Evaluation of Effects of the Human Immunodeficiency Virus on the Vestibular System by Using the Video Head Impulse Test.

OBJECTIVE: Some studies have suggested that the human immunodeficiency virus causes dizziness and other balance problems; however, the exact effects on the vestibular system in acute and chronic phases of the disease are not clear. In this study, we aimed to evaluate the effect of the human immunodeficiency virus on semicircular canals using a video head impulse test. MATERIALS AND METHODS: Seventy-two cases were included in the study. Twenty-six of the cases had positive human immunodeficiency virus RNA (group A) and 22 had negative human immunodeficiency virus RNA with positive anti-human immunodeficiency virus (group B) laboratory results. Twenty-four of the cases were healthy individuals (group C). The vestibular system was evaluated with a video head impulse test in all cases. RESULTS: In the evaluation of overt/covert saccades, a statistically significant difference was detected for the left posterior semicircular canal between group B and the other 2 groups. However, this was considered an incidental finding and not a clinically significant result. There was no other significant difference in the catch- up saccades for other canals. In addition, there was no statistically significant difference between the groups for the vestibulo-ocular reflex gain. CONCLUSION: Although the human immunodeficiency virus has been reported to be vestibulotoxic in previ- ous studies, we found that the video head impulse test findings were not affected in our patient groups. Because the video head impulse test is considered a high-frequency test of vestibulo-ocular reflex, it is pos- sible that vestibular effects of the human immunodeficiency virus can be confined to low frequencies. It is also possible that HIV affects the central structures while sparing the peripheral vestibular pathways.

Impact of Gender on Symptoms and Comorbidities in Obstructive Sleep Apnea.

OBJECTIVE: Obstructive sleep apnea (OSA) is more common in men than in women. In this study, we aimed to address the impact of gender on symptoms and comorbidities in patients with OSA. MATERIALS AND METHODS: This cross-sectional study was conducted among 1,317 consecutive patients, who were admitted to the Sleep Apnea Clinic of the Marmara University Hospital between November 2015 and October 2018, and who completed questionnaires and a sleep study with cardiorespiratory polygraphy. OSA was defined as Apnea Hypopnea Index (AHI) ≥15/hour. RESULTS: In all, 1,042 patients (334 women) fulfilled the inclusion criteria. OSA was observed in 589 patients (56.5%). Women were older than men (50.2±12.5 versus 45.6±15.1 years) and had lower AHI (22.1±20.1 versus 26.8±21.9 events/h). In the OSA group, women were older (53.7±11.5 versus 47.8±12.8 years) and more obese (BMI 34.6 versus 31.8 kg/m2). Symptoms were categorized as frequent/very frequent, and women with OSA complained more about daytime fatigue (74.6% versus 63.7%), nocturia (69.7% versus 51.8%), headache in the morning (50.0% versus 28.4%), depressive mood (49.0% versus 19.5%), and restless legs symptoms (43.1% versus 17.2%), than did men (all p values <0.05). Comorbidities were observed more in women than in men (lung disease [25.4% versus 13.7%], hypertension [29.6% versus 15.0%], diabetes [20.3% versus 11.3%], and hypothyroidism [14.0 % versus 4.1%]). In regression analysis, age (OR 1.03, p<0.001), BMI (OR 1.13, p<0.001), and male sex (OR 2.08, p<0.001) were significantly predictive for OSA while history of tonsillectomy was protective (OR 0.48, p=0.033). CONCLUSION: Fatigue, nocturia, headache, depressive mood, restless leg, and comorbidities were observed more in women. OSA-related symptoms develop late and/or the referral of women for diagnostic evaluation of OSA is delayed. Symptoms and comorbidities in women should be evaluated more attentively for earlier referral and diagnosis of OSA.

