In vitro study on immune response modifiers as novel medical treatment options for cholesteatoma.

OBJECTIVES: To investigate cytokine profile of cholesteatoma and to collect information about important intercellular signaling pathways by establishing two different cell culture models, to block important intercellular signaling pathways in cholesteatoma by applying immune system modifier drugs to develop alternative medical therapy options for cholesteatoma. METHODS: To observe the pathogenesis of cholesteatoma and to apply the immunomodulatory drugs, cholesteatoma tissue culture models were constituted with HEKa cells and cholesteatoma keratinocytes, which were obtained from 3 patients who underwent operations for cholesteatoma. Medicines including 5-fluorourasil, imiquimod, cyclosporine, and tacrolimus were applied on both cholesteatoma keratinocytes and HEKa cells. After 48 h of incubation, IL-1, IL-6, IL-8, IL-10, TNF-α, and Ki67 levels were measured to determine cell viability rates. RESULTS: In the cholesteatoma control group, IL-6 and TNF-α levels were found higher than in the HEKa control group. All repurposed drugs in the study demonstrated anti-inflammatory, anti-proliferative, and cytotoxic effects on cholesteatoma. Imiquimod and tacrolimus in particular are potential treatment prospects for cholesteatoma due to their strong anti-inflammatory and cytotoxic effects. CONCLUSION: Medical therapy options for cholesteatoma are still missing and surgery is not the ultimate solution. We have focused on intercellular inflammatory processes, which play significant roles in the pathogenesis of cholesteatoma in our paper. Inflammation and proliferation of cholesteatoma decreased after all repurposed drug applications in our study. Anti-inflammatory and anti-proliferative effects of tacrolimus and imiquimod was more significant than other drugs in the study. For this reason, tacrolimus and imiquimod should be examined in depth with in vivo studies in terms of efficacy and safety for medical treatment of cholesteatoma.

Olfactory and gustatory abnormalities in COVID-19 cases.

PURPOSE: At the time of writing, there is a pandemic affecting virtually every country on Earth. There is considerable discussion amongst clinicians as well as lay people about anosmia and ageusia in COVID-19 sufferers. We aimed to report the results from comprehensive olfactory and gustatory testing in a series of hospital in-patients. METHODS: The prospective study evaluated 81 individuals with a COVID-19 infection, as confirmed by 2019 n-cov Real-Time PCR laboratory testing. The control group consisted of forty individuals with COVID-19 negative. Olfactory and gustatory testings were carried out by an examiner utilizing stringent safety standards and wearing full personal protective equipment. The results obtained in the case group were then compared with those obtained for the controls. RESULTS: In the case group, 41(50.6%) of patients were male and 40 (49.4%) were female, mean age of 54.16 ± 16.98 years (18-95). In the control group, 21 (52.5%) of subjects were male and 19 (47.5%) were female, and mean age was 55 ± 15.39 years (18-90). Fifty (61.7%) COVID-19-positive patients had complaints related to olfaction. The distribution of olfactory symptoms in the case group differed at the level of statistical significance from the control group (p < 0.001). Turning to gustatory abnormalities, within the case group, 22 individuals (27.2%) had taste malfunction. A statistically significant difference was found in the distribution of gustatory abnormalities between cases and controls (p < 0.001). CONCLUSIONS: Olfactory and gustatory dysfunctions are strongly associated with SARS-CoV-2 infection. Hyposmia with or without hypogeusia is potentially a reliable indicator of latent COVID-19.

Uncommon Childhood Unilateral Cervical Giant Thymic Cyst.

Cervical thymic cysts are rare and present in the first decade of life. They constitute 0.3% to 1% of congenital neck masses. Thymic tissue foci, which exist between the mandible and the mediastinum, can be found at the descent of the thymic primordium. Thymic cysts should be considered in pediatric patients who present with cervical neck masses. The diagnosis of thymic cysts can only be made by histopathologic examinations. In recent years, the number of reports of thymic cyst cases have increased, one possible cause being the heightened awareness of thymic cysts among pathologists.

Is Transnasal Endoscopic Marsupialization Sufficient in Thornwaldt Cysts?

OBJECTIVE: Thornwaldt cyst is a rare nasopharyngeal lesion that develops from primitive notochord residues. The aim of this study is to evaluate the long-term results of transnasal endoscopic marsupialization surgery in the treatment of Thornwaldt's cyst, its success and its qualification in the treatment. METHOD: The data of 21 patients who underwent transnasal endoscopic marsupialization surgery for symptomatic Thornwaldt cyst in our hospital between 2009 and 2015 and followed up regularly after the operation were reviewed retrospectively. RESULTS: Eleven patients were female and 10 were male. The mean age of the patients was 35.5 years (15-60). All patients underwent transnasal endoscopic marsupialization as a surgical technique. No intraoperative and postoperative complications were observed. In all cases, the complaints regressed postoperatively. There was no recurrence at 4-year follow-up. CONCLUSION: Transnasal endocopic marsupialization as a surgical method can be performed safely in Thornwaldt cyst cases because of its easy applicability, short surgical time, low recurrence rates and efficacy in treatment.