Assessment of children with speech sound disorders in otolaryngology outpatient clinics.

OBJECTIVE: To analyze the utility of Ankara Articulation Test (AAT) for the diagnosis of Speech Sound Disorders (SSD) in children by an Otolaryngologist independent of Speech-Language Pathologist (SLP). METHODS: In this prospective single-center study, 83 children comprising 45 boys (54.2%) and 38 girls (45.8%) were enrolled. AAT was applied to the children aged 3-12 years with primary SSD who presented to the otolaryngology outpatient service. Video recording was carried out while testing and the responses to the test were evaluated by another otolaryngologist and SLP. RESULTS: A perfectly significant agreement was found between the speech-language pathologist and otolaryngologist's assessments (Cronbach's Alpha > 0.80). CONCLUSION: Otolaryngologists could evaluate SSD with the help of AAT as well as an SLP analysis. Standardized visual tests, such as the AAT, assist the otolaryngologist in the diagnosis of SSD in outpatient clinics.

Concentrations of Serum Cyclophilin A in Patients With Bell Palsy.

BACKGROUND: Cyclophilin A (CyPA) is the responder protein to stimuli that cause inflammation. To date, no association among CyPA and Bell palsy has been reported. METHODS: The concentrations of Serum CyPA were measured in 90 healthy participants and 92 patients with Bell palsy. Serum samples of patients and the control group were compared on the basis of CyPA levels. Facial latency and amplitude values on electromyography were evaluated and compared with serum CyPA concentrations. RESULTS: A total of 28, 37, 19, and 8 patients had grade 3, 4, 5, and 6 facial palsy cases, respectively. Comparing the control group and the patient group showed significant differences in CyPA values (P < 0.001). Cyclophilin A value can be evaluated as a marker with high disease discrimination capability. The results also showed that at low CyPA, the average recovery time was shorter than that of high CyPA (41.6 ±â€Š5.7 days vs 62.8 ±â€Š10.2 days, P = 0.036). We found no statistically significant relationship between electromyography parameters and CyPA level. (Facial latency: r: -0.014, P: 0.948; facial amplitude r: -0.081, P: 0.713). CONCLUSION: Serum CyPA concentrations increased in response to inflammation in Bell palsy patients. However, CyPA could not be used as an early prognostic marker in Bell palsy, low CyPA indicates the shorter average recovery time than that of high CyPA.

Investigation of the Effectiveness of Surgical Treatment on Respiratory Functions in Patients With Obstructive Sleep Apnea Syndrome.

OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) is a problem that involves many bodily systems and its effects on the respiratory system deserve special attention. Although many studies exist that investigate respiratory functions in patients using continuous positive airway pressure (CPAP) for the treatment of sleep apnea, there is a lack of research regarding the effect of OSAS surgery on respiratory function in the literature, which has motivated us to perform such a study. MATERIALS AND METHODS: Thirty-two patients diagnosed with OSAS with an apnea hypopnea index ranging between 15 and 30 and had undergone robotic tongue base resection and uvulopharyngoplasty were included as study participants. Pulmonary function tests were performed on all participants 1 day prior to, and at 3 and 6 months after the operation. Weight and body mass indices (BMIs) were also recorded at the same intervals for all participants. Data were electronically recorded and analyzed through SPSS 22.0. Values of P < .05 have been considered as statistically significant. RESULTS: Average age of the 32 participants was 43.2±10.7, average body weight was 94.1±12.6, and average BMI was 31.4±4.7. Decreases in body weight and BMI values recorded at 3 and 6 months postoperatively had statistical significance when compared with values recorded preoperatively (P < .05). Comparisons made in terms of pulmonary functions revealed a statistically significant increase in 3 and 6-month postoperative values of FVC, FEV1, FEV1/FVC, PEF, and FEF 25-75 (P < .05). CONCLUSION: Our study shows the positive effects of robotic tongue base resection and uvulopharyngoplasty operation on respiratory function parameters. This suggests that surgical treatment in OSAS patients is as effective as CPAP on respiratory function.

