An assessment of the effects of adenoid hypertrophy on mucociliary clearance and nasal cytology in children.

AIM/OBJECTIVE: The aim of this study was to demonstrate the benefits of the systematic use of nasal cytology and mucociliary clearance in the diagnostic workup of nasal disorders in children with adenoid hypertrophy (AH) to reach a well-defined diagnosis, establish a rational therapeutic approach, avert from complications, and develop the patient's life quality. MATERIALS/METHODS: In this prospective study, a total of 61 pediatric patients (aged 5-12 years) were evaluated. The case group consisted of 31 children with AH symptoms, while the control group comprised 30 children without AH symptoms.Exclusions included previous adenoidectomy/adenotonsillectomy, cardiovascular/neurological diseases, acute/allergic rhinitis, genetic disorders (e.g., Down syndrome), and immunodeficiency. The control group consisted of children without nasal obstruction symptoms and without AH, who admitted for various reasons. Medical history, examinations, fiberoptic nasopharyngoscopy, cephalometric evaluations, AST, and nasal cytology were conducted. RESULTS: At the end of the study, a significant increase in the mucociliary clearance time was observed in the group with AH compared to the control group (p < 0.05). Although AH may disrupt MCC, there is no correlation between the size of the hypertrophy and MCC time.When the distribution of cells in the nasal cytology is evaluated, no difference was detected between the AH group and control groups. CONCLUSION: Nasal mucociliary clearance has been found to be decreased, particularly in the presence of significant AH.

Birth outcomes in pregnant women with epilepsy: A Nationwide multicenter study from Türkiye.

OBJECTIVE: The present study was aimed at investigating the effects of anti-seizure medications (ASMs), patient demographic characteristics, and the seizure type and frequency on the development of congenital malformations (CMs) in the infants of pregnant women with epilepsy (PWWE). METHODS: PWWE followed up at the neurology outpatient clinic of 21 centers between 2014 and 2019 were included in this prospective study. The follow-up of PWWE was conducted using structured, general pregnant follow-up forms prepared by the Pregnancy and Epilepsy Study Committee. The newborns were examined by a neonatologist after delivery and at 1 and 3 months postpartum. RESULTS: Of the infants of 759 PWWE, 7.2% had CMs, with 5.6% having major CMs. Polytherapy, monotherapy, and no medications were received by 168 (22.1%), 548 (72.2 %), and 43 (5.7 %) patients, respectively. CMs were detected at an incidence of 2.3% in infants of PWWE who did not receive medication, 5.7% in infants of PWWE who received monotherapy, and 13.7% in infants of PWWE who received polytherapy. The risk of malformation was 2.31-fold (95% confidence interval (CI): 1.48-4.61, p < .001) higher in infants of PWWE who received polytherapy. Levetiracetam was the most frequently used seizure medication as monotherapy, with the highest incidence of CMs occurring with valproic acid (VPA) use (8.5%) and the lowest with lamotrigine use (2.1%). The incidence of CMs was 5% at a carbamazepine dose <700 mg, 10% at a carbamazepine dose ≥700 mg, 5.5% at a VPA dose <750 mg, and 14.8% at a VPA dose ≥750 mg. Thus the risk of malformation increased 2.33 times (p = .041) in infants of PWWE receiving high-dose ASMs. SIGNIFICANCE: Birth outcomes of PWWE receiving and not receiving ASMs were evaluated. The risk of CMs occurrence was higher, particularly in infants of PWWE using VPA and receiving polytherapy. The incidence of CMs was found to be lower in infants of PWWE receiving lamotrigine.

The efficacy of Kinesio taping on lymphedema following head and neck cancer therapy: a randomized, double blind, sham-controlled trial.

