Astrovirus induced nonpurulent encephalomyelitis in sheep: First report from Türkiye by high-throughput sequencing.

BACKGROUND: This study presents the case of non-purulent encephalomyelitis associated with astrovirus infection in a sheep from Eastern Anatolia, Türkiye. METHODS: A necropsy was performed on a sheep showing nervous signs. Afterwards, brain tissue samples were taken and examined with histopathological, immunohistochemical and molecular techniques. RESULTS: Neuropathologic changes included neuronal degeneration, diffuse gliosis, multifocal perivascular cuffing, neuronophagy and neuronal necrosis in the cerebrum, the cerebellum and the cervical spinal cord. Aerobic and anaerobic bacterial culture, selective culture for Listeria monocytogenes, and PCR analysis for rabies virus, tick-borne encephalitis virus, Türkiye encephalitis virus, small ruminant lentiviruses and border disease virus were negative. However, the presence of astrovirus RNA in cerebral, cerebellar and spinal cord samples was demonstrated by a pan-astrovirus RT-PCR. Immunohistochemical examinations revealed astrovirus antigens within the neuronal cytoplasm. High-throughput sequencing techniques identified the causative agent as a member of the genotype species Mamastrovirus 13 but representing a distinct genetic lineage with similarity to ovine astrovirus 1 in the open-reading frames (ORF)1ab region and muskox astrovirus in the ORF2 region. CONCLUSION: This report provides evidence that astroviruses are potentially encephalitis-causing pathogens in ovine populations in Türkiye, featuring an astrovirus strain distinct from those previously identified in sheep.

Potential effect dietary supplementation of calcium tetraborate in quails exposed to cadmium: Its impact on productive performance, oxidative stress, cecal microflora, and histopathological changes.

Cadmium (Cd) is a ubiquitous environmental pollutant, and Cd exposure harms human health, agriculture, and animal husbandry. The present study aimed to investigate the potential protective effect of dietary supplementation of calcium tetraborate (CTB) on productive performance, oxidative stress, cecal microflora, and histopathological changes in quail exposed to Cd. A total of one hundred twenty, 6-week-old Japanese quail (four females and two males/replicate) were divided into four groups (30 quails/group): the control group (feeding basic diet), CTB group (basic diet containing 300 mg/kg CaB4O7, 22.14% elemental B/kg diet), the Cd group (basic diet containing 100 mg/kg cadmium chloride (CdCl2) (total Cd content of 92.1 mg/kg)) and the CTB + Cd group (basic diet containing 300 mg/kg CTB and 100 mg/kg CdCl2). The results showed that Cd exposure caused decreased performance, increased the proportion of broken and soft-shelled eggs, induced oxidative stress, affected cecal microflora, epicardial hemorrhages in the heart, focal necrosis in the liver, degeneration in the kidneys, and degenerated and necrotic seminiferous tubules in the testicles. CTB prevented Cd-induced oxidative stress in liver tissue by increasing total antioxidant status and reducing total oxidant status. In addition, CTB improved egg production and feed conversion ratio (FCR). CTB protected the cecal microflora by inhibiting Enterobacteriaceae and promoting Lactobacillus. CTB also reduced Cd-induced histopathological damage in the heart, liver, kidneys, and testicles. In conclusion, these findings suggest that CTB could be used in Cd-challenged quail, and this compound provides new insights into the toxicity of environmental Cd.

Detection and molecular characterization of Clostridium perfringens, Paeniclostridium sordellii and Clostridium septicum from lambs and goat kids with hemorrhagic abomasitis in Turkey.

