Pub Date : 2025-01-10DOI: 10.4274/tao.2024.2024-4-4
Mehmet Emre Sivrice, Vural Akın, Hasan Yasan, Kuyaş Hekimler Öztürk, Yusuf Çağdaş Kumbul
Objective: Inflammatory processes play a role in the etiopathogenesis of chronic rhinosinusitis. Many gene polymorphisms have been associated with inflammation. In this study, we aimed to examine the relationship between angiotensin-converting enzyme insertion/deletion gene polymorphism and chronic rhinosinusitis.
Methods: Fifty-two cases with nasal polyps and 139 control patients were included in the study. Angiotensin-converting enzyme insertion/deletion gene polymorphisms, genotype, and allele distributions were determined. Results were statistically compared between groups.
Results: Statistically significant differences were found between the chronic rhinosinusitis with nasal polyps group and the control group in terms of genotype and allele distribution (p=0.015, 0.003, respectively). There were no significant differences in genotype distribution in the chronic rhinosinusitis with nasal polyps group in terms of non-steroidal anti-inflammatory drug (NSAID) allergy, asthma, and NSAID-exacerbated respiratory disease (p=0.645, 0.660, 0.095, respectively).
Conclusion: We observed that the risk of chronic rhinosinusitis is higher in individuals with the deletion-deletion genotype and D allele of the angiotensin-converting enzyme insertion/deletion gene polymorphism. We believe that these results could be related to the high angiotensin-converting enzyme levels in these patients.
{"title":"Angiotensin-Converting Enzyme Insertion/Deletion Gene Polymorphism in Chronic Rhinosinusitis with Nasal Polyps.","authors":"Mehmet Emre Sivrice, Vural Akın, Hasan Yasan, Kuyaş Hekimler Öztürk, Yusuf Çağdaş Kumbul","doi":"10.4274/tao.2024.2024-4-4","DOIUrl":"10.4274/tao.2024.2024-4-4","url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory processes play a role in the etiopathogenesis of chronic rhinosinusitis. Many gene polymorphisms have been associated with inflammation. In this study, we aimed to examine the relationship between angiotensin-converting enzyme insertion/deletion gene polymorphism and chronic rhinosinusitis.</p><p><strong>Methods: </strong>Fifty-two cases with nasal polyps and 139 control patients were included in the study. Angiotensin-converting enzyme insertion/deletion gene polymorphisms, genotype, and allele distributions were determined. Results were statistically compared between groups.</p><p><strong>Results: </strong>Statistically significant differences were found between the chronic rhinosinusitis with nasal polyps group and the control group in terms of genotype and allele distribution (p=0.015, 0.003, respectively). There were no significant differences in genotype distribution in the chronic rhinosinusitis with nasal polyps group in terms of non-steroidal anti-inflammatory drug (NSAID) allergy, asthma, and NSAID-exacerbated respiratory disease (p=0.645, 0.660, 0.095, respectively).</p><p><strong>Conclusion: </strong>We observed that the risk of chronic rhinosinusitis is higher in individuals with the deletion-deletion genotype and D allele of the angiotensin-converting enzyme insertion/deletion gene polymorphism. We believe that these results could be related to the high angiotensin-converting enzyme levels in these patients.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 3","pages":"95-100"},"PeriodicalIF":0.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-10DOI: 10.4274/tao.2024.2024-2-4
Meltem Akpınar, Beyza Demirci
Otitis media, a common childhood disease, can lead to serious complications such as acute mastoiditis and, rarely, Luc's abscess, with life-threatening consequences. Luc's abscess, a rare but severe complication, can occur without acute mastoiditis. This case report details a case of Luc's abscess in a 14-year-old girl with acute otitis media, presenting with ear pain, facial swelling, and hearing loss. Treatment involves a multidisciplinary approach, considering factors like age and abscess extent. Though there is no established standard treatment, this case emphasizes the need for prompt recognition and appropriate intervention to prevent severe complications. This case report emphasizes the importance of tailored, timely interventions for optimal outcomes in affected children.
