Bülent Topuz

Amaç: Bu çalışmanın amacı yapay temporal kemik modelinde diseksiyon ile sanal gerçeklik cerrahi anatomi eğitimin yararlılığının araştırılmasıdır. Yöntem: Yapay temporal kemik ile diseksiyon gerçekleştiren ve sanal gerçeklik ile cerrahi anatomi eğitimine katılan uzmanlık öğrencilerinden anket ile geribildirim alındı ve uygulamaların yararlılığı değerlendirildi. Bulgular: Yapay kemik ile diseksiyon %90,7 faydalı ve çok faydalı, %87,5 gerçek anatomiye uygun, %78,1 gerçek kemiğe benziyor ve çok benziyor bulundu. Faydası az ya da faydasız değerlendiren olmadı. Sanal gerçeklik eğitimi ise %87,5 faydalı ve çok faydalı olarak bulundu. Sonuç: Her iki yöntemde yüksek oranda faydalı olarak değerlendirilmiştir. Olası ekonomik, lojistik, etik avantajları, tekrarlanabilir ve kolay ulaşabilir olmaları nedenleri ile klasik eğitim ile kombine olarak kullanılmaları faydalı görünmektedir.

BACKGROUND: To compare the reliability of the House–Brackmann (HB), Facial Nerve Grading System 2.0 (FNGS 2.0), and Sunnybrook Facial Grading System (SB) which are widely used in the evaluation of peripheral facial paralysis (PFP) patients. METHODS: Thirty-five video-recorded adult PFP patients were included in the study. The evaluators comprised 6 physicians. Evaluations were conducted twice independently, utilizing video recordings. Simultaneously, the evaluators were asked to keep time during the evaluation. For the analysis of reliability, Fleiss’ kappa coefficient was used for the HB, and the intraclass correlation coefficient (ICC) was used for the FNGS 2.0 and SB. RESULTS: The mean evaluation time of 1 patient was found to be 1.06 ± 0.24, 1.47 ± 0.23, and 2.32 ± 0.41 minutes for the HB, FNGS 2.0, and SB, respectively. For interrater reliability, Fleiss’ kappa for the HB was 0.495 and 0.403; ICC for the FNGS 2.0 was 0.966 and 0.958; ICC for the SB was 0.960 and 0.967 for the first and second measurements, respectively. For intrarater reliability, Fleiss’ kappa for the HB was 0.391, 0.446, 0.564, 0.502, 0.626, and 0.455; ICC for the FNGS 2.0 was 0.87, 0.982, 0.966, 0.929, 0.933, and 0.948; ICC for the SB was 0.935, 0.96, 0.895, 0.941, 0.96, and 0.94 for the 6 raters, respectively. CONCLUSION: In the present study, statistically high intra- and interrater correlations were found for the FNGS 2.0 and SB, while a moderate correlation was found for the HB. Although the HB seems to be more practical, it has been concluded that the FNGS 2.0 and SB are more reliable Cite this article as: Mengi E, Kara CO, Ardıç FN, et al. Comparison of the reliability of the house-brackmann, facial nerve grading system 2.0, and sunnybrook facial grading system for the evaluation of patients with peripheral facial paralysis. J Int Adv Otol. 2024;20(1):14-18.

The aim of this study was to investigate how allergy practices in the otorhinolaryngology (ORL) residency departments in Turkey have changed over the last 20 years and to examine the current status in ORL residency training. A 17-item questionnaire was developed following the study goals by a team experienced in allergy practices. The questionnaire was sent via e-mail to the program directors of all the 95 ORL residency departments in Turkey. A total of 60 (63.2%) program directors completed the questionnaire. We found that allergy testing and immunotherapy had been performed in 70% and 28.3%, respectively, at any time to date. The most common reason for discontinuing in allergy practices over time was “the changes introduced by the Turkish Social Security Institute as stated in the healthcare implementation communiqué” and “the difficulties in obtaining vaccine supplies from companies”. Of all departments, allergy testing, immunotherapy, nasal smear, and nasal provocation tests were performed only by 35%, 8.3%, 28.3%, and 1.7%, respectively. Allergy practices have been increasingly used, especially in the 2000s, but came to a standstill upon the changes introduced by the Turkish Social Security Institute as stated in the healthcare implementation communiqué. These findings suggest that allergy training, in the recent years, has remained in the background in ORL residency programs in Turkey. To achieve standardization in allergy training in ORL residency programs, professional associations and authorities should develop solutions in cooperation with legislators.

To analyze the change over the 25 years period in the number of publications on allergic rhinitis from Turkey, and to compare the data of the four major relevant specialties. A search was conducted over 25-years between1994 and 2019 using the keywords “allergic rhinitis” and “Turkey” in PubMed®, and “allerji”, “alerji” and “rinit” in TRDizin®. The articles were grouped by specialty; namely, “Otorhinolaryngology (ORL),” “Pediatrics,” adult “Pulmonary disease” and adult “Allergy/immunology,” based on the affiliation of the first author. The total number of publications in each specialty group within the 25-year period were compared using a significance test for a difference in two proportions within the statistical assessment. The 25-year results revealed 624 and 213 publications in the PubMed® and the TRDizin® databases, respectively. When the number of publications in a specific field in both databases was examined, the highest number of publications were identified in the ORL group, followed by the Pediatrics group. The number of publications in the ORL group was statistically higher than those in the “Pulmonary diseases” and “Allergy/immunology” groups in both the PubMed® and the TRDizin® databases (p=0.0001). The analysis of the number of 25-year allergic rhinitis publications from Turkey revealed that the academic interest of otolaryngologists in allergic rhinitis was unaffected, despite the challenges experienced in practice, with an increasing number of publications noted. When the number of 25-year publications was examined, ORL recorded the highest number of publications among all specialties.

Intracranial pressure increase is known to affect inner ear pressure through the cochlear and vestibular aqueducts. This finding forms a good model for inner ear pressure studies. Standard techniques used to detect this pressure increase are neither reliable nor easily repeatable or cheap. Studies with immitancemetry and otoacoustic emissions have been giving hopeful results. This study aims to confirm the results in the literature with wideband tympanometry and add a new parameter of otoacoustic emissions to inner ear pressure testing. Wideband tympanometry (WBT) and distortion product otoacoustic emissions (DPOAE) tests were applied to 40 healthy participants in sitting, supine, and Trendelenburg positions. DPOAE were measured under ambient or peak pressure. Resonance frequency, tympanic peak pressure, 1000, 1500, 2000, 3000, 4000, and 6000 Hz frequencies in DPOAE were measured. The increase in the tympanic peak pressure and the decrease in resonance frequency (RF) due to position change were found statistically significant (p<0.01). Signal noise ratio (SNR) decrease at 1 kHz frequency and SNR increase at 2, 3, 6 kHz in the normal protocol, SNR decrease at 1 kHz in the pressurized protocol were found statistically significant (p<0.01). RF in WBT and 1 kHz DPOAE SNR parameters were found useful in supporting the diagnosis in pathologies that increase intracranial pressure and inner ear pressure. Future research may ease their widespread use in clinical practice as they are non-invasive and rapidly applicable.

Türk Otorinolarengoloji Arşivi