The efficacy of adenotonsillectomy on oxidative stress evaluated by thiol / disulfide balance.

BACKGROUND: Oxidative stress plays a role in the pathogenesis of many chronic diseases. Upper airway obstruction has been identified as a risk factor for increased oxidative stress-related disorders such as obstructive sleep apnea. The effect of adenotonsillar hypertrophy, which may result in a narrowing of the upper airways, on oxidative stress can be a valuable subject of research. This study aimed to investigate the efficacy of adenotonsillectomy on oxidative stress evaluated using the thiol / disulfide balance. METHODS: Thirty children who underwent adenotonsillectomy and 30 healthy controls, all aged from 3 to 18 years, were included in the study. Blood samples were taken preoperatively and 3 months postoperatively in the study group; in the control group, baseline blood samples were taken and samples were again taken 3 months later. Thiol / disulfide homeostasis items were analyzed. Antioxidant markers were native thiol, total thiol, and native / total thiol. Oxidative stress markers were disulfide, disulfide / native thiol, and disulfide / total thiol. RESULTS: At the preoperative period, oxidative stress parameters of thiol / disulfide homeostasis were higher in the study group than in the control group (P < 0.05) and antioxidant activity parameters were lower than in the control group (P < 0.05). Three months postoperatively, oxidative stress parameters were lower than in the control group (P < 0.05), and antioxidant parameters were no different from those in the control group (P > 0.05). In the adenotonsillectomy group considered separately, oxidative stress markers of disulfide and disulfide / native thiol decreased (P < 0.05) and antioxidant markers of native thiol and total thiol increased in the postoperative measurements (P < 0.05). CONCLUSIONS: Oxidative stress related to adenotonsillar hypertrophy decreased after adenotonsillectomy. The antioxidant parameters of the thiol homeostasis increased after adenotonsillectomy. We concluded that adenotonsillectomy operations should be planned and applied timeously to prevent the adverse effects of adenotonsillar hypertrophies on thiol homeostasis.

Evaluation of the vestibular system with video head impulse test in pregnant women with hyperemesis gravidarum.

AIM: We aimed to evaluate the semicircular canal functions of the vestibular system in pregnant women with hyperemesis gravidarum. METHODS: This is a prospective case-control study. Among pregnant women in their first trimester (<14. gestational weeks) who presented to our outpatient clinic, 36 patients diagnosed with hyperemesis gravidarum defined as persistent nausea and vomiting requiring intravenous hydration or loss of at least 5% of prepregnancy weight and 34 healthy pregnant without nausea and vomiting were included. Otorhinolaryngologic examination and video head impulse test (vHIT) was performed to all patients. Vestibular-ocular reflex (VOR) gain and gain asymmetry were assessed between groups. RESULTS: The VOR gains in each semicircular canal did not differ between hyperemesis and control groups. Using a VOR gain cut-off value of 0.8, the groups were compared in terms of the frequency of low values. In the hyperemesis group, abnormally low gain values of left anterior canal were more frequently observed than in the control group (32 [88.9%], 22 [64.7%], respectively, P = 0.01). In left anterior-right posterior (LARP) plane VOR gain asymmetry was higher in hyperemesis group (13.5 [1.0-71.0], 6.0 [0.0-35.0], P = 0.001). No significant gain asymmetry was detected between the groups in the other planes. CONCLUSION: Semicircular canal functions were not abnormal globally in women with hyperemesis gravidarum. However, higher LARP plane asymmetry and low LA gain in women with hyperemesis suggests need for further research to clarify functional role of vestibular system on hyperemesis gravidarum.

Olfactory dysfunction and oxidative stress in pregnant women with hyperemesis gravidarum.

PURPOSE: This study aimed to compare the first-trimester pregnancy serum total oxidative status (TOS), total antioxidant status (TAS), and serum estradiol levels as well as the olfactory functions assessed using the brief smell identification test (BSIT) of women with healthy pregnancies and those with hyperemesis gravidarum (HG). METHODS: In this prospective study, 60 pregnant women in the first trimester of their pregnancies were divided into two groups: 30 pregnant women with HG (study group) and 30 healthy pregnant women (control group). The following parameters were compared in the HG group and the healthy controls: TOS, TAS, serum levels of estradiol (E2), and olfactory function, which was measured using BSIT. RESULTS: Both groups were similar in terms of age, gravida, and parity. The mean total smell score was lower in the HG group than the healthy control group (p < 0.05). TOS was significantly higher in the HG group than the control group. TAS was significantly higher in the control group than the HG group (p < 0.05). CONCLUSION: The removal of sharp odors that will trigger the perception of odor in pregnant women with HG can contribute to the effective control of this disease; moreover, adding fetal-safe antioxidants to the treatment can contribute to the effective control of this disease.

