Early clinical outcomes of ınferior turbinate radiofrequency and lateralization combined with septoplasty / Resultados clínicos iniciais da utilização de radiofrequência e lateralização das conchas nasais inferiores combinadas à septoplastia

Abstract Introduction: Mechanical obstruction is the most common form of nasal obstruction. Among the types of mechanical obstructions, septum deviation and inferior turbinate hypertrophy are the most prevalent. Objective: This study evaluated the early clinical outcomes of inferior turbinate radiofrequency and inferior turbinate lateralization combined with septoplasty in the treatment of nasal obstruction symptoms. Methods: The research retrospectively evaluated data from 33 patients (24 male, nine female) undergoing septoplasty and inferior turbinate radiofrequency (RF group) and 32 patients (24 male, eight female) treated with septoplasty and inferior turbinate lateralization (LAT group), who were admitted, with complaints of nasal obstruction, to the University of Health Sciences, Department of Otorhinolaryngology, between January 1, 2017 and January 1, 2018. The patients' preoperative and 6-month postoperative symptoms were evaluated via the Nasal Obstruction Symptom Evaluation, the NOSE scale. Results: The mean preoperative NOSE scores were 10.3 ± 4.2 in the RF group and 10.9 ± 4.9 in the LAT group, and the mean six-month postoperative scores were 1.09 ± 1.3 in the RF group and 1.2 ± 1.3 in the LAT group. There was no significant difference in NOSE scores between the two groups (p > 0.05). Conclusion: The data obtained in this study show that both methods result in similar outcomes in terms of relieving nasal obstruction symptoms in patients requiring inferior turbinate intervention. Therefore, the researchers believe that, in each case, the intervention method should be selected at the discretion of the patient and surgeon(s).

Resumo Introdução: A obstrução mecânica é a forma mais comum de obstrução nasal. Entre os tipos de obstruções mecânicas, o desvio do septo e a hipertrofia de conchas inferiores são os mais prevalentes. Objetivo: Avaliar os resultados clínicos iniciais da aplicação de radiofrequência nas conchas inferiores e a lateralização delas combinada com septoplastia no tratamento dos sintomas de obstrução nasal. Método: O estudo avaliou retrospectivamente dados de 33 pacientes (24 homens, nove mulheres) que foram submetidos a septoplastia e aplicação de radiofrequência no concha inferior (grupo RF) e 32 pacientes (24 homens, oito mulheres) submetidos a septoplastia e lateralização de concha inferior (grupo LAT), que foram admitidos com queixas de obstrução nasal na University of Health Sciences, Departamento de Otorrinolaringologia, entre 1° de janeiro de 2017 e 1° de janeiro de 2018. Os sintomas pré-operatórios e pós-operatórios de 6 meses dos pacientes foram avaliados pela escala NOSE, do inglês Nasal Obstruction Symptom Evaluation. Resultados: Os escores médios pré-operatórios da escala NOSE foram 10,3 ± 4,2 no grupo RF e 10,9 ± 4,9 no grupo LAT e os escores médios pós-operatórios de seis meses foram 1,09 ± 1,3 no grupo RF e 1,2 ± 1,3 no grupo LAT. Não houve diferença significante nos escores da escala NOSE entre os dois grupos (p > 0,05). Conclusão: Os dados obtidos neste estudo mostram que ambos os métodos têm resultados semelhantes em termos de alívio dos sintomas de obstrução nasal em pacientes que necessitam de intervenção nas conchas inferiores. Portanto, os pesquisadores acreditam que, em cada caso, o método de intervenção deve ser selecionado a critério do paciente e do cirurgião.

Early clinical outcomes of inferior turbinate radiofrequency and lateralization combined with septoplasty.

