Kafa travması sonrası karşı kulakta ileri derecede işitme kaybı: olgu sunumu

Hearing loss is a known outcome following head trauma. The conductive as well as sensorineural hearing loss have been demonstrated both in cases of head injury. The labyrinthine concussion is postulated to be the underlying mechanism, and it is a common finding in head traumas. There is no specific treatment for labyrinthine concussion. The diagnosis mainly relies on audiometric tests. We reported a case of labyrinthine concussion in the opposite ear of a patient who had head trauma. At 2-month of follow-up, we observed that the contralateral hearing loss of our case persisted.Kafa travması sonrasında işitme kaybı görülebildiği bilinmektedir. Kafa yaralanmaları sonrası hem iletim tipi hem de sensörinöral tip işitme kaybı meydana geldiği gösterilmiştir. Altta yatan mekanizmanın kafa travmalarında sıklıkla rastlanan labirentin konküzyon olduğu varsayılmaktadır. Labirentin konküzyonun özel bir tedavisi yoktur. Tanı esasen odyometrik testlere dayanır. Bu yazıda kafa travması sonrası karşı kulakta labirentin konküzyon nedeniyle işitme kaybı oluşmuş bir hasta sunduk. İki aylık takip sonrasında, karşı kulaktaki işitme kaybının düzelmediğini gözlemledik

Evaluation of sexual functions in patients with chronic suppurative otitis media

Objectives: The aim of this study is to evaluate sexual function scores in patients with chronic suppurative otitis media.Patients and Methods: A total of 35 patients (20 male, 15 female) who had purulent discharge in one or both ears for at least threemonths and were diagnosed with chronic otitis media were included in the study group, while 30 volunteers (15 males, 15 females)who had no problem with their ears were included in the control group. Patients and controls underwent otolaryngology and urologyexaminations; female participants were asked to fill the female sexual function index and male participants were asked to accomplishthe international index of erectile function. Pure tone audiometry, tympanometry and speech discrimination tests were applied on allparticipants.Results: A significant difference was found between patients and controls in terms of scores for the subscales sexual desire(p=0.044), erectile function (p=0.012), and overall satisfaction (p=0.002) of the international index of erectile function in males.No significant difference was found between both groups in terms of other subscale scores (p>0.05). A significant difference wasfound (p0.05) between both groups only in the subscale pain (p=0.450).Conclusion: Chronic otitis media also negatively affected sexual function scores and it should also be examined from this aspect

Post-discharge heart failure monitoring program in Turkey: Hit-PoinT

Objective: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients. Methods: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up program (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC. Education included information on adherence to treatment, symptom recognition, diet and fluid intake, weight monitoring, activity and exercise training. Patients were contacted by telephone after 1, 3, and 6 months. The primary study endpoint was cardiovascular death. Results: Although all-cause mortality didn't differ between the EHFP and RC groups (p=NS), the percentage of cardiovascular deaths in the EHFP group was significantly lower than in the RC group at the 6-month follow up (5.6% vs. 8.9%, p=0.04). The median number of emergency room visits was one and the median number of all cause hospitalizations and heart failure hospitalizations were zero. Twenty-tree percent of the EHFP group and 35% of the RC group had more than a median number of emergency room visits (p=0.05). There was no significant difference regarding the median number of all-cause or heart failure hospitalizations. At baseline, 60% of patients in EHFP and 61% in RC were in NYHA Class III or IV, while at the 6-month follow up only 12% in EHFP and 32% in RC were in NYHA Class III or IV (p=0.001). Conclusion: These results demonstrate the potential clinical benefits of an enhanced HF education and follow up program led by a cardiologist in reducing cardiovascular deaths and number of emergency room visits with an improvement in functional capacity at 6 months in post-discharge ambulatory HF patients.Türk Kardiyoloji Derneği Kalp Yetmezliği Çalışma Grub

