Osman Fatih Boztepe

A novel predictive marker for the viscosity of otitis media with effusion.

OBJECTIVES To evaluate the significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for the prediction of the viscosity of otitis media with effusion. METHODS This retrospective study was performed on 81 patients who were admitted to the otolaryngology clinic.The patients were divided into two groups according to their effusion type, as serous or mucoid, which was defined intraoperatively after myringotomy. The NLR and PLR were calculated as a simple ratio between the absolute neutrophil/platelet and absolute lymphocyte counts.Tympanostomy tube insertion was performed for all cases.Under direct visualization, the effusion was aspirated and classified as serous or mucous. RESULTS We postulated that an NLR value of less than 1.38 may show mucoid effusion and if the PLR value is less than 97.96, the effusion is mucoid. CONCLUSIONS We speculate that a useful predictor of viscosity for a middle ear effusion could prevent unnecessary surgeries and additional costs in the treatment of EMO. Additional studies are needed to confirm our results.

Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study

Abstract Objectives: (1) To evaluate the effects of a platelet-rich fibrin (PRF) membrane in the repair of traumatic tympanic membrane (TM) perforations; and (2) to compare the use of a PRF membrane with the paper patch technique with regard to recovery rates, healing time, and correction of the mean air–bone gap. Methods: A randomized, prospective analysis was performed for 60 patients who were treated for traumatic TM perforations using one of the two methods. Closure rate, speed of healing, and hearing gain were compared between the PRF (Group 1) and paper patch (Group 2) groups. Results: Closure was obtained in 28 (93%) perforations in Group 1 and 25 (83%) perforations in Group 2 (p > 0.05). On day 10, full closure of the TM was observed in 24 (80%) patients in Group 1 and 16 (53%) patients in Group 2 (p < 0.05). The improvement in the mean air–bone gap was 14.1 dB in Group 1 and 12.4 dB in Group 2 on post-operative day 45 (p < 0.05). Conclusions: In comparison with the paper patch method, PRF, a new method, provided more rapid healing with more successful audiological results, and with no requirement for a second procedure.

Comparison of Hyaluronic Acid Fat Graft Myringoplasty, Fat Graft Myringoplasty and Temporal Fascia Techniques for the Closure of Different Sizes and Sites of Tympanic Membrane Perforations.

OBJECTIVE To compare the efficacy of three different myringoplasty techniques, namely hyaluronic acid fat graft myringoplasty (HAFGM), fat graft myringoplasty (FGM), and temporal fascia for the closure of different sizes and sites of tympanic membrane perforations. MATERIALS AND METHODS We retrospectively analyzed the medical records of patients who had undergone a type 1 tympanoplasty operation at our clinic between May 2007 and February 2013. The patients were divided into three groups depending on the patients choice of technique as follows: Fat Graft Myringoplasty (FGM) (Group I), Hyaluronic Acid Fat Graft Myringoplasty (HAFGM) (Group II), and Temporalis Fascia (TF) (Group III). A total of 136 patients were included in the study, split in to the FGM (57 patients; 56.1% female; median age: 30 years), HAFGM (31 patients; 54.8 female; median age: 25 years), and TF (48 patients; 58.3% females; median age: 33 years) surgery technique groups. RESULTS The patients were further divided into two groups, depending on the size of the perforation (small and large), and into three groups, depending on its location (anterior, inferior, and central). None of techniques provided a significantly better success rate in terms of perforation location (p>0.05). Also, none of the techniques provided a significantly better success rate in terms of perforation size (p>0.05). CONCLUSION We propose using HAFGM for large perforations and FGM alone for small perforations. The TF technique is a successful and well-defined technique for tympanic membrane perforations; however, in our opinion, its technical difficulties make it a secondary choice, particularly for small-sized perforations.

A Comparison of Cartilage Palisades and Temporal Fascia in Type 1 Tympanoplasty for Bilateral Tympanic Membrane Perforations in Children.

OBJECTIVE To compare the graft success rates and audiological outcomes of bilaterally performed type 1 tympanoplasty using cartilage palisades or temporal fascia in children. MATERIALS AND METHODS We retrospectively analyzed the medical records of patients who underwent type 1 tympanoplasty at Medical Park Hospital between May 2007 and February 2013. 27 patients (54 ears) were enrolled in the study: 15 (30 ears) in the palisade cartilage group and 12 (24 ears) in the fascia group. RESULTS The graft success rate for the fascia group was 79.2%, and that for the cartilage group was 96.7%. The difference was statistically insignificant (p=0.078). Audiological improvements were seen in both groups, and the difference was statistically insignificant. CONCLUSION The use of temporalis fascia grafting has similar outcomes to palisade cartilage tympanoplasty for both success rate and audiological values in children who have bilateral disease.

Giant antrochoanal polyp presenting as oropharyngeal mass

Antrochoanal polyps are benign mucosal lesions emerging from the maxillary sinus. The primary symptoms are nasal obstruction and rhinorrhea.

The advantages of platelet-rich fibrin membrane in the treatment of traumatic tympanic membrane perforations

In the first item it is stated that traumatic tympanic membrane perforations recover spontaneously at a very high rate, and the factors affecting healing are mentioned. It is stated that insufficient emphasis has been given to the factors affecting spontaneous healing and corrections should be made to the inclusion criteria. Traumatic perforations often develop because of a slap injury, blast injury, accident, sporting injury, or instrumental injury, and 53–94% recover spontaneously [1–4]. Research has revealed that the mean time of spontaneous healing of traumatic TM perforation is 25.9 days, but may be as long as 3 months [5]. Although the rates of closure of TM perforation do not vary greatly, immediate microsurgery procedures for the purpose of accelerating the healing process are preferred in patients with traumatic perforation [6,7]. In the current study, the mean time to closure of the TM perforation was 7.8 days in Group 1, where PRF was applied [8]. This is a double-blind study comparing PRF membrane and the paper-patch method in patients with traumatic perforation. Spontaneous healing is not the subject of this study. The aim of the study is to compare the success rates of the methods applied to similar groups. Factors affecting spontaneous healing include age, sex, size and position of perforation, left or right ear, cause of injury, curly edges, and pre-existing myringosclerosis [1,9–11]. The age and gender of the patients, dimensions of the perforation, and cause of injury have been stated in the article. It is clear that pre-existing myringosclerosis would have a negative effect on healing. As stated in the paper, patients with otological problems such as myringosclerosis were not included in the study (no other otological problems). There are studies showing that curly edges have an effect on healing and studies which have shown no effect [2,6,11,12]. Our views are that there is no effect. We have not understood the request for the effect on healing according to whether the perforation was in the right or left ear to be included in the criteria. (2) PRF technique has many advantages in treatment of traumatic TMPs

Unusual Lip Mass: Schwannoma of the Upper Lip: Case Report

Schwannomas are benign lesions of the peripheral nerve sheath. There are only a few cases of upper lip schwannomas in the literature. A male patient 23 years old, admitted to our clinic with mobile, non-tender, and 2x2 cm sized lip swelling. The mass was excised and the histological diagnosis was consistent with a schwannoma. Multinodular appearance was detected on microscopic evaluation. Most of the lip swellings are treated like a mucocele in outpatient clinics but the specimen should be examined carefully to differentiate the possible diagnosis.

An Assessment of the Levels of Anxiety and Depression in Patients with Recurrent Aphthous Stomatitis

Backgrounds: There is a lack of valid and reliable studies in literature on both the distinctive and ambiguous relationship between the psychological profile and the occurrence of recurrent aphthous ulcers in the individual.