Oncological Outcomes of Transoral Laryngeal Microsurgery with Fiber-Optic Diode Laser for Early Glottic Cancer: A Single-Center Experience.

Backgroud/Objectives: Transoral laser laryngeal microsurgery (LTLM) has been widely used in the treatment of early-stage glottic laryngeal squamous cell carcinoma (LSCC) for the past few decades. Although T stage, tumor grade, anterior commissure involvement, type of cordectomy, positive surgical margin, and postoperative additional therapies were accused as the prognostic factors for recurrence, there is still controversy about these data in the literature. The purpose of this study was to evaluate the oncological results of our patients with early glottic LSCC treated with LTLM as a single-modality therapy in a single-center study. METHODS: Patients with early-stage (Tis-1-2/N0) glottic LSCC who underwent LTLM as a primary treatment from 2011 to 2019 were retrospectively reviewed. The clinicopathological factors and oncologic outcomes were analyzed. RESULTS: One hundred and sixty-one patients were enrolled in this study. The 5-year overall (OS), disease-specific (DSS), disease-free (DFS), and laryngectomy-free survival rates were 84.5%, 97.9%, 79.2%, and 93.5%, respectively. The most common stage, histopathological type, and type of endoscopic cordectomy were T1 stage, well-differentiated cancer, and type 2 cordectomy, respectively. A positive surgical margin was defined in 20 (12.4%) patients. There was a significant relationship between histopathological grade and positive surgical margins (p = 0.038). OS and DSS rates of "wait and see" modality were lower, while DFS of radiotherapy was lower than that of other treatment modalities in patients with positive surgical margins, but the differences were not statistically significant. Nineteen (11.8%) patients had a recurrence. DSS was statistically significantly lower in patients with recurrence (p < 0.001). CONCLUSION: The results of our study showed that anterior commissure involvement, surgical margin positivity, and higher T stage statistically did not reduce survival rates in early-stage LSCC patients treated with LTLM. As the histopathological grade of the tumor worsens, the risk of surgical margin positivity increases. RT may have a negative effect on recurrence and organ preservation in the additional treatment of patient with positive surgical margins.

Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part I: Management, Diagnosis, and Follow-up.

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics.

Evaluation of Swallowing Function according to the Stage of Alzheimer's Disease.

BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disease, and swallowing difficulties may occur as the disease progresses. Dysphagia has many consequences, such as aspiration and pneumonia. In particular, in the advanced stage, approximately 70% of the causes of death in AD involve aspiration pneumonia. Therefore, it is vital to assess the presence or absence of dysphagia in AD. OBJECTIVE: This study aims to describe swallowing difficulty across the stages of AD. METHODS: Thirty-five AD patients were evaluated. The Mini-Mental State Examination was conducted. A bedside water swallow test (BWST) and the Eating Assessment Tool (EAT-10) were administered. Finally, fiberoptic endoscopic evaluation of swallowing was used to evaluate residual, aspiration and penetration conditions. RESULTS: EAT-10 scores, BWST results, and penetration-aspiration status were statistically significantly different according to AD stage (p < 0.05). Among all patients, 74.3% had residue, 25.7% had penetration, and 2.9% had aspiration. CONCLUSIONS: This study has demonstrated that swallowing dysfunction begins at a mild stage and progressively worsens toward the advanced stage in patients with AD. At all stages of AD, residue was observed, and this poses a risk for the development of penetration-aspiration. Therefore, it is necessary to evaluate the early dysphagia of individuals.

Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part II: Rehabilitation.

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diagnosis, follow-up, and rehabilitation methods, but also includes detailed algorithms for these topics. The recommendation paper has been written by a multidisciplinary team and offers 117 recommendations for stroke patients with dysphagia. While focusing on management principles, diagnosis, and follow-up in the 1st part (45 items), rehabilitation details were evaluated in the 2nd part (72 items).

