Volumetric evaluation of temporal bone structures in the cases with bilateral tinnitus: clinical and morphometrical study.

BACKGROUND: Tinnitus is the recognition of sound in the absence of any external auditory stimulus to the noise of ringing in the ears. Middle ear aeration carries important role for ossicular coupling and normal hearing. There is restricted morphometric data on the cases with bilateral tinnitus. MATERIALS AND METHODS: In this study we evaluated hearing findings of 18 cases with subjective nonpulsatile bilateral tinnitus and also morphometry and volumetry of temporal bone substructures on the computed tomography images using stereological method compared with the gender and age matched 12 healthy subjects. Duration of tinnitus, exposing acoustic trauma or/and high level noise levels, evaluation of middle ear volume, jugular bulb levels, distances between jugular bulb and both oval window and middle ear were evaluated. RESULTS: Both males and females with tinnitus showed worse hearing thresholds through bone and air conductions than healthy subjects but it was not statistically significant. Pure tone thresholds through bone and air conductions were not statistically different in both sexes with bilateral tinnitus. Right middle ear volume of the cases with bilateral tinnitus was mean 5.57 cm3 for males and 5.64 cm3 for females; and also the left middle ear volume of the cases with bilateral tinnitus was mean 5.87 cm3 for males and 5.65 cm3 for females. There were no significant differences between the cases with bilateral tinnitus and the control subjects according to the side of the body. CONCLUSIONS: The data on the hearing findings and morphometrical evaluation of the cases with bilateral tinnitus may be important for anatomists and clinicians. (Folia Morphol 2018; 77, 1: 57-64).

Infliximab has no apparent effect in the inner ear hearing function of patients with rheumatoid arthritis and ankylosing spondylitis.

Animal studies suggest that tumor necrosis factor (TNF) alpha blockers may pass to the inner ear in adequate concentration. In this prospective study, we aimed to evaluate the effect of infliximab on the inner ear hearing function in patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). The patients with high disease activity, who were planned to begin infliximab for therapy by physical medicine and rehabilitation department, were referred to ear-nose-throat clinic for consultation. After physical and otoscopic examination, audiological tests were performed. Air conduction thresholds between 250 and 8,000 Hz, bone conduction thresholds between 500 and 4,000 Hz, pure tone average, speech discrimination scores, distortion product otoacoustic emission (DPOAE) were used to evaluate the hearing function. The tests were repeated 2 and 6 months after the initiation of the drug "infliximab." A total of 44 ears of 22 patients (17 males and 5 females) were evaluated. Fifteen patients had a diagnosis of AS, and seven patients had RA. After initiation of infliximab therapy, statistically significant improvement was observed in disease activity scores [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, Disease Activity Score 28 (DAS-28) for RA] after 2 and 6 months (p < 0.05). We did not find any statistically significant difference between the air conduction thresholds, bone conduction thresholds, pure tone average, speech discrimination scores, and measurements of DPOAE before the initiation of treatment and after 2 and 6 months (p > 0.05). Any problem about the balance, vertigo, or dizziness was not reported from the patients during the treatment period. As a result, our study showed that there was no notable change or deterioration in the hearing function of the patients with AS and RA who were treated with infliximab. Further studies with higher number of patients with AS and RA and also with different TNF alpha inhibitors are needed to make more valid conclusion.

Patients with osteoporosis have higher incidence of sensorineural hearing loss.

OBJECTIVE: Osteoporosis is a common metabolic disorder that causes progressive changes in bone structure. Metabolic changes and possible degeneration of middle ear ossicles or the cochlear capsule may cause hearing loss in patients with osteoporosis. The aim of this study was to evaluate the hearing function and otolaryngologic symptoms of patients with osteoporosis. METHODS: One hundred patients with osteoporosis, 50 osteopenic patients and 25 healthy controls were evaluated prospectively. Bone mineral density (BMD) of patients was measured by dual-energy X-ray absorptiometry (DEXA). Otorhinolaryngologic examinations were performed on all patients together with an otologic symptoms survey, pure tone audiometry, word recognition test and distortion product otoacoustic emission (DPOAE). RESULTS: Patients with osteoporosis showed higher incidence of sensorineural type of hearing loss (SNHL). Mean pure tone audiometry findings of the patients and controls were significantly different in 500-8000 Hz frequencies (P < 0.01 for 500-2000 Hz, P < 0.05 for 4000-8000 Hz). Distortion product otoacoustic emission results of patients with osteoporosis at 6 kHz were significantly lower than controls and osteopenic patients (P < 0.05). Tinnitus complaints were remarkably higher in patients with osteoporosis (P < 0.01). No correlation was found between BMD scores and hearing levels. CONCLUSION: The data show that osteoporosis may be associated with SNHL. Cochlear dysfunction may play role in this hearing loss.

Evaluating the relationship between nasal obstruction and mean platelet volume by using acoustic rhinometry in patients with septum deviation.

BACKGROUND: Nasal airway obstruction is a common cause of upper airway obstruction. It is associated strongly with obstructive and hypoxic manifestations. Mean platelet volume (MPV) levels increase in hypoxic conditions. MPV is one of the platelet activation indices which re!ects the platelet production rate. We aimed to evaluate the relationship between MPV levels and nasal septal deviation (NSD) by using acoustics rhinometry in patients with septum deviation. METHODS: We performed a retrospective study of 51 patients with NSD and 58 healthy age matched subjects as control group. The diagnosis of patients with NSD was based on anterior rhinoscopy, endoscopic nasal examination and acoustics rhinometry. All the patients underwent Cottle- or Killian-type septoplasty under general anesthesia. Blood samples were collected before nasal septoplasty. RESULTS: MPV and platelet distribution width (PDW) levels were significantly higher and mean platelet count was lower in patients with NSD than the control group. A negative correlation was found between MPV, NDVol2 (volume2 of non-deviated side of the nose) and TNDVol (total volume of non-deviated side of the nose) values. CONCLUSION: MPV values increase in patients with NSD. Moreover, this increase was found in relation with the severity of obstruction.