Cochlear involvement in patients with ulcerative colitis.

OBJECTIVE: To investigate whether cochlear involvement is an extraintestinal manifestation in patients with ulcerative colitis. METHOD: Forty-four ulcerative colitis patients and 44 age-matched healthy subjects were included in the study. Pure tone and speech audiometry, and distortion product otoacoustic emission tests were performed on all participants. The audiometric test results were compared between groups and their relationship with disease activity was investigated. RESULTS: Pure tone threshold averages were significantly higher in ulcerative colitis patients compared to controls (p 0.05). CONCLUSION: Even though hearing thresholds may be within normal limits, decreased distortion product otoacoustic emission amplitude values indicate a cochlear involvement in ulcerative colitis patients.

Impact of mean platelet volume on the occurrence and severity of sudden sensorineural hearing loss.

OBJECTIVE: We aimed to determine: (1) whether mean platelet volume was elevated in patients with sudden sensorineural hearing loss, compared with healthy controls; and (2) whether mean platelet volume level was related to hearing loss severity. MATERIALS AND METHODS: The study included 31 patients with sudden sensorineural hearing loss and 31 age- and sex-matched, healthy controls. Peripheral venous blood samples were taken from subjects and mean platelet volume and levels of glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride were measured. RESULTS: Mean platelet volume was significantly greater in the sudden sensorineural hearing loss group compared with the control group. However, there was no significant correlation between mean platelet volume level and hearing loss severity. CONCLUSION: Mean platelet volume, a determinant of platelet activation, is elevated in patients with sudden sensorineural hearing loss. To our knowledge, this is the first report investigating mean platelet volume levels in such patients. Our findings indirectly support the hypothesis of vascular impairment as a pathogenetic factor in sudden sensorineural hearing loss.

Mean platelet volume in patients with nasal polyposis.

OBJECTIVE: To investigate whether mean platelet volume (MPV) levels rise in patients with nasal polyposis (NP) and whether higher MPV levels are correlated to the extension of polyps in these patients. MATERIALS AND METHODS: This study included 50 patients with NP and 40 age- and sex-matched healthy subjects as controls. The Lund-Mackay staging system was used to assess paranasal sinus computed tomography (CT) scans in patients with NP, and paranasal sinus CT scores were recorded. MPV was measured in a blood sample collected in EDTA tubes and was also used for whole blood counts in all patients. The Mann-Whitney U-test and Student's t-test were used to compare the results of the two groups. RESULTS: NP patients had higher MPV levels than the control group (9.60 +/- 1.06 fl and 8.77 +/- 0.88 fl, p < 0.001 respectively). However, there was no significant correlation between MPV and paranasal sinus CT scores. CONCLUSION: To our knowledge, this is the first study to investigate MPV levels in patients with NP. Our results suggest that MPV, a determinant of platelet activation, is elevated in patients with NP. Increased platelet activation may be related to an increase in cardiovascular risk in patients with NP.

An unusual dark pigmentation on the tympanic membrane.

OBJECTIVE: To report an extremely rare case of dark pigmentation on the tympanic membrane due to alkaptonuria, and to discuss the probable association between this condition and hearing loss. CASE REPORT: A 58-year-old man with alkaptonuria was admitted with tinnitus and hearing loss in both ears. Physical examination showed bluish-black pigmentation on the helixes of both ears and both sclerae. Otoscopic examination revealed dark discolouration of both tympanic membranes. Audiological evaluation revealed mixed high frequency hearing loss in both ears. Tympanometric examination revealed type A tympanograms bilaterally, and absence of acoustic reflexes both ipsilaterally and contralaterally. Computed tomography of the temporal bones revealed no abnormality. CONCLUSION: Clinicians should consider alkaptonuria in the differential diagnosis of patients with abnormal tympanic membrane pigmentation and hearing loss.

Effect of antioxidants on the clinical outcome of patients with nasal polyposis.

