Does myringosclerosis affect the success of butterfly myringoplasty?

OBJECTIVES: Butterfly inlay myringoplasty is a simple and practical surgical technique used in the repair of tympanic membrane perforation offering good outcomes in terms of hearing. The present study evaluates the effects of myringosclerosis on the success of surgery by reviewing demographic data, perforation size and hearing outcomes of patients undergoing endoscopic inlay butterfly myringoplasty due to chronic otitis media. METHODS: The study included 75 patients who underwent endoscopic inlay butterfly myringoplasty with the diagnosis of chronic suppurative otitis media in the Department of Otorhinolaryngology at Firat University Faculty of Medicine between March 2018 and July 2021. The patients were divided into three groups as the following. Group I: Patients without a myringosclerotic focus in the neighborhood of tympanic membrane perforation, Group II: Patients with a less than 50% myringosclerotic focus in the neighborhood of tympanic membrane, and Group III: Patients with a more than 50% myringosclerotic focus in the neighborhood of tympanic membrane. RESULTS: The comparison of all preoperative and postoperative parameters and the reduction in air-bone gap between the groups did not show statistically significant difference (p>0.05). The comparison of air-bone gaps between preoperative and postoperative measurements showed a statistically significant difference in all groups (p<0.05). The grafting success rate was 100% in Group I, 96.4% in Group II, and 95.6% in Group III. The mean operation time was 28.57±2.54 min in Group I, 32.14±2.44 min in Group II, and 30.69±3.43 in Group III; there was a statistically significant difference only between Group I and Group II (p = 0.001). CONCLUSIONS: The graft success rate and hearing gain in patients with myringosclerosis were similar to those in patients without myringosclerosis. Therefore, butterfly inlay myringoplasty is applicable to patients with chronic otitis media regardless of the presence or absence of myringosclerosis.

Comparison of Computed Tomography-Based Artificial Intelligence Modeling and Magnetic Resonance Imaging in Diagnosis of Cholesteatoma.

BACKGROUND: In this study, we aimed to compare the success rates of computed tomography image-based artificial intelligence models and magnetic resonance imaging in the diagnosis of preoperative cholesteatoma. METHODS: The files of 75 patients who underwent tympanomastoid surgery with the diagnosis of chronic otitis media between January 2010 and January 2021 in our clinic were reviewed retrospectively. The patients were classified into the chronic otitis group without cholesteatoma (n=34) and the chronic otitis group with cholesteatoma (n=41) according to the presence of cholesteatoma at surgery. A dataset was created from the preoperative computed tomography images of the patients. In this dataset, the success rates of artificial intelligence in the diagnosis of cholesteatoma were determined by using the most frequently used artificial intelligence models in the literature. In addition, preoperative MRI were evaluated and the success rates were compared. RESULTS: Among the artificial intelligence architectures used in the paper, the lowest result was obtained in MobileNetV2 with an accuracy of 83.30%, while the highest result was obtained in DenseNet201 with an accuracy of 90.99%. In our paper, the specificity of preoperative magnetic resonance imaging in the diagnosis of cholesteatoma was 88.23% and the sensitivity was 87.80%. CONCLUSION: In this study, we showed that artificial intelligence can be used with similar reliability to magnetic resonance imaging in the diagnosis of cholesteatoma. This is the first study that, to our knowledge, compares magnetic resonance imaging with artificial intelligence models for the purpose of identifying preoperative cholesteatomas.

Is it useful to use computerized tomography image-based artificial intelligence modelling in the differential diagnosis of chronic otitis media with and without cholesteatoma?

