The Effect of Unilateral Posterior Transverse Cordotomy on Quality of Life of Patients with Bilateral Vocal Fold Paralysis

Objective:The aim of this study was to investigate the effect of unilateral transverse posterior cordotomy on the quality of life of patients with bilateral vocal fold paralysis.Methods:This study included 19 patients with bilateral vocal fold paralysis who underwent unilateral transverse posterior cordotomy between 2007 and 2012. Assessment of preoperative and postoperative quality of life of the patients was performed using the Short Form-36 (SF-36) quality of life survey.Results:The etiology of bilateral vocal fold paralysis was thyroid surgery in 18 patients. It was idiopathic in 1 patient. Cold knife was used in 12 patients and CO2 laser was used in 7 patients for posterior cordotomy. Acute upper airway obstruction developed in 1 patient who required tracheotomy. No other significant complications have been noted. We found a statistically significant improvement in all SF-36 subscale scores postoperatively (p<0.05).Conclusion:Unilateral posterior transverse cordotomy either by using cold knife or CO2 laser is a safe surgical procedure and improves the quality of life of patients with bilateral vocal fold paralysis

Nasolacrimal duct intubation in the treatment of congenital nasolacrimal duct obstruction in older children

WOS: 000367856000013PubMed: 26449195Purpose the purpose of this study was to investigate the outcomes of nasolacrimal duct intubation in the primary treatment of congenital nasolacrimal duct obstruction (CNLDO) in children aged 7 years and older. Methods Thirty children aged >= 7 years who underwent primary unilateral nasolacrimal duct intubation because of CNLDO were enrolled in this study. CNLDO diagnosis was based on signs and symptoms including typical epiphora, increased tear meniscus, recurrent or persistent mucopurulent discharge, and an abnormal dye disappearance test (DDT). Surgical success was defined as complete resolution of previous signs and symptoms and DDT grade 0-1. Results the mean age was 10.7 +/- 2.5 years (ranging from 7 to 15 years). of the 30 patients, 18 were male and 12 were female. the mean follow-up period was 8.8 +/- 3.4 months (ranging from 6 to 16 months). the mean silicone tube removal time was 4.6 +/- 1.1 months (ranging from 3 to 6 months). the complete resolution of signs and symptoms with DDT grade 0-1 was observed in 22 of 30 cases (73.3%) during the follow-up period. the mean age of the patients with unsuccessful outcomes was 12.7 +/- 1.4 years, whereas that of the patients with successful outcomes was 10.0 +/- 2.4 years, and the difference was statistically significant (P = 0.006). No serious intra-and/or postoperative complication was observed. Conclusions the current study demonstrates that nasolacrimal duct silicone intubation with intranasal endoscopic visualization has favorable outcomes as a primary treatment of persistent CNLDO in children aged 7 years and older. It can be used to reduce the need for dacryocystorhinostomy which is a more invasive procedure

Cytokine gene polymorphisms and expression in Turkish pediatric cochlear implant patients

Objective: We assessed the association between the polymorphisms and expressions of three cytokine genes and clinical parameters in children who underwent cochlear implantation due to profound congenital sensorineural hearing loss

Cytokine gene polymorphisms and expression in Turkish pediatric cochlear implant patients

Objective: We assessed the association between the polymorphisms and expressions of three cytokine genes and clinical parameters in children who underwent cochlear implantation due to profound congenital sensorineural hearing loss

The Effect of Unilateral Posterior Transverse Cordotomy on Quality of Life of Patients with Bilateral Vocal Fold Paralysis

Abstract: doi:10.5152/tao.2013.21 Objective: The aim of this study was to investigate the effect of unilateral transverse posterior cordotomy on the quality of life of patients with bilateral vocal fold paralysis. Methods: This study included 19 patients with bilateral vocal fold paralysis who underwent unilateral transverse posterior cordotomy between 2007 and 2012. Assessment of preoperative and postoperative quality of life of the patients was performed using the Short Form-36 (SF-36) quality of life survey. Results: The etiology of bilateral vocal fold paralysis was thyroid surgery in 18 patients. It was idiopathic in 1 patient. Cold knife was used in 12 patients and CO2 laser was used in 7 patients for posterior cordotomy. Acute upper airway obstruction developed in 1 patient who required tracheotomy. No other significant complications have been noted. We found a statistically significant improvement in all SF-36 subscale scores postoperatively (p<0.05). Conclusion: Unilateral posterior transverse cordotomy either by using cold knife or CO2 laser is a safe surgical procedure and improves the quality of life of patients with bilateral vocal fold paralysis. Bibliography: 1. Benninger MS, Gillen JB, Altman JS. Changing etiology of vocal fold immobility. Laryngoscope 1998; 108: 1346-50. 2. Shvero J, Koren R, Stern Y, Segal K, Feinmesser R, Hadar T. Laser posterior ventriculocordectomy with partial arytenoidectomy for the treatment of bilateral vocal fold immobility. J Laryngol Otol 2003; 117: 540-3. 3. Olthoff A, Zeiss D, Laskawi R, Kruse E, Steiner W. Laser microsurgical bilateral posterior cordectomy for the treatment of bilateral vocal fold paralysis. Ann Otol Rhinol Laryngol 2005; 114: 599-604. 4. Rovó L, Jóri J, Brzózka M, Czigner J. Airway complication after thyroid surgery: minimally invasive management of bilateral recurrent nerve injury. Laryngoscope 2000; 110: 140-4. 5. Elsherief S, Elsheikh MN. Endoscopic radiosurgical posterior transverse cordotomy for bilateral median vocal fold immobility. J Laryngol Otol 2004; 118: 202-6. 6. Motta S, Moscillo L, Imperiali M, Motta G. CO2 laser treatment of bilateral vocal cord paralysis in adduction. ORL J Otorhinolaryngol Relat Spec 2003; 65: 359-65. 7. Yagudin RK, Demenkov VR, Yagudin KF. Plastic cordotomy in the treatment of bilateral vocal fold immobility. Head Neck 2012; 34: 1753-8. 8. Bosley B, Rosen CA, Simpson CB, McMullin BT, Gartner-Schmidt JL. Medial arytenoidectomy versus transverse cordotomy as a treatment for bilateral vocal fold paralysis. Ann Otol Rhinol Laryngol 2005; 114: 922-6. 9. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Kısa Form- 36’nın (KF-36) Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999; 12: 102-6. 10. Bizakis JG, Papadakis CE, Karatzanis AD, Skoulakis CE, Kyrmizakis DE, Hajiioannou JK, et al. The combined endoscopic CO(2) laser posterior cordectomy and total arytenoidectomy for treatment of bilateral vocal cord paralysis. Clin Otolaryngol Allied Sci 2004; 29: 51-4. 11. Bajaj Y, Sethi N, Shayah A, Harris AT, Henshaw P, Coatesworth AP, et al. Vocal fold paralysis: role of bilateral transverse cordotomy. J Laryngol Otol 2009; 123: 1348-51. 12. Demir LU, Şahin MS, Coskun H. İki taraflı vokal kord paralizili hastalarda CO2 lazer posteriyor kordotominin yaşam kalitesine etkisi. Kulak Burun Boğaz İhtisas Dergisi 2012; 22: 189-94

