Evaluation of patient satisfaction with different hearing aids: A study of 107 patients.

We retrospectively investigated patient satisfaction with different types of hearing aids in 107 patients-60 males and 47 females, aged 8 to 84 years (mean: 53.8)-with unilateral or bilateral hearing loss, each of whom used two different hearing devices for at least 3 years per device. The International Outcome Inventory for Hearing Aids, Turkish edition (IOI-HA-TR) was used to evaluate satisfaction levels; we also calculated our own total individual subjective satisfaction (TISS) scores. We divided 16 different hearing devices into two types: device 1 and device 2; on average, device 2 had more channels, a lower minimum frequency, and a higher maximum frequency. We found that the IOI-HA-TR scores and TISS scores were higher and usage time was greater during device 2 use, and that there was a positive correlation between IOI-HA-TR and TISS scores. A total of 69 patients (64.5%) used device 2 for more than 8 hours per day, while 38 patients (35.5%) used it for 4 to 8 hours per day during the final 2 weeks of the trial. In contrast, 40 patients (37.4%) used device 1 for more than 8 hours, 50 (46.7%) used it for 4 to 8 hours, and the remaining 17 (15.9%) used it for less than 4 hours; the difference in the duration of use of the two devices was statistically significant (p < 0.001). Younger patients and patients with more education were more satisfied with their devices than were older patients and those who were not as well educated. We conclude that devices with good technologic features such as more channels, a lower minimum frequency, and a higher maximum frequency result in better hearing. Also, based on the age difference that we observed, we recommend that psychological support be provided to older patients with aided hearing to enhance their mental health and quality of life.

Evaluation of the efficacy of curcumin in experimentally induced acute sinusitis in rats.

We investigated the possible beneficial effects of curcumin (CMN) in the treatment of sinusitis. An experimentally induced sinusitis model was created in rats, and the results were evaluated histologically. Thirty-two healthy, female Sprague Dawley rats weighing 270 to 310 g each, were randomly divided into four groups. Group 1 was the control group. In Groups 2 to 4, experimentally induced acute sinusitis was developed, and the rats in those groups were given saline, sulbactam-ampicillin, and CMN, respectively, for 10 days. Then all rats were dissected, and samples of sinus mucosa were taken. Histologic examination was performed via light microscopy. In the sinusitis + antibiotic group, values of inflammation, vascular congestion, vascular dilatation, and subepithelial glandular atrophy were significantly higher; and values of mucosal damage and cilia loss, and hyperplasia of goblet cells, were not significantly different from those in the control group. In the sinusitis + CMN group, values of inflammation, vascular congestion, and vascular dilatation were significantly higher; and values of mucosal damage and cilia loss, hyperplasia of goblet cells, and subepithelial glandular atrophy were not significantly different from those of the control group. Histologic examination revealed that in the sinusitis + CMN group, a nearly normal appearance of the epithelial tissue and reduced cellular inflammation in connective tissue were observed. Minimal vascular congestion in connective tissue remained. The efficacy of CMN in acute sinusitis may be related to its potent anti-inflammatory effects on modulation of various inflammatory cytokines. When low side effects are taken into account, CMN therapy may be a promising option in the treatment of acute sinusitis.

Fat-plug myringoplasty of ear lobule vs abdominal donor sites.

The purpose of this study is to compare the success rates of fat-graft myringoplasties harvesting adipose grafts from different donor sites (ear lobule vs abdomen). The clinical records of 61 patients (24 males and 37 females) who underwent fat-plug myringoplasty (FPM) were reviewed retrospectively. Fat from ear lobule (FEL) and abdominal fat were used as graft materials. The impact of age, gender, systemic diseases, topography of the perforation, utilization of fat graft materials of different origin on the tympanic membrane closure rate and the effect of FPM on hearing gain was analyzed. Our tympanic membrane (TM) closure rate was 82 %. No statistical significant difference was observed regarding age, gender, comorbidities (septal deviation, hypertension and diabetes mellitus) or habits (smoking). Posterior TM perforations had significantly lower healing rate. The change in TM closure rate considering different adipose tissue donor sites was not statistically significant. The hearing gain of the patients was mostly below 20 dB. Fat-plug myringoplasty (FPM) is a safe, cost-effective and easy operation for selected patients. Abdominal fat graft is as effective as ear lobe fat graft on tympanic membrane healing, has cosmetic advantages and should be taken into consideration when planning fat as the graft source.

