Ercan Kaya

Background: The eustachian tube is an anatomical structure that connects the nose, nasopharynx, middle ear, and mastoid air cells and has important functions. If the physiological functions of the eustachian tube are impaired, ear diseases may occur. There are many test methods used to evaluate the functions of the eustachian tube. However, none of these methods are accepted as the gold standard due to both the application difficulties of these methods and the reliability of their results. We aim to use tubomanometry for the detection of eustachian tube dysfunction (ETD) and so to increase the success rates of ear surgeries in patients diagnosed with tubal dysfunction with easily applicable methods.

Purpose Reinke’s edema is a benign lesion affecting the subepithelial layer of the vocal cords, often associated with moderate or heavy smoking. Smoking is the most significant risk factor for dysplastic laryngeal lesions, laryngeal carcinomas, and Reinke’s edema. Thus, Reinke’s edema could potentially be a predisposing factor for laryngeal malignancy in the long term. This study aimed to determine the rate of dysplasia and invasive carcinoma development in the larynx during long-term follow-up of histopathologically confirmed Reinke’s edema. Methods Between 2010 and 2019, 28 patients diagnosed with Reinke’s edema via microlaryngoscopy and histopathological confirmation were included in this study. Their clinical and pathological data were examined to identify the development of laryngeal dysplasia and malignancy during long-term follow-up. Results Among the 28 patients, 16 (57%) were female and 12 (43%) were male. A history of smoking was present in 24 (85%) patients. No new pathology was found during long-term follow-up in 21 (75%) patients. None of the patients developed dysplasia or malignancy histopathologically. Seven (25%) patients underwent repeated biopsies during follow-up, and minimal dysplasia was detected in 1 (4%) patient. No invasive carcinoma developed in any patient during long-term follow-up. Conclusion Despite the high rate of smoking among patients with Reinke’s edema, no malignancy developed during long-term follow-up, though there was a low incidence of dysplasia. Therefore, close monitoring of these patients is recommended.

Purpose To determine the frequency and clinical features of new- and early-onset benign paroxysmal positional vertigo (BPPV) after different otologic surgical operations with and without surgical drilling. Methods All unilateral otologic operations performed at the otolaryngology clinic of a tertiary university hospital between January 2021 and May 2023 were screened, and 437 adult cases were included in the study. Of these patients, those who were diagnosed with BPPV within the first month postoperatively were examined. Results The overall incidence of BPPV after otologic operations was 2.28% (10 out of 437 patients). This incidence was 3% (8/266 patients) in cases where a drill was used and 1.16% (2/171 patients) in those where a drill was not used. There was no significant difference between the two groups (p > 0.05). Clinical symptoms related to BPPV appeared on average in 13.3 ± 6.8 (range: 3–25) days following surgery and presented as canalolithiasis. All cases involved the posterior semicircular canal (SCC) on the operated side. In addition, one patient with a cochlear implant had involvement of both the posterior and lateral SCCs. All patients responded well to repositioning maneuvers during follow-up. Conclusion Otologic surgery, especially operations involving drilling, is a potential risk factor for the development of BPPV. Postoperative BPPV, primarily presenting as canalolithiasis in the posterior SCC on the operated side, can be effectively managed with repositioning maneuvers. Clinicians should be vigilant for BPPV in patients experiencing vertigo/dizziness within four weeks following otologic surgery.

Purpose This study aimed to compare the outcomes of patients with advanced congenital cholesteatoma who underwent microscopic or endoscope-combined Canal Wall Up Tympanomastoidectomy (CWUT) in our clinic and to determine the contribution of endoscope use in reducing recurrence/residual rates. Methods In this retrospective study, the data of individuals who underwent microscopic or combined endoscopic surgery between 2008 and 2022 in our clinic were scanned from the database. Demographic data, preoperative computed tomography (CT) findings, preoperative and postoperative hearing results, operation and intraoperative status of the ossicles, duration of surgery, postoperative follow-up period, recurrence and residual disease status during follow-up were investigated. Results The data of 37 pediatric cases operated in our clinic were included in the study. All of the included cases were Potsic Stage 4 patients who underwent CWUT. The mean age of the operated individuals was 8.7 years (5–12 years) and the mean follow-up period was 47.3 months (12–112 months). 19 cases were performed microscopically only, 2 recurrences and 5 residuals were detected. 18 cases were performed combined and 1 recurrence and 1 residual was found. Conclusion In this study, it was determined that using an endoscope together with a microscope in congenital cholesteatoma cases, decreased the rate of recurrence and residual disease by protecting the external auditory canal in patients with advanced mastoid invasion.

