Correlation of Tinnitus Severity Index and Tinnitus Handicap Inventory with Hematological Parameters in Patients with Subjective Tinnitus.

Introduction Tinnitus etiopathogenesis is still unclear and treatment options are controversial despite current advances in medicine. Objectives To analyze the correlation between patients' symptom scores, systemic inflammation, and trombosis biomarkers. Methods In this prospective study, we evaluated the degree of complaints of subjective tinnitus patients with the tinnitus severity index (TSI) and tinnitus handicap inventory (THI), and correlated these symptom scores with hematological parameters such as the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean thrombocyte volume (MPV), and platelet distribution width (PDW). Results A total of 44 patients with subjective tinnitus, 25 (56.8%) men and 19 (43.2%) women, were included in this study. The mean age of the patients was 42.3 ± 14.8 years. When the correlation between TSI and NLR, PLR, PDW, and MPV values of the patients were analyzed, no statistically significant correlation was found between TSI, NLR, and PLR ( p > 0.05). However, there was a statistically weak positive correlation between TSI, MPV, and PDW.( p < 0.05). When the correlation between THI and NLR, PLR, PDW, and MPV values of the patients were analyzed, no statistically significant correlation was found between THI, NLR, and PLR ( p > 0.05). There was a statistically weak positive correlation between THI, MPV, and PDW ( p < 0.05). Conclusion We were unable to detect any relationship between systemic inflammation markers (NLR and PLR) and symptom scores, but a weakly positive correlation was observed between thrombosis markers (MPV and PDW) and symptom scores, and as the subclinical thrombosis markers elevated, so did the symptom scores.

Correlation of Tinnitus Severity Index and Tinnitus Handicap Inventory with Hematological Parameters in Patients with Subjective Tinnitus

Abstract Introduction Tinnitus etiopathogenesis is still unclear and treatment options are controversial despite current advances in medicine. Objectives To analyze the correlation between patients' symptom scores, systemic inflammation, and trombosis biomarkers. Methods In this prospective study, we evaluated the degree of complaints of subjective tinnitus patients with the tinnitus severity index (TSI) and tinnitus handicap inventory (THI), and correlated these symptom scores with hematological parameters such as the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean thrombocyte volume (MPV), and platelet distribution width (PDW). Results A total of 44 patients with subjective tinnitus, 25 (56.8%) men and 19 (43.2%) women, were included in this study. The mean age of the patients was 42.3 ± 14.8 years. When the correlation between TSI and NLR, PLR, PDW, and MPV values of the patients were analyzed, no statistically significant correlation was found between TSI, NLR, and PLR (p > 0.05). However, there was a statistically weak positive correlation between TSI, MPV, and PDW.(p < 0.05). When the correlation between THI and NLR, PLR, PDW, and MPV values of the patients were analyzed, no statistically significant correlation was found between THI, NLR, and PLR (p > 0.05). There was a statistically weak positive correlation between THI, MPV, and PDW (p < 0.05). Conclusion We were unable to detect any relationship between systemic inflammation markers (NLR and PLR) and symptom scores, but a weakly positive correlation was observed between thrombosis markers (MPV and PDW) and symptom scores, and as the subclinical thrombosis markers elevated, so did the symptom scores.

Giant Ethmoid Sinus Osteoma Protruding into the Maxillary Sinus.

Ethmoid sinus osteomas are rare, benign, encapsulated neoplasms of the paranasal region. They can lead to various complications such as sinusitis, orbital cellulitis, proptosis, and diplopia. The treatment protocol of these lesions changed remarkably as powered instrumentation of functional endoscopic sinus surgery evolved and otolaryngologists gained experience. Here, the authors report a 30-year-old female who was diagnosed with a giant right-sided ethmoid sinus osteoma and discuss diagnostic and treatment modalities of these lesions in consonance with the current literature.

Clinicopathological analysis of parotid masses: six-year experience of a tertiary center.

