Blood prestin levels in COVID-19 patients.

BACKGROUND: Many studies have found that viral infections affect different tissues, including the inner ear. Coronavirus disease 2019 (COVID-19), a viral infection, is a significant health problem worldwide. Prestin is a motor protein with important functions both in the outer hair cells of the inner ear and in cardiac tissue. In addition, prestin is promising as an early biomarker in the detection of ototoxicity. To determine the severity of infection in COVID-19 patients and to determine whether other tissues are affected by the infection, lactate dehydrogenase (LDH), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase MB (CK-MB), biochemical markers such as ferritin and D-dimer are used. This study aimed to compare prestin levels in patients with COVID-19 and healthy volunteers. METHODS: In blood samples taken from 45 patients diagnosed with COVID-19 and 40 healthy volunteers, prestin levels were determined with the kit that used an enzyme-linked immunosorbent assay method and was commercially available. At the same time, LDH, CRP, ALT, AST, CK-MB, ferritin, and D-dimer levels were also detected in both patients and healthy control groups and correlations with prestin levels were examined. RESULTS: The main result of our study is that serum prestin levels in COVID-19 patients are significantly higher than in healthy controls ( p < 0.001). In addition, a statistically significant strong positive correlation was found between prestin-LDL ( r = 0.537, p = 0.001), prestin-CRP ( r = 0.654, p = 0.001), and prestin-D-dimer ( r = 0.659, p = 0.001). CONCLUSION: The levels of prestin, a motor protein in inner ear outer hair cells and cardiac myocytes, were found to be higher in COVID-19 patients than in healthy volunteers. It also showed a positive correlation with CRP and D-dimer. This may be associated with systemic dysfunction.

Embolization after internal carotid artery injury secondary to transsphenoidal pituitary surgery and delayed intranasal coil protrusion: illustrative case.

BACKGROUND: The authors presented a case of spontaneous nasopharyngeal coil migration that occurred 3 years after a patient had undergone transsphenoidal resection due to pituitary macroadenoma and was treated with coil application because of internal carotid artery injury secondary to transsphenoidal resection of the pituitary macroadenoma. OBSERVATIONS: In the literature, eight cases of coil migration that occurred between 2 and 120 months after coil application have been reported, most of which were treated with surgical removal of the coil in a same-day surgery setting. LESSONS: The case presented emphasized that coil protrusion and migration may lead to destruction in the skull base, thereby leading to serious consequences if left untreated, even in the absence of history of trauma. To the authors' knowledge, this is the first case in the literature that required additional invasive procedures due to recurrent bleeding that occurred several months after surgical removal of coils. Also, this report underlined the need for careful and long-term follow-up of coil materials used for the treatment of pseudoaneurysms caused by vascular injuries secondary to skull base injury during surgery.

Dacryocystitis With Skin Defects Secondary to Septorhinoplasty.

ABSTRACT: Septorhinoplasty is a surgical procedure frequently performed by surgeons dealing with facial aesthetic surgery and includes various risks. All surgical procedures have an increased risk of complications. Complication rate of nasal surgeries is approximately 4% to 19%. Although rhinoplasty is a nonsterile procedure, infections occur in less than 2% of all cases. This rate may decrease as the surgeon gains experience. Lacrimal ducts can be injured during nasal aesthetic surgery due to its anatomical structure. In addition to minor and temporary injuries, major injuries requiring surgical intervention may also occur. Most injuries to the lacrimal system remain asymptomatic. Postrhinoplasty dacryocystitis usually occurs secondary to soft-tissue edema that compresses the lacrimal system and typically resolves within 1 to 2 weeks. After reviewing the literature and examining possible traumatic mechanisms, we recommend that the infections in the lacrimal system should be treated with medical therapy before performing surgical interventions such as dacryocystorhinostomy and abscess drainage. Knowing the complications of surgical interventions before the study and administering some basic principles before and after surgery are highly essential. In this study, we present a relatively rare complication of septorhinoplasty known as acute postoperative dacryocystitis, which is mostly encountered in the early postoperative period.

Effect of Silver Nitrate Application on the Success of Endoscopic Dacryocystorhinostomy.

OBJECTIVES: To compare the clinical outcomes of patients undergoing additional procedures in endoscopic endonasal dacryocystorhinostomy (End-DCR) surgery and discuss the factors affecting the success of End-DCR surgery in light of relevant literature. METHODS: The study included 155 patients who underwent End-DCR surgery in our clinic due to epiphora. This was a prospective randomized, single-blind, controlled trial. Group I (control) included 54 patients who did not undergo silicone stent insertion or silver nitrate application, group II included 51 patients who underwent silicone stent insertion only, and group III included 50 patients who underwent silver nitrate application only. Statistical analysis was performed on follow-up data regarding anatomic and functional success rates. RESULTS: Revision surgery was performed in 16 patients who developed persistent epiphora in the postoperative period, including 6 in group I, 7 in group II, and 3 in group III (P = .4). The most common reason for revision surgery was stenosis of the neo-ostium (n = 8), followed by granulation tissue formation (n = 5) and synechia formation (n = 3). Granuloma formation was the most common postoperative complication, and a significant difference was found among the groups with regard to granuloma formation (P = .04). At postoperative month 12, the functional success rate was estimated to be 88%, 86%, and 94%, and the anatomic success rate was estimated to be 94%, 92%, and 96% in groups I, II, and III, respectively, with no significant difference, found among the 3 groups with regard to both rates (P = .79 and P = .76, respectively). CONCLUSION: The results indicated that stenting and silver nitrate application did not affect surgical success. Our preliminary results on silver nitrate cauterization showed that it is an effective, inexpensive, and practical method to reduce granulation formation in the postoperative period.