The importance of bone density and anatomical structure in superior semicircular canal dehiscence.

OBJECTIVE: This study investigates the importance of bone density, surface area, and diameter of anatomical structures of the superior semicircular canal (SSC), lateral semicircular canal (LSC), posterior semicircular canal (PSC), utricle, and saccule in patients diagnosed with superior semicircular canal dehiscence (SSCD). MATERIALS AND METHODS: The bone density, surface area, and diameter of SSC, LSC, PSC, utricle, and saccule were measured and compared between the SSCD group and control group. Fifteen ears in the SSCD group and 60 ears in the control group were evaluated. Additionally, within the SSCD group, the dehiscent and healthy sides were evaluated independently. RESULTS: SSC's bone density was significantly lower in the SSCD group compared to the control group (p = 0.008). No significant differences were found in surface area and diameter between the groups (p > 0.05). While most of the anatomical structures showed no significant difference in bone density between dehiscent and healthy ears (p > 0.05), SSC bone density was significantly lower in affected ears (p = 0.000) in SSCD group. CONCLUSION: Based on the data obtained in this study, bone density and anatomical structure may be useful in patients diagnosed with SSCD.

A Novel Technique for Septal Perforation Repair: Fascia Lata Graft.

BACKGROUND: Nasal septal perforation (NSP) is an anatomical defect involving the mucosa, cartilage/bone of the nasal septum, most commonly caused by septoplasty. Spontaneous healing of a perforated septum is rare; instead, it tends to worsen over time. Several surgical approaches have been described for NSP repair. In this study, the authors present a novel technique using only fascia lata graft for repairing NSP of various sizes. METHODS: The authors conducted a retrospective study, including 23 patients who underwent NSP repair between January 2020 and January 2022. Grafts were harvested, and the perforation was accessed through an open rhinoplasty approach, followed by insertion and suturing of the graft. RESULTS: The mean size of the septal perforations was 2.13 mm horizontally and 2.14 mm vertically. The mean follow-up period was 12 months. Complete closure of NSP was achieved in 21 out of 23 patients (91.30%). Among the cases, 17 were males (11.76%), and the age ranged from 20 to 43 years with a mean of 36.5. Eight cases (50%) were smokers. At 12 months postoperatively, 3 medium-sized NSPs were closed successfully, whereas 2 large NSPs did not achieve closure due to smoking. CONCLUSION: The fascia lata technique for NSP closure is a safe and reliable approach with a high success rate, which should be considered for patients with NSP.

Comparison of COVID-19 laboratory diagnosis by commercial kits: Effectivity of RT-PCR to the RT-LAMP.

Coronavirus disease 2019 or COVID-19 caused by novel coronavirus/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV) is an ongoing pandemic that has emerging global effects and requires rapid and reliable diagnostic testing. Quantitative reverse transcription-polymerase chain reaction (q-RT-PCR) is the gold standard method for SARS-CoV-2 detections. On the other hand, new approaches remedy the diagnosis difficulties gradually. Reverse transcription loop-mediated isothermal amplification (RT-LAMP) as one of these novel approaches may also contribute to faster and cheaper field-based testing. The present study was designed to evaluate this rapid screening diagnostic test that can give results in 30-45 min and to compare the effectiveness of LAMP to the q-RT-PCR. The 30 randomly chosen patient samples were generated by nasopharyngeal swabs with a portion of the SARS-CoV-2 nucleic sequence. The sample of quantification cycle (Cq) values was tested using RT-LAMP as well as by conventional q-RT-PCR. The patient samples were tested with four different kits (SENSObiz COVID-19 [SARS-CoV-2] LAMP Assay, the QIAseq DIRECT SARS-CoV-2 kit, Biospeedy SARS-CoV-2 Variant Plus kit, and CoVirion-CV19-2 SARS-CoV-2 OneStep RT-PCR kit) and two different PCR devices (GDS Rotor-Gene Q Thermocycler and Inovia Technologies GenX series). Based on 30 patient samples, the positive/negative ratio (P/N) was 30/0 as Biospeedy and Covirion (positivity 100%), 28/2 as Qiagen kit (positivity 93.3%) for the samples studied on the Inovia device while the same samples on the Rotor-Gene device were 30/0 as Biospeedy and Covirion (positivity 100%), 29/1 as Qiagen kit at the first day (96.7%). On the fifth day, the samples were studied in the Inovia device and the respective results were obtained: 27/3 as Biospeedy (positivity 90%), 16/14 as Qiagen (positivity 53.3%), 28/2 as Covirion kit (positivity 93.3%). When these samples were studied in the Rotor-Gene device, it was 29/1 in Biospeedy and Covirion (positivity 96.7%), 19/11 in the Qiagen kit (positivity 63.3%). When these samples were compared with the LAMP method it was found to be 19/11 (positivity 63.3%) on the first day and 18/12 (positivity 60%) on the fifth day. SARS-CoV-2 test studies will contribute to a proactive approach to the development of rapid diagnosis systems. The LAMP approach presents promising results to monitor exposed individuals and also improves screening efforts in potential ports of entry.

Validity and Reliability of the Turkish Translation of the Yale Pharyngeal Residue Severity Rating Scale.

This study aimed to assess the validity and reliability of the Turkish translation of the Yale pharyngeal residue severity rating scale. The scale measures the severity of residue in the vallecula and pyriform sinus. The original scale was translated into Turkish by two bilingual English-Turkish translators, and the Turkish version was translated back into English by two qualified professional translators to assess accuracy. The evaluators were divided into two groups (training and no-training) and two subgroups according to their experience. Intra-rater, inter-rater, and intra-class correlation coefficient measurements were analyzed by calculating agreement rates, kappa, and p values. In the analysis of the reliability, intra-class correlation coefficient values in the overall ratings for both the vallecula and the pyriform sinus were 0.9996 (95% CI 0.9992-0.9998) and 0.9997 (95% CI 0.9995-0.9999), respectively (p < 0.01). High agreement (> 95%) and perfect Fleiss kappa values were obtained for the vallecula and pyriform sinus ratings in the inter-rater initial assessments (κ = 0.959 and κ = 0.967, respectively). Perfect kappa values were found in the intra-rater results for both the vallecula and pyriform sinus (α = 0.9959 and κ = 0.9959, respectively). In the inter-rater secondary analysis, the vallecula and pyriform sinus kappa values were perfect (κ = 0.959 and κ = 0.967, respectively). In the intra-rater analysis, perfect kappa values were obtained for the vallecula and pyriform sinus in the no-training group and less-experience subgroup (κ = 0.9918 and κ = 1.0 for the vallecula, and κ = 1.0 and κ = 0.9902 for the pyriform sinus, respectively) In the inter-rater analysis, perfect kappa values were obtained for the vallecula and pyriform sinus in the no-training group and less-experience subgroup (κ = 0.9507 and κ = 0.9606 for the vallecula, and κ = 0.9836 and κ = 1.0 for the pyriform sinus, respectively). The Turkish translation of the Yale pharyngeal residue severity rating scale demonstrated high validity and reliability scores in determining pharyngeal residue location and value in the fiberoptic endoscopic evaluation of swallowing.

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.

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.

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.

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.

Analysis of snoring to determine the site of obstruction in obstructive sleep apnea syndrome.

BACKGROUND: The aim of this study was to integrate the physical findings of drug-induced sleep endoscopy with snoring sound analysis in patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and to compare the findings with previously published data. METHODS: This was a prospective, non-randomized study. Participants were all candidates for surgical treatment of OSAS and formed three groups, retropalatal (RP) obstructions, retrolingual (RL) obstructions, and multilevel (ML) obstructions. At the time of DISE, recordings of concurrent snoring sounds were made. Mean pitch frequency, peak sound frequency, and fundamental frequency (Fo) components were determined. RESULTS: A total of 55 participants had mean age 46.2 ± 7.3 years, mean BMI 30.0 ± 3.7 kg/m2, and included 11 women (20%). Differences in mean pitch frequency, Fo, and peak sound frequency were all statistically significant between the RP and RL (p = 0.001), between ML and RL (p = 0.025) but were not significantly different between RP and ML. Mean pitch frequency of RP was lower than RL, and ML frequency was between RL and RP. The sound analysis graphics revealed RP waves with sharp peaks and lower frequencies and RL with smooth curves and higher frequencies. ML showed irregular patterns. Mean pitch frequency of RL was always above 400 Hz, whereas RP was below this value. CONCLUSIONS: It is feasible to apply sound analysis to determine the site of obstruction during DISE. Combining the data may help surgeons make more accurate assessments of the pattern of the disease.

