A prognostic marker in idiopathic sudden sensorineural hearing loss serum calprotectin

Objectives. Calprotectin, a protein released by neutrophils, has been used in many studies as a biomarker showing the presence of inflammation. In this study, it was aimed to investigate the relationship between serum calprotectin level and response to the treatment of idiopathic sudden sensorineural hearing loss (ISSHL). Methods. The present study is a prospective, cross-sectional historical cohort study.The study group consisted of 44 patients with ISSHL, and the control group consisted of 41 healthy volunteers without ear pathology. At the same time, patients in the study group were divided into three groups according to the response to ISSHL treatment (recovered, partially recovered, unrecovered). The relationship between the groups was statistically evaluated in terms of serum calprotectin levels. Results. The mean serum calprotectin value was 75.67 +/- 19.48 ng/mL in the study group and 50.24 +/- 29.14 ng/mL in the control group (P=0.001). Serum calprotectin value according to the severity of hearing loss in the mild, moderate and severe was 66.20 +/- 8.82, 70.35 +/- 16.77, and 91.23 +/- 1.9.73 ng/mL, respectively. Serum calprotectin value in the severe group was significantly higher compared to the moderate and mild groups (P=0.004, P=0.001, respectively). Serum calprotectin value according to the treatment response in the recovered, partially recovered and unrecovered groups was 63.36 +/- 11.54, 80.17 +/- 12.06, and 85.33 +/- 22.33 ng/mL, respectively. Serum calprotectin value in the recovered group was significantly lower compared to the partially recovered and unrecovered groups (P=0.002, P= 0.001, respectively). Conclusion. Serum calprotectin value informs the clinician about both the severity of hearing loss and the response to treatment. Hence, serum calprotectin can be used as an important biomarker in ISSHL patients for the determination of the prognosis of disease

Elevated serum calprotectin as an inflammatory marker in obstructive sleep apnea

OBJECTIVE To investigate the serum calprotectin (SCal) levels and neutrophil/lymphocyte ratio (NLR) values in patients with obstructive sleep apnea (OSA). METHODS Sixty-seven OSA patients and 46 healthy volunteers without any sleep disorders were included in the study. The patient group was divided into three subgroups according to the severity of OSA. The SCal levels and NLR values were compared among subgroups and between the experimental and control groups. RESULTS The mean SCal level and NLR value were higher in the study group than in the control group (p = 0.002 and p = 0.001, respectively). The SCal levels were significantly higher in patients with severe OSA than in those with moderate and mild OSA (p = 0.004 and p = 0.001, respectively). DISCUSSION Unlike NLR, the SCal level may inform the severity of OSA and could be used as an indicator for OSA

Efficiency of Expansion Sphincter Pharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome

Objective:Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper respiratory- tract obstruction during sleep and decrease in arterial oxygen saturation. Expansion sphincter pharyngoplasty (ESP) is a simple, safe, and effective method for the surgical treatment of OSAS. The aim of our study was to evaluate the efficacy of ESP with polysomnography (PSG) in OSAS patients.Methods:This study was conducted on patients referred to our center for the treatment of snoring, apnea, witnessed apnea, and daytime sleepiness during 2010- 2018. Overall, 67 patients (16 females, 51 males) who had PSG test at postoperative three months and were considered suitable with history, physical examination, and surgery after PSG were included in the study. Patients were classified into three groups according to OSAS severity: mild, moderate, and severe. Patient age, sex, body mass index (BMI), pre- and postoperative period apnea-hypopnea index (AHI), Epworth sleepiness scores, and PSG data were recorded.Results:The mean BMI of all groups was 27.44±2.73. The postoperative AHI decreased from 18.26±2.23 to 8.01±0.97 (p<0.001). Surgical success rate was 67.2%; it was higher in females (p=0.047). The highest success rate was found in the mild OSAS group; however, this difference was not statistically significant when compared to the other groups (p=0.217). There were statistically significant improvement at postoperative Epworth sleepiness scores and minimum O2 saturations (p<0.001 and p=0.018, respectively).Conclusion:ESP is an effective and successful surgery in selected patients with lateral pharyngeal and retropalatal narrowing

