Risk of hearing loss in the opposite ear after tympanomastoidectomy.

PURPOSE: The definitive treatment for chronic suppurative otitis media is surgery. Surgical technique and procedure varies according to individual case findings and pathology and may require mastoidectomies in which the canal wall is preserved or lowered to eradicate disease from mastoid air cells. Surgical treatment of chronic middle ear disease carries a risk of damage to the inner ear. The aim of this study was to investigate whether the noise produced by the tour system following chronic ear surgery causes sensorineural hearing loss, a condition for which not many studies have been published in the literature. METHODS: The study consisted of a total of 49 patients with type I, type II and type III canal wall preservation and 62 patients with tympanoplasty with canal wall preservation and lowering. Bone and air thresholds were compared before and after middle ear surgery. Changes in bone and air thresholds were compared according to the type of tympanoplasty. RESULTS: In the ICW-I, ICW-II and ICW-III tympanoplasties, and in the ICW and CWD tympanoplasties, the preoperative and postoperative values of the opposite ear hearing measurements were performed, and did not differ according to the type of surgery. There is no correlation drilling duration and hearing for the opposite ear. CONCLUSION: The prevention of postoperative sensorineural hearing loss depends on multiple factors, and assessing the magnitude of hearing loss in relation to these factors is important in determining the success of the surgery.

Low Grade Chondrosarcoma of the Posterior Nasal Septum.

Chondrosarcoma originating from the nasal septum is extremely rare. CT, MRI and biopsy are standard in diagnosis. Although wide surgical excision of chondrosarcoma is used in the treatment, endoscopic excision can be recommended in appropriate cases. In this case report, we have presented a case of chondrosarcoma that was excised endoscopically and no recurrence or distant metastasis was observed in the 5-year follow-up.

Determining the effect of obstructive sleep apnea syndrome on peripheral vestibular system and hearing.

There have been studies in the literature regarding the effect of obstructive sleep apnea syndrome on hearing function, but studies on the effect of obstructive sleep apnea syndrome on the peripheral vestibular system are limited. The aim of the present study was to determine whether obstructive sleep apnea syndrome causes functional neurological changes, particularly in the peripheral vestibular system, using the video head impulse test. Overall, 57 patients with obstructive sleep apnea syndrome were included; the 'Snorers' group comprised 20 volunteers diagnosed with simple snoring in the polysomnography test. The severity of apnea was assessed by monitoring cardiac and respiratory functions during sleep in both groups. The video head impulse test and audiological evaluations were performed in both groups. Statistically significant differences were found in the cochlea and semicircular canals of our patients in the video head impulse test and audiological battery tests. It may be assumed that decreased blood oxygen concentrations and chronic hypoxaemia have negative effects on the vestibule, cochlear sensory epithelium, and the auditory pathways. We think that inner ear structures and pathways may be affected due to hypoxia in obstructive sleep apnea syndrome. Therefore, screening patients with obstructive sleep apnea syndrome with an audiometry battery may help to detect inner ear pathologies early.

Validity and Reliability of Turkish Version of Chronic Otitis Media Questionaire-12.

Disease-specific quality of life scales have garnered prominence in recent years. Chronic Otitis Media Questionnaire-12 (COMQ-12) is a new scale developed for evaluating health-related quality of life in patients with chronic otitis media (COM). This study aimed to investigate the validity and reliability of the Turkish version of COMQ-12. The COMQ-12 was translated into Turkish. The Turkish version was administered to four groups consisting of 35 individuals to assess its validity. Group 1 consisted of healthy individuals, group 2 had patients with inactive COM, group 3 had patients with healed COM and group 4 had patients with active COM. The questionnaire was administered to healthy participants twice to estimate test-retest reliability. The scores of the control group were compared with the others to test the validity of the questionnaire. The test and retest Cronbach's alpha values of the Turkish version of COMQ-12 were 0.918 and 0.917, respectively, which indicates excellent internal consistency. The total and each item scores of the active COM group were significantly higher than the control group (p < 0.001). The single measures intraclass correlation coefficient was 0.824 (with a 95% confidence interval from 0.678 to 0.907). The Turkish version of COMQ-12 was determined to be highly valid and reliable. It is thought that the effect of COM on the quality of life can be monitored more objectively by using this questionnaire.

Relationship between otitis media with effusions and pediatric obesity.