{"title":"An Unusual Acute Otitis Media Complication: Luc's Abscess.","authors":"Meltem Akpınar, Beyza Demirci","doi":"10.4274/tao.2024.2024-2-4","DOIUrl":"10.4274/tao.2024.2024-2-4","url":null,"abstract":"<p><p>Otitis media, a common childhood disease, can lead to serious complications such as acute mastoiditis and, rarely, Luc's abscess, with life-threatening consequences. Luc's abscess, a rare but severe complication, can occur without acute mastoiditis. This case report details a case of Luc's abscess in a 14-year-old girl with acute otitis media, presenting with ear pain, facial swelling, and hearing loss. Treatment involves a multidisciplinary approach, considering factors like age and abscess extent. Though there is no established standard treatment, this case emphasizes the need for prompt recognition and appropriate intervention to prevent severe complications. This case report emphasizes the importance of tailored, timely interventions for optimal outcomes in affected children.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 3","pages":"120-123"},"PeriodicalIF":0.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-10DOI: 10.4274/tao.2024.2024-5-2
Urmila Gurung, Narmaya Thapa, Sajish Khadgi
Objective: To assess the tolerability and efficacy of endoscopic sphenopalatine artery cauterization (ESPAC) under local anesthesia (LA) in managing posterior epistaxis.
Methods: It was a prospective, cohort study, conducted in the Otorhinolaryngology Department of a tertiary-level hospital. Patients aged 18 years or above with posterior epistaxis who underwent ESPAC under LA were included. The tolerability of the procedure was reflected by the intraoperative pain measured using an 11-point numerical rating scale while the rebleed rate up to three months postoperatively denoted its efficacy.
Results: A total of 35 patients, 23 males and 12 females, aged 31 to 86 years (mean 57.42 ± 12.94) were included. Five out of 35 (14.2%) patients needed additional procedures besides ESPAC; 82.8% (29/35) had pterygopalatine fossa (PPF) block before ESPAC. The numerical rating scale reflecting the intraoperative pain ranged from 1 to 7 with a mean of 3.6 (± 1.7). The mean score was slightly higher in females than in males. Similarly, those who did not receive PPF block had a higher mean score than those who received it; however, the differences were not statistically significant. Meanwhile, the mean score was the same (3.6) irrespective of any additional procedure besides ESPAC. Amongst the 30 patients who completed the three-month follow-up, two patients rebled, so the overall success rate amounted to 93.3% in three months.
Conclusion: Based on the outcome of this study, ESPAC under LA for posterior epistaxis is well tolerated and is as efficacious as under general anesthesia.
{"title":"Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy.","authors":"Urmila Gurung, Narmaya Thapa, Sajish Khadgi","doi":"10.4274/tao.2024.2024-5-2","DOIUrl":"10.4274/tao.2024.2024-5-2","url":null,"abstract":"<p><strong>Objective: </strong>To assess the tolerability and efficacy of endoscopic sphenopalatine artery cauterization (ESPAC) under local anesthesia (LA) in managing posterior epistaxis.</p><p><strong>Methods: </strong>It was a prospective, cohort study, conducted in the Otorhinolaryngology Department of a tertiary-level hospital. Patients aged 18 years or above with posterior epistaxis who underwent ESPAC under LA were included. The tolerability of the procedure was reflected by the intraoperative pain measured using an 11-point numerical rating scale while the rebleed rate up to three months postoperatively denoted its efficacy.</p><p><strong>Results: </strong>A total of 35 patients, 23 males and 12 females, aged 31 to 86 years (mean 57.42 ± 12.94) were included. Five out of 35 (14.2%) patients needed additional procedures besides ESPAC; 82.8% (29/35) had pterygopalatine fossa (PPF) block before ESPAC. The numerical rating scale reflecting the intraoperative pain ranged from 1 to 7 with a mean of 3.6 (± 1.7). The mean score was slightly higher in females than in males. Similarly, those who did not receive PPF block had a higher mean score than those who received it; however, the differences were not statistically significant. Meanwhile, the mean score was the same (3.6) irrespective of any additional procedure besides ESPAC. Amongst the 30 patients who completed the three-month follow-up, two patients rebled, so the overall success rate amounted to 93.3% in three months.</p><p><strong>Conclusion: </strong>Based on the outcome of this study, ESPAC under LA for posterior epistaxis is well tolerated and is as efficacious as under general anesthesia.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 3","pages":"88-94"},"PeriodicalIF":0.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-10DOI: 10.4274/tao.2024.2023-10-10
Nidhin Das, Sri Harsha Kombathula, Vidhu Sharma, Puneet Pareek, Kapil Soni, Amit Goyal
Objective: To compare the ototoxicity and survival in head and neck carcinoma patients treated with sequential (SEQ) and simultaneous integrated boost (SIB) of volumetric modulated arc therapy (VMAT).
