Effects of structured exercise program on severity of dizziness, kinesiophobia, balance, fatigue, quality of sleep, activities of daily living, and quality of life in bilateral vestibular hypofunction

BACKGROUND: A minimal number of studies have documented the impact of Vestibular rehabilitation (VR) on the recovery rate of patients with bilateral vestibular hypofunction (BVH). OBJECTIVE: The purpose of this study was to investigate the effectiveness of structured VR programs on severity of dizziness, kinesiophobia, balance, fatigue, quality of sleep, activities of daily living (ADL) and quality of life (QoL) in subjects with chronic BVH. METHOD: Twenty-five participants diagnosed with BVH were included in the study. A structured VR program was applied in 50-minute sessions once a week and as a home exercise program 3 times a day over 8 weeks. Participants were evaluated for severity of dizziness with the visual analog scale, for kinesiophobia with the tampa scale of kinesiophobia, for balance with the Semitandem, tandem, and standing tests, for quality of sleep with the Pittsburgh sleep quality index, for ADL with the vestibular disorders activities of daily life, for QoL with dizziness handicap inventory and for fatigue with the fatigue severity scale at the baseline (T1), at 4th week (T2), 8th week (T3), and 20th week (T4) after study started. RESULTS: Significant difference in terms of Tandem Test and 1 Leg Stand Test was found in favor of T3-T4 Period (P < .05). There were significant improvements in terms of vestibular disorders activities of daily life, tampa scale of kinesiophobia, Pittsburgh sleep quality index and dizziness handicap inventory in favor of the T3 to T4 Period (P < .05). Significant difference in terms of visual analog scale was found in favor of T2 Period (P < .05). CONCLUSIONS: A twelve-week structured VR program may enhance severity of dizziness, kinesiophobia, balance, quality of sleep, ADL and QoL in participants with chronic BVH

Anatomic and Functional Results of Cartilage Type 1 Tympanoplasty in Children and the Evaluation of the Success of Surgery with Parental Perceptions

Objective:This study aims to determine the anatomic and functional results of cartilage Type 1 tympanoplasty in children and to evaluate the success of surgery with parental perceptions.Methods:Only pediatric patients who had undergone cartilage Type 1 tympanoplasty were included in this study. Patients older than 16 years and patients who had otorrhoea during the previous month, chronic otitis media with cholesteatoma and patients who had undergone mastoidectomy or ossiculopasty were excluded. The ‘anatomical’ success was accepted as an intact graft in the last control in the at least 6th month postoperatively. A satisfaction questionnaire with four questions about the perceptual results of surgical intervention was applied to the patients’ parents on the telephone.Results:In total, 44 ears of 41 cases (22 male 19 female) were included in the study. The mean age was 13.2±2.7 (8-16) and the mean follow-up time was 17 (7-36) months. Anatomical success rate was 88.6% (39/44). As a preoperative mean, the pure tone hearing threshold was 30.7±7.7 dB and the postoperative mean pure-tone hearing threshold was 18.8±7.8 dB. Among the operated ears, 88.6% (39/44) of the perforations were treated successfully. Of the 41 paediatric patients’ parents, only 28 (68.2%) could be reached by telephone; nineteen (68%) of the 28 parents contacted thought that the hearing level had improved postoperatively and only 10 parents (35%) stated that his/her child could attend a preoperatively-restricted activity postoperatively.Conclusion:Outcomes of cartilage tympanoplasty in children satisfy both surgeons and parents. Chronic otitis media in children must be managed with surgery as soon as favourable conditions are provided

Diagnostic Value of the Video Head Impulse Test in Patients with Vertigo: Can It Be Used as a Screening Tool?

Background and Aim: Several laboratory tools are used to evaluate balance disorders but, there is still no screening test to determine the site and the severity of the lesion. The aim was to investigate whether video Head Impulse Test (vHIT) can be used as a screening test in patients with chronic or recurrent vertigo and dizziness. Methods: The files of 965 patients who were followed up in our vertigo outpatient clinic were reviewed retrospectively. Vestibulo-Ocular Reflex (VOR) gains and saccadic movements of the right and left lateral canals in the vHIT test, and Canal Paresis (CP) in the Caloric Testing (CT) were noted. Results: A total of 325 patients were included in our study. In CT results, the group that CP was most frequently detected was Menière’s Disease (MD) group (71 patients (74.7%). While vHIT results were found to be pathological in the vast majority of patients in the Vestibular Neuritis (VN) group (72.7%), the results were found to be normal at the highest rate in the vestibular migraine group (77.9%). Correlation analysis showed a significant but weak correlation between the degree of CP in the CT and the VOR gains of the lateral canals in vHIT in all groups. Conclusion: Although it has high sensitivity in cases with VN and vestibulopathy, we think that vHIT cannot be used as a screening tool in patients with vertigo, especially for chronic cases, since its sensitivity rate differs in the long term according to the cause of the disease

<b>Şeriat ve Tasavvuf Bağlamında Din-Çevre İlişkisi Üzerine Bir Değerlendirme</b> / The Relationship between Religion and Environment in the Context of Shari'a and Sufism

