Role of Cochlear Nerve Diameter as a Prognostic Indicator for Hearing Recovery in Older Adults with Idiopathic Sudden Sensorineural Hearing Loss.

BACKGROUND: Idiopathic sudden sensorineural hearing loss is a disabling condition that lowers the quality of life specifically in older adults living alone. It is crucial to determine the outcome of the disease and to offer early treatment to prevent isolation caused by hearing impairment in this population. The objective of our study was to investigate whether the initial cochlear nerve thickness may predict the outcome of hearing recovery in older adults with idiopathic sudden sensorineural hearing loss. METHODS: The study population was composed of older adults that were referred with idiopathic sudden sensorineural hearing loss in 1 ear. Long-term audiological data of the cohort were analyzed according to Siegel's criteria on hearing recovery and were grouped according to complete recovery or treatment failure. Cochlear nerve diameters of the diseased and safe ears of each group, measured on reformatted images on magnetic resonance imaging, at the fundus, in the mid-internal acoustic canal, and at the entry point into the Pons were compared in each group and between groups. RESULTS: Mean cochlear nerve diameter was significantly larger in the recovered older adults (1.11 ± 0.27 mm) than in the non-recovered adults (0.94 ± 0.21 mm) at the mid-internal acoustic canal (Student's t-test, P < .05). Cochlear nerve thickness at mid-internal acoustic canal (≤0.8 mm) sensitivity for recovery failure was 89% and displayed an odds ratio 5.333, 95% CI (1.000-28.435). CONCLUSION: Cochlear nerve thickness in mid-internal acoustic canal in non-recovered older adults with idiopathic sudden sensorineural hearing loss is significantly thinner than the completely recovered group. Older adults with mid-internal acoustic canal cochlear nerve greatest diameter cutoff level of ≤0.8 mm are 5.33 times more exposed to recovery failure.

lncRNA NORAD, soluble ICAM1 and their correlations may be related to the regulation of the tumor immune microenvironment in laryngeal squamous cell carcinoma (LSCC).

NORAD, non-coding RNA activated by DNA damage, is a Long non-coding RNA (lncRNA) transcript that modulates genome stability and has been reported to be dysregulated in different cancers. Although it has been reported to be upregulated in tumor cells mostly for solid organ cancers, it has also been reported to be downregulated in some cancers. Although the pathophysiological mechanism is not fully understood, a negative correlation between NORAD and intercellular cell adhesion molecule-1 (ICAM-1) has been shown in experimental models, but this situation has not been evaluated in terms of cancer. We aimed to evaluate the potential roles of these two biomarker candidates together and separately in the clinicopathological axis in Laryngeal squamous cell carcinoma (LSCC) in a case-control study setting. The interactions of NORAD and ICAM1 at the RNA level were evaluated interactively by the RIblast program. sICAM1 (soluble intercellular cell adhesion molecule-1) levels were determined by ELISA in one hundred and five individuals (forty-four LSCC, sixty-one control) and lncRNA NORAD expression in eighty-eight tissues (forty-four LSCC tumors, forty-four tumor-free surrounding tissues) was determined by Real-time PCR. While the energy treesholud was - 16 kcal/mol between NORAD and ICAM1, the total energy was 176.33 kcal/mol, and 9 base pair pairings from 4 critical points were detected. NORAD expression level was found to be higher in tumor surrounding tissue compared to tumor tissue, and sICAM1 was higher in the control group compared to LSCC (p = 0.004; p = 0.02). NORAD discreminte tumor surrounding tissue from tumor (AUC: 0.674; optimal sensitivity:87.50%; optimal specificity 54.55%; cut-off point as >1.58 fold change; P = 0.034). The sICAM1 level was found to be higher in the control (494,814 ± 93.64 ng/L) than LSCC (432.95 ± 93.64 ng/L) (p = 0.02). sICAM1 discreminte control group from LSCC (AUC: 0.624; optimal sensitivity 68,85%; optimal specificity 61,36%; cut-off point ≤115,0 ng/L; (p = 0.033). A very strong negative correlation was found between NORAD expression and patients' sICAM1 levels (r = -.967; n = 44; p = 0.033). sICAM1 levels were found to be 1.63 times higher in NORAD downregulated subjects compared to upregulated ones (p = 0.031). NORAD was 3.63 times higher in those with alcohol use, and sICAM 1 was 5.77 times higher in those without distant organ metastasis (p = 0.043; 0.004). The increased NORAD expression in the tumor microenvironment in LSCC, the activation of T cells via TCR signaling, and the decrease of sICAM in the control group in correlation with NORAD suggests that ICAM1 may be needed as a membrane protein in the tumor microenvironment. NORAD and ICAM1 may be functionally related to tumor microenvironment and immune control in LSCC.

