Validation and Clinical Application of the Turkish Version of the RhinoQOL Questionnaire in the Setting of Chronic Rhinosinusitis with Nasal Polyp Patients.

Objectives: Validation of the translations of questionnaires from foreign languages is important. Failure to validate surveys can lead to misapplication. Methods: A total of 64 patients who presented with nasal obstruction due to chronic rhinosinusitis with nasal polyps and 64 control subjects were included in this prospective instrument validation study. Translation and back-translation method was used to adapt the Rhinosinusitis quality of life (RhinoQOL) into Turkish. The test and retest reliability, internal consistency, reproducibility, construct validity, and sensitivity to change were assessed. Results: The mean±SD test and retest scores were similar in the control group. Cronbach correlation coefficients were 0.872, 0.873, and 0.959 for the test and were 0.799, 0.725, and 0.885 for the retest scores for the frequency, bothersomeness, and impact domains. Post-operative scores were significantly higher than pre-operative scores obtained for each domain of the RhinoQOL questionnaire in the patient group (p<0.001). Pre-operative scores for frequency, bothersomeness, and impact domains were significantly lower than the corresponding average test and retest scores for each domain in the control group (p<0.001), whereas other than significantly higher bothersomeness scores in patient versus controls (p=0.018), no significant difference was noted between post-operative scores and average test and retest scores. Conclusion: These results demonstrated that the Turkish translation is equivalent to the English version of RhinoQOL in terms of internal consistency, test and retest reliability, and construct validity, with good responsiveness to change and thus potential utility in the assessment of post-operative outcome.

Assessment of side effects after serial intralesional steroid injections for idiopathic subglottic stenosis.

PURPOSE: To assess the incidence and severity of 12 systemic side effects of serial intralesional steroid injections (SILSI) in patients with idiopathic subglottic stenosis (iSGS). METHODS: This retrospective study included patients with iSGS who underwent SILSI with Triamcinolone 40 mg/dL. After SILSI, the patients were asked to answer 12 questions regarding frequently encountered systemic side effects of steroids. Each answer was rated as mild, moderate, or severe. Descriptive statistics were used to analyze and present the findings. RESULTS: The study included 49 patients (42 female and 7 male) with a mean age of 59.1 years (range 21-83 years). Post-SILSI treatment, 27 (55%) reported experiencing side effects while 22 (45%) patients reported no side effects. The most frequent side effect reported in women of reproductive age (n: 8) was menstrual irregularities (3/8, 37%). Other frequently reported side effects were feeling joyful and sleeping difficulties, each reported by 30% of the patients. All side effects resolved after the completion of SILSI. CONCLUSIONS: SILSI can be administered with minimal tolerable side effects. Clinicians should make their patients aware of the most frequent side effects. Special attention should be given to women of reproductive age to inform them of the possibility of menstrual irregularities during SILSI.

The Impact of Septal Deviation on Intranasal Schirmer Test Values.

OBJECTIVE: Intranasal Schirmer test serves as an objective measurement for evaluation of nasal secretion and humidity. This study aimed to evaluate the effect of septal deviation on nasal secretion and humidity by measuring the intranasal Schirmer test values in patients who had septal deviation and compare it to the values of our healthy volunteers. METHODS: The study included 52 patients with nasal septum deviation and 52 volunteers without any rhinologic complaints or deviated nasal septum. Intranasal Schirmer test was performed to all patients and volunteers for both nasal cavities. RESULTS: The intranasal Schirmer test values of the convex (deviated) side were lower than that of the concave (non-deviated) side (20.71 and 23.35 respectively); although this difference was not statistically significant (p=0.054,). After excluding the four patients with equal Schirmer test results on both sides, 70% (34/48) of our patients had lower intranasal Schirmer test values on the deviated side. There was no statistically significant difference between the Schirmer test values of the patients with septal deviation and the volunteers without septal deviation (p>0.05). CONCLUSION: The Schirmer test values of the deviated sides were less than the values of the contralateral side in majority of our patients. This finding supports the negative effect of nasal septum deviation on nasal humidification, although the difference did not reach statistical significance.

Relations Between Hyoid-Related Cephalometric Measurements and Severity of Obstructive Sleep Apnea.

OBJECTIVE: To evaluate the relationship between the hyoid-related cephalometric measurements and the apnea-hypopnea index (AHI) in patients diagnosed with obstructive sleep apnea (OSA). METHODS: A total of 56 subjects were evaluated by lateral cephalometric radiography and polysomnography (PSG). The OSA diagnosis was made according to the patients' AHI. Included were 13 primary snoring, 16 mild OSA, 10 moderate OSA, and 17 severe OSA. C3-hyoid distance and mentum-hyoid distance were measured on lateral cephalogram. Cephalometric measurements and PSG parameters were compared among the different OSA groups. RESULTS: The distance between the mentum and hyoid was significantly longer in the severe OSA group than in the primary snoring, mild OSA, and moderate OSA groups (P = 0.029). There was a significant positive correlation between the AHI value and the distance of the mentum hyoid (r = 0.368, P = 0.005). The C3-hyoid distance among the groups was not statistically significant different (P = 0.889). CONCLUSION: The mentum-hyoid distance of patients with severe OSA was longer compared to the other OSA groups. These patients might have more benefit from the surgeries that have an impact on the position of the hyoid bone compared to other patients with OSA.

