A Narrative Review of the Clinical Trials in Sleep-Related Breathing Disorders from 2022 to Present.

Sleep-related breathing disorders (SRBD) comprise obstructive sleep apnea (OSA), central sleep apnea (CSA), obesity-hypoventilation syndrome (OHS), as well as isolated sleep-related hypoxemia (ISRH), according to the recent International Classification of Sleep Disorders 3. During the last decades, there have been cumulative research reports indicating an association between the SRBD and increased cardiometabolic illness and death, as well as decreased quality of life. Notwithstanding, the results have been inconclusive, and the evidence level was not high regarding the effect of treatment for the SRBD on adverse outcomes. In the current work, we aim to give a comprehensive review of the clinical trials published from January 2022 to August 31, 2023. We highlight the heterogeneity of cardiometabolic disorders among adults with SRBD and particularly emphasize OSA management, drug therapy for OSA, positive airway pressure (PAP) therapy and cardiovascular outcomes, other effects of PAP in pregnancy and neurocognitive function, as well as the effects of surgical treatment and oral appliances. We also underline future directions in OSA management, telemonitoring, and druginduced sleep endoscopy in managing the SRBD, especially OSA. We ascertain that more studies are needed within the CSA, OHS, and ISRH research fields.

Effects of Esterified Hyaluronic Acid, Adipose Tissue, and Blood Glue on Survival of Diced Cartilage Grafts.

OBJECTIVES: Diced cartilage grafts are used for correcting nasal dorsal deformities and irregularities. However, cartilage resorption is among most common problems after rhinoplasty. The purpose of this experimental study was to investigate the effects of esterified hyaluronic acid, adipose tissue, and blood glue on the viability of diced cartilage grafts. METHODS: A total of 24 Wistar albino rats were used for the study. Cartilage grafts were obtained from 1 side ear and diced. The rats were divided into 4 groups (6 in each group): bare diced cartilage (group 1), diced cartilage wrapped with adipose tissue (group 2), diced cartilage blended with blood glue (group 3), and diced cartilage wrapped with esterified hyaluronic acid (group 4). The grafts were inserted into the subcutaneous pockets of the back of same rat. After 2 months follow-up specimens were harvested for histopathological and dimensional examination. The sections were stained with Hematoxylin and Eosin, Masson-Trichrome, and Elastic Van-Gieson. Chronic inflammation, loss of chondrocyte nucleus, vascularization, foreign body reaction, collagen content of matrix, and extent of elastic fiber were assessed under light microscopy. RESULTS: Foreign body reaction in adipose tissue and blood group was significantly higher than bare cartilage and esterified hyaluronic acid group ( P = 0.001). With respect to loss of chondrocyte nucleus esterified hyaluronic acid group had significant higher rate of nucleus loss than other groups ( P = 0.002). CONCLUSIONS: This study suggests that blood glue, esterified hyaluronic acid and autologous adipose tissue have not beneficial effects in improving viability of diced cartilage grafts.

Comparison of the clinical course of COVID-19 infection in sickle cell disease patients with healthcare professionals.

It is highly expected that COVID-19 infection will have devastating consequences in sickle cell disease (SCD) patients due to endothelial activation and decreased tissue and organ reserve as a result of microvascular ischemia and continuous inflammation. In this study, we aimed to compare the clinical course of COVID-19 in adult SCD patients under the organ injury mitigation and clinical care improvement program (BASCARE) with healthcare professionals without significant comorbid conditions. The study was planned as a retrospective, multicenter and cross-sectional study. Thirty-nine SCD patients, ages 18 to 64 years, and 121 healthcare professionals, ages 21 to 53, were included in the study. The data were collected from the Electronic Health Recording System of PRANA, where SCD patients under the BASCARE program had been registered. The data of other patients were collected from the Electronic Hospital Data Recording System and patient files. In the SCD group, the crude incidence of COVID-19 was 9%, while in healthcare professionals at the same period was 23%. Among the symptoms, besides fever, loss of smell and taste were more prominent in the SCD group than in healthcare professionals. There was a significant difference between the two groups in terms of development of pneumonia, hospitalization, and need for intubation (43 vs 5%, P < 0.00001; 26 vs 7%, P = 0.002; and 10 vs 1%, P = 0.002, respectively). Prophylactic low molecular weight heparin and salicylate were used more in the SCD group than in healthcare professionals group (41 vs 9% and 28 vs 1%; P < 0.0001 for both). The 3-month mortality rate was demonstrated as 5% in the SCD group, while 0 in the healthcare professionals group. One patient in the SCD group became continously dependent on respiratory support. The cause of death was acute chest syndrome in the first case, hepatic necrosis and multi-organ failure in the second case. In conclusion, these observations supported the expectation that the course of COVID-19 in SCD patients will get worse. The BASCARE program applied in SCD patients could not change the poor outcome.

