The aim of this study was to evaluate the learning curve of endoscopic tympanoplasty for a surgeon already trained in microscopic tympanoplasty. We analyzed the clinical records of 81 patients who underwent transcanal endoscopic type 1 tympanoplasty and 30 control patients who underwent microscopic tympanoplasty between 2013 and 2015 in a tertiary hospital. All operations were performed by a single surgeon already trained in microscopic tympanoplasty. Patients were divided into four groups according to the date of surgery chronologically (group 1 early stage, group 2 intermediate stage, group 3 advanced stage and group 4 control). We evaluated the four groups according to surgery duration, audiometric results, and graft intake success. The operation duration shortened in accordance with the surgeon's experience and there were two subsequent steps during the learning curve: first, after 30 procedures; and second, after 60 procedures. The mean operation duration was 88.60 ± 21.10 min in group 1, and 62.00 ± 12.48 min in group 2. After 60 procedures, the mean operation duration was 43.81 ± 8.34 min in group 3. In the control group, the microscopic tympanoplasty duration was 69.93 ± 12.56 min. When we compared audiologic results (air conduction, bone conduction, and air-bone gap) and graft intake success rates, there were no significant differences between groups. Endoscopic tympanoplasty is a minimally invasive and effective technique. Mastering endoscopic tympanoplasty takes approximately 60 operations for a surgeon already trained in microscopic tympanoplasty. Graft intake success rates and hearing results are stable during the learning curve.

OBJECTIVES: Our aim was to investigate platelets (PLT) and their indices-mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT)-in the differential diagnosis of benign and malignant thyroid disorders. BACKGROUND: Platelet and platelet indices recently started to be defi ned as an useful clinical marker in cancer patients. Their higher reproducibility rates and low cost provide them a wide range of usage. MATERIAL AND METHODS: One-hundred and sixty patients were divided into three groups retrospectively. Group 1: papillary thyroid carcinoma patients (n = 65). Group 2: multi-nodular goiter patients (n = 65). Group 3: normal healthy subjects (n = 30). PLT, MPV, PDW and PCT measurements were compared between groups, and p < 0.05 was accepted as signifi cant. RESULTS: PDW was found to be signifi cantly decreased in Group 1 (p < 0.01), and PCT was observed to be signifi cantly increased in Group 1 (p < 0.01). There were no signifi cant differences in PLT and MPV results. CONCLUSION: Statistically signifi cant increases in PCT and decreases in PDW were observed in papillary thyroid cancer patients when compared with other groups. Platelet indices may be used as useful clinical markers in the differential diagnosis of benign and malignant thyroid disorders (Tab. 1, Fig. 2, Ref.

Angiofibroma of extranasopharyngeal origin is very rare. Although it is usually originated from any mucosal structure in the head and neck region, maxilla is the most common involvement site. The nasal septum is an exceptional anatomic site of an angiofibroma. Surgery is the best treatment modality and recurrence is very rare. Nasal septal angiofibromas must be considered in the differential diagnosis of nasal vascular masses arising from the nasal septum. In this article, we report a 37-year-old male case with nasal septal angiofibroma who underwent surgical resection of the tumor. This is the 16th case in the literature.

Neck mass can be an initial finding of many diseases at any age. The differential diagnosis is broad and includes inflammatory, congenital and neoplastic lesions. We retrospectively analyzed charts of the 145 patients with neck mass and without known primary malignancy whose diagnoses were confirmed with histopathologic and serologic examination between July 2003 and July 2008. Twenty-six patients (17.9%) were diagnosed with tularemia. Before 2004, serologic testing for tularemia was not a part of our workup for patients with an inflammatory neck mass. Otolaryngologists should be familiar with head and neck manifestations of tularemia and consider the disease in the differential diagnosis of neck masses. The tularemia outbreak in central Black Sea region, Turkey in 2004 changed our approach to a patient presenting with neck mass.

Parotitis may have occurred after retrograde air flow in the Stensen duct during CPAP application. After the exclusion of possible viral and bacteriological etiologies and possible drug reactions we can focus on this diagnosis.

