Effects of platelet-rich fibrin and dexamethasone on nerve regeneration after acute facial-nerve injury.

BACKGROUND: Acute facial-nerve injury. OBJECTIVE: To investigate the effects of platelet-rich fibrin (PRF) and dexamethasone on nerve regeneration. MATERIALS AND METHODS: Thirty-six rats were randomly divided into six groups. Facial-nerve injury was created using a full-thickness incision in all groups except Group E. Next, primary anastomosis, PRF application, topical dexamethasone application, primary anastomosis with topical PRF and dexamethasone application, and no facial-nerve repair were performed in Groups A, B, C, D, and F, respectively. Clinical, functional, and structural improvements were evaluated at eight weeks. RESULTS: The mean eye-closure movement score in Group B was significantly higher than that in Group F (p < .001). The mean whisker-movement score in Group B was significantly higher than that in Group F (p = .001). The mean amplitude of whisker movement in Group F was significantly lower than those in Groups A, B, C, and E, and the mean amplitude in Group D was significantly lower than that in Group E (p < .001). Furthermore, an improvement in nerve ultrastructure was observed in Group B. CONCLUSION: PRF application has a positive effect on nerve recovery after anastomosis. SIGNIFICANCE: Contribute to the literature to improve nerve regeneration.

Effect of perinatal and postnatal thiamine deficiency on auditory pathway of the Wistar-Albino rats

Abstract Objective: In this study, we created an animal model to demonstrate the effects of thiamine on the hearing pathways of new-borns during pregnancy and lactation by inducing a dietary thiamine deficiency in the mother. Methods: The study included 16 female Wistar albino rats. The animals were separated into four groups and provided the appropriate amounts of dietary thiamine according to their groups during pre-pregnancy, pregnancy, and lactation periods. Three pups from each mother were included in the study, and 12 pups were selected from each group. On the fortieth day after birth, the auditory pathways of 48 pups in the 4 groups were examined electro physiologically and ultra-structurally. Results: In Group N-N, morphology of hair cells stereocilia degeneration was not obtained in all turns of cochlea. In Group N-T, Inner Hair Cells (IHCs) and Outher Hair Cells (OHCs) stereocilia didn't show degeneration in all turns of cochlea but had rupture inrows of HCs stereocilia. In group T-N IHCs stereocilia less degeneration was observed in all turns of cochlea. OHC stereocilia partial loss was observed only in basal turn of cochlea. In Group T-T IHCs stereocilia was observed less degeneration and rupture in all turns of cochlea. Conclusion: Thiamine is vital for the development of cochlear hair cells during both prenatal and postnatal periods. Even partial deficiency of thiamine causes significant degeneration to the auditory pathway. Level of evidence: The level of evidence of this article is 5. This article is an experimental animal and laboratory study.

Effect of perinatal and postnatal thiamine deficiency on auditory pathway of the Wistar-Albino rats.

OBJECTIVE: In this study, we created an animal model to demonstrate the effects of thiamine on the hearing pathways of new-borns during pregnancy and lactation by inducing a dietary thiamine deficiency in the mother. METHODS: The study included 16 female Wistar albino rats. The animals were separated into four groups and provided the appropriate amounts of dietary thiamine according to their groups during pre-pregnancy, pregnancy, and lactation periods. Three pups from each mother were included in the study, and 12 pups were selected from each group. On the fortieth day after birth, the auditory pathways of 48 pups in the 4 groups were examined electro physiologically and ultra-structurally. RESULTS: In Group N-N, morphology of hair cells stereocilia degeneration was not obtained in all turns of cochlea. In Group N-T, Inner Hair Cells (IHCs) and Outher Hair Cells (OHCs) stereocilia didn't show degeneration in all turns of cochlea but had rupture inrows of HCs stereocilia. In group T-N IHCs stereocilia less degeneration was observed in all turns of cochlea. OHC stereocilia partial loss was observed only in basal turn of cochlea. In Group T-T IHCs stereocilia was observed less degeneration and rupture in all turns of cochlea. CONCLUSION: Thiamine is vital for the development of cochlear hair cells during both prenatal and postnatal periods. Even partial deficiency of thiamine causes significant degeneration to the auditory pathway. LEVEL OF EVIDENCE: The level of evidence of this article is 5. This article is an experimental animal and laboratory study.

