The evalution of central auditory processing in the geriatric population

Introduction: C: The purpose of this study is to evaluate whether the frequency auditory pattern recognition test (FAPRT) and the duration auditory pattern recognition test (DAPRT) have a place in the routine audiologic test battery for geriatric patients aged 60 years and older. Materials and Method: 88 ears of 44 patients (27 females and 17 males) aged 60 years and over were evaluated. Digital CD recordings of the Gaps-in-Noise (GIN) test (full version F. E. Musiek, Ph.D. Version 02.04.2003) were used to evaluate these patients. Results: A negative correlation was detected between increasing age and pure-tone hearing thresholds, discrimination scores, and FAPRT and DAPRT scores (p < 0.01). A positive correlation was found between aging, pure-tone threshold and speech dicrimination percentage, and FAPRT and DAPRT scores (p < 0.01). Moreover, discrimination percentages showed a positive correlation with FAPRT and DAPRT scores. Conclusion: A significant correlation was noted between FAPRT and DAPRT scores and classical auditory test battery scores. These results show that FAPRT and DAPRT can be included in the auditory test battery for the geriatric population

Obstrüktif tonsil hipertrofisi olan çocuk hastalarda mikrodebrider tonsillotomi

Aim: To compare intracapsular microdebrider tonsillotomy with conventional cold dissection tonsillectomy in the management of tonsillar hypertrophy causing obstructive airway problems in children. Material and Method: 37 children who underwent microdebrider tonsillotomy were compared with other 45 children who had conventional cold dissection tonsillectomy to examine intraoperative blood loss, operation time, duration of oral intake, intake of analgesics, recovery time and post-operative pain. Results: Children who underwent intra-capsular micro-debrider tonsillotomy had significantly less pain throughout their recovery period than those who had conventional tonsillectomy. In the microdebrider tonsillotomy group intraoperative blood loss, operation time, duration of oral intake, intake of analgesics, and postoperative pain score were found to be less than the conventional tonsillectomy group scores(p <0,05). Tonsillar hypertrophy recurred in two patients of micro-debrider tonsillotomy group. Discussion: Intracapsular tonsillotomy is as effective and safe as conventional tonsillectomy to relieve obstructive sleep apnea in pediatric patients. Intracapsular microdebrider tonsillotomy reduces postoperative pain, improves quality of life and shorthens the recovery time. Therefore; this procedure is more tolerable in children with obstructive tonsillar hypertropy in respect to conventional tonsillectomy

Temporal bone posterior wall defect, a new clinic entity?

OBJECTIVE: To define clinical and audiological findings in patients with temporal bone posterior wall defects (TBPWD) and to investigate possible relationships between these findings and the characteristics of the defect. MATERIALS and METHODS: The computed tomography (CT) views of 1198 patients with vestibulocochlear symptoms between 2007 and 2012 were retrospectively evaluated, and TBPWD and associated anomalies were investigated. Patients who had TBPWD were called back, and clinical and audiological examinations (tympanometry, pure tone audiometry, acoustic reflexes, and otoacoustic emission) were performed. RESULTS: Twenty-eight (2.34%) patients had TBPWD. Twenty-three of them were eligible for the study. Size of the defect was significantly correlated with the presence of tinnitus and/or vertigo (p< 0.005). The cut-off values for the largest size of TBPWD were 1.65 mm [sensitivity: 0.67 and specificity: 0.77 (95% CI: 0.58-0.97); p= 0.04] in case of the presence of tinnitus and 1.85 for vertigo (sensitivity: 0.78 and specificity: 0.86 (95% CI: 0.67-0.99); p= 0.006). In pure tone audiometry tests, mixed-type hearing loss was present in four (17%) patients, sensorineural hearing loss was present in three (13%) patients, and conductive-type hearing loss was present only in one (4%) patient. Otoacoustic emission tests revealed significant differences in signal/noise ratios at frequencies of 500, 750, 1000, and 6000 Hz. CONCLUSION: For the first time in the literature, we defined clinical and audiological findings in patients with TBPWDs. These defects seem to cause more prevalent symptoms of vertigo and tinnitus and disturb the audiological characteristics of patients

Boyun karotid üçgende atipik yerleşim gösteren dev tiroid nodülü: bir olgu sunumu

Ectopic thyroid tissue is a rare pathology of the thyroid that is formed by the abnormal migration of the thyroid tissue. It is seen once in about every 100.000 to 300.000 births and is generally asymptomatic. Asymptomatic ectopic thyroid tissue may grow larger and become symptomatic in the form of a neck mass due to thyroid tissue hyperplasia. The thyroid gland, apart from its normal localization before the trachea, may lie between the tongue root and the trachea generally on the middle line at any level. A 71-year-old male patient presented to our ear- nose and throat clinic with a mass of 5x4x3 cm located in the right carotid triangle. The thin-needle aspiration biopsy specimen was reported as thyroid tissue and sub-sequently the mass was excised under general anesthesia. The histopathological evaluation of the mass revealed that it was an atypically located ectopic thyroid nodule. No complications were seen within one year follow-up of the patient

