Comparison of Isotonic Seawater Nasal Spray Containing Chamomile Liquid Extract and Other Isotonic Seawater Nasal Washing Solutions for Allergic Rhinitis.

OBJECTIVE: We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions. METHODS: The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test. RESULTS: The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant (P ≤.001; P ≤ .001; P ≤ .001, and P = .048, respectively). Only Group A and Group B experienced a significant difference in nasal mucociliary clearance times (P ≤ .001; P = .010, respectively). When the Sino-nasal Outcome Test-22 score and nasal mucociliary clearance time differences before and after treatment were compared between all groups, the Sino-Nasal Outcome Test-22 score difference was higher in Group A than in Groups B, C, and D, the differences were found as statistically significant (P = .010; P = .003; P ≤ .001, respectively). The nasal mucociliary clearance time difference was higher in Group A than in Groups C and D, the differences were found as statistically significant (P = .010; P = .001, respectively). CONCLUSION: Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients.

The Effect of Gastric Helicobacter pylori Colonization on Nasal Functions.

The aim of this study is to investigate the effect of gastric Helicobacter pylori colonization on nasal functions. The study enrolled patients (n = 100) who underwent endoscopy for gastroesophageal reflux disease. Patients with laryngopharyngeal reflux (LPR) were identified by Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). Patients were divided into 2 groups: LPR (+) (n = 64) H pylori (+), RSI > 13, RFS > 7; LPR (-) (n = 36) H pylori (+), RSI < 13, RFS < 7. Visual analog scale (VAS), sinonasal outcome test-22 (SNOT-22), peak nasal inspiratory flowmeter (PNIF), mucociliary clearance (MCC), and olfactory tests were used to evaluate the nasal functions. The average VAS for nasal obstruction, PNIF, and MCC did not differ significantly between the LPR (+) and LPR (-) groups (P > .05). However, the average olfactory test scores were lower in the LPR (+) patients than the LPR (-) patients (P < .05). Also, the SNOT-22 scores were significantly higher in LPR (+) patients than in LPR (-) (P < .01). Nasal functions and symptom scores were also evaluated according to the H pylori grading. The PNIF, MCC, SNOT-22, and olfactory test results deteriorated as the gastric mucosal H pylori colonization increased (P < .05). In conclusion, nasal functions differed between LPR disease and GERD only, while the density of H pylori colonization in the gastric mucosa had an effect on nasal function.

Comparison of Olfactory Function and Quality of Life With Different Surgical Techniques for Nasal Septum Deviation.

OBJECTIVE: To assess the nasal functions, nasal resistance, olfactory function, and quality of life in different surgical techniques for nasal septum deviation STUDY DESIGN:: Randomized controlled trial. METHODS: This prospective controlled study was carried out on patients who underwent septoplasty. Patients participating in the study were divided into 2 groups; group 1: classic septoplasty (n: 25) and group 2: extracorporeal septoplasty (n: 14). The sinonasal outcome test-22 (SNOT-22), peak nasal flowmetry, and Connecticut Chemosensory Clinical Research Center test were applied to all patients before and 8 weeks after surgery. Surgical outcomes also assessed to evaluate complications 6 months after surgery. RESULT: In total, 39 (27 males, 12 females) patients diagnosed with nasal septum deviation were included in this study. A septoplasty was performed in all patients: 25 of them (18 males, 7 females; mean age = 29.4 [range, 23-50] years) underwent classic septoplasties and 14 (9 males, 5 females; mean age = 31.3 [range, 23-50] years) underwent extracorporeal septoplasties. Airway openness was achieved in all patients. As a result, the SNOT-22 scores, peak nasal inspiratory flowmeter results, and smell function scores showed significant improvements (P < 0.001). CONCLUSION: All corrective surgical methods for a septum deviation have positive effects on nasal airflow, quality of life, and olfaction. The rates of complications were not significantly different between 2 treatment groups.

Effects of Radioactive Iodine Ablation Therapy on Voice Quality.

OBJECTIVE: The goal of this study was to evaluate the effects of radioactive iodine ablation therapy on voice quality of patients diagnosed with well-differentiated thyroid carcinoma. METHODS: We enrolled 36 patients who underwent total or subtotal thyroidectomy due to well-differentiated thyroid carcinoma. Voice recordings from patients were analyzed for acoustic and aerodynamic voice. The Voice Handicap Index-10 was used for subjective analysis. The control group consisted of 36 healthy participants. Results taken before and after therapy were compared statistically. RESULTS: There were no differences in the results taken before and after therapy for the radioactive iodine ablation group. The Voice Handicap Index-10 results did not differ between groups before and after therapy. CONCLUSION: Radioactive iodine ablation therapy has no effect on voice quality objectively or subjectively.

