RESUMEN
Hearing loss that arises from various causes at different stages of life has a direct impact on individuals' physical and mental well-being. This paper aimed to evaluate the employment, workplace adaptation, productivity, and professional success of individuals who have hearing loss and whose hearing loss is corrected with a cochlear implant. In this cross-sectional study, data were collected between November 2022 and March 2023 with the participation of individuals with cochlear implants living in several settlements in all regions of Türkiye. A total of 142 participants with severe hearing loss who were corrected with a cochlear implant were included in this study. The survey method was used to collect data for the study. The questionnaire consisted of 32 questions and was distributed to the participants online. In the first part of the questionnaire (questions 1-10), the general characteristics of implant patients were investigated. In the second part (questions 11-32), the positive or negative effects of implantation on the work lives of the participants were evaluated. Almost half of the research group (49.3%, n = 70) consisted of women, and the mean age of the participants was determined to be 35.8 ± 14.8 years. There was no significant difference between gender, educational status, implanted side, working time, working style (physical, desk), and factors affecting work life (p > 0.05). Professional satisfaction and success at work increased significantly more in those with acquired hearing loss (p = 0.010). Post-implantation workplace compliance, success, and productivity were found to be higher in those with acquired hearing loss (p = 0.013). Hearing loss had a significantly less negative impact on work performance in those implanted in childhood than in those implanted in adulthood (p = 0.043). It was observed that hearing loss had a greater negative impact on the work life of married people (p = 0.006). Cochlear implantation greatly enhances workplace satisfaction, increases self-confidence, and has a positive impact on the future of profoundly deaf individuals.
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BACKGROUND: Cochlear implants are arguably the most successful neural prosthesis today. Cochlear implantation has several difficulties in patients with internal ear anomalies. This study was performed to analyze intraoperative, postoperative findings, and auditory performance of 55 patients who had inner ear malformations and were treated with cochlear implants at Otorhinolaryngology Department of Çukurova University Hospital. METHODS: Auditory performances were analyzed in 30 of 55 patients. Patients with cochlear anomalies were evaluated as group I, patients with vestibular malformation as group II, and patients with the normal bone labyrinth as group III. Listening progress profiles and meaningful auditory integration scale tests were used to determine performances. RESULTS: Comparison between the listening progress profiles test performance of the groups at 12th and 18th month of group I was significantly lower than other groups (P < .05) and reached at the same level after the 24th month. Comparison between the meaningful auditory integration scale test performance of groups at 24th and 36th month of group I was significantly lower than other groups (P < .05). Perilymph gusher was observed in 3 patients who had incomplete partition I malformation. Oozing was observed in 50% of incomplete partition II patients. Facial nerve traced a variant course in 4 of 55 patients and 6 patients had postoperative meningitis. CONCLUSION: Initially patients with inner ear anomalies showed that the level of language development was worse than patients with normal bone anatomy. However, it was shown that they both reached the same point as a result. Facial nerve anomaly and meningitis risk is higher in patients with inner ear malformations.
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Implantación Coclear , Implantes Cocleares , Oído Interno , Implantación Coclear/métodos , Oído Interno/anomalías , Oído Interno/cirugía , Pruebas Auditivas , Humanos , Perilinfa , Estudios RetrospectivosRESUMEN
Abstract Introduction: Human papilloma virus is an etiological risk factor for a subset of head and neck squamous cell carcinomas. HPV has been proven to be a powerful prognostic biomarker for oropharyngeal cancer, but its role in the larynx has not been explored in depth. The developmental mechanisms of laryngeal carcinomas are quite complex and controlled by various factors. Smoking and alcohol are most important risk factors. Recent studies indicate that HPV infection also plays an important role in larynx carcinomas. HPV related laryngeal carcinomas especially occur at the supraglottic region of larynx. Objective: We aimed to determine the frequency of HPV/protein16 positivity in patients with laryngeal carcinoma and association of HPV and/or p16 positivity with variables such as age, sex, smoking habits, tumor localization, lymph node metastasis, recurrence and survival in advanced stage laryngeal carcinoma in our study. Methods: This retrospective study included 90 patients with advanced laryngeal carcinoma. The Control group was 10 normal larynx mucosa specimens. The presence of HPV was investigated polyclonally by polymerase chain reaction, and protein16 with immunohistochemical method. In HPV positive cases, the presence of HPV types 16, 18 were evaluated by polymerase chain reaction. Demographic features of patients were noted. Patient survival and association with HPV/protein16 was determined. Results: Polyclonal HPV positivity was detected in 11 (12.2%) of 90 cases. Out of these 11 cases, HPV 16 was positive in 6, HPV 18 in 4, and both HPV 16 and 18 were positive in 1. In 18 (20%) of the cases, p16 was positive. Six of the cases (6.6%) had both HPV and protein16 positivity. In cases where protein16 alone or HPV and protein16 were co-positive, alcohol use was less and the tumor was found more likely to be localized in the supraglottic area. These ratios were statistically significant. Supraglottic localization of tumor was determined to be increased in protein16 positive cases. The correlation between protein16 positivity and supraglottic area location was determined to be statistically significant (p= 0.011). 55.6% of protein16 positive cases was located in the supraglottic region, 33.3% was glottic and 11.1% was transglottic. Although life expectancy over 5 years were numerically higher in HPV and protein16 positive cases, this was not found to be statistically significant. There was no statistically significant relationship between HPV positivity and mean age, differentiation, smoking and alcohol use, tumor progression, lymph node metastasis, localization, recurrence, cause of mortality and treatment methods in our study. The mean follow-up period of our patients was 6.7 years. Conclusion: The close relationship between HPV and oropharyngeal squamous cell carcinoma could not be shown in larynx malignancy in many studies, including our study. Our findings support a limited role of HPV in laryngeal carcinogenesis. Protein16 is not a reliable surrogate for HPV status in laryngeal cancers and is not a predictor of laryngeal cancer survival. Supraglottic localization of tumor was determined to be increased in protein16 positive cases. The correlation between protein16 positivity and supraglottic area location was determined to be statistically significant. There is a need for more populated clinical trials, where neoplastic proliferation is better demonstrated and the accuracy of the results obtained is supported by different techniques.
