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Background: Otosclerosis is characterized by abnormal bone growth in the otie capsule. Nowadays, stapedotomy is commonly used for otosclerosis treatment. Currently, postoperative dizziness has been associated with stapedotomy. In 1981, intratympanic dexamethasone was utilized to manage inner ear disorders like tinnitus and acute sensorineural hearing loss. However, there is much uncertainty regarding the effect and safety of topical steroid therapy in the middle ear during stapedotomy. In the present study, we assessed the effect of topical steroid therapy during stapedotomy on postoperative dizziness. Methods: Otosclerosis patients eligible for stapedotomy were randomly divided into two groups based on dexamethasone administration or placebo. Audiometric and tympanometry results were observed and recorded for the involved frequencies. The Dizziness Handicap Inventory was used to quantify patient perceptions of dizziness and balance issues. Audiometry and dizziness assessments were repeated at discharge and 4 months after the operation. Results: The study comprised 72 otosclerosis patients undergoing stapedotomy. At discharge, the intervention group showed a significant reduction in the incidence of dizziness compared to the placebo group. However, in the 4-month follow-up after the operation, both groups experienced a decrease in dizziness incidence, with no significant difference between them. There was also no significant difference in audiometric levels between the two groups. Interestingly, the intervention group had a significantly lower need for systemic anti-dizziness drugs after surgery compared to the control group. Conclusion: Topical dexamethasone during stapedotomy effectively minimizes dizziness at discharge and reduces the need for postoperative anti-dizziness medication. Level of evidence: 2.
RESUMEN
BACKGROUND: Considering the presence of squamous epithelial cells and fibroblasts in the tympanic membrane (TM), topical estrogen application may influence the repair of TM perforations. Therefore, this study was designed to investigate the healing effect of topical estrogen on chronic TM perforations and improvement in hearing threshold. MATERIALS AND METHODS: Sixty patients were enrolled in a randomized clinical trial. Thirty patients were treated with paper patch and 30 with estrogen-impinged paper patch. Complete closure of the TM perforation and hearing threshold were evaluated in both groups. Chronic unilateral perforations of the TM involving less than 40% of the total area of the TM without active disease in the middle ear were selected. The margin of the perforation was chemically trimmed using 15% trichloroacetic acid and patching performed under an operating microscope. Microscopic examination was performed after 14 days and repeated after 30 days. Complete closure of the TM perforation was considered as successful repair. Hearing threshold was determined before the start of the trial and 30 days after treatment. RESULTS: No significant difference was found between the two groups after 14 days in complete closure of the perforation (P = 0.310). After 30 days, patients treated with estrogen-impinged paper patch showed a significantly higher rate of closure of the perforation (63.4%) and improvement in hearing threshold (P = 0.017). CONCLUSION: Topical estrogen may have a healing effect on chronic TM perforations and improvement in hearing threshold.
RESUMEN
AIM: The aim of current study is to investigate whether tonsillar and/or adenoid tissue of patients with chronic adenotonsillitis plays a reservoir role for Helicobacter pylori (H. pylori) or Helicobacter hepaticus (H. hepaticus). BACKGROUND: Recently, there have been arguments ragarding Helicobacter pylori (H. pylori) being reserved in adenotonsillar tissue. PATIENTS AND METHODS: This study was performed with 90 patients with the diagnosis of chronic tonsillitis and adenoid hypertrophy, mean age 36 ± 22, 32 (36%) female and 58(64%) male. Presence of H. pylori and H.hepaticus were detected by glmM gene and 16S rRNA specific primers respectively. RESULTS: Of all patients 58 (65%) were found seropositive for H. pylori IgG while only 7(8%) patients had gentile gastrointestinal (GI) symptom, all gastritis. H. pylori and H.hepaticus was not detected in any of the patients by PCR. CONCLUSION: There was no correlation between GI symptom and/or seropositivity of H. pylori with presence of H. pylori and H. hepaticus in adenotonsillar tissues. Our results did not support the role of adenotonsills as a reservoir for H. pylori or H. hepaticus.
