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Objectives: Our aim in this study is to assess the effect of factors such as age, etiology, defect size, application of lumbar drainage and surgical technique on Cerebrospinal Fluid (CSF) fistula repair success rates. Methods: The Electronic Medical Records (EMR) system of our clinic was retrospectively reviewed for cases that were operated between 2006 and 2020 for CSF fistula originating from anterior skull base with endoscopic transnasal technique. A total of 35 patients were included in the study. Patients were grouped according to the number of layers used in repair (two, three or fourlayered reconstruction) and defect size (smaller than 5 mm, 5 to 10 mm and larger than 10mm), etiology, location of the defect and application of lumbar drainage as LD (+) and LD (-). Complications and CSF leak recurrence were compared between groups. Results: Recurrence rates in patients who had 2 layered reconstructions were significantly higher compared to patients who had 3 or 4 layered reconstructions (p=0.049). The recurrence rate in LD (+) group (41.7%) was significantly lower compared to LD (-) group (4.3%) (p=0.012). There were no significant difference in recurrence rates between groups in terms of age, defect size, defect location and etiology. Conclusion: In endoscopic transnasal repair of anterior skull base-derived bos fistulas, planning the reconstruction at least 3 times and applying lumbar CSF drainage increases the success rates. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether there was a difference in the nasal airway dimensions after dorsal preservation and classical structural rhinoplasty. Introduction: The surgical approach to rhinoplasty has improved over many decades. The first was the classic structural rhinoplasty (CSR) developed by Joseph, where the excess tissues are removed from the dorsal hump. In the following decades, dorsal preservation rhinoplasty (DPR) was established to prevent complications associated with CSR. Methods: One hundred twenty-four patients without self-reported nose obstruction syndromes underwent DPR or CSR according to the authors' shared surgical regime. Nasal airway dimensions of rhinoplasty patients were measured preoperatively and postoperatively with acoustic rhinometry (AR), and minimum cross-sectional areas (MCA) and internal nasal volumes (VOL) were acquired. Results: Dorsal preservation rhinoplasty was performed on 64 patients (51.6%), while classical structural rhinoplasty was performed on the remaining 60 (48.4%). There were no significant differences between the 2 techniques regarding VOL and MCA. (MCA1left side DPR vs CSR P =.539, VOL1 right side DPR vs CSR P =.843). Conclusion: We postulate that nasal airway dimensions do not predict or indicate whether the DPR or CSR technique will be/have been used in rhinoplasty surgery, and the employed technique does not significantly alter the dimensions of the nasal airways. Any significant change in nasal airway dimensions is more likely due to the septal intervention. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Rhinolithiasis is a rare condition which results from deposition of salt around a endogenous or exogenous nidus. In the literature, most of the reports are single case studies. In this study, we aimed to present the characteristics, symptoms, diagnosis, and treatment methods of 31 rhinolithiasis cases and to focus on the current literature. METHODS: We retrospectively reviewed 31 rhinolithiasis cases which have been diagnosed and treated in a tertiary care center between January 2014 and December 2018. Patient characteristics, presenting symptoms, concomitant sinonasal disorders, and type of surgery were noted. Descriptive statistics were carried out. RESULTS: Mean age was 25.4±15.7. The cases were comprised 14 female patients (45.2%) and 17 male patients (54.8%). The most common presenting symptom was nasal obstruction (71%). Malodorous unilateral rhinorrhea was present in 17 patients (54.8%). Epistaxis snoring and sleep apnea were other rare symptoms. In 21 of the cases (67.7%), rhinolith was located between inferior turbinate and septum which was the most common location seen in our series. The number of patients who were under the age of 18 was 13, in 2 of them, rhinolith was found to be formed around a plastic bead, and in 2 of them, fruit seeds were the nidus. The most common concomitant sinonasal pathology was septal deviation which was detected in 20 of the patients (64.5%), adenoid vegetation and nasal polyposis were other disorders. In 20 of the patients (64.5%), simple removal of the rhinolith using a forceps with the help of a rigid nasal endoscope was performed. Eight of the 17 patients had severe deviation and septoplasty was performed at the same time, which was the most common concomitant surgical intervention (25.8%). In 3 patients (9.6%), functional endoscopic sinus surgery was performed at the same time. CONCLUSION: Our series is one of the largest series in the literature. The most common presenting symptom was nasal obstruction followed by malodorous rhinorrhea. Accompanying sinonasal disorders should be addressed to improve the outcome. Rigid or flexible endoscopic examination should be used to detect a rhinolith. Computed tomography scan can diagnose a hidden rhinolith in a patient with nasal obstruction. [ABSTRACT FROM AUTHOR]