Assessment of the effects of menopause on semicircular canal using the video head impulse test.

This cross-sectional study included early menopausal and late menopausal women aged between 40 and 60 years to evaluate the effects of menopause on semicircular canal function. A video head impulse test (vHIT) was performed for all subjects. Vestibulo-ocular reflex (VOR) mean gains of each semicircular canal and gain asymmetry were compared between groups. Of the 87 subjects, 37(42.5%) were reproductive age 28(32.5%) were early menopausal and 22(25.3%) were late menopausal patients. VOR gain of semicircular canals or gain asymmetry values did not differ between groups. In postmenopausal women, presence of vasomotor symptoms was associated with higher gain asymmetry of the left anterior-right posterior (LARP) plane (p = .01), and presence of balance problems was associated with lower right anterior (RA) VOR gain (p = .01). In conclusion semicircular canal function in postmenopausal women was similar to that in women of reproductive age.IMPACT STATEMENTWhat is already known on this subject? During menopause, women face potential risks such as dizziness, balance problems, falls and fractures. Postmenopausal patients were tested with dynamic posturography to measure balance before and after oestrogen treatment, and it was shown that balance problems significantly improved with oestrogen treatment. Healthy vestibular system is one of the components for sustaining normal balance.What do the results of this study add? In postmenopausal women the function of the semicircular canals is normal and the balance deficit in postmenopausal women may not be caused by the vestibular system. In this study changes within normal limits were observed in vestibular system of postmenopausal women.What are the implications of these findings for clinical practice and/or further research? Reported balance deficits might have been due to central origin. Further research to differentiate origin of balance deficits are needed. Specific research on symptomatic postmenopausal patients would reveal more information.

Does Mastoid Pneumatization Affect Facial Canal Dimensions and Distances of Facial Tympanic Segment-Scutum and Lateral Semicircular Canal-Scutum?

OBJECTIVES: In the present study, we investigated whether mastoid pneumatization affects facial canal dimensions and distances of facial tympanic segment and scutum, and lateral semicircular (LSS) canal and scutum. METHODS: One hundred sixty-one temporal multidetector computed tomography scans were reviewed. Patients with unilateral sclerotic mastoid pneumatization (no aeration) (group 1, n = 81) and unilateral total mastoid pneumatization (100.0% aeration) (group 2, n = 80) were included. Facial canal dimensions at the labrythine, tympanic, and mastoid segments; facial canal dehiscence and length; and facial tympanic segment-scutum and LSS canal-scutum distances were evaluated. RESULTS: In the present study, facial canal dimensions of labyrinthine, tympanic, and mastoid segments in total pneumatized mastoid group were significantly lower than sclerotic mastoids on axial and coronal images (P < 0.05). Facial tympanic segment and scutum distance of the sclerotic mastoid group was significantly lower than those of the total pneumatized mastoid group (P < 0.05). However, LSS canal-scutum distance was not different between both groups (P > 0.05). The LSS canal-scutum distance of the females was lower than those of the males (P < 0.05). Facial canal dehiscence ratio was 11.3% and 11.1% in sclerotic and total pneumatized mastoids, respectively. The mean ± SD length of the dehiscence was 2.46 ± 1.29 mm in pneumatized mastoids and 1.92 ± 0.68 mm in sclerotic mastoids. CONCLUSIONS: In cholesteatoma cases, scutum erosion may occur. Because facial tympanic segment and scutum distance decreased in sclerotic mastoids compared with completely pneumatized ones, maximum care must be taken in the operations for avoiding to damage facial canal and nerve. Revision cases may be more difficult because of distorted anatomy. However, in pneumatized mastoids, the mean length of the facial canal was more than 2 mm, which must be kept in mind during operations.