Sodium valproate improves sensorimotor gating deficit induced by sleep deprivation at low doses

Background/aim: Sleep deprivation disrupts prepulse inhibition of acoustic startle reflex and can be used to mimic psychosis in ex- perimental animals. On the other hand, it is also a model for other disorders of sensory processing, including migraine. This study aims to assess the effects of sodium valproate, a drug that is used in a variety of neuropsychiatric disorders, on normal and disrupted sensorimotor gating in rats. Materials and methods: Sixty-two Wistar albino rats were randomly distributed into 8 groups. Subchronic and intraperitoneal sodium valproate were administrated to the sleep-deprived and nonsleep-deprived rats by either 50­100 or 200 mg/kg/day. Prepulse inhibition test and locomotor activity test were performed. Sleep deprivation induced by the modified multiple platform method. Results: Sleep deprivation impaired prepulse inhibition, decreased startle amplitude, and increased locomotor activity. Sodium valpro- ate did not significantly alter prepulse inhibition and locomotor activity in nonsleep-deprived and sleep-deprived groups. On the other hand, all doses decreased locomotor activity in drug-treated groups, and low dose improved sensorimotor gating and startle amplitude after sleep deprivation. Conclusion: Low-dose sodium valproate improves sleep deprivation-disrupted sensorimotor gating, and this finding may rationalize the use of sodium valproate in psychotic states and other sensory processing disorders. Dose-dependent effects of sodium valproate on sensorimotor gating should be investigated in detail.

Risk Factors for Lingual Nerve Injury Associated With Suspension Laryngoscopy.

PURPOSE: This prospective study was designed to identify risk factors for lingual nerve injury as a complication of suspension laryngoscopy. METHODS: Fifty-six adult patients (19 females and 37 males) who underwent microlaryngeal surgery (MLS) using the suspension laryngoscopy procedure under general anesthesia at our otorhinolaryngology department between January 2016 and January 2018 were enrolled in this study. All operations were performed using only a cold-steel microlaryngeal surgical set, and operations using laser and radiofrequency energy were not included. Unilateral or bilateral paresthesia, numbness of the tongue, and/or a change in taste sensation (dysgeusia) were considered to indicate lingual nerve injury. RESULTS: Operation time and difficulties during intraoperative intubation and/or suspension of the larynx were major risk factors for lingual nerve injury following suspension laryngoscopy ( P = .015 and P = .011, respectively). Difficulties in preoperative flexible fiberoptic examination and intraoperative laryngeal compression were not found as risk factors, and the associations were not significant. Additionally, females showed a higher complication rate of lingual nerve injury following suspension laryngoscopy than males. CONCLUSION: From a medical-legal standpoint, although lingual nerve injury is not a life-threatening complication, it is important to inform patients, especially those expected to undergo long-duration surgery.

Mastoid Cavity Obliteration with Cartilage Graft; Evaluation of 35 Patients.

OBJECTIVE: Cartilage is a rigid material that is highly resistant to infection and retraction and is tolerated well by the middle ear. The purpose of this study was to review retrospectively the results of cases of mastoid cavity obliteration with cartilage performed after canal wall down (CWD) mastoidectomy and to discuss the literature. METHOD: Of 983 patients who underwent surgery for chronic otitis media between January 2000 and June 2012, 54 patients who underwent CWD mastoidectomy plus mastoid cavity obliteration with cartilage and who were followed up regularly were selected from the database and invited for re-evaluation. All patients who came for a follow up after the invitation were examined and their data were evaluated retrospectively. RESULTS: Thirty-five of the patients who accepted the invitation were included in the study. All of the patients in the study underwent mastoid cavity obliteration with conchal and/or tragal cartilage grafts. The duration of follow up ranged from 21 to 41 months (average, 27.3 months). Epithelization occurred in all patients with dry cavity, except one who had residual cholesteatoma and underwent revision surgery. CONCLUSION: The results of this study indicate that cartilage can be preferred for obliteration of mastoid cavity after CWD mastoidectomy.

Tympanogram Findings in Hemodialysis Patients.

