Comparison of clinical outcomes using a Piezosurgery device vs. a conventional osteotome for lateral osteotomy in rhinoplasty.

Our aim for this study was to evaluate and compare the clinical outcomes in patients who underwent lateral osteotomy with a Piezosurgery device or a conventional osteotome in open-technique rhinoplasty. This cohort trial involved 65 patients (36 women and 29 men; average age: 23.6 ± 5.71 yr) who underwent surgery between May 2015 and January 2016. Piezosurgery was used for lateral osteotomy in 32 patients, whereas 33 patients underwent conventional external osteotomy. These 2 groups were compared for duration of surgery, perioperative bleeding, postoperative edema, ecchymosis, pain, and patient satisfaction on the first and seventh postoperative days. The Piezosurgery group revealed significantly more favorable outcomes in terms of edema, ecchymosis, and hemorrhage on the first day postoperatively (p < 0.001 for all). Similarly, edema (p = 0.005) and ecchymosis (p < 0.001) on the seventh postoperative day also were better in the Piezosurgery group. Hemorrhage was similar in both groups on the seventh postoperative day (p = 0.67). The Piezosurgery group not only experienced less pain on the first postoperative day (p < 0.001), but these patients also were more satisfied with their results on both the first and seventh postoperative days. Results of the present study imply that Piezosurgery may be a promising, safe, and effective method for lateral osteotomy, a critical step in rhinoplasty. The time interval necessary for the learning curve is counteracted by the comfort and satisfaction of both patients and surgeons.

Vestibular-evoked myogenic potentials before and after dental implant surgery.

OBJECTIVES: This study aims to examine the effects of dental implant surgery on vestibular-evoked myogenic potential (VEMP) responses. PATIENTS AND METHODS: Between October 2012 and October 2014, a total of 60 consecutive patients undergoing dental implant surgery at Baskent University Hospital, Department of Otorhinolaryngology were included in the study. The control group consisted of 40 healthy subjects undergoing routine clinical examination. The VEMP response was evaluated at baseline, second and seventh days. Positional tests and Dix-Hallpike testing for vertigo were performed at baseline, second and seventh days. RESULTS: Hundred-eight dental implants were placed in 60 patients. There was no significant difference in the p1 and n1 latencies in the control group at baseline, second day, and seventh day (p>0.05). However, there was a significant increase at the second day for p1 latencies in the study group, compared to the baseline and seventh day (p=0.038). There was a significant increase at the second day for n1 compared to the baseline (p=0.016) and seventh day in the study group (p=0.005). There was a significant increase at the seventh day for n1 compared to the baseline in the study group (p=0.016). CONCLUSION: The present study revealed a significant difference in the cervical VEMP response on the second postoperative day for p1 and n1 latencies compared to the baseline and seventh postoperative day in dental implantation patients. Dental implant patients should be informed of such possible temporary problems as dizziness and vestibular problems.

A rare presentation of langerhans cell histiocytosis tonsil infiltration: review of the literature: atypical presentation of langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is a rare disease that can infiltrate various organs. LCH presents with solitary organ involvement or as a multi-system disease. We present a patient who has tonsillary infiltration with LCH. A 74 year-old Caucasian male was admitted for swelling of the neck and difficulty swallowing for 3 months. Physical examination showed submandibular lymph node enlargement of approximately 3 cm and tonsil enlargement. A tonsillectomy and excisional biopsy of the lymph node were done. Histiocyte-like cell infiltration was seen in the tonsil biopsy. CD3, CD20, CD15, CD30, CD5, CD138, Lambda, Kappa, Bcl-2, ALK, CD23, CD10, Bcl-6, keratin, EMA, HMB-45, and Cyl D1 were negative. CD68, S-100, CD1a, and fascin were positive, and the Ki-67 proliferation index was 20 % in immunocytochemical staining. The most commonly infiltrated bones are the skull, femur, lower jaw, pelvis, and vertebrae in LCH. Oral or perioral lesions are present in 30 % of cases. Oral lesions most often involve bone loss, unexpected tooth loss, and gum inflammation. We administered oral prednisolone to our patient due to the presence of lytic lesion of the bone, mild anemia and a higher sedimentation rate, which was from a separate, explained cause. Isolated tonsillar involvement in adult LCH was reported in only 2 cases in the literature. There is no standard recommendation for treatment. Our patient responded well to steroid therapy.

Effects of septoplasty on speech and voice.

