Can CK-MB be used as a marker in benign paroxysmal positional vertigo attack?

OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the main causes of vertigo. More than 90% of cases of positional vertigo and nystagmus can be associated with BPPV. There is no known specific laboratory test for BPPV. Because of the possible muscle activity in BPPV (especially result of nause, vomiting and increasing heart rate) we thought the CK-MB levels may change in this situation. The purpose of this study was to investigate the relation between serum CK-MB levels and BPPV and attacks. MATERIALS AND METHODS: The medical records of 35 patients with BPPV presenting to our clinic between November 2014 and November 2015 were investigated retrospectively. Thirty-two control patients with no vertigo, muscular or cardiac disease and with measured CK-MB levels were randomized into a control group. Both groups' existing CK-MB levels were obtained from the patient records. CK-MB values measured before BPPV attack from 11 patients in the patient group were also recorded. RESULTS: The patient and control groups were similar in terms of demographic parameters. CK-MB values at time of attack in the patient group ranged between 5.4 and 38.9 (mean: 19.67 ± 6.81), while control group values ranged between 12 and 27.9 (mean: 20.31 ± 4.54). CK-MB values in 11 patients in the patient group measured before attack ranged between 8.9 and 24 (mean: 17.02 ± 4.97), and CK-MB values during attack ranged between 9 and 34 (mean: 19.74 ± 7.64). CONCLUSION: Although CK-MB elevation at time of attack was determined in patients with BPPV, this was not statistically significant.

Evaluation of the anatomical and auditory outcomes of minimally invasive cartilage myringoplasty: Our technique and experience.

The purpose of this study was to assess closure rates in tympanic membrane perforations of various dimensions using the tragal cartilage-perichondrium composite graft and its effect on hearing values and also to present our own experiences. MATERIALS AND METHODS: Sixty-one patients presenting to our clinic in 2014-2015 and diagnosed with tympanic membrane perforation were included in the study. Otomicroscopic and otoendoscopic examinations were performed preoperatively and at the 12th month postoperatively. Patients were divided into three groups depending on perforation diameter. Pure tone audiometry was performed at 500, 1000, 2000, and 4000Hz (Hz) preoperatively and at the 12th month postoperatively, air-bone values were recorded, and air-bone gap (ABG) was calculated. Surgery was performed under local anesthesia using the transcanal, push-through (transperforation) technique. Perichondrium supported by thinned cartilage graft obtained from the tragal cartilage was used for tympanic membrane repair. RESULTS: Graft acceptance levels after 12months in small, medium, and large perforations were 100%, 93.5%, and 93.75%, respectively, and 95% on average. Preoperative air-bone gap values were 18.64±9.63 decibel (dB), 22.51±9.66dB, and 28.43±11.36dB, respectively, and 23.18±11.36dB on average, while 12th month postoperative air-bone gap values were 9.14±8.27dB, 11.25±6.73dB, and 17.37±9.22dB, respectively, and 12.37±8.28dB on average. The difference between pre- and postoperative 12th month air-bone gap values was statistically significant (p<0.005). CONCLUSION: The use of thinned cartilage-supported perichondrial grafts in patients with all sizes of tympanic membrane perforation is safe and effective in terms of both anatomical healing and restoration of hearing and can represent a first-choice technique that is easy to perform and involves minimal morbidity.

The Anti-Inflammatory and Antioxidant Effects of Curcumin in Middle Ear Infection.

AIM: To investigate and analyze the anti-inflammatory and antioxidant efficacy of curcumin in experimentally induced middle ear infection. METHOD: Twenty-four Wistar albino rats with otomicroscopic examination findings within normal limits were included in the study. Study groups were established after Streptococcus pneumoniae was inoculated into the middle ear cavity of all rats. No medication was administered to Group 1, the control group. Group 2 was administered 50 mg/kg/day amoxicillin intraperitoneally. Group 3 was administered 50 mg/kg/day amoxicillin together with 30 mg/kg/day curcumin intraperitoneally. Blood specimens and temporal bones were collected on the 10th day of medication from the 22 rats in which acute otitis media developed. Serum glutathione peroxidase and superoxide dismutase activities and malondialdehyde levels were measured. Inflammatory cell infiltration, vascular proliferation, and epithelial proliferation were assessed histopathologically in middle ear mucosa specimens, and the results were compared among the groups. RESULTS: Malondialdehyde levels in the group given curcumin were significantly lower than those of the control group, while serum glutathione peroxidase activity was also lower compared to that of the control group. No significant difference was observed among the groups in terms of superoxide dismutase activity. Although there were no significant findings in terms of histopathological data, epithelial proliferation in the groups receiving antibiotherapy was suppressed compared to the control group. Similarly, curcumin was observed to have a positive effect on inflammatory cell infiltration. No significant changes were observed in terms of vascular proliferation. CONCLUSION: With its wide and safe dose range, curcumin represents grounds for optimism in terms of anti-inflammatory treatment in acute otitis media.

