Turkish Archives of Otorhinolaryngology最新文献

Objective: The Speech, Spatial and Qualities of Hearing Scale (SSQ) is a self-report scale that evaluates hearing in complex daily life situations in the areas of hearing quality, speech perception, and spatial perception. It is also frequently used in the follow-up of hearing-impaired people, hearing aid and cochlear implant users. It is aimed to translate and adapt SSQ into Turkish, and to investigate its test-retest reliability, and construct validity and reliability, and further to present associations of SSQ scores with the pure tone averages (PTA).

Methods: The Turkish SSQ (Tr-SSQ) scale was administered on 114 adults including those with and without hearing loss. Cronbach's alpha was used to assess its reliability. The reliability coefficient of the scale was calculated by test-retest method. Associations of SSQ scores with PTAs in better and worse hearing ears (BHE and WHE) were evaluated.

Results: Tr-SSQ presented high internal consistency (Cronbach's alpha = 0.984) and test-retest reliability (r=0.994). Tr-SSQ scores were lower in the subjects with hearing loss and correlated with PTAs. Age was found to be correlated with PTAs; regression analysis demonstrated that only WHE-PTA was extracted as explanatory variable for average Tr-SSQ, speech perception and spatial perception scores while both BHE-PTA and WHE-PTA were found to be predictors of hearing quality, but not age for any of Tr-SSQ scores.

Conclusion: Tr-SSQ is a convenient tool for assessing the hearing abilities of individuals with hearing impaired.

Objective: The rate of case report/series (CR/S) acceptance by the high impact journals is steadily declining mainly due to low citations. The aim of this study is primarily to investigate the bibliometric aspects of CR/S in the field of otorhinolaryngology (ORL) and secondarily to guide prospective authors as to which type of CR/S have better chances of acceptance and citation in the current publication climate.

Methods: Bibliometric and citation analysis of CR/S published in Science Citation Index (SCI) journals of ORL covering the years of 2012-2016 was conducted.

Results: There were 1332 (8.9%) CR/S among 14900 publications in 11 SCI ORL journals published between January 1^st, 2012 and December 31st, 2016. The most common published field and subject were the 'pediatric ORL' (33.2%) and 'rare cases/conditions' (47.1%) respectively. 'General ORL' (5.13) and 'treatment' (4.93) categories had the highest citations. Only 10% of CR/S had ≥10 citations. The mean citation counts were positively correlated with impact factors of journals (r=0.131, p<0.001), mean number of authors (r=0.151, p<0.001), mean number of cases (r=0.192, p<0.001), mean number of references (r=0.315, p<0.001) and mean number of Web of Science visits (r=0.291, p<0.001).

Conclusion: Although CR/S provides low citation rates in ORL SCI journals, they may serve important topics in terms of diagnosis, treatment, or complications. The findings and the main discussions of this study may direct the rationale for the consistent publication of CR/S in the evidence-based medicine era.

Objective: This study evaluates the available evidence regarding using topical intranasal fluorescein (TINF) to diagnose and localize nasal cerebrospinal fluid (CSF) leak.

Methods: A literature search was conducted through PubMed, the Cochrane Database, Scopus, and Ovid to identify the articles providing insight into using TINF to diagnose CSF leak preoperatively or to localize the leak intraoperatively. The articles from the database were screened and filtered by two authors according to the selection criteria. A spreadsheet was created to collect the data including demographic characteristics, the sensitivity and specificity of TINF for diagnosing and localizing a CSF leak, the protocol of applying TINF, and the complications.

Results: After excluding duplicates and articles that did not meet our selection criteria, we included five reports in the final analysis. The average age of the 94 participants was 39.5, and there was an equal distribution of males and females. The sensitivity of TINF to make a preoperative diagnosis of CSF leak was 100%, and it was 97% to localize the site intraoperatively. Complications associated with TINF were not reported in any of the reports. This review showed a grade C recommendation based on five case series.

Conclusion: Based on the current evidence, TINF cannot be recommended for standard clinical practice. It can, however, be considered in situations where other gold standard tools are unavailable since it is feasible and easy to use. A standardized control trial should be conducted to yield additional unbiased evidence.

Lip abscess is a rare condition encountered in clinical practice. Generally, it may be due to an infective agent, such as virus, bacteria, entering through a skin wound, or it can be seen through hematogenous spread when there is a serious underlying condition such as a general condition disorder or immunodeficiency. It requires rapid diagnosis and treatment as it may cause significant complications in terms of localization and lymphovascular drainage. In this case report, an 18-year-old male patient with unilateral lip abscess that regressed rapidly with external drainage and antibiotic therapy is presented with imaging and clinical-laboratory findings.

Objective: The objective of this study was to identify the characteristic features of patients with distant metastasis as the only manifestation of well-differentiated thyroid cancers and to analyze the treatment outcomes.

Methods: A retrospective review of all patients with well-differentiated thyroid cancers and distant metastasis as the sole initial presentation was carried out. Data regarding age, gender, tumor histology, site, symptoms, and treatment outcomes were collected.

Results: There were 10 patients who presented with distant metastasis as the only presentation. The mean age was 56.1 years. Eight (80%) patients had osseous metastasis, one (10%) had pulmonary and one (10%) had both. Follicular thyroid carcinoma was more common and seen in six (60%) patients. Seven (77.8%) out of nine patients had demised within five years of initial presentation.

