Eustachian tube dysfunction after using different types of masks during the coronavirus disease 2019 pandemic.

OBJECTIVE: This study aimed to investigate the relationship between the use of different types of masks (N95/filtering facepiece type 2, surgical) and Eustachian tube dysfunction in healthcare workers. METHODS: The study included 37 healthcare workers using N95/filtering facepiece type 2 masks and 35 using surgical masks for at least 6 hours per day, and 42 volunteers who are not healthcare workers using surgical masks for less than 6 hours per day. Participants' demographic features, clinical data and Eustachian Tube Dysfunction Questionnaire scores were compared. RESULTS: The frequencies of autophony and aural fullness were significantly higher in the healthcare workers using N95/filtering facepiece type 2 masks. Autophony and aural fullness were significantly greater in the post-mask period than the pre-mask period. Middle-ear peak pressures and Eustachian Tube Dysfunction Questionnaire scores were higher in healthcare workers who used N95/filtering facepiece type 2 masks. CONCLUSION: Healthcare workers who used N95/filtering facepiece type 2 masks had worsened middle-ear pressures and Eustachian Tube Dysfunction Questionnaire scores. Use of N95/filtering facepiece type 2 masks was associated with higher rates of autophony, aural fullness and higher Eustachian Tube Dysfunction Questionnaire scores in the post-mask period.

Disease and Quality of Life Aspects of Cat Allergy in Non-Pet Owners with Allergic Rhinitis.

INTRODUCTION: The severity of cat allergy-related symptoms varies widely. The rising prevalence of cat owning makes it a significant human health problem. The aim of this study was to evaluate disease severity and quality of life (QoL) aspects of cat sensitization and allergy in non-pet owners with allergic rhinitis (AR). METHODS: In this study, 231 out of 596 patients with AR were enrolled. The disease severity and QoL measures of the non-pet owner patients were evaluated according to their demographics and allergen sensitizations. The data were re-gathered after cat exposure for cat-sensitized patients (n = 53). RESULTS: The median age of the patients (174 females, 57 males) was 33 (18-70). The overall frequency of cat sensitization was 12.6% (75/596). The frequency of cat allergy in this cohort was 13.9% (32/231). Family history of atopy and multi-allergen sensitization were more common in the cat-sensitized patients. Disease severity and QoL scores were higher in the cat allergy group after cat exposure. Cat allergy was the major independent risk factor for the severity of AR and QoL measures. CONCLUSION: Due to the fact that indirect exposure to cat dander allergens can occur anywhere, even where cats are not present, cat-sensitized people should be aware of cat allergy. Cat allergy appears to be an independent risk factor for disease severity and QoL effects for non-pet owner patients with AR.

The Bibliometric Aspects of Case Report/Series in Science Citation Index Otorhinolaryngology Journals.

OBJECTIVE: The rate of case report/series (CR/S) acceptance by the high impact journals is steadily declining mainly due to low citations. The aim of this study is primarily to investigate the bibliometric aspects of CR/S in the field of otorhinolaryngology (ORL) and secondarily to guide prospective authors as to which type of CR/S have better chances of acceptance and citation in the current publication climate. METHODS: Bibliometric and citation analysis of CR/S published in Science Citation Index (SCI) journals of ORL covering the years of 2012-2016 was conducted. RESULTS: There were 1332 (8.9%) CR/S among 14900 publications in 11 SCI ORL journals published between January 1st, 2012 and December 31st, 2016. The most common published field and subject were the 'pediatric ORL' (33.2%) and 'rare cases/conditions' (47.1%) respectively. 'General ORL' (5.13) and 'treatment' (4.93) categories had the highest citations. Only 10% of CR/S had ≥10 citations. The mean citation counts were positively correlated with impact factors of journals (r=0.131, p<0.001), mean number of authors (r=0.151, p<0.001), mean number of cases (r=0.192, p<0.001), mean number of references (r=0.315, p<0.001) and mean number of Web of Science visits (r=0.291, p<0.001). CONCLUSION: Although CR/S provides low citation rates in ORL SCI journals, they may serve important topics in terms of diagnosis, treatment, or complications. The findings and the main discussions of this study may direct the rationale for the consistent publication of CR/S in the evidence-based medicine era.

Turkish Guideline for Diagnosis and Treatment of Allergic Rhinitis (ART).