Din-çevre ilişkisi, dinî araştırmalarda çok sayıda çalışmaya konu olmuştur. Bu çalışma ise, diğerlerinden farklı olarak, din çevre ilişkisinin sadece şeriat bağlamında değil, aynı zamanda tasavvuf bağlamında da ele alınabileceğini ortaya koymaktadır. Çalışmanın birinci bölümünde din-çevre ilişkisi şeriat bağlamında ele alınmış, din-fiziki çevre, din-sosyal çevre ve din-beden ilişkisi incelenmiştir. Ayrıca, din-beden ilişkisinin çevre bağlamında değerlendirilmesi konusunda önemli açılımlar getirilmiştir. İkinci bölümde ise, tasavvuf bağlamında din-çevre ilişkisine değinilmiş, ilk bölümde ele alınan konuların tamamı tasavvuf düşüncesi bağlamında yeniden ele alınmıştır. Bununla birlikte, çevre konusunda aslında şer’î ve tasavvufi düşüncenin birbirlerinden farklı argümanlar üretmediği ortaya konulmaya çalışılmıştır. A Sociological Approach to the Relationship between Religion and Environment in the Context of the Shari'a and Sufism The relationship between religion and the environment has been discussed in numerous studies. However this study, unlike the others, presents that the relationship between religion and the environment could be dealt with not only in the context of the Shari’a but also in the context of Sufism. In the first part of the study, the relationship between religion and the environment is dealt with in the context of the Shari’a. In this part, the relation between religion and the physical environment, religion and the social environment and religion and the body has been examined. In this part, significant developments over examination of the relation between religion and the body in the context of the environment have been provided. In the second part, the relationship between religion and the environment is touched upon in the context of Sufism. In this part, all the issues that have been addressed in the first part have been re-examined in the context of the thought of Sufism. Meanwhile, it has been endeavored to prove that the thought of the Shari’a and that of Sufism have not produced different arguments regarding with the environment

Nasal Fractures: Is Closed Reduction Satisfying?

Conclusion: Closed reduction is an easy and sufficient treatment for nasal fractures, especially for mild nasal fractures. Early intervention raises the patient satisfaction rate

Do Silicone Nasal Septal Splints with Integral Airway Reduce Postoperative Eustachian Tube Dysfunction?

Conclusion. Because they allow inhalation through the nose and cause less Eustachian tube dysfunction than Merocel, using silicone nasal septal splints with integral airway instead of packing after septoplasty seems a more reasonable option

Determination of Factors That Impact Patient Satisfaction Following Tympanoplasty

OBJECTIVE: The aim of this study was to assess the subjective evaluation of patients postoperatively about their hearing, otorrhea, and tinnitus by using a questionnaire and to determine factors affecting patient satisfaction following tympanoplasty. MATERIALS and METHODS: Patients who underwent tympanoplasty with or without mastoidectomy due to chronic otitis media were included the study. Patients were called by telephone and invited to a control examination and to answer a questionnaire survey. Patients who came to the control examination were asked about any changes in their hearing and the presence or absence of tinnitus and otorrhea. The overall subjective satisfaction of the surgery was measured by visual analog scale (VAS). RESULTS: One hundred forty-seven patients who underwent tympanoplasty with or without mastoidectomy with a mean age 33.32 +/- 11.27 were included the study. There were statistically significant differences between the patients whose grafts were successfully healed versus those not healed, according to VAS score (p<0.001). VAS score was significantly higher in patients whose tinnitus decreased or disappeared (p=0.001) and in patients whose otorrhea completely disappeared (p=0.008). CONCLUSION: Postoperative patient satisfaction must be taken into consideration for the evaluation of the success of tympanoplasty surgery, in addition to objective criteria. Healing of the tympanic membrane, relief of tinnitus, hearing improvement, and relief from otorrhea were highly correlated with patient satisfaction

Detection of Staphylococcal Exotoxins in Antrochoanal Polyps and Chronic Rhinosinusitis with Nasal Polyps

Conclusion. Inflammatory triggers in ACP remain a subject of debate, and this study does not support the hypothesis that staphylococcal exotoxins may play a role in ACP ethiopathogenesis. Our research is consistent with the possibility of SAgs as etiological agents in the development of bilateral nasal polyposis

Efficacy of closed reduction for nasal fractures in children

The aim of this study was to evaluate the efficacy of closed reduction and the effects of the time of intervention on young patients' satisfaction. Patients older than 16 years and those with additional maxillofacial fractures were excluded. All patients were treated by closed reduction and external fixation. The patients and parents were asked about their satisfaction in a survey 6 months' postoperatively. They were divided into groups according to the time of intervention, and the results. Twenty-four patients, age range 4-16 years, with isolated nasal fractures were included in the study. The mean (SD) time before intervention was 5.5 (1.8) days. The first group comprised 16 patients whose fractures were reduced between days 1 and 5 after the injury, and the second the 8 whose fractures were reduced between days 6 and 10. At 6 months 15 of the 24 were satisfied with the result, and 9 were not. In the group treated between days 1-5, 12/16 were happy with the result, and in the group treated between days 6-10, 3/8 were satisfied. Closed reduction gives good results in the treatment of nasal fractures in children. Early intervention increases the rate of satisfaction. (C) 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved