Effectiveness of pediatric nasal irrigation solution with or without xylitol.

OBJECTIVES: /Hypothesis: The aim of this study was to compare the efficacy and outcome of daily hypertonic saline irrigation versus saline/xylitol for treating pediatric chronic rhinosinusitis (CRS). STUDY DESIGN: This was a prospective, randomized, single-blinded study. METHODS: One hundred and twenty-five children diagnosed with CRS were enrolled in this study. The patients were randomized to twice-daily hypertonic irrigations with saline or saline/xylitol for 6 weeks. The treatment outcomes were measured using: Sinonasal Quality of Life Survey (SN-5) completed at baseline and after 6 weeks of irrigation. RESULTS: There were statistically significant improvements in the hypertonic nasal saline group's (reduction in SN-5 domain scores) four domains and an increase in the overall QoL score within each group after 6 weeks of treatment compared to baseline; however, there were no differences in the activity limitation (p = 0.1803). The xylitol solution groups had no differences between the two groups in the SN-5 scores in any of the domains or the overall score at baseline, and post irrigation treatment. CONCLUSIONS: Due to low tolerance, compliance, and the side effects, xylitol irrigation is not recommended as a first-line treatment for pediatric CRS. The use of a large volume of low pressure, twice-daily intranasal hypertonic irrigation for 6 weeks is safe and effective in the treatment of pediatric CRS; therefore, it can be used as a baseline treatment for pediatric CRS before considering surgical interventions.

Pediatric Sialorrhea: Submandibular Duct Rerouting and Intraparotid Botulinum Toxin A Injection With Literature Review.

OBJECTIVES:: The aim of this study was to assess the effectiveness of bilateral submandibular duct relocation and bilateral sublingual gland excision in combination with botulinum toxin A injection into the parotid glands in children with sialorrhea. Previously in the literature, either surgery or botulinum toxin injection but not their combination has been reported. METHODS:: Preoperative and at least 6-month postoperative assessments using the Drooling Severity Scale and Drooling Frequency Scale (Thomas-Stonell and Greenberg classification) and the Teacher Drooling Scale and by interviewing parents and caregivers face to face or via telephone were performed. Also, decreases in the daily number of bib changes and hourly frequency of saliva wiping were recorded as success. Complications were recorded. RESULTS:: The Drooling Frequency and Severity Scale, the Teacher Drooling Scale, daily number of bib changes, and hourly frequency of saliva wiping decreased significantly in 21 patients (95.5%) and remained unchanged in 1 patient (4.5%). Postoperative bleeding was observed in 1 patient (4.5%). CONCLUSIONS:: Drooling is a complex problem that benefits from a multidisciplinary approach. Many treatment methods exist, each with advantages and disadvantages. In this study botulinum toxin A injection was applied in conjunction with bilateral submandibular duct relocation and bilateral sublingual gland excision surgery, achieving a success rate of 95.5%. Moreover, minimal complications and no recurrence after at least 6-month follow-up were observed. The authors therefore recommend further use of this combination treatment. Larger and longer term studies may also help clarify its effectiveness.

Nasal care in intensive care unit patients.

PURPOSE: The aim of this study was to investigate nasal hygiene in intensive care patients and improve patient care using isotonic saline nasal spray. MATERIAL AND METHODS: In the study group, over a period of tendays saline nasal spray was administered four times daily. Nasal treatment was not given to the control group. Each patient was examined with a flexible nasopharyngoscope before and after the treatment and a nasal culture was taken. RESULTS: In the study group, the secretion score (1- absent; 2- serosal; 3- seropurulent and 4- purulent) mean value improved from 1.9 to 1.4. In the control group, the secretion score mean value had risen from 1.7 to 3.1. At the beginning of the study, there was no difference in secretion scores between the groups, but on the tenth day a statistically significant difference was found. CONCLUSION: The use of saline nasal spray in this group of intensive care patients was found to be effective in achieving nasal hygiene.

Effect of nasal antihistamine on secretory IgA in nasal lavage of rats.

