Is Salvage Hyperbaric Oxygen Therapy Effective for Sudden Sensorineural Hearing Loss in Patients with Non-response to Corticostreoid Treatment?

PURPOSE: The aim of this study was to evaluate the efficacy of salvage hyperbaric oxygen therapy (HBOT) for sudden sensorineural hearing loss (SSNHL); HBOT is performed after three weeks of the onset of the disease. METHODS: This retrospective clinical study included patients with unilateral idiopathic SSNHL. All patients admitted to the hospital with the diagnosis of SSNHL were given standard steroid treatment within the 14 days of the onset of the SSNHL. We compared the two study groups - Group A: patients receiving steroid treatment within the first 14 days; Group B: patients receiving corticosteroid treatment within the first 14 days, but unresponsive to this treatment, and began to receive HBOT after three weeks of the onset of SSNHL for the purpose of salvage therapy. RESULTS: A total of 50 patients were included in the study. The mean age of the patients was 50.6 ± 14.1 years. There was not a significant difference in the degree of hearing loss between the groups based on the findings from audiometric examinations performed at the time of diagnosis. It was observed that salvage HBOT was not effective when the initial and post-treatment audiometric tests were compared. CONCLUSION: According to our results, salvage HBOT was not efficient when performed three weeks after the onset of the SSNHL for patients who did not respond to corticosteroid treatment.

Graft Success and Hearing Results between Cartilage Island Graft and Temporal Muscle Fascia Graft Myringoplasty.

OBJECTIVE: To compare the graft success and hearing results in patients who underwent cartilage island graft (CIG) myringoplasty and temporal muscle fascia graft (TFG) myringoplasty. STUDY DESIGN: Retrospective clinical study. PLACE AND DURATION OF STUDY: Ankara Numune Training and Research Hospital, Otolaryngology Clinic, Ankara, from January 2013 to January 2018. METHODOLOGY: Patients who underwent cartilage island graft myringoplasty and temporal muscle graft myringoplasty for chronic non-suppurative otitis media were inducted. Age, gender, preoperative audiologic examination results, postoperative audiologic examination, perforation site, graft material, preoperative microscopic examination and graft success were documented. RESULTS: A total of 116 patients were included in the study. The mean age of the patients was 35 ±15.3 years. Fifty-four patients were females and 62 were males. Temporal muscle fascia graft was applied to 68 (58.6%) patients, while cartilage graft was applied to 48 (41.4%) patients. The success rate of graft was found to be 80.2% (55 cases with graft success) in TFG; whereas, this rate was found to be 93.8% (45 cases with graft success) in CIG group. Cartilage island graft material had a better graft success in terms of graft endurance (p = 0.048). There was no statistically significant difference between the two graft materials in terms of postoperative hearing success (p = 0.29). CONCLUSION: Cartilage island grafts can be preferable for myringoplasty operations.

Increased age adversely affects the therapeutic effect of CPAP treatment for olfactory functions.

PURPOSE: The aim of this study was to compare olfactory functions pre- and post-CPAP treatment in patients with moderate to severe OSA, and to evaluate the factors that cause changes in olfactory functions. METHODS: Twenty-two patients who had completed regular usage of CPAP treatment for 2 months were included in this prospective study. Olfactory tests using Sniffin' Sticks were performed pre- and post-treatment. RESULTS: The mean age of the subjects was 47.6 ± 9.5 years. We did not find a significant change in olfactory functions after 2 months of CPAP treatment in our study group. When the patients were divided into two groups-those whose olfactory functions showed improvement and those whose functions did not-it was found that the mean age of the patients whose olfactory functions did not improve was significantly higher statistically. A significant adverse correlation was found between age and post-treatment olfactory functions, specifically in odour threshold and odour identification scores. CONCLUSIONS: Increased age adversely affects the therapeutic effect of CPAP treatment for olfactory functions.

Cautionary Findings for the Presence of Facial Canal Dehiscence During Cholesteatoma Surgery.