OBJECTIVE: Cholesteatoma is an aggressive form of chronic otitis media (COM). For this reason, it is important to distinguish between COM with and without cholesteatoma. In this study, the role of artificial intelligence modelling in differentiating COM with and without cholesteatoma on computed tomography images was evaluated. METHODS: The files of 200 patients who underwent mastoidectomy and/or tympanoplasty for COM in our clinic between January 2016 and January 2021 were retrospectively reviewed. According to the presence of cholesteatoma, the patients were divided into two groups as chronic otitis with cholesteatoma (n = 100) and chronic otitis without cholesteatoma (n = 100). The control group (n = 100) consisted of patients who did not have any previous ear disease and did not have any active complaints about the ear. Temporal bone computed tomography (CT) images of all patients were analyzed. The distinction between cholesteatoma and COM was evaluated by using 80% of the CT images obtained for the training of artificial intelligence modelling and the remaining 20% for testing purposes. RESULTS: The accuracy rate obtained in the hybrid model we used in our study was 95.4%. The proposed model correctly predicted 2952 out of 3093 CT images, while it predicted 141 incorrectly. It correctly predicted 936 (93.78%) of 998 images in the COM group with cholesteatoma, 835 (92.77%) of 900 images in the COM group without cholesteatoma, and 1181 (98.82%) of 1195 images in the normal group. CONCLUSION: In our study, it has been shown that the differentiation of COM with and without cholesteatoma with artificial intelligence modelling can be made with highly accurate diagnosis rates by using CT images. With the deep learning modelling we proposed, the highest correct diagnosis rate in the literature was obtained. According to the results of our study, we think that with the use of artificial intelligence in practice, the diagnosis of cholesteatoma can be made earlier, it will help in the selection of the most appropriate treatment approach, and the complications can be reduced.

Can prestin level be a biomarker for determining sensorineural hearing loss?

OBJECTIVE: To determine prestin levels in patients with sensorineural hearing loss and to assess whether the prestin level could be a determining factor in predicting sensorineural hearing loss. MATERIAL AND METHODS: The study was carried out with patients that presented to the Department of Otorhinolaryngology of Firat University. Patients were divided into four groups of 30 subjects. Group 1: individuals aged ≥55 years with no hearing loss (control group); Group 2: individuals aged 20 to 55 years with no hearing loss (control group); Group 3: individuals aged 20 to 55 years with sensorineural hearing loss; Group 4: individuals aged ≥55 years with presbycusis. Following an audiometry examination, 5 cc blood was taken from all patients to assess serum prestin levels. RESULTS: Prestin levels were 445.32 pg/mL in Group 1; 452.79 pg/mL in Group 2; 123.64 pg/mL in Group 3; and 79.54 pg/mL in Group 4. No difference was found between the serum prestin levels of the younger patients with hearing loss (Group 3)] and of the patients with presbycusis (Group 4) (p=0.084). No difference was found between the serum prestin levels of the younger (Group 1) and the older (Group 2) patients with presbycusis (p=0.399). Significant differences (with higher levels in the control groups) were found in between the prestin levels of between Group 3 (the younger patients with sensorineural hearing loss) and Group 2 (younger controls), and between Group 4 (older patients with presbycusis) and Group 1 (older controls) (p<0.001 and p <0.001, respectively). CONCLUSION: Serum prestin levels can be used as biomarkers for assessing patients with presbycusis and sensorineural hearing loss. They can also be used together with audiometry tests to predict the patient's potential level of hearing loss.

Vestibular functions in patients with idiopathic sudden sensorineural hearing loss and its relation to prognosis.

