Effects of platelet-rich fibrin and dexamethasone on nerve regeneration after acute facial-nerve injury.

BACKGROUND: Acute facial-nerve injury. OBJECTIVE: To investigate the effects of platelet-rich fibrin (PRF) and dexamethasone on nerve regeneration. MATERIALS AND METHODS: Thirty-six rats were randomly divided into six groups. Facial-nerve injury was created using a full-thickness incision in all groups except Group E. Next, primary anastomosis, PRF application, topical dexamethasone application, primary anastomosis with topical PRF and dexamethasone application, and no facial-nerve repair were performed in Groups A, B, C, D, and F, respectively. Clinical, functional, and structural improvements were evaluated at eight weeks. RESULTS: The mean eye-closure movement score in Group B was significantly higher than that in Group F (p < .001). The mean whisker-movement score in Group B was significantly higher than that in Group F (p = .001). The mean amplitude of whisker movement in Group F was significantly lower than those in Groups A, B, C, and E, and the mean amplitude in Group D was significantly lower than that in Group E (p < .001). Furthermore, an improvement in nerve ultrastructure was observed in Group B. CONCLUSION: PRF application has a positive effect on nerve recovery after anastomosis. SIGNIFICANCE: Contribute to the literature to improve nerve regeneration.

Effect of perinatal and postnatal thiamine deficiency on auditory pathway of the Wistar-Albino rats

Abstract Objective: In this study, we created an animal model to demonstrate the effects of thiamine on the hearing pathways of new-borns during pregnancy and lactation by inducing a dietary thiamine deficiency in the mother. Methods: The study included 16 female Wistar albino rats. The animals were separated into four groups and provided the appropriate amounts of dietary thiamine according to their groups during pre-pregnancy, pregnancy, and lactation periods. Three pups from each mother were included in the study, and 12 pups were selected from each group. On the fortieth day after birth, the auditory pathways of 48 pups in the 4 groups were examined electro physiologically and ultra-structurally. Results: In Group N-N, morphology of hair cells stereocilia degeneration was not obtained in all turns of cochlea. In Group N-T, Inner Hair Cells (IHCs) and Outher Hair Cells (OHCs) stereocilia didn't show degeneration in all turns of cochlea but had rupture inrows of HCs stereocilia. In group T-N IHCs stereocilia less degeneration was observed in all turns of cochlea. OHC stereocilia partial loss was observed only in basal turn of cochlea. In Group T-T IHCs stereocilia was observed less degeneration and rupture in all turns of cochlea. Conclusion: Thiamine is vital for the development of cochlear hair cells during both prenatal and postnatal periods. Even partial deficiency of thiamine causes significant degeneration to the auditory pathway. Level of evidence: The level of evidence of this article is 5. This article is an experimental animal and laboratory study.

Effect of perinatal and postnatal thiamine deficiency on auditory pathway of the Wistar-Albino rats.

OBJECTIVE: In this study, we created an animal model to demonstrate the effects of thiamine on the hearing pathways of new-borns during pregnancy and lactation by inducing a dietary thiamine deficiency in the mother. METHODS: The study included 16 female Wistar albino rats. The animals were separated into four groups and provided the appropriate amounts of dietary thiamine according to their groups during pre-pregnancy, pregnancy, and lactation periods. Three pups from each mother were included in the study, and 12 pups were selected from each group. On the fortieth day after birth, the auditory pathways of 48 pups in the 4 groups were examined electro physiologically and ultra-structurally. RESULTS: In Group N-N, morphology of hair cells stereocilia degeneration was not obtained in all turns of cochlea. In Group N-T, Inner Hair Cells (IHCs) and Outher Hair Cells (OHCs) stereocilia didn't show degeneration in all turns of cochlea but had rupture inrows of HCs stereocilia. In group T-N IHCs stereocilia less degeneration was observed in all turns of cochlea. OHC stereocilia partial loss was observed only in basal turn of cochlea. In Group T-T IHCs stereocilia was observed less degeneration and rupture in all turns of cochlea. CONCLUSION: Thiamine is vital for the development of cochlear hair cells during both prenatal and postnatal periods. Even partial deficiency of thiamine causes significant degeneration to the auditory pathway. LEVEL OF EVIDENCE: The level of evidence of this article is 5. This article is an experimental animal and laboratory study.

The diagnostic importance of periostin as a biomarker in chronic rhinosinusitis with nasal polyp.

