Volume 12 Issue 2 (2022)

Nasal chondromesenchymal hamartoma is a benign tumor of the sinonasal tract that arises in young and older children. Here, we report a rare clinical case of nasal chondromesenchymal hamartoma in a 15-year-old patient. After performing the necessary diagnostic tests, surgical treatment was recommended for the patient. In the course of surgery, a mass in the area of the anterior cells of the labyrinth was removed. According to the histological examination of the operative material, the mass had the structure of a chondromesenchymal hamartoma.

Present-day electrode design is the result of 40 years of continuous effort of collaboration between cochlear implant manufacturers and clinicians. There are currently 2 types of electrodes on the market: straight and pre-curved. It is accepted that preservation of intra-cochlear delicate structures should be attempted even in non-hearing preservation surgery. This demands a flexible electrode array to minimize the incidence of electrode scalar translocation. It is known that the neuronal cell bodies are distributed inside the cochlea to an angular depth of 680°, which is equivalent to a linear length of approximately 18-30 mm, considering the overall variation in human cochlear size. This requires electrode arrays in various lengths to match the differences in cochlear size and to cover the majority of the neuronal cell bodies with electrical stimulation. The fixed size and the shape of pre-curved electrodes seems a deficit because it prevents the electrode from tightly hugging the modiolus in every cochlea. This is because it can neither accommodate the size variation of the cochleae nor reach the second turn of the cochlea with electrical stimulation. Nor does it accommodate the special population of patients with innerear malformations, in whom the central modiolus trunk is either fully or partially absent, which demands that electrode contacts are placed proximally to the lateral wall of cochlea. In this case, the straight configuration electrode is a better choice. Explantation of the electrode array years after the implantation should also warrants attention as reports on explantation forces in cochlear models seem to indicate that the force is greater in pre-curved electrode arrays. The future looks promising for drug-eluting electrodes, to minimize the inflammation and to even regenerate neuronal elements, but even when using drug therapy the cochlea should be free from any trauma, as for during reimplantation surgery.

Background: This study aimed to establish average laryngeal measurements in the Turkish pediatric population and measure the narrowest portion of the pediatric airway.

Methods: The laryngeal measurements of 88 pediatric patients between the ages 0 and 17 were retrospectively obtained from neck computed tomography scans performed between January 2018 and May 2021. Subjects were divided into 6 age groups. Four following measurements were made: cricoid anteroposterior, cricoid transverse, subglottic anteroposterior, and subglottic transverse. Cross-sectional areas were calculated using these dimensions. Subglottic cross-sectional area/cricoid crosssectional area ratio for each subject was calculated and patients were divided into 2 groups: group 1, subjects with ratio < 1; group 2, subjects with ratio ≥ 1.

Results: Mean age was 8.97 ± 5.7. Mean anteroposterior diameters at subglottis and cricoid ring levels were 13.74 ± 4.45 mm and 13.26 ± 4.39 mm; mean transverse diameters were 7.88 ± 2.62 mm and 9.06 ± 3.12 mm, respectively. The subglottic anteroposterior diameter was greater than cricoid (P < .001), but the transverse diameter was smaller than cricoid (P < .001). Subglottic cross-sectional area was 93.24 ± 59.20 mm2 and cricoid
cross-sectional area was 103.61 ± 69.15 mm2. Subglottic cross-sectional area/cricoid cross-sectional area ratio was smaller than 1 in 69 subjects (group 1; mean = 0.85) and equal to or greater than 1 in 19 subjects (group 2; mean = 1.33).

Conclusion: The narrowest portion of the airway was subglottis immediately below the vocal cords, in contrast to the common belief as to the cricoid ring. Subglottic cross-sectional area/cricoid cross-sectional area ratios showed that the pediatric airway was larger at cricoid (69 subjects, 78.4%), and this ratio does not differ based on age.

Background: The aim of this study is to evaluate whether there is any correlation among House–Brackmann scoring, elect roneu ronog raphy , and diffusion tensor imaging values of the cisternal and internal auditory canal segment of facial nerve and to examine diagnostic, prognostic, and grading usefulness of diffusion tensor imaging in patients with Bell’s palsy. 

Methods: Thirty-seven patients over 18 years old finally diagnosed as having Bell’s palsy were enrolled in this study. House–Brackmann scoring, elect roneu ronog raphy, and diffusion tensor imaging were performed at 3-5 and 21-24 days of Bell’s palsy onset. The data of diffusion tensor imaging were extracted from a line that starts from the cerebellopontine angle, extends to internal auditory canal, and covers the facial and vestibulocochlear nerve complex using manual or line tractography.

