Rhinitis medicomentosa and substance addiction.

BACKGROUND: Rhinitis medicomentosa (RM) is a form of non-allergic rhinitis caused by the use of nasal decongestants for longer than the recommended duration. Because of this problem of use, addiction to the drug occurs in individuals. In our study, we aimed to evaluate the susceptibility of RM patients to substance addiction. METHODS: The study was planned as a prospective, multicentric study between September 2022 and September 2023. Patients diagnosed with RM were included in the study. Beck depression scale, Drug use disorders identification test, Substance Abuse Proclivity Scale were applied to the patients participating in the study. The research data were analyzed electronically with SPSS program version 25. RESULTS: The study included 86 patients with an average age of 31 years. The average duration of medication use was 22 months. Age, gender, duration of nasal congestion, duration of drug use and smoking were not independent predictors for depression and substance use tendency. CONCLUSION: The relationship between RM and addictive substances is not clear. The tendency to use drugs did not increase in RM patients. In the light of these data, we think that there is no need for a practice other than routine functioning in the use of drugs and similar substances that are likely to cause addiction in RM patients.

Protective and Therapeutic Effect of Platelet-Rich Plasma on Experimental Cisplatin Ototoxicity.

Objective: Cisplatin is a chemotherapeutic agent with an ototoxic effect that is frequently used in head and neck cancers. There are studies in the literature conducted with various antioxidant substances to protect and/or prevent ototoxicity. This study aims to investigate whether platelet-rich plasma (PRP) has a protective and therapeutic effect on cisplatin ototoxicity. Methods: A total of 40 Sprague Dawley albino rats were divided into six groups as control group (n=6), PRP-only group (n=6), cisplatin group (n=6), cisplatin + PRP group (n=6), PRP + cisplatin group (n=6), and donor group (n=10). At the beginning of the study and the 8th day, they were tested with distortion product otoacoustic emission (DPOAE). Assessment of DPOAE results was based on the signal-to-noise ratio in 2000, 3000, 4000, 6000, and 8000 Hz frequency bands. On the 8th day, the rats were sacrificed. For histological examinations, the temporal bones were dissected and fixed. After hematoxylin and eosin staining, the tissues were evaluated by light microscopy. Results: In the DPOAE tests performed on the 0th and 8th days of the cisplatin group, it was observed that cisplatin caused hearing loss in the rat ears. It was determined that the cisplatin group at 2000 Hz, 3000 Hz and 4000 Hz had a significant decrease in hearing compared to all groups (p<0.015), while the cisplatin group at 6000 and 8000 Hz was characterized by hearing loss at a higher rate than all groups (p<0.001). At the end of the study, negative effects of cisplatin on both cellular dimensions (cytoplasmic vacuolization, cell degeneration, dilatation, apoptotic cells, nerve degeneration) and hearing function were observed. No protective or therapeutic effect of PRP on cisplatin ototoxicity was observed. Conclusion: Our study showed that platelet-rich plasma did not have a significant effect in the treatment of hearing loss due to cisplatin ototoxicity and in preventing hearing loss in rats.

Mucin receptors in chronic rhinosinusitis with nasal polyps.

BACKGROUND: Nasal polyps (NPs) are non-neoplastic, painless inflammatory lesions of the sino-nasal mucosa. Nasal polyp physiopathology is not yet fully understood. There are many potential etiologies of NP, including chronic infections, allergies, asthma, aspirin sensitivity, anatomical disorders, and genetic causes. OBJECTIVE: The purpose of our study was to immunohistochemically demonstrate the presence of mucin (MUC) receptors in chronic rhinosinusitis (CRS) with nasal polyps and determine the relationships between the presence of these receptors and clinical findings. MATERIAL AND METHODS: A total of 59 patients who underwent functional endoscopic sinus surgery due to CRS with NPs were included in the study. Groups with positive and negative MUC receptors were evaluated according to their clinical characteristics. RESULTS: According to the data we have obtained, surgery site quality and low-dose steroid response worsened with MUC5A receptor positivity and there were no significant relationships between MUC1 receptor positivity and clinical findings. CONCLUSION: According to our results, MUC5A receptor positivity was associated with impaired surgical site quality and a reduced response to low-dose systemic steroids by NPs.

