BACKGROUND: To evaluate the long-term functional hearing outcomes of ossicular chain reconstruction using glass ionomer cement (GIC) by comparing preoperative, early postoperative, and late postoperative audiological results. This study presents one of the limited series in the literature reporting very long-term (up to 12 years) audiological outcomes of ossiculoplasty using GIC. METHODS: This retrospective cohort study included 45 patients who underwent ossicular chain reconstruction using GIC between 2012 and 2024. Audiological outcomes, including air conduction (AC), bone conduction (BC), pure tone average, and air–bone gap (ABG), were evaluated preoperatively, early postoperatively (3-12 months), and late postoperatively. Patients were grouped according to follow-up duration as 1-5 years (n=19), 5-10 years (n=12), and ≥10 years (n=14). Changes in audiological parameters were analyzed statistically. RESULTS: A total of 45 patients were included. Significant improvement in AC thresholds and ABG values was observed in the early postoperative period compared to preoperative values (P < .05). In the 1- to 10-year follow-up group, early postoperative ABG results were largely preserved at late follow-up. However, in patients with ≥10 years of follow-up, a statistically significant deterioration in ABG was observed over time. CONCLUSION: Ossicular reconstruction using GIC provides significant early hearing improvement, and these gains are largely maintained in medium-term (1-5 years) and long-term (5-10 years) follow-up. Limited impairment is observed only in very long-term follow-up (≥10 years). Glass ionomer cement remains a highly viable option for limited ossicular defects, offering functional stability for at least 10 years.

Objective: Recently extracapsular dissection (ECD) for the parotid gland neoplasm have gained popularity, but the data about functional outcomes and complication rates are still limited and surgical technique is not standard. In this multicenter study, we have evaluated the safety, complications, utility and functional outcomes of ECD and necessity of drain requirement. Methods: This study was conducted as a retrospective multicenter study and two tertiary academic referral centers were involved. Records of the subjects who underwent extracapsular dissection between January 2015 and January 2017 were reviewed. Demographic data, size and location of tumors, results of fine needle aspiration cytology, intraoperative adverse events such as capsule rupture or facial nerve damage, postoperative complications, results of definitive pathology, and hospitalization time of the subjects were reviewed. Results: A total of 37 subjects were included in the study. There were no subjects with permanent or transient facial nerve dysfunction in either group. No patient complained of symptoms of Frey syndrome. Seroma developed in two of 37 patients. No recurrence has been encountered during the follow up period (min: 36 and max: 72 months). Conclusion: ECD is a safe technique with very low complications rates according to our results. Even without facial nerve monitoring, ECD could be performed without any damage to the nerve, if surgeon is experienced. Preoperative evaluation is important and patients with small, mobile and solitary benign parotid lesions are good candidates for ECD.

Purpose: The aim of this study was to identify the clinical and pathological features of patients with huge goiters and to investigate the relationship between tumor size, retrosternal extension, and the incidence of postoperative complications. Materials and Methods: All patients with huge goiters in the 5 years from 2018 to 2023 were reviewed in retrospect. The patients' clinicopathological and demographic details were recorded. Data from computed tomography scans were used to select the study patients. The study covered patients whose thyroid gland size was greater than 10 cm. Results: The study comprised 33 patients who met the inclusion criteria. Dyspnea was the most frequent symptom of compression (75.7%). Tracheal compression was observed in 15 cases (45.4%). Nineteen patients (57.5%) had retrosternal extension. Two patients experienced permanent recurrent laryngeal nerve paralysis postoperatively, while eleven patients exhibited transient hypocalcemia. No significant differences were found between male and female patients regarding clinicopathological characteristics and complications. Furthermore, there was no evidence indicating that retrosternal extension or increased goiter size elevated the risk of complications. Conclusion: Surgery remains the most effective way to quickly relieve compression symptoms in patients with huge goiters. Our experience indicates that thyroidectomy via a cervical incision can be safely conducted in nearly all patients with huge goiters, regardless of the presence of retrosternal extension, without elevating the risk of complications.

