Investigation of the Effectiveness of Kinesio Tape Treatment in Adult Individuals with Subjective Tinnitus.

Objective: Tinnitus is one of the most common otologic symptoms and has a serious effect on the quality of life. The pathophysiology of tinnitus is not fully understood and no consensus has been reached on an effective treatment method for tinnitus. To evaluate the effectiveness of the kinesiotape (KT) method in subjective tinnitus treatment. Material and Method: KT is a method used for sensory simulation. It is a method that aims to increase muscle function, positively affect lymphatic fluid and blood circulation, and stimulate the neurological system. In this study, KT method was applied and the study was prospective. 34 individuals with subjective tinnitus, and normal hearing were included. The study group (n = 17) was informed about tinnitus and KT was applied for 4 weeks, the control group (n = 17) was only informed about tinnitus. The information about tinnitus given to both groups included verbal information about what tinnitus is, how to deal with tinnitus and basic recommendations. All individuals were initially administered tinnitus measurements (pitch, loudness, minimal masking level, residual inhibition), Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), SF-36, and Beck Depression Inventory (BDI). All evaluations were repeated after 4 weeks. Results: Tinnitus loudness and pitch decreased in the KT group (P < .05). In both groups, there was a significant difference between the first and last measurements of the severity of tinnitus, the degree of discomfort from tinnitus with VAS, and the catastrophic and total scores of THI (P < .05). KT group, the emotional sub-score of THI improved significantly with KT (P < .05), and significant improvement was achieved in the BDI scores (P < .05). There was a significant difference in the SF-36 after the application of KT (P < .05). Conclusion: In subjective tinnitus, the pathophysiology of which is unknown and there is no consensus on an effective treatment method, improvement in tinnitus severity, quality of life and depression perception in both audiologic and perceptual evaluations were obtained as a result of KT application. We believe that KT, which has no side effects and is easy to apply, is a method that can be easily used in individuals with subjective tinnitus.

Analysis of the Correlation of the Lamina Papyracea-to-Midline Distance with the Location of Anterior Ethmoidal Artery and Keros Classification.

The aim of the study was to investigate the relations between anatomical structures that are susceptible to inadvertent injuries during the surgery using preoperative computed tomography (CT) scans. 153 CT scans were reviewed and the distance from the lamina papyracea (LP) to the midline and the distance of the anterior ethmoidal artery (AEA) to the skull base were measured bilaterally. Also, the depth of olfactory fossa was measured and categorized using the Keros classification. The measurements were analyzed to determine whether LP-to-midline distance was correlated with the distance between the AEA and the skull base and Keros classification. Additionally, correlation of Keros classification with the distance from the AEA to the skull base was investigated. In a total of 306 measurements, 26 (%8.49) were classified as Keros type I, 200 (65.35%) as Keros type II and 80 (25.14%) as Keros type III. Statistically, LP-to-midline distances on the right and left sides were significantly associated with the distance from the AEA to the skull base on the same side (R:p < 0.001, L:p = 0.01) and the Keros classification on the same side (R:p < 0.001, L:p = 0.004). Also, a significant association was found between the Keros classification and the distance from the AEA to the skull base (R:p < 0.001, L:p = 0.02). The locations of anatomical structures are defined in relation to each other during the development of maxillofacial bones. CT scans should be examined and anatomical structures and relations among them reviewed very carefully before ESS. Otherwise, some accidental injuries may arise during the surgery while trying to avoid complications. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03931-x.

Evaluating the Effectiveness of a New Auditory Training Program on the Speech Recognition Skills and Auditory Event-Related Potentials in Elderly Hearing Aid Users.

