Fakih Cihat Eravcı

This paper aimed to conduct a systematic search within a scoping review framework and provide a critical narrative appraisal of the current literature on artificial intelligence (AI) applications for tympanic membrane (TM) image analysis in the diagnosis of ear infections, with a focus on methodological rigor, dataset characteristics, and clinical applicability. A comprehensive search was performed across various online databases (Scopus, PubMed, Google Scholar, Embase, IEEE Xplore, and SPIE Digital Library) to identify studies published up to June 30, 2024. Studies employing AI for the analysis or classification of TM images in ear disease diagnostics were included. Inclusion and exclusion criteria were predefined. Data extraction covered dataset properties, imaging modalities, AI models, validation strategies, and performance metrics. The level of evidence, potential sources of bias, and methodological rigor were assessed qualitatively. Eighty-three studies met inclusion criteria, encompassing 90 experimental results. Considerable heterogeneity was observed regarding dataset size, image quality, device types, labeling protocols, and AI models. Most studies relied on small, private datasets, limiting model generalizability. While deep learning methods—especially convolutional neural networks—achieved high classification accuracies, methodological limitations included inconsistent data augmentation, imbalanced datasets, and lack of external validation. Few studies employed multidisciplinary teams or standardized protocols. Despite notable advances in AI-driven TM image analysis, direct comparison of studies remains challenging due to substantial heterogeneity and methodological shortcomings. A meta-analysis or systematic review was not performed, as quantitative synthesis would be misleading due to substantial data and labeling heterogeneity, wide methodological diversity, and a widespread lack of external validation across the included studies. Future research should prioritize larger, diverse, and well-annotated datasets, adoption of standardized protocols, and interdisciplinary collaboration to improve the clinical translation and reliability of AI-based diagnostic tools for ear infection management.

BACKGROUND: Audiological testing in individuals with common variable immunodeficiency (CVID) has shown that the inner ear is affected in this patient group. The study's objective was to investigate the vestibular system in the inner ear in individuals with CVID. METHODS: The study included 22 (13 males and 9 females) healthy individuals and 24 (12 males, 12 females) patients diagnosed with CVID. All participants underwent caloric testing, video head impulse test (vHIT), and computerized dynamic posturography (CDP). RESULTS: Healthy subjects’ mean age was 38.55 ± 7.82 years (min 22-max 53) and the patient group’s mean age was 37.33 ± 9.49 years (min 22-max 53). The groups exhibited comparable demographic and physical characteristics (P > .05). The caloric test results demonstrated a lower mean value in the CVID group compared to the control group (P < .05). The results obtained with CDP showed that there was a significant difference between the groups in both the anteroposterior and mediolateral planes, with lower vestibular and visual sensory organization scores in the CVID group (P < .05). According to vHIT test results, vestibulo-ocular reflex gains in the right lateral and left lateral semicircular canals were significantly lower in the CVID group compared to the control group (P < .05). CONCLUSION: It should be noted that this patient group may present to clinics with complaints of dizziness and hearing loss and may have dizziness even at the time of initial diagnosis.

Objective: This study aimed to evaluate the effect of postoperative oral antihistamine (clemastine) use on the incidence of salivary fistula and sialocele in patients undergoing superficial parotidectomy. Materials and Methods: A retrospective analysis was conducted on 202 patients who underwent superficial parotidectomy for benign parotid tumours at the Department of Otolaryngology—Head and Neck Surgery, Necmettin Erbakan University, between 2020 and 2024. All patients were prescribed clemastine‐containing antihistamines postoperatively; however, they were divided into two groups based on their access to and use of the medication. The development of salivary fistula and sialocele was assessed clinically. Data were analysed using Fisher's exact test, and p < 0.05 was considered statistically significant. Results: Salivary fistula was observed in 5 of 164 patients (3.0%) in the antihistamine group and in 5 of 38 patients (13.2%) in the non‐user group. This difference was statistically significant ( p = 0.022). The incidence of sialocele was three (1.8%) in the antihistamine group and two (5.3%) in the non‐user group, with no significant difference between the groups ( p = 0.237). The most common side effects in patients receiving antihistamines were drowsiness (12.1%), accommodation disorders (9.1%) and other mild anticholinergic symptoms. Conclusion: Oral antihistamine use following superficial parotidectomy may significantly reduce the incidence of salivary fistula. Most adverse effects were mild and tolerable. These findings suggest a potential benefit of antihistamines in the prevention of postoperative complications.