Impact of fetal brain tissue derived mesenchymal stem cell and fibrin glue on facial nerve crash injury

Background/aim: To evaluate the clinical and histopathological effects of fetal brain tissue derived mesenchymal stem cells (FBTMSC) and fibrin glue (FG) on the facial nerve (FN) regeneration in rats with traumatic FN injury. Materials and methods: Twenty-eight Sprague Dawley rats were included in the study and divided into 4 groups. Traumatic FN injury (FP) was created by a surgical clamp compression to the main trunk of left FN in all groups. In the control group (group 1) no treatment was applied, in group 2 (FBTMSC group) 2 × 106 FBTMSC was injected, in group 3 (FG group) only FG was applied, in group 4 (FBTMSC and FG groups) both FBTMSC and FG were applied to the injured section of the nerve. The FN functions were evaluated clinically, immediately after the procedure and at 3rd, 5th, and 8th weeks postoperatively. The FNs of all subjects were excised after the 8th week; then the rats were sacrificed. The presence of stem cells in the injured zone was assessed using bromo-deoxyuridine (BrdU), and apoptosis was determined by the TUNEL method. Results: After the damage, total FP was observed in all subjects. Statistically significant functional improvement was observed in group 4 compared to all other groups (P < 0.005). TUNEL-positive cell count was statistically significantly higher in the control group than the other groups (P < 0.001). TUNEL-positive cell count was statistically significantly lower in group 4 than the other groups. The proportion of BrdU-stained cells in group 4 (5%) was higher than group 2 (2%). Conclusion: Clinically and histopathologically FBTMSC applied with FG may play a promising role as a regenerative treatment in posttraumatic FP.

Lobectomy may not be suitable for patients with follicular neoplasm cytology

Background/aim: The most appropriate surgical management of follicular neoplasm/suspicious for follicular neoplasm (FN) lesions is still contradictory. We aimed to evaluate the data of our patients with follicular neoplasm treated with thyroidectomy. Materials and methods: We retrospectively analyzed the data of 74 patients who were diagnosed with follicular neoplasm cytology (FN cytology) by fine needle aspiration biopsy (FNAB) and had undergone total thyroidectomy or lobectomy with isthmectomy (LwI). Results: We examined a total of 74 patients, of which 64 (83.7%) were female and 10 (16.3%) were male. The malignancy rate in the pathological examinations of these patients was 31/74 (41.9%). The most common cancer among the patients with malignancy was papillary thyroid carcinomas (PTC) (20/31, 65%). Among the subtypes of PTCs, 11 were classical PTC, 5 were a follicular variant of PTC, 2 were the oncocytic variant of PTC, 1 was the diffuse sclerosing variant, and 1 was a columnar cell variant of PTC. Conclusion: Since most FN cytology has been pathologically diagnosed with papillary cancer and some papillary cancer subtypes have been unfavorable pathologically, total thyroidectomy should be the most suitable treatment option in this group. Lobectomy with LwI is not suitable for patients with FNAB-proven FN cytology.

Addition of intratympanic steroid or hyperbaric oxygen treatment to systemic steroid treatment in sudden idiopathic sensorineural hearing loss treatment, and long-term results of salvage treatment

