Investigation of factors affecting pediatric type 1 endoscopic tympanoplasty results and success rates of surgery.

OBJECTIVE: There are many factors that affect the results of tympanoplasty in children. Recurrent ear infections, hearing loss, and more serious complications due to cholesteatoma may be observed. This study examined factors affecting the success of type 1 endoscopic tympanoplasty surgery in pediatric patients and investigated recommended procedures to increase the success of the operation. METHODS: Our study included pediatric patients who underwent type 1 endoscopic tympanoplasty operation for chronic otitis media. Patient files were analyzed retrospectively. Hearing results before and after the operations were recorded.. Patients were divided into groups according to gender, age (<12 age group, ≥12 age group), and perforation type. Hearing results and physical examination findings were compared for each group. RESULTS: A total of 204 pediatric patients were included in our study: 114 were male and 90 were female. Patients' hearing results were compared according to the size and location of their tympanic membrane perforations. Hearing loss was found to increase as the size of the tympanic membrane perforation increased. In addition, it was observed that perforations in the posterior quadrant caused more severe hearing loss than in the other quadrants. The postoperative results of the two groups <12 years old, and ≥12 years old were evaluated according to age. Postoperative improvement was higher in the ≥12 age group compared to the <12 age group. CONCLUSION: According to the results of this study, tympanoplasty surgeries performed on patients younger than 12 have a decreased success rate. Among the many factors that affect the success of an operation, age is one of the most important. There are many factors that affect the results of the operation, perforation size and localization is one of them. There are many factors that affect the success of surgery such as pediatric patients and adult patients. It is useful to make a personal evaluation and to plan the surgery by evaluating the obstacles such as eustachian tube maturation and difficulty in postoperative care in pediatric patients.

Comparison of crushed cartilage used and not used as camouflage grafts in patients who had undergone septorhinoplasty.

OBJECTIVE: Septorhinoplasty is the most frequently performed aesthetic operation. Many techniques are used in septorhinoplasty, and these techniques can affect patient satisfaction, which is one of the most important parameters showing success in surgery. In this study, we aimed to compare the postoperative satisfaction of patients with and without crushed cartilage onlay grafts. METHODS: Patients who underwent septorhinoplasty between 2017 and 2019 were included in the study. A rhinoplasty outcomes evaluation (ROE) questionnaire and a visual analog scale (VAS) were completed before and after surgery. Pre- and postoperative values were compared. The patients were classified into two groups as patients with or without crushed cartilage grafts, and the results were compared. RESULTS: A total of patients were included in our study, 54 of which were female, and 39 were male. Results showed that post-operative ROE and VAS scores were statistically significantly improved (p < 0.05). In the group with crushed cartilage, the 12th month ROE and VAS scores were lower than the group without crushed cartilage (p < 0.05). CONCLUSION: In the group with crushed cartilage, the satisfaction levels in the 12th month were lower than those of the patients without crushed cartilage.

Is there a relationship between middle concha bullosa and ethmoid roof asymmetry? / Existe uma relação entre a concha média bolhosa e a assimetria do teto etmoidal?

Abstract Introduction The middle turbinate and ethmoid roof are intranasal structures and may have many anatomical variations. These structures, which serve as anatomical markers during functional sinus surgery, are important for preventing complications and performing a proper surgery. Knowledge of anatomical variations will increase surgical success and reduce complications. Objective We aimed to investigate the presence of asymmetry in the ethmoidal roof and anatomical variation in patients with and without concha bullosa. Methods In this study, the files of patients who underwent paranasal computed tomography between 2012 and 2018 were analyzed retrospectively. The patients were divided into two groups, as patients with and without concha bullosa. Differences between the two groups in terms of age, gender, septum deviation, ethmoid artery dehiscence, ethmoid roof asymmetry were examined. Results The 369 patients included in our study were divided into two groups; those with concha bullosa and those without concha bullosa. The mean age of the patients with concha bullosa was 36.1 ± 13.4 (min-max: 12-74) and the mean age of patients without concha bullosa was 37.5 ± 14.3 (min-max: 10-81). The ethmoid roof depths were compared between the two groups and a significant difference was observed (p < 0.001). The ethmoid roof depth was higher in the group with concha bullosa (p < 0.001). Conclusion The results of our study indicate that the ethmoidal roof tends to be higher in patients with middle concha bullosa.

