Effects of hookah and cigarette smoking on the recovery after septoplasty.

BACKGROUND: Hookah is a tobacco product of Middle Eastern origin; however, its popularity increases in Europe and the US. Despite its frequent use, hookah's potentially detrimental effects are underestimated as a result of the scarcity of the relevant research. Since septoplasty is one of the most commonly performed procedures of otolaryngology practice, we aimed to investigate the impact of hookah consumption on recovery after septoplasty. METHODS: Patients who underwent septoplasty in Sanliurfa Training and Research Hospital Department of Otolaryngology between January 2017 and December 2019 were divided into four groups based on their history of hookah and cigarette smoking. The patients' prospectively collected data, including demographic features, healing time, and presence or absence of septal perforation during follow-up, were compared between these four groups. RESULTS: The entire cohort included 270 patients. The mean patient age was 29.2 ± 5.8 years. One hundred and thirty-two (48.9%) patients were non-smokers, 96 (35.5%) were cigarette smokers, 27 (10%) were hookah smokers and 15 (5.6%) consumed both tobacco products regularly. Mean healing time was 10 days, and septal perforation was encountered in 10 patients (3.7%). A comparison of the groups revealed that cigarette smoking did not impact septal perforation rates (P = .326) but prolonged the healing time. However, hookah smoking with or without cigarette smoking significantly influenced septal perforation rates and healing times. CONCLUSION: Patients should be questioned about hookah smoking in addition to cigarette smoking before the septoplasty procedure. Patients with a positive history of hookah smoking should be followed closely in terms of delayed healing and increased septal perforation rates.

Neutrophil-lymphocyte and platelet-lymphocyte ratios in otitis media with effusion in children: Diagnostic role and audiologic correlations.

AIM: To investigate the relationship between hearing loss and complete blood count parameters including neutrophil, lymphocyte, platelet (PLT), mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in children with otitis media with effusion (OME). MATERIALS-METHOD: The study group was formed by 244 paediatric patients who underwent ventilation tube placement because of OME, and was split into two groups as serous and mucoid. The control group included 112 individuals who have no hearing problems. Hearing levels were determined with pure tone audiometry in the study group, preoperatively, and control group. The blood parameters were compared between the serous, mucoid and control groups. The correlation analysis was performed between the blood parameters and hearing levels in the study group. The blood parameters were compared between the groups identified by hearing loss classification. FINDINGS: There were significant negative correlations between hearing levels and each of NLR, PLR and MPV. There were significant positive correlations between hearing levels and each of the lymphocyte and PLT. According to the receiver operating characteristic (ROC) curves, serous OME can be estimated with 68% sensitivity and 61% specificity by the NLR value more than 1.1, and 77% sensitivity and 77% specificity by the PLR value more than 102.4. The ROC curve revealed that slight hearing loss could be estimated with 70% sensitivity and 73% specificity by the NLR value more than 1.31, and 78% sensitivity and 77% specificity by the PLR value more than 102.4. CONCLUSION: The present study revealed that NLR and PLR values were valuable parameters in the diagnosis of serous OME and predicting a hearing loss. These parameters may provide additional information to the audiogram that could influence the therapeutic decision.

Cranial nerve involvement in COVID-19.

INTRODUCTION: The COVID-19 disease emerged in Wuhan province of China in November 2019 and spread across the world in a short time, resulting in a pandemic. The first case in Turkey was detected on March 11, 2020. The aim of the current study was to reveal the effects of COVID-19 on cranial nerves by monitoring people infected with the disease based on repeated examinations and surveys. MATERIAL AND METHOD: The data of 356 patients with a positive COVID-19 polymerase chain reaction (PCR) test who received treatment between June 2020 and August 2020 in our hospital were prospectively evaluated after the study was approved by the relevant ethics committee. RESULTS: Of the 356 patients included in the study, 47 under the age of 18 years were excluded due to their unreliable examination and anamnesis findings. In addition, seven patients that died while in hospital were excluded from the study due to the lack of examination and survey records during their hospitalization. The data of the remaining 302 patients were statistically analyzed. Symptoms of cranial nerve involvement were observed in 135 patients. CONCLUSION: The COVID-19 disease caused by the SARS-CoV2 virus commonly results in cranial nerve symptoms. The fact that these findings are more common and severe in COVID-19 than previous SARS and MERS outbreaks suggests that it has a more neurotrophic and more aggressive neuroinvasion. While the negative effects of the virus on sensory functions resulting from cranial nerve involvement are evident, motor functions are rarely affected.

Is Rhinoplasty Surgery a Risk Factor for Low Back Pain among Otorhinolaryngologists?

