Does COVID-19 have an impact on hearing?

BACKGROUNDS: SARS-CoV-2 is known to be a neurotrophic virus. However, the effect of this virus on the hearing system is still uncertain. OBJECTIVES: We aimed to investigate the possible effect of COVID-19 on hearing. MATERIALS AND METHODS: Thirty healthcare workers who had COVID-19 after hearing evaluation with pure tone audiometry (PTA) for any reason in the last 1 year were included in the study. PTA and transient evoked otoacoustic emissions (TEOAE) tests were performed in 15 of 30 patients during the active infection period. For all 30 patients, otoscopic examination plus PTA and TEOAE tests were performed at the end of the first month after their treatment. RESULTS: When the PTA results of 30 patients (60 ears) before and after COVID-19 were compared, a significant decrease in hearing level was found only at 1000 Hz (p < .05). There were no significant differences at other frequencies. When the PTA and TEAOE test results of 15 patients (30 ears) that were performed during and after COVID-19 were compared, no significant differences were found. CONCLUSION AND SIGNIFICANCE: We conclude that COVID-19 may cause hearing loss. However, this result needs to be confirmed with comprehensive studies to be conducted in larger patient groups.

Inhibitory effect of mesna and 5-fluorouracil on propylene glycol-induced cholesteatoma in rats.

OBJECTIVE: The aim of this study was to investigate the inhibitory effect of different doses of sodium-2-mercaptoethanesulphonate (MESNA) and 5-fluorouracil on cholesteatoma formation. METHODS: Fifty-six Wistar albino male rats were divided into seven groups with eight rats in each. On the first, eighth and fifteenth days, 0.2 ml of saline was administered to the group 1 (control group), and propylene glycol to induce cholesteatoma the other groups. On the 22nd day of the study, 0.2 ml saline was given to Group 1 and Group 2. Groups 3 to 7 were treated with 0.2 ml 100% MESNA, 0.2 ml 50% MESNA, 0.2 ml 20% MESNA, 0.2 ml 5-fluorouracil and 0.1 ml 100% MESNA plus 0.1 ml 5-fluorouracil, respectively, with all applications performed by intratympanic injection. RESULTS: Significant differences were found between Group 1 and all other groups except Group 3. Significant differences were also found between Group 3 and Groups 2, 5 and 6 (P < 0.05). CONCLUSIONS: According to the results of this study, experimental cholesteatoma induced with propylene glycol may be inhibited by MESNA at 100% concentration.

The Protective Effect of Nigella sativa Oil against Experimentally Induced Cisplatin Ototoxicity: An Animal Study.

OBJECTIVES: The objective of this study was to investigate the potential protective effect of Nigella sativa oil (NSO) against cis-diamminedichloroplatinum or cisplatin (CDDP)-induced ototoxicity. MATERIALS AND METHODS: Twenty-four Wistar albino rats were randomly and equally divided into four groups. Groups 1 and 2 were given a total of 15 mg/kg CDDP intraperitoneally, which was divided equally into three doses on days 1, 3, and 5. Group 2 was treated via gavage feeding with 15 ml NSO that was divided into five doses on days 1, 3, 5, 7, and 9. Groups 3 and 4 received only 15 ml of NSO and 15 ml of 0.9% saline solution, respectively, which were orally administered and divided into five doses on days 1, 3, 5, 7, and 9. Baseline high-frequency (8, 12, 16, and 32 kHz) auditory brainstem response (ABR) measurements were collected in all the groups before the medical administrations and were repeated on the 14th day before sacrifice. Afterward, a histopathological evaluation of the cochlea was performed. RESULTS: There was a significant difference in the histopathological changes between group 1 and the other groups (p<0.01). Changes in the spiral ganglion cells, the stria vascularis, and the external ciliated cells were significantly different between groups 1 and 2 (p=0.019, 0.039, and 0.045, respectively). The ABR results revealed significant differences in the 16 and 32 kHz measurements between groups 1 and 2 (p=0.013 and p<0.01, respectively). CONCLUSION: According to the results, NSO may have a protective effect on cochlear function against the disruptive effects of CDDP in rats.

Investigation of the Protective Effect of Nigella Sativa Oil in Cisplatin Induced Oral Mucositis: An Experimental Study.

OBJECTIVE: The aim of this experimental study was to investigate the histopathologic effect of Nigella Sativa oil (NSO) on cisplatin (Cis) induced oral mucositis (OM) in rats. METHODS: Twenty-four rats were divided into four equal groups. The animals in Group 1 and Group 2 were given 5 mg/kg intraperitoneal (ip) Cis systemically on the 1st, 3rd and 5th days of the study. Additionally, 15 mL NSO were given to the rats in Group 2, with gavage feeding on days 1, 3, 5, 7, and 9. The animals in Group 3 were given per oral 15 ml NSO on days 1, 3, 5, 7 and 9. As the control group, Group 4 received a total of 15 mL 0.9% saline solution divided into 5 doses on days 1, 3, 5, 7 and 9 by oral gavage. On the 14th day, animals were euthanized and buccal mucosa from both sides, including submucosal tissues, were excised and taken to histopathological examination. RESULTS: The mean mucosal thicknesses of the groups were 224.58 µm, 276.1 µm, 323.33 µm, and 331.33 µm, respectively for Groups 1, 2, 3, and 4 (p<0.05). When the degree of mucosal inflammation was examined, the most intense inflammation was detected in Group 1 and the least intense inflammation was in Group 4 (p<0.01). The degree of inflammation in Group 2 and Group 3 were similar to Group 4 (p>0.05). CONCLUSION: According to the results of this study, NSO, for which anti-inflammatory and antioxidant properties have been shown in previous studies, may also be effective in preventing Cis-induced OM.

