Comparison of the protective effects of intratympanic dexamethasone and methylprednisolone against cisplatin-induced ototoxicity.

OBJECTIVE: This study aimed to compare the efficacies of intratympanic dexamethasone and methylprednisolone in preventing in cisplatin-induced ototoxicity in rats. METHODS: Experimental groups of rats (n = 8 each) received intratympanic isotonic saline, intraperitoneal cisplatin and intratympanic isotonic saline, intraperitoneal cisplatin and intratympanic dexamethasone, or intraperitoneal cisplatin and intratympanic methylprednisolone. Distortion product otoacoustic emission thresholds were compared on days 0 and 10 in all rats, and correlations between drug effects and changes in cochlear histology were evaluated. RESULTS: Distortion product otoacoustic emission thresholds were comparable in groups III and IV (p > 0.05). Significant protection against cisplatin-induced ototoxicity was seen in groups III and IV compared with group II (p < 0.05). Dexamethasone and, to a lesser extent, methylprednisolone protected against cellular apoptosis in cisplatin-induced ototoxicity. CONCLUSION: Dexamethasone (and possibly methylprednisolone) may be clinically useful as an intratympanic chemopreventive agent to treat cisplatin ototoxicity. Future clinical studies should investigate the use of dexamethasone for this purpose in adult patients.

Profound sensorineural hearing loss: analysis of 310 adult cases.

OBJECTIVES: Sensorineural hearing loss is caused by problems in the inner ear, vestibulocochlear nerve, or brain central processing centers. This study aimed to analyze the patient-reported etiology, clinical aspects, and hearing evolution of patients with profound sensorineural hearing loss (PSNHL). STUDY DESIGN: Retrospective. METHODS: A total of 310 adult patients diagnosed with PSNHL in one or both ears between January 2002 and January 2008 were studied at a secondary center. Most subjects were military-aged males who were diagnosed with PSNHL during routine examinations prior to recruitment. A pure-tone audiometry test was performed in all patients. Auditory brainstem response was recorded in 142 (45.8%) patients. RESULTS: A total of 310 adult patients (276 males [89%] and 34 females [11%]) with a mean age of 23.1 (range 20-81) years comprising 486 ears consisting of 176 (56.8%) bilateral and 134 (43.2%) unilateral PSNHL cases were evaluated. Etiology was based on patient self reporting. The disease was congenital in 93 (30%) patients and acquired in 217 (70%). Etiology was unknown in 35 (11.3%) patients. Acquired hearing losses were rapid in 188 (86.6%) and progressive in 29 (13.4%) patients. Articulation was impaired (no understandable speech) in a total of 146 patients (47.1%), including all patients with congenital PSNHL. CONCLUSION: The cause of hearing loss is often understood from medical history. Taking measures for the most common causes (congenital hearing loss and childhood infectious diseases) may reduce occurrences of PSNHL cases. Auditory screening and beginning hearing rehabilitation as soon as possible in newborns is vital.

Oxidative stress status and plasma trace elements in patients with asthma or allergic rhinitis.

INTRODUCTION: This study was conducted to evaluate the oxidant/antioxidant balance (oxidative stress status) and plasma essential trace element levels in patients with bronchial asthma or allergic rhinitis. METHODS: A total of 94 individuals consisting of 19 allergic asthmatics; 17 non-allergic asthmatics; 22 patients with allergic rhinitis; and 36 healthy control people were enrolled into this study. Superoxide dismutase (CuZnSOD) and glutathione peroxidase (GSH-Px) activity as antioxidant defence mechanism parameters, along with malondialdehyde (MDA) as a marker of lipid peroxidation, were determined in erythrocytes of patient groups and controls. Plasma copper and zinc levels were also determined in all groups. RESULTS: CuZnSOD activity was significantly lower in all groups of patients (p<0.001 for allergic asthmatics, p=0.008 for allergic rhinitis patients, and p<0.001 for non-allergic asthmatics) when compared to those of controls. Erythrocyte GSH-Px enzyme activity was not different when compared to that of the control group. Similarly, the patient groups had no difference from those of the controls with respect to erythrocyte MDA levels. While plasma Cu levels in all asthmatic patients were not different from those of the controls, allergic rhinitis patients had significantly elevated (p<0.001) Cu levels compared to those of the controls. No statistically significant difference was established between patient groups and controls with respect to plasma zinc levels. CONCLUSION: While defective CuZnSOD activity observed in all patients groups was expected to cause an increase in lipid peroxidation indicated by high MDA levels in these patients groups, the fact that MDA levels were not different from those of controls in all patient groups indicates that other components of anti-oxidant defence system preserve their functions in these patients. On the other hand, statistically significant difference between all patients groups and controls with respect to trace elements was only observed in allergic rhinitis patients who had higher levels of Cu than those of controls.

Sialadenoma papilliferum of nasal cavity: case report.

OBJECTIVE: We report a rare case of sialadenoma papilliferum. METHOD: A case report of sialadenoma papilliferum is presented. RESULTS: A 67-year-old woman presented with recurrent epistaxis. She was found to have an exophytic, well circumscribed mass on the nasal septum mucosa. The lesion was completely excised. A diagnosis of sialadenoma papilliferum was made based on the characteristic histological pattern. Follow up showed no evidence of recurrence. Subsequently, the patient remained well without complaint of epistaxis. CONCLUSION: To our knowledge, this is the first report in the world literature of sialadenoma papilliferum of the nasal cavity. This case indicates that this rare tumour can present with epistaxis, and can be resolved by means of total excision.