This study aimed to investigate the relationship between low back pain and performing rhinoplasty and presents the data related to the prevalence of low back pain among the otorhinolaryngologists included in a sample. The questionnaire prepared by the researchers was completed by volunteer otorhinolaryngologists who participated in the 22nd International Rhinocamp Congress. The questionnaire prepared to investigate low back problems contained items to obtain the demographic features of the participants, whether they were performing septorhinoplasty, how many years they had been performing this procedure, whether they had any problem (ache, pain, or discomfort) in the lumbar region, whether they had been hospitalized or had surgery due to this problem, low back pain frequency and intensity, and the presence of low back pathologies (e.g., protrusion, perforated disc, and bulging) detected by magnetic resonance imaging. The research was performed with the participation of 110 otorhinolaryngologists, of whom 37.3% (n = 41) were women and 62.7% (n = 69) were men, 79.1% (n = 87) were performing rhinoplasty surgery, and 69.1% (n = 76) had low back pain. Low back pain was reported in 72.4% (n = 63) of the doctors performing rhinoplasty and 56.5% (n = 13) of those who did not perform this surgery. There was a statistically significant relationship between the presence of low back pain and whether the doctors performed rhinoplasty surgery (χ2 = 4.151; p = 0.042 [< 0.05]). In addition, the complaints of low back pain were affected by the number of years the doctors had been performing rhinoplasty (p = 0.001 < 0.01). Low back pain was found to be frequent among otorhinolaryngologists performing rhinoplasty. Training, exercises, and performing the operation in a position that will prevent the occurrence of lower back pain can improve quality of life and minimize labor loss caused by pain among rhinoplasty surgeons.

Multiple cranial nerve injury in Ramsay Hunt Syndrome: a case report.

Herpes zoster oticus (Ramsay Hunt Syndrome) is characterized by facial nerve paralysis, ear pain and auricular skin rash. It occurs as a result of reactivation oflatent varicella zoster virus infection in the geniculate ganglion of the facial nerve. Major clinical symptoms include 7th nerve paralysis or cranial nerve paralysis and vesicles along the nerve with cocomitant ear pain. Other cranial nerve involvement although uncommon, can be found in some cases. In this study, a 74-year-old female patient had ipsilateral 8th, 9th and 10th cranial nerves injury. Cranial nerve paralysis accompanied with injury has been repor ted in R amsay Hunt Syndrome.

Effects of Anatolian Propolis and Hypertonic Saline Combination Nasal Spray on Allergic Rhinitis Symptoms: A Prospective, Multicenter Study.

Objectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P < .001). The mean total symptom score fell following treatment (P < .001): whilst the score was 11.09 ± 3.41 before administering Rhinapi; after administration, the average score was 6.23 ± 2.41. The mean QoL scores also altered after medication (P < .001), improving from a mean value of 6.44 ± 1.55 to a mean of 7.31 ± 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments.

Comparison of the histologic changes in conchae induced by radiofrequency thermal ablation and submucosal diathermy.

Objective of study was to determine the histological change induced in the conchae by submucosal diathermy and radiofrequency thermal ablation, two techniques used in the treatment of lower conchal hypertrophy, and to compare the two methods to each other. The study was performed on 15 rabbits. Radiofrequency was applied to the study animals in Group I (n = 5) and submucosal diathermy to Group II (n = 5), while Group III (n = 5) was the untreated control. The animals were decapitated 21 days after treatment and their conchae nasales ventrales excised on both sides. Histology slides were prepared and evaluated by light microscopy for ciliary loss, increase in submucosal vascularity, loss of goblet cells, inflammatory cellular infiltration, fibrosis and epithelial damage. The differences between Groups I and III were not significant regarding ciliary loss, increase in submucosal vascularity, loss of goblet cells and epithelial damage (p > 0.05), while the inflammatory cellular infiltration and fibrosis were significantly different between these groups (p < 0.05). As for the differences between Groups II and III, they were significant for each of the compared parameters (p < 0.05), while among Groups I and II they were significant for ciliary loss (p < 0.05), increase in submucosal vascularity, loss of goblet cells, inflammatory cellular infiltration and epithelial damage but not fibrosis (p > 0.05). Based on these findings, we can state that the use of radiofrequency thermal ablation causes less change in the normal conchal histology than submucosal diathermy application.

[Fibrous dysplasia of the frontal sinus: a case report]. / Frontal sinüste fibröz displazi: Olgu sunumu.

Fibrous dysplasia is a rare and indolent benign tumor of bone. Although it is a benign tumor, it has malignant transformation potential. Fibrous dysplasia can involve a single or multiple bones. The maxilla and mandible are the most common sites in the head and neck region. Paranasal sinus involvement is rare. Surgical excision is the preferred treatment of patients with symptomatic fibrous dysplasia. In this article, a 54-year-old male patient diagnosed with fibrous dysplasia of the frontal bone is presented.

