Refractive Error Impact on Video Head Impulse Test Outcomes.

OBJECTIVE: The objective of this study is to investigate the potential influence of refractive error on Video Head Impulse Test outcomes. MATERIAL AND METHODS: Eighty-two patients were included in the study, and all patients underwent video head impulse testing. Patients were divided into four groups according to their refractive error: myopia, myopia-astigmatism, astigmatism, and emmetropia as control. RESULTS: Patients with myopia are younger than patients with astigmatism and controls; similarly, patients with myopia-astigmatism are younger than patients with astigmatism. The right and left lateral, anterior, and posterior gain values were statistically significantly lower in the control group compared with myopia and myopia-astigmatism patients (p < 0.05). There was a statistically significant relationship between the right and left lateral, anterior, and posterior gain values and the degree of myopia in the patients (p < 0.05). CONCLUSION: The results of the Video Head Impulse Test gain in myopia patients are higher than that in patients without refractive error. In addition, age may have an effect on gain values. It is important to consider this factor when evaluating the results of the Video Head Impulse Test in patients, and corrections should be made if necessary. LEVEL OF EVIDENCE: Level 3 Laryngoscope, 2024.

Risk of hearing loss in the opposite ear after tympanomastoidectomy.

PURPOSE: The definitive treatment for chronic suppurative otitis media is surgery. Surgical technique and procedure varies according to individual case findings and pathology and may require mastoidectomies in which the canal wall is preserved or lowered to eradicate disease from mastoid air cells. Surgical treatment of chronic middle ear disease carries a risk of damage to the inner ear. The aim of this study was to investigate whether the noise produced by the tour system following chronic ear surgery causes sensorineural hearing loss, a condition for which not many studies have been published in the literature. METHODS: The study consisted of a total of 49 patients with type I, type II and type III canal wall preservation and 62 patients with tympanoplasty with canal wall preservation and lowering. Bone and air thresholds were compared before and after middle ear surgery. Changes in bone and air thresholds were compared according to the type of tympanoplasty. RESULTS: In the ICW-I, ICW-II and ICW-III tympanoplasties, and in the ICW and CWD tympanoplasties, the preoperative and postoperative values of the opposite ear hearing measurements were performed, and did not differ according to the type of surgery. There is no correlation drilling duration and hearing for the opposite ear. CONCLUSION: The prevention of postoperative sensorineural hearing loss depends on multiple factors, and assessing the magnitude of hearing loss in relation to these factors is important in determining the success of the surgery.

An Unusual Case: Nasolacrimal Stent Penetrating the Oral Cavity.

Lacrimal bypass tubes create a fistula from the conjunctiva to the lacrimal sac or the nasal cavity. Fluoroscopic nonoperative placement of a plastic stent has shown successful results in the treatment of epiphora. Polyurethane lacrimal stents have been reported as a safe, easy, non-surgical treatment in the treatment of distal lacrimal obstruction. Recurrence due to stent occlusion of the granulation tissue is common. Stent displacement is very rare. We presented the first case of the stent protruded into the mouth in the literature.

Low Grade Chondrosarcoma of the Posterior Nasal Septum.

Chondrosarcoma originating from the nasal septum is extremely rare. CT, MRI and biopsy are standard in diagnosis. Although wide surgical excision of chondrosarcoma is used in the treatment, endoscopic excision can be recommended in appropriate cases. In this case report, we have presented a case of chondrosarcoma that was excised endoscopically and no recurrence or distant metastasis was observed in the 5-year follow-up.

The effects of SARS-CoV-2 on hearing thresholds in COVID-19 patients with non-hospitalized mild disease.

INTRODUCTION: COVID-19 may have many nonspecific symptoms, such as hearing loss, tinnitus and dizziness. This study aims to investigate the effects of SARS-CoV-2 on the hearing thresholds of patients with COVID-19. METHODS: A total of 20 patients aged 20-55 years who were diagnosed with COVID-19 were included in this study. The relationship between the pure-tone thresholds of patients before and after COVID-19 was evaluated. RESULTS: There was no statistically significant difference between bone conduction pure-tone thresholds in all frequencies before and after COVID-19. CONCLUSION: SARS-CoV-2 has no effects on the hearing thresholds in patients with non-hospitalized mild COVID-19 disease. Further studies are needed to investigate the possible effects of SARS-CoV-2 on the auditory system.