OBJECT: To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients. METHODS: The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. RESULTS: A detailed guideline about all aspects of allergic rhinitis was created. CONCLUSION: The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals.

Dexamethasone-loaded chitosan-based genipin-cross-linked hydrogel for prevention of cisplatin induced ototoxicity in Guinea pig model.

OBJECTIVES: The aim of this study was to investigate the protective effects of a sustained release form of dexamethasone (dex) loaded chitosan-based genipin-cross-linked hydrogel (CBGCH) in a guinea pig model of cisplatin (CP) induced hearing loss. METHODS: Implantation of CBGCH was made by intratympanic (IT) injection. Ototoxicity was produced by intraperitoneal (IP) single dose of 14 mg/kg CP. Animals were randomly divided into four groups with 6 guinea pigs in each. Group 1 received only IP CP; group 2 received only IT dex-loaded CBGCH injections. Group 3 and group 4 received IP CP, plus IT nondrug CBGCH and IT dex-loaded CBGCH respectively 24 h prior to IP CP injections. Distortion product otoacoustic emissions (DPOAEs) and auditory brainstem response (ABR) measurements were obtained before the treatments and solely ABR measurements were done after 3 and 10 days. The ultrastructural effects were investigated by scanning electron microscopy (SEM) analysis. RESULTS: The postCP ABR thresholds at 4, 8, 12, 16, 32 kHz frequencies were significantly better in group 4 than groups 1 and 3 (p < 0.05). The comparison of time effective ABR thresholds between groups 1 and 4 and between groups 3 and 4 showed significantly lower ABR thresholds in group 4 (p < 0.05). The SEM analysis showed that stereocilia of inner and outer hair cells were preserved in group 4, almost like group 2, whereas cytotoxic degenerations were noted in groups 1 and 3. CONCLUSIONS: Intratympanic administration of dex-loaded CBGCH has been shown to provide functional and structural protection against CP-induced ototoxicity.

Sound energy absorbance characteristics of cartilage grafts used in type 1 tympanoplasty.

OBJECTIVE: The purpose of this prospective case-control study is to evaluate the sound energy absorbance characteristics of cartilage grafts in patients, who have undergone type 1 cartilage tympanoplasty. METHODS: Thirty-four operated ears of 32 patients and 70 ears of 35 control subjects were included. Differences of pure-tone audiometry thresholds and wideband ambient-pressure absorbance ratios with respect to the graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery were analyzed. Receiver operating characteristics curve was generated to detect the absorbance level at which the reconstructed tympanic membrane behaves as 'near-normal tympanic membrane'. RESULTS: In the surgical group, wideband energy absorbance ratios at all 1/2-octave band frequencies were significantly worse than normal ears. Energy absorbance ratios at 2000 and 2828Hz frequencies were higher in patients with tragal cartilage grafts. Higher absorbance ratios at 250-750Hz range were obtained in patients with 400µm cartilage graft thickness, <50% cartilage surface area ratio and ≥5 years since surgery. A multivariate generalized linear model revealed common effects of the independent variables at 8000Hz. The receiver operating characteristics analysis generated a cut-off level of 63.20% of sound energy absorbance at 1400Hz with 83% sensitivity and 88% specificity. CONCLUSION: Even though no differences in hearing thresholds were observed; graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery affected the course of sound energy absorbance after type 1 cartilage tympanoplasty as evidenced by wideband tympanometry.

Computed Tomographic Analysis: The Effects of Frontal Recess Morphology and the Presence of Anatomical Variations on Frontal Sinus Pneumatization.

The aim of this study is to describe the morphology of frontal recess area with its anatomical variations and to reveal if frontal recess morphology and the anatomical variations related to that region have effects on the pneumatization of the frontal sinuses. The frontal sinus and recess morphometry of 136 sides of 68 dry skulls were evaluated on multislice high-resolution computed tomography. The relationships between frontal sinus and frontal recess measurements were analyzed by correlation and linear regression analysis. The variables between the groups of anatomical variations were analyzed by Mann-Whitney U test and χ test or Fisher exact test. A positive relationship between the sagittal length of spina nasalis interna and morphometric measurements of frontal sinus was revealed (P <0.05). Agger nasi cells were present in 64.2% of sides, supraorbital ethmoid cells (SOECs) in 19.6%, type 3 frontal cells (FCs) in 18.9%, suprabullar cells in 24.3%, and frontal bulla was noted in 5.4%. Intersinus septal cells were observed in 16.2% of the skulls. There were statistically different increases in the measurements of frontal sinus morphometry in the presences of SOECs and type 3 FCs (P <0.05). The diameter of frontal sinus ostium was decreased in the presences of AN, SOEC, type 3 FC, and supraorbital ethmoid cell statistically (P = 0.049, P = 0.029, P = 0.043, P <0.001 respectively). In conclusion, frontal sinus pneumatization was affected by the spina nasalis interna and the presence of anatomical variations related to frontal recess or ostium region instead of the morphology of that area.