Evaluation of the predictive role of neutrophil/lymphocyte ratio in the diagnosis of lymphoma in patients with asymptomatic and isolated cervical lymphadenopathy.

INTRODUCTION: The diagnostic approach to patients with isolated asymptomatic cervical lymphadenopathy varies between excisional biopsy and follow-up. When the anamnesis, physical examination, laboratory and imaging findings are not sufficient to identify the etiology, an excisional biopsy is performed for the differential diagnosis between early-stage lymphoma and infectious or reactive causes. If the excisional biopsy, which may have some complications, is not performed, it may delay the diagnosis of lymphoma. This diagnostic challenge could be avoided by predictive markers. OBJECTIVES: This study was planned to determine the predictive value of neutrophil/lymphocyte ratio in the diagnosis of Hodgkin and non-Hodgkin limphoma in patients with asymptomatic, isolated cervical limphadenopathy and underwent excisional biopsy. METHODS: A total of 90 patients between the years 2016-2019 admitted to our clinics due to asymptomatic isolated cervical lymphadenopathy, present in at least 4 weeks with lympho nodes in pathological dimensions persisting in the cervical region, were included to our study. An excisional lympho node biopsy was performed in all 90 patients. RESULTS: Of the 90 patients who underwent excisional biopsy; 34 were diagnosed as reactive lymphadenopathy 30 were non-Hodgkin linphoma, and 26 were Hodgkin linphoma. A total of 56 (62.2%) patients were diagnosed as lymphoma, either Hodgkin or non-Hodgkin, while 34 patients (38.8%) were diagnosed as reactive lymphadenopathy. The median age, total whiteblood count, neutrophil count of the lymphoma groups were significantly higher than reactive lymphadenopathy group, whereas the lymphocyte count was significantly lower in the lymphoma patients. The median neutrophil/ lymphocyte ratio was 1.7 in the reactive lymphadenopathy group, 3.5 in the non-Hodgkin limphoma group, and 3.0 in the Hodgkin limphoma group (p< 0.001). CONCLUSION: According to the results of our study, neutrophil/lymphocyte ratio was significantly higher in patients who were admitted with isolated asymptomatic lymphadenopathy and were diagnosed with lymphoma, and who were diagnosed with early-stage Hodgkin and non- Hodgkin lymphoma compared to those who were found to have reactive lymphadenopathy. Neutrophil/lymphocyte ratio, which is a low-cost, fast and easy-to-access test, has a predictive value in the diagnosis of lymphoma in patients with asymptomatic lymphadenopathy.

The results of hearing screening in refugee school children living in Sanliurfa /Turkey and the related risk factors.

OBJECTIVES: Determining the frequency of and the risk factors for hearing loss among school-age children by comparing the results of hearing screening in children from Syrian refugee and native Turkish population. METHODS: The results of the official hearing test, which was conducted by the Ministry of Health of the Republic of Turkey for schoolchildren in the first grade in the 2017-2018 academic year in the Province of Sanliurfa, were analyzed. RESULTS: A total of 23,664 children were screened; 20,603 (87.1%) were Turkish native, and 3,061 (12.9%) were Syrian refugees. The age range was between 69 and 84 months. The screening results indicated in Turkish children, sensorineural hearing loss (SNHL) in 0.26%, otitis media with effusion (OME) in 0.41%, and chronic otitis media (COM) in 0.08%. In the refugee children, the frequency of SNHL was 1.11%, OME was 0.94%, and COM was 0.62%. The rate of COM and SNHL was significantly higher in the refugee children (p < 0.001). Moreover, among those with hearing loss, the frequency of low birth weight, inflammatory diseases, and the family history of consanguineous marriage was significantly higher in refugee children compared to those in Turkish native population (p = 0.018, p = 0.003, and p = 0.022, respectively). CONCLUSION: Hearing loss is a major preventable and treatable cause of developmental disorder in childhood. When untreated, hearing loss may delay speaking and prevent socio-emotional development, leading to longterm negative consequences. We believe that programs for hearing screening in schoolchildren should be expanded and that immigrants who carry several risk factors for developmental hearing loss should be included in these programs.

Newborn hearing screening results: Comparison of Syrian and Turkish newborns; factors influencing the difference.

