Obstrüktif uyku apnesi tan›s›nda periferik arteriyel tonometrinin de¤erlendirilmesi

Objective:Peripheral arterial tonometry (PAT) as a portable method of monitoring sleep quality is a relatively recent innovation. The aim was to compare the results of PAT and polysomnography (PSG) and to evaluate the role of PAT in diagnosing obstructive sleep apnea syndrome (OSAS). Methods: This study included adult patients who admitted to ENT clinic with OSAS complaints (excessive daytime sleepiness, snoring, and witnessed apnea), undergone sleep monitorization using PAT system (WatchPAT 200TM; Itamar Medical Ltd., Caesarea, Israel) and had single-blind, level 1 polysomnography at sleep laboratory of Chest Diseases Department. Results: For the two sleep monitoring sessions as conducted at different times: the apnea-hypopnea index (AHI) and respiratory disturbance index (RDI) values were strongly correlated between sessions (r=0.749, r=0.753; p<0.001). The oxygen desaturation index (ODI) values were very strongly correlated (r=0.861; p<0.001). When the AHI scores calculated using PAT for the patients enrolled in the trial were taken into consideration; 89.7% of the patients were correctly diagnosed with OSAS (AHI?5); for RDI calculated (RDI?5) using PAT, 100% of OSAS diagnoses were correct; for AHI values calculated with the PAT method, taking 15 as cut-off point, the sensitivity was found to be at an extremely high level of 96.1%. Conclusion: PAT and PSG values were highly correlated. This finding demonstrated that the reproducibility of the results obtained with PAT was also high. This study shows that PAT can be used as a screening test for OSAS and in a group of patients who are highly suspected for OSAS.Amaç: Periferik arteriyel tonometrinin (PAT), uyku monitörizasyonunda ta?›nabilir bir yöntem olarak kullan›m› k›smen yeni bir yöntemdir. Bu çal›?mada, PAT sonuçlar› ile polisomnografi (PSG) sonuçlar›n›n kar?›la?t›r›lmas› ve obstrüktif uyku apnesi sendromu tan›s›nda PAT’›n rolününün de¤erlendirilmesi amaçland›. Yöntem: Bu çal›?maya KBB klini¤ine OSAS ?ikayetleri (gündüz uykululuk hali, horlama ve tan›kl› apne) ile ba?vurmu? ve uyku monitörizasyonu PAT sistemi (WatchPAT 200TM; Itamar Medical Ltd., Caesarea, ‹srail) ile yap›lm›?, daha sonra Gö¤üs Hastal›klar› Uyku Laboratuvar›nda kör olarak level 1 polisomnografi uygulanm›? eri?kin hastalar dahil edildi. Bulgular: ‹ki farkl› zamanda yap›lm›? uyku monitörizasyonunda apne hipopne indeksi (AHI) ve solunum bozuklu¤u indeksi (RDI) de¤erleri yüksek oranda korele idi (r=0.749, r=0.753; p<0.001). Oksijen desatürasyon indeksi (ODI) de¤eri ise çok yüksek oranda korele saptand› (r=0.861; p<0.001). Çal›?maya dahil edilen hastalar›n AHI skorlar› PAT yöntemiyle ölçüldü¤ünde; hastalar›n %89.7’si OSAS için (AHI?5) do¤ru tan› ald›; PAT testinde, RDI’ye göre yap›lan de¤erlendirmede (RDI?5) OSAS tan›lar›n›n %100’ü do¤ru idi; PAT yöntemiyle yap›lan ölçümde AHI de¤eri için e?ik de¤eri 15 olarak kabul edildi¤inde, duyarl›l›k %96.1 olarak oldukça yüksek bulundu. Sonuç: PAT ve PSG de¤erleri yüksek oranda korele idi. Bu durum PAT ile elde edilen sonuçlar›n tekrarlanabilirli¤inin de yüksek oldu¤unu göstermi?tir. Çal›?mam›z PAT’›n OSAS’da tarama testi olarak ve yüksek oranda OSAS ?üphesi olan hasta grubunda kullan›labilece¤ini göstermektedir

Prominent response with helical tomotherapy in recurrent ameloblastic carcinoma of maxillary sinus: a case report

