Comprehensiveness of online sources for patient education on otosclerosis.

Purpose: This study aimed to assess the readability indices of websites including educational materials on otosclerosis. Methods: We performed a Google search on 19 April 2023 using the term "otosclerosis." The first 50 hits were collected and analyzed. The websites were categorized into two groups: websites for health professionals and general websites for patients. Readability indices were calculated using the website https://www.webfx.com/tools/read-able/. Results: A total of 33 websites were eligible and analyzed (20 health professional-oriented and 13 patient-oriented websites). When patient-oriented websites and health professional-oriented websites were individually analyzed, mean Flesch Reading Ease scores were found to be 52.16 ± 14.34 and 46.62 ± 10.07, respectively. There was no significant difference between the two groups upon statistical analysis. Conclusion: Current patient educational material available online related to otosclerosis is written beyond the recommended sixth-grade reading level. The quality of good websites is worthless to the patients if they cannot comprehend the text.

Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome / Acompanhamento em longo prazo da eficácia da tonsilectomia em crianças com síndrome de PFAPA

Abstract Introduction: The role of tonsillectomy in the periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome, is controversial. Although some studies reported high success rates with tonsillectomy, further investigations are needed with larger numbers of patients. Objective: To seek the long-term outcomes of tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome. Methods: Case series; multi-center study. The study comprised 23 patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome who underwent surgery (tonsillectomy with or without adenoidectomy) between January 2009 and November 2014. Results: 21 (91%) of 23 patients had complete resolution immediately after surgery. One patient had an attack 24 h after surgery, but has had no further attacks. One patient had three attacks with various intervals, and complete remission was observed after 3 months. Conclusions: Tonsillectomy is a good option for the treatment of periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome.

Resumo Introdução: O papel da tonsilectomia na síndrome da febre periódica, estomatite aftosa, faringite e adenite é controverso. Embora alguns estudos tenham relatado altas taxas de sucesso com a tonsilectomia, são necessárias mais pesquisas com um número maior de pacientes. Objetivo: Avaliar os resultados em longo prazo da tonsilectomia na síndrome de febre periódica, estomatite aftosa, faringite e adenite. Método: Série de casos; estudo multicêntrico. O estudo avaliou 23 pacientes com síndrome de febre periódica, estomatite aftosa, faringite e adenite submetidos a cirurgia (tonsilectomia com ou sem adenoidectomia) entre janeiro de 2009 e novembro de 2014. Resultados: Dos 23 pacientes, 21 (91%) apresentaram resolução completa imediatamente após a cirurgia. Um paciente apresentou um episódio 24 horas após a cirurgia, mas sem recorrência posterior. Um paciente teve três episódios com vários intervalos e a remissão completa foi observada após 3 meses. Conclusões: A tonsilectomia é uma boa opção para o tratamento da síndrome de febre periódica, estomatite aftosa, faringite e adenite.

Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome.

INTRODUCTION: The role of tonsillectomy in the periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome, is controversial. Although some studies reported high success rates with tonsillectomy, further investigations are needed with larger numbers of patients. OBJECTIVE: To seek the long-term outcomes of tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome. METHODS: Case series; multi-center study. The study comprised 23 patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome who underwent surgery (tonsillectomy with or without adenoidectomy) between January 2009 and November 2014. RESULTS: 21 (91%) of 23 patients had complete resolution immediately after surgery. One patient had an attack 24h after surgery, but has had no further attacks. One patient had three attacks with various intervals, and complete remission was observed after 3 months. CONCLUSIONS: Tonsillectomy is a good option for the treatment of periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome.

Anatomical and functional long-term results of endoscopic butterfly inlay myringoplasty.

PURPOSE: The aim of this study was to evaluate the long-term anatomical (graft success) and functional (audiological) results of endoscopic butterfly inlay myringoplasty. METHODS: The files of 56 patients (29 female, 27 male) who were diagnosed with noncomplicated chronic otitis media and underwent endoscopic butterfly inlay myringoplasty in 2014-2016 at a tertiary referral center were reviewed. Age, gender, follow-up time, perforation location (anterior, posterior and central), perforation size (small, medium), pre- and postoperative pure tone audiometry (PTA) thresholds, pre- and postoperative air-bone gaps (ABG) and complications were noted. RESULTS: Graft success rate was 98.2% in postoperative 12th month and 94.6% in postoperative 24th month. In all patients, mean PTA for air conduction was 35.2 ± 3.9 dB preoperatively and 27.5 ± 4.3 dB in postoperative 6th month, 25.1 ± 3.5 dB in postoperative 12th month and 20.4 ± 3.2 in postoperative 24th month. Preoperative mean ABG was 24.2 ± 3.8 dB, whereas 19.5 ± 4.3 dB 6 months after surgery, 17.1 ± 3.5 dB 12 months after surgery and 12.4 ± 3.1 dB 24 months after surgery. There was significant difference between pre- and postoperative PTA and ABG in all 6th, 12th, 24th month follow-up (p = 0.001 for all measurements). Three patients (5%) had myringitis after surgery. Two patients (3%) had total graft resorption. CONCLUSION: We suggested that endoscopic butterfly inlay myringoplasty is a safe surgical method with high graft success and effective hearing reconstruction. Follow-up is necessary for at least 2 years for precise anatomical and functional evaluation of the surgery.

Is neutrophil-lymphocyte ratio associated with the severity of allergic rhinitis in children?

