Objective: To analyze tracheal specimens obtained during tracheotomy in patients with prolonged intubation and investigate the relationship between intubation duration and the development of histopathological damage. Methods: Forty‐six adult patients undergoing surgical tracheotomy were categorized into three groups based on intubation duration: 7–14 days (Group A), 15–28 days (Group B), and ≥ 29 days (Group C). The control group comprised 20 patients with laryngeal cancer who underwent laryngectomy and tracheotomy. Tracheal specimens obtained during routine procedures were subjected to histopathological evaluation. Results: Significant differences were observed between the intubated groups and the control group in terms of ulceration, inflammatory cell infiltration, granulation tissue formation, microabscess formation, dilatation, neovascularization, desmoplasia, degeneration, perichondritis, and calcification. The incidence of dilatation and perichondritis increased significantly with longer intubation duration. Conclusion: Prolonged endotracheal intubation is associated with various histopathological changes in the trachea. Given that histopathological injury and complication rates increase with intubation duration, performing tracheotomy within the first 14 days may be considered. Level of Evidence: 3.

Objective: This retrospective study aimed to evaluate the risk and timing of malignant transformation in dysplastic laryngeal lesions, thereby contributing to clinical management. Materials and Methods: A total of 149 patients whose pathology results were reported according to the 2005 World Health Organization classification as mild, moderate, or severe dysplasia, or carcinoma in situ (CIS), were included in the study. Demographic information, smoking habits, follow-up period, and the rates of lesion progression to invasive carcinoma were recorded and analyzed. Results: Male predominance was observed across all groups, with older age associated with higher dysplasia grades. Malignant transformation occurred in 13.9% of mild, 33.3% of moderate, 36.8% of severe dysplasia, and 45.8% of CIS cases (p = 0.005). The mean follow-up period was significantly longer in the CIS group than in the mild dysplasia group. Conclusions: Although lesions with mild dysplasia retain a potential for malignant transformation, the risk of progression to invasive carcinoma is significantly elevated in the presence of severe dysplasia or carcinoma in situ.

Hypothesis: To clarify the ototoxic effects of Castellani solution by using histopathologic and audiological evaluations together, as contradictory results have been presented in the literature. Background: Castellani’s solution is effective in treating disorders of the external auditory canal, particularly fungal infections. However, in cases of perforation of the eardrum, it can pass into the middle ear and affect the cochlea or vestibular system adversely. Methods: Animals were divided into 4 groups: A: control; B: distilled water; C: Castellani’s solution; and D: a solution of 70% isopropyl alcohol and 2% chlorhexidine. After the baseline hearing thresholds were recorded using auditory brainstem responses (ABRs) at 8, 16, 24, and 32 kHz, 0.03 mL of the respective substances were injected intratympanically 3 times at 2-day intervals in groups B, C, and D. Group A underwent tympanic membrane perforation using a syringe. ABRs were repeated on days 7 and 21. All animals were then sacrificed and their temporal bones were prepared for a histologic examination of the cochlea. Results: ABRs conducted on days 7 and 21 after the intratympanic intervention revealed total hearing loss in groups C and D, whose hearing levels were significantly lower than those of group A. Histopathologic evaluation revealed cytoplasmic vacuolization and severe atrophy of marginal, basal, and intermediate cells in groups C and D, as well as loss and degeneration of outer hair cells and supporting cells. Conclusion: Due to its potential ototoxic effects and risk of passing into the middle ear, Castellani’s solution should be used with extreme caution in cases of tympanic membrane perforation.

The aim of this study was to evaluate the microbiological contamination rates of nasal topical preparations (sprays, drops, and ointments) used after septoplasty at the nozzle/tube tip and drug content levels. The study also aimed to compare contamination levels in different formulations. This prospective cross-sectional study included 110 patients (spray: n=38; drop: n=34; ointment: n=38) who underwent septoplasty at the ENT clinic. Patients returned their preparations after at least two weeks’ postoperative use. Two separate samples were obtained from each preparation: a swab of the nozzle or tube tip and the drug content. These specimens were inoculated onto blood agar, chocolate agar, and Sabouraud dextrose agar. Isolate identification was performed using the VITEK MS (MALDI-TOF MS) system. Nozzle contamination was detected in 62.7% (n=69) of the 110 preparations, and content contamination was detected in 40.9% (n=45). Nozzle contamination was significantly higher in the spray group (89.5%) than in the drop (44.1%) and ointment (52.6%) groups (p<0.001). The most frequently isolated microorganisms were coagulase-negative staphylococci (particularly Staphylococcus epidermidis) and Staphylococcus aureus. Gram-negative bacteria (e.g., Klebsiella spp. and Pseudomonas aeruginosa) and yeast species (e.g., Candida parapsilosis and Candida haemulonii) were detected less frequently. Spray formulations showed higher nozzle contamination rates than other formulations, whereas drug-content contamination appeared similar across groups. These findings suggest that contamination may occur in topical nasal preparations used after septoplasty and highlight the importance of patient education regarding hygienic use during the postoperative period. However, because baseline sterility testing and laboratory negative controls were not performed, the source of contamination cannot be determined conclusively.