Evaluation of inner ear damage by mastoid drilling with measurement of serum prestin (SLC26A5) levels.

OBJECTIVE: The objective of this study is to demonstrate any inner ear injury caused by drilling in mastoid surgery with prestin, outer hair cell motor protein specific to the cochlea. METHODS: The patients with chronic otitis media requiring mastoidectomy (n = 21) and myringoplasty (n = 21) were included. Serum prestin level obtained from blood samples was measured before surgery and on postoperative days 0, 3, and 7 using Human Prestin (SLC26A5) ELISA Kit. All patients underwent the Pure Tone Audiometry (PTA) test before surgery and on the postoperative 7th day. The drilling time was also recorded for all patients who underwent mastoidectomy. RESULTS: In both mastoidectomy and myringoplasty groups, the postoperative serum prestin levels increased on days 0 and 7 (pday-0 = 0.002, pday-7 = 0.001 and pday-0 = 0.005, pday-7 = 0.001, respectively). There was no significant difference in the serum prestin levels between the two groups, postoperatively. The PTA thresholds at day 7 did not change in either group. A significant decline at 2000 Hz of bone conduction hearing threshold in both groups and a decline at 4000 Hz in the myringoplasty group were found. There was no correlation between the drilling time and the increase of prestin levels in the postoperative day 0, 3, and 7. CONCLUSION: Our results showed that mastoid drilling is not related to a significant inner ear injury. Although the myringoplasty group was not exposed to drill trauma, there was a similar increase in serum prestin levels as the mastoidectomy group. Also, a significant decline at 2000 Hz of bone conduction hearing threshold in both groups and a decline at 4000 Hz in the myringoplasty group were found. These findings suggest that suction and ossicular manipulation trauma can lead to an increase in serum prestin levels and postoperative temporary or permanent SNHL at 2000 and 4000 Hz. LEVEL OF EVIDENCE: Level-4.

Semicircular canals are long in patients with benign paroxysmal positional vertigo.

OBJECTIVE: To search for any morphological variation contributing to aetiopathogenesis and the diagnosis of benign paroxysmal positional vertigo, we measured the sizes of the semicircular canals in patients with and without benign paroxysmal positional vertigo using multidetector computed tomography. METHODS: Cranial bone computed tomography images of 30 benign paroxysmal positional vertigo patients and 30 control patients were acquired with a 128-slice computed tomography scanner and a transverse plane with a thickness of 0.67 mm. The inner diameter, height and width of the canals were measured. RESULTS: The width of the anterior semicircular canals, and the width and height of the posterior semicircular canals of the affected ears in benign paroxysmal positional vertigo patients (n = 30) were significantly greater than in the control patients (n = 90; p = 0.001, p = 0.023, p = 0.003, respectively). CONCLUSION: In benign paroxysmal positional vertigo patients, the posterior and anterior semicircular canals are longer than those in people without benign paroxysmal positional vertigo. These morphological changes may contribute to elucidating the aetiopathogenesis and be used as a radiological sign for diagnosis of benign paroxysmal positional vertigo disease.

The association of allergic rhinitis severity with neutrophil-lymphocyte and platelet-lymphocyte ratio in adults.

OBJECTIVE: To investigate the association of allergic rhinitis (AR) severity with neutrophil-lymphocyte and platelet-lymphocyte ratios in adult patients. METHODS: The study design was prospective observational study and the study included 209 AR patients and 243 healthy individuals. The patient group comprised 38.2% males with a mean age of 31.8 years. All patients who were diagnosed with persistent AR were included. The healthy control group comprised 52.7% males with a mean age of 32.3 years. The blood examination results of patients and healthy individuals were compared in terms of neutrophil-lymphocyte and platelet-lymphocyte ratios. The values were further compared within the patient group, according to AR severity. RESULTS: The neutrophil-lymphocyte ratio was 1.70 ± 0.65 in the healthy group and 2.02 ± 1.24 in the patient group. The platelet-lymphocyte ratio result was 100.85 ± 25.33 in the healthy group and 120.67 ± 40.59 in the patient group. When we compared the neutrophil-lymphocyte and platelet-lymphocyte ratios between the groups, we found statistically significant differences in both ratios (p = 0.003, p = 0.000, respectively). Both the neutrophil-lymphocyte and the platelet-lymphocyte ratios were higher in patients with moderate-severe AR. CONCLUSION: Both neutrophil-lymphocyte and platelet-lymphocyte ratios are useful markers for diagnosis of persistent AR. Specialists may benefit from these markers to assess the severity of the disease at the beginning of the diagnostic process.

A new technique to find the facial nerve and recess by using the short process of the incus and the spine of Henle as landmarks: incus-spine angle.

BACKGROUND: Precise techniques to find the facial nerve (FN) and recess are lacking. OBJECTIVES: We aimed to define incus-spine and incus-FN angles which can be used to localize the FN and recess during mastoidectomy. MATERIAL AND METHODS: Thirty adult cadaveric temporal bones were studied. Canal-wall up mastoidectomy with a facial recess approach was performed. The temporal bones and microscope were positioned differently to change the visual angle. The following distances were measured: (1) Short process of the incus (SPI)-FN; (2) Body of the incus-FN. Photographs were taken. Three lines were drawn on the photographs between the SPI, FN, and the spine of Henle. The angles were created and measured. RESULTS: Three of the temporal bones were excluded due to the absence of the spine of Henle and two of them due to the displacement of the SPI. The mean of the incus-spine angle in 25 temporal bones was 90.12° and the mean of the Incus-FN angle was 135.96°. The mean distances of the SPI-FN and body of incus-FN were 4.85 and 9.26 mm, respectively. CONCLUSIONS AND SIGNIFICANCE: The incus-spine and the incus-FN angles along with the distances can help localize the FN and recess.