The impact of ankylosing spondylitis on audiovestibular functions.

In this study, we aimed to evaluate the audiovestibular functions in the patients with ankylosing spondylitis (AS). This prospective study was performed in collaboration by the Otolaryngology and Rheumatology Departments of Bozok University School of Medicine between May 1, 2012, and January 1, 2013. We studied 80 subjects consisting of 40 AS patients (37 men and 3 women) in whom the diagnosis confirmed by the criteria of New York and 40 healthy controls (35 men and 5 women). All participants were evaluated by routine audiologic (including tympanometric evaluation, pure-tone audiograms, speech tests) and vestibular studies (including spontaneous nystagmus, gaze, optokinetic, saccadic movements, smooth pursuit, caloric test and Dix-Hallpike tests). The tympanometric values did not show a statistically significant difference between the AS group and the healthy subjects (p > 0.05). At low frequencies (250, 500, 1,000, and 2,000 Hz) pure-tone audiologic evaluations also proved statistically non-significant results at mean air conduction thresholds (ACT) and bone conduction thresholds (BCT) between the AS and control groups (p > 0.05). At high frequencies (4,000, 6,000, and 8,000 Hz), the ACTs and BCTs in AS group were lower than control group which was statistically significant (p < 0.05). The results of spontaneous nystagmus, gaze, optokinetic, canal paresis and saccadic movement tests between the two groups were statistically insignificant (p > 0.05). The comparison of smooth pursuit and Dix-Hallpike tests reached statistical significance (p < 0.05). Videonystagmographic test (VNG) revealed central abnormalities in 7 patients (17.5 %), peripheral abnormalities in 16 patients (40 %), and mixed abnormalities in 3 patients (7.5 %). Our findings suggest a possible association between AS and audiovestibular system dysfunction. We assume that the hearing and vestibular disturbances in AS are more prevalent than previously recognized.

The correlation of serum levels of leptin, leptin receptor and NO x (NO 2 (-) and NO 3 (-)) in patients with obstructive sleep apnea syndrome.

The aim of this study was to investigate the relations between nitric oxide (NO) and leptin levels in a cohort of untreated adult Obstructive sleep apnea syndrome (OSAS) patients. Between June 1, 2012, and January 1, 2013, we evaluated a total of 58 subjects including 36 OSAS patients and 22 healthy controls, both polysomnographically confirmed. Following the completion of polysomnographic evaluation, serum samples were taken at 08:00. Leptin, leptin receptor, NO2 (-) and NO3 (-) levels were analyzed by commercial ELISA kits. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 16.0 (SPSS Inc., Chicago, IL, USA). There was no statistically significant difference between the OSAS patients and control groups with relation to the demographic parameters and body mass index (p > 0.05). Significantly higher serum leptin and plasma NO levels were found in OSAS patients compared to the controls (p < 0.001). In this study, higher leptin levels which were positively correlated with NO levels in OSAS group may indicate a possible link with increased incidence of airway pathologies in these patients.

The effect of nasal septal deviation on maxillary sinus volumes and development of maxillary sinusitis.

OBJECTIVES: The purpose of this study was to determine the possible role of nasal septal deviation on volume of maxillary sinuses and its relationship with development of maxillary sinusitis. MATERIALS AND METHODS: Between May 2010 and September 2012, paranasal sinus computed tomography (CT) findings of 825 patients (470 males, 355 females), who admitted to Ear Nose and Throat Department of Bozok University Medical Faculty were retrospectively analyzed. By excluding the other co-existent sino nasal pathologies, 109 consecutive patients (47 males, 62 females mean age 36 ± 13.4 years; range 18-71 years) with isolated nasal septal deviations were recruited for the study. The convex side of the septal curvature was accepted as the direction of deviation. The findings were grouped according to the radiologically measured angle of nasal septal deviations. The deviation angle of the nasal septum was described as; mild (<9°), moderate (the angle between 9° and 15°), or severe (15° and up). The volume of each maxillary sinus (ipsi- and contralateral to the deviation side) was also calculated using the computer program. Sinusitis was defined as any evident thickening of the maxillary sinus mucosa. RESULTS: There were 62 females and 47 males with a mean age of 36 ± 13.4. Nasal septal deviation angles were found to range between 5° and 27.2° (mean 13° ± 3.4°). The right sided deviations included 19 mild (<9°, Group I), 16 moderate (9°-15°, Group II), and 16 severe (15° and up, Group III) cases. The left sided deviations included 19 mild (<9°, Group I), 19 moderate (9°-15°, Group II), and 20 severe (15° and up, Group III) subjects. Maxillary sinus volumes were compared between right and left sided deviation groups. We could not demonstrate a statistically significant difference between the right maxillary sinus volumes of Groups I and II in left sided deviation cases (p = 0.77). In the same side, comparison of Groups I-III and Groups II-III, the maxillary sinus volume differences were found to be significantly meaningful (p = 0.001 and p = 0.013, respectively). Identical results were yielded in the right sided septal deviation group related to the maxillary sinus volumes of Groups I and II and Groups I-III and Groups II-III compartments (p = 0.99, p = 0.004 and p = 0.003, respectively). In both right and left deviation groups, ipsi and contralateral maxillary sinus volume comparements produced statistically significant results (p = 0.002 and p = 0.04, respectively). The presence of maxillary sinusitis findings were significantly increased in both group (p = 0.00). Statistical significance was set at p < 0.05. CONCLUSION: Our findings suggest that maxillary sinus volumes tend to be higher at the contralateral side of the severe septum deviations. In addition, the chance of finding maxillary sinusitis findings on ipsilateral to the severe septum deviation was significantly increased.