INTRODUCTION: The objective of this study was to evaluate the effectiveness of a new auditory training (AT) program on the speech recognition in the noise and on the auditory event-related potentials in elderly hearing aid users. METHODS: Thirty-three elderly individuals using hearing aids aged from 60 to 80 years participated. A new AT program was developed for the study. AT program lasts for 8 weeks and includes sound discrimination exercises and cognitive exercises. Seventeen individuals (mean age 72.17 ± 6.94) received AT and 16 individuals (mean age 71.75 ± 6.81) did not receive AT. The mismatch negativity (MMN) test and matrix test were used to evaluate the effectiveness of AT. Tests were conducted for the study group before and after the AT. The tests were carried out for the control group at the same times with the study group and the results were compared. RESULTS: In comparison with the first evaluation, the last evaluation of the study group demonstrated a significant difference regarding the decrease of mean latency in the MMN wave (p = 0.038), and regarding the improving score of matrix test (p = 0.004), there was no difference in the control group. CONCLUSION: The AT program prepared for the study was effective in improving speech recognition in noise in the elderly, and the efficiency of AT could be demonstrated with MMN and matrix test.

Analysis of the Effect of Weight Loss on Eustachian Tube Function by Transnasal Videoendoscopy.

OBJECTIVE: To investigate the effect of weight loss after bariatric surgery on eustachian tube (ET) function with video endoscopy. MATERIALS AND METHODS: The present study was conducted as a prospective cohort and was completed with 19 patients. Three-step tympanometry (basal, Toynbee, Valsalva), dynamic slow-motion video endoscopy, and the Eustachian Tube Dysfunction Questionnaire-7 (ETDA-7) were applied to the patients preoperatively before bariatric surgery and in the postoperative 6th month. Dynamic slow-motion video endoscopy was graded between 0 and 3, or classified as patulous, as indicated in the literature. RESULTS: The mean body mass index of 6 male and 13 female patients decreased from 47.3 ±â€Š4.6 to 31.2 ±â€Š5.4. Grade decline (median 2 ±â€Š1) was experienced in all patients in DSVE, and 1 patient resulted as patulous ET. The ETDA-7 scores decreased in11 patients, remained stable in 7 patients, and increased in 1 patient with patulous ET. The statistical analysis of the preoperative and postoperative DSVE grading and ETDA-7 scores, excluding the patulous ET patient, was found to be significant (P  = 0.001 and P  = 0.003, respectively). There was no significant change in any of the tympanometry parameters (P > 0.05). CONCLUSIONS: Rapid weight loss with bariatric surgery results in an improvement in both the DSVE images and in the complaints of ET dysfunction in the majority of patients, but in some patients it may result in patulous ET. Therefore, preoperative evaluation of the ET with DSVE and questioning the patient's complaints are important in predicting patients who may develop patulous ET.

Postoperative Audiometric Results of Patients with Otosclerosis in relation with High-resolution Computed Tomography and Intraoperative Macroscopic Findings.

OBJECTIVE: To analyse postoperative audiological findings in fenestral otosclerosis patients treated with stapedotomy, focal location-extensiveness findings on temporal high-resolution computed tomography (HRCT), and intraoperative macroscopic stapes footplate findings. Moreover, preoperative audiological findings were compared with HRCT and intraoperative macroscopic findings. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Otorhinolaryngology, University of Health Sciences, Ankara Numune Training and Research Hospital, Turkey from January 2015 to January 2018. METHODOLOGY: Patients were classified according to the temporal bone HRCT findings into three groups based on otosclerotic focus location and extensiveness. Macroscopic classification was based on the intraoperative findings of blue and white footplate. Patients with obliterative otosclerosis were not included in the study. Preoperative and postoperative audiological findings as well as surgical success were investigated. Findings were compared with HRCT and macroscopic classification groups. RESULTS: Postoperative air bone gap (ABG) increased as HRCT class increased from 0 to 3, meaning a more extensive otosclerotic focus (p=0.002). The comparison of the audiological outcomes, in accordance with the intraoperative findings, revealed that the postoperative air conduction pure-tone averages (AC PTA), ABG and ABG difference were higher in the white footplate group, with statistically significant differences compared to blue footplate group (p = 0.039, p = 0.001 and p=0.029, respectively). CONCLUSION: Postoperative audiological findings were found to be correlated with intraoperative and HRCT findings. A white footplate seen at surgery or a more extensive otosclerotic focus on temporal HRCT indicates a suboptimal audiological outcome. HRCT findings should be taken into account when planning the surgery. Key Words: Otosclerosis, Temporal bone HRCT, Footplate color, Stapedotomy, Audiometry.

