Effects of Anatolian Propolis and Hypertonic Saline Combination Nasal Spray on Allergic Rhinitis Symptoms: A Prospective, Multicenter Study.

Objectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P < .001). The mean total symptom score fell following treatment (P < .001): whilst the score was 11.09 ± 3.41 before administering Rhinapi; after administration, the average score was 6.23 ± 2.41. The mean QoL scores also altered after medication (P < .001), improving from a mean value of 6.44 ± 1.55 to a mean of 7.31 ± 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments.

Serum levels of heavy metals in patients with Bell's palsy: a case-control study.

PURPOSE: The exact etiology of Bell's palsy (BP) remains unknown, while its potential etiopathology includes neuritis and inflammation-related demyelination as in optic neuritis. It has been reported that disruption of heavy metal homeostasis may be associated with the inflammatory process of optic neuritis; therefore, heavy metals may be involved in the pathogenesis of facial nerve neuritis. In this study, we aimed to investigate serum levels of heavy metals including essential elements [iron (Fe), zinc (Zn), copper (Cu), cobalt (Co), and manganese (Mn)], and nonessential elements [lead (Pb) and cadmium (Cd)] in patients with BP. METHODS: The study included 25 patients with BP and 31 healthy volunteers. For each participant, serum levels of essential and nonessential elements were measured using the atomic absorption spectrophotometer method. RESULTS: Serum levels of essential elements were significantly lower in the patient group compared to the control group (p < 0.001, for each). Serum levels of Pb increased in the patient group compared to the control group although no significant difference was achieved (p = 0.105). In contrast, serum Cd levels increased significantly in the patient group compared to the control group (p < 0.001). CONCLUSION: Our findings suggest that decreased essential and increased nonessential elements may be associated with BP and thus, serum concentrations of these elements should be taken into account in BP. Studies are warranted to determine the role of these elements in treatment of BP.

Novel GPR156 variants confirm its role in moderate sensorineural hearing loss.

Hereditary hearing loss (HL) is a genetically heterogeneous disorder affecting people worldwide. The implementation of advanced sequencing technologies has significantly contributed to the identification of novel genes involved in HL. In this study, probands of two Turkish families with non-syndromic moderate HL were subjected to exome sequencing. The data analysis identified the c.600G > A (p.Thr200Thr) and c.1863dupG (p.His622fs) variants in GPR156, which co-segregated with the phenotype as an autosomal recessive trait in the respective families. The in silico predictions and a minigene assay showed that the c.600G > A variant disrupts mRNA splicing. This gene belongs to the family of G protein-coupled receptors whose function is not well established in the inner ear. GPR156 variants have very recently been reported to cause HL in three families. Our study from a different ethnic background confirms GPR156 as a bona fide gene involved in HL in humans. Further investigation towards the understanding of the role of GPCRs in the inner ear is warranted.

Genome sequencing identifies coding and non-coding variants for non-syndromic hearing loss.

Hearing loss (HL) is a common heterogeneous trait that involves variants in more than 200 genes. In this study, we utilized exome (ES) and genome sequencing (GS) to effectively identify the genetic cause of presumably non-syndromic HL in 322 families from South and West Asia and Latin America. Biallelic GJB2 variants were identified in 58 probands at the time of enrollment these probands were excluded. In addition, upon review of phenotypic findings, 38/322 probands were excluded based on syndromic findings at the time of ascertainment and no further evaluation was performed on those samples. We performed ES as a primary diagnostic tool on one or two affected individuals from 212/226 families. Via ES we detected a total of 78 variants in 30 genes and showed their co-segregation with HL in 71 affected families. Most of the variants were frameshift or missense and affected individuals were either homozygous or compound heterozygous in their respective families. We employed GS as a primary test on a subset of 14 families and a secondary tool on 22 families which were unsolved by ES. Although the cumulative detection rate of causal variants by ES and GS is 40% (89/226), GS alone has led to a molecular diagnosis in 7 of 14 families as the primary tool and 5 of 22 families as the secondary test. GS successfully identified variants present in deep intronic or complex regions not detectable by ES.

Blood prestin levels in COVID-19 patients.