Advanced-stage laryngeal squamous cell carcinoma (LSCC) carries a poorprognosis despite advances in surgical and adjuvant therapies. Identifying reliable prognostic markers remains critical to improving risk stratification and tailoring treatment strategies. This study evaluated the prognostic significance of inflammatory and nutritional markers, notably the Prognostic Nutritional Index (PNI) and modified Glasgow Prognostic Score (mGPS), alongside conventional pathological parameters in patients undergoing total laryngectomy. A retrospective cohort study was conducted on 111 patients with locoregional advanced LSCC treated with primary total laryngectomy between 2013 and 2020. Clinical, histopathological, and laboratory variables were analyzed. Survival outcomes were assessed using Kaplan–Meier analysis and log-rank tests. Multivariate prognostic factors were identified through Cox proportional hazards modeling. PNI < 45 was significantly associated with increased mortality (p = 0.001) and inferior mean survival (62 months vs. 98 months for PNI ≥ 45). In multivariate analysis, PNI < 45 (HR = 0.375; p < 0.001) and lymphovascular invasion (HR = 0.372; p = 0.012) emerged as independent predictors of overall survival. While nodal metastasis correlated with poor survival in univariate analysis, it did not retain significance in the multivariate model. Traditional inflammatory markers (mGPS, NLR, PLR) did not demonstrate prognostic relevance. Furthermore, PNI < 45 was associated with an increased risk of pharyngocutaneous fistula formation (p = 0.007), although neither fistula presence nor postoperative complications correlated with disease recurrence or survival. PNI and lymphovascular invasion are robust independent predictors of survival in patients with advanced LSCC undergoing total laryngectomy. Unlike mGPS, NLR, or PLR, PNI offers a simple, cost-effective prognostic tool that captures nutritional and immunological status. Integrating PNI into clinical practice may enhance individualized risk stratification, and prospective trials are warranted to explore whether preoperative nutritional optimization can improve outcomes in this high-risk population.

Purpose: This study assessed the influence of external carotid artery (ECA) versus combined ECA and internal carotid artery (ICA) supply on surgical outcomes of Juvenile nasopharyngeal angiofibroma (JNA). Materials and Methods: This retrospective observational study included patients with juvenile nasopharyngeal angiofibroma who underwent preoperative transarterial embolization followed by endoscopic resection between 2007 and 2025. Patients were stratified by vascular supply (ECA-only vs. ECA+ICA) and Andrews-Fisch stage. Demographic data, intraoperative blood loss, and residual tumor status were retrospectively analyzed. Results: The mean age was 17.7 years (range 9-62). Age and ECA branching patterns did not differ significantly between groups. All stage I-II tumors were supplied exclusively by the ECA, whereas stage III-IV tumors showed both ECA-only and ECA+ICA supply. Mean intraoperative blood loss did not differ significantly between vascular groups but was markedly higher in stage III-IV disease than in compared with stage I-II. Residual tumor occurred only in patients with ECA+ICA supply. Conclusion: ICA contribution is strongly associated with advanced-stage JNA and increased risk of residual tumor, although it does not significantly elevate intraoperative blood loss. These findings highlight tumor stage as the main predictor of bleeding and completeness of resection.

OBJECTIVE:This study evaluates the prognostic significance of systemic inflammatory markers ‒ NLR, LMR, PLR, and SII ‒ in patients with SSNHL. METHODS:This retrospective study included 120 patients diagnosed with SSNHL at the Otolaryngology Department of Hospital. Medical records from both SSNHL and healthy control groups were reviewed to collect demographic data, pure tone audiometry results, and routine blood parameters. Hearing recovery was assessed at baseline and after two months using Siegel's criteria, and patients were categorized as either recovered (complete, partial, or slight recovery) or unrecovered. RESULTS:Compared to controls, SSNHL patients showed significantly elevated neutrophil counts, platelet levels, NLR, PLR, and SII values. Statistically significant differences were observed between recovered and unrecovered groups in neutrophil count (p = 0.021), lymphocyte count (p = 0.001), PDW (p = 0.042), NLR (p = 0.001), PLR (p = 0.001), LMR (p = 0.001), and SII (p = 0.001). Logistic regression analysis identified low LMR as a significant independent predictor of poor prognosis (R² = 0.271). CONCLUSION:Elevated NLR, PLR, and SII values may reflect inflammatory processes and microvascular dysfunction in SSNHL. Among these, LMR emerged as a novel and potentially valuable prognostic biomarker for predicting treatment outcomes. LEVEL OF EVIDENCE: 3:

Objective: This study investigated whether attention-deficit hyperactivity disorder (ADHD) has an olfactory dysfunction and, if so, the effect of methylphenidate on this condition. Methods: The “Sniffin” Sticks Test and a questionnaire were applied to 50 children with ADHD and 50 healthy children as the control group before and after being treated with methylphenidate. Results: There was a statistical difference between ADHD and control groups in odor sensitivity, odor discrimination skills, and odor identification tests ( P < .001). General odor scores decreased in the ADHD group ( P < .001). A statistically significant score increase was also observed after treatment ( P < .001). There was no statistically significant difference between the groups in the taste questionnaire test. Conclusions: Although the sense of smell test in our study suggests that it may be a biological marker for diagnosing ADHD, treatment efficacy, and follow-up, further studies need to be conducted in more extensive series and with similar equipment.

