The Relationship Between American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) and Fine Needle Aspiration Cytology (FNAC) ; in Geriatric Thyroid Pathologies.

Introduction: The world population is getting older with each passing year.Thyroid cancer is the most common endocrinological cancer and its incidence is increasing in all populations. Although the increase in prevalence has been attributed more to the increased use of imaging methods and to the higher sensitivity of ultrasonography (USG) by some authorities, there are also studies suggesting a real increase.In our study, it was aimed to examine the USG and fine needle aspiration cytology (FNAC) results of thyroid nodules in the geriatric age group and to discuss them in the light of the literature. Methods: Files of 129 geriatric patients with thyroid nodules detected in the University Of Health Sciences Adana City Training and Research Hospital between 2018 and 2020 were retrospectively analyzed.The USG characteristics of the patients were categorized by scoring according to the ACR TIRADS system. FNAC diagnoses were grouped according to the Bethesda classification. Results: According to the ACR TIRADS grading, 4 patients (3.1%) were benign, 58 patients (45%) were not suspicious, 38 patients (29.5%) were mildly suspicious, 25 patients (19.4%) were moderately suspicious, and 4 patients (3.1%) were highly suspicious.In our study, although USG provided very valuable information in the approach to thyroid nodules, no relationship was found between TIRADS in the geriatric age group and FNAC results in our study (p = 0.117). Conclusion: We think that the approach to thyroid nodules in geriatric patients requires closer follow-up not only with USG data but also with clinical and history-based findings. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03215-w.

Loss of Smell in COVID-19 Patients: New Biomarkers.

Patients with emerging anosmia may be asymptomatic carriers of coronavirus disease 2019 infection requiring self-isolation; otherwise, there are risks of facilitating the spread of the disease.This study aims to evaluate the loss of smell with visual analogue scale and to determine the relationship between the loss of smell and blood parameters.All patients' coronavirus disease 2019 swab cultures were polymerase chain reaction positive and pneumonia was found in computed tomographies consistent with oronavirus disease 2019. The study was conducted on 114 patients hospitalized between 01.11.2020 and 31.12.2020 in the Otorhinolaryngology coronavirus disease 2019 Service of University of Health Sciences Adana City Training and Research Hospital and followed up by us.A score of 10 indicates that the olfactory function is completely normal in all patients undergoing visual analogue scale, and a score of 0 indicates that they cannot smell anything. Patients who received visual analogue scale scored 10 points were categorized as Group 1 and others as Group 2. Statistical significance level was determined as p < 0.05. A statistically significant difference was found between Group 1 and Group 2 in terms of visual analogue scale smell score, neutrophil, lymphocyte, neutrophil-lymphocyte ratio. Visual analogue scale smell score, neutrophil count, neutrophil-lymphocyte ratio value were found to be lower in Group 2 and lymphocyte count was found to be higher. Neutrophil, lymphocyte, neutrophil/lymphocyte ratio, platelet, platelet/lymphocyte ratio, which are also used in nasal diseases, may be used to detect loss of smell, predict, and even determine the prognosis of loss of smell if supported by further studies.

Effects of Infertility on Voice in male patients.

Purpose: In this study, we aimed to determine the differences in normospermic, oligospermic and azoospermic infertile men by performing voice analysis and to discuss this in the light of the literature. Methods: 71 male patients who applied to the urology clinic due to infertility and were then referred to us were included in the study. Hormone analysis and spermiogram were requested from the patients for routine infertility tests. Testosterone, Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Prolactin levels of the patients were recorded. Age and spermiogram results were recorded. According to the spermiogram results, the patients were categorized as Group 1 (azoospermic), Group 2 (oligospermic), Group 3 (normospermic). Voice Handicap Index-10 Turkish version (VHI-10) was applied to the patients and the results were recorded. Results: The age of the infertile patients ranged from 20 to 37. The mean age was 28.23. The distribution of the patients was 21 patients in Group 1, 40 patients in Group 2, and 10 patients in Group 3. The mean Testosterone level of the patients was 2.78; mean FSH level 12.14; mean LH level 7.26; mean Prolactin level was 8.1. The mean VHI-10 scores of the patients were 10.52. The fundamental frequency F0 Hz (mean pitch) values of the patients were 176,468; jitter % (frequency perturbation jitter) values average 0.25; shimmer % (amplitude perturbation shimmer) values average 2,322; HNR dB values averaged 24,862. Conclusions: Testosterone is more effective on the voice, especially in male individuals.It would be more logical to think that many hormones, growth factors and local factors are effective instead of a single hormone.