The additive value of continuous positive airway pressure treatment on psychological symptoms.

OBJECTIVE: To screen psychological problems of patients with obstructive sleep apnea syndrome (OSAS) by utilizing the psychological symptom screening test Symptom Checklist-90-Revised (SCL-90-R) and to evaluate the effect of continuous positive airway pressure (CPAP) treatment. METHODS: The SCL-90-R and Epworth Sleepiness Scale (ESS) test were applied to 66 patients with Apnea-Hypopnea Index (AHI ≥ 30/h) using CPAP device and 20 healthy individuals; the test results were compared. RESULTS: The age of the patients ranged from 28 to 67 years, and the patient group comprised 54 males (81.8%) and 12 females (18.2%). The AHI scores ranged from 30.05 to 99.80, with a mean of 49.34 ± 21.40. Significant improvement was seen in 6 of the 11 SCL-90-R scores in CPAP-treated patients. CONCLUSION: The authors conclude that the SCL-90-R test may be appropriate for evaluating the response to CPAP treatment in OSAS patients and monitoring the psychosocial effects of treatment.

A severe headache due to pigmented villonodular synovitis in a rare location: facial nerve on temporomandibular joint. A case report.

BACKGROUND: Pigmented villonodular synovitis (PVNS) is an infrequent benign tumor-like proliferative lesion developing from the synovial membranes of the joint, tendon sheath, and bursa. CLINICAL PRESENTATION: A 44-year-old woman with numbness on the right side of her face, severe headaches, and swelling in temporomandibular region is presented. On head and neck magnetic resonance imaging, an encapsulated mass approximately 2 cm was detected. The fine-needle aspiration biopsy resulted as suspicion of mesenchymal tumor. A complete resection with the capsule was performed over the temporal branch by monitoring of the facial nerve. The final histopathologic examination resulted as a giant cell tendon sheath tumor. CONCLUSION: Headache is not the main symptom in PVNS, but in severe pain spreading from the temporomandibular region, physical examination should be done carefully for slight swelling, and the possibility of pigmented villonodular synovitis should be considered. Because of the high recurrence rate, en bloc resection is necessary.

Significance of Intercellular adhesion molecule-1 Lys496Glu gene polimorphism on plasma redox status regulation in laryngeal carcinoma.

BACKGROUND: Intercellular adhesion molecule-1 (ICAM-1) is a surface glycoprotein important for tumor invasion and angiogenesis. The present research is conducted to investigate whether specific gene polymorphism of ICAM-1 K469E (rs5498) and plasma redox status could be associated with laryngeal cancer (LC) development. Since there is no clear evidence which investigates the relationship between ICAM-1 polymorphism and ROS-mediated plasma protein oxidation in LC, our study is the first significant contribution for investigating the relationship. METHODS: The study covered patients with primary LC and their age-matched healthy control subjects. Evaluation of ICAM-1 K469E (rs5498) gene polymorphism was performed by polymerase chain reaction-restriction fragment length polymorphism. Plasma redox status was assessed with spectrophotometric methods. RESULTS: In the current paper, we found that LC patients with GG genotype had a decreasing trend for the plasma oxidative damage biomarker levels when compared with all allele genotypes (AA and AG). CONCLUSION: We concluded that G allele of the ICAM-1 K469E gene plays a significant role in the optimal regulation of plasma redox homeostasis in patients with LC.

Glass Particles in the Nasal Cavity for 30 Years and Squamous Cell Carcinoma: Is There a Relationship?

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.