Methods: This long-term prospective study enrolled patients with histologically confirmed head and neck carcinoma, all receiving VMAT treatment. Audiological assessments were done using various tests at baseline, two weeks, treatment completion, six months, and 12 months. The changes in bone conduction pure tone thresholds were correlated with cochlear dose, comparing SEQ and SIB plans. We also investigated other significant late toxicities that led to dysphagia, voice changes, and xerostomia. Survival was assessed with the Kaplan-Meier analysis.
Results: The study included 93 patients (186 ears), 40 receiving radiation alone and 53 undergoing chemoradiation. Baseline hearing levels for the right and left ears were 13.3±2.3 dB and 14.2±1.5 dB. After 12 months of radiation, levels were 18.5±2.4 dB and 19.11±1.9 dB, respectively. No significant changes were observed between SEQ and SIB plans, but high-frequency shifts occurred. The cochlea tolerated up to 28 Gy without hearing loss in the radiation-alone group but showed loss at 9 Gy when combined with cisplatin chemotherapy. The maximum dose (Dmax) and the mean dose (Dmean) of pharyngeal constrictor muscles predicted dysphagia. No significant SEQ vs. SIB differences were found in late toxicity or survival outcomes.
Conclusion: Modern radiotherapy techniques like VMAT adhere to cochlear dose limits. No significant differences were found between SEQ and SIB plans in sensorineural hearing loss, late toxicity, or survival, making both suitable for head and neck carcinoma treatment.
{"title":"Long-term Prospective Comparative Analysis of Ototoxic and Survival Outcomes of Sequential Boost and Simultaneous Integrated Boost of Volumetric Modulated Arc Therapy for Head-Neck Carcinomas.","authors":"Nidhin Das, Sri Harsha Kombathula, Vidhu Sharma, Puneet Pareek, Kapil Soni, Amit Goyal","doi":"10.4274/tao.2024.2023-10-10","DOIUrl":"10.4274/tao.2024.2023-10-10","url":null,"abstract":"<p><strong>Objective: </strong>To compare the ototoxicity and survival in head and neck carcinoma patients treated with sequential (SEQ) and simultaneous integrated boost (SIB) of volumetric modulated arc therapy (VMAT).</p><p><strong>Methods: </strong>This long-term prospective study enrolled patients with histologically confirmed head and neck carcinoma, all receiving VMAT treatment. Audiological assessments were done using various tests at baseline, two weeks, treatment completion, six months, and 12 months. The changes in bone conduction pure tone thresholds were correlated with cochlear dose, comparing SEQ and SIB plans. We also investigated other significant late toxicities that led to dysphagia, voice changes, and xerostomia. Survival was assessed with the Kaplan-Meier analysis.</p><p><strong>Results: </strong>The study included 93 patients (186 ears), 40 receiving radiation alone and 53 undergoing chemoradiation. Baseline hearing levels for the right and left ears were 13.3±2.3 dB and 14.2±1.5 dB. After 12 months of radiation, levels were 18.5±2.4 dB and 19.11±1.9 dB, respectively. No significant changes were observed between SEQ and SIB plans, but high-frequency shifts occurred. The cochlea tolerated up to 28 Gy without hearing loss in the radiation-alone group but showed loss at 9 Gy when combined with cisplatin chemotherapy. The maximum dose (Dmax) and the mean dose (Dmean) of pharyngeal constrictor muscles predicted dysphagia. No significant SEQ vs. SIB differences were found in late toxicity or survival outcomes.</p><p><strong>Conclusion: </strong>Modern radiotherapy techniques like VMAT adhere to cochlear dose limits. No significant differences were found between SEQ and SIB plans in sensorineural hearing loss, late toxicity, or survival, making both suitable for head and neck carcinoma treatment.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 3","pages":"101-112"},"PeriodicalIF":0.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-10DOI: 10.4274/tao.2024.2023-10-2
Bülent Öcal, Mehmet Murat Günay, Kemal Keseroğlu, Murad Mutlu, İlker Akyıldız, Cem Saka, Emel Çadallı Tatar, Mehmet Hakan Korkmaz
Objective: To investigate the association between clinical factors and post-tonsillectomy hemorrhage (PTH) including rebleeding episodes.