Resumo Introdução: O papilomavírus humano é um fator de risco etiológico para um subconjunto de carcinoma espinocelular de cabeça e pescoço. Tem sido demonstrado que o HPV é um poderoso biomarcador prognóstico para o câncer de orofaringe, mas seu papel na laringe ainda não foi explorado em profundidade. Os mecanismos de desenvolvimento dos carcinomas de laringe são bastante complexos e controlados por vários fatores. Tabagismo e álcool são os fatores de risco mais importantes. Estudos recentes indicam que a infecção pelo HPV também desempenha um papel importante nos carcinomas da laringe. Os carcinomas laríngeos relacionados ao HPV ocorrem especialmente na região supraglótica. Objetivo: Nosso objetivo foi determinar a frequência da positividade para o HPV / proteína 16 em pacientes com carcinoma da laringe e a associação da positividade para o HPV e /ou proteína 16 com variáveis como idade, sexo, tabagismo, localização do tumor, metástase linfonodal, recidiva e sobrevivência de carcinoma da laringe em estágio avançado em nosso estudo. Método: Este estudo retrospectivo incluiu 90 pacientes com carcinoma laríngeo avançado. O grupo controle incluiu 10 amostras de mucosa laríngea normal. A presença de HPV foi inves-tigada por anticorpo policlonal através de reação de polimerase em cadeia e a proteína 16 por método imunohistoquímico. Nos casos positivos para o HPV, a presença dos tipos 16 e 18 do foi avaliada por reação de polimerase em cadeia. As características demográficas dos pacientes foram observadas. A sobrevida dos pacientes e a associação com HPV / proteína 16 foram determinadas. Resultados: A positividade com anticorpo policlonal do HPV foi detectada em 11 (12,2%) dos 90 casos. Desses 11 casos, o HPV 16 foi positivo em 6, o HPV 18 em 4 e o HPV 16 e 18 foram positivos em 1. Em 18 (20%) dos casos, a proteína 16 foi positiva. Seis dos casos (6,6%) apresentaram positividade para HPV e proteína16. Nos casos positivos apenas para a proteína 16 ou quando HPV e a proteína 16 foram co-positivos, a ingestão de álcool foi menor e o tumor apresentou maior probabilidade de estar localizado na área supraglótica. Essas proporções foram estatisticamente significantes. A localização supraglótica do tumor foi maior em casos positivos para proteína 16. A correlação entre positividade para proteína 16 e localização da área supraglótica foi estatisticamente significante (p = 0,011). Dos casos positivos para proteína 16, 55,6% foram supraglóticos, 33,3% glóticos e 11,1% transglóticos. Embora a expectativa de vida acima de 5 anos tenha sido numericamente maior nos casos positivos para HPV e proteína 16, isso não foi estatisticamente significante. Não houve relação estatisticamente significante entre positividade do HPV e média de idade, diferenciação, tabagismo e uso de álcool, progressão tumoral, metástase linfonodal, localização, recidiva, causa de mortalidade e métodos de tratamento em nosso estudo. O período médio de seguimento de nossos pacientes foi de 6,7 anos. Conclusão: A estreita relação entre HPV e carcinoma espinocelular orofaríngeo não pôde ser demonstrada na laringe em muitos estudos, inclusive no nosso estudo. Nossos achados confirmam um papel limitado do HPV na carcinogênese da laringe. A proteína 16 não é um substituto confiável para o status do HPV nos cânceres de laringe e não é preditor da sobrevida do câncer de laringe. A localização supraglótica do tumor foi maior em casos positivos para proteína16. A correlação entre positividade para proteína 16 e localização na área supraglótica foi determinada como estatisticamente significante. Há necessidade de ensaios clínicos com amostras maiores, nos quais a proliferação neoplásica seja melhor demonstrada e a precisão dos resultados obtidos seja apoiada por diferentes técnicas.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neoplasias Laríngeas/sangre , Neoplasias Laríngeas/virología , Inhibidor p16 de la Quinasa Dependiente de Ciclina/sangre , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Pronóstico , Neoplasias Laríngeas/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Estadificación de NeoplasiasRESUMEN
