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Retrospective cohort. The objective of the study is to evaluate a relationship between idiopathic intracranial hypertension (IIH) and superior semicircular canal dehiscence (SSCD) of bone overlying the superior semicircular canal (SSC). A total of 57 (114 ears) individuals, 20 of whom were controls and 37 of whom were IIH, were included in the study. Individuals were evaluated with 0.8 mm slice thickness computed tomography (CT) images for SSC bony roof thickness and SSCD. Thickness of the bony roof over the SSC was graded from Grade 1 to Grade 4. Grade 3 was defined as pre-dehiscence and Grade 4 as dehiscence. Bony roof thickness was 1.25 mm in the control group and 0.76 mm in the IIH group. When bony roof thickness was compared between the groups, it was found to be significantly thinner in the IIH group (p = 0.012). In the IIH group, while dehiscence was detected in 25 of 74 ears, no dehiscence was detected in 49 ears. In the control group, while dehiscence was detected in 5 ears, no dehiscence was detected in 35 ears. The difference is statistically significant (p = 0.015). The correlation between bony roof thickness and cerebrospinal fluid (CSF) pressure in the IIH group was not statistically significant (p = 0.343; rho = 0.110). The correlation between bony roof thickness and age in the IIH group was not statistically significant (p = 0.082; rho = − 0.164). Increased CSF pressure in patients with IIH may cause chronic, progressive, and irreversible damage to the bone of the SSC and, according to our study, the rate of SSCD was found to be high in IIH patients.

Objective: We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions. Methods: The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test. Results: The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant ( P ≤.001; P ≤ .001; P ≤ .001, and P = .048, respectively). Only Group A and Group B experienced a significant difference in nasal mucociliary clearance times ( P ≤ .001; P = .010, respectively). When the Sino-nasal Outcome Test-22 score and nasal mucociliary clearance time differences before and after treatment were compared between all groups, the Sino-Nasal Outcome Test-22 score difference was higher in Group A than in Groups B, C, and D, the differences were found as statistically significant ( P = .010; P = .003; P ≤ .001, respectively). The nasal mucociliary clearance time difference was higher in Group A than in Groups C and D, the differences were found as statistically significant ( P = .010; P = .001, respectively). Conclusion: Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients.

Aim:In search of better alternative material than gelatin sponge dressing (GSD) traditionally used in the external ear canal after tympanoplasty, it’s aimed to evaluate the use of new cross-linked hyaluronic acid gel (HYA) and compare it with GSD.Methods:This block-randomized controlled trial was performed in 50 patients who underwent tympanoplasty between April and December 2019. The patients were divided into two groups according to external ear filling material (HYA as study group n=25, GSD as control group n=25). The groups were compared in terms of edema, pain, graft morphology, epithelization, drainage parameters at postoperative 1st, 2nd, 3rd, and 4th weeks. In addition, pure-tone audiometry and graft success were also evaluated.Results:After the first week, edema in HYA was significantly less than GSD (p=0.033). Reaching the 2nd week, less discharge was observed in HYA (p=0.007). Third week results showed edema in HYA was significantly less than that of GSD (p=0.023). In the 4th week, the postoperative gap gain in the HYA group was significantly higher than GSD (p=0.037). The difference in graft intake between groups was not significant (p=0.189).Conclusion:New cross-linked HYA gel may act as a promoter in the healing process after tympanoplasty and may have positive effects on hearing restoration.