BACKGROUND: The aim of this study is to investigate whether changes in cerebrospinal fluid (CSF) pressure during the hemodialysis (HD) treatment are reflected on tympanometric measurements. METHODS: The study was performed on 24 HD patients. The static compliance and absorbance values of the patients before and after HD were measured using a wideband tympanometry. The tympanogram tests were performed immediately before and at the end of the HD session. RESULTS: The static compliance values of the patients after HD were significantly lower than those before HD. This decrease significantly correlated with the adequacy of dialysis determined by urea reduction rate and Kt/V. The absorbance values showed a decrease in the band 343 and 727 Hz, but no significant difference was found in other frequencies. The static admittance and absorbance values were influenced by the HD process. DISCUSSION: This influence might be due to the increase in CSF pressure as a result of the removal of urea from blood during HD session.

Facial canal dehiscence rate: a retrospective analysis of 372 chronic otitis media cases.

PURPOSE: This study aimed to investigate the rate and location of facial canal dehiscence (FCD) observed during surgery for chronic otitis media (COM) with or without cholesteatoma. MATERIAL AND METHOD: Operative details of 1296 patients who underwent chronic otitis media surgery from January 2000 to January 2017 by the same surgeon were included in this retrospective study focusing on intraoperative observations of FCD. RESULTS: Because of the type of the surgery, the Fallopian canal could not be seen completely, so 924 of the cases which only involved performing a tympanoplasty were not included in the study. A total of 372 patients (196 males and 176 females) who had a canal wall down (CWD) or canal wall up (CWU) mastoidectomy were included in the study. A CWD mastoidectomy was performed on 250 patients, while 122 patients underwent a CWU mastoidectomy. The prevalence of FCD was 11.29% (42/372 patients). The dehiscence was more common in patients with cholesteatoma (n = 37; 88.1%) than those with non-cholesteatoma (n = 5; 11.9%). The tympanic segment (n = 32; 76.19%) was the most common location for FCD. When we compared the ossicular erosion results of the cases that had FCD, erosion in three ossicles together was more statistically significantly frequent than the other possibilities. CONCLUSION: It is possible to see FCD because of COM, especially with cholesteatoma. FCD is most commonly seen around the oval window. If stapes or all three ossicles are eroded, the surgeons must be more careful regarding FCD to be more effective in preventing facial nerve damage.

Comparing Spontaneous Closure and Paper Patching in Traumatic Tympanic Membrane Perforations.

The authors aim to analyze the effects of oral antibiotic treatment for traumatic tympanic membrane perforations and to compare the outcomes of patients with traumatic tympanic membrane perforation after paper-patching procedure and spontaneous healing.In this study, 80 patients with traumatic tympanic membrane perforation diagnosed in the otorhinolaryngology emergency department and outpatient clinic from March 2010 to January 2015 were retrospectively reviewed. If the patient is diagnosed at first week and the edge of perforation is moist with blood, our routine procedure is paper-patching (group 1). However, if the patients reject treatment or delay in admission, the authors follow up patients for spontaneous closure (group 2). Some of the patients got oral antibiotics for 7 days (amoxicillin/clavulanic acid, 1000 mg 2 times/d) while some others did not. Closure rates and effectivity of oral antibiotics were evaluated and compared between 2 groups.In total, 80 patients were analyzed. The closure rates of perforations were 95.2% for group 1 (n = 42) and 81.6% for group 2 (n = 38). Although the paper-patched patients (group 1) perforation closure rate (95.2%) is higher than the nontreated patients (group 2) closure rate (81.6%), it is not statistically significant (P > 0.05). Antibiotic administered 55 patients had a significantly higher closure rate (94.5%) than the 25 patients who are not treated with antibiotics (76%) (P = 0.023; P < 0.05).In patients with traumatic tympanic membrane perforations, spontaneous closure rate is quite high. This study showed us that antibiotherapy and paper-patch treatments increase the healing rates.

Electrophysiological and Histopathological Evaluation of Effects of Sodium-2 Mercaptoethanesulfonate Used for Middle Ear Surgery on Facial Nerve Functions.

