Evaluation of the hearing status in carpenters.

PURPOSE: Carpenters are constantly exposed to a noise level of 82-100 dB(A) in their professional lives. The aim of this study is to evaluate the hearing status of carpenters with pure -tone audiometry and transient evoked otoacoustic emissions test. METHODS: A total of 62 individuals were enrolled. The study group consisted of 31 carpenters and the controls were age and sex matched healthy individuals who were not exposed to continuous or sudden noise. RESULTS: The average age of the carpenters is 44.58 ± 10.33, the average age of the control group is 41.84 ± 8.65 and there was no statistically significant difference (p = 0.262). There was a significant hearing loss in the study group nearly at all frequencies when compared to the control group (p < 0.05). The emission values of the right and left ears of the carpenters were significantly lower than the controls at 2000 and 2800 Hz (p < 0.05). CONCLUSION: Accordingly, carpenters seem to be susceptible to the development of noise-induced hearing loss.

Comparison of Rapid Absorbable Sutures with Nonabsorbable Sutures in Closing Transcolumellar Incision in Septorhinoplasty: Short-term Outcomes.

BACKGROUND: Following open rhinoplasty, a postoperative scar at the columellar incision line is a common morbidity. The aim of this study is to compare absorbable and nonabsorbable suture materials which had been used for closing the transcolumellar incision, in the aspect of risk of postoperative infection, wound healing, postoperative columellar scar and patient satisfaction. METHOD: A prospective, randomized, single-blind study was conducted between May 2017 and February 2018. Sixty-four rhinoplasty patients were randomly assigned to absorbable (n = 32) or nonabsorbable (n = 32) groups. The columellar incision was closed with 7 full-thickness skin sutures. Either nonabsorbable 6/0 polypropylene (Group 1) or absorbable 6/0 polyglytone 6211 (Group 2) sutures were placed at the columellar incisions. Polypropylene sutures were removed at the 7th postoperative day. A Mann-Whitney U test and Monte Carlo were used for statistical comparison. Photographs of the patients at the postoperative third month (Fig. 2) were evaluated and scored in terms of scarring, pigmentation, notching, level differences in the incision area by two different otorhinolaryngologists who did not know the randomization. Suture removing discomfort was assessed with visual analogue scale scores. A satisfaction survey was filled out by all the patients completing their third month after the operation. RESULTS: According to the results of both otorhinolaryngologists, there was no significant difference between the two groups in terms of pigmentation, level difference, notching, overall appearance and total score (p = 0.920, p = 0.498, respectively). The mean score on the Wong-Baker scale was 3.19 ± 1.67 in group 1. In the Satisfaction Survey, the average score of the group 1 was 6.90 ± 3.24, while the mean score of the group 2 was 7.062 ± 2.77. There was no statistically significant difference between the two groups (p = 0.715). CONCLUSIONS: Suturing inverted V transcolumellar incisions with rapid resorbable sutures caused significantly less discomfort but no difference in scarring compared to nonresorbable sutures as evaluated by patients and observers. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evaluation of Nasal Tip Support in Septorhinoplasty.

