Background: Sudden sensorineural hearing loss (SSNHL) is still a complex and challenging process which requires clinical evidence regarding its etiology, treatment and prognostic factors. Therefore, determination of prognostic factors might aid in the selection of proper treatment modality. Aims: The aim of this study is to analyze whether there is correlation between SSNHL outcomes and (1) systemic steroid therapy, (2) time gap between onset of symptoms and initiation of therapy and (3) audiological pattern of hearing loss. Study Design: Retrospective chart review. Methods: Patients diagnosed at our clinic with SSNHL between May 2005 and December 2011were reviewed. A detailed history of demographic features, side of hearing loss, previous SSNHL and/or ear surgery, recent upper respiratory tract infection, season of admission, duration of symptoms before admission and the presence of co-morbid diseases was obtained. Radiological and audiological evaluations were recorded and treatment protocol was assessed to determine whether systemic steroids were administered or not. Treatment started ≤5 days was regarded as "early" and >5 days as "delayed". Initial audiological configurations were grouped as "upward sloping", "downward sloping", "flat" and "profound" hearing loss. Significant recovery was defined as thresholds improved to the same level with the unaffected ear or improved ≥30 dB on average. Slight recovery was hearing improvement between 10-30dB on average. Hearing recovery less than 10 dB was accepted as unchanged. Results: Among the 181 patients who met the inclusion criteria, systemic steroid was administered to 122 patients (67.4%), whereas 59 (32.6%) patients did not have steroids. It was found that steroid administration did not have any statistically significant effect in either recovered or unchanged hearing groups. Early treatment was achieved in 105 patients (58%) and 76 patients (42%) had delayed treatment. Recovery rates were no different in these two groups; however, when unchanged hearing rates were compared, it was statistically significantly lower in the early treatment group (p<0.05). When hearing outcomes were compared according to initial audiological pattern, significant recovery and unchanged hearing rates did not differ between groups; however, slight recovery rate was highest in the "flat" type audiological configuration (p<0.05). Conclusion: According to this patient series, oral steroid therapy does not have any influence on the outcomes of SSNHL. However, mid-frequency hearing loss of flat type and initiation of treatment earlier than 5 days from the onset of symptoms, seem to have positive prognostic effects. Further randomized controlled subject groups might contribute to determine prognostic factors of SSNHL.

No abstract

No abstract

Objective: The objective of this study was to review patients who underwent stapes surgery in the Hacettepe University Ear Nose Throat and Head and Neck Surgery Department with subgroups, such as type of surgery, prosthesis used in the surgery, rate of revision, and audiological results. Methods:The data of 35 years were searched, and it was detected that 327 patients (190 females, 137 males) had undergone stapes surgery; the age was ranging between 11-70 years (mean: 39).In our clinic, stapes surgery is performed mostly by transmeatal incision. After entering the middle ear, we almost always look for stapes mobility. If there is mobility in the incus and malleus and no mobility in the stapes, a small fenestra is performed as stapedotomy and prosthesis and placed between the stapedotomy fenestra and incus long arm. To cover the space near the stapedotomy, small bony fragments are placed. In patients who had preoperative and postoperative audiograms, the mean value of 500, 1000, 2000, and 4000 Hz air-bone conduction thresholds of 199 cases were measured and compared.Results: In 62% of 327 patients who were operated on, the air-bone gap was less than 10 dB, less than 15 dB in 88%, and less than 20 dB in 94%. In 6% of patients, there was air-bone conduction gap of more than 20 dB. Revision surgery was performed in 20 patients. Of them, air-bone gap closure was achieved in 60%. One patient had sudden sensorineural hearing loss. There was also a perilymph fistula in one patient who had vertigo.Stapedotomy and using a Teflon piston with autogenous bone are successful methods of recovering conductive-type hearing loss in otosclerosis. In patients with advanced sensorineural hearing loss, a very low air-bone gap or unmeasured air-bone gap is not a contraindication. Conclusion:Stapes surgery (stapedectomy or stapedotomy) is a successful surgery in the case of conductive-type hearing loss with otosclerosis. Complications, such as total sensorineural hearing loss, facial nerve paralysis, and perilymph fistula, could be seen at variable rates, and the surgeon should be cautious, and the patients must be informed about these complications in the pre-operative period. Keywords

Papillary thyroid microcarcinoma (PTMC) is defined as a papillary cancer that is 1 cm or less in its maximal diameter. The incidence of thyroid cancer has increased during the past 30 years. The aim of this study is to evaluate the rising incidence of PTMC (papillary thyroid microcarcinoma) and whether is lobectomy enough or not. The data of 462 consecutive patients who underwent thyroidectomy (hemithyroidectomy and total thyroidectomy) at the Hacettepe University Hospitals Department of ENT from 2000 to 2015 were analyzed. Surgical procedure, histopathologic examinations, postoperative complications, follow-up time and mortality were recorded. USG and FNAC were performed on all cases. Of the 344 patients with thyroid malignancy and 118 patients underwent total laryngectomy with thyroidectomy. 364 patients with TT and 98 patients with HT. The first group included 204 patients (Surgery time 2000-2007), 91 of them ( 44.6%) had PTMC. The second group included 258 patients, 192of them (74,4%) had PTMC (p<0.001). 22 Patients with PTMC underwent completion surgery and 40 of them just followed by hemithyroidectomy. There was no recurrence. PTMC has been rising incidence because of ,pathological and radiological, increased awareness and completion surgery is not necessary for all PTMC cases especially incidental PTMC.

Case ReportSpontaneous herniation of the temporomandibular joint (TMJ) through the external auditory canal (EAC) is a relatively rare condition. It was first described by Hawke in 1987. In this article, 2 cases with spontaneous herniation of TMJ were reported together with clinical and radiological features, as well as the updated literature.The first case was a 56-year-old female patient, and she applied to our clinic because of itching at the EAC. On physical examination, herniation of the TMJ to the left EAC was detected. On computerized tomography, there was a bony defect at the anterior portion of the left EAC. The second case was a 52-year-old female, and she attended our clinic with sore throat. On routine physical examination, herniation of the TMJ through the left EAC was detected. Both patients were asymptomatic; none of them underwent surgery and follow-up visits were recommended.In the presence of herniation of the TMJ, a bony defect between the posterior wall of the glenoid cavity and anterior part of the EAC should be taken into consideration. Treatment of TMJ herniation through the EAC is controversial, and presence and the degree of the symptoms are the factors which were taken into consideration for management.

Although pediatric parotid masses are unusual, they can represent a variety of pathological diagnoses, including malignancy. Parotidectomy remains the mainstay of treatment and surgical experience is needed for low complication rates especially in children.

No abstract