Comparison of the protective efficacy between intratympanic dexamethasone and resveratrol treatments against cisplatin-induced ototoxicity: an experimental study.

PURPOSE: The main aim of this study was to compare the efficacy of intratympanic administration of dexamethasone and resveratrol in preventing cisplatin ototoxicity by measuring acoustic brainstem response (ABR) and distortion product otoacoustic emission (DPOAE). METHODS: Forty rats (80 ears) were divided into five groups. Cisplatin was administered intraperitoneally to the first group (n = 8). Group 2 (n = 8) received cisplatin after resveratrol had been administered intratympanically. Group 3 (n = 8) received cisplatin after dexamethasone had been administered intratympanically. Group 4 (n = 8) received cisplatin after sodium chloride (NaCl) had been given intratympanically. Group 5 (n = 8) received cisplatin after dimethylsulfoxide (DMSO) had been given intratympanically. ABR and DPOAE tests were performed on all groups before and 72 h after the procedure. RESULTS: ABR threshold values in rats that received dexamethasone and resveratrol were found to be less affected than those observed in the other post-cisplatin groups. ABR-IV and ABR-I-IV interval values were significantly reduced in rats that had been given dexamethasone and resveratrol compared to the other groups. After cisplatin treatment, otoacoustic emission (OAE) amplitudes were significantly decreased in Groups 1, 4, and 5 for all frequencies, while OAE values were sustained in the resveratrol and dexamethasone groups (Groups 2 and 3). At OAE frequency 5652, dexamethasone was more significantly associated with protective than resveratrol was, while no significant difference was found between the two groups at other OAE frequencies. CONCLUSION: In conclusion, intratympanic dexamethasone and intratympanic resveratrol treatments may provide a significant protection against cisplatin-induced ototoxicity.

Evaluation of Olfactory Sensation, Acoustic Rhinometry, and Quality of Life of the Patients With Nasal Septal Deviation.

OBJECTIVES: Nasal septum deviations are deformities that occur in the cartilage and bones of the septum. The aim of the present study is to evaluate the patients with septum deviation according to the acoustic rhinometry measurements in terms of changes in smell function and the effects on quality of life. METHODS: Twenty patients with septum deviation between the ages18 to 75 years old and 20 subjects without septum deviation were included in the study. Control group consisted of the 20 subjects with no septal deviation. After ENT examinations, acoustic rhinometry measurements, the SF-36 quality of life scale, and the Brief Smell Identification Tests were applied to all patients. Type of septum deviation is classified according to Mladina classification by anterior rhinoscopy examination, nasal endoscopy, and paranasal computed tomography. RESULTS: The study indicated that the most common deviation type was Mladina Type 3 (65%). Bilateral total smell score of the women in the septum straight group is significantly lower than the men in terms of total smell scores by gender (P < 0.05). The total smell score values in septum group were significantly lower than those of the control group (P < 0.05). According to the individual smell values, cinnamon, banana, and soap odors of the septum deviation group were seen to be significantly lower than the septum straight group (P < 0.05). CONCLUSION: The results of the study indicated that olfactory dysfunction occurs in patients with septum deviation. Therefore, treatment of septum deviation is necessary for the improvement of nasal obstruction besides the treatment of the smell dysfunction.

Sonoelastographic Evaluation of the Lower Lateral Nasal Cartilage Lateral Crus, Auricular Conchal Cartilage, and Costal Cartilage.

We investigated the sonoelastographic features of the lower lateral nasal cartilage lateral crus (LLNC-LC), auricular conchal cartilage (ACC), and costal cartilage (CC). In this prospective study, group 1 consisted of 60 participants (30 males and 30 females) between 18 and 35 years of age. Group 2 consisted of 60 participants (30 males and 30 females) between 35 and 50 years of age. Strain elastography (SE) and shear wave elastography (SWE) were performed. For all LLNC-LCs and ACCs, type I SE was detected more in group 2, type II SE was detected more in group 1, and type III SE was detected more in group 1 (p < 0.05). For CC, type I SE was detected more in both groups (p < 0.05). For LLNC-LC, type I SE was detected more in males compared with females in both groups (p < 0.05). For all LLNC-LC, ACC and CC, the SWE modulus of group 2 was significantly higher than that of group 1 (p < 0.05). In older participants, the SWE modulus increased. We recommend using ACC mainly in rhinoplasty operations for primary and revision cases as its SWE modulus is similar to that of the LLNC-LC. However, due to the higher SWE modulus of CC, CC grafts should not be used as the first choice in rhinoplasties, especially in the reconstruction of the nasal tip contour, but may be used in nasal dorsum augmentation.

