Navigating Early and Late Hematomas in Cochlear Implantation: A Tri-Case Analysis.

Cochlear implantation is a safe, popular procedure for severe hearing loss in both children and adults. Complications are categorized as major and minor, with hematomas and seromas being minor. This article discusses advanced diagnosis and treatment for three patients with post-implantation hematomas (two early, one late).

Betahistine add-on therapy for treatment of subjects with posterior benign paroxysmal positional vertigo: a randomized controlled trial / Terapia adjuvante de betaistina para o tratamento de indivíduos com vertigem posicional paroxística benigna posterior: um ensaio clínico randomizado

Abstract Introduction Benign paroxysmal positional vertigo is a common vestibular disorder that accounts for one fifth of hospital admissions due to vertigo, although it is commonly undiagnosed. Objective To evaluate the effects of betahistine add-on therapy in the treatment of subjects with posterior benign paroxysmal positional vertigo. Methods This randomized controlled study was conducted in a population of 100 subjects with posterior benign paroxysmal positional vertigo. Subjects were divided into the Epley maneuver + betahistine group (group A) and Epley maneuver only (group B) group. Subjects were evaluated before and 1-week after the maneuver using a visual analog scale and dizziness handicap inventory Results One hundred subjects completed the study protocol. The Epley maneuver had an overall success rate of 95% (96% in group A; 94% in group B, p= 0.024). Groups A and B had similar baseline visual analog scale scores (6.98 ± 2.133 and 6.27 ± 2.148, respectively, p= 0.100). After treatment, the visual analog scale score was significantly lower in both groups, and was significantly lower in group A than group B (0.74 ± 0.853 vs. 1.92 ± 1.288, respectively, p= 0.000). The change in visual analog scale score after treatment compared to baseline was also significantly greater in group A than group B (6.24 ± 2.01 vs. 4.34 ± 2.32, respectively, p= 0.000). The baseline dizziness handicap inventory values were also similar in groups A and B (55.60 ± 22.732 vs. 45.59 ± 17.049, respectively, p= 0.028). After treatment, they were significantly lower in both groups. The change in score after treatment compared to baseline was also significantly greater in group A than group B (52.44 ± 21.42 vs. 35.71 ± 13.51, respectively, p= 0.000). Conclusion The Epley maneuver is effective for treatment of benign paroxysmal positional vertigo. Betahistine add-on treatment in posterior benign paroxysmal positional vertigo resulted in improvements in both visual analog scale score and dizziness handicap inventory.

Resumo Introdução A vertigem posicional paroxística benigna é um distúrbio vestibular comum, responsável por um quinto das internações hospitalares por vertigem, embora seja comumente não diagnosticada. Objetivo Avaliar os efeitos da terapia adjuvante com betaistina no tratamento de indivíduos com vertigem posicional paroxística benigna posterior. Método Este estudo randomizado controlado foi feito em uma população de 100 indivíduos com vertigem posicional paroxística benigna posterior. Os indivíduos foram divididos nos grupos: manobra de Epley + betaistina (grupo A) e manobra de Epley apenas (grupo B). Os indivíduos foram avaliados antes e uma semana após a manobra por meio da escala visual analógica EVA e do questionário dizziness handicap inventory. Resultados Cem indivíduos completaram o protocolo do estudo. A manobra de Epley demonstrou uma taxa de sucesso global de 95% (96% no grupo A; 94% no grupo B, p = 0,024). Os grupos A e B tiveram escores basais semelhantes na EVA (6,98 ± 2,133 e 6,27 ± 2,148, respectivamente, p = 0,100). Após o tratamento, o escore na EVA foi significantemente menor em ambos os grupos e foi menor no grupo A do que no grupo B (0,74 ± 0,853 vs. 1,92 ± 1,288, respectivamente, p = 0,000). A mudança no escore da EVA após o tratamento em comparação com a linha basal também foi significativamente maior no grupo A do que no grupo B (6,24 ± 2,01 vs. 4,34 ± 2,32, respectivamente, p = 0,000). Os valores basais no dizziness handicap inventory também foram semelhantes nos grupos A e B (55,60 ± 22,732 vs. 45,59 ± 17,049, respectivamente, p = 0,028). Após o tratamento, eles foram significantemente menores em ambos os grupos. A mudança no escore após o tratamento em comparação com a linha basal também foi significantemente maior no grupo A do que no grupo B (52,44 ± 21,42 vs. 35,71 ± 13,51, respectivamente, p = 0,000). Conclusão A manobra de Epley é eficaz no tratamento da vertigem posicional paroxística benigna. O tratamento complementar com betaistina na vertigem posicional paroxística benigna posterior resultou em melhoria tanto no escore da EVA quanto no do dizziness handicap inventory.

Betahistine add-on therapy for treatment of subjects with posterior benign paroxysmal positional vertigo: a randomized controlled trial.

