Effect of Sleep Position and Body Mass Index on Severity of Sleep Apnea

Objective:To examine the effects of sleep position and body mass index on obstructive events in adults with obstructive sleep apnea syndrome (OSAS).Methods:The sleep studies of 51 adults with OSAS (apnea- hypopnea index >5/h) were retrospectively evaluated. The study population was classified into obese (body mass index (BMI) >30 kg/m2) and non-obese (BMI0.05). There was no statistically significant difference between non-obese cases and the supine and non-supine values of the obese subjects (p>0.05). There was no difference in the AHI index in the obese and non-obese group in the supine and non-supine position and in NREM periods (p>0.05). The AHI was worse in REM periods. The AHI was worse in all obese and non-obese subjects in the supine position (p<0.05-0.01).Conclusion:In OSAS the AHI was higher in the supine position. Obesity had no additional effect. On the other hand in all subjects while REM, NREM, AHI situations were indifferent, obese subjects AHI index in REM period is worsen

Vidian Canal Types and Dehiscence of the Bony Roof of the Canal: An Anatomical Study

Objective: To determine the prevalence of Vidian canal types and dehiscence of the bony roof of the canal.Methods: This study included 594 patients (391 males and 203 females; average age, 32.43±11.98 years; range, 18-65 years). Computed tomography (CT) images were analyzed in terms of the prevalence of Vidian canal types and dehiscence of the bony roof of the canal.Results: Vidian canal types 1, 2, and 3 based on the sphenoid sinus body were found on the right side in 33.8%, 29.7%, and 6.5%, and on the left side in 36.4%, 27.4%, and 36.2% of the patients, respectively. Dehiscence of the bony roof of the canal was found on the right side in 22.2% of the patients and on the left side in 26.6%. In terms of Vidian canal types based on the sphenoid sinus floor, types 1, 2, 3, and 4 were found on the right side in 53.5%, 27.4%, 7.6%, and 11.5%, and on the left side in 54.9%, 26.6%, 6.6%, and 11.9% of the patients, respectively. On the right side, Vidian canal type 2 was significantly (p=0.002) more frequent in males than in females.Conclusion:When studying the complex anatomy of the sphenoid sinus, it is essential to consider Vidian canal types. Before endoscopic sinus surgery the Vidian canal and other anatomical structures should be carefully evaluated in all patients during preoperative paranasal sinus CT imaging to avoid complications

Typical carcinoid tumor of the larynx in a woman: a case report

<p>Abstract</p> <p>Introduction</p> <p>Neuroendocrine tumors are the second most common neoplasms of the larynx. Histopathologically, neuroendocrine tumors can be classified into four types: typical carcinoid tumors, atypical carcinoid tumors, small cell neuroendocrine tumors and paragangliomas. Typical carcinoid tumor of the larynx is a particularly rare occurrence. We present a case of this rare disease, and review and discuss its diagnosis and treatment.</p> <p>Case presentation</p> <p>A 55-year-old Turkish woman presented with a two-year history of persistent hoarseness. Endoscopic laryngeal examination and computed tomography revealed a supraglottic mass. Direct laryngoscopy was performed and a biopsy taken. Results of the histopathologic examination and immunohistochemical analysis were consistent with typical carcinoid tumor of the larynx. A supraglottic laryngectomy was performed. There was no recurrence during a follow-up period of three years.</p> <p>Conclusion</p> <p>Carcinoid tumors require an accurate diagnosis because of their varied clinical behavior and prognosis. A correct pathologic diagnosis is essential, differentiating the tumors from other neuroendocrine neoplasms and medullary cancer of the thyroid gland. Immunohistochemical analysis is supplementary to a standard histopathologic evaluation. Currently, conservative surgical resection without elective neck dissection is the recommended treatment for typical carcinoid tumor of the larynx. Additional cases and case series with long-term follow-up will be useful for understanding the nature of this tumor and should clarify the prognosis.</p

Pediatric Tracheotomy: A Relatively Rare Indication Limited to Pediatric Intensive Care Subjects?

Objective:To evaluate indications, underlying conditions and outcome in pediatric tracheotomy subjects.Methods:Between January 2004 and September 2013, pediatric subjects who underwent a tracheotomy operation were included for study. All subjects were under the age of 14. Subjects’ primary diseases, indication of tracheotomy, age, gender and type of complications were recorded.Results:Forty five subjects were identified. The mean age of subjects was 26.3 months (range between 2 to 140 months). Twenty one (46.6%) subjects were under the age of 1 year. In 34 (75.5%) out of 45 subjects, tracheotomy indication was prolonged intubation. In the remaining 11 (24.4%) subjects, tracheotomy indication was upper respiratory tract obstruction. Thirteen (n=13- 28.8%) out of 45 experienced early complications and 2 (n=2-4.5%) out of 45 subjects experienced late complications. One tracheotomy related death occurred in the immediate period. Eight (18.1%) of subjects died during the study period from underlying conditions. Decannulation was successfully performed in 13 (36.1%) subjects. In the remaining 23 (63.8%) subjects, decannulation could not be done.Conclusion:All tracheotomies in this report were performed on pediatric intensive care subjects on an elective basis. No tracheotomy was performed for acute upper airway obstruction. Even when planned and elective tracheotomy is performed it still has significant mortality and morbidity

