Teratomas are benign tumours containing tissues derived from ectoderm, endoderm and mesoderm Epignathus is a rare congenital teratoma and originates from oropharyngeal region. We present a case of giant epignathus arising from tonsillar region in a neonate. A male neonate that was born with a 38-week cesarean section presented with a pedunculated mass from left tonsilla palatina and protruding outside the mouth. The patient did not have any airway problem. Magnetic resonance imaging and computed tomography scan showed no intracranial extension. The patient was operated on the postpartum 3rd day and the mass was excised successfully. After histopathological examination, mature teratoma was diagnosed. During post-operative 6 months control visit, there was no recurrence. Epignathus is a rare congenital oropharyngeal teratoma, it should be diagnosed in the fetus as early as possible. Teratomas of the tonsilla palatina are extremely rare. In such cases, the mass may cause airway obstruction and feeding difficulties so complete resection is curative in most cases during the early neonatal period.

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Background: We aimed to evaluate whether C-reactive protein(CRP)/ Albumin ratio (CAR) performed in the early postoperative period after total laryngectomy could be a predictive factor for the development of pharyngocutaneous fistula (PCF). Methods: The files of patients with laryngeal squamous cell carcinoma who underwent total laryngectomy between January 2005 and January 2019 were retrospectively reviewed. Patients were divided into two groups: patients with PCF (PCF group) and without (Non-PCF group). CAR values and risk factors were compared between groups. Results: The overall incidence of PCF was 23.2%. There was a statistically significant difference between the two groups in terms of CRP and CAR levels (p = 0.001). The CAR value of 27.05 (sensitivity = 75.0% , specificity 68.2%, area under curve (AUC) = 0.742, 95% confidence interval 0.616–0.868) was determined as a cutoff value to describe the development of fistula in the early postoperative period. In multiple linear regression analysis, there was an independent relationship between presence of PCF and previous RT and CAR value. Conclusions: CAR, performed in the early postoperative period, may be a new and useful marker for predicting PCF after total laryngectomy.

Objective: The aim of this study is to evaluate any possible effects of chronic otitis media (COM), with or without accompanying cholesteatoma, on bone conduction thresholds (BCT). Methods: A total of 112 cases who underwent surgery for unilateral COM between 2006 and 2014 were enrolled in the study. Eighty cases had no cholesteatoma (Group 1). Thirty-two cases did have cholesteatoma (Group 2). Prior to surgery, the temporal bone was evaluated radiologically by use of high resolution computed tomography. The presence of a clinically and radiologically normal contralateral ear was the principal selection criterion for the cases. BCT at 0.5, 1, 2, 4 kHz and their averages were evaluated with pure tone audiogram (PTA) and the normal and diseased ears in each group were compared. This comparison was also made between the diseased ears in Groups 1 and 2. Results: There was a statistically significant difference observed between the mean BCT scores obtained by PTA for the normal/diseased ears in Group 1 (9.78±0.98/17.34±1.71 dB) and in Group 2 (9.10±0.99/17.58±2.59 dB). This statistically significant difference was observed for each of the four different frequencies (p<0.0001). However, there was no statistically significant difference observed between the mean BCT scores obtained by PTA for the diseased ears in Groups 1 and 2 (17.34±1.71/17.58±2.59 dB). Similarly, in the comparison between the diseased ears, the differences of BCT at all four different frequencies (0.5, 1, 2, 4 kHz) lacked statistical significance (p>0.05). Conclusion: As a result of this study, we can say that COM may lead to sensorineural hearing loss. However, we observed that the presence of cholesteatoma does not exert an additional negative effect on cochlear function.

BackgroundThe aim of this study is to investigate the levels of acute phase reactants (APRs) in patients with ankylosing spondylitis (AS) at the time of diagnosis and during follow-up. We also evaluated the associations between APR levels and disease activity.MethodsThe study included 948 patients with AS who were followed-up at Dokuz Eylul University School of Medicine Rheumatology outpatient clinic. The patients’ erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels across all visits were retrospectively reviewed through the Turkbio registry and the hospital’s database. Disease activity and follow-up parameters as BASDAI, ASDAS, BASFI and BASMI were taken from Turkbio visit charts. The correlation between APR and follow-up parameters were evaluated with Spearman correlation coefficient analysis.ResultsThere were 948 AS patients (69% male, mean age 46,6±12,1 years) who fulfilled the 1984 modified New York criteria. At first visit, high levels of CRP and ESR were observed in 626 (68.5%) and 578 (64.6%) patients respectively. During follow-up 84.6% of patients had high CRP and 69.5% patients had high ESR at any visit (figure 1). However in 10% of AS patients APRs did not increase at any visits.There was good correlation between ESR and CRP (r=0.666, p<0.001). A better correlation was observed at first visit between CRP and BASDAI (r=0.81, p=0.23) or ASDAS (r=0.468, p<0.001) compared to ESR and BASDAI (r=0.111, p=0.02) or ASDAS (r=0.334, p<0.001) (table 2). Compared to BASDAI, ASDAS with either ESR (p<0.001) or CRP (very high disease activity-p <0.001, inactive disease-p=0.001) had better performance in evaluating the activity of the patient in inactive and very high levels of severe disease (table 2).Abstract AB0860 – Table 1Demographic and clinical featuresAge; Mean±SD (yrs) 46,6±12,1 Age at onset of illness; Mean±SD (yrs) 27,3±10,5Age of diagnosis; Mean±SD (yrs) 34,5±12,0Females/Males sex, n (%)293 (%30,9)/655 (%69,1)HLAB27 Pozitive/Negative/Unknown 237 (%25)/100 (%10,5)/611 (%64,5)Abstract AB0860 – Table 2Correlation between first visit ESR/CRP and disease activity parametersESRCRP rprp BASDAI01110,020,810023BASMI0123000302050,00BASFI02190,0002240,00ASDAS03340,0004680,00Abstract AB0860 – Figure 1Ven diagram of patients that elevation only ESR/CRP or with both elevation together at any visitConclusionsIn over 80% patients with AS had elevated levels of CRP, the most frequently used laboratory parameter, during follow-up. CRP is well correlated with ESR, and disease activity parameters as BASDAI, ASDAS, BASFI and BASMI. Compared to BASDAI; ASDAS had better agreement between activity and APRs. Interestingly, in 10% of AS patients APRs did never increase in follow-up.Disclosure of InterestNone declared

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