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INSTRUCTION: Large prospective studies have established an independent association between hearing impairment and cognitive decline (Lin FR et.al. 2011, Gallacher J et.al. 2012). Individuals with mild to severe hearing loss have a 2- to 5-fold increased risk of developing dementia compared with those with normal hearing (Lin FR et.al. 2011). Moreover, neuroimaging studies (Peelle JE 2011, Lin FR et.al. 2014) report an association between peripheral hearing impairment and temporal lobe cortex and whole brain atrophy. A combination of several interdependent mechanisms could account for this association, such as vascular risk factors, neurodegenerative processes affecting both peripheral auditory pathways and the cerebral cortex, social isolation, and reduced cognitive stimulation. Based on these reports, hearing rehabilitation using conventional hearing aids has logically been proposed as a treatment to help improve neurocognitive performance; however, the impact of the rehabilitation generated controversial results, with a beneficial effect reported in only half of the elderly groups presented in the published analyses (Mulrow CD et.al. 1990, Tesch-Römer C 1997, Acar B et.al. 2011, Choi AY et.al. 2011, Lin FR et.al. 2013, Van Hooren SA 2005). In cases of acquired severe to profound hearing loss with no benefit from conventional amplification, cochlear implantation that uses direct electrical stimulation of the auditory nerve has proved to be successful; patients 80 years or older are one of the groups receiving benefit (Carlson ML et.al. 2010, Williamson RA, et. al. 2009). Moreover, similar to younger patients with cochlear implants, most elderly patients who have received implants show an increase in social activities and improved confidence (Vermeire K et.al. 2005, Clark JH et.al. 2012, Olze H et.al. 2012). To the best of our knowledge, the relationship between hearing benefit following cochlear implantation and cognitive abilities in elderly patients has not been investigated. The longitudinal multicenter study was to assess speech perception, cognitive abilities, and quality-of-life scores before implantation and at 6 and 12 months after cochlear implant activation inpatients 65 years or older (Isabelle Mosnier MD et.al. 2015). So we aimed to determine these benefits on Alzheimer's Disease. CASE HISTORY: A 81 year old woman presented for evaluation of postlingual bilateral hearing loss which had been increased progressively during 25 years. She had been used hearing aid on left ear for 24 years. She had been diagnosed with Alzheimer's Disease for 15 years. Preoperative Evaluation: The case's preoperative evaluation included audiologic, otolaryngologic, linguistic - rehabilitative (included Ling's sound, three syllables - one syllable -- sentences discrimination tests), cognitive, quality of life, depression and neurological assessments. Surgical Procedure: A left cochlear implantation of a nucleus 22 CI24RE (ST) device was performed without difficulty. Radiologic findings confirmed that the implant had been properly positioned. The patient was discharged from the hospital the following day. Postoperative Evaluation: After one month an operation, the case's implant was connected to Nucleus 5 speech processor. Impedance levels of all electrodes were normal. NRT of the default electrodes (included 22, 16, 11, 6) were normal, but there was no NRT on first electrode. Mapping and aural rehabilitation procedures were performed according to standard guidelines. Audiologic tests, mapping procedure were repeated at 1, 3, 6 months, 1, 2 years postoperatively, and results were compared with the preoperative findings. Rehabilitation procedure was repeated at 3, 6 months, 1, 2 years postoperatively, and results were compared with the preoperative findings. Conclusion: Epidemiologic studies demonstrate that the anticipated number of people aged 60 years or older will double by the year 2050. As a consequence, the number of people with cognitive impairment and dementia will dramatically increase, reaching more than 100 million worldwide by 2050. Because there is no curative treatment available for cognitive decline, clinical research is needed that focuses on identification of risk factors to establish preventive measures that may reduce the burden of the disease. Further research is needed to evaluate the longterm influence of hearing restoration on cognitive decline and its effect on public health (Prince M et.al. 2009, Brookmeyer R et. al. 2007). [ABSTRACT FROM AUTHOR]

Objectives: Role of parents in early childhood language development is quite important. The children of young age learn the language from their daily life experiences and especially during their interactions with their parents. However, families with hearing-impaired children have difficulty communicating with their children. The language development characteristics of hearing-impaired children using hearing aids or cochlear implants are closely related to the characteristics of the language input provided to them by their families. The purpose of this study is to assess the use of facilitative language techniques by families of hearing-impaired children using cochlear implants Material and Method: Study was carried out with eight children who are hearing-impaired, aged one to three years, have severe to profound sensorineural hearing loss, use a cochlear implant (uni/bilateral) and were trained with the Auditory-Verbal Therapy (AVT) and the mothers of these children. In order to collect the data, the interactions of the mother with the child were recorded for 15 minutes. The techniques used by the mothers are marked according to their frequency in the entry form developed by the researcher. Results and Conclusions: A result of the study, a significant increase in both the number and variety of the use of facilitative language techniques were determined for all of the surveyed mothers in comparison to the preliminary evaluation. The use of facilitative language techniques by mothers has been found out to be feasible and it is thought to be beneficial to include these techniques in early childhood intervention programs. [ABSTRACT FROM AUTHOR]

