Applied surgical methods and outcomes in crooked nose rhinoplasty

OBJECTIVE

In this retrospective and multicentric study, we investigated applied surgical methods in rhinoplasty for crooked nose deformity.

PATIENTS AND METHODS

The retrospective data for 300 crooked nose deformity cases (191 males and 109 females) were used in our study. Classification of the initial deformities was performed as (1) I-shaped crooked nose deformity, (2) C-shaped crooked nose deformity, (3) Reverse C-shaped crooked nose deformity, and (4) S-shaped crooked nose deformity. As an operation technique, L-strut septoplasty was performed. The applied surgical methods in rhinoplasty to correct the crooked nose are evaluated and classified.

RESULTS

Our results showed that initial deformities in crooked nose patients were I-shaped crooked nose deformity (34%), C-shaped crooked nose deformity (28%), Reverse C-shaped crooked nose deformity (21.3%), and S-shaped crooked nose deformity (16.7%). L-strut septoplasty was performed, and the results of the applied methods to correct the crooked nose were evaluated and classified. It was noticed that more than one procedure was applied to each case: (1) double-side lateral osteotomy (86.6%), (2) wedge bone resection on one side of the osteotomy (7.3%), (3) single-side lateral osteotomy (6%), (4) symmetric spreader grafts (56%), (5) asymmetric spreader grafts (10.6%), (6) shaving of the transverse wing of dorsal septum (8%), (7) correction of deviated dorsal septum (16.3%), (8) displaced anterior nasal spine (12.6%), (9) clocking suture (dorsal septal rotation suture) (9%), (10) dorsal septal scoring and splinting graft (8.3%), and equalizing lateral cruses (12.6%).

CONCLUSIONS

I-shaped and C-shaped crooked nose deformities were mainly detected in crooked nose deformity patients. Correcting the crooked nose, double-side lateral osteotomy, and symmetric spreader grafts were the most applied techniques to correct the crooked nose. Other rhinoplasty techniques were also applied to these patients; more than one technique was needed.

Birth outcomes in pregnant women with epilepsy: A Nationwide multicenter study from Türkiye

OBJECTIVE

The present study was aimed at investigating the effects of anti-seizure medications (ASMs), patient demographic characteristics, and the seizure type and frequency on the development of congenital malformations (CMs) in the infants of pregnant women with epilepsy (PWWE).

METHODS

PWWE followed up at the neurology outpatient clinic of 21 centers between 2014 and 2019 were included in this prospective study. The follow-up of PWWE was conducted using structured, general pregnant follow-up forms prepared by the Pregnancy and Epilepsy Study Committee. The newborns were examined by a neonatologist after delivery and at 1 and 3 months postpartum.

RESULTS

Of the infants of 759 PWWE, 7.2% had CMs, with 5.6% having major CMs. Polytherapy, monotherapy, and no medications were received by 168 (22.1%), 548 (72.2 %), and 43 (5.7 %) patients, respectively. CMs were detected at an incidence of 2.3% in infants of PWWE who did not receive medication, 5.7% in infants of PWWE who received monotherapy, and 13.7% in infants of PWWE who received polytherapy. The risk of malformation was 2.31-fold (95% confidence interval (CI): 1.48-4.61, p < .001) higher in infants of PWWE who received polytherapy. Levetiracetam was the most frequently used seizure medication as monotherapy, with the highest incidence of CMs occurring with valproic acid (VPA) use (8.5%) and the lowest with lamotrigine use (2.1%). The incidence of CMs was 5% at a carbamazepine dose <700 mg, 10% at a carbamazepine dose ≥700 mg, 5.5% at a VPA dose <750 mg, and 14.8% at a VPA dose ≥750 mg. Thus the risk of malformation increased 2.33 times (p = .041) in infants of PWWE receiving high-dose ASMs.

SIGNIFICANCE

Birth outcomes of PWWE receiving and not receiving ASMs were evaluated. The risk of CMs occurrence was higher, particularly in infants of PWWE using VPA and receiving polytherapy. The incidence of CMs was found to be lower in infants of PWWE receiving lamotrigine.