Resumo Introdução A concha média e o teto etmoidal são estruturas intranasais e podem apresentar muitas variações anatômicas. Essas estruturas, usadas como marcadores anatômicos durante a cirurgia sinusal funcional, são importantes para evitar complicações e para a feitura adequada da cirurgia. O conhecimento das variações anatômicas aumenta o sucesso cirúrgico e reduz as complicações. Objetivo Investigar a presença de assimetria no teto etmoidal e variações anatômicas em pacientes com e sem concha bolhosa. Método Os prontuários dos pacientes submetidos à tomografia computadorizada de seios paranasais entre 2012 e 2018 foram analisados retrospectivamente. Os pacientes foram divididos em dois grupos, pacientes com e sem concha bolhosa. As diferenças entre os dois grupos em termos de idade, sexo, desvio do septo, deiscência da artéria etmoidal e assimetria do teto etmoidal foram avaliadas. Resultados Os 369 pacientes incluídos em nosso estudo foram divididos em dois grupos: com concha bolhosa e sem concha bolhosa. A média de idade dos pacientes com concha bolhosa foi de 36,1 ± 13,4 (mín-máx: 12-74 anos) e a média de idade dos pacientes sem concha bolhosa foi de 37,5 ± 14,3 (mín-máx: 10-81 anos). As profundidades do teto etmoidal foram comparadas entre os dois grupos, observou-se diferença significante (p < 0,001). Observou-se que a profundidade do teto etmoidal foi maior no grupo com concha bolhosa (p < 0,001). Conclusão O resultado do nosso estudo indica que pacientes com concha média bolhosa tendem a apresentar uma maior profundidade do teto etmoidal.

Is there a relationship between middle concha bullosa and ethmoid roof asymmetry?

INTRODUCTION: The middle turbinate and ethmoid roof are intranasal structures and may have many anatomical variations. These structures, which serve as anatomical markers during functional sinus surgery, are important for preventing complications and performing a proper surgery. Knowledge of anatomical variations will increase surgical success and reduce complications. OBJECTIVE: We aimed to investigate the presence of asymmetry in the ethmoidal roof and anatomical variation in patients with and without concha bullosa. METHODS: In this study, the files of patients who underwent paranasal computed tomography between 2012 and 2018 were analyzed retrospectively. The patients were divided into two groups, as patients with and without concha bullosa. Differences between the two groups in terms of age, gender, septum deviation, ethmoid artery dehiscence, ethmoid roof asymmetry were examined. RESULTS: The 369 patients included in our study were divided into two groups; those with concha bullosa and those without concha bullosa. The mean age of the patients with concha bullosa was 36.1 ±â€¯13.4 (min-max: 12-74) and the mean age of patients without concha bullosa was 37.5 ±â€¯14.3 (min-max: 10-81). The ethmoid roof depths were compared between the two groups and a significant difference was observed (p < 0.001). The ethmoid roof depth was higher in the group with concha bullosa (p < 0.001). CONCLUSION: The results of our study indicate that the ethmoidal roof tends to be higher in patients with middle concha bullosa.

Olfactory Cleft Width and Volume: Possible Risk Factors for Postinfectious Olfactory Dysfunction.

OBJECTIVES/HYPOTHESIS: Upper respiratory tract infections are a common cause of temporary and permanent olfactory dysfunction in the general population. Postviral or postinfectious olfactory loss (PIOL) develops only in rare cases. The aim of this study was to investigate the anatomical features of olfactory cleft (OC) in patients with PIOL to shed light on possible predisposing factors for PIOL. STUDY DESIGN: Retrospective study. METHODS: We retrospectively evaluated paranasal sinus computed tomography (CT) scan results of patients diagnosed with PIOL. A control group consisted of normosmic individuals who underwent paranasal sinus CT scans before septoplasty surgery. We compared the olfactory fossa depth, OC width, and volume on the CT scans of the PIOL and control groups. RESULTS: In total, 71 individuals fulfilled the study criteria (PIOL group, n = 32; control group, n = 39). There was no statistically significant difference in the olfactory fossa depth in the two groups. The OC width and volume in the PIOL group was found to be significantly increased than that in the control group (P < .001 for both). CONCLUSIONS: Patients with PIOL had increased OC width and volume than the healthy controls. An extra-wide olfactory cleft may be a predisposing factor in the pathogenesis of PIOL. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:5-9, 2021.

Is septoplasty effective rhinogenic headache in patients with isolated contact point between inferior turbinate and septal spur?

BACKGROUND: Rhinogenic headache is a painful sensation in the head and face due to intranasal contact point without any mass or inflammatory findings. Surgery is recommended in patients with nasal obstruction; however the approach in case of isolated mucosal contact point that does not cause obstruction is controversial. Our aim is to observe changes in the severity of headache in patients with isolated mucosal contact point and headache who do not complain of nasal obstruction. METHODS: Our study included patients with unilateral headache without any nasal and/or paranasal sinus pathology. We confirmed the presence of mucosal contact by nasal endoscopy and by computed tomography (CT). One hundred patients with isolated mucosal contact point without any problem in breathing were included in this study. All participants were treated by topical nasal corticosteroid for a month. Surgery was recommended to the patients with no satisfactory relieve of headache. Visual Analog Scales (VAS) were used to evaluate the severity of headache in patients at time of diagnosis (0 month), after a medical treatment (1st month) and after a surgical or medical treatment (6th month). The results were compared with each other statistically. RESULTS: There was a decrease in VAS values after a month of medical treatment in all patients with isolated contact point (Z = -8.352; p = 0.0). VAS values significantly improved after surgical treatment group (Z = -4.97; p = 0.0). However, VAS values of patients increased at 6th month in medical treatment group (Z = -5341 p = 0.0). After a successful surgical removal of mucosal contacts, the decrease of headache severity was more intense in patients with surgical treatment group than in the patients with medical treatment group (Z = -8.441; p = 0.0). CONCLUSION: Surgical correction provides a more effective outcome in patients with rhinogenic headache. However, it is difficult to convince that headache may improve with surgery in these patients especially with isolated mucosal contact point and without nasal obstruction. In order to prove the benefit of surgery, we believe that medical treatment can be used as a guide.

