Comparison of tympanometric volume measurement with temporal bone CT findings in the assessment of mastoid bone pneumatization in chronic otitis media patients.

OBJECTIVE: Since mastoid bone aeration is a pressure buffer for the middle ear, it can be accepted as a prognostic factor for tympanoplasty. Temporal bone computed tomography (TBCT) is a primary method for estimating mastoid aeration. However, due to the risk of radiation and its high cost, there is a need for a more straightforward, faster, and more reliable method in non-complicated chronic otitis media cases (COM). Tympanometric volume measurement might be used for this purpose. This study investigated tympanometric volume measurement's reliability in showing mastoid bone aeration by comparing tympanometric volume measurement with TBCT aeration grading. PATIENTS AND METHODS: Preoperative tympanometric volume measurements were performed in patients who underwent audiological examination and temporal computerized tomography (CT) with the diagnosis of COM and sequela of COM without discharge for the last three months and were indicated for surgery. CT was classified into six grades: grade 0: there is no aeration, sclerotic mastoid; grade 1: pneumatization only in the mastoid antrum; grade 2: <25% pneumatization; grade 3: 25-50% pneumatization; grade 4: >50 pneumatization, grade 5: full pneumatization. Averages of tympanometric volume values were determined according to CT degrees. RESULTS: 48 left and 52 right ears (n: 100) of 81 patients, 24 females and 57 males, were included in the study. The mean age was 37.69±13.38. Mastoid pneumatization grades of patients were 32 grade 0, 23 grade 1, 16 grade 2, 14 grade 3, 11 grade 4, and 4 grade 5, respectively. Each grade's mean tympanometric volume (mL) was grade 0: 1.1594, grade 1: 1.6991, grade 2: 2.2250, grade 3: 3.0471, grade 4: 4.0327, and grade 5: 2.9775. CONCLUSIONS: There is a statistically significant relationship between tympanometrically measured ear volume and mastoid degrees of pneumatization on temporal bone tomography. As the degree of mastoid aeration increases, the tympanometric volume also increases. According to the results of this study, tympanometric air volume can be used reliably in the preoperative evaluation of mastoid bone aeration in cases of simple COM without ear drainage.

Endoscope-assisted rhinoplasty: enhancing precision or extending procedure duration?

OBJECTIVE: The endoscope in rhinology surgeries is a modern tool that can provide significant benefits. By offering a better view of intranasal pathologies, it can assist in diagnosing and treating them more conveniently. In particular, in cases where minimal nasal invasion is required, endoscope assistance can be especially beneficial during short and comfortable periods of rhinoplasty surgery. PATIENTS AND METHODS: Twenty-one patients who underwent endoscope-assisted rhinoplasty were enrolled in this study. Four parameters were retrospectively evaluated: patients, endoscope, mentor-mentees, and postoperative. Under the patient parameters, we assessed sociodemographic data and intranasal pathologies such as septum deviation patterns and middle and inferior concha pathologies. The endoscope parameters include the evaluation of the advantages and disadvantages of using the tool during surgery. In mentor-mentee parameters, we evaluated self-designed satisfaction questionnaires from surgery assistants, nurses and surgeons and also postoperative parameters and Visual Analog Scale (VAS, 0-10) scores from surgery assistants, patients, and surgeons after surgery. RESULTS: Endoscopic septoplasty during rhinoplasty offers several advantages over traditional septoplasty with surgical headlight. Notably, high VAS scores were observed in surgery assistants and patients (9.57±0.8  and 9.28±0.9, respectively). Based on self-designed satisfaction questionnaires, 85% of participants (54 out of 63) expressed "very satisfied" ratings for endoscope-assisted rhinoplasty surgery, and 80% (50 out of 63) indicated a likelihood to recommend this surgical approach to colleagues. CONCLUSIONS: Endoscopic septoplasty during rhinoplasty is an educational, efficient, and more advantageous method recommended for correcting intranasal pathologies.

Evaluation of spiramycin for topical applications: a cell culture study.

OBJECTIVE: Through a cell culture test, we analyzed the cytotoxic effects of topical spiramycin on NIH/3T3 fibroblast cells. MATERIALS AND METHODS: Dulbecco's Modified Eagle Medium (DMEM) supplemented with 10% fetal bovine serum and 1% penicillin/streptomycin was used for the growth of NIH/3T3 fibroblast cells in a 5% CO2 incubator. Spiramycin's cytotoxicity was measured using the MTT assay. 5,000 NIH/3T3 cells per well of a 96-well plate were seeded in each well, and the cells were treated with spiramycin (3.13-100 µM) for 24, 48 and 72 hours while the plates were incubated at 37°C in a humidified 5% CO2 atmosphere. First, 105 NIH/3T3 cells were seeded onto coverslips in 6-well plates for morphological analysis of both untreated and spiramycin-treated cells. For 24 hours, NIH/3T3 cells were exposed to a 100 µM dosage of spiramycin. The cells in the control group were grown in complete growth media alone. RESULTS: Spiramycin was non-toxic to NIH/3T3 fibroblast cells in a MTT test. The concentration of spiramycin used to stimulate cell growth increased as the concentration was increased. After 24 and 48 hours of treatment with 100 µM NIH/3T3, the cells showed the most significant increase in size. Cell viability was shown to be significantly reduced at spiramycin doses of 50 and 100 µM. All MTT findings revealed that spiramycin enhanced cell viability and was not harmful to the fibroblast cells for short-term application of 24 and 48 hours but lowered the viability of fibroblast cells at the doses of 50 and 100 µM for long-term application duration of 72 hours. Confocal micrographs showed that spiramycin treatment did not affect the cytoskeleton or nucleus of fibroblast cells, in contrast to the control NIH/3T3 cells. Both untreated and treated with spiramycin, fibroblast cells were found to be fusiform and compact, with their nuclei remaining unaltered and unreduced in size. CONCLUSIONS: It was concluded that spiramycin has a beneficial effect on fibroblast cells and is safe for use over short periods. Spiramycin reduced fibroblast cell viability when applied for 72 hours. Confocal micrographs showed that fibroblast cell skeletons and nuclei were unharmed and undamaged, that cell shapes were fusiform and compact, and that nuclei were neither broken nor shrunken. Topical spiramycin could be recommended for septorhinoplasty procedures due to anti-inflammatory effects for short-term usage if clinical trials will confirm experimental data.