OBJECTIVE: The aim was to investigate the effectiveness of Kinesio taping for lymphedema following head and neck cancer therapy and its effect on patient compliance and quality of life. METHODS: A total of 66 patients with lymphedema following head and neck cancer therapy were randomly allocated to the therapeutic Kinesio taping group (n = 33) and the sham Kinesio taping group (n = 33). All participants received manual lymphatic drainage, Kinesio taping, and home exercises for the first four weeks, and only home exercises for the second four weeks. The tape measurements, a scale of external lymphedema, a scale of the internal lymphedema, and quality of life were evaluated in both groups. The perceived discomfort consisting of limitation of daily living activities, pain, tightness, stiffness, and heaviness were also recorded. RESULTS: When the group x time effect was evaluated, it was observed that external lymphedema was significantly reduced in both groups according to neck and face composite measurements (p < .001). However, in these measurements, a significant difference was found between the groups in favor of the KT group (p = .001, p = .032, respectively). At the end of the study, there was no significant difference in terms of internal lymphedema in both groups (p = .860). The quality of life parameters such as global health status and swallowing were significantly better in the Kinesio taping group (p < .001). There was no significant difference in the parameters of perceived discomfort between the two groups (p = .282, p = .225, p = .090, p = .155, p = .183, respectively). CONCLUSION: Kinesio taping is effective in tape measurements and positively affects the quality of life in lymphedema following head and neck cancer therapy.

Assessment of the Clinical Use of Vestibular Evoked Myogenic Potentials and the Video Head Impulse Test in the Diagnosis of Early-Stage Parkinson's Disease.

OBJECTIVES: To explore the usefulness of vestibular tests including "vestibular evoked myogenic potentials" (VEMPs) and the video head impulse test (vHIT) in the early diagnosis of "idiopathic Parkinson's disease" (PD). MATERIALS AND METHODS: The study involved 80 participants including 40 patients (24 males, 16 females; age average 63.20 ± 7.94 years) with PD and 40 healthy individuals (18 males and 22 females; age average of 60.36 ± 7.68 years). The Modified Hoehn and Yahr (H&Y) scale was used to measure how Parkinson's symptoms progress and the level of disability. Patients with PD underwent cVEMPs, oVEMPs, and vHIT and the results were compared with those of 40 age-matched healthy control (HC) subjects. vHIT results and VEMP responses were registered in all patients and HCs. RESULTS: One-sided absent cVEMP responses were found in 6 (15%) patients with PD and 8 (20%) patients had bilaterally absent responses. Five (12.5%) patients had 1-sided absent oVEMP responses and it was bilateral in 6 (15%). Patients with PD had significantly shorter cVEMP P1, N1 latency, lower cVEMP amplitudes, and oVEMP amplitudes than the HC group. The cVEMP and oVEMP amplitude asymmetry ratio was significantly higher in the PD group (P < .05). Evaluation of vHIT results and vestibular-ocular reflex (VOR) gain between the groups revealed that anterior canal and posterior canal VOR gains results were remarkably lower in the PD group than in the HCs (P < .05). There was no difference in right and left lateral canal VOR gains between the groups (P > .05). CONCLUSION: The results of this study suggest that cVEMP and vHIT can be used to evaluate the vestibular system in patients with early-stage Parkinson's disease.

Efficacy of Kinesio taping on Mutational Falsetto: A Double Blind, Randomized, Sham-controlled Trial.

OBJECTIVES: This study aimed to assess the efficacy of Kinesio taping on male patients with mutational falsetto undergoing voice therapy. DESIGN: Double blind, randomized, sham-controlled clinical trial. PARTICIPANTS: Interviews were conducted with thirty seven mutational falsetto patients. Included 32 participants were randomized and divided into two groups. Two were dropped out due to irregular attendance, 30 participants were included in final analysis. INTERVENTIONS: The study group was treated with voice therapy and applications of three different therapeutic Kinesio taping techniques with seven Kinesio tapes four times over two weeks, and the control group was treated with voice therapy, and applied to sham Kinesio taping. OUTCOME MEASURES: The values of fundamental frequency, jitter, shimmer, noise-harmonic ratio, maximum phonation time, Voice Handicap Index-10 scores, and Grade-Roughness-Breathiness-Asthenia-Strain Scale scores were recorded at the baseline and after the two weeks. RESULTS: There were significant differences between the study group and the control group with respect to the values of fundamental frequency (P = 0.011), jitter (P = 0.041), shimmer (P = 0.036), noise-harmonic ratio (P = 0.003), maximum phonation time (P ≤ 0.001), Voice Handicap Index-10 scores (P = 0.036), and Grade-Roughness-Breathiness-Asthenia-Strain Scale scores (P = 0.007; P ≤ 0.021; P = 0.022; P = 0.002; P = 0.021, respectively) at the end of the study. CONCLUSIONS: The study demonstrated that Kinesio taping with voice therapy is an efficient and effective technique for treating mutational falsetto patients.