Could digital photography be an alternative to postoperative physical examination for pediatric tonsillectomy patients?

OBJECTIVE: To evaluate and compare the efficacy of postoperative control with digital photographs and physical examination for children who underwent tonsillectomy? METHODS: In this prospective study, 86 children (46 boys (53.5%) and 40 girls (46.5%) were enrolled for postoperative clinical visit and for obtaining photographs of the tonsillar bed with a digital camera at clinic control. RESULTS: No difference in tonsillar fossa healing was observed between the two methods 2 weeks after surgery. CONCLUSIONS: Digital photographs proved to be a safe method for postoperative control of pediatric patients who underwent tonsillectomy. Adding control with outpatient follow-up will be useful for minimizing postoperative complications.

Comparison of radiofrequency and transoral robotic surgery in obstructive sleep apnea syndrome treatment.

INTRODUCTION: Radiofrequency tissue ablation (RFTA) and transoral robotic surgery (TORS) are the methods used in OSAS surgery. We also aimed to compare the advantages and disadvantages of RF and TORS as treatment methods applied in OSAS patients in terms of many parameters, especially apnea hypopnea index (AHI). MATERIALS AND METHODS: Patients were classified by performing a detailed examination and evaluation before surgery. 20 patients treated with anterior palatoplasty and uvulectomy -/+ tonsillectomy + RFTA (17 males, 3 females) and 20 patients treated with anterior palatoplasty and uvulectomy -/+ tonsillectomy + TORS (16 males, 4 females) were included in the study. PSG was performed preoperatively and postoperatively in all patients and Epworth sleepiness questionnaire was applied. All operations were performed by the same surgeon and these surgical methods -RF and TORS- were compared in terms of many parameters. RESULTS: When the patients treated with RF and TORS were compared in operation time, length of hospitalization and duration of transition to oral feeding; all parameters were significantly greater in the patients treated with TORS. CONCLUSIONS: TORS technique was found to be more successful than RF in terms of reduction of AHI value, correcting minimum arterial oxygen saturation value and decreasing Epworth Sleepiness Scale score.

A Rare Complication After Septoplasty: Visual Loss Due to Right Retinal Artery Spasm.

Septoplasty is a commonly used procedure for correcting septal cartilage deformities. Hemorrhage, abscesses, scaling, adhesions, and scar tissue are often seen after the operation of the septoplasty, but temporary or permanent visual loss due to local anesthetic use has been reported very rarely in the literature. The authors also aimed to present a female patient with retinal artery spasm in the right eye after septoplasty in this article. A 27-year-old female patient was admitted to the authors' clinic with long-standing nasal obstruction and postnasal drip. There was no feature in her history and also no sign other than nasal septal deviation on physical examination. The patient was informed about the operation and the operation was planned. Emergency eye consultation was requested after the patient said that the right eye of the patient had never seen in the postoperative wake-up hall. Examination by an ophthalmologist; mild exotropia and total loss of vision in the right eye (including loss of light reflex) was detected. The light reaction in the affected eye was negative and indirect reaction was positive. After enlargement of the pupil, fundus examination revealed that the right posterior pole region (inside of the macula and vessel arches) was pale and no central retinal artery pulsation was observed. The patient was diagnosed with central retinal artery occlusion and emergency intervention was performed. The right eye massage, paracentesis, and hyperbaric oxygen therapy returned to the patient's visual function.

Dorsal Augmentation of Saddle Nose Deformity With Toothpick-Shaped Costal Cartilage Grafts in the Secondary Septorhinoplasty.

