Evaluation of mean platelet volume and its ratio over platelet count in children with obstructive sleep apnea syndromeTıkayıcı uyku apne sendromu olan çocuklarda ortalama trombosit hacmi ve ortalama trombosit hacminin trombosit sayısına oranının değerlendirilmesi ABSTRACTObjectives: This study aims to determine the association between obstructive sleep apnea syndrome (OSAS) caused by adenotonsillar hypertrophy and mean platelet volume (MPV) and MPV/platelet count ratio in children, and to evaluate the impact of adenotonsillectomy on these two parameters. Patients and Methods:This prospective study consisted of 73 child patients (38 boys, 35 girls; mean age 8.6±3.3 years, range 2 to 17 years) with chronic adenotonsillar hypertrophy who applied to Gaziosmanpaşa University Faculty of Medicine, Ear, Nose and Throat policlinics due to witnessed apnea and snoring in January 2011 and January 2013. Also, 56 age and sex matched pediatric patients (28 boys, 26 girls; mean age 8.0±3.2 years; range 3 to 13 years) who admitted to our clinic due to reasons besides OSAS were included in the study as control group. Preoperative and postoperative third month hemoglobin, white blood cell, thrombocyte count, and MPV values of the patients were recorded. Results:Although ratio of MPV/platelet count was higher in patient group than in control group, the difference was not statistically significant. Mean platelet volume level was 7.68±1.07 fL in patient group and 7.21±0.84 fL in control group. Preoperative MPV level in patient group was significantly higher than that in control group (p<0.05). A statistically significant decrease was detected in postoperative third month MPV level and platelet count compared with preoperative MPV and platelet count (7.68±1.07 fL and 7.17±0.97 fL, respectively; p<0.05). Conclusion:High MPV and MPV/platelet count in children with adenotonsillar hypertrophy may be an important risk factor for cardiopulmonary and cerebrovascular morbidities which may develop both in childhood and in adulthood. Adenotonsillectomy may reduce this risk significantly.Keywords: Adenotonsillectomy; mean platelet volume; pediatric obstructive sleep apnea. ÖZAmaç: Bu çalışmada çocuklarda adenotonsiller hipertrofinin neden olduğu tıkayıcı uyku apne sendromu (TUAS) ile ortalama trombosit hacmi (OTH) ve OTH/trombosit sayısı oranı arasındaki ilişki belirlendi ve adenotonsillektominin bu iki parametre üzerindeki etkisi değerlendirildi. Hastalar ve Yöntemler: Bu prospektif çalışmaya Ocak 2011 -Ocak 2013 tarihleri arasında Gaziosmanpaşa Üniversitesi Tıp Fakültesi HastanesiKulak Burun Boğaz Polikliniği'ne tanıklı apne ve horlama nedeni ile başvuran, kronik adenotonsiller hipertrofisi olan 73 çocuk hasta (38 erkek, 35 kız; ort. yaş 8.6±3.3 yıl; dağılım 2-17 yıl) dahil edildi. Ayrıca kliniğimize TUAS dışı nedenlerle başvuran, yaş ve cinsiyet uyumlu 56 çocuk hasta (28 erkek, 26 kız; ort. yaş 8.0±3.2 yıl; dağılım 3-13 yıl) kontrol grubu olarak çalışmaya alındı. Hastaların ameliyat öncesinde ve ameliyat sonrası üçüncü ayda hemoglobin, beyaz...

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Objective: Comparison of endoscopic and external dacryocystorhinostomy (DCR) results and evaluation of patients' satisfaction.Methods: Forty six (35 females and 11 males) patients who underwent endoscopic DCR and 43 (37 females and six males) who underwent external DCR were included. Surgical success was objectively and subjectively assessed. The nasolacrimal duct was irrigated by a saline solution, and the saline solution was objectively visualized by endoscopy from the nose. Subjective assessment was performed asking the patients' epiphora. In addition to evaluating the success of the operation, satisfaction and result surveys were administered to the two groups.Results: There was no statistically significant difference between the two groups in terms of age and sex (respectively p=0.486, p=0.23). However, the number of females was higher than the number of males in the two groups, and the difference was statistically significant (endoscopic-DCR p=0.01, external-DCR p=0.001). There was no statistically significant difference between the two groups in terms of postoperative bleeding and punctum damage. The success rate was 84.7% in the endoscopic DCR group and 90.6% in the external DCR group. There was no statistically significant difference in the success rate between the two groups (p=0.397). The survey results revealed that there was no statistically significant difference between the two groups in terms of patient satisfaction (p=0.397). Conclusion:The results of many studies in the literature show operation success rates between the two groups that are similar to ours. Both techniques have advantages and disadvantages. Independent of the preferred procedure, our results show that functional success mainly determines patient satisfaction.

Among all polymorphisms that were investigated in this study, SLC11A1 gene showed a significance in the distriburtion of polymorphism allelle frequency at the INT4 region. Frequency of C allele was 54 (28%) in patients with oropharyngeal tularemia, and 31 (13%) in the control group (p = 0.006 and OR = 1.96 (1.21-3.20)). An association was detected between MBL2 C + 4T (P/Q) gene polymorphism and oropharyngeal tularemia (p < 0.005 and OR = 0.30 (0.19-0.48)). No significant relation was found between P2X (-762 C/T and 1513 A/C) gene polymorphism and oropharyngeal tularemia in this study (p > 0.05).

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