Turkish Archives of Otorhinolaryngology最新文献

Objective: This study aimed to investigate the factors affecting permanent sensorineural hearing loss (SNHL) and causing changes in bone conduction (BC) thresholds over time in patients after receiving radiotherapy (RT) or chemoradiotherapy (CRT) to the head and neck region.

Methods: A total of 63 patients with irradiated HNC that were admitted to the Radiation Oncology Department between 2011 and 2018 were included in the study. All patients were assessed with pure tone audiometry at eight different time points (first before RT and last five years after completion of RT). A chi-square test was used to analyze the variables that affected permanent SNHL occurrence. Repeated measure analysis of variance was conducted to investigate the factors affecting change in the BC threshold at pure-tone average (0.5-2 kHz) and the air conduction (AC) threshold at 4 and 6 kHz frequencies over time.

Results: Median follow-up was 52 months (range, 12-110 months). SNHL was found in 18 (14%) of the 126 ears. According to the receiver operating characteristic analysis, the cut-off values of cochlear D_mean and D_max radiation doses were 40 Gy [p=0.017, area under the curve (AUC): 0.676] and 45 Gy (p=0.008, AUC: 0.695). D_mean (≤40 Gy vs. >40 Gy) and D_max (≤45 Gy vs. >45 Gy) cochlear doses and age (≤40 vs. >40 years) were determined as factors affecting SNHL in the chi-square test. Repeated measures showed that BC thresholds between 0.5-2 kHz and AC thresholds at 4 and 6 kHz increased over time. Age (≤40 vs. >40 years), treatment of head and neck cancer (RT vs. CRT), cisplatin use, and D_mean (≤40 Gy vs. >40 Gy) and D_max cochlear dose (≤45 Gy vs. >45 Gy) were important factors affecting the course of BC threshold over time.

Conclusion: D_mean and D_max cochlear doses and age were found to be associated with permanent SNHL. Conduction thresholds worsened over time at all frequencies, and this trend was affected by cochlear doses, age, CRT, and cisplatin use.

Objective: This study aimed to evaluate clinical musical perception, analyze the relationship between speech recognition and music perception, and investigate the effects of a three-month musical perception activities on these parameters in adult cochlear implant (CI) users with post-lingual hearing loss.

Methods: Free-field hearing and speech tests in a quiet environment, the Turkish matrix test, and the Turkish version of the clinical assessment of musical perception test were performed on 18 adult unilateral CI users before and after the three-month music training. Results were compared with those of 18 healthy controls.

Results: Prior to the musical perception activities, word recognition scores, Turkish matrix test results, and 500, 1000, and 6000 Hz free-field hearing thresholds were significantly correlated with the clinical assessment of musical perception test scores in the CI group (p<0.047). Timbre recognition scores (p=0.019) had improved significantly in the CI group after the three-month musical perception activities. On the other hand, timbre recognition scores had significantly affected the Turkish matrix test results (R2adjusted=0.56).

Conclusion: Our study showed that speech perception in noise and clinical musical perception measurements affected each other in CI users. The inclusion of musical perception activities to support an auditory rehabilitation program may contribute to increased speech recognition skills in noise.

Sarcoidosis is a systemic disease of unknown etiology. It is characterized by non-caseating granulomatous inflammation. It most commonly affects the pulmonary and intrathoracic lymph nodes. Isolated nasopharyngeal involvement is very rare. Pediatric sarcoidosis and isolated nasopharyngeal involvement are rare entities. Symptoms of nasopharyngeal involvement can mimic adenoid hypertrophy. In this case report, we present a nine-year-old female who was diagnosed coincidentally with sarcoidosis with the adenoidectomy specimen.

Dermoid cysts are developmental anomalies that occur during midline fusion in embryological life. It is known that they can also be acquired as a result of traumatic and iatrogenic implantation. Laryngeal involvement of dermoid cysts has been reported very rarely in the literature. This report presents a case with multiple dermoid cysts originating from the epiglottis. A 59-year-old male patient was admitted to our clinic with complaints of foreign body sensation in the throat and dysphagia. Multiple cystic lesions originating from the epiglottis were observed in the laryngeal examination of the patient. After radiological examinations, the cysts were completely excised by endolaryngeal surgery. After excision of the lesions, which were reported as dermoid cysts, all complaints of the patient regressed, and no recurrence was observed in the 6th month after the operation and his follow-up continued. Dermoid cysts originating from the epiglottis are very rare, but they should be kept in mind in the differential diagnosis of epiglottis lesions.

Objective: This study aimed to investigate the expenditures related to hearing devices and compare the differences in expenditures in child and adult users.

Methods: A preliminary questionnaire was developed and conducted amongst hearing aid and cochlear implant users. A total of 178 patients (57.3% were hearing aid users, 42.7% were cochlear implant users) were included in the study and grouped as adults (first group, 50 patients), and children 1< (second group, 123 patients).