The humoral IgA is an immunoglobulin which plays a defensive role for organisms on mucosal surfaces. Today, intranasal antihistamines are effectively used in the treatment of allergic rhinitis. In our study, the effect of azelastine hydrochloride-a nasal antihistaminic-on humoral IgA of the nasal mucosa has been reviewed empirically. Twenty-four female Sprague-Dawley rats were included in our study. The rats were divided into three groups randomly. Group 1(azelastine hydrochloride): rats in this group had nasal azelastine hydrochloride (0.05%) applied for 30 days at 10 µl/nostril dosage. Group 2 (saline): saline (0.09%) was applied to the rats in this group for 30 days at 10 µl/nostril dosage. Group 3 (control): no application was made throughout the study. The chemicals applied in Groups 1 and 2 were applied to both nostrils by mounting a flexible micropipette to the end of an insulin injector. At the beginning of the study, nasal lavage was performed to both nostrils of the rats in every group on the 15th and 30th day to aspirate irrigation solution (distilled water). The aspirated liquids were kept at - 80° temperature and reviewed together at the end of study. Within-group comparisons: in Group 1 (azelastine hydrochloride), the humoral IgA value on the 15th day was significantly higher than the basal value (p = 0.037). There is a significant difference between humoral IgA value on the 30th day and humoral IgA value on the 15th day (p = 0.045). In Group 2 (saline), no significant difference is available between basal, 15th day and 30th day humoral IgA values (p = 0.265). In Group 3 (control), no significant difference is available between basal, 15th day and 30th day humoral IgA values (p = 0.374). Between-group comparison: there is no significant difference in between-group humoral IgA basal values (p = 0.714). On days 15 and 30, Humoral IgA value of Group 1 was significantly higher than that of Groups 2 and 3 (p = 0.013, p = 0.024, respectively). According to the results we achieved in our study, nasal antihistaminic (azelastine hydrochloride) significantly increases the level of humoral IgA. Our study is the first one in the literature to reveal a relation between nasal antihistaminic and humoral IgA and there is a further need for clinical, randomized and prospective studies.

Assessment of the effectiveness of cyclosporine nasal spray in an animal model of allergic rhinitis.

The aim of this study is to show if cyclosporine has an antiallergic role in a rat model of ovalbumin-induced allergic rhinitis. The 54 rats were divided into six equal groups. The first group was a negative control group without induced allergic rhinitis; the second group a positive control with induced allergic rhinitis not receiving treatment. The remaining four groups, after induction of allergic rhinitis, received intranasal cyclosporine treatment in doses of 0.05, 0.1, or 0.2% or nasal steroid treatment. In the biochemical examination, on the surface of the tissue tumor necrosis factor (TNF) interferon (IFN), interleukin (IL)-5, IL-13, as well as IL-2, IL-4, IL-17A, and IgE were studied. Histologically, ciliary loss, increase of goblet cells, vascular congestion, and the degree of eosinophil infiltration were rated. In all treatment groups, on average, a significant reduction in all histological and biochemical values was found compared to the positive control group. Comparing each of the three cyclosporine-using groups with the group of nasal corticosteroid did not show any significant difference in the average scores. Cyclosporine nasal drops are effective to be used in an animal model of experimental allergic rhinitis without systemic effects.

Conchal contractility after inferior turbinate hypertrophy treatment:A prospective, randomized clinical trial.

OBJECTIVE: The aim of this study is to evaluate the effects of these two methods (Nasal corticosteroids (NCS) and radiofrequency (RF) application) on conchal contractility utilizing objective rhinologic measurement parameters. METHODS: 82 patients were presented with the complaint of nasal obstruction and diagnosed with inferior turbinate hypertrophy and were included in the study. Patients in Group 1 received NCS for 12weeks. Patients in Group 2 were administered RF to their inferior turbinates. Acoustic rhinometry and rhinomanometry tests with and without decongestant were performed. RESULTS: In the evaluation of the contractility difference of rhinometry parameters, there was not a significant difference among pre and postoperative acoustic rhinometric parameters in Group 1. Whereas in Group 2, postoperative contractility difference was significantly decreased compared to preoperative values. In the evaluation of the contractility difference of rhinomanometric parameters, no significant difference was found between pre and postoperative values in Group 1. However, postoperative contractility difference was significantly decreased compared to preoperative values in Group 2 in terms. CONCLUSION: Because the RF procedure produces fibrosis in the vascular tissues, inferior turbinates do not have a shrinking response to decongestant administration. Administration of NCS administration maintains the contractility function compared to RF application.