INTRODUCTION: Ameloblastoma is a benign but locally aggressive tumor of odontogenic epithelial tissue. Reports of radiotherapy treatment modalities are limited in the literature. CASE PRESENTATION: A thirty-five year old male presented with complaints of headache radiating to his face for about six months and impaired vision. The patient’s Positron Emission Tomography (PET) showed a mass in the left maxillary sinus extending to the nasal cavity and invading the adjacent tissues. An R2 (macroscopic residual tumor) surgical resection performed to debulk the tumor. Due to the recurrence and residual mass, the patient was treated with helical tomotherapy. At 2 months post-radiotherapy, patient’s vision returned to normal. PET scan showed a significant reduction in lesion size 12 months post-radiation. CONCLUSION: In cases of ameloblastic carcinoma with, post-surgical recurrence or patients not suitable for surgical treatment, helical tomotherapy can be an effective treatment option

The evaluation of eustachian tube paratubal structures using magnetic resonance imaging in patients with nasal obstruction

Amaç: Bu çalışmada tek taraflı nazal tıkanıklığı olan hastaların östaki tüpü paratubal yapıları manyetik rezonans görüntüleme (MRG) yöntemi ile değerlendirildi. Hastalar ve Yöntemler: Ocak 2018 - Aralık 2020 tarihleri arasında kliniğimizde tek taraflı burun kitlesi tanısı ile izlenen ve MRG tetkiki ile değerlendirilen toplam 30 hasta (17 erkek, 13 kadın; ort. yaş: 56 yıl; dağılım, 18-67 yıl) çalışmaya dahil edildi. Çekilen MRG kesitlerinde, tensor veli palatini ve levator veli palatini kaslarının elde edilen en geniş kesit üzerinden kalınlığı, uzunluğu ve ortalama kas volümleri ölçülerek, sağlam taraf ölçümleri ile karşılaştırıldı. Bulgular: Hastaların nazal tıkanıklık olan tarafların ortalama tensor veli palatini kası kalınlığı, uzunluğu ve volümü sırasıyla 3.7±0.6 mm, 26.4±2.1 mm ve 2.1±0.5 cm³ idi. Ortalama levator veli palatini kası kalınlığı, uzunluğu ve volümü sırasıyla 5.7±0.5 mm, 23.9±2.3 mm ve 3.0±0.6 cm³ idi. Tıkanıklık olan ve olmayan tarafların paratubal yapıları arasında istatistiksel olarak anlamlı bir farklılık izlenmedi (p>0.05). Sonuç: Bu çalışmada tek taraflı nazal tıkanıklığın östaki tüpü paratubal yapılarında anlamlı bir değişiklik yapmadığı görüldü. Ancak bu konuda daha uzun süreli ve geniş serili klinik çalışmalara ihtiyaç vardır.Objectives: In this study, we aimed to evaluate the eustachian tube paratubal structures of patients with unilateral nasal obstruction using magnetic resonance imaging (MRI). Patients and Methods: Between January 2018 and December 2020, a total of 30 patients (17 males, 13 females; mean age: 56 years; range, 18 to 67 years) who were followed with a diagnosis of unilateral nasal mass in our clinic and evaluated by MRI were included in the study. The thickness, length, and mean muscle volumes of tensor veli palatini and levator veli palatini muscles were measured from the largest section obtained from the MRI sections and compared with the healthy side measurements. Results: The mean tensor veli palatini muscle thickness, length, and volume of the patients with nasal obstruction were 3.7±0.6 mm, 26.4±2.1 mm, and 2.1±0.5 cm³, respectively. The mean levator veli palatini muscle thickness, length, and volume were 5.7±0.5 mm, 23.9±2.3 mm, and 3.0±0.6 cm³, respectively. There was no statistically significant difference between the paratubal structures of the sides with and without obstruction (p>0.05). Conclusion: This study showed that unilateral nasal obstruction did not pose a significant change in the eustachian tube paratubal structures. However, further large-scale, longer-term clinical studies are needed on this subject

Concurrent Assay for Four Bacterial Species Including Alloiococcus Otitidis in Middle Ear, Nasopharynx and Tonsils of Children with Otitis Media with Effusion: A Preliminary Report