The role of septated concha bullosa on sinonasal pathologies.

The purpose of this study was to retrospectively determine the possible role of septated concha bullosa on sinonasal pathologies. Paranasal sinus computerized tomography scans of patients with symptoms of headache, postnasal drip, nasal obstruction and smell disorders were retrospectively evaluated. Twenty-eight subjects with unilateral septated concha bullosa and 13 subjects with unilateral concha bullosa without septation were selected as the study and control groups, respectively. Both groups were compared according to the presence of septal deviation and sinus pathology. There were no statistically significant differences in baseline characteristics (age and gender) between the groups. Sinus involvement was found in 20 patients (71.4 %) in the study group and in 10 patients (76.9 %) in the control group. The most common pathology accompanying septated concha bullosa was maxillary sinusitis (65 %), and ethmoid sinus was the second most involved sinus (25 %). Similar results in terms of sinus involvement were also seen in the control group. Septal deviation was seen in 18 patients in the study group (64.2 %) and in 12 patients in the control group (92.3 %). Eventually, there was no statistically significant difference between septated and non-septated concha bullosa groups according to the accompanying sinonasal pathologies.

The relationship between AHI, Epworth scores and sleep endoscopy in patients with OSAS.

This prospective study aimed to evaluate the relationship between sleep endoscopy findings, the apnea-hypopnea index (AHI) or the Epworth sleepiness scale in patients and obstructive sleep apnea syndrome (OSAS). Patients with symptoms of OSAS were searched, and their polysomnography findings, Epworth sleepiness scales and sleep endoscopy findings were recorded. Those who were diagnosed with mild, moderate or heavy OSAS were included in the study. Patients included in the study were observed under sedative-induced sleep in the operation room using flexible nasopharyngoscopy. The obstruction levels and degrees were recorded and compared with other variables. Of the 88 patients included in the study, 67 (76.1 %) were male, and 21 (23.9 %) were female. The mean age (±standard deviation) of all 88 patients was 43.77 ± 10.07 years (range 21-65 years). Sleep endoscopy findings were classified as uvulopalatal, lateral pharyngeal, tongue base and laryngeal collapses. The Epworth sleepiness scale showed no significant correlation with the sleep endoscopy findings. No significant relationship was found between the AHI and collapses in the uvulopalatal, lateral and laryngeal zones (p > 0.05). However, tongue base collapse was correlated with AHI (p < 0.05). AHI increased with the degree of collapse in the tongue base. No meaningful relationship was noted among the Epworth sleepiness scale, AHI, and number of involved zones (p > 0.05). The degree of collapse in the related zones was not meaningfully associated with AHI, which is accepted as the indicator of disease severity.

Effects of surfactant on biofilm formation on silicone nasal splints.

Biofilms are sessile communities of bacteria embedded in self-produced extracellular polysaccharide matrix and are considered to be responsible for bacterial infections in humans. Topical surfactant use on silicone nasal splints may have a preventive effect on biofilm formation. The objective of this study is to investigate the effect of surfactant-containing nasal solutions on biofilm formation over the surface of silicone nasal splints. Forty patients were randomized after septoplasty to receive surfactant-containing saline solution (group 1) or saline without surfactant (group 2). At the postoperative 48th, 72th and 96th hours, pieces of splint samples were taken and prepared for scanning electron microscopic evaluation. Biofilm formation was observed in 3, 6 and 14 of 20 samples in group 1 (surfactant used) and 3, 14 and 20 of 20 samples in group 2 (control) at 48th, 72th and 96th hours, respectively. Biofilm formation incidences of groups at 48th hour were similar (p > 0.05), whereas it was significantly lower at group 1 regarding 72th and 96th hours (p < 0.05). Surfactant-containing nasal solutions have an inhibitory effect on biofilm formation over the surface of silicone nasal splints especially after 48 h. Surfactant-containing nasal solutions may have an important role in nasal septal dressing in the future.

Microbial biofilm formation on silicone nasal splints: optimal time for splint removal.