Characteristics and predictors of chronic kidney disease in children with myelomeningocele: a nationwide cohort study

Background: Myelomeningocele (MMC) is highly prevalent in developing countries, and MMC-related neurogenic bladder is an important cause of childhood chronic kidney disease (CKD). This nationwide study aimed to evaluate demographic and clinical features of pediatric patients with MMC in Turkey and risk factors associated with CKD stage 5. Methods: Data from children aged 0–19 years old, living with MMC in 2022, were retrospectively collected from 27 pediatric nephrology centers. Patients > 1 year of age without pre-existing kidney abnormalities were divided into five groups according to eGFR; CKD stages 1–5. Patients on dialysis, kidney transplant recipients, and those with eGFR < 15 ml/min/1.73 m2 but not on kidney replacement therapy at time of study constituted the CKD stage 5 group. Results: A total of 911 (57.8% female) patients were enrolled, most of whom were expectantly managed. Stages 1–4 CKD were found in 34.3%, 4.2%, 4.1%, and 2.4%, respectively. CKD stage 5 was observed in 5.3% of patients at median 13 years old (range 2–18 years). Current age, age at first abnormal DMSA scan, moderate-to-severe trabeculated bladder on US and/or VCUG, and VUR history were independent risk factors for development of CKD stage 5 (OR 0.752; 95%; CI 0.658–0.859; p < 0.001; OR 1.187; 95% CI 1.031–1.367; p = 0.017; OR 10.031; 95% CI 2.210–45.544; p = 0.003; OR 2.722; 95% CI 1.215–6.102; p = 0.015, respectively). Only eight CKD stage 5 patients underwent surgery related to a hostile bladder between 1 and 15 years old. Conclusion: MMC-related CKD is common in childhood in Turkey. A proactive approach to neurogenic bladder management and early protective surgery in selected cases where conservative treatment has failed should be implemented to prevent progressive kidney failure in the pediatric MMC population in our country. Graphical abstract: [Figure not available: see fulltext.

Pediatric kidney care experience after the 2023 Turkey/Syria earthquake.

Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Türkiye. We report our experience with pediatric victims during these catastrophes, with a focus on crush syndrome related-acute kidney injury (Crush-AKI) and death. Method. Web-based software was prepared. Patient demographics, time under rubble (TUR), admission laboratory data, dialysis, and kidney and overall outcomes were recorded. Results. A total of 903 injured children (median age 11.62 years) were evaluated. Mean TUR was 13 h (interquartile range 32.5, max 240 h). Thirty-one of 32 patients with a TUR of > 120 h survived. The patient who was rescued after 10 days survived. Two-thirds of the patients were given 50 mEq/L sodium bicarbonate in 0.45% sodium chloride solution on admission day. Fifty-eight percent of patients were given intravenous fluid (IVF) at a volume of 2000-3000 mL/m2 body surface area (BSA), 40% at 3000-4000 mL/m2 BSA and only 2% at > 4000 mL/m2 BSA. A total of 425 patients had surgeries, and 48 suffered from major bleeding. Amputations were recorded in 96 patients. Eighty-two and 66 patients required ventilator and inotropic support, respectively. Crush-AKI developed in 314 patients (36% of all patients). In all, 189 patients were dialyzed. Age > 15 years, creatine phosphokinase (CK) =20 950 U/L, TUR =10 h and the first-day IVF volume 20 950 U/L, but not with death. Adolescent age and initial IVF of less than 3000-4000 mL/m2 BSA were also associated with Crush-AKI. Given that mildly injured victims can survive longer periods in the disaster field, we suggest uninterrupted rescue activity for at least 10 days