Dynamic visual acuity test findings of migraine patients: Observational case-control study.

OBJECTIVE: To evaluate computerized dynamic visual acuity (DVA) test findings among patients with migraine and to determine whether self-motion sensitivity and visually induced migraine symptoms that are seen in migraine patients can be explained by DVA results. METHODS: Twenty migraine patients and twenty control subjects were evaluated with DVA test during rapid horizontal (left and right) and vertical (up and down) head movements. The subjects were asked to quickly recognize the direction of the Landolt-C optotype on the monitor while moving their heads. Test began with the largest optotype and progressively decreased in size by 0.1 logMAR until the subject could no answer correctly state the orientation of the optotype. DVA test scores of migraine group and control group were compared. RESULTS: Patient with migraine had significant DVA loss as compared with control subjects in four positions (left DVA, right DVA, up DVA, down DVA respectively p < 0.001, <0.001 = 0.001 and <0.001). CONCLUSION: Migraine patients were found to have abnormal DVA scores mediated vestibular-ocular reflex. These abnormal DVA findings can explain the pathophysiology of head motion hypersensitivity and visual motion sensitivity that encountered by migraine patients.

The effectiveness of the Milan system for risk stratification of salivary gland lesions: The 10-year cytohistopathological correlation results of salivary gland FNA cytology at a tertiary center.

BACKGROUND: The Milan system reporting salivary gland cytopathology (MSRSGC) is a tiered classification scheme that is based on risk stratification. The aim of the current study was to assess the risk of malignancy (ROM) and risk of neoplasia (RON) in each of the diagnostic categories proposed by the MSRSGC. METHODS: A retrospective analysis and categorization according to the MSRSGC was made of salivary gland fine needle aspirations (FNA) performed from January 2007 to December 2017. The FNA cytology results were correlated with subsequent histological follow-up. RESULTS: A total of 578 FNAs were evaluated and histopathology was available for 198 cases (34.2%). The RON and ROM for individual diagnostic categories were: Non-diagnostic: 52.2% to 13%, non-neoplastic: 21.4% to 10.7%, atypia of undetermined significance: 74% to 22.2%, benign neoplasm: 100% to 1.1%, salivary gland neoplasm of uncertain malignant potential: 93.3% to 53.3%, suspicious for malignancy (SFM): 100% to 100%, and malignant: 100% to 100%. A diagnosis of 'SFM' or 'malignant' with FNA cytology carried a 100% risk for malignancy, while a diagnosis of "non-neoplastic," "benign neoplasm" reduced the probability of malignancy to 3.4%. CONCLUSION: The MSRSGC is useful for the management of salivary gland lesions as it can successfully differentiate between benign and malignant cases. It will bring uniformity in salivary gland FNA cytology reporting across various institutions globally.

Association of Toll-Like Receptor Polymorphisms With Nasal Polyposis.

Nasal polyposis is a disease characterized with chronic inflammation of the nasal mucosa. Toll-like receptors (TLRs) are defined as essential receptors of the innate immune system and may play in the development of nasal polyposis. A total of 71 patients with nasal polyposis and 74 healthy controls were included in this study. Three single-nucleotide polymorphisms (SNPs); TLR2 (2258 A>G), TLR4 (896 A>G), and TLR4 (1196 C>T) were analyzed in all patients. The degree of pair-wise linkage disequilibrium and the genotype and haplotype analyses were conducted using regression in this logistic model and the Multifactor Dimensionality Reduction (MDR) software package was used to construct all possible interactions among different genotype variants belonging to the TLR gene. There was significant difference in genotype and allele frequencies of the TLR4 (1196 C>T) polymorphism between the nasal polyposis and control groups (0.017). Also, it was observed that the probability of nasal polyposis was 62.7% in the presence of TLR4 (1196 C>T) polymorphism with asthma (P = .007). As a conclusion, this study showed that TLR4 and TLR2 polymorphisms were predisposing factors for nasal polyposis. Further functional studies investigating the consequences of loss of TLR function are needed.