Optical Properties of Cylindrical Quantum Dots with Hyperbolic-Type Axial Potential under Applied Electric Field.

In this paper, we have researched the electronic and optical properties of cylindrical quantum dot structures by selecting four different hyperbolic-type potentials in the axial direction under an axially-applied electric field. We have considered a position-dependent effective mass model in which both the smooth variation of the effective mass in the axial direction adjusted to the way the confining potentials change and its abrupt change in the radial direction have been considered in solving the eigenvalue differential equation. The calculations of the eigenvalue equation have been implemented considering both the Dirichlet conditions (zero flux) and the open boundary conditions (non-zero flux) in the planes perpendicular to the direction of the applied electric field, which guarantees the validity of the results presented in this study for quasi-steady states with extremely high lifetimes. We have used the diagonalization method combined with the finite element method to find the eigenvalues and eigenfunction of the confined electron in the cylindrical quantum dots. The numerical strategies that have been used for the solution of the differential equations allowed us to overcome the multiple problems that the boundary conditions present in the region of intersection of the flat and cylindrical faces that form the boundary of the heterostructure. To calculate the linear and third-order nonlinear optical absorption coefficients and relative changes in the refractive index, a two-level approach in the density matrix expansion is used. Our results show that the electronic and, therefore, optical properties of the structures focused on can be adjusted to obtain a suitable response for specific studies or goals by changing structural parameters such as the widths and depths of the potentials in the axial direction, as well as the electric field intensity.

Theoretical Study of the Exciton Binding Energy and Exciton Absorption in Different Hyperbolic-Type Quantum Wells under Applied Electric, Magnetic, and Intense Laser Fields.

In this study, we investigated the exciton binding energy and interband transition between the electron and heavy-hole for the single and double quantum wells which have different hyperbolic-type potential functions subject to electric, magnetic, and non-resonant intense laser fields. The results obtained show that the geometric shapes of the structure and the applied external fields are very effective on the electronic and optical properties. In the absence of the external fields, the exciton binding energy is a decreasing function of increasing well sizes except for the strong confinement regime. Therefore, for all applied external fields, the increase in the well widths produces a red-shift at the absorption peak positions. The magnetic field causes an increase in the exciton binding energy and provides a blue-shift of the absorption peak positions corresponding to interband transitions. The effect of the electric field is quite pronounced in the weak confinement regime, it causes localization in opposite directions of the quantum wells of the electron and hole, thereby weakening the Coulomb interaction between them, causing a decrease in exciton binding energy, and a red-shift of the peak positions corresponding to the interband transitions. Generally, an intense laser field causes a decrease in the exciton binding energy and produces a red-shift of the peak positions corresponding to interband transitions.

Validity and Reliability of the Turkish Version of the Sydney Swallow Questionnaire.

