Long-Term Balance Outcomes in Vestibular Ablative Surgeries

Objective:To evaluate the long-term balance outcomes of vestibular nerve section (VNS) and labyrinthectomy (L) operations. The indirect outcomes will be the correlation of objective and subjective test results and an analysis of anterior-posterior versus medial-lateral computerized posturography (CP) scores.Methods:This retrospective study evaluated objective CP and subjective Dizziness Handicap Inventory (DHI) results of patients who underwent VNS and L surgeries for Ménière’s disease.Results:A total of 55 (31 VNS and 24 L) patients were included in the study. The two operation groups were similar in terms of age, and mean time between surgery and the tests (p=0.465 and p=0.616) respectively. The vestibular and global scores at anterior-posterior CP showed statistically significant differences between the groups (p=0.000 and p=0.007) respectively in favor of the VNS group. In addition, the comparison of the vestibular CP scores of anterior-posterior and medial-lateral evaluations of the entire study population was lower in the medial-lateral evaluation (p=0.000). The mean DHI scores did not show statistically significant differences (p=0.359) between operation groups, nor did the correlation analysis between CP and DHI scores reveal statistical significance (p values >0.05).Conclusion:In the long term, objective balance outcomes are better for VNS patients than for L patients. Additionally, medial-lateral balance outcomes are more affected than anterior-posterior balance outcomes from unilateral ablative surgeries. Subjective balance perception is not different between the two surgery groups, and DHI scores do not show a correlation with CP scores

Cochlear implantation in inner ear malformations: Considerations related to surgical complications and communication skills

Introduction: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation. Methods: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group. Results: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637). Conclusion: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3

Surgical considerations and safety of cochlear implantation in otitis media with effusion

WOS: 000430035900005PubMed ID: 28756095Objective: To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Methods: Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Results: Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60 min (ranged from 28 to 75 min) in non-otitis media group, and 90 min (ranged from 50 to 135 min) in otitis media with effusion group (p 0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. Conclusion: There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells

Burun problemlerinin pozisyonel ve pozisyonel olmayan tıkayıcı uyku apnesiüzerindeki rolü

OBJECTIVES: This study aims to examine the relationship between nasal pathologies and positional (PP) obstructive sleep apnea (OSA) or nonpositional (NPP) OSA.PATIENTS AND METHODS: A total of 44 male OSA patients (mean age 48.0±6.8 years; range 31 to 60 years) suffering from nasal obstruction were retrospectively evaluated for nasal obstruction scores, overall apnea hypopnea index (AHI) and AHI in supine and nonsupine positions, daytime sleepiness scores, and body mass index (BMI). Patients were divided into two equal groups as PP group and NPP group. Output parameters were snoring severity index, clinical nasal obstruction score, septal deviation score, conchal hypertrophy score, and allergic rhinitis (AR) score. These parameters were correlated with the type of OSA.RESULTS: Apnea hypopnea index was significantly lower in PP group than in NPP group (p<0.03). Spearman correlation analysis revealed significant negative correlation between AR score and PP (r=-0.40, p<0.0001). Pearson correlation test revealed significant correlation between AHI and BMI (r=0.32, p<0.05).CONCLUSION: We suggest that AR is not only an important risk factor for OSA, but also patients with AR tend to be NPP OSA patients because of the serious nasal obstruction which already causes an increase in nasal resistance or pharyngeal collapsibility.Amaç: Bu çalışmada burun patolojileri ve pozisyonel (PP) tıkayıcı uyku apnesi (TUA) veya pozisyonel olmayan (PO) TUA arasındakiilişki incelendi.Hastalar ve Yöntemler: Burun tıkanıklığı olan toplam 44 erkek TUA hastası (ort. yaş 48.0±6.8 yıl; dağılım 31-60 yıl) burun tıkanıklığıskorları, genel apne hipopne indeksi (AHİ) ve sırtüstü ve sırtüstü olmayan pozisyonlarda AHİ, gündüz uykululuk skorları ve vücut kütleindeksi (VKİ) açısından retrospektif olarak değerlendirildi. Hastalar PP grubu ve PO grubu olmak üzere iki eşit gruba ayrıldı. Çıktıparametreleri horlama şiddeti indeksi, klinik burun tıkanıklığı skoru, septum deviasyonu skoru, konka hipertrofisi skoru ve alerjik rinit (AR)skoru idi. Bu parametreler TUA tipi ile ilişkiliydi.Bulgular: Apne hipopne indeksi PP grubunda PO grubundan anlamlı olarak daha düşüktü (p<0.03). Spearman korelasyon analizi ARskoru ve PP arasında anlamlı negatif ilişki gösterdi (r=-0.40, p<0.0001). Pearson korelasyon testi AHİ ve VKİ arasında anlamlı ilişkigösterdi (r=0.32, p<0.05).Sonuç: Alerjik rinitin sadece TUA için önemli bir risk faktörü olduğunu değil, AR’li hastaların nazal direnç veya farengeal çökebilirliktehalihazırda artışa yol açan ciddi burun tıkanıklığı nedeniyle PO TUA hastaları olma eğilimi gösterdiğini ileri sürmekteyiz

