In spite of the improvements in diagnosis and treatment, deep neck infection may be an important cause of mortality if complications develop. Comorbid anemia, Ludwig's angina and retropharyngeal involvement were identified as the strongest predictors in terms of development of complications. Duration of hospital stay extended in patients who developed complications.

Level IIb nodal involvement is very rare in LSCC. Therefore, the area can generally be preserved in elective neck dissection to lessen morbidity and, specifically, to avoid damaging the function of the spinal accessory nerve.

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Tympanosclerosis surgery has poor success rates, since the pathological process is still active. We suggest that high levels of matrix metalloproteinases may play a role in the continuation of the disease process.

Many techniques and graft materials have been used for the reconstruction of the tympanic membrane. We conducted a retrospective study to compare anatomic and functional outcomes of type 1 tympanoplasty that we performed with boomerang-shaped chondroperichondrial cartilage grafts (BSGs) and shield-shaped chondroperichondrial cartilage grafts (SSGs) in pediatric patients. Our study population was made up 121 patients—61 boys and 60 girls, aged 7 to 16 years (mean: 12.4)—who had undergone a type 1 tympanoplasty. Patients were divided into two groups according to the grafting technique used; there were 59 patients in the BSG group and 62 patients in the SSG group. Ear examinations were performed at postoperative months 3, 6, 12, and 24, and pure-tone average (PTA) for air-conduction threshold values and air-bone gaps (ABGs) were evaluated at 0.5, 1.0, 2.0, and 4.0 kHz at the same visits. We also investigated the impact of the graft material on functional graft success and intergroup differences (if any) in surgical success. Mean postoperative follow-up periods were 30.5 and 30.2 months in the BSG and SSG groups, respectively. We found that the success rates for tympanic membrane reconstruction were not significantly different in the two groups (91.5 and 88.7%). Postoperatively, the mean PTA and ABG values in both groups at 3, 6, 12, and 24 months were significantly lower than the preoperative values (p < 0.05). There were no significant differences in mean PTA values between the two groups at 3, 6, 12, and 24 months. However, the extent of the decrease in PTA values in the BSG group at 3 months was significantly greater than that of the SSG group (p < 0.05). There were no significant differences in mean ABG values between the two groups at 3, 6, and 12 months, but at 24 months, the value was significantly higher in the BSG group (p < 0.05). Finally, the extent of the decrease in ABG in the BSG group at both 3 and 6 months was significantly greater than that of the SSG group (p < 0.05). We conclude that the BSG procedure is a reliable and safe method of performing pediatric tympanoplasty.

OBJECTIVE: Myringosclerosis (MS) is a pathological condition characterized by hyaline degeneration and calcification of the collagenous structure of the fibrotic layer of the tympanic membrane, which may develop after trauma, infection, or inflammation as myringotomy, insertion of a ventilation tube, or myringoplasty. The aim of our study was to both reveal and evaluate the impact of the factors that might be effective on the post-tympanoplasty development of myringosclerosis in the graft. MATERIALS and METHODS:In line with this objective, a total of 108 patients (44 males and 64 females) aged between 11 and 66 years (mean age, 29.5 years) who had undergone type 1 tympanoplasty (TP) with an intact canal wall technique and type 2 TP, followed up for an average of 38.8 months, were evaluated. In the presence of myringosclerosis, in consideration of the tympanic membrane (TM) quadrants involved, the influential factors were analyzed in our study, together with the development of myringosclerosis, including preoperative factors, such as the presence of myringosclerosis in the residual and also contralateral tympanic membrane, extent and location of the perforation, and perioperative factors, such as tympanosclerosis in the middle ear and mastoid cavity, cholesteatoma, granulation tissue, and type of the operation performed. For statistical analysis of data, independent samples t-test was used. RESULTS:Our study comprised 44 male and 64 female patients. Median postoperative follow-up period was estimated as 38.8 months. The rate of postoperative development of myringosclerosis in grafts was significantly higher in patients with already existing sclerotic foci in TM (p=0.001). The location of the perforation had no effect on the postoperative development of MS in the graft (p=0.521). No statistically significant difference was detected between the size of the perforation and formation of MS (p=0.581). Statistical analysis of both groups could not discern any significant intergroup difference as to the impact of the presence or absence of cholesteatoma on the development and extent of MS (p=0.604). Impact of tympanosclerosis on the postoperative development and extent of MS in the graft was significant (p=0.001). Presence or absence of granulation tissue on the development or extent of myringosclerosis was not detected (p=0.697). Myringosclerotic foci in the contralateral ears had a statistically significant effect on the postoperative development and extent of MS in the grafts (p=0.001). Type of surgery performed did not exert any significant effect on the development or extent of myringosclerosis (p=0.765). CONCLUSION:We have determined that the presence of myringosclerosis in the residual membrane and in the contralateral tympanic membrane and tympanosclerosis in the middle ear have a significant role in the development of postoperative myringosclerosis in the tympanic membrane, contrary to the type of the surgical intervention, location and extent of perforation, presence of cholesteatoma, and granulation tissue.

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