PURPOSE: The current studies in the literature report that periostin contributes to the formation of nasal polyps and may be a molecular biomarker for chronic rhinosinusitis with nasal polyps (CRSwNP). This study aims to investigate the effect of periostin in determining polyp burden in CRSwNP patients and evaluate its impact on postoperative surgical results and its functionality as a biomarker. METHODS: The study included 26 patients who underwent endoscopic sinus surgery due to CRSwNP and 30 patients who were scheduled to undergo septoplasty due to isolated nasal septum deviation. We performed preoperative Lund-Mackay scoring and preoperative and postoperative SNOT-22 and Modified Lund-Kennedy scoring for the patients. Tissue and serum samples were collected from all patients in surgery and another serum sample was taken from CRSwNP patients at postoperative month 6. RESULTS: Tissue eosinophil (p < 0.001), preoperative serum (p < 0.001), and tissue (p = 0.002) periostin were significantly higher in the CRSwNP group. We observed a statistically significant positive correlation between tissue eosinophil values and tissue periostin values in CRSwNP patients (p = 0.004). We found a statistically significant positive correlation between the tissue periostin values and postoperative SNOT-22 scores of the CRSwNP group patients (p = 0.005). CONCLUSION: According to the results of our study, we think that periostin can be used as a biomarker in the prediction, determination of disease severity, and prognosis of CRSwNP. Comprehensive cohort studies with larger patient series are needed to provide more information on the role and effects of periostin in cases of CRSwNP undergoing surgical treatment.

The Effect of the Mother's Participation in Therapy on Children with Vocal Fold Nodules.

OBJECTIVES: Vocal fold nodules (VFN) are a bilateral epithelial thickening of the membranous vocal folds. In this study, children with VFN and their mothers took part in voice therapy. We then compared acoustic analyzes and subjective evaluations to those in previous literature to determine whether voice therapy is more effective for children with VFN when their mothers also take part in therapy. METHODS: Children aged eight to 12 years who were diagnosed with bilateral VFN between January 2018 and January 2020 were included in this study. Participating children diagnosed with bilateral VFN were divided into two groups based on the wishes and cooperation of their families. Group 1 consisted of 16 patients; Group 2 included 17 patients. The children in Group 1 received voice therapy alone; children in Group 2 took part in therapy with their mothers. For all participants, the average fundemental frequency (F0), jitter percentages, shimmer percentages, maximum phonation time (MPT) and s/z ratios were measured. Pediatric voice handicap index (p-VHI) values were calculated as well. RESULTS: The two groups' measures pre-treatment and post-treatment were compared. Except for p-VHI, no significant difference was observed between the two groups. However, p-VHI post-treatment was significantly lower in Group 2 than in Group 1. CONCLUSIONS: Involving the families and even teachers of children with VFN in voice therapy can increase the effectiveness of therapy. The family's involvement increases the child's motivation in therapy. The mother's presence during therapy, supporting the child or even doing the work with the child, can be a very important source of motivation for the child, who may already be tired from school and other activities. Thus, the mother's involvement increases the child's compliance with and interest in therapy.

Quantitative assessment of temporal skin elasticity using shear wave elastography in pediatric cochlear implant users.

OBJECTIVE: To evaluate temporal skin thicknesses and stiffness values using shear wave elastography (SWE) in asymptomatic pediatric patients who underwent cochlear implantation. SUBJECTS AND METHODS: Sixty-four deafened pediatric patients with unilateral cochlear implant (CI) who had no complications were enrolled. The age, sex, weight, height, body mass index (BMI), CI side, duration of CI use and CI device brand of all participants were noted. Temporal skin thickness and stiffness values were measured from implanted and contralateral unimplanted sides using SWE. RESULTS: The mean skin thickness measurements of implanted and unimplanted sides were 11.87 ± 3.42 and 5.34 ± 1.56 mm, respectively. The mean skin stiffness measurements of implanted and unimplanted sides were 3.08 ± 0.7 and 1.29 ± 0.26 m/s, respectively. There were statistically significant differences in skin thickness and stiffness between implanted and unimplanted sides (P < .001, P < .001). The mean skin thickness and stiffness measurements did not differ among types of CI devices (P = .948, P = .362). Age had positive correlation with implanted (P < .001, P = .019) and unimplanted sides (P < .001, P < .001) skin thickness and stiffness. BMI had positive correlation with implanted (P < .001, P = .023) and unimplanted sides (P < .001, P < .001) skin thickness and stiffness. Duration of CI use had positive correlation with implanted side skin thickness (P < .001) and stiffness (P = .031). CONCLUSION: Temporal skin thickness and stiffness increase after CI surgery. SWE has the potential to improve diagnostic accuracy, and our results may provide important data for evaluation of clinical entities that affect temporal skin structures.

Effect of perinatal biotin deficiency on auditory pathway of the Wistar-Albino rats.

Aim: Severe biotin deficiency associated with biotinidase enzyme deficiency in newborns is seen as severe neurological problems and hearing loss. However, the effect on the infant of deficiencies in the maternal diet during pregnancy are not clear. Material and methods: The study included 16 female Wistar albino rats and 4 male Wistar albino rats, that were mated and then the females were separated into 4 groups. At 40 days after the birth, 3 pups were selected from each group, and these 12 pups were evaluated with DPOAE and ABR electrophysiologically and the cochlea was examined ultrastructurally with electron microscopy. Results: In the DPOAE evaluation, At 8000 and 11,000 Hz, the signal-noise ratios in the B-N and B-B groups were statistically significantly higher (p < .05). In ABR, lengthening of the latency periods was determined in all the waves at both 8 and 16 kHz in the B-B group. When the IPL periods were examined, lengthening in IPL 1-5 was statistically significant in the B-B group only at 8 kHz. Conclusions: Biotin can be said to have an effect on hearing pathways. However, specifically where on the hearing pathways that biotin is involved has not been clarified.

Can apelin play a role in the etiology of tinnitus?

Background/aim: Tinnitus is seen in 15% of the general population; in 1%­6% of this number, the quality of life is seriously affected by this chronic condition. Chemical, oxidative, and emotional stressors are important in terms of the clinical course of tinnitus. Apelin is an endogenous peptide which is an oxidative stress mediator. It has been shown that the apelin/APJ (apelin junction receptor) system plays various roles in the physiology and pathophysiology of many organs. However, the role of the apelin/APJ system as an oxidative stress mediator in tinnitus is unknown. We investigated the level of apelin in patients with normal hearing and bilateral tinnitus. Materials and methods: We enrolled patients diagnosed with bilateral idiopathic tinnitus. Tinnitus severity was determined using the tinnitus handicap inventory (THI). We recorded the levels of plasma apelin-13 and biochemical parameters. Results: The mean apelin level of the control group was higher than that of the patient group (P = 0.002). A significant negative correlation was evident between the apelin level and the THI (r = ­0.460, P = 0.003). The triglyceride (TG) level was significantly higher in the patient group than in the control group (P < 0.001). Conclusion: In our study, we found a negative correlation between apelin and tinnitus severity. Thus, apelin may play a role in the pathophysiology of idiopathic tinnitus, and may be prescribed during follow-up to reduce oxidative stress in the future. Further clinical studies on the effects of the apelin/APJ (apelin junction receptor) system and the effects of antioxidants in patients with inflammatory diseases are required.

The Effects of Platelet-Rich Fibrin Membrane on Secondary Healing After Pleomorphic Adenoma Excision in the Hard Palate: A Preliminary Study.

AIM: This study aims to evaluate the effects of platelet-rich fibrin (PRF) membrane on secondary healing after pleomorphic adenoma (PA) excision in the hard palate. MATERIALS AND METHODS: PRF membranes were laid over mucosal defects which occurred following PA excision in the hard palate. The secondary healing process was monitored in the patients by follow-up examinations on postoperative days 5, 10, 15, 20, 25, 30, 35, and 40. RESULTS: In this preliminary study, epithelialization was observed to have completed on the 30th day of follow-up in the first patient and on the 35th day in the second and third patients. No bleeding or infection was seen in any of the three patients. CONCLUSIONS: PRF membrane as a new method in the secondary healing after PA excision in the hard palate provided rapid healing and reduced complications such as bleeding and infection.

The effect of platelet-rich fibrin membrane on the repair of perforated tympanic membrane: an experimental study.

