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 National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline.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.

[Turkey's place in Europe in respect of pediatric otorhinolaryngology publications in scope of Science Citation Index]. / Türkiye'nin Science Citation Index kapsamindaki pediatrik kulak burun bogaz yayinlari açisindan Avrupa'daki yeri.

OBJECTIVES: This study aims to evaluate quantitatively the pediatric otorhinolaryngology (ORL) publications belonging to the ORL journals of the Science Citation Index (SCI) made by Turkey and other European countries between five year periods during 1995 and 2012. MATERIALS AND METHODS: After SCI journals of 1995, 2000, 2005, 2010 and 2012 under the ORL heading were determined, the publications of all European countries in these journals were detected electronically using PubMed search engine. Then, the number of pediatric ORL publications and the journals which included them were determined and counted manually for each country. RESULTS: The number of total publications and pediatric ORL publications made by European countries in the mentioned years were 539/98, 737/123, 747/158, 757/175, and 746/171 respectively. Turkey was the country with the highest number of pediatric ORL publications in all years except 1995. It was detected that more than half of the total pediatric ORL publications were included in International Journal of Pediatric Otorhinolaryngology. CONCLUSION: It is pleasing that Turkey is ahead of many developed European countries in respect of the number of pediatric ORL publications. Further studies on type, evidence-based medicine or citation analysis of these publications will also enable qualitative evaluation.

Dual-phase F-18 FDG PET-CT in staging and lymphoscintigraphy for detection of sentinel lymph nodes in oral cavity cancers.

AIM: Our objective was to evaluate the diagnostic role of dual-phase fluor-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography-computed tomography (PET-CT) and planar lymphoscintigraphy in patients with oral cavity cancer (OCC). We also investigated the combined impact of F-18 FDG PET-CT and sentinel lymph node biopsy (SLNB) in decision making for patients with OCC. METHODS: Sixteen patients (4 female, 12 male; age range, 29-81 years) were included in this prospective study. F-18 FDG PET-CT [1 (early) and 2 h (delayed) after injection] and planar lymphoscintigraphy (2h before the surgery) were performed for all the patients before surgery. The sensitivity, specificity, and negative and positive predictive values in F-18 FDG PET-CT for the early and the delayed scans and tumor/liver uptake (T/L) in the lymph nodes were calculated. Receiver operating characteristic curves were obtained for standardized uptake value (SUV)max and T/L. RESULTS: Histopathological evaluations revealed that 5 patients had metastatic lymph nodes (pN+) whereas 11 patients had benign lymph nodes (pN-). Out of 43 lymph nodes visualized as cN(+) in F-18 FDG PET-CT, 14 were pathologically positive for malignancy, whereas 29 were pathologically benign. There was no statistical difference between the N(+) and N(-) patients in terms of age, depth of primary tumor, and the number of mitoses. However, there was a significant difference between the N(+) and N(-) patients (P=.011) in terms of early and delayed F-18 FDG uptake of primary tumors. There was a statistically significant difference in the value of SUVmax between the early and the delayed scans for the malignant lymph nodes (P=.00). CONCLUSION: This study indicates that F-18 FDG PET-CT is a reliable method for the correct evaluation of primary tumor and N staging in OCCs. Delayed phase of F-18 FDG imaging may increase primary lesion detectability due to higher FDG uptake in primary tumors compared to the early phase of imaging. F-18 FDG PET-CT might demonstrate skip metastasis in lymph nodes which can be missed with SLNB. Although SUV values increased in the delayed phase of F-18 PET-CT imaging in detecting lymph node metastases, the specificity and positive predictive value did not increase.

Role of Elective Neck Dissection in Early Stage Lip Cancers.

OBJECTIVE: To date, the management of the neck in early stage lower lip cancers remains controversial. The aim of this study is to investigate if prophylactic neck dissection is necessary in early stage lower lip cancers. METHODS: Charts of 11 patients who underwent surgery of the primary site and neck because of T1-2N0 lower lip cancer between 1997 and 2011 were retrospectively examined. Clinical stages, surgeries, histopatological examination results, and loco-regional recurrences were evaluated. RESULTS: Of the 11 patients, 10 were male (90.9%) and 1 was female (9.09%). The follow-up time of these patients was between 24-168 months (mean, 56.6 months). There were 5 patients with clinically diagnosed T1N0 tumors and 6 patients with clinically diagnosed T2N0 tumors. Suprahyoid neck dissection was performed in 4/5 T1N0 patients and supraomohyoid neck dissection was performed in the remaining 1 patient. For T2N0 tumors, 4 suprahyoid, 1 supraomohyoid, and 1 comprehensive neck dissection was performed. Histopathological examination revealed no occult metastasis in any of the patients. In 1 patient who had lower lip resection and suprahyoid neck dissection for T1N0 lower lip cancer, a contralateral neck metastasis was detected 22 months postsurgery, and a comprehensive neck dissection was performed. CONCLUSION: Our results show that in patients with T1N0 lower lip tumors, neck dissection may not be necessary; however, close follow-up is mandatory. Further researches with larger series dividing T2N0 tumors into subgroups for tumor size and thickness are necessary to determine neck treatment in these tumors.

Submandibular Sialolithiasis Perforating the Floor of Mouth: A Case Report.

Calculus formation in salivary glands (sialolithiasis) is one of the most common diseases of the salivary glands and is most commonly seen in the submandibular gland. Not only can the stones be small and inside the duct, they may also get larger and reside inside the gland. We can easily see submandibular sialolithiasis perforating the floor of the mouth in cases having sialolithiasis for decades and not having any treatment and its transoral removal as we look in the medical literature. A 52-year-old lady who had rejected surgical treatment for submandibular sialolithiasis for 25 years is presented as a case in this study. Treatment of the case was performed effectively by taking out the calculus transorally with a simple intervention whose examination revealed that the calculus was seen to perforate the floor of the mouth. It is aimed to stress with this case that transoral removal of submandibular sialolithiasis that perforates the floor of the mouth without performing external approaches is a method that has to be thought in the first step.