BACKGROUND: A good understanding of nasal tip support mechanisms is essential for achieving successful and functional rhinoplasty results. The loss of nasal tip support resulting from different maneuvers adopted during rhinoplasty and how this loss is affected by reconstructive applications should be known. This study evaluated and compared changes in nasal tip support perioperatively after different techniques were used during septorhinoplasty. METHODS: Patients who underwent primary open rhinoplasty between January 2018 and March 2018 in a tertiary medical center were included in this prospective blind case series. Nasal tip resistance measurements were taken after perioperative maneuvers by creating enough force to achieve 1 mm, 2 mm and 3 mm of displacement at the tip region. Measurements were obtained during six different stages using a Newton meter: preoperatively, after caudal septal resection, after skin flap elevation, after the columellar strut or tongue-in-groove procedure, after tip suturing and postoperatively. Our hypothesis was that during septorhinoplasty, each maneuver used changes the tip support intraoperatively. The predictor variables were the different rhinoplasty techniques used. The outcome variable was nasal tip resistance to compression intraoperatively and immediate postoperatively. Appropriate statistics were computed, and a p < 0.05 value was considered significant. RESULTS: Ten of the 15 patients were female, and 5 were male. The patient age ranged from 19 to 40 (mean 24.8 ± 4.9). The tongue-in-groove technique was applied in 5 of the patients, while columellar strut grafting was performed in 10. The application of columellar strut grafting did not create a significant increase in nasal tip support (p > 0.05). An increase in nasal tip support was observed at each stage (85%, 53%, 35%) after application of the tongue-in-groove technique (p < 0.05). CONCLUSIONS: A novel and reproducible technique for digitally evaluating manual force is presented for determining changes in nasal tip support with different maneuvers applied in living patients undergoing rhinoplasty. No significant difference was noted between the preoperative and postoperative measurements for columellar strut grafting. The tongue-in-groove technique is an important maneuver that has a significant effect on nasal tip support. According to our data, the interdomal and intercrural ligaments, the medial crus-septum connections and the connections between alar cartilage and overlying skin and muscle tissue are important structures for tip support. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Association of Interleukin-10 gene promoter polymorphisms with obstructive sleep apnea.

BACKGROUND: Interleukin-10 (IL) is an anti-inflammatory cytokine that regulates normal sleep patterns, and recent studies have reported that it is a potential useful biomarker to identify presence and severity of sleep apnea syndrome (OSAS). Promoter polymorphisms of IL-10 gene have been associated with altered expression levels, which contributes to OSAS. OBJECTIVE: The aim of this study was to determine the prevalence of -1082 G/A, -819 C/T, and -592 C/A promoter polymorphisms of IL-10 gene in individuals with OSAS and controls. SUBJECTS AND METHODS: An open-label study was performed in the Otorhinolaryngology and Sleep Disorders Outpatient Clinics. One hundred four cases with OSAS were included as the study group, and 78 individuals without OSAS were included as the controls. DNAs were extracted from peripheral blood leukocytes, and the sites that encompassed those polymorphisms were identified by DNA sequencing analyses. Data were analyzed with SNPStats and multifactor dimensionality reduction (MDR) software. RESULTS: The prevalence of OSAS was higher in males in the study group when compared to controls (P = 0.0003). The IL-10-1082 G/A, -819 C/T, and -592 C/A SNPs, and their minor alleles were associated with a significantly increased risk for OSAS compared to the controls (P ˂ 0.05 for all). Furthermore, ATA haplotype frequency was significantly higher in the study group compared to the control group, but the GCC haplotype frequency was lower (P = 0.0001 and P = 0.0001). As indicated in MDR analysis, combinations of IL-10 gene were associated with OSAS in single-, double-, and triple-locus analyses. CONCLUSION: The prevalences of the IL-10 gene promoter polymorphisms were different in OSAS patients and the controls in Turkish population. IL-10 gene polymorphisms may lead to altered inflammatory cascade, which might contribute to OSAS. Further studies on larger cohorts are needed to validate our findings.

Endoscopic modified medial maxillectomy for treatment of inverted papilloma originating from the maxillary sinus.

Endoscopic approaches have become an alternative to external approaches in the treatment of sinonasal inverted papillomas (IPs) in recent years. The aim of this study was to analyze the outcomes of endoscopic modified medial maxillectomy preserving the nasolacrimal duct and the inferior turbinate in selected IP cases. Medical charts of patients diagnosed with IP originating from the maxillary sinus between July 2008 and August 2013 were reviewed. Eight patients who had undergone endoscopic modified medial maxillectomy were included in the study. Attachment of IP was located on the medial wall of the maxillary sinus in all cases. The nasolacrimal duct was preserved in all of the patients. The inferior turbinate was completely preserved in 5 patients, and the anterior part of the inferior turbinate was preserved in 3 patients. The mean follow-up period of the patients was 30.8 months (12-60  mo). None of the patients had recurrence or major complications. The postoperative complaints were minor hemorrhagic discharge and crusting for the first few weeks. Endoscopic modified medial maxillectomy preserving the nasolacrimal duct and the inferior turbinate provides good surgical and functional outcomes in selected IP cases.

