Middle-Ear Resonance Frequency and Eustachian Tube Function in Players of Wind Instruments.

INTRODUCTION: The effect of the continuous forced expiration action of players of wind instruments to produce sound, on the eustachian tube functions and the middle-ear resonance frequency (RF), has not been investigated in the literature to date. The aim of this study is to evaluate eustachian tube functions and the middle-ear RF of players of wind instruments. METHODS: In this prospective case-control clinical study, a study group of 28 players of wind instruments in the orchestra (28 participants, 56 ears) and a control group of 34 volunteers (34 participants, 68 ears) were included. The eustachian function of wind instrument players in a symphony orchestra was measured using an automatic eustachian tube function test in acoustic tympanometry and the RF of the middle ear was determined in multifrequency tympanometry. RESULTS: There was a statistically significant difference among the musicians, especially in players of woodwind instruments, in terms of dysfunction of the eustachian tubes (p = 0.048). In the musicians, the pre- and postperformance RF mean values for all ears were 925 and 1,020 Hz, respectively, and these were significantly different (p = 0.004). CONCLUSION: This is the first study to uses multifrequency tympanometry to examine the middle-ear RF and eustachian tube function of wind instrument musicians in an orchestra. Eustachian tube dysfunction was found to be more prominent and a higher RF of the middle ear was seen after a performance, especially in players of wood wind instruments. However, the effect of these on the professional performance of players of wind instruments should be investigated in future work.

Evaluation of the possible effect of magnetic resonance imaging noise on peripheral hearing organ with the otoacoustic emission.

PURPOSE: The aim of this study is to evaluate the effect of noise produced by magnetic resonance imaging (MRI) device on hearing by using objective and subjective audiological assessments. METHODS: A total of 38 patients between the ages of 18 and 50 without hearing loss, and had performed MRI for brain, head, neck or cervical imaging were included in this prospective clinical study. Pure tone audiometry, speech audiometry, high frequency audiometry, transient evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emission (DPOAE) were performed before and after MRI. RESULTS: There was no statistically significant difference in TEOAE, pure tone audiogram, high frequency audiogram and speech audiogram thresholds. In DPOAE, the median value before and after MRI at the frequency of the left ear at 4.0 kHz was 13.6 (8.5-19.9) and 15.7 (8.9-20.7) SNR respectively (p > .05). The median value before MRI at the right ear 4.0 kHz frequency was 14.1 (9.1-20.5) SNR, whereas the median value after MRI was 13.2 (8.8-19.8 SNR (p = 0,03). There was no statistically significant difference in other frequencies in DPOAE. CONCLUSIONS: This is the first objective study that examines the MRI noise on speech audiometry and otoacoustic emission together. However, the effect of MRI noise on hearing pathway is still doubt. Based on the difference at 4 kHz frequency on DPOAE; on-earphones may not sufficiently protect the patients from the MRI noise and this issue should deserve further research.

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.

An Evaluation of the Relationship Between Professional Self-Esteem and Job Satisfaction Levels of Audiologists According to Their Workplace Types.

BACKGROUND: The concept of occupational self-esteem is the value judgment developed towards the chosen profession, while job satisfaction includes positive emotional attitudes towards the job. Professional self-esteem and job satisfaction levels of audiologists are a matter of curiosity. PURPOSE: To determine the effect of the workplace types of audiologists in Turkey on their professional self-esteem and job satisfaction levels. STUDY SAMPLE: The study included 307 audiologists working in various types of workplace. Participation in the study was voluntary. DATA COLLECTION: A Personal Information Form, Aricak's Occupational Self-Esteem Scale, and the Minnesota Job Satisfaction Scale were administered in all individuals via Google forms and the scale scores were compared according to the workplace types. RESULTS: A statistically significant relationship was found between professional self-esteem and job satisfaction, age, satisfaction with workplace, satisfaction with working conditions, effect of workplace on professional development, and income satisfaction (p<0.05). However, no statistically significant relationship was found between professional self-esteem and professional tenure and tenure in the current organization (p>0.05). There was a strong positive statistically significant relationship between job satisfaction and professional self-esteem of audiologists working at state hospitals, hearing aid centers, university hospitals, rehabilitation centers, and cochlear implant centers and academics (p<0.05). CONCLUSIONS: According to the present results, although the professional self-esteem of audiologists in Turkey showed a small difference according to the type of workplace, their mean score was high. This shows that audiologists enjoy their profession. Job satisfaction levels were lower especially in rehabilitation centers and private hospitals. We think that improving the working conditions of audiologists in private institutions will be effective in improving the services provided to patients by leading to better job satisfaction.