Serum vitamin D levels in children with recurrent otitis media.

The aims of this study were to evaluate serum vitamin D levels in cases of recurrent otitis media and investigate the effect of vitamin D therapy on the risk of re-occurrence of the disease. This prospective study was performed by comparing serum vitamin D levels in children with recurrent otitis media and healthy children. Eighty-four children between 1 and 5 years of age and diagnosed with recurrent otitis media were enrolled as the study group. One hundred-and-eight healthy children with similar demographic characteristics were enrolled as the control group. Patients were divided into groups according to their serum 25(OH) vitamin D levels. In patients with low initial serum vitamin D levels, vitamin D therapy was administered in addition to conventional treatment for otitis media. Mean serum 25(OH) vitamin D level in the study group was 11.4 ± 9.8 ng/mL Serum 25(OH) vitamin D levels were below 20 ng/mL in 69 % (n = 58) of cases in this group. In the control group, mean serum 25(OH) vitamin D level was 29.2 ± 13.9 ng/mL and was below 20 ng/mL in 30 % (n = 32) of cases. Comparison of serum 25(OH) vitamin D levels and PTH in the study and control groups revealed a statistically significant difference (p < 0.05). Treatment was initiated in cases diagnosed with vitamin D deficiency, and patients were followed up in due course. The only episodes detected over the course of 1-year follow-up were one attack in five patients and two attacks in two. We believe that co-administration of supplementary vitamin D together with conventional treatments is appropriate in the management of upper respiratory infections such as otitis media.

Vitamin D levels in children diagnosed with acute otitis media.

OBJECTIVE: To investigate the relationship between Vitamin D deficiency and acute otitis media infection. METHODS: The randomised, single-blind, case-control study was conducted at the Paediatric Department of Ataturk University, Erzurum, Turkey, from January to April 2010. It comprised ambulatory children diagnosed with acute otitis media and healthy controls. The subjects were divided into groups according to their serum 25-hydroxy vitamin D levels. SPSS 18 was used for statistical analysis. RESULTS: Of the 169 subjects in the study, 88(52%) were the cases and 81(48%) were controls. The mean age of the cases was 6.21±3.4 years, and 6.18±3.12 years for the controls (p<0.951). Serum 25-hydroxy vitamin D levels in the cases and controls were 20.6±10.2 ng/mL and 23.8±10.3 ng/mL (p<0.05). There was no statistically significant difference between the groups in terms of parathormone and calcium levels (p>0.05). CONCLUSION: Serum 25-hydroxy vitamin D levels being significantly lower in children diagnosed with acute otitis media compared to the controls in two otherwise similar groups suggests that Vitamin D deficiency plays a role in otitis media infection.

Assessment of salivary gland function in patients after successful kidney transplantation using (99m)Tc-pertechnetate salivary gland scintigraphy.

Chronic renal failure and its treatment can induce oral health problems and salivary glands dysfunction. The purpose of this study was to assess salivary glands function in patients with kidney transplantation using technetium-99m pertechnetate ((99m)Tc-P) salivary glands scintigraphy. We prospectively studied 34 patients with kidney transplantation (30 males and 4 females,mean age 39.76±11.6 years) and 28 healthy controls (12 males and 16 females, mean age 36.1±9.5 years). Salivary gland scintigraphy was performed nearly 4.4±2.9 years after successful kidney transplantation. Dynamic salivary glands scintigraphy was performed during 25min after the intravenous administration of 185MBq of (99m)Tc-P. Time-activity curves and glands functional parameters were calculated for the parotid and submandibular salivary glands: uptake ratio, maximum accumulation of the radionuclide, and excretion fraction. Statistical analysis of the functional parameters showed no significant differences between patients with kidney transplantation and healthy controls (P>0.05). In conclusion, this study showed that using (99m)Tc-P salivary gland scintigraphy, salivary glands function of patients with successful kidney transplantation do not differ statistically from those in healthy controls.