OBJECTIVES: The aim of this study was subjective and objective evaluation of changes in acoustic features of voice before and after septoplasty surgery. STUDY DESIGN: Prospective. METHODS: Twenty patients scheduled for septoplasty procedure were included in the study. Before and 1 and 3 months after septoplasty surgery, acoustic analysis were performed. The recordings of /a/ vowel were used to evaluate average fundamental frequency (F0), Jitter percent, and Shimmer percent. In spectrographic analyses, F3-F4 values for the vowels /i, e, a, o, and u/, nasal formant frequencies of the consonants /m/ and /n/ in the word /mana/, and four formant frequencies (F1, F2, F3, and F4) for nasalized /a/ vowel following a nasal consonant /n/ in the word /mana/ were compared. For the perceptual evaluation, the patients were asked to read the Turkish "Dere" passage. The differences in nasal resonance and subjective evaluations were rated. RESULTS: A statistically significant change was not observed in F0 (P=0.307), Jitter (P=0.919), and Shimmer (P=0.024) values measured before and after the operation for vowel /a/. Nasal formants measured before and after the operation for nasal formant /m/ and nasal formant /n/ in the word /mana/, which contains nasal consonants, and nasalized vowel /a/, which comes after a nasal consonant, did not differ statistically significant (P=0.096 and P=0.034, respectively). Comparisons among F1, F2, F3, and F4 values did not reveal a statistically significant change for nasalized vowel /a/, which comes after a nasal consonant in the word /mana/. CONCLUSIONS: Our study shows that a complete therapeutic approach to patients affected by nasal septum deviation do not reveal significant voice abnormalities.

Comparison of Acoustic and Stroboscopic Findings and Voice Handicap Index between Allergic Rhinitis Patients and Controls.

BACKGROUND: In our experience Allergic Rhinitis (AR) patients suffer from voice problems more than health subjects. AIMS: To investigate the acoustic analysis of voice, stroscopic findings of larynx and Voice Handicap Index scores in allergic rhinitis patients compared with healthy controls. STUDY DESIGN: Case-control study. METHODS: Thirty adult patients diagnosed with perennial allergic rhinitis were compared with 30 age- and sex-matched healthy controls without allergy. All assessments were performed in the speech physiology laboratory and the testing sequence was as follows: 1. Voice Handicap Index (VHI) questionnaire, 2. Laryngovideostroboscopy, 3. Acoustic analyses. RESULTS: No difference was observed between the allergic rhinitis and control groups regarding mean Maximum Phonation Time (MPT) values, Fo values, and stroboscopic assessment (p>0.05). On the other hand, mean VHI score (p=0.001) and s/z ratio (p=0.011) were significantly higher in the allergic rhinitis group than in controls. CONCLUSION: Our findings suggest that the presence of allergies could have effects on laryngeal dysfunction and voice-related quality of life.

Benign paroxysmal positional vertigo following septorhinoplasty.

We present 2 cases of benign paroxysmal positional vertigo (BPPV) following septorhinoplasty. Benign paroxysmal positional vertigo following septorhinoplasty is an unusual entity. Two young women who had difficulty in breathing and nasal deformity underwent septorhinoplasty. On the second and the third postoperative days, the patients experienced vertigo that was induced by position changes. Both patients had neither preexisting ear disease nor vertigo before the surgery. All the examinations were normal. With Dix-Hallpike maneuver, which is the criterion-standard test, the characteristic nystagmus was observed. Right posterior canal BPPV was diagnosed, and they were both treated with Epley canalith repositioning maneuver. Publications related to postsurgical vertigo are available in literature, but it is still an underdiagnosed disorder. We would like to mention about this rare entity and inform the surgeons that they must keep in mind that a patient who is complaining about vertigo or dizziness after the surgery should be observed and investigated for BPPV.

The Score For Allergic Rhinitis study in Turkey.

BACKGROUND: The clinical definition of allergic rhinitis (AR) is difficult to use in epidemiological settings of large populations where it is impossible to obtain the laboratory evidence of each immune response. However, the standardization of the definition of AR in epidemiological studies is of crucial importance. This study was designed to estimate the prevalence of AR in an adult general population with respect to seven distinct geographical regions in Turkey. METHODS: Individuals were evaluated with the Score for Allergic Rhinitis (SFAR) questionnaire for a national cross-sectional study. The Turkish version of the SFAR questionnaire was tested for clarity and sensitivity in a small sample of the general population. RESULTS: Among the 3967 interviewed subjects, the overall prevalence of AR was 29.6%, with regional variations (from 21.0% in the southeastern Anatolia region to 36.1% in the Marmara region). The prevalence was higher in women and in urban area of residence. CONCLUSION: This national survey confirmed the elevated prevalence of AR in Turkey. Our findings may contribute to the formulation of the public health policy and development of preventive and therapeutic strategies for AR in eastern Europe.