Methods: The medical records of 1,082 patients who underwent tonsillectomy between May 2018 and April 2019 were reviewed. The entire study cohort included 431 (39.7%) children aged less than six years and 292 (26.9%) adults older than 15 years. Data on patient demographics, surgical indication, dissection technique, tonsils' grade, postoperative analgesia, surgeon's experience, the season of surgery, management of hemorrhage, length of hospital stay, and rebleeding episode were noted.
Results: Postoperative hemorrhage occurred in 87 cases (8.0%) including 32 children (4.0% of children) and 55 adults (18.8% of adults). Age, surgical indication, tonsils' grade, and postoperative use of non-steroidal anti-inflammatory drugs (NSAIDs) were risk factors found to be statistically significant for PTH in univariate analysis (p<0.05). Multivariable analyses identified patients older than 15 years and those who received postoperative NSAIDs to be risk factors of PTH [Odds ratio (OR): 15.5, 95% confidence interval (CI): 7.68-31.27, p<0.001, OR: 0.22, 95% CI: 0.11-0.44, p<0.001, respectively]. About one out of every 60 (1.5%) children had severe oropharyngeal bleeding, whereas every 12th (8.2%) patient of those aged >15 years had severe hemorrhages that warranted surgical hemostasis in the operating room (p<0.001).
Conclusion: The risk of bleeding after tonsillectomy was significantly higher in adults and users of NSAIDs postoperatively. Also, the evidence of minor bleeding increased the risk of a second bleeding episode in adulthood.
{"title":"Risk Factors of Post-Tonsillectomy Bleeding and Differences Between Children and Adults: Implications for Risk Assessment.","authors":"Bülent Öcal, Mehmet Murat Günay, Kemal Keseroğlu, Murad Mutlu, İlker Akyıldız, Cem Saka, Emel Çadallı Tatar, Mehmet Hakan Korkmaz","doi":"10.4274/tao.2024.2023-10-2","DOIUrl":"10.4274/tao.2024.2023-10-2","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between clinical factors and post-tonsillectomy hemorrhage (PTH) including rebleeding episodes.</p><p><strong>Methods: </strong>The medical records of 1,082 patients who underwent tonsillectomy between May 2018 and April 2019 were reviewed. The entire study cohort included 431 (39.7%) children aged less than six years and 292 (26.9%) adults older than 15 years. Data on patient demographics, surgical indication, dissection technique, tonsils' grade, postoperative analgesia, surgeon's experience, the season of surgery, management of hemorrhage, length of hospital stay, and rebleeding episode were noted.</p><p><strong>Results: </strong>Postoperative hemorrhage occurred in 87 cases (8.0%) including 32 children (4.0% of children) and 55 adults (18.8% of adults). Age, surgical indication, tonsils' grade, and postoperative use of non-steroidal anti-inflammatory drugs (NSAIDs) were risk factors found to be statistically significant for PTH in univariate analysis (p<0.05). Multivariable analyses identified patients older than 15 years and those who received postoperative NSAIDs to be risk factors of PTH [Odds ratio (OR): 15.5, 95% confidence interval (CI): 7.68-31.27, p<0.001, OR: 0.22, 95% CI: 0.11-0.44, p<0.001, respectively]. About one out of every 60 (1.5%) children had severe oropharyngeal bleeding, whereas every 12<sup>th</sup> (8.2%) patient of those aged >15 years had severe hemorrhages that warranted surgical hemostasis in the operating room (p<0.001).</p><p><strong>Conclusion: </strong>The risk of bleeding after tonsillectomy was significantly higher in adults and users of NSAIDs postoperatively. Also, the evidence of minor bleeding increased the risk of a second bleeding episode in adulthood.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 3","pages":"81-87"},"PeriodicalIF":0.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-10DOI: 10.4274/tao.2024.2023-12-14
Nima Naderi, Soodabeh Emami, Mahsa Banifatemi, Maryam Ghadimi, Ensieh Shahriari, Mohammad Ali Sahmeddini
Objective: A pre-anesthetic medication that is ideal for pediatric patients undergoing tonsillectomy should alleviate pediatric anxiety, facilitate the smooth induction of anesthesia, and have an analgesic effect for postoperative care. This study compared the effectiveness of an oral combination of midazolam and ketamine (MK) with an oral combination of chloral hydrate and meperidine (CM) as premedication in pediatric patients undergoing tonsillectomy.
