Transoral robotic supraglottic laryngectomy with the da Vinci robotic system can be regarded as a feasible, safe, and effective technique. Although short-term results seem discouraging, long-term results are needed to evaluate the oncologic safety.

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This study evaluated the effectiveness of vitamins A, C, and E, with selenium, in the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL). This was a prospective, controlled study performed at a tertiary teaching and research hospital. Over a 32-month period, patients were treated with either our standard ISSNHL treatment regimen plus vitamins A, C, and E and selenium (ACE+ group) or with only our standard ISSNHL treatment regimen (ACE- group). The demographics, additional symptoms, mean initial and final hearing levels, mean hearing gain, and recovery data were compared between the two groups. The ACE+ group, consisting of 70 (55.5 %) patients, received vitamin A (natural beta-carotene, 26,000 IU), vitamin C (ascorbic acid, 200 mg), vitamin E (d-alpha-tocopherol, 200 IU), and selenium (50 μg) twice daily for 30 days in addition to our ISSNHL treatment regimen: methylprednisolone at an initial dose of 1 mg/kg body weight per day, tapered over 14 days; Rheomacrodex(®) [(10 g of dextran and 0.9 g of NaCl)/100 ml] 500 ml daily for 5 days; Vastarel(®) 20-mg tablet (20 mg of trimetazidine dihydrochloride) three times daily for 30 days; and ten 60-min hyperbaric oxygen (HBO) sessions (2.5 absolute atmospheres of 100 % O2), once daily, starting the day of hospitalization. The ACE- group comprised 56 (44.4 %) patients, who received only our ISSNHL treatment regimen. The mean hearing gains were 36.2 ± 20.3 dB in the ACE+ group and 27.1 ± 20.6 dB in the ACE- group. The mean hearing gain rates were significantly higher in the ACE+ group than in the ACE- group (p = 0.014). Treatment with vitamins A, C, and E and selenium was effective in ISSNHL patients undergoing treatment with methylprednisolone, dextran, trimetazidine dihydrochloride, and HBO, and might be more effective when the initial hearing level is below 46 dB.

Objective: To investigate the effects of septoplasty on the acoustic parameters of voice. Methods:In total, 23 patients (seven females and 16 males; average age, 32.13±9.67 years; age range: 19-56 years) with a diagnosis of nasal septal deviation and who underwent septoplasty were included. Preoperative and on postoperative 30th day, acoustic analysis of voice was conducted for all patients. The recordings of /mana/ vowel were used to evaluate average fundamental frequency (F0), jitter, shimmer, and noise-to-harmony ratio (NHR). F0, shimmer percent, jitter percent, and NHR of two terms were compared. A p-value<0.05 was considered to indicate statistical significance.Results: A statistically significant change was not observed in F0 (p=0.741), jitter (p=0.930), and shimmer (p=0.128) measured preoperatively and on postoperative day 30. However, the increase in NHR measured on postoperative day 30 were statistically significant compared with preoperative NHR (p=0.017). Conclusion:According to the findings of this study, except NHR value, no statistically significant changes on F0, jitter and shimmer were detected after septoplasty.

Reflectance-mode confocal laser scanning microscopy allows in vivo imaging of the human skin. We hypothesized that this high-resolution technique enables observation of dynamic changes of the cutaneous microcirculation. Twenty-two volunteers were randomly divided in two groups. Group 1 was exposed to local heating and group 2 to local cold stress. Confocal microscopy was performed prior t (0) (control), directly t (1) and 5 min t (2) after local temperature changes to evaluate quantitative blood cell flow, capillary loop diameter, and density of dermal capillaries. In group 1, blood flow increased at t (1) (75.82 +/- 2.86/min) and further at t (2) (84.09 +/- 3.39/min) compared to the control (61.09 +/- 3.21/min). The control capillary size was 9.59 +/- 0.25 microm, increased to 11.16 +/- 0.21 microm (t (1)) and 11.57 +/- 0.24 microm (t (2)). The dermal capillary density increased in t (1) (7.26 +/- 0.76/mm(2)) and t (2) (8.16 +/- 0.52/mm(2)), compared to the control (7.04 +/- 0.62/mm(2)). In group 2, blood flow decreased at t (1) (41.73 +/- 2.61/min) and increased at t (2) (83.27 +/- 3.29/min) compared to the control (60.73 +/- 2.90/min). The control capillary size was 9.55 +/- 0.25 microm, decreased at t (1) (7.78 +/- 0.26 microm) and increased at t (2) (11.38 +/- 0.26 microm). Capillary density decreased at t (1) (5.01 +/- 0.49/mm(2)) and increased at t (2) (7.28 +/- 0.53/mm(2)) compared to the control (7.01 +/- 0.52/mm(2)). Confocal microscopy is a sensitive and noninvasive imaging tool for characterizing and quantifying dynamic changes of cutaneous microcirculation on a histomorphological level.