The Role of Fusion Technique of Computed Tomography and Non-echo-planar Diffusion-weighted Imaging in the Evaluation of Surgical Cholesteatoma Localization.

Objective: In recent years, the fusion of computed tomography (CT) and non-echo-planar diffusion-weighted magnetic resonance imaging (non-EPI DWI) has been preferred in cholesteatoma localizations. This study aimed to investigate the role of CT and non-EPI DWI fusion imaging in cholesteatoma localizations. Methods: This retrospective study included 39 patients who underwent chronic otitis media operation [mean age of 35.10±15.33 years (18-67 years), 64.1% female, and 35.9% male] and had preoperative high-resolution temporal bone CT and non-EPI DWI examinations. Images were sent to the Advantage Workstation VolumeShare 7 for fusion. These selected images were fused on the workstation and were manually corrected by the radiologist. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracies of fused images of CT and non-EPI DWI were evaluated according to anatomic cholesteatoma localizations based on surgical data. Results: The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracies of non-EPI DWI for detecting cholesteatomas were 97.14%, 75.00%, 97.14%, 75.00%, and 94.87%, respectively. Three true-negative, one false-positive, and one false-negative case were observed according to surgical results in detecting the presence of a cholesteatoma with non-EPI DWI. Moderate agreement was determined between the surgical and radiological results in detecting the presence of a cholesteatoma (k=0.721). Detecting the lesion of localization on the fused images compared to surgical found an almost perfect agreement in the mastoid antrum (k=0.948), strong agreement in the hypotympanum and mastoid cells (k=0.894), moderate agreement in the epitympanum (k=0.653), and weak agreement in those in the mesotympanum (k=0.540). Conclusions: The surgeons' determinations are supported by the guidance of temporal CT and non-EPI DWI fused images. Therefore, preferring the fusion imaging technique could increase the quality of life by reducing unnecessary operations.

Potential role of immune cell genetic variants associated with tumor microenvironment response in laryngeal squamous cell carcinoma (LSCC) in terms of clinicopathological features.

Immunomodulatory signals regulate the self-tolerance, activation, priming and survival processes of T cells. Programmed cell death protein 1 (PD1), Programmed death-ligand 1 (PD-L1) inhibitory signals and CD27, CD28 costimulators have been detected for many solid organ cancers in tumor-infiltrating T cells. It was aimed to investigate the immune cell-based regulatory genetic variants in laryngeal squamous cell carcinoma (LSCC) in terms of clinicopathological features. Genotyping was performed by PCR-RFLP method for PD-1 rs2227981, PD-L1 rs2890658, CD28 rs3116496, CD27 rs2267966 genetic variants from genomic DNAs extracted from peripheral blood samples in One Hundred Thirty-Six individuals (Sixty-one LSCC and seventy-five controls). Analysis of SNPs was carried out according to multiple inheritance models (co-dominant, dominant, recessive, over-dominant and log-additive). There was no difference between LSCC and control groups in genotype/allele distribution for PD-1 and PD-L1 (p > 0.05). In the PD-1 overdominant model, the CT genotype was found to be high (p = 0.036) in those without a family history. The frequency of C allele (AC+CC) in the PD-L1 dominant model was higher in alcohol users and those with reflux (p = 0.024; p = 0.001 respectively). In the Dominant model for PD-L1, the AA genotype was lower in moderately and well-differentiated tumors than in poorly differentiated tumors (p = 0.02). CD27 AT and CD28 CT genotypes were found to be higher in LSCC patients compared to the control group (p = 0.009; p = 0.01 respectively), while linkage disequilibrium (LD) was detected between CD27 and CD28 (p = 0.02). In the CD28 dominant model, C allele (CT+CC) carriage was found to be high in those with family history and in those without reflux and perineural invasion (p = 0.01; p = 0.01; p = 0.03 respectively). In LSCC, PD-L1 rather than PD-1 has a prognostic effect in terms of clinicopathology, and the LD and clinicopathological relationships detected between CD28 and CD27 genotypes suggest that the hereditary immune checkpoint-dependent T cell traffic may be pathophysiologically important.

Comparative Columellar Scar Analysis Between W Incisions and Inverted-V Incision in Open Technique Nasal Surgery.

