The relationship between posttonsillectomy bleeding to hemogram and coagulation parameters.

PURPOSE: Tonsillectomy is a common surgery performed for indications such as chronic tonsilitis, tonsil hypertrophy and obsructive sleep apnea. Although posttonsillectomy bleeding (PTB) is rare and can be controlled with simple interventions in many patients, it is one of the most feared complications of tonsillectomy surgery. In our study, we investigated the effects of changes in hemogram and coagulation values and seasonal effects on PTB. METHODS: Pediatric and adult patients who underwent tonsillectomy with cold knife method between August 2020 and August 2023 in our clinic were retrospectively reviewed. Demographic data, hemogram and coagulation values of the patients in the control and study groups were recorded and the differences between the two groups in terms of these parameters were evaluated. RESULTS: Our study included 991 patients aged 1-51 years. The rate of PTB was calculated as 2.82%. No patient with primary PTB was found. The duration of bleeding development was 7.03 days. Age, WBC and neutrophil values were statistically significantly higher in the study group. There were no significant differences between two groups in terms of gender, season and other hemogram and coagulation parameters. CONCLUSIONS: Age, high WBC and neutrophil levels were determined as possible risk factors for PTB. Seasonal and gender distribution, aPTT and INR values were similar in the two groups. In order to prevent and predict bleeding, detailed infection investigation should be performed and the risk of bleeding should be considered to increase with increasing age.

Evaluation of newborn hearing screening results of infants with phenylketonuria.

OBJECTIVE: The purpose of this study is comparing the newborn hearing screening failure rate between phenylketonuria (PKU) infants and matched healthy control infants. PATIENTS AND METHODS: Between April 2021 and April 2023, data obtained from the national newborn hearing screening program were examined for patients who presented to the pediatric metabolism clinic of Konya City Hospital with a clinical and genetic diagnosis of PKU. A healthy control group, matched for age and gender, was established. The newborn hearing screening test results, demographic information, and pregnancy data of infants with PKU and the control group were compared to assess risk factors. RESULTS: In the initial screening test, 23 out of 73 PKU infants (31.5%) and 12 out of 73 infants in the control group (16.4%) failed the test (p = 0.033). Among the 23 PKU infants who did not pass the first test, 9 (35%) also failed the second test and were referred. In contrast, all 12 infants in the control group who did not pass the first test passed the second test. The failure rate in the second test was significantly higher in PKU infants compared to the control group (p = 0.003). It was observed that the maternal age of PKU infants who underwent the second test was significantly higher than that of the control group (p < 0.029). Diagnostic hearing test results were found to be normal in all nine PKU patients who failed the secondary screening test and were referred to a tertiary center. CONCLUSION: In our study, it was determined that infants with phenylketonuria (PKU) who did not have any risk factors for hearing loss failed the hearing screening test significantly more than healthy infants.

Comparison of Dorsal Preservation and Dorsal Reduction Rhinoplasty: Analysis of Nasal Patency and Aesthetic Outcomes by Rhinomanometry, NOSE and SCHNOS Scales.

BACKGROUND: Dorsal preservation techniques have been preferred and gained popularity in recent years. The current study compares the effects of dorsal preservation and dorsal reduction rhinoplasty on nasal patency and aesthetic outcomes by using Patient-Reported Outcome Measures (PROMs) and rhinomanometry. To our knowledge, this is the first study to compare dorsal preservation and dorsal reduction techniques with rhinomanometry. METHODS: This is a prospective study of 34 patients who underwent rhinoplasty between January 2021-June 2022. The patients were randomly selected preoperatively and divided into two groups as structural rhinoplasty (SR) and preservation rhinoplasty (PR). Nasal Obstruction and Symptom Evaluation (NOSE), Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) scales and rhinomanometric evaluation were performed preoperatively, at 3rd month and 12th month postoperatively. RESULTS: Nineteen patients (10 female, 9 male) were in SR group, 15 patients (7 female, 8 male) were in PR group. There was not significant difference in terms of age and gender between groups. In both groups, NOSE, SCHNOS-O and SCHNOS-C results were found to be significantly lower at postoperative 3rd and 12th month compared to preoperatively (p < 0.001 for the entire SR group, p = 0.001 for the entire PR group). There was no significant difference between groups in terms of PROMs. Mean total nasal volume (TNV) at 12th month were statistically higher than preoperative value in PR group (p = 0.031). Also there was no significant difference in SR group and between groups in terms of rhinomanometry results. CONCLUSION: Dorsal preservation with pushdown technique provides good functional and aesthetic results comparable with structural rhinoplasty. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . A well-designed prospective clinical trial.