Single-sided deafness after sudden hearing loss: late effect on cochlear nerve size.

PURPOSE: Single-sided deafness (SSD) is a condition where an individual has non-functional hearing in one ear and receives no clinical benefit from amplification in that ear, with the contralateral ear possessing normal audiometric function. Cochlear implant presents a good choice in rehabilitation of SSD. The presence of a deficient cochlear nerve (CN) has been linked to poor performance with cochlear implants. CN can be measured by imaging techniques. The objective of this study was to compare CN diameter in patients who had a history of single-sided deafness because of sudden hearing loss. METHODS: Retrospective study where radiologist was blind designed. 53 SSD patients who had a history of sudden hearing loss and MRI at least 5 years after the sudden hearing loss were included in this retrospective study. High-resolution 3-D constructive interference in steady state (CISS)-sequence magnetic resonance (MRI) images was review by the neurotology-experienced blind radiologist. Vertical, horizontal and area measurements of cochlear nerve between the deaf and the normal ear were made. RESULTS: There was no statistically significant difference between the normal ear and deaf ear of the subjects in terms of cochlear nerve vertical diameter, horizontal diameter and area. (respectively, p = 0.250; p = 0.183; p = 0.874) CONCLUSION: The numbers of remaining cochlear neurons and spiral ganglion cells in the implanted deaf ears are critical and evidence was not found for spiral ganglion cell loss in the sudden hearing loss deaf ear with SSD in MRI. In the light of all these findings, implantation would be a good choice for rehabilitation in postlingual SSD regardless of auditory deprivation duration.

Comparison between curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy in terms of Eustachian tube dysfunction / Comparação entre adenoidectomia por curetagem e adenoidectomia por microdebridador assistida por endoscopia, em relação à disfunção tubária

Abstract Introduction Adenoidectomy can be performed with many ways, including curettage and microdebrider endoscopic-assisted adenoidectomy. Those two techniques have advantages and disadvantages. Objective The objective of this study is to research the effects of curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy on the tympanum pressures in pediatric patients with adenoid hypertrophy without otitis media with effusion. Methods This prospective descriptive study was performed with 65 patients who had a normal tympanic membrane and normal tympanogram and then underwent adenoidectomy or adenotonsillectomy for adenoid and tonsil hypertrophy. The subjects were randomly divided into two groups: curettage adenoidectomy group and endoscopic microdebrider-assisted adenoidectomy group. They underwent tympanometry, and the preoperative as well as 1st and 7th day postoperative values of the tympanum pressures were compared within and among the groups. Results There were 32 patients in the curettage adenoidectomy group and 33 patients in the microdebrider adenoidectomy group. Statistically significant differences were observed in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears with curettage adenoidectomy (p < 0.001, p < 0.001). This difference occurred on the 1st postoperative day, and the value returned to normal on the 7th day. There was no significant difference in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears in the microdebrider adenoidectomy group (p = 0.376, p = 0.128). Conclusion Postoperative Eustachian tube dysfunction is seen less often with the endoscopic-assisted microdebrider adenoidectomy technique than with the conventional adenoidectomy technique.