BACKGROUND: Many studies have found that viral infections affect different tissues, including the inner ear. Coronavirus disease 2019 (COVID-19), a viral infection, is a significant health problem worldwide. Prestin is a motor protein with important functions both in the outer hair cells of the inner ear and in cardiac tissue. In addition, prestin is promising as an early biomarker in the detection of ototoxicity. To determine the severity of infection in COVID-19 patients and to determine whether other tissues are affected by the infection, lactate dehydrogenase (LDH), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase MB (CK-MB), biochemical markers such as ferritin and D-dimer are used. This study aimed to compare prestin levels in patients with COVID-19 and healthy volunteers. METHODS: In blood samples taken from 45 patients diagnosed with COVID-19 and 40 healthy volunteers, prestin levels were determined with the kit that used an enzyme-linked immunosorbent assay method and was commercially available. At the same time, LDH, CRP, ALT, AST, CK-MB, ferritin, and D-dimer levels were also detected in both patients and healthy control groups and correlations with prestin levels were examined. RESULTS: The main result of our study is that serum prestin levels in COVID-19 patients are significantly higher than in healthy controls ( p < 0.001). In addition, a statistically significant strong positive correlation was found between prestin-LDL ( r = 0.537, p = 0.001), prestin-CRP ( r = 0.654, p = 0.001), and prestin-D-dimer ( r = 0.659, p = 0.001). CONCLUSION: The levels of prestin, a motor protein in inner ear outer hair cells and cardiac myocytes, were found to be higher in COVID-19 patients than in healthy volunteers. It also showed a positive correlation with CRP and D-dimer. This may be associated with systemic dysfunction.

Embolization after internal carotid artery injury secondary to transsphenoidal pituitary surgery and delayed intranasal coil protrusion: illustrative case.

BACKGROUND: The authors presented a case of spontaneous nasopharyngeal coil migration that occurred 3 years after a patient had undergone transsphenoidal resection due to pituitary macroadenoma and was treated with coil application because of internal carotid artery injury secondary to transsphenoidal resection of the pituitary macroadenoma. OBSERVATIONS: In the literature, eight cases of coil migration that occurred between 2 and 120 months after coil application have been reported, most of which were treated with surgical removal of the coil in a same-day surgery setting. LESSONS: The case presented emphasized that coil protrusion and migration may lead to destruction in the skull base, thereby leading to serious consequences if left untreated, even in the absence of history of trauma. To the authors' knowledge, this is the first case in the literature that required additional invasive procedures due to recurrent bleeding that occurred several months after surgical removal of coils. Also, this report underlined the need for careful and long-term follow-up of coil materials used for the treatment of pseudoaneurysms caused by vascular injuries secondary to skull base injury during surgery.

Residual Dizziness in Elderly Patients after Benign Paroxysmal Positional Vertigo.

INTRODUCTION: The aim of this study was to compare the effects of Brandt-Daroff (BD) exercise and shopping exercise (SE) on the resolution of residual dizziness (RD) in patients with benign paroxysmal positional vertigo (BPPV) following a successful modified Epley canalith repositioning maneuver (CRP). METHODS: This single-blind, randomized clinical trial included patients with posterior semicircular canal type of BPPV. Following the modified Epley maneuver, patients that experienced RD were randomly assigned to 3 groups: (i) BD, (ii) SE, and (iii) control groups. Primary outcomes were quantified using the Dizziness Handicap Inventory (DHI). RESULTS: Following CRP, 240 (63%) participants experienced RD. All these patients were followed up weekly for RD. After the resolution of RD, patients were followed up monthly for recurrence. Mean time to recovery was 16.4 ± 10 (range, 5-49) days in the BD group, 11.5 ± 4.6 (range, 6-32) days in the SE group, and 23.4 ± 16.8 (range, 6-89) days in the control group. The SE group recovered significantly faster than the BD and control groups (p < 0.001). Baseline emotional DHI (E-DHI) scores were significantly correlated with the duration of pre-CRP symptoms (p < 0.001). Correlation analysis indicated that patients with obesity and diabetes mellitus (DM) recovered later than patients without these comorbidities. CONCLUSION: We found that RD improved significantly in the SE group compared to the BD and control groups. Additionally, a significant relationship was established between RD and high anxiety levels and DM, and obesity had a negative impact on the resolution of RD.

The relationship between thiol-disulfide balance and idiopathic sudden sensorineural hearing loss.

