The effect of type 1 diabetes mellitus on voice in pediatric patients.

PURPOSE: The aim of this prospective case-control study was to determine the effect on the voice of type 1 diabetes mellitus (T1DM) in paediatric patients. MATERIALS AND METHODS: The study included patients aged 6-18 years followed up for at least 1 year because of T1DM, and a control group of age and gender-matched healthy volunteers. Following an Ear, Nose, and Throat (ENT) examination, all subjects underwent flexible endoscopic laryngeal examination. Fasting venous blood samples were taken in the morning for the examination of fasting blood glucose (FBG), HgbA1C, and kidney, liver, and thyroid function tests. Data were recorded from the patient files of age, gender, comorbidities, and the development of diabetes-related complications. Voice recordings were taken and the Voice Handicap Index (VHI)-10 form was completed. The patients and control group were compared in respect of the parameters of fundamental frequency, jitter, shimmer, and acoustic voice quality index (AVQI). RESULTS: Evaluation was made of 64 children and adolescents as 32 in the patient group (Group 1) and 32 healthy control subjects (Group 2). Group 1 comprised 17 females and 15 males with a mean age of 12.75 ± 3.23 years. Group 2 comprised 17 females and 15 males with a mean age of 12.75 ± 3.33 years. In Group 1, mean disease duration was 5.21 ± 3.17 years (range, 1-13 years), the FBG value was mean 216.6 ± 122.3 mg/dl, mean HgbA1c was 10.7 ± 2.8, as ≤ 7 in 4 patients, 7-9 in 4, and > 9 in 24. Maximum phonation time (MPT) was determined as 10.66 ± 3.6 secs in Group 1 and 12.11 ± 4.43 in Group 2. VHI was determined as 2.33 ± 3 in Group 1 and 2.31 ± 2.77 in Group 2. No statistically significant difference was determined between the groups was determined in respect of acoustic analysis, perturbation parameters, AVQI and body mass index. CONCLUSIONS: This study is the first to have investigated the effects of T1DM on the voice in paediatric patients. The study results showed that the AVQI value was higher in the patient group but not to a statistically significant level. Therefore, there is a need for further studies with larger samples. The current study can be of guidance for further studies in this field.

The effect of autosomal dominant polycystic kidney disease on mucociliary clearance.

PURPOSE: Autosomal dominant polycystic kidney disease (ADPKD) is a renal disease with genetic transmisson. Mutations in the PKD1 and PKD2 genes, which encode integral membrane proteins of the cilia of primary renal tubule epithelial cells, are seen in ADPKD. The aim of this study was to evaluate the sinonasal epithelium, which is epithelium with cilia, by measuring the nasal mucociliary clearance time, and to investigate the effect of ADPKD on nasal mucociliary clearance. METHODS: The study included 34 patients, selected from patients followed up in the Nephrology Clinic, and 34 age and gender-matched control group subjects. The nasal mucociliary clearance time (NMCT) was measured with the saccharin test. RESULTS: The mean age of the study subjects was 47.15 ± 14.16 years in the patient group and 47.65 ± 13.85 years in the control group. The eGFR rate was determined as mean 72.06 ± 34.26 mL/min in the patient group and 99.79 ± 17.22 mL/min in the control group (p < 0.001). The NMCT was determined to be statistically significantly longer in the patient group (903.6 ± 487.8 s) than in the control group (580 ± 259 s) (p = 0.006). CONCLUSIONS: The study results showed that the NMCT was statistically significantly longer in patients with ADPKD compared to the control group, but in the linear regression analysis results, no correlation was determined between eGFR and NMCT.

Comparisons of Auditory and Vestibular Functions After Septorhinoplasty Performed with the Micro-compass Saw Technique and the Classical Technique.

