PROPELLER diffusion weighted imaging for diagnosis of cholesteatoma in comparison with surgical and histopathological results: emphasis on false positivity and false negativity.

PURPOSE: To investigate the role of non-echo planar diffusion weighted imaging (DWI) using "periodically rotated overlapping parallel lines with enhanced reconstruction" (PROPELLER) sequence for the diagnosis of cholesteatoma compared to surgical and histopathological results in an attempt to determine the factors causing false negative and false positive diagnoses. METHODS: Patients who had PROPELLER DWI before ear surgery were retrospectively reviewed. The presence of a lesion with diffusion restriction on PROPELLER DWI was accepted as positive for cholesteatoma, and the results were compared to the intraoperative and histopathological findings. RESULTS: A total of 112 ears in 109 patients were reviewed. On PROPELLER DWI, a lesion with diffusion restriction was found in 101 (90.2%) ears, while in 11 (9.8%) of the patients, no diffusion restriction was found. Surgery and histopathological analysis revealed a cholesteatoma in 100 (89.3%) ears, while in 12 (10.7%) ears, no cholesteatoma was found surgically. There were 96 (85.7%) true positives, 7 (6.2%) true negatives, 5 (4.5%) false positives and 4 (3.6%) false negatives. The accuracy, sensitivity, specificity, positive predictive and negative predictive values of non-echo planar DWI were calculated to be 91.96%, 96%, 58.33%, 95.05%, and 63.64%, respectively. CONCLUSION: Non-echo planar DWI using PROPELLER sequence has high accuracy, sensitivity and positive predictive value and can be used for the detection of cholesteatoma. The external auditory canal, postoperative ears and small lesions should be evaluated with caution to avoid false results.

A single-center multidisciplinary study analyzing thyroid nodule risk stratification by comparing the thyroid imaging reporting and data system (TI-RADS) and American thyroid association (ATA) risk of malignancy for thyroid nodules.

OBJECTIVES: The thyroid imaging reporting and data system (TI-RADS) and 2015 American Thyroid Association (ATA) guidelines are two well-known risk stratification systems for classifying thyroid nodules based on cancer risk. This study aims to evaluate the diagnostic efficacy of these two systems in predicting malignancy in patients undergoing thyroid surgery. METHODS: We studied data on 120 individuals who were scheduled to undergo surgery for benign or malignant nodular diseases of the thyroid gland between October 2017 and October 2019. The TI-RADS category and ultrasound pattern based on ATA guidelines were assigned to dominant thyroid nodule categories by two experienced radiologists blinded to patients' previous thyroid ultrasonography and fine-needle aspiration biopsy results. A pathologist with experience in thyroid diseases blinded to patients' sonographic and clinical data reviewed the thyroidectomy specimens. RESULTS: A total of 120 patients, 88 women and 32 men, were included in our study. Final histopathological results were as follows: 50% (n=60) papillary thyroid carcinoma, 36.6% (n=44) benign nodular thyroid diseases, 4.1% (n=5) follicular adenoma, 2.5% (n=3) hurtle cell adenoma, 1.7% (n=2) follicular thyroid carcinoma, 1.7% (n=2) medullary thyroid carcinoma, 1.7% (n=2) hurtle cell carcinoma, and 1.7% (n=2) follicular tumor of uncertain malignancy potential. The sensitivity, specificity, positive predictive value, and negative predictive value for TI-RADS were 80%, 56%, 72%, and 67%, respectively, and that for ATA were 80%, 64%, 76%, and 69%, respectively. CONCLUSION: The TI-RADS and ATA showed similar rates of sensitivity, specificity, NPV, and PPV. Our observed risk of malignancy was higher than expected for the ACR TI-RADS 3-5 categories and the very low, low, and intermediate suspicion risk strata in the ATA guidelines. We found no difference between observed and expected malignancy risk for the ACR TI-RADS 2's and ATA's high suspicion categories.

Laryngeal Framework Surgical Anatomy: A Radiological Study.