Methods: This double-blind clinical trial study was conducted with 68 pediatric patients scheduled to undergo tonsillectomy. The participants were randomly allocated into two groups: the CM group, which received oral premedication of 50 mg/kg chloral hydrate and 1.5 mg/kg meperidine, and the MK mixture group, which received oral premedication of 0.5 mg/kg midazolam and 5 mg/kg ketamine. Various parameters such as separation anxiety, agitation during emergence from anesthesia, postoperative pain, postoperative nausea, and vomiting, as well as respiratory depression within a 6-hour period following anesthesia, were carefully recorded and observed.
Results: There were no differences between the two groups in terms of separation anxiety (p>0.05) and post-surgery pain scores (p=0.12). Regarding postoperative agitation, there were significantly more patients in an awake but calm state in the CM group than in the MK (44% vs. 17.64%, p=0.01). The incidence of nausea and vomiting was lower in the CM than in the MK group (47% vs. 76.5%, p=0.02).
Conclusion: This study shows that an oral mixture of CM is more suitable as pre-anesthetic medication in pediatric patients undergoing tonsillectomy than a MK.
目的:一种理想的小儿扁桃体切除术患者的麻醉前用药应能减轻小儿焦虑,促进顺利诱导麻醉,并对术后护理有镇痛作用。本研究比较了口服咪达唑仑和氯胺酮(MK)与口服水合氯醛和哌哌啶(CM)联合作为扁桃体切除术儿童患者术前用药的有效性。方法:对68例拟行扁桃体切除术的儿童患者进行双盲临床研究。随机分为两组:CM组口服水合氯醛50 mg/kg、甲哌啶1.5 mg/kg; MK混合组口服咪达唑仑0.5 mg/kg、氯胺酮5 mg/kg。仔细记录和观察各种参数,如分离焦虑、麻醉苏醒时的躁动、术后疼痛、术后恶心和呕吐,以及麻醉后6小时内的呼吸抑制。结果:两组患者分离焦虑评分(p < 0.05)、术后疼痛评分(p < 0.12)差异无统计学意义。术后躁动方面,CM组清醒平静状态患者明显多于MK组(44% vs. 17.64%, p=0.01)。CM组恶心呕吐发生率低于MK组(47% vs. 76.5%, p=0.02)。结论:本研究表明,口服混合CM比MK更适合作为小儿扁桃体切除术患者的麻醉前用药。
{"title":"Comparative Analysis of Preoperative Sedation Modalities: Oral Midazolam and Ketamine Versus Chloral Hydrate and Meperidine in Pediatric Tonsillectomy - A Randomized Clinical Trial.","authors":"Nima Naderi, Soodabeh Emami, Mahsa Banifatemi, Maryam Ghadimi, Ensieh Shahriari, Mohammad Ali Sahmeddini","doi":"10.4274/tao.2024.2023-12-14","DOIUrl":"10.4274/tao.2024.2023-12-14","url":null,"abstract":"<p><strong>Objective: </strong>A pre-anesthetic medication that is ideal for pediatric patients undergoing tonsillectomy should alleviate pediatric anxiety, facilitate the smooth induction of anesthesia, and have an analgesic effect for postoperative care. This study compared the effectiveness of an oral combination of midazolam and ketamine (MK) with an oral combination of chloral hydrate and meperidine (CM) as premedication in pediatric patients undergoing tonsillectomy.</p><p><strong>Methods: </strong>This double-blind clinical trial study was conducted with 68 pediatric patients scheduled to undergo tonsillectomy. The participants were randomly allocated into two groups: the CM group, which received oral premedication of 50 mg/kg chloral hydrate and 1.5 mg/kg meperidine, and the MK mixture group, which received oral premedication of 0.5 mg/kg midazolam and 5 mg/kg ketamine. Various parameters such as separation anxiety, agitation during emergence from anesthesia, postoperative pain, postoperative nausea, and vomiting, as well as respiratory depression within a 6-hour period following anesthesia, were carefully recorded and observed.</p><p><strong>Results: </strong>There were no differences between the two groups in terms of separation anxiety (p>0.05) and post-surgery pain scores (p=0.12). Regarding postoperative agitation, there were significantly more patients in an awake but calm state in the CM group than in the MK (44% vs. 17.64%, p=0.01). The incidence of nausea and vomiting was lower in the CM than in the MK group (47% vs. 76.5%, p=0.02).</p><p><strong>Conclusion: </strong>This study shows that an oral mixture of CM is more suitable as pre-anesthetic medication in pediatric patients undergoing tonsillectomy than a MK.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 3","pages":"113-119"},"PeriodicalIF":0.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aims to present a series of patients with disseminated rhinosporidosis with diagnostic and therapeutic features.