INTRODUCTION: Impaired cochlear perfusion is a major etiological factor in idiopathic sudden sensorineural hearing loss. Oxidative stress has been shown to be a risk factor for oxidative damage. OBJECTIVES: We investigated the role of oxidative stress in idiopathic sudden sensorineural hearing loss by comparing serum levels of oxidant and antioxidant molecules including thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin and myeloperoxidase in patients who did and did not recover after treatment. METHODS: The amount of dynamic disulfide was calculated by determining half of the difference between the total thiols and native thiols. After the determination of native, total thiol, and disulfide amounts, the disulfide/total thiol percent ratio, native thiol/total thiol ratio and disulfide/native thiol percent ratio were calculated and then compared between the two groups. Additionally, clinical relationship between audiological recovery and native thiol, disulfide, disulfide/native thiol percent ratio, and disulfide/total thiol percent ratio levels was investigated. Blood samples were also analyzed for the assessment of thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels. RESULTS: A significant difference was found between the two groups with regard to total oxidant status disulfide, disulfide/native thiol percent ratio, disulfide/total thiol percent ratio, and native thiol/total thiol ratio levels (p =  0.001, p =  0.001, p =  0.001, p =  0.003, p =  0.001, p =  0.002, respectively). However, no significant difference was found between the two groups with regard to thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, ceruloplasmin, and myeloperoxidase levels (p >  0.05 for all). CONCLUSION: The results supported the common hypothesis that vascular pathologies are the primary cause of idiopathic sudden sensorineural hearing loss and that other etiological factors ultimately result in vascular pathologies. The oxidant-antioxidant and thiol-disulfide balances were impaired in the idiopathic sudden sensorineural hearing loss group.

Effect of Silver Nitrate Application on the Success of Endoscopic Dacryocystorhinostomy.

OBJECTIVES: To compare the clinical outcomes of patients undergoing additional procedures in endoscopic endonasal dacryocystorhinostomy (End-DCR) surgery and discuss the factors affecting the success of End-DCR surgery in light of relevant literature. METHODS: The study included 155 patients who underwent End-DCR surgery in our clinic due to epiphora. This was a prospective randomized, single-blind, controlled trial. Group I (control) included 54 patients who did not undergo silicone stent insertion or silver nitrate application, group II included 51 patients who underwent silicone stent insertion only, and group III included 50 patients who underwent silver nitrate application only. Statistical analysis was performed on follow-up data regarding anatomic and functional success rates. RESULTS: Revision surgery was performed in 16 patients who developed persistent epiphora in the postoperative period, including 6 in group I, 7 in group II, and 3 in group III (P = .4). The most common reason for revision surgery was stenosis of the neo-ostium (n = 8), followed by granulation tissue formation (n = 5) and synechia formation (n = 3). Granuloma formation was the most common postoperative complication, and a significant difference was found among the groups with regard to granuloma formation (P = .04). At postoperative month 12, the functional success rate was estimated to be 88%, 86%, and 94%, and the anatomic success rate was estimated to be 94%, 92%, and 96% in groups I, II, and III, respectively, with no significant difference, found among the 3 groups with regard to both rates (P = .79 and P = .76, respectively). CONCLUSION: The results indicated that stenting and silver nitrate application did not affect surgical success. Our preliminary results on silver nitrate cauterization showed that it is an effective, inexpensive, and practical method to reduce granulation formation in the postoperative period.

Paragangliomas cervicais: experiência de 114 casos em 14 anos / Cervical paragangliomas: experience of 114 cases in 14 years

Resumo Introdução e objetivo: Relatar a experiência de um único centro com casos de paraganglioma do corpo carotídeo tratados pelo mesmo cirurgião em uma cidade com alta prevalência de paragangliomas devido à alta altitude. Método: Foram investigados retrospectivamente os dados demográficos, clinico-patológicos e radiológicos de 104 pacientes com diagnóstico de paragangliomas cervicais entre 2003 e 2017. Os pacientes foram classificados de acordo com a classificação de Shamblin. Resultados: Neste estudo, foram incluídos 104 pacientes (33 homens e 71 mulheres, com média de 54,6 ± 13 anos, entre 2003 e 2017) com diagnóstico de paraganglioma cervical na bifurcação carotídea. Entre esses pacientes, 10 tinham tumores bilaterais e, no total, 114 paragangliomas foram tratados nesse período. O diâmetro médio dos tumores foi de 5,12 ± 1,45 cm. Um tumor maligno foi determinado em apenas um (0,9%) paciente. Todos os pacientes foram operados. Em 12 pacientes com diâmetro do tumor maior do que 5 cm, foi possível fazer embolização pré-operatória com molas; em 14 pacientes, foi feita embolização angiográfica e em 4 pacientes foram aplicadas injeções de agentes esclerosantes. Após o tratamento cirúrgico, paralisia facial foi observada em 2 pacientes, disfagia em um, síndrome de Horner em um e rouquidão em 7. Todas essas complicações melhoraram durante o acompanhamento. Não foi relatada mortalidade. Conclusão: A cirurgia é o tratamento definitivo em pacientes com paragangliomas cervicais. Embora possa ser difícil em pacientes com os tipos avançados de Shamblin, em mãos experientes as taxas de complicações são muito baixas.

