Over-under tympanoplasty is a technique aimed at eliminating the disadvantages of the two classical techniques of overlay and underlay myringoplasty, which are employed in repairing the tympanic membrane. In this retrospective study, a total of 104 patients underwent myringoplasty, which was performed by means of the underlay technique in 46 patients and over-under technique in 58 patients. The mean follow-up period was 11 months. In the first group of patients, the underlay technique was performed; the grafted membrane was placed medial to the remaining drum and the manubrium of the malleus. In the second group, the over-under technique was performed; the grafted membrane was placed under the remaining drum and over the malleus. The rate of success in the first group of 46 patients was 91.5%, and that of atelectasis was 19.5%. The rate of success in the second group of 58 patients was 94.9% and 12%, respectively. Lateralization of the graft was not observed in either of the groups. In the patients operated on by means of the underlay technique, the air-bone gap decreased by 16.55 dB this rate was 16.96 dB in those operated on by the over-under technique. The authors consider over-under tympanoplasty to be superior to the other two classical methods not only because of its effectiveness, but also because of the results achieved by this technique.

External approach septoplasty has a beneficial effect on olfaction and this effect may be partly due to interactions between the increased perception of nasal air flow, as well as surgery-associated improvement in the internal nasal valve area.

OBJECTIVE:Pediatric neck masses (PNMs) are a frequently encountered problem in otorhinolaryngology practice. The clinical approach to cervical masses in childhood varies from that of adults. Due to differences among clinicians in the assessment of a PNM, studies investigating this subject are significant contributions to the literature. For this reason, a review was conducted of pediatric PNM cases with an open biopsy (incisional/excisional) and a histopathological diagnosis.METHODS:The hospital records of 98 (34 girls, 64 boys) pediatric patients aged between 8.5 months and 16 years were reviewed. The history, physical examination findings, blood tests, medical treatments, imaging reports, and the pathology and/or microbiology results of the patients were recorded and evaluated. The cervical masses were categorized according to the etiology, imaging features, size, and location.RESULTS:Surgical biopsy was planned due to the suspicion of malignancy, typical clinical presentation or location, or size greater than 20 mm despite antibiotherapy for 2 to 6 weeks. Excisional biopsy (91.8%) was the first choice for histopathological sampling. Infectious masses were observed most commonly, followed by congenital and neoplastic masses, at a rate of 49%, 27.6%, and 23.4%, respectively. Hodgkin lymphoma was the most frequent type of malignancy (39.1%). Thyroglossal and branchial cysts constituted 74.1% of congenital masses. Sixty-seven percent of all masses were solid, and the lateral levels of the neck were the most affected locations (44.9%).CONCLUSION:In most cases, the diagnosis can be made with a detailed history and physical examination. In the presence of nonspecific findings, blood tests, imaging, and histopathological sampling are required. Ultrasound should be the first preference for imaging, and excisional biopsy is suggested rather than fine needle aspiration biopsy for histopathological sampling in pediatric neck masses.

Sonographic scoring of thyroid nodules is an effective method for predicting malignancy. The authors suggest including associated pathologic node in the scoring criteria. Further studies with larger cohorts will provide more evidence about its importance in sonographic scoring.

This study reveals that the nasal tip lost height from facial plane and rotated caudally in most patients who underwent OAES without simultaneous rhinoplasty. Patients demanding only relief of nasal obstruction and scheduled for OAES have to be informed about the potential cosmetic alterations when a simultaneous rhinoplasty is not requested.