Hypothyroidism in Children with Serous Otitis Media

Objective:In this study, we aimed to evaluate the co-existence and prevalence of hypothyroidism in patients with otitis media with effusion (OME) and to determine the possible relationship between OME and hypothyroidism.Methods:The subject group consisted of 46 paediatric patients (26 boys, 20 girls), ranging in age from 4 to 14 years (mean age±SD 7.78±2.86 years), who were treated in the department of otorhinolaryngology for OME; the control group composed of 30 healthy children (20 boys, 10 girls), ranging in age from 3 to 14 years (mean age±SD 7.20±2.86 years). Triiodothyronine (Free T3), thyroxin (free T4), and thyroid-stimulating hormone (TSH) values of 46 children who were treated for OME, in addition to 30 healthy children, were evaluated.Results:Seven patients (15.2%) in the OME group, and one patient (3.3%) in the control group had subclinical hypothyroidism marked only by serum TSH elevations. All of the children in this study, regardless of whether from the subject or control group, had normal serum free T3 and free T4 levels. There was no significant difference between subject and control groups (p>0.05).Conclusion:Although there was no statistically significant difference between subject and control groups in this study, further studies with larger patient groups are needed to investigate the role of hypothyroidism in the aetiology of OME

Assessment of Effects of Septoplasty on Acoustic Parameters of Voice: A Prospective Clinical Study

Objective:To investigate the effects of septoplasty on the acoustic parameters of voice.Methods:In total, 23 patients (seven females and 16 males; average age, 32.13±9.67 years; age range: 19-56 years) with a diagnosis of nasal septal deviation and who underwent septoplasty were included. Preoperative and on postoperative 30th day, acoustic analysis of voice was conducted for all patients. The recordings of /mana/ vowel were used to evaluate average fundamental frequency (F0), jitter, shimmer, and noise-to-harmony ratio (NHR). F0, shimmer percent, jitter percent, and NHR of two terms were compared. A p-value<0.05 was considered to indicate statistical significance.Results:A statistically significant change was not observed in F0 (p=0.741), jitter (p=0.930), and shimmer (p=0.128) measured preoperatively and on postoperative day 30. However, the increase in NHR measured on postoperative day 30 were statistically significant compared with preoperative NHR (p=0.017).Conclusion:According to the findings of this study, except NHR value, no statistically significant changes on F0, jitter and shimmer were detected after septoplasty

Is metabolic syndrome associated with obstructive sleep apnea in obese adolescents?

WOS: 000367581700004PubMed ID: 26156956Objective: To investigate whether there is an association between metabolic syndrome and obstructive sleep apnea syndrome (OSAS) in obese adolescents. Methods: In total, 240 pubertal children or prepubertal children older than 11 y recruited consecutively from the pediatric endocrinology unit, obesity clinic. Patients with tonsillar and adenoid hypertrophy (grade 3/4), systemic illnesses, or chronic drug usage were excluded. After anthropometric measurement and laboratory study, patients were divided into two groups according to metabolic syndrome (MS): MS and non-MS. Overnight polysomnographic evaluation was performed and 104 subjects were included for statistical analysis. The two groups were compared in terms of sleep efficiency, number of awakenings per night, oxygen desaturation index, snoring time, and obstructive/central/mixed apnea-hypopnea index (AHI). Results: Of the obese adolescents, 51 had MS and 53 did not. The AHI was >= 1 in 25 of the 53 non-MS children (47.2%) and in 25 of the 51 MS children (49%). The median obstructive AHI value was 0.9 (0.2-2.4) and total AHI was 0.9 (0.2-2.5) in the MS group; these values were 0.9 (0.25-3.55) and 0.9 (0.3-3.55), respectively, in the non-MS group. Obstructive, central, mixed, and total AHI values in the MS and non-MS groups were not statistically significantly different (p > 0.05). Conclusions: In our study, we did not find an association between MS and sleep apnea in obese adolescents

Otopsi Öncesi Doğru Bilgilenmenin Önemi Bir Olgu Sunumu

Cesedin otopsi yapılmak üzere bir başka merkeze gönderildiği durumlarda, olay yeri inceleme ve adli ölü muayenesi kayıtları çok önemlidir. Bu kayıtların eksik ve/veya hatalı olduğu durumlarda ciddi sorunlar yaşanır. Ölenin yakınlarının otopsi sırasında hazır bulunması, otopsiyi yapacak hekimin ölen hakkında tıbbi öykü ve olay hakkında ek bilgi alması açısından yararlıdır. Sunulan olguda, cumhuriyet savcısı ve pratisyen hekim tarafından düzenlenmiş olay yeri incelemesi ve adli ölü muayenesi tutanağında, ölenin travmaya uğradığına dair herhangi bir bilgi yer almamaktadır. Otopsi yapılmak üzere cesedin gönderildiği merkezde ölenin yakınlarından alınan öyküde, kişinin birkaç gün önce bir kavgaya karıştığı öğrenilmiştir. Otopsi sonucunda ölüm nedeninin ince bağırsak perforasyonu sonucu gelişen peritonit olduğu, yol açan etken hakkmda yapılacak incelemeler sonucu görüş belirtileceği kararma varılmıştır. Daha sonra düzenlenen ek raporda, ince bağnsak delinmesinin travma kökenli olduğu belirtilmiştir. Olgu bazmda, olayın yorumlanması ve doğru tanı koyulabilmesi için otopsi öncesi doğru bilgilenmenin önemine dikkat çekilmiştir. Otopsi, adli açıdan ölüm olaymın araştmlmasının sadece bir bölümü oluşturur. Sonradan sorulabilecek sorularm doğru bir biçimde yorumlanabilmesi için, ölüm öncesi dönemdeki olaylar, olay yeri, kişinin tıbbi ve sosyal öyküsü çok önemlidir. Anahtar kelimeler: Olay yeri incelemesi, otopsi, tıbbi öyk