OBJECTIVE: Sodium-2-mercaptoethanesulfonate (MESNA) is widely used in medicine because of its antioxidant and mucolytic effects. In recent years, it has been used in otologic surgery. Because it cleaves disulfide bonds, it is used to easily dissect the epithelial matrix in cholesteatoma and atelectasis. In this study, we hypothesized that MESNA does not have any toxic effect on the facial nerve, and the effects of MESNA on the facial nerve were examined histologically and electrophysiologically. MATERIALS AND METHODS: Twenty Wistar albino rats were used. Groups A and B were designated as the control and sham groups, respectively. The animals in groups C and D were administered 20% and 50% of MESNA solution, respectively, after the facial nerve was exposed in the parotid region. Electromyography (EMG) measurements were performed preoperatively and postoperatively at 4 weeks. The animals were subsequently euthanized; facial nerve samples were taken for histopathological examination. RESULTS: When EMG parameters were compared within and between each group, preoperative and postoperative results were not statistically significantly different. Histopathological examination showed that MESNA did not cause any inflammation, granulation tissue, or foreign body reaction. CONCLUSION: To the best of our knowledge, the effects of MESNA on facial nerve functions have not been investigated. In this study, the effects of MESNA after direct application to the facial nerve were examined electrophysiologically and histologically, and it was determined that MESNA did not cause any toxic effects. It was concluded that MESNA can, therefore, be safely used during middle ear surgery.

Comparison of the effects of radiofrequency ablation and microdebrider reduction on nasal physiology in lower turbinate surgery.

OBJECTIVES: This study aims to compare the effects of radiofrequency ablation and microdebrider reduction in lower turbinate surgery on nasal physiology. PATIENTS AND METHODS: Between January 2009 and March 2010, 40 patients with the complaint of nasal obstruction, who were diagnosed with lower turbinate hypertrophy, were randomly assigned into two groups to undergo either radiofrequency (group 1, n=20) or microdebrider (group 2, n=20) treatments. Nasal obstruction, the grade of turbinate hypertrophy and other symptoms were evaluated with subjective nasal obstruction scale and anterior rhinoscopy before the operation, and three days, seven days, four weeks, and eight weeks after the surgical intervention. RESULTS: The patients in group 2 had a significantly greater symptomatic improvement based on subjective nasal obstruction scale (SNOS) scores than the patients in group 1 (p<0.01). Acoustic rhinometry (ARM) measurements without decongestant application showed significant increase in postoperative MCA2 (Minimum Cross-sectional Area/cm2 2) and Vol 2 (Volume/cm3 2) (p<0.01), while there was no significant change in MCA1 (Minimum Cross-sectional Area/cm2 1) and Vol 1 (Volume/cm3 1). There was no statistically significant difference between the two groups with respect to ARM and anterior rhinoscopy (AnR) parameters (p>0.05). CONCLUSION: Based on these results, both radiofrequency ablation and microdebrider reduction may be considered as minimally invasive, straightforward, and reliable methods that provide sufficient airway passage without disruption of the nasal physiology.

Tortuous Carotid Artery Extended to Neck Level IIb Mimicking the Metastatic Mass.

Specifically in neck level IIb, the expected normal anatomy does not contain any vital structures and consequently it might direct a surgeon to perform rapid surgical dissection of tissues. Therefore aberrant anatomy of the vessels in the patients may be overlooked during neck dissection. Unexpected and potentially devastating injuries can be avoided by respecting the possible aberrant anatomy in any level of the neck. In this case report, a 74-year-old man was presented with laryngeal carcinoma who was treated with laryngectomy and bilateral neck dissection. During the left side neck dissection, tortuous internal carotid artery imitating a metastatic mass was unexpectedly encountered in level IIb. As in this case, surgeons should keep in mind possible aberrant anatomy during the neck dissection and perform surgery staying in surgical principles to be safe for an unforeseen and potential dangerous injuries.

Evaluation of transiently evoked otoacoustic emissions and auditory brainstem responses in patients with multiple sclerosis.

