Results
Between March 2014 and October
2018, 451 patients had BMT in our adult hematology clinic. 30 patients
had an ORL consultation visit in our ORL clinic. Among these 30
patients, 14 (46,7%) of them were female, and 16 (53,3%) were male
(female to male ratio of 0,87). The youngest patient was 24 years old,
and the oldest patient was 72 years old. The mean age of transplantation
was 46,55 years. Considering gender, the average age was 46,85 years in
women and 49,5 years in men. There was not any statistically significant
difference in age between female and male groups (p>0.05).
The ORL consultation period between the transplant and the ORL
examination was from the 8th day at the earliest to the 333rd day at the
latest. The average time between transplant and ORL review is 72.73. was
the day. Considering the gender, the average ORL consultation time
between transplantation and ORL examination was 101.42 days in women and
47.62 days in men. The mean time between transplant and ORL review was
significantly higher in the female group (p = 0.001). When we looked at
patients according to anatomical sites, 17 (56,7%) patients had ear
problems; 8 (26,7%) patents had sinonasal problems and 5 (16,6%)
patients had oropharyngeal problems.
All these distributions are shown
in table 1.
Table 1: Patient Distribution by
ORL Consultation Time, Gender and Anatomical Regions
Three (10%) of these 30 patients had TBR prior to BMT, and the
remaining 27 (90%) received chemotherapy for bone marrow suppression.
Hearing loss was the most common ear manifestation in BMT after
transplantation. It was seen in 13 (76,48%) patients. Among these
patients 10 had only hearing loss, one of these had hearing loss with
tinnitus, one of these had hearing loss with vertigo and one of these
hearing losses with external ear canal edema. In these hearing losses, 8
(61,54%) of them were neurosensorial type hearing loss and 5 (38,46%)
of them were conductive type hearing loss. 6 (46,15%) patients of them
were treated with medical ways (Ear drops or oral medication), 7 (53,85
%) of them referred for hearing aid devices. Among all ear manifested
patients 2 (11,76%) of them had ear discharge and treated by ear drops;
and last 2 (11,76%) of them had obstruction of outer ear canal by ear
wax and they treated by cleaning of ear wax. This distribution is shown
in table 2.
Table 2: Ear Findings of Patients with BMT After Transplant
Sinonasal problems were the second most common ORL consultation reason
for BMT patients. Eight (26,7%) patients were sent to ORL clinic for
consultation because of sinonasal problems. Among these 7 (87,5%) of
them applied for epistaxis which was not controlled by transplantation
team. Three (42,8%) of them had bleeding come from right nasal cavity,
2 (28,6%) of them had bleeding from left nasal cavity and 2 (28,6%) of
them had bleeding from both nasal cavities. 5 (71,4%) of these patients
were treated by silver nitrate cauterization. Two (28,6%) of them were
treated by other nonsurgical treatment methods such as topical
decongestants and nose moisturizer agents. None of these patients needed
surgical epistaxis treatment methods. One (12,5%) patient consulted for
cough problem which diagnosed as sinusitis and treated with antibiotics
and nasal saline wash. This distribution is shown in table 3.
Table 3: Sinonasal Findings of Patients with BMT After Transplant
In 30 ORL consulted patients, 5 (16,6%) of them consulted for
orphanageal problems. Among them 3 (60%) patients had widespread severe
mucosal lesions and submucosal bleedings. They were diagnosed as severe
mucositis and treated by medical measures. One (20%) patient had acute
pharyngitis and treated with antibiotics. One (20%) patient had abscess
formation within mouth and treated by surgical drainage. This
distribution is shown in table 4.
Table 4: Oropharyngeal Findings of Patients with BMT After Transplant