AIM: To evaluate hearing and labyrinth functions following different osteotomy types (micro-compass saw, osteotome, and no osteotomy) performed in septorhinoplasty operations. MATERIAL AND METHOD: The study included 74 patients operated between January 2020 and March 2022, separated into 3 groups: Group 1: 24 patients (16 females and 8 males): osteotome was used for the osteotomy; Group 2: 24 patients (12 females and 12 males): micro-saw was used for osteotomy; and Group 3: 26 patients (17 females and 9 males): open technique septoplasty with no osteotomy. At 1 day before and 1 week after the operation, all the patients underwent audiological examination, tympanometry, vestibular evoked myogenic potentials (c-VEMP), video head impulse test (v-HIT), videonystagmography (VNG), and distortion product otoacoustic emission (DPOAE) tests. RESULTS: In the c-VEMP tests, significant differences were determined between the groups in respect of N1, P1, and N1-P1 latencies and N1-P1 amplitudes before and after the operation. In the v-HIT test, the change in right-side posterior gain postoperatively was statistically significant in the micro-saw group (p<0.05). The postoperative right lateral canal values were determined to be statistically significantly increased in the micro-saw group compared to the osteotome group (p<0.05). CONCLUSION: This is the only study in the literature to have determined vestibular effects with the evaluation of such a wide range of techniques. Previous studies in the literature have found no effect of osteotomy technique on the balance and hearing systems. The results of this study demonstrated that the preoperative and postoperative difference between the osteotomy techniques had an effect on the balance system. The change in the balance tests following an operation with classic osteotomy shows a greater predisposition to benign positional vertigo. In this sense, the micro-saw can be considered safer. Level of Evidence II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Does Maras powder affect the nasal mucociliary clearence?

PURPOSE: Many studies have been conducted about the effect of cigarettes and other tobacco products on mucociliary clearance. However, there has been no study of the relationship between mucociliary clearance and Maras powder, which is a smokeless tobacco product. The aim of this study was to evaluate the effect of Maras powder use on mucociliary clearance through comparisons with cigarette smokers and those who used no tobacco products. METHODS: The study included 75 male volunteers, aged 23-54 years. Group 1 (n: 25) comprised subjects who do not use any tobacco products, Group 2 (n: 25) those who smoked cigarettes, and Group 3 (n: 25) those who used Maras powder. The saccharin test was used to evaluate mucociliary clearance and the time was recorded in seconds. The groups were statistically compared in respect of mean age and mucociliary clearance time (MCCT). RESULTS: The mean MCCT was determined to be 645.8 ± 200 secs for the whole study sample, 497 ± 108 secs for Group 1, 796 ± 200 secs for Group 2, and 644 ± 161 secs for Group 3. The difference between the groups in respect of MCCT was statistically significant (p < 0.001). No statistically significant difference was determined between the groups in respect of mean age (p = 0.730). CONCLUSION: The study results demonstrated that the nasal mucociliary clearance time was prolonged both by cigarettes and by the use of Maras powder, and that this time was prolonged more by cigarette smoking than the use of Maras powder.

Evaluation of preoperative and postoperative serum interleukin-6, interleukin-8, tumor necrosis factor α and raftlin levels in patients with obstructive sleep apnea.

BACKGROUND: Raftlin is a large, major lipid raft protein of cell membranes. Raftlin levels have not been previously examined in patients with obstructive sleep apnea (OSA). Our study aimed to evaluate the changes in raftlin, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor alpha (TNFα) values from the preoperative state to the third month postoperatively in patients undergoing expansion sphincter pharyngoplasty for OSA. METHODS: Of 60 patients, 10 patients had mild OSA (AHI 5-14), 10 moderate (AHI 15-29), 10 severe (AHI ≥ 30), and 30 with AHI < 5 formed a control group. Preoperatively and at 3 months post-operatively, IL-6, IL-8, TNFα, and raftlin values were measured. RESULTS: Preoperatively, mean raftlin levels were 914.4 ± 62.7 pg/mL for controls, 910.0 ± 42.5 pg/mL in mild, 1000.5 ± 63.3 pg/mL in moderate, and 1386.3 ± 101.4 pg/mL in severe groups, with moderate and severe groups significantly elevated compared to controls (p < 0.001). Preoperatively to 3 months post-operatively, raftlin levels decreased significantly in each OSA group (p < 0.05). Levels of IL-6, IL-8 and TNFα followed similar patterns at baseline and after surgical intervention. CONCLUSIONS: Raftlin levels at the third postoperative month decreased significantly compared with preoperative levels in parallel with other markers of inflammation.

