Tihana Mendeš

Background: Meniere’s disease is characterized by a triad of vertigo episodes, fluctuating hearing loss, and tinnitus. The disease is followed by a loss of quality of life in patients, with the severity depending on the individual and the stage of the disease. Since there are no quantitatively validated tests that connect all elements of the disease, the only source of subjective data that can be analyzed is the disease diary and questionnaires, among which the MDPOSI (Meniere’s Disease Patient-Oriented Symptom-Severity Index) stands out as a designated quality-of-life assessment tool. This study aims to evaluate the differences in the questionnaire depending on the clinical characteristics of the disease. Methods: The study recruited 60 patients, with clinical variables including age, gender, disease laterality, caloric testing results, and PTA results, the presence of spontaneous nystagmus, pathological values of calorimetric testing, or rotatory chair testing abnormalities. Results: The appearance of spontaneous nystagmus showed a significant association with worse hearing threshold values at 500 Hz (p = 0.036, OR 4.416) and higher. Worse SRT scores correlated with Q1 (p = 0.011), Q2 (p = 0.028), Q4 (p = 0.045), Q5 (p = 0.013), and the total MDPOSI score (p = 0.008, 0.339). Multivariate analysis showed that a higher total value of the MDPOSI questionnaire was statistically significantly associated with older age (p = 0.042) and spontaneous nystagmus (p = 0.037). Conclusions: There is a correlation between the clinical characteristics of Meniere’s disease and the MDPOSI questionnaire, making it useful for assessing quality of life and disease progression.

Functional vestibular disorders (FVDs) are the most common cause of chronic dizziness and among the most prevalent vestibular conditions in adults, representing a significant public health concern. In 2017, the Behavioral Subcommittee of the Bárány Society’s Classification Committee established consensus-based clinical criteria for persistent postural-perceptual dizziness (PPPD)—a unifying diagnostic category that encompasses previously described FVDs, including phobic postural vertigo, space and motion discomfort, visual vertigo, and chronic subjective dizziness. Beyond these well-defined disorders lies a group of unclassified functional vestibular disorders (UFVDs), such as chronic persistent dizziness, perceptions of simultaneous movement in multiple spatial planes, and voluntary nystagmus. While these conditions share a functional (non-organic) basis, they do not meet the diagnostic criteria for established entities like PPPD. Unclassified functional vestibular disorders differ from PPPD in their inconsistent symptom patterns, variable triggers, and notably lower prevalence. Although currently under-recognized and insufficiently characterized, these disorders remain clinically relevant. A comprehensive understanding of both common and rare vestibular disorders is essential for accurate diagnosis, reducing diagnostic uncertainty, and optimizing patient management.

Objectives: The aim of this study is to examine the association of vitamin D levels, ionized calcium, and densitometry findings with the onset of BPPV. Participants and methods: A cross-sectional study was conducted, including 40 subjects over the age of 18 who were diagnosed with BPPV based on a positive result of the Dix-Hallpike maneuver. Clinical assessments were performed by an otorhinolaryngology specialist. Subjects with a confirmed diagnosis of BPPV were further referred for laboratory tests to measure vitamin D levels, ionized calcium in the blood, and bone densitometry. Results: Out of 40 subjects, 37 (93%) were women, and 3 (7%) were men. In all cases, the posterior semicircular canal was involved. The right side was affected in 23 subjects (58%). Osteopenia and osteoporosis were recorded in 34 subjects (85%). Reference range values for vitamin D were recorded in 19 subjects (4%), while ionized calcium levels were within the reference range in 7 subjects (18%). Sixteen subjects (40%) had both values within the reference range. No significant associations were found between gender, clinical form, or affected side and the values of vitamin D, calcium, or densitometry findings. Conclusion: However, an association was observed between the presence of osteoporosis and BPPV, suggesting that osteoporosis may be a risk factor for the development of BPPV. The study could not establish the influence of low vitamin D or ionized calcium levels on the development of BPPV. Further research is needed to better understand these potential relationships.

The purpose of this research was to examine whether demographic variables, personality traits, and workplace variables (working in shifts, job tenure, and perceived organizational justice) contribute the most to the prediction of job satisfaction in nurses. The survey included 161 nurses. The instruments used in this research were as follows: the Demographic Data Questionnaire, the Perceived Organizational Justice Scale, the Job Satisfaction Scale, and the NEO five-factor inventory. The study findings indicated that age, health status, distributive justice, and procedural justice positively contribute to job satisfaction among nurses, while neuroticism contributes negatively. Older nurses, those in better health, those who are satisfied with the organization’s decision-making process, and those who feel adequately rewarded for their contributions tend to be more satisfied with their jobs. Conversely, nurses with a higher level of the neuroticism personality trait tend to be less satisfied with their job. The strongest predictors of job satisfaction among nurses were found to be health status, the personality trait of neuroticism, and distributive and procedural justice, with the age of nurses being slightly less powerful but still significant.