PURPOSE: Awareness of variations in laryngeal anatomy among different age and gender groups is crucial during laryngeal framework surgery. The aim of this study is to demonstrate the relationship between gender and laryngeal radiologic morphometrics among different age groups and the applicability of important anatomical landmarks of laryngeal surgery. METHODS: Laryngeal images of 180 adult patients older than 18 years of age were obtained by computed tomography and assessed. A total of 11 measurements of important laryngeal landmarks were taken from the patients' computed tomography images. Results were subgrouped according to gender and age, and these groups were compared for each measurement. RESULTS: The majority of laryngeal measurements obtained in the study were higher in males than females, with the exception of the interlaminar angle. The mean interlaminar angle value was 88.27°± 14.99 for males and 103.04°± 14.81 for females (P <0.005). The distance from the anterior commissure to the inferior border of the thyroid cartilage was 10.46 ± 2.5 mm for males and 7.72 ± 1.9 mm for females. The anterior commissure locates slightly higher than the midpoint of the distance from the thyroid notch to the thyroid inferior border. The shortest distance between the muscular process of the arytenoid cartilage and the thyroid cartilage was found to be 9.60 ± 3.47 mm for males and 7.72 ± 2.33 mm for females (P <0.001). CONCLUSION: Observation of obvious diversities in the size and distance of the important laryngeal structures between the gender groups is an important factor to be considered for successful laryngeal framework surgery. Also, using the midpoint of the thyroid cartilage as a landmark for anterior commissure is a practical method during surgery, especially for thyroplasty.

Relationship of PPARG overexpression with prognostic parameters in papillary thyroid carcinoma.

Objectives: PAX8/PPARG chromosomal rearrangement is frequently seen in thyroid cancer, and PPARG overexpression has been shown in the follicular variant of papillary thyroid carcinoma, but not in papillary thyroid carcinoma other than the follicular variant. The main aim of this study was to investigate the frequency of PPARG overexpression among papillary thyroid carcinoma and if there were any variants of papillary thyroid carcinoma with PPARG overexpression other than the follicular variant. Methods: Immunohistochemical analysis of PPARG overexpression was performed using a PPARG monoclonal antibody in a series of 111 paraffin-embedded blocks of thyroid tumours. Of the patients in our study, 100 were diagnosed with papillary thyroid carcinoma, 9 with follicular adenoma and 2 with follicular carcinoma. Results: PPARG staining was detected in 19 of the 111 cases. Sixteen patients with PPARG overexpression had papillary thyroid carcinoma and 3 had follicular adenoma. Conclusion: PPARG overexpression was detected mainly in follicular-variant papillary thyroid carcinoma. Vascular invasion, lymphatic invasion, thyroid capsule invasion and lymph node positivity were lower in patients with PPARG overexpression.

Evaluation of the Auditory System in Autistic Children Using Evoked Otoacoustic Emissions and a Contralateral Suppression Test.

In this study, we evaluated the cochlea, medial olivocochlear system, and brainstem function in autistic children using evoked otoacoustic emissions (OAEs) and a noninvasive contralateral suppression (CLS) test. In total, we included 21 autistic children with normal hearing (study group) and 11 healthy children (control group). Transient-evoked OAEs (TEOAEs) and CLS of TEOAE were evaluated in the left and right ears of all patients. In a silent room, spontaneous, transient, and dP ILO292 were evaluated. The mean age of the study and control group was 9.1 years (range: 6-13 and 6-12 years, respectively). For the study group, there was no statistically significant difference between the OAE and CLS values of the right ear (P > .05). However, for the left ears, OAE values were statistically significantly higher than the CLS values (P < .05). In the control group, the OAE values of both ears were statistically significantly higher than the CLS values (P < .05). In autistic children with normal hearing, the medial olivocochlear system functions more effectively in the right ear than the left ear. Asymmetry between the ears is likely responsible for the peripheral auditory lateralization and independence in auditory function between the left and right ears.

Accuracy of Frozen Section Examination in Oral Cavity Cancers.

