Turkish Archives of Otorhinolaryngology最新文献

Phosphaturic mesenchymal tumor (PMT) is a rare mesenchymal neoplasia usually located in the soft tissue and the bone. It is seen in older ages and is most commonly localized in the extremities. Here, we present a rare case of PMT located in the sinonasal region. A 56-year-old male patient was admitted with complaints of congestion in the right nasal cavity and limitation of upward gaze in the right eye. Computed tomography revealed a contrast-enhancing mass with heterogeneous density obliterating the bilateral frontal sinus, the frontoethmoidal recess, the right osteomeatal complex and the right sphenoid sinus, extending to the superior extraconal area in the right orbit. Since the tumor type cannot be determined precisely in the pathological evaluation of incisional biopsy, an excisional biopsy was performed with the preliminary diagnosis of malignancy. But histopathological examination revealed a PMT. PMT is a highly uncommon neoplasm that remains largely unfamiliar to clinicians, surgeons, and pathologists, particularly when arising in rare locations like the sinonasal region. Its histomorphological characteristics can overlap with various other entities, necessitating a broad differential diagnosis.

Objective: The goal of this study was to investigate the expression patterns and potential relationship of the Kirsten rat sarcoma viral oncogene homolog (KRAS) and B-raf proto-oncogene (BRAF) genes in nasal polyposis (NP).

Methods: Twenty-nine patients were included in the study. Small punch biopsies were collected from nasal polyps during each operation and immediately frozen in liquid nitrogen. Punch biopsies were also taken during surgery from the inferior turbinate or the septum mucosa of the patients as a control group, and these samples were also frozen. Total ribonucleic acid (RNA) was isolated using TRIzol reagent. The gene expression analyses of the KRAS and BRAF genes were performed by the real-time polymerase chain reaction method.

Results: When compared to control subjects, KRAS nasal polyp gene expression increased in 21, but decreased in eight of the 29 patients. This statistical analysis revealed a statistically significant difference between the nasal polyp group and the controls (p=0.023). Like KRAS, a decrease was observed in BRAF gene expression in six, and an increase in 23 patients (p=0.011).

Conclusion: Our findings suggest a potential association between BRAF and KRAS genes expression and NP, but further studies are needed to confirm this relationship. This finding suggests that the genetic background of NP could be a contributing factor, with the BRAF and KRAS mutations playing a role.

Objective: Acute otitis media (AOM), a common middle ear infection, can lead to severe complications if not properly managed. The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare delivery and disease management. This study aimed to evaluate the incidence of complicated AOM cases from the pre-pandemic to post-pandemic period.

Methods: A retrospective review was conducted at Necmettin Erbakan University, Department of Otolaryngology, on patients diagnosed with complicated AOM in the period from January 2014 to February 2024. Patients were categorized into three periods: pre-pandemic (2014-2020), pandemic (2020-2022), and post-pandemic (2023-2024). Clinical data, including demographics, types of AOM complications, and treatment methods, were analyzed.

Results: A total of 32 patients (20 females and 12 males) with AOM complications were identified. Mastoiditis was the most common complication, seen in 43.75% of the patients, with increased incidences of 64.3% in the post-pandemic period. Subperiosteal abscess was noted in 12.5 % of the patients, exclusively in the pandemic and post-pandemic periods. Facial nerve paralysis (12.5%) and labyrinthitis (9.3%) were noted only in the post-pandemic period. Meningitis was noted in 15.6% of the patients, with increased incidences in the post-pandemic period. Observed during the post-pandemic period, sigmoid sinus thrombosis was noted in only one patient (3.1%).

Conclusion: Despite the reduced AOM incidence rates during the early pandemic, a surge was seen in complicated AOM cases in the post-pandemic period. This increase could be linked to COVID-19's impact on the immune system, pathogen virulence changes, and disruptions in vaccination protocols. These findings highlight the need for improved surveillance of AOM cases regarding complications in the post-pandemic era.

Objective: This study was conducted to retrospectively analyze pediatric tonsillectomy in patients aged <18 years treated over the past five years, focusing on factors such as sex, surgical method, season of occurrence, transfusion requirement, and surgical intervention in patients presenting with post-tonsillectomy hemorrhage.

Methods: Tonsillectomies performed in the Otorhinolaryngology Clinic of the Kayseri City Training and Research Hospital between June 2019 and June 2024 were retrospectively analyzed using the hospital information management system. Patients re-admitted for post-tonsillectomy secondary hemorrhage were identified, including those managed conservatively, requiring surgical intervention, and/or needing blood transfusion. Hemorrhage incidents were categorized by season (warm: March-August; cold: September-February), and hemorrhage rates were calculated. Surgical methods and the first surgical techniques in patients presenting with hemorrhage were recorded.

Results: In total, 4,994 tonsillectomies had been performed in the study period. Sixty patients (1.20%) were re-admitted and hospitalized due to postoperative hemorrhage, of whom 22 (0.44%) were reoperated and 38 (0.76%) were managed conservatively. Ten patients (0.20%) needed transfusion. Of the patients presenting with hemorrhage, 39 (65%) were admitted during the warm season, and 21 (35%) during the cold season. The cold dissection technique was used in 95.03% of the cases, with a hemorrhage rate of 1.2%.

Conclusion: Tonsillectomy is a common procedure worldwide and post-tonsillectomy hemorrhages are a frequent complication. Reducing morbidity and mortality through preventive strategies is crucial. Patients presenting with post-tonsillectomy hemorrhage should be hospitalized, monitored closely, and evaluated with hemogram and coagulation tests to assess hemorrhage volume and transfusion needs.