Effect of Using N95 and Surgical Masks on Otoacoustic Emission in Cochlear Outer Hair Cells.

INTRODUCTION: Distortion product otoacoustic emission (DPOAE) was measured to investigate the effect of mask use and type on oxygen saturation on cochlear function in health care professionals during the COVID-19 pandemic. MATERIAL AND METHODS: Group 1 participants wore surgical masks; Group 2 participants wore N95 masks. Distortion product otoacoustic emission and oxygen saturation were measured in both groups before and after mask use. RESULTS: Comparison of signal-to-noise ratio (SNR) values before and after surgical mask use in DPOAE measurements of group 1 revealed statistically significant difference in the right and left ears. Comparison of the SNR values in DPOAE measurements of group 2 before and after 8 hours of N95 mask use revealed statistically significant differences in the right ear at 988, 2963, 4444, and 8000 Hz and in the left ear at 8000 Hz. CONCLUSION: We found that prolonged mask use may affect the outer hair cells in the cochlea, causing deterioration in DPOAE values.

Giant Ethmoid Sinus Osteoma Protruding into the Maxillary Sinus.

Ethmoid sinus osteomas are rare, benign, encapsulated neoplasms of the paranasal region. They can lead to various complications such as sinusitis, orbital cellulitis, proptosis, and diplopia. The treatment protocol of these lesions changed remarkably as powered instrumentation of functional endoscopic sinus surgery evolved and otolaryngologists gained experience. Here, the authors report a 30-year-old female who was diagnosed with a giant right-sided ethmoid sinus osteoma and discuss diagnostic and treatment modalities of these lesions in consonance with the current literature.

Vocal Quality Assessment of Patients with Pituitary Adenomas Operated via Endoscopic and Microscopic Approaches.

AIM: To evaluate whether there is any difference in voice quality between patients who were operated via microscopic and endoscopic approaches for pituitary adenomas. MATERIAL AND METHODS: The study group consisted of 59 patients and 30 healthy volunteers. They were all males and divided into three groups as; microscopically operated (MO) (n=30), endoscopically operated (EO) (n=29) and control (n=30). Subjective and objective voice analyses were performed. RESULTS: There was no significant relationship within groups according to Voice Handicap Index-10 (p=0.053). Fundamental frequency, jitter %, jitter PQQ5 parameters revealed that there was a statistically significant difference between EO and MO groups. No statistically significant difference was observed within EO, MO and control groups with respect to harmonics-to-noise ratio median scores. CONCLUSION: The present study assessed the effects of endoscopic and microscopic techniques for removal of pituitary adenomas on quality of voice. As it keeps the anatomically realistic model of sinuses and nasal cavity which provides resonance for the voice, endoscopic intervention found out to be superior by means of vocal quality.

IL-1RN VNTR, IL-2(-330), and IL-4 VNTR gene polymorphisms in patients with chronic rhinosinusitis with sinonasal polyposis

Background/aim: Sinonasal polyposis is a complex chronic disease displaying contributions from multiple genetic and environmental factors. In this study, we analyzed possible genetic factors that increase susceptibility to this widespread inflammatory disease. Materials and methods: A total of 176 adult patients, including 78 patients with sinonasal polyposis and 98 healthy controls, were analyzed for IL-1RN VNTR, IL-2(-330), and IL-4 VNTR gene polymorphisms using polymerase chain reaction and enzyme restriction. Results: IL-1RN and IL-4 VNTR polymorphisms were notably associated with sinonasal polyposis (P = 0.0001 and P = 0.036, respectively); however, regarding the IL-2(-330) gene polymorphism, no significant difference was shown between the patient and control groups (P = 0.235). Conclusions: Our study indicates that the RN2 allele of IL-1RN and the RP1 allele of IL-4 might be risk factors for developing sinonasal polyposis.

Effects of septoplasty on olfactory function evaluated by the Brief Smell Identification Test: A study of 116 patients.

