Assessment of Smell and Taste Disorders in COVID-19: A Cross-sectional Study.

BACKGROUND: It has been reported worldwide that patients with a diagnosis of COVID-19 usually suffer a loss of smell and taste. In this study, we aimed to evaluate the relationship between the severity of the disease and the loss of smell and taste. In addition, we evaluated patients' smell and taste functions after recovery. METHODS: Between March and May 2020, 418 patients diagnosed with COVID-19 were divided into 3 groups: home-quarantined, hospitalized, and intensive care patients. The disease, smell, and taste functions of patients were evaluated with visual analog scores before diagnosis of COVID-19, during the disease, and fourth week after recovery. The types of smell loss and types of taste flavor loss occurring during the disease were questioned. RESULTS: In all 3 groups, changes in smell and taste loss during the disease were statistically detected (P = 0.001). The smell loss rates determined in groups 1 to 3 were 45%, 43.7%, and 31.2%, respectively. The taste loss rates determined in groups 1 to 3were 46.6%, 32.1%, and 31.2% respectively. The rate of patients with a total recovery of smell loss in groups 1 to 3 were 95.5%, 93.7%, and 100%, respectively (P = 0.768). The rate of patients with a total recovery of taste loss in groups 1 to 3 were 97.1%, 91.4%, and 100%, respectively (P = 0.423). CONCLUSION: COVID-19 causes significant loss of smell and taste in patients. The loss of smell and taste does not correlate with the severity of COVID-19 disease. The loss of smell and taste improves at a high rate after the disease.

Laryngeal cytology: A cytological, histological, P16 and human papillomavirus study.

BACKGROUND: Invasive diagnostic methods, such as punch biopsies, have a potential to produce undesirable side effects in the larynx, such as scarring and vocal dysfunction. This study is an attempt to assess the diagnostic potential of cytology to efficiently diagnose premalignant and malignant laryngeal lesions, while sparing patients the risk of complications of punch biopsies. METHODS: Laryngeal smears, using endocervical-type brushes, and punch biopsies were procured from each patient. Smears were prepared and the brush was cut and put in Surepath preservative solution for cytological analysis and human papillomavirus (HPV) DNA testing. A Real-TM Quant kit that detects 14 HPV types was used for genotyping. Immunohistochemical staining for p16 was performed on cytological and histological specimens. RESULTS: Cytological diagnosis was correct in 84.6%, 100% and 100% of cases with a histological diagnosis of squamous cell carcinomas, high-grade squamous intraepithelial lesions and benign lesions, respectively. However, cytological interpretation was correct only in 25% of low-grade squamous intraepithelial lesions. HPV DNA test was positive in only one case, which was a laryngeal polyp. Testing for p16 was negative in all the cytological and histological material. CONCLUSION: Laryngeal cytology is a useful diagnostic tool in establishing the diagnosis of high-grade squamous epithelial cell abnormalities. Recognition of low-grade lesions, however, is challenging. HPV genotyping and p16 staining do not seem to be helpful ancillary techniques in cytological material procured from the larynx.

The protective effects of different treatments on rat salivary glands after radiotherapy.

This study was aimed to evaluate the efficacy of treatment modalities for minimizing salivary gland damage caused by radiotherapy. Forty rats were divided into five groups. Group 1 had no irradiation or any treatment. Group 2 underwent only 15 Gy single dose radiotherapy. N-acetylcysteine, dexamethasone, hyperbaric oxygen treatment were given, respectively to the group 3, 4 and 5 for 5 days. 15 Gy single dose radiotherapy was applied to the group 3, 4 and 5 on the second day. Pyknosis, lysis, and vacuolization were examined in ductal cells and pyknosis, lysis, vacuolization, inflammation and collective duct damage in acinar cells. Dexamethasone and hyperbaric oxygen did not prove to have a positive effect on acinar and ductal cell. N-acetylcysteine-applied group had statistically significantly lower amount of damage. We determined that the decrease of ductal and acinar cell damage in parotid glands of N-acetylcysteine-applied rats was more distinct and statistically.

Efficiency of hyperbaric oxygen and steroid therapy in treatment of hearing loss following acoustic trauma.