Cochlear pathology in preeclamptic rats: protective effects of vitamin D and magnesium sulfate.

Background/aim: This study investigated the possible degeneration in cochlear morphology induced by preeclampsia (PE) and the therapeutic/preventive effect of vitamin D (Vit D) and magnesium sulfate (MgSO4) used separately and together on feto-maternal outcomes. Materials and methods: We created PE in rats using a reduced uterine perfusion pressure (RUPP) animal model and recorded blood pressure (BP), embryonic survival (ES), and embryonic weight (EW) and evaluated cochlear morphology by electron microscopy. Results: The PE group had elevated BP, a decreased number and weight of live pups, and significant degeneration in the cochlea compared to the sham group. In the PEV group, we observed significant beneficial effects of Vit D supplementation at 14.5 and 19.5 dpc in terms of BP (p < 0.05), EW (p < 0.001), and cochlear degeneration compared to the PE group. In the PEM group, BP (p < 0.05) and cochlear degeneration nearly reached the level found in the sham group. However, although the EW was statistically different in the PE group, it did not reach sham group levels. We also observed that BP returned to sham level (p < 0.01) and noticed significant increases in the EW (p < 0.0001) and ES (p = 0.017) in the PEMV group compared to the PE group. According to the scanning electron microscope results, combined administration of VitD and MgSO4 is more effective than separate administration in improving cochlear degeneration induced by PE. Conclusion: The administration of Vit D and MgSO4 during pregnancy has beneficial effects on PE pathology and may play a significant role in preventing PE-related complications, including cochlear degeneration.

Reliability of CIR-S using the subperiosteal pocket technique under 2 years of age.

OBJECTIVE: It is aimed in this study to investigate the reliability of the cochlear implant receiver-stimulator (CIR-S) placement using unfixed subperiosteal tight pocket technique and the postoperative soft tissue changes that occur around the CIR-S, in toddlers under 2 years of age. METHODS: Nonsyndromic toddlers with normal radiological findings and who were planned to have cochlear implantation were included in the study. Preoperative and postoperative complications, device migration, and postoperative soft tissue changes occurred around the CIR were analyzed using objective methods. RESULTS: Twenty-six toddlers aged between 12 and 24 months who met the study criteria were followed up for a mean follow-up duration of 18 months. No intraoperative and postoperative surgical complications and device migration were observed in any of the cases included in the study. CONCLUSION: It was concluded as a result of this study that cochlear implant receiver-stimulator placement using the subperiosteal pocket technique is reliable in toddlers under 2 years of age, provided that the small incision tight subperiostal pocket technique is performed meticulously without fixation and well drilling, and that device-protective changes occur in the tissues around the CIR-S over time with the use of the device and as the child skull develops.

Can we use serum SCUBE 1 levels as a biomarker in obstructive sleep apnea hypopnea syndrome?

OBJECTIVE: To examine the SCUBE1 level, a biomarker in vascular biology that could determine the prognosis of cardiovascular events during OSA treatment. METHODS: In total, 129 patients were included in the study. Thirty were diagnosed with simple snoring and 99 with OSA. RESULTS: In males, significant correlation was determined between SCUBE1 non-REM AHI, hypopnea index, total apnea index, mean SO2, minimum SO2, and < 90% saturation duration. CONCLUSION: Serum SCUBE1 levels increased more in male patients with severe OSA compared to other OSA levels, and high serum SCUBE1 levels were found to be associated with lower oxygen levels in OSA patients. The SCUBE1 biomarker can correlate with severe OSA in males. There was a statistically significant difference between OSA groups in terms of SCUBE1 score for male patients (p = 0.002) but not for females (p = 0.498). It is important that future SCUBE1 studies evaluate males vs. females.

The Effect of the Mother's Participation in Therapy on Children with Vocal Fold Nodules.