A visible scar on the columella is undesirable result for both patient and surgeon. So it is one of the major disadvantage of open nose surgery. Different columellar incision types have been used in open technique of nasal surgery. In this prospective study, we compare W incisions and inverted-V columellar incisions with a scar assessment scale. In this prospective randomized study, open nasal surgery (open rhinoplasty and open technique septoplasty) were performed on 93 patients between November 2009 and July 2012. The inverted-V incision was used on 31 patients (24 males, 7 females). The "W" incision was used on 62 patients (40 males, 22 females). The entire surgical procedure was performed by a single surgeon. The columellar incision was closed using 6-0 interrupted polypropylene sutures. All sutures were removed on the seventh postoperative day. Scars were assessed at 6 moths, with 3 items scar assessment scale, we observed satisfactory scar, pigmentation, and notching. We compared both groups and found that the scar pigmentation, notching and scar formation are similar to each other. As a result of this study we concluded that the inverted-V incision or "W" incision might be a similar choice in open nasal surgery.

Outcomes of external septorhinoplasty in a Turkish male population.

INTRODUCTION: The first and one of the most important steps in facial plastic surgery is accurate preoperative facial analysis and recording of data that may help the surgeon to check the outcomes of his/her techniques, promoting a surgeon's professional development. OBJECTIVE: To evaluate the esthetic outcomes of external septorhinoplasty relevant to ethnic facial harmony and to investigate the relationship of the columellar incision scar with the type of skin and columellar incision type in a Turkish population. METHODS: In total, 28 consecutive adult male patients with a mean age of 32.14±10.66 years (range: 18-61 years) were included the study. Primary outcomes were preoperative and postoperative photogrammetric facial analyses of the patients including measurement of nasofrontal angle, nasolabial angle and nasal projection ratios (Gode) assessed according to the data derived from the Rhinobase program. Results were compared to facial proportions of the Turkish population. Columellar incision scar scores related to the Fitzpatrick skin type classification of the patients and columellar incision types used for the external approach were secondary outcomes of the study. RESULTS: Mean preoperative and postoperative nasofrontal angles were 148.04°±8.18° and 144.50°±7.15°, respectively, while mean preoperative and postoperative nasolabial angles were 87.59°±14.01° and 98.50°±9.71°, respectively. Mean preoperative and postoperative nasal tip projection ratios were 0.56±0.05 and 0.60±0.06, respectively. The differences between pre- and postoperative measurements were all significantly different and were in accordance with Turkish nasal harmony. Columellar inverted "V" incisions were performed in 15 (53.6%) patients while "V" incisions were used in 13 (46.4%) patients. Fitzpatrick skin Type 4 was seen in 46.42% of the patients, Fitzpatrick Type 3 in 46.42% and Fitzpatrick Type 2 in 7.14% of the patients. No significant difference was seen between columellar scar scores according to skin type and columellar incision type used for external septorhinoplasty. CONCLUSIONS: This study demonstrated that outcomes for nasofrontal angle, nasolabial angle and nasal tip projection ratios analyzed using the Rhinobase program in patients who underwent external septorhinoplasty were similar to reference values for the Turkish population.

Verruciform Xanthoma of a Lower Lip Lesion: A New Case and Review of the Literature.

A non-smoking man in his seventh decade presented with a lesion he had had for about 5 years on the right external surface of the lip 1 mm from the vermilion border. On physical examination, a yellowish-coloured, non-tender, verrucous mass of 0.5 × 0.7 cm was observed. A histopathological examination of the first 3-mm punch biopsy was non-diagnostic. The histopathological evaluation of a second, 5-mm-deep punch biopsy made by a pathology expert in oral lesions revealed a diagnosis of verruciform xanthoma. The key to the diagnosis of verruciform xanthoma is to recognize xanthoma cells. However, these cells may be insufficient in number in small and superficial biopsy material and overlooked by a pathologist especially when lacking knowledge of this uncommon lesion. Verruciform xanthoma of the lower lip at the vermilion border is an extremely rare entity described in 5 cases worldwide to date. We aimed to bring verruciform xanthoma to readers' attention for a differential diagnosis of lower lip diseases and to prevent overdiagnosis and overtreatment of this lesion unfamiliar to otorhinolaryngologists.