PURPOSE: This study aimed to compare the intraoperative frozen section with the surgical margin in the postoperative surgical margins of the postoperative pathology of oral squamous cell carcinomas in order to examine the reliability of the frozen section. METHODS: A retrospective analysis was conducted for patients who underwent surgery for oral squamous cell carcinoma in a tertiary hospital between January 2018 and 2019. The intraoperative frozen section examinations, grade of the tumor, number of lymph nodes, number of affected lymph nodes, depth of invasion, perineural invasion, lymphovascular invasion, and extranodal extension were recorded from the pathological records. The concordance between the frozen section examination and postoperative pathology 2 methods was examined using the Cronbach α coefficient. Sensitivity, specificity, positive predictive value, negative predictive value regarding surgical margins, and accuracy were calculated and reported. RESULTS: Overall, 181patients who underwent surgery for oral cavity cancers were included; 118 (65.2%) were males. The mean (± standard deviation) age of the included participants was 57.4 ± 16.1 years. The most common tumour subsite was the tongue (n = 71, 39.2%). There was concordancy between the frozen, positive intraoperative malignancy and the postoperative pathology malignancy. The frozen, negative intraoperative malignancy and postoperative safe surgical margin did not significantly differ. CONCLUSION: As a result of intraoperative frozen examination, we found conformity between the postoperative pathology results of patients with positive and negative surgical margins. Frozen section examination could be used safely to examine intraoperative surgical margins of oral squamous cell carcinoma.

Effect of Education and Social Anxiety on Acoustic, Perceptual and Aerodynamic Parameters of Adult Females.

In this study, we hypothesized that social anxiety disorder would be more common in women with lower education levels and that this could have a negative effect on acoustic parameters. A total of eighty-eight (88) healthy female volunteers were enrolled into the study. These volunteers were divided into two groups, which were categorized as those with graduation from elementary school or below (Group A, n = 42) and those with graduation from high school or above (Group B, n = 46). Personal anxiety and avoidance for all participants were evaluated using The Liebowitz Social Anxiety Scale. All subjects also underwent acoustic and aerodynamic voice analysis for evaluation of their objective voice quality and function. Additionally, the GRBAS scale was used for perceptual analysis. Social anxiety scores were higher in group A than group B (p < 0.05). In aerodynamic sound analysis, maximal phonation time was lower in group A than group B (p < 0.05). In perceptual sound analysis, the mean values of the GRBAS parameters for group B were lower than group A (p < 0.05). Mean F0 of Group-B was higher than Group-A in acoustic analysis (p < 0.05). However, there was no statistical difference in jitter, shimmer, NHR and HNR between the groups (p > 0.05). In this study, social anxiety and education has been shown to have an effect on voice in women. As the level of education increases, social anxiety decreases, and both maximum phonation time and fundamental frequency increase.

Thyroid Surgery and Inadvertent Removal of Parathyroids.

This study aimed to determine the incidence of inadvertent parathyroid removal during thyroid surgery and define its associated risk factors. In this single-center record-based study, we retrospectively analyzed the clinical and pathological records of 462 patients undergoing thyroidectomy. Incidental parathyroidectomy was detected in 61 of 462 patients (13.2%). The incidence of inadvertent parathyroid removal was 17.6% (36 of 205 patients) in patients having malign thyroid diseases, compared with 9.7% (25 of 257 patients) in patients with benign thyroid diseases (p = 0.045). Incidentally removed parathyroid tissue was intrathyroidal in 8 of the 61 patients. Thus, the ratio of intrathyroidal parathyroid tissue among all patients was 1.7% (8 out of 462). Central neck dissection was carried out in 40 patients (8.7%). Fourteen of these 40 patients (35%) had an incidental parathyroid in their specimen compared with 47 of 422 patients (11.1%) who did not undergo central neck dissection (p<0.001). Incidental parathyroidectomy occurred in 13.2% of patients undergoing thyroidectomy in our study. The majority of patients had one parathyroid identified in their specimen. Central neck dissection was significantly predictive for incidental parathyroidectomy. Well-trained senior otolaryngology residents can safely perform thyroid surgery with similar rates of incidental parathyroidectomy as their masters. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-021-02590-0.