Background/aim: This study aims to determine the therapeutic superiority of the addition of intratympanic steroid or hyperbaric oxygen therapy to systemic steroid treatment in idiopathic sudden sensorineural hearing loss as initial treatment, and evaluate the long- term results of salvage treatment. Materials and methods: This study was a retrospective clinical trial with a total of 96 patients with idiopathic sudden sensorineural hearing loss. Patients were divided into 3 groups. Group 1 (n: 32) received systemic steroid treatment. Group 2 (n: 32) received the Group 1 protocol plus intratympanic steroid treatment. Group 3 (n: 32) received the Group 1 protocol plus hyperbaric oxygen treatment. Pretreatment and postinitial audiologic evaluations were performed, and the hearing outcome was analyzed with Furuhashi criteria. All patients, except those who experienced total recovery after initial treatment, were directed to salvage treatment. Audiologic assessment was performed again after salvage treatment and a mean follow-up period of 36.5 months. Results: Each group was homogenous according to demographics, audiologic data, and prognostic factors. There was no statistically significant difference in recovery and success rate within the 3 groups after initial treatment. (P: 0.66, P: 0.248, respectively). Successful results were obtained after salvage treatment in only 3 patients (5%). These patients received follow-up treatment at a mean of 36.5 months, but there was no spontaneous recovery after the end of salvage treatment. Conclusion: The addition of intratympanic steroids or hyperbaric oxygen to systemic steroids caused no significant hearing improvement as the initial treatment of idiopathic sudden sensorineural hearing loss. The efficacy of salvage treatment was limited, and there was no spontaneous hearing improvement after the long-term follow-up.

Do CO2 and oxidative stress induce cancer?: a brief study about the evaluation of PON 1, CAT, CA and XO enzyme levels on head and neck cancer patients.

Head and neck cancer (HNC) is one of the most common malignancies in the world. HNC is a group of cancers that starts in the mouth, nose, throat, larynx, sinuses, or salivary glands. According to this section of the body parts; induction of cancer can be associated with CO2 and oxidative stress. The aim of this study is to assess the activities of carbonic anhydrase (CA), catalase (CAT), paraoxonase1 (PON1), and xanthine oxidase (XO) activities in 89 HNC patients and 115 healthy volunteers. Paraoxonase1 activity was found lower in HNC cancer patients. There is no statistically significant difference between patients and controls for catalase, carbonic anhydrase, and xanthine oxidase enzyme levels. According to this results, paraoxonase1 levels could be a candidate as an oxidative marker in HNC patients, but further studies are needed to investigate the other type of cancer related PON1 and the other enzyme levels.

Endovascular management of the carotid blowout syndrome: a single-center experience.

PURPOSE: It is aimed to present endovascular treatment of carotid blowout syndrome (CBS) in patients with head and neck cancer. METHODS: A retrospective review was performed on patients with carotid blowout syndrome between 2012 and 2018 in our hospital. A total of ten patients with prior history of head and neck cancer surgery and radiation therapy were investigated with clinical, postoperative and follow-up findings as well as technical outcome. Digital subtraction angiography of the carotid arteries was performed in all the cases for the diagnosis of the source of bleeding. Detachable coils and covered stents were used in endovascular treatment of carotid blowout syndrome. After the procedures, all patients were admitted to the intensive care unit for the follow-up of both hemodynamic and neurologic conditions. RESULTS: Thirteen diagnostic and endovascular treatment sessions were performed in 10 patients. Seven patients had major surgery for head and neck cancer and all patients were treated with chemoradiotherapy. Head and neck cancers in seven of the ten patients were persistent and pharyngocutaneous fistula developed in five patients. Two patients had impending CBS and eight patients had acute CBS. A total number of 19 vascular lesions in 10 patients were detected and 4 patients had multiple lesions. In three patients, additional endovascular treatment of stent-graft deployment had required due to recurrent hemorrhage after a mean time of 5.33 days (range 1-11 days). CONCLUSIONS: As a conclusion, covered stent application with or without coil embolization is a safe and efficient technique in treatment of CBS secondary to head and neck cancers.

Preparation and characterization of novel albumin-sericin nanoparticles as siRNA delivery vehicle for laryngeal cancer treatment.