The aim of this study was to investigate the relationship between obesity and otitis media with effusion. 471 cases with ages between 4 and 12 years were included. Of the 471 cases, 204 cases (97 girls, 107 boys) were diagnosed OME, the study group, 267cases (127 girls, 140 boys) were the control group. Body mass index of the two groups were compared to each other. The average body mass index for girls in all age groups was 17.93 ± 1.92 (n: 97) for cases with OME and 16.67 ± 1.28 (n: 127) for the control group.(p < 0.05). The average BMI for boys in all age groups was 18.25 ± 1.98 (n: 107) for cases with OME and 16.30 ± 1.26 (n: 140) for the control group. (p < 0.05). Children with a BMI greater than or equal to the 85th percentile were considered to be overweight or obese. Regarding the girls, of the 97 cases with OME, 23 cases were overweight, whereas of the 127 control cases, 7 cases were found to be overweight. This difference was statistically significant (p < 0.05). Regarding the boys, of the 107 cases with OME, 29 cases were overweight, whereas of the 140 control cases, 13 cases were found to be overweight. This difference was also statistically significant (p < 0.05). It is concluded that childhood obesity and overweight may play a role as a predisposing factor in the development of OME. It is also noted that even if a child is in the normal range of BMI percentile (less than 85th percentile; not obese or overweight), as the BMI increases, the relative risk of developing OME increases.

Linguistic Adaptation, Reliability, and Validation of the Turkish Version of the Reflux Symptom Index.

INTRODUCTION: The reflux symptom index (RSI) has been designed to raise the clinical suspicion of laryngopharyngeal reflux (LPR) in patients presenting with ear, nose, and throat symptoms. OBJECTIVE: To develop a Turkish version of the RSI (Tr-RSI) and to evaluate its internal consistency, reliability, and clinical validity METHODS: The RSI was translated into Turkish. A total of 44 asymptomatic control subjects without LPR and 62 patients with LPR were enrolled into this study. The patients were treated with diet and behavioral modifications combined with 20 mg of rabeprazole twice daily for 3 months. All individuals were asked to fill the Tr-RSI. Participants in the control group were asked to refill the Tr-RSI after 1 week, whereas those in the patient group after treatment. Test-retest reliability, validity, and internal consistency were computed. RESULTS: The Cronbach's alpha value of Tr-RSI was 0.959, indicating excellent internal consistency. The single-measurement intra-class correlation coefficient absolute agreement was 0.948 (with 95% confidence interval of 0.907-0.971), indicating good test-retest reliability. The Tr-RSI scores for total and each item were significantly higher in the LPR patient group than in the control group (P < 0.001). In the LPR patient group, the posttreatment Tr-RSI scores for each item and total were significantly lower than the pretreatment scores (P < 0.001). CONCLUSION: The Tr-RSI was successfully created. It can be used with strong internal consistency, high test-retest reliability, and optimal clinical validity.

Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Mean Platelet Volume in Patients with Branchial Cleft Cyst.

Branchial cleft cysts are benign masses of the head and neck. Etiopathogenesis is unclear and many factors such as inflammatory mechanisms can play a role. The aim of our study is to investigate the predictive value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV), which are hematologic inflammatory markers, in branchial cleft cyst (BCC). The records of 27 patients who were operated with the diagnosis of BCC in the ENT clinic between January 2011 and March 2020 and 27 healty subjects were retrospectively reviewed. The control group consisted age and sex-matched subjects scheduled for rhinoplasty. Neutrophil, lymphocyte, platelet and MPV values were recorded from the complete blood count samples for all participants. The statistical relationship for NLR, PLR and MPV values between the patient and the control groups was investigated. The NLR values of the patients were significantly lower than the healthy controls (p:0.007). But no statistically significant correlation was found for PLR (p:0.586) and MPV(p:0.676) values between the groups. This is the first study to evaluate the significance of NLR, PLR and MPV in branchial cleft cyst. Decreased NLR may be used as a predictive marker for BCC. But PLR ande MPV should not be used to predict branchial cleft cyst. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-021-02789-1.

The effects of SARS-CoV-2 on hearing thresholds in COVID-19 patients with non-hospitalized mild disease.

INTRODUCTION: COVID-19 may have many nonspecific symptoms, such as hearing loss, tinnitus and dizziness. This study aims to investigate the effects of SARS-CoV-2 on the hearing thresholds of patients with COVID-19. METHODS: A total of 20 patients aged 20-55 years who were diagnosed with COVID-19 were included in this study. The relationship between the pure-tone thresholds of patients before and after COVID-19 was evaluated. RESULTS: There was no statistically significant difference between bone conduction pure-tone thresholds in all frequencies before and after COVID-19. CONCLUSION: SARS-CoV-2 has no effects on the hearing thresholds in patients with non-hospitalized mild COVID-19 disease. Further studies are needed to investigate the possible effects of SARS-CoV-2 on the auditory system.

