Turkish Archives of Otorhinolaryngology最新文献

Objective: Skin cancers occur most commonly in the head and neck region where the nose is the most commonly affected unit. The nose is the part of the face that is most exposed to trauma, sunlight, and other environmental factors. From the aesthetic and functional point of view, reconstruction of the defects occurring after skin cancer removal creates a great challenge for the surgeon. In this retrospective study, we present the success rates achieved in the past 20 years with paramedian forehead flaps used for repairing large defects of the nose.

Methods: The study included 62 patients who underwent paramedian forehead flap due to nasal skin tumor [basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)] in Ege University Faculty of Medicine Otolaryngology Department between 2000 and 2020. Data on follow-up time, patients' age and gender, defect sizes, and tumor types were obtained retrospectively from patient files, histopathologic examination results and patient photographs. Additional diseases such as diabetes, hypertension, and coronary artery disease that could affect flap success, were noted.

Results: Out of 62 patients 29 (46.8%) were female and 33 (53.2%) were male. Their mean age was 61.4 (range: 46-88) years. Mean follow-up period was 125.6 (8-244) months. Of the 62 patients 33 (53.2%) were operated on for BCC and 29 (46.8%) for SCC. Four patients (6.5%) had recurrences during their follow-up. There was no loss of the paramedian forehead flap.

Conclusion: Paramedian forehead flap is a reliable option in the reconstruction of larger defects of the nose even in smokers and elderly patients who have comorbid diseases.

Objective: This study aimed to determine whether peripheral vertigo is related to the lunar cycle, the seasons, or meteorological factors, in patients who presented to the ear, nose, and throat clinic.

Methods: All the patients, diagnosed with vertigo between January 2020 and January 2022, were identified through a retrospective review of our hospital database. The clinical and demographic data of the patients were recorded. Daily humidity (minimum, average, and maximum; %), daily temperature (minimum, average, and maximum; °C), daily average and maximum wind speed (m/min), daily air pressure (minimum and average maximum; hPa) and wind direction (degrees) values were noted. Also, the phases of the moon, i.e., first quarter, new moon, last quarter, and full moon periods were determined.

Results: A total of 5,432 patients were included in the study. No statistically significant differences were noted among them with respect to the lunar cycle (p=0.233). However, patient density was found to increase in the winter months.

Conclusion: This study concluded that the frequency of diseases is related to meteorological factors, nonetheless, no statistical relationship was found between the lunar cycle and the frequency of patient entries.

Objective: The severe acute respiratory syndrome-coronavirus-2 pandemic is one of the largest of the recent times and can cause many symptoms including smell and taste disorders. In the literature, smell disorders caused by coronavirus disease-2019 (COVID-19) have been reported within a wide range from 3.2% to 98.3%. A small number of these studies demonstrated smell and taste disorders through objective tests. Our aim in this study was to determine the prevalence of smell and taste disorders in hospitalized patients due to COVID-19 infection.

Methods: The study was carried out with 100 patients who were positive for real-time polymerase chain reaction and treated at the Kayseri City Hospital, and 100 healthcare worker relatives. We used the Connecticut Chemosensory Clinical Research Center test to evaluate the sense of smell. Sense of taste was evaluated using four different standardized bottles of preparations, and the results were scored according to the patients' statements.

Results: Patient (Group 1) and control (Group 2) groups were compared for age, gender, smell and taste disorders. There were 39 women and 61 men in the patient group, and 40 women and 60 men in the control group. Mean age was 50.2±1.37 (range 21-70) years in Group 1 and 47.6±1.25 (range 18-70) years in Group 2, and there was no significant difference between the two groups. While the rate of smell disorder was 80% in Group 1, we found this rate as 35% in Group 2. Taste disturbance was identified in 38 patients, of whom 16 had mild hypogeusia, 17 had moderate hypogeusia, four had severe hypogeusia, and one patient had ageusia. We found that taste disorder was 38% in Group 1 and 3% in Group 2.

Conclusion: Smell and taste dysfunctions are very common symptoms in COVID-19 patients. The results obtained using objective test methods are higher than the rates obtained from patient statements.

Schwannomas are benign soft tissue tumors derived from the Schwann cells of the peripheral nerves. An intramuscular schwannoma arising within the trapezius muscle in the posterior neck is rare. We report a case of a 31-year-old woman with an intramuscular schwannoma in the trapezius muscle. A painless and smooth-surfaced mass from 10 years ago was evident on palpation in the right posterior neck. Ultrasonography revealed an oval mass with clear borders and slight internal blood flow. No continuous hypoechoic lesions were noted at the tip of the mass. Magnetic resonance imaging of the neck revealed a mass in the right posterior cervical trapezius muscle with isointensity on T1-weighted imaging and heterointensity on T2-weighted imaging. Based on these findings, a schwannoma was suspected. Ultrasonography guided fine needle aspiration cytology revealed no significant findings. During surgery, a white-colored, encapsulated-tumor mass was found in the trapezius muscle. Histopathologically, hypocellular and hypercellular areas of fusiform cells were conspicuous, and nuclear palisading was observed in a part of the hypercellular region, confirming the diagnosis of schwannoma. To our knowledge, this is an extremely rare report of an intramuscular schwannoma within the trapezius muscle; herein, we report its clinical, radiological, and pathological features.

