Comparative Analysis of the Healing Effects of the Transplanted Cell Sheets to the Experimentally Injured Maxillary Sinuses.

BACKGROUND: In our study, the authors aimed to obtain a live and functional sinus epithelium with mesenchymal stem cells and nasal mucosa epithelial cells from rabbits which are cultured in temperature-responsive culture plates to get a single-layer. METHODOLOGY/PRINCIPAL: Twenty-two female New Zealand rabbits were included in the study. Two of them were used to obtain mesenchymal stem cells. A total of 40 maxillary sinuses were randomly divided into 5 groups: 1) control group which is used to investigate normal rabbit maxillary mucosa, 2) secondary healing group, 3) mesenchymal stem cell graft group, 4) differentiated mesenchymal stem cell group, and 5) nasal mucosal graft group. The animals were sacrificed at the 28th day after the surgery.Scanning electron microscopy, transmission electron microscopy, and immunohistochemical investigations were performed. RESULTS: With these investigations, it was shown that; all graft groups were histologically better than secondary healing group and when the authors compared the graft groups, differentiated mesenchymal stem cell group were the best. CONCLUSION: Our study results showed that endoscopic sinus surgery and treatment with cell sheets, which were generated in temperature-responsive culture dishes, had more functional respiratory epithelium.

Prophylactic etanercept treatment in cisplatin ototoxicity.

The aim of our study was to evaluate the audiological protective effects of etanercept using distortion product otoacoustic emission (DPOAE) in rats with hearing loss due to cisplatin ototoxicity. The study began with 36 healthy female albino rats; 31 rats had good measurements in DPOAE and were included in the study. On day 0, a single dose of etanercept was given by intraperitoneal administration to 15 rats (etanercept group). No medication was given to the control group. After 24 h, 16 mg/kg cisplatin was given to all rats. DPOAE measurements were performed on the 3rd, 7th, and 21st day. After the DPOAE test on the 21st day, the animals were killed by decapitation. Between-group and intra-group comparisons were made using the data of the two groups. A statistically significant difference was observed on the 3rd day at 4921 Hz and higher frequencies, on the 7th day at 6064 Hz and higher frequencies, and on the 21st day at 6494 Hz and higher frequencies (p < 0.05). We observed 10% ototoxicity in the etanercept group and 56% ototoxicity in the control group. A single dose of etanercept 1 day before cisplatin administration decreases cisplatin ototoxicity in the early period. This effect comes to the fore especially over 4500 Hz frequencies at 65 dB and higher.

Comparing audiological test results obtained from a sound processor attached to a Softband with direct and magnetic passive bone conduction hearing implant systems.

The aim of this study was to compare audiological test results obtained from a sound processor (SP) attached to a Softband with those obtained from direct (abutment connection) bone conduction implant systems and magnetic passive bone conduction implant systems with different magnet strengths on patients implanted at our clinic. Twenty-four patients who were implanted with either an abutment or magnetic bone conduction implant system between January 2012 and December 2014 were analyzed for hearing results, such as free-field hearing thresholds, direct bone conduction hearing thresholds, and speech discrimination scores with aided and unaided conditions Both magnetic and direct osseointegrated bone conduction implant systems, as well as the Softband system, provide good hearing outcomes when compared with unaided performance; however, the abutment connection system gives better hearing thresholds in the higher frequencies. No significant difference in hearing gain was found between the Softband system, magnet 5, and magnet used by the patient. Magnetic and direct bone conduction hearing implant systems are both effective for rehabilitation of conductive and mixed hearing loss when conventional hearing aids cannot be used. However, patients with high-frequency hearing loss may be better suited to an abutment connection system if they are not satisfied with high-frequency hearing gains provided via the trial Softband system preoperatively and should be counseled accordingly.

A Simple Closure Technic for Tracheoesophageal Puncture Failures.

Tracheosephageal puncture is the one of the most favorable methods, and widely used by physicians for voice reconstruction after total laryngectomy. Intractable leakages from the tracheosephageal punctures are the most common complication, and management of these fistulas is still troublesome for the patients and physicians. Local surgical sutures, rotational flaps, injections are reported previously, but in this report the authors aimed to mention on a very simple method with silicone septal button. Insertion of a temporary silicone septal button may be well tolerated by patients and can help to manage this complication easily on exact indications. The authors discussed indications and long-term results of this method with different patients.

The effect of memantine on functional recovery of the facial nerve after crush injury.