Percutaneous rhinolift procedure for droopy tip.

OBJECTIVE: Droopy tip may lead to functional impairment due to nasal valve insufficiency. There are several techniques available in order to correct under rotated tip, including sutures, resection and grafting. The major drawback of these standart procedures is the correction of nasal cartilage framework rather than droopy skin envelope. In this study, we demonstrated the long-term results of percutaneous rhinolift procedure which aids in the correction of cartilage framework position and droopy skin at the same time, in patients who had isolated nasal tip ptosis. METHODS: Seventeen patients with nasal tip ptosis who underwent rhinolift procedure under local anesthesia, between September 2016 and February 2017, included in the study. Nasal obstruction was evaluated by Nasal Obstruction Symptom Evaluation (NOSE) Scale and Visual Analog Scale (VAS) before the procedure, and 1st month and 3rd month after the procedure. Long-term follow-up scores were also analyzed. RESULTS: There was a significant difference between preoperative NOSE scores and 1st, 3rd month and long-term follow-up scores (p < 0.001). When we analyzed the VAS scores of patients, there was significant difference between preoperative scores and 1st month, 3rd month and long-term follow-up scores (p < 0.001). DISCUSSION: Suspension sutures have been used to hang and lift the ptotic tissues of nasal tip. In this study, we found that rhinolift procedure is an effective method for droopy nasal tip cases especially with excess skin volume who cannot undergo a major invasive surgical operation. IMPLICATIONS FOR PRACTICE: It is a conservative and cheap method which does not require general anesthesia.

Change of respiratory functions, the STOP-Bang questionnaire, and Epworth sleepiness scale after bariatric surgery.

INTRODUCTION AND OBJECTIVE: Obesity is a highly morbid and fatal syndrome that reduces respiratory function. Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder in morbid obesity. Herein, we aimed to determine how respiratory function tests changed over time after bariatric surgery and to assess non-PSG (polysomnography) tests, namely STOP-Bang questionnaire and Epworth sleepiness tests, for predicting OSAS risk. METHOD: This retrospectively conducted study enrolled 35 patients who underwent bariatric surgery. Patients were divided into three groups formed on the basis of time passed after surgery (1, 2, or 3 years). Preoperative and postoperative respiratory function test parameters assessed by spirometry, body mass index (BMI), STOP-Bang questionnaire, and Epworth sleepiness test scores were recorded. RESULTS: Twenty-four (68.6%) patients were female, 11 (31.4%) male. The mean age was 36.5±10.5 years. Postoperative weight loss of the study groups was 26% p=0.001, 23.6% p=0.002 and 25.9% p=0.005. Reductions in BMI were 32 kg/m2 p=0.001, 34.5 kg/m2 p=0.002, 35.8 kg/m2 p=0.005 respectively. Postoperative FVC (440 ml, 390 ml, 430 ml p = 0.005) and FEV1 (220 ml p = 0.005, 250 ml p = 0.004, 214 ml p = 0.005) increased in all three groups. STOP-Bang questionnaire and Epworth sleepiness scale scores significantly decreased after weight loss compared to preoperative period in all the study groups. CONCLUSION: We showed that FVC and FEV1 increased in the short and long term after weight loss by bariatric surgery; we also found that STOP-Bang questionnaire and Epworth sleepiness scale scores decreased postoperatively. These tests may be helpful to assess OSAS risk before and after surgery. KEY WORDS: Bariatric surgery, Obesity, Respiratory functions, STOP-Bang questionnaire and Epworth sleepiness test.

Evaluation of Subclinical Atherosclerosis with Carotid Intima-Media and Epicardial Fat Thickness in Patients with Sarcoidosis.