Small interfering RNA (siRNA)-based gene silencing strategy has high potential on suppressing specific molecular targets, involved in cancer progression. However, the lack of an effective nanocarrier system that safely delivers siRNA to its target still limits the clinical applications of siRNA. This study aimed to develop albumin-sericin nanoparticles (Alb-Ser NPs) as a novel siRNA delivery system for laryngeal cancer treatment. Nanoparticle formulations composed of albumin and sericin at different ratios (1:1, 2:1, 1:2 w/w) were synthesized by desolvation method. The nanoparticles were modified with poly-L-lysine (PLL) for siRNA binding and decorated with hyaluronic acid (HA) to target laryngeal cancer cell line, Hep-2. HA/PLL/Alb-Ser NPs were individually loaded with siRNAs for casein kinase 2 (CK2), Absent, Small, or Homeotic-Like (ASH2L), and Cyclin D1 genes, which are overexpressed in Hep-2 cells. Downregulation of genes was confirmed by real-time PCR (RT-PCR). Size, morphological, and thermogravimetric characterizations revealed that Alb-Ser NPs having 2:1 (w/w) ratio are the most optimized formulation. Between 36.8 and 61.3% of siRNA entrapment efficiencies were achieved. HA/PLL-siRNA/Alb-Ser (2:1) NPs-mediated gene silencing resulted in a significant inhibition of cell growth and induction of apoptosis in cells. Our findings showed that HA/PLL/Alb-Ser (2:1) NPs were promising as a siRNA carrier.

The psychometric evaluation of the Turkish version of the Mann Assessment of Swallowing Ability in patients in the early period after stroke

Background/aim: The Mann Assessment of Swallowing Ability (MASA) is an efficient tool that allows physicians to determine the alertness, cooperation, and respiration of patients, which are important factors when assessing swallowing . This study aimed to translate the MASA into Turkish (T-MASA) and to assess its reliability and validity in patients during the early period after a stroke . Materials and methods: The scale was administered to 141 patients in the early period after a stroke. For reliability, both internal consistency (Cronbach's alpha and corrected item-to-total correlations) and interrater reliability were analyzed. The procedures were scored by two blinded independent expert observers. The validity was assessed using the convergent validity. The cut-off value of the T-MASA for dysphagia was accepted as 169 points. The correlation between the MASA and endoscopic evaluation was evaluated. Results: The T-MASA showed good internal consistency using Cronbach's alpha (0.899­0.901) and corrected item-to-total correlations. In addition, the intraclass correlation coefficient scores indicated excellent agreement. A significant moderate negative correlation was found between endoscopic evaluation and the T-MASA in terms of the presence of dysphagia (r: ­0.324, r: ­0.302, respectively, and both P = 0.001) Conclusion: Our results suggest that the Turkish version of the MASA is a valid and reliable instrument when determining dysphagia in patients in the early period after a stroke.

The need of prophylactic central lymph node dissection is controversial in terms of postoperative thyroglobulin follow-up of patients with cN0 papillary thyroid cancer.

PURPOSE: The objective of this study was to investigate whether prophylactic central lymph node dissection (pCLND) facilitates postoperative thyroglobulin (Tg) follow-up in the patients with papillary thyroid carcinoma (PTC). We also questioned whether radioactive iodine (RAI) remnant ablation provides any further advantage in this regard. METHODS: The records of patients with low-intermediate risk PTC who underwent either only total thyroidectomy (TT) or TT in conjunction with pCLND were reviewed. Adjuvant RAI ablation was performed depending on tumor diameter, multifocality, the presence of positive lymph nodes and adverse histopathologic features. Pre-ablative and post-ablative Tg levels, post-operative complications and clinico-pathological characteristics were compared between the two groups (TT alone and TT with pCLND). RESULTS: Among the 302 patients, TT was performed in 140 (46.4%) and TT with pCLND in 162 (53.6%). More than half of all patients in both groups had papillary microcarcinoma (58.0% and 53,1%, respectively). Postoperatively, the median preablative Tg level was higher in the TT only group than that of the TT with pCLND group (0.96 vs 0.27 ng/ml, respectively). The post-ablative Tg levels were undetectable in both groups at the last follow-up visit. Also, a subgroup of patients (19.5%) who did not receive RAI ablation all became athyroglobulinemic at one year after surgery. CONCLUSIONS: Although performing pCLND with TT seems to have an advantage over TT alone as to achieve lower Tg levels in the early post-operative period, Tg levels become comparable following RAI ablation. On the other hand, the patients who have not been treated with adjuvant RAI ablation, also became athyroglobulinemic regardless of the surgical method.

