An evaluation of the effects of adenoidectomy on voice and speech function in children.

OBJECTIVES: This study aims to evaluate the possible effects of adenoidectomy on voice and speech function. PATIENTS AND METHODS: Thirty-six children (20 boys, 16 girls; mean age 8.22±1.86 years) with adenoid hypertrophy and 50 healthy children (23 boys, 27 girls; mean age 8.54±1.92 years) were included in the study. Acoustic and spectrographic analyses, voice analysis and nasalance assessment were carried out preoperatively and at one week and three months postoperatively in children who underwent adenoidectomy operation and control group. RESULTS: A significant change in voice nasalance and F3 and F4 formants was observed in children who underwent adenoidectomy. There was no significant change in F0, shimmer %, amplitude perturbation quotient (APQ), jitter %, relative average perturbation (RAP), noise to harmonic ratio (NHR), F1 and F2 formant values, as assessed by objective voice analysis. CONCLUSION: Our study results show that adenoidectomy may affect voice resonance and nasalance, changing the shape and size of nasopharynx and upper respiratory tract. Adenoidectomy seems to be safe without any significant change in the voice quality.

Ghrelin levels in children with adenoid or chronic tonsil hypertrophies before and after surgery.

OBJECTIVE: We aimed to evaluate the ghrelin levels in the children with adenoid or tonsil hyperthrophies. METHODS: The study included 27 children (17 boys and 10 girls). Mean age was 6.9+/-3.5 years, ranging from 3 to 16. Ghrelin levels in the patients and their weight and height measurements were evaluated before surgery and after 3 months later of the operation. RESULTS: While 18 (67%) children were operated for adenoid hypertrophy, 9 (33%) children were operated for adenoid and tonsil hypertrophy. It was found that postoperative ghrelin levels were significantly decreased whereas weight and BMI scores were significantly increased (p<0.01). A weak correlation was observed between preoperative ghrelin and weight (r=-0.29). This negative correlation became more profound at the postoperative 3rd month examination (r=0.85) (p<0.01). CONCLUSIONS: The present study showed that the surgical treatment provides positive contributions on the growing of children with adenoid and tonsil hypertrophies. The ghrelin levels were significantly decreased at the postoperative period in the children, and a negative relationship was observed between the ghrelin levels and the weight. These findings suggest that blood ghrelin levels may be useful as a parameter for following the development of the children.

Evaluation of HLA-A, -B, -Cw, and -DRB1 alleles frequency in Turkish patients with nasal polyposis.

OBJECTIVE: To evaluate whether there is a relationship between HLA-A, -B, -Cw, and -DRB1 alleles and developing nasal polyposis (NP). STUDY DESIGN: Data from 66 patients with NP were compared with data from 100 healthy randomly selected controls. Asthma, ASA (acetylsalicylic acid) triad, polyp score, and previous sinonasal surgery were also recorded. SUBJECTS AND METHODS: Genotyping of the HLA-A, -B, -Cw, and -DRB1 alleles were performed with polymerase chain reaction (PCR) with the sequence-specific primer (SSP) method. Data were analyzed by using a Pearson chi(2) test. RESULTS: The HLA-B*07 and -Cw*12 alleles were found to be significantly higher in the NP patients compared with the control group, whereas the HLA-B*57 and HLA-Cw*04 alleles were significantly lower (P < 0.05). The HLA-A*24, HLA-Cw*12, and HLA-DRB1*04 alleles were determined to be significantly higher in the NP patients with asthma and ASA triad (P < 0.05). CONCLUSIONS: Our results show that some of the HLA alleles seem to be associated with the genetic susceptibility to develop NP in the Turkish population.

Relation of glutathione S-transferase genotypes (GSTM1 and GSTT1) to laryngeal squamous cell carcinoma risk.

The purpose of the present study was to investigate GSTM1 and GSTT1 genotypes by using multiplex polymerase chain reaction (PCR) in patients with laryngeal squamous cell carcinoma (LSCC). The genotypes of 110 patients with LSCC and of 197 healthy subjects as the control group were determined by PCR analysis for GSTM1 and GSTT1 genes. Results showed that frequencies of GSTM1-null, GSTT1-null, and both GSTs-null genotypes were 51.8, 30, and 16.4%, respectively, in the patients with LSCC and 37.6, 15.7, and 5.6% in the control group. There was a significant difference between the genotype distributions of all GSTs in patients and in control groups (P < 0.05). The results support the hypothesis that null genotypes of GSTM1 and GSTT1 can reduce detoxification capacity of GSTs as members of the xenobiotic enzyme system. GSTM1-null, GSTT1-null, and both GSTs-null genotypes were more common in the patients with LSCC than in the control group. Patients with both GSTs-null genotypes had the highest risk for supraglottic LSCC in the early period, even if they were light-to-medium smokers. Investigation and determination of the genetic basis of LSCC may contribute to detection of risk groups and to prevent LSCC in the population.

Frequency of pharyngeal reflux in children with adenoid hyperplasia.