ObjectivesTo detect the prevalences of Alloiococcus otitidis, as well as Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis in children with chronic otitis media with effusion (OME) and to simultaneously investigate the colonization of these bacteria in the nasopharynx and palatine tonsils of these patients.MethodsThe study included 34 pediatric patients with OME, and 15 controls without OME. In the study group, A. otitidis, H. influenzae, S. pneumoniae, and M. catarrhalis were investigated in the samples obtained from middle ear effusions (MEE), nasopharyngeal swabs (NPS) and tonsillar swabs (TS), using multiplex polymerase chain reaction (PCR) and conventional culture methods. Only the samples obtained from NPS and TS were studied with the same techniques in the control group.ResultsA. otitidis was isolated only in MEE and only with multiplex PCR method. A. otitidis, S. pneumoniae, M. catarrhalis, H. influenzae were identified in 35%, 8.8%, 8.8%, and 2.9%, respectively, in 34 MEE. A. otitidis was not isolated in NPS or TS of the study and the control groups.ConclusionThe prevalence of A.otitidis is high in children with OME and A.otitidis doesn't colonize in the nasopharynx or tonsil

Soft Palate Damage Due To Suicide Attempt by a Blank Cartridge Gun: A Case Report

Kişilerin kendini savunma gerekliliği için imal edilen ve zararsız olduğu düşünülen kurusıkı silahlar ilgili yasal kuralların bulunmaması nedeniyle erişkinler tarafından kolayca satın alınabilmektedir. Bu yazıda kliniğimize kurusıkı tabanca ile intihar girişimi sonrası ikinci günde sevk edilen erkek hastanın klinik bulguları ve uygulanan tedavi yöntemi sunulmuştur. Sonuç olarak kurusıkı silahlar toplum tarafından zararsız olduğu düşünülse de, bu silahlara bağlı yaralanmalarda özellikle yakın mesafeden yapılan ateşlemelerde hayati tehdit edici hasarlara sebep olabileceği unutulmamalıdırBlank cartridge guns which are thought to be harmless and manufactured for self-defense requirements, can be easily purchased due to lack of legal regulations. Clinical findings and treatment approach of a male patient referred to our clinic on the second day after a suicide attempt by a blank firing gun is presented in this report. As a result; although they are believed to be harmless among the community, it shoud be kept in mind that damages related with this weapon can cause life-threatening injuries, especially firing at close rang

Evaluation of prognostic factors in idiopathic sudden sensorineural hearing loss

Article HistoryReceived Accepted 06 / 01 / 201606 / 03 / 2016It was aimed to establish which identifiable variables for an idiopathic sudden sensorineural hearing loss (ISSHL) have a prognostic value in the hearing recovery. Patients hospitalized with diagnosis of ISSHL and treated in our clinic between 2009 and 2013 were evaluated retrospectively. Individuals received the same treatment were classified into two groups after a month from diagnosis by a pure tone audiogram regarding Siegel's criteria. Effect of patient's age, gender, side of ear, degree of hearing loss, patterns of initial pure-tone audiogram, comorbidities such as systemic diseases, time of initial treatment, contralateral ear hearing, presence of vestibular symptoms and tinnitus on the prognosis of ISSHL was evaluated in this study. Eighty two patients (46 male, 36 female, mean age 47.9, age ranging between 21 and 85) were included in this study. Hearing recovery was observed in 50 patients (61%). Recovery rate was significantly better in patients less than 60 years and received a medical treatment in the first seven days. On the other hand, it was lower in patients presenting with profound audiogram and contralateral hearing loss. Presence of comorbidities including systemic diseases, vestibular symptoms and tinnitus did not affected prognosis

The evaluation of eustachian tube paratubal structures using magnetic resonance imaging in patients with chronic suppurative otitis media

Celiker, Metin/0000-0002-9833-402XWOS: 000377932400006PubMed: 27008280Conclusion Eustachian tube (ET) dysfunction, which plays a role in the pathogenesis chronic suppurative otitis media (CSOM), does not seem to be due to differences in paratubal structures. Objective the aim of this study was to compare the magnetic resonance imaging (MRI) findings of the paratubal structures of the ET between normal ears and ears in patients with CSOM. Methods the MRI records of 40 patients who underwent tympanomastoidectomy for a diagnosis of CSOM were reviewed retrospectively. the healthy ears served as the control group. the length, diameter, surface area and volume of the tensor veli palatini muscle (TVPM) and levator veli palatini muscle (LVPM) were measured, in addition to the diameter of the pharyngeal orifice of the ET, volume of the Ostmann fat pad, bimucosal thickness of the lumen of the ET, and mucosal thickness. Results in the pathological ears, the mean length of the TVPM and LVPM was 22.6 mm and 19.3 mm, the mean diameter was 3.2 and 5.3 mm, and the mean volume was 1.75 and 3.2 cm(3), respectively. in addition, the mean diameter of the pharyngeal orifice of the ET was 1.9 mm. There were no significant between-group differences in the paratubal structures (p > 0.05)

Can use of a cold light source in endoscopic middle ear surgery cause sensorineural hearing loss?

WOS: 000387945900015Objectives: To investigate possible sensorineural hearing loss created by the use of a cold light source in patients undergoing endoscopic tympanoplasty surgery. Materials and Methods: the medical records of 203 patients, who underwent endoscopic Type 1 tympanoplasty surgery in our ear, nose, and throat clinic between 2012 and 2015, were checked retrospectively. Ninety-one patients were male and 112 were female, and their mean age was 34.4 +/- 11.2 years. Results of audiometric measurements performed during the preoperative period and repeated 1 and 3 months postsurgery were compared to each other. Results: the mean duration of the operations was determined to be 52.4 +/- 9.1 min. in addition, average preoperative bone-conduction was 11.4 +/- 7.4 dB nHL. However, it was 9.57 +/- 7.1 dB nHL and 9.51 +/- 7.4 dB nHL, respectively, in the 1st and 3rd postoperative months. Levels of postoperative average bone-conduction at the 1st and 3rd month, as well as the thresholds of bone-conduction at 500, 1000, and 2000 Hz, were significantly lower than the preoperative results (P 0.05). Conclusion: Based on our findings, the increased heat generated by the use of a cold light source during an endoscopic tympanoplasty surgery is unlikely to cause the development of sensorineural hearing loss

Nazal Septum Perforasyon Tamirinde Fasya Ve Yağ Dokusu Kullanımı: Deneysel Tavşan Modeli

Purpose: The objective of this study is to present a new method in septum perforation repair. Methods: In this study, 12 New Zealand White mature rabbits were used. The rabbits are divided into two groups equally. In all rabbits, a standard perforation was operated on nasal septum by using a 4mm-diamater punch(12.983 mm2). In the experiment group, the perforations were closed by fascia and fat tissue. Any procedure was not implemented in the control group. Rabbits were sacrified 4 weeks later. Cartilaginous septums were removed for digital evaluation. Samples were photographed and perforation areas were calculated by using photograph analyze program. Mean decrease in perforation size between the groups were compared. Results: At the end of the study period the mean perforation area in study group was 1.35±0.51 mm2 and in control group was 4.81±0.49 mm2 (P<0,0009). The mean rate of decrease in perforation size was 89.58 % and 62.95 % in experiment and control group, respectively (P<0.0009). Furthermore, a total closing was determined in a sample in experiment group. Conclusion: The method explained here is applicable and effective choice in septal perforation repair.Amaç: Bu çalışmanın amacı septum perforasyon tamirinde yeni bir metod ortaya koymaktır.. Gereç ve Yöntemler: Bu çalışmada 12 beyaz, erişkin Yeni Zelanda tavşanı kullanıldı.Tavşanlar eşit olarak iki gruba ayrıldı.Tüm tavşanlarda 4mm çaplı punch aleti(12.983 mm2) kullanılarak standart perforasyon oluşturuldu. Deney grubunda perforasyon fasya ve yağ dokusuyla kapatıldı. Kontrol grubuna herhangibir prosedür uygulanmadı. Dört hafta sonra tavşanlar sakrifiye edildi. Dijital değerlendirme için kartilaj septum çıkarıldı.Örnekler fotoğraflandı ve perforasyon alanları fotğraf analiz programı kullanılarak hesaplandı. Perforasyon alanındaki ortalama küçülme yönünden gruplar karşılaştırıldı. Bulgular: Çalışma periyodunun sonunda ortalama perforasyon alanı çalışma grubunda 1.35±0.51 mm2 iken kontrol grubunda 4.81±0.49 mm2 idi(P<0,0009). Perforasyon alanındaki ortalama küçülme oranı sırasıyla çalışma ve control grubunda 89.58 % and 62.95 % olarak bulundu(P<0.0009). Ayrıca çalışma grubunda bir örnekte total kapanma saptandı. Sonuç: Burada tanımlanan metod septum perforasyon onarımında uygulanabilir ve efektif bir seçenektir