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.

Olfactory Dysfunction: Its Association With Subjective Cognitive Impairment in Patients With Major Depression.

ABSTRACT: Olfactory disorders may be observed together with cognitive impairment in patients with major depressive disorder (MDD). This study compared olfactory performances between patients with MDD and healthy controls and investigated the relationship between olfactory performance and subjective cognitive impairment in these patients. This study included 52 patients diagnosed with MDD and 46 healthy controls. The participants were evaluated in terms of their olfactory capacities (threshold, discrimination, and identification), subjective cognitive impairment, and depression. Although the olfactory threshold (OT) and olfactory discrimination scores were lower in patients with MDD compared with those in the control group, their olfactory identification scores did not differ significantly. OT was negatively correlated with subjective cognitive impairment and may serve as a determinant for subjective cognitive changes. Consequently, patients with MDD had lower olfactory performances compared with healthy controls. Finally, OT may be a component of subjective cognitive impairment in MDD.

Comparison of Nasoseptal Cartilage Graft Versus Titanium Mesh in Reconstruction of Pure Orbital Blowout Fractures.

PURPOSE: To compare the efficacy of nasoseptal cartilage grafts versus titanium mesh implants in pure orbital blowout fractures. METHODS: A retrospective review was performed on 48 patients who had surgical repair of an orbital fracture. Patients who underwent pure orbital blowout fracture repair with either nasoseptal cartilage grafts or titanium mesh implants and at least 1 year postoperative follow-up were included in the study. The clinical features and treatment outcomes were analyzed. RESULTS: Twenty-five patients fulfilled our study criteria and were included in the analyses. Nasoseptal graft was used in 12 patients (48%) while titanium mesh was preferred in 13 patients (52%). Preoperative clinical features including age, size of the floor defect, and preoperative clinical findings (enophthalmos, diplopia, and restriction of ocular motility) were similar between 2 groups. Mean postoperative follow-up was 14.7 ±â€Š2.3 months in the nasoseptal group while it was 16.1 ±â€Š2.5 months in the titanium group (P = 0.84). Diplopia and ocular motility limitation were resolved in all patients at the last postoperative follow-up visit, while 1 patient in each group had enophthalmos (8.3% versus 7.6%, P = 1.0). No patient in the nasoseptal group experienced postoperative complications while 2 patients in the titanium group (15.3%) developed material-related complications (P = 0.48). CONCLUSIONS: Long-term clinical results of nasoseptal cartilage grafts and titanium mesh implants in pure orbital blowout fractures with preoperative floor defects smaller than 4 cm2 were comparable. Nasoseptal cartilage grafts may be preferred in patients with septal deviation and no spurs or turbinate hypertrophy.

Evaluation of the Efficacy of Hilotherapy for Postoperative Edema, Ecchymosis, and Pain After Rhinoplasty.

PURPOSE: Edema and ecchymosis are among the most important morbidities after rhinoplasty. The aim of the present study was to investigate the effects of hilotherapy application compared with traditional ice applications after rhinoplasty in terms of periorbital edema, ecchymosis, and pain. PATIENTS AND METHODS: A total of 60 patients (35 women and 25 men) had undergone primary rhinoplasty with the same surgeon. In the postoperative period, 30 patients in the study group received continuous cooling at 15°C using Hilotherm (Hilotherm GmbH, Argenbühl-Eisenharz, Germany), and 30 patients in the control group were treated with conventional cryotherapy with ice packs. Both treatments started within 45 minutes after the end of the surgery and were maintained for 24 hours. For the following 1 week, the patients were examined for edema, ecchymosis, and pain. RESULTS: When the postoperative periorbital region was evaluated for mean edema and mean ecchymosis for 7 days, less edema and less ecchymosis were detected in the Hilotherm group compared with that observed in the ice pack group (P < .001). When the mean pain scores were compared both morning and evening for 7 days, less pain had been recorded with Hilotherm application compared with ice application (P < .001). CONCLUSIONS: Hilotherapy is a useful method to prevent postoperative edema, ecchymosis, and pain compared with traditional ice application.

Costal Cartilage and Costal Perichondrium Sandwich Graft in Septal Perforation Repair.

BACKGROUND: Repair of the septal perforation is a challenging procedure and there are many different surgical techniques. In this study, the authors present a novel method which the authors use costal cartilage and costal perichondrium sandwich graft as an interposition graft with bilateral opposing mucoperichondrial flaps. PATIENTS AND METHODS: Fourteen patients (5 females, 9 males) underwent septal perforation repair. All surgeries were performed through an open approach septoplasty technique. The edges of the perforation were incised to excise the mucosa with a thickness of 2 mm. Bilateral mucoperichondrial flaps were raised. Then costal cartilage and costal perichondrium were harvested from the rib. The cartilage was divided into a smaller piece which is 2 mm thick and 1 cm wider than perforation size. The prepared cartilage was wrapped with perichondrium to obtain a sandwich graft. This sandwich graft was placed between the mucoperichondrial flaps, corresponding to the perforation. RESULTS: After 9 months of follow-up, 11 (78%) of the 14 perforations were completely closed. Failure of the repair was observed in 3 patients; 2 of the perforations were medium size and one perforation was large size. No complications occurred. CONCLUSION: Using costal cartilage and costal perichondrium sandwich graft is a novel and useful technique especially in large septal perforations. Considering that septum surgery has an important role in the etiology of septum perforation, this method provides a good graft source for both perforation closure and simultaneous rhinoplasty surgery.