Expression of miR-373 and its predicted target genes E-cadherin and CD44 in patients with laryngeal squamous cell carcinoma.

Laryngeal squamous cell carcinoma (LSCC) is a genomically complex disease that is difficult to target, and efforts have been made to identify new treatment strategies and   molecular markers that might stratify patients and individualize options for treatment. miR-373 has diametrically opposed roles in different stages and types of cancers. miR-373 has been suggested to quantitatively control E-cadherin and CD44 expression. We studied the expression of miR-373, E-cadherin and CD44 in laryngeal squamous cell carcinoma and evaluated the association between the disease and clinical characteristics of patients. Tumor tissues were collected from 24 laryngeal cancer patients. Adjacent normal tissue samples were also obtained as controls. After RNA isolation, we assessed the miR-373, E-cadherin and CD44 levels. As endogenous controls, we used the small RNA U6 and GAPDH TaqMan® to normalize the levels of expression of miR-373, E-cadherin and CD44. The fold change in the expression of the genes in larynx tumor and control tissues was calculated using the 2-ΔΔCT method. miR-373 was significantly upregulated in seventeen tumor samples compared to controls. However, the expression levels of both E-cadherin and CD44 mRNA were found to be significantly downregulated in tumor versus control regions (p=0.026 and p=0.005, respectively). We did not find any significant difference in the expression levels of miR-373, E-cadherin or CD44 and cancer risk factors. miR-373, E-cadherin and CD44 may be involved in the etiopathogenesis of laryngeal cancer. It can be suggested that E-cadherin and CD44 are functional targets of miR-373, but we need further studies to investigate this hypothesis.

Assessment of Patient Satisfaction With Evaluation Methods in Open Technique Septorhinoplasty.

The aim of this study was to measure the postoperative satisfaction of patients who underwent open technique septorhinoplasty (SRP) using Nasal Obstruction Symptoms Evaluation (NOSE), Rhinoplasty Outcomes Evaluation (ROE) and visual analog scale (VAS), and to assess the reliability and usability of these forms in the outcome of SRP.Forty-five patients who underwent primary open technique SRP were included in the study. The levels of patient satisfaction were assessed before the surgery and in the long-term using NOSE, ROE, and VAS.Nasal Obstruction Symptoms Evaluation scores were found to be decreased significantly after surgery, whereas ROE scores were increased postoperatively (P < 0.01). Patients' either functional (VAS) and aesthetic (VAS) increased significantly in the long-term after surgery (P < 0.01). There were no statistically significant differences between preoperative and postoperative measurements of NOSE, ROE, functional VAS, and aesthetic VAS by sex (P > 0.05).There was a statistically significant positive relationship between ROE difference before and after surgery, and functional VAS difference (r = 0.544, P = 0.001).There was a positive correlation between pre-postoperative ROE difference, and aesthetic VAS difference (r = 0.766, P = 0.001). The relationship between the pre-postoperative NOSE score difference and functional VAS difference was found to be significantly negative (r = -0.833, P = 0.001). The relationship between pre-postoperative NOSE difference and aesthetic VAS difference was also significantly negative (r = -0.475, P = 0.001). There was a significant negative correlation between ROE difference between before and after surgery, and NOSE difference (r = -0.640, P = 0.00).The disease-specific quality of life assessment forms used to evaluate patient esthetic and functional satisfaction correlate significantly with nasal obstruction and ROE.

Effect of laryngopharyngeal reflux on the improvement of chronic rhinosinusitis without polyposis after primary endoscopic sinus surgery.