Does inferior turbinate outfracture provide additional benefit when combined with inferior turbinate radiofrequency ablation?

PURPOSE: To evaluate, both subjectively and objectively, whether turbinate outfracture provides any additional benefit in the treatment of inferior turbinate hypertrophy when combined with radiofrequency ablation. METHODS: The study was conducted on 58 patients diagnosed with inferior turbinate hypertrophy. The patients were randomly divided into two groups according to the treatment they receive. Group A consisted of patients undergoing radiofrequency ablation and Group B included patients undergoing turbinate outfracture in combination with radiofrequency ablation. For the purposes of objective evaluation, all patients underwent acoustic rhinometry and anterior rhinomanometry preoperatively and at 6 months postoperatively. In addition, for subjective evaluation, the patients completed the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. Postoperative changes in objective and subjective parameters in both groups versus the preoperative period and their differences were compared statistically. RESULTS: In Group A, mean postoperative minimal cross-sectional area (MCA) and nasal volume (NV) values and NOSE scores were significantly greater compared to those obtained in the preoperative period. Similarly, Group B showed significantly greater mean postoperative MCA, NV and NOSE score values compared to the preoperative period. In Group A and B, mean postoperative total nasal resistance (TNR) value was significantly lower in comparison to the preoperative period. The differences in mean preoperative and postoperative MCA, NV, TNR and NOSE scores were significantly greater in Group B versus Group A. CONCLUSION: The addition of turbinate outfracture to inferior turbinate radiofrequency ablation treatment provides both objective and subjective benefits in the resolution of nasal obstruction.

The effect of chemotherapy on olfactory function and mucociliary clearance.

OBJECTIVES: Olfactory sensory neurons and the olfactory mucosa are both important for optimal olfactory function. The potential nasal mucosal toxicity of chemotherapy regimens has not been assessed yet. The aim of this study was to objectively investigate the effect of chemotherapy on mucociliary clearance and olfactory function and to evaluate whether this effect differs between different chemotherapy regimens and age groups. PATIENTS AND METHODS: The study included consecutive patients admitted for the treatment of a variety of primary tumors (except head and neck and brain malignancies). Patients were evaluated for olfaction and mucociliary clearance before and immediately after completing the last session of chemotherapy cycles, according to the therapeutic protocol. For objective evaluation, the saccharine test was used for mucociliary clearance and the Sniffin' Sticks test for olfactory function. Of the 46 initial patients, 30 completed the study. Groups were formed according to the chemotherapy regimen (four groups: CA (doxorubicin + cyclophosphamide), Folfox (oxaliplatin +5-FU + folinic acid), DCF (docetaxel + cisplatin +5-FU), and GC (gemcitabine + cisplatin)) and according to age (two groups: < 55 years and > 55 years). RESULTS: In the overall analyses, significant deterioration was noted in both mucociliary clearance time and smell scores (olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and the composite threshold-discrimination-identification (TDI) score). The changes in these scores showed no significant differences between chemotherapy groups. The decrease in OT and global TDI scores was more severe in the younger age group. CONCLUSIONS: Chemotherapy impairs both the mucociliary clearance and olfactory function in cancer patients. This might reflect the collective negative effect of chemotherapy on olfactory function, not only through the neurocytotoxic effect but also the cytotoxic effect on the nasal mucosa. In addition, the reduction in olfactory threshold and total olfactory function scores was seen to be more profound in younger patients, which could have been due to higher initial scores.