INTRODUCTION: Mechanical obstruction is the most common form of nasal obstruction. Among the types of mechanical obstructions, septum deviation and inferior turbinate hypertrophy are the most prevalent. OBJECTIVE: This study evaluated the early clinical outcomes of inferior turbinate radiofrequency and inferior turbinate lateralization combined with septoplasty in the treatment of nasal obstruction symptoms. METHODS: The research retrospectively evaluated data from 33 patients (24 male, nine female) undergoing septoplasty and inferior turbinate radiofrequency (RF group) and 32 patients (24 male, eight female) treated with septoplasty and inferior turbinate lateralization (LAT group), who were admitted, with complaints of nasal obstruction, to the University of Health Sciences, Department of Otorhinolaryngology, between January 1, 2017 and January 1, 2018. The patients' preoperative and 6-month postoperative symptoms were evaluated via the Nasal Obstruction Symptom Evaluation, the NOSE scale. RESULTS: The mean preoperative NOSE scores were 10.3±4.2 in the RF group and 10.9±4.9 in the LAT group, and the mean six-month postoperative scores were 1.09±1.3 in the RF group and 1.2±1.3 in the LAT group. There was no significant difference in NOSE scores between the two groups (p>0.05). CONCLUSION: The data obtained in this study show that both methods result in similar outcomes in terms of relieving nasal obstruction symptoms in patients requiring inferior turbinate intervention. Therefore, the researchers believe that, in each case, the intervention method should be selected at the discretion of the patient and surgeon(s).

Vestibular evoked myogenic potential (VEMP) results in migraine and migrainous vertigo.

Background: The pathophysiology of vertigo is not fully known; thus, it is difficult to diagnose vestibular migraine (VM) in some migraine patients with vertigo symptoms.Aims/objectives: We aimed to evaluate the diagnostic value of cervical vestibular evoked myogenic potential (cVEMP) in patients with VM.Materials and Methods: Thirty-two patients diagnosed with migraine and 31 patients with VM were prospectively included in this study. The cVEMP responses were obtained, and P1-N1 latency, interpeak amplitude, amplitude asymmetry ratio were calculated. The patients' demographics, results of physical and audiometric examinations, and VEMP records as well as absence of responses were evaluated and compared between groups.Results: The incidence of ears with absence VEMP responses was found to be numerically higher in the migraine group than in the VM group (p = .106). Additionally, there were no statistically significant differences detected between the groups in terms of the p13 or n23 latency, interpeak amplitude, and amplitude asymmetry ratio measured in both right and left ears (p > .05).Conclusions: The increased rate of absent VEMPs was associated with the hypoperfusion of the sacculo-collic reflex pathway in migraine patients. In addition, it was concluded that VEMP reflex responses appear to be insufficient to differentiate between VM and migraine diagnoses.

Anesthetic Efficiency of Three Medicinal Plant Oils for Aquatic Species: Coriander Coriandrum sativum, Linaloe Tree Bursera delpechiana, and Lavender Lavandula hybrida.

This study evaluated the potential of three essential oils (EOs) that were obtained from coriander Coriandrum sativum (CEO), linaloe tree Bursera delpechiana (BEO), and lavender Lavandula hybrida (LEO) as anesthetic agents. Convict Cichlids Amatitlania nigrofasciata (Günther 1867) were exposed to eight concentrations of anesthetic (50, 75, 100, 125, 150, 200, 250, and 300 µL/L). After exposure to the anesthetic, the fish were transferred to clean water to recover. All of the EOs produced an anesthetic effect after exposure to the compounds for 30 min at the minimal effective concentration (MEC), which was identified according to deep anesthesia (A5  < 3 min) and full recovery (R3  < 5 min) times. At 50 and 75 µL/L, the total loss of equilibrium was not observed for all tested EOs. The total loss of reflex was induced at a faster rate with higher concentrations of anesthetic in all groups. The recovery time generally increased as the concentration of the anesthetic increased. These findings suggest that CEO, BEO, and LEO are all novel potential anesthetics for aquaculture, and the optimal concentrations were identified as 150 µL/L (A5 ; 156 ± 1.7 s and R3 ; 165 ± 2.9 s), 125 µL/L (A5 ; 176 ± 3.5 s; R3 ; 125 ± 2.0 s), and 200 µL/L (A5 ; 20.1 ± 2.4 s and R3 ; 162 ± 3.4 s), respectively. When considering the active ingredients of EOs, this study also demonstrated that future studies should be focused on the major components such as linalyl acetate, 1.8-cineole, α-pinene, geraniol, and linalool. Their synergistic effects should be examined in herbal anesthetic treatments, since new commercial anesthetics will likely contain them.

