Relationships of orexigenic and anorexigenic hormones with body fat distribution in patients with obstructive sleep apnea syndrome.

PURPOSE: We aimed to examine the relationships of disease activity and risk factors with serum levels of orexigenic and anorexigenic hormones in patients with obstructive sleep apnea syndrome (OSAS). METHODS: Fasting blood samples were taken for hormonal analysis of all participants, abdominal/neck bioimpedance measurements were recorded, and polysomnography (PSG) analyses were performed. According to the apnea-hypopnea index (AHI), 34 patients with newly diagnosed OSAS and 34 participants without OSAS were compared. RESULTS: The median body mass index (BMI) measured in the OSAS group was 30.39 kg/m2 and AHI was 18.95 and these values were 25.40 kg/m2 and 1.55 in the control group. There was a higher level of visceral adiposity and neuropeptide Y (NPY) in the moderate-to-severe OSAS group compared to the mild OSAS and control groups, and in the mild OSAS group compared to the control group (p = 0.001, p < 0.001). A positive correlation between the level of NPY and AHI and BMI (p < 0.001, p = 0.011), and a negative correlation between NPY levels and oxygen saturation (p = 0.001) was found. Oxygen saturation and desaturation rates were correlated with body fat percentage, body fat mass, abdominal adiposity, visceral adiposity, resting metabolic rate, and NPY levels. CONCLUSIONS: The visceral adiposity ratio and increase in NPY levels are important parameters that increase the severity of OSAS. Considering the negative effects of NPY on vascular endothelium, measurement of basal NPY level before PSG in patients with OSAS is considered a parameter related to disease severity.

Sinonasal SMARCB1 (INI1) Deficient Carcinoma with Yolk Sac Tumor Differentiation: A Case Report and Treatment Options.

SMARCB1 (INI1) deficient carcinoma (SDC) is a newly-described, aggressive, high-grade malignancy of the adult population. Rarely, these tumors demonstrate yolk sac differentiation. Treatment protocols are not defined due to the rarity of this entity. A 55 year-old-male presented with a tumor originating in the maxillary sinus. He was treated with neoadjuvant therapy followed by radical surgery and adjuvant treatment. We review the literature and discuss the course of disease and treatments of sinonasal SDC with yolk sac tumor differentiation. To our knowledge, this is the sixth reported case of sinonasal SDC with yolk sac tumor differentiation. This is the first publication describing the clinical course and efficacy of therapeutic interventions.

Cochlear Implantation in Chronic Otitis Media with and without Cholesteatoma: Surgical Considerations and Auditory Outcomes.

INTRODUCTION: Cochlear implant (CI) surgery is a safe and standardized procedure in the presence of normal temporal bone anatomy. However, in the surgery of patients with chronic otitis media (COM), the surgeon may encounter several problems. The aim of this study was to evaluate the impact of COM with and without cholesteatoma on surgical and auditory outcomes of CIs. METHODS: The study group consisted of 39 patients with COM who received CIs. Age- and gender-matched 38 standard CI patients served as controls. The surgical techniques and complications, pure tone audiometry (PTA) scores, speech discrimination scores (SDS), and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire results of the groups were compared. RESULTS: The presence of COM was associated with a higher rate of complication than controls. Staging the surgeries, presence or absence of cholesteatoma, and type of surgical technique were not associated with surgical outcomes and complications (p > 0.05). There was no significant difference between the groups in terms of postoperative PTA scores, SDS, and IOI-HA scores (p > 0.05). CONCLUSION: Postoperative complications like device failure and skin breakdown are increased in cases of COM compared to standard CI surgeries. However, that increase is not associated with staging the surgeries, presence or absence of cholesteatoma, and type of ear surgery performed. It is advocated to close the external ear canal and eustachian tube without mastoid obliteration in the presence of a radical mastoidectomy cavity, which will decrease the postoperative complication rates and allow for radiological follow-up with computed tomography for the possibility of cholesteatoma recurrence. The auditory benefits of CI in patients with and without COM are comparable.