OBJECTIVE: The aim of this study was to determine the short- and long-term complications after cochlear implantation (CI) procedures and to discuss the management and prevention of these complications. METHODS: The study included a total of 1452 pediatric and adult cochlear implantation procedures performed in our clinic from March 2000 through September 2019. Of the 1452 implantations, 1201 were performed in children and 156 in adults. The minimum follow-up period was three months and maximum was 19 years. The mean age of the patients was 6.7±3.9 years (range, 10 months-69 years) at the time of their respective procedures. Complications were classified as major complications requiring reimplantation, major complications not requiring reimplantation and minor complications. All postoperative complications and treatment methods were examined. RESULTS: A total of 148 (10.1%) complications were observed in the 1452 cochlear implants. Of these, 69 (4.75%) were major and 79 (5.44%) were minor complications. While 40 (2.75%) of the major complications required reimplantation, 29 (1.99%) did not. The most common cause of major complications leading to reimplantation was device failure (29 patients, 1.99%). The most common cause of minor complications was hematoma (21 patients). Total complication rates (6.68%) were significantly higher in children than in adults (3.51%) (p=0.00). CONCLUSION: Our 19 years of clinical experience has shown that CI is a successful and safe procedure that can be performed with low major complication rates. It is important to know the possible complications and to manage them correctly.
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INTRODUCTION: Human papilloma virus is an etiological risk factor for a subset of head and neck squamous cell carcinomas. HPV has been proven to be a powerful prognostic biomarker for oropharyngeal cancer, but its role in the larynx has not been explored in depth. The developmental mechanisms of laryngeal carcinomas are quite complex and controlled by various factors. Smoking and alcohol are most important risk factors. Recent studies indicate that HPV infection also plays an important role in larynx carcinomas. HPV related laryngeal carcinomas especially occur at the supraglottic region of larynx. OBJECTIVE: We aimed to determine the frequency of HPV/protein16 positivity in patients with laryngeal carcinoma and association of HPV and/or p16 positivity with variables such as age, sex, smoking habits, tumor localization, lymph node metastasis, recurrence and survival in advanced stage laryngeal carcinoma in our study. METHODS: This retrospective study included 90 patients with advanced laryngeal carcinoma. The Control group was 10 normal larynx mucosa specimens. The presence of HPV was investigated polyclonally by polymerase chain reaction, and protein16 with immunohistochemical method. In HPV positive cases, the presence of HPV types 16, 18 were evaluated by polymerase chain reaction. Demographic features of patients were noted. Patient survival and association with HPV/protein16 was determined. RESULTS: Polyclonal HPV positivity was detected in 11 (12.2%) of 90 cases. Out of these 11 cases, HPV 16 was positive in 6, HPV 18 in 4, and both HPV 16 and 18 were positive in 1. In 18 (20%) of the cases, p16 was positive. Six of the cases (6.6%) had both HPV and protein16 positivity. In cases where protein16 alone or HPV and protein16 were co-positive, alcohol use was less and the tumor was found more likely to be localized in the supraglottic area. These ratios were statistically significant. Supraglottic localization of tumor was determined to be increased in protein16 positive cases. The correlation between protein16 positivity and supraglottic area location was determined to be statistically significant (pâ¯=⯠0.011). 55.6% of protein16 positive cases was located in the supraglottic region, 33.3% was glottic and 11.1% was transglottic. Although life expectancy over 5 years were numerically higher in HPV and protein16 positive cases, this was not found to be statistically significant. There was no statistically significant relationship between HPV positivity and mean age, differentiation, smoking and alcohol use, tumor progression, lymph node metastasis, localization, recurrence, cause of mortality and treatment methods in our study. The mean follow-up period of our patients was 6.7 years. CONCLUSION: The close relationship between HPV and oropharyngeal squamous cell carcinoma could not be shown in larynx malignancy in many studies, including our study. Our findings support a limited role of HPV in laryngeal carcinogenesis. Protein16 is not a reliable surrogate for HPV status in laryngeal cancers and is not a predictor of laryngeal cancer survival. Supraglottic localization of tumor was determined to be increased in protein16 positive cases. The correlation between protein16 positivity and supraglottic area location was determined to be statistically significant. There is a need for more populated clinical trials, where neoplastic proliferation is better demonstrated and the accuracy of the results obtained is supported by different techniques.