AIM: To investigate the therapeutic effects of antioxidants on the clinical and biochemical outcome of patients with nasal polyposis. METHODS: Thirty-four patients with nasal polyposis were divided into two groups receiving either intranasal steroid or intranasal steroid plus per-oral vitamins A, C and E and selenium. Paranasal sinus computed tomography, endoscopy, and polyp tissue and serum sampling were conducted pre- and post-therapy. Serum levels of malondialdehyde, superoxide dismutase, nitrite and myeloperoxidase and tissue levels of malondialdehyde and superoxide dismutase were measured. Group results were compared using the Mann-Whitney U test and Wilcoxon signed-rank test. RESULTS: Both groups had significantly lower tissue parameters, computed tomography scores and serum malondialdehyde levels, comparing pre- versus post-treatment results. Post-treatment, the steroid plus antioxidant group had significantly lower tissue malondialdehyde levels and a greater fall in tissue and serum malondialdehyde, compared with the steroid group. CONCLUSION: Serum and tissue levels of malondialdehyde (an oxidative marker) were significantly decreased by adding antioxidants to standard therapy. This is the first report of the positive effects of adding antioxidants to steroid therapy for nasal polyposis.

An unusual tumour of the cerebellopontine angle.

UNLABELLED: An unusual tumour of the cerebellopontine angle. OBJECTIVE: To report an extremely rare case of lipoma of the cerebellopontine angle (CPA). CASE REPORT: A 33-year-old woman presented with vertigo and tinnitus in the left ear. Her physical examination was unremarkable. Audiometric evaluation was normal in both ears. T1-weighted magnetic resonance imaging (MRI) without fat signal suppression revealed a hyperintense lesion of the left CPA. Based on the neuroimaging findings, the diagnosis was left CPA lipoma. The patient was managed conservatively. After 48 months, follow-up MRI revealed no further growth of the lesion and the patient was symptom free. CONCLUSION: Lipomas of the CPA should be considered in the differential diagnosis of vertigo and tinnitus. Accurate diagnosis by MRI is critical.

An unusual pneumatisation of turbinates.

OBJECTIVE: To report an extremely rare case of pneumatisation of all turbinates. CASE REPORT: A 17-year-old male patient presented with nasal obstruction. Anterior rhinoscopy and nasal endoscopic examination revealed left middle turbinate and bilateral inferior turbinate hypertrophy, septal deviation to the right. A coronal computed tomography (CT) scan of the paranasal sinuses showed pneumatisation of both superior and inferior turbinates and a left middle turbinate, and also showed pneumatisation of the right middle turbinate. The patient underwent endoscopic sinus surgery of the left side with lateral lamellar resection of the middle turbinate under local anaesthesia. CONCLUSION: We present the first case in the world literature of the pneumatisation of all six turbinates.

Nasopharyngeal tuberculosis: an unusual cause of nasal obstruction and snoring.

OBJECTIVE: To report an extremely rare case of nasopharyngeal tuberculosis. CASE REPORT: A 35-year-old male patient presented with nasal obstruction and snoring. Nasal endoscopic examination with a rigid endoscope revealed a large mass on the posterior wall and roof of the nasopharynx. A computed tomography scan of the nasopharynx revealed a polypoid mass in the posterior nasopharyngeal wall. Histopathological examination of a biopsy taken from the posterior nasopharyngeal wall revealed granulomatous lesions with caseation necrosis. Treatment was decided after histopathological examination and intradermal positive reaction to tuberculin test, and started a week later. The patient was treated with antituberculosis drugs including isoniazid, rifampicin, pyrazinamide, and ethambutol. After six months, the nasopharyngeal examination was absolutely normal, and the patient was also symptom free. CONCLUSION: This case highlights that nasopharyngeal tuberculosis should be considered in the differential diagnosis of a nasopharyngeal mass, especially in patients from regions of the world where tuberculosis is endemic.