OBJECTIVES: Since many similar mechanisms may play a role in the pathophysiology of sarcoidosis and atherosclerosis, the risk of subclinical atherosclerosis may be increased in patients with sarcoidosis. The aim of this study was to evaluate known markers of subclinical atherosclerosis, namely epicardial fat thickness (EFT) and carotid intima-media thickness (CIMT) in patients with sarcoidosis. MATERIALS AND METHODS: This cross-sectional study included a total of 183 subjects, including 94 patients with sarcoidosis (patient group) and a control group of 89 healthy individuals. Measurements of EFT and CIMT were taken from all subjects and recorded. The groups were compared, and differences were analyzed statistically. RESULTS: EFT was higher in patients than in control subjects (6.42±1.12 mm vs 7.13±1.41 mm, p<0.001). CIMT was higher in patients than in control subjects (0.51±0.02 mm vs 0.52±0.02 mm, p=0.003). CONCLUSION: EFT and CIMT were found to be higher in patients with sarcoidosis than in healthy people. These results indicate that the risk of subclinical atherosclerosis might be increased in these patients.

Comparative analysis of the patients with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP) requiring hospitalization.

INTRODUCTION: The recently introduced concept of health care-associated pneumonia (HCAP), referring to patients with frequent healthcare contacts and at higher risk of contracting resistant pathogens is controversial. MATERIALS AND METHODS: A prospective study comparing patients with HCAP and community-acquired pneumonia (CAP) in the our center. The primary outcome was 30 day mortality. RESULT: A total of the 169 patients HCAP 36 (21.3%); CAP 133 (78.7%) were evaluated. HCAP patients were older than patients with CAP [median age was 72.5 (43-96), 60.0 (18-91) years p<0.05]. The most common Klebsiella pneumoniae (16.6%) and Pseudomonas aeruginosa (8.3%) were gram-negative bacteria in the SBIP group; In the TGP group, gram-positive bacteria were more frequently isolated. Polymicrobial agents (22.2% vs. 3.7% p<0.05) and MDR pathogens (57.1% vs. 24% p<0.05) were more common in patients with HCAP. Mortality rate (22.2% vs. 6% p<0.05) was also higher in HCAP more than CAP. CONCLUSIONS: HCAP was common among patients with pneumonia requiring hospitalization and mortality rate was high. The patients with HCAP were different from CAP in terms of demographic and clinical features, etiology, outcome.

Epidemiology of NIV for Acute Respiratory Failure in COPD Patients: Results from the International Surveys vs. the "Real World".

Non-invasive ventilation (NIV) has been recommended as the  first-line ventilation modality for acute respiratory failure (ARF) due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) based on strong evidence. However, everyday clinical practice may differ from findings of multiple randomized controlled trials. Physicians and respiratory therapists involved in NIV management have been queried about its utilization and effectiveness. In addition to these estimates, cohort studies and analysis of large inpatient dataset of patients with AECOPD and ARF managed with NIV have been extensively published over the last two decades. This review summarizes the perception of medical staff vs. the "real life" data about NIV use for ARF in AECOPD patients.

Narcolepsy and cataplexy: a pediatric case report.

Narcolepsy is characterized by excessive sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis during the rapid eye movement period of sleep. Herein, we present a boy aged eight years who was diagnosed as having narcolepsy and cataplexy about thirteen months after his first presentation. He was admitted with symptoms of daytime sleepiness. In the follow-up, cataplexy in the form of head dropping attacks developed seven months after the first admission. The patient was investigated for different prediagnoses and was eventually diagnosed as having narcolepsy and cataplexy through polysomnography and multiple sleep latency tests thirteen months after the first presentation. He is being followed up and is under drug therapy; his symptoms have improved substantially.

Aging as the Impact Factor on Septoplasty Success.

OBJECTIVE: The aim of the study was to discuss the impact of aging on septoplasty success. STUDY DESIGN AND SETTING: This prospective case control study was conducted at the Umraniye Education and Research Hospital. METHODS: Our study group consists of 23 patients older than 60-year-old who have septal deviation and have previously been postponed for this surgery due to various reasons. Twenty-six patients under 40-year-old are randomly chosen as the control group who were running to septoplasty. Postoperative Glasgow Benefit Inventory Index, preoperative and postoperative NOSE score, and nasal mucociliary clearance time (MCCt) were noted for both the groups. All collected data were compared between the groups. RESULTS: In both the groups, postoperative NOSE scores decreased significantly compared to preoperative values (P < 0.01). This decrease was not significantly different between the groups. In both the groups, a significant decrease was noted in nasal MCCt with surgery (P = 0.004). However, this difference between two groups was not statistically significant. In addition, the Glasgow Benefit Inventory (GBI) index of control group was notably higher than the study group and this was statistically significant (P = 0.027). Also, the decrease of NOSE scores was conversely related to high GBI indexes and this is statistically significant (P = 0.005). CONCLUSION: For many surgical procedures, aging is considered as one of the important prognostic factors on success. To date no study in the literature discussed this relationship between aging and the success of septoplasty. At this point, our results showed that septoplasty is a successfully performed procedure in all ages. But, satisfaction of patients is statistically decreasing with aging.