CONCLUSION: Platelet-rich fibrin (PRF) membrane could be used successfully in the repair of tympanic membrane perforation and wound healing. OBJECTIVES: To evaluate the effect of platelet-rich fibrin membrane in the repair of perforated tympanic membrane. METHODS: After otoscopic examination, a 3-mm perforation was made in the posterior quadrant of both tympanic membranes of 50 adult male Sprague-Dawley rats. Venous blood was withdrawn from the rats, then centrifuged. PRF was obtained in membrane form. The membrane was placed on the right tympanic membrane perforation. The perforations on the left side were left to spontaneously heal and, thus, formed the control group. Daily examinations were made of 20 rats and the time to healing of the tympanic membrane was recorded. The remaining 30 rats were separated into five groups of six, and histopathological examination was made. Evaluation was made in respect of the presence of oedema in the lamina propria, neovascularization, fibroblastic reaction, and inflammatory cells. RESULTS: The healing time of the tympanic membrane perforation was determined as mean 10.3 ± 2.18 days in the study group applied with PRF and 17 ± 2.40 days in the control group. Higher values in respect of fibrosis and neovascularization were obtained in the study group.

Is Presence of Vascular Loop in Magnetic Resonance Imaging Always Related to Tinnitus?

INTRODUCTION: One of the most common otological complaints is tinnitus in adults. When there is a complaint of unilateral tinnitus and retrocochlear pathology is suspected, imaging methods are applied. However, the imaging findings obtained may not always be compatible with the severity and localization of the tinnitus. AIM: The aim of the present study was to determine whether or not there was a significant correlation between the findings on magnetic resonance imaging (MRI) and the presence and severity of tinnitus in patients with the complaint of unilateral tinnitus. METHOD: The study included 44 patients with no loss of hearing who presented with the complaint of unilateral tinnitus. The relationship between tinnitus severity and vascular loop presence was investigated. RESULTS: Various types of vascular loop were determined in 14 patients. No statistically significant relationship was determined between the presence of vascular loop and the Tinnitus Handicap Inventory scores. CONCLUSION: The results of this study showed no significant difference in respect of the presence of vascular loop on the MRI findings of symptomatic and healthy ears. The presence of vascular loop on MRI is not always a pathological event and should be considered only as an examination finding that could be an anatomic variation.

Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study.

OBJECTIVES: (1) To evaluate the effects of a platelet-rich fibrin (PRF) membrane in the repair of traumatic tympanic membrane (TM) perforations; and (2) to compare the use of a PRF membrane with the paper patch technique with regard to recovery rates, healing time, and correction of the mean air-bone gap. METHODS: A randomized, prospective analysis was performed for 60 patients who were treated for traumatic TM perforations using one of the two methods. Closure rate, speed of healing, and hearing gain were compared between the PRF (Group 1) and paper patch (Group 2) groups. RESULTS: Closure was obtained in 28 (93%) perforations in Group 1 and 25 (83%) perforations in Group 2 (p > 0.05). On day 10, full closure of the TM was observed in 24 (80%) patients in Group 1 and 16 (53%) patients in Group 2 (p < 0.05). The improvement in the mean air-bone gap was 14.1 dB in Group 1 and 12.4 dB in Group 2 on post-operative day 45 (p < 0.05). CONCLUSIONS: In comparison with the paper patch method, PRF, a new method, provided more rapid healing with more successful audiological results, and with no requirement for a second procedure.

A novel predictive marker for the recurrence of nasal polyposis following endoscopic sinus surgery.

We aimed to determine the value of neutrophil-to-lymphocyte (NLR) ratio for prediction of recurrence in patients subjected to endoscopic sinus surgery. Higher neutrophil counts mean more chronic inflammation so the NLR value could show the inflammatory level resulting with higher incidence of recurrence. From January 2011 to March 2013, we performed a retrospective review of the complete blood count samples from 192 patients with chronic sinusitis who underwent endoscopic sinus surgery. The patients were divided into two groups based on the presence of nasal polyps. NLR and platelet-to-lymphocyte (PLR) ratios were analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value for significant differences in variables between the recurrence and non-recurrence groups. The ROC analysis results revealed an NLR cut-off of 3.13 and a PLR cut-off of 208.75. Our analysis revealed that NLR is an independent risk factor for recurrence of chronic sinusitis in patients subjected to endoscopic sinus surgery (p = 0.006), whereas the PLR was not a predictive factor for recurrence (p = 0.167). Our study revealed that the NLR could be used to predict disease recurrence before endoscopic sinus surgery. However, additional studies are needed to confirm these results.

Influence of size and site of perforation on fat graft myringoplasty.