OBJECTIVE: Because of the anatomically close relationship between the cochlea and the vestibular organs, cochlear function disorders may be accompanied by vestibular disorders. This study aimed to evaluate vestibular functions in patients with idiopathic sudden sensorineural hearing loss using VEMP, caloric test, and VNG test battery and its relation to prognosis. MATERIALS AND METHODS: For this study, 42 patients aged 18-55 years with idiopathic sudden sensorineural hearing loss and 30 volunteers who had no hearing and balance problems were included. Audiometry, cVEMP, oVEMP, caloric tests, and VNG tests were performed. Moreover, the effects of age, sex, time of admission, degree and configuration of hearing loss, accompanying vertigo, tinnitus, and ear fullness on improvement in hearing were evaluated. RESULTS: Of the 42 patients in the study group, 26 (56.52%) were male, 20 (43.48%) were female, and the mean age was 41.54 ± 12.23 years. Of the 30 individuals in the control group, 19 (63.3%) were male, 11 (36.7%) were female, and the mean age was 39.53 ± 13.03 years. There was no significant difference in the incidence of sudden sensorineural hearing loss in terms of sex and age, and the prognosis was better for female patients. Early admission to treatment was a factor of good prognosis; profound hearing loss, bilateral hearing loss and vertigo were factors of poor prognosis. Prognosis was better in patients with rising type audiogram configuration, while the prognosis was worse in patients with flat, descending and total hearing loss. Tinnitus and ear fullness had no effect on the prognosis. No anomalies were observed in VNG findings. Moreover, abnormal caloric response was higher in patients with profound hearing loss and total hearing configuration. Shortening was observed in cVEMP / oVEMP P1 and N1 latency after treatment. Furthermore, there was an improvement in abnormal responses after treatment. CONCLUSION: In this study, vestibular function was affected in patients with idiopathic sudden sensorineural hearing loss. The present study can help the development of a clinical strategy in the evaluation of the vestibular system in idiopathic SSNHL, patient follow-up, patient information, and the implementation of vestibular rehabilitation. Note that additional studies involving larger patients series are required.

Comparison of Changes in Nasal Skin Sensation After Primary and Revision Rhinoplasty Procedures Using Semmes-Weinstein Monofilament Testing.

BACKGROUND: Numbness of the nasal skin is one of the most common complications following rhinoplasty. OBJECTIVES: The present study investigated postoperative changes in nasal skin sensation among primary and revision rhinoplasty patients and evaluated the recovery outcomes for both groups. METHODS: A prospective, randomized blinded study was undertaken involving 100 primary and 34 revision open rhinoplasty patients and 50 volunteers as control group. Semmes-Weinstein monofilament testing was performed on 7 designated nasal points preoperatively and at postoperative months 1, 3, 6, and 12, and the results were evaluated. RESULTS: Among the primary rhinoplasty patients, the change in reduced sensation on pressure to the tip and infratip over time was significant (P < 0.001), whereas there was no statistically significant difference for the other points. Among the revision rhinoplasty patients, the change in reduced sensation on pressure to the tip, infratip, and base of columella over time was significant (P < 0.001), whereas there was no statistically significant difference at the other points. In a comparison of the revision and primary rhinoplasty patients at all timepoints, a statistically significant reduction in sensation was noted on the application of pressure to all points in the revision patient group (P < 0.001). CONCLUSIONS: This study found that the sense of touch on pressure returned to normal, aside from at the tip and infratip, by the end of month 12 in primary rhinoplasty patients. The revision rhinoplasty patients, in turn, were observed to have reduced sensation on pressure by the end of month 12, with the greatest reduction at the tip, infratip, and columellar base.

Effects of Topical Carbonic Anhydrase Inhibitors on the Olfactory Sense.

OBJECTIVES: The sense of smell plays an important role in daily life. Olfactory impairment can significantly affect an individual's quality of life. Topical carbonic anhydrase inhibitors are commonly used to treat elevated intraocular pressure (IOP). One potential side effect of these drugs is a loss of the sense of smell. This study is an examination of changes in olfactory function in patients who used dorzolamide and brinzolamide to control IOP after a laser capsulotomy. METHODS: A total of 60 patients with posterior capsule opacification were included in the study. Sniffin' Sticks (Burghart Messtechnik GmbH, Wedel, Germany) were used to evaluate patient olfactory sensitivity before starting the topical treatment and after 1 week of treatment. RESULTS: No statistically significant decrease in olfactory performance was observed in users of either brinzolamide or dorzolamide (p=0.705, p=0.405 respectively). CONCLUSION: No negative effect on the sense of smell was determined after 7 days of topical application of a carbonic anhydrase enzyme inhibitor to the eye in patients with no previous anosmia.