We conducted a prospective study of 116 patients-61 men and 55 women, aged 17 to 64 years (mean: 26.4)-to investigate the effects of septoplasty on olfactory function in patients with septal deviation (SD). The Mladina classification system was used to define SD types, and olfactory function was assessed with the Brief Smell Identification test (BSIT). The BSIT, which includes 12 odorants, was administered preoperatively and at postoperative months 1 and 3. The most common SD types were types 2 (20.7% of patients) and 1 (19.0%), followed by types 3 and 5 (both 16.4%). At postoperative month 1, the mean BSIT score was significantly higher in men than in the women. For patients with types 1 and 2 SD, BSIT scores at 1 month were significantly lower than the scores preoperatively and 3 months postoperatively. For types 3 and 4, BSIT values were significantly higher at 3 months than preoperatively or at 1 month. For type 3 SD, the preoperative mean score was significantly lower than those for types 1, 4, 5, 6, and 7; for type 2 SD, the BSIT score was significantly lower than those of types 5 and 6 only. At 1 month, the scores for types 2 and 3 were significantly lower than those for types 4, 5, 6, and 7. At 3 months, the BSIT score for type 2 was significantly lower than those of types 1, 3, 4, 5, and 6; the type 3 SD score at 3 months was significantly higher than those for types 1, 2, 5, 6, and 7. We conclude that septoplasty surgery for patients with a type 3 SD may improve olfactory function. In contrast, we found that olfactory function in patients with a type 2 SD did not improve to a satisfactory degree, even when good nasal patency was achieved with a corrected septum and an enlarged intranasal volume. Our findings should be investigated further in future studies.

The effects of maternal presence during anesthesia induction on salivary cortisol levels in children undergoing tonsillectomy and/or adenoidectomy.

OBJECTIVE: Although parental presence during anesthesia induction is suggested to diminish operative stress level in children, there have been conflicting results about this strategy. The aim of this study was to evaluate the effects of maternal presence during induction on operative stress level in children who had tonsillectomy and/or adenoidectomy by determining the salivary cortisol levels. DESIGN: Non-randomized clinical study. SETTING: Preoperative and postoperative recovery rooms, operating room. PATIENTS: The study included 48 children between the ages of 5-12years who underwent tonsillectomy and/or adenoidectomy. INTERVENTIONS: The patients were divided into 2 groups. The children in group 1 were separated from their mothers at the preparation room. The children in group 2 stayed together with their mothers till the anesthesia induction. MEASUREMENTS: State Trait Anxiety Inventory (STAI) was performed to the mothers and children preoperatively. Salivary cortisol levels were evaluated in 4 different time frames: 1) in preparation room, 2) after anesthesia induction, 3) at the 30th minute of operation, and 4) in postoperative recovery room. MAIN RESULTS: There were no statistically significant differences between groups regarding demographic features, and operation or anesthesia times. The child's or mothers' preoperative anxiety scores were not different between the groups. Salivary cortisol levels in group 1 were significantly increased after induction and in recovery room compared to those in group 2 (p: 0.001, and p: 0.02, respectively). CONCLUSIONS: We have determined decreased salivary cortisol levels during anesthesia induction and recovery in the maternal presence revealing diminished stress in these periods. Further studies are warranted to determine the effects of parental presence during anesthesia induction especially on surgical outcomes.

Endoscopic Transnasal Transpterygoid Excision of an Infratemporal Dermoid Cyst.

OBJECTIVE: Intracranial dermoid cysts are rare, slow-growing masses of sellar, parasellar regions, and posterior cranial fossa. The symptomatology of these cysts depends on the localization and presence of rupture. The preoperative diagnosis of these cysts by imagining techniques is distinctive as they have characteristic appearances. PATIENT: Endoscopic transnasal transpterygoid approach to infratemporal fossa for an extradural dermoid cyst of a 24 year-old woman is presented in this clinical report. Headache, dizziness, and retro orbital pain were her main complaints and diagnostic imagining studies designated an intracranial dermoid cyst preoperatively. The cyst was excised uneventfully with no recurrence 6 months after the operation. CONCLUSION: Surgery of intracranial lesions neighboring critical vital neurovascular structures can be challenging to the surgeon. Alternative minimal invasive approaches should always be considered for averting life-threatening complications.

