Comparison of the Reliability of the House- Brackmann, Facial Nerve Grading System 2.0, and Sunnybrook Facial Grading System for the Evaluation of Patients with Peripheral Facial Paralysis.

BACKGROUND: To compare the reliability of the House-Brackmann (HB), Facial Nerve Grading System 2.0 (FNGS 2.0), and Sunnybrook Facial Grading System (SB) which are widely used in the evaluation of peripheral facial paralysis (PFP) patients. METHODS: Thirty-five video-recorded adult PFP patients were included in the study. The evaluators comprised 6 physicians. Evaluations were conducted twice independently, utilizing video recordings. Simultaneously, the evaluators were asked to keep time during the evaluation. For the analysis of reliability, Fleiss' kappa coefficient was used for the HB, and the intraclass correlation coefficient (ICC) was used for the FNGS 2.0 and SB. RESULTS: The mean evaluation time of 1 patient was found to be 1.06 ± 0.24, 1.47 ± 0.23, and 2.32 ± 0.41 minutes for the HB, FNGS 2.0, and SB, respectively. For interrater reliability, Fleiss' kappa for the HB was 0.495 and 0.403; ICC for the FNGS 2.0 was 0.966 and 0.958; ICC for the SB was 0.960 and 0.967 for the first and second measurements, respectively. For intrarater reliability, Fleiss' kappa for the HB was 0.391, 0.446, 0.564, 0.502, 0.626, and 0.455; ICC for the FNGS 2.0 was 0.87, 0.982, 0.966, 0.929, 0.933, and 0.948; ICC for the SB was 0.935, 0.96, 0.895, 0.941, 0.96, and 0.94 for the 6 raters, respectively. CONCLUSION: In the present study, statistically high intra- and interrater correlations were found for the FNGS 2.0 and SB, while a moderate correlation was found for the HB. Although the HB seems to be more practical, it has been concluded that the FNGS 2.0 and SB are more reliable.

Subjective Visual Vertical test with the 3D virtual reality system: effective factors and cybersickness.

BACKGROUND: 3D Virtual Reality (VR) offers new opportunities in vestibular science. It also presents new challenges and problems. AIMS/OBJECTIVES: The study aimed to evaluate the effective factors in the 3D VR Subjective Visual Vertical (SVV) test and the impact of cybersickness on the test results. MATERIAL AND METHODS: The effect of the foam surface, head position in the yaw axis, moving background, and arm position holding the controller was tested. Cybersickness was evaluated using the Simulator Sickness Questionnaire (SSQ). RESULTS: The head position and controller holding style significantly affected the results. The foam surface and the moving background did not have a significant effect. Although 61.4% of the patients fell into the bad category according to the symptoms of the SSQ score, cybersickness did not significantly affect the SVV results. CONCLUSIONS AND SIGNIFICANCE: In 3D VR SVV, additional factors should be considered: the headset's weight, head position, and how we hold the controller. The A-effect emerged when the head was 45 degrees turned on the yaw axis. A significant shift was detected in the test, with the arm holding the controller at 90 degrees. Most subjects felt cybersickness at a considerable level. Cybersickness should always be taken into account in VR when planning new applications.

Risk analysis in persistent cervical lymphadenopathies: Malignant or benign?

OBJECTIVE: The objective of the study was to determine the parameters that can be used to predict malignancy in persistent cervical lymphadenopathies. METHODS: We retrospectively reviewed the files of 162 patients diagnosed with persistent cervical lymphadenopathy who underwent an excisional biopsy in our department between January 2011 and October 2019. Patient demographics and the size, side, duration, and localization of lymphadenopathy were recorded, and their relationship with histopathological results was investigated. Multiple regression analysis was used to determine the relationship between clinical parameters and malignancy. RESULTS: Of the 162 patients, 91 (56.2%) were male and 71 (43.8%) were female, and the mean age was 45.40±20.41 (2-84) years. Male gender (OR=3.099; p=0.003), increasing age (OR=1.029; p=0.002), short duration of lymphadenopathy (OR=0.989; p=0.048), and neck level V (OR=2.604; p=0.031) patients had a statistically significantly higher risk of malignancy. There was no statistically significant relationship between the side and size of the lymph node and the risk of malignancy (p>0.05). CONCLUSION: In our study, male gender was determined to be the most predictive risk factor for malignancy in patients with cervical lymphadenopathy, followed by lymph node neck level, increased age, and duration of the disease.