RESUMEN
The primary objective of this study was to investigate the etiological causes and the underlying mechanism of post-earthquake dizziness in affected persons. The present study utilized an observational case-control design to recruit 69 participants (33 with self-reported dizziness complaints and 36 healthy persons) who were exposed to the 2023 earthquakes in Türkiye. The participants underwent assessments including the Dizziness Handicap Inventory for measuring dizziness-related disability, stress, and anxiety assessment using various scales, and equilibrium evaluation through the use of videonystagmography, video head impulse test, and vestibular evoked myogenic potential. The 2 groups were compared based on these assessments. The results indicate that the Dizziness Handicap Inventory score was significantly higher in the patient group compared to the control group (P < .001). The mean score of the Peritraumatic Distress Inventory, as well as the mean scores of the Hospital Anxiety and Depression Scale anxiety score and depression score, were found to be significantly higher in the patient group compared to the control group (P=.012, P < .001, and P < .001, respectively). Furthermore, it was observed that the mean vestibulo-ocular reflex gain of the left posterior semicircular canal exhibited a statistically significant decrease in the patient group (P=.02). The observed equilibrium dysfunction experienced by individuals following a significant earthquake is likely attributable to heightened stress and anxiety stemming from multiple sources, including the impact of recurrent vibrations on the inner ear. Therefore, it is essential to establish a holistic healthcare approach that addresses the psychological needs of individuals affected by earthquakes.
Asunto(s)
Mareo , Terremotos , Humanos , Mareo/etiología , Mareo/diagnóstico , Mareo/psicología , Mareo/fisiopatología , Estudios de Casos y Controles , Masculino , Femenino , Persona de Mediana Edad , Adulto , Ansiedad/etiología , Ansiedad/psicología , Ansiedad/diagnóstico , Anciano , Reflejo Vestibuloocular/fisiología , Potenciales Vestibulares Miogénicos Evocados/fisiologíaRESUMEN
PURPOSE: The involvement of the anterior commissure (AC) is regarded to be a risk factor for poor results after transoral laser microsurgery (TLM) for early glottic cancer. The objective of this study was to determine how AC-related clinical and radiological factors affected oncological outcomes in a cohort of patients with T1 stage early glottic carcinoma involving the anterior commissure who were treated with TLM with negative surgical margins. METHODS: Retrospective analysis was performed on clinical, radiological, and follow-up data of patients consecutively treated with TLM at a tertiary academic center between November 2011 and August 2021 for T1 glottic squamous cell carcinoma involving the anterior commissure. Recurrence-free survival (RFS), local control with laser alone (LCL), laryngeal preservation (LP), and overall survival (OS) rates (Kaplan-Meier) were the primary outcome metrics. RESULTS: In our series, 5-year OS probability was 75.1%, RFS was 64.8%, LCL was 73.8%, and LP was 83.4%. OS and RFS were higher in patients with early stages of AC pattern than in patients with advanced stage (p = 0.004, p = 0.034, respectively). Vertical extension ratio was found to be associated with OS and RFS (p = 0.023, p = 0.001, respectively), and thyroid cartilage interlaminar angle with LCL by multiple Cox regression analysis (p = 0.041). CONCLUSION: TLM remains a valuable treatment option for AC involvement. AC3 type involvement and elevated vertical extension ratio were associated with negative prognosis. There have been signs that thyroid cartilage with a narrow angle increases recurrence. Alternative modalities should be kept in mind in the treatment decision of these cases.
Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias Laríngeas , Terapia por Láser , Neoplasias de la Lengua , Humanos , Neoplasias Laríngeas/diagnóstico por imagen , Neoplasias Laríngeas/cirugía , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/cirugía , Estudios Retrospectivos , Microcirugia/métodos , Glotis/diagnóstico por imagen , Glotis/cirugía , Glotis/patología , Neoplasias de la Lengua/cirugía , Terapia por Láser/métodos , Neoplasias de Cabeza y Cuello/patología , Resultado del Tratamiento , Estadificación de Neoplasias , Recurrencia Local de Neoplasia/patologíaRESUMEN
PURPOSE: Our aim was to analyze the patients with diabetic rhino-orbital-cerebral mucormycosis that we have treated in our clinic in the last 5 years, and to reveal the altering conditions with COVID-19. MATERIALS AND METHODS: A retrospective study was conducted on 39 rhino-orbital-cerebral mucormycosis (ROCM) patients with diabetes mellitus between 2017 and 2022. The patients were divided into two groups as those associated with and not associated with COVID-19 and compared. RESULTS: Thirty-nine diabetic patients were included in the study, with 15 (38.5%) of them being COVID-19 associated mucormycosis (CAM) group. CAM patients showed higher orbital involvement and cavernous sinus involvement (p = 0.002 and p = 0.013, respectively). The mortality rate in the non-COVID-19 associated mucormycosis (non-CAM) group was statistically higher in patients with intracranial and cavernous sinus involvement (p = 0.015 and p = 0.033, respectively). The difference between the overall survival of the CAM patients and non-CAM patients was not statistically significant (p = 0.741). CONCLUSIONS: With COVID-19, progressive mucormycosis accompanied by orbital and intracranial involvement is observed more frequently. However, on the contrary, the mortality rate in COVID-19-associated mucormycosis is considerably lower than expected. The fact that temporary immune suppression can be ameliorated with adequate supportive treatment and liposomal amphotericin-B which can be given to patients in high doses may explain this situation. It has been attained hints that the essential factor in the treatment of COVID-19-associated ROCM is the control of the underlying disease and to be cautious in the decision of early aggressive surgery.
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COVID-19 , Diabetes Mellitus , Oftalmopatías , Mucormicosis , Enfermedades Orbitales , Humanos , Mucormicosis/terapia , Mucormicosis/tratamiento farmacológico , Antifúngicos/uso terapéutico , Estudios Retrospectivos , Enfermedades Orbitales/etiología , Enfermedades Orbitales/terapia , COVID-19/complicaciones , Diabetes Mellitus/epidemiologíaRESUMEN
BACKGROUND: Cochlear implants are arguably the most successful neural prosthesis today. Cochlear implantation has several difficulties in patients with internal ear anomalies. This study was performed to analyze intraoperative, postoperative findings, and auditory performance of 55 patients who had inner ear malformations and were treated with cochlear implants at Otorhinolaryngology Department of Çukurova University Hospital. METHODS: Auditory performances were analyzed in 30 of 55 patients. Patients with cochlear anomalies were evaluated as group I, patients with vestibular malformation as group II, and patients with the normal bone labyrinth as group III. Listening progress profiles and meaningful auditory integration scale tests were used to determine performances. RESULTS: Comparison between the listening progress profiles test performance of the groups at 12th and 18th month of group I was significantly lower than other groups (P < .05) and reached at the same level after the 24th month. Comparison between the meaningful auditory integration scale test performance of groups at 24th and 36th month of group I was significantly lower than other groups (P < .05). Perilymph gusher was observed in 3 patients who had incomplete partition I malformation. Oozing was observed in 50% of incomplete partition II patients. Facial nerve traced a variant course in 4 of 55 patients and 6 patients had postoperative meningitis. CONCLUSION: Initially patients with inner ear anomalies showed that the level of language development was worse than patients with normal bone anatomy. However, it was shown that they both reached the same point as a result. Facial nerve anomaly and meningitis risk is higher in patients with inner ear malformations.
Asunto(s)
Implantación Coclear , Implantes Cocleares , Oído Interno , Implantación Coclear/métodos , Oído Interno/anomalías , Oído Interno/cirugía , Pruebas Auditivas , Humanos , Perilinfa , Estudios RetrospectivosRESUMEN
INTRODUCTION: In the internet era we live in, it is very easy to access information. While this situation has positive effects for patients using the internet, it also brings some negative effects. The effects of the quality of YouTube™ videos on nasopharyngeal cancer were examined. METHODS: "Nasopharyngeal Cancer" as search term was used to conduct a search on YouTube™. The 'Sort by' search filter was set at 'relevance', which is the default for YouTube™ searches. The first 250 results were reviewed and analyzed. After the videos were eliminated according to the exclusion criteria, 45 videos were evaluated by two authors. Video materials were categorized according to "video type" and "source of content". According to "video type" and "source of content" the videos were categorized into two as educational and testimonial and three as medical institution, medical website, and individual users. After recording the features of all evaluated videos, accuracy score, audiovisual score, modified discern score, patient education materials assessment tool for audiovisual materials (PEMAT) score and usefulness score were determined for each video to evaluate the accuracy, reliability, and understandability of the videos. RESULTS: The usefulness score, modified discern score, and accuracy score of the educational videos were significantly higher than testimonial videos (p<0.001 for all). Educational videos provided more useful and accurate video content than testimonial videos. In addition, it was also determined that the median PEMAT actionability score and audiovisual score of the individual group were statistically significantly lower than medical institutions and medical websites (p=0.001 and p<0.001, respectively). The videos provided by medical institutions, including universities, did not have a significant advantage over other groups in terms of accuracy, reliability, and usefulness. CONCLUSION: Healthcare videos concerning nasopharyngeal cancer on YouTube™ are heterogeneous and are not peer reviewed. Therefore, medical professions on nasopharyngeal cancer need to upload more accurate, reliable and easy to understand videos onto online platforms such as YouTube™.