Evaluation of the protective effect of Botulinum toxin type A injection on otitis media with effusion.

OBJECTIVE: This study makes an analysis of the effect of Botulinum toxin type A on otitis media with effusion in rats. METHOD: As part of the study, 24 male Wistar Albino rats were divided into three groups: Group 1: Botulinum toxin Type A and Histamine (intratympanic 0.2 ml = 20 unit BTA); Group 2: Saline and Histamine (intratympanic 0.2 ml 0.9%); Group 3: Histamine (intratympanic 0.2 ml). Histamine (intratympanic 0.2 ml) was administered into the right ear for all groups. DPOAE and ABR tests were carried out on days 5, 10, 15 and 20 from the beginning of the study. RESULTS: There was no significant difference between DPOAE and ABR scores of the groups. In each group, the DPOAE scores for the right ear significantly decreased on day 5 when compared to the basal scores. In each group, there was no significant difference between days 5, 10 and 15 for the right ear. CONCLUSIONS: Botulinum toxin type A blocked the secretion of glands in the middle ear and showed no effect to prevent the formation of serous otitis. In addition, it was found out that Botulinum toxin did not lead to any morphological change in the cochlea.

Photographic Objective Alterations for Laryngopharyngeal Reflux Diagnosis.

OBJECTIVE: Diagnosis of laryngopharyngeal reflux (LPR) in clinical practice is generally made subjectively based on history, symptoms, and endoscopic assessment. This study presents the diagnostic role of the digital photographic assessment of the laryngopharyngeal region for LPR. METHODS: Seventy-two patients with LPR symptoms and 35 healthy volunteers were evaluated using the Reflux Finding Scores (RFS) and the Reflux Symptom Index (RSI). The results of these scales were recorded in 72 patients representing group 1 with LPR diagnosis; they returned after 1 and 2 months of treatment as groups 2 and 3, respectively. Thirty-five volunteers represented group 4. Laryngopharyngeal regions of all subjects were examined and photographed endoscopically. Red, green, and blue (RGB) values of particular oropharyngeal and laryngeal points were measured. RESULTS: RSI and RFS values of group 1 were significantly different from the other three groups, as were the scores of group 2; however, the comparison of the RSI and RFS values of groups 3 and 4 did not reveal a statistically significant difference. Laryngopharyngeal RGB values also duplicated statistical significance as above. CONCLUSION: Measurement of RGB values can be a cheap and easy-to-use method to quickly provide objective and corroborative information to help in the diagnosis of LPR in conjunction with subjective methods.

Repositioning intervals in the modified Epley's maneuver and their effect on benign paroxysmal positional vertigo treatment outcome.

INTRODUCTION: This study showed that short and long interval treatments achieved comparable success rates. There was no statistically significant difference in the rate of early and late recurrences between the two groups. Modified Epley maneuver can be applied in a short interval time with comparable success and recurrence rates which are as effective as in a long interval time. OBJECTIVE: The Epley maneuver is called the particle repositioning or canalith repositioning procedure. If a short time interval in each position is effective, it will allow for reduced time and avoid unnecessary physical burden. How long of a stay in each position is not determined in the literature. There is an absence of comparative studies of the BPPV repositioning time. The aim of this study is to compare the treatment time in patients with benign paroxysmal positional vertigo (BPPV). STUDY DESIGN: Longitudinal prospective study. SETTING: Outpatient practice in a tertiary care facility. SUBJECTS AND METHODS: Sixty consecutive patients with BPPV were included in this study. These patients were sequentially allocated to one of two groups (A or B). The interval times between each position in group A and B were 15 and 120 s, respectively. Modified Epley maneuver was performed in all patients. The maneuvers in both groups were exactly the same sequence of movements, except interval times. RESULTS: The mean age of the patients was 49.25 years (range =19-76 years). Of the 60 patients, 48 (80%) were women and 12 (20%) were men. Successful outcome was achieved in 26 patients (86.7%) after the first modified Epley maneuver in both groups. Three patients from each group (total six patients) responded to the third modified Epley maneuver and the remaining two patients did not respond to any modified Epley maneuver. Therefore, the Semont maneuver was applied with a successful result.

