Relationship between smoking and otorhinolaryngological symptoms.

OBJECTIVES: This study aims to investigate the possible relationship between smoking and otorhinolaryngological symptoms in smokers, non-smokers and ex-smokers. PATIENTS AND METHODS: Between March 01st, 2014 and March 31st, 2014, a total of 1,840 patients (823 males, 1,017 females) over 25 years of age who were admitted to the ear nose, and throat (ENT) outpatient clinic were included in the study. The patients who were smoking at least 10 cigarettes daily for at least five years were included in the smokers group (n=514). The patients who did not smoke for at least one year following at least five years of smoking were included in the ex-smokers group (n=268). The patients who never smoked were included in the non-smokers group (n=1,058). A form containing all ENT symptoms was given to all patients and the patients were asked to fill the form with their complaints following being informed by the same doctor. RESULTS: Cough, shortness of breath, reflux, dryness of throat, irritation, taste disorder, bad breath, toothache, nasal congestion, smell disorders, snoring, and nasal discharge were found to be significantly higher in the smokers group, compared to the non-smokers group. Cough, sputum, hoarseness, dysphagia, reflux, sore throat, dryness of throat, irritation, stinging, oral aphthae, taste disorder, toothache, bleeding gums, and bad breath were significantly lower in the ex-smokers group. Nasal congestion, nosebleeds, sneezing, nasal discharge, smell disorders, headache, feeling of facial fullness, ear discharge, hearing loss, pain, fullness, dizziness, and tinnitus were statistically significantly lower in the ex-smokers group. CONCLUSION: Our study results show that smoking causes symptoms particularly associated with upper respiratory tract and these symptoms may persist in ex-smokers.

The Evaluation of Relationship Between Body Mass Index and Nasal Geometry Using Objective and Subjective Methods.

INTRODUCTION: It is known that obesity causes obstructive sleep apnea syndrome by increasing upper airway resistance. Also, obese patients are admitted to the ear, nose, and throat clinic very often because of nasal obstruction complaint. The aim of this study is to identify the change and relation among body mass index (BMI), nasal resistance, reduction in nasal ariflow, nasal anatomy, and patients' subjective complaints. MATERIAL AND METHOD: A total of 67 patients admitted to our clinic between August 2013 and January 2014 were included in the study.The study group comprised 33 patients who had a chief complaint-nasal obstruction and the other group consisted of 34 patients who had no complaint and nasal pathology. Both the groups were checked with acoustic rhinometry (AR), active anterior rhinomanometer, nasal obstruction symptom evaluation (NOSE), and visual analog study (VAS) questionnaire. RESULTS: There is a significant statistical correlation between the body mass increase and VAS and NOSE score increase (P < 0.05). But the authors did not find any statistically significant relation between BMI and total inspiratory and expiratory MR and MF measured by anterior active rhinomanometer and left and right nasal cavity MCA, and volume measured by acoustic rhinometery (P > 0.05). CONCLUSIONS: Contrary to belief, obesity does not change the nasal resistance, airflow, and anatomy but it can cause subjective nasal complaints.

Is There a Relationship Between Bell's Palsy and Internal Auditory Canal?

In the present study, we evaluated the diameter of internal acoustic canal in patients with Bells palsy to investigate the role of anatomical differences of the temporal bone in etiology of Bell's palsy. Sixty-four patients who were diagnosed as Bells Palsy and temporal bone computed tomography imagings of them were included into the study group (Group 1). The control group (Group 2) was consisted of 35 healthy subjects without Bell's Palsy. All patients had temporal bone computed tomography imaging. The internal auditory canal inlet, mid-canal, outlet and canal lengths were measured at the most distinctive cross-section of the seventh and eighth cranial nerves bifurcation. In the study group, Bells palsy was on the right side in 26 patients (40.6 %) and on the left side in 38 patients (59.4 %). Initial House-Brackmann (HB) score was HB-2 in 29 patients (45.3 %), HB-3 in 18 patients (28.1 %), HB-4 in 13 patients (20.3 %) and HB-5 in 4 patients (6.2 %). At 6-month evaluation, HB-score of the patients were HB-1 in 37 patients (57.8 %), HB-2 in 25 patients (39.1 %) and HB-3 in 2 patients (3.1 %). Internal auditory canal (IAC) measurements of the groups showed that there were no significant differences between the measurements of right-mid canal, right canal length; and left canal outlet and left canal length of the study and control groups. Right inlet and outlet; and left inlet and mid-canal values of the study group (Bell's palsy) were significantly lower than those of the control group. In Bell's palsy group, left inlet, outlet and canal length values were significantly higher than those of the right ones. Correlation analysis showed that there were no significant correlation between paralysis side; initial HB stage; and IAC measurement results. In patients with higher initial HB score, their 6-month later HB-score was also higher. In patients with higher 6-month HB score; R canal inlet, R mid-canal, L-canal inlet, and L-mid canal values were lower. Lower IAC inlet and mid-canal values were detected in patients with Bell's palsy. Therefore narrow IAC inlet and mid-canal values may be one of the risk factors for Bell's palsy.

Sudden hearing loss and vertigo after tooth extraction successfully treated with combined therapy including HBO2: a case report.

