The effect of psychological inflexibility on health-related quality of life, depression, and anxiety in patients with chronic tinnitus without hearing loss.

OBJECTIVE: The purpose of this study was to investigate the relationship between psychological inflexibility, depression, anxiety, and quality of life in patients with chronic tinnitus without hearing loss. METHODS: The study was carried out involving 85 patients with chronic tinnitus without hearing loss and a control group of 80 individuals. All participants completed the Acceptance and Action Questionnaire-II, the State-Trait Anxiety Inventory-Trait, the Beck Depression Inventory, and Short Form-36. RESULTS: The patient group exhibited higher Acceptance and Action Questionnaire-II (t=5.418, p<0.001), State-Trait Anxiety Inventory-Trait (t=6.592, p<0.001), and Beck Depression Inventory (t=4.193, p<0.001) scores and lower physical component summary (t=4.648, p<0.001) and mental component summary (t=-5.492, p<0.001) scores than the control group. Psychological inflexibility predicted depression, anxiety, and impairment of quality of life. The effect of psychological inflexibility on physical component summary was mediated by depression (ß=-0.15, [95%CI -0.299 to -0.017]), while its effect on mental component summary was mediated by anxiety and serial anxiety and depression (ß=-0.17 [95%CI -0.344 to -0.055] and ß=-0.06 [95%CI -0.116 to -0.100], respectively). CONCLUSION: Psychological inflexibility plays an important role in patients with chronic tinnitus without hearing loss. It is associated with increased levels of anxiety and depression and decreased quality of life.

Decreased frontal and orbital volumes and increased cerebellar volumes in patients with anosmia Of Unknown origin: A subtle connection?

PURPOSE: Neuroimaging studies have shown that anosmia is accompanied by a decreased olfactory bulb volume, yet little is known about alterations in cerebral and cerebellar lobule volumes. The purpose of this study was to investigate structural brain alterations in anosmic patients. METHODS: Sixteen anosmic patients (mean age 42.62 ± 16.57 years; 6 women and 10 men) and 16 healthy controls (mean age 43.37 ± 18.98 years; 9 women and 7 men) were included in this retrospective study. All subjects who underwent magnetic resonance imaging scans were analyzed using VolBrain and voxel-based morphometry after olfactory testing. RESULTS: Despite being statistically insignificant, analysis using VBM revealed greater gray matter (GM) and white matter in the anosmia group compared to the healthy subjects. However, decreased GM (p < 0.001) and increased cerebellar (p = 0.046) volumes were observed in the anosmic patients. CONCLUSIONS: The study revealed structural brain alterations in specific areas beyond the olfactory bulb. Our results indicate that the cerebellum may play an exceptional role in the olfactory process and that this will be worth evaluating with further dynamic neuroimaging studies.

The effect of thymoquinone and propranolol combination on epidermoid laryngeal carcinoma cell.

PURPOSE: We aimed to evaluate the effects of thymoquinone and propranolol on Hep-2 cells representing laryngeal Ca cell type in comparison with cisplatin. We also evaluated their combined effects. METHODS: Apoptotic effects were directly analyzed via mitochondrial membrane potential and caspase-3 assays. In addition, effects on apoptosis and cell cycle via Bcl-2, Bax, P53, and Cyclin D1 mRNA expressions and effects on angiogenesis via VEGFA mRNA expression were evaluated by RT-qPCR. RESULTS: According to our results, it was determined that the anticancer effects of thymoquinone on Hep-2 cells were higher than propranolol. Our JC-1 and caspase-3 results showed an effect close to cisplatin, especially for 50 µM thymoquinone. Significant differences were also obtained in Bcl-2, Bax, P53, and cyclin D1 results for similar concentrations compared to the control. No effect of thymoquinone was seen for VEGFA. Propranolol alone had no significant effect on JC-1 and Caspase-3. Propranolol had an effect on Bcl-2, Bax mRNA expressions compared to the control, only at 250 µM concentration. Propranolol and its combinations increased VEGFA mRNA expression-like cisplatin. CONCLUSION: Thymoquinone induced apoptosis and blocked the cell cycle in Hep-2 cells. The effects of propranolol, which was reported to have an antiangiogenesis effect in some studies, on apoptosis and cell cycle were limited except at high concentrations. For this cell line, why propranolol causes an increase in VEGFA expression should be evaluated extensively. Thymoquinone shows promise for cancer therapy, but studies need to be designed in vivo to evaluate the effects more reliably.

Evaluation of the Mastoid Emissary Canals with Computerized Tomography in Patients with Chronic Otitis Media.