Minimal Invasive Radioguided Ectopic Parathyroidectomy in Upper Mediastinum

In this study we wanted to present a case with the history of multiple previous neck explorations and persisting upper mediastinal ectopic parathyroid adenoma who underwent a successful operation with radioguided minimal invasive approach.

Histopathological changes in parotid gland following submandibular gland failure: an experimental animal study / Alterações histopatológicas na glândula parótida após insuficiência da glândula submandibular: estudo experimental em animais

Abstract Introduction: Submandibular glands are exposed to many effects due to diseases and therapeutic interventions. A study evaluating the effect of submandibular gland dysfunction on the parotid gland has not been presented in the literature. Objective: The aim of this study was to evaluate the histopathological changes in the parotid gland following submandibular gland failure. Methods: Three groups of seven randomly selected female New Zealand rabbits weighing 2500-3000 g were studied. Unilateral and bilateral submandibular glands were removed in Groups 1 and 2, respectively. No procedure was performed in Group III, the control group. The parotid glands were removed 30 days later. Histological parameters were evaluated and graded between 0 (none) and 3 (severe). Differences between groups were compared using the Mann-Whitney U test. Results: Mean mucus accumulation in acinar cells was 2.57 ± 0.53 and 1.71 ± 0.75 in Groups 1 and 2, respectively (p < 0.05). This value was 0.57 ± 0.53 in Group 3, which was significantly lower than in Groups 1 and 2 (p < 0.05). Mean dilatation of the intercalated ducts' lumen was 1.28 ± 0.48 and 1.57 ± 0.53 in Groups 1 and 2, respectively (p > 0.05). This value was 0.28 ± 0.48 in Group 3, which was significantly lower than in Groups 1 and 2 (p < 0.05). Mean mucus accumulation in the intercalated ducts' lumen was 2.00 ± 0.81 and 1.00 ± 0.57 in Groups 2 and 3, respectively (p < 0.05). Conclusion: The findings of this study indicate that only 1 month after submandibular gland failure, the parotid glands exhibit significant changes.

Resumo Introdução: As glândulas submandibulares estão expostas a muitos efeitos causados por doenças e intervenções terapêuticas. Estudos que avaliam o efeito da disfunção da glândula submandibular na glândula parótida ainda não foram reportados na literatura. Objetivo: O objetivo deste estudo foi avaliar as alterações histopatológicas na glândula parótida após insuficiência da glândula submandibular. Método: Três grupos de sete coelhas fêmeas da raça Nova Zelândia, selecionadas aleatoriamente, pesando entre 2.500 e 3.000 gramas foram estudadas. As glândulas submandibulares unilaterais e bilaterais foram removidas nos Grupos 1 e 2, respectivamente. Nenhum procedimento foi realizado no Grupo III, o grupo controle. As glândulas parótidas foram removidas 30 dias depois. Os parâmetros histológicos foram avaliados e classificados entre 0 (nenhum) e 3 (grave). As diferenças entre os grupos foram comparadas usando o teste U de Mann-Whitney. Resultados: O acúmulo médio de muco nas células acinares foi de 2,57 ± 0,53 e 1,71 ± 0,75 nos Grupos 1 e 2, respectivamente (p < 0,05). Esse valor foi de 0,57 ± 0,53 no Grupo 3, significativamente menor do que nos Grupos 1 e 2 (p < 0,05). A dilatação média do lúmen dos dutos intercalados foi de 1,28 ± 0,48 e 1,57 ± 0,53 nos Grupos 1 e 2, respectivamente (p > 0,05). Esse valor foi de 0,28 ± 0,48 no Grupo 3, significativamente menor do que nos Grupos 1 e 2 (p < 0,05). O acúmulo médio de muco no lúmen dos dutos intercalados foi 2,00 ± 0,81 e 1,00 ± 0,57 nos Grupos 2 e 3, respectivamente (p < 0,05). Conclusão: Os achados deste estudo indicam que apenas um mês após a insuficiência da glândula submandibular as glândulas parótidas apresentam alterações significativas.

