Serifoglu, Berkay; Evginer, Sercan; Akdag, Mehmet; Bostanci, Asli; Turhan, Murat

Purpose: To evaluate the feasibility, morbidity, and efficacy of transoral robotic surgery (TORS) tongue base resection (TBR) combined with upper airway airflow-facilitating surgeries in patients with obstructive sleep apnoea (OSA) characterized by tongue base hypertrophy and collapse, and to identify anatomical and nonanatomical predictors of surgical success. Methods: This single-center, prospective observational cohort study included 110 adult patients with moderate to severe OSA (AHI ≥ 15) or positional OSA, who failed or refused conservative therapies. Retrolingual/hypopharyngeal obstruction and tongue base collapse were confirmed via drug-induced sleep endoscopy or flexible nasopharyngoscopy. Patients with contraindications for surgery, inadequate mouth opening, absence of postoperative polysomnography, or under 18 years of age were excluded. Demographic, polysomnographic, and perioperative data were collected and statistically analyzed. Results: The mean patient age was 47.4 ± 10.8 years, and mean BMI was 30.2 ± 4.0 kg/m²; 93.6% were male. All patients underwent TORS-TBR without the need for tracheostomy. The mean hospitalization period was 8.5 ± 4.3 days. Statistically significant differences between surgical success and failure groups included AHIREM, obstructive apnoea counts in REM and NREM, mean obstructive apnoea duration, total apnoea duration, lowest oxygen saturation, mean desaturation percentages, and sleep time with oxygen saturation below 90% (ST90). Postoperative polysomnography demonstrated significant improvements across almost all parameters. Based on surgical success criteria, 73.6% of patients achieved a successful outcome. Conclusion: Transoral robotic tongue base surgery, combined with individualized multilevel airway interventions, provides an effective, feasible early treatment option for OSA. This approach supports personalized management strategies and significantly improves polysomnographic outcomes, contributing to the reduction of OSA-related morbidity and mortality.

Salcan, İsmail; Karakeçili, Faruk; Salcan, Sara; Ünver, Edhem; Akyüz, Sümeyye; Seçkin, Ender; Cingi, Cemal

Objective: It is known that the COVID-19 disease, which has affected the whole world, causes symptoms, such as cough, fever, shortness of breath, muscle pain, fatigue, diarrhea, headache and sore throat, in addition to various clinical findings, such as loss of smell and taste. In this study, we aimed to reveal the loss of sense of taste and smell in COVID-19 patients and to investigate whether these sensory losses are permanent in the healing process of the disease. Method: This prospective study included 94 COVID-19 patients. Smell and taste tests were applied to all patients. Ten days after the first test, a second test was applied to the patients with an impaired sense of smell to compare the results. Results: Of the 94 patients, 55.3% were male, and the mean age was 53 ± 19.6 (21–90) years. There were 67 patients with smell and taste impairment, of whom 34 (50.7%) had smell impairment only, 3 (4.4%) had taste impairment only, and 30 (44.7%) had both smell and taste impairment. It was found that the smell scores of 55 patients with smell and taste impairment in the first evaluation were significantly higher at the second measurement; and their tasting period was significantly shortened compared to the first measurement (p˂0.001). Conclusion: COVID-19 patients may present to medical centers with a broad variety signs and symptoms. This study shows that impairment in the senses of smell and taste is common in this disease and strongly associated with COVID-19 infection. However, smell and taste impairment is mostly temporary and improves during the recovery period.

Erdurak, Selcuk Cem; Coskun, Berna Uslu; Sakalli, Erdal; Tansuker, Hasan Deniz; Turan, Fatih; Kaya, Deniz

The aim of the present study was to determine the rate of myringosclerosis after radiofrequency (RF) myringotomy and ventilation tube (VT) insertion and compare it with that after the incisional myringotomy and VT insertion. Thirty children (60 ears), 2-16 years old (mean age 7.06 ± 2.77 years) who were planned to undergo surgical intervention for bilateral otitis media with effusion (OME), were included in this study. The children were treated by RF myringotomy of the right ear, incisional myringotomy of the left ear, and insertion of VTs into both ears. Both ears were examined intraoperatively for bleeding, and patients were evaluated for myringosclerosis formation with otomicroscopy at the end of the ninth month. Myringosclerosis was observed in 22 of the 60 ears. The overall incidence was 36.6 %. Fifteen (50 %) left ears showed myringosclerosis by otomicroscopy, and seven (23.3 %) right ears showed myringosclerosis. The rate of myringosclerosis of the right ear was significantly lower than that of the left ear (p < 0.05). In addition, intraoperative tympanic membrane bleeding was observed in 24 (40 %) of the 60 ears: 21 (70 %) left ears and three (10 %) right ears were perforated by RF. The tympanic membrane bleeding rate of the right ear was significantly lower than that of the left ear (p < 0.01). The present study is the first to determine the myringosclerosis rate after RF myringotomy and VT insertion. Our results indicate that VT insertion with RF myringotomy decreased the incidence of myringosclerosis.