Safety of outpatient admission and comparison of different surgical techniques in adult tonsillectomy.

PURPOSE: To investigate the safety of outpatient admission and the effects of surgical technique in tonsillectomy operations of adult patients. METHODS: The digital database was scanned for patients aged ≥ 15 years that underwent tonsillectomy in our institution between years 2014 and 2018. Demographic and clinical characteristics, the surgical technique, length of stay (LOS) in hospital, re-admissions after discharge, complications and interventions performed were recorded. RESULTS: A total of 276 patients met the inclusion criteria, comprising 139 (50.4%) females and 137 (49.6%) males with a mean age of 27.17 ± 9.41 years. The most common indication was recurrent tonsillitis (n = 223, 80.8%), and surgical techniques used were bipolar scissors (CURIS®, Sutter Medizintechnik, Germany) (n = 137, 49.6%), cold dissection (n = 75, 27.2%) and/or plasma blade (PEAK Surgical, Medtronic, USA) (n = 64, 23.2%). A total of 43 (15.5%) re-admissions from 37 (13.4%) patients were recorded because of bleeding (n = 33, 70.2%) and/or odynodysphagia (n = 13, 27.7%). Non-surgical interventions were sufficient in 32 (74.4%) cases, while surgical interventions were required in 11 (25.6%) patients. In patients where "hot" techniques (bipolar scissors, plasma blade) were used and in patients with complaints in the first 24 h postoperatively, significantly increased rates of elongated LOS values for more than 1 day were determined (p < 0.01, p < 0.001). CONCLUSIONS: Adult tonsillectomy is a safe surgical procedure with low complication, re-operation and mortality rates. Significantly increased rates of elongated LOS values for more than 1 day and re-admissions after discharge were determined in those patients having complications in the first 24 h postoperatively. Cold dissection seems to be more advisable than hot techniques for outpatient tonsillectomy among adult patients.

The effect of caffeic acid phenethyl ester (CAPE) on tympanosclerosis.

OBJECTIVE: To investigate the effects of caffeic acid phenethyl ester (CAPE) on tympanosclerosis. MATERIALS AND METHODS: Thirty-two male Sprague Dawley rats were separated into 4 groups as CAPE (n = 10), alcohol (n = 10), control (n = 8) and normal (n = 4) groups. All tympanic membranes except normal group were myringotomised and type 3 Streptococcus pneumoniae strains was injected into their middle ears. Myringotomies were repeated for 5 weeks. Intraperitoneal (i.p) CAPE were administrated to the CAPE group at 10 µmol/kg/day and 10% ethyl alcohol administrated to the alcohol group for 5 weeks. The control group were left untreated. Findings of myringosclerosis were recorded by otomicroscope at sixth week. Then, all rats were sacrificed and tympanic membrane thickness and severity of middle ear mucosal inflammation evaluated histopathalogically. RESULTS: Severity of myringosclerosis was significantly higher in the alcohol and control groups compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The tympanic membrane thickness measured in the alcohol and control groups were significantly higher compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The severity of inflammation in the middle ear mucosa was significantly higher in the alcohol and control groups compared to the CAPE group (respectively, p < 0.001, p = 0.03). The severity of inflammation in the middle ear mucosa was not significant between alcohol and control groups (p = 0.30). CONCLUSION: CAPE has anti-inflammatory and antioxidant effects on the development of MS in myringotomized rats, so reduces the severity of tympanosclerosis.

Determination of bioaccumulation of heavy metals and selenium in tissues of brown trout Salmo trutta macrostigma (Duméril, 1858) from Munzur Stream, Tunceli, Turkey.