INTRODUCTION: Most commonly used treatment modalities for acute acoustic trauma (AAT) include steroid and hyperbaric oxygen (HBO2) therapy. The aim of this study is to investigate the effectiveness of combined steroid and HBO2 therapy in patients who develop AAT during firearms training and the effect of delay to treatment on treatment success. MATERIALS AND METHODS: Patients admitted with the complaint of hearing loss after firearms training between January 2011 and April 2013 were evaluated retrospectively. Patients were grouped according to date of admission; patients admitted within the first 10 days were included in Group A and those admitted between Days 11 and 30 in Group B. RESULTS: A total of 48 patients (73 ears) with AAT were included. There were 37 ears in Group A and 36 ears in Group B. The number of ears with complete treatment response, partial treatment response and treatment failure (unchanged) were one (2.7%), 7 (18.9%) and 29 (78.4%) in Group A and 0 (0%), 3 (8.3%) and 33 (91.7%) in Group B, respectively. There was no statistically significant difference between the groups (p = 0.095). Late-term results (at Week 6) demonstrated Group A showed higher hearing gain on high frequencies than Group B (p < 0.05), but this result was not consistent with clinical outcome results. CONCLUSION: The success rate of combined HBO2 and steroid therapy was very low in our study. However, early initiation of treatment results in better outcomes. Protective measures have great importance in preventing AAT.

Effect of applying head-shaking maneuver before Epley maneuver in BPPV.

INTRODUCTION: The Epley maneuver is applied in the treatment of benign paroxysmal positional vertigo, the BPPV. However, dizziness and balance problems do not improve immediately after the treatment. OBJECTIVE: In this study, the effectiveness of the head-shaking maneuver before the Epley maneuver was investigated in the treatment of BPPV. METHODS: Between March 2020 and August 2020, ninety-six patients with posterior semicircular canal BPPV were analyzed prospectively. The patients were divided into two groups: patients who underwent the Epley maneuver only in the treatment (Group 1) and patients who underwent the Epley maneuver after the head-shaking maneuver (Group 2). The results of the Berg balance scale and dizziness handicap index were evaluated before the treatment and at the first week after the treatment. RESULTS: The improvement in functional, emotional, and physical dizziness handicap index and Berg balance scale values after the treatment was found to be statistically significant in both groups. It was determined that the change in functional and physical dizziness handicap index and Berg balance scale values of the patients in Group 2 was statistically higher than those in Group 1. Although, the change in emotional dizziness handicap index values in Group 2 was higher than those in Group 1, no statistical significance was found between the groups. CONCLUSION: As a result of our hypothesis, we think that in the treatment of posterior semicircular canal BPPV, the otoliths adhered to the canal can be mobilized by the head-shaking maneuver, and this will contribute to the increase of the effectiveness of the Epley maneuver.

Hearing Aid Problems in Elderly Populations.

The use of hearing aid (HA) may improve the hearing performance and ease the perceived negative consequences of hearing difficulties in elderly individuals. The aim of this study was to determine the problems experienced by elderly individuals with HA and to investigate the factors that could increase the use of HA. A total of 122 female and 127 male patients with a mean age of 76.79 ± 6.91 years who were recommended HA were evaluated. The following details were taken from the patients: age, gender, duration of hearing complaint, whether or not they received HA, number of family members, number of hours they used HA in a day, type of device, number of ears with HA, educational status, whether they continued to work, whether they were tested before taking the device, the reasons for not taking HA, and the reasons that reduce their use of HA. A total of 18 patients did not receive HA for the following reasons: 9 considered HA too expensive, 8 thought it would be difficult to use HA, and 1 did not like it because of its appearance. No significant difference was found in the patients' daily HA use duration, age, sex, number of immediate family members, education level, type of device, test before taking the device, and use of HA in single ear or bilateral ears. There was a significant difference in the daily HA use duration and whether the patients continued to work. We need to help reduce the problems associated with the use of HA to help older individuals have a more active role in society and help them in their health problems.

Real-time PCR detection of Helicobacter pylori and virulence-associated cagA in nasal polyps and laryngeal disorders.