Our aim was to analyze the patients with diabetic rhino-orbital–cerebral mucormycosis that we have treated in our clinic in the last 5 years, and to reveal the altering conditions with COVID-19. A retrospective study was conducted on 39 rhino-orbital–cerebral mucormycosis (ROCM) patients with diabetes mellitus between 2017 and 2022. The patients were divided into two groups as those associated with and not associated with COVID-19 and compared. Thirty-nine diabetic patients were included in the study, with 15 (38.5

To evaluate the predictive value of CD44 and aldehyde dehydrogenase 1 (ALDH1) expression for prognosis and radiotherapy (RT) response in patients with early-stage laryngeal cancer receiving RT. Forty-four patients with early-stage laryngeal cancer diagnosed between 2002 and 2016 were included in the study. The correlation between RT response and pre-treatment immunohistochemical ALDH1 and CD44 staining was evaluated. In addition, survival times were compared between groups. The mean age of the 44 patients was 59.8 ±9.0 (43-81) years and 41 were male. There were 20 patients in the non-recurrent group (all men) and 24 patients in the recurrent group (21 men). Immunohistochemical positivity for ALDH1 was found to be a significant risk factor for RT failure (p = 0.0001), whereas CD44 positivity (p = 0.114) and age group (p = 0.287) were not significant. ALDH1 positivity was identified as a significant predictor of DFS and RT sensitivity, while CD44 positivity did not differ according to RT response.

Background: Cochlear implants are arguably the most successful neural prosthesis today. Cochlear implantation has several difficulties in patients with internal ear anomalies. This study was performed to analyze intraoperative, postoperative findings, and auditory performance of 55 patients who had inner ear malformations and were treated with cochlear implants at Otorhinolaryngology Department of Çukurova University Hospital. Methods: Auditory performances were analyzed in 30 of 55 patients. Patients with cochlear anomalies were evaluated as group I, patients with vestibular malformation as group II, and patients with the normal bone labyrinth as group III. Listening progress profiles and meaningful auditory integration scale tests were used to determine performances. Results: Comparison between the listening progress profiles test performance of the groups at 12th and 18th month of group I was significantly lower than other groups (P < .05) and reached at the same level after the 24th month. Comparison between the meaningful auditory integration scale test performance of groups at 24th and 36th month of group I was significantly lower than other groups (P < .05). Perilymph gusher was observed in 3 patients who had incomplete partition I malformation. Oozing was observed in 50% of incomplete partition II patients. Facial nerve traced a variant course in 4 of 55 patients and 6 patients had postoperative meningitis. Conclusion: Initially patients with inner ear anomalies showed that the level of language development was worse than patients with normal bone anatomy. However, it was shown that they both reached the same point as a result. Facial nerve anomaly and meningitis risk is higher in patients with inner ear malformations.

Aim: Acute invasive fungal rhinosinusitis (AIFRS) which is a serious disease with a high morbidity and mortality rate is mostly seen in diabetic and immunocompromised patients.Methods: In this study, seventeen diabetic patients who were treated for AIFRS in Çukurova University Faculty of Medicine, Department of Otorhinolaryngology between January 2010 and January 2020 were retrospectively analyzed from medical records.Demographic characteristics, risk factors, complaints at presentation, age at diagnosis, localization of fungal sinusitis, operation type, preoperative examination and lesion extensity, factors affecting prognosis and treatments of the patients were evaluated.Results: The mean age of the patients was 52 years.47% (n:8) of the patients were female and 53% (n:9) were male.All patients were diabetic, 2 patients had additional chronic renal disease and 1 patient had chronic liver disease.The most common presenting symptoms of patients with AIFS were facial swelling and pain (58.8%), periorbital edema (41,1%) and fever (35.2%).We performed endoscopic sinus surgery in 12 patients, open and endoscopic sinus surgery in 5 patients and orbital exenteration in 4 patients.The overall survival rate was 53%.Intracranial extension, high HbA1c level and advanced sinonasal involvement were found to be poor prognostic factors.Conclusions: Acute invasive fungal rhinosinusitis is still a disease with high mortality despite surgical and medical treatment.Because of diabetes-related immunosuppression, when any sinonasal symptoms and signs observed in these patients, clinicians should raise suspicion for invasive fungal rhinosinusitis.

