Effect of Suturation Plus Surgicel Application on Post-Tonsillectomy Bleeding and Pain.

OBJECTIVE: The aim of this study was to evaluate the effect of suturation (tonsillary fossa closure) plus Surgicel application on postoperative bleeding and pain after tonsillectomies performed using a classical dissection method. STUDY DESIGN: A prospective, randomized, double-blind, clinical trial was performed on 760 patients undergoing tonsillectomy or adenotonsillectomy during a 5-year period. METHODS: After excluding patients with hemorrhagic disorder, chronic disease, and peritonsillar abscess, both tonsils were removed via classic dissection technique (cold knife or blunt dissection) and then electrocauterized for hemostasis. The tonsillar fossa randomly assigned to the treatment protocol (Group 1) was closed by sutures, following Surgicel application. The other side was unaltered and acted as the control (Group 2). Pain was evaluated every day for 10 days postoperatively, and bleeding was reported at any time. RESULTS: A total of 760 patients (393 males, 367 females) between the ages of 4 and 35 years (mean age 13.46 ±â€Š7.98) were included in the study. Bleeding was observed in 31 patients: 8 from Group 1; and 23 from Group 2 (95% confidence interval [CI], P < 0.05). The average pain score was greater in Group 1 than in Group 2 on each postoperative day (95% CI, P < 0.05). CONCLUSION: Suturation plus Surgicel application increased pain levels while decreasing bleeding incidence during the postoperative period.

Values Range of Tympanometric Gradient in Otitis Media With Effusion.

INTRODUCTION: The aim of this study was to establish how reliable a given tympanogram is in predicting the presence or absence of a middle ear effusion, and to provide new views for the diagnostic information of tympanometry. The use of tympanometric gradient in addition to static admittance is the focus of this study. MATERIALS AND METHODS: The authors enrolled 146 female and 129 male patients. The participants were allocated into groups as follow: Group A1 consisted of 50 healthy children. Group A2 consisted of 86 children with otitis media with effusion. Group B1 consisted of 85 healthy adults. Group B2 consisted of 54 adults with otitis media with effusion. All diagnostic otoscopic examination and tympanometry were performed in both ears. The authors analyzed the distribution of tympanograms in patients with otitis media with effusion and healthy controls. RESULTS: When the right and left ear canal volume of either children or adults with otitis media with effusion compared with healthy controls, no statistically significant different was observed (P > 0.05). On the other hand, the statistically significant difference was detected for the values of compliance, pressure and gradient of either children or adults with otitis media with effusion compared with healthy controls (P < 0.05). CONCLUSION: The authors found the values range from 0.01 to 1.52 mL gradients (mean least value 0.15 mL) in adults and the values range from 0.01 to 0.93 mL gradients (mean least value 0.10 mL) in children in the presence of otitis media with effusion. The authors think that tympanometric gradient may be useful to detect the otitis media with effusion.

Effects of Anatolian Propolis and Hypertonic Saline Combination Nasal Spray on Allergic Rhinitis Symptoms: A Prospective, Multicenter Study.

Objectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P < .001). The mean total symptom score fell following treatment (P < .001): whilst the score was 11.09 ± 3.41 before administering Rhinapi; after administration, the average score was 6.23 ± 2.41. The mean QoL scores also altered after medication (P < .001), improving from a mean value of 6.44 ± 1.55 to a mean of 7.31 ± 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments.

How do different climatic conditions affect the quality of life of patients following septoplasty or septorhinoplasty?

