Objectives: Tonsillectomy is among the most frequently performed pediatric ENT procedures. Post-tonsillectomy pain and hemorrhage remain key determinants of postoperative morbidity and may differ by surgical technique. This work’s objective is to compare postoperative pain, bleeding, and operative duration across three pediatric tonsillectomy techniques: cold dissection with suturing, cold dissection with ligation, and hot dissection with bipolar cautery. Materials and Methods: In this single-center, prospective study, 150 children (n = 50 per group) undergoing tonsillectomy (with adenoidectomy) between October 2022 and October 2024 were assigned preoperatively to the following groups: Group 1—cold dissection + suturing; Group 2—cold dissection + ligation; Group 3—hot dissection (bipolar cautery). Pain was assessed with the Wong–Baker FACES scale at 1, 6, and 24 h, days 3 and 7, and with the Parents’ Postoperative Pain Measure (PPPM) at 1, 6, and 24 h. Primary bleeding was defined within 24 h; secondary bleeding was within 2 weeks. Operative time was recorded from first incision to hemostasis. Non-parametric tests and chi-square analyses were used with p < 0.05 considered significant. Results: Of 150 patients, 58% were male. No primary hemorrhage occurred. Secondary hemorrhage occurred in 4/150 (2.7%): 1/50 (2%) in Group 1, 0/50 (0%) in Group 2, and 3/50 (6%) in Group 3 (overall p > 0.05). Readmission for oral-intake difficulty occurred in 4/150 (2.7%): 1/50 (2%) in Group 1 and 3/50 (6%) in Group 3 (p > 0.05). Operative time differed significantly across groups (Kruskal–Wallis p < 0.05), being longest in Group 1 and shortest in Group 3 (17.53 ± 1.26 min); Group 2 averaged 18.60 ± 0.94 min and Group 1 21.89 ± 1.64 min. Pain decreased over time in all groups (Friedman p < 0.001). Across virtually all time points, Group 2 (ligation) had significantly lower Wong–Baker and PPPM scores than Groups 1 and 3 (Dunn post-hoc, adjusted p < 0.05), while Groups 1 and 3 did not differ consistently. Conclusions: Cold dissection with ligation yielded the most favorable pain profile while maintaining low bleeding rates; hot dissection minimized operative time but tended toward higher secondary bleeding and postoperative intake difficulties. Technique selection should prioritize postoperative comfort and morbidity reduction—particularly in pediatric populations—favoring cold dissection, with ligation offering a consistent analgesic advantage.

Objectives: This study aimed to evaluate the clinical and hearing outcomes of patients with cholesteatomatous chronic otitis media using the ChOLE classification system and to assess its utility in predicting recurrence, guiding surgical approach, and anticipating hearing recovery. Materials and Methods: This retrospective study included 130 patients (141 ears) who underwent surgery for cholesteatoma between 2011 and 2020. Data were collected from surgical notes, imaging studies, and audiological evaluations. Patients were classified according to the ChOLE criteria, which incorporate cholesteatoma extension (Ch), ossicular chain status (O), and life-threatening complications (L). Surgical procedures and functional outcomes were compared across different stages and classification groups. Hearing outcomes were assessed in the early (3rd month) and late (2nd year) postoperative period. Results: Among the 130 patients (141 ears) evaluated, Stage II was the most common ChOLE stage (74.4%), followed by Stage I (17.7%) and Stage III (7.8%). The most frequently observed cholesteatoma extent was Ch3. A statistically significant association was found between surgical technique and ChOLE stage (p = 0.001): canal wall-down (CWD) tympanomastoidectomy was performed in 91% of Stage III cases and 84% of Stage II cases, whereas 76% of Stage I cases underwent canal wall-up (CWU) procedures. The overall recurrence rate was 29.5% in the CWU group and 16.4% in the CWD group, although this difference did not reach statistical significance (p = 0.792). However, ossicular chain status (O) showed a strong association with both early and late hearing outcomes. At 2 years, conductive hearing success was achieved in 90.9% of O0 patients, compared to 14% of O3b and 0% of O4 patients (p = 0.001). With regard to cholesteatoma extent (Ch), a statistically significant correlation was observed with early air–bone gap (ABG) closure success (p = 0.008) and late air conduction thresholds (p = 0.015). Similarly, ChOLE stage was significantly associated with early conductive hearing success (p = 0.012) and late ABG closure (p = 0.015). Overall, long-term hearing outcomes were superior to early results. Hearing success increased from 19.1% to 24.8% for air conduction thresholds and from 23% to 31.2% for hearing gain when comparing early and late follow-up periods. Conclusions: The ChOLE classification proved useful in guiding surgical strategy and predicting functional outcomes in cholesteatoma surgery. Advanced stage and greater cholesteatoma extension were associated with more extensive surgical procedures and poorer hearing results. Long-term audiological follow-up provided more accurate insights into surgical success. The standardized ChOLE system facilitates consistent reporting and meaningful comparison across institutions and studies.