Background The mastoid emissary veins (MEVs) pass through the mastoid emissary canal-mastoid foramen (MEC-MF) in the mastoid region of the skull. MEVs can give rise to complications during surgical procedures. The purpose of our study was to investigate the morphological and morphometric characteristics of MECs of patients with clinical chronic otitis media (COM) using high-resolution computed tomography (HRCT). Methods Patients diagnosed with COM and undergoing temporal HRCT were identified by retrospectively scanning our hospital's automation system. Patients undergoing temporal HRCT for reasons other than COM, infection or tinnitus were identified for the control group by scanning the PACS archive. Sixty-two mastoid regions were examined in 38 unilateral and 12 bilateral COM patients, and 100 mastoid regions in the 50 patients in the control group. The presence of an accessory MEC-MF and MEC-MF diameters was evaluated in both groups. Results Main MEC diameters on the side of the ear with COM were 1.6 mm, and total accessory and main MEC diameters were 1.8 mm, both values being significantly higher than in the control group. Presence of accessory MEC on the side of the ear with COM was determined at 61.8%, significantly higher than in the control group. Conclusion Preoperative awareness of cranial venous drainage abnormalities is important to reduce surgical complications. Our study shows that MECs may be wider in diameter in patients with COM. MECs in COM patients must be identified before surgery to the mastoid region.

The Development of a New Medical Instrument: Modified Tongue Depressor.

In the oropharyngeal region examinations, the abeslang (tongue depressor) used to create a wider field of vision and press down the tongue to make the pharynx easier. In order to look under the tongue, the depressor is redesigned so that it can be examined under the tongue and transformed into a retractor by creating an angle in the body of the present invention. This technique is intended to be used in conjunction with new technology surgical procedures. Our invention consists of the stem (1), the body (2), the end (3) and the notch (4), and the angle (5) in the angled model. This model, which is more effective than the routine tongue depressors at the same time it will not make any difference regarding cost. It will also allow the use of new surgical techniques while at the same time ensuring the exclusion of language in operations.

Bilateral Post-Traumatic Facial Paralysis That Contains Longitudinal and Transverse Temporal Fracture.

Acute bilateral post-traumatic facial paralysis is rare in the literature. Post-traumatic facial paralysis is frequently accompanied transverse fractures of temporal more. The incidence of acute bilateral post-traumatic facial paralysis has been reported as 1 to 5 per million in the literature. Trauma and concurrent facial paralysis are usually in the same subsite (right temporal bone fracture and right facial paralysis). There is one pathophysiological pattern for a single temporal bone fracture in a subsite. The authors present a bilateral isolated different pathophysiological pattern sudden onset facial paralysis in a patient herein.

Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, Mean Platelet Volume and Red Cell Distribution Width Measures in Bells Palsy.

AIM: The purpose of this study was to investigate the usefulness of the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) Mean Platelet Volume (MPV) and Red Cell Distribution Width (RDW) in the differential diagnosis and follow-up of patients with Bells Palsy. MATERIAL AND METHODS: Twenty-eight patients diagnosed with Bells Palsy and 28 control patients were included in the study. Serum samples were analysed retrospectively on the initial presentation and the seventh day of admission. RESULTS: On admission, the NLR was 1.7±1.2. The mean absolute neutrophil count was 6100 ± 900/mm^3 in Bells Palsy Group. NLR was 0.9 ± 0.2. The mean absolute neutrophil count was 4400 ± 1100/mm^3 in control group. Statistically, significant changes were not observed in NLR, PLR, MPV and RDW measurements in Bells Palsy group between House-Brackman Staging. CONCLUSION: Statistically significant changes in the neutrophil count and NLR were determined in the measurements between Bells Palsy and control group (p = 0.013, p = 0.016 respectively) on admission. A grade of the disease and NLR measurements had no statistically significant connection. RDW value was investigated for the first time in the literature for Bells Palsy patients.

Evaluation of Patient Satisfaction After Nasal Septoplasty Operation Using Peak Nasal Inspratuar Flow and Nasal Obstruction Symptom Score Questionare.