Objectives: This study aims to investigate the serum 25-hydroxyvitamin D3 [25 OH D3] levels of patients with Bell’s palsy BP , and to evaluate their role in prognosis and their impact on the disease etiology. Patients and Methods: A total of 49 patients 30 males, 19 females; mean age: 42.2±13.6 years; range, 19 to 67 years who were diagnosed with BP and treated at our clinic between October 2019 and April 2020 were included. Blood samples were collected within 24 h after the onset of BP symptoms, and a standard oral pharmacological treatment was administered with prednisolone 1 mg/kg for 10 days and acyclovir 700 mg/day for six days. All patients were graded according to the House-Brackmann scale HBS . The patients were divided into three groups as Grade 2, Grade 3, Grade ≥4. The patients with BP were further divided into two groups as healed n=36 and not-healed ones n=13 . The vitamin D levels of the groups were compared. Results: Eleven 22% patients were in the Grade 2 group, 21 43% patients were in the Grade 3 group, and 17 35% patients were in the Grade ≥4 group. A significant decrease in vitamin D levels was observed in the patients with HBS Grade ≥4, compared to Grade 3 and Grade 2 groups p=0.002 and p

Background: Chronic hyperglycemia can affect the vestibular system by causing injury in cells and neural structures. In addition to alterations in the microvasculature and connective tissues, changes in inner ear fluid metabolism can also contribute to otolithic damage in patients with diabetes. We aimed to evaluate the effects of neurovascular degeneration occurring in diabetic polyneuropathy (DPN) on the vestibular system. Methods: Thirty-five patients with DPN (n = 70 ears) and 34 (n = 68 ears) healthy controls were enrolled. Patients were classified into two subgroups as sensorial axonal PNP and sensory-motor axonal PNP. To assess vestibular functions, cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP) testing were bilaterally performed. Results: Bilateral cVEMP and oVEMP P1 latency and N1 latency were significantly prolonged, whereas amplitude values were significantly decreased in patients with DPN compared with the controls (P = 0.001). The cVEMP amplitude asymmetry ratio (AAR) was statistically higher in the DPN group than in controls (P = 0.001); oVEMP AAR was not significant between the patient and control groups (P = 0.095). The cVEMP AAR values were found to be increased in both patient subgroups, and oVEMP AAR was elevated in the sensorineural PNP subgroup. In the DPN group, the nonresponse rate was 48.6% (n = 17) in cVEMP and 51.4% (n = 18) in oVEMP, significantly higher compared with the controls (P < 0.05). In cVEMP, nonresponse rates were found to be lower in both DPN subgroups. In oVEMP, the nonresponse rate was found to be higher in the sensory-motor PNP subgroup when compared with the sensorial PNP subgroup (P = 0.008 and P = 0.003, respectively). Conclusion: In diabetes mellitus with multisystemic effects, particularly in patients with polyneuropathy, vestibular testing before the onset of vestibular symptoms may be an early and beneficial diagnostic method for detecting the presence or degree of neurovascular degeneration.

Background/aim: The Zurich Chronic Middle Ear Questionnaire (ZCMEI-21) is a newly-developed German-language questionnaire. The purpose of this study was to analyze the quality of life (QoL) of chronic otitis media (COM) patients and translate, transculturally adapt, and validate the ZCMEI-21 into Turkish. Materials and methods: Based on internationally accepted guidelines, the ZCMEI-21 was translated into Turkish. To assess its validity, the total score of the ZCMEI-21-Tur was compared to the scores taken from the original validation study and a question that was directly related to the health-related QoL (HRQoL), as well as the general criterion EQ-5D-5L. Questionnaires were completed by healthy volunteers and the results were evaluated statistically. Results: A total of 80 COM patients and 40 healthy volunteers were prospectively enrolled in this study. Regarding internal consistency, the questionnaire showed a Cronbach α of 0.94, which indicated high internal consistency. Moreover, internal consistency was also determined to be excellent for the Cronbach α of the individual subscales, as follows: ear sign symptoms, 0.79; hearing, 0.83; psychosocial impact, 0.91, and medical resources, 0.84. Conclusions: The ZCMEI-21 was translated into Turkish and validated. Therefore, the ZCMEI-21-Tur was suitable for use in assessing HRQoL in adult patients with COM.