OBJECTIVES: In this retrospective study, we investigated the outcomes of fat graft myringoplasty (FGM) in different perforation sizes and locations. The outcomes were evaluated in terms of closure rates and audiological test results. METHODS: The study population included 172 patients who were operated between 2007 and 2012. 161 had unilateral and 11 had bilateral chronic otitis media; and 183 ears were operated by FGM. The patients were divided into two groups based on size as small and larger (size of ≤30 of TM was defined as small perforations, and size of >30% TM was defined as a medium-large perforations); and two groups based on location of perforation [anterior and other (non-anteriorly located)]. Patients' follow-ups were performed between 1 and 5 years; and follow-up examinations were performed with otoendoscopy. Air conduction (AC) thresholds and air-bone gap (ABG) were evaluated both preoperative year and postoperative 1st year. RESULTS: The total perforation closure rate was 84.7%. In this study, we found out that FGM is effective closing medium-large perforations just as small perforations with the success rate of 79.1% and 86.4% respectively (p>0.05). When audiological outcomes were evaluated in both groups, AC values got lower and ABG values improved postoperatively, whereas regarding AC thresholds and ABG improvement among the size groups, patients with small perforations had significantly better postoperative results (p<0.05). In terms of perforation location, closure rates were 85.2% in anteriorly perforations and 84.5% in the other located perforations. Audiological outcomes demonstrated that in both groups, AC values got lower and ABG values improved postoperatively; and hearing results were not different in anteriorly located perforations and other locations. CONCLUSION: Fat graft myringoplasty (FGM) may be used in all small and medium-large, and anteriorly and other located perforations. Although hearing improvement was detected in each of the small; and medium-large perforations; patients with small perforations had more satisfied audiological outcome than medium-large perforations.

Detection of Helicobacter pylori in adenoid tissue by real-time polymerase chain reaction.

OBJECTIVES: This study aims to investigate the presence of Helicobacter pylori (H. pylori) using the real-time polymerase chain reaction (PCR) method in the adenoid tissues in children undergoing surgical operation due to adenoid hypertrophy. PATIENTS AND METHODS: Adenoid tissues of 23 children (8 girls, 15 boys; mean age 6.2 years; range 3 to 9 years) who were operated with the diagnosis of adenoid hypertrophy, tonsil + adenoid hypertrophy or tonsil + adenoid hypertrophy + serous otitis media in our clinic between January 2012 and April 2012 were examined. RESULTS: Of 23 patients, H. pylori was detected in the adenoid tissues of two (8.7%). Regurgitation was present in seven patients. However, no regurgitation was found in H. pylori-positive patients. CONCLUSION: In this study the presence of H. pylori in patients with adenoid hypertrophy has been demonstrated using PCR method. To be able to support the hypothesis that H. pylori has a place in etiology of adenoid hypertrophy, multicenter studies are warranted.

Nasal obstruction: comparison of radiofrequency with lateral displacement of the inferior turbinate and radiofrequency alone.

OBJECTIVE: To compare the outcomes of the nasal obstruction, the main symptom of the patients who underwent radiofrequency and lateral displacement of the inferior turbinate and patients who were treated with radiofrequency alone. METHODS: The prospective randomised study was conducted at the Department of Otorhinolaryngology and Head-Neck Surgery, Balikesir University Medical School, Balikesir, Turkey, between July and December 2012. It included 60 patients, diagnosed with allergic or non-allergic chronic rhinitis with inferior turbinate hypertrophy which was refractory to medical therapy. Half of the patients were treated with radiofrequency, and the rest with radiofrequency and lateral displacement. The main symptom of the patients was nasal obstruction. The frequency and degree of nasal obstruction were evaluated by patients' self-assessments using the standard 10-cm visual analogue scale. The evaluations were performed first pre-operatively and on the 1st, 3rd, 5th and 7th days postoperatively as well as at the end of the 4th week. SPSS 18 was used for statistical analysis. RESULTS: Nasal obstruction frequency and severity scores in patients treated with both radiofrequency and lateral displacement on post-operative days 3, 5 and 7 were found to be significantly lower (p<0.001) compared to the patients treated with only radiofrequency. CONCLUSIONS: The study demonstrated that radiofrequency and lateral displacement together is an effective method to prevent inferior turbinate oedema in the early post-operative period.

[Three cases of mucosal malignant melanoma of the nose and paranasal sinuses]. / Uç olguda burun ve paranazal sinüs mukozal malign melanomlari

We evaluated the clinical course and treatment of three patients who were found to have mucosal malignant melanoma of the nose and paranasal sinuses. The presenting complaint was recurrent epistaxis in all the patients. One patient had been followed-up for nasal polyposis for a long time. In older patients with recurrent epistaxis, endoscopic examination of the nasal cavity and obtaining a biopsy from suspected regions are essential for early diagnosis of mucosal malignant melanomas.