The evaluation of the angles of Eustachian tubes in the patients with chronic otitis media on the temporal computerized tomography.

INTRODUCTION: Chronic otitis media (COM), affecting all over the world and in a wide range of age groups in Turkey, is an important cause of ear discharge and hearing loss. The main clinical manifestations are tympanic membrane perforation, ear, nose and throat problems. On the tympanic membrane perforation becomes persistent and cholesteatoma development, there are a lot of opinions today. Especially in the pathology associated with otitis media with effusion eustachian tube, it is known that COM and cholesteatoma develop. MATERIALS AND METHODS: In our study, we interpreted 210 patients' temporal computed tomography (CT). Seventy of these 210 patients had otitis media with cholesteatoma, 70 patients had only otitis media without cholesteatoma, and 70 patients had no otitis media. The eustachian tubes were evaluated using temporal CT multiplanar reconstruction method. Angles with the horizontal plane of the eustachian tube and Reid and tubotympanic angles were measured. RESULTS: The angles between eustachian tube and horizontally oriented Reid plane of the patients with cholesteatoma were found to be significantly lower than the patients with otitis media without cholesteatoma and the patients with no history of otitis media. For the tubotympanic angle, no statistically significant differences were observed between the groups. CONCLUSION: These results suggest that the decrease in the angle with the horizontal plane of Reid in the eustachian tube in adults may play a significant role in the etiology of cholesteatoma.

Transoral robotic tongue base reduction in surgical management of obstructive sleep apnea syndrome.

Management of base of tongue (BOT) is a challenging topic in surgical management of obstructive sleep apnea syndrome. After the introduction of transoral robotic surgery technology (TORS) into the otolaryngology practice, surgery on the BOT was performed more effectively. Base of tongue reduction can be performed alone or as a part of a multilevel surgery. Patient selection is important and will be discussed further in this study. Available studies show promising and encouraging results for TORS future use in BOT.

Transoral robotic surgery for base of tongue neoplasms.

Surgery to the base of tongue (BOT) in the presence of neoplasm is a challenging topic for head and neck surgeons. This area is difficult to access and includes important neurovascular structures such as the hypoglossal nerve and lingual artery. The pivotal role of the tongue base in swallowing makes planning the surgical approach more challenging. The surgical approaches vary from open neck/mandibulotomy to transoral laser surgery (TLS) which have significant disadvantages. After introduction of transoral robotic surgery (TORS) to otolaryngology practice with the da Vinci Surgical system, we have in our armamentarium a new approach to the BOT. The improved exposure with new retractors, 3-dimensional (3-D) visualization and magnification and advanced motion capacity allow for increased ease to perform surgery in this difficult area. In recent years, several articles published the data about safety and feasibility of TORS for various conditions. This article presents our approach to the BOT for neoplasms including malignant and benign lesions.

The da Vinci robotic system in head and neck surgery.

Intuitive Surgical Inc. (Sunnyvale, Ca, USA) extended the use of the da Vinci robot to head and neck surgery in 2005 following the previous use in urological, gynecological and cardiothoracic surgery. It then gained wide popularity throughout the globe. Our aim is to describe the da Vinci Robot System and discuss its applications in head and neck surgery. Continued refinements and applications in robotic surgery for otolaryngology will in time be possible as new robotic procedures are developed for endolaryngeal work.

Effectiveness of Ericksonian hypnosis in tinnitus therapy: preliminary results.

INTRODUCTION: The present study was performed to evaluate the efficacy of Ericksonian hypnosis in reducing the impact of tinnitus on patients' quality of life. PATIENTS AND METHODS: A controlled prospective longitudinal study was designed. The severity of tinnitus was assessed with Tinnitus Handicap Inventory (THI) before hypnotherapy and then 1 week, 1 month, 3 months, and 6 months after therapy. Health Survey SF-36 was used to assess health-related quality of life before and after hypnotherapy. Thirty-nine patients with severe idiopathic subjective tinnitus were enrolled in the study. RESULTS: The mean SD age of the patients was 44.5 +/- 12.5 years, ranging from 21 to 65 years; 48% were female. Mean THI scores assessed at the beginning and 4 times after commencement of therapy were evaluated. The changes in THI scores were significant. Health Survey SF-36 was assessed separately. The greatest increases were seen in physical role followed by emotional role difficulty. CONCLUSION: The preliminary results of our study demonstrated the effectiveness of Ericksonian hypnosis in the study group.

Destructive complication due to the use of a microdebrider: a case report.

Microdebriders are powered tools used in ear, nose, and throat surgeries. In this case, a use of a microdebrider in a patient who underwent revision endoscopic sinus surgery for nasal polyposis resulted in a destructive complication, namely a large skull base defect.

The effect of tobacco smoking on septoplasty outcomes: a prospective controlled study.

BACKGROUND: We evaluated the effects of tobacco smoking on functional outcomes of septoplasty and complication rates. METHODS: In total, 183 patients (127 males, 56 females) who had septum deviations and underwent septoplasties from January 2012 to December 2013 were evaluated. Subjects were divided into three groups: non­smokers (Group A), light smokers (<20 cigarettes/day, Group B), and heavy smokers (> 20 cigarettes/day Group C). Nasal Obstruction Symptom Evaluation (NOSE) scoring was used to evaluate the effects of tobacco smoking on septoplasty outcomes. Clinical evaluations were performed preoperatively and at one and six months postoperatively. Complications were evaluated during the clinical examinations. RESULTS: No significant differences were seen between the preoperative and 1-month postoperative NOSE scores, the 1- and 6-month postoperative NOSE scores, or the preoperative and 6-month postoperative NOSE scores among the groups (p =0.352, 0.737, and 0.344, respectively). The overall complication rate also did not differ among the three groups (p =0.860). CONCLUSIONS: Active smoking status does not affect operation outcomes and does not increase the postoperative complication rate among patients undergoing septoplasty. Although we should advise our patients to stop smoking because of its known harmful effects, smoking may not be a selection criterion for septoplasty. Hippokratia 2015; 19 (3): 219-224.

Recent medical devices for tonsillectomy.

The most frequent and probably the earliest described surgical intervention of ENT field is tonsillectomy. Various methods were described and devices were invented up to now in order to increase safety and decrease time consumption and complications. All new created devices promises lower intraoperative blood loss, intraoperative time, postoperative pain and bleeding. But with their widely use it is seen that they cannot fulfill what they promise. Debate also continues as to which technique yields the best outcome. This study reports a summary for common medical devices which were previously used in tonsillectomy.