Dose and time dependent ototoxicity of aspartame in rats.

CONCLUSION: Low-dose administration of Aspartame (Ap) did not produce a significant ototoxic effect at the end of the 6th month. However, duration of the ototoxic effect is shortened and severity of the effect is increased as dose and duration of Ap administration is increased. OBJECTIVES: While Ap toxicity has been studied in short- and long-term studies, its effects on hearing have not been investigated. This study was conducted to evaluate the effects of long-term consumption of Ap administered in various doses on hearing status of rats. METHODS: The study included 54 female Wistar Albino rats. Ap was given for 6 months to the rats. The groups were assigned according to levels of Ap dosage. DPOAE and ABR tests were utilized for serial hearing evaluations. Serial hearing measurement times were designed as baseline, 1st week, 2nd week, 1st, 2nd, 3rd, and 6th months. RESULTS: While audiological parameters deteriorated with 100 mg/kg/day dose after the 3rd month, ABR thresholds were elevated and DPOAE values were significantly decreased in 500 mg/kg/day and 1000 mg/kg/day applications after the 2nd month. In 2000 mg/kg/day and 4000 mg/kg/day applications, deteriorations in audiological parameters were detected as early as the first and second months; respectively.

Curative Treatment of Oronasal Fistulas With a Silicone Obturator.

Oronasal fistulas can occur as a complication and sometimes they are refractory to the adequate surgical interventions. Two patients of oronasal fistula were presented. The first one developed as a complication of nasal septal surgery. Following 2 failed operative closure, a custom-made silicone obturator resulted unexpectedly as the cure for the problem in this patient. Experience gained from this patient was utilized in the second presented patient by simply insertion of a tailored silicone obturator after elevation of the nasal lining under local anesthesia to the oronasal fistula transorally allowed closure without any formal surgical intervention. Silicone obturator application may be employed for curative treatment of the oronasal fistulas avoiding complex surgical treatments.

Efficacy of nasal corticosteroid in preventing regrowth after adenoidectomy.

OBJECTIVE: One of the most frequent reasons of nasal obstruction and sleep apnea in pediatrics is adenoid hypertrophy. Remaining adenoid tissue can reoccur following hypertrophied adenoid removal and a second operation may be needed. Nasal corticosteroids are utilized in order to reduce adenoid hypertrophy and eliminate adenoidectomy operation. The purpose of our study is to assess the effect of nasal corticosteroid administration after adenoidectomy on adenoid regrowth and symptom scores. MATERIAL AND METHOD: Seventy patients who had adenoidectomy were enrolled in our study. Patients were divided into two groups. Group I (35 patients) received Mometasone furoate (40mcg/day per nostril) intranasal spray for 6 months, starting at postoperative week 3 after wound healing. As for Group II (35 patients), they received intranasal saline spray. Patients were followed up for one year. Every patient had flexible nasal endoscopy at postoperative week 3 and one year after the operation. Choana was scored according to its occlusion level by the adenoid tissue. Additionally, nasal obstruction symptoms (nasal congestion, dry mouth, snoring, nasal speaking, apnea and night coughing) were scored. RESULTS: Remaining adenoid tissue in the nasopharynx was comparable in flexible endoscopic assessment and no significant difference was seen between postoperative week 3 nasal obstruction scores. In the flexible endoscopic assessment completed in the twelfth month of the study, significant reduction was found in Group 1 compared to Group 2 in terms of adenoid size. When patients in both groups were compared, statistically significant reduction was observed in nasal obstruction symptom scores at the twelfth month. CONCLUSION: This study has demonstrated that the use of steroid nasal spray following adenoidectomy significantly prevents regrowth and reduces nasal obstruction symptoms in the early period.