Laryngeal electromyographic changes in postthyroidectomy patients with normal vocal cord mobility.

Thyroidectomy has been used for the treatment of thyroid disease for more than 100 years. In spite of the advancement of surgical techniques, there is still a risk of laryngeal nerve injury. The risk of partial or complete injury still depends on some surgical and disease-related factors. The aim of this study is to show the partial injury and to establish these risk factors via laryngeal electromyographic analysis (LEMG) in postthyroidectomy patients with normal vocal cord motion and mucosal anatomy. Patients who had undergone thyroid surgery were enrolled in this prospective study. LEMG analysis was performed to all patients with normal vocal cord mobility preoperatively and was repeated after the first and the third months of surgery. Thyroarytenoid (TA) and cricothyroid (CT) muscles were used to evaluate recurrent and external branch of superior laryngeal nerves, respectively. Four of the 32 patients had mild-to-moderate degrees of partial LEMG changes during preoperative LEMG analysis of TA and CT muscles on each side. After 3 months of surgery, there was a statistically significant worsening of LEMG findings in the right and left external branches of superior and left recurrent laryngeal nerves. Disease and surgery-related risk factors were analyzed. However, there was no significant relationship on the progression of LEMG findings according to these parameters. This is the first prospective study which supports the risk of progression of LEMG changes in patients with normal laryngoscopic examination after thyroid surgery. No reliable significant risk factor was found influencing the LEMG progression.

The effect of sensory level electrical stimulation of the masseter muscle in early stroke patients with dysphagia: A randomized controlled study.

BACKGROUND: Dysphagia is a serious cause of morbidity and mortality in stroke patients. AIMS: As the first study in literature, we aimed to evaluate the effects of sensory-level electrical stimulation (SES) to bilateral masseter muscles in early stroke patients with dysphagia. SETTINGS AND DESIGN: This study was conducted at the Physical Medicine and Rehabilitation Clinic of our hospital between 2013 and 2015. MATERIALS AND METHODS: Ninety-eight patients with dysphagia within the first month after ischemic stroke were included in this study. Patients were evaluated by bedside screening tests (Bedside Dysphagia Score, Neurological Examination Dysphagia Score, Total Dysphagia Score, and Mann Assessment of Swallowing Ability test) and by flexible fibreoptic endoscopic evaluation of swallowing (FEES) methods. All patients were included in a traditional swallowing therapy. Patients were divided into two groups, namely the "stimulation group" and "sham group." SES was applied to bilateral masseter muscles. Evaluation parameters were compared between the groups before and after therapy. STATISTICAL ANALYSIS: The Friedman test, Wilcoxon Signed Rank test, Mann-Whitney U test, and Fisher exact test were used in this study. RESULTS: There was a significant improvement in dysphagia severity scores evaluated by bedside screening tests and FEES in cognitive and total functionality levels except in motor functional independence level in the stimulation group. In the sham group, there were no significant changes in the evaluation parameters. CONCLUSION: SES applied to bilateral masseter muscles may provide an effective treatment for both dysphagia and cognitive function in early stroke patients.

Protective/restorative Role of the Adipose Tissue-derived Mesenchymal Stem Cells on the Radioiodine-induced Salivary Gland Damage in Rats.