OBJECTIVES: Biofilms are sessile communities associated with persistent infections and are resistant to conventional therapeutic strategies. They survive on the surface of various inorganic medical devices and cause serious medical problems. METHODS: We recruited 25 patients who underwent nasal surgery between January and May 2013. All patients received silicone splints at the conclusion of the procedure. Pieces of the splints were collected 48, 72 and 96 h post-surgery and prepared for scanning electron microscopy evaluation to assess biofilm formation. RESULTS: Biofilm was observed in 3, 14 and 25 of the 25 samples at 48, 72 and 96 h, respectively. The differences in the proportions of the samples with biofilm formation at each time point (48, 72, and 96 h) were statistically significant. CONCLUSION: Our data demonstrated that biofilm formation on silicone splints increases significantly after 48 h following placement. Although packing may reduce complications, surgeons must consider the potential hazards of packing materials, such as biofilm formation at 48 h post-surgery.

Bilateral triple concha bullosa: a very rare anatomical variation of intranasal turbinates.

Pneumatization of the intranasal turbinates or concha bullosa is an anatomic variation of the lateral nasal wall. Concha bullosa is defined as the presence of air cells in turbinates. It can be best diagnosed with paranasal sinus computed tomography. Concha bullosa is a possible etiologic factor for recurrent sinusitis due to its negative effect on paranasal sinus ventilation and mucociliary clearance. Concha bullosa is most commonly seen in the middle turbinate and less frequently in the inferior or superior turbinate. Pneumatization of all turbinates is very rare. To our knowledge, there are only two publications about a case with concha bullosa in all turbinates in the current literature. Here, we present a woman with bilateral pneumatization in all three intranasal turbinates.

Bilateral superior concha bullosa: a rare case overlooked.

Concha bullosa is generally defined as the pneumatization of the middle turbinate and, rarely, of the superior or the inferior turbinates. A symptomatic pneumatization of the superior turbinate is extremely rare. When symptomatic, concha bullosa may cause various problems. Concha bullosa can be easily recognized in paranasal sinus computed tomography. In this article we present a very rare case with bilateral pneumatization of the superior turbinates in a patient with relevant symptomatology.

Epistaxis and Staphylococcus aureus colonization in the nasal vestibule: is it a cause or consequence?

The aim of this study was to investigate the relation between epistaxis and nasal colonization of Staphylococcus aureus in a population of patients with recurrent epistaxis. A total of 361 men and women were recruited, 245 patients with epistaxis (114 had crusting in the nasal vestibule; 131 did not) and 116 control subjects. A microbiology swab was taken from the anterior nasal cavity of each subject. Staphylococcus aureus was found to be more common in the epistaxis group when compared with the control group with a percentage of 31.8% and 4.3%, respectively (P < 0.05). There was no difference in the prevalence of S. aureus between the crust and non-crust groups (P > 0.05). When positive cultures were grouped and compared according to season, it was observed that the positive culture with epistaxis was much higher (44.82 %) in the autumn period. Staphylococcus aureus colonization in the nasal vestibule is more likely to be observed in individuals who have recurrent epistaxis than in those who do not have. It seems that this colonization may have a role in the etiology of epistaxis. However, with an altered medium of the nasal vestibule after each epistaxis period, it is also possible to speculate that this colonization is may be the consequence of epistaxis itself.

Cultural adaptation of an olfactory test: the odour in bottle test. [corrected].

OBJECTIVES: To compare the size of the nasal septal body (SB) and inferior turbinate (IT) of subjects grouped by sex and age. METHOD: We measured SB and IT areas (in cm2) bilaterally in computed tomography (CT) sections of 150 paranasal sinuses from 72 males and 78 females. RESULTS: The right and left SB areas were smaller in females than in males. In the ≤ 25-year-old group, the right IT (RIT) was significantly smaller in females than in males. In the 26-35 and 46-45 age groups, the right SB (RSB) was significantly smaller in females than in males. CONCLUSION: The nasal SB may play a role in nasal physiology similar to a turbinate and help support optimal airflow. The vascular and glandular structures of the SB should be investigated in detail, and minimal invasive procedures should be performed in nasal surgery to avoid damaging essential structures.

Comparison of the effects of mandibular protruding devices on obstructive sleep apnoea patients and healthy volunteers.