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Inhibidor p16 de la Quinasa Dependiente de Ciclina/sangre , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Neoplasias Laríngeas/sangre , Neoplasias Laríngeas/virología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Neoplasias Laríngeas/mortalidad , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Adulto JovenRESUMEN
INTRODUCTION: Aspiration of foreign bodies is an emergency condition in children and may result in death, especially in children under 3 years of age. Therefore, diagnosis and treatment must be made rapidly. OBJECTIVE: This study sought to summarize our experience with endoscope-assisted rigid bronchoscopy (RB) in the diagnosis and treatment of pediatric tracheobronchial foreign body emergencies to reduce complications and mortality. METHODS: This was a retrospective cross-sectional study. The medical records of 337 children diagnosed with clinically suspected airway foreign body aspiration in the pediatric emergency department were analyzed retrospectively. The patients were divided into 2 groups with endoscopy used during RB in group 1 whereas group 2 was RB only. The surgeons who performed the bronchoscopies completed a survey on the advantages/disadvantages of these 2 procedures. RESULTS: All of the patients had a positive history of suspected foreign body aspiration and foreign bodies were identified in 77.1% of the patients during RB. There were 161 (47.8%) patients in group 1 and 176 (52.2%) patients in group 2. In group 2, 5 patients showed transient hypoxia, and 6 patients had an episode of transient bleeding during the operations. These numbers were 3 and 3, respectively, in group 1. One patient in group 2 suffered cardiac arrest and died during surgery. The authors did not see any long-term complications after these operations and the authors did not find any statistically significant differences between the groups for complication rates. CONCLUSION: The RB is the gold standard procedure for removal of pediatric airway foreign bodies. The survey used in this study and our extensive experience have shown that the distal bronchi and foreign bodies can be visualized more effectively when using a rigid endoscope during RB, especially in children under the age of 3 years. In order to improve the safety of the surgical procedure, the authors propose that endoscope-assisted RB should be used in emergencies concerning foreign bodies in the airways of children.
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Broncoscopía , Cuerpos Extraños/cirugía , Niño , Preescolar , Urgencias Médicas , Femenino , Humanos , Lactante , Masculino , Estudios RetrospectivosRESUMEN
OBJECTIVES: The aim of the present study was to analyze the outcomes of cochlear implantation (CI) in patients with agenesis of the corpus callosum (CCA). A literature review and a retrospective analysis of our cochlear implant database were performed. MATERIALS AND METHODS: To the best of our knowledge, in the English literature, there was only one case reported with CCA who had undergone CI surgery. This case had Donnai-Barrow syndrome. In the Cukurova University School of Medicine Department of Otorhinolaryngology database, 5 of the 1317 patients who underwent CI surgery who had CCA were selected. The patients' demographic characteristics, operative findings, surgical outcomes, and additional disabilities were investigated. The patients' preoperative and postoperative Listening Progress Profile (LiP) and Meaningful Auditory Integration Scale (MAIS) tests were done to analyze the auditory performances. RESULTS: The participants of the study were 5 (0.38%) individuals (2 male and 3 female patients; ages 5.5, 7.5, 8, 9, and 12 years). Two of the patients had total agenesis, and the other three had partial agenesis of the CCA. In the histories of the patients, one patient had parental consanguinity, and one had febrile convulsion. No patient had an additional disability. None had experienced device failure. No patients were non-users or limited users of cochlear implants. Postoperative LiP and MAIS test scores were improved for all patients nearly as the patients without any deformity. They showed normal auditory performance in the analysis in their postoperative 48 months of follow-up. CONCLUSION: Patients who had CCA are good candidates for CI surgery.
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Agenesia del Cuerpo Calloso/cirugía , Implantación Coclear , Sordera/cirugía , Agenesia del Cuerpo Calloso/complicaciones , Niño , Preescolar , Sordera/congénito , Femenino , Pérdida Auditiva Sensorineural/congénito , Pérdida Auditiva Sensorineural/cirugía , Pruebas Auditivas , Hernias Diafragmáticas Congénitas/cirugía , Humanos , Desarrollo del Lenguaje , Masculino , Miopía/congénito , Miopía/cirugía , Proteinuria/congénito , Proteinuria/cirugía , Defectos Congénitos del Transporte Tubular Renal/cirugía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate all five vestibular end-organ functions (lateral, anterior, posterior semicircular canal, utricule, and saccule) and to investigate the relationship between Dizziness Handicap Inventory (DHI) and vestibular functions prior to CI (cochlear implantation) and at postoperative day 3 and month 3. METHODS: A total of 42 patients (age 16-70years) with normal vestibular functions preoperatively and undergoing unilateral CI were included in this prospective descriptive study. Video head impulse test (vHIT) for three semicircular canal (SSC) functions, ocular vestibular-evoked myogenic potential (oVEMP) for utricule function, cervical vestibular-evoked myogenic potential (cVEMP) for saccule function and DHI for subjective vertigo symptoms were performed prior to CI and at postoperative day 3 and month 3. RESULTS: There was a significant impairment of vestibular function in 12 patients (28.5%) on the implantation side and significant DHI increase was observed in 13 of 42 (30.9%) patients at postoperative day 3 after CI (p<0.05). We found SSC dysfunction in 7 patients (16,6%) who underwent observation with vHIT, saccule dysfunction in 8 patients (19%) with cVEMP and utricule dysfunction in 5 patients (11.9%) with oVEMP on the operated side 3days after surgery (p<0.05). Posterior SSC functions (5 patients) were more affected than lateral SSC functions (3 patients). At postoperative month 3, six patients (14.2%) still had deteriorating results in the objective tests and significant DHI increase was continued in 4 (9.5%) patients (p<0.05). The deterioration in vHIT continued in only 1 (2.3%) patient (p>0.05). The deterioration in cVEMP continued in 5 (11.9%) patients (p<0.05). The deterioration in oVEMP continued in 2 (4.7%) patients (p>0.05). There was a significant correlation between DHI and objective vestibular tests both in the early and late postoperative period (r=0.795; p<0.05). CONCLUSION: Our study showed that both canal and otolith functions can be damaged after CI especially in the early postoperative period. Surprisingly, posterior SSC functions were more affected than lateral SSC. Therefore, a gold standard vestibular test battery that can evaluate each of three SSC canals and two otoliths functions is essential. Since a single vestibular test for this purpose is not available, we recommend the use of the three available vestibular tests together. This test battery, which is capable of evaluating five vestibular end-organ functions in preoperative and postoperative vestibular evaluations, can provide more accurate results not only for CI but also for most otologic surgeries.