PURPOSE: This study aimed to assess the validity and reliability of the Turkish version of the Sydney Swallow Questionnaire (SSQ-T) and calculate a cutoff value to help clinicians to suspect/predict oropharyngeal dysphagia (OPD). METHOD: The original questionnaire was translated into Turkish by two bilingual English Turkish translators. The study included 170 Turkish adult subjects. Half of the participants were patients presenting with OPD, and half were healthy controls. Fiberoptic endoscopic evaluation of swallowing (FEES) was administered to all subjects. Patients were evaluated using the Turkish Penetration Aspiration Scale and the Yale Pharyngeal Residue Severity Rating Scale. Additionally, the final version of the SSQ-T questionnaire and the Turkish Eating Assessment Tool were administered to all subjects. RESULTS: Internal consistency was high on all questions (Cronbach's α = .974). Test-retest reliability was also high (intraclass correlation coefficient = .975, p < .001; 95% confidence interval [.948-.988]). The SSQ-T score range was 0-1,240 for all participants, 57-1,240 for the patients with OPD, and 0-152 for the healthy controls. The cutoff value was 174 with 85.96% sensitivity and 99.12% specificity. CONCLUSION: The SSQ-T was demonstrated to be a valid and reliable assessment to assess the self-perceived severity of OPD.

Effects of nasal packing and transseptal suturing on swallowing after septoplasty.

PURPOSE: This clinical trial aimed to investigate the effects of different nasal packing methods and transseptal suture technique on swallowing after septoplasty. METHODS: This randomized prospective study consists of 180 consecutive patients with septal deviation. All the patients underwent septoplasty. All the patients were randomly assigned to three groups. In group A, transseptal sutures were used for septal stabilization. In group B, both nasal passages were packed with Merocel tampons for septal stabilization. In group C, both nasal passages were packed with Doyle silicone splints for septal stabilization. For the evaluation of swallowing, the Eating Assessment Tool (EAT-10) questionnaire and a visual analog scale (VAS) were administered to all the patients preoperatively and on the second and seventh postoperative days. RESULTS: One hundred and twenty two of the patients (67.7%) were female and 58 of them (32.2%) were male. The mean age was 32.41 ± 12.37 years (range: 18-57 years). Both EAT-10 and VAS scores on the second postoperative day were significantly higher than the preoperative scores in all the groups (p < 0.05). The transseptal suture group had significantly lower EAT-10 and VAS scores on the second postoperative day than the Merocel packing and silicone packing groups (p < 0.05). Both EAT-10 and VAS scores on the postop 7th day significantly decreased in all groups compared to the postop second day (p < 0.05). CONCLUSIONS: Septoplasty affects swallowing, regardless of whether a tampon is applied. Transeptal suturing has a lesser effect on swallowing than other techniques. Although silicone packing is a less invasive method, it negatively affects swallowing, similar to Merocel packing. The transseptal suture technique is more comfortable than the other techniques in terms of swallowing function in the postoperative period.

A new halitosis screening tool: halitosis finding score derivation and validation.

OBJECTIVE: The lack of a valid and appropriate halitosis screening survey prompted us to develop and validate a simple, 15-item questionnaire to be used as a screening tool to score halitosis for the daily practise. METHODS: After calculating the sample size, 200 participants were included in the study. All participants filled a 15-item questionnaire with the subsequent measurements of halitosis through the organoleptic scoring system and a halimeter. The application of questionnaire and the halitosis measurements were repeated 15 days after the first control. RESULTS: Mann-Whitney's U test was statistically significant between the halimeter measurements and Halfins scores (p=.000, p<.05). ROC curve is drawn due to halitometer analyses. The cut-off point was determined such as Halfins scores greater than 14 indicated halitosis (65.75 sensitivity, 66.04 specificity). The content validation and concurrent validity were proven successful. CONCLUSIONS: A new halitosis-specific screening tool called Halfins was proven as a valid diagnostic tool for measuring halitosis in the present study. Nevertheless, we believe this questionnaire could be used as complementary tool for the diagnosis of halitosis, seeing as its use alone is not able to firmly conclude the presence of halitosis in all cases, an organoleptic test or VSC assessment would still be necessary.

Dehiscence or thinning of bone overlying the superior semicircular canal in idiopathic intracranial hypertension.

