The ossicles may be affected through the mass effect of the pathological tissue in chronic otitis media. Ossicular reconstruction may be accomplished using the patients' own ossicles or with alloplastic materials. Glass ionomer ossiculoplasty is a fast, efficient, safe and cost-effective method and it has been used more frequently in recent years. Forty-six patients who had surgery for chronic otitis media were included in this study. All patients had an incus long process defect and a normal stapes superstructure. Ossicular reconstruction was performed using glass ionomer cement (GIC) (Ketac-Cem, Espe Dental AG, Seefeld, Germany) in 23 patients (group 1), while incus interposition was performed in other 23 patients (group 2). Preoperative and postoperative air pure tone averages of the group 1 patients were 42.8 and 35.2 dB, respectively (p < 0.01). These values were 42.9 and 34.5 dB in group 2 (p < 0.01). Two groups were similar with respect to postoperative hearing gain (p > 0.05). The air bone gap of group 1 was 27 dB preoperatively and 20.7 dB postoperatively. These values were 28.7 and 20.2 dB, respectively, in group 2. The closure of air bone gap was statistically significant in both the groups (p < 0.01, p < 0.01). The comparison of the mean gains of the air bone gap revealed no difference between the groups (p > 0.05). In conclusion, the use of both GIC ossiculoplasty and incus interposition are efficient methods for reconstruction of incus long process and one is not superior to the other. A larger study population may be useful for comparison of these methods.

Dexamethasone (and possibly methylprednisolone) may be clinically useful as an intratympanic chemopreventive agent to treat cisplatin ototoxicity. Future clinical studies should investigate the use of dexamethasone for this purpose in adult patients.

Object: To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients. Methods: The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. Results: A detailed guideline about all aspects of allergic rhinitis was created. Conclusion: The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals.

The aim of this study is to investigate the thyroid functions and its correlation with polysomnography findings in obstructive sleep apnea patients. This study was conducted on 203 patients evaluated with the complaints of snoring, witnessed apnea and daytime sleepiness and established polysomnography (PSG) indication between May 2008 and August 2011. All patients' nocturnal PSG recordings were carried out. The thyroid function was classified as euthyroid, subclinical hypothyroidism and clinical hypothyroidism after analyzing serum TSH and free T4 values. The correlation between the data obtained from PSG records and thyroid function values was statistically compared. Apnea hypopnea index obtained from PSG was in the range of 5.4-132.9/h, and mean value was 32.7/h. The lowest oxygen saturation level was in the range of 20-92 %, and the mean value was 76.4 %. According to PSG results, 55 patients (27.09 %) had mild obstructive sleep apnea syndrome (OSAS), 48 patients (23.65 %) had moderate OSAS and 100 patients (49.26 %) had severe OSAS. On evaluation of the thyroid function test results, 10.8 % (n = 22) of the patients were defined to have subclinical hypothyroidism and 1.97 % (n = 4) clinical hypothyroidism. We found a total of 12.77 % subclinical and clinical hypothyroidism in patients with OSAS. Though the incidence of hypothyroidism was pretty high in patients with OSA, there was no statistically significant correlation between thyroid functions and polysomnography findings. We suggest that evaluation of the thyroid functions is important and necessary in patients with OSAS. Polysomnography findings do not correlate statistically with thyroid function tests, addressing the need for thyroid screening for all OSAS patients.

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Intratympanic methylprednisolone injection administered following an acoustic trauma appears to reduce cochlear outer hair cell loss. The impact on hearing loss is less certain. Early measurement of DPOAE within the 1st week shows significantly better amplitudes in the study group compared to controls. However at 2 weeks, there is no statistically significant difference in DPOAE amplitudes between the study and control group.

Decrease in airway volume does not signify the type of respiratory event, but significant narrowing of velopharynx in both dimensions; thus having the narrowest value below a certain level causes more apnea. Advances in knowledge: We did not find a similar study when we did a literature search, showing the relationship of apnea vs hypopnea predominance and upper airway parameters in CT in patients with OSA.

Original Article INTRODUCTIONCisplatin is an antineoplastic agent often used in malign neoplasms such as those in gastrointestinal systems, urinary system, and head and neck. Although it has successful results against cancer, there are restrictions in clinical use due to serious side effects such as gastrointestinal, peripheral neuropathic, nephropathic, bone marrow toxicity, and ototoxicity [1,2] . The increase in calcium rate is due to inner cellular calcium channel blockage in cochlear cells in cisplatin-induced ototoxicity; and increase electrolyte in imbalance and lipid peroxidation is due to the disruption in cell membrane, antioxidant system disruption, and emergence of free radicals such as oxygen and nitrogen [3][4][5][6] . As a result of these, progressive and irreversible sensorineural hearing loss in high frequencies and continuous or discontinuous tinnitus develops. In the studies conducted, it was shown that outer hairy cells in cisplatin cochlea, spiral ganglion cells (SGC), and cochlea basal and mid-turn parts in cochlea and Reissner's membrane and stria vascularis are affected [3,7,8] .In literature, different antioxidant agents such as vitamin E [9] , N-acetylcysteine [10] , dexamethasone [11] , lycopene [12] , and Ginkgo biloba [13] used in cisplatin-induced ototoxicity have been mentioned. Lycopene and G. biloba are also antioxidant agents. G. biloba contains biloba extract, EGb 761, 24% flavone glycosides, 6% terpene lactones, and 7% proanthocyaniclines which are strong antioxidants (14). In different in vivo and in vitro studies, it was shown that G. biloba prevents oxidative stress and has a role in the cleaning of free radicals [15,16] .