Effects of the Autologous Platelet-Rich Plasma in Nasal Pack on Postoperative Quality of Life.

AIM: The authors aimed to research the effects of autologous platelet-rich plasma, which is known for the positive effects on wound healing, on postoperatif living quality of the patients after using on nasal surgery. METHODS: Patients who undergo nasal operation according to randomized patient's choice have been injected with saline merocel pack and platelet-rich plasma (PRP) in their nasal path. Postoperative is followed by 1 month; Nose Obstruction Symptom Evaluation (NOSE) scala score, bleeding, pain, and crust rate have been compared between 2 groups. RESULTS: As a result of the 1 month follow-up, it was seen that the treatment group experienced better results in terms of NOSE scale than the control group patients and this was significant difference in terms of NOSE. Less bleeding and crust was seen on the treatment group patients than the control group patients and statically significant difference was found. In terms of visual analogue scale score no statically significant difference was found between 2 groups. CONCLUSION: According to the authors' study on PRP, the authors found out that by using PRP wound can be healed faster in early period of postoperative. It was seen with the authors' research that on postoperative early period crusts, bleeding and postoperative complaints are lesser.

Plasma Glycated Albumin Levels Clearly Detect Hearing Loss and Atherosclerosis in Patients with Impaired Fasting Glucose.

OBJECTIVE: To describe the relationship between atherosclerosis and hearing thresholds in prediabetic patients with impaired fasting glucose (IFG) and to determine the efficacy of glycated albumin in predicting carotid artery atherosclerosis in patients with isolated IFG. SUBJECTS AND METHODS: The study included 82 patients (aged 53.73-80 years) divided into two groups based on fasting glucose levels, the IFG group: 59 patients (32 females, 54.2%), and the normal fasting plasma glucose level group: 23 patients (12 females, 52.2%). Patients underwent audiological testing to determine hearing thresholds, and carotid intima-media thickness (CIMT) was measured using carotid artery Doppler sonography. Multivariate analyses were performed to determine whether or not the plasma glycated albumin levels could predict hearing loss and CIMT. RESULTS: Patients in the IFG group (mean age: 59.8 ± 9.5 years) had higher hearing thresholds and pure-tone average scores (PTA) than those in the group with normal glucose levels (mean age: 56.2 ± 10.1 years) (left ear: 27.65 ± 8.85 vs. 25.75 ± 21.96 dB, p = 0.021; right ear: 29.22 ± 8.51 vs. 22.39 ± 6.99 dB, p = 0.001). The CIMT was significantly higher in the IFG group than the control group (0.75 ± 0.26 vs. 0.56 ± 0.16 mm, p < 0.001 for the left and 0.74 ± 0.26 vs. 0.51 ± 0.19 mm, p < 0.001 for the right carotid arteries). Glycated albumin levels were independently related with increased CIMT (left CIMT: r = 0.32, p = 0.003; right CIMT: r = 0.42, p < 0.001), and serum glycated albumin levels were significantly associated with PTA (left ear: r = 0.28, p = 0.01; right ear: r = 0.30, p = 0.006). CONCLUSION: Sensorineural hearing loss was more common in patients with IFG. Plasma glycated albumin levels were strongly correlated with CIMT and carotid plaques as a marker of atherosclerosis and with hearing impairment thought to develop due to atherosclerosis in patients with IFG.

A simple technique for removal of orbital tumors: transmaxillary approach.

In this article, we present the case of a 43-year-old female with a tumor of the orbital base. Computed tomography revealed a well-defined contrast enhancing cavernous hemangioma behind the left bulbus oculi. The surgical resection was performed by transmaxillary approach to the orbit. No clinical complications were observed during three-month follow-up following surgery.

The relationship between heterotopic gastric mucosa in the cervical esophagus and laryngopharyngeal reflux.