BACKGROUND: The pathogenic Clostridia cause neurotoxic, histotoxic and enterotoxic infections in humans and animals. Several Clostridium species have been associated with abomasitis in ruminants. The present study aimed to investigate the frequency, and the presence of virulence genes, of Clostridium perfringens, Paeniclostridium sordellii and Clostridium septicum in lambs and goat kids with hemorrhagic abomasitis. RESULTS: A total of 38 abomasum samples, collected from lambs and goat kids of 1 week to 1 month of age in different farms located in eastern Turkey between 2021 and 2022, were evaluated by histopathology, culture and PCR. At necropsy, the abomasum of the animals was excessively filled with caseinized content and gas, and the abomasum mucosa was hemorrhagic in varying degrees. In histopathological evaluation, acute necrotizing hemorrhagic inflammation was noted in abomasum samples. The examination of swab samples by culture and PCR revealed that C. perfringens type A was the most frequently detected species (86.84%) either alone or in combination with other Clostridium species. P. sordellii, C. perfringens type F and C. septicum were also harboured in the samples, albeit at low rates. Beta2 toxin gene (cpb2) was found in three of C. perfringens type A positive samples. CONCLUSION: It was suggested that vaccination of pregnant animals with toxoid vaccines would be beneficial in terms of protecting newborn animals against Clostridial infections. This study investigated the presence of clostridial toxin genes in abomasal samples for the first time in Turkey.

Otolaryngology-Specific Symptoms May Be Highly Observed in Patients With a History of Covid-19 Infection After Inactivated Coronavirus Vaccination.

OBJECTIVE: To evaluate the otolaryngology-specific symptoms that occur after receiving the Covid-19 vaccine and its possible side effects in patients who had Covid-19 infection in the last 6 months before the vaccination. PATIENTS AND METHODS: The study comprised 3383 health care workers who were vaccinated against Covid 19. After excluding, the study was conducted with 1710 (51%) participants who agreed to answer the study questions. The participants were divided into 2 groups according to the history of Covid-19 positivity in the last 6 months before vaccination. The presence of symptoms related to otolaryngology practice, including cough, nasal congestion, rhinorrhea, sore throat, hearing loss, dizziness, loss of smell, loss of taste, ear pressure, and facial paralysis was recorded. RESULTS: The mean age of the study population was 35.79 ± 10.2 (19-71) years and 1454 (85%) of the patients had a history of Covid-19 infection in the last 6 months. Regarding otolaryngology-related symptoms, the most common complaints were rhinorrhea (4.4%), sore throat (3.2%), and nasal congestion (2.9%). The presence of smell and taste loss, nasal congestion, rhinorrhea, sore throat, and hearing loss was significantly more common in patients with a history of Covid-19 infection. CONCLUSIONS: The patients with a history of Covid-19 disease might have otolaryngology-specific symptoms more commonly than those without a history of Covid-19 disease in the last 6 months before vaccination.

Comparison of the effects of Aloe vera gel and coconut oil on the healing of open wounds in rats.

In this study, the effects of Aloe vera gel and coconut oil on wound healing were investigated and compared in rats. Forty-two Wistar albino rats were used during the experiment, in which they were operated on under general anaesthesia to create two full-thickness open skin wounds (created with a 0.5 cm diameter punch biopsy apparatus) on both back sides of the median line. A total of 42 rats were divided into three groups of 14 animals each to receive the topical application of Aloe vera gel (AV group - n = 14), coconut oil (CO group - n = 14) and cold cream (CONT group - n = 14). The medical applications were performed twice a day in all the groups. The wound borders were marked on a transparent sheet every day. Afterwards, this sheet was transferred to the millimetre graph paper. On days 0, 7, and 14, the unhealed wound area was measured in all the groups. On days 7 and 14, seven rats in each group were euthanised. Then, skin samples including the intact skin were taken from the wound sites for histopathological and biochemical evaluations. The topical application of Aloe vera gel showed a significant increase in the healing process of the open wounds in terms of the clinical evaluation, histopathological and biochemical data averages when compared with the coconut oil and cold cream groups of rats (P < 0.05). The results obtained in the present study demonstrate that Aloe vera gel may provide a good alternative for the treatment of open wounds.

Mucolytic and Antioxidant Effects of Intranasal Acetylcysteine Use on Acute Rhinosinusitis in Rats with an Acute Rhinosinusitis Model.