G protein coupled oestrogen receptor 1, aromatase, 17ß-HSD and cAMP level in mutational falsetto.

OBJECTIVES: Puberphonia or mutational falsetto (MF) is seen more in males, and hormonal changes are considered to be among the aetiological causes. Therefore, the aim of this study was to investigate the molecules [G protein-coupled oestrogen receptor 1 (GPER-1), aromatase, 17-beta-hydroxysteroid dehydrogenase (17ß-HSD), cyclic adenosine monophosphate (cAMP) levels] related to receptors and pathways in patients with MF. METHODS: The study included 30 MF patients and a control group of 30 healthy individuals. Voice recordings were made of the MF patients and acoustic analyses were applied. The serum GPER-1, aromatase, 17ß-HSD, cAMP levels and TSH, estradiol, prolactin, progesterone, and testosterone levels were evaluated in venous blood samples. RESULTS: In the MF patients, the GPER-1 level determined of mean 3.68 (1.95-4.26) pg/ml, 17 beta dehydrogenase of 5.25 (2.73-6.77) ng/ml, and cAMP of 24.62 (11.62-30.35) ng/ml were statistically signficantly higher than those of the control group (p = 0.008, p = 0.002, p = 0.003, respectively). The aromatase level in the MF patients was found to be 3.48 (2.01-4.91) and the difference between the two groups was not statistically significant (p = 0.067). CONCLUSION: The GPER-1, 17ß-HSD, and cAMP levels were found to be higher in the MF patients than in the control group, suggesting that they could be of importance in the diagnosis and treatment of MF.

Morphometric Analysis of Sphenoid Sinus in Patients With Nasal Septum Deviation.

This retrospective study aimed to assess the association of the volume and types of the sphenoid sinus with deviated nasal septum by analyzing multislice computed tomography images. A total of 93 patients with a deviated nasal septum and 70 healthy controls were included in the study. Patients with sinonasal morbidities other than deviation were excluded. Three-dimensionally reconstructed computed tomography images of the study participants were acquired. A total of 326 sphenoid sinus volumes from the patient and control groups were obtained and compared between the groups. Sphenoid sinus volumes and the angle of the deviation were measured for standardization and assessment of the severity. Deviated nasal septum was found on the right in 49.5% (n = 46) and on the left in 50.5% (n = 47) of the study participants. Deviation angles were in the range from 7.2° to 22.4° and the mean value was 13.2°â€Š±â€Š5.0°. The measured volumes were in the range from 1.8 cm to 9.6 cm with a mean of 4.8 ±â€Š1.5 cm. In the control group, the median values for the sphenoid sinus volumes were 4.40 cm (0.80-8.90 cm) on the right and 4.20 cm (0.90-8.70 cm) on the left. In the study group, sphenoid sinus volumes were found to be statistically significantly different between those on the ipsilateral and contralateral side of the septal deviation. Sphenoid sinus volumes were significantly smaller on the same side with septal deviation compared with those on the contralateral side. There was no statistical relationship between the presence of septal deviation, age and gender, and the type of sphenoid sinus.

An evaluation of G-protein coupled membrane estrogen receptor-1 level in stuttering.