Results: The apparent diffusion coefficient values of the affected nerve complexes measured in initial diffusion tensor imaging studies were significantly higher than those of contralateral nerve complexes (P < .05). The fractional anisotropy values of the affected nerve complexes were also significantly lower than those of contralateral nerve complexes (P < .05). The initial fractional anisotropy values were negatively correlated with initial House–Brackmann scoring (r = −0.35; P <.05) and degeneration indexes of orbicularis oculi and oris muscles (r = −0.36; P < .05, r = −0.35; P < .05, respectively).

Conclusion: Diffusion tensor imaging is giving us beneficial data for understanding the pathophysiology of Bell’s palsy in the acute stage of the disease. House– Brackmann scale and electroneuronography are still the most reliable prognostic and diagnostic tools for patients with Bell’s palsy. Clinical improvement in facial paralysis of patients with Bell’s palsy does not mean radiologic amelioration in diffusion tensor imaging.

Background: In this study, we aimed to investigate the functional and anatomical outcomes of the intact canal wall approach compared to modified canal wall down tympa nomas toide ctomy , for assessing the benefits or disadvantages of canal wall preservation. Methods: Patients who had a tympanomastoidectomy operation either with intact canal wall or canal wall down approach were retrospectively reviewed. The main indications for surgery, recurrent disease, and need for revision surgery, along with graft status for anatomic and air-bone gap and gain in decibel hearing level for hearing outcomes were noted. Results: Of 97 patients, 48 without a cholesteatoma had intact canal wall approach, and among 49 cholesteatoma cases, 36 had intact canal wall and 13 had canal wall down approaches. Recurrence was detected only in 4 cases (11.1%) operated with intact canal wall technique. In all groups, graft success rates were similar. Conversely, regarding hearing outcomes, a significant difference was detected in favor of intact canal wall approach in terms of postoperative air-bone gaps (P = 0.41). Conclusions: Our results showed a significant advantage of intact canal wall procedure in terms of better postoperative air-bone gaps in the functional benefit of our patients. Nevertheless, for a smaller group of patients, a canal wall down approach remains to be the optimum choice in management.

Background: Olfactory dysfunction became increasingly popular as an early symptom of COVID-19 infection, associated with a positive outcome and milder course of the disease. Initial studies suggest that interleukin-6 directly damages the olfactory bulb, thus playing an important role in the mechanism of anosmia. Higher plasma levels of interleukin-6, on the other hand, are related to the severe course of the disease after COVID-19 infection.

Methods: The present study explores the predictive power and the relationship between anosmia and plasma levels of interleukin-6 in 122 patients who were hospitalized with COVID-19 in the period March to November 2021 in the Hospital Base for Active Treatment of Military Medical Academy, Varna, Bulgaria.

Results: The positive correlation between plasma levels of interleukin-6 and disease severity was confirmed. Also, we observed a significant decrease in interleukin- 6 plasma levels during the course of the disease in patients with a favorable outcome. There was no statistically significant difference between plasma levels of interleukin-6 in recovered patients with and without anosmia. We also reported a high percentage of hospitalized and deceased patients with anosmia.

Conclusions: In patients with moderate-to-severe SARS CoV-2 infection, anosmia has not been proven to be a prognostic sign for a positive outcome of the disease. However, our data show that plasma levels of interleukin-6 have good predictive power for the course and outcome of the infection. We found a positive correlation between interleukin-6 and the severity of the disease. Favorable outcome was most often preceded by a rapid drop in interleukin-6 levels.

Background: Clinicians and researchers share their projects in congresses, which are collaborative meetings that enhance the dissemination of information among scientists. Furthermore, critical evaluations of their colleagues help the progress of their research. However, the main focus of any research is publication. In this study, we assess the effect of the European Society of Pediatric Otorhinolaryngology 2018 meeting on the publication rate of abstracts submitted. The aim of this study was to determine whether attending the ESPO 2018 congress had an impact on the publication rate of oral and poster presentations.

Methods: All abstracts submitted to the European Society of Pediatric Otorhinolaryngology 2018 Congress catalog were searched in Google Scholar via corresponding title and author to identify the ones that were published. The date of publication, name, and impact factor of the journals of published articles was recorded.

Results: A total of 785 abstracts (217 oral, 568 posters) were accepted. Of all abstracts, 21.3% (n = 167) were published. Out of all publications, 32% (n = 53) were oral presentations and 68% (n = 114) were poster presentations. There were 62 different journals with an average weighted 3-year impact factor of 2.06 (±1.09 standard deviation). The 3 most common journals were Int J Pediatr Otorhinolaryngol (n = 49, impact factor: 1.64 ), Laryngoscope (n = 12, impact factor: 2.81 ), and Eur Arch Otorhinolaryngol (n = 10, impact factor: 2.16).

Conclusion: Our publication rate of 21.27% is low when compared to oral-only meetings but is similar to others having both oral and poster presentations. We found out that poster presentations reduced the overall publication rate and were published in journals having lower impact factors when compared to oral presentations.