This study aimed to compare daily and total recreational music exposure levels and extended-spectrum audiogram results in young adults without pre-existing hearing problems. The study included healthy volunteers aged 18–25 with no known ear disease or hearing loss. Participants completed a questionnaire, underwent otoscopic and tympanometric examinations, and determined preferred music volumes in an audiometry booth using calibrated music samples of their preferred genres. Hearing thresholds up to 16 kiloHertz (kHz) were measured. Daily music exposure for each participant was normalized to 8 h to calculate a time-weighted average of 8 h (TWA8). Total exposure (TE) was calculated by multiplying TWA8 by the number of years of music listening. A total of 32.4

Objective: In this study, we described the boomerang suture technique to attach the nasal septum to the anterior nasal spine. We evaluated its outcomes and compared it with the traditional figure-of-8 suture technique. Methods: This study was carried out on 80 patients who underwent nasal surgery (boomerang suture in 40 patients and figure-of-8 suture in 40 patients) between September 2016 and January 2019. The decision to use the boomerang suture or figure-of-8 suture technique was randomized in a sequential fashion. The detected deviations and applied septoplasty methods were given. The surgical results were determined by the independent observers’ scorings. The Nasal Obstructive Symptom Evaluation scale was applied before and 1 year after surgery. A computer simulation was utilized to analyze the features of the techniques. Results: The most commonly used technique was the swinging door in 39 cases. Postoperative Nasal Obstructive Symptom Evaluation scale values were statistically lower than preoperative in both groups (P < .001). Surgical success rates for boomerang suture and figure-of-8 suture techniques were 97.5% and 87.5%, respectively, which were not statistically significant (P=.201). Boomerang suture can produce 4.3 times more vertical vectors than figure-of-8 suture, and figure-of-8 suture causes 3.7 times more torque in the same amount of misalignment in the biomechanical analysis. Conclusion: The boomerang suture and figure-of-8 suture are very successful techniques to fix the nasal septum. The boomerang suture technique, which creates a much larger vertical vector and less rotational force than the figure-of-8 suture, was also more successful, although it was not statistically significant. Cite this article as: Özer S, Ergun O, Jafarov S, Emre Süslü A, Yılmaz T, Metin Önerci T. Comparison of the novel “boomerang suture” technique used in fixing the nasal septum to the anterior nasal spine of the maxilla with figure-of-8 suture. B-ENT 2022;18(3):147-153.

Purpose In this study, we proposed a "sliced-partial thickness cartilage graft" for nasal contour restoration purposes and compared the long-term graft survival and histological changes of sliced, crushed, and intact cartilage grafts. Methods Nasal septal and auricular cartilage grafts were harvested from 8 rabbits. Sliced, crushed, or intact cartilage grafts were measured in thickness with a micrometer and re-implanted. 4 months later, specimens were histologically evaluated and thickness were measured. Results Both nasal septal and auricular crushed cartilage lost significantly more chondrocytes than sliced samples together with fibrosis, multiple fracture lines, and even ossification. Sliced and intact cartilages were histologically similar except sliced cartilage had some minor changes limited to its cut surface. Sliced cartilages retained their thickness, histology, and structural properties in the long term similar to intact cartilages whereas -contrary to expectations- crushed specimens had significantly higher thickness measurements at the end of 4 months. Conclusion Sliced cartilage grafts prepared with an atraumatic cartilage slicer are an ideal camouflaging material with its uniform thickness, and malleability. Crushed cartilages seemingly getting thicker without histological findings could be explained by lower than actual initial measurements due to its structural weakness and getting squeezed when the standard pressure of the micrometer was applied.

OBJECTIVE:The aim of this report is to share our experience and treatment outcomes with far-advanced otosclerosis (FAO) patients.METHODS:Patients that underwent surgery from 2003 through 2014 at a tertiary referral center were retrospectively reviewed. Nineteen FAO patients were included in the study. Audiological results and the ability to communicate face to face and over telephone were considered as the main outcome measures.RESULTS:Six FAO patients benefited well from stapedotomy with an average of 5.9-decibel (dB) air-bone gap and 86% median speech discrimination. Cochlear implantation (CI) was performed in 13 patients; two had disease progression after stapedotomy, five had failed stapes surgeries elsewhere, and six preferred CI as primary treatment. Median speech discrimination score of CI patients was 78.4%. Overall, all patients had satisfactory face-to-face communication and 90% could use telephone.CONCLUSION:Bilateral stapedotomy and wearing hearing aid is an effective and cost-effective solution for restoring natural binaural hearing and requires no specific training. Should stapedotomy fail, cochlear implantation is always a successful back-up option.

Purpose: The risk of sensorineural hearing loss (SNHL) as an acute otitis media (AOM) complication is a well-recognized condition. Here, we present a sudden sensorineural hearing loss due to acute otitis media in a patient with cochlear otosclerosis (COS). We hypothesize that the demineralization of otosclerosis around cochlea may have constituted a weak spot and facilitated the crossing of noxious substances into the inner ear. Although many possible means of connection between the middle ear and inner ear has been described, an increased risk of SNHL as an otitis complication at COS patients has not been mentioned in the literature. In order to decrease this risk, preventive pneumococcal vaccination should be offered to COS patients and in an event of AOM, a more aggressive treatment approach should be considered including early myringotomy together with antibiotics.

