The aim of this study was to investigate frequency and degree of ED in patients with severe sleep apnea and to evaluate the results of only continuous positive airway pressure (CPAP) therapy on ED in patients with severe obstructive sleep apnea syndrome (OSAS). This was a prospective clinical trial study. Patients with severe sleep apnea (40) were randomized into two groups. Multiple questionnaire investigation and laboratory evaluation were performed for ED, severity of OSAS and psychological status. Group 1 was treated with CPAP and group 2 was treated with only antidepressant medication for at least 1 month. Patients were evaluated after 1 month of therapy and compared with initial ones. Before CPAP, the International Index of Erectile Function (IIEF)-5 scores were significantly correlated only with body mass index (BMI; P ¼ 0.007) and not correlated significantly with Epworth Sleepiness Scale scores (P ¼ 0.286), lowest SaO 2 (P ¼ 0.182), Beck's Depression Inventory scores (P ¼ 0.302) and apnea/hypopnea index (P ¼ 0.279). After 1 month of regular CPAP usage, mean value of IIEF-5 score was 15.71 ± 5.12 before CPAP and were improved up to 19.06 ± 3.94, statistically significant. All subjects responded positively to the CPAP treatment and their erection status was improved positively. We have found a correlation between severe OSAS and ED. CPAP is effective in improvement of sexual performance of these patients.
The aim of this study was to investigate the effects of four different types of nasal packs on pain, nasal fullness and postoperative bleeding following septoplasty. Prospective randomised double blind study was conducted. The study group included 119 patients who underwent endonasal septoplasty under general anaesthesia. Four types of nasal packing materials were utilized: (1) Merocel standard 8-cm nasal dressing without airway, (2) Doyle Combo splint (DCS), (3) Merocel in a glove finger and (4) Vaseline gauze. All packs were removed at the 48th hour (±3 h) after the surgery. Three different variables were investigated following the surgical procedure: (1) pain, (2) nasal fullness and (3) bleeding after removal of the nasal packing material. DCS produced the greatest pain at the first and sixth postoperative hours. At the first postoperative day, the greatest pain score was reported for Merocel in the glove finger and the least for Merocel. The pain scores during the removal of the nasal packings were highest for Merocel and lowest for Merocel in the glove finger. DCS had the lowest nasal fullness score. Bleeding ratio was highest for Merocel, followed by Vaseline gauze, DCS and Merocel in the glove finger. Many different commercially available packing materials are presently used, each with inherent advantages and disadvantages. We evaluated the pain, nasal fullness and bleeding potential of four nasal packing materials and determined that Merocel had the highest pain potential during removal and the highest rate of bleeding following removal.
The aim of this study was to investigate the incidence of concha bullosa (CB) in cases with septal deviation (SD), correlation between the angle of deviation and degree of pneumatization and compare these correlations with qualitative and quantitative methods. We retrospectively searched our radiology database for all paranasal sinus computed tomography (CT) findings for 672 patients. All scans were grouped according to the presence and side of SD and/or CB. SD angles and pneumatization degree of the CB were measured with appropriate method. These findings were also classified according to the initial defined qualitative method. Generally, CB and SD incidences were 31.52 and 47.77%, respectively. CB ratio in SD patients was 45.34% whereas ratio in non-SD patients was 18.95%. Mean deviation angle of the isolated SD group (15.24 +/- 5.03) was found higher than both deviation angle of the unilateral CB + SD group (13.16 +/- 4.19) and bilateral CB + SD group (11.15 +/- 3.73) (P = 0.002, P = 0.0001 respectively). In conclusion, CB may tend to develop bilaterally in normal, non-deviated nose. However, the increasing incidence of unilateral CB, especially contralateral ones, in septal deviated patients suggested that SD may prevent the development of ipsilateral CB.
Chronic myeloid leukemia (CML) is one of the etiologic causes of sudden hearing loss and vertigo. However, deafness in association with vestibular symptoms rarely occurs in CML as the first sign. In this article, a 50-year-old male with CML whose first signs and symptoms were unilateral sudden hearing loss and tinnitus in the right ear, vertigo and nausea was presented. Aetiopathogenetic mechanisms, clinical and radiological aspects and therapeutic options for CML with deafness and vertigo were discussed reviewing the literature.
It is well established that symptoms are very important in the diagnosis of CRS. However, two major symptoms are insufficient for diagnosis. Therefore, endoscopy and CT have important differential diagnostic roles. Our study showed that in patients with three major symptoms, CT pathology may be sufficient for definitive diagnosis. However, in patients with two major symptoms such as nasal discharge and/or low grade nasal polyposis, endoscopy becomes considerably more important due to inspective findings. If no endoscopic findings are found, the importance of the CT scans is increased.
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