Effect of Postrhinoplasty Taping on Postoperative Edema and Nasal Draping: A Randomized Clinical Trial.

BACKGROUND: Edema persists for months after rhinoplasty. Numerous modalities have been described to counteract postoperative edema. OBJECTIVE: To evaluate the effect of postrhinoplasty taping (PRT) on nasal edema and nasal draping. DESIGN, SETTING, AND PARTICIPANTS: In this randomized clinical trial, 57 patients undergoing rhinoplasty at a tertiary reference center from August 1, 2014, to January 31, 2015, were assigned to a control group or to 2- or 4-week PRT groups. Baseline nasal thickness was measured with ultrasonography at the nasion, rhinion, supratip, and tip, and mean nasal skin thickness (MNST) was calculated. Participants in each group were categorized by the baseline MNST measurement from the lowest to greatest MNST; those in the upper half were categorized as having thick skin; those in the lower half, thin skin. The control group underwent no PRT after the removal of external packing. Patients in the 2- and 4-week PRT groups received additional taping during the allocated time. Data were collected from August 1, 2014, to June 31, 2015. Follow-up was completed on June 31, 2015, and data were analyzed from July 1 to August 1, 2015. MAIN OUTCOMES AND MEASURES: Postoperative measurements of MNST were performed at the end of weeks 1, 3, and 5 and month 6. RESULTS: Of the 57 total patients (33 male and 24 female patients; mean [SD] age, 30.0 [11.7] years), 17 were in the 2-week PRT group; 20, the 4-week PRT group; and 20, the control group. Compared with the control group, 4-week PRT had a significant effect on the supratip (P = .001). Comparisons of MNST with the control group revealed significant effects of 2-week (P = .02) and 4-week (P = .007) PRT. The effect on the tip was not significant (P = .052). Postrhinoplasty taping had no effect in thin-skinned patients. Comparison among thick-skinned patients revealed a significant effect on the MNST (P = .01) and the rhinion (P = .02) but not the tip (P = .06) and supratip (P = .07). CONCLUSIONS AND RELEVANCE: Postrhinoplasty taping helps the skin envelope to compress to the underlying framework and decrease postoperative edema. The procedure can be used particularly in thick-skinned patients, in whom skin draping and nasal refinement is crucial to the surgical outcome. LEVEL OF EVIDENCE: 1. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT02626585.

Dynamometric Analysis of Normative Auricular Stiffness and Comparison With Operated Prominent Ears.

AIM: Stiffness of the auricular cartilage is the main determining factor for the choice of operative technique of the prominent ear deformity. The aim of this study is to evaluate the stiffness of normal appearing ears objectively and quantitatively, compare the results with the operated prominent ear patients, and present prospective short-term dynamometric evaluation of the operated prominent ear patients. PATIENTS AND METHODS: A total of 190 volunteers without ear deformities were recruited and 9 age groups were formed: group (5-9), group (10-14), group (15-19), group (20-24), group (25-29), group (30-34), group (35-39), group (40-49), and group (50+). Total 28 ears (14 patients) with otoplasty were included in the study as group (operated 5-9) and group (operated 10-14). In addition, 3 patients with prominent ear deformity were prospectively followed for dynamometric changes that occur with otoplasty operation. The auriculocephalic angle (ACA) was measured once and auricle to scalp distance was measured at 4 different standardized levels. Ear stiffness was measured on each ear individually at 4 different points over the antihelix using digital computer-aided dynamometry. Each ear was compared in terms of ACA, distance, and dynamometric values. FINDINGS: Dynamometric values tend to increase with age, which increase and peak around 35 years of age and declines after 40 years of age. Measurements of the first 2 age groups were statistically different compared with the other groups. Postoperative dynamometric measurements (DNM) of group (operated 5-9) were similar with normative values of group (5-9) and postoperative satisfaction visual analogue scale (VAS) score was 92.8%. Postoperative DNM of group (operated 10-14) were higher compared with normative values of group (10-14) for each different measuring level and the postoperative satisfaction VAS score was 75.3. A total of 3 patients with prominent ears had lower dynamometric values preoperatively; these values approached closer to normative values of their age group postoperatively. CONCLUSIONS: Results show that auricular cartilage stiffens and malleability decreases with increased age. This stiffness peaks in the 35-39 age group and declines after 40 years of age. Dynamometric values increase, at all levels, suggesting increased cartilage stiffness is related to age. In the scope of these results, cartilage sparing techniques are more suitable for 5 to 14 years of age and cartilage-cutting techniques are more suitable for older patients.

