The affect of increasing radiofrequency surgery application regions to the medical treatment success of snoring

AMAÇ: Ciddi medikal sonuçları olan Obstrürüktif UykuApnesi Sendromu (OUAS)'nun en önemli belirtisi olan horlama sosyal ve medikal bir problem oldugundan titizlikle değerlendirilmesi gerekir. GEREÇ VE YÖNTEMLER: Cumhuriyet Üniversitesi Tıp Fakültesi, KBB Anabilim Dalı, horlama polikliniğine 1999-2002'de horlama şikâyeti ile başvuran, obstrüktif uyku apnesi öyküsü bulunmayan ve yumuşak damak ile uvulası normalden uzun olup değişen oranlarda vibrasyon gösteren 46 olguda yapıldı. Bu 46 olgu grup 1 (iki noktaya radyo frekans uygulaması yapılacak olgular) ve grup 2 (üç noktaya radyo frekans uygulaması yapılacak olgular) olmak üzere rastgele iki gruba ayrıldılar. BULGULAR: Preoperatif yumuşak damak vibrasyon dereceleri postoperatif 12. haftadaki vibrasyon dereceleri ile karşılaştırıldığında anlamlı düzeyde azaldığı görüldü (p<0,05). Subjektif olarak ilk 4 haftada horlama şikâyetinde belirgin artış gözlendi. PreoperatifVizüelAnalog Skala (VAS) değerlerinin ortalaması 7.76±0,25; postoperatif 12. haftadaki VAS değerlerinin ortalaması ise 4,41±0,18 olup aralarındaki fark istatistiksel olarak anlamlıdır (p<0,001). Iki grubun 4. haftadaki VAS değerlerindeki artıs preoperatif VAS değerleri ile karşılaştırıldığında istatistiksel olarak anlamlıdır (p<0,001). Yapılan istatistiksel değerlendirmede preoperatif VAS değerlerine göre postoperatif 12. haftadaki VAS değerlerinde anlamlı azalma saptandı (p<0,001). Subjektif sikâyetlerin de azalma olmaması nedeniyle grup1'de 8 (%40), grup 2'de 2 (%11,8) olguya ikinci seans radyo frekans uygulaması yapılması gerekti. Ikinci seans uygulaması gerekmesi açısından 2 grup karşılaştırıldığında istatistiksel olarak anlamlı bir fark tespit edilmedi. Bununla birlikte rölatif risk %95 güvenlik aralığında hesaplandığında grup1'de grup 2'deki olgulara göre ikinci seans radyo frekans uygulamasına 3,4 kez daha fazla gereksinim gösterdikleri saptandı. SONUÇ: Uygulama yeri sayısı arttıgında ikinci seans radyo frekans uygulaması daha az gerekir. Sonuç olarak uygulama yeri sayısı tedavi başarısında etkilidir.OBJECTIVE: Snoring is a social and medical problem because of the prime sign of OSAS this pathology must be scrupulously evaluate. MATERIALand METHODS: During 3 years period (from 1999 to 2002), the 46 patients with chief complaint of snoring without obstructive sleep apnea history and soft plate elongation was found who applied to snoring policlinic of Cumhuriyet University Faculty of Medicine Department of Otorhinolaryngology was included in this study. RESULTS: There were a prominent decrease preoperative vibrations degree and postoperative 12 week vibrations degree statistically meaningfully differences was found (p<0, 05) in this study participant In the first 4 weeks of treatment, it was observed increasing of snoring subjectively. Patients average-value of VAS were preoperative 7.76±0, 25 and postoperative 12 weeks 4, 41±0, 18 which differences statistically meaningfully was found (p<0,001). Both of 2 group's 4 weeks VAS degree were compare preoperative VAS degree which increase were found statistically meaningfully(p<0,001). Both of 2 group's postoperative 12. weeks VAS degree were compare preoperative VAS degree which decrease were found statistically meaningfully (p<0,001). Second treatment application of radio frequency was needed in 8 patients in group I (%40) and 2 patients of group II (%11.8) due to decrease of subjective complaints. There were no statistically meaningfully differences when the necessity of second treatment application of radio frequency in both groups included in the study compared. In addition, when the relative risk with %95 safe interval was calculated, the necessity of second treatment application of radio-frequency in group I was found 3.4 times more then the necessity of second treatment application of radio-frequency in group II. CONCLUSION: In this study shows second treatment requisiteness was decreased when the increasing number of radiofrequency application regions. Therefore, the treatment success of snoring number of radiofrequency application regions was very important