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Implantación Coclear , Pérdida Auditiva Sensorineural/rehabilitación , Complicaciones Posoperatorias/epidemiología , Vértigo/epidemiología , Adolescente , Adulto , Anciano , Mareo/diagnóstico , Mareo/epidemiología , Mareo/fisiopatología , Femenino , Prueba de Impulso Cefálico , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/fisiopatología , Estudios Prospectivos , Sáculo y Utrículo/fisiopatología , Canales Semicirculares/fisiopatología , Encuestas y Cuestionarios , Vértigo/diagnóstico , Vértigo/fisiopatología , Enfermedades Vestibulares/diagnóstico , Enfermedades Vestibulares/epidemiología , Enfermedades Vestibulares/fisiopatología , Potenciales Vestibulares Miogénicos Evocados , Adulto JovenRESUMEN
OBJECTIVES: The aim of the present study was to compare the therapeutic effectiveness of intratympanic (IT) methylprednisolone and dexamethasone in the initial treatment of patients with idiopathic sudden sensorineural hearing loss (ISSHL). MATERIALS AND METHODS: A total of 46 patients with ISSHL who had been treated with IT methylprednisolone or dexamethasone were included in the present study. Dexamethasone (4 mg/mL) and methylprednisolone (20 mg/mL) were given transtympanically to 22 and 24 patients, respectively, one dosage per day for 5 consecutive days. Audiologic evaluations were performed pretreatment, daily in inpatient clinics, and in the first week and second month after discharge, using four-frequency pure-tone average (PTA) and speech discrimination score (SDS). Audiologic improvement was classified according to the Furuhashi criteria. RESULTS: According to the Furuhashi criteria, the therapeutic success rate was 62.5% (complete improvement 16.7% and marked improvement 45.8%) in the methylprednisolone group, whereas it was 54.6% (complete improvement 27.3% and marked improvement 27.3%) in the dexamethasone group. Therapeutic success was higher in the methylprednisolone group; however, it was not statistically significant. When the audiologic improvement was accepted as >10 dB in PTA, the therapeutic success rates were 83.3% in the methylprednisolone group and 72.8% in the dexamethasone group. The mean (±SD) improvement of PTA before and after treatment was 30.8±21.4 in the methylprednisolone group and 24.7±2.5 in the dexamethasone group. The mean improvement in SDS was 32.6±25 in the methylprednisolone group and 23.7±26.9 in the dexamethasone group. CONCLUSION: IT steroids are safe, effective, and well-tolerated agents in the initial treatment of patients with ISSHL. Despite having different pharmacokinetic characteristics, IT methylprednisolone and dexamethasone have no superiorities over each other in the primary treatment in patients with ISSHL.
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Dexametasona/administración & dosificación , Glucocorticoides/administración & dosificación , Pérdida Auditiva Sensorineural/tratamiento farmacológico , Pérdida Auditiva Súbita/tratamiento farmacológico , Metilprednisolona/administración & dosificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Inyección Intratimpánica , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
Hearing function in older patients may be related to bone structure. We conducted an experiment to evaluate the effect of zoledronic acid on osteoporotic middle ear ossicles in an animal model. Our subjects were 19 female New Zealand white rabbits (38 ears) weighing 2 to 4 kg. We divided the rabbits into three groups: one group consisted of 6 rabbits with osteoporotic ears that were treated with zoledronic acid; the second group was made up of 8 rabbits with osteoporotic ears that were not treated; a control group included 5 rabbits with normal ears that were untreated. After an oophorectomy, the 6 study rabbits were administered 0.1 ml/kg of zoledronic acid intravenously. All rabbits were sacrificed 16 weeks later, and the middle ear ossicles were removed for investigation under light microscopy. Although osteoporosis enhanced the osteoclastic bone resorption of the ossicles, zoledronic acid enhanced osteoblastic activity on osteoporotic middle ear ossicles. The incidence of osteoporosis was 93.8% in the untreated osteoporosis group and 33.3% in zoledronic acid group-a statistically significant difference (OR: 0.24; 95% CI: 0.09 to 0.58; p < 0.001). Osteoporosis appears to increase the resorption of the middle ear ossicles, a process that can be avoided with zoledronic acid administration. Prevention of the effects of osteoporosis in humans may help decrease the irreversible changes in the middle ear ossicles.