Background: We evaluated the efficacy of medical treatment on thiol–disulfide balance despite ongoing allergic stimulation. Methods: The research design was a prospective observational study that included 35 persistent allergic rhinitis (AR) patients. All patients who were diagnosed with persistent AR were included. A skin prick test was applied to all patients, and the Sino-nasal Outcome Test-22 was used to evaluate sinonasal symptoms. Thiol/disulfide homeostasis balance parameters were measured using a novel automatic and spectrophotometric method and compared statistically. Serum total thiol (TT), native thiol (SH), disulphide (SS), disulphide/native thiol (SS/SH), disulphide/total thiol (SS/TT), and native thiol/total thiol (SH/TT) ratios were measured after the second month of the treatment. Results: The 35 patients included 20 (58%) females and 15 (42%) males. The mean age of the patients was 33.17 ± 9.9 years. Disulphide, SS/SH, and SS/TT ratios decreased significantly after the treatment ( P < .05), while SH and SH/TT increased significantly ( P < .05). The mean SH measurement increased significantly in the second month ( P = .001), but TT mean measurements showed no difference after the treatment ( P = .058). The mean SS measurements, on the other hand, decreased significantly in the second month ( P = .003). Conclusion: Thiol/disulfide homeostasis may be used as a marker to evaluate the efficacy of persistent AR treatments. After the treatment, the increase in SH levels suggested the decrease in oxidative stress, even though allergen exposure continued.

Objectives This study aimed to assess the efficacy of Kinesio taping on male patients with mutational falsetto undergoing voice therapy. Design Double blind, randomized, sham-controlled clinical trial. Participants Interviews were conducted with thirty seven mutational falsetto patients. Included 32 participants were randomized and divided into two groups. Two were dropped out due to irregular attendance, 30 participants were included in final analysis. Interventions The study group was treated with voice therapy and applications of three different therapeutic Kinesio taping techniques with seven Kinesio tapes four times over two weeks, and the control group was treated with voice therapy, and applied to sham Kinesio taping. Outcome measures The values of fundamental frequency, jitter, shimmer, noise-harmonic ratio, maximum phonation time, Voice Handicap Index-10 scores, and Grade–Roughness–Breathiness–Asthenia–Strain Scale scores were recorded at the baseline and after the two weeks. Results There were significant differences between the study group and the control group with respect to the values of fundamental frequency (P = 0.011), jitter (P = 0.041), shimmer (P = 0.036), noise-harmonic ratio (P = 0.003), maximum phonation time (P ≤ 0.001), Voice Handicap Index-10 scores (P = 0.036), and Grade–Roughness–Breathiness–Asthenia–Strain Scale scores (P = 0.007; P ≤ 0.021; P = 0.022; P = 0.002; P = 0.021, respectively) at the end of the study. Conclusions The study demonstrated that Kinesio taping with voice therapy is an efficient and effective technique for treating mutational falsetto patients.

To investigate the effect of thymic stromal lymphopoietin on the development of chronic otitis media with effusion MATERIALS AND METHODS: This study was conducted on 40 patients who had adenoidectomy operation. The objects were divided into two groups. Group 1; adenoidectomy with chronic serous otitis media, group 2; adenoidectomy without chronic serous otitis media. Serum and tissue thymic stromal lymphopoietin levels were measured by ELISA. Serum and tissue TLSP levels, mast cell count, adenoid size were compared between the groups.Twenty-four (60%) of patients were female and 16 (40%) were male. Twenty patients (55%) had adenoid hypertrophy with chronic serous otitis media, and 18 (45%) had adenoid hypertrophy without chronic serous otitis media. The mean age of the patients was 6.21 ± 2.31 years. The mean mast cell count was significantly higher in group 1 compared with group 2 (p = 0.017). The mean tissue thymic stromal lymphopoietin measurement was also significantly higher in group 1 than group 2 (p = 0.023). However, there was no significant difference in regards to serum levels between the groups (p = 0.480).The number of mast cells as well as thymic stromal lymphopoietin levels in the adenoids of children was significantly high in the chronic serous otitis media patients. The release of thymic stromal lymphopoietin from the adenoid tissue plays a role in initiating and maintaining a local inflammatory reaction in the eustachian tube that may lead eventually to middle ear effusion in non-atopic patients.