Research background. The role of dietary habits of patients with laryngopharyngeal reflux (LPR) is comparatively underexplored. The aim of the study is to examine dietary habits, onset and course of the disease as well as the quality of life of patients with LPR. Experimental approach. The results of the modified food frequency questionnaire (FFQ-m) and laryngopharyngeal reflux health-related quality of life (LPR-HRQL) questionnaires were compared between subjects with and without LPR. There were a total of 100 subjects with LPR and 65 subjects in the control group. The group of subjects with LPR was further randomly divided into two subgroups; the first subgroup was treated with esomeprazole at a dose of 20 mg twice daily combined with the instructions for dietary and general lifestyle changes, and the other with pantoprazole at a dose of 20 mg twice daily combined with the instructions for dietary and general lifestyle changes. Participants were instructed to fill out FFQ-m and LPR-HRQL questionnaires immediately after the initial examination and then after control examinations 30 and 60 days after the initial examination. Results and conclusions. Patients with LPR consume more food with high reflux potential, drink more carbonated drinks and juices and have a worse quality of life than the control group (p<0.001). Taking proton pump inhibitors at a dose of 20 mg twice daily in combination with a change in dietary habits such as substituting acidic, spicy, fermented, sweet, fried foods and other foods with a high reflux potential as well as carbonated drinks and juices with the food with a low reflux potential and water significantly reduced the symptoms of LPR and increased the quality of life of the patients (p<0.001). Novelty and scientific contribution. This is the first study showing the correlation between dietary habits and the quality of life of patients with LPR. The contribution of this research is an objective assessment of the follow-up of patients with LPR that could be used in their regular assessment.

In recent years, the prevalence of laryngopharyngeal reflux has risen, especially among pediatric patients. The diagnosis of laryngopharyngeal reflux relies on patient history and clinical assessment using the Reflux Finding Score and Reflux Symptom Index as crucial diagnostic tools. Some studies have proposed a link between pepsin and laryngopharyngeal reflux, potentially triggering palatine tonsil hypertrophy. Our study aimed to investigate the correlation between laryngeal and pharyngeal manifestations of laryngopharyngeal reflux through two questionnaires and the presence of pepsin in saliva and palatine tonsils in a pediatric population. Pepsin in saliva was detected using a Western blot method, while immunohistochemistry assessed its presence in palatine tonsils. Although no statistically significant differences in Reflux Finding Score and Reflux Symptom Index were found between the immunohistochemistry-positive (IHC-positive) and immunohistochemistry-negative (IHC-negative) groups, median reflux symptom index and Reflux Finding Score values consistently trended higher in the IHC-positive group. This suggests a potential connection between elevated index values and pepsin presence in tonsillar tissue. Further investigations are essential to fully comprehend the clinical implications of these findings.

This report aimed to investigate the relationship after successful left‐sided stapedotomy and postoperative benign paroxysmal positional vertigo (BPPV) due to vitamin D deficiency. A 56‐year‐old woman presented with a complaint of progressive heari...

Telemedicine is a term that covers all procedures supported by communication technology, which has the purpose of providing health services at a specific spatial distance. This is an area that is developing rapidly and has found particular application in otorhinolaryngology, given that a large number of surgeries are performed with the help of endoscopes and microscopes. Telemedicine also represents a significant advantage during the coronavirus pandemic, both in terms of treating patients and monitoring them more effectively. For the purpose of preparing this article, research published on Scopus, PubMed, Google Scholar, and Google was reviewed using the keywords “telemedicine” and “otorhinolaryngology”. This review article provides a summary and the latest insights in this broad and fast-growing area. The development of telemedicine in Croatia as well as a special review of the application of telemedicine during the coronavirus pandemic is also presented in this article.

Objectives: The current study was performed to determine the presence of pepsin in saliva and laryngeal tissue among participants with benign and malignant laryngeal neoplasms. Study design: Case–control study included three groups of patients with: (1) benign laryngeal neoplasms, (2) malignant laryngeal neoplasms and (3) control subjects without symptoms or signs of laryngopharyngeal reflux (LPR). Methods: Eighty-one voluntary participants were included into study. They were recruited from a group of patients with histologically proven benign and malignant laryngeal neoplasms and in case of control subjects among patients with nasal septum deformation without symptoms of LPR. Morning saliva samples were collected preoperatively. Tumor biopsies were collected by directoscopy of larynx and the control samples from interarytenoid unit of larynx. All samples were analyzed by Enzyme-Linked Immunosorbent Assay (ELISA) and Immunohistochemistry. Results: Pepsin was found in all samples of saliva and tissue biopsies in groups with malignant and benign neoplasms. The highest concentration of pepsin was found in a group of patients with malignant laryngeal neoplasms. Patients with benign laryngeal neoplasms had lower concentrations and the control subjects presented with the lowest concentration of pepsin measured from their saliva. Differences were not statistically significant. Immunohistochemical (IHC) analysis showed the largest number of high positive samples in the group of malignant lesions. Conclusion: These results suggest that pepsin and LPR can contribute to the development of benign and malignant laryngeal neoplasms. Further prospective studies, with far more patients, are necessary to prove the role of pepsin in multifactorial etiology of laryngeal neoplasms.

The aim of this study was to present the advantages and disadvantages of open approach in rhinoplasty. In it, we also present the development of this technique in Croatia and examine its application in the last five years at the Department of Otorhinolaryngology and Head and Neck Surgery of the Clinical Hospital Centre Osijek. Retrospectively, from January 2008 to August 2012, 400 patients with septal deviation and/or deformities of the nasal pyramid who underwent open rhinoplasty at the Department of Otorhinolaryngology, Head and Neck Surgery of the Clinical Hospital Centre of Osijek, Croatia were identified. The clinical diagnosis was based on a detailed medical history of the patient and nasal endoscopy. The patients were photographed in six projections before and after the surgery, and followed up on two occasions.