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.

Comparison of Nasoseptal Cartilage Graft Versus Titanium Mesh in Reconstruction of Pure Orbital Blowout Fractures.

PURPOSE: To compare the efficacy of nasoseptal cartilage grafts versus titanium mesh implants in pure orbital blowout fractures. METHODS: A retrospective review was performed on 48 patients who had surgical repair of an orbital fracture. Patients who underwent pure orbital blowout fracture repair with either nasoseptal cartilage grafts or titanium mesh implants and at least 1 year postoperative follow-up were included in the study. The clinical features and treatment outcomes were analyzed. RESULTS: Twenty-five patients fulfilled our study criteria and were included in the analyses. Nasoseptal graft was used in 12 patients (48%) while titanium mesh was preferred in 13 patients (52%). Preoperative clinical features including age, size of the floor defect, and preoperative clinical findings (enophthalmos, diplopia, and restriction of ocular motility) were similar between 2 groups. Mean postoperative follow-up was 14.7 ±â€Š2.3 months in the nasoseptal group while it was 16.1 ±â€Š2.5 months in the titanium group (P = 0.84). Diplopia and ocular motility limitation were resolved in all patients at the last postoperative follow-up visit, while 1 patient in each group had enophthalmos (8.3% versus 7.6%, P = 1.0). No patient in the nasoseptal group experienced postoperative complications while 2 patients in the titanium group (15.3%) developed material-related complications (P = 0.48). CONCLUSIONS: Long-term clinical results of nasoseptal cartilage grafts and titanium mesh implants in pure orbital blowout fractures with preoperative floor defects smaller than 4 cm2 were comparable. Nasoseptal cartilage grafts may be preferred in patients with septal deviation and no spurs or turbinate hypertrophy.

Efficacy of Low Mandible Maneuver on Mutational Falsetto.

OBJECTIVES: Mutational falsetto (MF) is a functional voice disorder involving failure to transition from the high-pitched voice of childhood to the lower-pitched voice of adolescence and adulthood. The low mandible maneuver (LMM) is used by professional singers to relax the larynx and expand the resonance space. It relaxes suprahyoid muscles and pushes the larynx backwards, so it can be used as a therapy for MF. MATERIAL AND METHODS: The data of 20 MF patients treated by the LMM were analyzed in this study. All of the patients were asked to complete the Voice Handicap Index-10 (VHI-10) before the first session, and again 2 weeks after the second visit. The Grade-Roughness-Breathiness-Asthenia-Strain (GRBAS) scale scores and fundamental frequency (F0) were analyzed for each patient. RESULTS: All except 1 patient reported that they completed the exercises without difficulty; the patient who did not perform the exercises cited reasons other than their difficulty. Only 2 patients failed to transition from MF to a lower-pitched voice. The GRBAS scale scores (all parameters) differed significantly between the first and second sessions. The VHI-10 score also changed, i.e., self-perceived voice quality was improved significantly, as was the F0. CONCLUSIONS: Our results showed that the LMM is an efficient and rapid technique for treating MF patients and shows high patient compliance.

Evaluation of the Efficacy of Hilotherapy for Postoperative Edema, Ecchymosis, and Pain After Rhinoplasty.

PURPOSE: Edema and ecchymosis are among the most important morbidities after rhinoplasty. The aim of the present study was to investigate the effects of hilotherapy application compared with traditional ice applications after rhinoplasty in terms of periorbital edema, ecchymosis, and pain. PATIENTS AND METHODS: A total of 60 patients (35 women and 25 men) had undergone primary rhinoplasty with the same surgeon. In the postoperative period, 30 patients in the study group received continuous cooling at 15°C using Hilotherm (Hilotherm GmbH, Argenbühl-Eisenharz, Germany), and 30 patients in the control group were treated with conventional cryotherapy with ice packs. Both treatments started within 45 minutes after the end of the surgery and were maintained for 24 hours. For the following 1 week, the patients were examined for edema, ecchymosis, and pain. RESULTS: When the postoperative periorbital region was evaluated for mean edema and mean ecchymosis for 7 days, less edema and less ecchymosis were detected in the Hilotherm group compared with that observed in the ice pack group (P < .001). When the mean pain scores were compared both morning and evening for 7 days, less pain had been recorded with Hilotherm application compared with ice application (P < .001). CONCLUSIONS: Hilotherapy is a useful method to prevent postoperative edema, ecchymosis, and pain compared with traditional ice application.