PURPOSE: To evaluate upper airway diameter differences before and after placement of custom made mandible protruding devices (MPD) in OSAS group and to compare with control group using computerized tomography. METHODS: The OSAS group was composed of 15 patients aged from 25 to 45 years with mild-moderate OSAS and the control group included 15 healthy volunteers, aged from 25 years to 44 years. On coronal and sagittal reformated CT images, anteroposterior (AP) and lateral (LAT) diameters at three levels (passing through soft palate [level 1], 5 mm above uvula [level 2] and 1 cm above the tip of epiglottis [level 3]) were measured before and after MPD placement in both groups. RESULTS: LAT diameters at level 1, level 2 and AP diameter at level 2 in OSAS group were significantly lower than in control group before MPD placement. Only LAT diameters at level 2 in OSAS group were significantly lower than in control group after MPD placement. When we compared upper airway diameters before and after placement of the MPD within each group, statistically significant increase in diameters at all levels were observed. CONCLUSION: MPD is a cheap, easily usable device providing increase in upper airway diameters.

An unusual anatomical variation of the superior turbinate: a case report.

INTRODUCTION: The only anatomical variation of the superior turbinate defined in the literature is concha bullosa. Determination of anatomical variations of the intranasal structures is important to perform safe endoscopic sinus surgery and avoid complications. CASE PRESENTATION: We report a case of an unusual anatomical variation of the superior turbinate in a 55-year-old Turkish man with nasal obstruction and headache. CONCLUSIONS: Anatomical variations of superior turbinate are very rare. Variations of intranasal structures can easily be detected with coronal plane paranasal sinus computed tomography.

An unusual cause of hemoptysis: leech in the supraglottic region of the larynx.

Leeches live in fresh water and moist terrestrial environments. Most infestations are cutaneous. However, internal infestation occurs principally in the rural parts of the Mediterranean countries as well as in Africa and Asia. Thus,the possibility of leech endoparasitism should be kept in mind for a patient presenting with hemoptysis and with a history of close contact with fresh water in tropical countries.Human infestation is rare and usually occurs after consumption of contaminated water or swimming in leech-infested still waters such as lakes and dams.Herein, we report 2 live leech cases with hemoptysis in the supraglottic region of the larynx.

The effects of air pollutants on nasal functions of outdoor runners.

Nowadays road running is becoming more and more popular in our country. Road running is mostly done under improper conditions. The aim of this study was to investigate the effects of running on nasal response combined with the effects of air pollutants. Twenty road runners were enrolled in the study. All subjects were male and between 20 and 41 years of age. They ran for 60 min on the right side of an avenue in the center of the city. It is in a residential area but has heavy traffic. One week later they were invited to run for 60 min through a running course away from traffic that is located outside the city center. Nasal resistances were measured by active anterior rhinomanometry. Nasal transport time was also measured by saccharin transport method. There was a reduction in nasal resistance, which was statistically significant in city center runners but was not statistically significant in those running outside of the city center after the exercise. Although nasal transport times were statistically shorter in both groups, there were no differences between two groups. Nowadays, everyone is advised to do sports. Due to increase in the number of breaths, the depth of breathing, and the reduction in nasal resistance in outdoor runners during exercise, harmful air pollution particles can easily reach the lower respiratory tract. Exercise is important for our health, but it should be noted that the environment in which we run is as important as doing sports for our health, especially in outdoor runners.

Influence of surface properties of Merocel® (polyvinyl acetal) and silicone nasal splints on biofilm formation.

The objective of the study was to investigate biofilm formation on Merocel(®) and silicone nasal splint after nasal septal surgery. 50 patients who were scheduled to undergo nasal septal surgery were included in this study. The patients were randomized into receiving an insert of Merocel(®) or silicone splint after septoplasty. In group 1 (8 females, 17 males) and group 2 (10 females, 15 males), Merocel (®) packs or silicone splints were inserted into nasal cavities at the end of the procedures, respectively. All packs were removed 48 h after insertion, and samples were taken from the packs under sterilized conditions. Scanning electron microscopy was performed to observe biofilm formation on the surfaces of Merocel(®) and silicone splints. Biofilm formation was observed in 25 (100%) and 3 (12%) of the Merocel(®) and silicone splint samples, respectively. Our study revealed that biofilm formation on Merocel(®) packs is significantly higher than silicone splints, mainly due to the different texture and surface properties of these materials. Considering the hazardous effects of biofilm formation on humans, our observations in this study may guide surgeons to choose the most appropriate packing material after nasal septal surgery.

Is there a relationship between cribriform plate dimensions and septal deviation angle?