Evaluation of Hearing Thresholds by Using a Mobile Application in Children with Otitis Media with Effusion.

OBJECTIVE: Otitis media with effusion (OME) is the most common cause of hearing loss in children. Early diagnosis is important as hearing loss affects speech and language development in children. The aim of this study was to compare conventional audiometry with the Android mobile operating system application Hearing TestTM in the evaluation of hearing thresholds in children with OME and to determine the accuracy and reliability of the mobile application. Design and Study Sample: Fifty school-age children aged between 5 and 15 years with OME in at least 1 ear were included in the study. First, hearing thresholds were obtained by conventional audiometric methods and the degree of hearing loss was determined. Then, the hearing thresholds of the patients were measured using the smartphone-based Hearing TestTM application. The data were compared using Cohen's kappa analysis. RESULTS: OME was detected in 88 ears. There was no statistically significant correlation between the hearing threshold results obtained with the mobile phone and conventional audiometry at 500, 1,000, 2,000, and 4,000 Hz. CONCLUSION: The Android mobile phone application Hearing TestTM (version 1.1.3) is not an appropriate screening test to detect hearing loss in children with OME.

The effect of adenoid hypertrophy on hearing thresholds in children with otitis media with effusion.

INTRODUCTION: Otitis media with effusion is common middle ear mucosa disease that can cause hearing loss in children. Adenoid hypertrophy can cause recurrent acute otitis media in addition to otitis media with effusion as a result of eustachian tube dysfunction and primary infection focus. The aim of this study was to investigate the effect of adenoid hypertrophy on the hearing threshold in children suffering from otitis media with effusion. METHODS: Children of school age with otitis media with effusion were included in the study. The size and location of the adenoid tissue were determined by examination with a flexible endoscope. Four adenoid size groups were determined according to the percentage of choanal closure. The coverage was 0-25% in the first group, 26-50% in the second group, 51-75% in the third group and 76-100% in the 4th group. The location of the adenoid tissue in the nasopharynx was divided into three groups. In group A, the adenoid tissue was not in contact with torus tubarius. In group B, the adenoid tissue was in contact with the torus tubarius but did not cover it. In group C, the adenoid tissue covered the torus tubarius completely. Bone and air conduction thresholds were determined using standard procedures. The statistical relationship between the size and location of adenoid tissue and the hearing thresholds was investigated. RESULTS: The study was conducted with the 88 ears of 50 children aged 5-15 years. The median values of mean air conduction thresholds at 500 Hz, 1000 Hz, and 2000 Hz in the adenoid tissue size groups 1-4 were 22 dB HL, 20 dB HL, 15 dB HL, and 20 dB HL respectively. The median values of the mean air conduction thresholds were 20 dB HL, 20 dBHL and 18 dB HL in the adenoid location group A-C, respectively. No significant correlation was found between the groups (p:0.213) and the relevant hearing values (p:0.670). Type B tympanogram was identified in 46 ears and type C tympanogram in 42 ears. The mean hearing thresholds were significantly higher in the ears with a type B tympanogram in the otitis media with effusion cases. (P < 0.001).There was no significant correlation between the duration of effusion and the adenoid size (p:0.931), adenoid location (p:0.626) and hearing threshold (p:0.815). CONCLUSION: We concluded that adenoid tissue size and location have no effect on hearing thresholds and the duration of effusion in otitis media with effusion. We suggest caution before deciding on adenoidectomy in otitis media with effusion cases. Adenoidectomy should not be performed in children over 4 years of age unless there is a definite indication such as nasal obstruction or chronic adenitis.

Hyperbaric oxygen therapy as adjuvant therapy in necrotizing fasciitis of the face: case report.

Facial necrotizing fasciitis is a rare bacterial infectious disease. Rapid necrosis of the tissues and suppurative fasciitis is pathognomonic. It can be seen following odontogenic infection. Early aggressive debridements and wide-spectrum antibiotic therapy are currently accepted treatments. A 60-year-old man was admitted to the otolaryngology clinic for facial pain and swelling after odontogenic infection. Inflamed left maxilla and orbit were seen, and abscess contents spontaneously drained into the mouth. It was determined that infectious markers were increased in the blood. On MRI, a broad abscess with edema and gas formation was seen. Debridement of the necrotic tissue was performed immediately and wide-spectrum antibiotic therapy was started. Infection was stopped and wound was closed, with four weeks of antibiotic therapy, three sessions of debridement, and 30 sessions of hyperbaric oxygen (HBO2) therapy. HBO2 therapy must not replace the combination of early aggressive debridements and wide-spectrum antibiotic therapy, but rather must be considered as an important adjuvant treatment.