OBJECTIVES: The effects of different climatic conditions on the quality of life (QoL) of patients following septoplasty or septorhinoplasty were investigated. METHODS: A total of 89 patients (47 males and 42 females) underwent either septoplasty or septorhinoplasty during the summer (summer group, n = 42) or winter (winter group, n = 47) season. To assess QoL, SinoNasal Outcome Test (SNOT)-22, Nasal Obstruction Symptom Evaluation (NOSE) scale, and Visual Analogue Scale were used. Postoperative (PO) pain, bleeding, and symptoms related to nasal packing (eating and sleep problems) were also evaluated. RESULTS: PO pain scores were lower in the winter group than that in the summer group (p<0.05). After pack removal, there was a slight serohemorrhagic nasal discharge in 2.1% of the patients in the winter group, but no patient required intervention. Slight leakage was detected in 47.6% of the patients and 2.4% of the patients called for intervention (p<0.05) in the summer group. The SNOT-22 values did not differ between the groups (p>0.05). NOSE scores in the winter group were higher than that in the summer group (p<0.05). In each group, SNOT-22 (padjusted<0.175) and NOSE scores (p<0.05) were lower at 1 month after surgery. The winter group patients rated headache, facial pain, and nasal crusting higher than those in the summer group did (p<0.05). However, nasal discharge and loss of smell were less troubling in the summer group than that in the winter group (p<0.05). CONCLUSION: Regardless of climate or season, septoplasty or septorhinoplasty increases patients' QoL. However, problematic PO bleeding was detected at a higher frequency in patients who underwent surgery in summer. The advantage of surgery in winter is that it leads to less frequent problematic bleeding PO.

The effects of dexamethasone, bupivacaine and topical lidocaine spray on pain after tonsillectomy.

OBJECTIVE: To compare the administration of bupivacaine hydrochloride, dexamethasone and lidocaine hydrochloride in decreasing post-tonsillectomy pain. METHODS: Eighty patients were enrolled in the study in ENT Clinic, Firat University, and in ENT Clinic Elazig SSK Hospital, Elazig (Turkey). Children between 6 and 14 years of age referred to our department for bilateral tonsillectomy for either recurrent tonsillitis or tonsillar hypertrophy. Data from 80 patients were analyzed. The first group had bupivacaine hydrochloride. The second group had dexamethasone infiltrated around each tonsil. The third group was given equal doses of 10% lidocain hydrochloride sprayed on the tonsillectomy fossa four times a day, and a placebo group received 9% NaCl applied to the tonsillar fossa four times a day. Pain scores, determined by visual analog scale, were obtained in the first, third and seventh postoperative days. RESULTS: Pain scores in the postoperative period were identical in the first, third and seventh postoperative days. According to VAS results the groups were compared on the basis of postoperative pain. In the first postoperative day, the difference between bupivacaine-placebo, dexamethasone-placebo and lidocaine-placebo groups was found to be statistically significant (P<0.05). Nevertheless the difference between bupivacaine-dexamethasone, bupivacaine-lidocaine and dexamethasone-lidocaine were not significant (P>0.05). In the third postoperative day, the difference between bupivacaine and lidocaine group found to be statistically significant (P<0.05). In the seventh post-operative day the results of bupivacaine, dexamethasone, lidocaine and placebo groups were similar (P>0.05). CONCLUSION: Bupivacaine, Dexamethasone and Lidocaine nasal aerosol decreased the pain significantly in the first postoperative day when it was compared with the placebo group. These three medicines can be used to reduce pain for children during the postoperative period applied tonsillectomy during the post-operative period. But lidocaine was more preferable, reducing pain in the third postop day better than bupivacaine.

The role of free oxygen radicals in noise induced hearing loss: effects of melatonin and methylprednisolone.