Melatonin's protective effect on the salivary gland against ionized radiation damage in rats.

OBJECTIVES: The aim of this study was to examine the effects of melatonin on ionized radiation-induced salivary gland damage using an experimental model. MATERIALS AND METHODS: Thirty-two rats were randomized into four groups: (i) the control group (C, n = 8) that received intraperitoneal (i.p.) 0.9% NaCl; (ii) the melatonin group (M, n = 8) that received i.p. 5 mg/kg melatonin; (iii) the radiotherapy group (RT, n = 8) that underwent irradiation; (iv) the melatonin plus radiotherapy group (M+RT, n = 8) that received i.p. 5 mg/kg of melatonin, followed by irradiation 30 min later; and (v) the radiotherapy plus melatonin group (RT+M, n = 8) that received irradiation followed by i.p. 5 mg/kg of melatonin 30 min later. The medications and irradiation were administered for 5 days and the salivary glands of the rats were excised 10 days later; the histopathological changes in the salivary glands were assessed and biochemical analyses were conducted (tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI)). RESULTS: Regardless of whether melatonin was administered before or after radiotherapy, melatonin decreased the radiation-induced parotid and submandibular histological damage. In addition, regardless of whether administration occurred before or after radiotherapy, melatonin decreased oxidative stress markers, such as MDA, TOS, and OSI. On the contrary, levels of antioxidative markers, such as CAT and GPx, were increased by melatonin. CONCLUSIONS: Melatonin may have a significant protective effect on salivary gland damage secondary to ionizing radiation.

Marked changes in olfactory perception during early pregnancy: a prospective case-control study.

Pregnancy seems to be related with a significant change in olfaction. Here, we investigate this theory by testing the odor identification abilities of uncomplicated pregnant women and compare the results with non-pregnant controls. The study included 31 healthy pregnant women in the first trimester (Group 1), 30 in the second trimester (Group 2), 31 in the third trimester, and 30 non-pregnant healthy controls (Group 4). In order to measure odor identification abilities, each subject completed the 12-item Brief Smell Identification Test (BSIT). Next, the demographic characteristics and BSIT scores of the groups were compared. The total BSIT scores of the subjects in Group 1 were found to be significantly lower than those of the other groups (p < 0.001). This reduction in odor identification abilities was particularly noticeable for leather, pine, and soot. Pregnant women in the second and third trimesters had similar odor identification abilities to the healthy controls (p > 0.05). Early pregnancy might be related to significant changes in olfactory performance. The distortion of odor identification in the first trimester might be a causative factor for the development of pregnancy-specific conditions, such as morning sickness and hyperemesis gravidarum, which are both common complaints during the early phase of parturition.

Does menopause effect nasal mucociliary clearance time?

The aim of this study was to investigate the effect of menopause on nasal mucociliary clearance time by comparing the results of premenopausal and postmenopausal women. A total of 60 women met the criteria and were divided into two groups: premenopausal women (n = 30) and postmenopausal women (n = 30). Nasal mucociliary clearance time of these women was measured and compared. Moreover, the correlation between nasal mucociliary clearance time and menopause duration in postmenopausal women was evaluated. Statistical analysis was performed using the SPSS (Statistical Package for the Social Sciences) 13.0 Evaluation for Windows. Normal distribution of continuous variables was tested with Kolmogorov-Smirnov test. Chi square test was used for comparisons between categorical variables. Kruskal-Wallis test and Mann-Whitney U tests were used for continuous variables when comparing the groups. The statistically significant level was accepted as p value <0.05. The mean nasal mucociliary clearance time in premenopausal and postmenopausal women was 11.43 ± 2.81 (7-16) and 16.76 ± 2.73 (12-22), respectively. The mean nasal mucociliary clearance time in postmenopausal women was significantly longer than in premenopausal women (p < 0.0001). Also, there was positive correlation between menopause duration and nasal mucociliary clearance time in postmenopausal women (r = 0.833, p < 0.0001). The clinicians must keep in mind that nasal mucociliary clearance time in postmenopausal women is prolonged and must follow up women in postmenopausal period more closely for respiratory tract diseases, sinonasal and middle ear infections.