Effects of Cartilage Scoring in Correction of Prominent Ear with Incisionless Otoplasty Technique in Pediatric Patients.

OBJECTIVE: The aim of this study was to investigate the efficacy, complication rates, patient satisfaction, and recurrence risks of the incisionless otoplasty technique performed with or without cartilage scoring for correcting the prominent ear in pediatric patients. MATERIAL AND METHODS: A total of 49 patients with prominent ears were operated with incisionless otoplasty. In Group 1, 44 ears of 24 patients were operated with incisionless otoplasty without cartilage scoring. In Group 2, 46 ears of 25 patients were operated with incisionless otoplasty with cartilage scoring. For comparison, auriculocephalic distances were measured at three different levels: preoperatively, at the end of surgery, and at 1th and 6th month post-operatively. Patient satisfaction was evaluated using a visual analog scale (VAS). The global esthetic improvement scale (GAIS) was applied by an independent, non-participating plastic surgeon at 6 months after surgery. RESULTS: Prior to surgery and at the end of surgery, no statistically significant difference was observed between the groups in terms of auriculocephalic distances at the three levels. At the and 6th month after surgery, auriculocephalic distances were significantly higher in Group 1. There were no significant differences in VAS results and GAIS values between the groups. The recurrence rate was 9.1% in Group 1 and 4.3% in Group 2. The suture extrusion rate was 18.2% in Group 1 and 13% in Group 2. CONCLUSION: Although there was a significant difference of 1-2 mm in auriculocephalic distances, our study showed that cartilage scoring is not mandatory to correct the prominent ear in pediatric patients with soft cartilages and to achieve patient and surgeon satisfaction.

Different anesthetic agents-soaked sinus packings on pain management after functional endoscopic sinus surgery: which is the most effective?

In the present study, we investigated the efficacy of local anesthetics soaked non-absorbable sinus packs on pain management after functional endoscopic surgery (FESS). One hundred and fifty patients with the diagnosis of bilateral chronic sinusitis with or without nasal polyps who underwent FESS were included into the study. Their pre-operative Lund-Mackay computerized tomography (CT) Scores were similar. We applied anesthetic agents of 2 % lidocaine HCl, 0.25 % Bupivacaine HCl, 0.2 % Ropivacaine, 2 % Prilocaine and 0.9 % NaCl (Saline) in groups 1-5 onto the sinus packs after FESS. At postoperative period, acetaminophen (250 mg/5 ml) was used in 10-15 mg/kg per dose (4 times a day). Bleeding grade, operation duration, postoperative number of gauze/24 h, additional painkiller need, pain values at 1, 2, 4, 8, 12 and 24 h were noted. Lund-Kennedy endoscopic scores were also evaluated at 1st, 2nd and 4th weeks postoperatively. In saline group, 93.3 % of the patients needed additional painkiller. Whereas, in Bupivacaine group, additional painkiller use (20.0 %) is less than the other groups. In Bupivacaine group, number of gauze/24 h use was lower than lidocaine, ropivacaine and prilocaine groups. In our study, except 1st and 24th hours, pain values of groups can be written in ascending order (from less to higher) as Bupivacaine, Lidocaine, Prilocaine, Ropivacaine and Saline. In the first hour, pain values of groups can be written in ascending order (from less to higher) as Lidocaine, Prilocaine, Bupivacaine, Ropivacaine and Saline. In the 2nd week, in the Bupivacaine and Lidocaine Groups separately, postoperative Lund-Kennedy scores were lower than the Prilocaine and Saline Groups. In the 1st month, Lidocaine Group's Lund-Kennedy scores were significantly lower than the Saline Group. Synechia values were not different between groups. Bupivacaine help the lower pain values and less additional painkiller need after FESS. Therefore, we recommend to use Bupivacaine soaked sinus packs after FESS for achieve less pain values and to improve patient satisfaction.

The Prevalence of Gap Junction Protein Beta 2 (GJB2) Mutations in Non Syndromic Sensorineural Hearing Loss in Çukurova Region.