Measurement of some serum cytokines in nasal polyp and evaluation of its correlation with disease severity.

PURPOSE: Nasal polyp is originating from the nasal mucosa or paranasal sinus mucosa. In our study, it was aimed to investigate the possible effects of inflammatory cytokines Interleukin-13 (IL-13), IL-25, IL-33 and Syndecan-1 (SDC-1) in the pathogenesis process of nasal polyp and relationship between these parameters and disease severity. METHODS: Our study was designed as a prospective case-control study. Patients diagnosed with nasal polyp were included in the patient group. The control group comprised volunteers with age and gender compatibility who does not have the disease. IL-13, IL-25, IL-33 and SDC-1 levels were detected in serum samples using enzyme-linked immunosorbent assay method. Nasal polyp disease severity was evaluated by means of "Sino-Nasal Outcome Test-22", "Lund-Mackay Score" and "Lund-Kennedy Score". RESULTS: In this study, 35 patients, 29 controls, a total of 64 participants were included. Our evaluation revealed that all cytokine levels in the patient group were statistically significantly higher than the control group (p < 0.05). However, there was no correlation found between scoring methods and cytokine levels (p > 0.05). CONCLUSION: The increase in cytokine levels in the patient group suggested that cytokine-mediated inflammation processes may be effective in nasal polyp pathogenesis.

Laryngeal Oncocytic Cystadenoma with Rare Location and Clinicopathological Aspects.

Laryngeal oncocytic cysts and cystadenomas are uncommon and observed in 0.1-1% of laryngeal biopsy specimens. A 66-year-old male was admitted to the hospital with a hoarse voice of 6 months duration. On laryngoscopic examination, a lesion of the left anterior vocal cord was present. It was excised by direct laryngoscopy and histopathologic examination revealed a cystic cavity with papillary projections into the lumen. The epithelial lining comprised bland oncocytic epithelium. These findings are characteristic of laryngeal oncocytic cystadenoma. Endoscopic excision is curative in these lesions. Oncocytic cystadenoma is a rare, cystic neoplasm that occurs in late adulthood. It may be considered in the clinicopathologic differential diagnosis of laryngeal lesions.

Development of Pharyngocutaneous Fistula after Total Laryngectomy: The Predictive Value of C-reactive Protein/Albumin Ratio.

BACKGROUND: We aimed to evaluate whether C-reactive protein(CRP)/ Albumin ratio (CAR) performed in the early postoperative period after total laryngectomy could be a predictive factor for the development of pharyngocutaneous fistula (PCF). METHODS: The files of patients with laryngeal squamous cell carcinoma who underwent total laryngectomy between January 2005 and January 2019 were retrospectively reviewed. Patients were divided into two groups: patients with PCF (PCF group) and without (Non-PCF group). CAR values and risk factors were compared between groups. RESULTS: The overall incidence of PCF was 23.2%. There was a statistically significant difference between the two groups in terms of CRP and CAR levels (p = 0.001). The CAR value of 27.05 (sensitivity = 75.0% , specificity 68.2%, area under curve (AUC) = 0.742, 95% confidence interval 0.616-0.868) was determined as a cutoff value to describe the development of fistula in the early postoperative period. In multiple linear regression analysis, there was an independent relationship between presence of PCF and previous RT and CAR value. CONCLUSIONS: CAR, performed in the early postoperative period, may be a new and useful marker for predicting PCF after total laryngectomy.

Comparison of Steroid Treatment with and without Hyperbaric Oxygen Therapy for Idiopathic Sudden Sensorineural Hearing Loss.