Resumo Introdução A adenoidectomia pode ser realizada de várias maneiras, inclusive por curetagem e por microdebridador, assistida por endoscopia. Essas duas técnicas têm algumas vantagens e desvantagens. Objetivo O objetivo deste estudo foi investigar os efeitos da técnica de adenoidectomia por curetagem e da adenoidectomia por microdebridador assistida por endoscopia sobre a pressão timpânica em pacientes pediátricos com hipertrofia adenoideana sem otite média com efusão. Método Estudo descritivo prospectivo feito com 65 pacientes que apresentavam membrana timpânica e timpanograma normais, que foram então submetidos à adenoidectomia ou adenotonsilectomia por hipertrofia adenoamigdaliana. Os pacientes foram divididos aleatoriamente em dois grupos: grupo adenoidectomia por curetagem e grupo adenoidectomia por microdebridador assistida por endoscópio. Todos os pacientes fizeram timpanometria e os valores das pressões do tímpano pré-operatórios e pós-operatórios no 1º e 7º dias foram comparados intragrupos e entre os grupos. Resultados Foram incluídos 32 pacientes no grupo adenoidectomia por curetagem e 33 pacientes no grupo adenoidectomia com microdebridador. Diferenças estatisticamente significantes foram observadas na mediana da diferença entre a pressão timpânica no pré-operatório e no 1º e 7º dias de pós-operatório para ambas as orelhas, direita e esquerda, na adenoidectomia por curetagem (p < 0,001, p < 0,001). Essa diferença ocorreu no 1º dia do pós-operatório e o valor retornou ao normal no 7º dia. Não houve diferença significante na mediana entre pressão timpânica no pré-operatório e no 1º e 7º dias de pós-operatório para as orelhas direita e esquerda no grupo de adenoidectomia com microdebridador (p = 0,376, p = 0,128). Conclusão A disfunção tubária no pós-operatório é observada menos frequentemente com a técnica de adenoidectomia por microdebridador assistida por endoscopia quando comparada com a técnica convencional.

Comparison between curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy in terms of Eustachian tube dysfunction.

INTRODUCTION: Adenoidectomy can be performed with many ways, including curettage and microdebrider endoscopic-assisted adenoidectomy. Those two techniques have advantages and disadvantages. OBJECTIVE: The objective of this study is to research the effects of curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy on the tympanum pressures in pediatric patients with adenoid hypertrophy without otitis media with effusion. METHODS: This prospective descriptive study was performed with 65 patients who had a normal tympanic membrane and normal tympanogram and then underwent adenoidectomy or adenotonsillectomy for adenoid and tonsil hypertrophy. The subjects were randomly divided into two groups: curettage adenoidectomy group and endoscopic microdebrider-assisted adenoidectomy group. They underwent tympanometry, and the preoperative as well as 1st and 7th day postoperative values of the tympanum pressures were compared within and among the groups. RESULTS: There were 32 patients in the curettage adenoidectomy group and 33 patients in the microdebrider adenoidectomy group. Statistically significant differences were observed in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears with curettage adenoidectomy (p<0.001, p<0.001). This difference occurred on the 1st postoperative day, and the value returned to normal on the 7th day. There was no significant difference in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears in the microdebrider adenoidectomy group (p=0.376, p=0.128). CONCLUSION: Postoperative Eustachian tube dysfunction is seen less often with the endoscopic-assisted microdebrider adenoidectomy technique than with the conventional adenoidectomy technique.

Investigation of Oxidative Stress in Antrochoanal Polyp Etiology.

Antrochoanal polyps (ACPs) are benign lesions of the paranasal sinuses. Similarities between ACPs and nasal polyps have been previously investigated. However, oxidative stress has been implicated but not investigated in terms of the etiology of ACPs. Thus, the aim of this study was to investigate oxidative stress in the etiology of ACPs. The study population comprised 93 patients divided into 3 groups. Group 1 consisted of 30 patients with ACPs. Group 2 consisted of 33 patients with nasal septal deviation. Group 3 comprised 30 healthy individuals. Venous blood was taken from all participants, and total thiol, native thiol, disulfide, and ischemic modified albumin (IMA) levels were evaluated. When the values of native thiol (P = .097), disulfide (P = .221), total thiol (P = .140), and IMA (P = .091) were compared, no significant differences were found among the 3 groups. While many studies have been conducted related to nasal pathologies and the role of oxidative stress in their etiologies, our study concluded that oxidative stress plays no role in ACP etiology.

New wand coblation turbinator vs coblation radiofrequency.