Objective: Despite the many medical problems arising from sleep disturbances, few studies have been conducted on vestibular disorders. In this study, we aimed to investigate the relationship between dizziness, sleep quality, severity of insomnia and duration of sleep, in young adults with dizziness.

Methods: Forty-nine individuals aged 20-40 years, with normal hearing and complaints of dizziness with an unknown origin were included. The Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Dizziness Handicap Inventory (DHI) were used.

Results: There was a very strong positive correlation between the PSQI and the ISI (r=0.838, p<0.001). Strong positive correlations were observed between PSQI and the total DHI scores (r=0.660, p<0.001), as well as between ISI and DHI scores (r=0.673, p<0.001). In addition, both PSQI and ISI showed strong positive correlations with the physical subscale of the DHI (r=0.673 and r=0.662, respectively; p<0.001 for both). A significant positive correlation was also found between the daytime dysfunction component of the PSQI and the total DHI score (r=0.640, p<0.001). Moreover, sleep duration was moderately and negatively correlated with the emotional subscale of the DHI (r=-0.454, p=0.001), indicating that shorter sleep duration was associated with greater emotional impairment related to dizziness.

Conclusion: Our study showed a high correlation between sleep quality, insomnia severity and dizziness in young adults with dizziness. With inventory, clinicians can contribute to improving people's quality of life by detecting dizziness associated with sleep disorders.

Primary hyperparathyroidism (pHPT) is caused by a single or multiple parathyroid adenomas in 85% of cases, by parathyroid hyperplasia in 15%, and by parathyroid carcinomas in less than 1%. Due to the embryological development characteristics of parathyroid tissues, ectopic parathyroid adenomas can be found in various locations. Although the incidence of pHPT varies, it is not considered a rare disease. Some unusual locations of ectopic parathyroid adenomas can make it difficult for clinicians and surgeons to detect them. For this reason, it is important to understand embryology thoroughly and to use complementary preoperative imaging methods. The detection and accurate localization of adenomas are important to avoid recurrent surgeries and to increase surgical success. We aimed to contribute to the literature by presenting a case of an adenoma located in the right pyriform sinus.

Objective: Principles of transparency and best practice in scholarly publishing is one of the important standards for the functioning and publishing quality of peer-reviewed scientific journals. The aim of this study is to evaluate Turkish otorhinolaryngology, head and neck surgery (ORL-HNS) journals according to these principles and to point out the areas that need improvement.

Methods: This descriptive study is based on the evaluation of website contents of eight Turkish ORL-HNS journals according to the 16 principles of transparency criteria. The number of scientific papers published in 2020 and 2021 were retrieved from the respective websites of the journals. The impact factors were calculated by analyzing the citations in 2022 via Google Scholar. The probable relationship between impact factor and compliance with transparency principles was investigated. Impact factor and transparency principles were studied to draw attention to the international standards which can contribute to journals for international scholarly publishing.

Results: The journals highly comply with website publishing, ethics, access, and ownership criteria; however, most of them do not comply with advisory council, advertising, other income, and business practices criteria. While the first three journals with the highest impact factors comply with 12 to 14 of the 16 criteria, the last three comply with five to 12.

Conclusion: The journals with high transparency criteria scores and high impact factors suggest that these criteria are important in terms of the reliability and validity of the information, and citation. Moreover, the websites of Turkish scientific ORL-HNS journals were seen to need improvement according to the transparency criteria, especially regarding financial issues such as business, financial status, and advertising.

Objective: This study aimed to conduct a Turkish validation study of the Head and Neck Carcinologic Handicap Index (CHI) and investigate its effectiveness in assessing morbidity in head-and-neck tumor patients.

Methods: The original CHI was translated into Turkish after a language validation study based on international standards. The study included 189 patients. Age, gender, primary tumor location, and tumor-node-metastasis stages were recorded. All patients were asked to complete the CHI form. A total of 37 patients completed the CHI form once more within 15 days to examine temporal stability. A control group was also formed to evaluate the validity of the CHI.

Results: The Cronbach's alpha coefficient was 0.898. For temporal validity, the global score showed a statistically significant correlation (p<0.001; r=0.604). There was a statistically significant difference between the global scores of the patient and the control groups (p<0.001). The global score and tumor stage differences were statistically significant (p=0.012). Review of the relationship between the tumor location and the scores showed a statistically significant difference in swallowing (p=0.001), feeding (p=0.001), and hearing (p=0.015).

Conclusion: The study adapted the CHI into Turkish and showed that it can be used as a valid and reliable index for the morbidity assessment of head-neck cancer patients. We recommend frequent use of the CHI throughout follow-up.

Mammary analogue secretory carcinoma (MASC) is a recently described rare salivary gland malignant tumor. A limited number of cases localized in the submandibular gland have been reported. A 56-year-old male patient presented with a slow growing mass in the left neck region. On physical examination, there was a mobile mass measuring approximately 5x4 cm in the left submandibular area. Radiologic imaging revealed a septated cystic mass with peripheral contrast enhancement, containing both solid and fluid components. Fine needle aspiration biopsy (FNAB) result was reported as atypia of uncertain significance. Submandibular gland excision was performed in the first stage. Since the pathology result was MASC and the tumor stage was T3, ipsilateral neck dissection was performed. On histopathological examination, neoplastic cells were seen to be rich in eosinophilic cytoplasm and vacuolization. Immunohistochemical examination revealed cytokeratin 7, mammaglobin and gross cystic disease fluid protein-15 positivity. By presenting this case report, we aimed to add a new case to the already limited number of submandibular gland localized MASC cases in the literature and contribute to the pool of knowledge on this subject. MASC should be considered especially in cases with submandibular gland localization in which the FNAB result is reported as atypia of uncertain significance.