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Objectives: This study aims to compare the efficacy and complications of different medical treatment modalities used to prevent otorrhea following ventilation tube placement. Patients and Methods: This single-center, evaluator-blinded, controlled study included a total of 241 consecutive children (137 males, 104 females; mean age: 7.3±2.6 years; range, 3 to 13 years) who underwent bilateral ventilation tube placement due to bilateral serous otitis media between July 2014 and June 2016. The patients were classified according to the medical treatment protocols applied. Group 1 (n=56) received oral antibiotics; Group 2 (n=57) received oral antibiotics + local antibiotic ear drops; Group 3 (n=65) received local antibiotic ear drops; and Group 4 (n=63) received local antibiotic-glucocorticoid ear drops. Results: The lowest rate of otorrhea seen was 5.2% in Group 2, followed by 6.34% in Group 4. The highest rate of otorrhea was seen in Group 1. In the evaluation of the efficacy of the treatments, otorrhea was eliminated in Group 2 at a rate of 75% on Day 4. The same success rate was reached on Day 6 in Group 4 and on Day 12 in the other groups. The highest rate (28%) of side effects was seen in Group 2. Although the rates in the groups applied with local treatments were lower than those of the other groups, the difference was not statistically significant (p=0.051). Conclusion: The administration of local antibiotic-glucocorticoid ear drops can be considered an effective and safe treatment option with similar otorrhea and lower complication rates.

• ÖZ

Objectives: The aim of this study was to evaluate serum copeptin levels in patients with obstructive sleep apnea (OSA) before and after the positive airway pressure (PAP) treatment.Patients and Methods: A total of 16 patients (14 males, 2 females; median age 48 years; range, 38 to 60 years) with severe sleep apnea based on the Apnea Hypopnea Index (AHI) >30 and 20 healthy controls (10 males, 10 females; median age 35.5 years; range, 22 to 47 years) were included in this study between October 2014 and December 2015. Full-night polysomnography was applied to each patient. Serum copeptin levels were determined using the enzyme-linked immunosorbent assay in both groups. Serum copeptin level measurement was repeated in the patient group after one year of PAP treatment.Results: After one year of PAP treatment, serum copeptin levels of the patients with OSA decreased, although there was no statistically significant difference before and after treatment.Conclusion: Increased serum copeptin concentration may reflect a response to moderate stress in many diseases, particularly cardiovascular diseases. Based on our study results, there was no significant difference between the severe OSA group and healthy volunteers and before and after treatment among the patients with severe OSA.

• ÖZ

Objectives: In this study, we aimed to evaluate whether intratumoral microhemorrhage detection on susceptibility-weighted imaging (SWI) could help in preoperative differentiation of cerebellopontine angle (CPA) vestibular schwannomas (VSs) from meningiomas. Patients and Methods: A total of 75 patients (32 males, 43 females; mean age: 45.5±16.7 years; range, 17 to 68 years) consisting of 61 VSs and 14 meningiomas located in the CPA cistern were retrospectively analyzed. All patients underwent contrast-enhanced magnetic resonance imaging (MRI) using the SWI sequence. All images in our study were obtained with a 12-channel phased-array head coil on a 1.5-Tesla clinical scanner. The presence of intratumoral microhemorrhages on SWI sequence was evaluated by demonstrating blooming artifacts as punctate hypointense regions. Both magnitude and phase-contrast images were used to verify microhemorrhages. All patients in our patient cohort underwent surgery and resected tumor specimens were evaluated by pathology. Results: All VS cases in our cohort exhibited multiple hypointense small foci causing blooming artifact on magnitude and processed SWI images. In the meningioma population, typical MRI signal intensity characteristics, including an intense homogenous contrast enhancement, were observed. In all the meningioma cases, except for one, there was no blooming artifact due to intratumoral hemorrhage within the mass lesions on SWI images. In only one meningioma case, SWI revealed hypointense microhemorrhages within the mass lesion. Following surgical procedures and tumor resections, pathology specimens were evaluated and absence or presence of intratumoral microhemorrhages were detected. These results were significantly correlated with the SWI findings. We obtained 100% sensitivity, 92.8% specificity, and 98.6% accuracy in terms of differentiating VSs from meningiomas located in the CPA cistern by using the SWI sequence. Conclusion: Meningiomas and VSs are the two most common masses of the CPA cistern and, in some cases, it seems to be difficult to reach an accurate diagnosis with conventional MRI sequences. The SWI can be helpful to solve this problem by demonstrating whether intratumoral microhemorrhages are present or not within mass lesions and, thus, can help to assume a probable accurate diagnosis prior to surgery.

• ÖZ

Objectives: This study aims to present the validation and cross-cultural adaptation of the Tonsil Adenoid Health Status Instrument (TAHSI) in Turkish language. Patients and Methods: This prospective single-center validation study was conducted between May 15th, 2019 and December 31st, 2019 in a tertiary care facility. The study group consisted of 41 patients (20 males, 21 females; mean age 6.8±3.2 years; range, 3 to 15 years) who were diagnosed with tonsil and/or adenoid disease who were scheduled for adeno/tonsillectomy, while the control group consisted of 42 healthy children (20 males, 22 females; mean age 9.5±3.8 years; range, 3 to 16 years). The original survey was translated to Turkish and cross-cultural adaptation process was carried out as stated in guidelines. Both groups were assessed twice in two to six weeks before surgery. Study group was assessed again six months following surgery. Internal consistency, test-retest reliability, validity, and responsiveness to change were analyzed. Results: Cronbach's alpha was 0.949 for the total scale. All subscales showed adequate internal consistency. Test-retest reliability was over 0.8 for all subscales. Subscale scores were statistically significantly lower in control group compared with study group (p<0.001). The scale showed high responsiveness to change for all subscales (p<0.001). Conclusion: Turkish version of TAHSI showed good psychometric properties and can be used for both research and clinical purposes in children with tonsil and adenoid disease.

• ÖZ

Objectives: This study aims to evaluate the clinical presentation, diagnosis, and management of infants with a congenital vallecular cyst (VC). Patients and Methods: Four infants (2 males, 2 females; mean age: 45±17 days; range, 28 to 63 days) who were operated or followed for a congenital VC were retrospectively analyzed between January 2016 and March 2020. Data including patient demographics, major symptoms (cyanosis, inspiratory stridor, suprasternal retraction, difficulty feeding), diagnostic methods, type of coexisting anomalies, surgical procedures, and length of follow-up and recurrence were recorded. Results: All patients presented with varying degrees of respiratory symptoms including inspiratory stridor and suprasternal retraction. The diagnosis was made based on awake flexible fiberoptic laryngoscopy (FFL) in all four infants. Two patients were treated with endoscopic cyst excision. One case underwent endoscopic cyst excision and supraglottoplasty, while the other was followed without surgery. All surgeries were successful, as none of the patients experienced recurrence. Conclusion: Although congenital VCs are extremely rare, they should be considered among the differential diagnosis of congenital stridor. A detailed examination with FFL should be performed for diagnosis. Based on our findings, transoral endoscopic excision of VCs is a safe, effective, and feasible procedure as a surgical treatment to prevent recurrence.