Multiple sclerosis (MS) is an inflammatory and demyelinating disease of the central nervous system. This prospective study was planned to evaluate these changes through brainstem evoked response audiometry (BERA) latency abnormalities and otoacoustic emissions (OAE). This study was performed between September 2009 and May 2010. A total of 160 recordings of BERA and OAE were examined, which were obtained from 80 ears of 40 participants. Twenty of these were MS patients and 20 were healthy volunteers in the control group. Mean ages of the MS group and the control group were 31.3 ± 4.73 and 30.95 ± 4.83 years, respectively. In patients' right ears in the MS group, the wave I, III, and V peak latencies and the I-V interpeak latencies were significantly prolonged compared to those in the control group. In patients' left ears in the MS group, the wave I, III, and V peak latencies and the I-III and I-V interpeak latencies also were significantly prolonged compared to those in the control group. There were no significant differences between the right and left ears for each group regarding wave latencies and intervals. In the MS group, the average of the interaural difference for I-V interpeak latency was significantly prolonged compared to that in the control group. The most reliable diagnostic method in MS is magnetic resonance imaging (MRI). However, sometimes plaques in the central nervous system may not be displayed. The pathologic process may exist and continue before these plaques become detectable on MRI, but electrophysiologic testing such as BERA can demonstrate these changes.

The effect of Nigella sativa oil on prevention of myringosclerosis in a Guinea pig model.

OBJECTIVES: In this study, our aim was to identify the possible effects of Nigella sativa L. (NS) [blackcumin] seed oil on the prevention of experimentally induced myringosclerosis (MS). MATERIALS AND METHODS: Fourteen Guinea pigs were used and they were divided into three groups. Tympanic membranes (TM) of all animals were perforated and then group I was treated with saline soaked gel foams as a control group, group II was treated with 0.5 ml NS oil soaked gel foams at 0, 24 and 48 h and group III was treated with 5 ml NS oil orally at 0, 24, 48, 72 and 120 h. After 15 days, all animals were euthanized. Tympanic membranes were evaluated macroscopically and histopathologically. RESULTS: Groups I showed extensive myringosclerosis in contrast to those of Groups II and III which had significantly less changes (p < 0.05). The fibrosis and inflammation in the lamina propria of the tympanic membranes of Groups I was found to be significantly more pronounced (p < 0.05). The tympanic membranes were found to be significantly thinner in Groups II and III when compared with Groups I (p < 0.05). CONCLUSIONS: The results of this study suggested that topical or oral administration of NS oil supressed the inflammation and fibroblastic activity in the lamina propria of the myringotomized TMs of the Guinea pigs. For providing further evidence to use plant extracts as antioxidant and antiinflammatory therapy after myringotomy or ventilation tube insertion, further clinical studies with larger population will be essential.

The Effect of Garlic Derivatives (S-Allylmercaptocysteine, Diallyl Disulfide, and S-Allylcysteine) on Gentamicin Induced Ototoxicity: An Experimental Study.

OBJECTIVES: Gentamicin is a potent aminoglycoside antibiotic. Ototoxicity and nephrotoxicity are the main side effects which restrict the use of gentamicin. Garlic with its intrinsic antioxidant activity may prove beneficial in prevention from ototoxicity. S-allylmercaptocysteine (SAMC), diallyl disulfide (DD), and S-allylcysteine (SAC) are three active compounds found in garlic. In this study, we investigated the effect of SAMC, DD, and SAC on the ototoxicity induced by gentamicin in rats, by using brainstem evoked response audiometry (BERA). METHODS: Thirty male Wistar rats with intact Preyer's reflex initially weighing 220-260 g were randomly assigned to either the gentamicin injection with SAMC treatment group (Genta-w SAMC), DD treatment group (Genta-w DD), SAC treatment group (Genta-w SAC), gentamicin injection without any active compounds (AC) treatment groups (Genta-w/o AC), or control group (n=6 rats each group). Gentamicin was given 120-mg/kg body weight, intraperitoneally once daily for 25 days to subjects in all groups except the control group. SAMC 100-mg/kg, and DD 50-mg/kg body weight were given intragastrically, and SAC 250-mg/kg body weight was given intraperitoneally once daily to subjects in Genta-w SAMC, and Genta-w DD, and Genta-w SAC groups, respectively during the study. After 25 days hearing thresholds were evaluated by using BERA test. RESULTS: The mean amplitude of auditory thresholds (sensation level [SL]) measured by using BERA for the Genta-w SAMC, Genta-w DD, Genta-w SAC, Genta-w/o AC, and control groups were 22±8, 25±5, 30±9, 54±11, and 10±7 dB SL, respectively (mean±SD). The differences between every active compound group (Genta-w SAMC, Genta-w DD, and Genta-w SAC) and Genta-w/o AC were statistically significant (P<0.016). CONCLUSION: SAMC, DD, and SAC are derivative of garlic seems to attenuate aminoglycoside-induced hearing loss. The effect of SAMC and DD seems to be more prominent than that of SAC.