The effect of transcutaneous electrical nerve stimulation (TENS) on chronic subjective tinnitus.

OBJECTIVES: Chronic Subjective Tinnitus is a very highly prevalent disorder worldwide. There is no definitive treatment. The aim of this study is to investigate the efficacy of transcutaneous electrical nerve stimulation (TENS) applied to the auricula for treating tinnitus using the Depression Anxiety Stress Scales (DASS) and Tinnitus Handicap Inventory (THI). METHODS: The 60 patients were randomly divided into 3 groups of 20 patients. The first group (A) had one ear stimulated with TENS, and the second group (B) had both ears stimulated. Group C (placebo group) received no electrical or sound stimulation. All group patients received total of 10 sessions with a maximum of 4 days between the sessions. RESULTS: The THI and DASS scores decreased significantly after the treatment (p < 0.05). A significant difference was also observed between the groups after treatment (p < 0.05). While there was no difference between group A and B, it was shown that group C's post-treatment score was significantly higher than those of both groups (p < 0.05.) CONCLUSION: It is important to note that TENS has a therapeutic effect on subjective chronic tinnitus as well as a placebo effect.

The impact of platelet-rich fibrin (PRF) on olfactory function and pain after septoplasty operations.

BACKGROUND: We aimed to investigate the effect of platelet-rich fibrin (PRF) on olfactory function and pain score in patients who underwent septoplasty. METHODS: This prospective randomized observational study was performed between 2018 January and 2019 April with 148 patients who had septoplasty operation. Patients were divided two groups and 74 patients were placed in group 1 to which PRF was applied after the completion of septoplasty whereas 67 patients were put in group 2 which did not undergo PRF. Sniffin' Sticks test was applied to all patients at pre-op, post-op 1-week, 6-week, and 6-month. Pain scores of patients were measured with visual analogue scale at 1 and 3 week. RESULTS: The distribution of patients according to pre-op olfactory function (normo-hypo-anosmia), there was no significant differences statistically (p > 0.05). When we compared the 1-week post-op results of Sniffin' Sticks test of patients, we found differences between the groups (p < 0.05). It was observed in the early postoperative period that according to the Sniffin' Sticks test scores, the results of the PRF group were better than those of the non-PRF group. At 6-week and 6-month, between the groups; there was no differences in terms of olfactory function. When we looked at the pain score of patients at 1 and 3 week after septoplasty; significant differences were obtained between groups. CONCLUSION: The application of PRF to the mucosal surface after the completion of septoplasty, has positive effect on olfactory function and pain especially in the early postoperative period. During the healing process, it was observed that prf maintained better odor functions. It is a minimally invasive technique with low risks and satisfactory clinical results.

Comparison of the Olfactory Functions in Conventional Endoscopic Sinus Surgery to the Balloon Sinuplasty in Frontal Sinus Surgery.

OBJECTIVE: Balloon sinuplasty is being used worldwide, however the olfactory functions after balloon sinuplasty are underestimated. The authors aimed to study the effects of conventional endoscopic sinus surgery (ESS) compared to the balloon sinuplasty on olfactory function. MATERIALS AND METHODS: Forty-four subjects were randomly divided into 2 groups as ESS and balloon sinuplasty. The olfactory functions of each subject were recorded preoperatively and at the 1st, 3rd, 6th, and 12th months postoperatively. RESULTS: The initial assessments of olfaction were the same in both groups. After the surgery, the olfactory functions were significantly better in those of ESS group (P < 0.05). CONCLUSION: The olfactory function is preserved better in the conventional surgery compared to the balloon catheter dilation of the frontal sinus.

Impact of Upper Airway Collapse and Sleep Parameters on Daytime Sleepiness and Sleep Quality.