OBJECTIVES: Vocal fold nodules (VFN) are a bilateral epithelial thickening of the membranous vocal folds. In this study, children with VFN and their mothers took part in voice therapy. We then compared acoustic analyzes and subjective evaluations to those in previous literature to determine whether voice therapy is more effective for children with VFN when their mothers also take part in therapy. METHODS: Children aged eight to 12 years who were diagnosed with bilateral VFN between January 2018 and January 2020 were included in this study. Participating children diagnosed with bilateral VFN were divided into two groups based on the wishes and cooperation of their families. Group 1 consisted of 16 patients; Group 2 included 17 patients. The children in Group 1 received voice therapy alone; children in Group 2 took part in therapy with their mothers. For all participants, the average fundemental frequency (F0), jitter percentages, shimmer percentages, maximum phonation time (MPT) and s/z ratios were measured. Pediatric voice handicap index (p-VHI) values were calculated as well. RESULTS: The two groups' measures pre-treatment and post-treatment were compared. Except for p-VHI, no significant difference was observed between the two groups. However, p-VHI post-treatment was significantly lower in Group 2 than in Group 1. CONCLUSIONS: Involving the families and even teachers of children with VFN in voice therapy can increase the effectiveness of therapy. The family's involvement increases the child's motivation in therapy. The mother's presence during therapy, supporting the child or even doing the work with the child, can be a very important source of motivation for the child, who may already be tired from school and other activities. Thus, the mother's involvement increases the child's compliance with and interest in therapy.

Quantitative assessment of temporal skin elasticity using shear wave elastography in pediatric cochlear implant users.

OBJECTIVE: To evaluate temporal skin thicknesses and stiffness values using shear wave elastography (SWE) in asymptomatic pediatric patients who underwent cochlear implantation. SUBJECTS AND METHODS: Sixty-four deafened pediatric patients with unilateral cochlear implant (CI) who had no complications were enrolled. The age, sex, weight, height, body mass index (BMI), CI side, duration of CI use and CI device brand of all participants were noted. Temporal skin thickness and stiffness values were measured from implanted and contralateral unimplanted sides using SWE. RESULTS: The mean skin thickness measurements of implanted and unimplanted sides were 11.87 ± 3.42 and 5.34 ± 1.56 mm, respectively. The mean skin stiffness measurements of implanted and unimplanted sides were 3.08 ± 0.7 and 1.29 ± 0.26 m/s, respectively. There were statistically significant differences in skin thickness and stiffness between implanted and unimplanted sides (P < .001, P < .001). The mean skin thickness and stiffness measurements did not differ among types of CI devices (P = .948, P = .362). Age had positive correlation with implanted (P < .001, P = .019) and unimplanted sides (P < .001, P < .001) skin thickness and stiffness. BMI had positive correlation with implanted (P < .001, P = .023) and unimplanted sides (P < .001, P < .001) skin thickness and stiffness. Duration of CI use had positive correlation with implanted side skin thickness (P < .001) and stiffness (P = .031). CONCLUSION: Temporal skin thickness and stiffness increase after CI surgery. SWE has the potential to improve diagnostic accuracy, and our results may provide important data for evaluation of clinical entities that affect temporal skin structures.

Can apelin play a role in the etiology of tinnitus?

Background/aim: Tinnitus is seen in 15% of the general population; in 1%­6% of this number, the quality of life is seriously affected by this chronic condition. Chemical, oxidative, and emotional stressors are important in terms of the clinical course of tinnitus. Apelin is an endogenous peptide which is an oxidative stress mediator. It has been shown that the apelin/APJ (apelin junction receptor) system plays various roles in the physiology and pathophysiology of many organs. However, the role of the apelin/APJ system as an oxidative stress mediator in tinnitus is unknown. We investigated the level of apelin in patients with normal hearing and bilateral tinnitus. Materials and methods: We enrolled patients diagnosed with bilateral idiopathic tinnitus. Tinnitus severity was determined using the tinnitus handicap inventory (THI). We recorded the levels of plasma apelin-13 and biochemical parameters. Results: The mean apelin level of the control group was higher than that of the patient group (P = 0.002). A significant negative correlation was evident between the apelin level and the THI (r = ­0.460, P = 0.003). The triglyceride (TG) level was significantly higher in the patient group than in the control group (P < 0.001). Conclusion: In our study, we found a negative correlation between apelin and tinnitus severity. Thus, apelin may play a role in the pathophysiology of idiopathic tinnitus, and may be prescribed during follow-up to reduce oxidative stress in the future. Further clinical studies on the effects of the apelin/APJ (apelin junction receptor) system and the effects of antioxidants in patients with inflammatory diseases are required.

Effect of perinatal biotin deficiency on auditory pathway of the Wistar-Albino rats.

