Can deep learning replace histopathological examinations in the differential diagnosis of cervical lymphadenopathy?

INTRODUCTION: We aimed to develop a diagnostic deep learning model using contrast-enhanced CT images and to investigate whether cervical lymphadenopathies can be diagnosed with these deep learning methods without radiologist interpretations and histopathological examinations. MATERIAL METHOD: A total of 400 patients who underwent surgery for lymphadenopathy in the neck between 2010 and 2022 were retrospectively analyzed. They were examined in four groups of 100 patients: the granulomatous diseases group, the lymphoma group, the squamous cell tumor group, and the reactive hyperplasia group. The diagnoses of the patients were confirmed histopathologically. Two CT images from all the patients in each group were used in the study. The CT images were classified using ResNet50, NASNetMobile, and DenseNet121 architecture input. RESULTS: The classification accuracies obtained with ResNet50, DenseNet121, and NASNetMobile were 92.5%, 90.62, and 87.5, respectively. CONCLUSION: Deep learning is a useful diagnostic tool in diagnosing cervical lymphadenopathy. In the near future, many diseases could be diagnosed with deep learning models without radiologist interpretations and invasive examinations such as histopathological examinations. However, further studies with much larger case series are needed to develop accurate deep-learning models.

Comparison of Resorption in Autogenous Dorsal Onlay Cartilage Grafts: An Experimental Study.

OBJECTIVES: The present study was designed to compare the graft resorption characteristics of autogenous cartilage from the septum, auricle, and costal in the superficial muscular aponeurotic system of the nasal dorsum of the rabbit model. METHODS: Equal-sized perichondrium-free septal, auricular, and costal cartilage grafts were collected from fifteen New Zealand white rabbits. Cartilage grafts were taken at the scale of two grafts from each animal's ear, two from its costal part, and one from its septum. Costal cartilage grafts that were shaped with a micro-motor device and monopolar electrocautery, elastic cartilage grafts that were shaped with a micro-motor device and monopolar electrocautery, and septal cartilage grafts that were shaped with a scalpel were all implanted into the dorsum of rabbit's noses to create five groups. All autogenous cartilage tissues were removed 3 months later. Cartilages were evaluated for histological features, graft mass, and chondrocyte density resorption. RESULTS: The elastic cartilage group, where electrocautery was used to shape the cartilage, had a higher resorption score than the other groups. The costal cartilage graft shaped with a micro-motor was also observed to have the best cartilage regeneration score. CONCLUSION: We observed that the resorption of costal cartilage was lower than that of ear and septum cartilage. It was determined that micro-motor application for the shaping process caused less resorption and stimulated more regeneration than cautery application. LEVEL OF EVIDENCE III: 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 .

Postoperative effects of bilateral sphenopalatine ganglion blockade in septorhinoplasty operations; double-blind randomized clinical trial.

OBJECTIVE: We aimed to investigate the effect of bilateral sphenopalatine ganglion blockade (SPGB) on the main postoperative complications in septorhinoplasty operations. METHODS: In this randomized, controlled, prospective study, 80 cases planned for Septorhinoplasty operations under general anesthesia were included in the study. The cases were divided into two groups; SPGB was performed with 2 mL of 0.25% bupivacaine bilaterally 15 min before the end of the operation in the SPGB group (Group S, n = 40). In the control group (Group C, n = 40), 2 mL of 0.9% NaCl solution was applied into both SPG areas. In the recovery unit after the operation; the pain and analgesic needs of the patients at 0, 2, 6 and 24 h were evaluated. RESULTS: There was no statistically significant difference between the groups in terms of hemodynamic parameters (ASA, MBP, HR) (p > 0.05) All VAS values were statistically lower in Group S than in Group C (p < 0.05). In Group S, the need for analgesic medication was found in 5 cases between 0-2 h, whereas in Group C, this rate was found in 17 cases, and it was statistically significant (p < 0.05). CONCLUSION: Bilateral SPGB application was determined to provide better analgesia in the early postoperative period compared to the control group, it was concluded that further studies are needed to say that there are significant effects on laryngospasm and nausea-vomiting. LEVEL OF EVIDENCE: 2, degree of recommendation B.