The Role of Fetuin-A and Electrolytes in the Etiology of Sialolithiasis.

Objective The aim of this study was to investigate serum and saliva fetuin-A, protein, and electrolyte levels in patients with sialolithiasis. Study Design Prospective randomized controlled study. Setting Tertiary center. Subjects and Methods Twenty patients with recurrent sialadenitis secondary to submandibular salivary gland stones and 20 asymptomatic healthy volunteers without salivary gland stones were included in the study. Bimanual palpation and ultrasonography were performed in the patient and control groups. The electrolyte, protein, and fetuin-A levels of the serum and saliva were measured. Results The serum calcium, phosphorus, and potassium levels of the patients were significantly lower than those of the control group (respectively, P = .04, P = .01, P = .04). There was no statistically significant difference between the serum fetuin-A levels of the 2 groups ( P = .06). The saliva phosphorus values of the patients were higher than those of the control group ( P = .05), as were their saliva fetuin-A and total protein values ( P = .001, P = .01). A positive correlation was determined between the saliva fetuin-A levels and the saliva phosphorus and potassium levels of the patients ( P = .04, P = .02). The magnesium level, which has been argued to be a factor in the prevention of calcification, showed an increased correlation with the total protein in the patient group ( P = .02). Conclusion It is possible that the high levels of saliva fetuin-A, total protein, and phosphorus with insufficient of saliva magnesium levels may make a contribution to the formation of sialoliths.

How does radioactive iodine affect the nose?

OBJECTIVES/HYPOTHESIS: To determine the effect of radioactive iodine (RAI) treatment on the nasal mucosa and nasal functions. STUDY DESIGN: Prospective clinical study. METHODS: This study included 41 patients (31 female and 10 male) who were treated with RAI for papillary thyroid carcinoma. A visual analogue scale (VAS) was used for subjective evaluation of nasal symptoms. The saccharine test, nasal Schirmer test, and acoustic rhinometry were used for objective evaluation of nasal functions. All tests were administered at baseline (before RAI treatment), and then 1 month and 1 year post-RAI treatment. Only 21 of the patients could be evaluated after 1 year of treatment and were included in the study's analysis. RESULTS: VAS obstruction and dryness scores 1 month and 1 year post-RAI were significantly higher than the baseline scores (P < .05 and P < .05, respectively). Mean cross-sectional area values 1 month and 1 year post-RAI did not differ significantly from baseline values (P > .05 and P > .05, respectively). Schirmer test results 1 month and 1 year post-RAI treatment were significantly lower than at baseline (P < .05 and P < .05, respectively). Saccharine test results 1 month and 1 year post-RAI were significantly higher than at baseline (P < .05). CONCLUSIONS: RAI treatment can adversely affect the nasal mucosa. Nasal dryness and obstruction can occur immediately after RAI treatment. Additional research is warranted to further elucidate the effects of RAI treatment on nasal function. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2698-2702, 2017.

Electrophysiologic Evaluation of the Facial Nerve and Blink Reflex Pathways in Asymptomatic Cochlear Implant Users.

OBJECTIVE: To evaluate the functional integrity of the facial nerve and blink reflex (BR) pathways in asymptomatic patients who underwent cochlear implantation (CI). STUDY DESIGN: Case series with planned data collection. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Twenty-four deafened patients with unilateral CI who had no complications were enrolled. Bilateral compound muscle action potentials (CMAPs) of the facial nerve were recorded over the nasalis and occipitalis muscles, whereas BR responses were recorded over the orbicularis oculi after supraorbital nerve stimulation. All recordings were performed when the external part of the implant was in place (CIp) and after its removal (CIr), except occipitalis recordings, which were performed only after removal. The amplitude and latency of CMAP were measured to evaluate the axonal integrity of the zygomatic and posterior branches of the facial nerve. Latency, amplitude, and duration of the BR were measured to investigate the integrity of trigeminofacial connections. RESULTS: The amplitude and latency of CMAP over the nasalis muscle were bilaterally normal, and the difference between CIp and CIr was not statistically significant. No CMAP of the occipitalis muscle was recorded in 4 (16.7%) patients, and low-amplitude responses were recorded on the implant side of 20 (83.3%). Amplitudes of the contralateral R2 response were higher in the CIp condition versus the CIr condition (P = .031). There were no differences among other BR components. CONCLUSION: During functioning of the CI system, excitability of the facial circuit may increase either through the facial motor nucleus or through removal of the inhibitory effect of the descending pathway.