STUDY DESIGN: Retrospective cohort. OBJECTIVES: The objective of the study is to evaluate a relationship between idiopathic intracranial hypertension (IIH) and superior semicircular canal dehiscence (SSCD) of bone overlying the superior semicircular canal (SSC). MATERIALS AND METHODS: A total of 57 (114 ears) individuals, 20 of whom were controls and 37 of whom were IIH, were included in the study. Individuals were evaluated with 0.8 mm slice thickness computed tomography (CT) images for SSC bony roof thickness and SSCD. Thickness of the bony roof over the SSC was graded from Grade 1 to Grade 4. Grade 3 was defined as pre-dehiscence and Grade 4 as dehiscence. RESULTS: Bony roof thickness was 1.25 mm in the control group and 0.76 mm in the IIH group. When bony roof thickness was compared between the groups, it was found to be significantly thinner in the IIH group (p = 0.012). In the IIH group, while dehiscence was detected in 25 of 74 ears, no dehiscence was detected in 49 ears. In the control group, while dehiscence was detected in 5 ears, no dehiscence was detected in 35 ears. The difference is statistically significant (p = 0.015). The correlation between bony roof thickness and cerebrospinal fluid (CSF) pressure in the IIH group was not statistically significant (p = 0.343; rho = 0.110). The correlation between bony roof thickness and age in the IIH group was not statistically significant (p = 0.082; rho = - 0.164). CONCLUSION: Increased CSF pressure in patients with IIH may cause chronic, progressive, and irreversible damage to the bone of the SSC and, according to our study, the rate of SSCD was found to be high in IIH patients.

Evaluation of the Swallowing and Voice Functions in Ankylosing Spondylitis Patients.

This study aimed to evaluate the swallowing and voice functions in patients with ankylosing spondylitis. Thirty patients with ankylosing spondylitis (Group 1) and 30 healthy individuals (Group 2) were included in the study. Following the laryngoscopic evaluation of the patients, the fiberoptic endoscopic evaluation of swallowing was performed, and then, the penetration-aspiration score was determined. The participants were asked to fill the eating assessment tool form. Voice recordings obtained to evaluate sound disorders were measured acoustically and analyzed using the PRAAT program. In terms of swallowing, the penetration-aspiration score obtained as a result of the flexible endoscopic swallowing assessment and eating assessment tool score was found to be higher in Group 1 than in Group 2, and a statistically significant difference was noted (p ≤ 0.001). When analyzing the maximum phonation time (p < 0.001) and fundamental frequency (p = 0.408) values in phonation evaluation, a statistically significant difference was found between the two groups. Group 1 showed a deterioration in terms of jitter (p = 0.040) and shimmer (p = 0.007) compared to Group 2, and a statistically significant difference was noted. There was no statistically significant difference in the harmonic/noise ratio (mean ± standard deviation) between the two groups (p = 0.051). Swallowing and voice functions significantly affect quality of life. Therefore, approaches aimed to improve the associated symptoms have become increasingly important. In patients with ankylosing spondylitis, swallowing quality and phonation ability may be negatively affected. These patients should be monitored for hidden or overt food aspiration.Trial Registry: https://clinicaltrials.gov/ct2/show/NCT04437394.

Comparison of Isotonic Seawater Nasal Spray Containing Chamomile Liquid Extract and Other Isotonic Seawater Nasal Washing Solutions for Allergic Rhinitis.

OBJECTIVE: We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions. METHODS: The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test. RESULTS: The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant (P ≤.001; P ≤ .001; P ≤ .001, and P = .048, respectively). Only Group A and Group B experienced a significant difference in nasal mucociliary clearance times (P ≤ .001; P = .010, respectively). When the Sino-nasal Outcome Test-22 score and nasal mucociliary clearance time differences before and after treatment were compared between all groups, the Sino-Nasal Outcome Test-22 score difference was higher in Group A than in Groups B, C, and D, the differences were found as statistically significant (P = .010; P = .003; P ≤ .001, respectively). The nasal mucociliary clearance time difference was higher in Group A than in Groups C and D, the differences were found as statistically significant (P = .010; P = .001, respectively). CONCLUSION: Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients.

The role of thymic stromal lymphopoietin in the development of chronic otitis media with effusion.