Does Septorhinoplasty-Related Periorbital Edema Affect Intraocular Pressure and Retina?

BACKGROUND: Open rhinoplasty has been performed for over 50 years. Rhinoplasty procedures have a risk of complications and it is important to follow each step diligently in order to avoid complications. Periorbital edema is the most common complication of septorhinoplasty. As far as we are aware, there are no studies in the available literature examining the impact of the septorhinoplasty on intraocular pressure and the retina. OBJECTIVES: The aim of this study was to evaluate the effects of septorhinoplasty-related periorbital edema on intraocular pressure and the retina by means of objective tests. METHODS: Ten patients with phase 4 periorbital edema (5 males and 5 females) who underwent open rhinoplasty with bilateral lateral osteotomies were enrolled in the study. All the patients were examined by an eye specialist for visual acuity, intraocular pressure, retinal nerve fiber layer, and ganglion cell complex pathologies with optical coherence tomography preoperatively and postoperatively on the seventh day. RESULTS: Preoperative and postoperative best-corrected visual acuity; intraocular pressure; average, superior, and inferior retinal nerve fiber layer thickness; and total, superior, and inferior ganglion cell complex thickness in both eyes for all patients were within normal limits. There was no statistical difference between preoperative and postoperative values (P > .05). CONCLUSION: We concluded that periorbital edema after septorhinoplasty causes no significant complications affecting intraocular pressure and visual acuity. We believe that when osteotomies and local anesthetic injections are undertaken correctly, periorbital complications do not affect vision.

Evaluation of Hearing Thresholds by Using a Mobile Application in Children with Otitis Media with Effusion.

OBJECTIVE: Otitis media with effusion (OME) is the most common cause of hearing loss in children. Early diagnosis is important as hearing loss affects speech and language development in children. The aim of this study was to compare conventional audiometry with the Android mobile operating system application Hearing TestTM in the evaluation of hearing thresholds in children with OME and to determine the accuracy and reliability of the mobile application. Design and Study Sample: Fifty school-age children aged between 5 and 15 years with OME in at least 1 ear were included in the study. First, hearing thresholds were obtained by conventional audiometric methods and the degree of hearing loss was determined. Then, the hearing thresholds of the patients were measured using the smartphone-based Hearing TestTM application. The data were compared using Cohen's kappa analysis. RESULTS: OME was detected in 88 ears. There was no statistically significant correlation between the hearing threshold results obtained with the mobile phone and conventional audiometry at 500, 1,000, 2,000, and 4,000 Hz. CONCLUSION: The Android mobile phone application Hearing TestTM (version 1.1.3) is not an appropriate screening test to detect hearing loss in children with OME.

Relationship Between Primary Acquired Nasolacrimal Duct Obstruction, Paranasal Abnormalities and Nasal Septal Deviation.

OBJECTIVES: This study aimed to investigate the relationship between nasal septal deviation and paranasal abnormalities in the etiology of primary acquired nasolacrimal duct obstruction (PANDO). METHODS: A total of 37 (8 men, 29 women) patients (48 eyes with PANDO) between the ages 20 and 77 years (mean age, 52.8 ±â€Š13.1 years) were included in the study. In the axial sections of paranasal sinus computed tomography, the transverse diameters at the most upper part and the most distal part of the nasolacrimal canal were separately measured. In addition, the relationships between PANDO and nasal septal deviation, inferior turbinate hypertrophy, agger nasi cells, paradoxical middle turbinate, concha bullosa, and the angle between the bony inferior turbinate and medial wall of the maxillary sinus were investigated. RESULTS: A statistically significant relationship was found between PANDO and the axial location of septal deviation classification, axial angle of septal deviation classification, paradoxical middle turbinate, angle between the bony inferior turbinate and medial wall of the maxillary sinus and inferior meatus measure. CONCLUSION: The authors concluded that the location and angle of the nasal septal deviation in the axial plane, width of the angle between the bony inferior turbinate and medial wall of the maxillary sinus, inferior meatus measure, and paradoxical middle turbinate may be effective factors in the etiology of PANDO.

