The Comparison of Inflammatory Markers for the Prediction of Recurrence of the Nasal Polyp After Endoscopic Sinus Surgery.

During the past decade, several inflammation-based periferic prognostic systems have been reported in the field of chronic rhinosinusitis with nasal polyps (CRSwNP). Recently, C-reactive protein (CRP) and albümin ratio (CAR) showed its impact on a large variety of diseases conditions that cause chronic inflammation. We aimed to compare the inflammatory markers in patients with recurrent and non-recurrent nasal polyps and if a significant inflammatory profile is associated with multiple recurrences. The study concerned 144 patients who underwent FESS for CRSwNP from 2012 to 2017 and had a postoperative follow-up longer than 12 months and 120 healthy individuals. We evaluated the impact of the CAR, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio, eosinophil-to-lymphocyte ratio (ELR) between patients with and without polyp recurrences and control groups. There was a statistically significant difference in CRP, CAR and ELR values between multiple recurrence group and no-recurrence group (p = 0.02; 0.004; 0.019 respectively), mean eosinophil and CRP values, CAR, NLR and ELR was significantly higher in NP patients than control group (p < 0.001). The receiver operating curve analysis showed CAR and ELR as a potential marker of recurrence of NP (AUC = 0.713 and 0.613, respectively p < 0.001). The cutoff values for were 1.03 for CAR and 0.22 for ELR. The mean CRP, CAR and ELR were significantly higher in patients with CRSwNP whose disease recurred after surgery. CAR may be a potential marker to predict the recurrence before endoscopic sinus surgery as well as ELR in CRSwNP disease.

Effects of nigella sativa oil on allergic rhinitis: an experimental animal study

Abstract Objectives: Nigella sativa oil is known antiallergic and immunomodulatory effects. We aimed to compare this oil with mometasone furoate, a topical steroid, on a rat model in the prevention of allergic rhinitis symptoms. Methods: A total of 28 two-to-four-month-old Wistar Hannover rats weighing 250-350 g were randomly divided into four groups of seven, which included control, allergic rhinitis, mometasone furoate, and Nigella sativa oil groups. Loss of cilia, an increase of goblet cells, vascular proliferation, inflammatory cell count, eosinophil infiltration, and the degree of hypertrophy in chondrocytes were assessed by light microscopy. Results: The frequency of nasal scratching in the Nigella sativa oil group was found to be significantly lower compared with the allergic rhinitis group (p < 0.05). Typical inflammatory changes seen in allergic rhinitis were not detected in the Nigella sativa oil group. No inflammation was observed in 85.7% of both the healthy control group and the Nigella sativa oil group. In addition, no inflammation was observed in 71.4% of the mometasone furoate group, and this difference was found to be significant compared with the control group (p < 0.05). In addition, eosinophil infiltration, cilia loss, chondrocyte hypertrophy, vascular proliferation, and goblet cell increase were found to be significantly decreased in the mometazone furoate and Nigella sativa oil groups compared to the allergic rhinitis group (p < 0.05). Conclusion: According to the findings obtained from this study, we found anti-inflammatory and anti-allergic effects of Nigella sativa oil as equally effective as mometasone furoate in the treatment of experimentaly generated allergic rhinitis. Level of evidence: IV.

Effects of nigella sativa oil on allergic rhinitis: an experimental animal study.

OBJECTIVES: Nigella sativa oil is known antiallergic and immunomodulatory effects. We aimed to compare this oil with mometasone furoate, a topical steroid, on a rat model in the prevention of allergic rhinitis symptoms. METHODS: A total of 28 two-to-four-month-old Wistar Hannover rats weighing 250-350 g were randomly divided into four groups of seven, which included control, allergic rhinitis, mometasone furoate, and Nigella sativa oil groups. Loss of cilia, an increase of goblet cells, vascular proliferation, inflammatory cell count, eosinophil infiltration, and the degree of hypertrophy in chondrocytes were assessed by light microscopy. RESULTS: The frequency of nasal scratching in the Nigella sativa oil group was found to be significantly lower compared with the allergic rhinitis group (p < 0.05). Typical inflammatory changes seen in allergic rhinitis were not detected in the Nigella sativa oil group. No inflammation was observed in 85.7% of both the healthy control group and the Nigella sativa oil group. In addition, no inflammation was observed in 71.4% of the mometasone furoate group, and this difference was found to be significant compared with the control group (p < 0.05). In addition, eosinophil infiltration, cilia loss, chondrocyte hypertrophy, vascular proliferation, and goblet cell increase were found to be significantly decreased in the mometazone furoate and Nigella sativa oil groups compared to the allergic rhinitis group (p < 0.05). CONCLUSION: According to the findings obtained from this study, we found anti-inflammatory and anti-allergic effects of Nigella sativa oil as equally effective as mometasone furoate in the treatment of experimentaly generated allergic rhinitis. LEVEL OF EVIDENCE: IV.