The effect of demographic characteristics on anxiety and hemodynamic response during intubation in patients undergoing septoplasty

Aim: To investigate whether the demographic characteristics of patients scheduled for septoplasty had an effect on their trait and preoperative state anxiety and hemodynamic response caused by endotracheal intubation. Material and Methods: In our prospective observational study, after the demographic characteristics of the patients were recorded, the State-Trait Anxiety Inventory (STAI) was administered three times to measure preoperative trait (STAI-1), preoperative state (STAI-2) and postoperative state (STAI-3) anxiety. The preoperative basal hemodynamic parameters were noted. The percentage changes in the hemodynamic responses of the patients during intubation (systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure) were evaluated. The relationship between the severity of anxiety and hemodynamic changes was investigated. Results: Preoperative state anxiety was present in 85% of the patients (STAI-2≥50). The mean STAI-1 score was found to be statistically significantly lower in men (42.81) than in women (45.46) (p=0.005). The mean STAI-2 score, showing preoperative state anxiety, was statistically significantly lower in males (53.89) than in females (57.72) (p=0.001). The mean STAI-2 score was 58.05 in patients aged 45 and over and 54.15 in those under 45 years (p<0.001). In addition, the percentage changes in hemodynamic response were significantly higher in the group aged 45 and over (systolic arterial pressure: 16.32 mm-Hg, diastolic arterial pressure: 23.88 mm-Hg, mean arterial pressure: 20.34 mm-Hg) (p<0.001). Conclusion: In this study, we observed that preoperative state anxiety was more prevalent in elderly and female patients, and the vital changes during endotracheal intubation were seen at a higher rate in elderly patients

Acupuncture treatment in patients with chronic subjective tinnitus: A prospective, randomized study

Objective: This study investigated the effect, onset, duration of action, and short-term outcomes of acupuncture therapy for treating patients with severe chronic subjective tinnitus. Materials and Methods: This randomized controlled trial evaluated patients with chronic, idiopathic, and severe tinnitus. A total of 105 participants were divided into 2 groups using a randomization method: a study group who received verum acupuncture therapy (n = 53) and a sham acupuncture group (n = 52). Ten acupuncture sessions were given over 5 weeks. After treatment, each participant was monitored for up to 3 months according to changes on a visual analogue Scale (VAS), and Tinnitus Handicap Inventory (THI), and Pure-Tone Audiometry and Speech Discrimination (Interacoustics AC-40, Denmark) scores. Results: The VAS and THI scores were evaluated. A statistically significant difference was noted between the sham and verum acupuncture groups at post-treatment follow-up (P < 0.001). Decreases in the THI and VAS scores became significant in the second week of treatment (P < 0.001 and P < 0.001, respectively), but these scores increased again in the third month post-treatment (P < 0.001 and P < 0.001, respectively). Conclusions: Acupuncture is an effective treatment for patients with severe chronic subjective tinnitus. Patient complaints, decreased beginning at the second treatment week; however, in the third post-treatment month, the complaints reappeared. Maintenance acupuncture therapy is necessary for patients with tinnitus; this approach should be investigated in future studies

A novel prognostic biomarker for recurrent aphthous stomatitis: Calprotectin

Objective. This study aims to investigate whether there is a correlation between serum calprotectin concentration and oral ulcer activity in patients with active recurrent aphthous stomatitis. Method. This prospective, cross-sectional, historical cohort study included 52 patients (26 with active lesions and 26 with inactive lesions) with recurrent aphthous stomatitis and 27 healthy volunteers. The relationship between the groups was statistically evaluated in terms of serum calprotectin level and other inflammatory parameters. Results. The median calprotectin value of the active lesion group (803 ng/ml) was significantly higher than that of the control group (55.4 ng/ml, p = 0.002). Furthermore, the median calprotectin value of the active lesion group was significantly higher than that of the inactive lesion group (72.5 ng/ml, p = 0.017). Conclusion. In patients with recurrent aphthous stomatitis and active ulcer lesions, the serum calprotectin value can be used as a reliable and robust prognostic marker for inflammation...