Assessment the long-term effects of septoplasty surgery on olfactory function.

OBJECTIVES: This research aimed to evaluate pre-operatively and post-operatively the olfactory function of patients who had undergone surgery in our clinic for chronic nasal blockage via the Connecticut Chemosensory Clinical Research Center (CCCRC) smell test. METHOD: Thirty-seven patients (24 females, 13 males) were enrolled in this study. All had undergone surgery in our clinic due to chronic nasal blockage (not for smell dysfunction), having been diagnosed with septal deviation in conjunction with concha bullosa and/or inferior turbinate hypertrophy. This is a prospective study without a control group. The mean age was 33.74 ± 8.98 (range =19-54). All of the operations were performed under general anesthesia. CCCRC smell tests were performed on every patient before the operation and at post-operative 1st week, 6th week, 6th month, and 1st year. RESULTS: In this study, we found that septoplasty, in conjunction with middle concha surgery and/or inferior concha radiofrequency, did not affect the olfactory function negatively. CONCLUSION: Although nasal surgery has the potential to affect the smell function negatively, it was found that olfactory function was not affected after the surgery during a considerably long follow-up period. Moreover, an improvement in smell function was detected at post-operative 6th month and 1st year.

Assessment of nasal airway patency during pregnancy and postpartum period: correlation between subjective and objective techniques.

OBJECTIVES: This study aims to determine the physiological changes in a pregnant woman's nasal airway, the frequency of pregnancy rhinitis, and the correlation among anterior rhinoscopy (AnR), anterior rhinomanometry (ARM), and subjective nasal obstruction score as she progresses through pregnancy into the postpartum period (PPP). PATIENTS AND METHODS: Twenty non-smoking healthy pregnant women aged 19-35 (average 27.5±4.7) without a history of either respiratory allergy or chronic nasal or sinus problems were included in the study. Detailed history taking, AnR, and ARM were performed by the same ear nose and throat specialist at each trimester and postpartum second week. From then on, the participants scored, subjectively, morning levels of nasal obstruction (0= none, 1= slight, 2= moderate, 3= severe, 4= total obstruction). RESULTS: The AnR scores were low and the ARM findings were in normal range in the first trimester. Increasing AnR scores through pregnancy and decreasing AnR scores at PPP were statistically significant. Similarly, the ARM findings increased through pregnancy and decreased to normal levels at PPP; however, these changes among trimesters and PPP were not statistically significant. CONCLUSION: Anterior rhinomanometry and AnR are useful tools in the determination of nasal physiological changes as pregnancy progresses to PPP.

Bilateral hypopharyngeal perforations caused by penetrating trauma to the neck.

External laryngeal trauma is a relatively rare-encountered and sometimes life-threatening emergency condition. Recognition of laryngeal injury related to either blunt or penetrating trauma is important for both initial preservation of life as well as long-term airway and vocal function. Treatment options include medical management with observation and open surgical treatment with or without tracheotomy. We, herein, describe a 23-year-old male case who sustained external penetrating trauma to lateral aspect of neck. The etiology, clinical manifestations, investigation modalities and management of penetrating neck trauma were discussed in the light of the literature data.