PURPOSE: To investigate the effect of thymic stromal lymphopoietin on the development of chronic otitis media with effusion MATERIALS AND METHODS: This study was conducted on 40 patients who had adenoidectomy operation. The objects were divided into two groups. Group 1; adenoidectomy with chronic serous otitis media, group 2; adenoidectomy without chronic serous otitis media. Serum and tissue thymic stromal lymphopoietin levels were measured by ELISA. Serum and tissue TLSP levels, mast cell count, adenoid size were compared between the groups. RESULTS: Twenty-four (60%) of patients were female and 16 (40%) were male. Twenty patients (55%) had adenoid hypertrophy with chronic serous otitis media, and 18 (45%) had adenoid hypertrophy without chronic serous otitis media. The mean age of the patients was 6.21 ± 2.31 years. The mean mast cell count was significantly higher in group 1 compared with group 2 (p = 0.017). The mean tissue thymic stromal lymphopoietin measurement was also significantly higher in group 1 than group 2 (p = 0.023). However, there was no significant difference in regards to serum levels between the groups (p = 0.480). CONCLUSION: The number of mast cells as well as thymic stromal lymphopoietin levels in the adenoids of children was significantly high in the chronic serous otitis media patients. The release of thymic stromal lymphopoietin from the adenoid tissue plays a role in initiating and maintaining a local inflammatory reaction in the eustachian tube that may lead eventually to middle ear effusion in non-atopic patients.

The effect of platelet-rich fibrin (PRF) on wound healing, adhesion, and hemostasis after endoscopic sinus surgery in patients with nasal polyposis.

PURPOSE: Chronic rhinosinusitis (CRS) is one of the most common chronic diseases seen worldwide. Endoscopic sinus surgery (ESS) has become a widely accepted procedure for medically refractory chronic rhinosinusitis and nasal polyps. Prevention of revision surgery often depends on good wound healing and less adhesion formation. In recent years, the effects of platelet-rich fibrin (PRF) on tissue healing have been addressed in many surgical branches, especially for dental implant surgery and plastic surgery. METHODS: This prospective study was conducted with 50 patients who underwent endoscopic sinus surgery for the diagnosis of nasal polyposis. While the middle meatus in one nasal cavity was filled with PRF and supported with Nasopore, only Nasopore was used in the other nasal cavity middle meatus. The patients were followed up clinically at weeks 1, 2, 3, 4, 8, and 12 postoperatively. The assessor determined the presence of adhesion, crusting, bleeding, frontal ostium stenosis, granulation, and infection, and if present, the grades of these complications were scored according to a questionnaire. RESULTS: In our study, adhesion, infection, bleeding, granulation, and frontal ostium stenosis were less common in the PRF group, and a statistically significant difference was found between the groups. CONCLUSION: In our study, better results were obtained in terms of adhesion, infection, bleeding, granulation, and frontal ostium stenosis after ESS as a result of the effects of PRF on wound healing. The application of PRF is an inexpensive and easy procedure. PRF can be a good alternative to other types of tampons after ESS.

Histopathological Comparison of 2-Octyl Cyanoacrylate and Primary Suturing for Tongue Lacerations.

OBJECTIVE: To enable tongue incisions to be repaired more easily, rapidly, and practically, particularly in pediatric patients by using 2-octyl cyanoacrylate (OCA) tissue adhesive. METHODS: A single linear incision was made on the midline dorsal part of the tongue. Twenty-four rats were randomly divided into the four groups: Group 1 (n = 6), OCA healing at day 5; group 2 (n = 6), OCA healing at day 21; group 3 (n = 6), Vicryl healing at day 5; group 4 (n = 6), Vicryl healing at day 21. In groups 1 and 2, OCA was applied to the incision site. The incisions of the rats in groups 3 and 4 were closed using Vicryl sutures. Histopathological examination was compared between and within the groups at day 5 and 21. RESULTS: The operation duration was significantly shorter with OCA than with Vicryl sutures(P < 0.001). Regarding the histopathological results, there were no differences between group 1 and group 3 in epithelial regeneration, inflammation, fibroblastic activity, edema, presence of giant cells, fibrin deposition, ulceration, abscess formation, and granulation tissue. However, moderate infiltration of acute inflammatory cells was significantly more frequent in group 1 than in group 3. At day 5, the incidence of moderate foreign body residue was significantly higher in group 1 than in group 3. No difference was observed between group 2 and group 4 at day 21 (P > 0.05). CONCLUSION: OCA is a practical, rapid, and effective method for repairing tongue lacerations. Although infiltration by inflammatory cells and foreign bodies increased in the early period, the long-term results of OCA were indistinguishable from those of suturing.