Adenotonsiller hipertrofisi olan okul öncesi çocuklarda gelişimsel gecikmeler

Objectives: This study aims to investigate the effects of adenotonsillar hypertrophy on general development, as well as fine and gross motor capabilities, social communication, and language development in children with adenotonsillar hypertrophy by applying the Denver Developmental Screening Test-II.Patients and Methods: The study included 30 patients (12 boys, 18 girls; mean age 53.3±12.2 months; range 32 to 72 months) who were indicated for adenotonsillectomy due to adenotonsillar hypertrophy between February 2013 and July 2013. The control group comprised 30 children participants (12 boys, 18 girls; mean age 53.1±12.8 months; range 32 to 72 months) with no adenotonsillectomy indication. All participants included in the study were performed routine physical examination, flexible fiberoptic nasopharyngoscopy, and tympanometry. Brodsky scale and fiberendoscopic findings were used to categorize tonsil and adenoid sizes, respectively. Following ear, nose, and throat evaluation, a psychologist conducted Denver Developmental Screening Test-II in all participants blindly.Results: Adenotonsillar hypertrophy patients had higher abnormal levels of general development (c2=7.13, p=0.028). Although patients and controls had similar levels of fine motor, gross motor, and personal-social development levels, there was a statistically borderline difference between them in terms of language development (t=1.82, p=0.074).Conclusion: The possibility of adenotonsillar hypertrophy should definitely be considered in children with delayed general and language developments.Amaç: Bu çalışmada adenotonsiller hipertrofili çocuklarda Denver Gelişimsel Tarama Testi-2 uygulanarak adenotonsiller hipertrofinin genel gelişimin yanı sıra ince ve kaba motor yetenekler, sosyal iletişim ve dil gelişimi üzerindeki etkileri araştırıldı.Hastalar ve Yöntemler: Şubat 2013 - Temmuz 2013 tarihleri arasında adenotonsiller hipertrofi nedeniyle adenotonsillektomi endikasyonu konulan 30 hasta (12 erkek, 18 kız; ort. yaş 53.3±12.2 ay; dağılım 32-72 ay) çalışmaya dahil edildi. Kontrol grubuna adenotonsillektomi endikasyonu olmayan 30 çocuk katılımcı (12 erkek, 18 kız; ort. yaş 53.1±12.8 ay; dağılım 32-72 ay) dahil edildi. Çalışmaya alınan tüm katılımcılara rutin fizik muayene, fleksibl fiberoptik nazofarengoskopi ve timpanometri uygulandı. Tonsil ve adenoid boyutlarını sınıflandırmak için sırasıyla Brodsky skalası ve fiberendoskopik bulgular kullanıldı. Kulak, burun, boğaz değerlendirmesinin ardından tüm katılımcılara bir psikolog tarafından kör olarak Denver Gelişimsel Tarama Testi-2 uygulandı.Bulgular: Adenotonsiller hipertrofi hastalarının anormal genel gelişim seviyeleri daha yüksek idi (c2=7.13, p=0.028). Hastalar ve kontrollerin ince ve kaba motor ile kişisel-sosyal gelişim düzeyleri benzer olmasına karşın dil gelişimi açısından aralarında istatistiksel olarak sınır düzeyde farklılık vardı (t=1.82, p=0.074).Sonuç: Genel gelişim ve dil gelişimi geriliği olan çocuklarda adenotonsiller hipertrofi olasılığı mutlaka akla getirilmelidir

Hearing status in vitamin B12-deficient children

Aim The aim of this study is to investigate the effects of vitamin B12 deficiency on hearing in school-aged children by pure-tone audiometry. Methods Forty-three vitamin B12-deficient children and 37 age-matched control subjects were enrolled in the study. Tympanometric evaluations and pure-tone audiometry including high frequencies were performed on the subjects. The results were compared between the two groups. Results Both right and left ear pure-tone hearing thresholds (PTHTs) at 0.25-4 kHz, and four-frequency pure-tone average values were significantly better in the control group compared with the patient group (P 0.05). Vitamin B12 level also did not show any significant correlation with the PTHTs at 0.25-16 kHz (P > 0.05). Conclusion This study indicates that vitamin B12 deficiency may contribute to hearing impairment at low frequencies as a possible aetiological factor in children

Cog graft, a new septal extension graft for designing nasal tip rotation and projection in rhinoplasty

Background: Adjusting the nasal tip rotation and tip projection according to the patient's face and wishes is a very important stage in rhinoplasty with the use of a cog graft positioning the tip point in the appropriate place is possible by adjusting the nose length, tip projection and tip rotation together. Objective: The aim of this study is to facilitate positioning the tip rotation and projection in the appropriate place according to the patient's needs in rhinoplasty with Cog graft. Materials and methods: Cog graft was applied in 32 patients who underwent rhinoplasty. Cog graft was prepared from costal cartilage in 10 patients and from septal cartilage in 22 patients. Cog graft was prepared by shaping the superior edge of the septal extension graft like a gear wheel. It is fixed to provide desired projection to the caudal septum. In the position where rotation and projection are evaluated adequately, the graft is fixed with sutures. They were followed in average 18 months (between 6 and 24 months). Results: Twenty of the patients were primary cases and 12 were revision cases. The targeted rotation and projection results were achieved in all patients. All patients had satisfactory esthetic results. Conclusions: Cog graft is a useful graft with which we can adjust the nose length, projection and rotation appropriately and in a short time with a single graft