INTRODUCTION: Inferior turbinate hypertrophy is a common reason of nasal obstruction. One of the most preferred surgical metod is radiofrequency tecnique. Coblation submucosal reduction turbinator (SCT);new surgical device; started to use recently. Since the method is new, very few study has been done yet. We compare coblation radiofrequency (CR) with SCT. MATERIAL AND METHODS: Patients with only inferior turbinate hypertrophy but no other diseases included in study. Paranasal CT was made to all patient to rule out turbinate bone hypertrophy. Group 1 32 patient; performed CR. Group 2 25 patients performed SCT. To all patients preoperative and 3 weeks later post operative mucosiliary activity test was performed. Nasal flow was measured with nasal flow meter preoperatively and 3 weeks post operatively. VAS and NOSE was measured. Results compared between two groups. SCT performed under general; CR performed under local anesthesia. RESULTS: There was significant nasal flow changes in CR group. (p < 0.001) There was no difference in pre-and-post operatively saccharin test results in CR group. (p = 0.385) There was slightly nasal flow gain in SCT group but this was not statistically significant. (p < 0.192) Also there was no statistically significant changes in pre-and-post operatively saccharin test results in SCT group. (p = 0.167) There was no difference between two groups in terms of post operative nasal flow values and mucociliary activity. (respectively p = 0.562, p = 0.355). (Table 2). Both two tecnique has significant increase in VAS and NOSE scores. (p < 0.001). CONCLUSIONS: According to our study two tecnique is suitable and safe for nasal mucociliary activity. Tecniques has positive effect on nasal flow, VAS and NOSE scores.

The protective effect of metformin against the noise-induced hearing loss.

OBJECTIVE: To test the protective effect of metformin against noise-induced hearing loss. METHODS: 24 rats were included in the study. The first group was exposed to noise only, the second group took metformin, the third group was exposed to noise and took metformin, and the fourth group was neither exposed to noise nor took metformin as control group. After measurement of baseline DPOAE and ABR of rats, the metformin group and the metformin + noise group received 300 mg/kg/day metformin via gavage for 10 days. On the 11th day, group 1 and group 3 were exposured to white noise at 105 dB SPL for 15 h. After noise exposure, DPOAE and ABR measurements of all rats were repeated on days 1st, 7th, and 21st. At the end of the study, all animals were sacrificed and cochlear tissues were separated for immunohistochemical assessments. RESULTS: ABR threshold values and DPAOE measurements of groups 1 and 3 were deteriorated on the 1st day after noise, while deterioration in group 1 continued on 7th and 21st days, but normalized on 7th day in group 3. After immune staining, a significant immunoreaction was observed in the noise group, while the reaction in the noise + metformin group was close to the control group. CONCLUSION: Metformin has a protective effect on noise-induced hearing loss in rats. As a conclusion, it is determined that metformin protects from permanent threshold shift in rats. It can be considered a good alternative for protecting noise-induced hearing loss.

Arsenic related hearing loss in miners.

PURPOSE: Arsenic is a toxic metalloid that carries number of potential risks to human health, although there is little evidence of the ototoxic effect of arsenic. The aim of this study was to identify the relationship between arsenic exposure and hearing loss by measuring blood arsenic concentrations and hearing among miners. MATERIALS AND METHODS: This research is a retrospective case control study. Included in the study were miners employed in a single silver mine whose blood arsenic concentrations were high. A comparison was made on the pure tone audiometry measurements taken from miners exposed only to arsenic (Group 1), those exposed to both arsenic and noise (Group 2) and a control group exposed to neither arsenic nor noise (Group 3). RESULTS: It was found that for both ears at all frequencies, the hearing level of Group 3 was better than the hearing levels of both Group 1 and Group 2. There was no correlation between the blood arsenic levels and hearing levels in both ears. CONCLUSION: This study has revealed the ototoxic effects of arsenic. As blood arsenic concentrations do not reflect long-term exposure, no correlation was identified between blood arsenic concentrations and hearing levels. Further studies will be needed to clarify the mechanisms involved in the effect of arsenic on hearing. This paper represents the largest study to date focusing on the isolated effects of arsenic on hearing through the use of a clinical auditory test.

The effect of duration of nasal obstruction on mean platelet volume in patients with marked nasal septal deviation.

