The pre-treatment neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and red cell distribution width predict prognosis in patients with laryngeal carcinoma.

The aim of this study was to identify the potential prognostic roles of the preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) in patients with laryngeal squamous cell carcinoma (LSCC). 81 patients who underwent surgery for the larynx carcinoma were enrolled in the study. NLR, PLR and RDW were used as outcome measures. Local recurrence was detected in 30 (37.0 %) patients and neck lymph node metastasis was detected 6 (7.4 %) patients during follow-up period. Mortality was seen in 7 (8.6 %) patients. The mean PLR in the T1 and T2 stage tumors were significantly lower than the T4 stage. The mean RDW and PLR were significantly higher in the exitus group than the survivor group. The mean NLR in the patients with local recurrence was significantly higher than the non-recurrent patients. Progression-free survival (PFS) was lower in patients with high NLR. When analyzed by the Cox regression analysis of factors affecting the local recurrence, NLR was found to significantly affect the recurrence. According to ROC analysis for mortality, NLR was not found to be a prognostic factor, although the PLR and RDW were significant prognostic factors. According to Cox regression analysis, a high PLR increases mortality 4.2 times and a high RDW 4.6 times. Although in univariate analysis MCV, RDW and tumor grade were predictors of mortality, RDW and tumor grade independent predictors were found. Further studies involving large patient groups are required.

Evaluation of Sleep Quality in Patients With Nasal Septal Deviation via the Pittsburgh Sleep Quality Index.

OBJECTIVE: To investigate the effect of nasal septum deviation, without obstructive sleep apnea, on sleep quality. METHODS: The present case-controlled study enrolled patients older than 16 years with nasal septum deviation who attended the Otorhinolaryngology Clinic between December 2013 and July 2014. The control group was selected from patients attending the clinic for another complaint. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, and differences between the groups were compared using the Mann-Whitney U test. RESULTS: During the study period, 55 patients with nasal septum deviation were included in the study group, and the control group consisted of 51 patients with no complaints of nasal obstruction. Compared with the control group, patients with nasal septum deviation were found to be significantly higher (P <0.05) in all parameters of Pittsburgh Sleep Quality Index. CONCLUSION: The presence of nasal septum deviation with nasal obstruction should be investigated in patients with sleep disorders. If any pathology is present, opening the nasal passages should be ensured and sleep disorders reevaluated.

An evaluation of the effects of adenoidectomy on voice and speech function in children.

OBJECTIVES: This study aims to evaluate the possible effects of adenoidectomy on voice and speech function. PATIENTS AND METHODS: Thirty-six children (20 boys, 16 girls; mean age 8.22±1.86 years) with adenoid hypertrophy and 50 healthy children (23 boys, 27 girls; mean age 8.54±1.92 years) were included in the study. Acoustic and spectrographic analyses, voice analysis and nasalance assessment were carried out preoperatively and at one week and three months postoperatively in children who underwent adenoidectomy operation and control group. RESULTS: A significant change in voice nasalance and F3 and F4 formants was observed in children who underwent adenoidectomy. There was no significant change in F0, shimmer %, amplitude perturbation quotient (APQ), jitter %, relative average perturbation (RAP), noise to harmonic ratio (NHR), F1 and F2 formant values, as assessed by objective voice analysis. CONCLUSION: Our study results show that adenoidectomy may affect voice resonance and nasalance, changing the shape and size of nasopharynx and upper respiratory tract. Adenoidectomy seems to be safe without any significant change in the voice quality.

[Frontal sinus obliteration with pericranial-subgaleal flap]. / Perikraniyal-subgaleal flep ile frontal sinüs obliterasyonu.

OBJECTIVES: We evaluated the results of patients who underwent frontal sinus obliteration with vascularized pericranial-subgaleal flap. PATIENTS AND METHODS: Charts of patients (7 males 1 female; mean age 40.5+/-17.1 years; range 9 to 61 years) who underwent frontal sinus obliteration with pericranial-subgaleal flap between June 2001 and January 2008 were retrospectively reviewed. Demographics, indications for frontal sinus obliteration, immediate and late postoperative complications were recorded. All patients were invited to the clinic and underwent control examinations and computed tomography. The indications for frontal sinus obliteration were fracture of frontal sinus anterior and posterior walls in four cases, frontal sinus mucoceles in two cases, mucopyoceles in one case and fracture of frontal sinus anterior wall in one case. Bicoronal incision was used in all patients and then they underwent frontal sinus obliteration with lateraly based pericranial-subgaleal flap. RESULTS: In the postoperative period rhinorrhea and meningitis, which lasted for two days, developed in one patient with fracture of frontal sinus anterior-posterior walls and hypoestesia developed in the frontal skin area in one patient with fracture of frontal sinus anterior wall. No complications were observed in the other cases. CONCLUSION: Pericranial-subgaleal flap is a well vascularized, close to surgical area, inexpensive, safe and effective tissue that can be used for frontal sinus obliteration.

