st (T1), 3rd (T3), 7th (T7), 10th (T10), and 14th days (T14). Results: There was no significant difference in post-operative pain between study groups on the post-operative 1st, 3rd, and 7th days ( P >0.05), a statistically significant difference was present between groups 1 and 3, and groups 1 and 2 on the post-operative 10th and 14th day ( P =0.018 and 0.037, respectively). Pain was less in groups 2 and 3 than in group 1 on the 10th and 14th day. Also there was a significant difference in healing time of the tonsillary beds between groups 1 and 2, and groups 1 and 3 on the 10th and 14th post-operative day ( P =0.031 and 0.001, respectively). Healing was better in groups 2 and 3 than in group 1 on the 10th and 14th day. Conclusion: Fusafungine administration after tonsillectomy was found to be beneficial on post-operative pain and wound healing of tonsillary beds in pediatric population.

We investigated the effect of carnitine on wound healing of trachea in tracheotomyzed rats. This study was undertaken to test the hypothesis that treatment with carnitine would protect the wound tissue, which was evaluated by measuring nitrite and nitrate, thus nitric oxide, malondialdehyde and cholinesterase in blood, and examining the histopathological changes.Standard vertical tracheotomy was performed on 24 Wistar-Albino type rats. Then the animals were randomly divided into two groups; group A (the study group) was administered intraperitoneal carnitine 100 mg/kg for 10 days; group B (the control group) was administered intraperitoneal saline for 10 days. On the 10th day, all animals were decanulated. Three weeks later, cardiac blood samples were taken for biochemical assays and trachea specimens were harvested for histopathologic examination.In the carnitine-administered group, granulation tissue thickness resulting from the wound healing in the level of tracheotomy incision was lower compared to the control group (P0.01). When serum malondialdehyde levels were considered, a lower malondialdehyde level was found in the carnitine-administered group (P0.01). However, serum nitric oxide levels were close to each other in both groups (P0.05), while serum cholinesterase level was higher in the carnitine-administered group than in the control group (P0.01).Carnitine treatment partially prevents and significantly reduces the severity of tracheotomy induced laryngotracheal stenosis.

Objective: Antrochoanal polyp (ACP) is a polypoid lesion originating from the maxillary sinus, emerging from the ostium and extending to the choana. Although the etiologic causes of ACP are not known completely, it presents a fairly uniform clinical appearance. Nitric oxide (NO) has an important role in non-specific immunoreactions and inflammation in various tissues and has a main regulatory role in airway function and seems to involve in pathomechanism of several respiratory system diseases. NO is synthesized by the effect of three isoforms of nitric oxide synthase i.e. inducible NOS (iNOS). Some studies revealed that ACP has some different characteristics from the ordinary nasal polyps. In the present study, in order to compare ACP with allergic and non-allergic nasal polyps (NANP), we detected and localized the iNOS expression and also evaluate some histological parameters. Methods: Twenty-six cases were chosen from the files and four controls were used. The cases were separated as follows: normal inferior turbinate mucosa as control ( n =4) ACPs ( n =8), allergic nasal polyps (ANP) ( n =9), and NANP ( n =9). Five-micrometer thick sections were prepared from the paraffin sections of polyps and normal nasal mucosa to quantify the iNOS expression. iNOS protein was observed in the cytoplasm of epithelial and stromal inflammatory cells. iNOS protein expression in the groups was assessed according to the intensity of staining and histomorphological parameters, oedema, lymphocytic and eosinophilic cell infiltration were detected semi quantitatively. Results: iNOS expressions, either stromal or epithelial, were not different from each other among the four groups. Although it is not statistically significant, we noted that ANP and ACP frequently showed moderate and severe iNOS protein expression in epithelial and stromal parts when compared with NANPs and controls. Also, iNOS expression was significantly higher in the stroma of the ANPs than NANPs ( P =0.012). Conclusions: ACPs and ANPs have frequently showed moderate and significant epithelial and stromal iNOS expression. Further studies are needed in large groups to elucidate differences between ACP and the other nasal polyps.

A laryngocele is an abnormal dilatation of the laryngeal saccule. The relationship between layngoceles and laryngeal carcinoma is still debated. We present the case of a 45-year-old male patient with bilateral asymptomatic laryngocele and laryngeal squamous cell carcinoma. We discuss the possible etiopathogenetic influence of increased intralaryngeal pressure with preoperative CT and explorative findings, and the current literature is reviewed.

SOMMAIRE Objectif: Evaluer le fonctionnement du systeme nerveux autonome dans la rhinite vaso-motrice en utilisant les parametres de variabilite du rythme cardiaque. Methode: Nous avons compare les parametres de variabilite du rythme cardiaque (SDANN, SDNN, index du SDNN, rMSSD, pNN50, index triangulaire) de 26 patients avec une rhinite vaso-motrice avec ceux de 25 controles. Resultats: La diminution du SDANN et de l'index du SDNN chez les patients avec rhinite vaso-motrice est significative. Le SDNN et l'index triangulaire ont aussi diminues mais sans atteindre le seuil statistique. La diminution du rMSSD et du pNN50 qui sont des signes d'hyperactivite parasympathique est statistiquement significative par rapport aux controles (p

Presbycusis is defined as the natural hearing loss accompanying aging, caused by degenerative changes in the inner ear. The etiology of presbycusis is uncertain. However, it would appear that a complex genetic cause is most likely. The determinants of mastoid size continue to be controversial. One of the pneumatization theories is the hereditary theory. In this study, the possible relationship between presbycusis and the extent of mastoid pneumatization was investigated. This study was carried out on 21 patients with presbycusis and 21 normal subjects of similar ages. The pneumatized volume was measured by computerized tomography. The temporal bone was scanned at 2 mm thickness intervals. Exposure (kV 130, mA105). The scan plane was parallel to the orbitomeatal line and the CT images covered the entire mastoid region. The average mastoid pneumatization in presbycusis group was 6.08 +/- 2.52 cm(3) in the right ear and 6.19 +/- 2.93 cm(3) in the left ear. However, in the control group it was 4.69 +/- 3.17 cm(3) in the right ear (p=0.12) and 5.10 +/- 3.49 cm(3) in the left ear (p=0.28). No significant difference was found between the presbycusis patients and normal subjects in terms of the volume of mastoid pneumatization.