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Conservadores de la Densidad Ósea/farmacología , Osículos del Oído/efectos de los fármacos , Osteoporosis Posmenopáusica/tratamiento farmacológico , Ácido Zoledrónico/farmacología , Animales , Modelos Animales de Enfermedad , Osículos del Oído/citología , Femenino , Humanos , Osteoblastos/efectos de los fármacos , Osteoporosis Posmenopáusica/etiología , Ovariectomía , ConejosRESUMEN
OBJECTIVE: The aim of this study was to evaluate the effect of Botulinum toxin type A by injecting in the submandibular and parotid glands on the frequency and severity of sialorrhea. METHODS: Pediatric patients who were referred to our department with sialorrhea were evaluated using their parents' frequency and severity scores of sialorrhea with visual analog scales before and after 3 months of botulinum toxin type A injections. Bilateral submandibular and parotid glands were injected with Botulinum toxin type A. RESULTS: Twenty-seven pediatric patients who were referred to our department with a complaint of sialorrhea were included in this study. Seventeen patients were female and 10 were male. Severe sialorrhea with cerebral palsy was present in all the patients. There were no complications after the procedure. CONCLUSION: Botulinum toxin A injected in the major salivary glands in pediatric patients with neurological disorders is a safe and effective method.
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OBJECTIVE: The aim of this study was to discover Turkish regional differences in the risk factors of newborn hearing loss. METHOD: A multi-centered retrospective design was used. A total of 443 children, registered to the national newborn hearing screening programme, with bilateral hearing loss, from five different regions of Turkey, were evaluated in terms of the types of hearing loss, the degree of hearing loss, the types of risk factors, parental consanguinity, age at diagnosis and age of auditory intervention, respectively. RESULTS: There was no significant difference in the prevalence of hearing loss between regions (χ2 = 3.210, P = 0.523). Symmetric Sensorineural Hearing Loss (SSHL) was the most common type of HL in all regions (91.8%). Profound HL was the most common degree of HL in all regions (46.2%). There were statistically significant differences between regions in terms of types of HL (χ2 = 14.151, P = 0.000). As a total, 323 (72.9%) of subjects did not have any risk factors. There were statistically significant differences between regions in terms of the types of risk factors (pre, peri and post-natal) for SSNHL (χ2 = 16.095, P = 0.000). For all regions, the age of diagnosis was convenient with the JCIH criteria. However the age of hearing aid application was prolonged in some regions. There were statistically significant differences between regions in terms of the age of diagnosis (χ2 = 93.570, P = 0.000) and the age of auditory intervention (χ2 = 47.323, P = 0.000). The confounding effects of gender, age of diagnosis, age of hearing aids applications, HL in the family, types of risk factors for HL on SSNHL were detected. CONCLUSION: To reach the goal of a high quality newborn hearing screening, there is a need to develop an evidence-based standard for follow up guideline. In addition, risk factors should be re-evaluated according to regional differences and all regions should take their own precautions according to their evidence based data.
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Pérdida Auditiva Bilateral/epidemiología , Niño , Consanguinidad , Femenino , Audífonos , Humanos , Recién Nacido , Masculino , Padres , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Turquía/epidemiologíaRESUMEN
OBJECTIVE: The aim of this study to compare the outcomes and complications of endoscopic stapes surgery versus microscopic stapes surgery. METHODS: This study involved patients who underwent stapedotomy at the Department of Otorhinolaryngology, Faculty of Medicine, Cukurova University between January 2012 and July 2014. The patients were divided into two groups. Patients in group I were operated with endoscope and patients in group II were operated with microscope. Pure tone audiometry was carried out in all patients preoperatively. Peroperative surgical findings, complications, and duration of surgery were noted and compared between the two groups. Air conduction and bone conduction thresholds were measured at frequencies of 500, 1000, 2000, and 4000Hz, and the mean (±SD) air-bone gap was noted. RESULTS: Mean preoperative air-bone gap was 36.9±6.8dB (23.3-50dB) in group I and 35.1±6dB (26.6-50dB) in group II. Mean postoperative air-bone gap was 9.3±7.1dB (0-30dB) in group I and 13.5±9.7dB (1.6-35dB) in group II. The difference in preoperative and postoperative air-bone gap between the two groups was statistically significant (p=0.023). Patients in group I did not complain of postoperative pain but this was felt in four patients in group II. The difference was statistically significant (p=0.045). CONCLUSION: Endoscopic stapes surgery has many benefits such as good visualization, and easy accessibility to the stapes, oval window niche, and facial nerve. Removal of the scutum and manipulation of the chorda tympani nerve are less frequent with the endoscopic technique.