Prognostic Value of Acoustic Rhinometry and Rhinomanometry in Tympanoplasty Surgery.

OBJECTIVE: Chronic otitis media (COM) is a disorder characterized by perforation of the eardrum and hearing loss following chronic inflammation of the middle ear cavity, ossicules, and mastoid cells. Eustachian dysfunction plays an important role in COM etiopathogenesis and postoperative prognosis. The determinants of postoperative prognosis are still being researched. This study aimed to research the prognostic value of acoustic rhinometry (ARM) and rhinomanometry (RMM) in COM surgery in terms of eradication of the infection after operation, graft success, and hearing gain in operated cases. MATERIALS AND METHODS: This study included 58 patients who underwent surgery with a diagnosis of COM. Patients were assessed in terms of age, gender, COM type, treatment methods used, eradication of infection, graft success, and hearing gain. ARM and RMM measurements were performed in the preoperative period. ARM and RMM values were statistically compared in terms of the existence of postoperative infection, graft success, and hearing gain. RESULTS: In terms of ARM and RMM measurements, there was no statistically significant difference between cases where postoperative infection control was assured and cases with ongoing infection; successful and failed cases in terms of grafting; or successful and failed cases in terms of postoperative hearing. When preoperative and postoperative air-bone gap averages were compared, statistically significant differences were observed. CONCLUSION: In the presence of a nasal obstruction in cases with chronic otitis, elimination of this situation is the first line of treatment. Infection control, graft success, and improvement of hearing will be possible to a greater extent in the postoperative period for patients with the nasal pathology remedied.

Clinical significance of Ki-67, c-erbB-2 and E-cadherin expressions in open partial laryngectomy patients.

OBJECTIVES: This study aims to analyze the correlation between biomarkers and risks of cervical lymph node invasion, recurrence, distant metastasis and survival regarding the clinicopathological variables in laryngeal cancers. PATIENTS AND METHODS: Forty-one patients with laryngeal cancers were examined retrospectively. The correlations evaluated between E-cadherin, Ki-67, c-erbB-2 expressions, tumor site, differentiation, the risk of cervical lymph node metastasis, perineural, perivascular, pericapsular invasion and recurrence as well as survival time. RESULTS: There was significant correlation between T-grade and the survival rates, and between pericapsular invasion and the lowest survival rates. There was no significant correlation between E-cadherin, Ki-67, c-erbB-2 expressions and clinicopathological variables of tumor. Positive correlation between strong stain of E-cadherin and Ki-67 proliferation index was determined. CONCLUSION: These markers are not reliable prognostic and predictive factors for laryngeal cancers. E-cadherin expression was protected in well-differentiated and less invasive cancers, which maintain their cell-cell adhesions whereas it was reduced in undifferentiated cancers. Positive correlation between E-cadherin and Ki-67 proliferation shows that histopathological differentiation of laryngeal cancers is maintained in spite of the high proliferation index.

Evaluation of the protective effects of hesperetin against cisplatin-induced ototoxicity in a rat animal model.

