The aim of this study was to document patients with clinical mastoiditis who were reported to have mastoiditis by radiologists due to increased fluid signal intensity in the mastoid air cells on magnetic resonance imaging (MRI). Brain and temporal bone MRI reports between January 2004 and November 2009 were obtained from the radiology units of four different hospitals of the same Health Care Group. MRI reports for keyword mastoiditis and 406 patients were reported to have radiological mastoiditis on MRI due to increased fluid signal intensity. Otoscopic examination findings of 275 of these 406 radiological mastoiditis patients were documented and compared with MRI reports for clinical infectious otological disease. Forty-eight (17, 45%) (48/275) patients were found to have clinical otological disease on examination. The remainder of the patients (227/275, 82%) did not show any evidence of clinical otologic infectious disease. Of these 48 patients, 18 patients (37, 5%) had eustachian tube dysfunction, 13 patients (27%) had serous otitis media, nine patients (9%) had chronic otitis media, five patients (10%) had tympanosclerosis, and three patients (6%) had acute otitis media. The results of this study showed that MRI is not an effective diagnostic tool for mastoiditis. 82% of the MRI mastoiditis did not show clinical mastoiditis contradicting MRI reports. Fluid signal in the mastoid on MRI should not always be interpreted as mastoiditis by radiologists. Radiological mastoiditis does not necessarily point out to clinical mastoiditis.
The objective of the study was the assessment of the long-term efficacy of submucosal uvulopalatopharyngoplasty in patients with obstructive sleep apnea syndrome. Thirty-two of 156 patients who underwent UPPP between January 2001 and March 2007 with a follow-up period of 36-96 months (mean, 56 months) were included in the study conducted at the university affiliated center. Preoperative and postoperative snoring evaluation forms and Epworth Sleepiness Scale (ESC) scores were used for subjective analysis. Preoperative and postoperative respiratory distress index (RDI) levels were evaluated objectively. Patients who had 50% or more reduction in RDI levels postoperatively were named as responders to the procedure. The other patients were named as non-responders. Body mass index (BMI) was also analyzed preoperatively and postoperatively. Snoring disappeared in 83% of the patients, did not change in 13% and deteriorated in 4% of the patients (p < 0.001). Excessive daytime sleepiness decreased in 22 patients (68%) and ESC values decreased from 14.6 ± 3.7 to 6.5 ± 3.9 (p = 0.0001). RDI decreased by more than 50% of the preoperative values in 15 (46.9%) of 32 patients forming the responders and the mean RDI decreased from 33.3 ± 22.9 to 23.7 ± 22.8 (p = 0.027). BMI increased over years (p = 0.0001) evidencing a preponderance in non-responder patients. Submucosal uvulopalatopharyngoplasty is an effective tool in treating patient's subjective symptoms of OSAS. Objective findings suggest that smUPPP is inadequate in treating OSAS. It cannot abolish OSAS, though it can decrease the intensity of the condition in nearly half of the patients. Weight gain decreases the success of the procedure over the years.
The routine use of INSs after septoplasty and removing them 24 hours after septoplasty are sufficient to avoid postoperative complications, and it minimizes postoperative discomfort.
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