[Short term olfactory memory and olfactory function after inhalation anesthetic agents: a randomized clinical trial]. / Memória olfativa de curta duração e função olfativa após anestésicos inalatórios: estudo clínico randomizado.

BACKGROUND AND OBJECTIVES: This clinical trial aimed to evaluate the effects of two different inhalation anesthetic agents on postoperative olfactory memory and olfactory function in patients who underwent micro laryngeal surgery. METHODS: This randomized prospective controlled study consisted of 102 consecutive patients with a voice disorder. The patients underwent micro laryngeal surgery for voice disorders under general anesthesia. Patients who did not meet inclusion criteria and/or declined to participate (n=34) were excluded from the study. Patients were divided into two groups. Four patients from Group 1 and four patients from Group 2 were lost to follow-up. Group 1 (n=30) received sevoflurane, and Group 2 (n=30) received desflurane during anesthesia. We compared the results by performing the pre-op and post-op Connecticut Chemosensory Clinical Research Center Olfactory test. RESULTS: Thirty-three patients (55%) were male and 27 (45%) were female. The mean age was 48.18±13.88 years (range: 19-70 years). Preoperative and postoperative olfactory functions did not show a significant difference within the groups postoperatively (p> 0.05). Preoperative and postoperative olfactory memory showed a significant decrease 3hours after the surgery (p <0.05). CONCLUSIONS: Olfactory functions and memory were not affected by desflurane in the early postoperative period. Although sevoflurane did not affect olfactory functions, it had a temporary negative effect on olfactory memory in the early postoperative period.

Short term olfactory memory and olfactory function after inhalation anesthetic agents: a randomized clinical trial / Memória olfativa de curta duração e função olfativa após anestésicos inalatórios: estudo clínico randomizado

Abstract Background and objectives: This clinical trial aimed to evaluate the effects of two different inhalation anesthetic agents on postoperative olfactory memory and olfactory function in patients who underwent micro laryngeal surgery. Methods: This randomized prospective controlled study consisted of 102 consecutive patients with a voice disorder. The patients underwent micro laryngeal surgery for voice disorders under general anesthesia. Patients who did not meet inclusion criteria and/or declined to participate (n = 34) were excluded from the study. Patients were divided into two groups. Four patients from Group 1 and four patients from Group 2 were lost to follow-up. Group 1 (n = 30) received sevoflurane, and Group 2 (n = 30) received desflurane during anesthesia. We compared the results by performing the pre-op and post-op Connecticut Chemosensory Clinical Research Center Olfactory test. Results: Thirty-three patients (55%) were male and 27 (45%) were female. The mean age was 48.18 ± 13.88 years (range: 19‒70 years). Preoperative and postoperative olfactory functions did not show a significant difference within the groups postoperatively (p > 0.05). Preoperative and postoperative olfactory memory showed a significant decrease 3 hours after the surgery (p < 0.05). Conclusions: Olfactory functions and memory were not affected by desflurane in the early postoperative period. Although sevoflurane did not affect olfactory functions, it had a temporary negative effect on olfactory memory in the early postoperative period.