Blood parameters as indicators of upper airway obstruction in children with adenoid or adenotonsillar hypertrophy.

UNLABELLED: Adenotonsillar hypertrophy (ATH) is the most common cause of obstructive sleep apnea in children. This study aimed to evaluate the blood parameters of children with ATH who underwent surgery. METHODS: The study included a review of the medical records of 130 children who underwent adenoidectomy or adenotonsillectomy with a diagnosis of adenoid hypertrophy and/or chronic tonsillitis. Patients were classified into 3 groups: group 1 (n=69) underwent adenoidectomy, group 2 (n=61) underwent adenotonsillectomy, and group 3 consisted of 82 healthy children. White blood cell count, platelet count, hemoglobin levels, mean platelet volume, and platelet distribution width values were the primary outcome measures. RESULTS: Mean platelet volume, platelet distribution width and hemoglobin values decreased in the groups that underwent surgery. Whereas the decrease in group 1 was insignificant, it was significant in group 2. White blood cell count values increased in both group 1 (adenoidectomy) and group 2 (adenotonsillectomy), but the increase in group 2 was significant. No significant difference in platelet count was detected before versus after the operation. CONCLUSIONS: Upper airway obstruction caused by ATH remarkably changes the blood parameters related to chronic hypoxia. Significant improvement can be achieved after adenotonsillectomy rather than adenoidectomy alone.

Mean Platelet Volume Decreases in Adult Patients With Obstructive Sleep Apnea After Uvulopalatal Flap Surgery.

AIM: The main purpose of the study was to investigate changes in mean platelet volume (MPV) values in patients with obstructive sleep apnea syndrome (OSAS) who had undergone uvulopalatal flap (UPF) surgery. METHOD: The study included a review of the medical records of 37 adult patients who had undergone UPF surgery after being diagnosed with OSAS. The baseline blood parameters of patients, including the MPV and platelet distribution width (PDW) values, were measured and repeated 3 months after treatment. Polysomnographic evaluations of the patients were also performed during admission and the 3rd month control. Comparisons of MPV values and their correlation with polysomnographic parameters were the main outcomes measured. RESULTS: The blood parameters of all patients were similar except for MPV values, which were significantly lower after treatment (P < 0.001). Patients' apnea hypopnea index (AHI) and apnea episodes were significantly reduced after the UPF surgery, whereas their oxygen saturation significantly increased (P < 0.001). The MPV values were not correlated with polysomnographic parameters (P > 0.05). CONCLUSION: The UPF surgery, which is a relatively simple surgical intervention to treat OSAS, alleviates nocturnal hypoxic episodes and lowers platelet volume. These may both be important predictors of adverse cardiovascular outcomes related to OSAS.

The Presence of Clival Foramen Through Multidetector Computed Tomography of the Skull Base.

OBJECTIVES: Technological advancements in the diagnostic radiology recently permitted reviewing the normal anatomy through multidetector computed tomography (MDCT) imagination. The aim of this paper is retrospectively investigation of the clival foramen and canal through MDCT. MATERIALS AND METHODS: One hundred eighty-six MDCT scans were reviewed. First, images were taken at axial plane, and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these three-dimensional images (3-D imaging). The images were evaluated as clival foramen "present" or "absent." RESULTS: In our 186 patients, evaluation of MDCT showed that clival foramen was absent in 66.7% (n = 124) of patients. Only 33.3% (n = 62) of patients had a clival foramen. In 3-D images, clival canal and clival foramen were shown more clearly compared with the MDCT. CONCLUSIONS: Knowledge of the clival canal might be useful in patients of questionable clival fracture or during neurosurgical operations in this region. During life the canal contained a vein connecting the basilar plexus with the venous plexus of the vertebral canal, and inferior petrosal sinuses. Before the surgical interventions in the clival region, the presence of the clival canal and foramen should also be known due to its vascular contents. By multidetector computed tomography and 3-D images, clival canal and foramen may be viewed preoperatively.

Comparison of the Effects of Total Nasal Block and Central Facial Block on Acute Postoperative Pain, Edema, and Ecchymosis After Septorhinoplasty.