OBJECTIVE: To identify Helicobacter pylori and major virulence factor, cagA, in patients with laryngeal diseases and nasal polyps. STUDY DESIGN: Cross-sectional study with planned data collection. SETTING: The study was performed on fresh tissue samples from patients with 32 nasal polyps, 29 normal nasal mucosa, and 27 laryngeal diseases presenting to the Otolaryngology-Head and Neck Surgery department of a major military hospital in Istanbul, Turkey. SUBJECTS AND METHODS: Tissue specimens were evaluated by in-house polymerase chain reaction (PCR) and real-time PCR for bacterial DNA and by real-time PCR for cagA. The impact of commercial and in-house DNA extraction methods was also evaluated. RESULTS: H pylori DNA was detected only by real-time PCR in 59.4 percent of nasal polyps, 70.4 percent of nasal mucosa samples, and 58.6 percent of larynx samples. cagA was identified in 78.9, 89.5, and 82.4 percent of positive polyp, nasal mucosa, and larynx samples, respectively. No statistically significant differences were observed between groups. DNA purification methods were equally effective. CONCLUSION: H pylori DNA is present in nasal polyp and larynx tissues as well as normal nasal mucosa, as detected by a sensitive real-time PCR assay. cagA-positive strains dominate in all groups.

Comparison of uvulopalatopharyngoplasty and uvulopalatal flap in Turkish military personnel with primary snoring.

OBJECTIVE: To compare the surgical results of uvulopalatopharyngoplasty (UPPP) and uvulopalatal flap (UPF) procedures in the treatment of primary snoring. MATERIALS AND METHODS: Two study groups were formed and UPPP and UPF procedures were performed. All patients were stratified according to the modified Friedman staging system. Patients with tonsil size 2-4, palatal position scale grade 2, and body mass index lower than 30 were enrolled in the study. The success of surgical procedures was evaluated by applying a snoring questionnaire and Epworth sleepiness scale preoperatively and 90 days after the operation. Patients were followed for postoperative pain and other complications. RESULTS: Snoring was relieved in 85% of UPPP and in 83.3% of UPF patients 90 days after the operation. Postoperative pain complaint was more prominent in the UPPP group and mean duration of pain was significantly longer compared with the UPF group. CONCLUSIONS: Despite similar success rates in the short-term, we can say that the UPF procedure is more practical and comfortable when compared to the UPPP in the military setting.

Long-Term Outcomes of Sialendoscopy in the Management of Sialolithiasis and Idiopathic Chronic Sialadenitis with Ductal Scars.

OBJECTIVE: We aimed to present the long-term outcomes and sialendoscopic findings in only patients with sialolithiasis and ductal scars in idiopathic chronic recurrent sialadenitis who experienced unsuccessful results with conservative treatment and were treated with sialendoscopy. METHODS: We retrospectively analyzed the patients with a diagnosis of only sialolithiasis and ductal scars in chronic recurrent sialadenitis who underwent sialendoscopy between January 2011 and June 2016. We collected clinical and intraoperative data including patient age, sex, date of the procedure, the involved gland, operative findings and complications. Follow-up data included whether the symptoms were resolved or recurred and whether any further procedures were performed. RESULTS: Of a total of 38 patients, 16 were excluded from the study due to missing clinical or follow-up data, and analysis was conducted on 22 patients. Twelve were diagnosed with sialolithiasis, while the remaining 10 were diagnosed with idiopathic chronic sialadenitis and had ductal scars. Stone sizes ranged from 2 mm to 10 mm. Mean follow-up time was 39.5 months. The final success rate was 100%. Of the 10 patients with ductal scarring, five had scar in the parotid gland duct, and five in the submandibular gland duct. The mean follow-up time of all ductal scar patients was 47.1 months. The final success rate was 70%. CONCLUSION: Sialendoscopy is a minimally invasive method for the diagnosis and treatment of sialolithiasis and ductal scars of the salivary glands after failure of conservative treatments in adults.

[Type I Chiari malformation presenting with isolated unilateral hypoglossal nerve and vocal cord paralysis]. / Izole tek tarafli hipoglossal sinir ve vokal kord paralizisi ile ortaya çikan Chiari tip I malformasyonu.

Chiari malformation refers to caudal displacement of posterior fossa structures through the foramen magnum in the cervical canal and is classified according to the severity of displacement and accompanying cranial nerve and cervical pathologies. We presented a 24-year-old male patient who had isolated unilateral paralysis of the hypoglossal nerve and vagus nerve, with thyroid cartilage asymmetry. Chiari type I malformation was diagnosed by craniospinal magnetic resonance imaging. Suboccipital craniectomy and cervical 1-level large partial laminectomy were performed by the neurosurgery department. No improvement was observed in hypoglossal and vagal paralysis during an 18-month follow-up.