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Endoscopía/métodos , Pérdida Auditiva Conductiva/cirugía , Microcirugia/métodos , Cirugía del Estribo/métodos , Adulto , Anciano , Audiometría de Tonos Puros , Conducción Ósea , Mareo/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/epidemiología , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Adulto JovenRESUMEN
Diagnostic imaging methods are very important for patients with bilateral sensourinoural hearing loss. Magnetic resonance imaging (MRI) is able to demonstrate the vestibulocochlear nerve and facial nerve in the internal acoustic canal. Also computed tomography can be helpful to determination of the deficiency of the cochlear nerve. Cochlear nerve anomalies are classified into three group according to the magnetic resonance imagings. Patients who have cochlear nerve deficiency may not hear with cochlear amplifications. Auditory brain stem implant (ABI) is most suitable for these cases. In this case report, we presented a 3 years old girls with bilateral totally hearing loss who performed cochlear implantation despite of cochlear nerve deficiency on magnetic resonance imaging (MRI) and computed tomography (CT).
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Implantación Coclear/métodos , Nervio Coclear/anomalías , Pérdida Auditiva Bilateral/cirugía , Pérdida Auditiva Sensorineural/cirugía , Preescolar , Femenino , Pérdida Auditiva Bilateral/etiología , Pérdida Auditiva Sensorineural/etiología , HumanosRESUMEN
OBJECTIVE: The aim of this study was to determine and classify inner ear abnormalities in patients who had cochlear implants because of congenital sensorineural hearing loss using preoperative temporal bone computed tomography and magnetic resonance imaging. MATERIALS AND METHODS: Patients in the otolaryngology department who had cochlear implants because of congenital sensorineural hearing loss between January 2011 and December 2013 were included in the study. There were 167 male and 133 female patients, a total of 300. All of the patients were evaluated with 4-detector-row computed tomography and 1.5 Tesla magnetic resonance imaging. RESULTS: Inner ear abnormalities were found in 136 of 600 ears (20.3%). There were six ears with incomplete partition-II (4.4%), five ears with incomplete partition-I (3.6%), two ears with Michel deformity (1.4%), two ears with cochlear hypoplasia (1.4%), two ears with cochlear otosclerosis (1.4%), and one ear with common cavity deformity (0.7%). Dilatation of the internal acoustic canal was found in 42 ears (30.9%); also, 21 ears with cochlear nerve aplasia/hypoplasia (15.4%), 5 ears with internal acoustic canal aplasia, and 1 ear with internal acoustic canal hypoplasia (0.73%) were detected. There were 10 ears with posterior semicircular canal (7.3%), 10 ears with lateral semicircular canal (7.4%), 8 ears with superior semicircular canal aplasia/hypoplasia (5.9%), and 8 ears with lateral semicircular canal-vestibular dysplasia. An enlarged vestibular aqueduct was found in 16 ears (11.7%). High jugular bulbs were found in 21 ears; however, this variation was not considered to be an inner ear abnormality. CONCLUSION: Computed tomography and magnetic resonance imaging are essential for the evaluation, determination, and classification of inner ear abnormalities in patients with congenital sensorineural hearing loss who are candidates for cochlear implant operations. Also, these radiological instruments aid in determining contraindications and predicting intraoperative difficulties. Computed tomography and magnetic resonance imaging findings for these patients should be evaluated by an experienced radiologist before the operation.
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Sordera/congénito , Oído Interno/anomalías , Imagen por Resonancia Magnética , Tomografía Computarizada Multidetector , Adolescente , Adulto , Encéfalo/anomalías , Encéfalo/patología , Niño , Preescolar , Implantación Coclear , Nervio Coclear/anomalías , Nervio Coclear/patología , Contraindicaciones , Sordera/clasificación , Sordera/rehabilitación , Diagnóstico Diferencial , Oído Interno/patología , Femenino , Humanos , Lactante , Masculino , Adulto JovenRESUMEN
OBJECTIVE: To review the alternative techniques in cochlear implantation and to compare the complications with different techniques. MATERIALS AND METHODS: Patients who had undergone cochlear implantation were reviewed. Those patients who were operated using alternative techniques were selected and evaluated for the cause of their hearing loss and for the type of alternative technique that was utilized. Complication types and rates in these patients were evaluated. RESULTS: In total, 38 patients were operated using alternative techniques following preoperative or intraoperative findings. The mean age of the patients was 8.3 (1-51) years. There were 20 male and 18 female patients. Thirteen patients were operated with a suprameatal approach and 18 with a transcanal approach. Resection of the bony part of the external ear canal and reconstruction (canal wall down technique) was performed in seven patients. Postoperative complications included wound infection, hematoma, chorda tympani injury, and tympanic membrane perforation. CONCLUSION: Cochlear implantation is an effective method in the rehabilitation of sensorineural hearing loss. Complications are rare but can sometimes cause hematoma, taste impairment, tympanic membrane perforation, or wound infections. The standard procedure is not always suitable for patients with temporal bone abnormalities. Surgeons performing cochlear implantation should be aware of these variations and should be able to perform alternative implant techniques in these cases.
