Stapes stabilizing cartilage graft.

PURPOSE: This study aimed to evaluate hearing results in patients with type 3 tympanoplasty using autologous cartilage grafts. METHODS: The study included patients treated with "stapes stabilizing cartilage graft" (SSCG) and Plastipore partial ossicular replacement prosthesis (PPORP) for hearing reconstruction. Hearing results and complications were assessed and postoperative audiological tests were performed at least 6 months after surgery. RESULTS: There were 18 patients (5 men, 13 women) in the SSCG group and 12 patients (5 men, 7 women) in the PPORP group. The air conduction threshold changed by 22.4 ± 7.5 dB in the SSCG group, and by 13.2 ± 12.9 dB in the PPORP group (p = 0.022), after hearing reconstruction. The air-bone gap (ABG) changed by 20.1 ± 8.3 dB in the SSCG group and by 16.3 ± 12.3 dB in the PPORP group. Although the change in ABG was greater in the SSCG group than in the PPORP group, the difference was not statistically significant (p > 0.05). No complications were recorded in the SSCG group, whereas two patients experienced a severe vertigo attack after surgery in the PPORP group, which lasted for approximately 2 weeks with conservative management. Extrusion was not encountered in the PPORP group, while extrusion of the titanium partial ossicular replacement prosthesis occurred in one patient in the SSCG group who underwent revision surgery. CONCLUSIONS: Better hearing outcomes were obtained with SSCG than with PPORP. SSCG can be used as an alternative hearing reconstruction technique in cases of type 3 tympanoplasty.

Effect of adenotonsillectomy on sleep problems, attention deficit hyperactivity disorder symptoms, and quality of life of children with adenotonsillar hypertrophy and sleep-disordered breathing.

OBJECTIVE: Chronic adenotonsillar hypertrophy is the most common etiologic reason for upper airway obstruction in childhood and has been found to be associated with a variety of psychiatric disorders and poor quality of life. In the present study, we investigated the impact of adenotonsillectomy on attention deficit hyperactivity disorder symptoms, sleep problems, and quality of life in children with chronic adenotonsillar hypertrophy. METHODS: The parents of children with chronic adenotonsillar hypertrophy filled out the Conners's Parent Rating Scale-Revised Short form (CPRS-RS), Children's Sleep Habits Questionnaire (CSHQ), and Pediatric Quality of Life Inventory, Parent version (PedsQL-P) before and six months after adenotonsillectomy. RESULTS: A total of 64 children were included in the study (mean age = 6.8 ± 2.4 years; boy:girl ratio= 1). The mean attention deficit hyperactivity disorder index and oppositionality subdomain scores of the CPRS-RS and all of the CSHQ subdomain scores (bedtime resistance, sleep-onset delay, sleep anxiety, night waking, parasomnias, sleep-disordered breathing, and daytime sleepiness) except for sleep duration significantly decreased after adenotonsillectomy ( p < 0.05). The PedsQL-P total score and both PedsQL-P physical health and psychosocial health subdomain scores were significantly higher at six months after adenotonsillectomy ( p < 0.001). CONCLUSIONS: Child and adolescent psychiatrists should check the symptoms of chronic adenotonsillar hypertrophy to identify children with chronic adenotonsillar hypertrophy who suffer from sleep disturbance, attention deficit hyperactivity disorder symptoms, and oppositionality. Adenotonsillectomy seems to be beneficial for coexisting attention deficit hyperactivity disorder and sleep disorder symptoms and quality of life in these children.

Evaluation of iron and zinc levels in recurrent tonsillitis and tonsillar hypertrophy.

OBJECTIVES: The aim of this study is to look into the roles of iron and zinc metals in etiopathogenesis of recurrent tonsillitis and tonsillar hypertrophy by evaluating the levels of iron and zinc elements in the palatine tonsillar tissue. METHODS: In total, 40 patients who underwent a tonsillectomy to treat recurrent tonsillitis and tonsillar hypertrophy were included in the study. Patients were classified into two groups, recurrent tonsillitis and tonsillar hypertrophy, determined by the results of clinical and histopathological examination. The levels of iron and zinc elements were determined for each tonsillar tissue sample. RESULTS: There was a significant difference in the iron and zinc concentrations (p<0.001) between the tonsillar hypertrophy and recurrent tonsillitis groups. The levels of iron and zinc were significantly lower in the recurrent tonsillitis group. CONCLUSIONS: This study suggests that low tissue concentrations of iron and zinc may lead to recurrent tonsillitis.