BACKGROUND: Pain, ecchymosis, and edema are major postoperative transient complications of septorhinoplasty procedures. They increase the patient's anxiety and decrease satisfaction levels as well as extend recovery time in the early postoperative period. The aim of this study was to compare the effects of total nasal block (TNB) and central facial block (CFB) on postoperative pain, edema, and ecchymosis. METHODS: A total of 60 consecutive patients enrolled in this study and were divided into three groups as Controls (n = 20), TNB (n = 20), and CFB (n = 20). The two block methods mentioned above were performed at both the beginning and end of the surgery in the TNB and CFB groups. The Control group was not subjected to any block methods. Pain, edema, and ecchymosis score results according to the three scales were recorded postoperatively after 24 h, and on days 2, 5, 7, and 10. Results were analyzed statistically. RESULTS: Of all patients, 28 were male and 32 were female. Ages were between 18 and 52 years (mean = 26.3 years). Pain, edema, and ecchymosis scores were significantly lower in the TNB and CFB groups than in the Control group. Additionally, there was a significant difference between the TNB and CFB groups in terms of pain and edema at postoperative 24 h and on day 2. Ecchymosis scores were lower in the CFB group than in the TNB group at 24 h and on days 2 and 5 after the operation. CONCLUSION: Both TNB and CFB decreased postoperative pain, edema, and ecchymosis in septorhinoplasty. However, CFB was more effective than TNB in terms of pain, edema, and ecchymosis relief after septorhinoplasty procedures. 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.

Early paper patching versus observation in patients with traumatic eardrum perforations: comparisons of anatomical and functional outcomes.

The purpose of this study was to compare the outcomes of patients with acute tympanic membrane perforation after spontaneous healing and paper-patching procedure. METHODS DESIGN, SETTING, AND PARTICIPANTS: In this study, we performed a retrospective chart review with a prospective follow-up in 63 patients with tympanic membrane perforations. The patients undergoing a paper-patching procedure were assigned to group 1 (n = 33), whereas the patients that healed spontaneously were included in group 2 (n = 30). Retrospective analyses of the otoscopic examination findings and audiometric test results of the groups at the sixth-week follow-up were compared. RESULTS: Eardrum healing was achieved in 90.9% of the patients in group 1 and 76.7% of the patients in group 2 at the sixth week (P > 0.05). The mean values of air conduction were significantly improved, and the air-bone gap was markedly decreased in the patients treated with paper patching, when compared with the patients in group 2 (P < 0.001). The area of perforation was found to be inversely related to the healing success. CONCLUSIONS: Early intervention by paper patching, which is a readily applicable procedure, may be offered to the patients with acute perforation of the tympanic membrane, because of the slightly better closure rates and significantly higher hearing functions when compared with simple observation.

Comparison of surgical outcomes and patient satisfaction after 2 different rhinoplasty techniques.

UNLABELLED: Various methods of surgical treatment are defined in nasal deformities that cause nasal obstruction. Open technique septorhinoplasty is a method that is frequently used for this purpose. This study aims to compare surgical results of open technique septorhinoplasty operations with and without osteotomies. In addition, changes in the quality of life of patients before and after treatment were investigated, and the effects of the 2 methods on patients' quality of life were compared. METHODS: Patients with nasal deformity were included in the study. Forty patients with wide nasal dorsum and a prominent hump underwent septorhinoplasty with lateral osteotomy (group 1), and 35 patients with a narrow nasal dorsum and a minimal hump underwent septorhinoplasty without osteotomy (group 2). A Nasal Obstruction Symptom Evaluation (NOSE) questionnaire was used to evaluate disease-specific quality of life for patients in both groups. Basic characteristics, operative parameters, and preoperative and postoperative NOSE scores were compared between the groups. RESULTS: Demographic properties of the groups were similar. Intraoperative parameters and postoperative complications were not different between the groups, with the exception of operation time (which was significantly longer in group 1) and ecchymosis (which was seen in whole cases of group 1 and none of the group 2). Preoperative NOSE scores were similar in both groups. Postoperative NOSE scores were 5 (0-45) in group 1 and 10 (0-45) in group 2 (P > 0.05). The NOSE scores were significantly decreased after the operation in both groups (P < 0.001). The 2 groups were not significantly different when comparing the change in preoperative and postoperative NOSE scores. CONCLUSIONS: Rhinoplasty with or without osteotomy is an effective treatment for alleviating nasal obstruction symptoms. Osteotomy is an integral but not obligatory part of the operation. The addition of the osteotomy procedure in selected cases prolonged the operation time and significantly enhanced patient satisfaction.