Objectives: Hydrocephalus can be defined broadly as a disorder of cerebrospinal fluid (CSF) formation or absorption, leading to an increase in volume occupied by this fluid in the central nervous system (CNS). Birth defects or acquired other things in later life can cause Hydrocephalus. Birth defects arise from neural tube defects or aquaductal stenosis. Other reasons include meningitis, brain tumors, intracerebral hemorrhages, subarachnoid hemorrhage, traumatic brain injury. Hydrocephalus is generally treated by the surgical intervention of shunt system. The aim of this report of case with hydrocephalus is to demonstrate early outputs in pursuit of cochlear implantation in the same side with shunt system in teenage girl. We investigate whether the shunt system suitable or not when thought together with other complications. Case Presentation: There are not any risk factors at prenatal medical history of the 14 year-old girl who suffers from Hydrocephalus. At natal medical history low birth weight, premature birth and anoxaemia problems are observed. Also, the mentioned patient was born via in vitro fertilization and her twin sister was born as dead. Considering the postnatal medical history, the patient has undergone the highest increased level of bilirubin and throughout 2 months she has been treated with phototherapy at newborn intensive care unit. She had a shunt surgical operation at the right side when she was just 3 months because of hydrocephalus as craniofacial abnormality. Up to 13 years old, she had hypothyroid treatment, epilepsy treatment, laser eye surgical operation and now, she has only hearing and communication disorders. Her hearing loss was recognized by her teacher when she was 6 years old and then she has been bilateral hearing aid user. In addition her hearing loss progressed in time, we determined bilaterally profound hearing loss at last assessment. And also her hearing aids are not sufficient for hearing performance and language development. Gains of left hearing aid were better than right one so when the cochlear implantation was planned, it should be operated on the right side. Language performance was assessed with PLS- 4 and receptive-expressive language age was detected as 5,5-6 year-old and she lives many difficulties at her academic progress. On the other side there aren't any complications with regards to cochlear implantation at brain diffusion and temporal bone magnetic resonance imaging and computerized tomography. In accordance with these findings, she was followed as a cochlear implant candidate and eventually she underwent surgery at last March. Med --El Synchrony implant was implanted and Sonnet sound processor was preferred. Because of the shunt system has not an electromagnetic feature, there were not any complications during the surgical placement. Also during follow- up, she was assessed and supported through therapies in the sense of auditory perception. Conclusion: The most comfortable levels with cochlear implant were adjusted via auropalpebral reflexes at the first post-op fitting whereas the threshold levels were regulated according to automatically %10 of most comfortable levels. We determined free field thresholds with cochlear implant at post-op first control approximately 40 -50 dB HL. In conclusion, she has better hearing performance and enhanced quality of life according to before. We will continue intensive auditory verbal therapy and following for the best outcomes from implantation. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to attenuate cochlear inflammation following noise-induced hearing loss by targeting IL-1. We evaluated the effectiveness of IL-1 inhibition through auditory and histological assessments in an animal model., Study Design: Experimental animal study., Setting: Gazi University Faculty of Medicine, Ankara, Turkey., Methods: Twenty-four rats were randomly assigned into 3 groups: Anakinra, dexamethasone, and control groups. All animals were exposed to broadband noise (110 dB SPL, 8 hours), auditory brainstem response (ABR) tests were conducted before noise exposure, immediately after, and on Day 14. Anakinra, dexamethasone, and saline were administered intraperitoneally, cochlear tissues were harvested for histological and immunohistochemical evaluation., Results: On Day 14, ABR thresholds in Anakinra group were better than the control group across all frequencies, with a significant difference observed at 8 kHz (P = .036). The mean number of OHC was significantly higher in Anakinra group compared to the control group (P < .05). The mean number of IHC in the Anakinra group was greater than in the dexamethasone group. IL-1β immunopositivity in the stria vascularis and spiral ganglia was significantly higher in Anakinra group compared to dexamethasone group (P = .022 and P = .013, respectively). TNF-α immunopositivity in the stria vascularis and spiral ganglia was significantly greater in control group than in Anakinra group (P = .037 and P = .01, respectively)., Conclusion: The comparable efficacy of Anakinra and dexamethasone in both histological and auditory assessments suggests that Anakinra may serve as a promising therapeutic option for noise-induced hearing loss., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Purpose: The effect of the inter-implant interval time on language and communication skills has been a subject of research for years in children with bilateral cochlear implants. This study aimed to investigate language and some attention and memory skills in children with bilateral sequential and simultaneous cochlear implants., Method: The study included a total of 40 children aged between 6 and 8 years old, grouping bilateral simultaneous cochlear implanted children, sequential implanted children with 0-2 years interval, sequential implanted children with 2-4 years interval, and normal hearing peers. The language skills of the children were assessed using the Test of Language Development: Primary 4th edition, their selective attention and coping skills with disruptive effect were evaluated using the Stroop test, sustained attention and visual-motor synchronization skills were assessed using the Cancellation Test, and short-term memory skills were evaluated using the Visual Auditory Digit Span Test. The findings were analyzed using nonparametric statistical methods, with a significance level set at 0.05., Results: Children with bilateral simultaneous cochlear implants demonstrated better performance in language skills and the attention-related subtests of the Stroop test (p < 0.05). On the other hand, children with simultaneous and sequential cochlear implants achieved similar scores in the Cancellation and the Visual Auditory Digit Span Test (p > 0.05)., Conclusions: Bilateral simultaneous cochlear implantation in children is beneficial for language, selective attention, and coping with the Stroop effect. However, these children may still lag behind their normal-hearing peers in terms of language, attention, and memory skills., Competing Interests: Declarations. Conflicts of interest: There are no conflicts of interest, financial, or otherwise., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: This study aims to evaluate the effect of auditory neuropathy spectrum disorder (ANSD) on postoperative auditory perception and listening difficulties in pediatric cochlear implant (CI) recipients., Method: The Children's Auditory Perception Test (CAPT) assesses auditory perception skills, and the Children's Home Inventory of Listening Difficulties (CHILD) Scale evaluates daily listening difficulties. The study involved pediatric CI recipients ( n = 40) aged between 5 and 7 years, with and without diagnosis of ANSD. The research ensured homogeneity across various factors, including chronological age, age at diagnosis, age at initial implantation, bilateral simultaneous surgery, etiologies of hearing loss, and family education level., Results: The findings have demonstrated that children without ANSD exhibited better performance in integrating visual-auditory stimuli and overall listening performance, distant sound source scores, and noisy environment scores (respectively p = .047, p = .001, p = .028, and p = .010). Additionally, children with better speech perception also have a better ability to integrate audiovisual stimuli ( p = .005, r = .438)., Conclusions: There are significant differences in postoperative listening skills and auditory perceptions between children with and without an ANSD who have CIs. Accordingly, children without an ANSD perform better.

Background: Hematopoietic stem cell transplantation (HSCT) is a critical treatment for various hematologic malignancies but can lead to complications, including ototoxicity., Aim/objectives: This study aims to explore the relationship between patient-specific factors and ototoxicity in adult HSCT patients., Material and Methods: We conducted a retrospective analysis of 129 adult patients who underwent HSCT between 2003 and 2020. Age, gender, transplant indications, conditioning regimens, and pre- and post-transplant audiometry thresholds data were collected from patient files. A hearing loss of 10 decibels or more at two consecutive frequencies or a hearing loss of 20 decibels or more at a single frequency was considered as significant hearing loss (SHL). Statistical analyses were performed to describe factors associated with SHL., Results: SHL occurred in 16.3% of patients. Older age was significantly associated with an increased risk of SHL ( p  = .035). Poorer pretransplant hearing thresholds at 4000 Hz and 6000 Hz were also significant predictors of SHL ( p  = .039 and p  = .014, respectively). There was no significant relationship between the donor type of HSCT (autologous vs. allogeneic) and ototoxicity ( p  = .45), and between conditioning regimens and ototoxicity ( p  = .860)., Conclusions: Age and pre-existing hearing levels are significant predictors of ototoxicity post-HSCT. Careful management and monitoring are essential to prevent and address hearing loss in HSCT patients to improve hearing-related quality of life.