Effects of halofuginone on fibrosis formation secondary to experimentally induced subglottic trauma.

OBJECTIVE: The aim of the study was to assess the antifibrotic effect of systemically applied halofuginone after subglottic injury. MATERIALS AND METHODS: After standardized trauma to subglottic area, rats were divided into two groups: a study group that received treatment and a control group that did not. The rats were treated with 0.1 mg/kg/day intraperitoneal halofuginone injection for 30 days. The larynx specimens were examined histopathologically under light microscope for epithelization, inflammation, necrosis, and fibrosis. RESULTS: The fibrosis indexes of the treated group were significantly less than those of the control group (P < .01). CONCLUSIONS: Systemically applied halofuginone hydrobromide decreases fibrosis/scar tissue formation secondary to experimentally induced acute subglottic trauma.

Effect of applying head-shaking maneuver before Epley maneuver in BPPV / Efeito da aplicação da manobra de balanço da cabeça antes da manobra de Epley na VPPB

Abstract Introduction: The Epley maneuver is applied in the treatment of benign paroxysmal positional vertigo, the BPPV. However, dizziness and balance problems do not improve immediately after the treatment. Objective: In this study, the effectiveness of the head-shaking maneuver before the Epley maneuver was investigated in the treatment of BPPV. Methods: Between March 2020 and August 2020, ninety-six patients with posterior semicircular canal BPPV were analyzed prospectively. The patients were divided into two groups: patients who underwent the Epley maneuver only in the treatment (Group 1) and patients who underwent the Epley maneuver after the head-shaking maneuver (Group 2). The results of the Berg balance scale and dizziness handicap index were evaluated before the treatment and at the first week after the treatment. Results: The improvement in functional, emotional, and physical dizziness handicap index and Berg balance scale values after the treatment was found to be statistically significant in both groups. It was determined that the change in functional and physical dizziness handicap index and Berg balance scale values of the patients in Group 2 was statistically higher than those in Group 1. Although, the change in emotional dizziness handicap index values in Group 2 was higher than those in Group 1, no statistical significance was found between the groups. Conclusion: As a result of our hypothesis, we think that in the treatment of posterior semicircular canal BPPV, the otoliths adhered to the canal can be mobilized by the head-shaking maneuver, and this will contribute to the increase of the effectiveness of the Epley maneuver.

Resumo Introdução: A manobra de Epley é aplicada no tratamento da vertigem posicional paroxística benigna (VPPB). Entretanto, a tontura e os problemas de equilíbrio não melhoram imediatamente após o tratamento. Objetivo: Investigar a eficácia da manobra de balançar a cabeça antes da manobra de Epley no tratamento da VPPB. Método: De março de 2020 a agosto de 2020, 96 pacientes com VPPB de canal semicircular posterior foram analisados prospectivamente. Os pacientes foram divididos em dois grupos: pacientes que foram submetidos apenas à manobra de Epley no tratamento (Grupo 1) e pacientes que foram submetidos à manobra de Epley após a manobra de balanço da cabeça (Grupo 2). Os resultados da escala de equilíbrio de Berg e do dizziness handicap index foram avaliados antes do tratamento e na primeira semana após o tratamento. Resultados: A melhoria nos valores funcionais, emocionais e físicos do dizziness handicap index e da escala de equilíbrio de Berg após o tratamento foi estatisticamente significante em ambos os grupos. Foi determinado que a alteração nos valores funcionais e físicos do dizziness handicap indexe da escala de equilíbrio de Berg dos pacientes do Grupo 2 foi significantemente maior do que aqueles do Grupo 1. Embora a alteração nos valores do dizziness handicap index emocional no Grupo 2 tenha sido maior do que no Grupo 1, não houve significância estatística entre os grupos. Conclusão: Como resultado de nossa hipótese, acreditamos que no tratamento da VPPB do canal semicircular posterior os otólitos aderidos ao canal podem ser mobilizados através da manobra de balanço da cabeça, o que contribuirá para o aumento da eficácia da manobra de Epley.