Resumo Introdução e objetivos: O estudo avaliou o efeito pós-operatório de dois agentes anestésicos inalatórios distintos na memória olfativa de curta duração e na função olfativa em pacientes submetidos à microcirurgia de laringe. Método: O estudo prospectivo controlado randomizado avaliou, consecutivamente, 102 pacientes com alteração vocal submetidos à microcirurgia de laringe sob anestesia geral. Trinta e quatro pacientes não obedeceram aos critérios de inclusão e/ou não aceitaram participar do estudo e foram excluídos. Os pacientes foram divididos em dois grupos. Quatro pacientes do Grupo 1 e quatro do Grupo 2 foram perdidos durante o seguimento. O Grupo 1 (n = 30) recebeu sevoflurano durante a anestesia e o Grupo 2 (n = 30), desflurano. Comparamos resultados pré e pós-operatórios de memória olfativa e funções olfativas, realizando o Connecticut Chemosensory Clinical Research Center Olfactory test. Resultados: Foram incluídos um total de 33 (55%) homens e 27 (45%) mulheres. A idade média foi 48,18 ± 13,88 anos (variação: 19-70 anos). As funções olfativas pré e pós-operatórias não apresentaram diferença estatisticamente significante dentro dos grupos no pós-operatório (p > 0,05). A memória olfativa pré e pós-operatória não mostrou diminuição estatisticamente significante quando avaliada três horas após a cirurgia (p< 0,05). Conclusões: Memória e funções olfativas não foram alteradas pelo desflurano no pós-operatório imediato. Embora o sevoflurano não tenha alterado as funções olfativas, causou efeito temporário negativo na memória olfativa no pós-operatório imediato.

A simple method to reduce halitosis; tongue scraping with probiotics.

OBJECTIVE: We aimed to assess the effects of probiotic implantation to the dorsum of the tongue against halitosis. MATERIALS AND METHODS: 100 participants were randomly divided into three groups as tongue back scraping (TS), probiotic implantation to the dorsum of the tongue (PB) and mouthwash alone as the control group (MW). Measurements were taken before the treatment, after the first month of treatment and one month after the cessation of treatment. RESULTS: Halimeter, winkel and woodlight scores were evaluated initially, in the first month and after the cessation of the treatment. All of MW measurements showed no difference throughout the study. All of TS measurements decreased significantly in the first month (p < 0.05) but rose again in the final count. All of PB measurements significantly decreased in the first month and kept their low levels after the cessation of the treatment (p < 0.05). CONCLUSION: Probiotics and tongue scraping are widely used against halitosis but they are not intended to be used together. In this study, we proposed and proved an effective method of probiotic implantation by tongue scraping and showed that halitosis did not recur after the cessation of the treatment.

Preservation of Autogenous Septal Cartilage for Revision Surgery.

The aim of this study is to find the ideal solution and the optimum temperature to protect the viability of the cartilage graft. This randomized prospective study consists of 30 patients with septal deviation. All patients had septoplasty operation for chronic nasal obstruction. Ten strips of cartilages were prepared from each excised septum and then immersed in formalin, alcohol (96%), saline (0,9%), gentamicin (80 mg), and cefazolin sodium (Cezol 1gr) solutions in a total of 300 vials. Those vials were stored for 6 months at both +4°C and -18°C temperatures. Two groups were compared with each other. 22 cases were male (73%) and 8 patients were female (7%). The age range was between 20 and 48 (average 25.34 ±â€Š4.09 years). Parameters at +4°C; the cartilage volume was not significantly different among the solutions (P >0.05). Necrosis was significantly lower in the alcohol (46.7%) compared to other solutions (P = 0.001). Calcification was lower in the gentamicin group (56.7%). The loss of metachromasia was lower in the alcohol solutions (P = 0.000). Parameters at -18°C; the loss of metachromasia was higher in the gentamicin group (56.7%) than the other solutions (P = 0.003). The authors observed no significance in the rates of necrosis, calcification, metaplasia, inflammation, vascularity, or fibrosis among the solutions (P >0.05). Less necrosis and metachromosis loss in the alcohol solution indicated that alcohol was more suitable for preservation of the cartilage. In addition, temperature degree for the preservation of the cartilage did not show any significant differences.