Early clinical outcomes of ınferior turbinate radiofrequency and lateralization combined with septoplasty / Resultados clínicos iniciais da utilização de radiofrequência e lateralização das conchas nasais inferiores combinadas à septoplastia

Abstract Introduction: Mechanical obstruction is the most common form of nasal obstruction. Among the types of mechanical obstructions, septum deviation and inferior turbinate hypertrophy are the most prevalent. Objective: This study evaluated the early clinical outcomes of inferior turbinate radiofrequency and inferior turbinate lateralization combined with septoplasty in the treatment of nasal obstruction symptoms. Methods: The research retrospectively evaluated data from 33 patients (24 male, nine female) undergoing septoplasty and inferior turbinate radiofrequency (RF group) and 32 patients (24 male, eight female) treated with septoplasty and inferior turbinate lateralization (LAT group), who were admitted, with complaints of nasal obstruction, to the University of Health Sciences, Department of Otorhinolaryngology, between January 1, 2017 and January 1, 2018. The patients' preoperative and 6-month postoperative symptoms were evaluated via the Nasal Obstruction Symptom Evaluation, the NOSE scale. Results: The mean preoperative NOSE scores were 10.3 ± 4.2 in the RF group and 10.9 ± 4.9 in the LAT group, and the mean six-month postoperative scores were 1.09 ± 1.3 in the RF group and 1.2 ± 1.3 in the LAT group. There was no significant difference in NOSE scores between the two groups (p > 0.05). Conclusion: The data obtained in this study show that both methods result in similar outcomes in terms of relieving nasal obstruction symptoms in patients requiring inferior turbinate intervention. Therefore, the researchers believe that, in each case, the intervention method should be selected at the discretion of the patient and surgeon(s).

Resumo Introdução: A obstrução mecânica é a forma mais comum de obstrução nasal. Entre os tipos de obstruções mecânicas, o desvio do septo e a hipertrofia de conchas inferiores são os mais prevalentes. Objetivo: Avaliar os resultados clínicos iniciais da aplicação de radiofrequência nas conchas inferiores e a lateralização delas combinada com septoplastia no tratamento dos sintomas de obstrução nasal. Método: O estudo avaliou retrospectivamente dados de 33 pacientes (24 homens, nove mulheres) que foram submetidos a septoplastia e aplicação de radiofrequência no concha inferior (grupo RF) e 32 pacientes (24 homens, oito mulheres) submetidos a septoplastia e lateralização de concha inferior (grupo LAT), que foram admitidos com queixas de obstrução nasal na University of Health Sciences, Departamento de Otorrinolaringologia, entre 1° de janeiro de 2017 e 1° de janeiro de 2018. Os sintomas pré-operatórios e pós-operatórios de 6 meses dos pacientes foram avaliados pela escala NOSE, do inglês Nasal Obstruction Symptom Evaluation. Resultados: Os escores médios pré-operatórios da escala NOSE foram 10,3 ± 4,2 no grupo RF e 10,9 ± 4,9 no grupo LAT e os escores médios pós-operatórios de seis meses foram 1,09 ± 1,3 no grupo RF e 1,2 ± 1,3 no grupo LAT. Não houve diferença significante nos escores da escala NOSE entre os dois grupos (p > 0,05). Conclusão: Os dados obtidos neste estudo mostram que ambos os métodos têm resultados semelhantes em termos de alívio dos sintomas de obstrução nasal em pacientes que necessitam de intervenção nas conchas inferiores. Portanto, os pesquisadores acreditam que, em cada caso, o método de intervenção deve ser selecionado a critério do paciente e do cirurgião.

Voice Quality After Radiotherapy and Cordectomy in Early-Stage Glottic Carcinomas.

Laryngeal carcinomas are the most common upper respiratory tract cancers and most commonly involve the glottic region. The aim of this study is to evaluate the voice quality after radiotherapy (RT) and microsurgical cordectomy (MC) treatments using Voice Handicap Index (VHI) and Grade, Roughness, Breathiness, Astenicity, and Strain (GRBAS) perceptual evaluation scale in patients with early-stage glottic carcinoma. A total of 37 patients with early-stage glottic carcinomas, 19 patients had RT and 18 patients with MC, were included in our study. The patients were evaluated in terms of their sound quality by using VHI-10 and GRBAS perceptual assessment scale 3 months after the treatment was completed. Although the findings were better in favor of RT according to GRBAS perceptual assessment scale of patients who received RT (n = 19) and MC (n = 18), no statistically significant difference was found between the 2 groups (P = .613). Patients in both groups were evaluated with VHI-10, emotional (P = .036) and physiological (P = .038) scores were significantly higher in MC group and no significant difference was found in functional scores (P = .192). However, there was no statistically significant difference between the 2 groups in terms of voice quality (P = .185). In early-stage (Tis, T1a, T1b) glottic carcinoma, there was no significant difference between RT and MC in terms of voice quality. Therefore, the choice of treatment modality in patients with early-stage glottic carcinoma should be taken into account in terms of the patient's occupation, comorbid diseases, cost of treatment, hospital stay, and, most importantly, patient preference.