Fractalkine receptor polymorphism and chronic tonsillitis.

The objective of this study is to examine whether there is an association of fractalkine gene receptor polymorphisms with chronic tonsillitis. This is a cross-sectional study in the setting of a tertiary referral center. The study group included 79 patients with chronic tonsillitis and 76 controls without history of chronic tonsillitis. Genotypes were identified by restriction fragment length polymorphism analyses after polymerase chain reaction. c.745G>A (V249I) single nucleotide polymorphism and the frequencies of the G and A alleles did not differ in the patient and control groups (p = 0.363; p = 0.743, respectively). c.839C>T (T280M) single nucleotide polymorphism was found to be higher in controls than in the patients with chronic tonsillitis (p < 0.001). Consistent with this result, T allele frequency was higher in controls than in the patients with chronic tonsillitis (p < 0.001). In this study, we suggested that fractalkine gene receptor c.839C>T (T280M) single nucleotide polymorphism could be associated with a reduced risk of chronic tonsillitis.

Investigation of SCGB3A1 (UGRP2) gene arrays in patients with nasal polyposis.

The aim of the current study is to investigate the potential relationship between polymorphisms and nasal polyposis (NP) pathogenesis in the SCGB3A1 (UGRP2) gene, which is a member of the secretoglobin gene super family. Genotypic variations were studied by performing DNA sequencing in blood samples of 80 patients with NP and 70 healthy individuals to evaluate nucleotide changes and their positions that might be in the SCGB3A1 gene (promotor, splicing points, and exon distributions). In the SCGB3A1 gene, three single-nucleotide changes labeled IVS1-89 T>G, c. -183 G>T, IVS1-189 G>A were identified. IVS1-89 T>G and IVS1-189 G>A belong to the first intronic region of the gene, whereas c. -183 G>T was observed in the promoter region of the gene. The IVS1-89 T>G nucleotide change was observed in the patient and control groups, whereas c. -183 G>T and IVS1-189 G>A nucleotide changes were observed in the control group only. SCGB3A1 (IVS1-89) genotype frequencies between patients with NP and control group were not significantly different (p = 0.311). There was a statistically significant difference in the control group in comparison to patients with NP in terms of SCGB3A1 (c. -183 GT) and SCGB3A1 (IVS1-189 GA) frequency (p = 0.0045 and p = 0.009, respectively). The findings of the current study suggest that SCGB3A1-183 T and SCGB3A1 IVS1-189 A alleles might have a protective effect against NP, and that SCGB3A1 (-183 GT and IVS1-189 GA) genotypes should be studied in future population-based studies.

Ocular vestibular evoked myogenic potentials in response to air conducted stimuli: clinical application in healthy adults.

OBJECTIVES: This study aims to determine the normal values for ocular vestibular evoked myogenic potentials in response to air conducted stimuli in healthy adults. PATIENTS AND METHODS: Thirty-six healthy adult participants with no ear complaints were enrolled. Ocular vestibular evoked myogenic potential tests were performed to all participants. Latency and amplitude values of the waves were recorded. RESULTS: The mean N1 latency was 9.62±2.02 (4.30-16.00) msec and the mean P1 latency was 14.90±2.33 (9.0-21.00) msec. The mean amplitude was 3.36±1.36 (1.06-8.48) µV. There was a positive correlation between N1 and P1 latencies and age (r=242, p=0.0359 for N1; r=250, p=0.030 for P1). CONCLUSION: Ocular vestibular evoked myogenic potentials can be obtained easily and can be used in the evaluation of vestibular disorders. However, the effect of age should be considered when interpreting results.

Comparison of cervical vestibular evoked myogenic potentials between late preterm and term infants.