OBJECTIVE: Stuttering is a widespread but little understood disease. There has been a recent increase in neuropathophysiological, genetic, and biochemical studies related to the etiopathogenesis. As developmental stuttering continues in adult males, hormonal factors are thought to have an effect. In this study, an evaluation was made for the first time of serum GPER-1 level in patients with a stutter. STUDY DESIGN: Prospective case control. MATERIALS AND METHODS: The study included 30 patients with a stutter, aged < 18 years, and 35 age-matched children as the control group. The Stuttering Severity Instrument-3 form was administered to the patients. Evaluations were made of serum GPER-1, TSH, estradiol, prolactin, and progesterone and testosterone levels. RESULTS: GPER-1 level was determined as 0.51 (0.42-0.67) ng/mL in the patients and as 0.19 (0.13-0.25) ng/mL in the control group, and the difference was statistically significant (p < 0.001). A statistically significant difference was determined between genders with GPER-1 level of 0.56 (0.44-0.68) ng/mL in the male stuttering patient group and 0.44 (0.35-0.49) ng/mL in the female patient group (p = 0.026). Differential diagnosis with ROC analysis for the serum GPER-1 levels was statistically significant [Area under the ROC curve (AUC): 0.998, confidence interval, CI 0.992-1.000, p < 0.001]. CONCLUSION: The GPER-1 levels of the stuttering patients were found to be higher than those of the control group and GPER-1 levels of male patients were higher than those of females. As GPER-1 has high sensitivity and sensitivity, it could be considered important in the diagnosis and treatment of stuttering.

Clinical and Histopathological Findings of Chordomas: a Case Report.

Chordomas are rare malignant tumors that develop from the residual of embryonic notochord. These tumors may be seen along the spine and have a local aggressive progression. Skull base chordomas often originate from the clivus as localization. These tumors are usually found to be overgrown when they are diagnosed. They are locally invasive and rarely develop distant metastasis. These chordomas cannot usually be completely removed due to their localization. Because these tumors are advanced at the time of diagnosis and are adjacent to important structures, they are among the tumors with high rates of mortality and morbidity. Surgery and/or radiotherapy is administered for the treatment.

Importance of Delphian Lymph Node Evaluation in Autoimmune Thyroiditis: Fact or Fiction?

BACKGROUND: Our main objective was to evaluate the association between autoimmune thyroiditis and the Delphian lymph node during different stages of thyroiditis. MATERIAL/METHODS: The relationships between the ultrasonography (US) results of thyroiditis and characteristics of the Delphian lymph node in different stages of AT were evaluated. Thyroid hormone and antibody levels were assessed. A total of 126 patients were divided into four groups according to the thyroid US findings: Group 1: control cases; Group 2: indeterminate cases; Group 3: established thyroiditis cases; Group 4: advanced-late stage thyroiditis cases. Indeterminate cases attended a 1-year follow-up, and the cases with a sonographic finding matching thyroiditis formed Group 2. RESULTS: The rate of Delphian lymph node presence in Group 4 was significantly higher than in Groups 1 and 2 (p<0.01). In addition, its presence was significantly higher in Group 3 than in Group 1 (p<0.05). Although there was a difference in Delphian lymph node presence between Groups 2 and 3, it was not significant (p=0.052), nor was there a significant difference between Groups 1 and 2 (p>0.05). Both the long and short axis measurements were significantly higher in Groups 2, 3, and 4 compared to those in the control group. However, the same increase was not observed in the long/short axis ratio. CONCLUSIONS: Both the presence and dimensions of the Delphian lymph node were highly correlated with the progress of autoimmune thyroiditis. Evaluating the Delphian lymph nodes might prevent missing a diagnosis of autoimmune thyroiditis.

The analysis of the maxillary sinus volumes and the nasal septal deviation in patients with antrochoanal polyps.

The aim of this study was to evaluate the relationship between the maxillary sinus volumes and the nasal septal deviation angles in patients with antrochoanal polyps (ACP). 76 patients who underwent ACP surgery were included in the study. Of those 36 patients who had multislice computed tomography (MSCT) were evaluated to calculate maxillary sinus volume. The records of paranasal MSCT of 36 healthy people without any paranasal sinus diseases or surgery constituted age- and gender-matched healthy controls. Maxillary sinüs volumes and septal deviation angles were calculated using the paranasal MSCT volume-rendering technique. Thirty-six patients in the ACP group were compared with 36 polyp side-matched healthy people. The mean age was 16.6 ± 6.7 years in both groups. Statistically, the mean value of the maxillary sinus volume was significantly higher in the ACP group compared with the ACP side-matched control group (15.1 ± 4.6 versus 12.0 ± 3.5 mm(3)) (p = 0.002). Furthermore, the mean value of the maxillary sinus volume in the non-polyp side (14.2 ± 4.7 mm(3)) was statistically higher in the ACP group compared with the side-matched control group volume (11.9 ± 3.8 mm(3)) (p = 0.024). In addition, Fifty-three of 76 ACP patients had septal deviation. While the septal deviation was on the same side with the ACP in 17 patients, it was on the opposite side in 36 patients. In conclusion, the maxillary sinus volumes increased in ACP patients compared with the healthy control group. Many patients had nasal septal deviation on the opposite side of the ACP.

