Evaluation of Oropharyngeal Dysphagia in Elderly Patients with Pharyngeal Aberrant Internal Carotid Artery Using the Eating Assessment Tool-10 (EAT-10).

Pharyngeal aberrant internal carotid artery (PAICA) has been reported to be a cause of oropharyngeal dysphagia (OD) in case reports. However, as there have been no clinical studies, the relationship between PAICA and OD is not clear. The aim of this study was to investigate the perception of OD in elderly PAICA patients using the Eating Assessment Tool-10 (EAT-10). A study group (Group 1) was formed of patients diagnosed with PAICA from the visualization of a pulsatile mass in the pharynx in flexible fiberoptic endoscopic examination and carotid magnetic resonance angiography tests, and a control group (Group 2) was formed of age-matched healthy volunteers. The study group was subdivided as patients with unilateral PAICA (Group 1a) and patients with bilateral PAICA (Group 1b). The Turkish version of the EAT-10 was applied to all the participants. Total EAT-10 points of ≥ 3 were accepted as abnormal. Normal (< 3) and abnormal (≥ 3) total EAT-10 points were determined in 88.9% (24/27) and 11.1% (3/27), respectively, of the control group, in 55.2% (16/29) and 44.8% (13/29) of Group 1, in 70.6% (12/17) and 29.4% (5/17) of Group 1a, and in 33.3% (4/12) and 66.7% (8/12) of Group 1b. A statistically significant difference was determined between the control group and Group 1 and Group 1b in respect of abnormal (≥ 3) EAT-10 total points (p = 0.007, p = 0.001, respectively). No statistically significant difference was determined between the control group and Group 1a (p = 0.227). Problems (EAT point ≥ 1) in item 4 (swallowing solids takes extra effort) were experienced by 13 (44.8%) patients in Group 1, 9 (75%) patients in Group 1b, and 5 (18.5%) subjects in the control group (p < 0.05). These results demonstrated that unilateral PAICA does not significantly affect swallowing, whereas bilateral PAICA created a significant negative effect. These patients experience more problems when swallowing solid food.

Device-related epistaxis risk: continuous-flow left ventricular assist device-supported patients.

BACKGROUND: The aim of this study was to analyze the effect of device-dependent factors on epistaxis episodes comparing patients supported with a continuous-flow left ventricular assist device (CF-LVAD) to patients under the same antithrombotic therapy. METHODS: Patients who underwent CF-LVAD between 2012 and 2018 were reviewed retrospectively from the institutionally adopted electronic database. Patients who underwent mitral valve replacement (MVR) surgery receiving the same anticoagulant and antiaggregant therapy were included as a control group. Demographics, epistaxis episodes, and nonepistaxis bleeding between the two groups were compared. RESULTS: A total of 179 patients met the inclusion criteria (61 patients CF-LVAD group, 118 patients MVR group). The median (range) follow-up periods for the study (CF-LVAD) and control (MVR) groups were 370 (2819) and 545.70 (2356) days, respectively. There was a significant difference for frequency of bleeding episodes per month between CF-LVAD and MVR groups (p = 0.003 < 0.05). The most common site of bleeding was the anterior septum in both groups (90.9% for the CF-MVR group and 100% for the MVR group). While 14 patients (23%) had nonepistaxis bleeding in the CF-LVAD group, only two patients (1.7%) had nonepistaxis bleeding in the MVR group. There were significant differences in nonepistaxis bleeding rates between the CF-LVAD and MVR groups (χ2=19.79, p < 0.001). CONCLUSION: Both epistaxis and nonepistaxis bleeding rates were higher in the CF-LVAD group than in the MVR group. This suggests that the use of CF-LVAD support could directly increase the risk of hemorrhagic complications. LEVEL OF EVIDENCE: 2A (Etiology/Harm).

[Ocular vestibular evoked myogenic potentials in response to bone-conducted sound stimuli: results of measurements in healthy adults]. / Kemik iletimli ses uyarilarina yanit olarak elde edilen oküler vestibüler uyarilmis miyojenik potansiyeller: Saglikli eriskinlerdeki ölçüm sonuçlari.

OBJECTIVES: This study aims to determine the normal values of ocular vestibular evoked myogenic potentials (oVEMP) in response to bone-conducted sound stimuli in healthy adults. PATIENTS AND METHODS: The study included 42 healthy adult volunteers (18 males, 24 females; mean age 39.7±11.2 years; range 20 to 60 years) (84 ears) with pure tone mean thresholds better than 20 dB, no detected nystagmus during positional tests, and no complaint involving the ear. The participants were performed otorhinolaryngologic examination, audiologic evaluation, and positional tests. Ocular vestibular evoked myogenic potentials were measured using air-conducted and bone-conducted sound stimuli and results were compared. RESULTS: No statistically significant difference was detected between the side of the ear tested and sex in terms of the latency and amplitude values (p>0.05). There was no correlation between n1, p1 latency and amplitude values with age and (p>0.05). Mean n1 latency was 9.9±1.87 milliseconds and p1 latency was 12.75±1.41 milliseconds. Mean amplitude was 5.06±1.97 µV. Interaural asymmetry ratios were 4±3% for p1, 4±3% for n1, and 8±6% for amplitude. CONCLUSION: Data obtained in this study may be accepted as normal values for healthy adults and used as reference in oVEMP studies with bone-conducted sound stimuli.