OBJECTIVE: To date, studies in all populations showed that mutations in the gene of Gap junction protein beta 2 (GJB2) play an important role in non-syndromic autosomal recessive congenital hearing loss. The aim of this study was to evaluate GJB2 gene of patients with hearing loss in our region using deoxyribonucleic acid (DNA) sequencing method and to demonstrate region-specific mutation and polymorphism distribution. MATERIALS AND METHODS: Patients who had bilateral severe sensorineural non-syndromic hearing loss identified by audiologic evaluation were included. Peripheral blood samples were collected and the GJB2 gene exon1 and exon 2 regions were amplified by polymerase chain reaction (PCR). Obtained PCR products were sequenced by the DNA sequence analysis method (SeqFinder Sequencing System; ABI 3130; Foster City, CA, USA) and analyzed using the SeqScape software. RESULTS: Of the 77 patients, 16 had homozygous or heterozygous mutation. CONCLUSION: The mutation of 35delG, which is known as the most frequent mutation of GJB2 gene, was also the most frequently seen mutation at a ratio of 5.5% in patients with hearing loss in our region; this was followed by the V27I mutation. As this is the first study conducted by sequence analysis in our region, it was worth to be presented in terms of showing the distribution of mutation.

Role of Laryngopharyngeal Reflux in the Pathogenesis of Otitis Media with Effusion.

OBJECTIVE: To determine whether there is an association between otitis media with effusion and laryngopharyngeal reflux in children. MATERIALS AND METHODS: This study included 31 children with otitis media with effusion. The pepsinogen level in the middle ear fluid of all patients was measured by sandwich enzyme-linked immunosorbent assay. Each patient's middle ear fluid was investigated for Helicobacter pylori (H. pylori) using the Campylobacter-like organism (CLO) test. The middle ear pepsinogen levels were compared with those in the serum. The correlation between pepsinogen levels and H. pylori positivity in the middle ear fluid was investigated. RESULTS: The mean middle ear pepsinogen level (211.69 ng/mL) was significantly higher than that in the serum (24.18 ng/mL) in patients with otitis media with effusion. The middle ear aspirates of six patients (19%) were positive for H. pylori, and the correlation between H. pylori positivity and increased pepsinogen levels in the middle ear fluid was statistically significant in patients with otitis media with effusion. CONCLUSION: We detected higher pepsinogen levels and H. pylori positivity rates in the middle ear fluid than in the serum of patients with otitis media with effusion. These results support the role of laryngopharyngeal reflux in the pathogenesis of otitis media with effusion.

Relief of pain at rest and during swallowing after modified cautery-assisted uvulopalatopharyngoplasty: bupivacaine versus lidocaine.

OBJECTIVES: We investigated the efficacy of bupivacaine, lidocaine, and saline infiltrations to peritonsillar region and uvula and soft palate regions for pain relief after tonsillectomy and modified cautery-assisted uvulopalatopharyngoplasty (MCAUP) in patients with obstructive sleep apnea. METHODS: In this prospective study, 91 patients (32-65 years old) with obstructive sleep apnea underwent tonsillectomy and MCAUP and were divided into 3 groups. In group 1 patients (n = 31), 0.25% bupivacaine HCl + 1/200,000 epinephrine (10  mL); in group 2 patients (n = 31), 1% lidocaine HCl + 1/200,000 epinephrine (10  mL); and in group 3 patients (n = 29), 0.9% saline (10  mL) were injected to peritonsillar region and uvula and soft palate regions. Operation duration, amount of bleeding, and analgesic requirement and visual analog scale for pain at rest and at swallowing were evaluated in all groups. RESULTS: Mean body mass index values were between 27.0 and 27.3  kg/m in all groups. Their apnea-hypopnea index values were between 15.3 and 16.9 per hour, and there were no significant differences between their body mass index and apnea-hypopnea index values. Duration of operation of patients in the bupivacaine group was significantly lower than that of patients in the lidocaine and saline groups. In addition, in the lidocaine group, operation duration was significantly lower than that in the saline group. Bleeding amount and postoperative analgesic requirement of the saline group were significantly higher than those of the bupivacaine and lidocaine groups. Although both these measures (operation duration and amount of bleeding) were statistically significant, a mean operating time of 44.3 versus 46.0 minutes and 64.4-mL versus 68.4-mL blood loss for the bupivacaine and lidocaine groups were clinically irrelevant and not too important. In terms of visual analog scale for pain at rest and/or swallowing, Bupivacaine provided more relief than lidocaine and saline injections. The lidocaine provides pain relief less than bupivacaine and more than saline at rest and/or swallowing. CONCLUSION: We recommend the use of bupivacaine injections in peritonsillar, uvular, and soft palate regions during tonsillectomy + MCAUP operations. It reduces operation duration and provides more pain relief postoperatively. When patients had cardiac problems, lidocaine may also be recommended because of its cardiac depressant and antiarrhythmic effects and positive effects for pain relief compared with saline injections.