Perspectives of Young Otolaryngologists on Pediatric ENT and the Future of the Field in Turkey.

OBJECTIVE: The purpose of this study was to examine the current status and the future of pediatric otolaryngology in Turkey by evaluating the opinions of young otolaryngologists on pediatric otolaryngology. METHODS: The study included 224 otolaryngology physicians who were senior residents registered with the Turkish Otolaryngology and Head-Neck Surgery Association (TORL-HNS). The physicians were in their last two years of otolaryngology training (154 physicians) or had completed their residency training and were in their first year of otolaryngology practice (70 physicians). They were approached via e-mail and Short Message Service (SMS) in October through December 2019 with a descriptive letter and asked to voluntarily complete an online questionnaire consisting of total 25 questions in five sections. RESULTS: The online questionnaire was sent to 224 physicians, and 109 (49%) participated in the survey. All 109 participants answered all the questions. Overall, 71 participants (65.1%) were in training for residency and 38 (34.9%) were in their first year of expertise. According to their professional interests, the participants listed rhinology (45 participants, 41.3%), head and neck surgery (27 participants, 24.8%), facial plastic surgery (19 participants, 17%), otology-neurotology (16 participants, 14.7%), and laryngology-phoniatry (2 participants, 1.8%) as their first preference for subspecialty. Pediatric otolaryngology was never a first choice among the participants, although four (3.7%) listed pediatric otolaryngology as their second preference. CONCLUSION: The aim of this study was to shed light on the current and future status of pediatric otolaryngology in Turkey. We believe the establishment of exclusive pediatric otolaryngology clinics under the umbrella of general ear, nose and throat (ENT) clinics and the foundation of officially approved fellowship programs would bring this subspecialty field to its deserved and desired level in our country.

Postauricular Island Flap in Reconstruction of Auricula Tumor Defects.

The most common malignant tumor in humans is skin cancers. Skin cancers are most commonly seen in the head and neck region due to direct exposure to sunlight. Most frequently seen skin cancer in the auricula are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The aim of this study is to evaluate the results of postauricular island flap after resection of tumors in the auricula.Twelve patients aged 58 to 84 years were included in the study. Eight patients had BCC, 3 had SCC, and 1 had basosquamous carcinoma (BSC). The tumor was located at the cavum concha in 7 cases, antihelix in 3 cases, triangular fossa in 1 case and scapha in 1 case. Surgical procedure was performed under local anesthesia in 7 patients and under general anesthesia in 5 patients. Postauricular island flap was used in all cases. There were no early complications. Three patients had non-apparent narrowing of the auriculomastoid angle. The patients were followed for an average of 2.6 years between 1 and 9 years. Only one patient with basosquamous carcinoma of the cavum concha had recurrence at 19 months.We believe that the postauricular island flap may be a good alternative for the reconstruction of the defect after resection of tumors in the auricle due to its proximity to the surgical site, color matching, adequate thickness, good vascularization, aesthetic acceptance by the patient and completion of the procedure in one session.

Bone turnover in chronic otitis media with bone destruction.

PURPOSE: This study aims to determine the relationship between bone destruction and bone turnover markers in patients with chronic otitis media (COM). METHODS: Subjects with COM were divided into two groups: those with and without bone destruction. Thirty-seven patients were included in the group with bone destruction; 30 patients were included in the group without bone destruction. The enzyme values were evaluated. RESULTS: There was no difference between the two groups in terms of enzyme levels of serum and urine. However, the osteocalcin, which is a bone formation marker, and the C-terminal telopeptide of type I collagen marker, which is bone destruction marker, were found to be lower in the group with bone destruction than the group without bone destruction. CONCLUSION: Data obtained in the present study suggest that the pressure necrosis theory and acid lysis theory provide the most valid explanations of bone destruction. However, the data provide limited preliminary information to clarify this mechanism.

Endoscopic butterfly inlay myringoplasty: new technique extended perichondrium butterfly.