OBJECTIVES: This study aims to investigate the possible correlations between the heterotopic gastric mucosa (HGM) islets in the cervical esophagus and laryngopharyngeal reflux (LPR). PATIENTS AND METHODS: Between May 2010 and April 2011, 45 patients (36 females, 9 males; mean age 39.8±14.1 years; range 18 to 72 years) who had reflux symptom index (RSI) >10 and reflux finding score (RFS) >7 were included. The study group consisted of 21 patients who were diagnosed with HGM islets in the cervical esophagus, while control group consisted of 24 patients without any HGM islets assessed by upper gastrointestinal system endoscopy. Esophagus manometric examination and dual-channel 24-hour pH monitoring were performed on all patients. RESULTS: Pretreatment mean RSI and RFS were 25.6±3.5 and 15.1±3.4 in group 1, while it was found to be 21.1±4.4 and 11.9±2.6 in group 2 (p=0.001, p=0.001). A total of 29.7% of patients who underwent pH monitoring had distal reflux, whereas 43.2% of them had proximal reflux. In group 1, distal reflux was observed in 15.4% and proximal reflux was found in 54% of the patients, while distal reflux was observed in 38% and proximal reflux was found in 38% of the patients in group 2 (p=0.152; p=0.27). Fourteen patients diagnosed with HGM had antral- and seven patients had fundal-type epithelium. CONCLUSION: Our study results suggest that HGM islets may be considered as an etiological factor in the patients with severe LPR with isolated proximal reflux based on the 24-hour pH monitoring.

Comparison of efficacy of different treatment methods in the treatment of idiopathic tinnitus.

OBJECTIVES: This study aims to detect whether any differences were present between betahistine dihydrochloride, transcutaneal electrical nerve stimulation and pure tone masking-tinnitus retraining therapy (TRT) methods in the effects on quality of life and treatment of the symptoms of the patients. PATIENTS AND METHODS: A total of 91 patients (42 females, 49 males; mean age 49.3±8.3 years; range 30 to 70 years) who admitted to the Otorhinolaryngology Clinic of the Ufuk University between June 2009 and June 2010 with a complaint of subjective tinnitus and who had no hearing loss were included in the study. In this study, the effects of these three treatment methods on healing and quality of life in patients suffering from bilateral subjective tinnitus were comparatively evaluated using Tinnitus Handicap Inventory Score (THIS), visual analog scale (VAS) and audiological parameters. The evaluations were made immediately before the treatment, immediately after the treatment and three weeks after the treatment. Kolmogorov-Smirnov analysis was used to test the normal distribution of the data and Wilcoxon signed rank test was used to show the differences between the different treatment methods before the treatment, immediately after the treatment and three weeks after the treatment. Mann-Whitney U and Kruskal-Wallis H tests were used to show the inter-group differences. RESULTS: In the inter-group analyzes, success rate of the pure tone masking-TRT was much higher when compared to the other treatment methods. In the evaluations performed at the end of the three-month period, it was seen that the efficacy of the treatment was continuing. CONCLUSION: According to these results, pure tone masking-TRT was found to be the best treatment method when compared to other methods and it was concluded that this treatment may be considered as the first choice in patients with idiopathic tinnitus.

[Isolated hypoglossal nerve paralysis: a case report]. / Izole hipoglossus sinir felci: bir olgu sunumu.

Cranial nerve paralysis is an uncommon complication of radiotherapy for head and neck carcinomas because cranial nerves are relatively resistant to radiation. The incidence of this complication has been declared to be 1-5% in different studies. Unlike the other cranial nerves, isolated hypoglossal nerve paralysis in patients who have been treated with radiotherapy for nasopharyngeal carcinomas is a worrisome sign of recurrence. We report a 45-year-old male patient admitted to our clinics with complaints of difficulty in moving his tongue and dysphasia five years after combined radiotherapy and chemotherapy for nasopharyngeal carcinoma. Recurrence of the tumor was thought to be the cause of the isolated hypoglossal nerve paralysis at first, however late toxicity of radiotherapy was found to be the etiological factor after detailed examinations.

Pulsatile oropharyngeal and neck mass caused by bilateral tortuous internal carotid artery: a case report.

The cervical course of the internal carotid artery is almost straight in contrast to the intracranial portions which are highly tortuous. The incidence of variations in the cervical course of the internal carotid artery of the population is approximately 10-40 percent. In this case report, a 76-year-old female patient with a pulsatile mass at the posterior oropharyngeal wall and anterior neck was presented. Physical examination revealed a pulsatile anterior neck mass, and a pulsatile mass at the right posterior wall of the oropharynx. Imaging revealed a bilateral tortuous internal carotid artery and segmental left internal carotid arterectomy and distal internal carotid artery - lateral common carotid artery anastamosis were performed with no postoperative complications.

