Publication rates of congress abstracts is associated with abstract quality: Evaluation of Turkish National Medical Education Congresses and Symposia between 2010 and 2014 using MERSQI.

There are many parameters that could be used to evaluate the quality of scientific meetings such as publication rates of meeting abstracts as full-text articles after the meeting or scoring with validated quality scales/tools that evaluate individual papers, project proposals, or submitted abstracts. This study aimed to determine the full-text publication rates for abstracts presented at Turkish National Medical Education Congresses and Symposia and to assess the quality of given abstracts. Abstracts presented at national medical education congresses and symposia between 2010 and 2014 in Türkiye were evaluated. Initially, the abstracts were evaluated if they were published as full-text articles in international and national peer-reviewed journals following the meeting. Secondly, the quality of presented abstracts was assessed with the Medical Education Research Study Quality Instrument (MERSQI) scale. Overall publication rate for the abstracts was 11.3%. The publication rate of oral and poster presentations were 26.6% and 8.1%, respectively. Oral presentations had a statistically higher publication rate than poster presentations (p = .000). The mean MERSQI score for abstracts was 7.73 ± 2.59. The oral presentations had higher MERSQI mean scores than poster presentations (8.28 ± 2.46 vs. 7.61 ± 2.6; p = .032). Similarly, published abstracts had a significantly higher score compared to unpublished abstracts (10.07 ± 2.74 vs. 7.43 ± 2.41; p = .000). Interestingly, there was no statistical difference between the mean MERSQI scores of the published oral and poster presentations (9.33 ± 2.45 vs. 10.61 ± 2.72; p = .101). This study showed that the main factor for a meeting abstract to be published as a full-text article is the scientific quality of the study. The quality of presentations at annual medical education meetings in Türkiye were low compared with international meetings which did not improve over five years. An institutional policy that would set quality standards for medical education research and increase the awareness of researchers on the topic might help improve the design, execution, and reporting of such studies in Türkiye. The MERSQI could be a valuable tool to monitor the quality of submitted abstracts and to increase the awareness of novice researchers on high quality research.

Impact of magnetic resonance on the decision of conservative surgery in advanced larynx cancer.

OBJECTIVE: To evaluate the utility of magnetic resonance images (MRI) in the selection of treatment procedures for intermediate-advanced laryngeal cancers. MATERIAL AND METHOD: This study included patients with histologically proven laryngeal squamous cell carcinoma defined as cT3 and T4a at our tertiary academic care hospital. All scans were evaluated by two radiologists experienced in head and neck cross-sectional studies. Signal patterns in MRI sections of laryngeal compartment subsites were delineated as T1w, T2w hyperintensity, and T2w intermediate signals, and were compared with the postoperative pathological results. Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were calculated. RESULTS: The study included 51 patients with a mean age of 62.55 ± 9.14 (range, 45-80) years. Tumor was glottic in 12 (23.5%) patients, supraglottic in 19 (31.4%) patients, glottic-supraglottic in 11 (21.6%) patients, transglottic in 9 (27%) patients. The posterior paraglottic space had the strongest specificity of MRI according to tumor infiltration in the histologic analysis (specificity 96.9% and sensitivity 78.6%). The specificity of MRI was poor for tumor infiltration in thyroid cartilage (specificity 70.0%). Spearman's test demonstrated that there was a statistically significant correlation between the MRI-based prediction scores of all subunites and the findings of histopathologic analyses (mean±SD: 4.96±4.46-5.53±4.38, respectively, R2: 0.711, p<0.001). CONCLUSION: The high specificity values of the predictions, which were MRI-based in all subsites, indicated that MRI could provide an important contribution for defining tumor infiltration and the presurgical assessment of patients with tumors of the larynx.

Surgical considerations and audiological results of cochlear implantation in patients with otosclerosis

Background/aim: To emphasize the role of cochlear implantation (CI) in the auditory rehabilitation of patients with otosclerosis (OS) and share our surgical experiences on this rare group of patients. Materials and methods: Retrospective analysis of the patients who have a diagnosis of otosclerosis and implanted between January 1998­May 2019 was performed. Preoperative and postoperative clinical, radiological, audiological and surgical findings are presented. Results: Among 2195 patients who have been implanted in our institution, 12 (0.54%) met the diagnostic criteria of OS according to their preoperative (clinical, radiological, audiological) and peroperative (surgical) findings. Electrode insertion was performed via "round window membrane and cochleostomy" in 8 and 4 patients, respectively. No major complications occured. All patients showed satisfactory performances by means of audiometric scores postoperatively. Nonauditory stimulation (NAS) which manifested as "facial twitching" was a challenging problem in one patient during the surgery and subsided after the operation. Conclusion: Our experience on CI in patients with OS revealed that the implantation was a relatively safe procedure and had satisfactory impact on audiological performances.