Background: Preservation of septal cartilage harvested during primary septoplasty can reduce the need for secondary donor sites in future revision rhinoplasty. However, the optimal storage conditions for maintaining tissue viability and extracellular matrix (ECM) integrity remain unclear. Objectives: The aim of the study is to evaluate the histological structure and chondrocyte viability of autologous septal cartilage stored at −40°C without a preservation solution for 1 week, 1 month, and 3 months. Methods: This prospective study, conducted between May 2024 and May 2025, included septal cartilage samples from 40 patients who underwent primary septoplasty. Specimens were randomly assigned to 4 groups without the use of any preservation solution: fresh control and storage at −40°C for 1 week, 1 month, or 3 months. All samples were analyzed histopathologically in a blinded manner for chondrocyte viability, peripheral proliferation, stromal degradation, and ECM integrity. Results: The mean chondrocyte viability rate progressively decreased from 95% in the fresh group to 89%, 85%, and 81% in the 1-week, 1-month, and 3-month groups, respectively (P < .001). Prolonged storage correlated with increased stromal loss, vascularization, inflammation, ossification, and calcification (P < .05), whereas fibrosis and peripheral chondrocyte proliferation did not differ significantly. Conclusions: Short-term storage of autologous septal cartilage at −40°C without a preservative maintains substantial histological and cellular integrity. Nonetheless, longer storage durations lead to gradual ECM degradation and decreased chondrocyte viability. These findings highlight the importance of optimizing storage duration to preserve the structural and functional reliability of cartilage grafts in revision septorhinoplasty. Level of Evidence: 2 (Therapeutic):

Prenatal Diagnosis of a Large Oropharyngeal Teratoma and Airway Management with EXIT: A Case Report - Turkish Archives of Otorhinolaryngology

Objective: To investigate the frequency of micronuclei (MN) and binucleated (BN) cells in thyroid nodules and adjacent normal tissue, and evaluate their correlation with cytological (Bethesda classification) and histopathological diagnoses to assess their potential utility in preoperative malignancy prediction. Methods: This prospective study included 39 patients (16 benign, 19 papillary carcinoma, 4 follicular carcinoma) who underwent thyroidectomy. Tissue samples from both nodular and adjacent normal thyroid regions were collected. MN and BN frequencies were evaluated in 1000 cells per sample using May‐Grünwald and 5% Giemsa staining. Data were analyzed in relation to Bethesda categories and final surgical pathology using mixed‐effects models in R 4.4.1. ROC analysis was conducted to assess the diagnostic performance of MN/BN frequency. Results: MN and BN frequencies were significantly higher in nodular tissue compared to adjacent normal thyroid tissue ( p < 0.05). Malignant lesions showed significantly increased MN/BN frequencies compared to benign ones, although no significant difference was observed between papillary and follicular subtypes ( p < 0.05). MN/BN frequencies were also significantly higher in Bethesda categories III–VI compared to categories I–II ( p < 0.05). No significant variation was found in normal thyroid tissue across cytological or pathological groups. Conclusion: MN and BN cell frequencies were elevated in malignant nodules and higher Bethesda categories, supporting their potential role as adjunctive cytogenetic markers in thyroid nodule assessment. While findings are promising, their diagnostic utility in indeterminate nodules remains unclear. Larger, FNAB‐based studies are required to validate their feasibility and clinical relevance in routine preoperative evaluation.

Acute otitis media (AOM), a common middle ear infection, can lead to severe complications if not properly managed. The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare delivery and disease management. This study aimed to evaluate the incidence of complicated AOM cases from the pre-pandemic to post-pandemic period. A retrospective review was conducted at Necmettin Erbakan University, Department of Otolaryngology, on patients diagnosed with complicated AOM in the period from January 2014 to February 2024. Patients were categorized into three periods: pre-pandemic (2014-2020), pandemic (2020-2022), and post-pandemic (2023-2024). Clinical data, including demographics, types of AOM complications, and treatment methods, were analyzed. A total of 32 patients (20 females and 12 males) with AOM complications were identified. Mastoiditis was the most common complication, seen in 43.75% of the patients, with increased incidences of 64.3% in the post-pandemic period. Subperiosteal abscess was noted in 12.5 % of the patients, exclusively in the pandemic and post-pandemic periods. Facial nerve paralysis (12.5%) and labyrinthitis (9.3%) were noted only in the post-pandemic period. Meningitis was noted in 15.6% of the patients, with increased incidences in the post-pandemic period. Observed during the post-pandemic period, sigmoid sinus thrombosis was noted in only one patient (3.1%). Despite the reduced AOM incidence rates during the early pandemic, a surge was seen in complicated AOM cases in the post-pandemic period. This increase could be linked to COVID-19's impact on the immune system, pathogen virulence changes, and disruptions in vaccination protocols. These findings highlight the need for improved surveillance of AOM cases regarding complications in the post-pandemic era.