OBJECTIVES: The purpose of the study is to investigate whether there is any association between pharyngeal reflux and adenoid hyperplasia by using 24-h esophageal pH monitoring with a dual probe in children. METHODS: The study group consisted of 30 children with adenoid hyperplasia, and the control group consisted of 12 healthy children, studied prospectively. All children underwent 24-h esophageal pH monitoring with a dual probe (distal and proximal esophageal pH monitoring). The results were evaluated by the Measurement and Analysis Software of Medical Measurement System program (Version: 7.2a). RESULTS: In the study group, the frequency of pharyngeal reflux was 46.7% and the gastroesophageal reflux (GER) was 64.5%, while, in the control group, they were 8.3% and 25%, respectively. There was a significant difference between study and control groups for frequencies of pharyngeal reflux and GER. Mean adenoid nasopharyngeal ratio (ANR) was 0.78+/-0.11 in children with adenoid hyperplasia. There was not a significant difference between positive pharyngeal reflux, positive GER and mean ANR (p>0.05). CONCLUSIONS: Children with adenoid hyperplasia had higher frequency of pharyngeal reflux than children at the same age healthy group. These results supported that pharyngeal reflux may play an important role in the etiology of adenoid hyperplasia.

Increased expression of epidermal growth factor receptors in the tracheal epithelia after topical mitomycin-C in rabbits.

The aim is to examine histopathological changes and expression of epidermal growth factor receptor (EGFR) in tracheal epithelia caused by application of topical mitomycin-C (MMC) in rabbit model after the tracheotomy procedure. The conventional tracheotomy was performed in 16 rabbits. They were randomly divided into two equal groups. The first group was applied MMC at a concentration of 0.4 mg/ml around tracheotomy for 5 min, and the other group was not taken a treatment as a control. The animals were sacrificed at the end of 4 weeks. Their tracheas were evaluated with H&E and Masson's trichrome histochemically, and with antiepidermal growth factor receptor immunohistochemically. Results showed that there was no significant difference between MMC and control group for inflammatory cells (P=0.09). The numbers of fibroblasts and subepithelial tissue thickness in the group exposed to MMC were significantly lower than the control group (P<0.05). In contrast, the percentage of EGFR in the application of MMC group was significantly higher than the control group (P<0.05). The application of topical MMC on airway epithelia after tracheotomy showed significant elevation in the levels of epithelial EGFR expression compared to controls in a rabbit model. The activation of epithelial EGFR may facilitate epithelial healing, but further studies are needed to assess the effect of topical MMC on respiratory epithelia.

Micronucleus frequency in acquired middle ear cholesteatoma.

OBJECTIVE: To determine the micronucleus (MN) frequency of acquired cholesteatoma tissue using an MN assay. MATERIAL AND METHODS: Eighteen patients were diagnosed as having chronic otitis media with acquired cholesteatoma and were divided into primary and secondary acquired cholesteatoma groups. Cholesteatoma tissue and normal tissue specimens from the external ear canal skin were taken from the patients during surgical operations. MN frequencies of cholesteatoma and control samples were determined according to standard criteria. RESULTS: The MN frequencies of the cholesteatoma and control tissues were 0.54%+/-0.31% and 0.24%+/-0.11%, respectively (p<0.01). MN frequencies for the primary and secondary acquired cholesteatoma groups were 0.63%+/-0.36% and 0.46%+/-0.26%, respectively (p>0.05). MN frequencies in cholesteatoma patients without and with complications were 0.42%+/-0.19% and 0.85%+/-0.37%, respectively (p<0.05). CONCLUSION: MN frequencies were found to be increased in cholesteatoma tissues when compared with external ear canal skin. The MN frequency in five cases with complications was higher than in cases without complications. These results indicate that there could be associations between MN frequency and acquired cholesteatoma and between MN frequency and complications.

Pharyngeal reflux in children with chronic otitis media with effusion.

OBJECTIVE: To investigate whether there is an association between chronic otitis media (COM) with effusion and pharyngeal reflux in children by using 24-h pH monitoring with a dual probe. MATERIAL AND METHODS: This was a prospective study. The study group consisted of 25 children with COM with effusion and the control group comprised 12 healthy children. All children underwent 24-h esophageal pH monitoring with a dual probe (distal and proximal esophageal pH monitoring). RESULTS: In the study group, the frequencies of pharyngeal and gastroesophageal reflux (GER) were 48% and 64%, respectively, and the corresponding values in the control group were 8.3% and 25%. Both of these differences were significant (p <0.05). In the study group, 28% of patients were positive for at least 1 symptom of GER; 72% of the patients did not have any symptoms but 56% of these patients had silent GER. CONCLUSIONS: These findings indicate that pharyngeal reflux may play an important role in the etiology of COM with effusion. If patients have typical symptoms of GER, such as pyrosis, regurgitation, dysphagia and emesis, the presence of GER should be considered. The presence of silent GER and pharyngeal reflux should also be considered.