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.

Grinspan's Syndrome: A Rare Case with Malignant Transformation.

AIM: Oral lichen planus (OLP) is one of the common chronic inflammatory, noninfectious, and precancerous oral mucosal diseases that affect the stratified squamous epithelium in adults. Grinspan et al. reported an association of OLP with diabetes mellitus and vascular hypertension and called that Grinspan's syndrome in 1966. We aim to present a case of Grinspan's syndrome with malignant transformation. CASE PRESENTATION: A 60-year-old man who presented with a ten-year history of OLP diagnosed clinically and histologically was referred to our otolaryngology department with a painless swallowing in the left buccal mucosa for 3 months. Clinical examination revealed several plaques, striated white lesions in the buccal mucosa bilaterally, and an exophytic tumor in the left buccal mucosa. Histopathological examination showed lichen planus bilaterally and oral squamous cell carcinoma in the left buccal mucosa. The tumor had been developed on the preexisting areas of lichen planus which had been histologically proven before. The tumor was removed completely, and the tissue defect on the buccal mucosa was repaired with a split-thickness skin graft. CONCLUSION: Patients with OLP should be followed up periodically in a long term at close intervals for early diagnosis of malignant transformation.

Evaluation of the Possible Neurotoxic Effect of the Bone Cement on the Facial Nerve: An Experimental Study.

OBJECTIVES: To investigate neurotoxic effect of bone cement (BC) on facial nerve by using electrophysiological and histopathological methods. METHODS: This study included 20 male albino Wistar rats, divided into four equal groups. Group A was designed as the control group, while group B was sham group. In the group C, BC solution was dropped onto the facial nerve trunks of rats and washed with physiological saline after 5 seconds. In the group D, BC solution was dropped onto the facial nerve trunks of rats and after allowing 5 minutes to dry, wounds were closed. Pre- and postoperative (on 4th week) evoked electromyography (EMG) measurements were done. For histopathological assessments, the rats were euthanized and tissue samples of facial nerve and surrounding areas were collected. RESULTS: According to the wave amplitude levels of evoked EMG, postoperative amplitude levels of group D were significantly decreased, compared to preoperative amplitude levels (P=0.043). We found no statistically significant difference in inflammation among the groups. In none of the groups, foreign body reaction and granulation tissue were not detected in any of the groups. In addition, degeneration in axon, myelin, or perineural nets was not detected in any of the groups. CONCLUSION: This study results suggest that BC has no direct toxicity on facial nerve, while it has indirect effects, by decreasing amplitude. Therefore, we conclude that direct contact of BC with nerve should be avoided, and the area should be cleaned by aspiration or washing with physiological saline in case of contact.

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.

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.

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.

Research on the Submission, Acceptance and Publication Times of Articles Submitted to International Otorhinolaryngology Journals.

OBJECTIVE: The aim of this study was to provide insight into the acceptance and publication times of articles submitted to international otolaryngology journals. MATERIAL AND METHODS: The study was carried out by examining the top 37 journal titles returned in an online search for otolaryngology journals published from 1999 to 2013 that have an international status based on their impact factor. RESULTS: In total, 9,765 publications were examined. When journals were compared based on journal impact factor, statistically significant differences (p<0.01) were found. Comparisons of the acceptance and publication times for both original research and case reports revealed that these times have become shorter over the years. DISCUSSION: Journals with higher impact factors likely have larger workloads in terms of articles, and consequently, their acceptance and publication times might be longer. An implication from this study finding that these periods have decreased over the years is that these processes can be expedited by more intensive use of the Internet and increases in journal capacity and number of issues published. CONCLUSION: The expedition of these processes over time might result from journals' ability to use technology more intensively or from increases in journal's capacity and number of issues published.

[Questionnaire methods used in the psychosomatic evaluation of tinnitus]. / Tinnitusun psikosomatik degerlendirilmesinde kullanilan anket yöntemleri.

Tinnitus is a common disorder in ear, nose and throat practice. Not only muscular, vascular, neuronal, odiologic and ear pathologies, also psychological parameters contribute to the formation of tinnitus. Scales which evaluate patients' perception of tinnitus and how they are affected from tinnitus psychosomatically have gained increasing importance. Questionnaire studies are very assisting in terms of showing the degree of anxiety and depression experienced by the patients, diagnosis of the disease, evaluation of treatment efficacy, and patient follow-up. In this study, we reviewed the visual analog scale which measures the level of subjective perception in tinnitus, tinnitus evaluation questionnaires, and questionnaires measuring the level of quality of life and depression.

Tegmen tympani defect and brain herniation secondary to mastoid surgery: case presentation.

Brain herniation into the middle ear is very rarely seen. In addition to reasons like congenital factors, trauma, and infection, tegmen defect may develop as a result of iatrogenic events secondary to chronic otitis media surgery with or without cholesteatoma. Since it may cause life-threatening complications, patients must be evaluated and monitored for tegmen defect. In this paper, diagnosis and treatment of a brain herniation case due to iatrogenic tegmen defect were described along with relevant literature.

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%).