Previous studies reported that positive airway pressure (PAP) treatment may improve olfaction function in patients with obstructive sleep apnea (OSA) through various mechanisms. Olfactory function before and after PAP treatment is understudied regarding patient group at issue. The aim of this study is to investigate the contribution of PAP to olfactory function in patients with OSA. The study was conducted on 26 patients with OSA (10 females and 16 males, mean age 50.1 [9.3] years) who scheduled for PAP treatment. The Connecticut Chemosensory Clinical Research Center odor test was performed before and 4 months after PAP treatment. Patients were grouped (normal, anosmia, mild hyposmia, moderate hyposmia, and severe hyposmia) with respect to olfactory function by measuring odor test parameters, including threshold determination and identification. The odor test average scores of the patients after 4-month PAP treatment compared to pretreatment scores were increased and the difference was statistically significant (P =.002). In the apnea hypopnea index groups, statistically significant difference was found in the threshold and discrimination values regarding before PAP treatment (P =.038, P =.022, respectively). This study revealed that improvement in olfactory thresholds in patients with OSA receiving PAP treatment seems to improve olfactory dysfunction. This provides minimization of OSA consequences, including progressive upper airway inflammation, cognitive impairment, and associated olfactory dysfunction. Resolving the associations between olfactory function and PAP treatment is an important area for future research. [ABSTRACT FROM AUTHOR]

Objective: Peritonsillar abscess (PTA) is defined as pus accumulation between the tonsillar capsule and constrictor pharyngeal muscle. It can be seen as a complication of acute tonsillitis, but other mechanisms have also been proposed. In this study we aimed to reveal the seasonal variations and epidemiologic features of PTA. Methods: This is a retrospective, observational study. We reviewed 221 patients, and together with 24 recurrent cases, 245 admissions were reviewed in total. Age, gender, the duration of admission, seasonal and monthly distribution of cases, diabetes and smoking status, white blood cell count, and C-reactive protein (CRP) levels were recorded. Monthly and seasonal incidences of PTA were reviewed to see if there is any association of climate variations and PTA incidence rate. Features associated with the length of hospitalization and recurrence were also analyzed. Results: A total of 245 PTA cases were admitted to our clinic between June 2014 and June 2017. The highest amount of cases was observed in spring and winter. The C-reactive protein and white blood cell count (WBC) levels were found to be positively correlated with the length of hospitalization. There was no statistically significant correlation with recurrence and smoking, the WBC levels, CRP levels, and length of prior hospitalization. Diabetes status was not found to be associated with length of hospitalization and CRP levels. Conclusion: The present study reflects the epidemiologic and clinical features of PTA in İstanbul. Our findings showed that seasonal variation was not significant, consistent with previous studies. The highest incidence rate was observed in spring and winter. Length of hospitalization was found to be positively correlated with C-reactive protein and white blood cell count (WBC) levels. Recurrence was not statistically correlated with and smoking, the WBC levels, CRP levels, and length of hospitalization. More studies are recommended to reveal the different epidemiologic factors affecting the incidence of PTA. [ABSTRACT FROM AUTHOR]

The Hounsfield unit density value (HUDV) is a relative quantitative measurement of radio density used by radiologists in the interpretation of computed tomography (CT) images. Our aim is to investigate the role of HUDV in evaluating pre-epiglottic space (PES) involvement of laryngeal carcinoma. Seventy-four patients treated for laryngeal carcinoma in our clinic between 2014 and 2019 were included in the study. The invasion status of PES was determined radiologically and pathologically. HUDV was measured with a circular selected region of interest, with a constant size of 10 mm2 for PES. The relationship between patological PES invasion, radiological PES invasion, and HUDV was evaluated. Measuring HUDV to determine PES invasion (74.3 %) was significantly higher than​​ conventional CT evaluation (59.5 %) (p = 0.001). The agreement coefficient (kappa value) of the conventional CT evaluation and the HUDV regarding PES involvement was 0.673, which was interpreted as 'good'. HUDV could be used as an additional tool in diagnosing pre-epiglottic space invasion in laryngeal cancer. [ABSTRACT FROM AUTHOR]

Our aim is to investigate the effects of the submucoperichondrial application of Platelet Rich Plasma (PRP) on nasal mucosal healing after septoplasty surgery. This prospective randomized observational study was conducted between July 2019 and February 2021, with 40 patients aged 18–60 years who underwent closed the only septoplasty operation for similar septal deviations. Patient divided into two group; 21 patients were placed in PRP group to which PRP was applied on all mucosal surface and submucoperichondrial area of septum and 19 patients were placed in control group to which saline solution was applied on same regions. Nasal obstruction score, mucociliary clearance time, presence of nasal crusting, and bleeding time were evaluated on 5th, 10th, 15th day after surgery and compared between groups. Intranasal crusting on day 10 was found to be lower in the PRP group (n :13 68.4 %) than control group (n :7 33.3 %) with a statistically significant difference (p = 0.028). The nasal obstruction score on day 10 and 15 were found to be lower in the PRP group (3,33 ± 2,75, 2,07 ± 2,20) (than the control group (5,44 ± 2,26, 3,37 ± 1,92) with a statistically significant difference (p = 0,003, p = 0,009). The mucociliary clearance rate was found to be higher and the bleeding time was found to be lower in the PRP group, but a statistically significant difference was not observed. Application of submucoperichondrial PRP could have beneficial effects on nasal mucosal repair, nasal crusting, and congestion after septoplasty surgery. [ABSTRACT FROM AUTHOR]