Recent investigations have shown that late preterm infants have increased risk for attention deficit hyperactivity disorder, neurosensory impairment, and emotional, behavior and learning problems. Vestibular evoked myogenic potential (VEMP) abnormality may partly contribute to these problems. Our aim was to measure VEMP in late preterm infants and to compare the findings between late preterm and term infants. Seventeen late preterm infants (mean gestational age: 35.11 weeks +/- 0.78) postnatal aged 8 weeks and 17 full-term (mean gestational age: 38.05 weeks +/- 0.96) infants postnatal aged 4 weeks underwent cervical (c)VEMP test without sedation. Mean latencies of p13 were calculated in all study subjects. cVEMPs were elicited in all late preterm and term infants. Mean latencies of p13 in late preterm and term infants were 14.53 and 13.34 ms, respectively. Mean latencies of n23 were determined as 23.18 ms and 19.92 ms for late preterm and term infants, respectively. There were statistically significant differences between late preterm and term infants for latency of p13 (p < 0.001) and latency of n23 (p < 0.000). Abnormal VEMP results might be related to a delay in the maturation of the sacculocollic pathways in late preterm infants.

Risk of nasal septal perforation following septoplasty in patients with allergic rhinitis.

Nasal septal perforation (NSP) is an uncomfortable condition that usually has a negative effect on the quality of life and is frequently seen as a complication of nasal surgical procedures. The aim of this study was to evaluate the effect of allergic rhinitis (AR) on the occurence rates of septal perforation as a complication of septoplasty. The medical records of 352 patients who had septoplasty at our department between January 2006 and May 2009 were searched thoroughly and those with a follow-up period of at least 1 month were included in the study. Septal perforation rates were compared between two groups, one of which was formed by patients known to have AR besides septum deviation and the other with no history of AR. Of the 352 patients, 70 (19.8%) had accompanying AR. Only three patients (0.9%), two in the non-allergic group (NAG) and one in the allergic group (AG), were noted to have NSP after septoplasty. According to this clinical data, NSP rates were 1.4 and 0.7%, respectively, in AG and NAG. No statistical significance was found between the two groups (p = 0.487). AR had no impact on the risk of NSP after septoplasty. To our opinion, an appropriate surgical technique and a respectful approach to the tissue planes are the key points of avoiding undesired results.

Medial olivary complex reflex in term newborns with hyperbilirubinemia.

OBJECTIVE: This study aimed to compare the integrity of the efferent auditory pathways of newborns that had high hyperbilirubinemia levels and required treatment due to these and healthy newborns. METHODS: Term-born (37 weeks or later) infants that were brought to the Newborn Polyclinic of the Baskent University Hospital were included in the study. The study included a total of 84 infants including healthy newborns (n = 42) and those that had jaundice and were receiving phototherapy (n = 42). After conducting a general otorhinolaryngology examination on all newborns included in the study, Transient Otoacoustic Emission (TEOAE) test was carried out in the absence and presence of contralateral noise. The obtained contralateral suppression values were compared between the two groups. RESULTS: In the TEOAE test, the responses obtained at 1 kHz in the newborns receiving phototherapy were found to be lower. The difference between the groups was significant (p = 0.038). The rates of suppression presence at 2 kHz, 2.8 kHz and total OAE were found significantly higher (p < 0.05) in the group not receiving phototherapy. Among the phototherapy-receiving infants, the hyperbilirubinemia levels of the infants in whom suppression was obtained in the contralateral suppression test did not show a statistically significant difference in comparison to those in whom suppression was not obtained (p > 0.05). CONCLUSION: Based on the obtained data, hyperbilirubinemia may have a disruptive effect on the efferent auditory system in newborns. Consequently, we are of the opinion that, in addition to hearing screening in risky newborn infants, a MOC suppression test would be useful.

Vestibular evoked myogenic potentials in preterm infants.

