Assessment of Vestibular Function in Adults with Prelingual Hearing Loss Using c/oVEMP Tests.

OBJECTIVES: The aim of the present study was to compare the vestibular system integrity of individuals with normal hearing with that of prelingual hearing impaired individuals. It is well known that ocular vestibular evoked myogenic potentials (oVEMPs) reflect utricular function, whereas cervical vestibular evoked myogenic potentials (cVEMPs) reflect saccular function. Therefore, oVEMP and cVEMP tests were applied to evaluate the vestibular system integrity of hearing impaired individuals participating in the research. MATERIALS AND METHODS: The study group consisted of sensorineural prelingual hearing-loss volunteers aged from 18 to 60 years, whereas the control group consisted of age- and gender-matched healthy volunteers. cVEMP and oVEMP tests were performed to evaluate the integrity of the vestibular system, and the results were compared with those of the control group. RESULTS: The study included 20 (76.9%) women and 6 (23.1%) men in the study group; on the other hand, the control group consisted of 19 (73.1%) women and 7 (26.9%) men. There was a difference between the study group and the control group when oVEMP and cVEMP responses were compared, and the response percentage was higher in the control group. The response rates of oVEMP and cVEMP in patients with prelingual hearing loss were 44.2% and 59.6%, respectively. There was also a statistically significant difference between the groups for oVEMP amplitude and cVEMP P1 latency (p≤0.05). CONCLUSION: These findings suggest that prelingual hearing loss is related to both utricular and saccular dysfunctions. However, oVEMPs were more often abnormal in prelingual deaf patients than cVEMPs, suggesting that utricular dysfunction may be more common than saccular dysfunction.

The role of meteorologic factors and air pollution on the frequency of pediatric epistaxis.

Fluctuations in atmospheric temperature, humidity, and air pollution are associated with the incidence of epistaxis. To date, no study in the literature has evaluated the effect of air pollution and meteorologic conditions on the pediatric population. We aimed to evaluate the effect of meteorologic factors and air pollution on the frequency of epistaxis in children. Children presenting to an outpatient clinical setting at a tertiary care hospital during a 5-year period (July 1, 2009, to June 30, 2014) and diagnosed with epistaxis formed the study population. Daily temperature and humidity parameters and average daily atmospheric water vapor pressure, average daily concentration of particulate matter <10 µm in diameter, and sulfur dioxide readings were obtained. The distribution of daily parameters was analyzed. Of the 1,559 children with the primary diagnosis of epistaxis, data from 1,330 children were analyzed after excluding patients with coexisting pathologies. Positive correlations were found between the frequency of epistaxis and both the average daily temperature and the difference between the maximum and minimum daily temperature. There was a negative correlation between the epistaxis frequency and the average daily humidity, the difference between the maximum and minimum daily humidity, the average daily concentration of particulate matter, and the sulfur dioxide levels. Our findings suggest that epistaxis in children is related to high temperatures and low humidity.

[Cochlear implantation in far advanced otosclerosis: series of four cases]. / Asiri ilerlemis otosklerozda koklear implantasyon: Dört olguluk seri.

In this article, we present four patients who underwent cochlear implantation due to far advanced otosclerosis. Preoperative evaluations, intraoperative findings, complications, and postoperative benefits were analyzed. Cochlear implantation is a treatment option providing excellent audiological results for rehabilitation of patients with far advanced otosclerosis. However, facial nerve stimulation after cochlear implantation is observed more frequently in patients with otosclerosis. Also, caution should be paid in patients with otosclerosis in terms of cochlear ossification and inconsistent results.

[Our surgical treatment results in pediatric cholesteatoma]. / Pediatrik kolesteatomda cerrahi tedavi sonuçlarimiz.