INTRODUCTION: The aim of this study was to investigate whether N-acetylcysteine (NAC) is effective in the treatment murine model of acute rhinosinusitis in rats. MATERIALS AND METHODS: Twelve rats were included in the study. The left nasal cavity of all rats was infected with Streptococcus pneumoniae. Group 1 was the group in which NAC was administered into the left nasal cavity twice daily. Group 2 was selected as the control group. All rats were then sterilely sacrificed under anesthesia after intracardiac blood sampling. After sacrifice, sterile culture samples were collected from the posterior nasal cavity. RESULTS: Total oxidant status and oxidative stress index (OSI), interleukin 1ß, interleukin 6, and tumor necrosis factor α levels decreased significantly in the treatment group. Total antioxidant status was significantly increased. There was a statistically significant increase in total serum thiol levels and native thiol levels. Histopathologic evaluation showed a statistically significant decrease in submucosal gland hypertrophy in the treatment group. CONCLUSION: According to our study, intranasal application of NAC can decrease the inflammatory findings in murine acute rhinosinusitis.

First report of Serotype-1 Marek's disease virus (MDV-1) with oncogenic form in backyard turkeys in Turkey: a molecular analysis study.

BACKGROUND: Marek's disease (MD) is a lymphoproliferative disease caused by Gallid alphaherpesvirus 2 (GaHV-2, MDV-1), which primarily affects chickens. However, the virus is also able to induce tumors and polyneuritis in turkeys, albeit less frequently than in chickens. RESULTS: This is the first study in Turkey reporting the molecular characterization of a MDV-1 strain detected in a flock of backyard turkeys exhibiting visceral lymphoma. Here, MEQ, vIL-8, pp38 and 132-bp tandem repeat regions, which are frequently preferred in the pathotyping of MDV-1, were examined. It was determined that the MEQ gene of MDV-1/TR-21/turkey strain obtained in the present study encoded 339 amino acids (1020 nt) and had four proline-rich repeat regions (PPPP). Based on the nucleotide sequence of the MEQ gene of the MDV-1/TR-21/turkey strain, a phylogenetic tree was created using the MEGA-X software with the Maximum Likelihood Method (in 1000 replicates). Our strain was highly identical (> 99.8) to the Italian/Ck/625/16, Polish (Polen5) and some Turkish (Layer-GaHV-2-02-TR-2017, Tr/MDV-1/19) MDV-1 strains. Also, nt and aa sequences of the MEQ gene of our strain were 99.1 and 99.41% identical to another Turkish strain (MDV/Tur/2019) originated from chickens. Sequence analysis of pp38 and vIL-8 genes also supported the above finding. The identity ratios of nucleotide and amino acid sequences of vIL-8 and pp38 genes of MDV-1/TR-21/turkey strain were 99.64-100% and 99.79-100%, respectively, when compared with those of the Polish strain. According to 132-bp tandem repeat PCR results, the MDV-1/TR-21/turkey strain had five copies. CONCLUSIONS: These results suggested that the MDV-1/TR-21/turkey strain obtained from backyard turkeys can be either very virulent or very virulent plus pathotype, though experimental inoculation is required for precise pathotyping.

Detection and molecular characterization of a highly oncogenic Marek's disease virus from vaccinated hens in Turkey.

Marek's disease (MD) is a highly contagious neoplastic disease of chickens associated with economic losses, often due to visceral lymphomas. The etiological agent is MD virus serotype 1 (MDV-1), also called Gallid alphaherpesvirus 2 (GaHV-2). Despite intensive vaccination, MDV is constantly evolving and maintaining its presence in the world. The aim of this study was to genetically analyze a highly oncogenic MDV/Tur/2019 strain obtained from a poultry farm in Turkey's Elazig province in 2019. Genes associated with viral pathogenicity and oncogenicity Marek's EcoRI-Q-encoded protein (MEQ), phosphoprotein-38 (pp38), and viral interleukin 8 (vIL-8) were selected for this purpose. The vIL-8 nucleotide sequence showed high similarity (100% identity) to some European (EU-1, Polen 5) and Asian (03 India, GADVASU-M2) MDV strains. The pp38 nucleotide sequence showed high similarity (100% identity) to some American (CU-2, JM/102W, RB1B) and European (MD70/13, ATE2539) MDV strains. There were no disrupted four-proline molecules (PPPP) within the transactivation domain of the MEQ. However, according to phylogenetic results, the MDV/Tur/2019 strain was included in cluster 2a alongside European MDV strains (Polish, Hungarian, Italian) with very virulent and very virulent plus pathotypes. In conclusion, we believe that the MDV/Tur/2019 strain obtained from turkey herpesvirus (HVT)-vaccinated chickens has a very virulent or very virulent plus pathotype. Although this result provides some clues regarding the virulence of this strain, in vivo studies are needed to achieve exact pathotyping. Further, combination of HVT with the CVI988 strain should be used for vaccination to provide the best protection, as highly pathogenic MDV strains can break sterile immunity against the HVT vaccine. Keywords: GaHV-2; Marek's disease; oncogenes; Turkey.

