Assessment of the relationship between polysomnography parameters and plasma malondialdehyde levels in patients with obstructive sleep apnea.

PURPOSE: The relationship of plasma malondialdehyde (MDA) with major parameters of PSG was investigated to find out if there was a correlation between these variables. METHODS: Polysomnograms were done on a total of 37 adults who do not have a history of any systemic illness, smoking, and supplement use. Plasma MDA measurements and their relationship with PSG parameters were analyzed. RESULTS: The mean MDA concentrations in patients with lower AHI values were also lower than those in the patients with higher AHI (p < 0.001). Higher predominance of apnea in patients with similar AHI values, longer mean apnea durations, O2 saturation dips to < 90%, and higher ODI values predicted higher plasma MDA concentrations. CONCLUSIONS: Higher oxidative stress measurements predicted more severe clinical picture. These findings show that oxidative stress measurement with MDA may provide a simple tool to screen patients for OSA and help select them for PSG study appropriately, if indicated.

The status of the middle turbinate and the risk of sinusitis after endoscopic transnasal sphenoidotomy.

The objectives of this study are to evaluate the occurrence of postoperative middle turbinate lateralization and the relationship between this lateralization and the risk of iatrogenic sinusitis after endoscopic transnasal sphenoidotomy procedure. Patients who undergone endoscopic transnasal sphenoidotomy and came under the surveillance of our otorhinolaryngology department between the January of 2010 and the December of 2015 were retrospectively scanned. Among them, the patients who were evaluated with paranasal sinus computed tomography (CT) postoperatively were included in the study. The amount of middle turbinate lateralization in each patient was evaluated by comparing their routine preoperative CT image with the postoperative CT image. The air-fluid levels or soft tissue opacifications in the sinuses or obstruction of the ostiomeatal complex were accepted as the evidence of sinusitis on the images. The patients were asked questions regarding their symptoms of sinusitis on a phone interview for the statistical evaluation of their preoperative and postoperative Visual Analog Scale scores of complaints of sinusitis. The difference between preoperative and postoperative measurements was found to be statistically significant (p < 0.001, 95% CI). The middle turbinate position was lateralized in 31 patients (81.6%), medialized in four patients (10.5%), and remained unchanged in three patients (7.9%). Overall, the sinus opacification and mucosal thickening rates did not change significantly which suggested the operation did not pose patients at increased risk of sinusitis. Mean VAS scores of complaints of sinusitis did not change significantly except for sensation of facial pressure, which showed a minor but statistically significant decrease (p < 0.001). This study revealed the lateralization of the middle turbinate after transnasal sphenoidotomy. However, it seemed that this lateralization did not create a predisposing factor for the development of acute and chronic sinusitis.

The reliability and validity of the Turkish version of the Facial Disability Index.

PURPOSE: To translate and cross-culturally adapt the Turkish version of the Facial Disability Index (FDI) and evaluate its psychometric properties, including reliability and validity. METHODS: Translation of the original FDI was followed by international guidelines. Paralysis classification was evaluated with House-Brackman Rating System (HBGS). Patients completed Short Form-36 (SF-36) along with the Turkish version of the FDI and refilled the Turkish FDI one week later. Internal consistency and test-retest reliability were analyzed using Cronbach's alpha coefficient and intraclass correlation coefficient (ICC), respectively. Construct validity was assessed by calculating the Spearman's correlation coefficient. Also, exploratory factor analysis was carried out by identifying the factor structure of the scale. RESULTS: After the pre-test of the Turkish FDI, there was no need for linguistic and cultural adaptation. The internal consistency of the physical function subscale was high (0.82). The social/well-being subscale's Cronbach alpha (0.63) was within the acceptable range. Test-retest reliability was excellent (ICC of physical function = 0.91 and social/well-being = 0.93, p < 0.05). The physical function subscale was correlated with the PF subscale of SF-36 and HBGS (r = -0.837 and 0.292, respectively; p < 0.05). Besides, the social/well-being function subscale was correlated with HBGS and all subscales of SF-36, except RP (p < 0.05). Factor analysis results of the Turkish FDI were similar to the other version studies. CONCLUSION: The Turkish version of the FDI is a valid and reliable questionnaire in patients with peripheral facial paralysis.IMPLICATIONS FOR REHABILITATIONThe Turkish version FDI is the first Turkish tool translated cross-culturally adapted for specific assessment of facial paralysis.The Turkish version of the FDI is a valid and reliable questionnaire and can be used in all native Turkish speaking patients in peripheral facial paralysis.This assessment tool can be used in clinical routine and research settings to evaluate facial paralysis.

Cochlear Implantation in Neurobrucellosis.

BACKGROUND: Neurobrucellosis is a disease consisting of a wide spectrum of complications such as peripheral neuropathy, cranial nerve involvement, ataxia, meningeal irritation, paraplegia, seizures, coma, and even death. The vestibulocochlear nerve seems to be the most commonly affected cranial nerve (10%). We present a patient with neurobrucellosis whose auditory perception and speech intelligibility skill performances improved after cochlear implantation. CASE REPORT: A 35 year-old woman was admitted to another hospital 2 years ago with the symptoms of headache, nausea, and altered consciousness, who was finally diagnosed with neurobrucellosis. She developed bilateral profound sensorineural hearing loss during the following 6 months. There was no benefit of using hearing aids. After successful treatment of her illness, she was found to be suitable for cochlear implantation. After the operation, her auditory perception skills improved significantly with a Categories of Auditory Performance (CAP) score of 5. According to clinical observations and her family members' statements, her Speech Intelligibility Rating (SIR) score was 3. Her speech intelligibility skills are still improving. CONCLUSION: Our case report represents the second case of hearing rehabilitation with cochlear implantation after neurobrucellosis. Cochlear implantation is a cost-effective and time-proven successful intervention in post-lingual adult patients with sensorineural hearing loss. Early timing of the surgery after appropriate treatment of meningitis helps the patient to achieve better postoperative results.