The impact of platelet-rich fibrin (PRF) on olfactory function and pain after septoplasty operations.

BACKGROUND: We aimed to investigate the effect of platelet-rich fibrin (PRF) on olfactory function and pain score in patients who underwent septoplasty. METHODS: This prospective randomized observational study was performed between 2018 January and 2019 April with 148 patients who had septoplasty operation. Patients were divided two groups and 74 patients were placed in group 1 to which PRF was applied after the completion of septoplasty whereas 67 patients were put in group 2 which did not undergo PRF. Sniffin' Sticks test was applied to all patients at pre-op, post-op 1-week, 6-week, and 6-month. Pain scores of patients were measured with visual analogue scale at 1 and 3 week. RESULTS: The distribution of patients according to pre-op olfactory function (normo-hypo-anosmia), there was no significant differences statistically (p > 0.05). When we compared the 1-week post-op results of Sniffin' Sticks test of patients, we found differences between the groups (p < 0.05). It was observed in the early postoperative period that according to the Sniffin' Sticks test scores, the results of the PRF group were better than those of the non-PRF group. At 6-week and 6-month, between the groups; there was no differences in terms of olfactory function. When we looked at the pain score of patients at 1 and 3 week after septoplasty; significant differences were obtained between groups. CONCLUSION: The application of PRF to the mucosal surface after the completion of septoplasty, has positive effect on olfactory function and pain especially in the early postoperative period. During the healing process, it was observed that prf maintained better odor functions. It is a minimally invasive technique with low risks and satisfactory clinical results.

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.

Effects of intratympanic dexamethasone on noise-induced hearing loss: An experimental study.

AIM: Aim of the study was to evaluate the effect of intratympanic steroid treatment on hearing based on oto-acoustic emission. METHODS: A total of 16 healthy female Wistar albino rats weighing were used in this study. They were divided in to 2 groups and each group was exposed to noise at 110dB for 25min to induce acoustic trauma. Intratympanic dexamethasone was administered to the middle ears of animals in the experimental group on the same day as exposure to noise. The control group was given 0.09% saline solution. Distortion product otoacoustic emission measurements were performed on days 7 and 10. RESULTS: There were no differences between the emission results of two groups before treatment at 4004, 4761, 5652, 6726, and 7996Hz. There were significant group differences on measurement days 7 and 10 at all frequencies. CONCLUSION: Our study revealed a significant difference in DPOAE measurements on days 7 and 10 between the experimental and control groups. We detected a positive effect of dexamethasone on noise-induced hearing loss.

Comparison of Voice Quality Between Patients Who Underwent Inferior Turbinoplasty or Radiofrequency Cauterization.

OBJECTIVES: The aim of this study was to analyze and compare the vocal quality in patients who underwent either submucosal turbinectomy or radiofrequency cauterization. METHODS: In this study, we enrolled 60 patients diagnosed with inferior concha hypertrophy. These patients were divided into two groups by using computer program "Research Randomizer." Of the 60 patients, 30 underwent submucosal inferior turbinoplasty and 30 underwent radiofrequency cauterization. The control group was composed of 30 healthy adults with no nasal or upper aerodigestive system pathology. The patients were checked at weeks 1, 2, and 4. Voice records were taken before the procedure and at week 4 postprocedure. RESULTS: The mean age of patients in the inferior turbinoplasty group was 29.4 years (range: 19-42 years); in the radiofrequency group, it was 30.30 years (range: 18-50 years). There was no statistical difference in age between groups. In the inferior turbinoplasty group, there were 16 male and 14 female patients, and in the radiofrequency group, there were 13 male and 17 female patients. There was no significant difference in the number of males and females between groups. CONCLUSIONS: Voice professionals, especially singers, actors, and actresses, should be informed about possible voice changes before undergoing endonasal surgery because these individuals are more sensitive to changes in resonance organs. We believe that voice quality should be regarded as a highly important parameter when measuring the success of endonasal surgery.

Effects of sleep bruxism related tinnitus on quality of life.

OBJECTIVES: This study aims to analyze the subjective and objective characteristics of tinnitus in sleep bruxism patients. PATIENTS AND METHODS: The study included 57 patients (12 males; 45 females; mean age 33.89±12.50 years; range 19 to 55 years) with sleep bruxism and tinnitus (sleep bruxism group) and 24 patients (6 males, 18 females; mean age 43.75±16.19 years; range 21 to 58 years) only with tinnitus (control group). Sleep bruxism was diagnosed by the diagnostic criteria of American Academy of Sleep Medicine. Patients were performed pure tone audiometry to detect hearing thresholds at standard and high frequencies. Tinnitus frequency and loudness were assessed. Subjective aspects of tinnitus were identified by tinnitus handicap inventory. RESULTS: The statistical analysis revealed that the sleep bruxism group had significantly lower hearing thresholds except 1000 Hz and 2000 Hz. Tinnitus frequency was between 3000 Hz and 18000 Hz in sleep bruxism group while it was between 6000 and 16000 Hz in control group with no statistically significant difference (p=0.362). Sleep bruxism group had significantly lower tinnitus loudness and tinnitus handicap inventory scores in comparison to control group (p=0.024 and p=0.000, respectively). CONCLUSION: Tinnitus caused by sleep bruxism and temporomandibular joint issues has higher frequency and lower loudness compared to patients with only tinnitus.