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.

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.

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.

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.

[Short term olfactory memory and olfactory function after inhalation anesthetic agents: a randomized clinical trial]. / Memória olfativa de curta duração e função olfativa após anestésicos inalatórios: estudo clínico randomizado.

BACKGROUND AND OBJECTIVES: This clinical trial aimed to evaluate the effects of two different inhalation anesthetic agents on postoperative olfactory memory and olfactory function in patients who underwent micro laryngeal surgery. METHODS: This randomized prospective controlled study consisted of 102 consecutive patients with a voice disorder. The patients underwent micro laryngeal surgery for voice disorders under general anesthesia. Patients who did not meet inclusion criteria and/or declined to participate (n=34) were excluded from the study. Patients were divided into two groups. Four patients from Group 1 and four patients from Group 2 were lost to follow-up. Group 1 (n=30) received sevoflurane, and Group 2 (n=30) received desflurane during anesthesia. We compared the results by performing the pre-op and post-op Connecticut Chemosensory Clinical Research Center Olfactory test. RESULTS: Thirty-three patients (55%) were male and 27 (45%) were female. The mean age was 48.18±13.88 years (range: 19-70 years). Preoperative and postoperative olfactory functions did not show a significant difference within the groups postoperatively (p> 0.05). Preoperative and postoperative olfactory memory showed a significant decrease 3hours after the surgery (p <0.05). CONCLUSIONS: Olfactory functions and memory were not affected by desflurane in the early postoperative period. Although sevoflurane did not affect olfactory functions, it had a temporary negative effect on olfactory memory in the early postoperative period.

Short term olfactory memory and olfactory function after inhalation anesthetic agents: a randomized clinical trial / Memória olfativa de curta duração e função olfativa após anestésicos inalatórios: estudo clínico randomizado

Abstract Background and objectives: This clinical trial aimed to evaluate the effects of two different inhalation anesthetic agents on postoperative olfactory memory and olfactory function in patients who underwent micro laryngeal surgery. Methods: This randomized prospective controlled study consisted of 102 consecutive patients with a voice disorder. The patients underwent micro laryngeal surgery for voice disorders under general anesthesia. Patients who did not meet inclusion criteria and/or declined to participate (n = 34) were excluded from the study. Patients were divided into two groups. Four patients from Group 1 and four patients from Group 2 were lost to follow-up. Group 1 (n = 30) received sevoflurane, and Group 2 (n = 30) received desflurane during anesthesia. We compared the results by performing the pre-op and post-op Connecticut Chemosensory Clinical Research Center Olfactory test. Results: Thirty-three patients (55%) were male and 27 (45%) were female. The mean age was 48.18 ± 13.88 years (range: 19‒70 years). Preoperative and postoperative olfactory functions did not show a significant difference within the groups postoperatively (p > 0.05). Preoperative and postoperative olfactory memory showed a significant decrease 3 hours after the surgery (p < 0.05). Conclusions: Olfactory functions and memory were not affected by desflurane in the early postoperative period. Although sevoflurane did not affect olfactory functions, it had a temporary negative effect on olfactory memory in the early postoperative period.

Resumo Introdução e objetivos: O estudo avaliou o efeito pós-operatório de dois agentes anestésicos inalatórios distintos na memória olfativa de curta duração e na função olfativa em pacientes submetidos à microcirurgia de laringe. Método: O estudo prospectivo controlado randomizado avaliou, consecutivamente, 102 pacientes com alteração vocal submetidos à microcirurgia de laringe sob anestesia geral. Trinta e quatro pacientes não obedeceram aos critérios de inclusão e/ou não aceitaram participar do estudo e foram excluídos. Os pacientes foram divididos em dois grupos. Quatro pacientes do Grupo 1 e quatro do Grupo 2 foram perdidos durante o seguimento. O Grupo 1 (n = 30) recebeu sevoflurano durante a anestesia e o Grupo 2 (n = 30), desflurano. Comparamos resultados pré e pós-operatórios de memória olfativa e funções olfativas, realizando o Connecticut Chemosensory Clinical Research Center Olfactory test. Resultados: Foram incluídos um total de 33 (55%) homens e 27 (45%) mulheres. A idade média foi 48,18 ± 13,88 anos (variação: 19-70 anos). As funções olfativas pré e pós-operatórias não apresentaram diferença estatisticamente significante dentro dos grupos no pós-operatório (p > 0,05). A memória olfativa pré e pós-operatória não mostrou diminuição estatisticamente significante quando avaliada três horas após a cirurgia (p< 0,05). Conclusões: Memória e funções olfativas não foram alteradas pelo desflurano no pós-operatório imediato. Embora o sevoflurano não tenha alterado as funções olfativas, causou efeito temporário negativo na memória olfativa no pós-operatório imediato.

A simple method to reduce halitosis; tongue scraping with probiotics.

OBJECTIVE: We aimed to assess the effects of probiotic implantation to the dorsum of the tongue against halitosis. MATERIALS AND METHODS: 100 participants were randomly divided into three groups as tongue back scraping (TS), probiotic implantation to the dorsum of the tongue (PB) and mouthwash alone as the control group (MW). Measurements were taken before the treatment, after the first month of treatment and one month after the cessation of treatment. RESULTS: Halimeter, winkel and woodlight scores were evaluated initially, in the first month and after the cessation of the treatment. All of MW measurements showed no difference throughout the study. All of TS measurements decreased significantly in the first month (p < 0.05) but rose again in the final count. All of PB measurements significantly decreased in the first month and kept their low levels after the cessation of the treatment (p < 0.05). CONCLUSION: Probiotics and tongue scraping are widely used against halitosis but they are not intended to be used together. In this study, we proposed and proved an effective method of probiotic implantation by tongue scraping and showed that halitosis did not recur after the cessation of the treatment.

Preservation of Autogenous Septal Cartilage for Revision Surgery.

The aim of this study is to find the ideal solution and the optimum temperature to protect the viability of the cartilage graft. This randomized prospective study consists of 30 patients with septal deviation. All patients had septoplasty operation for chronic nasal obstruction. Ten strips of cartilages were prepared from each excised septum and then immersed in formalin, alcohol (96%), saline (0,9%), gentamicin (80 mg), and cefazolin sodium (Cezol 1gr) solutions in a total of 300 vials. Those vials were stored for 6 months at both +4°C and -18°C temperatures. Two groups were compared with each other. 22 cases were male (73%) and 8 patients were female (7%). The age range was between 20 and 48 (average 25.34 ±â€Š4.09 years). Parameters at +4°C; the cartilage volume was not significantly different among the solutions (P >0.05). Necrosis was significantly lower in the alcohol (46.7%) compared to other solutions (P = 0.001). Calcification was lower in the gentamicin group (56.7%). The loss of metachromasia was lower in the alcohol solutions (P = 0.000). Parameters at -18°C; the loss of metachromasia was higher in the gentamicin group (56.7%) than the other solutions (P = 0.003). The authors observed no significance in the rates of necrosis, calcification, metaplasia, inflammation, vascularity, or fibrosis among the solutions (P >0.05). Less necrosis and metachromosis loss in the alcohol solution indicated that alcohol was more suitable for preservation of the cartilage. In addition, temperature degree for the preservation of the cartilage did not show any significant differences.