Neutrophil lymphocyte ratio (NLR) could be an important measure of systemic inflammation. There is a lack of knowledge about the neutrophil-lymphocyte ratio in rhinitis. We aimed to determine the relationship between the clinical parameters of allergic rhinitis and NLR in children. 438 children who were diagnosed with allergic rhinitis and followed up in our hospital were included in the study. The control group included 180 control children with no evidence of allergic disease. The immunoglobulin E levels, skin prick tests and complete blood count were measured. Mean NLR was 1.77 ± 1.67 in the study group and 1.70 ± 1.65 in the control group. Mean NLR was significantly higher in children with allergic rhinitis compared to controls (p < 0.05). The patients with allergic rhinitis were grouped according to the severity of AR as Group I (mild group) and Group II (moderate/severe group). No statistically significant difference was present between groups in terms of gender, age, familial atopy, exposure to smoke, the presence of asthma and/or eczema, the percentage of eosinophil, serum IgE levels, number of positive sensitivity, and sensitivity to allergens (p > 0.05). However, NLR was significantly higher in the moderate/severe AR compared to mild AR (p < 0.05). Mean NLR was statistically higher in children with allergic rhinitis compared to the control group. In addition, elevated ratio is associated with the severity of allergic rhinitis in children. Neutrophil-lymphocyte can be used as an indicator of inflammation in allergic rhinitis. But further studies are needed in this issue.

Adenoid hypertrophy in children with allergic disease and influential factors.

OBJECTIVES: Adenoid hypertrophy (AH) may cause several comorbid conditions including sleep apnea, chronic serous otitis and sinusitis. Such conditions are more common among children with allergic diseases. In our study, we aimed to determine the patient profile associated with higher incidence of adenoid hypertrophy and the related influential factors. METHODS: The study included 1322 children being treated and followed up for allergic conditions. 100 children with no allergic diseases presenting during the same period to the clinic were included as the control group. Skin prick test for the same allergens was performed for all patients. Adenoid tissue was analyzed by an ENT specialist and the diagnosis was confirmed based on the patient history, endoscopic physical examination and radiology. RESULTS: Of the patients, 765 (57.9%) were males and 557 (42.1%) were females and their mean age was 5.9±3.3 years. In the control group, 56 (56%) children were males and 44 (44%) were females and their mean age was 6.3±4.1 years. Children with allergic disease and control subjects did not differ significantly by age and gender. Adenoid hypertrophy was identified in 164 (12.4%) of the patients with allergic disease and in 3 (3%) of the controls. Allergic children were divided into two groups, as children with and without AH, respectively. The groups did not differ statistically significantly by gender, age or familial history of atopic disease. However, cigarette smoke exposure at home and presence of allergic rhinitis was significantly more frequent in the group of patients with AH. In the logistic model investigating the effect of variables on AH presence (according to age, gender, cigarette smoke exposure, asthma, AR, AD presence, atopy presence, sensitivity to house dust, pollen, epithelium, Alternaria alternata and cockroach), AR presence and cigarette smoke exposure were statistically significant. CONLUSIONS: AH frequency is higher in children with allergic disease compared to controls. The most common sensitivity to allergens among patients with AH was to house dust. Presence of allergic rhinitis and cigarette smoke exposure are risk factors for developing AH. Children with these risk factors should be questioned for AH during their routine examinations.

The role of drug-induced sleep endoscopy in surgical planning for obstructive sleep apnea syndrome.

This study investigated the role of drug-induced sleep endoscopy (DISE) in the surgical treatment planning of patients with obstructive sleep apnea syndrome (OSAS). This study was conducted using patients diagnosed with OSAS between January 2007 and March 2009, who were scheduled for surgical treatment. DISE was performed using propofol in patients considered to have upper respiratory tract obstruction as indicated by Muller's maneuver. After completing the sleep endoscopy, the patient was intubated and surgery was performed (tonsillectomy and uvulopalatopharyngoplasty). A successful operation was defined as a decrease in the respiratory disturbance index to below 5 or a decrease of ≥50 % following the operation. The study included 20 patients (4 female and 16 male) aged 19-57 years. No statistically significant correlation between modified Mallampati class and operation success or between the polysomnographic stage of disease and operation success was identified. A significantly high operation success rate was found in the group with obstruction of the upper airway according to DISE (p < 0.05), whereas a significantly low operation success rate was found in the group with obstruction of the lower airway according to DISE (p < 0.01). DISE may be used to identify the localization of obstruction for diagnostic purposes, and it can be helpful in selecting the treatment method.

Effectiveness of intratympanic dexamethasone for refractory sudden sensorineural hearing loss.

The purpose of this study was to investigate the effectiveness of intratympanic steroids in patients with idiopathic sudden sensorineural hearing loss who did not respond to initial systemic steroid therapy. This retrospective study involved 51 patients, who did not respond to systemic steroids as a first-line treatment. Initial systemic steroid therapy consisted of administration of methylprednisolon intravenously (250 mg) at the first day and followed by orally (1 mg/kg) tapering for 14 days. Twenty-one patients accepted intratympanic treatment, and the remaining 30 patients who refused intratympanic treatment were evaluated as the control group. Steroids (dexamethasone drops, 1 mg/mL) were administered through a ventilation tube. Hearing was assessed immediately before treatment and 2 months after treatment. Recovery of hearing was defined as an improvement of >20 dB in the pure tone average. We tested 250, 500, 1,000, 2,000, 4,000, and 8,000 Hz frequencies for the pure tone audiometric evaluation. Statistically Student's t test, Mann-Whitney U test, Chi-squared and Fisher's exact tests were used. The pure tone average improved in 47.6% of the intratympanic group and in 10% of the control group (p = 0.002), with pure tone average improvements of 19.9 ± 16.5 and 4.76 ± 9.6 dB in the intratympanic and control groups, respectively. When the hearing threshold at each frequency was analyzed, improvements at all frequencies were significantly greater in the intratympanic steroid group when compared with the control group (p < 0.01). Intratympanic steroid administration is an effective therapy for sudden sensorineural hearing loss in patients, who are refractory to primary systemic steroid therapy.