Nadir bir burun tıkanıklığı nedeni: dev invaziv nonfonksiyonel hipofiz adenomu

Nasal obstruction is a very rare symptom caused by a pituitary adenoma. A 57-year-old man admitted to our clinic with bilateral nasal obstruction for the last six months. Endoscopic examination revealed soft pinkish pulsatile tissues in both nasal cavities. Radiologic investigation revealed a suprasellar mass extending to the frontal lobes, spheno-ethmoidal sinuses and nasal cavities. He had bitemporal superior quadrant hemianopsia. Pituitary hormone levels were normal. Biopsies were taken from the patient endonasally. Pathological evaluations and laboratory findings were compatible with nonfunctioning pituitary adenoma.Burun tıkanıklğı hipofiz adenomun neden olduğu çok nadir bir semptomdur. Elli yedi yaşında erkek hasta altı aydır süren iki taraflı burun tıkanıklığı ile kliniğimize başvurdu. Endoskopik muayenesinde her iki burun boşluğunda yumuşak pembemsi, pulsatil doku izlendi. Radyolojik incelemelerinde frontal loba, sfeno-ethmoidal sinüslere ve burun boşluklarına uzanım gösteren suprasellar kitle izlendi. Hastada bitemporal üst kadran hemianopsi vardı. Hipofiz hormon düzeyleri normal idi. Biyopsiler hastadan endonazal yol ile alındı. Patolojik değerlendirmesi ve laboratuvar bulguları nonfonksiyonel hipofiz adenomu ile uyumluydu

Supraclavicular thoracic duct cyst

[No Abstract Available

PPI kullanımının clostridium difficile serum antijen değerlerine olan etkisi

Aim: To evaluate the effects of proton-pump inhibitor (PPI) use on distrubtion of intestinal flora by measuring serum Clostridium Difficile antigen levels before and at the end of a three- months treatment in patients with Laryngopharyngeal reflux (LFR) treatment. Material and Method: The study covers 32 patients with LFR, out of which 24 were female (75%) and 8 were male (25%). The mean age of the patients was 34.13 +/- 11.59. All patients included in the study were administered Lansoprazole 30 mg tablets perorally before meals and twice a day for treatment. Reflux Symptom Index (RSI), Reflux Finding Score (RFS), white blood cell count, CRP and serum Clostridium Difficile toxin A, B measurement results were comparatively evaluated through the blood serum samples drawn from the patients before and at the end of the three- months treatment. Results: While the mean values of pre-treatment RSI and RFI were 20.81 +/- 4.05 and 13.31 +/- 3.30 respectively, the mean values were measured to be 3.41 +/- 2.37 and 1.50 +/- 1.88 respectively following the three- months treatment (p< 0.05). The pre-treatment mean value of serum Clostridium Difficile Ag was 140.56 +/- 11.74, while it was seen that the same value became 114.94 +/- 10.70 after the three- months treatment (p< 0.05). There was, however, no statistically significant change in the other parameters. Discussion: According to the results obtained, it was seen that the treatment with PPI was not cause to increase Clostridium difficile toxin A, B serum antigen levels. So these drugs could be used in long time therapies confidently.Amaç: Larengofarengeal Reflü (LFR) hastalığının tedavisi amacıyla Proton pompa inhibitörü (PPİ) kullanan hastalarda tedavi öncesi ve üç aylık tedavinin sonunda serum Clostridium Difficile antijen miktarı ölçülerek PPİ kullanımının serum Clostridium Difficile serum antijen miktarı üzerindeki etkisinin değerlendirilmesi. Gereç ve Yöntem: Çalışmaya LFR hatalığı tespit edilen 32 hasta ( 24 ( % 80)’ü kadın, 8 (% 20)’i erkek) dahil edildi. Hastaların yaş ortalaması 34.13 ± 11.59 idi. Çalışmaya dahil edilen tüm hastalara tedavi için günde iki kez yemeklerden önce alınacak şekilde lansoprazol 30 mg tablet peroral olarak başlandı. Tedavi öncesinde ve üç aylık tedavinin sonunda hastaların LFR şiddeti Reflü Semptom İndeksi ( RSI) ve RBS ( Reflü Bulgu Skoru) kullanılarak değerlendirildi. Ayrıca hastalardan tedavi öncesi ve üç aylık tedavinin sonunda alınan kan serum örneklerinde beyaz küre, CRP, sedimantasyon ve serum Clostridium Difficile toxin A, B ölçümleri yapılarak karşılaştırmalı olarak değerlendirildi. Bulgular: Tedavi öncesi RSI ve RBS ortalamaları sırasıyla 20.81±4.05 ve 13.31±3.30 iken, üç aylık tedavi sonrasında bu ortalamalar sırasıyla 3.41±2.37 ve 1.50±1.88 olarak tespit edildi ( p< 0,05). Tedavi öncesi serum Clostridium Difficilie Ag değerlerinin ortalaması 140.56±11.74 iken üç aylık tedavi sonrasında bu ortalamanın 114.56±10.70 olduğu görüldü ( p 0,05). Tartışma: Elde ettiğimiz sonuçlara göre, proton pompa inhibitörü kullanan hastaların Clostridium difficilie toxin A, B serum antijen düzeylerinde istatistiksel olarak anlamlı bir düşüş olduğunu görüldü