Purpose: The main purpose of the study is to investigate whether the presence of residual hearing before cochlear implantation has an effect on temporal pattern recognition skills and musical perception in adults., Method: The study included adults with cochlear implants who were between the ages of 20 and 45 years. Adults with cochlear implants were divided into two groups: absent ( n = 20) and available ( n = 20) groups according to residual hearing before implantation. Frequency Pattern and Duration Pattern tests were applied to evaluate temporal pattern recognition, and the "Music-Related Quality of Life Questionnaire" was applied to evaluate musical perceptions., Results: There were no statistically significant differences between the groups in terms of cochlear-implanted hearing thresholds and speech recognition scores, musical perception, and musical activities, according to their residual hearing. On the other hand, the frequency and duration pattern recognition skills were statistically significantly better in adults with residual hearing. Also, statistically significant correlations were obtained in terms of temporal skills and musical perception subskills., Conclusions: The presence of residual hearing before cochlear implantation may affect temporal auditory processing skills. It is concluded that the integration of cochlear implants may affect temporal processing skills in adults as well as quality of life. It is recommended that experts be aware of this issue and pay attention to residual hearing.

Background: To ensure that subjective tinnitus patients develop positive attitudes toward tele-audiology., Aims/objectives: This study investigates the appropriateness of the internet-based software in patients with subjective tinnitus., Material and Methods: Patients between the ages of 19 and 59 applying to the clinic with the subjective tinnitus filled in Tinnitus Handicap Index (THI) and Coronavirus Anxiety Scale (CAS). Visual Numeric Scale (VNS) was applied to the patients to complaint of tinnitus. Parameter measurements related to hearing and tinnitus were performed clinically. After the evaluations, 54 participants were divided into two groups to receive the 'Basic Information Material Service' (BIMS) face-to-face and online. Afterwards, THI and VNS were used to determine the current status., Results: There was no significant difference between the groups that received BIMS with 2 different methods ( p > .05). A significant difference was found in the scores before and after BIMS in terms of THI and VNS ( p < .05). A strong negative correlation was found between the duration of tinnitus and the change in THI. In addition, there is a stronger-negative relationship between the number of centers consulted and the informational benefit revealed by the scales., Conclusions and Significance: Online intervention is as effective as face-to-face interaction in the management of tinnitus.

Background:  Coronavirus disease 2019 (COVID-19) and its effects on hearing performance have been an interesting topic for researchers recently., Purpose:  The objective of this study was to assess the audiological profile of people affected by COVID-19 and also to compare them with a control group who has never had COVID-19., Research Design:  An experimental study., Study Sample:  The study group consisted of 54 participants, aged 18 to 60, who were diagnosed with COVID-19 by polymerase chain reaction and recovered at least 2 months prior to audiological assessment. The control group consisted of 60 subjects in the same age range who did not have a history of COVID-19 or hearing loss., Data Collection and Analysis:  Post-COVID audiological data were compared. The pre-COVID-19 audiological data of 43 subjects in the study group were also compared with their post-COVID-19 data. All participants were evaluated with pure tone audiometry, acoustic immittancemetry, speech audiometry, and high-frequency audiometry., Results:  Pure tone hearing thresholds, speech recognition and discrimination scores, and high-frequency hearing thresholds were all statistically different between the study and control groups ( p  < 0.05). There were statistically significant differences between the study group's pure tone hearing thresholds before and after COVID-19 ( p  < 0.05)., Conclusion:  COVID-19 can adversely affect hearing performance. Further studies including auditory brainstem response, otoacoustic emissions, and similar cross-check tests are needed to reveal further effects of COVID-19 on hearing., Competing Interests: None declared., (American Academy of Audiology. This article is published by Thieme.)

Objectives: We investigated the correlation between magnetic resonance imaging (MRI) parameters and tumor pathological depth of invasion (pDOI), between pDOI and radiological DOI (rDOI), between rDOI and duration between biopsy and MRI, and between rDOI and duration between MRI and surgery to determine the efficacy of rDOI in identifying small lesions and other conditions., Study Design: We examined 36 adult patients who had been diagnosed histopathologically with cancer of the tongue and had undergone a glossectomy. Using 1.5 Tesla (T) and 3.0T MRI, we measured rDOI at the deepest infiltration point on 4 MRI sequences. We calculated the correlations between rDOI and the variables examined by Spearman rho analysis and evaluated the diagnostic performance of rDOI by receiver operating characteristic curve analysis., Results: Axial T2-weighted images using 1.5T MRI provided the closest approximation of pDOI. Although the correlation between rDOI and pDOI was significant, rDOI showed poor or acceptable discrimination in identifying small lesions and other conditions. There were no significant correlations between rDOI and the time between biopsy and MRI or between MRI and surgery., Conclusions: The correlation between rDOI and pDOI is significant, but rDOI is ineffective in predicting malignancy and other conditions. Axial T2-weighted images using 1.5T MRI provide the closest approximation of pDOI., Competing Interests: Declaration of interest The authors declare they have no conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction  Adolescents with cochlear implants may have difficulty developing language and memory abilities. Objective  The primary objectives of this study are (1) to evaluate the language skills and verbal working memory performance of early and late diagnosed-intervened cochlear implanted adolescents and (2) to investigate the relationship between the verbal working memory and phonemic analysis skills in adolescents with cochlear implant. Methods  This study included 72 participants with cochlear implant aged between 10 and 18 years. The participants were divided into two groups; those who had first hearing aid at the age of 6 months at the latest and had a first cochlear implant in at least one ear at the latest at 24 months were included in the early group, all the others were in the late group. The phonemic analysis test, a subtest of the test of language development: Primary, 4th edition (TOLD: P-4) - Turkish version, was used to assess language-based abilities, and the meaningless word repetition (MWR) test was utilized to assess verbal working memory. Results  The adolescents with cochlear implants who received early diagnosis and intervention performed statistically significantly better in phonemic analysis scores and verbal working memory tests ( p  < 0.001). A statistically significant relationship was found between phonemic analysis and verbal working memory skills (Pearson, r = 0.567 and r = 0.659, p  < 0.001). Conclusions  Rehabilitation of phonological skills can contribute to the development of verbal working memory in adolescents with cochlear implants. There is a need for further studies on this issue with more detailed tests., Competing Interests: Conflict of Interests The authors have no conflict of interests to declare., (Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Purpose: The purpose of this study was to evaluate the stress, quality of life, and access to hearing health services experienced by adults and children who use hearing aid and/or cochlear implant and their families during the COVID-19 pandemic., Method: Perceived Stress Scale, Personal Wellbeing Index, and World Health Organization Quality of Life questionnaires were applied online to 30 adults with hearing loss and parents of 61 children with hearing loss. Also, a survey was conducted to acquire more about the demographics of people who use cochlear implants and conventional hearing aids, as well as the difficulties they encountered during the COVID-19 period., Results: Although child user families experienced more problems than adults during the COVID-19 period, the stress levels of child user families were higher than that of adult user families ( p = .05). Even though there was no statistically significant difference, the families of pediatric users had lower quality of life than adult users., Conclusions: The stress/anxiety problems that arise as a result of this are coming to the forefront of both patients and their relatives. The findings indicate that creative strategies should be developed to give individuals with hearing loss efficient access to hearing health services.