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Implantación Coclear/métodos , Sordera/rehabilitación , Complicaciones Posoperatorias/etiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: The aim of this study is to compare the clinical audiological outcomes as well as patient satisfaction of bone-anchored, hearing aid surgery between the percutaneous Dermalock and the transcutaneous Attract systems. STUDY DESIGN AND METHODS: This is a multicenter, retrospective clinical study. The patients who underwent Baha Dermalock and Baha Attract surgery were analyzed for hearing results, surgical complications, and postoperative follow-up specifications for both systems. Speech reception thresholds and bone conduction thresholds with and without aided conditions were evaluated. Patient satisfactions were also determined for both groups by Glasgow Benefit Inventory questionnaire. RESULTS: Both of the groups had some minor complications such as skin irritations around the abutment and skin erythema over the magnet. Both of the groups benefit from the devices audiologically; however, when the groups were compared, better results were observed in the percutaneous, bone-conduction group. CONCLUSION: We can confirm that both transcutaneous and percutaneous techniques are effective in the rehabilitation of conductive hearing loss when conventional hearing aids cannot be used. However, both of the systems have some advantages and limitations in terms of audiological and surgical perspectives.
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Audífonos , Pérdida Auditiva Conductiva/rehabilitación , Adulto , Anciano , Anciano de 80 o más Años , Audiología , Conducción Ósea , Femenino , Audición , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Retrospectivos , Encuestas y Cuestionarios , Anclas para Sutura , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the satisfaction of patients with a cochlear implant using a Parents' Perspective Questionnaire and analyze the significant parameters. MATERIALS AND METHODS: Patients who received a cochlear implant in Çukurova University between March 2002 and November 2012 were included in the study. Parents were asked to answer the Parents' Perspective Questionnaire. RESULTS: The age ranges of 62 patients were 2-5 years and of 99 patients were 6-11 years and over. In total, 144 parents were satisfied with the cochlear implant. Patients who attended school had more self-confidence, and users of an implant aged over 18 months had better social relations and self-confidence. CONCLUSION: Cochlear implants' positive effect on the quality of life is a fact, but parents have concerns in the preoperative and postoperative periods. Patients and parents should be informed carefully about cochlear implants. Also, patients' satisfaction is correlated with increasing duration of the implant and age.
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Implantación Coclear/psicología , Satisfacción del Paciente , Calidad de Vida , Factores de Edad , Niño , Preescolar , Pérdida Auditiva Sensorineural/psicología , Pérdida Auditiva Sensorineural/cirugía , Humanos , Padres , Periodo Posoperatorio , Periodo Preoperatorio , Encuestas y CuestionariosRESUMEN
OBJECTIVES: This study aims to report early postoperative complications and hearing results in patients with chronic otitis media undergoing endoscopic transcanal tympanoplasty. PATIENTS AND METHODS: Twenty-four patients (6 males, 18 females; mean age 25.9 years; range 9 to 46 years) who were operated with endoscopic transcanal tympanoplasty in the Department of Otorhinolaryngology, Faculty of Medicine, Çukurova University between December 2012 and January 2014 were included. Postoperative complication rates, graft success, and hearing outcomes (mean air-bone gap) were evaluated. RESULTS: The mean preoperative air bone gap was found 25.1 dB and the mean postoperative air bone gap was found 20.3 dB. Postoperative duration of hospital was 24 hours. Reperforation was seen in one patient and medialization of the anterior quadrant of the graft was seen in one patient. The mean follow-up time was 7.3 months. CONCLUSION: Endoscopic transcanal tympanoplasty can be easily applied, cheap and safe method and can be given successful results in challenging cases.
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Otitis Media/cirugía , Timpanoplastia/métodos , Adolescente , Adulto , Niño , Endoscopía/métodos , Femenino , Pérdida Auditiva , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Retrospectivos , Resultado del Tratamiento , Membrana Timpánica/cirugía , Adulto JovenRESUMEN
Nasal and oral corticosteroid therapy is the ultimate treatment for sinonasal polyposis. Although there are numerous clinical studies regarding the factors associated with the formation of nasal polyposis, there is not enough literature on how these factors are influenced by steroid treatment. Twenty-one patients that had no prior medical therapy for nasal polyposis or had received medical therapy at least 6 months earlier were included in the study. Patients were treated with oral and nasal corticosteroid therapy. Nasal polyp biopsies were taken before and after medical treatment and immunohistochemical staining for cyclooxygenase 2 (COX-2), vascular endothelial growth factor (VEGF) and inducible nitric oxide synthase (iNOS) were applied to the specimens. In this study, we tried to demonstrate the effects of corticosteroid therapy on nasal polyposis tissue immunohistochemically. There was no change at immunohistochemical expression level of COX-2; however, the decline of immunohistochemical expression levels of VEGF and iNOS was statistically significant. Short-term steroid therapy does not affect COX-2 level of the nasal polyposis tissue, but has an influence on iNOS and VEGF levels. Our findings were harmonious with those of the previous studies of the literature. Further studies are needed to demonstrate the long-term effects with a larger patient group.