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 National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline.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.

Background: Voice may be affected during the period of pregnancy, especially in the third trimester. However, the exact mechanisms leading to the phonatory changes have not yet uncovered. Aims: The aim of this study is to investigate the possible histological changes in the vocal cords of the pregnant rats in three separate trimesters. Study Design: Animal experiment. Methods: Twenty-five Wistar-Albino female rats were divided into four groups: control group, pregnancy day 7 (Group 1), pregnancy day 14 (Group 2) and pregnancy day 20 (Group 3). The laryngeal specimens were obtained under general anesthesia. Histological assessment was performed using Hematoxylin-eosin and toluidine blue. A stereological analysis of vocal cord tissue was performed using a NISElements D32 Imaging Software.Results: Lamina propria was observed to be edematous, and the lamina propria area was thickened starting from the second trimester. Glycosaminoglycans were observed to increase in the second trimester. Although none was encountered in the control, mast cells were observed in the lamina propria layer of the vocal cord starting in the muscular layer in the first trimester proceed to the subepithelial region as degranulated just before term. The covering epithelium remained unchanged throughout pregnancy. Conclusion: Lamina propria thickening may be attributed to both edema and increased glycosaminoglycans. The presence of mast cells in the cordal tissue may induce edema during pregnancy in rats.

We aim to demonstrate possible autonomic dysfunction based on salivary α-amylase measurements during and after the vertigo attacks associated with Ménière disease (MD) and benign paroxysmal positional vertigo (BPPV). Patients admitted to the emergency room with a diagnosis of vertigo attacks caused by either MD (n = 15) or BPPV (n = 9) constituted the study groups. The control group (n = 10) consisted of volunteer patients admitted to the emergency department with minor soft-tissue trauma. The first saliva samples were obtained immediately during the attacks and the second and third samples were obtained on the third and fifteenth days of the attack, respectively. In the controls, the first sample was obtained after admission to the hospital and the second sample was obtained on the third day. Salivary α-amylase levels were evaluated. The difference between salivary α-amylase levels in patients with MD and BPPV was not significant. The amylase value measured early after the BPPV attack was significantly lower than that of the controls (p = 0.008). Although not significant, an undulating pattern of salivary α-amylase levels was observed with both diseases. An autonomic imbalance could be partly demonstrated by salivary α-amylase measurement early after the attack in patients with BPPV. Therefore, amylase may be a promising marker that is worth further investigation.

Objectives: Sarcoidosis is an idiopathic and multisystemic chronic disease characterized by non-caseating granulomas. Sinonasal sarcoidosis may be seen in an isolated form or related to a multisystemic disease. A 48year-old female patient visited the otolaryngology department with complaints of headache and nasal obstruction for two years. The physical examination revealed a saddling on the nose, and crusted fragile mucosa was observed bilaterally in nasal endoscopy. Paranasal CT showed invasion of the right orbita. In chest X-ray, there was bilateral hilar enlargement, and lung biopsy revealed non-caseating granulomas. A bilateral endoscopic sinus surgery was applied to the patient. Upon histopathological demonstration of multiple noncaseating granulomas in the specimen, the diagnosis of sinonasal sarcoidosis was made. The patient responded well to the following steroid treatment. Although rare, sarcoidosis should be taken into consideration in differential diagnosis of sinonasal diseases.

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