Objective: Carotid body tumors (CBTs) are rare neurogenic tumors that may indirectly affect cardiac autonomic regulation. This study aims to investigate the relationship between tumor size and electrocardiographic (ECG) findings, particularly the corrected QT (QTc) interval. Methods: This retrospective study included 21 patients with histologically or radiologically confirmed CBTs treated at a tertiary center between 2021 and 2025. Patients with comorbidities or medications affecting cardiac conduction were excluded. Tumor sizes were measured via contrast-enhanced computed tomography or magnetic resonance imaging. Preoperative ECGs were analyzed for heart rate, P wave, PR, QRS, T wave, and QTc intervals. The correlation between tumor size and ECG parameters was assessed using Spearman’s rank correlation. Results: A statistically significant and strong positive correlation was observed between tumor size and QTc interval ( r = 0.940, P < .001). No other ECG parameter showed a significant association with tumor size. Tumor size explained 88.36% of the variance in QTc duration ( r ² = 0.8836). Conclusion: This study demonstrates a strong correlation between CBT size and QTc prolongation, suggesting vagal overactivity as a possible mechanism. QTc may serve as a noninvasive marker of subclinical autonomic dysregulation in CBT patients. Larger prospective studies are warranted to validate this association and explore its clinical significance.

The aim of this study was to investigate the association between intraoperative chorda tympani nerve (CTN) manipulation time and early postoperative taste disturbance after primary stapes surgery. This retrospective study included 56 patients who underwent primary stapes surgery. CTN manipulation time was measured objectively using archived surgical video recordings. Early postoperative subjective taste symptoms were assessed at postoperative week 1 using a patient-reported ordinal scale. Patients were grouped according to manipulation duration, and taste outcomes were compared. Receiver operating characteristic (ROC) analysis was performed to determine the discriminative ability of manipulation time and identify an optimal cutoff value. In addition, logistic regression analysis was performed to evaluate the association between CTN manipulation time as a continuous variable and the risk of postoperative taste disturbance. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Postoperative taste disturbance occurred in a total of 13 patients (23.2%), including 3 patients (10.7%) in the short manipulation group and 10 patients (35.7%) in the long manipulation group (Fisher's exact test p = 0.041; OR = 4.63). Postoperative taste scores were significantly lower in the long manipulation group, with median scores of 3 (IQR: 2-3) versus 3 (IQR: 3-3) in the short manipulation group (p = 0.021). ROC analysis demonstrated high discriminative performance (AUC = 0.93; 95% CI: 0.80-1.00); however, given the limited number of outcome events, these findings should be interpreted as exploratory and hypothesis-generating. When CTN manipulation time was analyzed as a continuous variable, univariable logistic regression analysis demonstrated that longer manipulation time was significantly associated with an increased risk of postoperative taste disturbance (OR = 1.06 per second increase, 95% CI: 1.02-1.11, p = 0.008). Prolonged CTN manipulation time may be associated with an increased risk of subjective early postoperative taste disturbance after primary stapes surgery and may reflect underlying surgical complexity and intraoperative conditions rather than a direct causal mechanism. However, given the potential influence of perioperative confounders, these findings should not be interpreted as indicating a direct causal relationship.