The comparison of thermal tissue injuries caused by ultrasonic scalpel and electrocautery use in rabbit tongue tissue

The aim of this study compares to the increase in tissue temperature and the thermal histological eff ects of ultrasonic scalpel, bipolar and unipolar electrosurgery incisions in the tongue tissue of rabbits. The is study evaluates the histopathological changes related to thermal change and the maximum temperature values in the peripheral tissue brought about by the incisions carried out by the three methods in a comparative way. To assess thermal tissue damage induced by the three instruments, maximum tissue temperatures were measured during the surgical procedure and tongue tissue samples were examined histopathologically following the surgery. The mean maximum temperature values of the groups were 93.93±2.76 Cº for the unipolar electrocautery group, whereas 85.07±5.95 Cº for the bipolar electrocautery group, and 108.23±7.64 Cº for the ultrasonic scalpel group. Th ere was a statistically signifi cant relationship between the increase in maximum temperature values and the separation among tissue layers, edema, congestion, necrosis, hemorrhage, destruction in blood vessel walls and fi brin accumulation, and between the existence of fi brin thrombus and tissue damage depth (p<0.05). It was concluded that the bipolar electrocautery use gives way to less temperature increase in the tissues and less thermal tissue damage in comparison to the other methods

The efficacy of submucosal tramadol in the postoperative treatment of pain following septoplasty operations

Tramadol is a centrally acting opioid which is effective for moderate-severe pain and is being used for various acute and chronic pain scenarios. The primary endpoint of this controlled, randomized double blind study was to evaluate the effect of submucosal tramadol on VAS scores after septoplasty operations and secondary endpoint was to investigate the effects on total opioid and additional analgesic consumption and patient satisfaction. 60 patients scheduled for septoplasty under general anaesthesia were enrolled. In Group T, at the end of surgery following hemostasis, 2 mg/kg tramadol was applied as submucosal infiltration to both surgical sites, 2 ml (total 4 ml), by the surgeon. In Group P, at the end of surgery following hemostasis, 2 ml isotonic solution (total 4 ml) was applied as submucosal infiltration to both surgical sites by the surgeon. Total opioid consumption, VAS scores, patient satisfaction was evaluated at the end of 24 h VAS values were higher in Group P on the first and second postoperative hours. Patient controlled analgesia demand and delivery values were higher in Group P on the postoperative 1, 2, 4, 6, 12 and 24th hours. Patient satisfaction was higher and opioid consumption was lower in Group T compared to Group P. There was no difference in additional analgesic consumption between two groups.The results show that patients receiving tramadol had lower VAS scores compared with the placebo groups postoperatively

Evaluation of the clinical effects of isotretinoin on chronic rhinosinusitis

Objectives: This study aims to evaluate the clinical effects of isotretinoin (13-cis-retinoic acid), a derivative of retinoic acid, on the clinical features of chronic rhinosinusitis. Patients and Methods: The study group included 25 chronic rhinosinusitis patients (16 females, 9 males; mean age 25.2±6.8 years; range 15 to 25 years) who were on isotretinoin for acne treatment, while the control group consisted of 25 chronic rhinosinusitis patients (15 females, 10 males; mean age 25.2±6.8 years; range 15 to 25 years) who were not on isotretinoin treatment. The patients’ symptom scores in visual analog scale (VAS), Lanza and Kennedy nasal endoscopic scores and Newman computed tomography (CT) scores were obtained in order to evaluate the their symptom, examination and radiological findings. These patients’ symptom and examination results were evaluated first day, week two and at months 3-5 and 6-10. Paranasal sinus CT results were studied first day and at months 6-10. Results: In the group of patients being administered isotretinoin, no significant change in the mean symptom and examination scores was detected during the acute phase (week 2), while there was a significant regression in the longterm (months 3-5 and 6-10). There was a significant regression in the mean CT score after isotretinoin therapy. In the control group no significant change was seen in any of the scores. The number of acute sinusitis attacks were significantly lower in the isotretinoin group than in the control group. No significant difference was found between the two groups in terms of the duration of the healing period of acute sinusitis attacks. Conclusion: We conclude that the long-term administration of isotretinoin has positive effects on the clinical results of chronic rhinosinusitis