E-ISSN 2602-4837
The Turkish Journal of Ear Nose and Throat - Tr-ENT: 29 (4)
Volume: 29  Issue: 4 - 2020

Pages I - IV

2.Women’s perspectives of aesthetic surgery in relation to religious beliefs and associated socioeconomic variables: A questionnaire-based survey among women with and without previous aesthetic surgery
Ayhan Okumuş
doi: 10.5606/Tr-ENT.2019.08370  Pages 159 - 165
INTRODUCTION: This study aims to evaluate women's perspectives of aesthetic surgery in relation to religious beliefs and associated socioeconomic variables in a general population of women with and without previous aesthetic surgery.
METHODS: A total of 500 volunteer women (mean age, 37 years; range, 18 to 63 years) with (n=250) and without (n=250) previous aesthetic surgery were included in this questionnaire survey. The questionnaire form was applied via face-to-face method and elicited items on sociodemographic characteristics and women's perspective of aesthetic surgery in relation to religious beliefs, provider selection, and partner’s support.
RESULTS: Overall, 28.8% strongly agreed/agreed that aesthetic surgery contradicted their religious beliefs. Gender of the surgeon was considered not important in provider selection by 69.2% of women, while 45.6% of women with previous aesthetic surgery reported that their partners were fully supportive during their previous surgery decision. Aesthetic procedures were considered not to contradict religious beliefs by a higher rate of women with versus without previous aesthetic surgery (58.9% vs. 31.4%), women aged <55 year vs. ≥55 year (41.4 to 53.2% vs. 15.8%), women with vs. without higher education (63.0% vs. 26.7 to 39.4%), and women with high vs. moderate or poor socioeconomic level (59.3% vs. 36.4% and 32.2%, respectively). Overall, 15.8% of women with previous aesthetic surgery reported they agreed/strongly agreed that aesthetic procedures contradicted religious beliefs.
DISCUSSION AND CONCLUSION: Our study findings indicate that aesthetic surgery is considered by one-third of women to contradict their religious beliefs, being more likely in case of no previous aesthetic surgery, older age, illiteracy, and poor socioeconomic status.

3.Learning curve of septoplasty procedure
Filiz Gülüstan, Selçuk Güneş, Emine Demir, Ayşe Öznur Akidil, Mehmet Akif Abakay, Zahide Mine Yazıcı, İbrahim Sayın
doi: 10.5606/Tr-ENT.2019.65265  Pages 166 - 171
INTRODUCTION: The aim of this study was to investigate possible relationship between surgical experience and septoplasty-related data and to determine the learning curve based on surgery duration.
METHODS: The first 60 septoplasty patients of four Ear, Nose and Throat residents who completed an 18-month residency training in our clinic between August 2015 and December 2017 were included in the study. A total of 240 patients (155 males, 85 females; mean age 32.8±10.6 years; range, 17 to 60 years) were evaluated. The first 10 patients were grouped as Group A, 11-20 patients as Group B, 21-30 patients as Group C, 31-40 patients as Group D, 41-50 patients as Group E, and 51-60 patients as Group F. The patients’ files were retrospectively reviewed to obtain information on demographics, postoperative hospital stay, complications, revision operation requirements, and operation time. The mean operation time was calculated. Duration of surgery was used to evaluate the maturity of surgical skills.
RESULTS: The mean operation time was 60.0±17.3 min. The mean operation times of the patients in Group A and Group B were significantly longer than that of the patients in Group C, Group D, Group E, and Group F. There was no significant difference between the groups in terms of length of hospital stay, complications, and revision rates.
DISCUSSION AND CONCLUSION: As the surgeon's experience increases, the operation time decreases, and after 20 patients, it reaches the plateau level. Based on these data, it can be concluded that ENT residents should practice more than 20 patients to learn the septoplasty procedure sufficiently.

4.Evaluation of neutrophil-to-lymphocyte ratio in patients with symptomatic rhinitis
Engin Başer, Papatya Bayrak Degirmenci, Ilker Burak Arslan, İbrahim Çukurova
doi: 10.5606/Tr-ENT.2019.85856  Pages 172 - 177
INTRODUCTION: In this study, we aimed to measure the diagnostic value of neutrophil-to-lymphocyte ratio (NLR) in both perennial allergic rhinitis (AR) and non-allergic rhinitis (NAR) patients during their period of active symptoms.
METHODS: A total of 161 patients (101 males, 60 females; mean age 34.0±11.1 years; range, 18 to 56 years) consisting of 70 persistent allergic rhinitis (PAR) and 39 NAR patients diagnosed between March 2018 and March 2019 in the adult allergy outpatient clinic, having a Total Nasal Symptom Score (TNSS) of ≥8, and recent complete blood count results available before undergoing any medical treatment and 52 control patients (28 males, 24 females; mean age 31.7±7.8 years; range, 18 to 44 years). The NLR was calculated by dividing the number of neutrophils by the number of lymphocytes.
RESULTS: There was no statistically significant difference in the age or gender between the groups (p>0.05). There was no statistically significant difference in the neutrophil, lymphocyte, and NLR between the groups (p>0.05).
DISCUSSION AND CONCLUSION: Our study shows that NLR is not a useful tool in the diagnosis and management of treatment in PAR and NAR in adults.