Molecular Characterization of Hydatid Cysts Cases in a Wild Boar and Mule in Turkey

Objective: Cystic echinococcosis (CE) is a zoonotic infection that affects humans, livestock and wild animals through the larval form of Echinococcus granulosus sensu lato (s.l.). Molecular and taxonomic studies carried out in the recent years accept that Echinococcus granulosus s.l., a complex of 5 cryptic species, causes CE. In this study, we performed morphological and molecular characterisation of cyst isolates obtained from a wild boar and mule naturally infected with hydatid cyst. Methods: After gDNA isolation, the mitochondrial cytochrome oxidase subunit 1 (mt-CO1) gene region was amplified by polymerase chain reaction (PCR) with specific primers. The amplified mt-CO1 PCR products were purified and one-way DNA sequence analysis was performed. Results: Comparison of the partial sequences of mt-CO1 gene from the hydatid cyst isolates with that of reference sequences in GenBank revealed 100% similarity with E. granulosus sensu stricto (G1-G3) sequences. Conclusion: To the best of our knowledge, this is the first study to determine the molecular characterisation of Echinococcus species in a wild boar in Turkey.

Impact of Allergic Rhinitis on Voice in Children.

INTRODUCTION: The purpose of the present study was to determine the possible effect of allergic rhinitis (AR) on voice change in children with acoustic analysis and Turkish children's voice handicap index-10 (TR-CVHI-10). METHODS: This is a case-control study. Forty-one children with AR, and a positive skin prick test, as well as 39 children of controls who had produced a negative skin prick test and lacked a history of allergic disease, were selected for the study. Each assessment included recordings for the purposes of acoustic voice analysis (fundamental frequency [f0], jitter %, shimmer %, and harmonics-to-noise ratio (HNR)), and aerodynamic analysis (maximum phonation time (MPT) and s/z ratio). All participants completed TR-CVHI-10. RESULTS: The mean TR-CVHI-10 score of the AR group was significantly higher than the control group (p = 0.013). No difference was observed between the AR and control groups in terms of jitter, shimmer, HNR, and MPT values and s/z ratio (p > 0.05). Conversely, the f0 value was more pronounced in controls (270.9 ± 60.3 Hz) than in the AR group (237.7 ± 54.3 Hz) (p = 0.012). CONCLUSION: The study's results revealed that AR can have an effect on fundamental frequency and voice quality in children. The diagnostic process should include AR as a potential cause of voice disorders in children.

The Relation Between Otolaryngology-Specific Symptoms and Computed Tomography Findings in Ambulatory Care COVID-19 Patients.

OBJECTIVE: This study aimed to conduct a study to evaluate the relation between otolaryngology-specific symptoms and computed tomography findings in ambulatory care COVID-19 patients. PATIENT AND METHODS: The study was conducted with medical records of 987 (82%) patients with confirmed COVID-19 virus via real-time reverse transcription-polymerase chain reaction between March 11, 2020, and April 21, 2020. Patients were divided into 2 groups as computed tomography (CT)-negative and CT-positive groups considering the presence of the CT findings depicting COVID-19 disease. RESULTS: The mean age was significantly higher in CT-positive group than CT-negative group (41.53 ± 12.82 vs 36.61 ± 11.81, P < .001). Cough and shortness of the breath were observed with a significantly higher rate in CT-positive group than that of CT-negative group (44% vs 29.9%, P = .001 and 18.4% vs 9.7%, P = .002, respectively). CONCLUSIONS: In conclusion, advanced age, cough, and shortness of breath could be related to CT scan positivity.