Investigating the effects of inferior turbinate outfracture on the lacrimal system by evaluating the results of paranasal sinus computed tomography and nasolacrimal irrigation test.

OBJECTIVES: This study aims to investigate the effects of inferior turbinate outfracture on the nasolacrimal system and tear flow. METHODS: Forty-seven patients (26 males, 21 females) between the ages 18 and 52 years (mean age-29.0 ± 9.6 years) were included in the study. Preoperative nasal examinations and paranasal sinus computed tomography of the patients were carried out; the direction, location, nasal septum deviation classification and inferior turbinate hypertrophy size classification were evaluated. Lacrimal irrigation test was performed preoperatively and 14 days postoperatively. RESULTS: The study included 47 patients who underwent septoplasty and inferior turbinate outfracture. The mean duration of lacrimal irrigation test was 2.9 ± 0.8 s on the right side and 3.0 ± 1.1 s on the left side preoperatively, and 2.1 ± 0.8 s on the right side and 2.2 ± 1.0 s on the left side postoperatively. No significant relationship between direction, location classification, angle nasal septum deviation classification and lacrimal irrigation test duration was found. A significant relationship between size classification of the left inferior turbinate and preoperative lacrimal irrigation test duration was noted (p = 0.030). Moreover, a significant decrease between preoperative and postoperative lacrimal irrigation test duration after inferior turbinate outfracture (p = 0.000) was noted. CONCLUSION: We concluded that outfracture of the inferior turbinate with septoplasty surgery may benefit the regulation of tear flow. In addition, we concluded that lacrimal irrigation test duration may be effective in determining the patients with subclinical nasolacrimal duct partial obstruction due to inferior turbinate pathologies.

Mattress Suture Technique for Caudal Septum Dislocations in Open and Endonasal Septoplasty: Which Approach is Better?

OBJECTIVES: Various techniques have been described to correct caudal septum dislocations but the issue has not been resolved conclusively. This study aimed to describe a suture technique that can be used to correct and stabilize the caudal septum on the maxillary spine and also to evaluate the effects on patientsymptoms. METHODS: Fifty-two patients with caudal septal dislocation were included in this study. Nineteen of the patients underwent open septoplasty and 33 patients underwent endonasal septoplasty. The caudal cartilage septums were fixed to the maxillary spine with horizontal mattress suturing in all patients. The patient followed up between 3 and 24th month. The modified "NOSE" survey was used to assess surgical outcome in all patients. The degree of septal correction was also classified. RESULTS: Complete correction was achieved in the postoperative period in 96% of the patients. The status was near complete correction in 2 (3.8%) of the patients. But in these 2 patients, degree of caudal septal dislocation was corrected from severe to moderate after surgery and the fixation suture side is correct and stable. Postoperative modified NOSE survey scores were lower than the preoperative scores in all open and endonasal septoplasty groups (P <0.05). NOSE 2 (nasal blockage or obstruction) and NOSE 4 (trouble sleeping) scores were higher in patients with higher follow-up duration in open septoplasty group. CONCLUSION: Suturing technique is quite suitable for caudal septum dislocations and can easily be used in open and endonasal septoplasty. This suture reduces postoperative NOSE scores and the patients are satisfied with the results of the surgery. The septal stability may decrease in open septoplasty group with the longer post-operative duration. However, wide exposure can be ensured with an open septorhinoplasty approach. We concluded that it will be better to use endonasal septoplasty in appropriate cases and suture with nonabsorbable sutures.

The effect of adenoid hypertrophy on hearing thresholds in children with otitis media with effusion.

