Volume 9 Issue 1 (2019)

Objectives: Bronchiectasis typically manifests with persistent coughing, pus-filled discharge, lethargy, dyspnoea, sternal pain, haemoptysis and dilated airways. Such symptoms can adversely affect the quality of life and voice characteristics of sufferers from bronchiectasis. This study had as its objective the objective comparison of vocal differences between healthy children and those with bronchiectasis.

Methods: The parameters examined were jitter, percentage jitter, shimmer, noise-to-harmonics ratio (NHR), voice turbulence index (VTI), and soft phonation index (SPI). Data from the cases and controls were compared by means of paired t-tests.

Results: The mean age for the cases was 11.53 years. In terms of absolute jitter, percentage jitter, shimmer and SPI, no differences were detected at the level of statistical significance. However, the NHR and VTI did differ between cases and controls at the level of statistical significance.

Conclusion: The research reveals that an holistic approach has an influence on patient outcomes. Sufferers from bronchiectasis experience vocal alterations, especially with respect to NHR and VTI, the values of which were raised in comparison with healthy controls.

Objective: The aim of the the study was to compare CT-obtained measures related to the cross-sectional area of the airway at various points (nasal valve, mid-nasal cavity, choanal, retro-lingual and retro-uvulal) in cases of obstructive sleep apnoea (OSA) with their values in normal controls. Such abnormal values may act as markers of risk for OSA.

Methods: CT (computerised tomographic) imaging from 27 cases of OSA attending the Otorhinolaryngology Dept. of the Adana City Training and Research Hospital were evaluated retrospectively, alongside 9 normal controls.

Results: the means of the nasal valve and choanal cross sectional areas differed from the normal control means at the level of statistical significance (p=0.019 and p=0.012, respectively).

Conclusion: The authors hypothesize that the area of the nasal valve and the choanae have a bearing on the likelihood of developing OSA, but state that further research involving larger populations is needed to draw firm conclusions.

Purpose: This study aimed to elucidate how histopathological findings relate to the existence of metastases in lymph nodes in a cohort of surgical cases with squamous cell carcinoma of the larynx.

Material and Methods: A cohort of cases from the ENT department, who had partial or total laryngectomy and dissection of the neck in the period spanning January 2008 to June 2017 were evaluated retrospectively. 150 cases were deemed appropriate for inclusion in the study. The histopathological notes and clinical findings of these cases were compared to each other.

Findings: The glottic group had lower levels of lymphovascular invasion (p<0.05). Tumours staged at T3 or T4 level or endophytic in subtype were, however, more likely to have lymphovascular invasive features (p<0.05). For neoplasms with a high degree of differentiation, it was less frequent to observe invasion of lymphatics, metastasis to the cervical nodes or invasion beyond the capsule (p<0.05). Perineural invasion was not associated with a greater risk of the neoplasm metastasizing to the cervical lymphovasculature, but invasion of the lymphatics did signal an increase in metastasis (p<0.05).

Conclusion: Cervical lymphatic metastasis of squamous cell carcinoma of the larynx has a high degree of correlation with histopathological grading.

Objective: The study compares the histological appearances of an induced open wound injury as it heals in rabbits, where healing was assisted by either Batticon (a topical antiseptic solution), or Glubran (a surgical glue).

Materials And Methods: The study protocol was first approved by the Research Ethics Committee of Çukurova University. Twenty-eight rabbits with a weight of between 3 and 4kg, of female sex, were subjected to handling every day for a fortnight preceding the experimental injury so that they could be behaviourally assessed. Seven of the 28 rabbits acted as controls, with the 21 others put into one of 3 groups, depending on the day they were to be sacrificed. For the control animals, a portion of the external ear was excised and examined histologically alongside the intervention group animals, to allow comparisons to be made. The intervention group underwent exposure of a 1cm2 area of epidermis bilaterally. The resulting open injury was then treated on one side with topical antisepis using Batticon and on the other with the Glubran tissue glue. At days 2, 4 and 6 post-surgery, the rabbits were sacrificed and sections of the open wound were viewed with the electron microscope. The control group was also examined histologically for comparison.

