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The etiology of bacterial meningitis in Turkey changed after the implementation of conjugated vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) in the Turkish National Immunization Program (NIP). Administration of Hib vaccine and PCV-7 (7-valent pneumococcal conjugate vaccine) was implemented in NIP in 2006 and 2009, respectively. In 2011, PCV-7 was replaced with PCV-13. Meningococcal vaccines have not yet been included in Turkish NIP. This prospective study comprised 27 hospitals located in seven regions of Turkey and represented 45% of the population. Children aged between 1 month and 18 years who were hospitalized with suspected meningitis were included. Cerebrospinal fluid (CSF) samples were collected, and bacterial identification was made according to the multiplex PCR assay results. During the study period, 994 children were hospitalized for suspected meningitis, and Hib ( n  = 3, 2.4%), S. pneumoniae ( n  = 33, 26.4%), and Neisseria meningitidis ( n  = 89, 71%) were detected in 125 samples. The most common meningococcal serogroup was MenB. Serogroup W comprised 13.9% ( n  = 5) and 7.5% ( n  = 4) of the meningococci in 2015 to 2016 and 2017 to 2018, respectively. Serogroup C was not detected. There were four deaths in the study; one was a pneumococcus case, and the others were serogroup B meningococcus cases. The epidemiology of meningococcal diseases has varied over time in Turkey. Differing from the previous surveillance periods, MenB was the most common serogroup in the 2015-to-2018 period. Meningococcal epidemiology is so dynamic that, for vaccination policies, close monitoring is crucial. IMPORTANCE Acute bacterial meningitis (ABM) is one of the most common life-threatening infections in children. The incidence and prevalence of ABM vary both geographically and temporally; therefore, surveillance systems are necessary to determine the accurate burden of ABM. The Turkish Meningitis Surveillance Group has been performing a hospital-based meningitis surveillance study since 2005 across several regions in Turkey. Meningococcus was the major ABM-causing agent during the 2015-to-2018 period, during which MenB was the dominant serogroup., (Copyright © 2020 Ceyhan et al.)

Objectives: We evaluated the effect of neck metastasis on the survival rate of patients who underwent surgery for laryngeal cancer., Patients and Methods: A total of 256 patients who had undergone surgery between 1995 and 1999 were retrospectively reviewed. Of these, 186 patients (72%; 185 males, 1 female; mean age 57.5 years) who were accessible for follow-up were evaluated with respect to the localization and type of the primary tumor, neck metastasis, surgical procedures, and the survival. Survival rates were determined by the Kaplan-Meier method and compared by the log-rank test. The rates of neck metastasis and extracapsular spread in survivors and non-survivors were compared with the use of the chi-square test. The minimum follow-up period was two years (mean 41.2 months)., Results: Twenty-nine patients died from locoregional recurrences or distant metastasis and six patients died from other causes. The cumulative survival period was 69 months (75 months and 54 months with or without neck metastasis, respectively; log rank test 27.96, p<0.0001). The rates of neck metastasis and extracapsular spread in survivors (22%, 33/151; 7%, 10/151) and non-survivors (69%, 20/29; 59%, 17/29) were significantly different (p<0.001)., Conclusion: Neck metastasis and cervical recurrence were found as the most important factors affecting the results of laryngeal cancer surgery.

Objectives: To determine the speech perception levels of cochlear implant patients and to evaluate the possible effects of implant type, duration of deafness, and bacterial meningitis on the patients' hearing performance., Patients and Methods: A three-section test battery on speech perception was administered to 21 cochlear implant patients (12 males, 9 females; mean age 25 years; range 9 to 40 years). The patients' performance was assessed with respect to single- or multi-channel implant design, duration of hearing loss, and etiologic factors of hearing loss., Results: The overall mean success score was 74.6 (range 49-100). No significant difference was found between patients using single- or multi-channel implants. The mean score of 12 patients whose duration of hearing loss was below the average (8.2 years) was significantly higher than those of nine patients with a longer history of hearing loss (85.7 versus 59.6, p=0.001). Patients with meningitis-associated hearing loss exhibited a significantly lower performance than those presenting with other etiologic factors (61.9 versus 84.1, p=0.001)., Conclusion: Early diagnosis and rehabilitation are essential to achieve better performance following cochlear implantation.

Objectives: We compared the levels of hearing and tympanic membrane healing obtained by cartilage palisade and temporal fascia tympanoplasty techniques., Patients and Methods: Tympanoplasty procedures with the use of cartilage palisade (30 patients; 14 males, 16 females; mean age 28 years; range 10-62 years) and temporal fascia (30 patients; 17 males, 13 females; mean age 30 years; range 12-58 years) were compared with respect to tympanic membrane healing and hearing levels. The size of perforations in the cartilage tympanoplasty group was greater than that of the temporal fascia group. Audiological assessments were performed in the postoperative third and sixth months. The follow-up period was at least six months. Tympanic membrane healing and hearing levels were statistically analyzed using the chi-square and Mann-Whitney U-tests., Results: Tympanic membrane healing rates were 80% (24 patients) and 86% (26 patients) in the temporal fascia and cartilage tympanoplasties, respectively. Postoperatively, hearing levels improved in both groups. However, no significant differences were found between the two treatment groups with respect to tympanic membrane healing and hearing levels., Conclusion: Our findings suggest that cartilage palisade graft can be safely used in the treatment of tympanic membrane perforations, with no adverse effects on the hearing levels in the postoperative six months.