5.The role of the external nasal measures of patients with sleep disordered breathing in determining disease severity
Mustafa Avcu, Mehmet Metin, Tufan Ulcay, Zeynel Abidin Erbesler
doi: 10.5606/Tr-ENT.2019.59254  Pages 178 - 186
INTRODUCTION: In this study, we aimed to investigate the influence of nasal anthropometric measurements on severity of obstructive sleep apnea syndrome (OSAS) and to assess the correlation between nasal anthropometric measurements and severity of OSAS after excluding internal factors causing nasal obstruction.
METHODS: A total of 241 consecutive patients (181 males, 60 females; mean age 50.3±11.3 years; range, 18 to 65 years) with daily sleepiness and/or snoring complaints between February 1st 2018 and December 15th 2018 were included in the study. All patients were divided into eight groups as obese and non-obese according to the disease severity and BMI values.
RESULTS: According to the obese and non-obese groups, none of the anthropometric measurements in the obese group were correlated with OSAS, while only nasal width (r: 0.282, p=0.001), nasal tip height (r: 0.235, p=0.008), and alar-pronasal distance (r: 0.156, p=0.031) were found to be correlated in the non-obese patient groups. Linear regression analysis of variables which appeared to correlate with the OSAS severity revealed that no variables except for age and BMI significantly contributed to the OSAS severity in the obese group. For the non-obese group, in addition to age and BMI values, nasal width significantly contributed to the disease severity.
DISCUSSION AND CONCLUSION: Although there are many factors in the etiology of OSAS, no external nasal anatomic measurement, except for the nasal width, seems to be correlated with the disease severity.

6.Which approach is better for the protection of vestibular receptors in cochlear implant surgery: Round window or standard cochleostomy?
Muhammed Dağkıran, Ülkü Tuncer, Özgür Sürmelioğlu, Özgür Tarkan, Süleyman Özdemir, Elvan Onan, Mete Kıroğlu
doi: 10.5606/Tr-ENT.2019.76376  Pages 187 - 195
INTRODUCTION: This study aims to compare electrode insertion techniques in cochlear implantation (CI) as the standard cochleostomy approach (SCA) versus the round window approach (RWA) on five vestibular end-organ functions and vertigo in the pre- and postoperative period.
METHODS: In total, 51 patients (22 males, 29 females; mean age 38.2 years; range 16 to 70 years) with normal vestibular function and operated with single-sided CI were included in this study between January 2015 and December 2019. Of the patients, 30 were operated with the RWA and 21 with the SCA. All of the patients were evaluated with the Dizziness Handicap Inventory (DHI) and a complete vestibular test battery including the video head impulse test (vHIT), cervical vestibular-evoked myogenic potential (cVEMP), and ocular vestibular-evoked myogenic potential (oVEMP) at one week preoperatively and one month postoperatively.
RESULTS: Patients in the RWA group had a statistically significantly better protected vestibular functions and fewer subjective vertigo symptoms in the postoperative period (p<0.05). Deterioration in at least one of the five vestibular end-organ functions was observed in eight of 21 patients (38.09%) in the SCA group, compared to three of 30 (10%) in the RWA group. A significant correlation was detected between the vestibular tests and DHI in both groups (r=0.686, p=0.001 in the SCA group and r=0.630, p<0.001 in the RWA group).
DISCUSSION AND CONCLUSION: Our study results suggest that RWA for CI may minimize damage to vestibular receptor functions and vertigo symptoms than SCA.

7.Merkel cell carcinoma of the oral cavity: A case report
Bedir Recep, Mehpare Suntur, Orhan Semerci, Engin Dursun
doi: 10.5606/Tr-ENT.2019.95967  Pages 196 - 199
Merkel cell carcinoma (MCC) is a rare, but highly aggressive neuroendocrine neoplasm. It usually affects the head and neck region of the skin exposed to ultraviolet radiation from the sun. Although rare, there are primary oral cavity cases reported in the literature. Herein, we present an 80-year-old male case with a mucosal MCC located in the oral cavity as evidenced by both morphological and immunohistochemical findings.

8.Pathogenesis and pathophysiology of Meniere’s disease: An update
Pelin Koçdor, Michael Paparella, Meredith Adams, Sebahattin Cüreoğlu
doi: 10.5606/Tr-ENT.2019.04274  Pages 200 - 206
Meniere’s disease is known with certain clinical symptoms such as fluctuating hearing loss, episodic vertigo, and tinnitus and characterized by endolymphatic hydrops found on post-mortem examination. The pathophysiology of Meniere’s disease is still questionable, and it has not been fully understood despite almost a century of research. Many determinants are effective in the occurrence of endolymphatic hydrops and in the pathogenesis of relevant cochleovestibular dysfunction. This review discusses research studies conducted in recent years concerning the pathogenesis and pathophysiology of Meniere’s disease. Histopathological research studies conducted in recent years on patients with Meniere’s disease have often focused on certain subjects as follows: aquaporins, oxidative stress, genetics, cochlear lateral wall changes, longitudinal flow blockage, intraskeletal channels of the otic capsule, hydropic and cellular changes in Reissner’s membrane, cochlear hair cells and spiral ganglion cells, round window thickness, basement membrane pathology, and otolithic membrane damages. Recent studies conducted on pathogenesis mechanisms of Meniere’s disease would provide an insight for the improvement of diagnosis and treatment of this weakening disease.

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