The goal of this study was to determine whether there was an association between perinatal risk factors of prematurity and vestibular evoked myogenic potentials (VEMPs). A prospective case-control trial was designed. Fifty preterm newborns (100 ears) with a gestational age <37 weeks were included. The control group consisted of 20 healthy term infants (40 ears). VEMP recordings were performed, and mean latencies of p13 were calculated in all study subjects. Multivariable logistic regression was used to investigate the influence of perinatal variables on abnormal VEMP responses. VEMPs were elicited in all term infants (40 ears). In preterm infants, the responses were normal in 71 ears, delayed in 24 and absent in 5. There was a significant difference between abnormal VEMP rates for preterm and term infants (p < 0.001). Asphyxia (OR = 13.985, p = 0.048) and time of VEMP test (OR = 0.865, p = 0.038) were related to abnormal VEMP responses. There was no association between delayed VEMPs and gestational age, birth weight, hemoglobin and bilirubin levels, phototherapy, intracranial hemorrhage, convulsions, sepsis, ototoxic drugs, transfusion, mechanical ventilation, retinopathy of prematurity, bronchopulmonary dysplasia and respiratory distress syndrome. These results suggest a delay in the maturation of VEMPs in premature infants. Asphyxia was the most important risk factor for abnormal VEMP responses in preterm infants.

[Function of outer hair cells in patients with pseudoexfoliation]. / Psödoeksfoliyasyon sendromunda dis tüylü hücre fonksiyonu.

OBJECTIVES: In this study, we aimed to assess whether outer hair cell function in patients with pseudoexfoliation syndrome (PES) was affected or not. PATIENTS AND METHODS: Thirty-two patients (21 males, 11 females; mean age 69.8+/-9.3 years; range 49 to 86 years) with the diagnosis of PES and 23 healthy subjects (12 males, 11 females; mean age 65.3+/-9.1 year; range 51 to 79 years) as control group were included in the study. All of the subjects were evaluated with pure tone audiometry, tympanometry, and transient otoacoustic emission tests. RESULTS: Sensorineural hearing loss was present in 28 patients with PES and in 13 healthy subjects (p<0.05). Transient otoacoustic emissions were present in 42 ears of patients with PES and in 32 ears of healthy subjects and there was no statistically significant difference between these two groups (p>0.05). Signal to noise ratios for PES and control groups were 5.1+/-4.4 dB and 5.2+/-4.2 dB, respectively (p>0.05). CONCLUSION: Our results confirmed the presence of sensorineural hearing loss in PES patients. However, we failed to show a difference in outer hair cell functions of this group. Further postmortem histopathologic studies are needed to delineate the causes of sensorineural hearing loss in patients with PES.

[Fungal allergy in chronic rhinosinusitis with or without polyps]. / Polipli veya polipsiz kronik rinosinüzitli olgularda mantar alerjisi.

OBJECTIVES: Fungi, by systemic or local allergic effect, may play a role in the pathogenesis of chronic rhinosinusitis (CRS). We investigated the incidence of fungal allergy in patients with CRS and its effect on the clinical characteristics of the disease. PATIENTS AND METHODS: The study included 127 patients, aged 18 years or over, with CRS (42 females, 85 males; mean age 43+/-12 years; range 19 to 78 years). Fungal allergy was determined by skin prick test and its effect was analyzed on blood eosinophil and total immunoglobulin E levels, the presence of polyps, and paranasal sinus computed tomography scores. RESULTS: Eighty-five patients (66.9%) were found to have allergy. The incidence of allergy did not differ between patients with and without polyps (p>0.05). House dust mites (62.2%) were the most frequent allergens. The incidence of fungal allergy was 38.8% in allergic patients. Isolated fungal allergy was detected in two patients (1.6%). The most frequent fungal allergens were Aspergillus, followed by Alternaria, and Penicillium. No association was found between fungal allergy and blood eosinophil and total immunoglobulin E levels, presence of polyps, or paranasal sinus computed tomography scores (p>0.05). CONCLUSION: The incidence of fungal allergy in patients with CRS was found to be high in this study. Tissue culture studies are required to determine the definitive relationship between fungal allergy and clinical features of CRS.

[The relationship between smoking and nasal polyposis]. / Sigara içme ile nazal polipozis arasindaki iliski.

