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.

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.

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.

An Analysis of Surgical Treatment Results of Patients With Tympanosclerosis.

OBJECTIVE: The authors aimed to evaluate the intraoperative features and the results of postoperative hearing gain successes of patients with tympanosclerosis who were treated surgically in our clinic. MATERIAL AND METHODS: A retrospective analysis was conducted on 151 ears with tympanosclerosis of 138 patients who operated because of chronic otitis media or only tympanosclerosis, between January 2007 and June 2014. They were evaluated by appealing complain, complain duration, accompanying systemic disorders, tympanic membrane condition, localization of sclerotic plaque, damage in ossicular chain, existence of cholesteatoma, operation procedure type, hearing reconstruction type, preoperative, and last postoperative audiometric findings in every frequency both bone and air way. RESULTS: In the group of Wielinga-Kerr Group 3 (isolated stapes fixation), no statistically significant results were found in preoperative and last postoperative audiometric findings in every frequency both bone and air conduction (BC and AC) (P > 0.05). In the Wielinga-Kerr Group some results had significant (P < 0.05) and some results had highly significant (P < 0.001). CONCLUSIONS: Patients with less impact on ossicular chain and limited localization of sclerotic plaques have better hearing gain. Although surgery is still controversial in tympanosclerosis; it is the most effective treatment till new effective medication is discovered.

Evaluation of functional results of CWD surgery with ossicular replacement prosthesis due to cholesteatoma using computed tomography.

With the use of high-resolution computed tomography, this retrospective clinical study evaluated the factors affecting hearing in patients who were operated on due to chronic otitis media with cholesteatoma and underwent ossiculoplasty with titanium total ossicular replacement prosthesis (TORP). Fifteen patients with postoperative hearing results of 20 dB or less air-bone gap, and thirteen patients with postoperative hearing results of 21 dB or more air-bone gap were the subjects of this study. All patients were operated on due to chronic otitis media and underwent ossiculoplasty with titanium TORP. High-Resolution Computed Tomography (HRCT) and pure-tone audiometry were performed on each patient after an average of 17 months, postoperatively. Three-dimensional oblique CT cross-sections were analyzed with Vitrea 2(®) software. The presence of soft tissue in the middle ear and contact between the prosthesis head plate and the bone had an adverse effect on hearing (p < 0.05). The angle between the TORP and the oval window did not seem to affect the hearing results (p > 0.05). The study results indicate that an examination of the patients with poor postoperative hearing with HRCT may help find the possible cause and allow for the determination of the prosthesis location.

[Sinonasal teratocarcinosarcoma]. / Sinonazal teratokarsinosarkom.

Sinonasal teratocarcinosarcoma is an extremely rare malignant neoplasm presenting with the characteristics of a malignant teratoma and carcinosarcoma. The most common sites of origin of teratocarcinosarcomas are the nasal cavity and paranasal sinuses. The clinical presentation is usually with nasal obstruction and episodes of epistaxis. Teratocarcinosarcomas are aggressive and rapidly growing tumors with a poor prognosis. The incidence of sinonasal teratocarcinomas is higher in men than women. Treatment is primarily surgery, followed by radiotherapy. In this article, we report a 46-year-old male case of sinonasal teratocarcinosarcoma who was admitted with complaints of pain and swelling around the right eye and treated surgically followed by radiotherapy.

[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.

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.

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.

Cerebrospinal fluid otorrhea and recurrent bacterial meningitis in a pediatric case with Mondini dysplasia.

Mondini dysplasia is a congenital malformation of the inner ear, which is characterized by a short and large cochlear canal of 1.5 turn rather than 2.5 turns and an apical region with cystic dilatation. Patients present with congenital deafness, when both cochlea are affected. Unilateral disease may cause recurrent meningitis, otorrhea or rhinorrhea. In this article, we report a three-year-old pediatric case with a history of meningitis and cerebrospinal fluid otorrhea following tympanostomy tube placement for serous otitis media.

[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.

Retroauricular inflammatory myofibroblastic tumor: a case report.

Inflammatory myofibroblastic tumors are rare lesions which show benign histological features with highly local aggressive growth. These tumors usually tend to involve lungs. Head and neck location is very rare. In this article, a four-year-old patient who underwent a procedure for a retroauricular mass which evolved into inflammatory myofibroblastic tumor was presented in the light of data from the literature review.

Postoperative Radiologic Assessment and Long-Term Clinical Results of Tegmen Mastoideum Defects.

