Turkish Archives of Otorhinolaryngology最新文献

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.

Objective: To investigate the prognostic value of the magnetic resonance imaging in Bell's palsy patients.

Methods: Patients who were diagnosed and treated with Bell's palsy between October 2013 and March 2016 retrospectively selected. House-Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell's palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data.

Results: No significant correlation was observed between pretreatment House-Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell's palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement.

Conclusion: The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell's palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell's palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression.

Nasal cavity tumors constitute a very small part of head and neck malignancies. Although paranasal sinus tumors due to the presence of backward foreign bodies, neoplasms of nasal cavity associated with a foreign body are extremely rare. In this article, we presented a rare case of carcinoma in the right nasal cavity which includes glass particles inside it, and the role of glass particles in carcinogenesis was discussed. The patient was a 55-year-old male with history of a car accident 30 years ago. During right medial maxillectomy via a right lateral rhinotomy approach, three pieces of glass beads, approximately 0.5 cm in size, were removed from the inside of the mass. The patient had also under gone postoperative radiotherapy. No complication emerged during the postoperative recovery period. The patient had been followed up with no finding of local recurrence for 12 months.

Objective: Our primary objective was to develop a three-dimensional (3D) model of the vestibular labyrinth to understand the pathophysiological mechanisms of benign paroxysmal positional vertigo (BPPV) observed during common diagnostic positional tests. We secondarily aimed to monitor the effects of the repositioning maneuvers and use this tool in teaching.

Methods: A 3D model of a human semicircular canals (SSCs) system was created by 3D printing the core and assembling it with silicone tubing filled with lubricant oil containing colored small stones in the lumen mimicking otoconia. We used the model in horizontal canal BPPV diagnostic tests and therapeutic maneuvers. The working mechanism of the model we designed was recorded with video.

Results: The model allowed for a clear display of the anatomy and the respective orientations of the SSCs. Otolith movement in the horizontal canals could be imitated during diagnostic positional tests (Dix-Hallpike and Pagnini-McClure) and therapeutic maneuvers (Epley, Semont, Lempert and Gufoni).

Conclusion: As well as helping to understand the anatomy and physiology of the SSCs, this simple 3D model also provides a teaching tool for the diagnosis and treatment of BPPV. The mechanism of horizontal canal canalithiasis and the effect of therapeutic repositioning maneuvers could be clearly observed by watching the markers in the lumen demonstrating the progress of otolith movements with changes in head position relative to gravity.

Chondroblastoma is a rare cartilaginous benign bone tumor. Chondroblastoma in the temporal bone is also quite rare. Total excision is the main treatment. Data regarding tumor response to radiation therapy (RT) is insufficient. We describe a case of chondroblastoma that was treated with RT following subtotal tumor resection. In this case, the patient was a 14-year-old male who presented with a three-month history of ear fullness and hearing loss in his right ear. Magnetic resonance imaging revealed a mass partly filling the right external auditory canal and the inferior part of the middle ear. Histopathological findings indicated chondroblastoma. Subtotal tumor resection was performed due to risk of complications. RT was planned upon the growth of the tumor during follow-up. Treatment with subtotal resection and postoperative RT has been successful and the patient had no recurrence in the course of the 12-year follow-up. In chondroblastoma, complete surgical resection is still the gold standard. But the success of subtotal resection followed by adjuvant RT should also be kept in mind for cases where the total excision would pose high morbidity.