Funda Tümkaya

Does tonsillectomy reduce the risk of being a habitual or severe snorer

We assessed the relationship between tonsillectomy and being a habitual or severe snorer. Volunteers were asked to provide their age and sex, a detailed snoring history covering the frequency and intensity of snoring, and their smoking and alcohol intake habits. After oral and nasal examinations, the tonsil size scores, Mallampati index scores, and nasal obstructions of the volunteers were recorded. Body heights and weights were measured, and body mass indexes were calculated. Being male, aging, an increase in body mass index and tonsillectomy were identified as independent risk factors for being a habitual and severe snorer. Although a nasal obstruction was found to be an independent risk factor for being a habitual snorer, an obstructive tongue base was identified as an independent risk factor for being a severe snorer. Tonsillectomy reduces the risk of being both a habitual and severe snorer. This reduced incidence and intensity of snoring following tonsillectomy could be accepted as a long-term beneficial side effect of the operation.

MRI and CT Imaging of an Intrasphenoidal Encephalocele: A Case Report

Summary Background Intrasphenoidal encephalocele (ISE) is a rare clinical entity. The incidence of congenital encephalocele is very low. Accurate diagnosis and surgical approach is of critical value. Case Reports We present a case of intrasphenoidal encephalocele in a 40-year-old man. He complained of cerebrospinal fluid (CSF) rhinorrhea and recurrent meningitis. In images of computed tomography (CT) and magnetic resonance imaging (MRI), intrasphenoidal encephalocele herniating through a defect of the left lateral sphenoid sinus wall was determined. Incisional biopsies were taken by endoscopic transnasal approach and histopathological examination revealed an encephalocele. In the differential diagnosis, ISE can be taken for inflammatory or malignant sinusoidal soft tissue masses. ISE is differentiated from other entities by demonstrating continuity with normal brain tissue. Conclusions MRI clearly demonstrates that the herniating soft tissue is isointense with brain and continuous with brain tissue via the sphenoid sinus, thereby the treatment decision-making process is very important.

The subscales and short forms of the dizziness handicap inventory: are they useful for comparison of the patient groups?

Abstract Purpose: Dizziness Handicap Inventory (DHI) is one of the most frequently used surveys for vertigo. The aim of the study was re-analyze the consistency of subscales and correlation between original and different short forms. Method: The data of 2111 patients were analyzed. Original three subscales, screening form of DHI and short form of DHI were evaluated. The suitability of the data set for factor analysis and factor structure was analyzed with Kaiser–Meyer–Olkin (KMO) coefficient, Bartlett’s Sphericity Test, and Varimax method. Pearson correlation analysis was performed. Results: Factor analysis showed that two factor solutions are more prominent in our data. The factors proposed in different studies are not in harmony with each other. There is high correlation between the original and screening and short forms of DHI. Conclusions: This study indicated that the factor structure of the scale was not consistent. It is not advised to use subscale scores for comparison especially in international level. Therefore, total score should be used rather than the scores of the subscales. Using DHI screening form instead of original 25 questions is more convenient, because it is highly correlated with the original one and has fewer questions. Implications for rehabilitation Factor structure of the DHI is not consistent enough for comparison of the international studies. Total score of DHI is reliable. Using the screening version of DHI is better, because it is highly correlated with the original form and has fewer questions (10 questions).

An Unusual Complication of Otitis Media: Luc's Abscess

Lucs abscess is an extremely rare complication of otitis media, caused by the spread of the middle ear infection to the subperiosteal area and its accumulation beneath the temporal muscle. Unlike other subperiosteal abscesses relating to otitis media, infection may not be associated with mastoid bone involvement. Therefore, it is defined as a benign complication of otitis media. However, its rare occurrence may lead to delayed diagnosis and treatment. Here we report a case of an 11-year-old boy diagnosed with Lucs abscess with mastoid involvement. We discuss its clinical presentation and treatment with a review of the literature.

Selective Window Application of Gentamicin Dexamethasone in Meniere's Disease

OBJECTIVE The purpose of the study is to prevent hearing loss when using intratympanic (IT) gentamicin for intractable Menieres disease. MATERIALS AND METHODS It is a retrospective case review study. Twenty five patients who had definite Menieres disease and had either selective window application or weekly IT gentamicin were included into the study. First group (selective) had dexamethasone on the round window and gentamicin on oval window during exploratory tympanotomy procedure. The second group had IT gentamicin at weekly intervals. The degree of caloric weakness (CW), average hearing level in low pitch (HLP) (250, 500, 1000, 2000 Hz) and high pitch (HHP) (4000, 6000, 8000 Hz) were compared before and after treatment. The need for further treatment was noted. RESULTS In the first group, the average HLP was increased from 51.6±7dB to 52.2±5.6 dB. The average HHP was increased 41.96±20.2 dB to 47.2±18.3 dB after treatment. The CW changed from 37.6±23.9 % to 54.6±30.6 %. In the second group, the average HLP was increased from 56.3±10.5 dB to 61.65±18.3 dB. The average HHP was increased 59.05±17.4 dB to 69.4±21.98 dB after treatment. The CW changed from 45.8±22.3% to 71.53±29.63 %. Both methods had statisticaly significant increase in caloric weakness. But only IT gentamicin led a significant hearing loss in HHP. CONCLUSION The use of dexamethasone and gentamycin via different windows in the middle ear is safe and effective method for Menieres disease in the short term. Application of dexamethasone protects not only the hearing cells but vestibular cells also.