Comparison of two incisionless otoplasty techniques for prominent ears in children.

OBJECTIVES: In the present study, we applied two incisionless suture techniques for otoplasty: Haytoglu et al.'s modification of incisionless otoplasty technique and Fritsch's incisionless otoplasty technique for correction of prominent ears. METHODS: In this prospective study, 60 patients with prominent ears were included in the study. In Group 1, 55 ears of 30 patients (25 bilateral and 5 unilateral) were operated with Haytoglu et al.'s modification of incisionless otoplasty technique. In Group 2, 57 ears of 30 patients (27 bilateral and 3 unilateral) were operated with Fritsch's incisionless otoplasty technique. For comparison of two methods, auriculocephalic distances were measured at three levels which were level 1 (the most superior point of the auricle), level 2 (the midpoint of the auricle) and level 3 (level of the lobule) pre-operatively (preop); and measurements were repeated at the end of the surgery (PO(0-day)), 1st month (PO(1-Mo)) and 6th month (PO(6-Mo)) after the surgery, in both groups. Patient satisfaction was evaluated using a visual analog scale (VAS). Moreover, Global Aesthetic Improvement Scale (GAIS) was rated by an independent, non-participating plastic surgeon at 6 months after the surgery. RESULTS: Operation time was 15.9±5.6min in Group 1 (Haytoglu et al.'s) and 19±4.7min in Group 2 (Fritsch). Hematoma, infection, bleeding, keloid scar formation, sharp edges or irregularities of the cartilage were not observed in any group. Suture extrusion was detected in 14.03% of Group 1 and 16.1% of Group 2. No statistically significant difference was observed between auriculocephalic distances at levels 1-3 of groups at preop, PO(0-day), PO(1-Mo) and PO(6-Mo) separately. Similarly, difference in auriculocephalic distances (preop values-PO(6-Mo) values) was not detected as statistically significant in Groups 1 and 2 at three levels. In both techniques, No statistically significant difference was observed in patient satisfaction at 6th months after the operation which was measured using Visual Analogue Scale (VAS) on 0 to 100 scales. According to GAIS, the patients were rated as 92.9% "improved" and 7.1% "no change" in Group 1; as 94.6% "improved" and 5.4% "no change" in Group 2. CONCLUSIONS: Due to the similar results, Haytoglu et al.'s and Fritsch's incisionless otoplasty techniques are good options in the treatment of prominent ears, especially in pediatric patients with isolated inadequate development of antihelical ridge, and with soft auricular cartilage.

Does glubran 2 improve the graft uptake in tympanoplasty? A retrospective study.

Tympanoplasty is a common procedure in otolaryngology practice and several factors have been described to increase graft uptake. Independent of the technique and graft material, the revascularization process of the graft is related to patient factors as well as contact of the tympanic membrane remnant's edges with the graft material. A number of different tissue glue materials and other packing methods have been used for graft stabilization. Glubran 2, a cyanoacrylate containing surgical tissue adhesive, has highly effective anticoagulant and adhesive properties, and the present study aims to reveal the effectiveness of this glue on tympanoplasty surgery. The study is designed as retrospective chart review and it was set up at Etlik Ihtisas Research and Training Hospital which is a tertiary care center. The study population consisted of 68 consecutive patients aged between 9 and 75 years who underwent over-underlay tympanoplasty. The patients were divided into two groups according to use of glubran 2 as a sealing material for graft fixation. The patients in whom glubran 2 was not used served as the control group. There were 20 women and 16 men in the glubran 2 group, 17 women and 15 men in the control group. These two groups were also subdivided into two groups for the graft type used (temporal muscle fascia or tragal cartilage). The overall graft take rate was 88.9 % in the tympanoplasty group sealed with glubran 2 and 84.4 % in the control group. A statistically significant decrease was seen in hearing thresholds in both groups postoperatively when compared to the preoperative values (p < 0.001 for both). There was no significant otorrhea in either group. Graft uptake and hearing recovery were similar in glubran 2 and control groups. These findings suggest that glubran 2 is an effective material for fixation of the graft in tympanoplasty, but it does not have a notable effect on the success of the surgery.