Clinical results and health-related quality of life in otoplasty patients using cartilage resection and suturing methods.

In this study, we evaluated clinical results and health-related quality of life in our otoplasty patients in whom we used cartilage resection method (CRM) and suturing method (SM). A total of 132 ears of 77 patients (36 males, 41 females; mean age 14.6 ± 6.4) between January 2006 and February 2013 were included in this study. Patients were divided into two groups according to the type of surgery performed: Group 1 was the cartilage resection group (CRG) and Group 2 was the suturing group (SG). CRM was performed on 64 ears of 37 patients (unilateral in 10 cases and bilateral in 27 cases), and SM was performed on 68 ears of 40 patients (unilateral in 12 cases and bilateral in 28 cases). The parameters of the groups, including operation time, measurements of the auriculocephalic distances, complication rates, postoperative satisfaction rates, and health-related quality of life were compared. Mean operation time was 53.7 ± 7.8 min in the CRG and 44.9 ± 4.2 min in the SG (P ≤ 0.05). Mean postoperative auriculocephalic measurements were similar in both groups. The complications were more frequent in the CRG (10/37 patients, 27.02 %) than in the SG (3/40 patients, 7.54 %) with statistically significant difference (P < 0.05). Three months after the surgery, visual analog scale increased from 25 (preoperatively) to 70 in the CRG and from 30 to 90 in the SG, with a statistically significant difference (P < 0.05). Patients' health-related quality of life showed a statistically significant increase after the operation in both groups (P < 0.05). CRM and SM are effective treatment methods with high success rates for patients with prominent ears. In the selected cases, SM seems to represent a better option for otoplasty than CRM because clinical results, cosmetic outcomes, patient satisfaction, and health-related quality of life scores were better than CRM.

Otoplasty: results of suturing and scoring techniques.

In this study, we evaluated our otoplasty surgery results in patients with prominent ears. A total of 76 ears in 42 patients (20 male, 22 female; mean age 14; range 6-34 years) who underwent otoplasty surgery under general anesthesia between April 2005 and February 2012 were evaluated retrospectively. Of the 76 surgical cases, while 65 were operated on for the first time (primary), 6 had had previous unsuccessful surgical interventions at other institutes (secondary) and 5 were our own revision surgery cases. Of the primary cases; 11 had unilateral and 27 had bilateral surgery. Postoperative follow-ups were performed at week one, months one, three and six and at 1 year. While 60 of the 65 primary surgeries and all 6 of the secondary surgeries had successful results, 5 cases required revision surgery. The revision otoplasty surgeries were found to be successful in all patients on follow-up visits. Otoplasty surgery is an effective treatment method with high success rates for patients with prominent ears.

An unusual cause of conductive hearing loss: bilateral complete meatal obstruction following otoplasty.

There are many causes of conductive hearing loss. Otoplasty is a commonly performed cosmetic surgery to correction for prominent ear. We discussed an unusual cause of conductive hearing loss, bilateral complete meatal obstruction following otoplasty, in this article. This complication was probably due to unsuitable placement of the Furnas sutures. In the literature, as a cause of conductive hearing loss, unilateral complete meatal obstruction has been described rarely, but bilateral complete obstruction has not been defined. Hearing loss recovered completely after revision surgery. Correct diagnosis, accurate preoperative or perioperative examination, choice of the proper technique and surgeon experience are essential for avoiding inadequate results or complications of otoplasty. The surgeon should be aware of the cartilage elasticity and suture techniques to avoid this complication.

Does being a healthcare professional affect satisfaction after septorhinoplasty?