Objective: Tegmen defects occur mainly due to cholesteatoma and iatrogenic trauma, and the intervention for the related defects is still a debate. In this study, we aimed to discuss our clinical experience on the management of the tegmen defects which were revealed during the mastoidectomy surgeries. Methods: This study was designed as a retrospective chart review study and patients who were operated between 2007-2017 were included. The causes of the defects, repair technics, and results of the long-term follow up were evaluated. The perioperative and postoperative defect sizes which were obtained from the radiological studies were analyzed. Results: Total number of 62 patients had tegmen defects, and their etiologic factors were cholesteatoma in 31 (50%), iatrogenic factors in 29 (46.7%), and chronic infection in 2 (3.3%) patients. The number of the tegmen defects was higher in intact canal wall technic. All of the tegmen defects were repaired with different materials, and no complication was detected. The obtained data from the postoperative radiological images revealed that the related perioperative defects were significantly decreased (p<0.001). Conclusion: The perioperative bone defects were observedly decreased significantly in postoperative period. Early detection of the defect and appropriate interventions may help to manage this problem without any complication in the long term.

Comparison of two different bone anchored hearing instruments: Baha-5 vs Ponto-plus.

BACKGROUND: To our knowledge, there is no study comparing Ponto Plus® (Oticon Medical AB, Askim, Sweden) and Baha® 5 (Cochlear Bone Anchored Solutions AG, Mölnlycke, Sweden) available in the literature. AIMS/OBJECTIVES: The primary aim was to compare the performance of the Baha 5 with the Ponto Plus device in terms of speech understanding in quiet and in noise. In addition, to determine statistically whether or not the difference between the abutment systems created any variation in terms of skin reaction. MATERIALS AND METHODS: Twenty bone-anchored hearing instrument users, ten in each group, were evaluated for speech understanding in quiet and several signal-to-noise ratios using the Turkish Matrix Test in a two-speaker setup. The Holger classifications were also reviewed to determine adverse skin reactions. RESULTS: It was revealed that the hearing results of both devices were similar and, when the skin reactions were compared, there was no statistically significant difference between the two-implant systems. CONCLUSIONS AND SIGNIFICANCE: Because of the similar results of the groups, it can be interpreted as the key different device features such as the size, weight, colour alternatives, and the ease of use of the devices might be important in terms of device preference.

Laryngeal adenoid cystic carcinoma in an adolescent.

Malignant tumors of the larynx are extremely rare in children and adolescents. Adenoid cystic carcinoma accounts for less than 1% of all malignant tumors in the larynx. We presented a 16-year-old girl with subglottic adenoid cystic carcinoma, whose symptoms of prolonged and exacerbating dyspnea had been attributed to asthma at another medical center. Indirect flexible and rigid laryngoscopy revealed a smooth mass in the subglottic region occupying 80% of the airway passage. The lesion was also confirmed by both CT and MRI. There was no lymphadenopathy in the neck. The patient was successfully treated by surgery and postoperative radiotherapy. Pathological staging was T4N0M0 according to the AJCC, 2003. During six years of follow-up, there was no evidence for local recurrence or regional and distant metastasis.

Hearing loss after spinal anesthesia: the effect of different infusion solutions.

OBJECTIVE: We speculate that the preoperative volume replacement with a convenient solution may protect the inner ear function after spinal anesthesia. METHODS: The patients were randomized in a single-blind fashion into two groups: group LR (n = 40) received lactated Ringer's and group GF (n = 40) received gelatin polysuccinate 4% (Gelofusine). Spinal anesthesia was performed with a 25 G Quincke needle and was given bupivacaine 0.5% 10 mg and fentanyl 25 microg. Audiograms were performed preoperatively and 2 days postoperatively. RESULTS: The overall incidence of hearing loss was 7.5%. The hearing loss was unilateral in two and bilateral in four patients. Hearing loss occurred within the low-frequency range and the hearing thresholds returned to normal by the fifth postoperative day. CONCLUSIONS: Although the incidence of hearing loss for the lactated Ringer's group was higher than the Gelofusine group, there was no statistically significant difference between the groups. For medicolegal and ethical reasons, patients should be informed about the possibility of hearing loss after spinal anesthesia.

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.

Laryngeal reconstruction with porous high-density polyethylene.

OBJECTIVE: This study was undertaken to evaluate the use of the Medpor (Porex Surgical, College Park, GA) implant in laryngeal reconstruction and to discuss potential indications of this material in head and neck surgeries. METHOD: Twelve rabbits were used in this particular study. Laryngoplasties were performed by extracting 5 x 10-mm thyroid cartilage and replacing it with Medpor implant. Animals were sacrificed in the 1st, 2nd, and 4th weeks and 2, 6, and 9 months after implantation. The degree of fibrous capsule formation, histiocytic reaction, foreign body giant cell reaction, lymphocytic and neutrophilic reactions, vocal fold changes, and hyaline cartilage formation in the implant bed were evaluated. RESULTS: Fibrous capsule was formed around the implant in 2 weeks. Four weeks after the implantation cellular reaction in the implant bed decreased significantly. Foreign body giant cell reaction was detected only the first 2 weeks after the implantation. CONCLUSION: According to the results of this study, the Medpor implant can be safely used in laryngeal reconstruction.