Aim: Severe biotin deficiency associated with biotinidase enzyme deficiency in newborns is seen as severe neurological problems and hearing loss. However, the effect on the infant of deficiencies in the maternal diet during pregnancy are not clear. Material and methods: The study included 16 female Wistar albino rats and 4 male Wistar albino rats, that were mated and then the females were separated into 4 groups. At 40 days after the birth, 3 pups were selected from each group, and these 12 pups were evaluated with DPOAE and ABR electrophysiologically and the cochlea was examined ultrastructurally with electron microscopy. Results: In the DPOAE evaluation, At 8000 and 11,000 Hz, the signal-noise ratios in the B-N and B-B groups were statistically significantly higher (p < .05). In ABR, lengthening of the latency periods was determined in all the waves at both 8 and 16 kHz in the B-B group. When the IPL periods were examined, lengthening in IPL 1-5 was statistically significant in the B-B group only at 8 kHz. Conclusions: Biotin can be said to have an effect on hearing pathways. However, specifically where on the hearing pathways that biotin is involved has not been clarified.

The Effects of Platelet-Rich Fibrin Membrane on Secondary Healing After Pleomorphic Adenoma Excision in the Hard Palate: A Preliminary Study.

AIM: This study aims to evaluate the effects of platelet-rich fibrin (PRF) membrane on secondary healing after pleomorphic adenoma (PA) excision in the hard palate. MATERIALS AND METHODS: PRF membranes were laid over mucosal defects which occurred following PA excision in the hard palate. The secondary healing process was monitored in the patients by follow-up examinations on postoperative days 5, 10, 15, 20, 25, 30, 35, and 40. RESULTS: In this preliminary study, epithelialization was observed to have completed on the 30th day of follow-up in the first patient and on the 35th day in the second and third patients. No bleeding or infection was seen in any of the three patients. CONCLUSIONS: PRF membrane as a new method in the secondary healing after PA excision in the hard palate provided rapid healing and reduced complications such as bleeding and infection.

Is Presence of Vascular Loop in Magnetic Resonance Imaging Always Related to Tinnitus?

INTRODUCTION: One of the most common otological complaints is tinnitus in adults. When there is a complaint of unilateral tinnitus and retrocochlear pathology is suspected, imaging methods are applied. However, the imaging findings obtained may not always be compatible with the severity and localization of the tinnitus. AIM: The aim of the present study was to determine whether or not there was a significant correlation between the findings on magnetic resonance imaging (MRI) and the presence and severity of tinnitus in patients with the complaint of unilateral tinnitus. METHOD: The study included 44 patients with no loss of hearing who presented with the complaint of unilateral tinnitus. The relationship between tinnitus severity and vascular loop presence was investigated. RESULTS: Various types of vascular loop were determined in 14 patients. No statistically significant relationship was determined between the presence of vascular loop and the Tinnitus Handicap Inventory scores. CONCLUSION: The results of this study showed no significant difference in respect of the presence of vascular loop on the MRI findings of symptomatic and healthy ears. The presence of vascular loop on MRI is not always a pathological event and should be considered only as an examination finding that could be an anatomic variation.

The effect of platelet-rich fibrin membrane on the repair of perforated tympanic membrane: an experimental study.

CONCLUSION: Platelet-rich fibrin (PRF) membrane could be used successfully in the repair of tympanic membrane perforation and wound healing. OBJECTIVES: To evaluate the effect of platelet-rich fibrin membrane in the repair of perforated tympanic membrane. METHODS: After otoscopic examination, a 3-mm perforation was made in the posterior quadrant of both tympanic membranes of 50 adult male Sprague-Dawley rats. Venous blood was withdrawn from the rats, then centrifuged. PRF was obtained in membrane form. The membrane was placed on the right tympanic membrane perforation. The perforations on the left side were left to spontaneously heal and, thus, formed the control group. Daily examinations were made of 20 rats and the time to healing of the tympanic membrane was recorded. The remaining 30 rats were separated into five groups of six, and histopathological examination was made. Evaluation was made in respect of the presence of oedema in the lamina propria, neovascularization, fibroblastic reaction, and inflammatory cells. RESULTS: The healing time of the tympanic membrane perforation was determined as mean 10.3 ± 2.18 days in the study group applied with PRF and 17 ± 2.40 days in the control group. Higher values in respect of fibrosis and neovascularization were obtained in the study group.