Postoperative effects of bilateral sphenopalatine ganglion blockade in septorhinoplasty operations; double-blind randomized clinical trial

Abstract Objective We aimed to investigate the effect of bilateral sphenopalatine ganglion blockade (SPGB) on the main postoperative complications in septorhinoplasty operations. Methods In this randomized, controlled, prospective study, 80 cases planned for Septorhinoplasty operations under general anesthesia were included in the study. The cases were divided into two groups; SPGB was performed with 2 mL of 0.25% bupivacaine bilaterally 15 min before the end of the operation in the SPGB group (Group S, n = 40). In the control group (Group C, n = 40), 2 mL of 0.9% NaCl solution was applied into both SPG areas. In the recovery unit after the operation; the pain and analgesic needs of the patients at 0, 2, 6 and 24 h were evaluated. Results There was no statistically significant difference between the groups in terms of hemodynamic parameters (ASA, MBP, HR) (p> 0.05) All VAS values were statistically lower in Group S than in Group C (p< 0.05). In Group S, the need for analgesic medication was found in 5 cases between 0-2 h, whereas in Group C, this rate was found in 17 cases, and it was statistically significant (p< 0.05). Conclusion Bilateral SPGB application was determined to provide better analgesia in the early postoperative period compared to the control group, it was concluded that further studies are needed to say that there are significant effects on laryngospasm and nausea-vomiting. Level of evidence: 2, degree of recommendation B.

Evaluation of carotid intima-media thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy.

BACKGROUND: Adenotonsillar hypertrophy can produce cardiopulmonary disease in children. However, it is unclear whether adenotonsillar hypertrophy causes atherosclerosis. This study evaluated carotid intimamedia thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy. METHODS: The study included 40 children with adenotonsillar hypertrophy (age: 5-10 years) and 36 healthy children with similar age and body mass index. Systolic blood pressure, diastolic blood pressure, and pulse pressure were measured in all subjects. Carotid intima-media thickness, carotid arterial systolic diameter, and carotid arterial diastolic diameter were measured using a high-resolution ultrasound device. Based on these measurements, carotid arterial strain, carotid artery distensibility, beta stiffness index, and elasticity modulus were calculated. RESULTS: Carotid intima-media thickness was greater in children with adenotonsillar hypertrophy (0.36±0.05 mm vs. 0.34±0.04 mm, P=0.02) compared to healthy controls. Beta stiffness index (3.01±1.22 vs. 2.98±0.98, P=0.85), elasticity modulus (231.39±99.23 vs. 226.46±83.20, P=0.88), carotid arterial strain (0.17±0.06 vs. 0.17±0.04, P=0.95), and carotid artery distensibility (13.14±3.88 vs. 12.92±3.84, P=0.75) were similar between children with adenotonsillar hypertrophy and the healthy controls. CONCLUSIONS: The present study revealed increased carotid intima-media thickness in children with adenotonsillar hypertrophy. The risk of subclinical atherosclerosis may be higher in children with adenotonsillar hypertrophy.

Effect of systemic clarithromycin and prednisolone on histamine-induced otitis media in guinea pigs.

CONCLUSION: The results of the study showed that clarithromycin has anti-inflammatory and antioxidant effects and, when it is combined with prednisolone, those effects gain strength. OBJECTIVES: The present study aims to investigate the effects that the antioxidant and anti-inflammatory activities of clarithromycin and/or prednisolone have on experimental otitis media in effusion-induced guinea-pigs. METHOD AND RESULTS: In this study, 35-male guinea pigs were randomly divided into five-groups. For the experimental otitis media, intra-tympanic histamine (0.1 ml) was injected into the guinea pigs in all of the groups except the control group. Then, 24-h after the intra-tympanic injections, clarithromycin (15 mg/kg/day) and/or prednisolone (1 mg/kg/day) were applied intraperitoneally to the guinea-pigs for 7-days. The biochemical analysis showed an increase in antioxidant capacity and a decrease in oxidant status and malondialdehyde (MDA) levels in the clarithromycin group and the prednisolone group and especially in the clarithromycin+prednisolone group, as compared to the experimental group (p < 0.05). In the cytokine analysis, lower levels of interleukin (IL)-6 and IL-17A and higher IL-10 were found in the clarithromycin, prednisolone, and clarithromycin+prednisolone groups than in the experimental group (p < 0.05). Furthermore, the histologic analyses showed histopathologic changes in the middle ear mucosa of the experimental group, but comparatively fewer-histopathologic changes were observed in the clarithromycin, prednisolone, and clarithromycin+prednisolone groups.