Methods: A retrospective study was conducted in a tertiary health care centre in South India from 2007 to 2020 with disseminated rhinosporidiosis. Twelve patients with multiple sites of involvement like the nose, nasopharynx, oropharynx, larynx, lacrimal sac and skin were included in the study. All patients underwent surgical excision, followed by peroral dapsone for one year.
Results: The age group was around 30-55 years, with male predominance (11:1). Pond bathing history was present in 50% (n=6). The most common site of lesion was the nose (100%), oropharynx (83.3%), skin (75%), larynx (50%) and less commonly, nasopharynx (41.6%) and lacrimal sac (25%). One patient underwent surgery four times (8.3%), followed by thrice and twice by five (41.6%) and six (50%) patients, respectively. On two years of follow-up, two patients (16.6%) had a recurrence in the nose and larynx whereas eight patients (66.6%) had no recurrence and two patients (16.6%) were lost to follow-up.
Conclusion: This original article highlights the rare occurrence of disseminated rhinosporidiosis, the possibility of which should be kept in mind, mainly when two or more sites are involved. The most significant number of disseminated rhinosporidiosis cases in the literature is reported here. Dissemination with the cutaneous and multisite disease is rarely reported and poses difficulty in management. Early diagnosis and intervention prevent the dissemination of spores into various parts of the body.
{"title":"Management of Disseminated Rhinosporidiosis: Experience From a Single Tertiary Institution.","authors":"Kalaiarasi Raja, Saranya Thangavel, Akshat Kushwaha, Bheemanathi Hanuman Srinivas, Rakhee Kar, Arun Alexander, Lokesh Kumar Penubarthi, Sunil Kumar Saxena","doi":"10.4274/tao.2023.2022-9-5","DOIUrl":"10.4274/tao.2023.2022-9-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to present a series of patients with disseminated rhinosporidosis with diagnostic and therapeutic features.</p><p><strong>Methods: </strong>A retrospective study was conducted in a tertiary health care centre in South India from 2007 to 2020 with disseminated rhinosporidiosis. Twelve patients with multiple sites of involvement like the nose, nasopharynx, oropharynx, larynx, lacrimal sac and skin were included in the study. All patients underwent surgical excision, followed by peroral dapsone for one year.</p><p><strong>Results: </strong>The age group was around 30-55 years, with male predominance (11:1). Pond bathing history was present in 50% (n=6). The most common site of lesion was the nose (100%), oropharynx (83.3%), skin (75%), larynx (50%) and less commonly, nasopharynx (41.6%) and lacrimal sac (25%). One patient underwent surgery four times (8.3%), followed by thrice and twice by five (41.6%) and six (50%) patients, respectively. On two years of follow-up, two patients (16.6%) had a recurrence in the nose and larynx whereas eight patients (66.6%) had no recurrence and two patients (16.6%) were lost to follow-up.</p><p><strong>Conclusion: </strong>This original article highlights the rare occurrence of disseminated rhinosporidiosis, the possibility of which should be kept in mind, mainly when two or more sites are involved. The most significant number of disseminated rhinosporidiosis cases in the literature is reported here. Dissemination with the cutaneous and multisite disease is rarely reported and poses difficulty in management. Early diagnosis and intervention prevent the dissemination of spores into various parts of the body.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 2","pages":"66-71"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Muscle tension dysphonia (MTD) is a functional voice condition that causes irregular and imbalanced laryngeal and paralaryngeal muscle activation. Our study aimed to examine the acoustic characteristics of patients with MTD and reveal the differences between genders.
Methods: The study retrospectively reviewed the acoustic examination findings from the files of patients diagnosed with MTD during evaluations in the laryngology outpatient clinic at a tertiary reference hospital between 2015 and 2022. The parameters assessed in prolonged vowel phonation analysis were fundamental frequency (F0), jitter, shimmer, noise-to-harmonic-to-ratio, and soft phonation index; in the counting task analysis, they were intensity, frequency, and semitone. Gender differences in acoustic measurements obtained during prolonged vowel phonation and counting tasks were also examined.