The levels of advanced oxidation protein products in patients with obstructive sleep apnea syndrome.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is characterized by repeated episodes of complete or partial obstructions of the upper airway during sleep, frequently followed by transient hypoxemia. Advanced oxidation protein products (AOPP) are a family of oxidized protein products, and oxidative stress has a substantial role in the morbidity of OSAS. AIMS: The aim of this study was to investigate the serum levels of advanced oxidation protein products (AOPP) as a marker of oxidative stress, and their correlation with polysomnographic parameters in patients with obstructive sleep apnea syndrome (OSAS). Additionally, we investigated the effect of positive airway pressure (PAP) treatment on serum AOPP values and compared the levels before and after the treatment. METHODS: The study enrolled a total of 125 subjects including 59 patients with severe OSAS, 34 patients with moderate OSAS, 32 patients with mild OSAS, and 40 healthy controls. Mean AOPP values were compared between OSAS groups and control groups. Correlations between AOPP and polysomnographic parameters were investigated. Mean AOPP values before and after 6-month PAP therapy were compared. RESULTS: Significantly elevated AOPP levels were found in severe and moderate OSAS groups in comparison with mild OSAS and control groups. AOPP was directly correlated with apnea-hypopnea index, percentage of total time spent with oxygen saturation below 90%, oxygen desaturation index, maximum obstructive apnea duration, arousal index, and number of obstructive apneas accompanying bradycardia but inversely correlated with average SPO2 (%), minimum SPO2, and percentage of non-REM stage 3 sleep. There was no statistically significant difference between AOPP values before and after PAP therapy. CONCLUSIONS: AOPP, which is an oxidative stress marker, was found to be high in OSAS patients. Especially, high levels in moderate and severe OSAS patients may be an indicator of increased morbidity. After 6 months of PAP treatment, there was no statistically significant change in these levels.

Is Nasal Septum Deviation Severity a Significant Factor on Voice in Patients Undergoing Septoplasty?

OBJECTIVE: To determine whether septoplasty is an effective factor on the voice in patients with varying degrees of nasal septum deviation. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Ankara Numune Training and Research Hospital, Ear Nose Throat Clinic, Ankara, Turkey, from November 2018 to March 2019. METHODOLOGY: A total of 69 patients formed groups I, II and III. Groups I, II and III consisted of patients with mild, moderate and severe nasal deviation, respectively. All patients underwent septoplasty under general anesthesia. Subjective and objective voice analyses were performed for each patient preoperatively and at the postoperative third month. RESULTS: There was no statistical difference between the mean pre- and postoperative voice handicap index-30 (VHI-30) scores in group I and group II. Postoperative mean VHI-30 scores were significantly lower in group III. In groups I and II, the differences between the mean pre- and postoperative fundamental frequency (F0), frequency perturbation (jitter), amplitude perturbation (shimmer) and noise-to-harmonics ratio (NHR) values were not statistically significant. While the differences between the mean preoperative and postoperative F0, jitter and NHR values in group III were not statistically significant, mean postoperative shimmer value was lower than preoperative one with significantly difference. CONCLUSION: Septoplasty affects the voice positively in patients having severe septum deviation.

The Effect of the Körner's Septum on Graft and Hearing Success after Type 1 Tympanoplasty.

OBJECTIVE: To determine the effect of Körner's septum (KS) on graft success and hearing in patients who were treated with type 1 tympanoplasty. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Otorhinolaryngology, University of Health Sciences, Ankara Numune Training and Research Hospital, Turkey, from July 2013 to July 2018. METHODOLOGY: Patients undergoing type 1 tympanoplasty were divided into 2 groups as patients with KS and without KS (WKS), according to the findings of high-resolution computed tomography of the temporal bone. Two different grafts (fascia and cartilage) in two groups (KS and WKS) were compared for graft success rate of different graft materials and pre- and postoperative hearing levels. The effect of the presence of KS on hearing was examined. RESULTS: The anatomical graft success rate of type 1 tympanoplasty was 75.9% in the KS group and 88.5% in the WKS group (p = 0.026). In the presence of KS, graft success rate decreased with the use of a fascia graft (p = 0.044). In the presence of KS, the use of cartilage graft did not affect functional hearing; whereas, poor functional outcomes were obtained in ears operated using a temporalis fascia graft in the KS group than in the WKS group (p = 0.003). CONCLUSION: KS adversely affects graft success in type 1 tympanoplasty. Cartilage should be preferred as the graft material for patients with KS.

