Hearing stimulation of the pediatric patient with congenital aural atresia: surgical and audiological evaluation of 38 patients.

The aim of this work is to stress the importance of and discuss the timing and options for the treatment of congenital aural atresia (CAA), including non-surgical alternative treatment modalities and amplification, and to report the audiological and surgical results of a series of patients. Thirty-eight children with CAA were evaluated with regard to hearing and anatomical anomalies accompanying CAA: the state of the ossicles and the facial nerve, postoperative complications and audiological results. The ages of the patients ranged between 4 and 18 years, with a mean of 10 years. All underwent surgical treatment; 32 had unilateral atresia, while 6 had bilateral atresia. The mean follow-up duration was 7 months. The facial canal was dehiscent in 36.8% of cases. In 70.2% cases, the malleus and incus were present as an ossicular mass, fixed and attached to the atretic bone. The stapes was normal in 97.3% of the patients; in 2.7% the suprastructure was deformed. The success rate, defined as an air-bone gap of 20 dB or less, was 63.1% in this series of patients. If atresia is bilateral, very early hearing stimulation to prevent the maldevelopment of children's speech and cognitive skills is of the utmost importance. In unilateral cases, surgery may be postponed until early adulthood, when the patient is able to make his/her own decision and cooperate in the treatment and postoperative aspects.

[Endonasal phototherapy in the treatment of allergic rhinitis]. / Alerjik rinit tedavisinde endonazal fototerapi.

OBJECTIVES: In this study, we assessed the effect of endonasal phototherapy on quality of life, nasal obstruction and the other symptoms in allergic rhinitis with visual analog scale (VAS), sinonasal outcome test-20 (SNOT-20), and acoustic rhinometry. PATIENTS AND METHODS: Twenty-four patients (6 males, 18 females; mean age 41.3±13.0 years; range 20 to 60 years) suffering allergic rhinitis refractory to anti allergic drugs for at least two years were enrolled in the study. Each patient underwent a total of six sessions of endonasal phototherapy with Rhinolight (Rhinolight Ltd, Szeged, Hungary) performed three times a week for two weeks. During course of the investigation, additional therapy was not applied to any of the patients. Before and one month after treatment, patients completed visual analog scale and SNOT-20 forms and nasal obstruction was evaluated with acoustic rhinometry. RESULTS: After the treatment, the mean VAS score and the mean total SNOT-20 score were found lower than the results before the therapy (p=0.0001, p=0.0001). A significant decrease was found in the scores of sneezing, nasal discharge, postnasal drainage, coughing after treatment (p=0.0001). During objective evaluation of nasal obstruction with acoustic rhinometry, no statistically significant difference was found between pre- and post-treatment findings. CONCLUSION: Endonasal phototherapy is an effective modality in the treatment of symptomatology in allergic rhinitis patients refractory to antiallergic drugs. It is detected that endonasal phototherapy has positive effects on the quality of life. However, no effect on nasal obstruction was found with acoustic rhinometry which is an objective method.

Evaluation of the effect of dexamethasone in experimentally induced endolymphatic hydrops in guinea pigs.

PURPOSE: The aim of this study was to investigate the audiological and histopathologic effects of dexamethasone in the treatment of experimentally induced endolymphatic hydrops. MATERIALS AND METHODS: Thirty mature, male guinea pigs weighing 400 +/- 50 g were operated on to induce experimental endolymphatic hydrops in their right ear. Left ear served as control. Subjects were separated into control and dexamethasone groups, with the latter receiving dexamethasone 5 mg/(kg d) intraperitoneally for 10 days. Electrocochleography and auditory brainstem response were applied to all subjects at preoperation, on the second postoperative day and also on the 15th postoperative day in animals that lived for a long time. The histopathologic examination of the inner ear in all animals was done at the end of the study. RESULTS: The summating potential and the ratio of the summating potential to the action potential measured on the second postoperative day were found to be increased in both groups, but more significantly in the control one. When the left and right ears were compared, significant difference was found in the control group; however, no significant difference was found between the ears in the dexamethasone group. Histopathologic examination revealed varying degrees of hydrops in the control group, but showed only normal findings or minor changes in the dexamethasone group. CONCLUSIONS: Dexamethasone can prevent the audiological and histopathologic findings of experimentally induced endolymphatic hydrops. However, these results must be supported by clinical and experimental studies designed with a large number of subjects.