Measuring Oxidative DNA Damage With 8-Hydroxy-2'-Deoxyguanosine Levels in Patients With Laryngeal Cancer.

OBJECTIVES: 8-Hydroxy-2'-deoxyguanosine is a biomolecule associated with DNA damage. We evaluated oxidative stress and DNA damage in patients with laryngeal cancer by measuring 8-hydroxy-2'-deoxyguanosine levels. METHODS: This study enrolled 117 subjects, including 64 controls and 53 patients who had benign vocal cord lesions or laryngeal cancer. The benign excised lesions, tumor tissue, noncancerous laryngeal tissue, blood, and urine were subjected to high-performance liquid chromatography, and 8-hydroxy-2'-deoxyguanosine levels were compared between groups. RESULTS: Blood and urine 8-hydroxy-2'-deoxyguanosine levels in patients with laryngeal carcinoma were significantly higher than in the controls ( P = .00002, P = .00001). The 8-hydroxy-2'-deoxyguanosine level was significantly higher in tumor tissues than in non-tumor tissue and benign vocal cord lesion tissues ( P = .00002, P = .000001). CONCLUSIONS: We determined that laryngeal cancer was associated with oxidative stress, which may be quantified by measuring 8-hydroxy-2'-deoxyguanosine. For a patient with a suspicious laryngeal lesion, 8-hydroxy-2'-deoxyguanosine levels in blood and urine can provide advance information about the likely diagnosis.

Estimation of the efficacy of chemo-radiotherapy on tumor regression in the patients with laryngeal cancer via computerized tomography using the Cavalieri method.

CONCLUSION: Calculating tumor volume using the Cavalieri method in laryngeal tumors before and after treatment may be useful to optimize the treatment and to minimize the side-effects of radiotherapy. PURPOSE: This study aimed to estimate the pre-treatment and post-treatment tumor volumes of the patients to whom radiotherapy or radio-chemotherapy was applied as a treatment using Cavalieri's Principle as a stereological method and to assess tumor regression rates in the patients with Laryngeal Squamous Cell Carcinoma (LSCC) statistically. MATERIALS AND METHOD: Sixteen patients (eight patients with stage T3 and eight patients with stage T4) diagnosed with LCCC bearing the appropriate characteristics to criteria in the otorhinolaryngology clinic were included. Patients had computerized tomography (CT) scans in the axial plane before treatment and 2 months after the treatment. Pre-treatment and post-treatment tumor volumes on CT images were calculated using Cavalieri's principle as a stereological method and then compared. FINDINGS: Average tumor volumes in patients with stage T3 before and after treatment were 10.12 ± 3.58 cm(3) and 1.33 ± 1.74 cm(3), respectively (p = 0.008). These volumes were 11.92 ± 4.61 cm(3) and 2.17 ± 2.34 cm(3) (p = 0.008) for patients with stage T4, respectively. Post-treatment tumor volumes were statistically reduced compared to pre-treatment volumes in all stages.

A Rare Entity: Adult Asymptomatic Giant Vallecular Cyst.

Background. Cysts in the larynx are rare and generally asymptomatic. However, large cysts in adults can be symptomatic. If they are symptomatic, they typically present with respiratory and feeding difficulties. They are usually benign in terms of pathology. Several surgical techniques may be used for treatment. Case Report. A 56-year-old man presented to our clinic with hoarseness. Routine laryngeal examination revealed a giant mass and the larynx could not be visualized. At magnetic resonance imaging (MRI), a cystic mass originating from the vallecula was detected. There was no pathology at the glottic level. We planned tracheotomy for the airway and endoscopic surgery for excision. The mass was excised using CO2 laser and was reported as benign. Conclusion. An asymptomatic vallecular cyst may cause difficult intubation in any operation. It may also cause respiratory or other complications. Airway management should be led by an ear, nose, and throat surgeon, since tracheotomy may be required. Endoscopic excision with CO2 laser is a good choice for treatment in elective cases. In this report, we discuss the diagnosis and treatment of a patient with an asymptomatic giant vallecular cyst.