Efficacy of Trimetazidine Dihydrochloride for Relieving Chronic Tinnitus: A Randomized Double-Blind Study.

OBJECTIVES: To evaluate the efficacy of trimetazidine dihydrochloride as a treatment for chronic tinnitus. METHODS: A total of 97 chronic tinnitus patients were evaluated in this randomized, prospective, double-blind, placebo-controlled trial. After assessing for eligibility, 82 patients were randomly assigned into placebo or trimetazidine groups according to the medication. The trimetazidine group received 20×3 mg/day per oral trimetazidine dihydrochloride and the placebo group received 20×3 mg/day per oral placebo for 3 months. Tinnitus handicap inventory (THI), visual analogue scale (VAS) questionnaires and audiometric results were used to determine the effectiveness of trimetazidine treatment. RESULTS: The study group comprised 82 tinnitus subjects, 42 (51%) of whom received trimetazidine dihydrochloride and 40 (49%) who received placebo. There was no significant difference between placebo and trimetazidine groups in THI grade and VAS (both pre- and posttreatment scores) (P>0.05) and no significant improvement was observed in subjective loudness score in either group (P>0.05). Additionally there was no significant difference between groups in pre- and posttreatment pure tone hearing thresholds at all measured frequencies (P>0.05). CONCLUSION: Trimetazidine dihydrochloride therapy was ineffective for relieving chronic tinnitus.

Objective and Subjective Aspects of Voice in Pregnancy.

OBJECTIVE: This study aimed to evaluate vocal changes in pregnancy according to trimesters both objectively and subjectively. METHODS: Fifty pregnant women and 15 nonpregnant women were included in the study. Eighteen of the 50 pregnant women were in the first trimester, 17 in the second trimester, and 15 in the third trimester of their pregnancies. The fundamental frequency (F0), jitter, shimmer, noise-to-harmonics ratio (NHR), and minimum and maximum pitch were determined during acoustic voice analysis. Laryngologic examination was evaluated via reflux finding score (RFS). Voice Handicap Index 10 (VHI-10) was used for subjective analysis. RESULTS: Maximum phonation time (MPT), VHI-10, and RFS were the parameters that differed significantly. MPT was significantly shorter in the third trimester. Acoustic analysis revealed that F0, jitter, shimmer, NHR, and minimum and maximum pitch values were not significantly different in any groups. RFS was higher in the first and third trimesters than the second trimester and control groups. VHI-10 scores were significantly higher in the third trimester. CONCLUSIONS: Our results showed that MPT is decreased during the third trimester, although acoustic parameters did not differ. VHI-10 results deteriorated in the third trimester significantly.

Pediatric Ramsay Hunt Syndrome: Analysis of Three Cases.

Ramsay Hunt syndrome (RHS) is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction and is attributed to varicella zoster virus (VZV) infection in the geniculate ganglion. Although it is a common cause of acute peripheral facial paralysis, children are not usually affected. The diagnosis is based on history and physical findings. Treatment of RHS uses a combination of high-dose corticosteroids and acyclovir. This paper presents three cases diagnosed as RHS in the pediatric age group in association with the literature review. The aim of this paper is to emphasize the importance of careful examination and early initiation of therapy in suspected cases of RHS.

How to rehabilitate long-term facial paralysis.

OBJECTIVE: To project the surgical resuscitation methods that we apply to the lower part of the face and the eyes with the aim of preventing functional and psychological problems that can occur in patients with facial paralysis. MATERIALS AND METHODS: Twenty-two patients with facial nerve paralysis due to acoustic neuroma, trauma, cholesteatoma, and parotid carcinoma were included in this study. In the lower facial region, the temporal muscle was suspended to the lower lip. In the upper facial region, eyelid gold implantation was performed. The reanimation results of the upper and lower facial regions were graded as excellent, good, fair, and poor in consideration of the symmetry after rest and smile according to May classification in the third month after the surgery. RESULTS: The study group comprised 15 men (68.2%) and 5 women (31.8 %) (mean age, 63.82 ± 14.18 years; range, 8-78 years). Of the patients, 18.2% (n = 4) had acoustic neuroma, 40.9% (n = 9) had facial trauma, 27.3% (n = 6) had cholesteatoma, and 13.6% (n = 3) had parotid carcinoma.Reanimation techniques were applied to 40.9% (n = 9) of the patients during the first 2-4 years, whereas 59.1% (n = 13) of patients underwent surgery after 4 years.In a total of 17 patients (77.3%) who had lower lip intervention, 4 patients (23.5%) had excellent results, 7 patients (41.2%) had good results, and 6 patients (35.3%) had moderate results.In the 22 patients who underwent the eyelid procedure, 5 patients (22.7 %) had excellent results, 13 patients (59.1 %) had good results, and 3 patients (18.2 %) had moderate results. Poor results were not observed in any patient. CONCLUSION: Facial paralysis is a disease that causes serious functional and psychological problems in patients. Therefore, the choice of treatment method is dependent on the etiology, duration of paralysis, expectations of the patient, and experience of the surgeon. Being less invasive methods, obtaining immediate results, requiring single surgical stage, and having long-lasting results and dynamic muscle transfer and static suspension methods are preferred.