Comparison of Voice Quality of Life in Early Stage Glottic Carcinoma Treated with Endoscopic Cordectomy Using Radiofrequency Microdissection Electrodes, Laser Cordectomy, and Radiotherapy.

PURPOSE: To compare the quality of life of patients with early glottic carcinoma who have been treated using three treatment modalities: endoscopic cordectomy using radiofrequency microdissection electrodes (ECRM), transoral laser cordectomy, and radiotherapy (RT). ECRM, transoral laser cordectomy, and RT can all be used as alternatives to invasive open surgery to treat the early stages of glottic cancer such as stage T1. Patients treated using these different modalities could have different outcomes with respect to voice quality of life. MATERIALS AND METHODS: The voice quality of life was measured in patients who underwent ECRM, transoral diode laser excision, or RT for early laryngeal cancer. Post-treatment quality of voice was assessed using the Turkish version of the Voice-Related Quality of Life questionnaire in all patients after 1 year of cancer-free survival. A comparison was then made between the outcomes of the three groups. RESULTS: The total score of the ECRM group, when compared independently to that of the laser and the RT groups, was found to be statistically higher in both cases. However, no statistically significant differences were found between laser and RT groups in terms of any parameters. There was a statistically significant difference between the RT group and the other groups in terms of percentage jitter, percentage shimmer, and fundamental frequency (F0) (P < 0.05). While the RT group had the longest maximum phonation time (P < 0.001), no significant differences were found between the maximum phonation time of the ECRM and the laser groups (P < 0.001). CONCLUSIONS: Overall, the worst outcome with respect to voice quality of life is seen with ECRM. Since there were no significant differences in quality of life between the other two treatment modalities, it is recommended to leave the choice between RT and laser surgery up to the patient.

The Effect of Passive Smoking on Mucociliary Clearance and Inferior Concha Reactivity.

INTRODUCTION: The aim of this study is to investigate the effect of cigarette smoke on turbinate reactivity and mucociliary clearance (MCC) in passive smokers. METHODS: 60 adult patients (30 passive smokers and 30 healthy subjects as the control group) were recruited for this study. Following a questionnaire on passive smoke exposure, MCC measurement using the saccharin test was carried out to all participants. The baseline and after decongestant acoustic rhinometry values (MCA1, MCA2, VOL1, VOL2) were measured and the percentage changes between the two test values (ie; response to nasal decongestants = concha reactivity) were recorded. RESULTS: All 60 patients, including 37 women (61.7%) and 23 men (38.3%) were between 18-57 years of age . MCC's average measurements were 11.13 minutes in the passive smokers group, 7.87 minutes in the control group, which was statistically significantly different (p < 0.05). There was a statistically significant difference between the passive smokers and control group for acoustic rhinometric measurement of the ratio of MCA2 and VOL2 values before and after decongestant application (p < 0.05). DISCUSSION: Passive smoking can damage the nasal mucosa at least as active smoking. The number of studies on this subject is limited. There are no studies in the literature showing the effect of cigarette smoke on the inferior turbinate mucosal response. In our study, the inferior turbinate decongestant capacity was found to be significantly decreased in the passive smokers compared to the control group. CONCLUSION: As a result of cigarette exposure, the erectile function of the lower turbines may be impaired. The task of the ENT physicians is to warn the passive smokers in this regard.

Clinicopathologic Results of the Surgical Management of Thyroid Gland Pathologies.

