Effect of Piezoelectric Technique on Auditory Function on Postoperative Day One in Septorhinoplasty Surgery.

AIM: To examine the effect of the piezoelectric application used increasingly for osteotomy and correction of nasal dorsum in septorhinoplasty surgeries on early auditory functions. METHODS: Our study was conducted after the decision of 10840098-604.01.01-E.9057 taken from Istanbul Medipol University Clinical Research Local Ethics Committee. This study was designed to be prospective, randomized and controlled. Twenty patients between 18 and 50 years of age that piezoelectric technique was used in the study group and 10 patients in the same age range who underwent nasal surgery (endoscopic sinus surgery, septoplasty, lower concha radiofrequency and nasal valve surgery) for any reason in the control group were included in the study. Audiologic functions of the patients in both the groups were assessed by pure audio audiometry, tympanometry and distortion product otoacoustic emission test before the surgery and 24 hours after the surgery. The data obtained were statistically compared using the SPSS 22.0 program and P < 0.05 was considered significant. RESULTS: Twenty patients (5 males, 15 females) that piezoelectric (ultrasonics) technique was used during septorhinoplasty in the study group and 10 patients (5 males, 5 females) in the control group were included in the study. In the study and the control groups, preoperative and postoperative air/bone path thresholds at the right and left ears did not differ significantly (P > 0.05) at 250, 500, 1000, 2000, 4000, 6000, and 8000 Hz. The results of distortion product otoacoustic emission results (signal/noise ratio) obtained postoperatively were not statistically significant (P > 0.05) with the results obtained preoperatively. CONCLUSION: The results of the study show that the piezoelectric technique used in septorhinoplasty does not cause a negative effect on auditory functions. This study is the first comparative study to investigate the effect of piezoelectric technique used in septorhinoplasty surgery on auditory functions. After further clinical studies performed with well-selected and large patient population, the piezoelectric techniques can be a preferred technique during septorhinoplasty operations.

Symptomatology and etiology of chronic pediatric rhinosinusitis.

OBJECTIVES: This study aims to define symptoms and etiology and determine how to prevent chronic rhinosinusitis in children. PATIENTS AND METHODS: Between February 2003 and February 2005, 50 pediatric patients (25 girls and 25 boys; mean age 8.22 years; range 4 to 14 years) with chronic rhinosinusitis were included in the study. The patients were questioned about anterior/posterior nasal dripping, night cough, headache, nausea, vomiting and nasal obstruction for symptomatology; about school condition, smoking behavior of parents and history of asthma for etiology. Hemogram, serum biochemistry, allergy test, nasal smear, chest and lateral neck radiography and sweat test were performed. RESULTS: Symptomatologic examination revealed that 48% had anterior nasal dripping, 62% with postnasal dripping, 70% with headache and 90% with nasal obstruction. Evaluation of etiological factors revealed that 68% were going to school, 48% of the parents had the history of smoking, 42% with allergy test-positivity and 60% with adenoid vegetation. CONCLUSION: Our study results indicated that environmental factors are important as etiological factors in rhinosinusitis. For prevention, we recommend restriction of close relationship at school, not to smoke at home and vaccination in each year with influenza and S. pneumonia vaccine.

Determination of optimum dosage of intraoperative single dose dexamethasone in pediatric tonsillectomy and adenotonsillectomy.

OBJECTIVE: Our objective is to determine the optimum dosage of intraoperative single dose dexamethasone and its effect upon postoperative morbidity in pediatric tonsillectomy and adenotonsillectomy patients. STUDY DESIGN AND METHODS: Totally 150 pediatric patients whom underwent adenotonsillectomy or tonsillectomy surgery are offered to participate in this study at otorhinolaryngology clinic between 2002 and 2003. 150 patients are divided into three randomized groups, each composed of fifty patients. Anesthesia protocol is standardized in each group and 0.2 mg/kg intraoperative dexamethasone is given to first group, 0.7 mg/kg (maximum dose 25 mg) intraoperative dexamethasone is given to second group and third group is accepted as control group without giving any intravenous dexamethasone. Each group is compared for postoperative nausea, vomiting and tolerability to take oral foods within first 24h with the same questionnaire. RESULTS: There is significantly higher ratio of postoperative nausea and vomiting within first 24h in group III (80%) when compared with group I (8%) (p: 0.001; p<0.01) and group II (4%) (p: 0.001; p<0.01). Also there is significantly higher ratio of patient's tolerability to take oral semisolid/solid foods within postoperative first 24h in group II (94%) when compared with group I (58%) (p: 0.001; p<0.01) and group III (12%) (p: 0.001; p<0.01). We didn't encounter any side effect of dexamethasone in group I and II. CONCLUSIONS: We thought that 0.7 mg/kg dosage of IV dexamethasone is much a preferable choice depending of its effectiveness on decreasing postoperative morbidity rather than 0.2 mg/kg dosage and beside to this advantage we didn't encounter any side effects.