Results: The study included 80 individuals diagnosed with MTD. Although all parameters in the acoustic analysis of/a/ phonation were increased, differences were statistically significant only in the F0 and jitter parameters between females and males (p≤0.05). In the analysis of the counting task, the mean and minimum F0 parameters were significantly higher in females than in males (p=0.000). The mean dB level was decreased, particularly in the counting task, but the results for the intensity parameter did not differ significantly between genders (p>0.05).
Conclusion: The values in the acoustic voice analysis parameters of patients with MTD were determined. These acoustic parameters are thought to guide the clinician in evaluating voice and determining voice therapy goals for MTD patients.
{"title":"Investigation of Acoustic Voice Characteristics of Individuals Diagnosed with Muscle Tension Dysphonia.","authors":"Elife Barmak, Esma Altan, Dilara Söylemez, Emel Çadallı Tatar","doi":"10.4274/tao.2024.2024-3-15","DOIUrl":"10.4274/tao.2024.2024-3-15","url":null,"abstract":"<p><strong>Objective: </strong>Muscle tension dysphonia (MTD) is a functional voice condition that causes irregular and imbalanced laryngeal and paralaryngeal muscle activation. Our study aimed to examine the acoustic characteristics of patients with MTD and reveal the differences between genders.</p><p><strong>Methods: </strong>The study retrospectively reviewed the acoustic examination findings from the files of patients diagnosed with MTD during evaluations in the laryngology outpatient clinic at a tertiary reference hospital between 2015 and 2022. The parameters assessed in prolonged vowel phonation analysis were fundamental frequency (F0), jitter, shimmer, noise-to-harmonic-to-ratio, and soft phonation index; in the counting task analysis, they were intensity, frequency, and semitone. Gender differences in acoustic measurements obtained during prolonged vowel phonation and counting tasks were also examined.</p><p><strong>Results: </strong>The study included 80 individuals diagnosed with MTD. Although all parameters in the acoustic analysis of/a/ phonation were increased, differences were statistically significant only in the F0 and jitter parameters between females and males (p≤0.05). In the analysis of the counting task, the mean and minimum F0 parameters were significantly higher in females than in males (p=0.000). The mean dB level was decreased, particularly in the counting task, but the results for the intensity parameter did not differ significantly between genders (p>0.05).</p><p><strong>Conclusion: </strong>The values in the acoustic voice analysis parameters of patients with MTD were determined. These acoustic parameters are thought to guide the clinician in evaluating voice and determining voice therapy goals for MTD patients.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 2","pages":"58-65"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-23DOI: 10.4274/tao.2024.2024-1-2
Ergin Eroğlu, A Erim Pamuk, Serdar Özer, Tevfik Metin Önerci
Objective: This study aims to present the surgical and oncological long-term outcomes of patients with locally recurrent nasopharyngeal cancer (NPC) following endoscopic endonasal nasopharyngectomy (EEN).
Methods: The medical records of 11 patients who underwent EEN due to recurrent NPC were retrospectively reviewed.
Results: The mean age of the patient cohort, consisting of 10 males (90.9%) and one female (9.1%), was 44±13.01 years at the time of initial diagnosis. Seven patients (63.7%) had local recurrence, and four patients (36.3%) had loco-regional recurrence. The mean time to first recurrence from the initial diagnosis was 40.3 months, with a 5-year overall survival (OS) rate of 72.7% and a disease-free survival (DFS) rate of 27.3%. There were no significant differences between the concurrent chemoradiotherapy (CRT) and induction chemotherapy+concurrent CRT treatment groups in terms of DFS and OS as a first-line treatment (p=0.645).
Conclusion: EEN is a viable alternative approach for selected cases of locally recurrent NPC, considering the morbidities associated with re-irradiation.