The aim of this study was to investigate the role of cochlear damage caused by free oxygen radicals occurring as a result of exposure to noise and to determine the prophylactic effects of melatonin and methylprednisolone. Fifty male albino guinea pigs were randomly divided into five groups. All groups were exposed to 60 h of continuous wide band noise at 100+/-2 dB, except group I. Group I was not exposed to noise or treated with drugs. Group II was exposed to noise and not treated with drugs. Group III was exposed to noise and treated with melatonin. Group IV was exposed to noise and treated with methylprednisolone. Group V was exposed to noise and treated with melatonin and methylprednisolone. A high dose of 40 mg/kg methylprednisolone and/or 20 mg/kg melatonin were administered intramuscularly 24 h before exposure to noise, immediately before noise exposure and once a day until noise exposure was completed. Just after the noise ended, guinea pigs were decapitated. Venous blood was obtained into tubes with EDTA and it was used to measure activity levels of plasma malondialdehyde, erythrocyte glutathione peroxidase and the cochlear tissue malondialdehyde. After the noise ended, in comparison group II with I; it was found that the malondialdehyde activity of the plasma and tissue had increased, the erythrocyte glutathione peroxidase activity levels had decreased and consequently, hearing thresholds had increased (P<0.01). A significant difference was found in the malondialdehyde and erythrocyte glutathione peroxidase activity levels between groups II and III (P<0.01) and the hearing thresholds exhibited a parallel trend (P<0.05). The hearing threshold and malondialdehyde activity levels obtained from groups IV and V were found to be similar to those of group II (P>0.05). As a conclusion, we suggest that the use of methlyprednisolone in order to prevent the cochlear damage caused by noise does not provide sufficient prophylaxy, however the use of melatonin provides a more effective prophylaxy, thus being a promising alternative.

[The effect of lidocaine HCL aerosol on postoperative pain in tonsillectomy patients]. / Tonsillektomi yapilan hastalarda lidokain HCl spreyin ameliyat sonrasi agri üzerine etkisi.

OBJECTIVES: We evaluated the efficacy of lidocaine hydrochloride aerosol on postoperative pain relief in patients undergoing tonsillectomy. PATIENTS AND METHODS: The study included 60 patients (25 females, 35 males; mean age 25.43 years; range 16 to 35 years) undergoing tonsillectomy. The procedure was performed by the same surgeons under local anesthesia. The patients were randomly divided into two groups to receive either lidocaine HCl (n = 30) or NaCl (n = 30). A total of 4 mg/kg of 10% lidocaine HCl aerosol and 2 ml of 0.9% NaCl were applied to the tonsillectomy fossa eight times daily, respectively. Evaluation of pain was made on the first, third, and seventh postoperative days using a visual analogue scale. RESULTS: Significant differences were found between the groups on the first, third, and seventh postoperative days (p < 0.05). In each group, patient's evaluation of pain differed significantly (p < 0.05). The significance levels were higher for lidocaine on the first and third days. CONCLUSION: Our results suggest that lidocaine HCl aerosol exerts a therapeutic effect on postoperative pain control in tonsillectomy patients.

[The effect of vitamin E on histopathologic healing and lipid peroxidation levels in experimentally induced traumatic tympanic membrane perforations]. / Travmatik timpanik membran perforasyonlarinda E vitamininin histopatolojik iyilesme ve lipid peroksidasyon düzeyleri üzerine etkileri: Deneysel çalisma.

OBJECTIVES: To examine the favorable effects of vitamin E on tympanic membrane perforations induced mechanically in guinea pigs. STUDY DESIGN: Bilateral tympanic membrane perforations of 1.8 mm were induced in 40 guinea pigs. The animals were randomly divided into two groups equal in number. One group remained untreated, while the other was administered vitamin E (100 mg/kg/day) through intramuscular injections. On days 1, 3, 5, and 7, five animals in each group were randomly sacrificed. Histopathologic changes in the tympanic membranes were evaluated and malondialdehyde levels were determined. RESULTS: Significant increases were observed in epithelial thickness, fibroblastic proliferation, and neovascularization in the study group (p<0.05). Epithelial thickness was found to be increased in both groups beginning from the first day; however, this increase was more rapid in the study group. Although malondialdehyde levels showed significant increases on days 3 and 5 in both groups (p<0.05), they returned to the first day values in vitamin E-treated animals on day 7, whereas controls still maintained high malondialdehyde levels. CONCLUSION: Vitamin E hastens the healing process of traumatic tympanic membrane perforations.