E-ISSN 2602-4837
The Turkish Journal of Ear Nose and Throat - Tr-ENT: 30 (1)
Volume: 30  Issue: 1 - 2020
1.Cover

Pages I - V

ORIGINAL ARTICLE
2.Adaptation and validation of Turkish version of tonsil adenoid health status instrument
Nurullah Seyhun, Ebubekir Toprak, Egehan Salepci, Kerem Sami Kaya, Senem Kurt Dizdar, Suat Turgut
doi: 10.5606/Tr-ENT.2020.05924  Pages 1 - 7
INTRODUCTION: This study aims to present the validation and cross-cultural adaptation of the Tonsil Adenoid Health Status Instrument (TAHSI) in Turkish language.
METHODS: This prospective single-center validation study was conducted between May 15th, 2019 and December 31st, 2019 in a tertiary care facility. The study group consisted of 41 patients (20 males, 21 females; mean age 6.8±3.2 years; range, 3 to 15 years) who were diagnosed with tonsil and/or adenoid disease who were scheduled for adeno/tonsillectomy, while the control group consisted of 42 healthy children (20 males, 22 females; mean age 9.5±3.8 years; range, 3 to 16 years). The original survey was translated to Turkish and cross-cultural adaptation process was carried out as stated in guidelines. Both groups were assessed twice in two to six weeks before surgery. Study group was assessed again six months following surgery. Internal consistency, test-retest reliability, validity, and responsiveness to change were analyzed.
RESULTS: Cronbach's alpha was 0.949 for the total scale. All subscales showed adequate internal consistency. Test-retest reliability was over 0.8 for all subscales. Subscale scores were statistically significantly lower in control group compared with study group (p<0.001). The scale showed high responsiveness to change for all subscales (p<0.001).
DISCUSSION AND CONCLUSION: Turkish version of TAHSI showed good psychometric properties and can be used for both research and clinical purposes in children with tonsil and adenoid disease.

3.Hyperbaric oxygen therapy: The last remedy for sudden sensorineural hearing loss?
Yüksel Olgun, Fatih Yunus Emre, Aslı Çakır Çetin, Günay Kırkım, Hülya Ellidokuz, Enis Alpin Güneri
doi: 10.5606/Tr-ENT.2020.76598  Pages 8 - 13
INTRODUCTION: This study aims to evaluate hyperbaric oxygen (HBO) therapy as a salvage treatment option for sudden sensorineural hearing loss (SSNHL) and analyze factors influencing treatment outcomes.
METHODS: Charts of 27 patients (20 males, 7 females; mean age 50.8 years; range, 30 to 74 years) who received HBO therapy as salvage treatment were retrospectively evaluated between January 2007 and December 2017. Patients’ demographics, time between onset of SSNHL to the initiation of steroid and HBO treatments, audiogram curves, tinnitus, vestibular symptoms, and pure tone audiometry results before and after steroid and HBO therapies were evaluated. Siegle’s criteria were used to evaluate treatment outcomes.
RESULTS: According to Siegle’s criteria, while seven patients had slight improvement, partial improvement was seen in two patients. With HBO therapy, a statistically significant improvement was seen at 250, 500, and 8000 Hz frequencies. Diabetes mellitus and patients’ age were related with treatment outcomes.
DISCUSSION AND CONCLUSION: Hyperbaric oxygen therapy may be beneficial as a salvage treatment option in some patients. Better results may be expected particularly in young and non-diabetic patients.

4.Evaluation of cochlear implantation effects on middle ear pressure
Şenol Acar, Hakan Avcı, Mehmet Melih Çiçek, Beldan Polat, Kadir Serkan Orhan
doi: 10.5606/Tr-ENT.2020.43265  Pages 14 - 18
INTRODUCTION: This study aims to investigate the effects of cochlear implantation on middle ear aeration, tympanometric values, and otitis media with effusion (OME) occurrence.
METHODS: This prospective study conducted between February 2010 and May 2013 included 100 ears of 100 patients (57 males, 43 females; mean age 6.4±2.8 years; range, 1 to 18 years) who underwent cochlear implantation and had no prior history of ear surgery. Patients who had middle and/or external ear anomalies were excluded. During the preoperative evaluation, otoscopic, rhinoscopic and nasopharynx examinations, along with tympanometric investigations were performed. Postoperative tympanometric evaluations over 12-36 months’ follow-up were performed and the values were compared, respectively.
RESULTS: In the postoperative otoscopic examinations, tympanic membrane retraction was observed in 14 ears. The mean values of compliance and gradient were significantly lower in the postoperative evaluations. The peak pressure and external ear canal volume measurements were not significantly different after cochlear implantation surgery. The mean preoperative value of peak pressure of the male patients was significantly lower than that in the female patients. The mean preoperative value of external ear canal volume was lower in patients with adenoid hypertrophy. These differences were statistically significant (p<0.05).
DISCUSSION AND CONCLUSION: The values of compliance and gradient were lower in postoperative tympanograms. Nevertheless, this does not mean that patients with low compliance and gradient values are more likely to develop OME or acute otitis media. Males and patients with adenoid hypertrophy also have a predisposition to OME.