BACKGROUND: To analyze protective/regenerative effects of adipose tissue-derived mesenchymal stem cells (ADMSC) on 131I-Radioiodine (RAI)-induced salivary gland damage in rats. MATERIALS AND METHODS: Study population consisted of controls (n:6) and study groups (n:54): RAI (Group 1), ADMSC (Group 2), amifostine (Group 3), RAI+amifostine (Group 4), concomitant RAI+ADMSC (Group 5) and RAI+ADMSC after 48 h (Group 6). We used light microscopy (LM), transmission electron microscopy (TEM), and salivary gland scintigraphy (SGS), and analyzed data statistically. RESULTS: We observed the homing of ADMSC in salivary glands at 1st month on LM. RAI exposure affected necrosis, periductal fibrosis, periductal sclerosis, vascular sclerosis and the total sum score were in a statistically significant manner (P < 0.05). Intragroup comparisons with LM at 1st and 6th months revealed statistically significant improvements in Group 6 (P < 0.05) but not in Groups 4 and 5. Intergroup comparisons of the total score showed that Groups 4 and 5 in 1st month and Group 6 in 6th month had the lowest values. TEM showed vacuolization, edema, and fibrosis at 1st month, and an improvement in damage in 6th month in Groups 5 and 6. SGSs revealed significant differences for the maximum secretion ratio (Smax) (P = 0.01) and the gland-to-background ratio at a maximum count (G/BGmax) (P = 0. 01) at 1st month, for G/BGmax (P = 0.01), Smax (P = 0.01) and the time to reach the maximum count ratio over the time to reach the minimum count (Tmax/Tmin) (P = 0.03) at 6th month. 1st and 6th month scans showed differences for Smax and G/BGmax (P = 0.04), but not for Tmax/Tmin (p > 0.05). We observed a significant deterioration in gland function in group 1, whereas, mild to moderate deteriorations were seen in protective treatment groups. CONCLUSIONS: Our results indicated that ADMSC might play a promising role as a protective/regenerative agent against RAI-induced salivary gland dysfunction.

Satisfaction and compliance of adult patients using hearing aid and evaluation of factors affecting them.

The aims of this study are to reveal patient compliance and satisfaction in hearing aid-prescribed adult population and to determine the relevant clinical factors. The study was designed retrospectively, and those patients who have been using hearing aid for at least 6 months were invited for evaluation. Demographical data, hearing aid type (digital vs analog), general satisfaction, and daily usage time were asked. Then, the Hearing Aid Satisfaction Questionnaire (HASQ) was applied to all patients which included visual analog scale (VAS)-based 10 questions about the effects of hearing aid on social communication, efficiency, cosmetics, life quality and cost. Totally 400 patients were included in the study. The HASQ was confirmed to be highly reliable by "Kaiser Meyer Olkin and Bartlett Sphericity" tests after exclusion of aid-cost question. There was a negative correlation between age and satisfaction, and a positive correlation between hearing aid usage time (years) and satisfaction (p < 0.05). There was no significant difference between mean HASQ scores regarding gender, employment status, hearing aid type and the site of hearing aid wearing. HASQ scores were significantly worse in pure sensorineural loss type, lower educational status, shorter daily usage time, but better in higher pure tone threshold levels (p < 0.05). Age, time of hearing aid usage daily, type of hearing impairment, the threshold of hearing and education were the factors affecting satisfaction. Regular daily usage of hearing aid should be encouraged in patients, since by this way aid usage and satisfaction may be improved.

Risk Factors and Prognosis for Myoepithelial Carcinoma of the Major Salivary Glands.

BACKGROUND: The clinical behavior and treatment outcomes of salivary gland myoepithelial carcinoma have yet to be clearly defined. The current study investigated risk factors and prognoses for this tumor. METHODS: A retrospective review of the medical records for 32 patients with myoepithelial carcinoma of the major salivary glands was performed. Their clinical parameters were assessed to identify correlations with local-regional recurrence, distant metastasis, and survival. RESULTS: The 5-year survival rate was 71 %. Of the reviewed patients, 41 % had local-regional recurrences, and 22 % had distant metastases. Age of 60 years or younger was a predictive factor for distant metastasis. Patients with neck lymph nodes clinically positive for carcinoma had shorter overall survival durations than those with nodes negative for carcinoma. CONCLUSIONS: Myoepithelial carcinoma of the major salivary glands is characterized by a high incidence of local-regional recurrence and distant metastasis. Adjuvant therapy is indicated for selected patients with high-risk disease.