OBJECTIVES: This study aims to evaluate surgical techniques and obtained outcomes in pediatric cholesteatoma. PATIENTS AND METHODS: A total of 62 patients (41 males, 21 females; mean age 13 years; range 3 to 17 years) diagnosed as pediatric cholesteatoma between January 1998 and December 2014 were enrolled into the study. Of the patients, canal wall down (CWD) mastoidectomy was performed in 31, canal wall up (CWU) mastoidectomy in 13, inside-out (ISO) mastoidectomy in eight, and tympanoplasty in 10. Surgical approaches, staging, hearing outcomes, relapse status, and surgical data were retrospectively analyzed. RESULTS: Cholesteatoma recurred in seven patients (11%). Recurrence rates for CWU and CWD mastoidectomies were 31% and 6%, respectively. While the number of patients with good serviceable hearing (pure-tone average ≥25 dB) was 10 preoperatively, it became 16 postoperatively. Ossicular erosion was higher in CWD group. Twenty-nine patients (47%) had extensive disease and CWD mastoidectomy was performed in 86% of these. Number of patients not requiring care was 45 (72.6%). CONCLUSION: In this study, we observed no differences in terms of good serviceable hearing between CWU and CWD mastoidectomies. The preferred method was mainly CWD in patients with extensive disease and ossicular erosion. Recurrence rates were higher in CWU group. Therefore, ISO or CWD mastoidectomy come to the forefront as appropriate treatment options in the treatment of pediatric cholesteatomas according to the extensiveness of disease.

[Comparison of patients undergoing functional endoscopic sinus surgery combined with septoplasty or septorhinoplasty]. / Fonksiyonel endoskopik sinüs cerrahisi ile eszamanli septoplasti veya septorinoplasti uygulanan hastalarin karsilastirilmasi

OBJECTIVES: We compared patients who underwent functional endoscopic sinus surgery combined with septoplasty or septorhinoplasty and evaluated the concurrent applicability of septorhinoplasty and endoscopic sinus surgery. PATIENTS AND METHODS: We retrospectively analyzed 145 patients (96 males, 49 females; age range 16 to 78 years) who underwent endoscopic sinus surgery in conjunction with septoplasty or septorhinoplasty. The two patient groups were compared with respect to demographic characteristics, systemic diseases, allergy histories, the presence of nasal polyposis, preoperative paranasal sinus tomographies, Lund-Mackay scores, surgical procedures, operation times, and complication rates. RESULTS: Patients who underwent septorhinoplasty were younger than those undergoing septoplasty. There were no significant differences between the two groups in terms of paranasal sinus tomography scores, allergy histories, systemic diseases, and complication rates (p>0.05). The number of patients with nasal polyposis was significantly greater in the septoplasty group (p<0.05). Septorhinoplasty in conjunction with endoscopic sinus surgery required a significantly longer operation time (p<0.05). CONCLUSION: Complications and the severity of sinus pathologies were similar in the two groups. Concurrent applications of septorhinoplasty and endoscopic sinus surgery significantly increase operation time.

[Non-Hodgkin's lymphoma of the parotid gland]. / Parotis bezi non-Hodgkin lenfomasi

Most of the primary malignant lymphomas of the salivary glands originate from the parotid gland. We presented two patients who were admitted with a painless mass in the parotid region and diagnosed to have a lymphoma. Physical examination of a 66-year-old male patient showed a relatively mobile, painless, and firm mass at the inferior aspect of the right parotid gland. Ultrasonography, computed tomography, and magnetic resonance imaging (MRI) were performed and a needle biopsy was obtained from the solid lesion extending from the right parotid superficial lobe to the medial deep lobe. Pathological examination revealed large B-cell lymphoma. The patient was treated according to the CHOP chemotherapy protocol. The second patient had undergone surgery for orbital lymphoma and received CHOP chemotherapy. On physical examination, there was a painless mass in the parotid cauda on the left and a subcutaneous lymph node, 0.5 x 1 cm in size, inferior to the parotid cauda. Computed tomography and MRI showed an irregularly contoured solid lesion, 2 x 1 cm in size, in the posteroinferior aspect of the superficial lobe. Lymph node biopsy yielded a diagnosis of small cell malignant lymphoma. The patient was referred to the medical oncology department for staging, further investigation, and planning of the treatment.