Evaluation of the frequency and awareness of obesity among healthcare workers

OBJECTIVE

The aim of this study is to determine the frequency of obesity in healthcare workers and to evaluate the awareness of obesity by using Obesity Awareness Scale.

SUBJECTS AND METHODS

This descriptive frequency study was conducted between January 1 and March 31, 2021, in 17 Family Health Centers in the Health Training and Research Area. 119 health personnel working in Family Health Centers were included in the study. The Body Mass Index (BMI) classification accepted by the World Health Organization for adults was used to determine obesity. Obesity Awareness Scale adapted to the Turkish language was used to evaluate obesity awareness.

RESULTS

The frequency of obesity among healthcare workers was 11.8% and overweight was 37.8%. 51.9% of physicians were overweight, 14.8% were obese; 38.5% of midwives were overweight, 15.4% were obese; 24.4% of the nurses were overweight and 9.8% were obese. The mean BMI of the participants was 18.00±0.52 for underweight, 22.65±1.35 for normal, 27.32±1.43 for overweight, and 31.53±1.68 for obese. The obesity awareness total score average of the participants was 63.97±7.47 (high level). According to the obesity awareness scale sub-dimension mean scores, obesity awareness was 28.7±3.9 (high), nutrition awareness was 20.0±3.1 (high), and physical activity was 15.3±1.8 (good).

CONCLUSIONS

The frequency of obesity was found to be low, and the awareness of obesity was found to be high among HCWs in Family Health Centers. In addition, obesity was mostly detected in physicians, midwives, and nurses. Urgent act policies are needed to encourage both patients and HCWs to the awareness and prevention of obesity and to have a healthy lifestyle.

Dehiscence or thinning of bone overlying the superior semicircular canal in idiopathic intracranial hypertension

STUDY DESIGN

Retrospective cohort.

OBJECTIVES

The objective of the study is to evaluate a relationship between idiopathic intracranial hypertension (IIH) and superior semicircular canal dehiscence (SSCD) of bone overlying the superior semicircular canal (SSC).

MATERIALS AND METHODS

A total of 57 (114 ears) individuals, 20 of whom were controls and 37 of whom were IIH, were included in the study. Individuals were evaluated with 0.8 mm slice thickness computed tomography (CT) images for SSC bony roof thickness and SSCD. Thickness of the bony roof over the SSC was graded from Grade 1 to Grade 4. Grade 3 was defined as pre-dehiscence and Grade 4 as dehiscence.

RESULTS

Bony roof thickness was 1.25 mm in the control group and 0.76 mm in the IIH group. When bony roof thickness was compared between the groups, it was found to be significantly thinner in the IIH group (p = 0.012). In the IIH group, while dehiscence was detected in 25 of 74 ears, no dehiscence was detected in 49 ears. In the control group, while dehiscence was detected in 5 ears, no dehiscence was detected in 35 ears. The difference is statistically significant (p = 0.015). The correlation between bony roof thickness and cerebrospinal fluid (CSF) pressure in the IIH group was not statistically significant (p = 0.343; rho = 0.110). The correlation between bony roof thickness and age in the IIH group was not statistically significant (p = 0.082; rho =  - 0.164).

CONCLUSION

Increased CSF pressure in patients with IIH may cause chronic, progressive, and irreversible damage to the bone of the SSC and, according to our study, the rate of SSCD was found to be high in IIH patients.

Prevalence and clinical characteristics of headache in juvenile myoclonic epilepsy: experience from a tertiary epilepsy center

The comorbidity of headache and epilepsy is often seen in neurological practice. The objective of this study was to assess the prevalence, types of, and risk factors for headache in juvenile myoclonic epilepsy (JME). We assessed a total of 200 patients and 100 healthy controls in our study. Headache was classified in participants using a self-administered questionnaire. Demographical, clinical features and headache characteristics were recorded. Seizure and headache temporal profiles were noted. Headache was present in 111 (56%) patients and 50 (50%) healthy participants. From these patients, 47 (42.3%) JME patients had migraine [30 (27%) migraine without aura (MO), 17 (15.3%) migraine with aura (MA)], 52 (46.8%) had tension type headache (TTH), 4 (3.6%) had both migraine and TTH, and 8 (7.2%) had other non-primary headaches. In the healthy control group, migraine was detected in 16 (32%) subjects, TTH in 33 (66%), both migraine and TTH in 1 (2%) subject. A positive migraine family history and symptom relief with sleep were more frequent in JME patients (p = 0.01). Headache was classified as inter-ictal in 82 (79.6%) patients and peri-ictal in 21 (20.4%) patients. In conclusion, the present study revealed that headache frequency was not significantly different between JME patients and healthy controls (p > 0.05). However, migraine frequency was higher in JME patients than healthy controls. Some migraine and TTH characteristics were different in between groups. We suggest that our results support both genetic relationship and shared underlying hypothetical pathopysiological mechanisms between JME and headache, especially migraine.