Lifecycle cost assessment of high strength carbon and stainless steel girder bridges.

This paper addresses the lifecycle cost assessment of a steel girder bridge considering the material costs and maintenance activities along the bridge's lifecycle. A reference highway bridge case study is chosen. It was initially designed using carbon steel S355. Two more steel grades are included in the comparison: high strength carbon steel S460 and duplex stainless steel EN 1.4162. For each design option, fatigue appears to be the driving design criterion for the following critical welded details: transversal stiffeners, cope holes and full penetration butt welds in the flanges. In addition to ultimate limit state verifications, specific attention is therefore given to fatigue through the use of different verification methods: the well-known nominal stress method and the hot spot stress method. It is concluded that the net present value of the lifecycle cost of the stainless steel option is attractive compared to painted the carbon steel options.

Is It Important Which Suturing Technique Used for Pharyngeal Mucosal Closure in Total Laryngectomy? Modified Continuous Connell Suture May Decrease Pharyngocutaneous Fistula.

OBJECTIVE: The aim of this study is to research the correlation between pharyngeal mucosal suture techniques and pharyngocutaneous fistula (PCF) development after total laryngectomy. We also aimed to investigate other risk factor for fistula development. METHODS: Medical charts of 85 patients who had total laryngectomy during August 2016 and February 2020 were reviewed. Sixteen patients were excluded due to exclusion criteria. Patients were grouped according to pharyngeal mucosal suture technique. Group 1 had modified continuous Connell suture and group 2 had interrupted submucosal suture for mucosal closure of pharynx. Demographic, medical, and surgical records reviewed for comparison. RESULTS: Overall PCF rate was 28%;PCF rates were 16% (5/31) in group 1 and 39% (15/38) in group 2. This difference was significant (Pearson χ2 P = .033). There was no difference between groups due to age, gender, smoking history, tumor stage preoperative albumin levels, preoperative hemoglobin levels, radiotherapy status, chronic obstructive pulmonary disorder and diabetes mellitus history of patients, previous tracheostomy, neck dissection. But correlation analysis revealed that PCF formation significantly related with suture technique (P = .032), preoperative albumin level <3.5 g/dL (P = .028), preoperative hemoglobin level <12.5 g/dL (P = .041), and previous radiotherapy status (P = .012) of the patients. We also showed that suture technique is an independent predictive factor for PCF formation when other factors were controlled by univariate analysis. CONCLUSION: The suture technique used for pharyngeal mucosal closure, preoperative albumin level <3.5 g/dL, preoperative hemoglobin levels<12.5 g/dL, and previous radiotherapy to the head and neck are risk factors for PCF development. Modified continuous Connell suture is a good option for pharyngeal closure.

Epithelial-myoepithelial carcinoma on lower lip and microinvasive verrucous carcinoma in vocal cord: Case report.

Epithelial-myoepithelial carcinoma is a biphasic low-grade malignant tumor, which represents approximately 1% of all salivary gland tumors. This tumor occurs mostly in the parotid gland, followed by submandibular gland and minor salivary glands. Women, mostly fifth to the eighth decade of life, are commonly affected. Histopathologically, epithelial-myoepithelial carcinoma is composed of an inner single layer of eosinophilic cuboidal ductal cells and outer single or multiple layers of clear myoepithelial cells. We present a case of a 69 years old man who had a scar on lower the lip for 10 years and voice annoyance for three months. The biopsy for lower lip was reported "infiltrative clear cell epithelioid neoplasm" and vocal cord biopsy result was "verrucous carcinoma". After cordectomy and wedge resection of the lower lip, histopathology revealed Epithelial-Myoepithelial Carcinoma for the lower lip and microinvasive verrucous carcinoma for the left vocal cord. Our case has a very uncommon location and presentation for EMC. The tumor location was minor salivary glands of the lower lip and the clinical presentation was quite different. Coexistence with microinvasive verrucous carcinoma of the vocal cord is the other unique part of our case.