Protective effects of resveratrol on cisplatin-dependent inner-ear damage in rats.

Cisplatin is a common chemotherapeutic agent used in many solid and hematologic malignancies. The main unwanted effect of cisplatin is ototoxicity, for which no standard treatment has been reported. The present study examined the protective efficacy of resveratrol on cisplatin-dependent ototoxicity through an experimental model. Fifteen rats were randomized into three groups. Group 1 (control group) (n = 5) received intraperitoneal (i.p.) 15 mg/kg cisplatin; group 2 (resveratrol group) (n = 5) received i.p. 100 mg/kg resveratrol, followed by i.p. 15 mg/kg cisplatin; group 3 (n = 5) served as a vehicle group and received i.p. 1 ml dimethyl sulfoxide. All rats underwent the auditory brainstem response (ABR) test before and 72 h after the treatment. Pretreatment ABR values of the groups were not significantly different. The pretreatment hearing threshold values of the groups were 30 ± 6.60 and 28.5 ± 5.29 dB in groups 1 and 2, respectively (p > 0.05). The post-ABR-I and post-ABR-IV values were, respectively, 1.41 ± 0.18 and 5.83 ± 0.16 ms in the control subjects and 1.19 ± 0.22 and 4.58 ± 0.27 ms in the study group. The ABR-I and ABR-IV durations in rats treated with resveratrol were significantly shorter (p < 0.01). A comparison of threshold values shows that the resveratrol-treated rats had significantly lower values than the control rats. After cisplatin injection, ABR I-IV intervals were compared among the groups. The ABR I-IV interval duration was 4.42 ± 0.16 ms in the control group, while the resveratrol-treated rats showed a significantly shorter ABR I-IV interval duration of 3.49 ± 0.27 ms (p < 0.001). Resveratrol attenuated cisplatin-dependent inner-ear damage, as shown by the ABR-I, ABR-IV, ABR I-IV interval, and hearing threshold values. Our results suggest that this natural antioxidant may be effectively used in reducing the unwanted effects of cisplatin on the ear physiology of patients, particularly those undergoing chemotherapy.

[A comparison of the long-term efficacy of cochlear implantation at early and late age]. / Erken ve geç yas koklear implant uygulamasinda uzun dönem etkinliklerinin karsilastirilmasi

OBJECTIVES: This study aims to investigate the effects of age factor on the long-term efficacy of cochlear implantation. PATIENTS AND METHODS: The electronic records of patients, who underwent cochlear implantation with the initial diagnosis of bilateral severe to profound sensorineural hearing loss in our clinic between January 2001 and December 2008, were analyzed retrospectively. The patients were divided into two groups according to their age at the time of cochlear implantation, including group 1 with the patients less than four years of age and group 2 with the patients more than four years of age. Groups were evaluated and compared for the in terms of demographic characteristics, Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) at three years following surgery. RESULTS: A total of 37 patients underwent cochlear implantation. Of them, 18 patients (48.6%) were operated at less than four years of age, while 19 patients (51.4%) were operated at more than four years of age. No significant difference was found between the groups in terms of sex, educational level and profession of the parents, operated side and duration of implant use. According to CAP and SIR categories, group 1 patients had statistically significantly higher level of the CAP and SIR categories (p=0.009 and p<0.001 respectively). CONCLUSION: Our study results suggested that the age of cochlear implantation has significant effects on long-term hearing and speech abilities. Cochlear implantation carried out at earlier ages (<4) enhances more satisfactory results in terms of long-term efficacy.

Traumatic Dislocation of the Globe into the Ethmoid Sinus

Traumatic globe dislocation into the paranasal sinuses is a rare condition. Globe displacement with preserved integrity can result in functional and cosmetic recovery with rapid and appropriate intervention. In this article, we discuss the presentation and treatment of globe dislocation into the ethmoid sinus in a 36-year-old patient who presented to the emergency department with the complaint of vision loss due to a fall.