Purpose: The ongoing literature suggests that COVID-19 may have a potential impact on voice characteristics during the infection period. In the current study, we explored how the disease deteriorates different vocal parameters in patients who recovered from COVID-19., Methods: A total of 80 participants, 40 patients with a prior history of COVID-19 (20 male, 20 female) with a mean age of 39.9 ± 8.8 (range, 21-53) and 40 gender and age-matched healthy individuals (mean age, 37.3 ± 8.8; range, 21-54) were included to this study. The data of acoustic voice analyses, durational measurements, patient-reported outcomes, and auditory-perceptual evaluations were compared between the study group and the control group. Correlation analyses were conducted to examine the association between the clinical characteristics of the recovering patients and measured outcomes., Results: Maximum phonation time (MPT) and the scores of both Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (V-RQOL) questionnaires significantly differed between the groups, which was more evident in female participants. The overall severity score of dysphonia was found to be higher in the study group than the control group (p = 0.023), but gender-based comparisons reached significance only in males (p = 0.032). VHI-10 and V-RQOL revealed significant correlations with the symptom scores of the disease., Conclusions: Patients with a prior history of COVID-19 had significantly lower MPT, increased VHI-10 scores, decreased voice-related quality of life based on the V-RQOL questionnaire, and higher overall severity scores in the auditory-perceptual evaluation. Self-reported voice complaints disclosed close relationships with the symptom scores of COVID-19 disease., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation., Methods: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group., Results: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637)., Conclusion: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3., (© 2021 S. Karger AG, Basel.)

Background/aim: This study aims to evaluate of olfactory and gustatory functions of COVID-19 patients and possible risk factors for olfactory and gustatory dysfunctions., Materials and Methods: The cross-sectional study included adult patients who were diagnosed with COVID-19 in Gazi University Hospital between April 2020 and June 2020. Volunteered patients participated in a survey in which olfactory and gustatory functions and various clinical information were questioned. Sinonasal Outcome Test-22 was also administrated to all patients., Results: A hundred and seventy-one patients participated in this study. Olfactory and gustatory dysfunctions rates were 10.5% (n: 18) and 10.5% (n: 18), respectively. Patients without any symptom other than smell and taste dysfunctions were clustered as group 1 and patients who are clinically symptomatic were clustered as group 2. Olfactory dysfunction occurred in 8% of group 1 and 17.4% of group 2 (p = 0.072). Gustatory dysfunction rate of smokers was 19.7% and significantly higher than gustatory dysfunction rate of nonsmokers (5.5%) (p = 0.007). Twenty-seven-point-eight percent of the patients with olfactory dysfunction (n = 5) were male and 72.2% (n: 13) were female. Sex did not show significant effect on rate of olfactory dysfunction. Twenty-five patients participated in psychophysical olfactory function test. No participant reported olfactory dysfunction at the time of test. Of the participants, 64% (n: 16) were normosmic and 36% (n: 9) were hyposmic according to Sniffin’ Stick test., Conclusion: Olfactory and gustatory dysfunctions are more common in patients who are clinically symptomatic than those diagnosed during contact tracing. Objective tests may show that frequency of olfactory dysfunction is greater than frequency of self-reported olfactory dysfunction., Competing Interests: All the authors meet the criteria for authorship. The authors have no funding, financial relationships, or conflicts of interest to report., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background: The study aims to evaluate the usage of gold weight implants and monitor complaints and comfort of patients., Methods: A hundred and ninety-one implantations performed between January 2009 and January 2019 were analyzed. Seventy-eight patients included in this study The average age of the patients was 51.3 ± 14.5 years. Forty-five (57.7%) of them were male and 33 (42.3%) female. Patient satisfaction was measured with a questionnaire containing the most common complaints related to gold weight in the literature through telephone surveys., Results: The average follow-up time was 74.5 months. Ninety-three-point-five percent of subjects had operational causes, among which the most widespread was acoustic neuroma (44.9%). The average time between facial paralysis and implantation was 141.1 days. Implantation was performed 26.6 days on average after acoustic neuroma surgery and 3.2 days on average after temporal zone malignancy surgery. Thirty-eight patients had their implants removed over either complication (n = 14) or recovery (n = 24). Recovery was the fastest after facial nerve decompression (mean= 4.75 ± 3.6 (2-10) months) and the slowest after 7-12 cranial nerve transfer (mean= 18.3 ± 8.2 (3-31) months). Twenty-six-point-nine percent (n = 21) of patients had complications, of which the most common was extrusion (n = 10). The overall satisfaction rate was 88.5% with the highest in visual acuity and the lowest in continuous requirement for artificial tear., Discussion: The gold weight implantation is an effective, reversible, and easy procedure significantly reducing complaints regarding paralytic lagophthalmos. Early implementation may be beneficial for ocular complications. A dynamic facial reanimation could terminate need of implant.

The relationship between objective vestibular tests and subjective vestibular tests is a controversial topic. In this study, to contribute to this issue, the vestibulo-ocular reflex features and their relationship with balance perception at long-term follow-up in vestibular neurectomy (VN) and total labyrentectomy patients were evaluated. Prospectively, 19 VN and 18 labyrinthectomy patients were enrolled in this study. Patients underwent video head impulse test (VHIT) as objective vestibular test and dizziness handicap inventory (DHI) as subjective vestibular test when they attended to their control visit follow-up between March and September 2017. Lateral canal corrective saccades were classified as organized pattern and deorganized (scattered) pattern. In our results, the saccade pattern analysis (between organized and deorganized saccades) regarding the DHI scores gave P value as .039 for covert saccade pattern and .050 for overt saccade pattern. Therefore, we conclude that the presence of saccades, their patterns, and amplitudes provide extra information at assessing the results of the VHIT test, and the organized pattern of saccades is related to a stable vestibular system and better balance perception.