The Voice Performance After Septoplasty With Surgical Efficacy Demonstrated Through Acoustic Rhinometry and Rhinomanometry.

OBJECTIVE: To demonstrate the surgical efficacy of septoplasty using acoustic rhinometry (AR) and anterior rhinomanometry (ARM) and to evaluate the effect of septoplasty on voice performance through subjective voice analysis methods. MATERIALS AND METHODS: This prospective study enrolled a total of 62 patients who underwent septoplasty with the diagnosis of deviated nasal septum. Thirteen patients with no postoperative improvement versus preoperative period as shown by AR and/or ARM tests and three patients with postoperative complications and four patients who were lost to follow-up were excluded. As a result, a total of 42 patients were included in the study. Objective tests including AR, ARM, acoustic voice analysis and spectrographic analysis were performed before the surgery and at 1 month and 3 months after the surgery. Subjective measures included the Nasal Obstruction Symptom Evaluation questionnaire to evaluate surgical success and Voice Handicap Index-30 tool for assessment of voice performance postoperatively, both completed by all study patients. RESULTS: Among acoustic voice analysis parameters, F0, jitter, Harmonics-to-Noise Ratio values as well as formant frequency (F1-F2-F3-F4) values did not show significant differences postoperatively in comparison to the preoperative period (P > 0.05). Only the shimmer value was statistically significantly reduced at 1 month (P < 0.05) and 3 months postoperatively (P < 0.05) versus baseline. Statistically significant reductions in Voice Handicap Index-30 scores were observed at postoperative 1 month (P < 0.001) and 3 months (P < 0.001) compared to the preoperative period and between postoperative 1 month and 3 months (P < 0.05). CONCLUSION: In this study, first operative success of septoplasty was demonstrated through objective tests and then objective voice analyses were performed to better evaluate the overall effect of septoplasty on voice performance. Shimmer value was found to be improved in the early and late postoperative periods.

Evaluation of olfactory function in patients with obstructive sleep apnea syndrome.

PURPOSE: To investigate the pathophysiological mechanisms underlying the effects of obstructive sleep apnea syndrome (OSAS) on olfactory functions. METHODS: Study subjects consisted of patients with newly diagnosed OSAS divided by polysomnography into subgroups of mild, moderate, and severe disease. Subjects identified as not having OSAS served as controls. All subjects were subjected to the Sniffin' Sticks test to evaluate olfactory functions. Control subjects and subgroups with OSAS were compared for sleep characteristics and olfactory scores. In the patient group, correlations were investigated between olfactory scores and polysomnographic parameters. RESULTS: Of 99 subjects (64 men), there were 20 controls, 23 with mild OSAS, 25 moderate, and 31 severe. There was a decreasing trend from the control group towards the severe subgroup in mean odor threshold, odor discrimination, odor identification, and threshold-discriminationidentification (TDI) scores. In the patient group, there was a strong inverse correlation between AHI and TDI scores (r = - 0.62, p < 0.001). Arousal index and TDI scores had a strong negative correlation (r = - 0.81, p < 0.001). There was a weak positive correlation between the minimum SPO2% and TDI scores (r = 0.34, p = 0.002) and a weak negative correlation between TST <90% and TDI scores (r = - 0.24, p = 0.027). CONCLUSION: The finding that arousal index showed a stronger correlation with odor scores than with hypoxemia-related parameters suggests that sleep fragmentation may be a more prominent mechanism underlying the pathophysiology of olfactory malfunction in patients with OSAS.