BACKGROUND Mucormycosis is a fatal invasive fungal infection seen most often in patients with compromised defense mechanisms. The aim of this article was to review the data of pediatric mucor in the South of Turkey. METHODS Twenty pediatric cases with biopsy proven mucormycosis were reported, between January 2007 through January 2017. Data were extracted from the medical charts of patients retrospectively. RESULTS Underlying conditions were hematological malignancy (75%), in whom 93% had acute leukemia, aplastic anemia (15%), diabetes mellitus (5%) and other malignancies (5%). The main sites of infection were sinus (85%); alone (29.4%) or with cerebral (17.6%), and orbital involvement (17.6%). Pulmonary involvement was reported in 11 patients (55%), two of them had the alone form and nine cases were associated with nasal sinus involvement. Disseminated mucormycosis was documented in 45%. Fever and pain/swelling of organs were the most commonly encountered signs and symptoms. Treatment compromised of am-photericin B monotherapy in five patients. All patients except one received liposomal formu-lations (LAmB). A combination of surgery and antifungal therapy was performed in 75%. Crude survival was 55%; among 15 cases treated with a combination of surgery and antifun-gal therapy, survival rate was 8/15 (53%). The overall mortality rate was high in patients diagnosed with disseminated infection (100%). CONCLUSIONS Mucormycosis in pediatric cases requires a high index of suspicion and urgent evaluation of clinical samples. Surgical debridement should be considered when feasible. Initial medical therapy should include an amphotericin preparation with or step-down to posaconazole.

Objective: This study aimed to comparatively analyze the indications, treatment outcomes, and reliability levels of the intraductal pneumatic lithotripsy (IPL) and holmium laser-assisted lithotripsy (HLL) methods that are used to sialendoscopically separate stones into smaller pieces in submandibular gland sialolithiasis (SMGS) patients. To the best of the author's knowledge, there is no study that compared these 2 methods in the literature in English. Methods: The retrospectively designed study included 51 patients with SMGS. The IPL was used to break up 32 stones in 28 patients, while HLL was used to break up 28 stones in 23 patients. Results: The stones could be completely extracted in 95.6% of the patients in the HLL group, 92.8% of those in the IPL group and 94.1% of all patients. The complete and partial recovery rates of the patients were respectively 91.3% and 8.7% in the HLL group and 92.8% and 7.2% in the IPL group. There was no significant difference based on the lithotripsy method that was used in the patients’ laterality of stones, location of stones, stone diameter, operation time, need of papillotomy and silicone stent, complete removal status of stones and the symptomatic assessments of the patients in the 6th postoperative month. Conclusion: This study showed that both HLL and IPL treatments are effective, minimally invasive, and promising methods in difficult/complex SMGS treatments which may provide success rates of higher than 90% when they are performed by an experienced surgeon and by selection of appropriate patients.

Background: Soft tissue sarcomas are a highly heterogenous group of tumors that are classified by differentiation. Their invasive or destructive growth pattern, recurrence and distant metastatic capacity are variable according to their subtype and also their localization. Aim: The aim of this study is to evaluate clinical characteristics, histopathologic subgroups, therapeutic modalities and clinical course of head and neck sarcomas. Study Design: Retrospective study and review of literature Materials and Methods: Patients with head and neck sarcomas who underwent surgery at XXXX University, Faculty of Medicine, Department of Otorhinolaryngology between 2007 to 2016 were retrospectively evaluated. Demographic features of the patients, histopathologic subtypes, immunohistochemical markers, locations of the tumor, type of surgery, margins of the specimens, type of reconstructive surgery and type of adjuvant treatment were reviewed. Results: The histopathologic subtypes were rhabdomyosarcoma, primitive neuroectodermal tumor, osteosarcoma, chondrosarcoma, leiomyosarcoma, Ewing’s sarcoma and synovyal sarcoma. The most frequent site was nasal cavity and was detected in 7 cases. Local recurrence developed in three patients. Conclusion: Sarcomas of the head and neck region are relatively rare tumors. Radical resection of the tumors is essential for these cases.