Cochlear Implantation in Postmeningitic Deafness.

PURPOSE: The aim of this study is to evaluate long-term outcomes of cochlear implantation (CI) in patients with postmeningitic deafness. METHODS: Twenty-seven patients with severe to profound hearing loss due to bacterial meningitis and received CI were the subjects of this study. Surgical findings and long-term audiological performances were evaluated. Speech perception and speech intelligibility of the implanted patients were evaluated with the categories of auditory performance-II (CAP-II) test and speech intelligibility rating (SIR) test, respectively. RESULTS: Eighteen of the 27 patients had received full electrode insertion through the patent cochlear lumen. Remaining 9 patients had varying degrees of ossification throughout the cochlea and needed to be drilled to achieve partial electrode insertion. None of the patients exhibited surgical complication. Scores in both test batteries (CAP-II and SIR) were comparable between patients who received full or partial electrode insertion (P > 0.05). CONCLUSION: Cochlear implantation after postmeningitic deafness has favorable outcomes especially in long term. Although this type of inner ear pathology may require special considerations during surgery, it is a relatively safe procedure.

Surgical Methods and Auditory Outcomes of Cochlear Implantation in Cochlear Ossification.

BACKGROUND: The aim of this study was to evaluate the surgical and auditory outcomes of cochlear implantation in patients with cochlear ossification. METHODS: This study comprised 54 patients with cochlear ossification who underwent cochlear implantation in the cochlear implant center of a tertiary care hospital between January 1998 and May 2019. Clinical data were evaluated including surgical findings and audiological performances. The auditory outcomes of the implanted patients were assessed through the Categories of Auditory Performance-II test and Speech Intelligibility Rating test, respectively. The outcomes of patients with cochlear ossification were compared with those of 54 patients selected for the control group who underwent implantation with no cochlear ossification. RESULTS: Auditory outcomes were comparable between the study group and the control group. The control group obtained significantly higher scores than those of the study group when compared using the Categories of Auditory Performance-II test and Speech Intelligibility Rating test batteries. Patients with meningitis produced poorer outcomes within the group comparisons of the study group. None of the patients experienced surgical complications. The extent of ossification was analyzed in terms of its effectiveness on audiological performance. Patients with complete ossification had significantly lower Categories of Auditory Performance-II and Speech Intelligibility Rating test scores. CONCLUSION: Cochlear implantation is a safe and beneficial procedure, even in patients with cochlear ossification. The ossified cochlea may require varied drill techniques beyond traditional implantation surgery for the insertion of the electrode array. It is, however, still difficult to predict audiological outcomes in patients with cochlear ossification.

Quality of Life in Older Adults with Cochlear Implantation: Can It Be Equal to That of Healthy Older Adults?

BACKGROUND AND OBJECTIVES: This study aimed to evaluate the audiologic results after cochlear implantation (CI) in older patients and the degree of improvement in their quality of life (QoL). Subjects and. METHODS: Patients over 65 years old who underwent CI at implant center in Bozyaka Training and Research Hospital were included in this study (n=54; 34 males and 20 females). The control group was patient over 65 years old with normal hearing (n=54; 34 males and 20 females). We administered three questionnaires [World Health Organization Quality of Life-BREF (WHOQOL-BREF), World Health Organization Quality of Life-OLD (WHOQOL-OLD)], and Geriatric Depression Scale (GDS) to evaluate the QoL, CIrelated effects on activities of daily life, and social activities in all the subjects. Moreover, correlations between speech recognition and the QoL scores were evaluated. The duration of implant use and comorbidities were also examined as potential factors affecting QoL. RESULTS: The patients had remarkable improvements (the mean score of postoperative speech perception 75.7%) in speech perception after CI. The scores for the WHOQOL-OLD and WHOQOL-BREF questionnaire responses were similar in both the study and control groups, except those for a two subdomains (social relations and social participation). The patients with longer-term CI had higher scores than those with short-term CI use. In general, the changes in GDS scores were not significant (p<0.05). CONCLUSIONS: The treatment of hearing loss with CI conferred significant improvement in patient's QoL (p<0.01). The evaluation of QoL can provide multidimensional insights into a geriatric patient's progress and, therefore, should be considered by audiologists.