Is Adenotonsillar Size a Significant Factor on Voice in Children Undergoing Adenotonsillectomy?

OBJECTIVE: To determine whether adenotonsillar size is a significant determinant of voice in children who have undergone adenotonsillectomy. STUDY DESIGN: Prospective cohort study. PLACE AND DURATION OF STUDY: Ear Nose Throat Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey, from July 2017 to June 2018. METHODOLOGY: A total of 57 patients, who have been diagnosed with chronic adenotonsillitis and operated for obstruction or infection, were included in the study. Patients were divided into two groups according to their palatine tonsil sizes. Each patient performed voice analysis preoperatively and one month postoperatively, recruiting both objective and subjective methods. F0, jitter % and shimmer % values were assessed with objective methods; while subjective methods evaluated pediatric voice handicap index (pVHI) scores. Pre- and post-operative F0, jitter % and shimmer % values and pVHI scores from each study group were compared. RESULTS: In each study group, pre- and post-operative F0, jitter % and shimmer % values were found to be similar. In Group A, postoperative pVHI scores were found to be significantly reduced (p<0.001). In Group B, however, pre- and postoperatively assessed pVHI scores were similar. CONCLUSION: Adenotonsillar hypertrophy in children, who underwent adenotonsillectomy, seems to be an important and positively effecting factor on the subjective, but not the objective, parameters of voice.

Clinical and polysomnographic features of patients with Restless Legs Syndrome.

OBJECTIVE: To reveal clinical and polysomnographic features in patients treated for restless leg syndrome, and to examine the compatibility of sleep data and clinical features. METHODS: The study was conducted at the Department of Neurology, Ankara Numune Training and Education Hospital, Ankara, Turkey, and comprised patients who presented to the outpatient clinic between January and July 2014 who were diagnosed with restless leg syndrome based on the International RestIess Leg Syndrome Study Group criteria. Patients underwent polysomnography test in spontaneous sleep in a single room. SPSS 18 was used for statistical analyses. RESULTS: Of the 18 patients, 13(72%)were females and 5(28%)were males. Overall mean age was 51.56±11.57years (range: 23-66 years). Fourteen (77.8%) patients reported insomnia; 10(55.5%) patients had excessive daytime sleepiness; 13(72.2%) reported snoring; and 3(17%) had apnoea. Mean International Restless Legs Syndrome Study Group Rating Scale score was 26.11±7.9 (range: 16-40).Mean Epworth Sleepiness Scale score was 9.17±5.1 (range: 0-20). CONCLUSIONS: Restless leg syndrome was more common in women and the most common complaint was insomnia.

Evaluation of autoinflammatory disease genes in nasal polyposis.

BACKGROUND/AIM: To investigate cold-induced autoinflammatory syndrome 1 (CIAS 1) gene polymorphisms that cause autoinflammatory diseases in patients with nasal polyposis (NP). MATERIALS AND METHODS: The study included 30 patients diagnosed with NP and 30 healthy age-matched individuals as a control group. CIAS1 polymorphisms were assessed by DNA sequence analysis. Patients with nasal polyps and the control group were compared in terms of gene polymorphisms. Each of the 8 polymorphisms of the CIAS1 gene was analyzed separately in the patient group. RESULTS: The most frequently observed polymorphisms in the patient group were c.732G > A in 83%, c.663C > T in 23%, and c.1308C > A in 23% of the patients. c.732G > A polymorphism was evaluated separately. Guanine was transformed to adenine at the 732nd nucleotide position of the CIAS1 gene in the cDNA of chromosome 1. CONCLUSION: The CIAS1 gene c.732G > A polymorphism was thought to be responsible for an increase in disease susceptibility. The frequency of the "A" allele is higher in the patient group compared to the control group. Autoinflammatory diseases seem like a candidate to be one of these factors. This is the first report to define the role of autoinflammatory diseases among these factors.