Background:An assessment of rhinoplasty from the patient’s perspective, in terms of satisfaction and quality of life, is quite important because these are the predominant factors indicating the success of rhinoplasty.Aims:To translate the Rhinoplasty Outcomes Evaluation into Turkish and then validate the new version for use in Turkish patients.Study Design:Validation study.Methods:We enrolled 30 participants who were able to read and write Turkish and underwent primary rhinoplasty. The control group consisted of 58 healthy volunteers with no need for aesthetic or functional nasal surgery. The reliability of the Rhinoplasty Outcomes Evaluation-T was analyzed according to its internal consistency and test-retest reproducibility. Discriminant validity was calculated by comparing the Rhinoplasty Outcomes Evaluation-T scores between the patient and control groups. Responsiveness and sensitivity to changes in rhinoplasty outcomes were analyzed by comparing the patients’ pre- and postoperative Rhinoplasty Outcomes Evaluation-T scores.Results:The scores for questions 1-6 of the Rhinoplasty Outcomes Evaluation-T, as well as the total scores, were significantly lower in the patient group than in the control group (all p<0.05). In the patient group, the scores for questions 1-6 of the Rhinoplasty Outcomes Evaluation-T, as well as the total scores, were higher postoperatively than preoperatively (all p<0.05). The scores for each Rhinoplasty Outcomes Evaluation-T question, as well as the total scores, did not differ significantly with respect to test-retest reproducibility (all p>0.05). The internal consistency of the Rhinoplasty Outcomes Evaluation-T was high, as evidenced by Cronbach’s α values of 0.887 preoperatively and 0.798 postoperatively.Conclusion:The Rhinoplasty Outcomes Evaluation-T constitutes a validated instrument with which to measure rhinoplasty outcomes among Turkish patients.

Objectives: To explore the interobserver consistency of drug-induced sleep endoscopy (DISE) for patients with obstructive sleep apnea syndrome (OSAS) and review the current literature. Methods: In total, 55 patients with an apnea–hypopnea index >5, as determined by on overnight sleep study, were included in this study, 45 males and 10 females, with an average age of 46.87 ± 10.06 years old (range, 19–71). For all OSAS patients, DISE was performed by the same surgeon, which was recorded digitally. The video recordings of DISE were evaluated independently by 3 experienced surgeons who were asked to note his or her decisions as the pattern, site, and degree of upper airway collapse using a VOTE (velum, oropharynx lateral wall, tongue base, and the epiglottis) classification system. Results: Interobserver consistency in the diagnosis of velum-related obstruction in anteroposterior, lateral, and concentric configurations ranged from poor to good. Only significant interobserver consistency among observers A and B was obtained in the diagnosis of oropharynx-related obstruction in the lateral configuration (concordance 60.0%, kappa: 0.365, P < 0.05). Interobserver consistency in the diagnosis of the tongue-related collapse in an anteroposterior configuration, the epiglottis-related collapse in an anteroposterior and lateral configuration ranged from fair to moderate (all kappa values >0.20, all P values < 0.05). Conclusion: Our data suggested that the interobserver consistency of DISE ranged from poor to good. Therefore, further studies with larger numbers of patients are needed to standardize DISE procedures, training, and interpretation.

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