Presence of vascular loops entering internal acoustic channel may increase risk of Sudden sensorineural hearing loss and reduce recovery of these patients.

OBJECTIVES/HYPOTHESIS: To analyze whether there is correlation between branching patterns of anterior inferior cerebellar artery/posterior inferior cerebellar artery (AICA/PICA) in cerebellopontine angle (CPA) area, as demonstrated by three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) magnetic resonance imaging (MRI) and 1) idiopathic sudden sensorineural hearing loss (ISSNHL) outcomes and 2) recovery of ISSNHL. STUDY DESIGN: We evaluated patients with idiopathic SSNHL for branching patterns of AICA/PICA in CPA area, as demonstrated by 3D FIESTA MRI. METHODS: Sixty-eight patients with SSNHL (32 [47.1%] women; mean age 45.3 ± 14.6 [minimum-maximum: 18-77]) and 38 healthy volunteers [17 (44.7%) women; mean age 48.6 ± 14.0 (minimum-maximum: 26-81)] were included in this study. We evaluated patients for branching patterns and classified as type IA, IB, IIA, and IIB. Branching patterns were evaluated at the diseased side of the patients and both sides of the control group. Pretreatment and posttreatment audiological values were also studied. RESULTS: AICA/PICA branching patterns in control group versus study group in the affected side were: 26 (34.2%) versus 12 (17.6%) subjects had type IA; seven (9.2%) versus nine (13.2%) subjects had type IB; 31 (40.8%) versus 23 (33.8%) subjects had type IIA; and 12 (15.8) versus 24 (35.3%) subjects had type IIB branching patterns, respectively. Presence of vascular loops entering internal acoustic channel (type IIB branching pattern) was more prominent in the study group (P = 0.017). In addition, type IIB branching pattern was significantly associated with unresponsiveness to treatment (18 [75%] of 24 patients with type IIB were unresponsive and 14 [47.0%] of 30 patients with nontype IIB were unresponsive, P < 0.001). CONCLUSION: Type IIB branching pattern has been shown to be more common in patients with ISSNHL, and these patients come across with unresponsiveness to standard therapy more than the other branching types. LEVEL OF EVIDENCE: 3b. Laryngoscope, 127:210-215, 2017.

Non-invasive detection and monitoring of experimental hydrocephalus with distortion product otoacoustic emissions.

OBJECTIVE: We aimed to find out the effects of short term and long term hydrocephalus and intracranial ventricular volume changes on cochlear functions by using distortion product otoacoustic emission (DPOAE) in experimental hydrocephalus rat models for the first time in literature. METHODS: This study was performed with 48 healthy, adult (8 weeks old), Sprague-Dawley rats which weighed between 200 and 240g. Six groups were formed in this study: short term control, short term sham, short term hydrocephalus, long term control, long term sham and long term hydrocephalus groups. Each group contained eight rats. Short term period was 4 weeks and long term period was 8 weeks after the study started. At the end of these periods, DPOAE measurements were performed and then rats were sacrificed to determine ventricular volumes. RESULTS: DPOAE values at all frequencies were significantly decreased in the short term hydrocephalus group when compared to the short term control and short term sham groups. DPOAE values at all frequencies were significantly decreased in the long term hydrocephalus group when compared to the long term control and long term sham groups. Besides, long term sham group which had higher ventricular volumes than long term control group also had lower DPOAE measurements. Significant associations were present between DPOAE measurements and ventricular volumes in hydrocephalus models. CONCLUSION: The functional disturbances in cochlear functions due to hydrocephalus have been demonstrated with DPOAE measurements in this study. DPOAE measurements may be thought as an easily applicable non-invasive method in detection and follow-up of patients with hydrocephalus. Our findings should be supported with clinical studies in humans.

Diagnosis and Management of Cornu Cutaneum of Nasal Vestibule: A Rare Case Report.

Cornu cutaneum is a relatively uncommon projectile, irregular, hyperkeratotic nodule that can be seen in places such as scalp, forehead, eyelids, ear, nose, lips, and upper extremities which are subjectable to sunlight. Treatment is surgery with radical margins. Excisional biopsy is enough for treatment of the lesion on head and face. However, there is only little literature about cornu cutaneum on the nasal vestibule. We present an 82-year-old male patient with a necrotic, irregular shaped lesion with pedicle on the left nasal vestibule excised and diagnosed as cornu cutaneum.