Objective: Foreign body aspiration remains a serious health problem with a potential for severe consequences, and acute and chronic problems in children. It therefore demands immediate intervention. Rigid bronchoscopy has long been the method of choice for foreign body removal but is now being replaced by flexible bronchoscopy which offers reduced trauma and the ability to access distal bronchial regions. In the presented study we assessed the patients who underwent flexible bronchoscopy for foreign body removal in our clinic.

Methods: We reviewed the records of 20 patients who underwent flexible bronchoscopy due to suspected foreign body aspiration and had a foreign body removed in our clinic. Patients were analyzed in terms of sociodemographic data, foreign bodies removed, method of foreign body removal, foreign body location and time to diagnosis.

Results: Our study group included nine females and 11 males. The removed foreign body was organic in 19 of the 20 patients and inorganic in one patient. Hard organic food, such as hazelnuts, peanuts, seeds, almonds, and raw corn kernel were identified in 12 patients, a piece of fishbone in one patient and a piece of gelatin in another. The pieces of soft organic food identified were apple in one patient, egg in one patient, and boiled corn kernel in one patient and removed by suction. The foreign body was removed using forceps in nine patients, and a basket was used successfully in seven patients.

Conclusion: Foreign bodies can be removed with minimal complication using flexible bronchoscopy, basket, and forceps in children.

Objective: To reveal the correlation between implantation age, the internal acoustic canal (IAC) width, bony cochlear nerve canal (BCNC) width, and auditory performance in primary school children with bilateral cochlear implantation (CI).

Methods: Preoperative IAC and BCNC widths of 57 pre-lingually deaf children aged 7-11 years who had previously undergone bilateral CI in our institution were reviewed and cut-off values were calculated. Twenty-four patients who had additional problems and could not attend school and those who refused to participate in the study were excluded. The remaining 33 were invited to the hospital, and their speech perception tests, and language development scores were analyzed (16 of 33 patients had been operated on before the age of 24 months).

Results: The cut-off values calculated from the 114 ears of 57 patients were 3.86 mm for IAC width and 1.56 mm for BCNC width. The auditory performances of the 33 patients after CI were not significantly different in the narrow and normal width groups. However, speech perception test results, and language development scores of patients implanted before the age of 24 months were significantly higher.

Conclusion: There are some studies showing that children with bilateral sensorineural hearing loss have narrower IAC and BCNC widths. However, we concluded that the widths of the IAC and the bone cochlear nerve canal did not affect auditory performance. We found that implantation age is the single most important determinant of speech-language development after CI.

Objective: The purpose of this study was to evaluate the functional and oncological outcomes of total glossectomy with laryngeal preservation (TGLP) compared to near-total glossectomy with laryngeal preservation (nTGLP).

Methods: In this retrospective study, the data of 23 patients who underwent either TGLP or nTGLP between January 2010 and December 2020 in a tertiary university hospital were analyzed. The data including demographic findings, tumor stage, extent of surgery and technique, method of reconstruction, complications, overall survival (OS) and recurrence-free survival (RFS), and tracheostomy and gastric tube dependence during follow-up were assessed.

Results: Of the 23 eligible patients, 15 had undergone nTGLP (Group 1) and 8 had undergone TGLP (Group 2). Tracheostomy dependence and gastric tube dependence rates at the sixth month were 3/19 (15.7%) and 12/19 (63.1%), respectively, with no significant differences between the two groups. OS and RFS at one year were 47.6% and 27.8%, respectively, for the study population. OS rate showed significance with nodal positivity and extranodal extension (p=0.004 for both) only, but not within patient groups (p=0.734).

Conclusion: Both TGLP and nTGLP are feasible treatment options in patients with advanced tongue cancer with no differences in terms of functional and oncological results. Survival rates are still not satisfactory, and recurrences are high despite appropriate treatments. Proper selection of patients who are highly motivated and willing for long-term postoperative rehabilitation is essential.

Objective: How the presence of olfactory structures in olfactory cleft polyps (OCPs) affect olfaction function outcomes after surgical removal has not yet been investigated. In this study we aimed to assess the presence of olfactory structures in OCPs and correlate these findings with olfactory outcomes after endoscopic sinus surgery (ESS).

Methods: Twenty seven patients with OCP underwent preoperative topical and systemic steroid treatment and ESS. Biopsies from the middle meatal polyps (MMPs) and OCPs were immunohistochemically analyzed for olfactory marker protein (OMP). The smell diskettes olfaction test was applied to patients at baseline, after steroid treatment (AST) and after ESS.

Results: OCPs exhibited OMP staining more commonly and intensely compared to MMPs (p=0.008), however, there were no correlations between OMP staining scores and any of the olfaction scores (p>0.05). Steroid treatment increased smell function significantly (p<0.001), however, there were no significant differences between AST and after ESS smell scores (p=0.17). There were significant correlations between smell gains AST and final smell gains after ESS (r=0.665, p<0.001).

Conclusion: OCPs contain olfactory neuroepithelium more commonly and intensely than MMPs in nasal polyp patients. However, surgical importance of this finding is controversial because removal of these polyps did not decrease smell function postoperatively in our study. Nasal polyp patients who will take steroid treatment pre-operatively must be informed that the success of ESS on olfaction depends on the response of the steroid treatment and ESS AST might not have additional favorable effect on smell function.