Results: The sections from ears treated with Glubran had electron microscopic appearances indicative of more extensive regeneration than those where Batticon was used at days 2, 4 and 6.

Conclusion: The results of the study show that N-butyl-2-cyanoacrylate (Glubran) is suitable for the treatment of open injuries to the head or neck.

Cutaneous malignant melanoma is potentially an important health problem for white people. The incidence of melanoma is rising faster than other solid cancers. Despite the new melanoma drugs surgery for localised melanoma and regional metastasis is still the standard of care. However management of cutaneous melanoma differs from other cancers at some points such as biopsy technique, surgical margine, incorporation ofsentinel lymph node biopsy for staging etc. In this review we focused on the role of the head and neck surgeon in management of cutaneous melanoma of head and neck region according to current knowledge.

Objective: Objective: Choice and positioning of the pros thesis is a fundamental element in successful operations for otosclerosis. The present study compares two different techniques for placing a prosthesis when undertaking surgery for otosclerosis. 

Materials and Methods: A retrospective review was undertaken of records from 50 cases of individuals (33 women, 17 men) undergoing stapedotomy between the years 2009 and 2016. Two alternative procedures were used: in the “reverse” technique, placement of the prosthesis preceded stapes removal; in the “conventional” technique, placement of the prosthesis followed stapes removal. These groups were labelled groups 1 and 2, respectively. There were 25 cases in each. The two groups were compared for hearing outcome and incidence of complications.

Results: An air-bone gap below 20 dB was obtained in 80% of cases following the reverse technique, and 76% of cases after conventional surgery. The difference between the two techniques lacked statistical significance (p>0.05). A single case in group 1 required a revision procedure since the prosthesis was taken out 4 months post-surgery. In group 2, a single case sustained injury to the chorda tympani. Vertigo symptoms occurred in 7 individuals in group 1, and 8 in group 2.

Conclusion: There is no significant difference between treatments in terms of improved auditory function or fewer complications. The authors suggest clinicians’ experience is the key factor in deciding which technique to favour.

Objective: This research aims to compare fine needle aspiration biopsy (FNAB) with magnetic resonance imaging (MRI) in differentiating between neoplasms found within the parotic gland.

Methods: Using a retrospective methodology, records were reviewed from 74 cases who had surgery for a parotid neoplastic lesion between January 2013 and November 2018. 41 cases were men and 33 women, with a mean age of 51.3±12.8 years. In each instance, comparison was made between the eventual histopathological diagnosis and the results of evaluation by FNAB or MRI prior to surgery. The comparison looked at how the two methods influenced surgical choice, their ability to distinguish between malignant and benign lesions and power to predict histopathological subtype.

Results: 57 cases (out of 74) represented benign lesions (77%), whilst 17 were malignant (23%). Superficial parotidectomy was carried out on 54, and total parotidectomy on 20 individuals. FNAB had a sensitivity in the detection of malignancy of 73.3% with a specificity of 100%. The accuracy was 93.4%. MRI, on the other hand, had a sensitivity in the detection of malignancy of 81.2% with a specificity of 90.5%. The accuracy was 88.4%. Amongst benign lesions found, the most frequently occurring were pleomorphic adenome and Warthin’s tumour. MRI could accurately identify the histopathological type in 90% of such cases, whilst FNAB identified 89.1%.

Conclusion: In distinguishing between benign and malignant neoplastic lesions of the parotid gland, FNAB and MRI have similar abilities. Although MRI is unable to adequately predict the histopathological subtype in malignant lesions, unlike FNAB, its role in surgical planning and tumour staging remains highly significant.