Juvenile spring eruption: a report of two cases.

Juvenile spring eruption is a photodermatosis characterized by the development of papules and vesicles on the light-exposed helix of the ears after sun exposure, usually in the springtime. It mainly affects boys and young male adults, and has a tendency to occur in the form of small epidemics. We report an outbreak in a group of soldiers who were performing military exercises during cold and sunny weather during a midwinter season. The clinicopathologic features and laboratory test results are described in two of these cases.

Histologic effects of injection snoreplasty and radiofrequency in the rat soft palate.

OBJECTIVE: This study was undertaken to compare the effects of radiofrequency and injection snoreplasty on the histological structure of the soft palate in an animal model. STUDY DESIGN AND SETTING: This is a blinded, controlled histologic evaluation of rat soft palates that underwent separate palatal interventions. Fifty rats were divided into 5 groups of 10 rats (Group 1 = injection snoreplasty [IS], Group 2 = IS + steroid, Group 3 = saline injection, Group 4 = radiofrequency ablation [RFA], and Group 5 = no intervention). The animals were sacrificed after 24 hours, 1 week, 3 weeks, and 5 weeks. Then the soft palates were subjected to histological analysis. RESULTS: Histological analysis demonstrated normal remucosalization in all specimens, with fibrosis increased in Group 1. Interstitial edema was minimal in Group 2. Keratinization was most apparent in Group 4. CONCLUSION: Radiofrequency and injection snoreplasty stiffen the rat soft palate compared with controls.

Nasal septal cyst: a case report.

Nasal septal cyst is a rare complication seen after submucous resection of the nasal septum. A 25-year-old male patient presented with a complaint of nasal obstruction four years after submucous resection. Physical examination revealed a grey mass obstructing both nasal cavities and the nasal airway. Magnetic resonance imaging showed a nasal septal cyst filling the nasal cavity. Following aspiration of the cyst content, endoscopic examination was performed and perforation of the lower part of the nasal septum was noted. Under local anesthesia, superior, posterior, and anterior parts of the cyst and the left wall of the septum were endoscopically released and prepared to be used as a flap. It was sutured on the lower part of the septal perforation. No recurrence was seen during a follow-up of 18 months.

Effects of topical application of mitomycin-C and 5-fluorouracil on myringotomy in rats.

OBJECTIVE: The effects of topical application of Mitomycin-C (MMC) and 5-fluorouracil (5-FU) for maintaining myringotomy patency were investigated in this experimental study. STUDY DESIGN: We performed simple myringotomy with a knife on 140 tympanic membranes of 70 rats. Rats were divided in two study groups and a control group. Each study group had 60 tympanic membranes, and the control group had 20. We applied Mitomycin-C (0.4 mg/ml) in Group A, 5-fluorouracil (50 mg/ml) in Group B topically, and sterile saline in the control group for 10 minutes. Examination was made with otoendoscope on days 1, 3, 5, 7, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, and 70, and patency rates were recorded. RESULTS: MMC and 5-FU Groups remained open for a mean of 46.17 days and 14.62 days, respectively. The control ears healed within 10.4 days. Fibrosis of the MMC-treated group was the same as that of 5-FU-treated groups. Fibrosis of both study groups was significantly lower than that of the control group. CONCLUSIONS: MMC is more effective than 5-FU, which is more effective than the simple myringotomy procedure in extending the patency of myringotomies in rat tympanic membranes (p < 0.05). Both medications are useful as an adjunct in preventing myringotomy closure.

[The effectiveness of fiberoptic endoscopic swallow study and modified barium swallow study techniques in diagnosis of dysphagia]. / Yutma güçlügü olan hastalarin tanisinda fiberoptik endoskopiyle yutma degerlendirmesi ve modifiye baryumlu yutma testinin etkinlikleri.