Hekim internet sayfalarındaki rinoplasti bilgilendirmelerinin okunabilirlik açısından farklı branşlar bazında karşılaştırılması

*Kuzucu, İhsan ( Aksaray, Yazar )Rinoplasti operasyonu; plastik cerrah ve kulak burun boğaz (KBB) hastalıkları uzmanları tarafından yapılan, sıklıkla hangi bölüme gidecekleri konusunda kararsız kaldıkları, sık yapılan bir ameliyattır. Bu operasyonun kim tarafından yapılacağına karar vermede sosyal medyanın etkisi fazladır. Bu çalışmada, plastik ve KBB uzmanlarının internet üzerinde yer alan rinoplasti bilgilendirme metinlerini okunabilirlik açısından değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Google arama motoru kullanılarak 'Rinoplasti' kelimesi taratıldı. İlk 30 plastik cerrah ve ilk 30 kulak burun boğaz uzmanının web sitesindeki rinoplasti hakkında bilgilendirme metinlerinin ilk 100 kelimesi LIDA programı kullanılarak Gunning-Fog indeksi, Flesch-Kincaid ve Ateşman değerleri açısından karşılaştırıldı. Bulgular: Flesch-Kincaid değerleri karşılaştırıldığında, plastik cerrahların (23,18±3,38) bilgilendirme yazılarının KBB uzmanlarına (25,25±3,60) oranla istatistiksel olarak daha az olduğu bulunmuş; bu nedenle daha okunabilir olduğu düşünülmüştür. Öte yandan, Ateşman ve Fog-Gunning değerleri plastik cerrahi grubunda daha iyi sonuçlar vermekle beraber, KBB ile karşılaştırıldığında anlamlı bir fark bulunmamıştır. Sonuç: Rinoplasti operasyonları için plastik cerrah ve KBB hekimleri tarafından hazırlanmış bilgilendirme yazılarının okunabilirliği karşılaştırıldığında, plastik cerrahların metinlerinin daha okunabilir olduğu; bu nedenle hastaların rinoplasti için daha çok plastik cerrahları tercih ettiği düşünülmüştür, ancak her iki yazıda Türkçe için daha uygun görülen Ateşman değeri okunabilirliği zor olarak göstermiş, ancak istatistiksel bir fark gözlenmemiştir. Bu durumun hastaların yazıları zor okuyabildiğini; bu nedenle internet ortamında yer alan bilgilendirme yazılarından ziyade sosyal medyada yer alan resimlerin ve kendi yakınlarının tecrübelerinin rinoplasti operasyonu açısından kişileri yönlendirmelerine neden olduğu düşünülmektedir. Bu nedenle, internet üzerinde paylaşılan bilgilendirme metinlerine daha fazla özen gösterilmelidir.Rhinoplasty is an operation usually carried by both plastic surgeons and otorhinolaryngologists. Patients decide the surgeons and social media plays a crucial role for this decision. Social media plays a crucial role in choice of operations. In our research we compared the readability of information texts between web sites of otolaryngologists and plastic surgeons. Material and Methods: We searched the word 'Rhinoplasty' using google and first 30 web sites were investigated. First 100 words of rhinoplasty information texts from these web sites of plastic surgeons and otolaryngologists were included in our study using LIDA program. Gunning-Fog index, Flesch-Kincaid and Atesman values were mea-sured and compared between groups. Results: Flesch-Kincaid value from web sites of plastic surgeons (23.18±3.38) was found significantly lower regarding to otolaryngologists (25.25±3.60) suggesting better readability. Gunning-Fog index and Atesman values were also beter on plastic surgeons group without any statistical significance. Conclusion: Our results showed the readability of rhinoplasty texts of plastic surgeons was slightly better than otola-ryngologists. This might be the reason for choosing plastic surgeons for rhinoplasty operations. However, Atesman scores which is believed to be more related with Turkish language; the readability of both groups were found to be hard and there was no significant difference. This causes patients' pictures in social media and experiences of their relatives to be more reliable than information texts. As a result, we believe the information texts especially prepared for surgeries should be written with more care