This study aims to determine the differences in satisfaction levels after septorhinoplasty between patients who are healthcare workers and those who are not. The study includes patients who underwent primary septorhinoplasty surgery, divided into two groups: healthcare workers and non-healthcare workers. The Rhinoplasty Outcome Evaluation (ROE) questionnaire was administered to the patients at the 6th postoperative month. Among the 37 patients, 18 were healthcare workers, and 19 were non-healthcare workers. The mean Rhinoplasty Outcome Evaluation score for healthcare workers at the 6th postoperative month was 75.69 ± 16.06, while in the non-healthcare worker group, the ROE scores were 60.31 ± 27.69. The findings from our study indicated that individuals in the healthcare profession exhibited significantly greater satisfaction rates following septorhinoplasty in comparison to those in the non-healthcare worker group, with a statistically significant difference noted (p: 0.046). Having more knowledge about septorhinoplasty surgery and its complications among healthcare workers may allow for more realistic expectations regarding the surgical intervention. Simultaneously, it may facilitate better communication with the surgeon and the expression of expectations. Clinicians should pay attention not only to the patient's intellectual level but also to their health literacy in communication with the patient.

The effect of BMP-2, BMP-4 and BMP-6 on bone destruction of cholesteatoma presence.

OBJECTIVE: The aim of our study was to investigate the relationship between the destruction of temporal bone structures, ossicular chain destruction, dissemination of cholesteatoma and the expressions of bone morphogenetic proteins (BMPs), BMP-2, BMP-4 and BMP-6 in patients with acquired cholesteatoma. MATERIAL AND METHODS: This study was performed in a total of 80 patients with cholesteatoma and without cholesteatoma who had undergone surgery due to chronic otitis media. The patients were grouped as the study and the control groups. The study group comprised patients with primary acquired cholesteatoma, and the control group consisted of chronic otitis media patients without cholesteatoma. The samples were obtained from cholesteatoma tissue and the external acoustic meatus skin in study group patients and they were obtained from the external acoustic meatus skin only in control group patients. The Reverse Transcriptase Polymerase Chain Reaction method was used for the measurements of BMPs, BMP-2, BMP-4 and BMP-6 expressions. Polymerase Chain Reaction was studied by isolation of Ribonucleic Acid from the tissue samples. RESULTS: When the expressions of BMP in the external acoustic meatus skin were compared between the study and the control groups, the BMPs, BMP-2 and BMP-6 were determined to have a statistically significant relation in the study group (p<0.05), but BMP-4 was not significant (p>0.05). When the expression of BMP in cholesteatoma tissue was investigated in the study group patients, the BMPs, BMP-2 and BMP-6 were determined with statistically significant positivity (p<0.05), but there was no significant positivity for BMP-4 (p>0.05). In the study group, there was no statistical significance between the expressions of BMPs, BMP-2, BMP-4 and BMP-6 in cholesteatoma tissue, in the external acoustic meatus skin, and temporal and ossicular chain destruction, and dissemination of cholesteatoma (p>0.05). A statistically significant positivity for BMPs expression in cholesteatoma tissue was determined in patients with destruction of the incus+malleus+stapes (p<0.05). CONCLUSION: The expressions of BMPs, BMP-2 and BMP-6, were elevated in cholesteatoma tissue. Furthermore, the positivity of BMPs expression was statistically significant in patients with destruction of all the ossicles, and we think that this marker can be used for evaluation of the aggressiveness of cholesteatoma.

The role of allergy in the etiopathogenesis of idiopathic sudden sensorineural hearing loss.

To evaluate the role of allergy in the etiopathogenesis of sudden hearing loss using cytokine profile, allergic parameters, and lymphocyte subgroups, a total of 31 patients aged between 30 and 62 years (mean age: 42.48 ± 15.86 years) with the diagnosis of sudden hearing loss were enrolled in the study between 2008 and 2011. The control group comprised 30 age-matched adult subjects accepted as clinically healthy individuals living in the same region with comparable socioeconomic parameters. The patient and the control group were questioned for history of allergy. Lymphocyte subgroups in the peripheral blood were evaluated using Becton-Dickinson monoclonal CD4, CD8, CD19, and CD23 antibodies. In the patient and control groups, the levels of IFN- γ, IL4, IL10, and total IgE were measured and compared between the groups. Skin test was used for detection of inhaler allergens in the patient and the control groups, and specific IgE tests were performed using the RAST method for food allergens. The Spearman's rho correlation, the unpaired t test, the Mann-Whitney U test, and the Shapiro-Wilk test were used to determine the differences between the groups. The limit for statistical significance was p < 0.05. When the patient and the control group were compared, the differences between CD4, CD23, IL4, IL10, and IgE were statistically significant. On analyses of the patients' serum samples, strongly positive correlations were determined between IgE and CD23, IL10, IL4; IL4 and IL10, CD23, CD4; IL10 and CD23, CD4 (Spearman rho, p = 0.000), while a weakly positive correlation was found between IgE and CD4 (Spearman rho, p = 0.020). A correlation between IFN-γ and CD4 was weakly negative (Spearman rho, p = 0.040). The total IgE levels were estimated to be above the normal reference ranges (0-100 IU/ml) in 25.8 % of the cases in the patient group. History of allergy was found in 61.9 % of the patients. The results of this study substantiate the role of allergy in the etiopathogenesis of sudden hearing loss. We think that during the diagnostic work-up of these patients allergy should be interrogated seriously, necessary tests should be performed, and allergy should be considered in the decision-making process of the treatment of sudden hearing loss.