Comparison of Tumor Infiltrating Lymphocyte Density with Histopathological Parameters and Effect on Prognosis in Head and Neck Squamous Cell Cancers.

OBJECTIVES: The study aims to determine the ratio of the tumor-infiltrating lymphocytes (TIL) in the tumor microenvironment in squamous cell carcinoma of head and neck and its effect on prognosis using histopathological parameters. METHODS: The patients who underwent head and neck surgery with the diagnosis of squamous cell carcinoma of head and neck at Cerrahpasa medical faculty ENT Clinic between January 2010 and November 2013 were included in this study. The age, gender, smoking status, alcohol use, radiologic images, and operation technique were analyzed for all patients. TNM pathologic staging, histologic differentiation grade, desmoplastic stromal reaction, vascular and perineural invasion, and lymph node metastasis were also evaluated. Representative hematoxylin-eosin stained slides from each block were cut and the ratio of tumor-infiltrating lymphocytes in tumor tissue was examined by an expert to confirm histology. RESULTS: In this study, 114 patients (105 males and 9 females) met inclusion criteria and were included. The mean age was 60.3±9.7 (ranging from 27 to 85 years). TIL and desmoplastic stromal reaction were compared statistically to the extent of primary tumor, vascular and perineural invasion, lymph node metastasis and histological grade of the tumor. While there was no statistically significant difference between TIL and these parameters, there was a statistically significant correlation between desmoplastic stromal reaction and these parameters. Considering five years of patient survival, although TIL had a positive impact on the prognosis of the tumor, there was no statistically significant difference. CONCLUSION: We suggest that besides TNM pathologic staging and histologic parameters, immune cells reacting to the tumor will be a distinctive factor in determining the prognosis and new treatment methods. We believe that TIL will affect the current cancer treatments by increasing its anti-tumor effects and will give promising results in cancer immunotherapy.

Pediatric Bell's palsy: prognostic factors and treatment outcomes.

BACKGROUND: Idiopathic facial paralysis or Bell`s palsy is the most common type of peripheral facial paralysis. Children with Bell`s palsy is an uneasy situation for the family and physician with questions about the etiology, treatment options and the healing process. Here, we aimed to compare the epidemiologic features and prognostic factors of patients with Bell`s palsy aged < 18 years. METHODS: Records of patients with Bell`s palsy who were admitted to our clinic between January 2008 and December 2017 were evaluated. RESULTS: Forty-seven patients with Bell`s palsy were included to this study. The patients` ages varied between 7 and 17 (14.7±2.5) years. At the end of at least 6 months of follow-up, 32 (68.1%) of the patients presented with House Brackmann (HB) grade 1 facial paralysis, while 12 (25.5%) of them had grade 2 and 3 (6.4%) of them had grade 3 facial paralysis. Mean neutrophil-to-lymphocyte ratio (NLR) in patients with advanced grades (grade 4, 5, 6) was higher, compared to that of patients with grade 2 and 3 (4.10 ± 1.06 vs 1.34 ± 1.02 (p < 0.001). CONCLUSIONS: In our study, the response rate to treatment was high. In differential diagnosis, congenital anomalies, malignancy, trauma, middle ear infection and surgery should be considered. In addition, NLR at admission can be considered as a prognostic factor.

Parents' View on Quality of Life after Cochlear Implantation in Children with Auditory Neuropathy.

OBJECTIVES: The aim of this study is to evaluate the quality of life in pediatric patients with auditory neuropathy according to the perspective of their parents after cochlear implantation. MATERIALS AND METHODS: The pediatric patients, who underwent cochlear implantation with the diagnosis of auditory neuropathy at Izmir Bozyaka Training and Research Hospital ENT Clinic between January 1997 and May 2017, were included to the study. "Parents' Perspective Questionnaire" developed by Nottingham Pediatric Cochlear Implant Programme was used in the study. The questionnaire was composed of 11 subscales and 58 questions in total. RESULTS: The study included 26 pediatric patients (14 female, 12 male) who used cochlear implant for at least 1 year. The mean age of patients was 10.91±3.85 ( 4.3-17.3 years old) and implantation age varied between 14 months and 80 months. (median; 35.65±20.03 months). Patients who attended school had more self-confidence, and also those having implant use over 6 years had a better self confidence and social relationship. CONCLUSION: Cochlear implantation not only improves the ability of hearing but also provides development of speech and language skills and therefore enhancing the patient's quality of life. From the perspective of parents, the use of cochlear implant in the children with auditory neuropathy improves the quality of life in many different ways. The perspective of parents can provide a multidimensional evaluation about the child's progress, therefore, it should be taken into consideration by the staff in implant centers.