This study aims to find out the incidence of malignant tumors originating from the salivary gland or other organs in patients with Warthin tumor (WT) and compare the clinicopathological, radiological, and demographic data of WT patients with or without malignant tumors. The study population consisted of 170 patients diagnosed with WT from cytology, surgery, and consultation materials between 2010 and 2021 in our hospital. Patient files were reviewed in terms of demographic data, smoking status, presence of malignant tumor, radiological findings, symptom duration, and operation procedure. A total of 40 malignant tumors were detected in 36 (21.2%) of 170 patients with WT. The most common localizations of malignant tumors were lung (35.0%), head and neck (35.0%), and genitourinary (12.5%) regions. The mean age of the patients with malignant tumor diagnosis (62.1±9.2) was higher than the patients without (56.5±9.8) (p=0.002). There was no significant difference between cases with and without malignant tumors in terms of gender, multifocality, bilaterality, amount of smoking, and pain complaints (p>0.05). The SUVmax of WTs ranged from 3 to 17.7 (median: 6.8, IQR: 5.5-11.0), and that of malignant tumors ranged from 2.7 to 16.2 (median: 8, IQR: 5.1-10.3) (p=0.756). This study demonstrates that WT can be seen with malignant tumors synchronously but also encountered before and after the malignant tumor diagnosis. This possibility should be considered, especially in the head and neck region, in patients diagnosed with malignant tumors or being investigated.

This study aimed to examine the results of the video head impulse test (vHIT), and suppression head impulse paradigm (SHIMP) in adult diagnosed with definite Meniere’s disease (MD). This study was conducted with 20 patients aged 18-45 years with canal paresis and sensorineural type hearing loss in symptomatic ears, who were diagnosed with unilateral definite MD. The subjects were assessed with conventional audiometry (0.125–8 kHz), the bithermal binaural air caloric test, vHIT, and SHIMP. The mean SHIMP vestibulo-ocular reflex (S-VOR) gain of the MD side was 0.69, and that of the healthy side was 0.77. The S-VOR gain values were statistically lower than the mean vHIT VOR gain (V-VOR) values on both sides (p0.05). In the MD group, the vHIT results were abnormal in 35% (7/20 ears) of the ears, and the SHIMP results were abnormal in 50% (10/20 ears). On the healthy side, the vHIT results were abnormal in 10% (2/20 ears) of the ears, and the SHIMP results were abnormal in 35% (7/20 ears). In this study, the V-VOR and S-VOR gains, vHIT saccades, SHIMP saccade latency, and SHIMP saccade amplitude were not found to be beneficial parameters in differentiating affected and healthy ears in the patients with MD. In other words, contrary to expectations, vHIT and SHIMP tests were not sufficient to detect pathological involvement in Meniere's disease.

Background: Individuals with single-sided deafness have difficulty understanding speech in noise and determining sound direction in their daily lives. Cochlear implantation, a globally accepted rehabilitation method, has recently become used in Turkey in patients with single-sided deafness. In this study, the effects of cochlear implants on auditory temporal processing skills, speech-in-noise perception performance, tinnitus, and subjective benefit were reported in two patients with single-sided deafness. Case presentation: The cochlear implant was applied to two children with single-sided deafness with and without inner ear malformation. Speech in noise score, gaps in noise test, duration, and frequency pattern test were used. Also, cochlear implant benefits and the presence of tinnitus were questioned by questionnaires. Speech-in-noise perception performance and auditory temporal processing skills improved in the postoperative period compared to the preoperative period. It was also observed that although the cochlear implant improved the quality of life, motivation for device use decreased in the first 6 months of the postoperative period. Conclusions: Cochlear implantation in individuals with single-sided deafness with and without inner ear malformation is useful in increasing auditory temporal processing skills and understanding speech in noise ability. In addition, cochlear implantation is a useful method to improve quality of life, especially regarding spatial perception, and it did not cause tinnitus in our patients. Selecting an implant model that enables data logging provides an advantage in determining the motivation to use the implants.