Association between XRCC3 Thr241Met polymorphism and laryngeal cancer susceptibility in Turkish population.

DNA repair systems are essential for normal cell function. Genetic alterations in the DNA repair genes such as X-ray repair cross-complementing group 3 (XRCC3), can cause a change in protein activity which results in cancer susceptibility. The aim of this study was to investigate the association of XRCC3 Thr241Met single nucleotide polymorphism (SNP), smoking and alcohol consumption with the risk of laryngeal cancer in Turkish population. The frequencies of Thr241Met SNP were studied in 58 laryngeal cancer cases (SSC) and 67 healthy individuals. Genomic DNA was isolated from peripheral blood samples of both controls and laryngeal cancer cases. Thr241Met SNP was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The genotype and allele frequencies of Thr241Met polymorphism were not statistically significant between the laryngeal cancer and control groups. Carrying mutant allele was not associated with the risk of laryngeal cancer. On the other hand, smoking and chronic alcohol consumption were associated with the risk of laryngeal cancer but there is no association between Thr241Met, smoking and alcohol consumption in laryngeal cancer cases. These results indicate that Thr241Met polymorphism was not associated with the development of laryngeal cancer in Turkish population. However, it should be kept in mind that the association of a polymorphism with cancer susceptibility can differ due to several factors such as cancer type, selection criteria, ethnic differences and size of the studied population.

Detection of XRCC1 gene polymorphisms in Turkish head and neck squamous cell carcinoma patients: a comparative analysis with different populations.

PURPOSE: X-ray repair cross-complementing (XRCC1) is one of the most important genes for the maintenance of genomic integrity and protection of cells from DNA damage. Although tobacco and alcohol consumption are the major risk factors for the development of head and neck squamous cell carcinoma (HNSCC), sequence variation in XRCC1 gene may alter HNSCC susceptibility. Reports on the relationship between HNSCC and polymorphisms in XRCC1 gene have been inconsistent so far. The aim of this study was to investigate the association of XRCC1 Arg194Trp and Arg399Gln single nucleotide polymorphisms (SNP), smoking and alcohol consumption with the risk of HNSCC in Turkish population and also to compare to these results with the ones from both Turkish and different populations in the literature. The frequencies of Arg194Trp and Arg399Gln SNPs were studied in 55 HNSCC and 69 healthy individuals. METHODS: Genomic DNA was isolated from peripheral blood and SNP was genotyped by PCR-RFLP method. RESULTS: The genotype and allele frequencies of both polymorphisms were not statistically different between the HNSCC and control groups. On the other hand, smoking and chronic alcohol consumption were associated with risk of HNSCC, but there was no association between Arg194Trp, Arg399Gln polymorphisms, smoking and alcohol consumption in HNSCC cases. CONCLUSION: These results indicate that both Arg194Trp and Arg399Gln polymorphisms were not associated with the development of HNSCC in Turkish population. In addition, the allele frequencies of polymorphisms were in line with other Turkish population results that were studied previously. However, compared to different populations, there were marked differences in allele frequencies.

Permanent central diabetes insipidus as a complication of sphenoid sinus mucocele.

Although mucocele is a benign lesion, its unavoidable expansions may result in irreversible damages in adjacent organs. In spheno-ethmoid mucoceles which are extremely rare, this condition may cause more severe problems. Central diabetes insipidus, developed secondary to sphenoid sinus mucocele, was detected in a 54-year-old male patient, who underwent endoscopic sinus surgery 2 times due to nasal polyposis. Endoscopic sphenoid mucocele marsupialization was performed to the patient, but despite partial regression in the 1-year follow up, complete recovery was not observed.