Our aim was to investigate the relationship between facial canal dehiscence (FCD) and surgical findings and procedures in patients with cholesteatoma. A total of 186 patients (118 males, 39.2 ± 15 years) who underwent surgery for advanced cholesteatoma between 2013 and 2018 were included in the study. The relationship between FCD and surgical findings was investigated via the surgical registries. The prevalence of FCD was 36.6% (68/186). The prevalence of FCD was 44%, and 13.2% for the patients who underwent canal wall down mastoidectomy (62/141) and canal wall up mastoidectomy (6/45), respectively (P < .001). Facial canal dehiscence was detected in 73.9% of the 23 patients who had a lateral semicircular canal (LSCC) defect (P < .001), in 61.9% of 21 patients who had a tegmen tympani defect, and in 58.1% of the 31 patients who had erosion on the posterior wall of the external auditory canal (EAC; P < .05). The prevalence of FCD was 3.1% in patients with isolated incus erosion, 59.1% in patients with erosion of malleus and incus, 60.7% in patients with erosion of stapes suprastructure and incus, and 43.2% in patients with whole ossicular chain deformation (P < .001). The defects on LSCC, EAC, tegmen tympani, and malleus and incus might be cautionary findings for the presence of FCD during cholesteatoma surgery.

Smoking cessation improves olfactory functions.

OBJECTIVES: The aim of this study was to investigate changes in olfactory function after smoking cessation. METHODS: We conducted a cross-sectional study involving 28 volunteers who were admitted to the smoking cessation section of our hospital. Olfactory tests were performed immediately before smoking cessation and 45 days after smoking cessation. The duration of smoking and the number of cigarettes smoked per day were noted. RESULTS: The mean duration of smoking was 25.5 ± 12 years, and the participants smoked 21.6 ± 6.6 cigarettes per day. There was a significant improvement in odor discrimination, odor identification, and TDI scores (i.e., the total score of odor threshold, odor discrimination, and odor identification tests) 45 days after smoking cessation (P = .003, P = .002, and P < .001, respectively). Furthermore, a statistically significant negative correlation was found between the duration of cigarette smoking and the Sniffin' Sticks olfactory tests performed after smoking cessation, namely odor discrimination, odor identification, and TDI (P = .008, P = .002, P = .001, respectively). CONCLUSION: A significant improvement was observed in odor discrimination, odor identification, and TDI scores after smoking cessation. However, this improvement was inversely associated with the duration of smoking, indicating that a longer duration of smoking may result in an insufficient improvement after smoking cessation. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:E35-E38, 2020.

The effect of surgical margin positivity on survival in laryngeal cancer surgery.

AIM: The aim of this retrospective study was to investigate possible factors affecting the survival in patients who were operated due to laryngeal squamous cell carcinoma (SCC) MATERIAL AND METHOD: The study included patients who underwent surgery in our clinic due to laryngeal SCC between May 2010 and June 2018. It was learned whether the patients were alive or not by hospital records, death notification system records and patient / family interviews. Surgical reports, pathology reports, tumor clinical council notes and preoperative hematological examinations were retrospectively evaluated and recorded from the hospital registry system. RESULTS: The mean age of the 63 patients included in the study was 59.3 (age range; 38 to 83 years). The mean postoperative follow-up period was 56.8 months (minimum 6 months to maximum 102 months). We found that surgical margin positivity had a statistically significant negative negative effect on survival (p = 0.049, r = -0.26). Perineural invasion, perivascular invasion, the presence of neck metastasis and the effect of tumor differentiation on survival were not found to be statistically significant (p values; 0.9, 0.1, 0.9 and 0.4, respectively). CONCLUSION: The absence of a tumor at the surgical margin is one of the most basic rules in oncologic surgery. KEY WORDS: Laryngeal carcinoma, Oncologic surgery, Survival, Surgical Margin.

Lymph node yield and lymph node density for elective level II-IV neck dissections in laryngeal squamous cell carcinoma patients.

PURPOSE: To determine the minimum lymph node yield (LNY) in patients with laryngeal squamous cell carcinoma (LSCCs). METHODS: This retrospective study was performed in a tertiary care hospital setting and included 42 LSCC patients aged 39-81 years (females, n = 2; males, n = 40) who underwent a total or partial laryngectomy and elective bilateral level II-IV neck dissections (unilateral neck dissections: n = 84). RESULTS: The average LNY in the unilateral level II-IV lymph node dissections was 25.9 ± 10, and the average metastatic LNY was 0.9 ± 1.9. The unilateral neck dissections were grouped according to the number of lymph nodes. There was no significant difference between the groups in terms of the metastatic LNY (p = 0.5). The metastatic lymph node density (LND) (metastatic lymph node yield/LNY) was 0.043 for unilateral neck level II-IV neck dissections. A Cox regression analysis revealed no significant relationship between survival and the LNY and LND in bilateral neck dissections (p = 0.4 and p = 0.8, respectively). CONCLUSIONS: The results revealed no minimum number of lymph nodes that could reliably detect metastatic lymph nodes in LSCC patients.