OBJECTIVES: Research on the role of environmental factors in the pathogenesis of nasal polyposis (NP) is limited. The aim of this study was to evaluate the effect of smoking on NP. PATIENTS AND METHODS: A total of 125 patients (80 men, 45 women; mean age 44+/-12 years; range 19 to 78 years) with NP were evaluated with regard to the presence or absence of smoking, polyp stage, paranasal sinus computed tomography (CT) score, total IgE level, blood eosinophil count, and symptom scores. RESULTS: The rate of smoking in NP patients was 16.8% (21 patients), being significantly low (p<0.001) compared to the general rate of smoking previously reported in the study area (34.2%). There was no association between smoking and polyp size, paranasal sinus CT score, total IgE level, and blood eosinophil count (p>0.05). The frequencies of allergy, asthma, and aspirin allergy were not different between smokers and nonsmokers (p>0.05). Symptom scores did not differ significantly between smokers and nonsmokers, except for nasal obstruction score, which was significantly low in nonsmokers (p=0.034). CONCLUSION: Our results showed that the rate of smoking in patients with NP and the severity of nasal obstruction in smokers compared to nonsmokers were significantly low. Tissue studies in patients with NP may provide useful data on the relationship between smoking and NP.

[Epidemiological characteristics, distribution of allergens, and symptom severity in patients with perennial allergic rhinitis, living in Konya region]. / Konya yöresinde yasayan perennial alerjik rinitli hastalarda epidemiyolojik özellikler, alerjen dagilimi ve semptom ciddiyeti.

OBJECTIVES: We investigated epidemiological characteristics, distribution of allergens, and symptom severity of patients with perennial allergic rhinitis (PAR), living in Konya region. PATIENTS AND METHODS: The study included 165 adult patients (89 females, 76 males; mean age 34.5+/-10.7 years; range 18 to 68 years) diagnosed as having PAR based on clinical symptoms and skin prick test (SPT) results. Total IgE levels, distribution of allergens in SPT, and symptom severity were determined. RESULTS: The most frequent allergens were house dust mites (84.9%), followed by pollen mixture (42.8%), fungi (38.6%), and animal dander (36.7%). Serum total IgE levels were higher than normal in 30.3%. Age at onset of symptoms was = or <25 years in 45.2% of the patients. Patients with a university degree accounted for 46.5%. Urban and rural residents accounted for 66.2% and 33.8%, respectively. Coexisting asthma and aspirin allergy were detected in 2.9% and 2.2%, respectively. A family history of allergy was present in 22.3%. The most common nasal symptom was itching, but blocked nose had the highest severity score. CONCLUSION: In our region, house dust mites were the most frequent allergens, itchy nose was the most common symptom, and blocked nose had the highest symptom severity score in patients with PAR.

The role of meteorologic factors and air pollution on the frequency of pediatric epistaxis.

Fluctuations in atmospheric temperature, humidity, and air pollution are associated with the incidence of epistaxis. To date, no study in the literature has evaluated the effect of air pollution and meteorologic conditions on the pediatric population. We aimed to evaluate the effect of meteorologic factors and air pollution on the frequency of epistaxis in children. Children presenting to an outpatient clinical setting at a tertiary care hospital during a 5-year period (July 1, 2009, to June 30, 2014) and diagnosed with epistaxis formed the study population. Daily temperature and humidity parameters and average daily atmospheric water vapor pressure, average daily concentration of particulate matter <10 µm in diameter, and sulfur dioxide readings were obtained. The distribution of daily parameters was analyzed. Of the 1,559 children with the primary diagnosis of epistaxis, data from 1,330 children were analyzed after excluding patients with coexisting pathologies. Positive correlations were found between the frequency of epistaxis and both the average daily temperature and the difference between the maximum and minimum daily temperature. There was a negative correlation between the epistaxis frequency and the average daily humidity, the difference between the maximum and minimum daily humidity, the average daily concentration of particulate matter, and the sulfur dioxide levels. Our findings suggest that epistaxis in children is related to high temperatures and low humidity.

Proinflammatory cytokine single nucleotide polymorphisms in nasal polyposis.