The objective of this study is to establish whether memantine is an alternative and effective treatment on facial nerve recovery after crush injury, and also to analyze the effective doses of this promising agent. This is a randomized controlled animal study. 40 rats underwent crush injury to left main trunk of the facial nerve, and divided into 4 groups; (1) control (saline treated), (2) 5-mg/kg memantine, (3) 10-mg/kg memantine, and (4) 20-mg/kg memantine group. Facial nerve functions were evaluated by eye reflex, and whisker movement compared to the unaffected side. They were scored on a 3-point scale. On day 28, the rats were sacrificed, and the facial nerves were dissected. The paraffin sections were studied with caspase-3 immunostaining. According to statistical data, the recovery in Group 4 began significantly earlier than the other groups on the basis of restoring eye blink reflexes and whisker movement. Groups 2 and 3 showed faster recovery than Group 1 on the basis of whisker movement. The caspase-3 positive staining was rarely detected in all groups. The Kruskal­Wallis test revealed that Group 4 showed fewer apoptotic cells than other groups; this was statistically significant. However, the Mann­Whitney U test with the Bonferroni correction did not reveal any significant difference between the groups. In conclusion, this study revealed that memantine acted to restore facial nerve functions, and accelerate recovery after facial nerve injury by inhibiting apoptosis.

[Bilateral inverted papilloma originating from the frontal sinus]. / Iki tarafli frontal sinüs kaynakli inverted papillom.

Inverted papilloma is a benign neoplasm characterized by its high rate of recurrence, local aggressiveness, and malignancy potential. Nasal obstruction is the most frequent presenting complaint. Bilateral inverted papillom involving both sides of the frontal sinus is extremely rare. Herein, we present a 64-year-old male case with a bilateral inverted papilloma involving the frontal sinus which was removed by an endoscopic surgery.

A new transcutaneous bone anchored hearing device - the Baha® Attract System: the first experience in Turkey.

OBJECTIVES: In this study, we reported our experience with a new transcutaneous bone conduction hearing device, the Baha® Attract System. PATIENTS AND METHODS: This multi-center clinical study included the first 12 patients (8 females, 4 males; mean age 27.6 years; range 5 to 65 years) in whom a new transcutaneous bone conduction system was implanted in Turkey. RESULTS: The mean air-bone gap was 41 dB. Bone smoothing around the implant was needed in five patients. We placed a sound processor in the fourth postoperative week for all patients. CONCLUSION: Our study results suggest that the new bone conduction implant is promising for the patients with conductive or mixed hearing loss who are unable to wear conventional air conduction hearing aid and comparable to percutaneous systems.

[Evaluation of efficacy of otosclerosis surgery on hearing outcomes]. / Otoskleroz cerrahisinin isitme sonuçlari üzerine etkinliginin degerlendirilmesi.

OBJECTIVES: In this study we aimed to evaluate the audiologic results and audiologic success rates following otosclerosis surgery and to discuss surgical complications and their management. PATIENTS AND METHODS: We retrospectively analyzed 115 ears of 100 patients who were diagnosed with clinical otosclerosis and operated at Kocaeli University, Faculty of Medicine, Department of Otolaryngology between May 2002 and April 2013. Postoperative air-bone gap was used in the evaluation of the success of the hearing results. The postoperative air-bone gap less than 20 dB was accepted as a success criterion. Intraoperative and postoperative complications were recorded. RESULTS: Functional success was achieved in 105 of 115 operated ears (91.3%). Functional success rates according to types of piston for 0.6 mm wire Teflon piston (n=71), fluoroplastic Teflon piston (n=30), K piston (n=12) and Easy piston (n=2) groups were, 88.7%, 93.3%, 100%, and 100% respectively. Six patients (5.2%) underwent revision surgery. CONCLUSION: Our study results suggest that stapes surgery is a successful and safe treatment modality with high success and low complication rates in the management of otosclerosis.

Possible protective effect of sertraline against cisplatin-induced ototoxicity: an experimental study.

BACKGROUND/OBJECTIVE: Cisplatin is a widely used chemotherapeutic agent, but its ototoxicity side effect can occur in the majority of patients. Lots of agents were tried to prevent this, but there is not a routine treatment modality yet. The aim of this study was to evaluate the otoprotective effect of sertraline, which is an antidepressant with neuroprotective effects, against cisplatin, in rats. DESIGN: Experimental animal study. MATERIAL AND METHODS: Forty-eight rats were randomly separated in two groups as groups I and II. Group I was identified as the control group and only a single dose of intraperitoneal cisplatin was administered. In group II, in addition to cisplatin, sertraline was administered to the rats through an oral cannula for ten-day period. Distortion product otoacoustic emission measurements were performed at the first day and the 10th day. RESULTS: When the ototoxicity rates after cisplatin in group I and group II in distortion product otoacoustic emission measurements were compared, it was statistically significantly lower in group II in frequencies of 5652, 6165, 6726, 7336, and 7996 Hz (P < 0.05). CONCLUSION: Sertraline seems to have a protective effect on cisplatin ototoxicity and could be used to prevent the ototoxicity and also to treat the depression that occurred in cancer patients together.