{"title":"Salvage Endoscopic Nasopharyngectomy for Recurrent Nasopharyngeal Cancer: an Institutional Experience.","authors":"Ergin Eroğlu, A Erim Pamuk, Serdar Özer, Tevfik Metin Önerci","doi":"10.4274/tao.2024.2024-1-2","DOIUrl":"10.4274/tao.2024.2024-1-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to present the surgical and oncological long-term outcomes of patients with locally recurrent nasopharyngeal cancer (NPC) following endoscopic endonasal nasopharyngectomy (EEN).</p><p><strong>Methods: </strong>The medical records of 11 patients who underwent EEN due to recurrent NPC were retrospectively reviewed.</p><p><strong>Results: </strong>The mean age of the patient cohort, consisting of 10 males (90.9%) and one female (9.1%), was 44±13.01 years at the time of initial diagnosis. Seven patients (63.7%) had local recurrence, and four patients (36.3%) had loco-regional recurrence. The mean time to first recurrence from the initial diagnosis was 40.3 months, with a 5-year overall survival (OS) rate of 72.7% and a disease-free survival (DFS) rate of 27.3%. There were no significant differences between the concurrent chemoradiotherapy (CRT) and induction chemotherapy+concurrent CRT treatment groups in terms of DFS and OS as a first-line treatment (p=0.645).</p><p><strong>Conclusion: </strong>EEN is a viable alternative approach for selected cases of locally recurrent NPC, considering the morbidities associated with re-irradiation.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 2","pages":"42-47"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Large language models (LLMs) are used in various fields for their ability to produce human-like text. They are particularly useful in medical education, aiding clinical management skills and exam preparation for residents. To evaluate and compare the performance of ChatGPT (GPT-4), Gemini, and Bing with each other and with otorhinolaryngology residents in answering in-service training exam questions and provide insights into the usefulness of these models in medical education and healthcare.
Methods: Eight otorhinolaryngology in-service training exams were used for comparison. 316 questions were prepared from the Resident Training Textbook of the Turkish Society of Otorhinolaryngology Head and Neck Surgery. These questions were presented to the three artificial intelligence models. The exam results were evaluated to determine the accuracy of both models and residents.
Results: GPT-4 achieved the highest accuracy among the LLMs at 54.75% (GPT-4 vs. Gemini p=0.002, GPT-4 vs. Bing p<0.001), followed by Gemini at 40.50% and Bing at 37.00% (Gemini vs. Bing p=0.327). However, senior residents outperformed all LLMs and other residents with an accuracy rate of 75.5% (p<0.001). The LLMs could only compete with junior residents. GPT- 4 and Gemini performed similarly to juniors, whose accuracy level was 46.90% (p=0.058 and p=0.120, respectively). However, juniors still outperformed Bing (p=0.019).
Conclusion: The LLMs currently have limitations in achieving the same medical accuracy as senior and mid-level residents. However, they outperform in specific subspecialties, indicating the potential usefulness in certain medical fields.
{"title":"Evaluating the Performance of ChatGPT, Gemini, and Bing Compared with Resident Surgeons in the Otorhinolaryngology In-service Training Examination.","authors":"Utku Mete","doi":"10.4274/tao.2024.3.5","DOIUrl":"10.4274/tao.2024.3.5","url":null,"abstract":"<p><strong>Objective: </strong>Large language models (LLMs) are used in various fields for their ability to produce human-like text. They are particularly useful in medical education, aiding clinical management skills and exam preparation for residents. To evaluate and compare the performance of ChatGPT (GPT-4), Gemini, and Bing with each other and with otorhinolaryngology residents in answering in-service training exam questions and provide insights into the usefulness of these models in medical education and healthcare.</p><p><strong>Methods: </strong>Eight otorhinolaryngology in-service training exams were used for comparison. 316 questions were prepared from the Resident Training Textbook of the Turkish Society of Otorhinolaryngology Head and Neck Surgery. These questions were presented to the three artificial intelligence models. The exam results were evaluated to determine the accuracy of both models and residents.</p><p><strong>Results: </strong>GPT-4 achieved the highest accuracy among the LLMs at 54.75% (GPT-4 vs. Gemini p=0.002, GPT-4 vs. Bing p<0.001), followed by Gemini at 40.50% and Bing at 37.00% (Gemini vs. Bing p=0.327). However, senior residents outperformed all LLMs and other residents with an accuracy rate of 75.5% (p<0.001). The LLMs could only compete with junior residents. GPT- 4 and Gemini performed similarly to juniors, whose accuracy level was 46.90% (p=0.058 and p=0.120, respectively). However, juniors still outperformed Bing (p=0.019).</p><p><strong>Conclusion: </strong>The LLMs currently have limitations in achieving the same medical accuracy as senior and mid-level residents. However, they outperform in specific subspecialties, indicating the potential usefulness in certain medical fields.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 2","pages":"48-57"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}