The efficacy of tranexamic acid and corticosteroid on edema and ecchymosis in septorhinoplasty.

The aim of this study was to investigate the efficacy of tranexamic acid (TA) and methylprednisolone on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open septorhinoplasty (oSRP). Seventy-five patients performing hump extraction and osteotomies were allocated into 3 groups as follows: group 1, 25 patients as control; group 2, 25 patients who were administered oral TA as first dose 1 g starting 2 hours before surgery, 3 g daily in divided doses (1 g, every 8 hours) for 5 days; and group 3, 25 patients who were administered a single dose of 1 mg/kg intravenous methylprednisolone at the beginning of the surgery. Operation time, amount of intraoperative bleeding, and complications were recorded. Scoring of eyelid edema and periorbital ecchymosis was evaluated on postoperative first, third, and seventh days using scale of 0 to 4 by 2 observers. In groups using TA and methylprednisolone, periorbital edema and ecchymosis scores were significantly lower compared with the control group (P < 0.05). No significant difference was seen clinically and statistically in preventing or decreasing both periorbital edema and ecchymosis between group 2 and group 3. Patients given TA showed significantly less intraoperative bleeding compared with controls and patients who were administered methylprednisolone. We observed that the administration of methylprednisolone significantly decreases periorbital edema and ecchymosis. Additionally, our results support that TA use in patients who underwent oSRP with osteotomies was found clinically and statistically effective for prevention of bleeding during oSRP operations and reduction of both periorbital edema and ecchymosis.

The effects of aminoguanidine, methylprednisolone, and melatonin on nerve recovery in peripheral facial nerve neurorrhaphy.

BACKGROUND: The medications may enhance the recovery after nerve paralysis. We aimed to evaluate the effects of aminoguanidine (AG), melatonin, and methylprednisolone on peripheral facial nerve neurorrhaphy. METHODS: The buccal branch of the facial nerve was transected and autografted in 32 New Zealand rabbits. Subjects were divided into 4 groups equally (AG, melatonin, methylprednisolone, and control). After the medical treatment latency and amplitude were measured with nerve conduction study at 3, 6, and 10 weeks. Then, coapted segments of nerve were examined microscopically. The groups were compared with each other. RESULTS: The latent period was shortened, and the amplitudes were increased in the AG group; the latent period was shortened, and the amplitudes did not show significant change in the melatonin group with the time. There were no significant differences between the amplitudes at 3 to 6 and 3 to 10 weeks in the methylprednisolone group, and the latent period was shortened. There was no significant difference between the amplitude values at 3, 6, and 10 weeks in the control group. In the histological examination, AG had the best influence on preventing myelin degeneration and reducing the accumulation of myelin debris. Considering the increase in collagen fibers, the best results were achieved in the melatonin group. The degree of myelin-axonal degeneration was higher in the methylprednisolone group. The degree of collagen fiber increase, axonal degeneration, myelin degeneration, and the accumulation of myelin debris were detected quite high in the control group. CONCLUSIONS: Aminoguanidine and melatonin alone achieved an increase in regeneration after peripheral facial nerve neurorrhaphy, but methylprednisolone did not. The best healing was determined in the AG group.

The effects of air pollutants on nasal functions of outdoor runners.