OBJECTIVE: Standard overnight polysomnography (PSG) scores only the apneahypopnea index (AHI) as a predictor of sleep apnea. It is proven that the arousals also contribute especially to the daytime symptoms of obstructive sleep apnea syndrome (OSA). The authors aimed to search the relevance of arousals and obstruction site in the upper airway with the sleep parameters, daytime sleepiness and the sleep quality. MATERIALS AND METHODS: A total number of 118 subjects were recruited. All of them received a full-night attended PSG and a thorough otolaryngologic examination to identify the site of obstruction in the upper airway and 2 different sleep questionnaires to present the daytime sleepiness and the sleep quality. RESULTS: The level of nasal airway blockage had no impact on AHI, daytime sleepiness and the sleep quality. The increase in level of tonsillar hypertrophy had a negative impact on oxygen desaturation index (ODI) only (P = 0.021). The level of retrolingual obstruction worsen ODI (P = 0.022), AHI (P = 0.041), daytime sleepiness (P = 0.047) and sleep quality (P = 0.033). CONCLUSION: Arousals during sleep deserve better attention in scoring PSG events, as they reliably reflect daytime somnolence and sleep quality. Retrolingual obstruction was the main contributor for cortical arousals. It is imperative to cure retrolingual obstruction properly which may be easily detected in sleep endoscopy.

Costal Cartilage and Costal Perichondrium Sandwich Graft in Septal Perforation Repair.

BACKGROUND: Repair of the septal perforation is a challenging procedure and there are many different surgical techniques. In this study, the authors present a novel method which the authors use costal cartilage and costal perichondrium sandwich graft as an interposition graft with bilateral opposing mucoperichondrial flaps. PATIENTS AND METHODS: Fourteen patients (5 females, 9 males) underwent septal perforation repair. All surgeries were performed through an open approach septoplasty technique. The edges of the perforation were incised to excise the mucosa with a thickness of 2 mm. Bilateral mucoperichondrial flaps were raised. Then costal cartilage and costal perichondrium were harvested from the rib. The cartilage was divided into a smaller piece which is 2 mm thick and 1 cm wider than perforation size. The prepared cartilage was wrapped with perichondrium to obtain a sandwich graft. This sandwich graft was placed between the mucoperichondrial flaps, corresponding to the perforation. RESULTS: After 9 months of follow-up, 11 (78%) of the 14 perforations were completely closed. Failure of the repair was observed in 3 patients; 2 of the perforations were medium size and one perforation was large size. No complications occurred. CONCLUSION: Using costal cartilage and costal perichondrium sandwich graft is a novel and useful technique especially in large septal perforations. Considering that septum surgery has an important role in the etiology of septum perforation, this method provides a good graft source for both perforation closure and simultaneous rhinoplasty surgery.

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.

A novel Turkish instrument for assessing quality of life in chronic otitis media ­translation and validation of Zurich chronic middle ear inventory

Background/aim: The Zurich Chronic Middle Ear Questionnaire (ZCMEI-21) is a newly-developed German-language questionnaire. The purpose of this study was to analyze the quality of life (QoL) of chronic otitis media (COM) patients and translate, transculturally adapt, and validate the ZCMEI-21 into Turkish. Materials and methods: Based on internationally accepted guidelines, the ZCMEI-21 was translated into Turkish. To assess its validity, the total score of the ZCMEI-21-Tur was compared to the scores taken from the original validation study and a question that was directly related to the health-related QoL (HRQoL), as well as the general criterion EQ-5D-5L. Questionnaires were completed by healthy volunteers and the results were evaluated statistically. Results: A total of 80 COM patients and 40 healthy volunteers were prospectively enrolled in this study. Regarding internal consistency, the questionnaire showed a Cronbach α of 0.94, which indicated high internal consistency. Moreover, internal consistency was also determined to be excellent for the Cronbach α of the individual subscales, as follows: ear sign symptoms, 0.79; hearing, 0.83; psychosocial impact, 0.91, and medical resources, 0.84. Conclusions: The ZCMEI-21 was translated into Turkish and validated. Therefore, the ZCMEI-21-Tur was suitable for use in assessing HRQoL in adult patients with COM.