How does parental smoking affect nasal mucociliary clearance in children?

Correlation between passive smoking and nasal mucociliary clearance (MCC) in pediatric population has not been reported before. Therefore, in this study, we aimed to investigate the relationship between environmental tobacco smoke and nasal MCC in children whose parents smoke in or outside the house. Three groups of subjects were evaluated: control group (group 1) with 18 children who were not exposed to environmental smoke, 15 passive smokers living with at least one adult household member smoking outside the house (group 2), 17 passive smokers living with at least one adult household member smoking inside the house (group 3). Parents of children were asked to answer our questions regarding their smoking history, and nasal MCC time was assessed for all individuals of the 3 groups. The mean MCC value in control group, group 2 and group 3 were 7.33 ± 2.91, 10.00 ± 4.78 and 12.41 ± 3.44, respectively. Differences between the mean nasal MCC values of the groups were statistically significant (p < 0.01). The comparison of MCC values between control group and group 2 did not reveal significant difference, but since p value was very close to significance level, in larger series it could be significant. (p = 0.067). Also, when we compared the MCC values between group 2 and group 3, there was no significant difference (p = 0.173). But, the difference between MCC values of control group and group 3 was statistically significant (p < 0.001). Parental smoking both inside or outside the house seemed to increase nasal mucociliary clearance time when they are compared with healthy controls. Further studies with larger study groups also measuring direct quantitative doses of smoking are needed to verify this important issue.

Platelet-rich fibrin plays a role on healing of acute-traumatic ear drum perforation.

OBJECTIVE: Our objective was to demonstrate the effects of platelet-rich fibrin (PRF) for the healing of acute ear drum perforation. METHODS: Thirty-two patients with acute traumatic ear drum perforations were randomly separated into 2 groups. In group 1 (n = 14), PRF was used for the repair of ear drum perforation; in group 2 (n = 18), we did not make any intervention. RESULTS: At initial inspection, perforation sizes were measured as 10.93 ± 3.58 mm in group 1 and 10.05 ± 4.02 mm in group 2. After 1 month, perforation sizes were 1.35 ± 2.53 mm in group 1 and 4.44 ± 3.34 mm in group 2 (P < 0.01). In the study group, the rate of ear drum closure was 64.3% and in the control group it was 22.2% (P < 0.05). CONCLUSION: Here we found that PRF is a biomaterial that quickens the healing of ear drum which is autogenous and simply prepared.

Co-occurrence and possible role of sinonasal anomalies in primary acquired nasolacrimal duct obstruction.

OBJECTIVE: Our objective was to determine the co-occurrence of sinonasal anomalies and primary acquired nasolacrimal duct obstruction. METHODS: A total of 41 patients were enrolled in the study, of which 41 had primary unilateral acquired nasolacrimal duct (NLD) obstruction. All patients included in the study were evaluated by anterior rhinoscopy, endoscopic nasal examination, and paranasal sinus computed tomography (CT) in order to reveal significant nasal and paranasal pathology. RESULTS: A significant increase was noted in the rate of concha bullosa, inferior turbinate hypertrophy, osteomeatal complex disease, and maxillary sinusitis in favor of the study group (P < 0.05). Nasal septal deviation, irregularity of middle turbinate, paradoxical middle turbinate, ethmoidal sinusitis, and Onodi cell and agger nasi cell incidence were found to be high in the study group. However, none of this increase was statistically significant (P > 0.05). CONCLUSIONS: Although primary acquired NLD obstruction seems to be an ophthalmologic problem, rhinologic problems have great importance in etiology. Detailed endoscopic examination and preoperative paranasal sinus computed tomography will reveal the possible role of nasal and paranasal structures adjacent to lacrimal sac in etiology of NLD obstruction. This will be effective both on conservative treatment and postoperative success in patients scheduled for surgery.

Effects of polycystic ovary syndrome and menopause on rat soft palate and base of tongue.