Vertical alar lengthening technique in correcting short noses

Background: It is crucial that the nose length must be compatible with the face in order to obtain beautiful results that suits the face. Shorter and upturned noses appear as if the tip of the nose is cut from the front and gives a piggy appearance to the patient's face. Objective: The aim of this study is to obtain longer noses with increased tip definition by effectively lengthening the medial and lateral crura's in patients with short nose and Asian noses. Materials and methods: Vertical Alar Lengthening (VAL) technique was applied to 17 revision and 12 primary Asian noses. VAL technique consists of three steps. In the first step, the medial crus were lengthened by stealing from the lateral crus. Later, a lateral crural extension graft was applied to the shortened lateral crus, and the lateral crus was lengthened and sutured to the medial crus. In the final stage, a subdomal graft was placed and supported in the space formed underneath the alar tip between the mucosa and the new dome. They were followed in average 12 months (between 6 and 18 months). Results: VAL technique was applied to 17 revision and 12 primer Asian noses. Suggested surgical technique move the tip forward and downward reduced its cephalic rotation and lengthened the nose. Targeted tip point, rotation and projection results were achieved in all patients. All patients had satisfactory esthetic results. Conclusions: In revision cases and short nose deformities in Asian noses, the nasal tip point was extended forward and downward with the VAL technique, reducing its rotation and lengthening the nose

The hammer graft: A novel technique to provide dorsal support, tip projection, and rotation in rhinoplasty

Background: There are numerous cartilaginous grafts that can be used in rhinoplasty, depending on the specific needs of the patient. These include spreader grafts, dorsal onlay, tip grafts, septal extension, and columellar struts grafts, among others. Objective: The aim of this study is to demonstrate use of the hammer graft in rhinoplasty; this technique can be used to improve dorsal support, tip projection, and tip rotation using a single cartilage graft. Materials and methods: This novel graft was applied in 18 patients who underwent rhinoplasty. In revision patients, hammer graft was harvested from costal cartilage and in primary cases from septum cartilage. They were followed in average 12 months (between 6 and 18 months). Result: Three of these patients were revision cases and 15 were primary cases. In revision patients, hammer graft was harvested from costal cartilage and in primary cases from septal cartilage. The targeted results were achieved to a large extent in all patients. All patients had satisfactory esthetic results. Conclusion: The hammer graft as a single and stable graft useful support for the dorsal part, caudal part and extension part of the septum to be used in primary and revision rhinoplasty

The prevelance of psichiatric symptoms in preschool children with adenotonsillar hypertrophy

WOS: 000321535300008PubMed ID: 23643332Objectives: The aim of this study was to determine the prevalence of psychiatric disorders and. symptoms in preschool-age children who are indicated for operation due to adenotonsillar hypertrophy. Materials and methods: Forty-eight patients between the ages of three and five years with indication for adenotonsillectomy were included in the study, as well as 40 control patients. Cases underwent routine ear nose throat (ENT) examination, flexible nasopharyngoscopy and tympanometry. The Early Childhood Inventory-4 (ECI-4) parent form and Strengths and Difficulties Questionnaire (SDQ) parent form were completed by the parent caring for the child. The SPSS for Windows 16.0 program was used for statistical analysis. Results: Groups were compared according to they received at least one psychiatric diagnosis measured by ECI-4, the group of adenotonsillar hypertrophy was diagnosed more than the control group. Attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and sleep disorders were detected at a higher rate in patients with adenotonsillar hypertrophy. It also was established that in the comparison of the severity of psychiatric symptoms determined by ECI-4, symptom severity of ADHD, ODD, anxiety disorders, and sleep disorders was higher in the adenotonsillar hypertrophy group than in the control group. In the evaluation of the SDQ parent form, it was determined that attention deficit, hyperactivity, behavioral, and peer relations problems occurred more frequently in the adenotonsillar hypertrophy group. Conclusions: In addition to oral respiration, snoring, and disordered breathing during sleep, adenotonsillar hypertrophy may also associated with psychiatric disorders and symptoms

Pólipos pilosos bilaterais de orofaringe: Uma causa rara de dispneia em neonatos

Hairy polyp (HP) is one of the causes of congenital dyspnea, a rare developmental malformation of bigerminal origin that comprises both ectodermal and mesodermal elements foreign to the site in which it is found. It typically presents as a pedunculated mass in the oropharynx and nasopharynx. Major symptoms at presentation are related with respiratory obstruction and feeding problems. In the literature, congenital pharyngeal hairy polyps are generally unilateral