Neutrophil-lymphocyte ratio findings and larynx carcinoma: A preliminary study in Turkey

Background: To identify the potential prognostic role of the neutrophil/lymphocyte (N/L) ratio in larynx carcinoma. Materials and Methods: Oncologic archive charts of patients with a larynx carcinoma diagnosis between the years 2010 and 2013 were retrospectively reviewed. The inclusion criterion was to be available with hemogram test prior to diagnostic procedure. Patients undergoing septorinoplasty comprised the control group. Results: There were 65 cases in the study and 42 cases in control group meeting inclusion criteria. In general a non-significant increase in N/L ratio was observed with increasing tumor size and stage (p>0.05) in larynx carcinoma. The N/L ratio was found to be significantly higher in larynx carcinoma compared to control group (p=0.004). Conclusions: In conclusion, the N/L ratio was shown to be significantly increased in larynx carcinomas compared to control group. Further studies are needed to assess any prognostic role

Comparison of Carina active middle-ear implant with conventional hearing aids for mixed hearing loss

WOS: 000373127800005PubMed ID: 26991874Objective: To compare the auditory outcomes of Carina middle-ear implants with those of conventional hearing aids in patients with moderate-to-severe mixed hearing loss. Methods: The study comprised nine patients (six males, three females) who underwent middle-ear implantation with Carina fully implantable active middle-ear implants to treat bilateral moderate-to-severe mixed hearing loss. The patients initially used conventional hearing aids and subsequently received the Carina implants. The hearing thresholds with implants and hearing aids were compared. Results: There were no significant differences between: the pre-operative and post-operative air and bone conduction thresholds (p > 0.05), the thresholds with hearing aids and Carina implants (p > 0.05), or the pre-operative (mean, 72.8 +/- 19 per cent) and post-operative (mean, 69.9 +/- 24 per cent) speech discrimination scores (p > 0.05). One of the patients suffered total sensorineural hearing loss three months following implantation despite an initial 38 dB functional gain. All except one patient showed clinical improvements after implantation according to quality of life questionnaire (Glasgow Benefit Inventory) scores. Conclusion: Acceptance of Carina implants is better than with conventional hearing aids in patients with mixed hearing loss, although both yield similar hearing amplification. Cosmetic reasons appear to be critical for patient acceptance

Impact of the demographic and aetiological factors and intraoperative findings on postoperative outcomes in chronic otitis media surgery

Background/aim: Surgical success is related with many factors belonging to both the patient and the disease. This study aims to analyse the preoperative and intraoperative characteristics, the postoperative results, and the factors affecting the surgical success in different types of chronic otitis media (COM).Materials and methods: A total of 1510 ears of 1398 patients who underwent COM surgery were included in the study. Postoperative results were obtained from 376 ears of 356 patients who had been followed after surgery. The demographic characteristics of the patients, such as age and sex, operative findings, preoperative audiological examination results, and final audiometric and otoscopic examination findings, were retrospectively obtained from the archives of the department.Results: The most frequent diagnosis was simple COM (39.9%), and the most frequently performed surgery was tympanoplasty without mastoidectomy (46.6%). The overall hearing success rate was found to be 75.8%. Postoperative hearing success was significantly associated with the chronic otitis subgroup, ossicular pathologies, and the condition of the middle ear mucosa. Postoperative graft take rate was found to be 78.6%. Graft success was statistically significantly higher in patients with normal middle ear mucosa. Performing mastoidectomy, the presence of patency in aditus ad antrum, and being a paediatric case had no impact on graft success.Conclusion: Factors affecting the success of COM surgery include age, chronic otitis subgroup, location and size of perforation, the condition of the middle ear mucosa, and the level of the ossicular disease. These factors should be known and an appropriate treatment plan should be prepared

The effects of sodium-2-mercaptoethanesulfonate application on the neural and neurovascular tissues: An experimental animal study.

Sodium-2-mercaptoethanesulfonate (MESNA) is a protective agent that is also used as "a chemical dissector" in various surgical fields. The aim of this study is to evaluate the toxic effects of MESNA on neural and neurovascular structures based on a morphological analysis and examine its safety in neurotological applications

A case of Warthin tumor with atpical location

Papiller kistadenoma lenfomatozum (Warthin tümörü) parotis bezi kaynaklı benign bir tükrük bezi neoplazisidir. Genellikle parotis bezi kuyruğunda yerleşik olan ve yavaş büyüme şekli gösteren bu tümör nadiren parotis bezi dışında; servikal lenf nodlarında ve minör tükrük bezlerinde de görülebilir. Biz de bu yazıda atipik yerleşimli bir warthin tümörü olgusunu sunduk. Kırk yaşında herhangi başka bir sağlık problemi bulunmayan erkek hasta sağ çene köşesinin altında yerleşik kitle nedeniyle kliniğimize başvurdu. Yapılan fizik muayene ve görüntüleme sonrası servikal lenfadenopati ön tanısı ile eksizyonel biyopsi yapıldı. Histopatolojik görünümü warthin tümörü olarak yorumlandı. Postoperatif takiplerinde nüks ya da komplikasyon izlenmedi. Bu vakayı sunarak warthin tümörünün parotis bezi dışında boyunda herhangi başka bir lokalizasyonda da karşımıza çıkabileceği ve servikal bölgeye yerleşik kitlelere yaklaşımda akılda tutulması gerektiğini vurgulamak istedik.Papillary cystadenoma lymphamatosum (Warthin's tumor) is a benign salivary gland neoplasm of the parotid gland. It is usually encountered as a slowly growing mass located in the tail of the parotid gland, however it can be rarely derived from the cervical lymph nodes and minor salivary glands. In this article, we reported a case of warthin tumor with atpical location. A forty year-old patient consulted to our clinic who was suffering from a swelling below the right angulus mandible and otherwise healthy. He has undergone an excisional biopsy with the preliminary diagnosis of lymphadenopathy after physical examination and imaging. The histopathologic appearence was interpreted as warthin tumor. No complication or recurrence was observed in the follow-up period. We aimed to emphasize that this tumor may be also seen outside the parotid gland in any other localization of the neck and so it must be born in mind in cervical mass management

A case of Warthin tumor with atpical location

Papiller kistadenoma lenfomatozum (Warthin tümörü) parotis bezi kaynaklı benign bir tükrük bezi neoplazisidir. Genellikle parotis bezi kuyruğunda yerleşik olan ve yavaş büyüme şekli gösteren bu tümör nadiren parotis bezi dışında; servikal lenf nodlarında ve minör tükrük bezlerinde de görülebilir. Biz de bu yazıda atipik yerleşimli bir warthin tümörü olgusunu sunduk. Kırk yaşında herhangi başka bir sağlık problemi bulunmayan erkek hasta sağ çene köşesinin altında yerleşik kitle nedeniyle kliniğimize başvurdu. Yapılan fizik muayene ve görüntüleme sonrası servikal lenfadenopati ön tanısı ile eksizyonel biyopsi yapıldı. Histopatolojik görünümü warthin tümörü olarak yorumlandı. Postoperatif takiplerinde nüks ya da komplikasyon izlenmedi. Bu vakayı sunarak warthin tümörünün parotis bezi dışında boyunda herhangi başka bir lokalizasyonda da karşımıza çıkabileceği ve servikal bölgeye yerleşik kitlelere yaklaşımda akılda tutulması gerektiğini vurgulamak istedik.Papillary cystadenoma lymphamatosum (Warthin's tumor) is a benign salivary gland neoplasm of the parotid gland. It is usually encountered as a slowly growing mass located in the tail of the parotid gland, however it can be rarely derived from the cervical lymph nodes and minor salivary glands. In this article, we reported a case of warthin tumor with atpical location. A forty year-old patient consulted to our clinic who was suffering from a swelling below the right angulus mandible and otherwise healthy. He has undergone an excisional biopsy with the preliminary diagnosis of lymphadenopathy after physical examination and imaging. The histopathologic appearence was interpreted as warthin tumor. No complication or recurrence was observed in the follow-up period. We aimed to emphasize that this tumor may be also seen outside the parotid gland in any other localization of the neck and so it must be born in mind in cervical mass management