The objective of the present work was to determine the bioaccumulation of arsenic (As), cadmium (Cd), copper (Cu), lead (Pb), mercury (Hg), uranium (U) and selenium (Se) in gill, liver, and muscle tissues of the fresh water fish Salmo trutta macrostigma (Duméril, 1858) in Munzur Stream, Tunceli, Turkey. The highest concentrations of U (1.83 µg kg(-1)), Pb (119.84 µg kg(-1)) and Se (1.31 µg kg(-1)) were recorded in the gills of S. t. macrostigma. Concentrations of As (46.27 µg kg(-1)), Cd (109.19 µg kg(-1)), Hg (16.40 µg kg(-1)), Cu (18.19 µg kg(-1)) were recorded at highest levels in the liver. The results showed that there were significant differences in concentrations of As, Cd, Cu, Pb, Se, U and Hg in gill, liver and muscle tissue (p < 0.05). Heavy metals were within the edible parts of the investigated fish were in the permissible safety levels for human uses.

Ozone disinfection of eggs from gilthead seabream Sparus aurata, sea bass Dicentrarchus labrax, red porgy, and common dentex Dentex dentex.

The risk of fish pathogen transmission via eggs can be reduced by disinfection in ozonated seawater. The aim of this study was to determine the suitable conditions for ozone disinfection of the eggs of gilthead seabream Sparus aurata, sea bass Dicentrarchus labrax, red porgy Pagrus pagrus, and common dentex Dentex dentex. The eggs were disinfected with a concentration (C) of 0.5 mg of ozone/L of water at four different exposure times (T = 2, 4, 8, and 16 min). The hatching rate was determined in triplicate for each treatment. Bacterial colonies were counted on tryptic soy agar and thiosulfate-citrate-bile salts-sucrose agar. At the end of the experiment, bacterial load and hatching rate were assessed together to determine the optimal ozone treatment values, which were estimated in CT units (i.e., C [= 0.5 mg/L] x T [min]). Optimal values were CT 2-4 (T = 4-8 min; 18 degrees C) for gilthead seabream and red porgy, CT 2 (T = 4 min; 18 degrees C) for common dentex, and CT 4 (T = 8 min; 15 degrees C) for sea bass.

Assessment of bone mineral density and risk factors in children completing treatment for acute lymphoblastic leukemia.

BACKGROUND: Reduced bone mineral density and increased fracture risk have been reported in children with cancer. In this study, we aimed to determine the growth and bone mineral density (BMD) of the children off chemotherapy for acute lymphoblastic leukemia, and the probable risk factors. PROCEDURE: The age, anthropometric measurements, lumbar spine BMDs were recorded in 70 children. The risk factors on BMD; daily calcium intake, the time interval from the completion of the chemotherapy, cranial radiotherapy, cumulative steroid dose, decrease in physical activity were investigated. Serum calcium, phosphate, alkaline phosphates, magnesium, insulin-like growth factor-1 (IGF-1) and 25 (OH) vitamin D levels were determined. RESULTS: The mean height percentile at the time of diagnosis was decreased from the value of 53 to a value of 47 at the beginning of the study (P=0.071). Of them; 44% had osteoporosis, 41% had osteopenia, and the rest had normal BMD. BMD z-scores were decreased during the first 2 years from the completion of the treatment. There was a positive correlation between BMD z-scores and daily calcium intake (CC=0.366, P=0.0015). A negative correlation was determined between the time spent on TV and computers and BMD z-scores (CC=-0.464, P=0.0019). Serum IGF-1 and 25 (OH) vitamin D levels of patients were significantly lower than controls (P=0.033). CONCLUSIONS: Our data revealed that 85% of the survivors had bone mineralization defect. BMDs and z scores were decreased during the first 2 years from the completion of the treatment and then gradually began to increase. The most important risk factor for decreased BMD was low daily calcium intake. Therefore, patients and their families should be encouraged to take sufficient amount of calcium. Prophylactic vitamin D may also be supplemented.