OBJECTIVES: This study aimed to compare the hearing screening results of Syrian and Turkish newborns and reveal the risk factors faced by Syrian refugees. METHODS: The neonatal hearing screening results of newborns born in, or admitted to, the Sanliurfa Research and Education Hospital, Sanliurfa/Turkey, between January 01, 2018, and December 31, 2018, were analyzed. Newborns with congenital anomalies and syndromes were excluded from the study. Also, the neonatal hearing screening results and risk factors of newborns diagnosed with hearing loss were analyzed. RESULTS: A total of 6034 Syrian and 37,219 Turkish newborns were included in the study. Hearing loss was found in 84 (0.2%) of 37,219 Turkish newborns and 26 (0.4%) of 6034 Syrian newborns. In this study, the risk factors such as consanguineous marriages, familial hearing loss, hospitalization in intensive care, prematurity, low birth weight (less than 1500 g), hyperbilirubinemia, use of ototoxic drugs, history of congenital infection, blood incompatibility, and trauma at birth were found in newborns with hearing loss. The risk factors were present in 41.7% of Turkish newborns and 65.4% of Syrian newborns with hearing loss. CONCLUSIONS: The high hearing loss rates found in Syrian newborns showed how accurate it was to include the Syrian migrants born in Turkey into the neonatal hearing screening program and the newborns with hearing loss into appropriate rehabilitation programs. Further studies should focus on the risk factors faced by Syrian migrants so that the number of Syrian newborns with hearing loss can be reduced.

Avaliação do papel preditivo da relação neutrófilos/linfócitos no diagnóstico de linfoma em pacientes com linfadenopatia cervical assintomática e isolada / Evaluation of the predictive role of neutrophil/lymphocyte ratio in the diagnosis of lymphoma in patients with asymptomatic and isolated cervical lymphadenopathy

Resumo Introdução: A abordagem diagnóstica de pacientes com linfadenopatia cervical assintomática isolada varia entre biópsia excisional e o simples seguimento. Quando a anamnese, o exame físico, os achados laboratoriais e de imagem não são suficientes para identificar a etiologia, faz-se uma biópsia excisional para o diagnóstico diferencial de linfoma em estágio inicial ou causas infecciosas ou reativas. Se a biópsia excisional, a qual pode incorrer em algumas complicações cirúrgicas, não é feita, isso pode gerar atraso no diagnóstico de linfoma. Esse desafio diagnóstico pode ser evitado com o uso de marcadores preditivos. Objetivos: Determinar o valor preditivo da relação neutrófilos/linfócitos no diagnóstico do linfoma Hodgkin e não Hodgkin em pacientes com linfadenopatia cervical assintomática isolada e submetidos à biópsia excisional. Método: Foram incluídos no estudo 90 pacientes entre 2016 a 2015 admitidos em nossa clínica com linfadenopatia cervical assintomática isolada, presente por pelo menos 4 semanas, com linfonodos patológicos persistentes na região cervical. Biópsia excisional de linfonodo foi feita em todos os 90 pacientes. Resultados: Dos 90 pacientes submetidos à biópsia excisional, 34 apresentaram linfadenopatia reativa, dos quais 30 tinham linfoma não Hodgkin e 26 linfoma Hodgkin. Foram diagnosticados 56 pacientes com linfoma (62,2%), tanto Hodgkin quanto não Hodgkin, e 34 pacientes (38,8%) foram diagnosticados com linfadenopatia reativa. A mediana da idade, a contagem total de leucócitos e a contagem de neutrófilos dos grupos com linfoma foram significantemente maiores do que no grupo linfadenopatia reativa, enquanto a contagem de linfócitos foi significantemente menor nos pacientes com linfoma. A mediana da relação neutrófilos/linfócitos foi de 1,7 no grupo linfadenopatia reativa, 3,5 no grupo não Hodgkin e 3,0 no grupo Hodgkin (p < 0,001). Conclusão: A relação neutrófilo/linfócito foi significantemente maior em pacientes admitidos com linfadenopatia assintomática isolada e com diagnóstico de linfoma e com diagnóstico de linfoma Hodgkin e não Hodgkin em estágio inicial em comparação com aqueles que apresentaram linfadenopatia reativa. A relação neutrófilo/linfócito, um teste de baixo custo, rápido e de fácil acesso, tem um valor preditivo no diagnóstico de linfoma em pacientes com linfadenopatia assintomática.

Giant ulcerative dermatofibroma.

Dermatofibroma is a slowly growing common benign cutaneous tumor characterized by hard papules and nodules. The rarely seen erosions and ulcerations may cause difficulties in the diagnosis. Dermatofibrosarcoma protuberans, which is clinically and histopathologically of malignant character, displays difficulties in the diagnosis since it has similarities with basal cell carcinoma, epidermoid carcinoma, and sarcomas. Head and neck involvement is very rare. In this study, a giant dermatofibroma case, which is histopathologically, ulcerative dermatofibroma, the biggest lesion of the head and neck region and seen rarely in the literature that has characteristics similar to dermatofibrosarcoma protuberans, has been presented.