The effect of Hypericum perforatum L. (St. John's Wort) on prevention of myringosclerosis after myringotomy in a rat model.

OBJECTIVES: The purpose of this study was to identify the possible effects of Hypericum Perforatum (HP) on the prevention of experimentally induced myringosclerosis (MS). METHODS: Twenty eight Wistar Albino rats were used and they were divided into four groups. Tympanic membranes of all animals were perforated and then group I had no treatment as a control group, group II had treated with olive oil only, group III had treated with HP orally and group IV had treated with HP topically. RESULTS: Groups I and II showed extensive myringosclerosis in contrast to those of Groups III and IV which had significantly less changes (p<0.05). The inflammation and fibrosis in the lamina propria of the tympanic membranes of Groups I and II were found to be significantly more pronounced (p<0.05). The tympanic membranes were found to be significantly thinner in Groups III and IV when compared with Groups I and II (p<0.05). CONCLUSIONS: The results of the present study suggested that oral or topical administration of HP extract after myringotomy suppressed the inflammation and fibroblastic activity in the lamina propria of the myringotomized TMs of the rats. Further clinical studies with larger population using HP and other antioxidants will be essential to provide further evidence for use of antioxidant therapy in patients with myringotomy and ventilation tube insertion for otitis media with effusion.

What is the Role of Diffusion Weigh Magnetic Resonance Imaging in Evaluation of Thyroid Nodules?

This study aimed to compare ultrasonography (US), contrast-enhanced computed tomography (CCT) of the neck, and diffusion-weigh magnetic resonance imaging (DW-MRI) in differentiating between benign and malignant nodules while approaching to thyroid nodules, and to estimate sensitivity and specificity of these methods. On thyroid US, echogenicity, calcification, presence/absence of halo, nodule size being larger/smaller than 20 mm, and nodule nature (cystic/solid nature) were evaluated. Findings on CCT of the neck were grouped according to the heterogeneity/homogeneity, presence/absence of enhancement, and intensity. On DW-MRI, diffusion restriction was evaluated. The findings of these tests were compared with postoperative histopathological findings, and specificity and sensitivity of the tests in differentiating malignant and benign nodules were assessed. The study included 38 patients (34 females, 4 males). The sensitivity and specificity of DW-MRI were 20 and 75 %, respectively. Presence of a >20 mm nodule in thyroid US had the highest sensitivity, whereas thyroid fine-needle aspiration biopsy (FNAB) had the highest specificity in detecting malignancy. The sensitivities and specificities of CCT of the neck and DW-MRI appeared relatively low. Evaluation of thyroid US findings together with thyroid FNAB findings provided high specificity and sensitivity and yielded better results than findings of CCT of the neck and DW-MRI.

Assessment of nasal airway resistances and nasal mucociliary activities of patients with unilateral chronic otitis media by acoustic rhinometry and saccharin test.

CONCLUSIONS: A significant increase was determined in nasal airway resistance of the pathological side of the patients with unilateral chronic otitis media (COM) compared with the non-pathological side and the patients with normal ears. Based upon this result, nasal pathologies should also be considered during the diagnosis and treatment stages of patients with COM. OBJECTIVES: We aimed to investigate whether there was a causal relationship between nasal pathologies causing eustachian tube dysfunction and COM. METHODS: Thirty patients were randomly selected from among patients who presented due to hearing loss and ear discharge, and 30 healthy volunteers were randomly selected as the control group. Acoustic rhinometry and saccharin tests were performed in all of the subjects. Test results were recorded for both the groups and statistical analysis was performed. RESULTS: A statistically significant correlation was found between the pathological results and COM side in acoustic rhinometry (p < 0.01). The prevalence of pathology in the right side of the nasal cavity was found to be higher in the group with perforation in the right ear (73.7%) and in the left side of the nasal cavity was also found to be higher in the group with perforation in the left ear (54.5%).