Background:Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) is a primary systemic vasculitis that affects medium to small sized vessels throughout the body. It often presents with symptoms and signs involving the ear, nose, and head and neck area.Objective:To highlight salient features of ENT-related issues in granulomatosis with polyangiitis, and raise awareness of the condition.Methods:A case report of a patient with limited disease and an insidious onset is presented, along with a review of the current literature. In addition, basic initial management is described.Results:Eighty-six publications were used to describe salient features of ENT-related issues in granulomatosis with polyangiitis.Conclusion:The time to diagnosis has not reduced significantly in the last 10 years in the UK. A high index of suspicion is required for an earlier diagnosis of granulomatosis with polyangiitis. [ABSTRACT FROM PUBLISHER]

Conclusion: High risk perforations including total, subtotal, atelectatic perforations, those with cholesteatoma and revision cases can be treated efficiently with cartilage reinforcement tympanoplasty. Objective: The purpose of this study was to describe the perforation closure rates and hearing results of cartilage reinforcement tympanoplasty. Methods: This was a retrospective chart review and included 60 patients who underwent surgery with the cartilage reinforcement technique between November 2006 and October 2008 at the Department of Otorhinolaryngology of Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey. The male to female ratio was 28 (46.7%)/32 (53.3%). The mean age of the patients was 30.10 ± 11.50 years (range 13–55). Results: Preoperatively, only one patient had a retraction pocket but not a perforation, 12 (20%) patients had perforation of < 25% of the total tympanic membrane diameter, 12 patients had perforation between 25% and 50% of the total membrane diameter, 18 patients had a perforation between 50% and 75% of total membrane diameter and 17 patients had a perforation of > 75% of the total membrane diameter. Postoperatively we achieved total closure of tympanic membrane perforations for 47 patients but the perforations of 13 patients remained in various sizes (7 patients had tympanic membrane perforation < 25% of the total membrane diameter, 3 between 25% and 50%, 2 between 50% and 75% and 1 patient had a perforation > 75% of the total membrane diameter). There was a statistically significant difference between percentages of preoperative perforation and postoperative perforations ( p = 0.001). Only 1.7% of patients had no perforation preoperatively and this ratio increased to 78.3% postoperatively. Also, 30% of patients had a perforation between 50% and 75% of the total membrane diameter, 28.3% of the patients had a perforation > 75% of the total membrane diameter preoperatively and this ratio decreased to 3.3% and 1.7%, respectively. Concerning the audiological parameters, the difference between preoperative and postoperative hearing levels was statistically significant ( p = 0.001). [ABSTRACT FROM AUTHOR]

OBJECTIVES. The objective of this study was to evaluate long-term speech perception abilities of comparable groups of postmeningitic and congenitally deaf children after cochlear implantation. METHODS. This prospective longitudinal study comprised 46 postmeningitic deaf children and 83 congenitally deaf children with age at implantation of [less than or equal to] 5.6 years. Both groups were comparable with respect to educational setting and mode of communication and included children with additional disabilities. RESULTS. Both postmeningitic and congenitally deaf children showed significant progress after implantation. Most (73% and 77%, respectively) could understand conversation without lip-reading or use the telephone with a known speaker 5 years after implantation, whereas none could do so before implantation. At the same interval, the postmeningitic and congenitally deaf children scored a mean open-set speech perception score of 47 (range: 0-91) and 46 (range: 0-107) words per minute, respectively, on connected discourse tracking. The respective mean scores at the 3-year interval were 22 and 29 correct words per minute, respectively. None of these children could score a single correct word per minute before implantation. The progress in both groups was statistically significant. When the 2 groups were compared, there was no statistically significant difference. CONCLUSION. Postmeningitic and congenitally deaf children showed significant improvement in their auditory receptive abilities at the 3- and 5-year intervals after cochlear implantation. There was no statistically significant difference between the outcomes of the 2 groups, suggesting that, provided that children receive an implant early, cause of deafness has little influence on outcome. Although the prevalence of other disabilities was similar in both groups, for individual children, their presence may have profound impact. The study supports the concept of implantation early in life, irrespective of the cause of deafness. Key Words cochlear implant, speech perception, children, auditory perception, outcome, meningitis, congenital, etiology, results Abbreviations PMD--postmeningitic deaf CD--congenitally deaf CDT--connected discourse tracking CAP--categories of auditory performance, WHEN PEDIATRIC COCHLEAR implantation began, considerable doubts were expressed about the advisability of implantation for congenitally deaf children. In 1989, Shannon (1) suggested that, because of lack of auditory input, [...]