Microanatomic analyses of extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve.

OBJECTIVE: To investigate microanatomic organizations of the extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve. METHODS: Nerve samples were dissected in 12 postmortem autopsies, and histomorphometric analyses were conducted. RESULTS: There was no significant difference between the right and left sides of the nerve samples for the nerve area, fascicle area, number of fascicles and average number of axons. The lowest mean fascicle number was found in the hypoglossal nerve (4.9 ±â€¯1.4) while the highest was in great auricular nerve (11.4 ±â€¯6.8). The highest nerve area (3,182,788 ±â€¯838,430 µm2), fascicle area (1,573,181 ±â€¯457,331 µm2) and axon number (14,772 ±â€¯4402) were in hypoglossal nerve (p < 0.05). The number of axons per unit nerve area was higher in the facial nerve, truncus temporofacialis, truncus cervicofacialis and hypoglossal nerve, which are motor nerves, compared to the sural nerve and great auricular nerve, which are sensory nerves (p < 0.05). The number of axons per unit fascicle area was also higher in motor nerves than in sensory nerves (p < 0.05). CONCLUSION: In the present study, it was observed that each nerve contained a different number of fascicles and these fascicles were different both in size and in the number of axons they contained. All these variables could be the reason why the desired outcomes cannot always be achieved in nerve reconstruction.

Development of the sphenoid sinus from newborn to age 18: A computed tomography imaging analysis.

OBJECTIVES: The sphenoid sinus (SS) is an important anatomical formation in terms of its location and relationship with important neurovascular structures. It is essential to evaluate the pneumatization and dimensions of the SS with Computed Tomography (CT) in the preoperative period of transsphenoidal interventions to be performed on tumors located in this region. The aim of this study was to evaluate the correlation of the volume and dimensions of the SS measured with CT with age in the period from birth to 18 years of age. METHODS: In this retrospective study, a total of 360 brain, paranasal sinus, temporal bone and maxillofacial CT scans of individuals from birth to 18 years of age were evaluated. The cohort was divided into 18 groups with 20 (10 female, 10 male) patients in each age group. The height, width, length and volume values of the SS were measured on CT and their correlations with age and the differences between genders were evaluated statistically. RESULTS: It has been determined that the increases in the size and volume of the SS accelerate especially between 1 and 2 years of age and begins to reach adult dimensions after 12 years of age. Height and length of the sphenoid sinus showed a high correlation coefficient (r = 0.717 and r = 0.731 respectively) with age, while its width and volume showed a moderate correlation coefficient (r = 0.662 and 0.543 respectively). There was no statistically significant difference between the genders in terms of SS height, width, length and volume. CONCLUSIONS: SS dimensions and volume showed a logaritmic growth pattern from birth to 18 years. The results of this study may help to better understand the normal development of SS in children and may serve as a reference for more comprehensive CT studies. In addition, it can help surgeons to evaluate the developmental characteristics of SS in surgical interventions for SS in children.

The effect of genistein on cisplatin induced ototoxicity and oxidative stress.