OBJECTIVE: To analyse the clinical and histopathological characteristics of parotid gland masses at a tertiary referral centre and to compare the results with those cited in literature. METHODS: The retrospective study was conducted at Adana Numune Training and Research Hospital, Adana, Turkey, and comprised data of patients undergoing parotid surgery between January 2011 and December 2016. They were evaluated in terms of age, gender, surgery method, fine-needle aspiration biopsy results, specimen reports and complications after the surgery for one year. SPSS 20 was used for data analysis. RESULTS: Of 170 parotidectomies, 97(57.1%) had been performed on males and 73(42.9%) on females. There were 145(85.3%) benign and 25(14.7%) malignant tumours. Pleomorphic adenoma 67(39.4%) and Warthin's tumour 56(32.9%) were the two most common benign tumours. Mucoepidermoid carcinoma 7(4.1%) and adenoid cystic carcinoma 6(3.5%) were the two most prevalent malignant tumours. Superficial parotidectomy 133(78.2%) was the main type of surgical intervention. The sensitivity of fine needle aspiration cytology for identifying malignant tumours was 64.71%, the specificity was 100% and overall accuracy of the procedure was 94.92%. CONCLUSIONS: Repeated aspirations for sampling different parts of the lesion should be performed on suspicion of malignancy, especially if fine needle aspiration cytology reported pleomorphic adenoma.

The effect of frontal sinus pneumatization on anatomic variants of paranasal sinuses.

PURPOSE: The aim of this study is to determine the effect of frontal sinus pneumatization on various variations of paranasal sinuses on maxillofacial CT. MATERIALS AND METHODS: A total number of 120 patients (62 females, 58 males) were included in this study. Patients were divided into three groups regarding their frontal sinus pneumatization extent on paranasal sinus CT as Type 1 pneumatization (aplasia and hypoplasia), Type 2 pneumatization (medium) and Type 3 pneumatization (hyperplasia). The prevalence of various variations on paranasal sinus CT like pneumatization of upper and middle concha, presence of agger nasi, Haller and Onodi cell, maxillary sinus and sphenoid sinus hypoplasia, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid sinus, dehiscence and protrusion of internal carotid artery and optic nerve and vidian canal types were ascertained and compared within each group. RESULTS: The prevalence of upper and middle concha pneumatization, Haller cell, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid and internal carotid artery dehiscence and protrusion was higher in Type 3 group compared with other groups. CONCLUSION: Excessive pneumatization of frontal sinus has various effects on paranasal sinus variations at maxillofacial CT. Surgeons dealing with endoscopic sinus surgery, maxillofacial and skull base surgery must be vigilant of association between certain variations when analyzing CT scan preoperatively for avoiding complications.

The Analysis of Computed Tomography of Paranasal Sinuses in Nasal Septal Deviation.

OBJECTIVES: Anatomic variations of paranasal sinuses are frequent among population that should be analyzed and interpreted accurately. The purpose of this study is to analyze anatomical variants and their relationships of paranasal sinuses in patients with nasal septal deviation undergoing septoplasty. METHODS: A total number of 150 patients (74 males, 76 females) with nasal septal deviation undergoing septal surgery were included in this retrospective study. The authors analyzed the direction and the angle of the nasal septal deviation, variations of the nasal turbinates, ethmoidal air cells, paranasal sinus pneumatization, accessory pneumatization of the paranasal complex and sphenoid sinus-related structures and the Keros, optic nerve and Vidian canal classification, and relationships between these structures in the paranasal computed tomography of the patients. RESULTS: The incidence of concha bullosa, Onodi cell, and anterior clinoid pneumatization were higher in patients with nasal septal deviation when compared with current literature. CONCLUSION: Physicians and surgeons dealing with the nose and maxillofacial region should be able to analyze paranasal computed tomography by themselves and must be aware of these variations during performing septal and craniomaxillofacial surgery.

Endoscopic Transnasal Transpterygoid Excision of an Infratemporal Dermoid Cyst.

OBJECTIVE: Intracranial dermoid cysts are rare, slow-growing masses of sellar, parasellar regions, and posterior cranial fossa. The symptomatology of these cysts depends on the localization and presence of rupture. The preoperative diagnosis of these cysts by imagining techniques is distinctive as they have characteristic appearances. PATIENT: Endoscopic transnasal transpterygoid approach to infratemporal fossa for an extradural dermoid cyst of a 24 year-old woman is presented in this clinical report. Headache, dizziness, and retro orbital pain were her main complaints and diagnostic imagining studies designated an intracranial dermoid cyst preoperatively. The cyst was excised uneventfully with no recurrence 6 months after the operation. CONCLUSION: Surgery of intracranial lesions neighboring critical vital neurovascular structures can be challenging to the surgeon. Alternative minimal invasive approaches should always be considered for averting life-threatening complications.

Is There a Relationship Between Snoring Sound Intensity and Frequency and OSAS Severity?