BACKGROUND AND OBJECTIVES: In this study, we compared the outcomes of patients with idiopathic sudden sensorineural hearing loss who underwent steroid treatment with or without hyperbaric oxygen (HBO) therapy and were followed-up in our clinic. SUBJECTS AND METHODS: Patients were divided into two groups according to their treatment regimen. Steroid group received intravenous 1 mg/kg methylprednisolone which was due to be completed in 2-3 weeks with decreasing doses, and five doses of 0.5 mL intratympanic dexamethasone. Steroid+HBO group received the same steroid treatment with the addition of HBO therapy. The audiologic results of both treatment groups were compared after considering the patients' risk factors. RESULTS: There was no significant difference between the steroid and Steroid+HBO groups in terms of hearing gain and degree of recovery, both at all degrees of hearing loss, and in severe and profound hearing loss. Hearing gain was similar when evaluated by audiogram type and admission time in both treatment groups. CONCLUSIONS: We found that the addition of HBO therapy to systemic plus intratympanic steroid treatment did not affect hearing gain at all degrees of hearing loss in this study. Furthermore, audiogram type and admission time did not affect hearing gain between the two groups.

Newborn hearing screening results of refugees living in our city and the factors affecting the results.

OBJECTIVES: To investigate the changes in the risk factors affecting the results of the Newborn Hearing Screening (NHS) and the hearing test results of the Syrian refugees in our city. METHODS: Syrian and Turkish newborns, born in our hospital between 01.01.2016 and 31.12.2017 and referred to our hospital from environmental hospitals for NHS, were included in this study. NHS results and risk factors were analyzed. RESULTS: 786 Syrian and 7230 Turkish newborns were included in this study. 53 (6,74%) infants referred in both ears, 26 (3,30%) infants in the one ear. There was a significant relationship between the presence of hearing loss and the history of intensive care unit admittance, presence and absence of low birth weight and neonatal icterus at Syrian newborns. In the same period, 20 (0,3%) Turkish infants referred bilaterally and 45 (0,6%) newborns unilaterally (25 right ear, 20 left ear). There was a significant difference between Turkish and Syrian newborns in terms of very low and low birth weight and intensive care unit admittance. CONCLUSIONS: The rate of hearing loss in Syrian refugee patients is quite high. Pregnant refugee women who are forced to migrate because of war face many risk factors and these people need to be included into the newborn hearing screening programs in the country where they took refuge in.

Effect of statins on hearing function and subjective tinnitus in hyperlipidemic patients.

INTRODUCTION: It is known that hyperlipidemia reduces hearing functions. In this study, we aimed to study the effect of antihyperlipidemic drugs on hearing functions and tinnitus. METHODS: Eighty-four patients aged 18 to 84, who were diagnosed with hyperlipidemia and started treatment with the statin group (atorvastatin 20 mg and 40 mg, rosuvastatin 10 mg and 20 mg, and simvastatin 20 mg) of antihyperlipidemic drugs, were included in this study. All patients underwent pure-tone audiometry before starting treatment with antihyperlipidemic drugs. Patients with tinnitus were evaluated by Tinnitus Severity Index and Visual Analogue Scale. In the 6th month of therapy, otologic examination, pure-tone audiometry and tinnitus evaluation of the patients were repeated. RESULTS: No significant difference was found in the pure-tone averages of the patients before and after statin use (p > 0.05). However, it was found in the audiometry that, after statin use, all drugs caused to statistically significant decrease in the hearing thresholds at 6000 Hertz (p < 0.05). Also, a strong increase was found in the Speech Discrimination percentages after treatment in patients using rosuvastatin 10 mg (p = 0.022). A significant decrease was found in the tinnitus frequency, duration, severity and degree of annoyance in patients using rosuvastatin 10 mg and 20 mg (p < 0.05). CONCLUSION: Statin group of drugs can have a positive effect on the hearing functions and subjective tinnitus. In particular, it is seen that rosuvastatin group of statins has a more notable effect on tinnitus. It was considered that further studies with larger patient groups are needed.

Transnasal Endoscopic Removal of a Knife Causing Penetrating Brain Injury in a Child.

Transnasal penetrating brain injuries are rare and a medical emergency, which needs to be treated promptly. A 4-year-old male patient was brought to our emergency room with a knife sticking out of his nose. The patient was immediately taken to the operating room and the knife was removed under general anesthesia. No cerebrospinal fluid leakage or any bleeding was seen and so the operation was terminated. The authors herein report a penetrating brain trauma through to the cella turcica with a knife that improved without any sequelae at a child.