OBJECTIVE: Cisplatin is an antineoplastic agent used in adults and children for the treatment of various malignant diseases. It can cause irreversible ototoxicity. Genistein is a phytoestrogen. Genistein functions as an antioxidant and cell cycle inhibitor by inhibiting the DNA topoisomerase and tyrosine protein kinase enzymes. The protective effect of genistein in preventing cisplatin-induced ototoxicity and levels of the oxidative stress was investigated. METHODS: 32 Sprague Dawley rats were used in 4 groups (control, cisplatin, cisplatin + genistein, genistein). Otoacoustic emission measurements of the distortion product were performed on the 1st, 2nd and 5th days of the test protocol. Serum malondialdehyde, superoxide dismutase, catalase, glutathione peroxidase, total antioxidant status, total oxidant status and oxidative stress index measurements were made. RESULTS: The hearing of the cisplatin + genistein group was found to be better than that of the cisplatin group. While the malondialdehyde, total oxidant status and oxidative stress index parameters decreased significantly in the cisplatin + genistein group compared to the cisplatin group, superoxide dismutase increased significantly (p < 0.05). CONCLUSION: Genistein showed positive effects against ototoxicity with its antioxidant effect. LEVEL OF EVIDENCE: Level 3.

Otorhinolaryngologic Evaluation of Brick Kiln Workers: ENT Findings of Brick Kiln Workers.

Brick kiln workers were evaluated in the field using otorhinolaryngologic and head and neck surgery (ENT) assessments. One-hundred and twenty laborers were assessed. The subjects were divided into three categories according to the work area: before the brick kiln, in the brick kiln, and after the brick kiln. Two evaluations were made, a questionnaire and an ENT examination. If structural changes were observed during the examination, the complication was deemed structural. Seventeen laborers who completed the questionnaire did not participate in the examination. A total of 103 laborers participated in the study: 29 before the brick kiln, 63 in the brick kiln, and 11 after the brick kiln. While general otologic complications were observed in 26 (25.2%) laborers, structural otologic complications were observed in 2 (1.9%). While general nasal complications were observed in 70 (68.0%) laborers, structural nasal complications were observed in 27 (26.2%). Although the general otologic and structural nasal complication rates were higher in the brick kiln group, the general, structural otologic, and nasal complication rates did not reach statistical significance among groups (p > 0.05). Both the general and structural nasal complication rates were significantly higher in laborers who had worked for more than 10 years and did not wear a mask (p < 0.01). We detected prominent nasal pathologies in brick kiln workers in our ENT-based study. These pathologies were much more common in laborers who had worked for over 10 years and did not wear a mask.

Histopathologic and functional effects of facial nerve following electrical stimulation.

The aim of the study is to investigate the functional and histopathologic changes in facial nerve due to the application of various violent and numerous electrical stimuli to the facial nerve. The study was carried out with Wistar rats weighing between 200 and 300 g. The facial nerves of the subjects were located and stimulated with electrical stimulator. Then five groups were created with 18 subjects in each group: Group 1, 1 milliampere (mA) electrical stimulus applied; Group 2, 2 mA electrical stimulus applied; Group 3, 3 mA electrical stimulus applied; Group 4, 4 mA electrical stimulus applied; Group 5, 5 mA electrical stimulus applied. All groups were divided into three sub-groups, each consisting of six subjects. The facial nerves of the subjects in first sub-group were stimulated 10 times, in second sub-group were stimulated 20 times and those in third sub-group were stimulated 30 times. The functions of the facial nerves were evaluated on first day, first week and first month, respectively. The facial nerves with branches were dissected from the surrounding tissues carefully. These specimens were investigated by light microscope about axonal degeneration, macrovacuolization and vascular congestion. Loss of facial functions was not observed in the subjects during follow-up process. There was no significant difference between groups regarding axonal degeneration, macrovacuolization and vascular congestion (P > 0.05). While less axonal degeneration was observed in group which was stimulated 10 times, more axonal degeneration was observed in groups which were stimulated 20 and 30 times (P < 0.05). The axonal degeneration, macrovacuolization and vascular congestion were observed more in 1-day groups (P < 0.05). Consequently, lesser violence and lesser number of electrical stimulus application to the facial nerve appears to be an important criterion for not damaging the facial nerve in patients in whom stimulators have been used.

A new classification for septal perforation and effects of treatment methods on quality of life.