OBJECTIVE: The aim of this study is to share our surgical approach and results in patients with benign and malignant thyroid diseases. METHODS: All patients who underwent thyroid gland surgery at our University Hospital Ear, Nose, and Throat Department between 2012 and 2017 were retrospectively analyzed. The study included 293 patients. RESULTS: Of the 293 patients included in the study, 76 (25.9%) were male and 217 (74.1%) were female. Mean follow-up period was 47.1 months. Patients' ages ranged from 4 to 77 years. In terms of the pathology, 160 patients had benign and 133 had neoplastic thyroid diseases. None of the patients who underwent thyroid surgery due to benign diseases required revision surgery. Recurrence occurred in 15 out of the 116 patients that were operated on for well-differentiated thyroid cancer. Out of these 15 patients with disease recurrence, 11 had biochemically incomplete responses and four had structurally recurrent diseases. CONCLUSION: Thyroidectomy, when performed safely and correctly, is a very effective way of treating both benign and malignant thyroid diseases. Total thyroidectomy or total lobectomy and isthmectomy are the gold-standard surgical approaches to prevent recurrence. A national form is needed regarding thyroid surgery for following up on patients and for the regular and systematic collection of data.

Effect of Hyperbilirubinemia on Medial Olivocochlear System in Newborns.

OBJECTIVES: To evaluate medial olivocochlear efferent system of babies with hyperbilirubinemia with normal auditory brain stem responses. MATERIALS AND METHODS: This was a prospective study in a tertiary referral hospital. The study involved 40 hyperbilirubinemic and 44 healthy newborns. Cochlear and auditory activity of participants was evaluated by transient otoacoustic emissions (TOAEs) and brainstem auditory evoked response components (BAER). Medial olivocochlear (MOC) reflex was evoked with contralateral acoustic stimulation and recorded with TOAEs. RESULTS: A comparison of the MOC reflex activity between two groups with Mann Whitney U test revealed that MOC reflex activity were significantly decreased in the hyberbilirubinemic group for both ears (p<.05). This difference was significant for all frequencies in both ears. There was no significant relation between total serum bilirubin level and MOC reflex activity. CONCLUSION: Hyperbilirubinemic newborns had decreased MOC reflex activity. This may be indicative of future problems in speech discrimination and effective hearing in noisy background. Additional long cohort studies are needed to evaluate the clinical importance of MOC reflex measurements in this group. MOC reflex measurement has the potential to form part of the audiologic evaluation of newborns with hyperbilirubinemia in the future.

Comparison of Voice Quality and Cost Effectiveness of Endoscopic Cordectomy Using Microdissection Electrodes with Laser Cordectomy and Radiotherapy.

OBJECTIVE: To compare the acoustic parameters and the cost effectiveness achieved after endoscopic cordectomy using radiofrequency microdissection electrodes (ECRM) with those of transoral laser cordectomy and radiotherapy. METHODS: The study included 81 disease-free patients previously treated for early larynx carcinoma (30 with ECRM, 27 with transoral laser cordectomy, 24 with primary radiotherapy). Post-treatment voice analysis was performed in all patients. Additionally, the cost effectiveness of all treatment procedures was calculated. RESULTS: The GRBAS (G: Grade, R: Roughness, B: Breathiness, A: Asthenia, and S: Strain) scale showed a significant difference between the groups (p<0.001). The mean values for perceptive assessment score in the radiotherapy group were significantly lower than those in the ECRM group (p<0.05). There were no significant differences between the ECRM group and the transoral laser cordectomy group in terms of the perceptive assessment scores (p>0.05 for all). Percent jitter, percent shimmer and fundamental frequency (F0) were significantly different in the radiotherapy group than the ECRM and the transoral laser cordectomy groups (p<0.05). Maximum phonation time (MPT) in the radiotherapy group was significantly longer than the ECRM and transoral laser cordectomy groups (p<0.001). There were no significant differences between the ECRM group and the transoral laser cordectomy group in terms of the MPT (p>0.05). The mean cost of the ECRM technique was statistically lower than the other treatment techniques (p<0.05). Moreover, the length of hospital stay after ECRM was statistically significantly shorter than was after laser cordectomy (p<0.05). CONCLUSION: Objective and perceptive voice analysis after ECRM showed comparable results with transoral laser cordectomy, but poorer results than radiotherapy. Cost effectiveness of ECRM was found to be better than the other two treatment techniques.

Evaluation of the Effect of Topical Application of Nigella sativa on Acute Radiation-Induced Nasal Mucositis.