OBJECTIVES: The purpose of this study was to evaluate the effectiveness of fiberoptic endoscopic evaluation of swallowing (FEES) and the modified barium swallow test (MBST) in patients with dysphagia. PATIENTS AND METHODS: Eighty patients with dysphagia were evaluated in three groups consisting of 27 patients with oral, pharyngeal, or esophageal masses; 26 patients with neurogenic dysphagia; and 27 patients with no distinct pathology. All the patients underwent FEES and MBST to examine elevation of the soft palate, nasal regurgitation, pharyngeal residue, penetration, aspiration, and pooling of secretions in the pyriform sinus and vallecula. RESULTS: In neurogenic dysphagia, MBST was more efficacious in detecting aspiration and pooling in the vallecula (p<0.05). Evaluation of the internal anatomy, visualization of masses, and laryngopharyngeal sensory discrimination were only possible with the FEES. On the other hand, evaluation of the elevation of the larynx and the hyoid, the relaxation of the upper esophageal sphincter, and the oral phase of swallowing, and the detection of esophageal pathologies were only possible with the MBST. CONCLUSION: The leading advantages of the two evaluation techniques seem to lie in the detection of aspiration for the FEES, and dynamic evaluation of the oral and esophageal phases of swallowing for the MBST.

Rosai-Dorfman disease associated with neurosensorial hearing loss in two siblings.

Rosai-Dorfman disease (RDD) is an uncommon pathologic condition of unknown ethiology with an idiopathic proliferation of the hystiocytes. It is generally presented with massive bilateral hypertrophy of the cervical lymph nodes. But other lymph nodes may also be involved. Approximately, 30% of these patients have extra nodal mass or lesion with different signs or symptoms depending on localization. We present two male siblings with Rosai-Dorfman disease who have classical cervical lymphadenopathy associated with progressive neurosensorial hearing loss and dural-based intracranial lesions.

Outer hair cell activity of the cochlea in patients with iron deficiency anemia.

OBJECTIVE: Iron deficiency anemia is a common disorder, which has been reported to affect the auditory system. However, there are some conflicting points related with the pattern of hearing impairment. The aim of this study is to analyze the outer hair cell activity of the cochlea in patients with iron deficiency anemia. METHOD: Pure-tone audiometry (PTA) (250-6000 Hz) and distortion product otoacoustic emission (DPOAE) results of 42 patients with iron deficiency anemia and 22 healthy, age and sex matched subjects for the control group were compared. Cubic DPOAEs (2f1-f2) were obtained at 65 and 55 dB sound pressure level (SPL). DP grams were plotted as a function of f2 and signal-to-noise ratio (SNR) was specified as the difference in decibels SPL between DPOAE amplitude and the ambient noise level at a given f2. In DP grams, DP amplitudes and noise levels obtained from the baseline measurements were presented as the upper and lower limits of DP amplitude and noise level that were the 10th and 90th percentiles calculated by adding and subtracting standard deviations and from mean baseline DP amplitude and noise level. Independent-samples t-test is used for comparison of the groups. RESULTS: Pure-tone audiometry was normal in patients with iron deficiency anemia and control subjects and there was no significant difference in comparison of DPOAE in both groups and both sides and the results were between two percentiles (P > 0.05). CONCLUSION: The results of the present study did not support a casual relationship between the iron deficiency anemia and the auditory dysfunction on the basis of DPOAE.

[The effect of ostioplasty and nasoantral window opening on mucociliary activity in the maxillary sinus: an experimental study in the rabbit]. / Endoskopik sinüs cerrahisinde kullanilan ostioplasti ve nazoantral pencere açilmasi tekniklerinin maksiller sinüs mukosilier aktiviteye etkisi: Tavsanlarda deneysel çalisma.

OBJECTIVES: We evaluated the effects of ostioplasty and nasoantral window opening techniques employed in endoscopic surgery procedures for maxillary sinuses on mucociliary activity in rabbits. STUDY DESIGN: The study included 15 adult male New Zealand white rabbits (mean weight 3.5 kg). The animals were divided into three groups equal in number. Following a vertical incision in the midline, one group underwent ostioplasty to widen the natural ostium of the maxillary sinus; a new nasoantral window was opened in another group; the other group (controls) underwent only sinus exploration. Thirty days after surgery, mucociliary activity of the maxillary sinuses was evaluated scintigraphically. RESULTS: Compared with the control group, mucociliary activity decreased significantly in both groups, showing a higher deterioration with the nasoantral window opening technique (p<0.001) than that with the ostioplasty technique (p<0.05). CONCLUSION: Since both techniques have adverse effects on the mucociliary activity of the maxillary sinuses, ostioplasty and nasoantral window opening techniques should be reserved for patients in whom they are uniquely required.