INTRODUCTION: Septal perforation is a condition characterized by loss of cartilage and/or bony structures along with the mucoperichondrium and mucoperiosteum lining them. The etiology includes a history of nasal surgery or trauma, nose picking, bilateral septal cauterization, overuse of nasal sprays, cocaine abuse, vasculitis, and malignancies. OBJECTIVE: Comparison of quality of life in patients with septal perforation after conservative or surgical treatment, and a new approach for the determination of the diameter of the perforation from a different point of view. METHODS: The diameter of septal perforation, total vertical diameter of septum, and horizontal diameter of the perforation were measured in a total of 34 patients. Nineteen of the patients underwent surgical septal perforation repair, and 15 of them received septal button application. The patients were asked to complete the Glasgow Benefit Inventory quality of life questionnaire. RESULTS: The septal perforation successfully healed in 18 of 19 patients who underwent surgical treatment. The quality of life scores were statistically significantly higher in the surgical treatment group when compared to the button group (p<0.05). CONCLUSION: The septal perforation classification we propose would be beneficial for providing realistic dimensions, treatment methods, and surgical techniques.

Impact of Hard Palate Angulation Caused by Septal Deviation on Maxillary Sinus Volume.

OBJECTIVE: To investigate the effect of hard palate angulation caused by septal deviation on the volume of the maxillary sinus. METHODS: Coronal computed tomographic (CT) scans of 1568 patients aged from 18 to 60 were examined. CT scans of 402 patients were included in the study. On these scans, the maxillary sinus volume, the angle of the nasal septal deviation, and the angulation of the hard palate were calculated using the ImageJ software. Each maxillary sinus volume was statistically compared with each other and with those in the control group. Correlations between palatal angulation and septal deviation were determined. RESULTS: Deviated nasal septum whether with or without deflection of the hard palate was noted to have caused changes in the volume of the maxillary sinus in both female and male patients. The volume of the maxillary sinus on the deviated side was less than that of the opposite side, and the differences between the volumes of both sinuses were statistically significant (p<0.05). No significant differences were noted when compared with the control group. A positive correlation was observed between the nasal septal deviation angle and the angulation of the hard palate. CONCLUSION: Regardless of whether or not it affects the hard palate, nasal septal deviation reduces the volume of the maxillary sinus on the deviated side but does not affect the total volume of the maxillary sinuses. Significant differences between the volumes on the two sides can lead to facial asymmetry.

Microanatomic analyses of extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve

Abstract Objective: To investigate microanatomic organizations of the extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve. Methods: Nerve samples were dissected in 12 postmortem autopsies, and histomorphometric analyses were conducted. Results: There was no significant difference between the right and left sides of the nerve samples for the nerve area, fascicle area, number of fascicles and average number of axons. The lowest mean fascicle number was found in the hypoglossal nerve (4.9 ± 1.4) while the highest was in great auricular nerve (11.4 ± 6.8). The highest nerve area (3,182,788 ± 838,430 μm2), fascicle area (1,573,181 ± 457,331 μm2) and axon number (14,772 ± 4402) were in hypoglossal nerve (p < 0.05). The number of axons per unit nerve area was higher in the facial nerve, truncus temporofacialis, truncus cervicofacialis and hypoglossal nerve, which are motor nerves, compared to the sural nerve and great auricular nerve, which are sensory nerves (p < 0.05). The number of axons per unit fascicle area was also higher in motor nerves than in sensory nerves (p < 0.05). Conclusion: In the present study, it was observed that each nerve contained a different number of fascicles and these fascicles were different both in size and in the number of axons they contained. All these variables could be the reason why the desired outcomes cannot always be achieved in nerve reconstruction.