Objectives: Our aim in this study is to assess the effect of factors such as age, etiology, defect size, application of lumbar drainage and surgical technique on Cerebrospinal Fluid (CSF) fistula repair success rates., Methods: The Electronic Medical Records (EMR) system of our clinic was retrospectively reviewed for cases that were operated between 2006 and 2020 for CSF fistula originating from anterior skull base with endoscopic transnasal technique. A total of 35 patients were included in the study. Patients were grouped according to the number of layers used in repair (two, three or four-layered reconstruction) and defect size (smaller than 5 mm, 5 to 10 mm and larger than 10mm), etiology, location of the defect and application of lumbar drainage as LD (+) and LD (-). Complications and CSF leak recurrence were compared between groups., Results: Recurrence rates in patients who had 2 layered reconstructions were significantly higher compared to patients who had 3 or 4 layered reconstructions (p=0.049). The recurrence rate in LD (+) group (41.7%) was significantly lower compared to LD (-) group (4.3%) (p=0.012). There were no significant difference in recurrence rates between groups in terms of age, defect size, defect location and etiology., Conclusion: In endoscopic transnasal repair of anterior skull base-derived bos fistulas, planning the reconstruction at least 3 times and applying lumbar CSF drainage increases the success rates., Competing Interests: None declared., (© Copyright 2024 by The Medical Bulletin of Sisli Etfal Hospital.)

Objectives: General anesthesia is preferred in most otorhinolaryngologic surgeries. The aim of the present study was to evaluate upper airway complications secondary to intubation including sore throat, cough, dysphonia, and dysphagia considering endotracheal tube (ET) cuff pressure, tube diameter, and duration of intubation., Methods: After the assignment of 67 patients to the study and control groups, ET cuff pressure was adjusted to be between 20 and 30 cm H 2 O using a cuff pressure manometer in the study group. In the control group, the cuff pressure was decided by the anesthesiologist using the conventional palpation method. Sore throat, cough, dysphonia, and dysphagia were compared between the groups at 4, 8, and 24 h postoperatively., Results: Cuff pressure was significantly higher in the control group than in the study group. In the control group, sore throat was more frequently observed at 4, 8, and 24 h, whereas in the study group, cough and dysphonia were more often observed at 4 and 8 h. At 4 and 8 h, cough was found to be related to the duration of intubation., Conclusion: Arrangement of cuff pressure using a cuff manometer is suggested to decrease complications of the upper airway secondary to intubation because of the higher rate of these complaints in patients whose cuff pressure is arranged by the conventional palpation method., Competing Interests: Conflict of Interest: None declared., (Copyright: © 2018 by The Medical Bulletin of Sisli Etfal Hospital.)

Objectives: Chronic otitis media (COM) reveals a spectrum of otoscopic findings, and both ears may be affected to a different degree. The analysis of contralateral ear in patients with COM is important to detect the early signs of the disease. This may enable the follow-up and treatment of abnormalities in contralateral ear without delay. Therefore, in this study, we aimed to investigate the otoscopic and audiologic findings of contralateral ears of patients with COM., Methods: The institutional data of patients who underwent surgical treatment between 2014 and 2017 due to COM were reviewed. Suppurative ears with cholesteatoma, polyps, and otorrhea refractory to medical treatment and ears with dry middle ear mucosa, with otorrhea responsive to medical treatment, and without cholesteatoma were divided into two groups (Group 1 and Group 2, respectively). All patients were examined with regard to the presence of perforation, retraction, myringosclerosis, atrophy, and audiological results before the groups were compared., Results: Approximately 50% of contralateral ears of patients with COM showed abnormalities at an otoscopic examination in both groups. Tympanic membrane retraction in Group 1 was greater than in Group 2, and the difference was statistically significant (p<0.05). Both the mean air and bone conduction thresholds of the contralateral ears in Group 1 were also found to be elevated when compared with Group 2, and the differences were statistically significant (p<0.05)., Conclusion: COM may be seen bilaterally due to the same predisposing factors affecting the ears. Therefore, detection, follow-up, and early treatment of abnormalities of contralateral ear associated with otitis media have clinical importance in the prevention or delaying progression of these abnormalities to COM., Competing Interests: Conflict of Interest: None declared., (Copyright: © 2018 by The Medical Bulletin of Sisli Etfal Hospital.)