Comparison of two partial middle turbinectomy techniques for the treatment of a concha bullosa.

OBJECTIVES/HYPOTHESIS: To assess the nasal functions, nasal resistance, and olfactory function in middle turbinate surgery. STUDY DESIGN: Randomized controlled trial. METHODS: This prospective controlled study was carried out on patients who underwent laminectomy for aeration of the middle turbinate. Patients participating in the study were divided into two groups-group 1: medial laminectomy (n = 34) and group 2: lateral laminectomy (n = 38). Patients underwent the preoperative visual analogue score, sinonasal outcome test-22 (SNOT-22), peak nasal inspiratory flowmeter, and Connecticut Chemosensory Clinical Research Center smell test. All patients were reevaluated 3 months after the operation. RESULTS: The study group comprised 72 consecutive patients. The mean age of the patients was 31.03 ± 9.7, with a range of 17 to 54 years. A total of 47.2 % (n = 34) had medial and 52.8% (n = 38) had lateral laminectomy. Bilateral turbinate intervention was performed in 27.8% (n = 20), whereas unilateral middle turbinate intervention was performed in 72.3% (n = 52). Overall, both groups showed strong significant improvement over time in visual analogue scale results, SNOT-22 scores, peak flowmeter results, and olfactory function between preoperative and postoperative scores (P < 0.001). There was no significant difference between the groups for all parameters (P > 0.05). CONCLUSIONS: This study revealed that medial laminectomy for aeration of the middle turbinate was as effective as lateral laminectomy. LEVEL OF EVIDENCE: 1b. Laryngoscope, 125:1062-1066, 2015.

Real-time ultrasound elastography for the differentiation of malignant and benign masses in the head and neck.

OBJECTIVES: The objective of this study was to evaluate head and neck masses with real-time elastography to differentiate malignant masses. MATERIALS AND METHODS: Between January 2011 and December 2012, a total of 51 patients with a palpable mass in the neck region were included in this study. Excisional histopathologic data were compared with elastographic results and Doppler ultrasonography. RESULTS: The study group comprised 27 males (52.9%) and 24 females (47.1%) (mean [SD] age, 41.47 [19.59] y; range, 4-80 y). Fourteen masses were malignant (27.5%) and 37 were benign (72.5%). Comparing the elastographic results of benign and malignant masses, elastographic scores of the malignant masses were significantly higher than those of the benign masses (P < 0.005).The elastographic scores were divided into 2 groups: 34 (91.9%) patients with the diagnosis of benign mass had the score of 1 to 2, whereas 9 (64.3%) patients with the diagnosis of malignant cases had the score of 3 to 4. There was a significant difference between the groups (P < 0.005).However, 2 squamous cell carcinomas (28.6%) and 1 lymphoma (8.1%) were diagnosed with an elastographic score of 1 (Table 2). This showed that even an elastographic score of 1 was not enough to issue a diagnosis of benign masses. CONCLUSIONS: With improvements in the device and increased experience, this modality can become a useful tool for the routine use. However, this modality cannot be used for screening to merely provide additional information about the nature of the masses.

The development of dorsal nasal cyst formation after rhinoplasty and its reconstruction with conchal cartilage.

The dorsal nasal cyst formation is a rare and late complication of rhinoplasty. It has been rarely reported in the literature and it is usually mucous cysts. Migration and planting to the subcutaneous space during the surgical procedure has been recognized as the formation mechanism. This case report has presented 42-year-old male patient with a destructing dorsal nasal mucous cyst that developed 10 years after the rhinoplasty operation. There was no complication in the primary rhinoplasty and the patient was satisfied with his appearance. There was a swelling of the nasal dorsum over the past year and surgical excision of the cyst was performed. During the surgery, the defect was reconstructed with conchal cartilage. There was no recurrence during follow-up.