Post-tonsillectomy pain is one of the most common morbidities in children, markedly affecting comfort and recovery. Although several factors influencing pain have been explored, the role of tonsil volume remains unclear. To investigate the relationship between objectively measured tonsil volume and postoperative pain in pediatric tonsillectomy. This prospective observational study included 150 children aged 4-12 years who underwent bilateral cold-dissection tonsillectomy. Tonsil volume was measured intraoperatively by the water-displacement method. Patients were divided into three groups by total tonsil volume. Postoperative pain was assessed using the Wong-Baker Faces Pain Rating Scale (WB) and the Parents' Postoperative Pain Measure (PPPM) at 1, 6, and 24 h and on postoperative days 3 and 7. Correlations were analyzed with Spearman's test. Pain scores differed significantly among groups. The largest-volume group showed the highest PPPM scores at all time points (p < 0.001). The strongest correlation occurred between tonsil volume and PPPM scores at 6 h (r = 0.65, p < 0.001), while WB scores on day 7 correlated moderately (r = 0.41, p < 0.001). Tonsil volume is positively correlated with postoperative pain after pediatric tonsillectomy. Objective volumetric assessment offers greater predictive value than subjective grading and may guide individualized analgesic and counseling strategies.

Nüfusun yaşlanması ve estetik beklentilerin artması, yüz gençleştirme prosedürlerine olan talebi her geçen gün artırmaktadır. Yaşlanma süreci; kemik, kas, bağ dokusu ve cilt seviyesinde meydana gelen yapısal deformasyonlarla kendini göstermektedir. Bu süreçte hücresel düzeyde kolajen ve elastin üretimi azalırken, yüzün derin yağ yastıkçıklarında atrofi, yüzeysel katmanlarında ise pitoz yani sarkmalar meydana gelir. Yaşlanan yüz ve boyun anatomisini restore etmek amacıyla uygulanan kozmetik cerrahi yöntemlerinin başında yüz germe (ritidektomi) operasyonları gelmektedir. Yüz germe cerrahisi, tarihsel süreçte basit cilt eksizyonlarından başlayarak günümüzde derin doku manipülasyonlarına kadar uzanan geniş bir teknik çeşitliliğe evrilmiştir. Bu teknikler arasında Klasik Deri Altı Yüz Germe, SMAS Plikasyonu, Minimum Erişimli Kraniyal Süspansiyon Germe (MACS Lift), Derin Plan Yüz Germe, Genişletilmiş SMAS Germe, Lateral SMASektomi, Kompozit Yüz Germe ve Subperiostal Yüz Germe yer almaktadır. Her cerrahi yöntemin diseksiyon düzlemi, etki süresi, skar boyutu ve fasiyal sinir yaralanma riski gibi kendine özgü avantaj ve dezavantajları bulunmaktadır. Cerrahın en büyük zorluğu; hastanın cilt yapısı, anatomik deformasyonları, beklentileri, iyileşme süresi ve ekonomik durumu gibi bireysel faktörleri değerlendirerek en doğru kişiselleştirilmiş tekniği seçmektir. The aging population and increasing aesthetic expectations drive the demand for facial rejuvenation procedures. The aging process manifests through structural deformations in bones, muscles, connective tissues, and skin. At the cellular level, collagen and elastin production decreases, leading to the atrophy of deep facial fat pads and the ptosis of superficial layers. Facelift (rhytidectomy) operations are primary cosmetic surgery methods used to restore the aging face and neck anatomy. Historically evolving from simple skin excisions, facelift surgery now includes advanced deep tissue manipulations. These techniques comprise Classical Subcutaneous Facelift, SMAS Plication, Minimal Access Cranial Suspension Lift (MACS Lift), Deep Plane Facelift, Extended SMAS Lift, Lateral SMASectomy, Composite Facelift, and Subperiosteal Facelift. Each surgical method possesses distinct advantages and disadvantages regarding dissection planes, duration of effect, scar size, and facial nerve injury risks. The primary challenge for surgeons is selecting the most accurate personalized technique by evaluating individual factors, including the patient's skin condition, anatomical deformations, expectations, recovery time, and economic status.