BACKGROUND: The purpose of this study was to investigate the usefulness of the peak nasal inflamatuar flow (PNIF) and Nasal Obstruction Symptom Score (NOSE) questionnaire in the diagnosis and follow-up of nasal septum deviation surgery. METHODS: Sixty patients diagnosed with nasal septum deviation were included in the study. Nasal Obstruction Symptom Score scales of patients, PNIF and is measured preoperatively and 14 days after surgery. RESULTS: Preoperative NOSE scores were 14.9 ±â€Š2.7 and PNIF scores were 129.6 ±â€Š15.5 L/min in study group. Postoperatively NOSE scores were 7.9 ±â€Š1.8 and PNIF scores were 154.2 ±â€Š9.2 L/min in study group. Nasal Obstruction Symptom Score scores were 3.3 ±â€Š2.3 and PNIF scores were 169.3 ±â€Š13.5 L/min in control group. CONCLUSION: Anterior and anteroposteriorly located nasal septum deviation (NSD) had statistically higher degrees of NOSE scores and lower levels of PNIF scores. Posterior located NSD PNIF scores changed postoperatively but NOSE scores do not change statistically. There was a statistically significant correlation in Pearson correlation analysis between NOSE and PNIF scores. The authors recommend using PNIF and NOSE scores in NSD patients.

Somatoform disorders in patients with chronic subjective tinnitus.

This study aimed to investigate the correlation of psychiatric disorders with tinnitus and tinnitus handicap scores. A total of 30 patients and 30 otherwise healthy people were enrolled for the study. Somatoform disorder questionnaire SDQ-20 was filled in by both the study and the control group. Tinnitus handicap scores were filled in study group. Tinnitus handicap scores were 28.1 ± 19.8, and somatoform disorder questionnaire scores were 30.5 ± 7.3 in the tinnitus group. In the control group the somatoform disorder questionnaire scores were 25.4 ± 4.6. (1) We found a statistically significant difference between somatoform disorder questionnaire scores between groups (p < 0.05). (2) There was a statistically significant difference between tinnitus handicap scores and somatoform disorder questionnaire scores in study group (p = 0.0). The correlation between these tests was positively strong (R = 0.782). (3) There was no statistical difference between genders. We recommend investigating patients with long-lasting tinnitus for psychiatric comorbidity in relation to somatoform disorders in cooperation with psychiatric clinics.

Influence of nasal pack removal on patients' anxiety after septoplasty.

OBJECTIVES: This study aims to investigate the effects of the removal of Merocel nasal packs on patients' anxiety after septoplasty. PATIENTS AND METHODS: Fifty patients (26 males, 24 females; mean age 30 years; range 18 to 56 years) who underwent septoplasty in the Department of Ear Nose and Throat of our hospital between January 2013 and January 2015 were enrolled in this prospective study. Patients' anxiety was measured using the State-Trait Anxiety Inventory. Anxiety levels were measured 24 hours preoperatively, 48 hours postoperatively before nasal pack removal, and 60 minutes after nasal pack removal. RESULTS: The State-Trait Anxiety Inventory scores were 44.2±7.4 preoperatively, 45.1±7.1 postoperatively before pack removal, and 37.4±6.7 after pack removal. There was no statistically significant difference between pre- and postoperative evaluations. However, patients' anxiety decreased statistically significantly in the evaluation 60 minutes after pack removal (p=0.0). CONCLUSION: We recommend administering soluble packs or sewing techniques without nasal packs after septoplasty due to concerns related to quality of life after surgery.

Application of drill in otoplasty: a technical modification.

PURPOSE: Prominent ear is one of the most common congenital deformities in the head and neck region. More than 100 techniques have been described for correction of prominent ears in literature. Mustarde technique is one of the most widely accepted procedures of otoplasty. In our study, we used a surgical method using a drill for correction of prominent ears in combination with the Mustarde technique. Patients with only lack of antihelical fold were included the study. METHODS: Thirty patients were operated on during 2007-2010. The angle of prominent ear from the mastoid tip to the tip of the posterior surface of the auricle was measured preoperatively and postoperatively (3 months after operation) using jib and protractor. Patient satisfaction was evaluated using a questionnaire. RESULTS: The angulation of prominent ear was 45.2 ± 8.6 degrees preoperatively. Postoperatively, the angulation was 25.6 ± 6.3 degrees. The difference was statistically significant (P < 0.001). Fifteen patients (50%) reported that the operation was very satisfactory, 13 patients (43.4%) reported that the operation was satisfactory, and 2 patients (6.6%) reported that the operation was not satisfactory cosmetically. CONCLUSION: The described technique of otoplasty using a drill to thin the auricular cartilage is a safe and easy-to-learn procedure. In Mustarde technique, permanent sutures are used to reshape the cartilage structure in fixed position. Over time, structural strength elasticity of cartilage can weaken the force of sewing forces. Combining the technique with permanent sutures, results were satisfactory. This technique can be used to recreate the antihelical fold. We will follow the cases long term to further show more results.