Objective: To evaluate the long-term balance outcomes of vestibular nerve section (VNS) and labyrinthectomy (L) operations. The indirect outcomes will be the correlation of objective and subjective test results and an analysis of anterior-posterior versus medial-lateral computerized posturography (CP) scores., Methods: This retrospective study evaluated objective CP and subjective Dizziness Handicap Inventory (DHI) results of patients who underwent VNS and L surgeries for Ménière's disease., Results: A total of 55 (31 VNS and 24 L) patients were included in the study. The two operation groups were similar in terms of age, and mean time between surgery and the tests (p=0.465 and p=0.616) respectively. The vestibular and global scores at anterior-posterior CP showed statistically significant differences between the groups (p=0.000 and p=0.007) respectively in favor of the VNS group. In addition, the comparison of the vestibular CP scores of anterior-posterior and medial-lateral evaluations of the entire study population was lower in the medial-lateral evaluation (p=0.000). The mean DHI scores did not show statistically significant differences (p=0.359) between operation groups, nor did the correlation analysis between CP and DHI scores reveal statistical significance (p values >0.05)., Conclusion: In the long term, objective balance outcomes are better for VNS patients than for L patients. Additionally, medial-lateral balance outcomes are more affected than anterior-posterior balance outcomes from unilateral ablative surgeries. Subjective balance perception is not different between the two surgery groups, and DHI scores do not show a correlation with CP scores., Competing Interests: Conflict of Interest: The authors declare that they have no conflicts of interest to disclose., (©Copyright 2021 by Official Journal of the Turkish Society of Otorhinolaryngology and Head and Neck Surgery.)

Purpose The effects of neurological diseases on the auditory system have been a notable issue for investigators because the auditory pathway is closely associated with neural systems. The purposes of this study are to evaluate the efferent auditory system function and hearing quality in Parkinson's disease (PD) and to compare the findings with age-matched individuals without PD to present a perspective on aging. Method The study included 35 individuals with PD (mean age of 48.50 ± 8.00 years) and 35 normal-hearing peers (mean age of 49 ± 10 years). The following tests were administered for all participants: the first section of the Speech, Spatial and Qualities of Hearing Scale; pure-tone audiometry, speech audiometry, tympanometry, and acoustic reflexes; and distortion product otoacoustic emissions (DPOAEs) and contralateral suppression of DPOAEs. SPSS Version 25 was used for statistical analyses, and values of p < .05 were considered statistically significant. Results There were no statistically significant differences in the pure-tone audiometry thresholds and DPOAE responses between the individuals with PD and their normal-hearing peers ( p = .732). However, statistically significant differences were found between the groups in suppression levels of DPOAEs and hearing quality ( p < .05). In addition, a statistically significant and positive correlation was found between the amount of suppression at some frequencies and the Speech, Spatial and Qualities of Hearing Scale scores. Conclusions This study indicates that medial olivocochlear efferent system function and the hearing quality of individuals with PD were affected adversely due to the results of PD pathophysiology on the hearing system. For optimal intervention and follow-up, tasks related to hearing quality in daily life can also be added to therapies for PD.

Introduction: Cochlear implant (CI) surgery is a safe and standardized procedure in the presence of normal temporal bone anatomy. However, in the surgery of patients with chronic otitis media (COM), the surgeon may encounter several problems. The aim of this study was to evaluate the impact of COM with and without cholesteatoma on surgical and auditory outcomes of CIs., Methods: The study group consisted of 39 patients with COM who received CIs. Age- and gender-matched 38 standard CI patients served as controls. The surgical techniques and complications, pure tone audiometry (PTA) scores, speech discrimination scores (SDS), and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire results of the groups were compared., Results: The presence of COM was associated with a higher rate of complication than controls. Staging the surgeries, presence or absence of cholesteatoma, and type of surgical technique were not associated with surgical outcomes and complications (p > 0.05). There was no significant difference between the groups in terms of postoperative PTA scores, SDS, and IOI-HA scores (p > 0.05)., Conclusion: Postoperative complications like device failure and skin breakdown are increased in cases of COM compared to standard CI surgeries. However, that increase is not associated with staging the surgeries, presence or absence of cholesteatoma, and type of ear surgery performed. It is advocated to close the external ear canal and eustachian tube without mastoid obliteration in the presence of a radical mastoidectomy cavity, which will decrease the postoperative complication rates and allow for radiological follow-up with computed tomography for the possibility of cholesteatoma recurrence. The auditory benefits of CI in patients with and without COM are comparable., (© 2021 S. Karger AG, Basel.)

Purpose: To investigate and provide objective documentation of the possible differences in the axonal reinnervation process of facial muscles after hypoglossal-facial nerve anastomosis. Then, to search for the presence of the trigemino-hypoglossal reflex and determine whether it indicates better peripheral recovery., Methods: Electrophysiological examination performed on 20 patients who had undergone VII-XII anastomosis, with follow-up periods of more than 2 years., Results: The mean follow-up time after surgery was 4.1 ± 1.3 years (range 2-8 years). The degrees of axonal reinnervation for the orbicularis oculi (OOc) and orbicularis oris (OOr) were 46.91 ± 19.77 and 32.65 ± 14.85, respectively. And the difference between these muscles was statistically significant (p = 0.018) in favor of the OOc. In addition, R1 blink reflexes that were not followed by R2 components were observed in 30% of the patients. However, these 6 patients with short-latency potential did not differ from the others in terms of latency, the amplitude of compound muscle action potential (CMAP), and degree of axonal reinnervation (p > 0.05) at both muscles (OOc and OOr)., Conclusion: The recoveries of the lower face and upper face are different after VII-XII anastomosis, and in our patients the OOc healed better. In addition, R1 blink reflexes that were not followed by R2 components were observed in 30% of the patients. However, the patients with these blink reflexes did not have better peripheral healing in their neuromuscular units, which suggests that the blink reflex is not an indicator for peripheral recovery.