The goal of this study was to demonstrate the effect of radiotherapy (RT) on nasal mucosa in rats and to evaluate the radioprotective effects of the topical application of black seed oil (Nigella sativa [NS]) to treat acute radiation-induced nasal mucositis.A total of 18 rats were randomized into 3 groups, with 6 animals per group. The rats in group 1 were topically administered saline in the nasal cavity after sham irradiation. Group 2 received saline at the same dose after irradiation. Group 3 was given NS after irradiation. The rats in groups 2 and 3 were irradiated with a single dose of 40 Gy to the nasal and paranasal area. Only one drop of saline (0.05 mL) was applied to each nostril in the first, second, and third days after RT in groups 1 and 2. One drop of cold press NS (0.05 mL) was applied to each nostril in group 3. Fourteen days after irradiation, the nasal mucosal tissues were excised for histopathological evaluation. Vascular dilatation, inflammatory cell infiltration, superficial erosion, and formation of exudates were classified according to the severity.No evidence of mucositis was observed in group 1. Of all the parameters the only statistically significant difference between groups 2 and 3 were observed for "superficial erosion' (P < 0.05). Overall microscopic observations in the NS-treated group were better than in group 2.The preliminary results of our study have shown that local application of NS to the nasal mucosa may be an effective treatment of acute nasal mucositis due to RT.

The Effect of Nasal Functions on the Integrity of Grafts after Myringoplasty.

OBJECTIVE: We aimed to evaluate the effects of nasal functions for the integrity of grafts after myringoplasty. METHODS: In our study 78 patients who underwent myringoplasty operation between 2011-2013 were included. Group I was defined as the group with an intact tympanic membrane following surgery. Group II was defined as the group with a tympanic membrane perforation following surgery. Group I consisted of 44 and Group II consisted of 34 patients. Subjective and objective measurements of nasal functions, Eustachian tube function (ETF), and allergic status were performed using nasal obstruction symptom evaluation (NOSE) scale, visual analog scale (VAS), and the score for allergic rhinitis (SFAR) questionnaires and acoustic rhinometry and saccharin test. It was investigated whether there was any difference between these two groups in terms of these parameters. RESULTS: There was statistically no significant difference between groups according to the age, sex and the presence of tubal dysfunction and allergic rhinitis (p>0.05). In the group of intact tympanic membranes, the likelihood of right ear being the operated one was significantly higher compared to the group of myringoplasty failures (p=0.037). The VAS and NOSE scales did not show any significant difference between groups in terms of successful outcome of myringoplasty (p>0.05). The nasal congestion index (NCI) and the mucociliary clearance (MCC) did not show any significant difference between groups in terms of successful outcome of myringoplasty (p>0.05). CONCLUSION: This study has shown that nasal functions measured by objective and subjective methods had no effects on the success of myringoplasty.

Correlation between cVEMP and ABR for the Evaluation of Vestibular Migraine.

OBJECTIVE: Vestibular migraine (VM) is a clinical condition characterized by temporal overlap between vestibular symptoms and migraine. In this study, we aimed to determine the changes in vestibular myogenic potential (cVEMP) and auditory brainstem response (ABR) in patients with VM and migraine. MATERIALS AND METHODS: A total of 86 participants with no hearing loss or additional disease between the ages of 18 and 45 were enrolled in three different groups: group 1, VM; group 2, migraine without aura; and group 3, healthy controls. cVEMP and ABR were performed for all participants during attacks and attack-free periods. The differences between the right and left sides were calculated. RESULTS: There was no significant difference in cVEMP p13-n23 latencies between any of the groups. There were statistically significant differences related to cVEMP p13-n23 amplitudes between groups 1, 2, and 3. This significant difference originated from group 1 when compared with the other groups (p<0.05). When we compared the cVEMP results of patients with VM during attack and attack-free periods, a statistically significant decrease was determined in the p13-n23 amplitude values during the attack period (p<0.01). Additionally, when we compared group 1 and group 3, the wave V peak latencies in ABR were significantly prolonged in group 1 (p<0.05). CONCLUSION: cVEMP and ABR can be used as diagnostic criteria for patients with VM during attacks. Further studies with larger groups are needed to verify our findings.