Cartilage graft or fascia in tympanoplasty in patients with low middle ear risk index (anatomical and audological results).

The aim of this study was to compare anatomic and audiological results of cartilage graft with temporal fascia graft in type 1 tympanoplasty patients with low middle ear risk index (MERI). In this retrospective study, 63 patients that underwent type 1 tympanoplasty with chondroperichondrial island graft between July 2009 and November 2010 were compared with 45 patients in whom temporal muscle fascia was used. Patients in both groups had low MERI values varying between 1 and 3. Five and nine patients underwent masteidectomy in cartilage and fascia group, respectively. Mean duration of follow-up was 11.9 ± 3.7 (5-17) months. Mean value was calculated at pre-operative and post-operative hearing threshold 0.5, 1, 2, 4 kHz, and air bone gap (ABG) gain was compared in both cartilage and fascia groups. when pre-operative and post-operative ABG gain were compared, significant decrease was seen in ABG levels (p < 0.001). However, no significant difference was seen in ABG gain values (p = 0.608), which was 10.1 ± 7.00 dB in cartilage group and 10.8 ± 5.38 dB in fascia group. In both groups, age, sex, and the addition of mastoidectomy procedure had no significant effect on ABG gain and success. Cartilage is a graft material that may be preferred without concern about the effects on hearing results, especially, in patients with low MERI values. The addition of mastoidectomy had no impact on the outcome of operation and audiological results. However, further studies with larger case series may be carried out to further clarify the issue.

Quick Diagnosis in Obstructive Sleep Apnea Syndrome: WatchPAT-200.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a highly prevelant disorder and found in approximately 2-4% of middle-aged adults. OBJECTIVES: To assess the efficacy of Watch-PAT-200 in the diagnosis of obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHODS: Patients suspected of having OSAS underwent overnight Level I polisomnography and simultaneously wore Watch-PAT-200 in the sleep laboratory. RESULTS: 51 adult patients included in the study. The average age was 45.3±10.5 years and the average body mass index (BMI) was 29.4±4.0 kg/m2. There was a high agreement between PSG and Watch PAT regarding apnea-hypopnea index, respiratory disturbance index and oxygen desaturation index. Significant but a low agreement was found in stage 1 and 2 of non-REM sleep when two methods compared. No agreement was found between PSG and Watch-PAT regarding stage 3 and 4 of non-REM sleep. Very low agreement was found between PSG and Watch-PAT regarding the REM sleep. CONCLUSIONS: Watch-PAT-200 is an effective method in the diagnosis of OSAS.

Comparison of montelukast and mometasone furoate in the prevention of recurrent nasal polyps.

BACKGROUND: The aim of our study was to compare the effects of montelukast and mometasone furoate nasal spray on the postoperative course of patients with nasal polyposis. PATIENTS AND METHODS: Fifty patients diagnosed with nasal polyposis between March 2006 and August 2007 were included in the study. All patients underwent bilateral endoscopic sphenoethmoidectomy and were randomized postoperatively into two groups. Group A (n = 25) received 10 mg montelukast per day and group B (n = 25) received 400 µg mometasone furoate nasal spray twice daily. All patients were followed up for 6 months. Sino-Nasal Outcome Test (SNOT)-22 scores, polyp grades, computerized tomography (CT) scores (Lund-Mackay), eosinophils in peripheral blood and polyp tissue were evaluated before and after surgery. RESULTS: There was a significant reduction in SNOT-22 scores in both groups throughout the study period. There was a significant difference in the recurrence rate between both groups with a marginal advantage of mometasone furoate nasal spray. Eosinophils in peripheral blood were found to be effective on the recurrence rate (p < 0.05). CONCLUSIONS: In conclusion, both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.