Effects of the Lunar Cycle, Seasons and the Meteorological Factors on Peripheral Vertigo

Objective:This study aimed to determine whether peripheral vertigo is related to the lunar cycle, the seasons, or meteorological factors, in patients who presented to the ear, nose, and throat clinic.Methods:All the patients, diagnosed with vertigo between January 2020 and January 2022, were identified through a retrospective review of our hospital database. The clinical and demographic data of the patients were recorded. Daily humidity (minimum, average, and maximum; %), daily temperature (minimum, average, and maximum; °C), daily average and maximum wind speed (m/min), daily air pressure (minimum and average maximum; hPa) and wind direction (degrees) values were noted. Also, the phases of the moon, i.e., first quarter, new moon, last quarter, and full moon periods were determined.Results:A total of 5,432 patients were included in the study. No statistically significant differences were noted among them with respect to the lunar cycle (p=0.233). However, patient density was found to increase in the winter months.Conclusion:This study concluded that the frequency of diseases is related to meteorological factors, nonetheless, no statistical relationship was found between the lunar cycle and the frequency of patient entries

Examination of the Relationship between Umbilical Cord Blood Gas Values and Hearing Function in Neonates

Objective: The aim of the present study was to examine the relationship between the results of the transient otoacoustic emission (TEOAE) test used in neonatal hearing screening and the results of the umbilical cord blood (UCB) analysis in neonates.Methods: This retrospective study included 209 neonates born in the obstetric unit at the 37th gestational week. Based on the results of the TEOAE test, the neonates included in the study were divided into two groups as the study group composed of those “REFER” (n=141) and the control group consisting those “PASS” (n=68) the test. The UCB sampling procedure was performed on all neonates. In the blood samples, the pH parameters were evaluated by using glass electrodes, and the pCO2 and pO2 parameters were evaluated directly by using sensitive electrodes.Results: When the additional maternal diseases were compared with the TEOAE results, the ratio of hypothyroidism was found to be statistically higher in the study group (p0.05).Conclusion: The results of the present study showed that there was no statistically significant difference between the results of UCB analysis and the TEOAE test. However, we believe that conducting a larger study evaluating other parameters and employing UCB analysis would be useful, and UCB evaluation, which is an inexpensive, easy and effective method in determining hypoxia in neonates, might be a significant marker in cases at risk of hearing loss

Does the use of recombinant TSH in preparation for I-131 scintigraphy scan affect hearing function?

Objective: The objective of this study was to examine the effect of hypothyroidism on hearing function in patients surgically treated for differentiated thyroid cancer and subsequently experienced hypothyroidism during preparation for follow up I-131 scintigraphy scan by either recombinant human thyroid stimulating hormone (rhTSH) treatment or thyroid hormone withdrawal (THW). Methods: A total of 55 patients undergoing I-131 scintigraphy scan following surgeries for differentiated thyroid cancer were included in the study, including 25 patients prepared by administration of recombinant TSH (rhTSH Group) and 30 patients by thyroid hormone withdrawal (THW Group). Results: Air conduction thresholds at 1, 2 and 4 kHz for both ears were higher during hypothyroid period than during euthyroid period for patients in the THW group (p < 0.05) but not for patients in the rhTSH group. Conclusion: Sensorineural hearing loss was detected, especially at low frequencies, in patients with DTC after surgical treatment whose hormone replacement therapy was withdrawn but not in those receiving rhTSH. It is therefore preferred to use rhTSH when preparing for I-131 scintigraphy scan in patients at risk for hearing loss

Nasopharyngeal teratoma causing airway obstruction in the neonate

Teratomas are the most common congenital tumours, but teratomas of the nasopharynx are rare in neonates. The present report concerns a premature 30-week-old infant girl with an extensive nasopharyngeal teratoma protruding from the oral cavity. The tumour completely obstructed the airway and necessitated immediate intubation. The tumour was successfully resected directly via the transoral route without needing external incisions. Histological examination of the specimen revealed it to be a mature teratoma. The management and differential diagnosis is discussed, accompanied by a review of the literature

Tularemia: potential role of cytopathology in differential diagnosis of cervical lymphadenitis: Multicenter experience in 53 cases and literature review