Objective: The objective of this study was to review the management of deep neck space infections in pediatric patients and to evaluate the efficacy of intravenous antibiotic treatment alone before surgical drainage, and also to point out the indications for the drainage. Methods: We reviewed sixty pediatric cases who were treated in our clinic because of deep neck space infections. The details of demographic data, medical history, initial complaints and physical examination, radiological examination, microbiology and laboratory results (C-reactive protein level and leukocyte count), treatment modality and follow-up findings were collected. The bacteriological results, management, complications, follow-up data and outcomes were also noted. A basic treatment algorithm for the management of the pediatric deep neck space infections was constituted. Results: In 47 (78.3%) of the children, infection did not require any surgical intervention or puncture - in other words, needle aspiration - and it was successfully treated with antibiotic therapy alone. Fifty-six patients (93%) were initially treated with sulbactam-ampicillin. Conclusion: We advise surgical drainage in cases of fluctuating large abscesses and infections without clinical improvement despite antibiotic treatment, and in complicated or life-threatening cases such as retropharyngeal abscess and mediastinitis. An otolaryngologist should be patient before any surgical intervention.

Introduction: Petrous temporal bone cholesteatoma (PTBC) poses a significant management challenge. The location and nature of the disease as well as surgery carry risks to vital anatomical structures with potential impact on quality of life. Traditionally an aggressive surgical approach has been used. We present our series of PTBC; their classification, management, hearing and facial nerve outcomes.

PURPOSE:The aim of this study was to determine the correlation between acute invasive fungal rhinosinusitis (AIFRS) and underlying diseases, micro-organisms, presenting symptoms, extent of disease, radiologic findings, and outcomes and propose a new classification system. MATERIALS AND METHODS:The data of 19 AIFRS cases were analyzed retrospectively. Magnetic resonance imaging and computed tomography were performed in all patients preoperatively. All patients underwent at least 1 surgical debridement. RESULTS:Hematologic diseases were the most common (52%) underlying diseases. Patients with type 2 diabetes and those with multiple etiologies causing immunosuppression had the lowest survival. Aspergillus and Mucoraceae species were isolated in 9 patients but were not associated with poor prognosis. Headache and nasal discharge or crusting were the most common presenting symptoms. Premaxillary involvement was significantly correlated with poor prognosis (P = .001). Unilateral involvement was correlated with poor prognosis, although this finding was not significant (P = .111). The overall mortality rate was 61.2%. Patients with neutropenia that was corrected had 80% survival (P = .014). Cessation of corticosteroids and regulating blood glucose levels in patients with immunosuppression from corticosteroid use resulted in 75% survival. CONCLUSION:There is no single curative treatment for AIFRS. For a favorable prognosis, underlying conditions must be treated in addition to surgical debridement and antifungals.

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Synchronous tumors of the parotid gland are two or more neoplasms originating from different sites of the gland, making up less than 1% of all parotid tumors, most frequently as Warthin tumors at more than one site. In this study, 3 cases of synchronous parotid tumors out of 193 parotid surgeries performed between 2004-2010 in our clinic will be presented with their clinical, radiological and histopathological findings, and discussed according to the current literature. The first case was diagnosed as synchronous parotid tumor in composition of pleomorphic adenoma and Warthin tumor. The second case was Warthin tumor at 2 different sites, and the third case was a salivary duct carcinoma with Warthin tumor. Synchronous tumors, despite being rare, are remarkable as they can affect the prognosis and should be kept in mind during the differential diagnosis of parotid tumors.

Purpose: The aim of the study is to compare long term otoscopic and audiological findings of cleft palate patients with or without early grommet insertion.Methods: Cleft palate patients followed-up in Hacettepe University between 2008 and 2013 were included in the study. Age, gender, cleft types and palate surgery data, grommet tube insertion history and otological audiological evaluations of the patients were recorded. Patients were evaluated in three groups according to grommet insertion history: A-early routine grommet insertion, B-grommet insertion during follow-up, C-no grommet insertion. Otological and audiological findings were compared.Results: There were 154 patients in the study, with a median age of 7.7 years. There were 67 patients in group A (43.5%), 22 patients in group B (14.3%) and 65 patients in group C (42.2%). OME was identified significantly higher in group A and normal otoscopic examination findings were higher in group C. Complications showed a higher rate than other otoscopic findings in group B patients. There was no significant difference for any frequencies in between the groups in terms of mean air-bone gap (ABG) values. There were 20 grade I, 25 grade II, 77 grade III and 32 grade IV patients in the study according to the Veau classification.Conclusion: Prophylactic grommet insertion may not be applied as some cleft palate patients with no OME. Wait and see protocol can be recommended for these patients, and they should be followed-up up closely to avoid complications. If the effusion does not recover or tympanic membrane changes occur in follow-up, grommet insertion should be considered. (C) 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Infectious diseases are important causes of granulomatous diseases of the nasal cavity and paranasal sinuses. The most frequent bacterial agents responsible for granulomatous infections are Mycobacterium species (spp.) and Actinomyces spp. In the case of fungal pathogens, Aspergillus spp. are the most frequent. Mucor spp., Cryptococcus spp. and Histoplasma spp. are the other fungal microorganisms causing granulomatous reactions. In this case report, a patient suffering from a chronic nasal cavity lesion for 4 years with a recently developed premaxillary skin lesion is presented. Despite many biopsies having been performed and pathological studies conducted, a definitive diagnosis and an effective treat-ment could not be achieved. Finally, Aspergillus growth was observed in the fungal growth media when the material of the last skin biopsy was sent to microbiology as well as pathology. The patient was diagnosed as "chronic nasal fungal infection" and voricanozole treatment was initiated. Nine months after therapy, symptoms were almost totally resolved. In order to prevent similar difficulties of differential diagnosis, biopsy materials should be sent for aerobic, tuberculosis and fungal cultivation, as well as pathological examination, in order not to miss infectious diseases from the aetiology.