The effect of genistein on cisplatin induced ototoxicity and oxidative stress / Efeito da genisteína na ototoxicidade induzida pela cisplatina e estresse oxidativo

Abstract Highlights Cisplatin is an antineoplastic agent used malignant diseases. Cisplatin ototoxicity is generally bilateral, irreversible, and progressive. Genistein is a phytoestrogen. Genistein functions as antioxidant and cell cycle inhibitor by inhibiting DNA topoisomerase. Genistein showed positive effects on ototoxicity with its antioxidant. Objective Cisplatin is an antineoplastic agent used in adults and children for the treatment of various malignant diseases. It can cause irreversible ototoxicity. Genistein is a phytoestrogen. Genistein functions as an antioxidant and cell cycle inhibitor by inhibiting the DNA topoisomerase and tyrosine protein kinase enzymes. The protective effect of genistein in preventing cisplatin-induced ototoxicity and levels of the oxidative stress was investigated. Methods 32 Sprague Dawley rats were used in 4 groups (control, cisplatin, cisplatin + genistein, genistein). Otoacoustic emission measurements of the distortion product were performed on the 1st, 2nd and 5th days of the test protocol. Serum malondialdehyde, superoxide dismutase, catalase, glutathione peroxidase, total antioxidant status, total oxidant status and oxidative stress index measurements were made. Results The hearing of the cisplatin + genistein group was found to be better than that of the cisplatin group. While the malondialdehyde, total oxidant status and oxidative stress index parameters decreased significantly in the cisplatin + genistein group compared to the cisplatin group, superoxide dismutase increased significantly (p < 0.05). Conclusion Genistein showed positive effects against ototoxicity with its antioxidant effect. Level of evidence Level 3.

Resumo DESTAQUES A cisplatina é um agente antineoplásico usado em lesões malignas. A ototoxicidade da cisplatina é geralmente bilateral, irreversível e progressiva. A genisteína é um fitoestrógeno. A genisteína funciona como antioxidante e inibidor do ciclo celular ao inibir a topoisomerase do DNA. A genisteína apresentou efeitos positivos sobre a ototoxicidade com seu efeito antioxidante. Objetivo A cisplatina é um agente antineoplásico usado em adultos e crianças para o tratamento de diversas lesões malignas. Pode causar ototoxicidade irreversível. A genisteína é um fitoestrógeno que funciona como antioxidante e inibidor do ciclo celular ao inibir as enzimas DNA topoisomerase e tirosina-quinase. O efeito protetor da genisteína na prevenção da ototoxicidade induzida pela cisplatina e os níveis de estresse oxidativo foram investigados. Método Trinta e dois ratos Sprague Dawley foram usados em 4 grupos (controle, cisplatina, cisplatina + genisteína, genisteína). As medidas das emissões otoacústicas por produto de distorção foram tomadas nos dias 1, 2 e 5 do protocolo do teste. Foram medidos os níveis séricos de malondialdeído, superóxido dismutase, catalase, glutationa peroxidase, estado antioxidante total, estado oxidante total e índice de estresse oxidativo. Resultados A audição do grupo cisplatina + genisteína foi melhor do que a do grupo cisplatina. Enquanto os parâmetros malondialdeído, estado oxidante total e índice de estresse oxidativo diminuíram significantemente no grupo cisplatina + genisteína em comparação com o grupo cisplatina, o superóxido dismutase mostrou aumento significantemente (p < 0,05). Conclusão A genisteína apresentou efeitos positivos contra a ototoxicidade com seu efeito antioxidante. Nível de evidência Nível 3.

Hereditary angioedema type 2 presented as an orbital complication of acute rhinosinusitis.

Hereditary angioedema is an autosomal dominant and life-threatening disorder characterized by recurrent episodes of non-pitting edema affecting the skin, respiratory system and digestive tracts and caused by a congenital deficiency or function defect of the C1 esterase inhibitor. Preseptal cellulitis is defined as an infection of the tissues of the anterior orbital septum. It is generally caused by complications from an upper respiratory tract infection, dacryocystitis, dermal infection, and, rarely, sinusitis. The disease presents with orbital pain, edema on the eyelids, erythema, and fever. In this case, a child with hereditary angioedema type 2 who presented as mimicking a complication of acute sinusitis is discussed.

Post-radiotherapy bilateral external auditory canal cholesteatoma.

In this article, we report a 55-year-old female case was treated with radiotherapy due to nasopharynx carcinoma and diagnosed with bilateral external auditory canal cholesteatoma four years after radiotherapy. Persistent otorrhea was present in the patient and the diagnosis was established through noticing a soft tissue mass eroding external auditory canal anterior wall in temporal bone tomography as well as the otoscopic findings. Canaloplasty and cholesteatoma excision were administered as the surgical treatment.