[Endoscopic management of cerebrospinal fluid fistulas and clinic outcomes]. / Beyin omurilik sivisi fistüllerine endoskopik yaklasim ve klinik sonuçlari

OBJECTIVES: This study aims to evaluate the efficacy of endoscopic repair of cerebrospinal fluid (CSF) fistulas. PATIENTS AND METHODS: Between January 2005 and December 2012, 10 patients (7 females, 3 males; mean age 36.1 years; range 1 to 52 years) who were diagnosed with CSF fistulas in Kocaeli University, Faculty of Medicine, Ear Nose and Throat Clinic were retrospectively analyzed. Complaints of the patients on admission and the characteristics of CSF fistulas (etiology, location, and stage) were recorded. Treatment modalities based on the characteristics of CSF fistulas and treatment outcomes were analyzed. RESULTS: The etiology of the fistula was encephalocele in six, iatrogenic trauma following functional endoscopic sinus surgery (FESS) in three, and spontaneous CSF rhinorrhea in one patient. The mean follow-up was 32.4 months (range, 12 to 84 months) postoperatively. None of the patients had recurrent disease. CONCLUSION: The endoscopic surgery is an effective modality with low morbidity and high success rate in the management of CSF fistulas.

Expansion to the Motion Sickness Susceptibility Questionnaire-Short Form: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: The primary objective of this study is to investigate the necessity of questioning virtual reality systems in the motion sickness susceptibility questionnaire (MSSQ)-short form. The secondary objective of this study is to determine the validity and reliability of the Turkish version of the MSSQ-short form, with proven validity and reliability. SUBJECTS AND METHODS: In the questionnaire form, for which expert opinion was obtained to maintain linguistic equivalence, the virtual reality items were added to the questionnaire. The questionnaire was then administered to 297 individuals. The results were statistically analyzed with and without these virtual reality items for validity and reliability. RESULTS: After the addition of the virtual reality items, the reliability of the questionnaire was found to be quite high (Cronbach's alpha r=0.912). The norm values between the original MSSQ-short form (12.9±9.9) and the Turkish MSSQ-short form (13.8±12.9) were found to be consistent. CONCLUSIONS: Motion sickness symptoms can occur not only during movement, but also with indirect stimulus. Our findings suggest that adding virtual reality items to the original form is important in long term practical applications. Our results show that the Turkish version of the original questionnaire is quite reliable. Submission of the MSSQ-short form in Turkish will be useful for documentation and will also encourage further research in this area.

Doppler ultrasonography can be useful to determine the etiology of idiopathic sudden sensorineural hearing loss.

OBJECTIVE: This study aims to evaluate clinical features of both carotid and vertebral arteries in the idiopathic sudden sensorineural hearing loss (ISSNHL) patients and healthy individuals to contribute additional knowledge on vascular compromise theory. METHODS: This study was designed as a retrospective case control study in a tertiary referral center. 55 patients for ISSNHL and 35 healthy participants (70 ears) are involved to the study. All of the patients were evaluated for the systemic disorders and excluded other possible causes (autoimmune diseases, acoustic schwannoma, drug toxicity, etc) of ISSNHL. The carotid and vertebral arteries were assessed with Doppler USG; in fact, the vascular diameter (VD), intima media thickness (IMT), peak systolic velocity (PSV), blood flow (BF) and resistive index (RI) were evaluated. Related parameters were compared with the control groups. RESULTS: In carotid artery system; common carotid artery intima-media thickness (CC-IMT) (p<0.001), and internal carotid artery intima-media thickness (IC-IMT) (p<0.001) were found significantly increased. Otherwise; PSV, VD and BF were not differed significantly. In vertebral artery system; VD (<0.001), PSV (<0.002) and BF (<0.001) were decreased significantly but vertebral artery RI was statistically increased (<0.001). CONCLUSION: In our study, we found the carotid artery thickening on vascular wall. We also demonstrate the vascular compromise on vertebral arteries. The Doppler USG may lead to determine the etiology of ISSNHL and further investigations are needed to define the exact results. LEVEL OF EVIDENCE: III b.