Cervical paragangliomas: experience of 114 cases in 14 years.

INTRODUCTION AND OBJECTIVE: To report a single center experience with carotid body paraganglioma cases that were treated by the same surgeon in a city with high prevalence of paragangliomas due to high altitude. METHODS: We retrospectively investigated the demographic, clinicopathological and radiological data of 104 patients diagnosed with cervical paragangliomas between 2003 and 2017. The patients were classified according to the Shamblin classification. RESULTS: In this study a total of 104 patients (33 male and 71 female, with a mean age of 54.6±13 years) diagnosed with cervical paragangliomas located on carotid bifurcation between 2003 and 2017 were included. Among those patients, 10 presented with bilateral tumors and in total, 114 paragangliomas were managed in this period. The mean diameter of the tumors was 5.12±1.45cm. Malignant tumor was determined in only one (0.9%) patient. All patients were operated. In 12 patients with the tumor diameter larger than 5cm, preoperative coil embolization was achieved. In 14 patients, preoperative angiographic embolization was employed and in 4 patients intraoperative sclerosing agent injections were performed. Facial paralysis was observed in 2 patients and dysphagia was present in 1 patient, Horner syndrome was seen in 1 patient and hoarseness was reported in 7 patients after operation. All those complications improved during follow-up. Mortality was not reported in any cases. CONCLUSION: Surgery is the definitive treatment for patients with cervical paragangliomas. Although, it may be difficult in patients with the advanced Shamblin types, in experienced hands, complication rates are very low.

The Effect of Nitrous Oxide on the Outcomes of Underlay Tympanoplasty: A Prospective Study.

The main aims of tympanoplasty are eradication of chronic middle ear disease, repair of the tympanic membrane, and restoration of hearing. Nitrous oxide (N2O) is not a commonly preferred anesthetic agent for tympanoplasty because this agent may increase middle ear pressure and displace the graft. In this study, we researched the surgical outcomes of the underlay tympanoplasty performed with N2O anesthesia. Patients who underwent tympanoplasty were included in this prospective study. A type 1 tympanoplasty was performed in all patients using the underlay technique. Patients were randomized to groups that did and did not receive N2O. Preoperative and postoperative hearing thresholds were evaluated, postoperative pain scores were recorded, and the differences between the groups were statistically evaluated. There were 44 patients who received N2O and 44 who did not. The graft success rate was 93.2% in the N2O-receiving group and 84.1% in the nonreceiving group (P > .05). Hearing levels improved significantly after surgery in each group (P < .05), but the difference between the groups was not significant (P > .05). The postoperative pain score was 3.72 ± 1.3 in the N2O-receiving group and 4.45 ± 2.3 in the nonreceiving group (P > .05). Nitrous oxide is a cheap, safe, and readily available anesthetic agent that provides acceptable success rates in patients undergoing tympanoplasty.

Evaluation of the Relationship Between Nasal Septum Deviation and Oxidative Stress Markers.

INTRODUCTION: Nasal septum deviation (NSD) may lead to chronic hypoxia and increased oxidative stress.The main goal of this study was to investigate the effect of NSD on malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and glutathione (GSH) levels. METHODS: There were 30 patients with NSD and 30 healthy subjects in this study. Malondialdehyde, CAT, SOD, and GSH levels were determined in the control and study groups. The measurements were done preoperatively and postoperatively. Study group patients completed the Nasal Obstruction Symptom Evaluation questionnaire preoperatively and postoperatively to determine the success of the septoplasty. RESULTS: Higher CAT, SOD, and GSH levels and lower MDA levels were found in the control group compared with the study group (P < 0.05). After septoplasty, Nasal Obstruction Symptom Evaluation scores improved significantly and CAT, SOD, and GSH levels increased significantly (all, P < 0.05). Malondialdehyde levels did not decrease significantly after surgery (P > 0.05). CONCLUSIONS: Nasal obstruction due to nasal septal deviation led to lower antioxidant enzyme levels, and correction of the septum led to an increase in antioxidant levels.