Nasal obstruction is a common cause of marked nasal septal deviation. It is related strongly with hypoxia. Hypoxic conditions increase mean platelet volume levels. This study aimed to investigate the effect of age on mean platelet volume in patients with marked nasal septal deviation. We made a retrospective study of patients with marked nasal septal deviation between January 2012 and May 2014. The patients were divided into four groups according to duration of nasal obstruction (less than 10, 10-20, 20-30 and more than 30 years). The groups were compared with each other in terms of mean platelet volume, platelet distribution width, platelet count in preoperative hemogram. This study was performed on 356 male and 139 female patients. Mean age was 33.9 ± 12.3 years. It was determined that the platelet count, mean platelet volume did not constitute statistically significant difference between groups (p > 0.05). Nevertheless, it was determined that as the duration of nasal obstruction elongated the mean platelet volume value increased and platelet count values decreased. Mean values of platelet distribution width constituted statistically significant difference between all groups (p = 0.026). Patients with marked nasal septum deviation should be subjected to surgery as soon as possible because of the increase in mean platelet volume and platelet distribution width values which are related to increase in the risk of cardiopulmonary complications of nasal obstruction.

Arsenic ototoxicity.

High levels of arsenic are found in many parts of the world and more than 100 million people may have been exposed to it. There is growing evidence to indicate that arsenic has a deleterious effect on the auditory system. This paper provides the general information of arsenic and its ototoxic effects.

Evaluation of middle ear pressure in the early period after adenoidectomy in children with adenoid hypertrophy without otitis media with effusion.

OBJECTIVE: Our aim was to analyze the changes in middle ear pressure in the early period after adenoidectomy in children with adenoid hypertrophy without otitis media with effusion. METHODS: This prospective, descriptive study was performed on 64 patients (with normal tympanic membranes and tympanograms) undergoing adenoidectomy or adenotonsillectomy. All patients were operated by single experienced team using curettage technique. First tympanometry was done on the day before surgery. Tympanometry was repeated on the first-, third-, and seventh-day after the operation. Patients are separated into two groups according to age as patients younger than 6 years (Group A) and patients older than 6 years (Group B). All data were separately evaluated for each ear using Jerger Classification. RESULTS: Of the 64 patients included in the study, 35 were male and 29 were female, and the average age was 91.01 ± 37.4 (35-178) months. Pathological decreases in the middle ear pressures of at least one ear were determined in 48 (75%) patients on the first postoperative day and in 10 (15.6%) patients on the third postoperative day. Middle ear pressures returned to preoperative values by the seventh postoperative day except in two patients. There were statistically significant differences (p<0.0001) among preoperative and first, third, and seventh postoperative day mean middle ear pressure. There were no statistically significant differences between Groups A and B in terms of tympanometry values of both ears obtained preoperatively and on the first, third, and seventh postoperative day. CONCLUSION: In our study, temporary eustachian dysfunction and aural fullness occur in the early period after adenoidectomy and/or adenotonsillectomy. This situation may be due to post-surgery clots and edema in nasopharynx. We consider that tubal orifice can be exposed to surgical trauma as adenoidectomy surgeries are done by curettage technique. There is a need for comparative studies using microdebrider or laser adenoidectomy accompanied by an endoscope.

A comparison of the effects of solvent and noise exposure on hearing, together and separately.

The objective of the present study was to assess the effects of occupational exposure to noise and organic solvents on hearing loss in bus and truck plant workers. Our case control study contained 469 workers from a bus and truck plant divided into three groups. The first group contained workers exposed to only noise; the second group contained workers exposed to both noise and mixture solvents at a permissible level; and the third group included workers exposed to permissible levels of solvents. The control group (Group 4) included 119 individuals selected randomly, persons who were not exposed to noise and solvents. These groups were compared in terms of each individual's frequency hearing loss in both ears. Our study demonstrates that combined exposure to mixed solvents and noise can exacerbate hearing loss in workers. Hence, a suitable hearing protection program is advised that would contain short-interval audiometric examinations and efficient hearing protectors.