Repeated Atmospheric Pressure Alteration Effect on the Cochlea in Rats: Experimental Animal Study.

OBJECTIVE: This study aimed to evaluate the effects of repeated pressure alterations on cochlear structures in rats in an attempt to understand indirectly the inner ear status of flight crew who are repeatedly exposed to pressure alterations.METHODS: There were 12 adult Wistar albino rats equally divided into 2 groups: Group 1 (controls) and Group 2 (study group). The animals in Group 2 were exposed to repeated pressure changes in a pressure cabin which is regulated by manometers. The animals in Group 1 were placed in the cabin without being exposed to pressure changes. Auditory brainstem response (ABR) testing was performed in all animals at the beginning and at the end of the study. After 12 wk the animals were sacrificed and their cochleas were investigated using scanning electron microscopy (SEM).RESULTS: In the study group, hearing decreases at 2 kHz, 4 kHz, 6 dB at 8 kHz, and 32 kHz were encountered at the end of 3 mo. On SEM evaluation of the control group, the outer hair cells (OHC) and stereocilia were normal throughout the cochlea. In the study group, there were irregularities in lateral surface connections and separations, collapse, and adhesions in the basal segment of the cochlea and partial loss of stereocilia throughout the cochlea.CONCLUSION: Repeated alterations in the atmospheric pressure can lead to damage in the inner ear with subtle or evident hearing loss. Frequent flyers like air workers may be at risk of inner ear damage, which may be considered an occupational health problem.Eroglu S, Dizdar HT, Cevizci R, Cengiz AB, Ogreden S, Bulut E, Ilgezdi S, Dilci A, Ustun S, Sirvanci S, Kaya OT, Bayazit D, Caki BO, Oktay MF, Bayazit Y. Repeated atmospheric pressure alteration effect on the cochlea in rats: experimental animal study. Aerosp Med Hum Perform. 2021; 92(7):550555.

Comparison of preoperative diagnostic accuracy of fine needle aspiration and core needle biopsy in parotid gland neoplasms.

BACKGROUND: Fine needle aspiration (FNA) and core needle biopsy (CNB) are two commonly used approaches for the diagnosis of suspected neoplastic parotid gland lesions. We aimed to compare the diagnostic efficiency of FNA and CNB performed with ultrasound guidance preoperatively for the diagnosis of parotid neoplasms. METHODS: We retrospectively analysed the preoperative specimens of 113 patients (66 FNA, 47 CNB) who underwent surgical excision at our institute between 2014 and 2017. Patient selection was based on lesion type and dimension, preliminary and final pathology, imaging characteristics, clinical course, and treatment data for accurate statistical analysis. The final diagnosis was based on surgery in all of the patients. We compared the diagnostic accuracy of FNA and CNB regarding the correct tissue-specific diagnosis of benign and malignant tumours. The recurrence and complication rates were analysed to determine the safety of each technique. RESULTS: Among the 113 patients, the average follow-up period was 65.4 (50-88) months. Seventy-one patients (62.8%) were males, and the median age was 50 years. The most common type of surgery was superficial parotidectomy (83.2%), and the median tumour size was 30.0 mm. Pleomorphic adenoma was the most frequent neoplasm. The diagnostic rates of preoperative pathological evaluation of FNA and CNB samples were 68.2% and 91.5%, respectively. The sensitivity, specificity, and positive predictive value of FNA for detecting malignant lesions were 40, 100, and 100%, respectively, and those of CNB were 100, 100, and 100%, respectively. Only one complication occurred (haematoma) in the biopsy area after CNB. No recurrences were seen after CNB and FNA during the follow-up period. CONCLUSION: Our findings suggest that the diagnostic ability, sensitivity, and specificity of CNB are excellent compared with those of FNA. The only disadvantage of CNB is the need for experienced staff and good-quality equipment. The complication rates of each technique are very low, and the risk of tumour tract seeding is controversial. CNB should be considered the technique of choice when a nodule is detected in the parotid glands.

Effects of oral isotretinoin on normal and wounded nasal mucosa: an experimental study.