Nowadays road running is becoming more and more popular in our country. Road running is mostly done under improper conditions. The aim of this study was to investigate the effects of running on nasal response combined with the effects of air pollutants. Twenty road runners were enrolled in the study. All subjects were male and between 20 and 41 years of age. They ran for 60 min on the right side of an avenue in the center of the city. It is in a residential area but has heavy traffic. One week later they were invited to run for 60 min through a running course away from traffic that is located outside the city center. Nasal resistances were measured by active anterior rhinomanometry. Nasal transport time was also measured by saccharin transport method. There was a reduction in nasal resistance, which was statistically significant in city center runners but was not statistically significant in those running outside of the city center after the exercise. Although nasal transport times were statistically shorter in both groups, there were no differences between two groups. Nowadays, everyone is advised to do sports. Due to increase in the number of breaths, the depth of breathing, and the reduction in nasal resistance in outdoor runners during exercise, harmful air pollution particles can easily reach the lower respiratory tract. Exercise is important for our health, but it should be noted that the environment in which we run is as important as doing sports for our health, especially in outdoor runners.

Morphometric analysis of the maxillary sinus in patients with nasal septum deviation.

The aim of this study was to evaluate the relationship between nasal septum deviation, which is common in the general population, and maxillary sinus volume. A retrospective assessment was made for 96 patients with nasal septum deviation without coexisting sinonasal morbidity and compared to 60 healthy individuals. A three-dimensional reconstruction of computed tomography images was used to assess a total of 312 maxillary sinus volumes. Septal deviation angles and volumes were also measured to standardize and determine the severity of the septal deviations. Septal deviations were right-sided in 36.5% of the cases (n = 35) and left-sided in 63.5% (n = 61). Deviation angles varied between 5° and 24.4°, with a mean value of 12.9 ± 5.0. The mean value for the deviation volume was 4.6 ± 1.5 cm(3) (range 1.7-9.4). The right and left maxillary sinus volumes were 11.8 ± 4.7 cm(3) and 11.5 ± 4.4 cm(3), respectively, in control group. Statistically significant discrepancy was observed between the ipsilateral and contralateral maxillary sinus volumes, in regard to the side of the septal deviation in study group. Maxillary sinus volumes were found to be significantly smaller on the ipsilateral side of septal deviation compared with the contralateral side.

Tympanometric changes and eustachian tube function in patients with hypothyroidism.

OBJECTIVE: The aim of this study was to investigate the tympanometric changes and eustachian tube function (ETF) in patients with hypothyroidism. METHODS: Automatic ETF tests were performed and tympanometric measurements were evaluated to assess ETF in 40 patients diagnosed with hypothyroidism and a 40-patient euthyroid control group. Levothyroxine sodium tablet treatment was started in patients with hypothyroidism. After achieving a euthyroid state in these patients, the tympanometric measurements and automatic ETF tests were repeated. RESULTS: When the patient groups (hypothyroid and control) were compared in terms of ETF, a statistically significant ET dysfunction was observed in the hypothyroid patient group (P < 0.01).When hypothyroid patients were evaluated in terms of ETF before and after treatment, whereas 61.3% of cases had ET function before treatment, this ratio increased to 78.8% after treatment. Furthermore, according to pressure and compliance measurements, statistically significant increases were found in the after treatment measurements (P < 0.05). CONCLUSIONS: As a result of this study, we have come to the opinion that hypothyroidism can change tympanometric measurements and also cause ET dysfunction. However, more comprehensive and detailed studies researching the effects of hypothyroidism on tympanometric measurements are needed.

Oropharyngeal branchial cyst in a young child.

Second branchial cleft cysts are almost always located in the neck. Their presence in the oropharynx is extremely rare. An oropharyngeal branchial cyst in a 4-year-old child diagnosed by magnetic resonance and histopathology was presented. Anatomic location and pathological findings indicated the second branchial pouch origin. The cyst was excised transorally. Six months' follow-up of the child was uneventful and there was no recurrence.

The impact of pharyngeal repair time and suture frequency on the development of pharyngocutaneous fistula after total laryngectomy.