Association between skin flap thickness and Frey's syndrome in parotid surgery.

BACKGROUND: Frey's Syndrome is a frequent complication of parotid surgery. The aim of this study was to evaluate the association between skin flap thickness and Frey's Syndrome in patients who underwent superficial parotidectomy. METHODS: Thirty adult patients were randomized into 2 groups: subcutaneous and subsuperficial musculoaponeurotic (sub-SMAS) skin elevation. In both groups skin flap thickness was measured by a micrometer at defined points. The patients were queried for subjective Frey's Syndrome and Minor's test was performed for objective Frey's Syndrome. RESULTS: The thickness of skin flap in the subcutaneous group was significantly less than that in the sub-SMAS group. There was no statistical significance between skin flap thickness and objective Frey's Syndrome, although the dimension of the colored area in the subcutaneous group was larger compared with that of the sub-SMAS group: 7.5 cm(2) (0-48 cm(2) ) and 0.5 cm(2) (0-18 cm(2) ), respectively. CONCLUSIONS: In conclusion, sub-SMAS elevation of the skin flap in parotid surgery provides better results regarding Frey's Syndrome.

Efficacy of radiofrequency turbinate reduction: evaluation by computed tomography and acoustic rhinometry.

BACKGROUND: Radiofrequency ablation (RFA) of the inferior turbinates is a popular surgical intervention that aims to reduce turbinate volume. However, in a few studies, the amount of volume loss was analyzed objectively. OBJECTIVE: The aim of this study was to investigate the effects of RFA on the inferior turbinate by comparing its volume before and 6 weeks after surgery via computed tomography (CT) and the change in minimal cross-sectional areas (MCAs) via acoustic rhinometry objectively. METHODS: Eighteen patients who underwent RFA with the diagnosis of isolated bilateral inferior turbinate hypertrophy were enrolled in the study. All patients were evaluated pre- and postoperatively with paranasal CT and acoustic rhinometry quantitatively for the assessment of inferior turbinate volume decrement and nasal cavity volume increment. Also, the subjective relief of obstructive symptoms was assessed with a visual analogue scale. RESULTS: There were significant reductions in volume for both right and left turbinates in the tomographic evaluation (p  =  .007 and .004, respectively). Acoustic rhinometry revealed nonsignificant increments for both MCA1 and MCA2 values except MCA2 of the right side. We also indicated a statistically significant correlation between the mean volume reduction in CT and improvement in mean MCA2 volume (2 to 5 cm from the nostril) obtained from acoustic rhinometric data in 36 turbinates (r  =  .337, p  =  .044). CONCLUSION: We showed that the use of RFA was highly effective in both reducing turbinate volume (demonstrated by radiologic findings and rhinometric analysis) and improving obstructive symptoms in patients with an isolated inferior turbinate.

[The role of sentinel lymph node biopsy in oral cavity cancer]. / Oral kavite kanserlerinde sentinel lenf nodu biyopsisinin rolü

OBJECTIVES: This study aims to evaluate the role of sentinel lymph node (SLN) biopsy in patients who had clinically N0 oral cavity cancer in the neck assessment. PATIENTS AND METHODS: Between May 2006 and May 2008, nine patients with clinically N0 oral cavity cancer (6 females, 3 males; mean age 57±24.7 years; range 31 to 71 years) who underwent surgical treatment were enrolled in this study. Eight of them had corpus linguae carcinoma, while one had lower lip carcinoma. Tumor stages were T1 in four, T2 in four patients, and T4a in one patient. The patients underwent surgery within 8 to 16 hours after lymphoscintigraphy was performed for detecting SLNs. Initially primary tumor was excised. Then, SLNs which were identified by a gamma probe, lifting skin flap of the neck were excised. Neck dissection was performed as scheduled. SLNs were examined in frozen sections. The results of frozen section and definitive histopathological diagnosis of SLNs were compared with each other, as well as the definitive histopathological diagnosis of the dissection materials. RESULTS: In all patients SLNs were completely identified and excised successfully, including one node in one patient, two nodes in six patients and three nodes in two patients. All nodes were localized ipsilaterally in the neck. In addition, the frozen section and definitive histopathological examination results of all nodes were consistent. Biopsy results indicated that eight patients were SLN-negative, while one was SLN-positive. Only one patient was SLN-negative, although the pathological diagnosis was found to be N1. CONCLUSION: Our study results suggests that SLN biopsy may be applicable for early stage oral cavity tumors.