OBJECTIVES: We aimed to investigate the effects of hesperetin as a flavanon both histopathologically and immunohistochemically on cochlear apoptosis in a rat model of cisplatin-induced ototoxicity (CIO). The evaluation of the effects of hesperetin on cisplatin-induced hearing loss was performed using distortion product otoacoustic emission (DPOAE). METHODS: Twenty-eight wistar albino rats were used in the current study. The rats were randomly divided into four groups with seven rats in each group. Group C was exposed to a single dose of cisplatin (12mg/kg) by intraperitoneal injection. Group CH received intraperitoneally cisplatin (12mg/kg) and hesperetin (20mg/kg). Group H was exposed to hesperetin (20mg/kg) intraperitoneally. The sham group (group S) received normal saline (6cc) intraperitoneally. The measurements of DPOAE and signal-noise ratios (SNR) were performed before the treatment and again on the first and 6 days after administration of the drugs. Rats were sacrificed and cochleae were dissected 10 days after drug administration. The cochlear tissue was assessed in all groups by histopathologic, immunohistochemical and TUNEL assay. In addition, serum oxidative stress markers and antioxidant parameters were analyzed. RESULTS: There was a significant difference between the basal value and the sixth day at frequencies 8.4, 9.6 and 9.96 for group C. We also found a significant difference between the first and sixth day at frequencies 7.2, 8.4, 9.6 and 9.96. On the 6th day, there were significant differences between C and S groups at all frequencies except 2.4. We showed a significant difference between C and H groups at frequencies 4.8, 6.0, 8.4, 9.6 and 9.96. There was also a significant difference between C and CH groups at frequencies 2.4, and 3.6. We found lower levels of oxidants and higher levels of antioxidants in CH group as compared to C group. C group had a significantly greater number of TUNEL-positive cells than did S, H and CH groups. The number of TUNEL-positive cells in CH group was higher than in S and H groups. There was a significant difference between the positive PCNA cells of CH group compared to S and H groups in spiral ganglion and stria vascularis. In addition, there were no positive PCNA cells in C group. CONCLUSIONS: Hesperetin may prevent ototoxicity by increased antioxidant enzymes and reduced oxidant parameters and protected against apoptosis resulting from a proliferation of cochlear cells in CIO.

[Foreign body in the submandibular gland: a tooth extraction complication]. / Submandibüler bezde yabanci cisim: Bir dis çekimi komplikasyonu.

The head and neck region includes many vital anatomic structures. So, diseases of this region may have a more morbid and mortal course compared to other anatomic regions. In this article, we report a patient showing various symptoms due to a suture needle which was left in the surgical region during the extraction of the left inferior molar tooth three years ago.

[Rhino-orbito-cerebral mucormycosis: two case reports in the light of the literature]. / Rino-orbito-serebral mukormikozis: Literatür esliginde iki olgu sunumu.

Rhino-orbito-cerebral mucormycosis is an acute onset and often fatal disease. Risk factors include uncontrolled diabetes mellitus, hematological malignancies, and long-term corticosteroid use. Early diagnosis and treatment are important. The underlying causes should be treated, surgical debridement should be performed and appropriate antifungal drugs should be given. In this article, we report two diabetic ketoacidosis patients who developed rhino-orbito-cerebral mucormycosis and were treated with surgical debridement and amphotericin B therapy.

Agenesis of submandibular glands: a report of two cases with review of literature.

Background. Congenital absence of the submandibular gland (SMG) is a rare condition. Although complaints such as dry mouth, dental problems, or difficulty in swallowing may be seen, the subjects may also be asymptomatic. The absence of the SMG may be associated with hypertrophy of the contralateral SMG. Case Report. We report the case of a 44-year-old woman with incidentally detected left SMG aplasia, with contralateral SMG hypertrophy mimicking a mass, and the case of a 46-year-old woman with incidentally detected bilateral SMG aplasia, demonstrated by computerized tomography (CT) and magnetic resonance imaging (MRI). Conclusion. It is important for the clinician to know that this very rare abnormality may exist. When such a case is encountered, symptoms and findings should be reevaluated and, if necessary, conservative therapy should be initiated. The possibility of observing additional deformities should be kept in mind and an evaluation should be done for other cases in the family.

Ghrelin levels in children with adenoid or chronic tonsil hypertrophies before and after surgery.

OBJECTIVE: We aimed to evaluate the ghrelin levels in the children with adenoid or tonsil hyperthrophies. METHODS: The study included 27 children (17 boys and 10 girls). Mean age was 6.9+/-3.5 years, ranging from 3 to 16. Ghrelin levels in the patients and their weight and height measurements were evaluated before surgery and after 3 months later of the operation. RESULTS: While 18 (67%) children were operated for adenoid hypertrophy, 9 (33%) children were operated for adenoid and tonsil hypertrophy. It was found that postoperative ghrelin levels were significantly decreased whereas weight and BMI scores were significantly increased (p<0.01). A weak correlation was observed between preoperative ghrelin and weight (r=-0.29). This negative correlation became more profound at the postoperative 3rd month examination (r=0.85) (p<0.01). CONCLUSIONS: The present study showed that the surgical treatment provides positive contributions on the growing of children with adenoid and tonsil hypertrophies. The ghrelin levels were significantly decreased at the postoperative period in the children, and a negative relationship was observed between the ghrelin levels and the weight. These findings suggest that blood ghrelin levels may be useful as a parameter for following the development of the children.