Background: Various graft materials and surgical methods are used in the treatment of tympanic membrane perforations.Aims/Objectives: The aim of this study was to evaluate the operation method and graft success of extended perichondrial butterfly myringoplasty performed by an endoscopic method and the hearing gain of patients.Material and Method: This was a retrospective study evaluating the hearing tests of 54 ears of 48 patients (28 male, 20 female) who underwent surgery between February 2017 and March 2019. Pure-tone audiometric results were analyzed preoperatively and six months postoperatively by recording the perforation size, the duration of surgery, and graft success.Results: The graft success rate was 98.1% (53/54 ears). The perforations were most frequently located in the anterior quadrant and were small-sized. The mean preoperative air-bone gap (ABG) was 17.4 ± 5.24 dB. The mean ABG was 9.2 ± 2.13 dB 1 month postoperatively and 8.5 ± 2.26 dB 6 months postoperatively (p < .005).Conclusions: The endoscopic inlay extended perichondrial butterfly myringoplasty method is safe and doesn't require tympanomeatal flap elevation. Moreover, it shortens hospitalization time, facilitates anatomical closure of the membrane, and sometimes closes perforations in the anterior part, which cannot be clearly evaluated after graft placement.

What Are We Missing From Asymmetric Relationship Between the Retinal Nerve Fiber Layer Thickness Profiles and Sphenoid Sinus Volume?

PURPOSE/AIM OF THE STUDY: Detailed analysis of retinal structure such as the retinal nerve fiber layer can be performed by spectral-domain optical coherence tomography (OCT). There are no published studies concerning a relationship between retinal nerve fiber layer and human sphenoid sinus volumes. We investigated this relationship. MATERIAL AND METHODS: Spectral-domain OCT. The peripapillary retinal nerve fiber layer (RNFL) thickness and sphenoid sinus volume estimation of both sides of sex-matched patients were retrospectively analyzed. RESULTS: The mean RNFL thicknesses at the left side (91.8 µm) were significantly smaller than the right side (94.5 µm) (P = 0.040). However, the mean left sinus volume (44.5 cm) is larger than the right side, (34.5 mm) (P < 0.005). Left and right differences of both parameters are statistically significant (P < 0.05). CONCLUSION: There is a negative correlation between mean RNFL thicknesses and mean sinus volumes. To our knowledge, this article is the first report demonstrating the asymmetry relationship between RNFL and sphenoid sinus volumes.

Does Postauricular Incision Cause Auricula Protrusion After Tympanoplasty?

BACKGROUND: An ear surgery can be performed via transcanal, endaural, or postauricular approach according to the surgeon's desicion. The postauricular one is the most commonly performed approach. OBJECTIVE: The objective of this study was to evaluate whether preferring postauricular approach during ear surgery cause auricular protrusion in over time. METHODS: Thirty-six patients who underwent tympanoplasty operation with postauricular incision were included in this study. Any patient who was under 18 years of age, those with auricular deformity and patients who underwent tympanoplasty operation with mastoidectomy were excluded from this study. The distances from mastoid area to superior and mid-point of helix were measured preoperatively and 1 year postoperatively. RESULTS: A total of 36 patients' data were analyzed. There were 13 males and 23 females. The mean age was 28.2 ±â€Šyears (18-59). The preoperative mean distance from mastoid area to superior point of helix was 15.03 ±â€Š2.86 mm, whereas it was 17.92 ±â€Š2.96 mm at mid-helix level. At postoperative 1 year, the same distances were measured 14.67 ±â€Š3.12 mm and 17.25 ±â€Š3.17 mm, respectively. There were no statistically significant differences between preoperative and postoperative measures. CONCLUSION: Although the structures that provide the stability of the auricle are cut during postauricular sulcus incision, long-term follow-up of patients did not show any protrusion of auricula.

Outcomes of endoscopic transcanal type 1 cartilage tympanoplasty.

PURPOSE: We aimed to evaluate air-bone GAP (ABG), graft success and hearing gain according to the size and location of perforation in patients who underwent endoscopic transcanal type 1 cartilage tympanoplasty due to the tympanic membrane perforation and chronic otitis media. METHODS: The 104 patients (52 male and 52 female) who underwent endoscopic transcanal type 1 cartilage tympanoplasty, were evaluated retrospectively. Tragal cartilage grafts were utilized in all patients. Perforation size/location, duration of surgery, pre-operative and post-operative (6th month) average ABG, and pure-tone audiometric results (at 500-1000-2000-4000 Hz) as well as overall graft success were evaluated. RESULTS: The mean duration of surgery was 45.60 ± 17.39 min. Perforations were most frequently located in anterior quadrant with moderate sized. The post-operative air-conduction results were significantly improved at 500-1000-2000-4000 Hz frequencies. Similarly, pre-operative air-conduction pure-tone average (PTA) (35.36 ± 11.9 dB) was significantly decreased (22.34 ± 7.9 dB) after postoperative 6 months (p ≤ 0.001). The overall graft success rate was 93.2%. Moreover, pre-operative mean ABG (19.82 ± 7.4 dB) was significantly decreased (9.05 ± 4.3 dB) after postoperative 6 months (p ≤ 0.001). CONCLUSIONS: Endoscopic transcanal type 1 cartilage tympanoplasty achieved a high graft success rate, and improved hearing results, regardless of the perforations' location and size. Endoscopic tympanoplasty provides high patient safety and comfort in middle-ear surgery by wide visualization, easy applicability, short-operation duration, low complication risk, and less invasive approach.