Anti-inflammatory effects of hyperbaric oxygen on irradiated laryngeal tissues / Efeitos anti-inflamatórios do oxigênio hiperbárico sobre tecidos laríngeos irradiados

Abstract Introduction To manage the complications of irradiation of head and neck tissue is a challenging issue for the otolaryngologist. Definitive treatment of these complications is still controversial. Recently, hyperbaric oxygen therapy is promising option for these complications. Objective In this study, we used biochemical and histopathological methods to investigate the efficacy of hyperbaric oxygen against the inflammatory effects of radiotherapy in blood and laryngeal tissues when radiotherapy and hyperbaric oxygen are administered on the same day. Methods Thirty-two Wistar Albino rats were divided into four groups. The control group was given no treatment, the hyperbaric oxygen group was given only hyperbaric oxygen therapy, the radiotherapy group was given only radiotherapy, and the radiotherapy plus hyperbaric oxygen group was given both treatments on the same day. Results Histopathological and biochemical evaluations of specimens were performed. Serum tumor necrosis factor-α, interleukin-1β, and tissue inflammation levels were significantly higher in the radiotherapy group than in the radiotherapy plus hyperbaric oxygen group, whereas interleukin-10 was higher in the radiotherapy plus hyperbaric oxygen group. Conclusion When radiotherapy and hyperbaric oxygen are administered on the same day, inflammatory cytokines and tissue inflammation can be reduced in an early period of radiation injury.

Resumo Introdução O manejo das complicações da irradiação do tecido da cabeça e pescoço é uma questão desafiadora para o otorrinolaringologista. O tratamento definitivo dessas complicações ainda é controverso. Recentemente, a oxigenoterapia hiperbárica tem sido uma opção promissora para essas complicações. Objetivo Nesse estudo foram usados métodos bioquímicos e histopatológicos para investigar a eficácia do oxigênio hiperbárico contra os efeitos inflamatórios da radioterapia no sangue e nos tecidos laríngeos, quando a radioterapia e oxigênio hiperbárico são administrados no mesmo dia. Métodos Trinta e dois ratos Wistar albinos foram divididos em quatro grupos. O grupo controle nao recebeu tratamento, o grupo de oxigenio hiperbarico recebeu apenas oxigenoterapia hiperbarica, o grupo de radioterapia recebeu apenas radioterapia e o grupo de radioterapia com oxigenio hiperbarico recebeu ambos os tratamentos no mesmo dia. Resultados Foram realizadas avaliaçoes histopatologicas e bioquimicas dos especimes. Os niveis sericos de fator de necrose tumoral-α, interleucina-1β e inflamaçao tecidual foram significativamente maiores no grupo de radioterapia do que no grupo de radioterapia mais oxigenio hiperbarico, enquanto que a interleucina-10 foi maior no grupo de radioterapia mais oxigenio hiperbarico. Conclusão Quando a radioterapia e o oxigênio hiperbárico são administrados no mesmo dia, as citocinas inflamatórias e a inflamação tecidual podem ser reduzidas no período inicial da radiação.

Anti-inflammatory effects of hyperbaric oxygen on irradiated laryngeal tissues.

INTRODUCTION: To manage the complications of irradiation of head and neck tissue is a challenging issue for the otolaryngologist. Definitive treatment of these complications is still controversial. Recently, hyperbaric oxygen therapy is promising option for these complications. OBJECTIVE: In this study, we used biochemical and histopathological methods to investigate the efficacy of hyperbaric oxygen against the inflammatory effects of radiotherapy in blood and laryngeal tissues when radiotherapy and hyperbaric oxygen are administered on the same day. METHODS: Thirty-two Wistar Albino rats were divided into four groups. The control group was given no treatment, the hyperbaric oxygen group was given only hyperbaric oxygen therapy, the radiotherapy group was given only radiotherapy, and the radiotherapy plus hyperbaric oxygen group was given both treatments on the same day. RESULTS: Histopathological and biochemical evaluations of specimens were performed. Serum tumor necrosis factor-α, interleukin-1ß, and tissue inflammation levels were significantly higher in the radiotherapy group than in the radiotherapy plus hyperbaric oxygen group, whereas interleukin-10 was higher in the radiotherapy plus hyperbaric oxygen group. CONCLUSION: When radiotherapy and hyperbaric oxygen are administered on the same day, inflammatory cytokines and tissue inflammation can be reduced in an early period of radiation injury.

Melatonin prevents possible radiotherapy-induced thyroid injury.

