Local Effect of Neurotrophin-3 in Neuronal Inflammation of Allergic Rhinitis: Preliminary Report.

BACKGROUND: Allergic rhinitis is a common inflammatory nasal mucosal disease characterized by sneezing, watery nasal discharge, nasal obstruction and itching. Although allergen-specific antibodies play a main role in the allergic airway inflammation, neuronal inflammation may also contribute to the symptoms of allergic rhinitis. Neuronal inflammation is primarily caused by the stimulation of sensory nerve endings with histamine. It has been shown that neurotrophins may also have a role in allergic reactions and neuronal inflammation. Nerve growth factor, neurotrophin 3 (NT-3), neurotrophin 4/5 and brain-derived neurotrophic factor are members of the neurotrophin family. Although nerve growth factor and brain-derived neurotrophic factor are well studied in allergic rhinitis patients, the exact role of Neurotrophin-3 is not known. AIMS: To investigate the possible roles of neurotrophin-3 in allergic rhinitis patients. STUDY DESIGN: Case-control study. METHODS: Neurotrophin-3 levels were studied in the inferior turbinate and serum samples of 20 allergic rhinitis and 13 control patients. Neurotrophin-3 staining of nasal tissues was evaluated by immunohistochemistry and ELISA was used for the determination of serum Neurotrophin-3 levels. RESULTS: Neurotrophin-3 staining scores were statistically higher in the study group than in the control patients (p=0.001). Regarding serum Neurotrophin-3 levels, no statistically significant difference could be determined between allergic rhinitis and control patients (p=0.156). When comparing the serum NT-3 levels with tissue staining scores, there were no statistically significant differences in the allergic rhinitis and control groups (p=0.254 for allergic rhinitis and p=0.624 for control groups). CONCLUSION: We suggest that Neurotrophin-3 might affect the nasal mucosa locally without being released into the systemic circulation in allergic rhinitis patients.

Nasopharyngeal tuberculosis presenting as massive cervical lymphadenopathy and hearing loss.

Lymphadenitis is the most common form of tuberculosis in the head and neck region, but it can be seen in the other areas of the head and neck. Nasopharyngeal tuberculosis is a rare condition without pulmonary and systemic involvement. The majority of patients present with neck mass. A 17-year-old female patient admitted to our outpatient clinic with the complaints of swelling on both sides of the neck and hearing loss. The endoscopic examination revealed a nasopharyngeal mass, and biopsies were taken from the mass. The result of pathologic examination was reported as caseating granulomatous inflammation compatible with tuberculosis. In this report, a nasopharyngeal tuberculosis case associated with massive cervical lymphadenopathy was reported, and etiopathogenesis and treatment were also discussed.

Is speech therapy useful as a complementary treatment for post-tonsillectomy pain?

OBJECTIVES: To evaluate the efficacy of speech therapy for relief of post-tonsillectomy pain in children. METHODS: Fifty patients who underwent tonsillectomy and were randomly divided into three groups were analyzed in this study. Groups I and II received medical and speech therapy including two different phonemes group, and Group III received only medical therapy. For Group I (20 patients) soft palate phonemes and for Group II (20 patients) lips and gingival phonemes were used. The patients who received medical treatment without speech therapy were used as the control group. Postoperative pain levels were recorded with our standard visual analog scale (VAS) forms for each patient during the postoperative 10 days. The pain score of the patients were compared statistically among the three different groups. RESULTS: The postoperative pain score was lower in Group I as compared to Group II (p=0.001) and III (p=0.045), and it was statistically significant. There was no significant difference regarding postoperative pain scores between Group II and Group III patients (p=0.356). CONCLUSION: Speech therapy may cause to strengthen the soft palate muscles and alleviate constant post-tonsillectomy pain. This therapy may be used as a complementary treatment with standard analgesics.