Sudden sensorineural hearing loss (SSNHL) is a decrease in hearing of at least 30 dB that occurs within three days and which affects at least three consecutive frequencies in either ear or both ears. This case report describes a woman who had sudden hearing loss and vertigo in the right ear after tooth extraction. As the first-line therapy, systemic and intratympanic steroid injections were used this led to a slight improvement; however, the majority of improvement in hearing was not observed until hyperbaric oxygen (HBO2) therapy was instituted on the 20th day of hearing loss. Sudden hearing loss and vertigo after tooth extraction is an otologic emergency and early evaluation and treatment are effective. HBO2, although employed beyond the Undersea and Hyperbaric Medical Society's recommended initial 14 days of symptom onset, very was effective for this particular case.

Topical Nigella Sativa for nasal symptoms in elderly.

OBJECTIVE: To compare the effects of intranasal application of black seed (Nigella Sativa) oil (NSO) and isotonic sodium chloride solution (ISCS) on nasal symptoms of the elderly. METHODS: In this prospective, crossover randomized controlled trial, 42 geriatric patients with nasal dryness and related symptoms were randomized to receive either 2 weeks of isotonic sodium chloride solution (ISCS) followed by 2 weeks of N. sativa oil (NG oil) or the same treatment in the opposite order. There was a washout period of 3 weeks in between the treatment periods. Subjective symptoms including nasal dryness, burning, obstruction, itching and crusting were evaluated by a visual analog scale. Mucociliary function was evaluated with saccharin test. RESULTS: Nasal dryness, obstruction and crusting improved significantly with the use of NSO compared to ISCS without any evidence of relevant carryover effects (p<0.05 for all for the difference in treatment). There was no significant difference between the effect of NSO and ISCS on nasal burning and itching (p>0.05 for all). There was no change in mucociliary clearance during any of the treatment periods. CONCLUSION: NSO is a better alternative to ISCS to treat nasal mucosa symptoms due to aging.

The role of mometasone furoate nasal spray in the treatment of adenoidal hypertrophy in the adolescents: a prospective, randomized, cross-over study.

Aim of this work is to find out whether the symptoms attributable to adenoid hypertrophy in adolescents may be treated with intranasal mometasone furoate (MF) application. To learn if adenoid hypertrophy in adolescents may decrease in size with intranasal MF. A prospective, double blind, randomized, cross-over study was conducted in 28 subjects (12-18 years) with adenoidal hypertrophy. Subjects used intranasal MF or placebo for a duration of 6 weeks with a wash out period of 3 weeks. Subjective symptoms and adenoid size were evaluated. At the initiation of the study, there was no significant difference between the mean symptom scores for any of the sinonasal symptoms between the two treatment groups. There was significant improvement in total subjective symptoms (nasal blockage, rhinorrhea, cough, snoring and disruption of quality of life scores) with MF compared with placebo. Analysis of the symptoms separately showed a significant positive effect of MF on all symptoms except for rhinorrhea. Nasal endoscopic evaluation failed to demonstrate any difference in the reduction of the adenoid size between the two groups. MF has significant advantage over placebo for the symptoms attributable to adenoid hypertrophy in adolescents.

Is it necessary to do temporal bone computed tomography of the internal auditory canal in tinnitus with normal hearing?

OBJECTIVE: To investigate the compression of the vestibulocochlear nerve in the etiology of the tinnitus in the normal hearing ears with temporal bone computed tomography scans. METHODS: A prospective nonrandomized study of 30 bilateral tinnitus and 30 normal hearing patients enrolled in this study. RESULTS: A total of 60 patients (ages ranged from 16 to 87) were included. The tinnitus group comprised 11 males and 19 females (mean age 49,50 ± 12,008) and the control group comprised 6 males and 24 females (mean age 39,47 ± 12,544). Regarding the right and left internal acoustic canals measurements (inlet, midcanal, and outlet canal lengths), there were no significant differences between the measurements of the control and tinnitus groups (P > 0.005). There was no narrowness in the internal acoustic canal of the tinnitus group compared with the control group. High-frequency audiometric measurements of the right and left ears tinnitus group at 8000, 9000, 10000, 11200, 12500, 14000, 16000, and 18000 Hz frequencies were significantly lower than the control group thresholds (P < 0.05). There was high-frequency hearing loss in the tinnitus group. CONCLUSION: There were no anatomical differences in the etiology of tinnitus rather than physiological degeneration in the nerves.

Effect of oral magnesium supplementation on cisplatin ototoxicity.

OBJECTIVE: The purpose of this study is to evaluate the effect of Mg supplementation on cisplatin ototoxicity in guinea pigs. METHODS: Twenty guinea pigs were divided into two groups and were fed different Mg-containing diets. Following 6 mg/kg of cisplatin injection, the animals were sacrificed and the extent of cochlear damage was assessed with the scanning electron microscope and compared with the control group. Additionally, intracardiac blood samples were taken to determine the plasma Mg levels of the subjects before and after cisplatin exposure. RESULTS: The outer hair cell damage owing to cisplatin was not statistically different in both groups (p > .05). Following cisplatin injection, the plasma Mg levels of both groups were found to be significantly lower than the plasma Mg levels before exposure, but the resulting values of the Mg-rich fed group was compatible with control group Mg levels. CONCLUSION: Our study showed that a Mg-rich diet can prevent the severe hypomagnesemia that cisplatin causes in guinea pigs, but this measure has not been enough to protect the inner ear against its ototoxic effect.