Temporal Bone Posterior Wall Defect, a New Clinic Entity?

OBJECTIVE: To define clinical and audiological findings in patients with temporal bone posterior wall defects (TBPWD) and to investigate possible relationships between these findings and the characteristics of the defect. MATERIALS AND METHODS: The computed tomography (CT) views of 1198 patients with vestibulocochlear symptoms between 2007 and 2012 were retrospectively evaluated, and TBPWD and associated anomalies were investigated. Patients who had TBPWD were called back, and clinical and audiological examinations (tympanometry, pure tone audiometry, acoustic reflexes, and otoacoustic emission) were performed. RESULTS: Twenty-eight (2.34%) patients had TBPWD. Twenty-three of them were eligible for the study. Size of the defect was significantly correlated with the presence of tinnitus and/or vertigo (p<0.005). The cut-off values for the largest size of TBPWD were 1.65 mm [sensitivity: 0.67 and specificity: 0.77 (95% CI: 0.58-0.97); p=0.04] in case of the presence of tinnitus and 1.85 for vertigo (sensitivity: 0.78 and specificity: 0.86 (95% CI: 0.67-0.99); p=0.006). In pure tone audiometry tests, mixed-type hearing loss was present in four (17%) patients, sensorineural hearing loss was present in three (13%) patients, and conductive-type hearing loss was present only in one (4%) patient. Otoacoustic emission tests revealed significant differences in signal/noise ratios at frequencies of 500, 750, 1000, and 6000 Hz. CONCLUSION: For the first time in the literature, we defined clinical and audiological findings in patients with TBPWDs. These defects seem to cause more prevalent symptoms of vertigo and tinnitus and disturb the audiological characteristics of patients.

The comparison of thermal tissue injuries caused by ultrasonic scalpel and electrocautery use in rabbit tongue tissue.

The aim of this study compares to the increase in tissue temperature and the thermal histological effects of ultrasonic scalpel, bipolar and unipolar electrosurgery incisions in the tongue tissue of rabbits. This study evaluates the histopathological changes related to thermal change and the maximum temperature values in the peripheral tissue brought about by the incisions carried out by the three methods in a comparative way. To assess thermal tissue damage induced by the three instruments, maximum tissue temperatures were measured during the surgical procedure and tongue tissue samples were examined histopathologically following the surgery. The mean maximum temperature values of the groups were 93.93±2.76 Cº for the unipolar electrocautery group, whereas 85.07±5.95 Cº for the bipolar electrocautery group, and 108.23±7.64 Cº for the ultrasonic scalpel group. There was a statistically significant relationship between the increase in maximum temperature values and the separation among tissue layers, edema, congestion, necrosis, hemorrhage, destruction in blood vessel walls and fibrin accumulation, and between the existence of fibrin thrombus and tissue damage depth (p<0.05). It was concluded that the bipolar electrocautery use gives way to less temperature increase in the tissues and less thermal tissue damage in comparison to the other methods.

The effect of subcutaneous Insulin-like Growth Factor-1 (IGF-1) injection on rabbit auricular cartilage autograft viability.

Insulin-like Growth Factor-1 (IGF-1) is one of the significant substances affecting the growth and development of cartilage tissue in the body. The aim of this study is to evaluate the possible histopathological effects of local IGF-1 injection on the viability of rabbit auricular cartilage autografts. To this end, the single-piece and sliced cartilage tissues obtained from 20 albino rabbits' auricula were implanted in the subcutaneous pockets created on the back skins of the experimental animals. Every two weeks IGF-1 (10 mg/ml) injections were performed on the autograft implants of one group and normal saline (0.9%) injections were performed on the other group. Experimental animals were sacrificed at the end of the third month. A total of 34 tissue samples obtained after dissection were evaluated and scored histopathologically according to their cartilage viability, environmental reaction, and regenerative activities. The intergroup evaluation carried out for the single-piece and sliced cartilage grafts revealed that there was statistically more cartilage viability and less foreign-body reaction in the IGF-1 group than the normal saline group (p<0.05). While there was a statistically significant difference between the groups for single-piece grafts regarding regenerative activity (p<0.05), there was no significant difference for sliced grafts. The IGF-1 group, however, showed more activity. The results we obtained point out to the fact that IGF-1 increases the tissue viability of the implanted auricular autograft and it suppresses immune modulation effect.