Comparison of Sinonasal Complications of Microscopic and Endoscopic Approaches for Transsphenoidal Hypophyseal Surgery: Prospective Study.

AIM: To compare sinonasal complications after microscopic and endoscopic approaches for pituitary adenomas. MATERIAL AND METHODS: At our clinic, sinonasal complications occurred in 31 patients who underwent microscopic transsphenoidal surgery between 2007 and 2014 and in 32 patients who underwent endoscopic transsphenoidal surgery between 2014 and 2016. We statistically compared the complications observed during endoscopic sinonasal examination performed by an otorhinolaryngologist. RESULTS: Sinonasal pathology occurred in 22 of the 31 patients (70.9%) in the microscopy group (Group 1) and 19 of the 32 (59.3%) in the endoscopy group (Group 2). Of the 31 patients in Group 1, 13 had nasal septal perforation, 13 had nasal synechiae, three had anosmia, two had hyposmia and one had saddle nose deformity. In Group 2, no patient had nasal septal perforation, whereas eight had nasal synechiae, one had anosmia, 11 had hyposmia, and 4 had infection. CONCLUSION: There were no statistically significant differences in sinonasal complications (e.g. synechiae, anosmia, deformity, and sinusitis) between the two groups. Although the perforation rate (especially for perforations in the middle portion of the septum) was statistically greater in Group 1 than in Group 2, the hyposmia rate was statistically greater in Group 2 than in Group 1.

Follow-Up Results of Newborns after Hearing Screening at a Training and Research Hospital in Turkey.

OBJECTIVE: This study aimed to present the follow-up results of newborns after universal newborn hearing screening at a Training and Research Hospital in Istanbul and to determine the ages of diagnosis, hearing aid fitting, and cochlear implantation in newborns with hearing loss. MATERIALS AND METHODS: A total of 5985 newborns were screened between December 2009 and August 2011 using the transient evoked otoacoustic emission test as the first two steps and automated auditory brainstem response (ABR) test as the third step. Newborns who failed the screening tests were referred to a tertiary hospital for clinic ABR and were followed up at least for 2 years. RESULTS: Of 5985 newborns, 5116 (85.5%) completed the screening. Of 53 newborns who were referred to a tertiary hospital, 13 (0.25%) had a hearing impairment. The mean age of diagnosis, hearing aid fitting, and cochlear implantation were 6.1, 9.5, and 24.5 months, respectively. Among the risk factors for hearing impairment, neonatal intensive care (60%) and consanguineous marriage (50%) were the most common ones that were encountered. CONCLUSION: Our results were consistent with the national literature. Consanguineous marriage may be a risk factor for hearing impairment where it is commonly practiced because consanguineous marriage is significantly high in parents of deaf children. The ages of diagnosis and hearing aid fitting are still beyond the recommended ages by the Joint Committee on Infant Hearing.

Surgical outcomes of primary and revision endoscopic dacryocystorhinostomy.

OBJECTIVE: In the current study, whereas the results of endoscopic primary and revision endoscopic dacryocystorhinostomies (END-DCR) were evaluated, the success rates in patients who did or did not undergo nasal surgery were also compared. METHODS: A retrospective medical record review of 70 patients (with a total of 72 affected cases) who were admitted to our clinic with a primary complaint of epiphora between January 2002 and July 2009 was performed. Patients who required additional nasal procedures were also included in the analysis. A successful DCR was defined as relief of symptoms on testing with irrigation at the last follow-up visit. RESULTS: The success rates were 82.1% (23/28 DCRs) in the primary END-DCR group and 84.1% (37/44 DCRs) in the revision END-DCR group. There were no significant differences between the groups regarding overall surgical success rates (P = 0.829). The need for additional nasal surgery was significantly higher in the revision cases (52.3%) than the primary cases (28.6%; P = 0.048). No significant difference regarding success rates existed between the patients who required an additional septoplasty or ancillary sinus surgery and the patients who did not have nasal pathology and underwent END-DCR alone (P = 0.456). The mean follow-up period was 11 months in the revision END-DCR group and 8 months in the primary END-DCR group. CONCLUSIONS: Endoscopic DCR should be considered as the treatment of choice in cases with intranasal pathologies. Endoscopic DCR is a safe and effective procedure in revision cases, as well as in primary cases.

The results of concurrent functional endoscopic sinus surgery and rhinoplasty.

OBJECTIVE: The indications, management, and results are discussed in 45 patients who underwent the concurrent functional endoscopic sinus surgery (FESS) and rhinoplasty. STUDY DESIGN: Retrospective clinical study. PATIENTS AND METHODS: There were 27 women and 18 men with a mean age of 28 years. 28 patients had chronic rhinosinusitis and 17 patients had nasal polyposis refractory to medical therapy underwent the combined procedure by the same otolaryngologist. RESULTS: A review of our 45 combined procedure performed between 2000 and 2005. There were no life-threatening severe complications noted in this population. The patients were also satisfied with the aesthetic outcome. CONCLUSION: Combined rhinoplasty and endoscopic sinus surgery can be performed safely, cost- effectively and with perfect results in selected patients.