Histopathological changes in parotid gland following submandibular gland failure: an experimental animal study.

INTRODUCTION: Submandibular glands are exposed to many effects due to diseases and therapeutic interventions. A study evaluating the effect of submandibular gland dysfunction on the parotid gland has not been presented in the literature. OBJECTIVE: The aim of this study was to evaluate the histopathological changes in the parotid gland following submandibular gland failure. METHODS: Three groups of seven randomly selected female New Zealand rabbits weighing 2500-3000g were studied. Unilateral and bilateral submandibular glands were removed in Groups 1 and 2, respectively. No procedure was performed in Group III, the control group. The parotid glands were removed 30 days later. Histological parameters were evaluated and graded between 0 (none) and 3 (severe). Differences between groups were compared using the Mann-Whitney U test. RESULTS: Mean mucus accumulation in acinar cells was 2.57±0.53 and 1.71±0.75 in Groups 1 and 2, respectively (p<0.05). This value was 0.57±0.53 in Group 3, which was significantly lower than in Groups 1 and 2 (p<0.05). Mean dilatation of the intercalated ducts' lumen was 1.28±0.48 and 1.57±0.53 in Groups 1 and 2, respectively (p>0.05). This value was 0.28±0.48 in Group 3, which was significantly lower than in Groups 1 and 2 (p<0.05). Mean mucus accumulation in the intercalated ducts' lumen was 2.00±0.81 and 1.00±0.57 in Groups 2 and 3, respectively (p<0.05). CONCLUSION: The findings of this study indicate that only 1 month after submandibular gland failure, the parotid glands exhibit significant changes.

Association Between Anxiety, Depression, and Salivary Cortisol Levels in Patients with Recurrent Aphthous Stomatitis.

OBJECTIVE: Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease of the oral mucosa that commonly affects the general population. The objective of this study was to conduct a research in assesing the relationship between psychological disorders including anxiety, depression and salivary cortisol levels in patients with RAS. METHODS: Thirty-nine patients suffering from minor RAS were enrolled in the study after obtaining an informed consent. The control group consisted of 25 age and gender matched healthy individuals. All subjects were evaluated by using both psychological tests (Hamilton's anxiety rating scale [HARS] and Hamilton's depression rating scale [HDRS]) and physiological testing instrument (salivary cortisol level). RESULTS: While no statistical difference was found between the patients with RAS and controls for both salivary cortisol levels and anxiety, there was statisticaly significant difference between the groups for depression. CONCLUSION: There was no significant increase in salivary cortisol levels in patients with active disease when compared to the healthy subjects. But we found that depression scale values were significantly higher in patients with RAS.

An Epithelioid Hemangioendothelioma of the Head and Neck.

An epithelioid hemangioendothelioma (EHE) is a rare vascular tumor of the head and neck region, which carries a risk of recurrence and metastasis. Its etiology is still unclear. It frequently involves the lungs, liver, and bones. Rarely, it may manifest in other parts of the body. Pathologic immunohistochemical investigations are essential to make the definite diagnosis. As it is uncommon, there is no standardized protocol for the treatment of EHE. Herein, the authors report a rare patient with of an EHE localized in the head and neck region.

Posttravmatik frontoetmoidal mukopiyosel.

Paranasal sinus mucoceles are mucus-containing cystic structures with an epithelial lining that completely fills in the paranasal sinuses. Although they are benign in nature, they may result in the destruction of the surrounding bony structures over time. Clinical findings such as exophthalmia, visual impairment, and diplopia occur due to pressure of the fronto-ethmoidal mucocele on the orbita. Currently, the endoscopic intranasal approach is preferred in the treatment of paranasal sinus mucoceles due to its minimal morbidity and low recurrence rates. Here, we present a patient aged 12 years who had a right fronto-ethmoidal mucopyocele secondary to a probable trauma 2 years prior, which resulted in proptosis due to pressure on the orbita.