Effects of Radioactive Iodine Ablation Therapy on Voice Quality

OBJECTIVE

The goal of this study was to evaluate the effects of radioactive iodine ablation therapy on voice quality of patients diagnosed with well-differentiated thyroid carcinoma.

METHODS

We enrolled 36 patients who underwent total or subtotal thyroidectomy due to well-differentiated thyroid carcinoma. Voice recordings from patients were analyzed for acoustic and aerodynamic voice. The Voice Handicap Index-10 was used for subjective analysis. The control group consisted of 36 healthy participants. Results taken before and after therapy were compared statistically.

RESULTS

There were no differences in the results taken before and after therapy for the radioactive iodine ablation group. The Voice Handicap Index-10 results did not differ between groups before and after therapy.

CONCLUSION

Radioactive iodine ablation therapy has no effect on voice quality objectively or subjectively.

Effects of Oxcarbazepine and Levetiracetam on Calcium, Ionized Calcium, and 25-OH Vitamin-D3 Levels in Patients with Epilepsy

Objective

The primary objective of the present study was to further elucidate the effects of oxcarbazepine (OXC) and levetiracetam (LEV) monotherapies on the bone health status of patients with epilepsy.

Methods

This study included 48 patients who attended our epilepsy outpatient clinic, had a diagnosis of epilepsy, and were undergoing either OXC or LEV monotherapy and 42 healthy control subjects. The demographic and clinical features of the patients, including gender, age, onset of disease, daily drug dosage, and duration of disease, were noted. Additionally, the calcium, ionized calcium, and 25-OH vitamin-D3 levels of the participants were prospectively evaluated.

Results

The 25-OH vitamin-D3, calcium, and ionized calcium levels of the patients taking OXC were significantly lower than those of the control group. These levels did not significantly differ between the patients taking LEV and the control group, but there was a significant negative relationship between daily drug dose and ionized calcium levels in the LEV patients.

Conclusion

In the present study, anti-epileptic drugs altered the calcium, ionized calcium, and 25-OH vitamin-D3 levels of epilepsy patients and resulted in bone loss, abnormal mineralization, and fractures. These findings suggest that the calcium, ionized calcium, and 25-OH vitamin-D3 levels of patients with epilepsy should be regularly assessed.

Validation of refractive index structure parameter estimation for certain infrared bands

Variation of the atmospheric refraction index due to turbulent fluctuations is one of the key factors that affect the performance of electro-optical and infrared systems and sensors. Therefore, any prior knowledge about the degree of variation in the refractive index is critical in the success of field studies such as search and rescue missions, military applications, and remote sensing studies where these systems are used frequently. There are many studies in the literature in which the optical turbulence effects are modeled by estimation of the refractive index structure parameter, C(n)(2), from meteorological data for all levels of the atmosphere. This paper presents a modified approach for bulk-method-based C(n)(2) estimation. According to this approach, conventional wind speed, humidity, and temperature values above the surface by at least two levels are used as input data for Monin-Obukhov similarity theory in the estimation of similarity scaling constants with a finite difference approximation and a bulk-method-based C(n)(2) estimation. Compared with the bulk method, this approach provides the potential for using more than two levels of standard meteorological data, application of the scintillation effects of estimated C(n)(2) on the images, and a much simpler solution than traditional ones due to elimination of the roughness parameters, which are difficult to obtain and which increase the complexity, the execution time, and the number of additional input parameters of the algorithm. As a result of these studies, Atmospheric Turbulence Model Software is developed and the results are validated in comparison to the C(n)(2) model presented by Tunick.