Objective: Despite vaccination and early antibiotic treatment, pneumococcal meningitis remains a disease with significant mortality and morbidity. The resulting inflammatory response can lead to cochlear fibrosis, ossification where cochlear implant surgeries are far challenging. Our study aimed to investigate the preventive effect of controlled-release dexamethasone implant in such cases in terms of structural integrity. Methods: Twenty-four rats were induced with pneumococcal meningitis and randomized into study (n = 16) and control (n = 8) groups. Controlled-release dexamethasone implants were placed transbullarly into the right round window of the study group. Bilateral cochleas underwent histological examination 3 months post-infection. Results: In the study, cochlear effects of pneumococcal meningitis were evaluated. The basal turn was significantly more affected by fibrosis and ossification ( P = .013 and .010, respectively). Compared with control ears, the dexamethasone implant group showed less fibrosis in all turns and less ossification in the basal turn ( P = .014, .003, .044, and .035, respectively). Conclusion: In pneumococcal meningitis, fibrosis and ossification occur more intensively in the basal turn of the cochlea. Controlled-release dexamethasone implants are effective in preventing cochlear ossification and fibrosis. The prevention from the structural damage indicates the potential role of these dexamethasone implants in post-meningitic hearing loss and easing cochlear implant surgeries.

To compare postoperative edema, ecchymosis, and pain after rhinoplasty using conventional (classical) osteotomy versus powered (electric) micro-saw osteotomy techniques. Between December 2021 and May 2023, 90 patients aged 18 to 45 underwent rhinoplasty at our clinic. Of these, 45 patients underwent lateral and transverse osteotomy with powered saw instruments, whereas 45 underwent conventional osteotomy. A resident examined edema, ecchymosis, and pain on the first, third, and seventh postoperative days. The specialist was blinded to the osteotomy method (single-blind). Edema and ecchymosis were categorized using the Yücel modification of the Kara and Gokalan classification, and the pain was evaluated using the visual analog scale. The patients who underwent osteotomy with an electric micro-saw (group 1) had less edema on the first and third days than with conventional osteotomy (group 2). However, on the seventh day, although group 1 had slightly less edema than group 2, there were no significant differences. On the other hand, group 2 had significantly more ecchymosis on the first and third postoperative days compared with group 1, but there were no significant differences on the seventh day. On the first postoperative days, patients in group 2 reported significantly more pain on average compared with group 1. There were no significant differences in pain levels between the two groups on the third and seventh days following the surgery. After rhinoplasty, patients commonly suffer from edema, ecchymosis, and pain. Our research suggests that using a powered micro-saw effectively reduces early-stage ecchymosis and pain compared with the conventional low-to-low osteotomy technique. However, there were no notable differences between the two methods regarding edema, ecchymosis, and pain on the seventh day after surgery. The electric micro-saw appears to be a feasible alternative in the osteotomy step, showing effectiveness comparable to that of the conventional method.

Impaired olfaction negatively impacts nutrition and appetite, particularly gaining more significance in cancer patients for whom nutrition and calorie intake are crucial. In our study, we aimed to investigate the effects of advanced-stage colorectal cancer treatment on olfactory functions. Fourteen patients (78.5% males, n = 11 and 21.5% females, n = 3) scheduled for Anti-VEGF (Bevacizumab) and FOLFOXIRI (folic acid, 5-flourouracyl, irinotecan, oxaliplatin) treatment due to advanced-stage cancer colorectal cancer were voluntarily participated in our study. Objective smell tests were conducted using the Sniffin’s stick battery before the start of treatment. After 3 months, tests were repeated to investigate the treatment’s effects. The average age of participants was 58.4 ± 8.5 years. The mean values of the threshold (T), discrimination (D), identification (I), and total (TDI) scores before treatment were found to be 9.43 ± 3.76, 11.92 ± 2.86, 12.71 ± 1.63, and 34.07 ± 5.79, respectively. After treatment, the mean scores for T, D, I, and TDI were 9.29 ± 3.53, 11.42 ± 2.84, 12.71 ± 1.59, and 33.43 ± 5.88, respectively. Statistically significant decrease was observed in post-treatment D and TDI scores (p = 0.015 and p = 0.035, respectively). FOLFOXIRI combined with Bevacizumab, may affect olfactory functions Informing patients about this aspect before treatment could be beneficial.