Change in nasal congestion index after treatment in patients with chronic rhinosinusitis with nasal polyposis.

BACKGROUND: The management of chronic rhinosinusitis with nasal polyposis (CRSwNP) involves both surgical and medical approaches, and remains a controversial subject. OBJECTIVE: The objective of this prospective, randomized, controlled trial was to compare the medical and surgical treatments of CRSwNP in terms of their effect on the nasal congestion index (NCI). METHODS: Forty-eight patients with CRSwNP were randomized either to medical or surgical therapy. Pretreatment and 3- and 6-month posttreatment assessments of the visual analog scale score, the 20-Item Sino-Nasal Outcome Test, saccharine clearance time, nasal endoscopy, and NCI measurement with acoustic rhinometry were performed. Forty-one subjects were included in the analysis. RESULTS: Both the medical and surgical interventions for CRSwNP resulted in significant improvement in the visual analog scale score, 20-Item Sino-Nasal Outcome Test, saccharine clearance time, and nasal endoscopic examination scores. There was no difference between the two groups in terms of the percentage change from baseline for any of the parameters at the 6-month posttreatment assessment. NCI showed no significant difference from baseline. Similarly, no significant difference was found between the medical and surgical groups in terms of their effect on the NCI (p > 0.05). CONCLUSION: Because NCI does not correlate with standard subjective measures in outcomes for this group of patients, it cannot be used as an outcome measurement of treatment of subjects with CRSwNP. Results of this prospective randomized study did not find any additional benefit of surgical therapy over medical therapy in subjects with CRSwNP.

Clinical evaluation of inner ear changes as result of chronic otitis media and its surgery.

OBJECTIVES: This study aims to evaluate whether chronic otitis media (COM) may cause inner ear damages or middle ear surgery may improve this damage with regard to sensorineural hearing loss (SNHL) and tinnitus and dizziness-related disability. PATIENTS AND METHODS: An observational prospective study was performed on a series of 65 patients (41 males, 24 females; mean age 26.4±12.6; range 11 to 62 years) who were diagnosed with COM and were scheduled for surgical intervention at the Department of Otorhinolaryngology of the Haydarpasa Numune Education and Research Hospital. Patients were divided into two subgroups as tympanoplasty and mastoidectomy group according to the surgical procedure. Standard patient work-up included otomicroscopy, pure tone audiometry and completion of the Turkish translation of Dizziness Handicap Inventory (DHI) and Tinnitus Handicap Inventory (THI) before surgery and eight weeks after surgery. RESULTS: We found higher bone conduction thresholds in the group of patients with mastoidectomy preoperatively. There was a statistically significant difference in the mean preoperative and postoperative THI and DHI scores between the groups (p<0.05). CONCLUSION: Our study results suggest that a successful surgery results in improved tinnitus and vertigo symptoms in patients with COM.

Platelet-rich fibrin plays a role on healing of acute-traumatic ear drum perforation.

OBJECTIVE: Our objective was to demonstrate the effects of platelet-rich fibrin (PRF) for the healing of acute ear drum perforation. METHODS: Thirty-two patients with acute traumatic ear drum perforations were randomly separated into 2 groups. In group 1 (n = 14), PRF was used for the repair of ear drum perforation; in group 2 (n = 18), we did not make any intervention. RESULTS: At initial inspection, perforation sizes were measured as 10.93 ± 3.58 mm in group 1 and 10.05 ± 4.02 mm in group 2. After 1 month, perforation sizes were 1.35 ± 2.53 mm in group 1 and 4.44 ± 3.34 mm in group 2 (P < 0.01). In the study group, the rate of ear drum closure was 64.3% and in the control group it was 22.2% (P < 0.05). CONCLUSION: Here we found that PRF is a biomaterial that quickens the healing of ear drum which is autogenous and simply prepared.