Results: The results of the study showed that individuals used approximately 4.5% of their annual income as health expenditure related to hearing loss. This rate was over 5% for child users, and about 2.7% for adult users. Moreover, the expenditure made by adult users was below the amount of expenditure made for children in all health expenditure indicators.

Conclusion: Supporting the family budget for hearing loss expenditures not covered by the public health insurance will minimize the financial problems caused by the disability.

Objective: Malignant mucosal melanomas of the head and neck comprise a very small portion of all melanomas, particularly in the oral cavity. These lesions are associated with high rates of local recurrence, distant metastasis, and a very poor 5-year survival rate; however, the clinical outcomes of mucosal melanoma in situ of the oral cavity are unclear. Therefore, we present a case report of mucosal melanoma in situ and a systematic review of the literature to shed light on this rare but important disease.

Methods: PubMed, Scopus, and CINAHL were searched per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were only considered for inclusion if they described oral cavity melanoma in situ and documented specific data pertaining to treatment including modality, lesion size, or outcomes.

Results: A total of 28 reported cases from the literature fulfilled the inclusion criteria, as well as one case from our own institution. Men comprised the majority (64.3%) of the cases, and the average age at presentation was 57.4 years. The hard palate was the most common location, and most cases were treated with surgical excision. Eight had no evidence of disease after a minimum of six months of follow-up, one reported spread to the cervical lymph nodes, and only one reported progression with distant metastasis.

Conclusion: Oral mucosal melanoma in situ is a rare entity and most commonly treated with surgical excision. High rates of recurrence necessitate long term follow-up. Further studies may be useful to determine whether adjuvant therapy may play a role in reducing recurrence.

Objective: Despite all the recent advancements, larynx cancer has shown no improvement in survival rates. The aim of this study was to investigate the expressions of toll-like receptor (TLR)-2, -3, and -4 genes, and determine any relationships with the histopathologic characteristics of the disease.

Methods: This retrospective study included 50 subjects who underwent total or partial laryngectomy with an open surgical method for larynx squamous cell carcinoma. Measurements of TLRs-2, -3, and -4 expression values were taken with quantitative real time-polymerase chain reaction in normal tissue and tumor tissue samples of the patients.

Results: Evaluations were made of TLR-2, -3, and -4 mRNA expressions according to 2^-ΔΔCT calculations in 50 subjects with larynx cancer. When the tumor tissue was compared with the healthy tissue from the same subjects, reductions were determined in TLR expression in 86%, 84%, and 82%, respectively. This reduction in each gene expression was statistically significant (p<0.001). No statistically significant correlation was determined between the change in TLR-2, -3, and -4 expression and the histopathologic characteristics of the disease.

Conclusion: The data obtained in this study demonstrated that TLR-2, -3, and -4 expressions were reduced in larynx squamous cell cancer. The results of further studies targeting these genes would be useful in the diagnosis and treatment of the disease.

Objective: Otoacariasis is the presence of ticks and mites in the ear canals of humans or animals, and particularly common in rural areas. This study aimed to present the clinical characteristics of patients that presented with ticks in their ear canal.

Methods: The study was conducted with a total of 425 patients with 527 ticks in their ear canal at the Muş Malazgirt State Hospital Ear-Nose-Throat Clinic between June 2019 and June 2020. The removed ticks were examined at the parasitology laboratory of Van Yüzüncü Yıl University.

Results: Of the 425 cases included in the study, 72% (n=306) were female and 28% (n=119) were male (mean age 40±20, minimum-maximum: 4 months-81 years). A total of 527 ticks were removed in the one-year period. Three-hundred-and-fifty-one patients had adult or nymph ticks, and 74 patients had a larval form of the tick. Of the patients with adult or nymph tick, foreign body sensation was the dominant symptom in 68.7% (n=242), whereas pain was the dominant symptom in 62% (n=46) of those with larval tick. In the comparison between groups, foreign body sensation was statistically significantly higher in the adult tick group, and pain was higher in the larval tick group (p<0.001). There were no systemic diseases related to the ticks in any of the cases.

Conclusion: Ticks in the ear is endemic in Eastern Anatolia and poses a public health problem. Tick infestations could be minimized with various precautions and educating the general public on preventive methods. Our study is the largest series in the literature on cases with ear ticks.

The most commonly reported superior thyroid cornu (STC) anatomical variation is in STC syndrome, where the cornu is enlarged or medially displaced. STC agenesis is a rare laryngeal variation that can be unilateral or bilateral. Previous studies have reported STC agenesis in cadaveric or forensic studies in patients with an otherwise normal larynx. We report a case of unilateral STC agenesis in the context of a stage III glottic laryngeal squamous cell carcinoma. The variation was discovered intra-operatively during a total laryngectomy and was clinically unknown beforehand. There were no clinical or histological signs of bony erosion by the tumor. To our knowledge, this is the first report of unilateral STC agenesis in a patient with laryngeal malignancy. This article draws attention to a rare anatomical variant of the larynx and highlights the surgical implications including potential diagnostic challenges and operative considerations.