Values Range of Tympanometric Gradient in Otitis Media With Effusion.

INTRODUCTION: The aim of this study was to establish how reliable a given tympanogram is in predicting the presence or absence of a middle ear effusion, and to provide new views for the diagnostic information of tympanometry. The use of tympanometric gradient in addition to static admittance is the focus of this study. MATERIALS AND METHODS: The authors enrolled 146 female and 129 male patients. The participants were allocated into groups as follow: Group A1 consisted of 50 healthy children. Group A2 consisted of 86 children with otitis media with effusion. Group B1 consisted of 85 healthy adults. Group B2 consisted of 54 adults with otitis media with effusion. All diagnostic otoscopic examination and tympanometry were performed in both ears. The authors analyzed the distribution of tympanograms in patients with otitis media with effusion and healthy controls. RESULTS: When the right and left ear canal volume of either children or adults with otitis media with effusion compared with healthy controls, no statistically significant different was observed (P > 0.05). On the other hand, the statistically significant difference was detected for the values of compliance, pressure and gradient of either children or adults with otitis media with effusion compared with healthy controls (P < 0.05). CONCLUSION: The authors found the values range from 0.01 to 1.52 mL gradients (mean least value 0.15 mL) in adults and the values range from 0.01 to 0.93 mL gradients (mean least value 0.10 mL) in children in the presence of otitis media with effusion. The authors think that tympanometric gradient may be useful to detect the otitis media with effusion.

Endoscopic tympanoplasty.

Middle ear surgery is usually performed using a surgical microscope. Initially, in otorhinolaryngology practice, endoscopes were used for paranasal sinus surgeries. It was only later that they were applied in the area of otology. In otologic surgeries, endoscopes were first used to visualize the middle ear, before being used to assist with visualization of instruments during cholesteatoma surgeries, although they are still not used alone in various otologic surgeries. As in other surgical fields, there is also a trend towards minimally invasive intervention in the field of otorhinolaryngology. Smaller incisions performed under the guidance of endoscopes are preferred over conventional large incisions. Using this approach, improved outcomes can be achieved and postoperative morbidities can be reduced. In addition, the outcomes of grafts performed using the endoscopic approach are similar to that achieved by the microscopic approach. Therefore, endoscopic ear surgery implementations are becoming increasingly popular.

Genetic polymorphism of antioxidant enzymes in eosinophilic and non-eosinophilic nasal polyposis.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the paranasal sinuses, and its pathophysiology is not yet precisely known. It is suggested that oxygen free radicals play an important role in the pathogenesis of nasal polyposis. This study aimed to identify genetic polymorphisms of superoxide dismutase (SOD 2), catalase (CAT), and inducible nitric oxide synthase (iNOS) enzymes in eosinophilic CRSwNP and non-eosinophilic CRSwNP patients; the study also aimed to evaluate the effect of genetic polymorphism of antioxidant enzymes on CRSwNP etiopathogenesis. One hundred thirty patients, who received endoscopic sinus surgery due to CRSwNP, and 188 control individuals were included in this study. Nasal polyp tissues were divided into two groups histopathologically as eosinophilic CRSwNP and non-eosinophilic CRSwNP. Venous blood samples were taken from the patient and control groups. Polymorphisms in the Ala16Va1 gene, which is the most common variation of SOD-2 gene, and 21 A/T polymorphisms in catalase gene were evaluated with the restriction fragment length polymorphism method and -277 C/T polymorphism in the iNOS gene was evaluated with the DNA sequencing method. The GG genotype distribution for the (-277) A/G polymorphism in the iNOS gene was a statistically significant difference between eosinophilic CRSwNP and control groups (p < 0.05). The CC genotype distribution for the SOD2 A16V (C/T) polymorphism was not statistically significant in all groups (p > 0.05). The TT genotype distribution for the A/T polymorphism in catalase gene at position -21 was statistically significant differences in eosinophilic CRSwNP and control groups (p < 0.05). Increased free oxygen radical levels, which are considered effective factors in the pathogenesis of CRSwNP, can occur due to genetic polymorphism of enzymes in the antioxidant system and genetic polymorphism of antioxidant enzymes in eosinophilic CRSwNP patients might contribute to the pathophysiology.