Conclusion: Distant metastases without a neck lump as the initial presentation of well-differentiated thyroid cancers are extremely rare. No specific guidelines are available to manage such patients due to lack of relevant data in the literature.

Objective: This study aimed to analyze the effectiveness of the Turkish matrix sentence test in evaluating the speech recognition performance of hearing aid users under different noise conditions.

Methods: Speech recognition performance of 42 individuals, 20 to 65 years of age (mean 49.1±14 years) with bilateral sensorineural hearing loss was measured in noise with the Turkish matrix sentence test without a background noise and with headphones. Additionally, the participants' speech recognition thresholds were measured with a matrix test while wearing their hearing aid under three different listening conditions in which the phases of speech and noise stimuli were changed with constant and fluctuating noise.

Results: Speech-recognition thresholds were better in fluctuating noise than in constant noise in all listening conditions, and this difference was statistically significant (p=0.02). In both types of noise, speech-recognition thresholds of bilateral hearing aid users (n=29) were lower (better) than those of unilateral hearing aid users (n=13) under three different listening conditions, but there was no statistically significant difference (p=0.67). Speech-recognition thresholds without hearing aids were statistically higher (worse) than those obtained with hearing aids (p=0.001).

Conclusion: Since the Turkish matrix sentence test gives useful results, this test can be used in the diagnosis, follow-up, and rehabilitation planning of hearing aid users. We observed that speech intelligibility was better, although there were differences among those with hearing loss when the speech test was conducted in fluctuating background noise with the Turkish matrix sentence test.

Ectopic cervical thymus (ECT) is a rare pediatric pathology usually with an asymptomatic course. In fewer cases, the patient may present with dyspnea, hoarseness, stridor, dysphagia and pain. The mass may present in cystic or solid forms. Solid forms are rare, constituting only 10% of all ECT cases and these are mostly symptomatic. We aimed to present the case of an infant with ECT in the submandibular region that led to shortness of breath. ECTs in the submandibular region are mostly solid and larger in size, and therefore, likely to result in compressive symptoms. In this case report, we tried to cover the important aspects of the diagnosis of ECT, its treatment, and discussed the results with a literature review. We additionally aimed to emphasize the importance of considering pediatric ECT in the differential diagnosis of pediatric neck mass as well as considering surgical excision to prevent serious consequences.

Objective: The aim of this study was to investigate how allergy practices in the otorhinolaryngology (ORL) residency departments in Turkey have changed over the last 20 years and to examine the current status in ORL residency training.

Methods: A 17-item questionnaire was developed following the study goals by a team experienced in allergy practices. The questionnaire was sent via e-mail to the program directors of all the 95 ORL residency departments in Turkey.

Results: A total of 60 (63.2%) program directors completed the questionnaire. We found that allergy testing and immunotherapy had been performed in 70% and 28.3%, respectively, at any time to date. The most common reason for discontinuing in allergy practices over time was "the changes introduced by the Turkish Social Security Institute as stated in the healthcare implementation communiqué" and "the difficulties in obtaining vaccine supplies from companies". Of all departments, allergy testing, immunotherapy, nasal smear, and nasal provocation tests were performed only by 35%, 8.3%, 28.3%, and 1.7%, respectively.

Conclusion: Allergy practices have been increasingly used, especially in the 2000s, but came to a standstill upon the changes introduced by the Turkish Social Security Institute as stated in the healthcare implementation communiqué. These findings suggest that allergy training, in the recent years, has remained in the background in ORL residency programs in Turkey. To achieve standardization in allergy training in ORL residency programs, professional associations and authorities should develop solutions in cooperation with legislators.

Objective: Some inner ear malformations may cause recurrent meningitis, which may be fatal. The etiology is usually a stapes footplate fistula which enables microorganisms to pass into the inner ear containing cerebrospinal fluid (CSF), causing repeated attacks of meningitis. Radiological signs of the fistula are not obvious and are not reported in detail in the literature. The aim of the study is to investigate the radiological features of stapes footplate fistula in inner ear malformations.

Methods: Radiological findings were analyzed for seventeen patients with inner ear malformations (IEMs) operated on because of recurrent meningitis. Using this information, images of 1,010 patients with IEMs were retrospectively reviewed to investigate the radiological findings of stapes footplate fistula and their relationship to IEMs. They were classified according to the Sennaroglu classification system, and according to different stages of stapes footplate fistula.

Results: In the case of a stapes footplate cyst, computerized tomography shows an opacity at the oval window. On magnetic resonance imaging, a fluid filled cystic structure continuous with and having similar signal characteristics to the CSF in the inner ear is a pathognomonic finding of a stapes footplate cyst. It is most commonly found in common cavity anomaly (18.2%); the second most frequent finding is incomplete partition type I (15%). And it can even be seen in cases of cochlear aplasia where only the vestibule is present.

Conclusion: If the history reveals recurrent meningitis, particular attention should be given to the oval window area, where an opacity, cyst or a leaking lesion should be looked for on the imaging. It is the responsibility of the otolaryngologist to notice these findings, and to operate on the patient to prevent further attacks of meningitis.