OBJECTIVE: To investigate the histopathologic changes in rat soft palate and base of tongue by performing experimental polycystic ovary syndrome (PCOS) and menopause models. STUDY DESIGN: Experimental study. SETTING: The study was conducted at the animal care facility of Haydarpasa Numune Education and Research Hospital. SUBJECT AND METHODS: Thirty healthy female Albino Wistar rats were divided into 4 groups (PCOS study group [n = 10], per oral letrozole given; PCOS control group [n = 6], per oral saline given; menopause study group [n = 8], ovariectomized; menopause control group [n = 6], sham operated). At the end of the follow-up periods, all animals were euthanized, and soft palates and base of tongues of all groups were removed to observe the histopathologic changes. RESULTS: When we compared the PCOS study group with the PCOS control group, submucous gland hypertrophy, mast cell infiltration, vascular engorgement, and acanthosis were significantly different in the soft palate (P < .05), and in addition to these findings, lymphocyte infiltration, subepithelial edema, and dilated glandular excretory duct were significantly different in base of tongue (P < .05). When we compared the menopause study group with the menopause control group, only vascular engorgement was significantly different in the soft palate (P < .05), and in addition to this finding, submucous gland hypertrophy, lymphocyte infiltration, polymorphonuclear leukocyte infiltration, and subepithelial edema were significantly different in base of tongue (P < .05). CONCLUSION: Our findings suggest that PCOS and menopause induce significant histopathologic changes in the soft palate and base of tongue that are similar to the histopathologic changes seen in the soft palate and base of tongue of patients with obstructive sleep apnea syndrome.

Is there any predictor for tinnitus outcome in different types of otologic surgery?

Our objective was to determine the effect of different types of otologic surgeries on tinnitus symptoms. Our study consisted of 63 patients who were operated between January and June 2011. Variables such as age, sex, presence of systemic diseases, location and size of the perforation, duration of dry period, type of otological surgery, peroperative presence of cholesteatoma, timpanosclerotic plaques and ossicular chain discontinuity were evaluated. Audiologic evaluation by pure tone audiometry and assessment of THI scores were conducted before surgery and 12 weeks after surgery. There was a very significant difference between preoperative and postoperative mean THI scores (p < 0.01). There was no significant effect of presence of ossicular discontinuity, cholesteatoma, tympanosclerotic plaques, type of surgery or duration of symptoms on the difference of preoperative and postoperative THI scores (p > 0.05). There was a significant positive relationship between audiological gain and THI scores (r = 0.355, p < 0.01). In our study, we investigated the relationship between many types of otological surgeries including some preoperative and peroperative pathological findings and tinnitus. As a result, we found that postoperative audiologic gain is an important factor determining outcome of tinnitus in these types of otological surgeries.

Role of allergy in primary acquired nasolacrimal duct obstruction.

OBJECTIVE: Our objective was to determine the role of allergy in primary acquired nasolacrimal duct obstruction. METHODS: A total of 41 patients were enrolled in the study, 41 of whom had primary unilateral acquired nasolacrimal duct obstruction. All patients included in the study were evaluated by anterior rhinoscopy, endoscopic nasal examination, and multiprick skin test to reveal allergic rhinitis. RESULTS: Allergy incidence was found to be high in study group. This was statistically significant (P < 0.05). CONCLUSIONS: Although primary acquired nasolacrimal duct obstruction seems to be an ophthalmologic problem, rhinologic problems have great importance in etiology. Detailed endoscopic examination and multiprick skin test will reveal the possible role of allergic rhinitis. This may increase the success rate both of the conservative treatment options and of the surgical treatment.

Does passive smoking have an effect on nasal mucociliary clearance?

OBJECTIVE: The aim of this study is to review the literature about nasal mucociliary clearance (MCC) and passive smoking in otorhinolaryngology by clearly explaining their relationship in a cross-sectional study. STUDY DESIGN AND SETTING: This cross-sectional study was conducted at the Umraniye Education and Research Hospital in Turkey. Umraniye Education and Research Hospital Ethical Committee approved the study, and informed consents of the patients were obtained. METHODS: Our study consisted of patients who presented to the Ear-Nose-Throat Department of Istanbul Umraniye Education and Research Hospital between February 2011 and July 2011. Three groups of subjects were evaluated: 15 passive smokers (group 1), 17 active smokers (group 2), and 15 healthy matched controls (group 3). All patients were asked to answer our questions regarding their smoking history, and nasal MCC time was assessed for all individuals of the 3 groups. RESULTS: The mean MCC value was 23.59 ± 12.41 in the smoking group, 12.6 ± 4.67 in the passive smoking group, and 6.4 ± 1.55 in the healthy group. The comparison of MCC values between the smoking group and passive smoking group and between the smoking group and healthy group revealed statistically significant differences (P < .01). There was also a significant difference between the MCC values of the passive smoking group and the healthy group (P < .01). In addition, we compared MCC values according to exposure number of cigarettes. CONCLUSION: In this study, we conclude that passive smoking affects nasal MCC. Both active and passive smoking increases nasal MCC time when compared with healthy controls.