5.Outcomes of masking and habituation therapy with the implementation of a new sound therapy protocol
Göksel Turhal, İsa Kaya, Sercan Göde, Fatih Öğüt
doi: 10.5606/Tr-ENT.2019.69783  Pages 19 - 25
INTRODUCTION: This study aims to evaluate the outcomes of masking, counseling, and a new sound therapy protocol in subjective tinnitus patients.
METHODS: This prospective study, conducted between November 2014 and November 2015, included 60 subjective tinnitus patients (33 males, 27 females; mean age 51.6±11.0 years; range, 29 to 76 years) randomly assigned to five groups. Total masking was implemented in four groups (groups 1, 2, 3, and 4), while combined habituation therapy and sound therapy were implemented in one group (group 5). Patients that did not benefit from masking therapy were offered habituation therapy. Directive counseling was applied during each session in group 5 and patients were started on a new sound protocol. Patients were evaluated with the tinnitus handicap questionnaire (THQ) in the beginning of the study (THQ1) and in the second (THQ2) and fourth months (THQ3). Patients were evaluated in the second month and regrouped: Patients that benefited from masking therapy were regrouped as group A, patients that did not benefit from masking therapy and continued with habituation therapy were group B, and patients that were only treated with habituation formed group C.
RESULTS: Median THQ2-THQ1 and THQ3-THQ1 scores were significantly lower in group A (p=0.00063 and p=0.00109, respectively). Median THQ2-THQ1 and THQ3-THQ1 scores were significantly lower in group B (p=0.02421 and p=0.00503, respectively). Median THQ3-THQ1 and THQ3-THQ2 scores were significantly lower in group C (p=0.04685 and p=0.00506, respectively).
DISCUSSION AND CONCLUSION: Masking with tinnitus masker could be beneficial in a limited group of patients. Further studies with longer follow-up duration for patients receiving only habituation and habituation after masking failure are warranted.

6.Reliability and validity of the Turkish version of the questionnaire of olfactory disorders
Belgin Tutar, Ziya Saltürk, Güler Berkiten, Ayşe Enise Göker, Melis Ece Arkan, Muhammet Enis Ekincioğlu, Semih Karaketir, Ercan Kulak, Yavuz Uyar
doi: 10.5606/Tr-ENT.2020.28291  Pages 26 - 32
INTRODUCTION: This study aims to test the reliability and validity of the Turkish version of the Questionnaire of Olfactory Disorders (QOD).
METHODS: This prospective study was conducted between June 2018 and January 2019. Patients who presented to Okmeydanı Training and Research Hospital outpatient clinic with a diagnosis of chronic sinusitis and/or septum deviation completed the Connecticut Chemosensory Clinical Research Center smell test. Forty patients (24 males, 16 females; mean age 42.3±13.7 years; range, 18 to 71 years) with olfactory disorders (anosmia, hyposmia) completed the QOD at the time of diagnosis and one day prior to surgery. Forty volunteers (control group) (22 males, 18 females; mean age 38.3±13.4 years; range, 18 to 65 years) without nasal pathology, olfactory dysfunction or a history of head trauma also completed the QOD. The results of the two tests were then compared.
RESULTS: The QOD-parosmia (QOD-P), QOD-statements of QoL (QOD-LQ), and QOD-visual analog scale (QOD-VAS) values were significantly higher in the study group (p<0.001). There was no statistically significant change in the QOD-P, QOD-LQ, QOD-sincerity, and QOD-VAS values of the patients with anosmia and hyposmia at the time of diagnosis compared with those one day prior to surgery. In all patients, the Cronbach’s alpha coefficient for the QOD-P, QOD-LQ, and QOD-VAS was 0.719, 0.892, and 0.984, respectively, with relatively high internal consistency.
DISCUSSION AND CONCLUSION: We conclude that the Turkish version of the QOD is a reliable and valid instrument, particularly in patients with parosmia.

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