A Comparison Study of Partial Ossicular Reconstruction Prosthesis (PORP) Placement under the Malleus or Tympanic Membrane Graft in the Presence of the Malleus.

OBJECTIVE: The aim of this study was to compare the hearing results of embedding the partial ossicular reconstruction prosthesis (PORP) underneath the malleus with the malleus relocation technique and tympanic membrane graft in the presence of the malleus. MATERIALS AND METHODS: A retrospective review of patient charts and audiometric results in a tertiary referral center was conducted. In total, 83 patients who underwent intact canal tympanoplasty with mastoidectomy between 2010 and 2015 were included and divided into two different groups: malleus assembly to the stapes head (MASH) and tympanic membrane assembly to the stapes head (TASH). Pre- and postoperative audiometric results were assessed. The air-bone gap (ABG) and hearing gains were evaluated according to the groups. RESULTS: In MASH, 86.1% (n=31) of the patients were received successful surgery and the postoperative average ABG was 10.41 dB. In TASH, 82.9% (n=39) of the patients were considered successful and the postoperative ABG was 13.27 dB. According to the overall data, MASH was more statistically successful than TASH, and hearing gains at 500 Hz (p<0.036), 2000 Hz (p<0.031), and PTA (p<0.22) were statistically significant better in the MASH group. CONCLUSION: Malleus relocation is a successful technique with the presence of the malleus and provides better hearing outcomes than direct placement under the tympanomeatal flap. Both malleus- and tympanomeatal flap-linked groups were successful, but the malleus-linked group showed better ABGs.

The Healing Effects of Autologous Mucosal Grafts in Experimentally Injured Rabbit Maxillary Sinuses.

OBJECTIVES: Healing processes of the nose and paranasal sinuses are quite complex, and poorly understood. In this study, we aimed to compare the effect of mucosal autologous grafts on the degenerated rabbit maxillary sinus mucosa with spontaneous wound healing. It is hypothesized that mucosal grafts will enhance ciliogenesis and improve the morphology of regenerated cilia. METHODS: Ten female New Zealand rabbits were included in the study. They underwent external maxillary sinus surgery through a transcutaneous approach. A total of 20 maxillary sinuses were randomly divided into 2 groups: 'spontaneous healing group' and 'autologous graft group.' The animals were sacrificed at the 14th day after the surgery. Scanning electron microscope (SEM), and light microscope were used for the evaluation. RESULTS: Cellular composition of the graft group is better than the spontaneous healing group. The graft group had larger areas covered with ciliary epithelium than the spontaneous healing group, and the mean length of the cilias were also longer. Additionally, there were wider cilia with abnormal morphology areas in the spontaneous healing group. CONCLUSION: In our opinion, covering of the denuded areas with a graft improves re-epithelization, and may prevent the early complications after sinus surgeries.

Laryngeal verruca vulgaris.

Laryngeal verruca vulgaris is a rare disease of the larynx that is easily misdiagnosed as other laryngeal lesions. This article reports three patients with laryngeal verruca vulgaris and discusses the differential diagnosis of laryngeal verrucous lesions to avoid over treatment.

Paranasal sinus mucoceles: our clinical experiments.

OBJECTIVES: We present the clinical and radiological features, treatment protocols, and medium-long-term results of our patients following surgery for paranasal sinus mucocele, along with a review of the relevant literature. MATERIALS AND METHODS: A total of 18 patients (11 women and 7 men) who underwent surgery for paranasal sinus mucocele at Kocaeli University Faculty of Medicine, Department of Otolaryngology, between 2006 and 2013 were examined retrospectively. The mean patient age was 41 (range 4-73). Demographic and radiological features, symptoms, treatment protocols, and postoperative outcomes were recorded. RESULTS: The most frequently affected sinus was the maxillary sinus (n=9, 50%) followed by the frontal sinus (n=6, 33%) and sphenoidal sinus (n=3, 16%). The main symptom was headache. Endoscopic marsupialization of the mucocele was applied in all 18 patients, while frontal sinus exploration with the osteoplastic flap procedure was performed in one patient and the Caldwell-Luc operation was performed in another patient. The Caldwell-Luc procedure was subsequently required in one patient (6%) and endoscopic revision surgery was required in another patient (6%). CONCLUSION: Sinus mucocele that enlarges, eroding the surrounding bone tissue, and induces various clinical symptoms due to the impression of the expansile mass, is treated surgically, and must be planned carefully to prevent serious complications.