OBJECTIVE Balloon sinuplasty is being used worldwide, however the olfactory functions after balloon sinuplasty are underestimated. The authors aimed to study the effects of conventional endoscopic sinus surgery (ESS) compared to the balloon sinuplasty on olfactory function. MATERIALS AND METHODS Forty-four subjects were randomly divided into 2 groups as ESS and balloon sinuplasty. The olfactory functions of each subject were recorded preoperatively and at the 1st, 3rd, 6th, and 12th months postoperatively. RESULTS The initial assessments of olfaction were the same in both groups. After the surgery, the olfactory functions were significantly better in those of ESS group (P

Introduction:Otorhinolaryngology (ENT) physicians may be effective in the early diagnosis of autism spectrum disorder (ASD). The aim of this study was to investigate the awareness of ENT residents in İstanbul about recognizing ASD.Methods:The type of the study was cross-sectional. The study population consisted of 97 ENT residents, and 83 (85%) of these residents were included in the study. The questionnaire consisted of questions about the sociodemographic data of the participants and Autism Spectrum Disorder Awareness Questionnaire. Autism Spectrum Disorder Awareness Questionnaire contains the findings of ASD reported in the literature. This questionnaire includes observable findings of possible ASD in a child during routine examination of the ENT physician.Results:In our study, the most known finding of childhood autism was found to be difficulty in making eye contact (97.5%). Regarding work experience, “difficulty in making eye contact” (100%) and “lack of age-appropriate language development” (91.5%) findings were well-known findings among residents with less than four years of experience. On the other hand, “very sensitive vision, hearing and touch senses” (95.8%) and “seem unable to hear even if hearing tests are normal” (91.7%) findings were more prominent among residents with four or more years of experience.Conclusion:The ASD awareness of the ENT residents participating in our study can be considered as relatively good. The “Autism Spectrum Disorder Awareness Questionnaire” developed by the researchers is planned to be validated with the studies to be carried out later and developed to be used for ENT specialists. Such questionnaires can also be used to raise awareness among ENT residents and specialists.

This clinical trial aimed to investigate the effects of different nasal packing methods and transseptal suture technique on swallowing after septoplasty. This randomized prospective study consists of 180 consecutive patients with septal deviation. All the patients underwent septoplasty. All the patients were randomly assigned to three groups. In group A, transseptal sutures were used for septal stabilization. In group B, both nasal passages were packed with Merocel tampons for septal stabilization. In group C, both nasal passages were packed with Doyle silicone splints for septal stabilization. For the evaluation of swallowing, the Eating Assessment Tool (EAT-10) questionnaire and a visual analog scale (VAS) were administered to all the patients preoperatively and on the second and seventh postoperative days. One hundred and twenty two of the patients (67.7%) were female and 58 of them (32.2%) were male. The mean age was 32.41 ± 12.37 years (range: 18–57 years). Both EAT-10 and VAS scores on the second postoperative day were significantly higher than the preoperative scores in all the groups (p

Purpose Chronic rhinosinusitis (CRS) is one of the most common chronic diseases seen worldwide. Endoscopic sinus surgery (ESS) has become a widely accepted procedure for medically refractory chronic rhinosinusitis and nasal polyps. Prevention of revision surgery often depends on good wound healing and less adhesion formation. In recent years, the effects of platelet-rich fibrin (PRF) on tissue healing have been addressed in many surgical branches, especially for dental implant surgery and plastic surgery. Methods This prospective study was conducted with 50 patients who underwent endoscopic sinus surgery for the diagnosis of nasal polyposis. While the middle meatus in one nasal cavity was filled with PRF and supported with Nasopore, only Nasopore was used in the other nasal cavity middle meatus. The patients were followed up clinically at weeks 1, 2, 3, 4, 8, and 12 postoperatively. The assessor determined the presence of adhesion, crusting, bleeding, frontal ostium stenosis, granulation, and infection, and if present, the grades of these complications were scored according to a questionnaire. Results In our study, adhesion, infection, bleeding, granulation, and frontal ostium stenosis were less common in the PRF group, and a statistically significant difference was found between the groups. Conclusion In our study, better results were obtained in terms of adhesion, infection, bleeding, granulation, and frontal ostium stenosis after ESS as a result of the effects of PRF on wound healing. The application of PRF is an inexpensive and easy procedure. PRF can be a good alternative to other types of tampons after ESS.