ObjectiveThe aim of this study was to determine the short- and long-term complications after cochlear implantation (CI) procedures and to discuss the management and prevention of these complications.MethodsThe study included a total of 1452 pediatric and adult cochlear implantation procedures performed in our clinic from March 2000 through September 2019. Of the 1452 implantations, 1201 were performed in children and 156 in adults. The minimum follow-up period was three months and maximum was 19 years. The mean age of the patients was 6.7±3.9 years (range, 10 months-69 years) at the time of their respective procedures. Complications were classified as major complications requiring reimplantation, major complications not requiring reimplantation and minor complications. All postoperative complications and treatment methods were examined.ResultsA total of 148 (10.1%) complications were observed in the 1452 cochlear implants. Of these, 69 (4.75%) were major and 79 (5.44%) were minor complications. While 40 (2.75%) of the major complications required reimplantation, 29 (1.99%) did not. The most common cause of major complications leading to reimplantation was device failure (29 patients, 1.99%). The most common cause of minor complications was hematoma (21 patients). Total complication rates (6.68%) were significantly higher in children than in adults (3.51%) (p=0.00).ConclusionOur 19 years of clinical experience has shown that CI is a successful and safe procedure that can be performed with low major complication rates. It is important to know the possible complications and to manage them correctly.

Meniere Hastaligi, epizodik spontan vertigo ataklari, genellikle tek tarafli fluktuasyon gosteren isitme kaybi, aural dolgunluk ve tinnitus ile karakterize bir ic kulak hastaligidir. Semptomlarinin cok iyi bilinmesine ragmen, gunumuzde halen tani konulmasi zor bir hastaliktir. Kesin tanisi sadece postmortem inceleme ile histopatolojik olarak konulabilmekte ve tedavisi de klinikler arasi farkliliklar gostermektedir. Bu makalede Meniere hastaliginin tani ve tedavisindeki son gelismeler, yeni klavuz ve metaanaliz calismalari gozden gecirilerek sunulmustur.

Introduction: Human papilloma virus is an etiological risk factor for a subset of head and neck squamous cell carcinomas. HPV has been proven to be a powerful prognostic biomarker for oropharyngeal cancer, but its role in the larynx has not been explored in depth. The developmental mechanisms of laryngeal carcinomas are quite complex and controlled by various factors. Smoking and alcohol are most important risk factors. Recent studies indicate that HPV infection also plays an important role in larynx carcinomas. HPV related laryngeal carcinomas especially occur at the supraglottic region of larynx. Objective: We aimed to determine the frequency of HPV/protein 16 positivity in patients with laryngeal carcinoma and association of HPV and/or p16 positivity with variables such as age, sex, smoking habits, tumor localization, lymph node metastasis, recurrence and survival in advanced stage laryngeal carcinoma in our study. Methods: This retrospective study included 90 patients with advanced laryngeal carcinoma. The Control group was 10 normal larynx mucosa specimens. The presence of HPV was investigated polyclonally by polymerase chain reaction, and protein16 with immunohistochemical method. In HPV positive cases, the presence of HPV types 16, 18 were evaluated by polymerase chain reaction. Demographic features of patients were noted. Patient survival and association with HPV/protein16 was determined. Results: Polyclonal HPV positivity was detected in 11 (12.2%) of 90 cases. Out of these 11 cases, HPV 16 was positive in 6, HPV 18 in 4, and both HPV 16 and 18 were positive in 1. In 18 (20%) of the cases, p16 was positive. Six of the cases (6.6%) had both HPV and protein 16 positivity. In cases where protein 16 alone or HPV and protein 16 were co-positive, alcohol use was less and the tumor was found more likely to be localized in the supraglottic area. These ratios were statistically significant. Supraglottic localization of tumor was determined to be increased in proteinl6 positive cases. The correlation between protein 16 positivity and supraglottic area location was determined to be statistically significant (p= 0.011). 55.6% of protein 16 positive cases was located in the supraglottic region, 33.3% was glottic and 11.1% was transglottic. Although life expectancy over 5 years were numerically higher in HPV and protein 16 positive cases, this was not found to be statistically significant. There was no statistically significant relationship between HPV positivity and mean age, differentiation, smoking and alcohol use, tumor progression, lymph node metastasis, localization, recurrence, cause of mortality and treatment methods in our study. The mean follow-up period of our patients was 6.7 years. Conclusion: The close relationship between HPV and oropharyngeal squamous cell carcinoma could not be shown in larynx malignancy in many studies, including our study. Our findings support a limited role of HPV in laryngeal carcinogenesis. Protein16 is not a reliable surrogate for HPV status in laryngeal cancers and is not a predictor of laryngeal cancer survival. Supraglottic localization of tumor was determined to be increased in protein16 positive cases. The correlation between protein16 positivity and supraglottic area location was determined to be statistically significant. There is a need for more populated clinical trials, where neoplastic proliferation is better demonstrated and the accuracy of the results obtained is supported by different techniques. (C) 2019 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.