Serum levels of oxidative stress indicators and antioxidant enzymes in Bell palsy.

We conducted a prospective study to comparatively evaluate serum levels of malondialdehyde, an oxidative stress indicator, and the antioxidant enzymes glutathione, catalase, and superoxide dismutase in patients with Bell palsy. Our study population was made up of 30 patients with Bell palsy-15 men and 15 women, aged 25 to 68 years (mean: 50.4)-who were seen in the Department of Otorhinolaryngology at a tertiary care medical center. For comparison purposes, we recruited 26 healthy age- and sex-matched controls-16 men and 10 women, aged 40 to 67 years (mean: 54.3). Serum samples were obtained from all participants before the initiation of steroid treatment to the Bell palsy patients. A correlation was sought between demographic data and serum levels of malondialdehyde, glutathione, catalase, and superoxide dismutase. We found that the serum level of malondialdehyde was significantly higher in the Bell palsy group and that the levels of glutathione, catalase, and superoxide dismutase were all significantly lower (p < 0.001 for all comparisons). Correlation analysis revealed that only superoxide dismutase levels were positively correlated with age (r = 0.347, p = 0.009). We suggest that oxidative stress and antioxidant mechanisms may be involved in the pathogenesis of Bell palsy. In this context, serum levels of malondialdehyde, glutathione, catalase, and superoxide dismutase may serve as biomarkers in the diagnosis and follow-up of Bell palsy. Confirmation of the validity, reliability, and reproducibility of these findings necessitates further prospective, randomized clinical trials in larger populations.

Gradenigo Syndrome Induced by Suppurative Otitis Media.

Gradenigo syndrome was defined as a clinical triad of otitis media, severe orbito-facial pain, and ipsilateral sixth cranial nerve palsy. It may occur as a complication of either acute or chronic otitis media. Herein, we will report a case of Gradenigo syndrome induced by suppurative chronic otitis media that was promptly diagnosed and aggressively treated.

Alterations in oxidative stress markers in laryngeal carcinoma patients.

BACKGROUND: Data describing how laryngeal cancer affects oxidative stress markers and antioxidants are limited. This study investigated serum antioxidant enzyme activities and oxidative stress markers before and after laryngectomies in patients with laryngeal cancer. METHODS: A total of 29 patients with laryngeal cancer and 25 healthy control subjects were enrolled. Serum malondialdehyde (MDA) levels and superoxide dismutase (SOD), glutathione peroxidase (GSHPx), catalase (CAT), paraoxonase (PON), and arylesterase activities were measured spectrophotometrically. Blood samples were obtained from each patient just before surgery and 1 month after a laryngectomy. RESULTS: The serum PON, arylesterase, CAT, SOD, and GSHPx activities were significantly decreased (all p < 0.001) and serum MDA levels were significantly increased (p < 0.001) in patients with laryngeal cancer, compared with control subjects. In laryngeal cancer patients, the serum GSHPx and arylesterase activity levels increased significantly following laryngectomies (both p < 0.001), whereas the MDA levels decreased significantly (p = 0.007). CONCLUSION: In patients with laryngeal cancer, the oxidant/antioxidant balance shifted toward oxidative stress. In addition, following laryngectomies, laryngeal cancer patients had increases in serum antioxidant enzyme activities and decreases in oxidative stress markers.

Is There a Role for Oxidative Stress in Temporomandibular Joint Disorders?

PURPOSE: Data on the role of oxidative stress in temporomandibular joint (TMJ) disorders are limited. This study compared serum levels of oxidative stress indicators and antioxidant enzymes in patients with TMJ disorders. PATIENTS AND METHODS: In this prospective study, patients with TMJ disorders and healthy controls were compared for descriptive characteristics (age and gender) and serum levels of malondialdehyde (MDA), an oxidative stress marker, and antioxidant enzymes catalase (CAT), glutathione (GSH), and superoxide dismutase (SOD). RESULTS: This study included 32 patients with TMJ disorders and 32 healthy controls. There were no differences between the 2 groups for age (P = .98) and gender (P = .599). MDA levels were higher in the TMJ disorders group than in the control group (P < .001), whereas serum levels of CAT, SOD, and GSH were significantly higher in the control group (P < .001 for all comparisons). There was no correlation between age or gender and MDA, SOD, CAT, and GSH levels in the TMJ disorders or control group. CONCLUSION: Oxidative stress markers might have promising potential as biomarkers in the diagnostic strategy and therapeutic targets of TMJ disorders.

