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.

Primary triple head and neck tumors: Laryngeal squamous cell carcinomas, Kaposi's sarcoma, and non-Hodgkin's lymphoma.

Simultaneously triple head and neck malignancies are extremely rare. We report a case who had epithelial and mesenchymal malignant tumor with lymphoid malignancy in head and neck area. A patient who is 74 year old male patient presented to the otorhinolaryngology department with severe breathing difficulty due to laryngeal mass. The result of laryngeal biopsy was invasive SCCs, so patient underwent total larygectomy and bilateral level 2,3,4 neck disection operation. Primary 3 different type head and neck tumors were observed with histopathological examination. These were orderly invasive SCCs in larynx, B-cell Non-Hodgkin's lymphoma in tongue root and one lymph node of left neck dissection material, Kaposi's sarcoma in one lymph node of right neck dissection material. Although synchronous head and neck tumors occurs very rare with laryngeal carcinoma, the neck dissection materials should be researched for synchronous tumors.

Single-sided sinonasal mass: A retrospective study.

OBJECTIVE: A unilateral sinonasal mass is a common pathology in ear, nose, and throat clinical practice. However, it may be confused with early stage inflammatory pathologies. The aim of this study was to examine the diagnostic histopathological, clinical, and radiological criteria for a unilateral nasal mass. METHODS: The present study examined the clinical and pathological profiles of unilateral sinonasal masses observed in patients at an ear, nose, and throat clinic in Istanbul between January 2008 and January 2016. During the period of this retrospective study, 195 patients presented with a single-sided sinonasal mass (males: 130, females: 65; age range: 9-93 years). The data analyzed were obtained from patient records. RESULTS: The single-sided sinonasal mass was benign in 187 (95.9%) cases and malignant in 8 (4.1%) cases. Inflammatory polyps (81.03%) were the most frequent benign finding. Squamous cell carcinoma (1.54%) was the most commonly diagnosed malignant lesion. CONCLUSION: A single-sided sinonasal mass is commonly detected by otorhinolaryngologists. Although most often the diagnosis is inflammatory nasal polyposis, the risk of malignancy should not be overlooked. For this reason, careful endoscopic examination should be performed, all lesions should undergo a pathological examination, and it should be kept in mind that neoplastic disease can occur at any age and may be associated with many symptoms.

A Case of Cranial Meningioma with Symptoms Similar to Nasopharyngeal Mass.

Meningiomas are generally slow-growing benign tumors associated with the dura. They form lumps that mostly grow extra-axially, by repulsing, rather than infiltrating the surrounding neural parenchyma. Majority of meningiomas are intracranial. However, although rare, meningioma formation has been reported in almost all other organs. We report the case of a patient with an extra-neuraxial meningioma presenting as a nasopharyngeal mass.

Assessment of adenosine deaminase (ADA) activity and oxidative stress in patients with chronic tonsillitis.

To emphasize the effectiveness of adenosine deaminase (ADA) enzyme, which has important roles in the differentiation of lymphoid cells, and oxidative stress in patients with chronic tonsillitis. Serum and tissue samples were obtained from 25 patients who underwent tonsillectomy due to recurrent episodes of acute tonsillitis. In the control group, which also had 25 subjects, only serum samples were taken as obtaining tissue samples would not have been ethically appropriate. ADA enzyme activity, catalase (CAT), carbonic anhydrase (CA), nitric oxide (NO) and malondialdehyde (MDA) were measured in the serum and tissue samples of patients and control group subjects. The serum values of both groups were compared. In addition, the tissue and serum values of patients were compared. Serum ADA activity and the oxidant enzymes MDA and NO values of the patient group were significantly higher than those of the control group (p < 0.001), the antioxidant enzymes CA and CAT values of the patient group were significantly lower than those of the control group (p < 0.001). In addition, while CA, CAT and NO enzyme levels were found to be significantly higher in the tonsil tissue of the patient group when compared to serum levels (p < 0.05), there was no difference between tissue and serum MDA and ADA activity (p > 0.05). Elevated ADA activity may be effective in the pathogenesis of chronic tonsillitis both by impairing tissue structure and contributing to SOR formation.

Psychopathological dimensions of tinnitus and psychopharmacologic approaches in its treatment.

BACKGROUND: The aim of this review to investigate presence of psychopathological states and efficacy of psychopharmacological drugs in the treatment of tinnitus. MATERIALS AND METHODS: An extensive Internet search has been performed for this aim through PubMed by using related key words in English. RESULTS: Higher anxiety and depression levels and somatoform disorder clusters are defined in patients with tinnitus. Additionally, impulsivity, hostility, demanding, physical discomfort, anxiety for health, emotionality and suicidal tendency are also defined in these people. Personality characteristics in these patients are depression, hysteria and hypochondriac features. Besides these symptom clusters, more severe psychopathologies like personality disorders may be encountered in these patients. Sertraline, paroxetine and nortriptyline can be considered as the first-line antidepressants in the psychopharmacological treatment of tinnitus. There are studies which have reported the efficacy of sulpiride. Carbamazepine, valproate and gabapentin can be effective as mood stabilizers. Short-acting benzodiazepines like alprazolam and midazolam are effective in signs of anxiety. Clonazepam and diazepam can be evaluated as other options. However, some glutamate receptor antagonists also can be used in the treatment of tinnitus. Disturbed sleep is frequently associated with tinnitus. Sleep disturbance can disrupt the quality of life in the patients with tinnitus. These patients might benefit from cognitive-behavioral therapy, which offers the promise of relief from tinnitus-related distress and insomnia. CONCLUSION: When pathophysiologic reasons are excluded, it should be at least considered that tinnitus is exaggerated by psychopathological symptoms. Life quality of patients can be increased by treating these symptoms.

