Detection and Grading of Early-Stage Cochlear Damage in Land Hunters by Comparison of Extended High-Frequency Audiograms with Conventional High-Frequency Audiograms.

BACKGROUND AND OBJECTIVES: Firearms used by hunters produce intermittent loud noises. These sounds, which are above the safe limits set by the World Health Organization, can cause cochlear damage. Detection of cochlear damage at an early stage, before clinical complaints appear, will enable serious treatment measures. SUBJECTS AND METHODS: A total of 105 male hunters without hearing complaints and 45 controls who were not exposed to loud noise were compared and investigated. Extended high-frequency audiograms and conventional audiograms were used to compare the groups. RESULTS: The problem detection rates of conventional high-frequency audiometry, extended high-frequency audiometry, and both tests together were 59.1, 78.1, and 82.9%, respectively. There was no statistical difference between audiometric values at the extended high-frequency and at the acoustic notch at 4 kHz. When the extended high-frequency audiogram was grouped, values at the frequencies of 16, 14, and 12 kHz were affected before that at the acoustic notch at 4 kHz. CONCLUSIONS: The results of our study indicate that hearing at extended high frequencies was affected before that at conventional high frequencies in individuals exposed to intermittent loud sounds. The first affected extended high frequencies were 16, 14, and 12 kHz. Although there was no statistically significant relationship between values at the notch and at extended high frequencies, the presence of a notch at 4 kHz, provided that 8 kHz is normal, may indicate a later stage of damage.

Can Oblique Sliced Method Avoid Warping?

Warping is the most important problem of costal cartilage grafts used in secondary rhinoplasties. The aim of this study is to show that costal cartilage grafts prepared with oblique sliced method (OSM), can solve the warping problem and provides successful results in both functional and aesthetic appearance. There are 42 patients who had previous nose surgery and dissatisfied with their facial appearance included in the study to perform secondary rhinoplasty with costal cartilage graft OSM technique. The outcomes of the operations were performed objectively using facial measurements and subjectively using rhinoplasty outcomes evaluation (ROE) scale, before and 12 months after the operation. The mean of total ROE score was 8.171 ±â€Š3.285 on the pre-operative period and it was increased to 19.11 ±â€Š3.652 where the P value was found to be <0.0001. And the post-operative 12th month period all values of nasal dorsal angulation was lower then 1° and the mean of angulation degrees was 0.224° with the minimum value 0.000° and maximum value 0.801°. The study revealed the outcome of rhinoplasty which done by OSM was statically significant both subjective patient's satisfaction and objective facial measurements. The authors suggest using of OSM in secondary rhinoplasties because the graft can be easily prepared with the desired thickness and carved into different shape without risk of warping.

Fascia lata: for the repairment of post-intubation tracheoesophageal fistula.

Tracheoesophageal fistulas are challenging formations for surgeons which can be treated with various surgical procedures. In an acquired tracheoesophageal fistula, fascia lata grafting can be accepted as a safe, easy accesible and a promising procedure, which can be one of the treatment options. We present a case of post-intubation tracheoesophageal fistula in which fascia lata was used as a reinforcement graft for the repairment in an adult patient.

Extrusion of Alloplastic Septal Silicone Implant: 25 Years After Rhinoplasty.

Multiple techniques and a variety of materials used for grafting have been described and applied over the years. Silicone implants are one of the most widely used alloplastic materials in Asian rhinoplasty, however, there are several complications. The authors report a case of an Asian woman who presented with implant rejection after 25 years later as a late complication of rhinoplasty. The patient was underwent revision augmentation rhinoplasty and stayed uneventful for 6 months as she was satisfied with aesthetic results and nasal airflow. The silicone implants are still going to be the most popular grafts in Asian augmentation rhinoplasty even so the long term complications must be kept in mind.

Does intratympanic xylitol administration have ototoxic effects in a mouse ear model?

OBJECTIVE: To research the ototoxicity of xylitol after intratympanic injection in mice ear model. METHODS: 24 female mice Balb/c mice (48 ears) included in the study. The mice were divided into 4 groups as 6 mice were found (12 ears) in each group. Solutions of 0.9% NaCl solution (Group A), 155 mg/ml (Group B), 310 mg/ml (Group C) and 620 mg/ml (Group D) xylitol, were applied into the middle ear cavity. Microscopic ear examination and auditory brainstem response test were done for each mouse before application of xylitol and on the 1st, 3rd and 10th day of injection. RESULTS: There are some statistically significant alterations found in the threshold values at 8000, 12000, 16000, 24000 Hz frequencies when each group were compared in itself on day 0, 1,3 and 10, which were independent from the increasing dosage. CONCLUSION: According to our findings intratympanic xylitol injection does not have any ototoxic effect in the inner ear. To evaluate the effects of xylitol more clinical studies are need to carried out.