Purpose: We wished to draw attention to the changes in the surgical method and indications for the Caldwell-Luc (CL) operation in the endoscopic era., Patients and Methods: The patients who had undergone the CL operation in the previous 7 years were included in the present study. All operations had been performed by otolaryngologists. The CL operation was performed as 2 types of antrostomy: radical canine fossa antrostomy (RA) and mini-canine fossa antrostomy (MA). The surgical methods were grouped as follows: RA alone, endoscopic sinus surgery (ESS) plus RA, and ESS plus MA., Results: RA alone, ESS plus RA, and ESS plus MA had been performed in 24 (25.5%), 6 (6.3%), and 64 (68.1%) patients, respectively. RA had been used for a total of 30 patients and had been combined with ESS for only 6 patients. The indications were categorized as mucosal sinus disease and odontogenic lesions. A statistically significant difference was found between the rates of the preferred antrostomy type for the treatment of sinus mucosal disease and odontogenic lesions (P < .001)., Conclusions: In otorhinolaryngology practice, the CL procedure has mostly been required to provide easy access to the maxillary sinus when ESS alone would be inadequate. However, the formal CL operation, including RA, could still be considered a main surgical technique in oral and maxillofacial surgery practice., (Copyright © 2020 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background/aim: Subjective noise sensitivity (SNS) is not only one of the most important predictors of perceived noise annoyance for the subjects exposed to the noise, but also strongly related with some psychological conditions and poor health perception of the subjects. Weinstein’s Noise Sensitivity Scale (WNSS) is widely used for measuring of SNS., Materials and Methods: In this study we adapted WNSS to Turkish (Tr-WNSS) and evaluated its psychometric properties and effect of age, sex and education level on SNS., Results: The study included 105 males and 105 female subjects between 18 and 55 years of age., Conclusion: Our data demonstrated that Tr-WNSS was a reliable, valid, and invariant scale for the Turkish population, and not affected by sex, age and education level., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background/aim: Surgical success is related with many factors belonging to both the patient and the disease. This study aims to analyse the preoperative and intraoperative characteristics, the postoperative results, and the factors affecting the surgical success in different types of chronic otitis media (COM)., Materials and Methods: A total of 1510 ears of 1398 patients who underwent COM surgery were included in the study. Postoperative results were obtained from 376 ears of 356 patients who had been followed after surgery. The demographic characteristics of the patients, such as age and sex, operative findings, preoperative audiological examination results, and final audiometric and otoscopic examination findings, were retrospectively obtained from the archives of the department., Results: The most frequent diagnosis was simple COM (39.9%), and the most frequently performed surgery was tympanoplasty without mastoidectomy (46.6%). The overall hearing success rate was found to be 75.8%. Postoperative hearing success was significantly associated with the chronic otitis subgroup, ossicular pathologies, and the condition of the middle ear mucosa. Postoperative graft take rate was found to be 78.6%. Graft success was statistically significantly higher in patients with normal middle ear mucosa. Performing mastoidectomy, the presence of patency in aditus ad antrum, and being a paediatric case had no impact on graft success., Conclusion: Factors affecting the success of COM surgery include age, chronic otitis subgroup, location and size of perforation, the condition of the middle ear mucosa, and the level of the ossicular disease. These factors should be known and an appropriate treatment plan should be prepared., Competing Interests: None declared, (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background/aim: Autoimmune diseases are a remarkable issue for researchers due to their adverse effects on the auditory system, but for primary Sjögren’s syndrome (pSS) there is little research on the comprehensive audiological findings in literature. The main objective of this study was to investigate the medial olivocochlear efferent functions of subjects with pSS and to examine the audiological findings., Materials and Methods: The study included 36 subjects with pSS and 36 healthy subjects. All the subjects underwent testing including pure tone, speech, and high frequency audiometry; tympanometry and acoustic reflexes; distortion product otoacoustic emissions (DPOAE); and suppression of DPOAE., Results: The hearing thresholds of the pSS group were higher than those of the control at all frequencies (P < 0.001). Minimal to mild sensorineural hearing loss was observed in 52.77% of all the subjects with pSS. Additionally, all of the subjects had type A curve tympanograms, but the static compliances of the pSS group were lower and the acoustic reflex thresholds were higher than in the control (P < 0.001). In suppression levels of DPOAE, no statistically significant difference was found between the groups (P > 0.05)., Conclusion: The study indicates that because of obtaining normal suppression levels in DPOAE, the medial olivocochlear efferent system is functional in pSS. However, there is a need for more tests, including auditory brainstem response, to evaluate the afferent auditory system in pSS., Competing Interests: none declared, (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background/aim: To compare outcomes of canal wall up (CWU) and canal wall down (CWD) techniques in the treatment of middle ear cholesteatoma., Materials and Methods: Medical records of 76 patients who had a primary surgery due to middle ear cholesteatoma between July 2015 and November 2017 were reviewed retrospectively. Hearing thresholds, speech discrimination scores (SDS), recurrences, and revision surgeries of CWU and CWD surgeries were compared., Results: Of 76 cholesteatoma cases, 40 (52.6%) had a CWU and 36 (47.4%) had a CWD operation. Postoperatively, the mean air conduction thresholds were significantly better in CWU compared to CWD surgeries (P = 0.016). The presence of the stapes and the type of reconstruction material used did not have a significant effect on auditory success rates (P = 0.342 and P = 0.905, respectively). Auditory success was affected by the status of the middle ear mucosa as well. The recurrence and revision rates did not differ between the surgical techniques (P > 0.05)., Conclusion: Status of the middle ear mucosa and external auditory canal are important factors affecting the outcomes in cholesteatoma. Instead of a CWD surgery, a CWU surgery seems applicable in cases of cholesteatoma when the bone in the external auditory canal is not eroded by the disease., Competing Interests: none declared, (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Objective: To assess the etiology, demographics, rates and outcomes of revision surgeries, and device survival rates after cochlear implantation., Study Design: Retrospective case review., Setting: Tertiary Otology & Neurotology center., Patients: Cochlear implantees who received revision surgeries after implantation INTERVENTIONS:: Any surgical intervention, performed due to device failure or the major complications of cochlear implantation., Main Outcome Measure: Medical records of the patients who received cochlear implants (CIs) between July 2002 and March 2018 were reviewed retrospectively regarding postoperative complications. Demographic data, device survival rates, and causes of revisions were recorded., Results: Totally, 924 implantations were performed in 802 patients. Eighty one (8.7%) of them underwent 102 revision surgeries. The most common causes of revision surgeries were device failures and flap related problems which were seen in 28 and 18 patients, respectively.Overall CI survival rate was 91.9% in a 10 years period, which remained almost stable after 10 years. Although age was not found to be related with device failure (p = 0.693), device loss rates were significantly higher in adult implantees than children (p = 0.006)., Conclusion: Device failure seems the most common cause of revision. The revision surgeries are usually safe and help to resolve the problem although flap problems are the most difficult to treat and may necessitate multiple revision surgeries. The device failure rate may reach to a plateau after 6 years. Overall CI survival rate exceeds 90% in 10 years period, and then remains stable.

