Objective: The aim of this study was to use subjective and objective methods to investigate the effects of total or nearly total nasal obstruction due to nasal polyposis on nasal resonance and voice perception. Patients and Methods: A total of 63 nasal polyposis patients (53 men and 10 women), aged between 19 and 72 years (mean age 37.01 ± 13.70), were included in the study. The severity of the nasal obstruction was assessed using a visual analog scale. Nasal resonance and voice perception were evaluated subjectively by the voice handicap index (VHI)-10 questionnaire and objectively by computerized analysis (nasometry) before and after treatment of patients with nasal polyposis. Results: Significant improvement was seen in the nasal obstruction values in all patients (100%; p < 0.001) and in the VHI-10 scores in 62 patients (98%; p < 0.001). Nasalance scores increased in all patients following treatment (100%; p < 0.001). Conclusion: Voice perception is negatively affected by nasal obstruction due to nasal polyposis, and changes in voice perception may arise after the surgery. Before the surgery, informing the patient about potential voice perception changes may be useful for the prevention of legal disputes.
Both transcervical and transoral methods will improve the functional swallowing pathologies and decrease aspiration-penetration. Transoral approach is not recommended due to slow healing times and postoperative pain, although it creates easier access to the spine.
ObjectivesTransnasal esophagoscopy (TNE) is a relatively new diagnostic procedure in the evaluation of patients with globus sensation and dysphagia. Enabling doctors to examine all of the upper aerodigestive system without the need for sedation, this technique is becoming more popular among otolaryngology specialists. The aim of this study is to evaluate the practicability of TNE and tolerability of patients to the test.MethodsThe study group consisted of 314 patients who were admitted to the swallowing center of a tertiary medical institution with the symptoms of dysphagia and globus sensation. In addition to other diagnostic procedures, patients were informed of the TNE and the necessary consents were obtained. Before the examination, patients were asked to foresee the level of discomfort they would presumably feel, according to the information they had. After the TNE, patients were asked to score the real level of discomfort they experienced during the test. A visual analog scale was used to note the levels. The duration of the tests and any complications were also noted.ResultsWe could not perform TNE in 12 of the 314 patients due to nasal obstruction, intractable retching and vasovagal syncope (7, 4, and 1 patients, respectively). The average discomfort score foreseen before the test was 4.7±1.4 (mean±standard deviation). The post-procedure discomfort score was 1.6±1.1, and the difference was statistically significant (P<0.001). The average time to perform the TNE was 5 minutes (range, 3 to 13 minutes). Except for minor epistaxis in 7 patients (2%), no complications occurred.ConclusionAccording to our results, TNE is an easy and well-tolerated procedure, it may be logical to tell the patient that the procedure will be less annoying and irritating than they assume. It is also a time saving procedure with low complication rates.
Dermoid cysts are rare, benign, congenital ectodermal inclusion cysts in the skull base, comprising skin supplements surrounded by squamous epithelium. In the period of embryological development, the cysts originate from ectodermal cells left behind in the cranial region by the closure of the neural tube and are primarily located at the midline, especially in the subarachnoid spaces. These lesions are usually asymptomatic and diagnosed incidentally. When the cysts reach large sizes, they can be symptomatic due to infection, rupture, or mass effect around neurovascular tissue. The cysts typically demonstrate accurate radiological diagnostic features. In this case report, we present a rare dermoid cyst in the middle cranial fossa, treated by an endonasal endoscopic approach. The endonasal endoscopic management of appropriate middle cranial fossa is discussed as a recent advance in the extended applications of endoscopic sinus surgery.
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