A truncating mutation in SERPINB6 is associated with autosomal-recessive nonsyndromic sensorineural hearing loss.

More than 270 million people worldwide have hearing loss that affects normal communication. Although astonishing progress has been made in the identification of more than 50 genes for deafness during the past decade, the majority of deafness genes are yet to be identified. In this study, we mapped a previously unknown autosomal-recessive nonsyndromic sensorineural hearing loss locus (DFNB91) to chromosome 6p25 in a consanguineous Turkish family. The degree of hearing loss was moderate to severe in affected individuals. We subsequently identified a nonsense mutation (p.E245X) in SERPINB6, which is located within the linkage interval for DFNB91 and encodes for an intracellular protease inhibitor. The p.E245X mutation cosegregated in the family as a completely penetrant autosomal-recessive trait and was absent in 300 Turkish controls. The mRNA expression of SERPINB6 was reduced and production of protein was absent in the peripheral leukocytes of homozygotes, suggesting that the hearing loss is due to loss of function of SERPINB6. We also demonstrated that SERPINB6 was expressed primarily in the inner ear hair cells. We propose that SERPINB6 plays an important role in the inner ear in the protection against leakage of lysosomal content during stress and that loss of this protection results in cell death and sensorineural hearing loss.

Effectiveness of the combined hearing and masking devices on the severity and perception of tinnitus: a randomized, controlled, double-blind study.

OBJECTIVE: The aim of this study was to evaluate the effect of combined hearing and tinnitus masking devices that are appropriately programmed for acoustic stimulations using wide-band noise over the specific frequency range of tinnitus. MATERIAL AND METHODS: A total of 21 patients were randomly divided into 2 groups. Group I (12 patients) was managed with betahistine dihydrochloride (2HCl) and fitted either with a combined hearing aid or a sound generator, and group II (9 patients) was treated with betahistine 2HCl for 3 months. Audiological tests, pitch matching to determine the frequency of tinnitus, an assessment of tinnitus severity, and subjective scores (visual analog scale, VAS; Mini-Tinnitus Questionnaire) were used to assess the patients in both groups, and a loudness scale was also analyzed in group I. The results were evaluated in a double-blinded manner. RESULTS: Significant decreases in the severity of tinnitus, Mini-Tinnitus Questionnaire score and VAS were observed in both groups. No significant differences were obtained in pitch-matched frequency of tinnitus in the two groups. CONCLUSION: The findings obtained using either the combined devices or the masking devices with wide-band masking demonstrate that these devices are an effective tinnitus treatment alternative.

[Normative values of middle ear resonance frequency in normal hearing adults]. / Normal isiten yetiskinlerde orta kulak rezonans frekansi normatif degerleri.

OBJECTIVES: This study aims to determine the normative values of middle ear resonance frequency in healthy adults. PATIENTS AND METHODS: Sixty adult volunteers (32 females, 28 males; mean age 31.8±7.1 years; range 21 to 46 years) with normal otoscopic examination, audiometry and electroacoustic immitancemetry findings were enrolled in the study. The middle ear resonance frequencies were calculated by multifrequency tympanometry. RESULTS: The mean resonance frequency for all volunteers was 999.6±134.9 Hz. The mean resonance frequency was 1020.8±140.6 Hz for the right ear, and 978.3±180.5 Hz for the left ear. The mean resonance frequencies for the right- and left-side were 1023.2±146.9 Hz and 912.5±177.8 Hz in males, and 1018.8±137.2 Hz and 1035.9±164.7 Hz in females, respectively. There was no statistically significant difference in the mean resonance frequency of the right ears between the males and females (p=0.9), whereas the mean resonance frequency of the left ears was statistically significantly higher in females (p=0.007). CONCLUSION: The middle ear resonance frequency values may vary according to the side of the ear or gender.

Vestibular evoked myogenic potentials in term newborn infants with severe hyperbilirubinemia.

BACKGROUND: The aim of this study was to determine the effects of severe hyperbilirubinemia on vestibular evoked myogenic potentials (VEMP). METHODS: A prospective study was designed. Seventeen term infants who suffered from severe hyperbilirubinemia in the first 5 postnatal days of age were included in the study group. The control group consisted of 17 healthy term infants. Audiological evaluation was performed, including tympanometry and transient evoked otoacoustic emissions, and VEMP tests. RESULTS: All newborns passed audiological evaluation. Biphasic waveforms of VEMP were obtained in all of the 34 infants who had been tested. Both latencies of p13 and n23 were significantly delayed in the severe hyperbilirubinemia group (P < 0.05). CONCLUSION: This pilot is the first study to show that severe hyperbilirubinemia causes delay in VEMP latencies. We suggest that severe hyperbilirubinemia might affect the vestibular nuclei or the integrity of the inferior vestibular nerve and vestibulospinal tract. Further studies need to explain the relation between hyperbilirubinemia and the vestibular system.