Is there any effect of anxiety and depression scores on the improvement of tinnitus after surgery in chronic otitis patients with tinnitus.

BACKGROUND: Tinnitus is a common disease in public. It is not only associated with neuronal, muscular, vascular pathologies, but also with related psychological parameters. In this study, we aimed to investigate the relationship between tinnitus, anxiety and depression in patients undergoing tympanoplasty. METHODS: Patients with tinnitus and operated for chronic otitis media were included in our study. Before and after the operation, tinnitus handicap inventory, beck anxiety and depression scales were filled and pre- and postoperative values were compared. In addition, our patients were divided into two groups as tinnitus improve and did not improve and differences between them were investigated. RESULTS: 148 patients were included in our study. Of 148 patients, 60 were male and 88 were female. There was no significant difference between the patients with and without tinnitus when the dermografic features, hearing levels and physical examination findings were compared. After the operation, the patients who did not improve tinnitus had higher levels of depression and depression than others (<0.001). CONCLUSION: As a result of our study, anxiety and depression scales of the patients whose tinnitus did not improve were found to be higher than the patients whose tinnitus improved.

Association of Benign Paroxysmal Positional Vertigo with Osteoporosis and Vitamin D Deficiency: A Case Controlled Study.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is a common type of vertigo caused by the peripheral vestibular system. The majority of cases are accepted as idiopathic. Calcium metabolism also plays a primary role in the synthesis/absorption of otoconia made of calcium carbonate and thus might be an etiological factor in the onset of BPPV. In this study, we aimed to investigate the role of osteoporosis and vitamin D in the etiology of BPPV by comparing BPPV patients with hospital-based controls. MATERIALS AND METHODS: This is a case-control study comparing the prevalence of osteoporosis and vitamin D deficiency in 78 BPPV patients and 78 hospital-based controls. The mean T-scores and serum vitamin D levels were compared. The risk factors of osteoporosis, physical activity, diabetes mellitus, body mass index, and blood pressure were all compared between the groups. To avoid selection bias, the groups were stratified as subgroups according to age, sex, and menopausal status. RESULTS: In this study, the rates of osteoporosis and vitamin D deficiency detected in BPPV patients were reasonably high. But there was no significant difference in mean T-scores and vitamin D levels, osteoporosis, and vitamin D deficiency prevalence between the BPPV group and controls. CONCLUSION: The prevalence of osteoporosis and vitamin D deficiency is reasonably high in the general population. Unlike the general tendencies in the literature, our study suggests that osteoporosis and vitamin D deficiency are not risk factors for BPPV; we conclude that the coexistence of BPPV with osteoporosis and vitamin D deficiency is coincidental.

Evaluation of Cervical Vestibular-Evoked Myogenic Potential Findings in Benign Paroxysmal Positional Vertigo.

OBJECTIVE: Although there has been a wide consensus on the mechanism of nystagmus and clinical presentation of benign paroxysmal positional vertigo (BPPV), the neuroepithelial pathophysiology of BPPV still remains unclear. In this study, we aimed to clarify the pathophysiology of BPPV by evaluating the cervical vestibular-evoked myogenic potential (cVEMP) findings of patients. MATERIALS AND METHODS: Thirty-six BPPV patients and 20 healthy volunteers were included. Bilateral cVEMP tests were performed on all participants. The participants were divided into the following three groups: those with a BPPV-affected ear, those with a BPPV-unaffected ear, and the healthy control group. RESULTS: There were no significant differences regarding the latencies of the first positive (p1) and negative (n1) peaks among the three groups. The mean normalized amplitude asymmetry ratio also did not differ between the BPPV and control groups. However, the normalized amplitudes of the BPPV patients (with both affected and unaffected ears) were significantly lower than those of the healthy control group. CONCLUSION: We detected that the cVEMP data of the affected and unaffected ears of the BPPV patients was similar and that their normalized amplitudes significantly differed from those of the healthy controls. Eventually, we concluded that even if the symptoms of BPPV were unilateral, the findings suggest that the bilateral involvement of the macular neuroepithelium is important in understanding the pathophysiology of BPPV. This finding supports the conclusion that the pathophysiological process starts with neuroepithelial membrane degeneration and continues with otoconia separation.