OBJECTIVES: We investigated the relationship between snoring sounds and severity of obstructive sleep apnea syndrome (OSAS). METHODS: A total number of 103 snoring patients (60 males and 43 females) were evaluated by means of polysomnographic findings and snoring sound recordings. Snoring sound intensity was assessed using fast Fourier transform (FFT) method by measuring maximal frequency (Fmax) and average snoring sound intensity level (SSIL). RESULTS: Maximal frequency and SSIL are correlated with apnea-hypopnea index (AHI), REM AHI, and severity of the OSAS. So, as the severity of the OSAS increased, so did the Fmax and SSIL of the snoring recordings, meaning patients started snoring louder with more frequency. In older patients, in females, in severe OSAS group, and in patients with higher body mass index (BMI), AHI and AHI REM values and SSIL and Fmax values increased. As mean oxygen (O2) saturation and lowest O2 saturation decreased, SSIL and Fmax values increased. CONCLUSION: Maximal frequency and SSIL analysis of the snoring sound increased in severe OSAS patients. People should be aware of the importance of snoring sounds. In particular, patients with snoring sounds increasing in intensity and of higher frequency should discuss with their physicians the possibility of OSAS.

Fat-plug myringoplasty of ear lobule vs abdominal donor sites.

The purpose of this study is to compare the success rates of fat-graft myringoplasties harvesting adipose grafts from different donor sites (ear lobule vs abdomen). The clinical records of 61 patients (24 males and 37 females) who underwent fat-plug myringoplasty (FPM) were reviewed retrospectively. Fat from ear lobule (FEL) and abdominal fat were used as graft materials. The impact of age, gender, systemic diseases, topography of the perforation, utilization of fat graft materials of different origin on the tympanic membrane closure rate and the effect of FPM on hearing gain was analyzed. Our tympanic membrane (TM) closure rate was 82 %. No statistical significant difference was observed regarding age, gender, comorbidities (septal deviation, hypertension and diabetes mellitus) or habits (smoking). Posterior TM perforations had significantly lower healing rate. The change in TM closure rate considering different adipose tissue donor sites was not statistically significant. The hearing gain of the patients was mostly below 20 dB. Fat-plug myringoplasty (FPM) is a safe, cost-effective and easy operation for selected patients. Abdominal fat graft is as effective as ear lobe fat graft on tympanic membrane healing, has cosmetic advantages and should be taken into consideration when planning fat as the graft source.

The effect of corticosteroid therapy on cyclooxygenase 2, vascular endothelial growth factor, and inducible nitric oxide synthase expression levels in nasal polyposis.

Nasal and oral corticosteroid therapy is the ultimate treatment for sinonasal polyposis. Although there are numerous clinical studies regarding the factors associated with the formation of nasal polyposis, there is not enough literature on how these factors are influenced by steroid treatment. Twenty-one patients that had no prior medical therapy for nasal polyposis or had received medical therapy at least 6 months earlier were included in the study. Patients were treated with oral and nasal corticosteroid therapy. Nasal polyp biopsies were taken before and after medical treatment and immunohistochemical staining for cyclooxygenase 2 (COX-2), vascular endothelial growth factor (VEGF) and inducible nitric oxide synthase (iNOS) were applied to the specimens. In this study, we tried to demonstrate the effects of corticosteroid therapy on nasal polyposis tissue immunohistochemically. There was no change at immunohistochemical expression level of COX-2; however, the decline of immunohistochemical expression levels of VEGF and iNOS was statistically significant. Short-term steroid therapy does not affect COX-2 level of the nasal polyposis tissue, but has an influence on iNOS and VEGF levels. Our findings were harmonious with those of the previous studies of the literature. Further studies are needed to demonstrate the long-term effects with a larger patient group.

A thyroid tumor extending to the parapharyngeal space.

BACKGROUND: The metastasis of papillary thyroid carcinoma to the parapharyngeal space is rare and discussed in the English literature before. Encountering a parapharyngeal mass with cystic appearance on imaging, one should rule out thyroid malignancy as differential diagnosis. CASE PRESENTATION: The case presented here is a 22-year-old woman who was referred to our clinic with complaints of painless neck mass, dysphagia and hoarseness for two years. After radiologic and pathological examination, the mass thought to be relevant with the thyroid gland. Peroperatively, the tumor was found to originate from the superior pole of the right thyroid gland, with a narrow stalk, and extended following the neurovascular bundle to the lower part of the parapharyngeal space. The bulk was removed via transservical approach with total thyroidectomy. CONCLUSION: The occurrence of the follicular variant of papillary thyroid carcinoma in the parapharyngeal space is extremely rare. The management of this rare case was discussed with the review of literature.