[Analysis and publication rate of the presentations at the Turkish National Otorhinolaryngology and Head and Neck Surgery meetings]. / Türk Ulusal Kulak Burun Bogaz ve Bas Boyun Cerrahisi Kongre bildirilerinin analizi ve yayimlanma oranlari

OBJECTIVES: This study aims to evaluate the analysis and publication rates of presentations presented at the Turkish National Otorhinolaryngology and Head & Neck Surgery (TNORL and HNS) meetings. MATERIALS AND METHODS: The TNORL and HNS meetings of 2008, 2009 and 2010 were included in the study. The number, subjects, types (clinical study, experimental study, case report) and institutions of the oral presentations and posters were documented using the abstract CD's of the meetings. The conversion rate of presentations into the full-text articles in the peer-reviewed journals were reviewed through the search engines Pubmed for the international indexes and Türk Medline and Ulakbim for the national ones. The time from presentation in the meetings to publication was determined. The distribution of journals according to the publication dates of the articles were evaluated in terms of the Science citation index (SCI), SCI expanded (SCI-E), PubMed and Turkish citation index. RESULTS: The total number of presentations submitted in the three TNORL and HNS meetings was 1,454 and posters accounted for 75.4% of all presentations. While case reports were 53.2% of the total presentations, the ratios were found to be 43% and 3.8% for the research and experimental studies, respectively. Of the oral presentations, 88% included research studies, whereas 70.3% of the posters were case reports. The origin of the presentations was university hospitals, education hospitals, other national institutions, and international institutions with ratios of 51.6%, 44.3%, 3% and 1.1%, respectively. The conversion rate of presentations into the full-text articles was found as 21.9%. The rate was 37.3% for oral presentations and 17% for the posters (p=0.00). For all of the 319 published papers, the overall mean time from presentation to publication was 18.6 months. While 62.7% of the articles were published in international journals, 37.3% were published in national journals. The conversion rate of oral presentations into publications was higher than the posters (p=0.00). CONCLUSION: The first study related to TNORL and HNS meetings in Turkey revealed that, although the quantity of presentations was high, the rate of conversion into the full-text journal articles was lower compared to the similar international annual meetings held by otorhinolaryngology or other disciplines. The quality and success of our scientific meetings can be enhanced with some particular precautions.

[Quantitative and qualitative analysis of four national otorhinolaryngology journals between 2002 and 2010]. / Dört ulusal KBB dergisinin 2002/2010 yillari arasindaki niceliksel ve niteliksel analizi.

OBJECTIVES: This study aims to perform a quantitative and qualitative analysis of four national peer-reviewed otorhinolaryngology journals between 2002 and 2010 and compare various parameters in 1990-1994 period. MATERIALS AND METHODS: The number of authors and female authors, gender of first author, city and the institution where the article was submitted, number of references and national references were noted separately for each article in all issues of four national peer-reviewed journals in years 2002, 2005 and 2010. Language of articles was noted and they were grouped under six main headings based on their subjects. Quantitative analysis was performed considering evidence-based medicine principle and evidence levels of articles were noted between 1 and 5. Statistical analysis was performed using Pearson chi-square and one-way ANOVA tests. RESULTS: A total of 424 articles including 143 in 2002, 147 in 2005 and 134 in 2010 in four national otorhinolaryngology journals were evaluated. The number of authors per article was found to be 4.49, indicating no statistically significant difference between the years (p>0.05). The mean number of female authors per article was 0.85. When the institutions submitted articles were assessed, number of publications from university hospitals was higher than the education hospitals and other health care services; however, this difference was reduced in 2010. In the evaluation of cited references, the mean number of references and national references per article increased from 16.90 to 18.12 and from 1.54 to 1.68 in 2002 and 2010, respectively. According to the articles categorized to their main subjects, it was found that most of the publications were related to upper respiratory/digestive tract and neck and the least was related to facial plastic surgery. The qualitative analysis in terms of evidence-based medicine revealed no articles with level 1 evidence through three years studied. CONCLUSION: It will be useful to make similar periodical studies to improve the quality of otorhinolaryngology journals and related articles in Turkey.

[Publication rates of presentations which were presented at Turkish National Rhinology Congresses]. / Türk Ulusal Rinoloji Kongrelerinde sunulan bildirilerin yayinlanma oranlari

OBJECTIVES: This study aims to determine the publication rates of oral presentations and posters presented at Turkish National Rhinology Congresses in the medical journals and to make a comparison with related literature data. MATERIALS AND METHODS: The name and surname of the first authors and the title of presentation presented at 2007, 2008, 2009 and 2010 were searched using PubMed, Turkmedline and Ulakbim national search engines. RESULTS: Of the 218 papers presented, 61 (28%) were published. The mean time from presentation at congress to publication was 21.8 months. The mean time to publication for oral presentations was 23.2 months, while it was 20.8 months for poster presentations. The publication rates of oral and poster presentations were 35.8% and 24.5%, respectively, indicating no statistically significant difference between two groups (p=0.08). The publication rate of research articles was statistically significantly higher than that of case reports (20.7% vs. 33.3%; p=0.04). CONCLUSION: The publication rate of presentations presented at four Turkish National Rhinology Congresses is lower compared to the previously reported publication rates in otorhinolaryngology. Giving wider publicity to research presentations and being more selective for case reports will provide inclusion of more qualified papers with high possibility of publication and also enhance the scientific value of such congresses.