Objective: This study investigated effects of S-allylmercaptocysteine (SAMC), diallyl disulfide (DADS), and vitamin B 12 on inner ear functions and morphology after long-period high-level broadband noise exposure., Materials and Methods: Twenty-four healthy rats were randomly divided into four groups. First group was chosen as the control group. Vitamin B 12 , SAMC, and DADS were applied to other groups for 4 weeks. On the 14th day, each group was exposed to broadband noise. Auditory brainstem response test was performed before and immediately after noise exposure and repeated on the 2nd and 14th day., Results: Permanent threshold shifts were significantly lower in groups treated with vitamin B 12 , SAMC, and DADS. Histologically, cochleae of SAMC and DADS groups were found to be better preserved than the cochleae of vitamin B 12 and control groups., Conclusion: Physiologically and histologically, SAMC and DADS reduced the long-term effects of noise. However, physiological recovery was not consistent with the morphological findings in vitamin B 12 group., Competing Interests: None

Objective: To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications., Methods: Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group., Results: Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (p<0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation., Conclusion: There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background/aim: Obstructive sleep apnea syndrome (OSAS) is a disease characterized by repeated hypoxia attacks during sleep. The effect of hypoxia on the central nervous system is a well-known entity. In this study we aimed to investigate the effect of OSAS on the central auditory system. Materials and methods: Twenty-one OSAS patients diagnosed by polysomnography (PSG) and 10 control subjects were included in the study. After a thorough otorhinolaryngology examination, all subjects underwent pure tone audiometry (250 to 8000 Hz frequency). The subjects with normal otoscopic examination and hearing threshold were included in the study. All participants underwent speech discrimination analyses and auditory time processing and sequencing tests, i.e. frequency pattern test (FPT) and duration pattern test (DPT). Results: Although hearing was normal in the OSAS patients, significant loss was observed in the speech discrimination rates compared to the control group (P < 0.05). Significant disruption was also detected in the FPT and SPT in the OSAS patients (P < 0.05). Conclusion: Repeated hypoxic episodes in OSAS resulted in statistically significant impairments in the central auditory pathways, even if the hearing threshold was within normal limits.

Nasal obstruction is known to cause resistance to continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea syndrome (OSAS). In this paper, short- and long-term nasal congestion in OSAS patients receiving CPAP treatment were evaluated with acoustic rhinometry (AR). A total of 36 patients with moderate-to-severe OSAS, diagnosed with polysomnography were included in the study. Ten healthy subjects without OSAS constituted the control group. Pre-treatment nasal patency were measured with AR in all participants. 26 patients used the recommended CPAP treatment. Ten patients did not accept CPAP treatment. The AR test was repeated for all the subjects after 1 and 3 months except the 3rd month's measurements of the control group. There was no statistically significant difference between the initial minimum cross-sectional area (MCA) measurements of OSAS patients, using or not using CPAP, and the control group (P > 0.05). However, the first month MCA measurements of patients receiving CPAP were found to be significantly decreased compared with the initial values (P < 0.001). There was no significant change in the first and third months MCA values in the control group and patients who did not use CPAP (P > 0.05). No significant difference revealed in the 3rd month MCA measurements of the patients using CPAP compared with the initial values (P > 0.05). In this study, the increased nasal congestion, which is thought to be the cause of CPAP resistance, was objectively demonstrated in OSAS patients using CPAP. In addition, the nasal congestion developing at the first month was shown to disappear over time, supporting the opinion that patient compliance in CPAP treatment is expected to increase after regular device usage.

Background/aim: This study aimed to examine the demographics and histopathological features of oral cavity cancers (OCCs) managed in our clinic., Materials and Methods: Patients who were diagnosed with OCCs in the Gazi University Otorhinolaryngology Department between the years 1993 and 2013 were retrospectively enrolled in the study. Surgical archive charts and pathology records were reviewed in detail regarding the anatomical and histopathological profiles of the tumors, as well as the demographic data of the patients., Results: Out of 230 patients with OCCs, the most common anatomic location and histopathological diagnosis were found to be the oral tongue (41.4%) and squamous cell carcinoma (SCC) (84.3%), respectively. A marked predominance of SCC was observed in all subsites of the oral cavity except the hard palate location. The mean age at presentation was 55.5 ± 13.4 years (±SD). The male:female ratio was found to be 2.2:1. A male predominance was also present in all subsites except the retromolar trigon., Conclusion: OCCs particularly concern the elderly population with a male predominance. The most common location and histopathological type are the oral tongue and SCC, respectively.

Introduction: Temporal bone paragangliomas (TBPs) are benign tumors arising from neural crest cells located along the jugular bulbus and the tympanic plexus. In general surgical excision, radiotherapy and wait-and-scan protocols are the main management modalities for TBPs., Objective: In this paper we aim to present our clinical experience with TBPs and to review literature data., Methods: The patients who were operated for tympanomastoid paraganglioma (TMP) or tympanojugular paraganglioma (TJP) in our clinic in the last 15 years were enrolled in the study. A detailed patient's charts review was performed retrospectively., Results: There were 18 (52.9%) cases with TMPs and 16 (47.1%) cases with TJPs, a total of 34 patients operated for TBPs in this time period. The mean age was 50.3± 11.7 (range 25-71 years). The most common presenting symptoms were tinnitus and hearing loss for both TMPs and TJPs. Gross total tumor resection was achieved in 17 (94.4%) and 10 (62.5%) cases for TMPs and TJPs, respectively. Five patients (31.2%) with TJP experienced facial palsy following the operation. For all the patients the mean follow-up period was 25.8 months (range 4-108 months)., Conclusion: In conclusion, based on our findings and literature review, total surgical excision alone or with preoperative embolization is the main treatment modality for TBPs. However radiotherapy, observation protocol and subtotal resection must be considered in cases of preoperative functioning cranial nerves, large tumors and advanced age., (Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

Objectives: This study aims to examine the relationship between nasal pathologies and positional (PP) obstructive sleep apnea (OSA) or nonpositional (NPP) OSA., Patients and Methods: A total of 44 male OSA patients (mean age 48.0±6.8 years; range 31 to 60 years) suffering from nasal obstruction were retrospectively evaluated for nasal obstruction scores, overall apnea hypopnea index (AHI) and AHI in supine and nonsupine positions, daytime sleepiness scores, and body mass index (BMI). Patients were divided into two equal groups as PP group and NPP group. Output parameters were snoring severity index, clinical nasal obstruction score, septal deviation score, conchal hypertrophy score, and allergic rhinitis (AR) score. These parameters were correlated with the type of OSA., Results: Apnea hypopnea index was significantly lower in PP group than in NPP group (p<0.03). Spearman correlation analysis revealed significant negative correlation between AR score and PP (r=-0.40, p<0.0001). Pearson correlation test revealed significant correlation between AHI and BMI (r=0.32, p<0.05)., Conclusion: We suggest that AR is not only an important risk factor for OSA, but also patients with AR tend to be NPP OSA patients because of the serious nasal obstruction which already causes an increase in nasal resistance or pharyngeal collapsibility.