Objective: The goal of this research was to investigate how biomarkers, i.e. SII (an index calculated from blood counts of various leucocytes), NLR and MLR correlate with features used in the staging of laryngeal squamous cell carcinoma (LSCC), i.e. perineural infiltration, lymphatic involvement and histological grade. Methods: A retrospective review of clinical records from 146 cases (143 men and 3 women) of LSCC occurring between January 2008 and January 2018 was undertaken. The sample included every stage of LSCC and all biomarker results were found from the full blood count (FBC) results obtained prior to surgery and documented for each case. SII is a newly introduced index of inflammation calculated according to the formula: SII = NxP/L, where N represents neutrophil, P platelet and L lymphocyte counts. Histopathological parameters (presence of perineural or lymphatic involvement, grade of tumour) were evaluated alongside results for NLR, MLR and SII. Results: All three biomarkers were different at the level of statistical significance between individuals with LSCC and the controls. For NLR, p=0.003; for MLR, p=0.008; for SII, p<0.001. Both NLR and SII were different at a statistically significant level when compared at early and advanced stages of LSCC (p values were 0.011 and <0.001, respectively. MLR did not differ at the level of statistical significance (p=0.944). (See Table 3). Conclusion: SII is straightforward to calculate, economical and reproducible from FBC results. It can provide important clues to the likelihood of perineural or lymphatic involvement in cases of LSCC.

Objective: In our study, we aimed to investigate the success of Platelett-rich fibrin matrix (PRFM) septorhinoplasty cartilage graft applications obtained from the patient’s own blood easily and cheaply.

Methods: Four patients who presented at the Otorhinolaryngology Clinic of Ankara Numune Training and Research Hospital underwent open technical septorhinoplasty. Preoperative 10 cc venous blood was taken into two separate biochemistry tubes and centrifuged at 3000 rpm for 12 minutes. PRFM was prepared. The cartilages taken from the septum were divided into 0.3-0.5 cm in average. Cartilages were divided into PRFM and dorsal irregularity and type were applied.

Results: 2 patients were implanted PRFM-wrapped cartilage graft to the type 2 region of the other 2 patients who were implanted in the dorsal region PRFM split cartilage graft.

Conclusion: Although our findings were short-term in our study, considering the problems in other grafting methods used in routine, it can be a grafting method that can be used safely in PRFM-wrapped cartilage graft septorhinoplasty

Objective: Vocal cord polyps are benign lesions of the larynx that are frequently seen and are treated surgically. These lesions generally develop in the free edge of the vocal cords, and form an incomplete glottal closure accompanied by irregular vibration of the vocal cords. In this study, the aim is to investigate the effect of surgery on vocal cord vibration in patients with vocal cord polyps who are treated with the endolaryngeal cold knife microsurgery.

Method: Patients treated with endolaryngeal microsurgery at our clinic between 2014 and 2016, who were reported as vocal cord polyps by postoperative pathology result, and who regularly coming for follow-up examinations were included in the study. Using a scale which was first described by Hirano and Bless and modified and confirmed to be reliable in a study performed by Gürbüz et al., the preoperative and postoperative second month images of the patients were statistically compared.

Results: 10 of the 25 patients included in our study were female (40%) and 15 were male (60%). In all patients, vocal cord polyps were unilateral, and were located in anterior 1/3 of the vocal cord in 12 patients (48%), and in medial 1/3 of the vocal cord in 9 patients (36%). It was determined that impaired vocal cord vibratory functions showed statistically significant recovery in the postoperative period compared to the preoperative period (p<0.05).

Conclusion: Successful endolaryngeal cold knife microsurgery excision can correct impaired vibratory functions of vocal cords in patients with vocal cord polyps.

Objective: The present study aimed to evaluate the long term results of our previous study. In the previous study, we found that temporomandibular joint disorders(TMJDs) are related to habitual prone sleeping position and nasal septal deviation.

Methods: Of 200 participants 104 patients were diagnosed as TMJD. After five years we evaluated 101 of 104 patients by means of TMJD sympthoms. By these years 27 of 65 patients with nasal septal deviation had gone to septoplasty.

Results: 24 of 27 patients with nasal septal deviation were improved (88.8%). Additionally, 27 of 50 patients who changed their habitual sleeping position also improved (54%).

Conclusion: This study showed that correcting nasal septal deviation and habitual prone sleeping position improves temporomandibular joint disorder sympthoms.