Protective Effect of Whortleberry Extract on Salivary Gland Damage Induced by Neck Irradiation in Rats.

Radiotherapy is a method of treatment used on malignant head and neck tumors; however, it may lead to adverse effects by influencing other tissues because its effects are not specific to tumor tissues. These adverse effects limit the effectiveness of the treatment and sometimes lead to termination of the treatment. This study aims to histopathologically and biochemically investigate the protective effect of whortleberry against the cellular degeneration and oxidative stress that take place in salivary glands due to radiotherapy. The rats were divided into 6 groups. One group was given radiotherapy only, one group was given radiotherapy and 100 mg/kg of whortleberry, and one group was given radiotherapy and 200 mg/kg of whortleberry. The remaining 3 groups were designated as whortleberry, sham, and control groups. At the end of the study, samples collected were histopathologically and biochemically analyzed. In the group given radiotherapy only, acinar areas were reduced histopathologically, whereas ductal areas increased (P < .01). Oxidative stress increased only in the group given radiotherapy, whereas the oxidative stress levels in the other groups were close to those in the control groups. In conclusion, whortleberry reduces cellular degeneration and oxidative stress that take place in salivary glands due to radiotherapy.

The protective effects of whortleberry extract against cisplatin-induced ototoxicity in rats.

INTRODUCTION: Cisplatin is one of the main chemotherapeutic agents used for the treatment of many types of cancer. However, ototoxicity, one of the most serious side effects of cisplatin, restricts its usage. OBJECTIVE: We aimed to investigate the protective effects of whortleberry extract against cisplatin-induced ototoxicity by evaluating hearing and histopathological cochlear damage and by measuring the biochemical parameters affected byoxidative stress. METHODS: Forty-eight male rats were included in the study after performing Distortion Product Otoacoustic Emission test to confirm that their hearing levels were normal. The rats were randomly divided into six groups: the control group, the sham group, and, which received only whortleberry extract, only cisplatin, cisplatin+100mg whortleberry extract, cisplatin+200mg whortleberry extract, respectively. Audiologic investigation was performed by performing the Distortion Product Otoacoustic Emission test at the beginning and at the eighth day of the study. Cardiac blood samples were collected for biochemical analysis, and the rats were sacrificed to obtain cochlear histopathological specimens on the eighth day. RESULTS: The results revealed that whortleberry protects hearing against cisplatin-induced ototoxicity independent of the dose. However, high doses of whortleberry extract are needed to prevent histopathological degeneration and oxidative stress. CONCLUSION: The results obtained in this study show that whortleberry extract has a protective effect against cisplatin-induced ototoxicity.

Transcanal Endoscopic Type 1 Cartilage Tympanoplasty in Children.

OBJECTIVE: Transcanal endoscopic type 1 tympanoplasty is a minimally invasive procedure that enables better visualization of deep and narrow spaces compared to conventional microscopic methods. In our study, we aimed to evaluate air-bone gap difference, graft success, and hearing gain according to the perforation size and location in pediatric patients who underwent transcanal endoscopic type 1 cartilage tympanoplasty. METHODS: Fifty pediatric patients who underwent transcanal endoscopic type 1 cartilage tympanoplasty for chronic otitis media were included in the study. Tragal cartilage grafts were used in all patients. Air conduction pure tone audiometry hearing results (500, 1000, 2000, and 4000 Hz), mean air-bone gap levels, operating times, postoperative gap closure, and graft success rates were evaluated. RESULTS: Mean operating time was 43.34±8.56 minutes. Overall graft success was 94% (47/50). Mean hearing levels at all frequencies (500, 1000, 2000, and 4000 Hz) were found to have significantly improved after the operation (p<0.001). Mean preoperative air conduction pure tone threshold and mean air-bone gap had statistically significantly improved by the 6th postoperative month (p<0.001). CONCLUSION: Transcanal endoscopic type 1 cartilage tympanoplasty was found to be a minimally traumatic, easy and safe method with a low complication rate. In pediatric patients, this method allows for high rates of anatomic and functional recovery with optimal surgery time regardless of the location and the size of the perforation.