BACKGROUND: We aimed to investigate the effect of systemic isotretinoin therapy on normal and wounded nasal septal mucosa histopathologically in an experimental rabbit model. METHODS: Circular mucosal defect with a 7 mm diameter was made in the left septum of 12 New Zealand white rabbits. The rabbits were divided into two groups (six rabbits in each group) oral isotretinoin was given with olive oil at the operation day to the first group. The control group was only oil given group. The harvested septum mucosas were divided into four groups (1-wounded-drug given side, 2-unwounded and drug-given side, 3-wounded-control and 4-unwounded-control side). The diameter of the defect, mucosal thickness, epithelial thickness, ciliated cell level, goblet cell level and inflammation were evaluated every week for 4 weeks. RESULTS: At both wounded and normal side, thinning of normal respiratory ciliated epithelium was observed in the postoperative period. In study group at the wounded side; mean mucosal thickness was measured 139.66 µ (± 26.24), and in the control group, mean mucosal thickness was 238.33 µ (± 39.7) at the wounded side. (p < 0.001). The difference between the groups in thickness of normal septal mucosa was also statistically significant (p = 0.016) [190 µ (± 14.6) and 256.66 µ (± 44.66)]. The average cilia level was observed 1.16 in the wounded study group, while the average level was 2.33 in the wounded control group (p = 0.012). Average score measurements of the regenerated mucosa suggested that isotretinoin-given wounded animals have reduced goblet cell recovery, compared to the control both on the regenerated and unwounded mucosas (p = 0.007, p = 0.002, respectively). Inflammation was significantly higher in the wounded isotretinoin group (p = 0.018). CONCLUSION: Oral isotretinoin has negative effects on epithelial and ciliary regeneration, significantly reduces mucosal thickness and goblet cell counts of the normal and regenerated mucosa, causes severe inflammation and significant reactive changes.

Dermoscopic and clinical features of head and neck melanoma.

BACKGROUND: The dermoscopic criteria of extrafacial melanomas are well-known. OBJECTIVE: To determine the frequency of dermatoscopic findings in head and neck melanomas (HNM) and to assess the distinguishing dermoscopic criteria of facial and extrafacial melanoma. METHODS: This observational study included 108 patients with HNM (63% male, mean age 64 years). Participants underwent individual dermoscopic imaging of clinically melanoma. All lesions were excised, and histopathological examination was performed on all specimens. RESULTS: Drawing on histopathological analysis, lentigo maligna melanoma or lentigo maligna was diagnosed in 60 lesions, superficial spreading melanoma in 18, nodular in 10, desmoplastic in 8, superficial spreading melanoma in situ in 12. The most frequent location for head and neck melanoma was the cheek (60 patients, 55.6%). Eight prominent dermatoscopic features were observed in facial melanoma: annular-granular pattern (18%); rhomboidal structures (29%); pseudonetwork (29%); asymmetrical, pigmented, follicular openings (51%); obliterated hair follicles (8%); red rhomboidal structures (18%); increased density of the vascular network (32%); scar-like depigmentation (59%). CONCLUSIONS: HNM has specific dermoscopic features, and classical extrafacial dermoscopic rules are less useful for diagnosis of facial melanoma. In our study, further characteristic dermatoscopic findings were detected in facial melanoma such as low frequencies of irregular dots, 2 or fewer colors in lesions, the presence of pseudonetwork, increased density of the vascular network, red rhomboidal structures, in addition to dermatoscopic findings of extrafacial melanoma. Thus, it is concluded that the prediction and identification of HNM may be evident with the help of these signs.

Dermoscopic and clinical features of head and neck melanoma

AbstractBACKGROUND:The dermoscopic criteria of extrafacial melanomas are well-known.OBJECTIVE:To determine the frequency of dermatoscopic findings in head and neck melanomas (HNM) and to assess the distinguishing dermoscopic criteria of facial and extrafacial melanoma.METHODS:This observational study included 108 patients with HNM (63% male, mean age 64 years). Participants underwent individual dermoscopic imaging of clinically melanoma. All lesions were excised, and histopathological examination was performed on all specimens.RESULTS:Drawing on histopathological analysis, lentigo maligna melanoma or lentigo maligna was diagnosed in 60 lesions, superficial spreading melanoma in 18, nodular in 10, desmoplastic in 8, superficial spreading melanoma in situ in 12. The most frequent location for head and neck melanoma was the cheek (60 patients, 55.6%). Eight prominent dermatoscopic features were observed in facial melanoma: annular-granular pattern (18%); rhomboidal structures (29%); pseudonetwork (29%); asymmetrical, pigmented, follicular openings (51%); obliterated hair follicles (8%); red rhomboidal structures (18%); increased density of the vascular network (32%); scar-like depigmentation (59%).CONCLUSIONS:HNM has specific dermoscopic features, and classical extrafacial dermoscopic rules are less useful for diagnosis of facial melanoma. In our study, further characteristic dermatoscopic findings were detected in facial melanoma such as low frequencies of irregular dots, 2 or fewer colors in lesions, the presence of pseudonetwork, increased density of the vascular network, red rhomboidal structures, in addition to dermatoscopic findings of extrafacial melanoma. Thus, it is concluded that the prediction and identification of HNM may be evident with the help of these signs.