Betahistine exacerbates amikacin ototoxicity.

OBJECTIVE: Betahistine augments cochlear blood flow and is currently used as an efficient therapeutic agent. Amikacin is used in a wide range of areas, but its ototoxic effect continues to be problematic. This study investigates the effect of betahistine on amikacin-induced ototoxicity. METHODS: Thirty-two healthy rats were randomized to 4 groups of 8 rats in each group (amikacin, amikacin+betahistine, betahistine, and no treatment). Amikacin was administered intramuscularly to groups 1 and 2 for 14 days. Betahistine was delivered by oral gavage to groups 2 and 3 for 21 days. Distortion-product otoacoustic emissions (DPOAE) and auditory brainstem response (ABR) tests were conducted on all rats. RESULTS: There were significant decreases in the DPOAE levels and significant increases in the ABR thresholds of the amikacin and amikacin+betahistine groups on the 7th, 14th, and 21st days, as compared to their basal values. The DPOAE levels of the amikacin+betahistine group significantly decreased on days 7, 14, and 21, and the ABR thresholds significantly increased on the same days, as compared to the amikacin group. CONCLUSION: Our study implies that amikacin's ototoxic effects are augmented by the concurrent use of betahistine. Experimental and clinical research, supported by histopathological studies, is needed to affirm our findings.

Evaluation of the nasal contractility capacity in postmenopausal women.

BACKGROUND: The aim of this study was to objectively compare nasal contractility in premenopausal and postmenopausal patients by means of rhinomanometry, acoustic rhinometry, and peak inspiratory nasal flow. METHODS: Design: prospective, clinical case-controlled study. Setting: university tertiary-care hospital, referral center. Participants: the study included 97 participants divided into two groups: 49 postmenopausal (the study group) and 48 premenopausal (control) females. Nasal evaluations were made utilizing anterior rhinoscopy, peak inspiratory nasal flow, acoustic rhinometry, and anterior rhinomanometry. RESULTS: The differences between before and after decongestant application of Minimal Cross-sectional Area (MCA) 1, Minimal Cross-sectional Area (MCA) 2, Peak inspiratory nasal flow (PNIF), Rhinomanometry (RMM), Flow, and Volume values were been statistically significant in both postmenopausal and premenopausal group (control). CONCLUSION: Before and after all the subjects were administered nasal decongestant, nasal contractility was evaluated using objective nasal tests (acoustic rhinometry, rhinomanometry, and peak inspiratory nasal flow. Results showed that erectile tissues were not affected after menopause: postmenopausal women have the same nasal contractility capacity as premonopausal women.

A comparison of the long-term results of crushing and crushing with intrinsic stripping techniques in concha bullosa surgery.

BACKGROUND: A prospective endoscopic and radiologic evaluation of long-term outcomes of crushing and crushing with intrinsic stripping, 2 minimally destructive techniques used for the surgical treatment of concha bullosa. METHODS: Forty-two patients who underwent concha bullosa surgery (a total of 55 conchae surgeries) were included in the study. The patients were allocated consecutively to either of the 2 groups: Group 1 (crushing, n = 28) and Group 2 (crushing with intrinsic stripping, n = 27). All procedures were performed endoscopically. The presurgical and 1-year postsurgical endoscopic nasal cavity images and computed tomography (CT) scans of all patients were recorded. Preoperative and postoperative measurements were compared using paired t test and Student t test. RESULTS: Gender and mean age of the 42 patients (55 conchae bullosa) were as follows: 23 males, mean age 25.6 (range, 18 to 41) years; 18 females, mean age 24.2 (range, 18 to 33) years. The patients were followed for 12.5 ± 1.3 months. Comparisons of both the grading of endoscopic images and the concha bullosa volumes measured in CT images before and after treatment showed significant postsurgical reductions in both groups; comparison between groups showed significant postsurgical decreases for Group 2 in both concha bullosa volumes and in endoscopic scoring (p < 0.05). CONCLUSION: Crushing with intrinsic stripping is an effective and easy technique; when compared to crushing alone; this technique provides a significantly more decrease in middle concha volumes as demonstrated both by the CT and by endoscopic evaluations.