A proinflammatory marker in chronic rhinosinusitis: serum calprotectin

*Kayabaşı, Serkan ( Aksaray, Yazar )Introduction: Studies have shown that calprotectin has a strong pro-inflammatory effect. Elevated calprotectin levels in the serum can be used as a strong clinical marker indicating the presence of inflammation. Objective: To investigate serum calprotectin levels in patients with chronic rhinosinusitis (CRS) and to determine the applicability of calprotectin as a potential molecular proinflammatory biomarker for CRS. Methods: The study consisted of three groups: chronic rhinosinusitis with polyps (CRSwNP group), chronic rhinosinusitis without polyps (CRSwoNP), and healthy control. CRS patients with polyps were further divided into two groups depending on the presence/absence of Samter’s triad. The Nose Obstruction Symptom Evaluation (NOSE) scale score and serum calprotectin value were evaluated in all participants. Results: The mean serum calprotectin value was 79.5±11.8 ng/ml for the CRSwNP group, 71.3±16 ng/ ml for the CRSwoNP group, and 61.9±11.6 ng/ml for the control group (p<0.001). The Samter’s triad group had a significantly higher calprotectin value than the non- Samter’s triad group (p=0.03). There was a significant correlation between the NOSE scores and calprotectin levels (rho=0.734, p<0.001). Conclusion: Serum calprotectin values were correlated with the severity of symptoms in patients with CRS; thus, it seems to be a valuable pro-inflammatory biomarker for the diagnosis of the disease and determining its severity. Further studies with larger series are needed to evaluate the preoperative and postoperative serum calprotectin values in patients undergoing surgery

Type 1 tympanoplasty in pediatric patients: a review of 102 cases

Abstract Background The aim of this study was to investigate the success of type 1 tympanoplasty in pediatric patients with chronic otitis media, and to evaluate the prognostic factors that may influence its success. Materials and methods Medical records of 102 children aged between 8 and 18 years (46 female, 56 male) who underwent type 1 tympanoplasty for chronic tympanic membrane perforation between January 2010 and July 2017 were reviewed. Age, gender, condition of contralateral ear (unilateral, bilateral), type (central, marginal) and location of perforation (anterior, posterior, inferior), graft material (fascia, cartilage), pre- and post-operative hearing levels, mean air-bone gap (ABG), surgical approach (postauricular, endaural) and length of follow up were recorded. Results Anatomical and functional success (ABG  0.05). Conclusion Our results showed that type 1 tympanoplasty can be performed effectively in pediatric population regardless of age, location and type of perforation and surgical approach. Bilateral perforations are prone to reperforation, and should be treated with cartilage graft

Cautionary high-resolution computed tomography findings for the presence of facial canal dehiscence in patients with cholesteatoma

Kuzucu, İhsan ( Aksaray, Yazar )This study aimed to investigate the abnormal high-resolution computed tomography (HRCT) findings in cholesteatomatous chronic otitis media (CCOM) patients preoperatively and the coexistence of abnormal HRCT findings with facial canal dehiscence (FCD) observed intraoperatively to identify the predictive factors associated with FCD. Methods The medical records of 151 CCOM patients who had undergone tympanomastoidectomy at our center were retrospectively examined in terms of the patients' age and gender, preoperative HRCT findings [scutum defect, posterior wall of external auditory canal (PWEAC) defect, lateral semicircular canal (LSSC) defect, tegmen defect, and sigmoid plate erosion]. Operation records containing information about FCD were also analyzed. Results The prevalence of FCD was found to be 33.8% (51/151). There was a significant correlation between the presence of scutum, PWEAC, LSSC, and tegmen defects and the presence of FCD. However, no statistically significant correlation was found between the presence of sigmoid plate erosion and the presence of FCD. The results of regression analysis of the coexisting pathologic findings for FCD showed that the risk of FCD was highest in patients with LSSC + scutum defects (34.3-fold increase), followed by LSSC + PWEAC defects (31.6-fold increase)