Serum Trace Elements and Heavy Metal Levels in Patients Diagnosed with Chronic Otitis Media and Their Association with Surgical Treatment Outcomes.

OBJECTIVE: To determine the serum iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), magnesium (Mg), cobalt (Co), and lead (Pb) levels in patients with chronic otitis media (COM) and to evaluate the association of the serum levels of these elements with treatment outcomes. MATERIALS AND METHODS: Thirty-one healthy volunteers and 31 patients with COM were prospectively included in this study. Serum levels of Fe, Zn, Mn, Mg, Cu, Co, and Pb were determined by an atomic absorption UNICAM-929 spectrophotometer. RESULTS: Serum Co, Pb, and Fe levels were significantly increased (p<0.001) and serum Cu, Zn, Mg, and Mn levels were significantly reduced in patients with COM compared with controls (p<0.001). Serum Co and Mn levels were significantly decreased (p<0.001 and p<0.005, respectively) and serum Cu levels were significantly increased after surgery (p<0.005). The other evaluated blood chemicals and heavy metals did not exhibit significant differences (p>0.05). CONCLUSION: Significant alterations in the serum chemical composition of patients with COM were observed. Moreover, with surgical treatment, serum levels of some of these chemicals were significantly altered. Further prospective studies are warranted to elucidate the exact association of these alterations in the etiopathogenesis of COM.

The effects of adenotonsillar hypertrophy corrective surgery on left ventricular functions and pulmonary artery pressure in children.

OBJECTIVE: Comparison of left ventricular functions in preoperative and postoperative periods of children with adenotonsillar hypertrophy (ATH) who have findings of upper airway obstruction (UAO), using echocardiographic parameters. METHODS: Thirty children who were diagnosed with UAO due to ATH, and who have undergone adenoidectomy/adenotonsillectomy and 30 healthy children, between 2 and 11 years of age, were included in the study. Patient group was evaluated by the pulsed wave tissue Doppler echocardiography, as well as with conventional echocardiography, before and 6 months after the operation. RESULTS: Of 30 children in study group, 18 (60%) had adenotonsillectomy and 12 (40%) had adenoidectomy. The differences between groups regarding myocardial performance index (MPI) was not statistically significant (p = 0.847). There was not any statistically significant difference between groups in terms of mitral isovolemic acceleration (MIVA) (2.28 ± 0.67, 2.24 ± 0.55, 2.23 ± 0.49; p = 0.943, respectively). Interventricular septum diameter (IVSD) was significantly higher in preoperative group than postoperative and control groups (3.68 ± 0.52, 3.50 ± 0.40, 3.38 ± 0.60; p = 0.028, respectively). Pulmonary acceleration time (PAcT) was found to be significantly lower in preoperative group compared to postoperative and control groups (107.64 ± 16.60, 119.52 ± 15.95, 120.47 ± 16.19; p = 0.004, respectively). Mean pulmonary arterial pressure (mPAP) was significantly higher in preoperative group than postoperative and control groups (30.58 ± 8.11, 25.23 ± 9.07, 25.00 ± 6.52; p = 0.002, respectively). In postoperative group mPAP was found to be similar to the control group. CONCLUSIONS: Clinical or subclinical left ventricle (LV) dysfunction in children with ATH who have findings of UAO was not determined while mean pulmonary arterial pressure was significantly higher compared with the control cases. Besides early adenotonsillectomy is a beneficial treatment option for these patients.

Meatal obstruction following canal wall down mastoidectomy.

Chronic otitis media (COM) is completely treated with a single procedure in most patients but may require multiple surgeries in some cases. The main goals of open cavity mastoidectomy are to completely eradicate the disease, create a large enough meatus for examination and mastoid air cells, and provide a self-cleaning epithelized dry cavity, and achieve maximum hearing. In this report, we present a very rare case of COM who underwent revision mastoidectomy in our clinic due to meatal obstruction in the right ear, total sensorineural hearing loss, and pain and tenderness in the postauricular region.