Olfactory Neuroblastoma: A Rare Cause of External Ophthalmoplegia, Proptosis and Compressive Optic Neuropathy.

Olfactory neuroblastoma (ONB), which is a neuroectodermal tumor of the nasal cavity, is a rare and locally aggressive malignancy that may invade the orbit via local destruction. In this study, we report a patient with proptosis, external ophthalmoplegia, and compressive optic neuropathy caused by ONB. A detailed clinical examination including ocular imaging and histopathological studies were performed. The 62-year-old female patient presented to our clinic with complaints of proptosis and visual deterioration in the left eye. Her complaints started 2 months prior to admission. Visual acuity in the left eye was counting fingers from 2 meters. There was relative afferent pupillary defect. She had 6 mm of proptosis and limitation of motility. Fundus examination was normal in the right eye, but there was a hyperemic disc, and increased vascular tortuosity and dilation of the retinal veins in the left eye. Computerized tomography and magnetic resonance imaging of the brain and orbits demonstrated a large heterogeneous mass in the left superior nasal cavity with extensions into the ethmoidal sinuses as well as into the left orbit, compressing the medial rectus muscle and optic nerve. Endoscopic biopsy of the lesion was consistent with an ONB (Hyams' grade III). Orbital invasion may occur in patients with ONB. Therefore, it is important to be aware of this malignancy because some patients present with ophthalmic signs such as external ophthalmoplegia, proptosis, or compressive optic neuropathy.

Waardenburg Syndrome: An Unusual Indication of Cochlear Implantation Experienced in 11 Patients.

OBJECTIVE: The aim of this study was to present the surgical findings of children with Waardenburg syndrome (WS) and investigate speech development after cochlear implantation in this unique group of patients. MATERIALS AND METHODS: A retrospective chart review of the patients diagnosed with WS and implanted between 1998 and 2015 was performed. Categories of auditory performance (CAP) test were used to assess the auditory skills of these patients. CAP is a nonlinear hierarchical scale used to rate a child's developing auditory abilities. Preoperative test results and intraoperative surgical findings of these patients have been presented. RESULTS: In total, 1835 cases were implanted a tour institution, and 1210 of these were children. Among these implantees, 11 were diagnosed with WS (0.59% of all implantees). Four of the 11 patients showed incomplete partition type 2bony labyrinth abnormality (Mondini deformity) and all patients showed intraoperative gusher during cochleostomy, which was subsided through routine interventions. No other complications occurred during surgery, and all patients showed satisfactory CAP results in the late postoperative period. CONCLUSION: Our experiences with cochlear implantation in patients with WS showed that the procedure is safe and effective in this group of patients. Surgeons should be aware of possible labyrinth malformations and intraoperative problems such as gusher in these patients. In long term, auditory performances may exhibit satisfactory results with optimal postoperative educational and supportive measures.

Investigation of myringosclerosis development in different grafting materials after myringo-/tympanoplasty.

OBJECTIVES: This study aims to investigate the prevalence of myringosclerosis in tragal perichondrium (TP) and temporalis fascia (TF) grafts after myringo-/tympanoplasty. PATIENTS AND METHODS: Thirty patients, who were diagnosed with non-suppurative chronic otitis media and administered myringo-/tympanoplasty under general anesthesia using TP or TF as grafting material in our clinic between January 2012 and May 2013, were recruited in this retrospective case-control study. Patients were divided into two groups according to used graft material as group 1 (TP) (9 males, 6 females; median age 35.4 years; range 20 to 62 years) and group 2 (TF) (7 males, 8 females; median age 39.8 years; range 19 to 63 years). Occurrence of myringosclerosis on the intact tympanic membrane grafts was evaluated postoperatively by the same surgeon under surgical microscope. RESULTS: Postoperative myringosclerosis was detected in six patients (40%) in TP group and 13 patients (86.7%) in TF group. CONCLUSION: Prevalence of myringosclerosis on graft materials used in myringo-/tympanoplasty was lower in TP group compared to TF group. We believe that this may be due to different vascular structures of different graft tissues and that the low predisposition of perichondrium towards development of myringosclerosis can be considered as an advantage for this graft. We hope that this study adds a new dimension to etiopathogenesis of myringosclerosis and assists otologists in the prevention and treatment of this lesion.