Tinnitus is the perception of sound with no external stimulus and idiopathic subjective tinnitus is the most common type in adults. Mean platelet volume (MPV) alterations were shown in some inflammatory diseases and were evaluated as a clinically useful marker. Our aim was to investigate MPV alterations in idiopathic subjective tinnitus patients. A total of 101 patients and 54 age- and sex-matched healthy control subjects were enrolled in the study. Patients included in the study had complaints of tinnitus for at least 3 months. All patients underwent detailed otolaryngologic examination, blood sampling, pure tone audiometry, magnetic resonance imaging of ear, and vertebrobasilar artery Doppler ultrasonography to make the differential diagnosis of tinnitus. Blood sampling consisted of renal-liver-thyroid function tests, lipid profile, and complete blood count. All tests and examinations except the imaging modalities were also performed for the control group. There were no differences in age and sex distribution of groups. Mean platelet volume values were significantly increased in tinnitus patients when compared with controls (p = 0.001). We think that MPV can be qualified as a useful marker in tinnitus patients.

Objective/Hypothesis Button batteries (BBs) impacted in the nasal cavity can cause several complications. Understanding the injury mechanism and developing possible mitigation strategies can reduce these complications. Study design Cadaveric sheep nasal septum model. Methods Lithium, alkaline, silver oxide, and zinc‐air BBs were placed on segments of the nasal septum of cadaveric sheep. The BB voltage, tissue temperatures, and pH were measured every 30 minutes for 6 hours. Subsequently, 5 drops of lemon juice, apple cider vinegar, tea, Coke (Coca‐Cola Co., Atlanta, GA), tap water, and normal saline were applied separately to the other segments with the lithium BBs every 10 minutes for 3 hours. The visible injuries and the necrosis depths were assessed through the tissue temperatures, pH, and the voltage changes. Results Both nonlithium and lithium BBs increased tissue pH without significant temperature changes. The 3V lithium BBs led to the greatest depth of necrosis, with a voltage loss of approximately 50% within the first 2 hours. Lemon juice and apple cider vinegar were the most effective liquids for reducing visible injury, pH, and necrosis without increasing the temperature during pre‐removal time period. Conclusion Nonlithium and lithium BBs caused alkaline tissue injury in a nasal septal model. Given the hazard severity, expedited BB removal is critical. For situations when removal cannot be immediately performed, further in vivo study is needed prior to considering human use of any pre‐removal mitigation strategies in the nasal cavity. Level of Evidence NA Laryngoscope, 130:2487–2493, 2020

The etiology of primary nasolacrimal duct obstruction (NLDO) is unknown, and the disease may exist bilaterally in a small number of patients. Dacryocystorhinostomy (DCR) surgery is the recommended treatment for these patients, but concomitant nasal pathologies are believed to be related to decreased surgical success. The authors aim to assess the concomitant required nasal surgical procedure frequency for endoscopic surgical access retrospectively in bilateral and unilateral NLDO patients. Twenty-eight patients who underwent bilateral endoscopic DCR simultaneously and 30 patients who underwent unilateral endoscopic DCR were enrolled in this retrospective study. Required concomitant nasal procedure frequency was recorded. In the bilaterally applied DCR group, septoplasty, partial midline turbinectomy, and inferior nasal concha submucosal resection rates were 16 (57.1%), 5 (17.8%), and 3 (10.7%) patients, respectively. Septoplasty and concha bullosa resection were performed simultaneously in 2 patients. Also, uncinectomy was performed with septoplasty in 1 patient. The concomitant nasal surgery rate was 22 of 28 patients (78.6%). On the other hand, in the unilaterally applied DCR group, septoplasty, partial midline turbinectomy, and inferior nasal concha submucosal resection rates were 5 (16.7%), 1 (3.3%), and 2 (6.7%) patients, respectively. Both septoplasty and concha bullosa resection were done in 1 patient. Uncinectomy was performed on 1 (3.3%) patient. A concomitant surgery rate was observed in 8 of 30 patients (26.7%). Nasal pathology, which requires surgical intervention, is seen much more frequently in bilateral than in unilateral NLDO patients.