Evaluation of the Relationship Between the Air-Bone Gap and Prolonged ABR Latencies in Mixed-Type Hearing Loss.

OBJECTIVE: The aim of this study was to determine the air-bone gaps in adults with mixed-type hearing loss using air-conduction auditory brainstem response (ABR) latencies. MATERIALS AND METHODS: Thirty adults with mixed-type hearing loss (study group) and 30 adults with normal hearing (control group) were included in this study. Before performing ABR measurements, ear, nose, and throat examinations, pure tone audiometry, speech audiometry, acoustic immittance audiometry, and transient evoked autoacoustic emission testing were performed for all participants. Absolute latencies of I, III, and V waves and interpeak latencies (IPL) at 90 decibel hearing level dB nHL were evaluated and compared with air-bone gap results. RESULTS: ABR latencies using click and tone-burst stimulation were obtained and found to be longer in the mixed-type hearing loss group than in the normal hearing group (p<0.05). A moderate positive relationship was detected between the air-bone gap and wave III/V latencies at 0.5/1 kHz, I-V/I-III/III-V IPL at 1 kHz. Only one strong relationship was found between 1 kHz air-bone gap and I-V IPL. CONCLUSION: In this study, the magnitude of the air-bone gap could not determined using prolonged ABR latencies. Delays in ABR latencies were observed, but prolonged ABR latencies was not helpful for calculating the air-bone gap on mixed-type hearing loss.

Endoscopic cartilage butterfly myringoplasty in children.

OBJECTIVE: The present study evaluated the results of the graft success rate and hearing gain of children who underwent endoscopic inlay butterfly myringoplasty due to chronic otitis media. METHODS: The study included 32 pediatric patients aged between 8 and 17, who had endoscopic inlay butterfly myringoplasty with the diagnosis of chronic otitis media between September 2012 and January 2015 in Elazig Training and Research Hospital Otorhinolaryngology Clinic and Firat University Otorhinolaryngology Clinic. All patients' demographics, perforation size, and hearing status were examined. RESULTS: Tympanic membrane perforation was ≤3mm in 12 patients and between 3 and 6mm in 20 patients. The air-bone gap (ABG) of the patients was 18.5±6.29dB preoperatively, 8.81±3.53dB postoperatively second month, 8.09±3.55dB postoperatively sixth month, and 7.96±3.32dB postoperatively 12th month. Two (6.3%) of the patients had postoperative myringitis. Two (6.3%) patients had recurrent perforation in the postoperative follow-ups. CONCLUSION: In children, endoscopic inlay butterfly tympanoplasty is a surgical technique with short duration, high graft success, effective hearing reconstruction, and high levels of postoperative patient comfort.

[Ectopic thyroid tissue localized in submandibular region]. / Submandibüler bölge yerlesimli ektopik tiroid dokusu.

An ectopic thyroid tissue is often localized in the midline between the foramen caecum and mediastinum, while it is rarely laterally localized. Submandibular location of thyroid tissue is extremely rare. In this article, we report a 56-year-old female case admitted with a painless, non-tender, and firm mass in the right submandibular region. The patient was operated. The mass was detected to be separate from the right lobe of the thyroid. The histopathological examination result was reported as an ectopic thyroid tissue. Ectopic thyroid tissues should be considered in the differential diagnosis of submandibular masses.