INTRODUCTION: Otitis media with effusion is common middle ear mucosa disease that can cause hearing loss in children. Adenoid hypertrophy can cause recurrent acute otitis media in addition to otitis media with effusion as a result of eustachian tube dysfunction and primary infection focus. The aim of this study was to investigate the effect of adenoid hypertrophy on the hearing threshold in children suffering from otitis media with effusion. METHODS: Children of school age with otitis media with effusion were included in the study. The size and location of the adenoid tissue were determined by examination with a flexible endoscope. Four adenoid size groups were determined according to the percentage of choanal closure. The coverage was 0-25% in the first group, 26-50% in the second group, 51-75% in the third group and 76-100% in the 4th group. The location of the adenoid tissue in the nasopharynx was divided into three groups. In group A, the adenoid tissue was not in contact with torus tubarius. In group B, the adenoid tissue was in contact with the torus tubarius but did not cover it. In group C, the adenoid tissue covered the torus tubarius completely. Bone and air conduction thresholds were determined using standard procedures. The statistical relationship between the size and location of adenoid tissue and the hearing thresholds was investigated. RESULTS: The study was conducted with the 88 ears of 50 children aged 5-15 years. The median values of mean air conduction thresholds at 500 Hz, 1000 Hz, and 2000 Hz in the adenoid tissue size groups 1-4 were 22 dB HL, 20 dB HL, 15 dB HL, and 20 dB HL respectively. The median values of the mean air conduction thresholds were 20 dB HL, 20 dBHL and 18 dB HL in the adenoid location group A-C, respectively. No significant correlation was found between the groups (p:0.213) and the relevant hearing values (p:0.670). Type B tympanogram was identified in 46 ears and type C tympanogram in 42 ears. The mean hearing thresholds were significantly higher in the ears with a type B tympanogram in the otitis media with effusion cases. (P < 0.001).There was no significant correlation between the duration of effusion and the adenoid size (p:0.931), adenoid location (p:0.626) and hearing threshold (p:0.815). CONCLUSION: We concluded that adenoid tissue size and location have no effect on hearing thresholds and the duration of effusion in otitis media with effusion. We suggest caution before deciding on adenoidectomy in otitis media with effusion cases. Adenoidectomy should not be performed in children over 4 years of age unless there is a definite indication such as nasal obstruction or chronic adenitis.

Does amikacin treatment cause subclinical hearing loss in patients with cystic fibrosis?

INTRODUCTION: Aminoglycosides (AGs) have been widely used for potential life-threatening bacterial infections. Although AGs are well known for their ototoxic side effects, some AGs such as amikacin are considered less harmful to auditory functions; thus, auditory monitoring is mostly neglected during treatment with these drugs. OBJECTIVE: To reflect the potential auditory hazards of repeated amikacin use on the patients with cystic fibrosis (CF). METHOD: 32CF patients with prior exposure to at least 3 courses of amikacin (the CF group) and 35 non-CF patients visiting the outpatient clinic with any complaint other than hearing loss and no history of treatment with any AG(the control, or C group) were compared with pure-tone audiometry(PTA). The diagnosis of CF was made by Nanoduck sweat test. RESULTS: The average age of the participants were 8.25 ± 2.76 years in the CF group and 8.58 ± 2.00 years in the C group (ranging from 5 to 13 years). 29 (43.28%) of the cases were female and 38 (56.71%) were male. Clinical SNHL(sensorineural hearing loss) was detected in 4 of the 32 subjects in the CF group. None of the subjects in the C group exhibited clinical SNHL. There was no statistically significant difference between the groups with regard to presence or absence of clinical SNHL (p > 0.05). However, hearing levels of the CF group were around 20 dB(decibel) HL(hearing loss), whereas hearing levels of the C group were around 5 dB. This difference was statistically significant for the pure tone averages of both all frequencies and speech frequencies (p < 0.05). CONCLUSION: Repetitive exposure to AGs can cause permanent, although mild, sensorineural hearing loss. For prevention, hearing status of the patient should be closely monitored and treatment of choice should be precisely tailored according to the audiological evaluation. This is especially important in patients with CF who frequently experience medical conditions necessitating AGs use.