OBJECTIVE: To investigate the association between nasal polyposis (NP) and single nucleotide polymorphisms of the proinflammatory cytokines IL (interleukin) 1alpha (the IL1A gene), IL-1beta (the IL1B gene), and tumor necrosis factor alpha (the TNFA gene). DESIGN: Prospective case-control trial. SETTING: Tertiary referral center. PATIENTS: Eighty-two patients with NP and 106 healthy volunteers without sinonasal disease. MAIN OUTCOME MEASURES: Genotypes of IL1A (4845G, 4845T), IL1B (-511C, -511T) and TNFA (-238G, -238A and -308G, -308A) were identified by restriction fragment length polymorphism analyses after polymerase chain reaction. RESULTS: The 4845 GT and 4845 TT genotypes of the IL1A gene were associated with NP (P<.05). The frequency of the -511 CC genotype of the IL1B gene was significantly higher in patients with NP than in controls (P=.01). The frequency of the -511 CT genotype of IL1B was significantly higher (P=.01) in the controls than in the patients with NP. The -238 AA genotype of the TNFA gene was higher in the patients with NP than in the controls (P=.05). There was a significantly high risk of susceptibility to NP in patients with the -308 GA genotype of TNFA (P=.001). None of the genotypes of the proinflammatory cytokines were related to sex, the presence of atopy, asthma, or aspirin intolerance (P>.05). CONCLUSION: The IL1A (4845 GT and 4845 TT), IL1B (-511 CC), and TNFA (-238 AA and -308 GA) genotypes were associated with susceptibility to NP in our study population.

Clinical application of vestibular evoked myogenic potentials in healthy newborns.

OBJECTIVE: Auditory and vestibular functions have critical importance in infancy because they may affect motor and mental development. We aimed to determine the normal values of the vestibular evoked myogenic potential (VEMP) parameters to provide a reference for further research regarding the early diagnosis of vestibular dysfunction in newborns. METHODS: Twenty-four term newborns (12 girls, 12 boys), with birth weights greater than 2500 g and Apgar scores higher than 7 at 1 min, were studied. Tympanometry, auditory-evoked brainstem responses, transient-evoked otoacoustic emissions, and VEMP recordings were assessed in all subjects during fourth week after birth. RESULTS: All newborns passed the audiologic evaluation, and biphasic waveforms of the VEMP were obtained in all 48 tested ears. Mean latencies of p13, n23, and p13-n23 intervals were 13.7+/-1.1, 20.5+/-1.6, and 7.1+/-2.1 ms, respectively. The mean amplitude value was 22.6+/-18.4 microV. There were no significant differences in latency values or amplitudes with regard to sex or side of ear tested in newborns. CONCLUSIONS: VEMP may easily be used for early evaluation of vestibular dysfunction in newborns. Because results may differ owing to test techniques and age, every laboratory should have its own normal values.

Abnormal electronystagmography in rheumatoid arthritis.

OBJECTIVE: Although sensorineural hearing loss has been widely investigated in those with rheumatoid arthritis, studies assessing the vestibular system in patients with rheumatoid arthritis are limited. The aim of this study was to assess the vestibular system in patients with rheumatoid arthritis. METHODS: The study consisted of 43 patients with rheumatoid arthritis and 30 healthy controls. Otorhinolaryngologic and neurotologic examinations, pure-tone audiometry, impedancemetry, electronystagmography including smooth pursuit, saccade, positional, and caloric tests were performed in all patients with rheumatoid arthritis and in controls. The erythrocyte sedimentation rate, C-reactive protein level, and rheumatoid factor level were evaluated in all patients with rheumatoid arthritis. RESULTS: Audiograms revealed sensorineural hearing loss in 12 patients (27.9%) with rheumatoid arthritis and in two controls (6.6%); the difference was statistically significant (P=.033). In those with rheumatoid arthritis, the results of electronystagmography revealed central abnormalities in nine patients (20.9%), peripheral abnormalities in three (6.9%), and mixed abnormalities in three (6.9%). Smooth pursuit and saccade tracing impairments were significantly higher in patients with rheumatoid arthritis (P>.05). Canal paresis in patients with rheumatoid arthritis were significantly higher than those in the control group (P=.039). No association was found between electronystagmographic abnormalities in patients with rheumatoid arthritis and age, sex, duration of disease, the results of laboratory testing, sensorineural hearing loss, or medication use. CONCLUSION: Our results suggest an association of rheumatoid arthritis with vestibular system dysfunction as well as auditory impairment.