Effects of adenoid/tonsillectomy on inflammatory response in snoring children with witnessed apnoea.

OBJECTIVE: The aim of this study was to investigate the clinical significance of preoperative serum C-reactive protein (CRP), interleukin-6 (IL-6), fetuin-A, cystatin C, adiponectin and tumour necrosis factor-alpha (TNF-α) levels in children with adenoid/tonsillar hypertrophy and compare these results with postoperative values. STUDY DESIGN: Prospective clinical trial. SETTING: Single tertiary care centre. PARTICIPANTS: Thirty-five children (14 boys and 21 girls) participated in this study. MAIN OUTCOME MEASURES: The operations were performed with the indication of sleep-disordered breathing (SDB). Blood samples were taken preoperatively and at 6 months postoperatively to determine the changes in serum high-sensitivity CRP (hs-CRP), IL-6, fetuin-A, cystatin C, adiponectin and TNF-α levels. Pre- and postoperative values of body weights and heights of the participants were recorded preoperatively and at postoperative 6 months. RESULTS: Patients underwent adenoidectomy (n = 21) or adenotonsillectomy (n = 21). The mean age at surgery was 8.74 ± 3.33 years (range 3-16 years). Mean serum levels of parameters measured preoperatively and at postoperative 6 months. The observed differences between pre- and postoperative values were statistically significant (P < 0.05), excluding cystatin C levels (P > 0.05). CONCLUSION: High levels of IL-6, hs-CRP and TNF-α and low levels of fetuin-A in serum might have a clinical significance in patients with sleep-disordered breathing. Levels of cytokines in children with sleep-disordered breathing because of adenotonsillar disease decreased after surgical treatment. The risks of development of cardiovascular disease are decreased in association with lower levels of cytokines, which are also closely associated with many disease states.

Audiological evaluation in patients with Behçet's disease.

OBJECTIVE: This study aimed to determine the characteristics of hearing loss in patients with Behçet's disease. METHODS: Twenty-six consecutive patients with Behçet's disease and a control group consisting of 25 age-matched healthy subjects were prospectively included in this study. Pure tone and speech audiometry, tympanometry, distortion product otoacoustic emission testing, and auditory brainstem-evoked response assessment were performed in the patients and controls. RESULTS: The pure tone audiograms and the results of distortion product otoacoustic emission testing showed statistically significant hearing loss in the Behçet's disease patients (p < 0.05). Auditory brainstem-evoked response results were not significantly different between the patients and controls (p > 0.05). CONCLUSION: The findings of the present study demonstrated that audiological involvement is more frequent in patients with Behçet's disease than in healthy controls. Therefore, all patients with Behçet's disease should be regularly monitored by an otolaryngologist and be given information about the possibility of inner-ear involvement.

Effect of local use of L-carnitine after myringotomy on myringosclerosis development in rats.

OBJECTIVES: This study aimed to investigate the effect of local and intraperitoneal administration of L-carnitine on the prevention of experimentally induced myringosclerosis, and to compare treatment efficiency. METHODS: Twenty-four Albino-Wistar rats (48 ears) were bilaterally myringotomised and divided randomly into four groups: group one received no treatment, group two received intraperitoneal L-carnitine, group three received local L-carnitine, and group four received both intraperitoneal and local L-carnitine. On the 15th day after treatment, tympanic membranes were harvested and evaluated histopathologically for myringosclerotic plaque formation, fibroblastic proliferation, tympanic membrane thickness and new vessel formation. RESULTS: The group one tympanic membranes showed extensive thickness, and the incidence of myringosclerosis and fibroblast proliferation were greater than in groups two and four. There were statistically significant differences in tympanic membrane thickness between groups three and four, and in myringosclerosis incidence and fibroblast proliferation, comparing groups two, three and four. CONCLUSION: Myringosclerosis development was significantly reduced in rats receiving myringotomy plus intraperitoneal L-carnitine. Intraperitoneal L-carnitine administration prevented fibroblastic proliferation and tympanic membrane thickening (both of which cause further tympanic membrane destruction), thus reducing myringotomy-associated morbidity. Local L-carnitine administration had limited effectiveness in this experimental setting.

Protective effects of vitamins E, B and C and L-carnitine in the prevention of cisplatin-induced ototoxicity in rats.

OBJECTIVE: This experimental study aimed to investigate the effects of vitamins E, B and C and L-carnitine in preventing cisplatin-induced ototoxicity. METHODS: Twenty-five adult, male, Wistar albino rats were randomly allocated to receive intraperitoneal cisplatin either alone or preceded by vitamins B, E or C or L-carnitine. Auditory brainstem response (i.e. hearing thresholds and wave I-IV intervals) and distortion product otoacoustic emissions (i.e. signal-to-noise ratios) were recorded before and 72 hours after cisplatin administration. RESULTS: The following statistically significant differences were seen: control group pre- vs post-treatment wave I-IV interval values (p < 0.05); control vs vitamin E and B groups' I-IV interval values (p < 0.05); control vs other groups' hearing thresholds; vitamin E vs vitamin B and C and L-carnitine groups' hearing thresholds (p < 0.05); and vitamin B vs vitamin C and L-carnitine groups' hearing thresholds (p < 0.05). Statistically significant decreases were seen when comparing the initial and final signal-to-noise ratios in the control, vitamin B and L-carnitine groups (2000 and 3000 Hz; p < 0.01), and the initial and final signal-to-noise ratios in the control group (at 4000 Hz; p < 0.01). CONCLUSION: Vitamins B, E and C and L-carnitine appear to reduce cisplatin-induced ototoxicity in rats. The use of such additional treatments to decrease cisplatin-induced ototoxicity in humans is still under discussion.