We aimed to investigate the effect of platelet-rich fibrin (PRF) on olfactory function and pain score in patients who underwent septoplasty. This prospective randomized observational study was performed between 2018 January and 2019 April with 148 patients who had septoplasty operation. Patients were divided two groups and 74 patients were placed in group 1 to which PRF was applied after the completion of septoplasty whereas 67 patients were put in group 2 which did not undergo PRF. Sniffin’ Sticks test was applied to all patients at pre-op, post-op 1-week, 6-week, and 6-month. Pain scores of patients were measured with visual analogue scale at 1 and 3 week. The distribution of patients according to pre-op olfactory function (normo-hypo-anosmia), there was no significant differences statistically (p > 0.05). When we compared the 1-week post-op results of Sniffin’ Sticks test of patients, we found differences between the groups (p

Edema and ecchymosis are among the most important morbidities after rhinoplasty. The aim of the present study was to investigate the effects of hilotherapy application compared with traditional ice applications after rhinoplasty in terms of periorbital edema, ecchymosis, and pain.A total of 60 patients (35 women and 25 men) had undergone primary rhinoplasty with the same surgeon. In the postoperative period, 30 patients in the study group received continuous cooling at 15°C using Hilotherm (Hilotherm GmbH, Argenbühl-Eisenharz, Germany), and 30 patients in the control group were treated with conventional cryotherapy with ice packs. Both treatments started within 45 minutes after the end of the surgery and were maintained for 24 hours. For the following 1 week, the patients were examined for edema, ecchymosis, and pain.When the postoperative periorbital region was evaluated for mean edema and mean ecchymosis for 7 days, less edema and less ecchymosis were detected in the Hilotherm group compared with that observed in the ice pack group (P .001). When the mean pain scores were compared both morning and evening for 7 days, less pain had been recorded with Hilotherm application compared with ice application (P .001).Hilotherapy is a useful method to prevent postoperative edema, ecchymosis, and pain compared with traditional ice application.

Objectives: The objective of this study is to determine the subclinical vestibular dysfunction of patients with vestibular migraine (VM) in the interattack period who had no vestibular symptoms. We assessed ascending utricular and descending saccular pathways using cervical vestibular-evoked myogenic potentials (cVEMP) and ocular vestibular-evoked myogenic potentials (oVEMP) in patients with VM and a healthy control group and then compared the electrophysiologic findings with each other. Materials and Methods: Between January 2017 and January 2018, 116 patients (aged 18–62 years) were enrolled in the study. The study group consisted of 68 women with VM and the control group comprised 48 healthy women. Results: For cVEMP findings, the mean left ear P1 latency of the VM group was statistically significantly longer than that of the control group (P = 0.024; P < 0.05). No statistical significance was found in left ear N1 latency, P1-N1 interpeak intervals and mean amplitudes between the VM and the control groups (P > 0.05). Amplitude asymmetry ratios (AARs) were not statistically significantly different between the two groups in cVEMP (P > 0.05). In terms of oVEMP findings, no statistically significant difference was found in the right ear parameters of N1, P1, P1-N1 intervals, and amplitudes of the VM and the control groups (P > 0.05). The left ear oVEMPs of the VM group showed absent responses in 12 cases and were statistically significant compared with the control group (P = 0.037; P < 0.05). The AARs were significantly greater for the the VM group than the control group in oVEMP (P = 0.006; P < 0.05). Conclusion: These electrophysiologic findings suggest that peripheral vestibular structures such as the utricle, saccule and also other central vestibular structures might be affected in VM. Patients with VM had subclinical vestibular dysfunction despite being in the interattack period. To support the diagnosis of VM, VEMPs are easy and cost-effective tests.