Supraclavicular Flap Reconstruction in Head and Neck Oncologic Surgery.

Free flaps have been considered as the gold standard for reconstruction of head and neck region after ablative oncologic surgery. However, the reconstructive surgeon's armamentarium should also involve pedicled flaps for certain situations such as patients having comorbid diseases necessiating shorter duration of surgical procedure. The supraclavicular flap is a pedicled thin fasciacutaneous flap used to reconstruct the defects in head and neck area. The flap has advantages of wide rotation of arc, easy matching with skin color of recipient area and relatively shorter flap harvesting time. Its bloods supply depends on supraclavicular artery which is a branch of transverse cervical artery. Between August 2016 and September 2019, the pedicled supraclavicular flap was used to reconstruct 17 head and neck cancers patients after ablative oncologic surgery. In 15 patients this flap was primary choice and in 2 patients it was used as a salvage reconstructive tool. Two of 17 flaps had very distal partial necrosis. There was no total loss of any flap. Flap harvesting time was always less than 1 hour. Mean duration for drainage tube removal at the donor side was 5 days. Functional outcomes were perfect. In our suggestion pedicled supraclavicular flap is a very good alternative option to free flap reconstruction especially for skin and oral cavity defects.

Expression of the anti-Mullerian hormone, kisspeptin 1, and kisspeptin 1 receptor in polycystic ovary syndrome and controlled ovarian stimulation rat models.

Polycystic ovary syndrome represents a significant cause of female infertility. The aim of this study was to investigate the expression of anti-Mul-lerian hormone (AMH), kisspeptin 1 (KISS-1), and kisspeptin 1 receptor (KISS1r) in rat models of polycystic ovary syndrome (PCOS) and controlled ovarian stimulation (COS). For this purpose, 28 rats were assigned into four groups. Estrus and Diestrus groups consisted of rats in estrus and diestrus phases, respectively, while COS and PCOS groups consisted of rats with induced COS and PCOS, respectively. The serum AMH, KISS-1, and estradiol levels, and ovarian KISS1r levels were analyzed by enzyme-linked immunosorbent assay. Furthermore, histopathological analysis of the ovary tissue was done and ovarian KISS-1 expression was determined by immunohistochemical assay. The results revealed that ovarian KISS1r levels were higher in the Estrus (1271.43±51.98 pg/mL) and COS (1191.43±85.67 pg/mL) groups, compared to Diestrus and PCOS groups. The highest level of AMH was found in the Estrus group (16.91±2.12 ng/mL). The results indicate that AMH had no effect on the development of COS and PCOS, while KISS-1 was found to affect the development of COS in rats.

A Life Threatening Subglottic and Mediastinal Hemangioma in an Infant.

Subglottic and mediastinal hemangioma are rare benign vascular tumors of childhood. They cause potentially life threatening condition which requires intervention. Several therapeutic options have been described in the literature with varying degrees of success and complications. We report a case of a stridulous 2-month old female infant with mediastinal and subglottic hemangioma. The child was treated with propranolol without the need for tracheostomy or any other surgical intervention, and with no reported side effects. Propranolol is an effective, non-invasive treatment for life threatening infantile hemangiomas compressing the airway, should be used as a firstline treatment for subglottic hemangiomas when intervention is required.

Predictive fiberoptic endoscopic findings of upper airway in children with allergic rhinitis.