Saddle nose deformity is a challenging complication of septoplasty or septorhinoplasty, characterized by underprojected cartilaginous dorsum. Nasal dorsal augmentation is a significant part of reconstructive surgery of saddle nose deformities. In this study, the authors aimed to discuss the results of using toothpick-shaped costal cartilage grafts in nasal dorsal augmentation of saddle nose deformity. Twelve patients who underwent nasal dorsal augmentation due to moderate to severe saddle nose deformity secondary to the previous septoplasty or septorhinoplasty were retrospectively reviewed. Costal cartilage grafts prepared in the shape of toothpicks were used in all patients. Costal cartilage was used as toothpick-shaped free grafts in 12 patients (female: 7, male: 5) with a mean age of 42 (range: 24-56) for dorsal augmentation in the secondary septorhinoplasty. All patients had a history of previous surgery (septoplasty, n = 9; and septorhinoplasty, n = 3). All patients were operated under general anesthesia with open technique septorhinoplasty. The mean follow-up was 18 (range: 9-48) months. In only 1 of the 12 patients, a postoperative complication was observed including an infection of the tip area in the second postoperative week. None of the patients experienced donor site complications or major graft resorption. All patients were satisfied with functional and esthetic outcomes. No revision surgery was needed in any patient. Toothpick-shaped costal cartilage grafts are useful in nasal dorsal augmentation of moderate to severe saddle nose deformity. This technique offers smooth camouflage, satisfactory accordance with the recipient region, and shorter operation time. In addition, it avoids the side effects from wrapping techniques such as foreign body reaction or additional donor site morbidities.

Flexible CO2 Laser Treatment for Subglottic Stenosis.

OBJECTIVES: To assess the efficacy and safety of flexible fiber CO2 laser surgery for subglottic stenosis and to present retrospective experience of 14 patients treated with flexible fiber CO2 laser system. To determine the characteristics, management protocols, prognostic factors, and postoperative outcomes of the sample. METHODS: Retrospective review of patients with subglottic stenosis undergoing flexible fiber CO2 laser surgery at the tertiary medical center. All demographic and clinical data were collected, radiologic and endoscopic evaluations were performed to assess the characteristics of stenosis. Myer-Cotton grading scale was used for classification of stenotic area. RESULTS: All patients have subglottic stenosis due to intubation-related causes and inappropriate tracheostomy procedure. The duration of intubation period ranged from 15 days to 4 years; 11 patients have grade III stenosis according to Myer-Cotton system and there was cricoid involvement in 2 patients. The mean follow-up period was 5.2 months and postoperative decannulation was achieved in 10 patients (71.4%). CONCLUSIONS: Subglottic stenosis is the difficult situation to manage minimal invasively. Flexible fiber CO2 laser surgery is safe and effective in the management of properly selected patients and can be used as a first option for patients.

Effect of anesthesia without a neuromuscular blocking agent on intraoperative bleeding in adenotonsillectomy patients.

OBJECTIVE: The purpose of this study was to examine the effect of general anesthesia, applied without a neuromuscular blocking agent, on the extent of intraoperative bleeding in children undergoing adenotonsillectomy. MATERIALS AND METHODS: A total of 81 adenotonsillectomy cases were examined retrospectively. The patients' ages, genders, and tonsil and adenoid sizes, as well as anesthetic technique, operation time, extent of bleeding during operation, and period of stay in the postanesthesia care unit, were reviewed. Among the patients, 38 were administered anesthesia with a neuromuscular blocker (control group) and 43 patients were given anesthesia without a neuromuscular blocker (study group). RESULTS: No statistically significant difference was found between groups in terms of age, gender, and tonsil and adenoid sizes (p > 0.05). The operation times of the study group were significantly lower than those of the control group (p = 0.036; p < 0.05). A highly statistically significant difference was found between groups in terms of extent of bleeding (p = 0.001; p < 0.01). Bleeding in the study group was significantly lower than that in the control group. No statistically significant difference was found in terms of period of stay in the post anesthesia care unit (p > 0.05). CONCLUSION: In this study, we determined that, general anesthesia without a neuromuscular blocking agent significantly decreases operation time and intraoperative bleeding in adenotonsillectomy patients.