Asunto(s)
Neoplasias Nasofaríngeas , Medios de Comunicación Sociales , Humanos , Reproducibilidad de los Resultados , Universidades , Grabación en VideoRESUMEN
AIM: To evaluate the risk factors associated with nocturia in patients with obstructive sleep apnea syndrome (OSAS). MATERIALS AND METHODS: Patients aged over 18 years who had been diagnosed with OSAS using polysomnography (PSG) from January to December 2019 were evaluated. The number of nocturia episodes had been assessed in a 3-day bladder diary. We analysed the age, sex, body mass index (BMI) score, apnea-hypopn ea index (AHI) score and severity, hypertension, diabetes mellitus, smoking and heart diseases in all patients. RESULTS: A total of 124 patients with a mean age of 49.9 ± 11.6 years (range: 25-81 years) were included in the study. Ninety-two (75.8%) patients had nocturia. The mean number of nocturia episodes of patients with nocturia was 2.4 ± 1.3. To determine factors affecting the risk of nocturia, the logistic regression analysis was performed. Patient age and BMI scores were found as the most effective risk factors determining nocturia (P < .05). The odds of patient age were 1.06 (odds ratio: 1.12; 95% confidence interval: 1.01-1.11; P = .010) times higher for patients with nocturia. Every 1-unit increase in the BMI score increased the risk of nocturia 1.12 times. In the study period, 48 patients with nocturia had undergone the continuous positive airway pressure (CPAP) therapy or surgical treatment. The mean number of nocturia episodes of these patients was 2.3 ± 1.4 before treatment and 1.7 ± 2.2 after treatment, showing a significant decrease (P = .032). Although the total daily urine volume increased significantly with the treatment, the total night-time urine volume decreased significantly at night (P = .016 and P = .024, respectively). CONCLUSION: The age and BMI score were the risk factors associated with nocturia in patients with OSAS.
Asunto(s)
Nocturia , Apnea Obstructiva del Sueño , Adulto , Anciano , Anciano de 80 o más Años , Presión de las Vías Aéreas Positiva Contínua , Humanos , Persona de Mediana Edad , Nocturia/epidemiología , Nocturia/etiología , Estudios Prospectivos , Factores de Riesgo , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/epidemiología , Apnea Obstructiva del Sueño/terapiaRESUMEN
OBJECTIVE: The aim of this study was to determine the short- and long-term complications after cochlear implantation (CI) procedures and to discuss the management and prevention of these complications. METHODS: The study included a total of 1452 pediatric and adult cochlear implantation procedures performed in our clinic from March 2000 through September 2019. Of the 1452 implantations, 1201 were performed in children and 156 in adults. The minimum follow-up period was three months and maximum was 19 years. The mean age of the patients was 6.7±3.9 years (range, 10 months-69 years) at the time of their respective procedures. Complications were classified as major complications requiring reimplantation, major complications not requiring reimplantation and minor complications. All postoperative complications and treatment methods were examined. RESULTS: A total of 148 (10.1%) complications were observed in the 1452 cochlear implants. Of these, 69 (4.75%) were major and 79 (5.44%) were minor complications. While 40 (2.75%) of the major complications required reimplantation, 29 (1.99%) did not. The most common cause of major complications leading to reimplantation was device failure (29 patients, 1.99%). The most common cause of minor complications was hematoma (21 patients). Total complication rates (6.68%) were significantly higher in children than in adults (3.51%) (p=0.00). CONCLUSION: Our 19 years of clinical experience has shown that CI is a successful and safe procedure that can be performed with low major complication rates. It is important to know the possible complications and to manage them correctly.