INTRODUCTION: Benign paroxysmal positional vertigo is a common vestibular disorder that accounts for one fifth of hospital admissions due to vertigo, although it is commonly undiagnosed. OBJECTIVE: To evaluate the effects of betahistine add-on therapy in the treatment of subjects with posterior benign paroxysmal positional vertigo. METHODS: This randomized controlled study was conducted in a population of 100 subjects with posterior benign paroxysmal positional vertigo. Subjects were divided into the Epley maneuver + betahistine group (group A) and Epley maneuver only (group B) group. Subjects were evaluated before and 1-week after the maneuver using a visual analog scale and dizziness handicap inventory RESULTS: One hundred subjects completed the study protocol. The Epley maneuver had an overall success rate of 95% (96% in group A; 94% in group B, p =  0.024). Groups A and B had similar baseline visual analog scale scores (6.98 ±â€¯2.133 and 6.27 ±â€¯2.148, respectively, p = 0.100). After treatment, the visual analog scale score was significantly lower in both groups, and was significantly lower in group A than group B (0.74 ±â€¯0.853 vs. 1.92 ±â€¯1.288, respectively, p = 0.000). The change in visual analog scale score after treatment compared to baseline was also significantly greater in group A than group B (6.24 ±â€¯2.01 vs. 4.34 ±â€¯2.32, respectively, p = 0.000). The baseline dizziness handicap inventory values were also similar in groups A and B (55.60 ±â€¯22.732 vs. 45.59 ±â€¯17.049, respectively, p = 0.028). After treatment, they were significantly lower in both groups. The change in score after treatment compared to baseline was also significantly greater in group A than group B (52.44 ±â€¯21.42 vs. 35.71 ±â€¯13.51, respectively, p = 0.000). CONCLUSION: The Epley maneuver is effective for treatment of benign paroxysmal positional vertigo. Betahistine add-on treatment in posterior benign paroxysmal positional vertigo resulted in improvements in both visual analog scale score and dizziness handicap inventory.

Incidence and Management of Delayed Epistaxis Following Endoscopic Skull Base Surgery.

OBJECTIVE: Among other complications of endoscopic skull base surgery, delayed epistaxis has not been given much importance. This report presents postoperative delayed nosebleed cases in a large number of patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of lesions. METHODS: Three hundred and sixty three patients who were reached to the sellar region by endoscopic endonasal transsphenoidal route and operated was included in the study. Retrospective chart reviewing of these patients was performed. The correlation between the duration of nosebleeds, bleeding location, treatment methods and comorbidities of the patients were evaluated. RESULTS: Ten patients (3.6%) reported delayed epistaxis in the postoperative period and were referred to the otolaryngology department. Postoperative epistaxis occurred between days 7th and 33th (mean 16.5) days. The treatment consisted of chemical silver nitrate cauterization in two patients, return to the operating room in three patients, nasal packing in five patients. CONCLUSION: Delayed postoperative epistaxis often has no obvious etiology, and intervention requires teamworking. Well-coordinated teamworking of the neurosurgeon with other specialities such as neuroradiology and otorhinolaryngology is needed to achieve better results.

The impact of bariatric surgery on eustachian tube dysfunction.

PURPOSE: We aimed to evaluate the relationship between acute loss of weight after 6 months of bariatric surgery and the occurrence of tubal dysfunction symptoms METHODS: We recruited 76 patients who had undergone bariatric surgery between 2018 and 2019. It was planned to see if the change in Body Mass Index (BMI) caused changes in the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores of individuals. Regardless of the questionnaire, patients were also asked for 3 symptoms (autophony, fullness in the ear, hearing their own breath in the ear) before and 6 months after bariatric surgery. RESULTS: The mean age of the study group was 39.32 ± 11.09 years and 80.3% percent of the patients were female. The mean weight loss of the patients at the 6th month was 44.67 ± 13.10 kg, and mean weight loss rate was % 35.06 ± 8.01. The incidence of hearing their own breath, autophony and fullness of the ear were 25%, 22.4% and 11.8%, respectively. The proportion of those experiencing any of these three complaints was 30.3% (n = 23). The ETDQ scores of the cases ranged from 7 to 27, with an average of 9.38 ± 4.28. There are 10.5% (n = 8) paints with a score of ≥ 14.5 as regarded as patients with Eustachian tube dysfunction (ETD). The mean age of patients with ETD was significantly higher (p < 0.05) than patients without ETD. Gender distributions, weight loss rates, smoking, previous operation and additional disease distributions do not show statistically significant differences between patients with and without ETD (p > 0.05). CONCLUSION: Present study indicated a 10.5% ETD incidence after bariatric surgery. ETDQ questionnaire can be used for ETD screening in patients who underwent bariatric surgery, which will be an overlooked complication in this group of subjects.