OBJECTIVES: This study aims to investigate the influence of laryngopharyngeal reflux on the improvement of chronic rhinosinusitis (CRS) in patients who underwent endoscopic sinus surgery (ESS). PATIENTS AND METHODS: A total of 48 patients (28 males, 20 females; mean age 41.6±15.1 years; range 18 to 75 years) with CRS without polyposis were assessed for the presence of gastric reflux with Reflux Symptom Index (RSI) and Reflux Finding Scores (RFS) before undergoing primary ESS. Patients with a RSI >12 and RFS >7 were included in the reflux(+) and those with either score under these cutoffs in the reflux(-) group. Improvement scores were accepted as the difference between preoperative scores and postoperative sixth-month Lund-Mackay Radiology Scores, Lund-Kennedy Endoscopy Scores (LKES), and Sinusitis Symptom Scores (SSS). RESULTS: There was no significant difference between improvements of the reflux(+) and reflux(-) groups in terms of radiology, endoscopy, and symptom scores (p>0.05). However, preoperative and postoperative six-month radiology scores were significantly higher in reflux(+) patients (p<0.01). Also, postoperative six-month LKES were significantly higher in reflux(+) patients. No statistically significant differences were detected between preoperative and postoperative six-month SSS in reflux(+) or reflux(-) patients. CONCLUSION: Laryngopharyngeal reflux was associated with worse radiology and endoscopy scores in CRS without polyposis; however, it had no role on the improvement scores after primary ESS.

Efficacy of multimodality approach to sudden hearing loss.

OBJECTIVES: This study aims to investigate whether addition of intratympanic steroid (ITS) to systemic steroid and hyperbaric oxygen (HBO) is effective in the treatment of sudden hearing loss (SHL). PATIENTS AND METHODS: Between January 2008 and October 2011, 58 patients diagnosed with SHL were enrolled in the study. Twenty patients (11 males, 9 females; mean age 45.3±21 years; range 24 to 66 years) who received systemic steroid and HBO composed group 1, while 38 patients (19 males, 19 females; mean age 41.6±16 years; range 25 to 61 years) who received ITS in addition to systemic steroid and HBO composed group 2. RESULTS: Post-treatment hearing improvement was statistically significant in both groups in terms of the mean pure tone according to the Siegel's criteria (p<0.05). Treatment was successful at 55% of patients in group 1 and 63% in group 2. Despite increased success rate with the addition of ITS, it did not indicate statistical significance (p>0.05). However, there was a strong statistically significant difference in terms of profound hearing loss over 90 dB (p<0.05). None of six patients (0%) with profound hearing loss in group 1 benefited treatment, while addition of ITS to the treatment yielded success in six of 12 patients with profound hearing loss (50%) in group 2 (p<0.05). CONCLUSION: Addition of ITS to systemic steroid and HBO treatment may yield better results in patients with SHL. However, ITS injection seems beneficial for patients with profound SHL.

Prevalence of chronic rhinosinusitis in the setting of Behçet disease.

Behçet disease (BD) is a systemic autoimmune/autoinflammatory, T helper 1-mediated condition. It is well known that the prevalence of a T helper 1-mediated disease increases in the presence of another T helper 1-mediated comorbidity. The purpose of this study was to investigate the prevalence of T helper 1-mediated chronic rhinosinusitis without nasal polyposis (CRSsNP) and T helper 2-mediated chronic rhinosinusitis with polyposis in the presence of comorbid BD. Sixty-nine patients and 74 healthy controls were included in the study. Participants were asked to complete a questionnaire for symptoms of rhinosinusitis. Nasal cavities were scored using the Lund-Kennedy endoscopy scores. Paranasal sinus computed tomography imagings were scored according to Lund-Mackay radiology scores. Skin prick tests were carried out for all participants to determine the predisposing role of allergy (T helper 2 disease) in the etiopathogenesis of rhinosinusitis among patients and controls. Patients' endoscopy, radiology, and skin prick testing scores were evaluated with regard to BD activity.The prevalence of CRSsNP was 23.2 % in BD and 2.7% in normal population. The CRSsNP was more frequently seen in patients than in the healthy controls (P = 0.002). The BD patients displayed worse scores on their left sinonasal endoscopy. No statistically significant difference was seen between BD and control groups with regard to Lund-Mackay radiology scores of both sides. The presence of an allergic response to a specific allergen in skin-prick testing were confirmed in 25 patients (36.2%) and 17 controls (23.0%). However, the difference was not statistically significant. There were positive responses to more allergens when BD activity was reduced.The CRSsNP thought to be of T helper 1-mediated origin was more frequently seen in the presence of comorbid BD.