Nasal type natural killer/T-cell lymphoma is a rare type of extranodal non-Hodgkin lymphoma which originates from nasal cavity and paranasal sinuses. Exact diagnosis of nasal natural killer/T-cell lymphoma, which is a rapidly progressive clinical condition, may be established by immunohistochemical analysis on biopsy material after clinical suspicion. In this article, we report four cases of nasal natural killer/T-cell lymphoma who were followed-up in our clinic and discuss the diagnosis and treatment of the disease in light of the literature data.

Objective: To assess the histopathological effects of parylene C (PC) (poly-chloro-p-xylylene) in the inner ear., Methods: Nine adult Dunkin Hartley guinea pigs (500-600 g) were included in the study. PC pieces were inserted into the cochlea in the right ear of the animals (study group). The round windows were punctured in the left ears comprised the control group. After three months, the animals were sacrificed, and the dissected temporal bones were examined under a light microscope., Results: No significant difference was revealed between the study and control groups regarding histopathological findings such as perineural congestion, perineural inflammation, neural fibrosis, number of ganglion cells, edema, and degeneration of ganglion cells (p>0.05)., Conclusion: PC did not cause any additional histopathologic damage in the cochlea. This finding may be promising regarding the use of PC in cochlear implant electrodes as an alternative to silicon materials in the future., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Background: Sodium-2-mercaptoethanesulfonate (MESNA) is a protective agent that is also used as "a chemical dissector" in various surgical fields. The aim of this study is to evaluate the toxic effects of MESNA on neural and neurovascular structures based on a morphological analysis and examine its safety in neurotological applications., Methods: Three groups of guinea pigs were used as subjects. MESNA solution (50 and 100%) and saline solution were applied to the subarachnoid space over the brain tissue via a middle fossa approach of study and control groups, respectively. Effects of MESNA were assessed by means of light microscope. McNemar Chi-square test was used to evaluate the histopathological findings. Statistical significance of P < 0.05 was taken as criterion., Results: No morphological changes were observed on vascular and neural structures in the study groups in both concentrations, compared to the control group., Conclusions: On a morphological basis, a single application of MESNA does not cause any morphological changes that indicate a toxicity in neural and neurovascular structures.

Polysomnography is currently considered as the gold standard for the diagnosis of obstructive sleep apnea syndrome (OSAS). But high expense and the backlog of the sleep centers have resulted in a search for an alternative method of diagnosis. The aim of this study is to assess the efficacy and reliability of Watch PAT as an alternate option in OSAS diagnosis. The patients have worn a Watch PAT(®) 200 device in the sleep laboratory during a standard polysomnography. The correlation in REM and Non-REM AHI scores, sleep periods and the mean O2 saturation percentage between Watch PAT and PSG sleep studies were assessed. There was a statistically significant very strong correlation between PSG and Watch PAT AHI scores (Spearman's rho = 0.802 p < 0.001). The mean recording time with PSG and Watch PAT was 463.06 ± 37.08 and 469.33 ± 72.81 min, respectively, and there was no statistically significant difference (p = 0.068). However, there was a statistically significant difference between two methods regarding the average sleep time and REM sleep period. No statistically significant difference was revealed in the mean O2 saturation percentage (p < 0.001). Watch PAT is an efficient device and is considered to be an adjunctive diagnostic method for PSG in diagnosis of OSAS.

Background: To identify the potential prognostic role of the neutrophil/lymphocyte (N/L) ratio in larynx carcinoma., Materials and Methods: Oncologic archive charts of patients with a larynx carcinoma diagnosis between the years 2010 and 2013 were retrospectively reviewed. The inclusion criterion was to be available with hemogram test prior to diagnostic procedure. Patients undergoing septorinoplasty comprised the control group., Results: There were 65 cases in the study and 42 cases in control group meeting inclusion criteria. In general a non-significant increase in N/L ratio was observed with increasing tumor size and stage (p>0.05) in larynx carcinoma. The N/L ratio was found to be significantly higher in larynx carcinoma compared to control group (p=0.004)., Conclusions: In conclusion, the N/L ratio was shown to be significantly increased in larynx carcinomas compared to control group. Further studies are needed to assess any prognostic role.

Epistaxis is a frequent health problem and the most common cause of emergency in otorhinolaryngology practice. In this report, a case of a 26-year-old patient with intractable epistaxis after endoscopic sinus surgery was presented. The epistaxis began at the fourth postoperative day and was unresponsive to endoscopic cauterization and anterior and posterior nasal packing. On angiographic investigation, a pseudoaneurysm of the sphenopalatine artery was detected and treated with microcatheter embolization. This is the second case of postoperative sphenopalatine pseudoaneurysm as a complication of endoscopic sinus surgery in the literature.

Objective: To analyze the association of GJB2 gene mutations with cochlear implant performance in children., Methods: Sixty-five consecutive children who underwent cochlear implantation due to congenital profound senseurineural hearing between 2006 and 2008 were included in the study. In children, GJB2 gene mutation analysis was performed. Their auditory performance was assessed using MAIS, MUSS and LittlEARS tests., Results: Twenty-two of sixty-five patients GJB2 mutations, and 35delG was the most frequent mutation. No significant difference was found between the auditory performance of mutation positive and negative children after one year follow up (p>0.05)., Conclusion: GJB2 gene mutations do not impact on the outcome of cochlear implantation., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Most nonsyndromic hearing losses are caused by mutations in the GJB2 gene, and studies have revealed that the forms and frequencies of these mutations are largely dependent on ethnic origin. In the present study, we aimed to characterize the mutation profiles of 151 patients with hearing loss in Turkey. The entire coding region of the GJB2 was directly sequenced in all patients. We found 35 (23.2%) individuals carrying GJB2 mutations. Seven different mutations were identified, five of which were previously known (35delG, delE120, R184P, M163V, L90P), the remaining two being novel variants (M34V, L205V). The most common mutation was 35delG followed by delE120. The 35delG mutation was homozygous in 22 cases (14.5%) and heterozygous in 4 cases (2.6%). Compound heterozygosity for 35delG was also observed. The delE120 mutation was found in three patients in homozygous form. A homozygous L90P and heterozygous mutations M163V and M34V were found in single cases.