Assessment of psychopathological aspects and psychiatric comorbidities in patients affected by tinnitus.

The aim of present study was to determine the psychiatric symptoms and comorbidities in patients affected by tinnitus. The study sample, between June 2004 and September 2005, consisted of 180 Turkish adults living in Elazig. Ninety consecutive tinnitus patients were enrolled on their first visit to the outpatients clinic. Control subjects were recruited partly from the social surroundings of the authors. All subjects with significant medical and/or psychiatric pathologies, such as schizophrenia, manic-depressive psychosis, dementia, and behavioural disorders with social withdrawal or suicidal risk, were excluded, as were those unwilling to take part in the study. For the psychopathological examination, patients underwent the Structured Clinical Interview for DSM-III-R (SCID-I, SCID-II). Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Check list-90 (Revised) (SCL-90-R) were also administered to patients with tinnitus and control subjects. SCL-90-R subscales scores, Beck Anxiety Inventory and Beck Depression Inventory scores were significantly higher in tinnitus patients than in normal control subjects. Twenty-four patients (26.70%) with tinnitus had at least one psychiatric diagnosis. Five control subjects (5.60%) had at least one psychiatric diagnosis. There were significant differences between the two groups (P < 0.001). Anxiety disorders and somatoform disorders were significantly higher in tinnitus patients than in normal control subjects. We conclude that psychiatric symptoms (such as symptoms of anxiety, depression or somatization) among patients with tinnitus should alert clinicians for the presence of a chronic and complex psychiatric condition (Axis-I and Axis-II disorders).

Relation of isolated tonsillar hypertrophy with body mass index.

OBJECTIVE: The purpose of this study was to investigate the relationship between tonsillar hypertrophy and body mass index (BMI). MATERIAL AND METHODS: This is a cross-sectional study which was conducted in three primary schools located in Duzce. A total of 1,282 children between 7 and 12 years of age were evaluated and the size of their tonsils was investigated with regard to height and weight. This study was performed in the course of school screening, and the correlation between estimated tonsil size and BMIs of the children was investigated. RESULTS: Sixteen of 1,282 students were excluded from the study, leaving 1,266 children in the study. The mean (+/-SD) age of the children was 9.13 +/- 1.45 (range 7-12) years. The mean height of the 1,266 children was 129.07 +/- 9.95 (range 105-163) cm, the mean weight was 28.81 +/- 6.96 (range 15-68) kg, and the mean BMI was 17.09 +/- 2.33 (range 12.07-30.0) kg/m(2). There was no statistically significant effect of tonsil size on BMI. We could not find a significant relation of isolated tonsillar hypertrophy with BMI. CONCLUSIONS: No relation could be found between tonsillar hypertrophy and BMI.

Evaluation of deaf children in a large series in Turkey.

OBJECTIVE: Evaluation of the deafness etiology, ear examination findings and hearing levels of deaf children in a large series. PATIENTS AND METHODS: We studied 840 deaf primary school children (486 male, 354 female, mean age 12.69+/-3.52, range 5-22). A questionaire investigating the prenatal, perinatal and postnatal etiological causes was prepared and pedigree analysis was performed. After ENT examination, odyologic tests were performed. RESULTS: The etiological features of deafness were found for genetic causes as 429 cases (51.1%), 127 children (15.1%) for acquired group and 284 children (33.8%) for unknown group. We confirmed 136 (15.5%) syndromic deaf children and 19 of them (13.9%) were autosomal recessive (AR), 105 of them (77.2%) were autosomal dominant (AD), six (4.4%) of them were X-linked. Two hundred and ninety-three deaf (33.4%) children were in the familial nonsyndromic group. In this group, the inheritance of 255 (87%) were AR, 23 (7.8%) were AD and 15 (5.2%) were X-linked recessive. Febrile convulsion was identified as the most common etiology in 36 (4.3%) cases in the acquired group. Three hundred and twenty-two (67.7%) children had profound HL (above 91 dB), 111 (23.3%) had severe HL and 43 (9%) had moderately severe HL. Sensorineural HL was found in 439 (92.2%) and mixed type hearing loss was seen 37 (7.8%) of 476 cases. We found many major and minor abnormalities and ocular, ear and dental pathologies. The prevalence of ear diseases was found in 203 (24.2%) of children. Impacted wax was found in 80 (9.5%) of 840 children with otoscopic examination and was the most common pathology, retraction in 70 (8.3%) and perforation in 15 (1.8%) followed it. CONCLUSION: Preventable ear disease are important health problems among school children for the deaf because these diseases can affect the real level and type of deafness, so determining early diagnostic criteria, ear diseases and minor abnormalities is important for early rehabilitation. Syndromes can be prevented in pregnancy, infections can be prevented in prenatal or postnatal period but unknown group cannot be prevented although the unknown etiology can be reduced by multidiciplinary approach.