Mehmet Düzlü

Neutrophil-lymphocyte Ratio Findings and Larynx Carcinoma: a Preliminary Study in Turkey

BACKGROUND To identify the potential prognostic role of the neutrophil/lymphocyte (N/L) ratio in larynx carcinoma. MATERIALS AND METHODS Oncologic archive charts of patients with a larynx carcinoma diagnosis between the years 2010 and 2013 were retrospectively reviewed. The inclusion criterion was to be available with hemogram test prior to diagnostic procedure. Patients undergoing septorinoplasty comprised the control group. RESULTS There were 65 cases in the study and 42 cases in control group meeting inclusion criteria. In general a non-significant increase in N/L ratio was observed with increasing tumor size and stage (p>0.05) in larynx carcinoma. The N/L ratio was found to be significantly higher in larynx carcinoma compared to control group (p=0.004). CONCLUSIONS In conclusion, the N/L ratio was shown to be significantly increased in larynx carcinomas compared to control group. Further studies are needed to assess any prognostic role.

Management of Cerebrospinal Fluid Leak following Retrosigmoid Posterior Cranial Fossa Surgery

Objective: To detail our experience in the management of cerebrospinal fluid (CSF) leak following posterior cranial fossa surgery by the retrosigmoid approach. Patients and Methods: 412 patients who underwent posterior cranial fossa surgery by the retrosigmoid approach for a variety of diseases were included in the study. Results: There were 32 CSF leaks (7.7%) in the 412 patients. Of these, 16 were leaks from the incision site (50%) and 16 (50%) were CSF rhinorrheas. The CSF leaks were documented in 22 of the vestibular schwannoma surgeries (68.7%) and 10 of the vestibular nerve sectioning surgeries (31.3%). No CSF leak was seen following microvascular decompression and auditory brain stem implantation surgeries. Ten patients could be treated conservatively. Twelve patients needed the placement of a lumbar drainage. Surgical reexploration was performed in 10 patients. Conclusions: Initially, a conservative treatment should be instituted in the case of a CSF leak. If the conservative treatment fails, the placement of a lumbar drainage should be considered. Patients that do not respond to lumbar drainage require surgical reexploration. The abovementioned algorithm represents the safest and best option in the presence of a CSF leak, as confirmed by the absence of recurrences or multiple revisions in this study.

Thermal welding versus cold knife tonsillectomy: A prospective randomized study

This is a prospective randomized study conducted in a group of children who underwent two methods of tonsillectomy: thermal welding or cold knife tonsillectomy. Parameters, such as postoperative pain scores, intraoperative blood loss, operation time, and postoperative bleeding rates, were analyzed to find out which technique is better. Ninety‐one children (aged between 2 years and 13 years) with recurrent tonsillitis, obstructive sleep apnea syndrome, or both were included in the study. According to the type of tonsillectomy procedure, the patients were divided into two groups: cold knife and thermal welding procedure. The two groups were compared on the basis of postoperative pain scores, intraoperative blood loss, operation time, and postoperative bleeding. Fifty‐seven patients underwent thermal welding tonsillectomy and 34 had cold knife tonsillectomy. The mean pain score in thermal welding group was significantly lower (p < 0.001). There was no remarkable blood loss intraoperatively in the thermal welding procedure. The operation time was not significantly different between two groups. No postoperative bleeding was encountered in the thermal welding group. Compared with the cold knife technique, thermal welding was found to be a relatively new and safe technique for tonsillectomy as it results in significantly less postoperative pain and no remarkable blood loss.

Preliminary results of a novel quorum sensing inhibitor against pneumococcal infection and biofilm formation with special interest to otitis media and cochlear implantation

Abstract The purpose of the study is to assess the effect of a novel quorum sensing inhibitor (QSI), coded as ‘yd 47’, against otitis media and biofilm formation on Cochlear implants (CIs). Small pieces cut from cochlear implant were implanted under the skin in the retroauricular area on both sides of four guinea pigs. The implant pieces in the study and control sides were implanted in Streptococcus pneumoniae strain solution and saline, respectively. The right and left middle ears were also instilled with a solution containing pneumococci and saline, respectively. The animals were only given an intraperitoneal ‘yd 47’ twice daily for three months to be assessed later with electron microscopy. Clinical examination with palpation, inspection and otoscopy did not reveal any sign of implant infection or otitis media. In the study and control implant materials, soft tissues around the implant and tympanic membranes, there was no biofilm formation by pneumococci. Contamination by various cells and some rod-shaped bacteria (not diplococcic) were seen in some of the materials. In conclusion, the novel QSI seems promising in the prevention of otitis media and biofilm formation on CIs by pneumococci.

Audiological correlates of tumor parameters in acoustic neuromas

The objective of this study was undertaken to evaluate a correlation of pure tone audiometry, speech audiometry with tumor size, the presence of intrameatal extension, contralateral pure tone audiometry, and contralateral speech audiometry results at acoustic neuroma (AN) patients. Seventy-six patients with a unilateral-cerebellopontine angel tumor with/without internal acoustic canal (IAC) were included in this study. Data on pure tone audiometry, speech discrimination scores (SDS), speech reception thresholds (SRT), tumour size, and extension to IAC were analyzed retrospectively. As a result, patients with unilateral ANs had an asymmetric sensorineural hearing loss and had an asymmetric finding on the results of speech audiometry was present. We could not find any correlation between the size of the tumor and the hearing levels at each frequency. In addition, there appeared to be no significant correlation between the extension of tumor to the IAC and the audiological findings.