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.

Clinical Interpretation of Positional Nystagmus Provoked by both Dix-Hallpike and Supine Head-Roll Tests.

BACKGROUND: Both the Dix-Hallpike test and the supine head-roll test can provoke positional nystagmus in a group of benign paroxysmal positional vertigo patients, including but not limited to those with multiple canal involvement. This study aimed to determine the incidence and interpret the clinical significance of positional nystagmus provoked by both the Dix-Hallpike and the supine head-roll tests. METHODS: The results of video-nystagmography sessions recorded in the computer database that included both the Dix-Hallpike and the supine head-roll tests were examined. RESULTS: The records belonging to 2880 video-nystagmography sessions of 2387 patients were examined. Nystagmus was detected in both the Dix-Hallpike and the supine head-roll tests of 131 (5.5%) patients. The video images belonging to 142 session records of 122 patients were accessed and further analyzed. The diagnosis was posterior canal BPPV in 9.0%, and lateral canal BPPV in 62.3%. More than one canal was involved in 3.3%, one rehabilitation maneuver was performed in 75.0%, and recurrence was observed in 7.4% of those patients. CONCLUSION: In both geotropic and apogeotropic variants of lateral canal BPPV, nystagmus can be observed during the Dix-Hallpike test in addition to the supine head-roll test. In patients with posterior canal benign paroxysmal positional vertigo, nystagmus can also be observed in the head-roll test. To reach a correct and comprehensive diagnosis and apply appropriate treatment in benign paroxysmal positional vertigo, the Dix-Hallpike test and the head-roll test should be completely performed on both sides, and the results of those tests must be interpreted concomitantly.

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.

[Castleman's disease in a patient with recurrent reactive lymphadenopathy]. / Tekrarlayan reaktif lenfadenopatili bir olguda Castleman hastaligi.

Castleman's disease is an uncommon benign disorder associated with progressive lymph node enlargement. It most commonly involves the mediastinum and involvement of the neck accounts for 6%. A 28-year-old male presented with a progressively enlarging left-sided neck mass. He had a history of excisional lymph node biopsy that yielded a histopathologic diagnosis of reactive lymphadenopathy. In our clinic, a repeat excisional biopsy was performed and the diagnosis was made as Castleman's disease. Although it is an uncommon cause of lymphadenopathy in the neck, Castleman's disease should be considered in the differential diagnosis of recurring lymphadenopathies. Repeated excisional biopsies may be necessary (from the largest lymph node when possible) to uncover the disease.

The protective effect of adrenocorticotropic hormone treatment against noise-induced hearing loss.

OBJECTIVE: NIHL is a common problem, and steroids are the most effective treatment option. In this study, we aimed to evaluate the protective effects of the synthetic adrenocorticotropic hormone (ACTH) analogues, which induce endogenous steroid secretion, against noise-induced hearing loss (NIHL) and to compare their effectiveness with that of steroid treatment. METHODS: Twenty-four male Sprague-Dawley albino rats were divided into four subgroups as follows: group 1 (n=6) control, group 2 (n=6) saline, group 3 (n=6) dexamethasone (2mg/kg/day intramuscularly [IM]), group 4 (n=6) ACTH analogue (0,4mg/kg/day IM), respectively. Three groups (groups 2-4) were exposed to white noise (105dB SPL, 12h). All the rats were evaluated for hearing thresholds of 10kHz, 20kHz, and 32kHz via acoustic brainstem responses (ABR) measurement. After the basal threshold measurements, measurements were repeated immediately after the noise and on day 7 and day 21. RESULTS: Both steroid and ACTH analogue groups showed significantly better hearing outcomes than the saline group on day 7 (p<0.001) and day 21 (p<0.001) after the noise exposure. No superior treatment effect was demonstrated in either the steroid or ACTH analogue group. None of the related intervention groups reached the basal hearing thresholds. CONCLUSION: Steroids were effective drugs for the treatment of NIHL. ACTH analogues also demonstrated promising therapeutic effects for NIHL. Further studies to establish ACTH analogues as an alternative NIHL treatment option to steroids are needed.

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.