Histological evaluation of rat larynx in experimental polycystic ovary syndrome model.

This study aimed at studying the histopathological effects of hyperandrogenemia and estrogen deficiency on larynx mucosa in experimentally designed polycystic ovary syndrome of female rats. Two groups of experimental polycystic ovary syndrome model were composed in healthy female rats by per oral letrozole administration of for 21 and 42 days. Also a control group which only took vehicle (saline) for 42 days was designed. Laryngeal mucosa and ovaries of all animals were examined histopathologically by light microscopy and the serum hormone levels were analyzed using a solid-phase, two-site chemiluminescent enzyme immunometric assay. Statistically significant edema, vascular engorgement, inflammation, cilia loss and differentiation of goblet cell distribution were observed when the control group and study groups were compared (p < 0.01). In serum hormonal analysis there was a significant increase in levels of androgens and decrease in levels of estrogens. In addition, polycystic appearance of ovaries in letrozole-administered groups and normal appearance of ovaries in control group have been proven histopathologically. Polycystic ovary syndrome which causes estrogen deficiency and hyperandrogenemia in fertile ages resulted in histopathological changes in laryngeal mucosa.

Clinical, radiologic, and functional evaluation of 304 patients with bronchiectasis.

BACKGROUND: Bronchiectasis continues to be one of the major causes of morbidity and mortality in developing countries, with a probably underestimated higher prevalence than in developed countries. OBJECTIVE: To assess the clinical profile of adult patients with bronchiectasis. METHODS: We retrospectively reviewed the clinical, radiologic, and physiologic findings of 304 patients with bronchiectasis confirmed by high-resolution computed tomography. RESULTS: Mean age of participants (45.7% males, 54.3% females) was 56 ± 25 years and 65.8% of them were lifetime non-smokers. Most common identified causes of bronchiectasis were childhood disease (22.7%), tuberculosis (15.5%), and pneumonia (11.5%). The predominant symptoms were productive cough (83.6%), dyspnea (72%), and hemoptysis (21.1%). The most common findings on chest examination were crackles (71.1%) and rhonchi (28.3%). Types of bronchiectasis were cylindrical in 47%, varicose in 9.9%, cystic in 45.1%, and multiple types in 24.3%. Involvement was multilobar in 75.3% and bilateral in 62.5%. Of 274 patients, 20.8% displayed normal pulmonary function test results, whereas 47.4%, 8% and 23.7% showed obstructive, restrictive, and mixed pattern, respectively. Patients with cystic disease had a higher frequency of hemoptysis (42%) and a greater degree of functional impairment, compared to other types. CONCLUSION: In patients with bronchiectasis from southern Turkey, generally presenting with recurrent productive cough, hemoptysis, dyspnea, and persistent bibasilar rales, the etiology remains mainly idiopathic. Post-infectious bronchial destruction is one of the major identified underlying pathological processes. The clinical picture and the deterioration of the pulmonary function test might be more severe in patients with cystic type bronchiectasis.

Effect of type I tympanoplasty on the quality of life of children.

OBJECTIVES: Quality-of-life issues related to chronic otitis media (COM) include physical symptoms, emotional symptoms, hearing loss, speech symptoms, social symptoms, and parents' emotional symptoms. In this study we evaluated the effects of tympanoplasty on the quality of life of pediatric patients. METHODS: In a questionnaire-based outcome study, we reviewed 56 of 78 pediatric patients with COM who were treated with type I tympanoplasty at our institution between December 2008 and February 2010. All patients were asked to fill out the COM-5 questionnaire with their parents, before operation and 6 months after operation. Preoperative and postoperative total ear scores, preoperative and postoperative ear scores with an intact tympanic membrane, preoperative and postoperative ear scores with a perforated tympanic membrane, and preoperative and postoperative audiological results were assessed. RESULTS: After type I tympanoplasty, 45 patients (80.3%) had successful closure of the tympanic membrane, but 11 patients (19.7%) had unsuccessful closure of the tympanic membrane. There was a significant decrease in physical suffering, hearing loss, emotional distress, activity limitations, and caregiver's concerns scores in patients with intact tympanic membranes after operation (p < 0.01). CONCLUSIONS: Children with COM had a significant increase in their quality of life after successful tympanoplasty. Our results also suggested that tympanoplasty was successful in pediatric patients with COM.