Posterior plica perforation: rare complication of adenotonsillectomy.

Tonsillectomy is one of the most common operations performed by otolaryngologists. Some extraordinary complications of this surgery are massive bleeding, taste perception disorders due to glossopharyngeal nerve damage, hematoma of the mouth floor, jugular vein thrombosis, Grisel syndrome, cervical osteomyelitis, nasopharyngeal stenosis, pulmonary edema, infection, and lingual artery pseudoaneurysm. In this clinical report, an 8-year-old girl presented with a posterior plica perforation after adenotonsillectomy performed 1 week previously and this complication has led to velopharyngeal insufficiency. This rare complication may result from traumatic damage or excessive cauterization of the posterior plica.

Is transnasal endoscopic examination necessary before and after adenoidectomy?

The present study aimed to investigate the amount of residual adenoid tissue following the conventional adenoidectomy as compared with preoperative values. A total of 32 girls and 44 boys (range, 3-15 years) in whom adenoidectomy procedure was planned were included in the study. Adenoid tissue sizes before adenoidectomy and residual tissue sizes after conventional curettage adenoidectomy were measured by transnasal endoscopic examination and were recorded. Adenoid tissue size before and after adenoidectomy was compared. The mean age of the patients was 7.7 years (range, 3-15 years). Before adenoidectomy grade 4 adenoid tissue was noted in 43.4% (n = 33), grade 3 was noted in 28.9% (n = 22), grade 2 was noted in 25% (n = 19), and grade 1 was noted in 2.6% (n = 2) of the patients. Following adenoidectomy, no significant difference was noted with respect to residual adenoid tissue sizes of grade 4 and grade 3 patients (P = 0.75, P = 0.76). Transnasal endoscopic examination is suggested to be the most appropriate method to assess the amount of residual adenoid tissue after conventional curettage adenoidectomy. The residual adenoid tissue with the help of a microdebrider in case of a large residual adenoid tissue located in the choana are necessary for complete adenoidectomy.

Investigation of poly (ADP-ribose) polymerase-1 genetic variants as a possible risk for allergic rhinitis.

Recent studies point toward the involvement of poly (ADP-ribose) polymerase-1 (PARP-1) in the pathogenesis of allergic airway inflammation, such as asthma and allergic rhinitis (AR). It has been suggested that inhibition of PARP-1 provides significant protection against systemic or tissue inflammation in animal models. The objective of this study was to investigate whether single-nucleotide polymorphisms of PARP-1 gene are associated with genetic susceptibility to AR. We studied the effect of promoter variations and Val762Ala polymorphism of the PARP-1 gene on the risk for developing AR in a case-control association study with 110 RA patients and 130 control subjects in a Turkish population. The polymorphisms of 410 C/T, -1672G/A, and Val762Ala in the PARP-1 gene were analyzed using the polymerase chain reaction-restriction fragment length polymorphism method. Haplotype analysis of these groups was also performed. The results were statistically analyzed by calculating the odds ratio (OR) and their 95% confidence intervals using χ(2) tests. The heterozygote genotype of the promoter polymorphism (-1672) was significantly found to be associated with susceptibility to AR (OR: 0.56) among the tested single-nucleotide polymorphisms. Haplotypes of PARP-1 -410, -1672, and 762 were not associated with an increased risk for AR. These results raise the possibility that the promoter (-1672) polymorphism of the PARP-1 gene may be a risk factor for AR.