The Effect of Nasal Packing Removal on Patients Anxiety.

AIM: We aimed to investigate the effect of removal of merocel nasal packings on patients anxiety after septoplasty using Hamilton Anxiety Scale. MATERIAL AND METHODS: Total amount of 50 patients who had septoplasty operation in the Department of Ear, Nose and Throat Clinic of our hospital were enrolled to the study. Patients anxiety determined using Hamilton Anxiety Scale. The patients anxiety levels were measured before 24 hours before the operation (Group 1), 48 hours after operation before nasal packing removal (Group 2) and 60 minutes after nasal packing removal (Group 3). RESULTS: Patients were evaluated according to the Hamilton Anxiety Scale; in Group 1 15.3 ± 7.2, 19.3 ± 7 in Group 2, 14.6 ± 6,5 in Group 3 was measured. CONCLUSION: There was no statistically significant difference between Groups 1 and 3. There is a statistically significant difference on patients anxiety levels 48 hours after operation before nasal packing removal (p<0.001). There is an statistically significant increase of patients anxiety before packing removal. We recommend using soluble packings or sewing techniques without nasal packings after septoplasty because of patient comfort after operation.

Giant rhinophyma: Excision with coblation assisted surgery.

An 83-year-old man presented with an unusually severe case of rhinophyma. Giant rhinopyhma is very rare in literature. The giant lesion was widely excised using sharp surgical incision and coblation assisted surgery. Using direct coblation to the nasal dorsum may cause edema in the surrounding tissue. There was minimal edema in surrounding tissue using this technique. A full thickness-skin graft was applied after excision. Cosmetic and functional postoperative results were satisfactory.

Malignant peripheral nerve sheath tumor of lower lip.

Malignant peripheral nerve sheath tumors (MPNSTs) are rare, highly aggressive tumors capable of arising de novo or from preexisting benign neurofibromas or schwannomas. The treatment of choice is surgery. Trunk and extremities are the commonest sites involved. Malignant peripheral nerve sheath tumors are rarely encountered in head and neck region. Here, we report a patient with MPNST of lower lip who had neither a family history nor stigmata of neurofibromatosis.

[Ophthalmic complications of paranasal sinus mucoceles]. / Paranazal sinüs mukosellerinin göz komplikasyonlari.

OBJECTIVES: This study aimed to describe ophthalmic complications of paranasal sinus mucoceles and principles of treatment. PATIENTS AND METHODS: The medical records of 25 paranasal sinus mucoceles patients (18 males, 7 females; mean age 35 years; range 20 to 62 years) that had been treated in two different ear, nose and throat clinics between the years January 2004 and June 2009 were evaluated retrospectively. Out of 22 patients of who had developed internal mucoceles in anterior paranasal sinuses, diplopia was observed in five, proptosis in four and partial loss of sight in one. Out of three patients with posterior paranasal sinus mucoceles, two developed diplopia and one developed proptosis, with loss of sight in all three. Eight patients were treated using osteoplastic flap technique and the remaining 17 were treated using endoscopic sinus surgery. RESULTS: In only one patient was loss of sight permanent whereas, in all the other patients eye complications resolved. CONCLUSION: In mucoceles that involve the posterior ethmoid and sphenoid sinuses loss of sight can be observed often because of their adjacency to the optic nerves, and loss can be permanent in advanced disease. It is possible to obtain good results in most patients treated in time with endoscopic sinus surgery and osteoplastic flep techniques.

Nasolabial cyst.

Nasolabial cyst is a rare nonodontogenics, soft-tissue cyst occurring in the sublabial area and anterior maxillary region. The patient usually presents with a slowly enlarging asymptomatic swelling. They are usually diagnosed in early stages because of cosmetic problems. In our paper we report a nasolabial cyst of a 53-year-old man and discuss the diagnosis, differential diagnosis, and treatment in the light of the literature.

Choanal polyp originated from the inferior nasal concha.

Almost all choanal polyps originate from the maxillary sinus and a choanal polyp (CP) originating from the inferior nasal concha (INC) is a rare entity. It presents in a similar manner to the more common antrochoanal polyp and may be confused on anterior rhinoscopy. In this report, an unusual case of a CP taking origin from the INC that was removed by endoscopic endonasal surgery in a young man is presented. No intraoperative or postoperative complication occurred, and the symptoms immediately resolved after the operation. Although very rare, CPs arising from the INC should be kept in mind in the differential diagnosis of a solitary nasal polyp.