Does fibromyalgia have an effect on hearing loss in women?

Background/aim: Fibromyalgia (FM) patients may have several neuroendocrine dysfunctions, resulting in a hypervigilant sensory output that may be responsible for sensorineural complaints. In this study, we evaluated the audiological findings of a cohort of female fibromyalgia patients. Materials and methods: Between 1 September 2012 and 1 June 2013, 35 female FM patients, followed by the Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bozok University, were recruited for the study. The patients were referred to the Department of Otolaryngology for routine otolaryngological and audiological evaluations. Age range was between 30 and 65 years, with a mean age of 48.10 years. The control group consisted of 25 healthy female volunteers ranging from 32 to 65 years (mean age: 45.52). All subjects were audiologically tested, including tympanometric evaluation. Low- and high-frequency audiometry was carried out by a single experienced investigator under standard audiometric testing conditions.Results: At low frequencies, the mean air conduction threshold values between the two groups were not statistically significant. At high frequencies, the mean air conduction threshold values and tympanometric values between the FM and control groups were statistically significant (P < 0.05 for both). Conclusion: Our results point to a pathophysiologic link between FM and the development of audiological abnormalities in these patients.

An Unusual Cause of Bleeding on the Floor of Mouth: Leech Infestation.

Leech infestation is a very rare phenomenon in humans. It mostly occurs in humans when rural untreated water is drunk or while swimming in streams or lakes. When leeches adhere to the mucous membrane, they ingest blood. Thus, they can sometimes cause severe anemia that may require blood transfusion. We report a case that was referred to emergency service with bleeding in the floor of the mouth. A 10-year-old child was referred to the emergency service of a city hospital with a complaint of swelling in the floor of the mouth and spitting of blood. The patient was promptly taken to the operating room. Using local anesthesia, a surgical incision was made, and a moving, dark brown foreign body was removed from the floor of the mouth and identified as a leech. Leech endoparasitism should be considered as a cause of unexplained anemia due to bleeding from the throat. Accordingly, leech infestation must be considered in differential diagnosis when a patient complains of spitting of blood, hoarseness, or dysphagia.

The correlation of serum growth differentiation factor-15 level in patients with obstructive sleep apnea.

PURPOSE: Growth differentiation factor-(GDF-) is a prognostic biomarker in cardiovascular disorders (CVD). GDF-15 level was not studied in patients with obstructive sleep apnea syndrome (OSAS) before. In this study, we investigated serum GDF-15 levels in OSAS patients and compared them with healthy controls. MATERIAL AND METHODS: Polysomnographically, confirmed forty consecutive OSAS patients (20 men and 20 women) and forty consecutive healthy controls (23 men and 17 women) were enrolled in the study. The samples in each group had similar demographic characteristics and body mass index (BMI) values. RESULTS: In the study, no significant correlation was found about GDF-15 levels of OSAS group and healthy controls. However, there was a significant statistical correlation between age and GDF-15 level. In correlation analysis, there was not any significant correlation between age and BMI. CONCLUSION: Although various developing biomarkers have been studied in cardiovascular disorders, GDF-15 levels have attracted a widespread interest as predictors of cardiovascular risk. GDF-15 level has not been evaluated previously in patients with OSAS. A significant statistical correlation was found between age and GDF-15 level. To reveal close relation between OSAS and GDF-15, further studies are needed with combination of GDF-15 and other biomarkers in OSAS.

Ocular surface culture changes in patients after septoplasty.

AIM: To investigate the interrelationships between pre- and postoperative microbiological changes by taking samples from both eyes of 40 patients who underwent septoplasty due to septal deviation. MATERIALS AND METHODS: Forty patients diagnosed with septal deviation who underwent a septoplasty operation under general anesthesia were enrolled in this study. The study was conducted on 40 patients who met the inclusion criteria and attended follow-up visits. One day before the operation and 48 h after the operation, cultures were taken individually from the conjunctivas and puncta of both eyes and sent to the microbiology laboratory. RESULTS: Patients who were candidates for nasal surgery due to their symptoms and clinical examination results were randomly selected and 40 of these completed the study. No statistically significant differences in bacterial growth were observed between the eyes before the operation (P > 0.05). There were, however, statistically significant differences between the eyes in terms of bacterial growth in the postoperative period (P < 0.05). Pathogenic bacterial cultures were grown in 47 eyes in the postoperative period, and this finding was statistically significant. In the eye cultures, the most commonly isolated pathogens were S. epidermidis, and S. aureus. CONCLUSION: Although the indicated microorganisms isolated from the patient groups were grown in cultures, there were neither clinical symptoms nor signs related to ocular infections.