PURPOSE: We aimed to investigate the protective effect of melatonin in radiotherapy-induced thyroid gland injury in an experimental rat model. MATERIALS AND METHODS: Thirty-two rats were divided into four groups: the control group, melatonin treatment group, radiotherapy group and melatonin plus radiotherapy group. The neck region of each rat was defined by simulation and radiated with 2 Gray (Gy) per min with 6-MV photon beams, for a total dose of 18 Gy. Melatonin was administered at a dose of 50 mg/kg through intraperitoneal injection, 15 min prior to radiation exposure. Thirty days after the beginning of the study, rats were decapitated and analyses of blood and thyroid tissue were performed. RESULTS: Tumor necrosis factor-α (TNF-α), interleukin-1 beta (IL-1ß), thiobarbituric acid reactive substances (TBARS) and nitric oxide (NO) levels in the radiotherapy group were significantly higher than those in the melatonin plus radiotherapy group (p < .05), whereas interleukin-10 (IL-10) and glutathione (GSH) values were higher in the melatonin plus radiotherapy group (p < .05). The infiltration of inflammatory cells and percentage of apoptosis in the radiotherapy group were significantly higher than those in the melatonin plus radiotherapy group (p < .05). CONCLUSIONS: Melatonin helped protect thyroid gland structure against the undesired cytotoxic effects of radiotherapy in rats.

Can Platelet and Leukocyte Indicators Give Us an Idea about Distant Metastasis in Nasopharyngeal Cancer?

This study aimes to evaluate platelet and leucocyte indicators, such as the mean platelet volume, platelet distribution width, plateletcrit, white blood cell count, neutrophil to lymphocyte ratio in nasopharyngeal cancer patients and also to evaluate the relationship between these indicators and nasopharyngeal cancer with distant metastasis. The medical records of 118 patients diagnosed with nasopharyngeal cancer in our hospital between January 2006 and August 2015 were reviewed. The nasopharyngeal cancer group was further sub grouped according to the presence or absence of distant metastasis and TNM (tumour - T, node - N, metastasis - M) classification. A control group consisted of 120 healthy patients. The platelet and leucocyte values at the time of the initial diagnosis were recorded. Neutrophil to lymphocyte ratio and platelet distribution width values were significantly higher in the nasopharyngeal cancer group. But only platelet distribution width values were significantly higher in the nasopharyngeal cancer group with distant metastasis compared to the nasopharyngeal cancer group without distant metastasis. Neutrophil to lymphocyte ratio and platelet distribution width values may increase in nasopharyngeal cancer. But only the platelet distribution width values may give us an idea about the distant metastasis in nasopharyngeal cancer.

The evaluation of cochlear functions in Familial Mediterranean Fever.

Familial Mediterranean Fever (FMF) is a progressive disease characterized by chronic inflammation, which also has negative effects on cochlear functions and hearing levels. We investigated whether the cochlear functions and hearing levels of FMF patients were different than healthy controls and also evaluated the relationship of hearing levels with the age at diagnosis, duration without treatment, and inflammation and lipid parameters in this study. A total of 60 patients diagnosed with FMF and 48 age, gender and body mass index (BMI)-matched healthy controls were included in the study. The hemogram, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and lipid parameters of the subjects were studied and they all underwent pure tone audiometry and Transient evoked otoacoustic emission tests after an otologic examination. The hearing levels of the FMF group were significantly higher than those of the control group. The TEOAE signal/noise (S/N) ratios were similar in both groups. A positive relationship was present between the audiometric test results and the age, BMI, low-density lipoprotein and triglyceride levels and a negative relationship with the high-density lipoprotein levels. A negative relationship was present between the TEOAE S/N ratios and the age of the patients, duration without treatment, lipid parameters, inflammation markers and the creatinine level. FMF patients are exposed to chronic inflammation and this can influence their hearing levels. The age at diagnosis, duration without treatment, chronic inflammation, unfavorable lipid parameters, and obesity can affect hearing tests negatively.

Cervico-Thoracic Giant Lipoma in a Child.

Lipomas are benign mesenchymal tumors that can be observed all over the body. In total, 25% of lipomas are observed in the head and neck region, and most of them are located in the posterior cervical triangle. Lipomas that are greater than 10 cm in width or more than 1000 g in weight are called giant tumors. Cervico-thoracic lipomas are extremely rare, and only four cases have been reported in the English literature. We report successful surgical excision of a giant lipoma, which started from middle-anterior cervical region covered the anterior cervical triangle, and extended to the mediastinum, without thoracotomy.