Comparison of Carina active middle-ear implant with conventional hearing aids for mixed hearing loss.

OBJECTIVE To compare the auditory outcomes of Carina middle-ear implants with those of conventional hearing aids in patients with moderate-to-severe mixed hearing loss. METHODS The study comprised nine patients (six males, three females) who underwent middle-ear implantation with Carina fully implantable active middle-ear implants to treat bilateral moderate-to-severe mixed hearing loss. The patients initially used conventional hearing aids and subsequently received the Carina implants. The hearing thresholds with implants and hearing aids were compared. RESULTS There were no significant differences between: the pre-operative and post-operative air and bone conduction thresholds (p > 0.05), the thresholds with hearing aids and Carina implants (p > 0.05), or the pre-operative (mean, 72.8 ± 19 per cent) and post-operative (mean, 69.9 ± 24 per cent) speech discrimination scores (p > 0.05). One of the patients suffered total sensorineural hearing loss three months following implantation despite an initial 38 dB functional gain. All except one patient showed clinical improvements after implantation according to quality of life questionnaire (Glasgow Benefit Inventory) scores. CONCLUSION Acceptance of Carina implants is better than with conventional hearing aids in patients with mixed hearing loss, although both yield similar hearing amplification. Cosmetic reasons appear to be critical for patient acceptance.

The demographics and histopathological features of oral cavity cancers in Turkey

BACKGROUND/AIM This study aimed to examine the demographics and histopathological features of oral cavity cancers (OCCs) managed in our clinic. MATERIALS AND METHODS Patients who were diagnosed with OCCs in the Gazi University Otorhinolaryngology Department between the years 1993 and 2013 were retrospectively enrolled in the study. Surgical archive charts and pathology records were reviewed in detail regarding the anatomical and histopathological profiles of the tumors, as well as the demographic data of the patients. RESULTS Out of 230 patients with OCCs, the most common anatomic location and histopathological diagnosis were found to be the oral tongue (41.4%) and squamous cell carcinoma (SCC) (84.3%), respectively. A marked predominance of SCC was observed in all subsites of the oral cavity except the hard palate location. The mean age at presentation was 55.5 ± 13.4 years (±SD). The male:female ratio was found to be 2.2:1. A male predominance was also present in all subsites except the retromolar trigon. CONCLUSION OCCs particularly concern the elderly population with a male predominance. The most common location and histopathological type are the oral tongue and SCC, respectively.

A rare pediatric malignant neck mass: Synovial sarcoma

Synovial sarcomas are rare soft tissue sarcomas that typically seen in the periarticular region and predominantly located in the extremities. It most commonly affects young adults of the second to fourth decade. Head and neck synovial sarcomas are uncommon and carry a poor prognosis. In the head and neck region, tumor is localized laterally in the parapharyngeal space often. The tumor can spread loco -regionally and systemically easily, so it makes management challenging. Herein, we report a case of a 12-year-old child with a synovial sarcoma located in the right parapharyngeal space of the neck. The lesion extended from parapharyngeal space to subglottic level of the neck and it fills the parapharyngeal space and compresses the major vascular, laryngeal and neural structures.

[Co-existence of nasopharyngeal carcinoma and sinonasal paraganglioma: a case report].

Paragangliomas are very rarely seen in the nose, paranasal sinuses and nasopharynx. The development of paraganglioma concurrently with nasopharyngeal carcinoma in the same region has not been reported to date. In this study we reported a 59-years-old a female case of nasopharyngeal carcinoma who underwent radiotherapy six years ago and got the diagnosis of sinonasal paraganglioma in the same region during follow-up and underwent nasal endoscopic excision.

Differences in opinions on disaster myths between first-year and sixth-year medical students.

Objective We aimed to determine the influence of a medical school program on altering the opinion of medical students on disaster myths. Methods This cross-sectional survey study was conducted in October 2005 in Hacettepe University Faculty of Medicine, Turkey, with the participation of 191 (83.0%) first-year and 232 (80.8%) sixth-year medical students. The opinions of the students with regard to 22 disaster myths and the influence of the medical school program on these opinions were evaluated. Chi-square test was used in the statistical analysis. Results One hundred and fifty-nine first-year (83.2%) and 178 (76.7%) sixth-year students had knowledge about disasters (χ2=2.75, P=0.972). Television was cited as the leading source of knowledge among both first-year (63.9%, 122) and sixth-year (62.1%, 144) students. The medical school was the last resource for knowledge as reported by first-year students (0.5%, one student), and ranked fourth as a knowledge resource according to sixth-year students (47.0%, 109 students). Statistically significant differences were determined in opinions between the two groups of students, with sixth-year students having a higher rate of correct answers in only seven myths. In 17 myths, the number of correct responses for both groups was below 60%. Conclusion If the myths and realities in disaster situations are valid, we demonstrated that the medical education curriculum at one of the leading medical faculties in Turkey failed to correct the misconceptions of the medical students. As the opinions of students regarding disaster myths may reflect those of their trainers, similar surveys conducted among the faculty would be informative.