The classification of frontal sinus pneumatization patterns by CT-based volumetry.

PURPOSE: We aimed to define the classification of frontal sinus pneumatization patterns according to three-dimensional volume measurements. METHODS: Datasets of 148 sides of 74 dry skulls were generated by the computerized tomography-based volumetry to measure frontal sinus volumes. The cutoff points for frontal sinus hypoplasia and hyperplasia were tested by ROC curve analysis and the validity of the diagnostic points was measured. RESULTS: The overall frequencies were 4.1, 14.2, 37.2 and 44.5 % for frontal sinus aplasia, hypoplasia, medium size and hyperplasia, respectively. The aplasia was bilateral in all three skulls. Hypoplasia was seen 76 % at the right side and hyperplasia was seen 56 % at the left side. The cutoff points for diagnosing frontal sinus hypoplasia and hyperplasia were '1131.25 mm(3)' (95.2 % sensitivity and 100 % specificity) and '3328.50 mm(3)' (88 % sensitivity and 86 % specificity), respectively. CONCLUSIONS: The findings provided in the present study, which define frontal sinus pneumatization patterns by CT-based volumetry, proved that two opposite sides of the frontal sinuses are asymmetric and three-dimensional classification should be developed by CT-based volumetry, because two-dimensional evaluations lack depth measurement.

Laryngeal leiomyosarcoma with coexistent tuberculous mediastinal lymphadenopathy.

Laryngeal leiomyosarcoma is an extremely rare malignancy originating from the smooth muscles of blood vessels. Herein, we present the first case of leiomyosarcoma arising from the glottic area of the larynx with coexistent tuberculous mediastinal lymphadenopathy. The patient was treated with vertical laryngectomy and anti-tuberculous medication. He has been disease-free for 24 months since initial treatment.

Elective superior mediastinal dissection for laryngeal carcinoma involving subglottis.

CONCLUSION: Despite the low incidence of superior mediastinal metastasis (SMM) we recommend elective superior mediastinal dissection (ESMD) and close follow-up for all patients with laryngeal carcinoma involving the subglottis, because higher peristomal recurrence (PR) rates and lower survival rates were observed in the presence of SMM numerically even though statistical support was lacking. BACKGROUND: This study was undertaken to identify the incidence of SMM and to evaluate the need for ESMD in laryngeal tumors involving the subglottis. METHODS: Medical records of patients who had undergone total laryngectomy for laryngeal carcinoma were reviewed retrospectively and 68 patients (45 with ESMD and 23 without ESMD) who had pathologically proven subglottic involvement were included in the study. RESULTS: SMM was found in 3 of 45 (6.6%) patients who underwent ESMD. The PR rate was higher in patients with SMM (66.7%) than in patients without SMM (9.5%) and the presence of SMM was significantly related to PR (p = 0.043) in univariate analysis. However, this relationship was not preserved in multivariate analysis. The 3- and 5-year survival rates of patients with SMM were lower (both 66.7%) than patients without SMM (83.3% and 76.2%, respectively), but decreased survival rates did not differ statistically from the survival rates of 42 patients without SMM.

[Primary intraosseous squamous cell carcinoma of the mandible]. / Alt çenenin primer intraosseöz yassi hücreli karsinomu.

Primary intraosseous squamous cell carcinoma is an extremely rare tumor of the mandible. The diagnosis is based on the evidences showing that the tumor is neither originated from a distant metastasis of another primary tumor nor an invasive oral cancer. In this article, we report a 59-year-old female case with a medical history of ductal carcinoma of the breast, lichen planus, and rheumatoid arthritis who was admitted with complaints of a painful and swollen left lower jaw, and was surgically treated for primary intraosseous carcinoma of the mandible and with postoperative adjuvant radiotherapy.