OBJECTIVES: To examine the efficacy of an intratympanic steroid injection in tinnitus cases unresponsive to medical treatment. MATERIALS and METHODS: The study was carried out at the Ear, Nose, and Throat Department with 107 patients (46 male, 61 female) between the ages of 20 and 77 with a mean of 42.8 years who had idiopathic tinnitus. Patients were randomized by simple randomization to receive intratympanic dexamethasone or isotonic solution. The patients received six intratympanic injections, two per week for three weeks. Tinnitus handicap index (THI) was performed before treatment and at first week, first month, and six months after the completion of the study protocol. The audiometric tests were performed six months after the treatment. RESULT: In the study group, pretreatment THI and post-treatment first month THI scores and pretreatment THI and post-treatment sixth month THI scores were significantly different whereas the same scores were not significantly different in the control group. The comparison of THI scores between the groups revealed significantly lower scores in the first and sixth months for the study group. CONCLUSION: The effect of the intratympanic injection of dexamethasone on the efficacy of treatment of tinnitus severity was statistically significant. Cite this article as: Yener HM, Sarı E, Aslan M, Yollu U, Gözen ED, İnci E. The Efficacy of Intratympanic Steroid Injection in Tinnitus Cases Unresponsive to Medical Treatment. J Int Adv Otol 2020; 16(2): 197-200.

Background: Tympanoplasty, essential for repairing tympanic membrane perforations, requires careful postoperative care for successful recovery. However, timely access to healthcare guidance can be challenging, especially in rural or underserved areas. ChatGPT-4, an artificial intelligence (AI) tool, offers a potential solution for continuous postoperative support and patient education. This study assesses the feasibility and effectiveness of using ChatGPT-4 as a supplementary information resource for tympanoplasty patients, focusing on its ability to provide accurate, precise, and relevant postoperative guidance in situations where access to healthcare professionals is limited.

Background: Bilateral sudden hearing loss (BSHL) is a rare otologic emergency, representing 1–2% of all sudden hearing loss cases. Autoimmune processes are considered one of the key contributors to BSHL, with immune responses targeting inner ear structures. The aim of our study is to identify the role of autoimmune and inflammatory markers in patients with BSHL and assess their prognostic significance. Materials and methods: This retrospective study reviewed 30 BSHL patients out of 420 sudden hearing loss cases. Data including audiometric results, medical histories, autoimmune and inflammatory markers (ANA, RF, ESR, CRP, ACA, ANCA), and autoimmune diseases such as Ankylosing Spondylitis (AS), Hypothyroidism (HT), Rheumatoid Arthritis (RA), and Systemic Lupus Erythematosus (SLE) were analyzed. Audiometric recovery was assessed using Siegel’s criteria, and the presence of autoimmune markers was evaluated for their impact on clinical outcomes and recovery. Results: Autoimmune markers were detected in 60% of the patients with BSHL, with elevated levels of ANA, RF, ESR, and CRP observed most frequently. Patients who tested positive for autoimmune markers demonstrated significantly lower recovery rates compared to those without marker positivity. Specifically, 13% of patients with positive markers showed partial hearing recovery, while 100% of patients without markers exhibited partial recovery. The average hearing improvement across all frequencies was around 21.5 dB. These results suggest that autoimmune marker positivity is associated with poorer clinical outcomes and lower recovery rates following standard corticosteroid treatment. Conclusion: Our study demonstrates that autoimmune and inflammatory markers play a significant role in the prognosis of BSHL. Patients with positive autoimmune markers exhibit poorer recovery rates, indicating the potential importance of these markers in predicting treatment outcomes for BSHL.

Objectives: The internal acoustic meatus is an osseous canal that connects the inner ear to the posterior cranial fossa. It is located in the petrous portion of the temporal bone. A thin cribriform osseous plate known as the fundus is situated at the lateral end of the canal. This study assesses the structural and numerical variations of the fundus formations. Methods: Fifty-four temporal bones of unknown gender and age were examined with the surgical microscope. Results: The temporal bones analyzed were 46.2% right-sided and 53.7% left-sided. Only one temporal bone had two parallel transverse crests, while three had a single anterior crest that split into two branches posteriorly. The number of foramina at the transverse crest varied, with 29.6% having none, 48.1% having a single foramen, and 22.2% having several foramina. An anterior crest structure was seen in 53.7% of the temporal bones, with 5% having a slightly constricted entry to the facial canal. In cases with a single nerve foramen, 48.1% had one, while 51.8% had more than one, including examples with three or four foramina. A crest was found between the foramina of the single nerve in 7% of patients. Furthermore, a crest between the saccular nerve foramen and the high fiber foramina was seen in 25.9% of cases, and 5% had two saccular nerve foramina. Conclusion: We think that revealing the anatomical, structural and numerical variations in the fundus will be useful in explaining the disease-symptom relationship. Level of evidence: Level 4.

Objective: Head and neck cancers are diagnostically complex, with lymph node metastasis significantly impacting prognosis and clinical management. The presence of lymph node involvement drastically reduces survival rates, making its accurate detection critical. Standard diagnostic tools such as CT, MRI, and PET-CT are widely used to assess tumor extent, lymph node involvement, and cartilage invasion. However, limited studies exist correlating physical examination, imaging findings, and histopathological results. This study aims to evaluate these correlations in head and neck cancer patients who underwent surgery. Methods: A retrospective analysis was performed on 48 patients with head and neck cancers. Data collection included demographic details, cancer type, physical examination findings, imaging results (CT, MRI, PET-CT), and histopathological evaluations. Statistical analyses included sensitivity, specificity, and correlation coefficients for each diagnostic method, with pathology as the gold standard. Descriptive statistics, chi-square tests, and correlation analyses were used to determine diagnostic accuracy. Results: The median age of the patients was 60.15 years (±9.57), with 41 males (85.42%) and seven females (14.58%). The most common cancer type was larynx cancer (62.5%), followed by tongue cancer (14.6%). Physical examination identified right neck positivity in 25% and left neck positivity in 16.67% of cases. CT/MRI showed right neck positivity in 31.25% and left neck positivity in 25%, while PET-CT showed 8.33% right neck and 6.25% left neck positivity. CT/MRI had the highest sensitivity (70%) and specificity (75%) for neck positivity, while PET-CT was less sensitive but complementary for cases missed by physical exams. Conclusion: This study highlights the complementary roles of physical examinations, CT, MRI, and PET-CT in diagnosing head and neck cancers. CT/MRI demonstrated superior sensitivity and specificity in detecting cartilage invasion and lymph node involvement, particularly for larger tumors. PET-CT proved useful in detecting smaller or metabolically active tumors. Accurate diagnosis requires an integrated approach combining multiple diagnostic modalities.