OBJECTIVE: To determine predictive fiberoptic findings of upper airway in children with allergic rhinitis. METHOD: 129 children had fiberoptic evaluation of nasal cavity, pharynx and larynx. They were divided into allergic rhinitis group and normal group based on skin prick test results. All video recordings were randomly reviewed by three independent national board-certified otolaryngologists who were blinded to the clinical details and outcomes of the participants' allergy testing. Each physician assessed and documented 10-item questionnaire. Intra-rater, inter-rater reliability and correlation between items and allergic status was calculated. RESULTS: Intra-rater reliability was moderate to perfect for all physicians on all items (kappa = 0.578-0.962). Inferior turbinate hypertrophy (κ = 0.714, p = 0.02), middle turbinate hypertrophy (κ = 0.728, p = 0.01), discoloration of inferior turbinate (κ = 0.685, p = 0.01), adenoid hypertrophy (κ = 0.662, p = 0.02) had good inter-rater reliability and these findings were predictive of allergic rhinitis. Adenoid hypertrophy was less encountered in allergic rhinitis. All other endoscopic findings beyond the nasal cavity were not predictive for allergic rhinitis in children. CONCLUSION: Nasal cavity findings including inferior turbinate hypertrophy, middle turbinate hypertrophy, discoloration of inferior turbinate and adenoid tissue assessment rather than pharyngolaryngeal findings are predictive of allergic rhinitis in children.

Comparison of Voice Quality and Cost Effectiveness of Endoscopic Cordectomy Using Microdissection Electrodes with Laser Cordectomy and Radiotherapy.

OBJECTIVE: To compare the acoustic parameters and the cost effectiveness achieved after endoscopic cordectomy using radiofrequency microdissection electrodes (ECRM) with those of transoral laser cordectomy and radiotherapy. METHODS: The study included 81 disease-free patients previously treated for early larynx carcinoma (30 with ECRM, 27 with transoral laser cordectomy, 24 with primary radiotherapy). Post-treatment voice analysis was performed in all patients. Additionally, the cost effectiveness of all treatment procedures was calculated. RESULTS: The GRBAS (G: Grade, R: Roughness, B: Breathiness, A: Asthenia, and S: Strain) scale showed a significant difference between the groups (p<0.001). The mean values for perceptive assessment score in the radiotherapy group were significantly lower than those in the ECRM group (p<0.05). There were no significant differences between the ECRM group and the transoral laser cordectomy group in terms of the perceptive assessment scores (p>0.05 for all). Percent jitter, percent shimmer and fundamental frequency (F0) were significantly different in the radiotherapy group than the ECRM and the transoral laser cordectomy groups (p<0.05). Maximum phonation time (MPT) in the radiotherapy group was significantly longer than the ECRM and transoral laser cordectomy groups (p<0.001). There were no significant differences between the ECRM group and the transoral laser cordectomy group in terms of the MPT (p>0.05). The mean cost of the ECRM technique was statistically lower than the other treatment techniques (p<0.05). Moreover, the length of hospital stay after ECRM was statistically significantly shorter than was after laser cordectomy (p<0.05). CONCLUSION: Objective and perceptive voice analysis after ECRM showed comparable results with transoral laser cordectomy, but poorer results than radiotherapy. Cost effectiveness of ECRM was found to be better than the other two treatment techniques.

Effect of Hyperbilirubinemia on Medial Olivocochlear System in Newborns.

OBJECTIVES: To evaluate medial olivocochlear efferent system of babies with hyperbilirubinemia with normal auditory brain stem responses. MATERIALS AND METHODS: This was a prospective study in a tertiary referral hospital. The study involved 40 hyperbilirubinemic and 44 healthy newborns. Cochlear and auditory activity of participants was evaluated by transient otoacoustic emissions (TOAEs) and brainstem auditory evoked response components (BAER). Medial olivocochlear (MOC) reflex was evoked with contralateral acoustic stimulation and recorded with TOAEs. RESULTS: A comparison of the MOC reflex activity between two groups with Mann Whitney U test revealed that MOC reflex activity were significantly decreased in the hyberbilirubinemic group for both ears (p<.05). This difference was significant for all frequencies in both ears. There was no significant relation between total serum bilirubin level and MOC reflex activity. CONCLUSION: Hyperbilirubinemic newborns had decreased MOC reflex activity. This may be indicative of future problems in speech discrimination and effective hearing in noisy background. Additional long cohort studies are needed to evaluate the clinical importance of MOC reflex measurements in this group. MOC reflex measurement has the potential to form part of the audiologic evaluation of newborns with hyperbilirubinemia in the future.