Nasobronchial interaction.

Upper and lower airways can be considered as a unified morphofunctional unit. In this paper, nasobronchial interactions are evaluated based on literature.To discuss nasobronchial interactions, literature review from PubMed since 1982 is evaluated. Data base was including the terms "nasobronchial interaction, nasal and bronchial". Asthma and rhinosinusitis may be associated with environmental factors and immunological predisposition. Treatment of rhinosinusitis may decrease asthma exacerbations. It was concluded that "one airway, one disease"-concept may be accepted when considering naso-bronchial interaction. Asthma treatment should also mean treating the nose as good as treating patients with nasal symptoms. To reach the succesful results it should be associated with evaluation of lung functions.

Subjective audiological tests and transient evoked otoacoustic emissions in patients with rheumatoid arthritis: analysis of the factors affecting hearing levels.

We investigated hearing functions in patients with rheumatoid arthritis (RA) using audiological tests and transient evoked otoacoustic emissions (TEOAEs). The study group consisted of 20 adult patients with RA (7 males, 13 females); 20 adult healthy subjects without RA (7 males, 13 females) were recruited as controls. All patients were evaluated by pure tone audiometry, high frequency audiometry, tympanometry and TEOAEs. There were no statistical differences between the study and control groups with respect to the pure tone and high frequency audiometries. TEOAE results of 1.0-2.0 kHz % and of 1.5 and 3.0 kHz amplitude values were significantly lower, and ipsilateral stapes reflex threshold value at 1.0 kHz was significantly higher in the study group when compared to respective values in the control group. In elderly patients and those with longer disease duration, RA nodules and higher methotrexate cumulative doses, hearing thresholds increased and TEOAE values decreased. In active stage of the disease, hearing thresholds diminished and in higher Brinkman Index values, TEOAE values decreased. Compliance values decreased in patients with higher Ritchie Articular Index, C-reactive protein, erythrocyte sedimentation rate and platelet counts, and longer disease duration. Sensorineural hearing loss is generally observed in patients with RA, and this condition may be detected by TEOAEs in an early period of the disease. Inflammation during the active stage of the disease and the subsequent fibrosis may cause conductive hearing loss of varying degrees. In those patients detected as having initiation of TEOAE decrease, vasodilator treatment and antioxidant drugs may be useful in protecting the inner ear.

Does subjective tinnitus cause sexual disturbance?

OBJECTIVE: Tinnitus can cause psychological problems, which can affect sexual performance. The aim of this study was to investigate sexual disturbance related to the psychological problems of patients with subjective tinnitus. MATERIALS AND METHOD: The subjective tinnitus group with normal hearing levels consisted of 20 patients (10 male, 10 female) who were nonpsychiatric. The control group consisted of 20 healthy patients (10 male, 10 female) with normal hearing levels who did not have tinnitus and were nonpsychiatric. All subjects were married and had an active sexual life. Using a questionnaire, the subjective tinnitus loudness level score (STLL-Sc) was found. Using Zung Anxiety and Depression Scale, self-rating depression scale (SDS) was found in the study and control groups. Sexual function was assessed in all male subjects with the International Index of Erectile Functions (IIEF) and in all female subjects with the Female Sexual Function Index (FSFI). RESULTS: In females, the satisfaction subscore was slightly lower than normal limits in both the study and control groups. In males, the IIEF showed an insignificant, negative correlation with the STLL-Sc and the SDS and a positive correlation with tinnitus duration. In females, the FSFI showed an insignificant negative correlation with the STLL-Sc and a positive correlation with tinnitus duration and the SDS. CONCLUSION: Sexual disturbance is seen in very quiet- and intermediate-level tinnitus sufferers in the early period of the disease. Over time, they become used to living with their tinnitus, and no loss in sexual performance is seen. In the future, we plan to investigate the sexual disturbance of patients with severe STLL-Scs.