Auditory neuropathy in late preterm infants treated with phototherapy for hyperbilirubinemia.

OBJECTIVE: To evaluate the prevalence of auditory neuropathy (AN) in late preterms treated with phototherapy for hyperbilirubinemia. DESIGN: Prospective observational study comprising late preterms treated with phototherapy for hyperbilirubinemia. Newborns were screened with combined transient-evoked otoacoustic emissions (TEOAEs) / automated auditory brainstem responses (AABR). Infants who failed screening underwent diagnostic (ABR). Infants were all re-evaluated with AABR at one year. STUDY SAMPLE: Eighty-five infants with a mean serum total bilirubin concentration of 22.3 ± 1.76 mg/dl; severe-hyperbilirubinemia (SH), and 102 infants with a mean serum total bilirubin concentration of 18.6 ± 1.26 mg/dl; non-severe hyperbilirubinemia (NSH) were included. RESULTS: From 85 late preterms with SH, six (7.1%) failed screening and underwent diagnostic ABR for six weeks. AN was diagnosed in two (2%) infants with SH. Four (3.9%) of the 102 controls with NSH demonstrated failure at TEOAE/AABR. No AN was diagnosed in the control group at the diagnostic ABR. No statistically significant difference was found between infants treated with phototherapy for SH and NSH with regard to AN/AD either in the postnatal period or at one year. No correlation was found between serum bilirubin levels and ABR latencies or thresholds. CONCLUSIONS: AN (2%) in late preterms treated with phototherapy for severe-hyperbilirubinemia was not higher than in those with non-severe hyperbilirubinemia.

Is septoplasty effective on habitual snoring in patients with nasal obstruction?

We aimed to find out whether snoring relieve with nasal surgery in patients with nasal obstruction. Sixty-four patients who underwent septoplasty under general anesthesia with complaint of nasal obstruction and snoring at Haydarpasa Numune Education and Research Hospital were enrolled in the study. All patients were evaluated by otolaryngological examination. Septal deviation was graded as mild, moderate and severe with endoscopy. Variables examined included age, sex, body mass index. All patients also completed the questionnaires, including Nose Obstruction Symptom Evaluation scale (NOSE), Epworth Sleepiness Scale (ESS), and Snore Symptom Inventory (SSI) before and after septoplasty. NOSE scale, ESS, and SSI scores showed statistically significant improvement after nasal surgery (p < 0.01) but we could not find any statistically significant association between septal deviation grading and improvement in scores of NOSE scale, ESS, and SSI (p > 0.05). Added to this, the association between body mass index (BMI) and improvement in scores of NOSE scale, ESS, and SSI did not reach statistical significance (p > 0.05). Our results demonstrated that septoplasty is effective on the subjective parameters of nasal obstruction in habitual snorers irrespective of the nasal septal deviation and severity of BMI.

Extramedullary plasmacytoma of the frontal sinus: case report and Turkish literature review.

Solitary extramedullary plasmacytomas (EMPs) are nonepithelial neoplasms of plasma cell origin categorized among non-Hodgkin lymphomas, without the bone marrow involvement and systemic spread seen in multiple myeloma. They are uncommon tumors comprising 3% of all plasma cell neoplasias. Although they usually occur in the upper respiratory tract, only 1 case of EMP localized to the frontal sinus has been reported in the English literature. We present in this report a rare case of EMP originated from the left frontal sinus leading to left eyeball proptosis and movement restriction. A survey of sinonasal EMPs in the Turkish literature is reported, as well. Paranasal computerized tomography and magnetic resonance imaging of a 69-year-old female who presented with left eyeball proptosis and left-sided headache revealed a solid mass in the left frontal sinus. Histopathological analysis of the completely excised mass supported the diagnosis of plasmacytoma. The definitive diagnosis of solitary EMP was confirmed with further investigations at hematology and oncology clinics. The patient was treated with surgery followed by local radiotherapy to the head and neck region, and she was disease-free at her 1-year follow-up. Treatment of sinonasal EMP is surgery alone or surgery combined with radiotherapy. Long-term follow-up is a requisite for systemic control because of the disease's high potential to transform into multiple myeloma.