OBJECTIVE: Pharyngocutaneous fistula (PCF) is the most common postoperative complication after total laryngectomy. The aim of this study was to determine the relationship between PCF with pharyngeal repair time and the number of mucosal sutures. METHODS: The medical records of 47 patients who underwent total laryngectomy were assessed prospectively. The pharyngeal repair time and the number of horizontal, vertical, and cricopharyngeal muscle sutures were recorded. We observed the occurrence of PCF in 14 patients (29.8%). The mean time for pharyngeal repair in the PCF group was 22 minutes 59 seconds ± 5 minutes, and the mean number of vertical, horizontal, and cricopharyngeal muscle sutures was 8.57 ± 2.6, 11.14 ± 2.1, and 8.45 ± 1.9, respectively. The mean time for pharyngeal repair in the non-PCF group was 22 minutes 21 seconds ± 5 minutes, and the mean number of vertical, horizontal, and cricopharyngeal muscle sutures was 9.54 ± 2.6, 10.84 ± 2.3, and 7.36 ± 2.7, respectively. The differences in the pharyngeal repair time and the number of vertical, horizontal, and cricopharyngeal sutures between the 2 groups were not statistically significant (P > 0.05). Besides, there was no statistically significant difference between the mean suture counts per centimeter in horizontal plane (1.46 ± 0.35) and vertical plane (0.98 ± 0.25) in the PCF group and the mean suture counts per centimeter in horizontal plane (1.42 ± 0.37) and vertical plane (1.13 ± 0.3) in the non-PCF group (P > 0.05). CONCLUSIONS: There was no relation between PCF development with pharyngeal repair time, mucosal suture count, and suture frequency after total laryngectomy.

The effect of BMP-2, BMP-4 and BMP-6 on bone destruction of cholesteatoma presence.

OBJECTIVE: The aim of our study was to investigate the relationship between the destruction of temporal bone structures, ossicular chain destruction, dissemination of cholesteatoma and the expressions of bone morphogenetic proteins (BMPs), BMP-2, BMP-4 and BMP-6 in patients with acquired cholesteatoma. MATERIAL AND METHODS: This study was performed in a total of 80 patients with cholesteatoma and without cholesteatoma who had undergone surgery due to chronic otitis media. The patients were grouped as the study and the control groups. The study group comprised patients with primary acquired cholesteatoma, and the control group consisted of chronic otitis media patients without cholesteatoma. The samples were obtained from cholesteatoma tissue and the external acoustic meatus skin in study group patients and they were obtained from the external acoustic meatus skin only in control group patients. The Reverse Transcriptase Polymerase Chain Reaction method was used for the measurements of BMPs, BMP-2, BMP-4 and BMP-6 expressions. Polymerase Chain Reaction was studied by isolation of Ribonucleic Acid from the tissue samples. RESULTS: When the expressions of BMP in the external acoustic meatus skin were compared between the study and the control groups, the BMPs, BMP-2 and BMP-6 were determined to have a statistically significant relation in the study group (p<0.05), but BMP-4 was not significant (p>0.05). When the expression of BMP in cholesteatoma tissue was investigated in the study group patients, the BMPs, BMP-2 and BMP-6 were determined with statistically significant positivity (p<0.05), but there was no significant positivity for BMP-4 (p>0.05). In the study group, there was no statistical significance between the expressions of BMPs, BMP-2, BMP-4 and BMP-6 in cholesteatoma tissue, in the external acoustic meatus skin, and temporal and ossicular chain destruction, and dissemination of cholesteatoma (p>0.05). A statistically significant positivity for BMPs expression in cholesteatoma tissue was determined in patients with destruction of the incus+malleus+stapes (p<0.05). CONCLUSION: The expressions of BMPs, BMP-2 and BMP-6, were elevated in cholesteatoma tissue. Furthermore, the positivity of BMPs expression was statistically significant in patients with destruction of all the ossicles, and we think that this marker can be used for evaluation of the aggressiveness of cholesteatoma.