Oxidative stress in otosclerosis.

OBJECTIVES: Otosclerosis is a disease involving abnormal bone turnover in the human otic capsule that results in hearing loss. Several hypotheses have been suggested for the etiopathogenesis of otosclerosis; however, its etiology remains unclear. METHODS: This study evaluated the correlation between otosclerosis and levels of paraoxonase-1 (PON1), arylesterase, total antioxidant status, total oxidant status (TOS), oxidative stress index (OSI), total sulfhydryl (-SH) groups, lipid hydroperoxide, and ceruloplasmin in the serum of otosclerosis patients and healthy subjects with respect to oxidative stress. RESULTS: In our study, TOS and OSI levels were higher in the otosclerosis patients than in the controls. The PON1 levels showed that oxidative stress was severe, and as a result, antioxidants were consumed and depleted. DISCUSSION: When an imbalance between oxygen free radical production and antioxidative defense mechanisms occurs, reactive oxygen species levels may increase, which in turn may damage cells and tissues through the peroxidation of phospholipid membrane structures. The body initially responds with increased antioxidant production, but if the oxidative stress is severe, decreased antioxidant levels may result. This study reports expression levels of oxidative stress species in otosclerosis patients.

Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study.

OBJECTIVES: (1) To evaluate the effects of a platelet-rich fibrin (PRF) membrane in the repair of traumatic tympanic membrane (TM) perforations; and (2) to compare the use of a PRF membrane with the paper patch technique with regard to recovery rates, healing time, and correction of the mean air-bone gap. METHODS: A randomized, prospective analysis was performed for 60 patients who were treated for traumatic TM perforations using one of the two methods. Closure rate, speed of healing, and hearing gain were compared between the PRF (Group 1) and paper patch (Group 2) groups. RESULTS: Closure was obtained in 28 (93%) perforations in Group 1 and 25 (83%) perforations in Group 2 (p > 0.05). On day 10, full closure of the TM was observed in 24 (80%) patients in Group 1 and 16 (53%) patients in Group 2 (p < 0.05). The improvement in the mean air-bone gap was 14.1 dB in Group 1 and 12.4 dB in Group 2 on post-operative day 45 (p < 0.05). CONCLUSIONS: In comparison with the paper patch method, PRF, a new method, provided more rapid healing with more successful audiological results, and with no requirement for a second procedure.

A novel predictive marker for the viscosity of otitis media with effusion.

OBJECTIVES: To evaluate the significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for the prediction of the viscosity of otitis media with effusion. METHODS: This retrospective study was performed on 81 patients who were admitted to the otolaryngology clinic.The patients were divided into two groups according to their effusion type, as serous or mucoid, which was defined intraoperatively after myringotomy. The NLR and PLR were calculated as a simple ratio between the absolute neutrophil/platelet and absolute lymphocyte counts.Tympanostomy tube insertion was performed for all cases.Under direct visualization, the effusion was aspirated and classified as serous or mucous. RESULTS: We postulated that an NLR value of less than 1.38 may show mucoid effusion and if the PLR value is less than 97.96, the effusion is mucoid. CONCLUSIONS: We speculate that a useful predictor of viscosity for a middle ear effusion could prevent unnecessary surgeries and additional costs in the treatment of EMO. Additional studies are needed to confirm our results.

Effects of polylactic acid film on middle ear mucosa and cochlear function in Guinea pigs.

Our aim was to assess the effects of polylactic acid (PLA) on middle ear mucosa and cochlea, to be used as a film barrier for postoperative adhesion prevention in the middle ear. Twenty-one albino Guinea pigs were included in the study. A window was opened on both tympanic bulla and on one side PLA material was placed in the middle ear and on the other side only fenestration was performed and used as a control. All Guinea pigs underwent evaluation of tympanic membranes microscopically; functional hearing was analyzed by auditory brainstem responses preoperatively, in the first and the sixth month. All Guinea pigs were killed on the sixth month for histopathologic evaluation of their temporal bones. There was no statistical difference between both groups regarding hearing thresholds, interpeak wave latencies preoperatively and on first and the sixth months postoperatively. Histopathological evaluation revealed no specific changes. There was a mild local inflammation both in the PLA implanted and control ears. PLA film barrier most likely has no toxic effects on Guinea pig middle ear and does not show any ototoxic side effects.