Tularemia is a zoonosis caused by Francisella tularensis. Tularemia outbreaks occurred in Central Anatolia during 2009 and 2011. We evaluated the clinical characteristics and cytomorphologies of fine needle aspirations (FNAs) from cervical lymph nodes in serologically confirmed tularemia cases. To our knowledge, this is the first large series concerning FNA morphology of Tularemia. FNA smears of 53 patients of the 290, diagnosed by microagglutination tests and PCR, were evaluated at three Pathology centers. FNAs were performed by cytopathologists or ear-nose-throat surgeons. Of all patients, 17 had also lymph node resections. FNAs showed the presence of suppuration and abscess. Rare epithelioid histiocytes and granulomas, seldom phagocytosed bacilli-like microorganisms were observed. On histopathology; granulomas, necrosis, and suppurative inflammation extending extracapsular areas were seen. Tularemia is endemic in certain areas of the Northern Hemisphere. The benefit from cytopathology is limited and cytological suspicion should be confirmed by serology. However FNA cytology is helpful in differential diagnosis of tularemia and other diseases presented with suppurative, granulomatous cervical lymphadenitis. It is also useful in providing the material for PCR and culture in early phase when the serology is negative and the treatment is more effective

Kulak burun boğaz alerjisi hastalıkları alanında ne durumdayız?

Amaç; Alerjik hastalıklar Kulak Burun Boğaz ve Baş Boyun Cerrahisi Uzmanlık eğitiminin en önemli başlıklarından birisidir. KBBuzman hekimlerinin konuya ilgilerinin giderek azaldığı gözlenmektedir. Bu durumun sebepleri bilinmemektedir. Bu çalışmada gelişmelerinve sorunların saptanması, çözüm önerileri sunulması amacıyla KBB Alerjik hastalıklardaki durumun belgelenmesi amaçlanmıştır.Gereç ve Yöntem; Bu makalede 41. Ulusal KBB-BBC kongresindeki oturumdaki konuşmalardan elde edilen veriler geliştirilerek,KBB’da alerjik hastalıklar alanındaki durum dökümante edilmiştir.Bulgular; 1999 yılında “Otolarengolojik Alerji Derneği” kurulmuştur. 1978 yılında başlayan, epidermal deri testi ve immünoterapiuygulamaları, 2000’li yıllarda ivme kazanmıştır. 2013 yılında KBB uzman hekimlerinin epidermal deri testi ve immünoterapi hizmetlerininSGK tarafından ödenmediği gerekçesi ile hastane idarecileri tarafından engellenmesi, konuyla ilgili uygulamaları sekteye uğratmıştır. KBBBBC Uzmanlık eğitimi çekirdek programında alerjik hastalıklarla ilgili yeterli sayıda başlık yer almaktadır. Tüm Ulusal KBB ve rinolojikongrelerinde alerjik hastalıklarla ilgili çeşitli sayıda ve konuda oturumlar yapıldığı görülmektedir. Günümüze kadar KBB’da alerjikhastalıklar konusunda ülkemizde 6 kitap basılmıştır. 2018 yılından beri alerji ve rinoloji konusunda çevrim içi yayın yapan, uluslararası birdergi yayınlanmaktadır.Sonuç; KBB uzman hekimlerinin alerjik hastalıklar konusuna ilgisini çekecek yeni stratejiler geliştirilmelidir. KBB alanında alerjiuygulamalarıyla ilgili değişim ve ortaya çıkan sorunlar düzenli olarak değerlendirilmelidir. Ortaya çıkan sorunlara alerji ile aktif ilgilenenKBB uzman hekimleri tarafından ortak çözümler geliştirilmelidir

Vocal Cord Paralysis in Multifocal Motor Neuropathy: A Case Report

Multifocal motor neuropathy is characterized by slowly progressive, asymmetrical weakness of the arms without sensory loss. The disease can also cause vocal cord paralysis as it runs its course. A 34-year-old man developed progressive weakness in his hand muscles for one year and dysphonia for three weeks. Neurological examination revealed there was moderate weakness and mild muscle wasting in distal muscles of the upper limbs, predominantly in the left hand. Left laryngeal nerve palsy was also discovered during his otolaryngological examination. Nerve conduction studies revealed multiple sites of conduction block without sensory abnormalities consisting of selective involvement of motor fibers. The patient received intravenous immunoglobulin treatment after multifocal motor neuropathy diagnosis. Multifocal motor neuropathy with conduction block is rarely associated with vocal cord paralysis. This condition should be kept in mind in cases of laryngeal nerve palsy with an asymmetric motor neuropathy, as patients might benefit from immunoglobulin treatmen