The aim of this retrospective study was to investigate the relationship between cribriform plate (CP) dimensions and septal deviation degree. Coronal paranasal CT scans of 99 patients were reviewed. We measured depth and width of cribriform plate on both sides and compared with septal deviation side and septal deviation degree. Deviation angles were 6.85 ± 1.47° for right deviations; and 7.11 ± 1.63° for the left deviations. The mean depth of CP was 5.08 ± 1.57 mm at the right side and 5.06 ± 1.59 mm at the left side; and the mean width of CP was found 4.71 ± 1.36 mm at the right side and 4.56 ± 1.51 mm at the left side. When CP dimensions were evaluated according to the septal deviation side, mean width of CP was 4.69 ± 1.36 mm at ipsilateral side (deviated side); and 4.58 ± 1.51 mm at the contralateral side. The mean depth of CP was 4.9 ± 1.56 mm at the ipsilateral side (deviated side); and 5.22 ± 1.58 mm at the contralateral side. The CP depth at the contralateral side was significantly higher than that of the ipsilateral side (deviated side). In right SD, ipsilateral and contralateral CP depth increased. As deviation angle increased, ipsilateral and contralateral CP width, right and left CP width increased. Ipsilateral and contralateral CP width; and additionally ipsilateral and contralateral CP depth increased together. In other words, right and left CP width; and CP depth increased simultaneously. It is well known that the higher incidence of intracranial penetration is on the side where the position of the ethmoid roof (ER) is lower. The presence of septal deviation, the possibility of the deeper CP at the contralateral side should be taken into consideration to avoid iatrogenic injury.

Efficacy of Curcumin in the healing of paracentesis in rats.

OBJECTIVES: The present study was designed to investigate the possible beneficial effect of Curcumin (CMN) in healing of paracentesis in terms of wound thickness, sclerosis and closure by histological evaluation. To evaluate the efficacy of CMN, paracentesis was performed experimentally in the rats; and the results were presented histologically. METHODS: Sixteen, each 270-310g weighted, healthy Sprague-Dawley female rats were included into the study. In both groups, paracentesis was performed into the eardrum bilaterally. In Group 1 (Paracentesis+Saline Group), saline drop was applied; and in Group 2 (Paracentesis+Curcumin group), Curcumin drop treatment was applied. Paracentesis area did not healed bilaterally in two rats (one in Group 1 and one in Group 2). Therefore, these two rats were excluded from the study. Histological examination performed in 14 rats and 28 temporal bones on the 15th day after the completion of drop treatment and closure of the paracentesis-area and wound healing were evaluated according to the histological examination criteria: Thickening of the tympanic membrane (ThicTM); and sclerosis. RESULTS: Both tympanic membrane thickening and sclerosis values of Paracentesis+Curcumin Group (Group 2) were significantly lower than those of the Paracentesis+Saline Group's (median: 2.0) (p=0.001). Histological examination by light microscopy showed that in Paracentesis+Curcumin Group (Group 2), the structure of the tympanic membrane is near to the normal and decreased sclerosis was observed in connective tissue. Whereas in Paracentesis+Saline Group (Group 1), tympanic membrane thickening and connective tissue sclerosis were observed. CONCLUSIONS: Curcumin improves wound healing process in paracentesis of TM. By using Curcumin drops, the closured paracentesis area was observed near to the normal eardrum; and thickness of the TM and sclerosis were less than the control, showing the improved healing at 15th day. The possible mechanisms may be anti-inflammatory effect, improving collagen deposition, and increasing fibroblast and vascular density in wounds thereby enhancing impaired wound healing.

Effects of body mass index and adenotonsillar size on snoring sound intensity levels at highest power.

OBJECTIVES: Snoring during sleep is a major clinical symptom of adenoid and tonsil hypertrophy in paediatric patients. The aim of this study was to determine the effects of adenoid and tonsil size on snoring sound frequency and intensity in children. METHODS: Twenty-seven patients with adenotonsillar hypertrophy were included the study. Adenoid size was graded from 1+ to 4+ by rigid endoscopy. Patients were staged (I-III) according to body mass index (BMI) and tonsil and adenoid size. Snoring was recorded and analysed. The analysis focused on the highest power frequency (Fmax) and snoring sound intensity levels (SSILs). RESULTS: SSIL and Fmax values for Stage III were significantly higher than those for Stages I and II. BMI for Stage III was higher than for Stages I and II, and that for Stage II was higher than for Stage I. The BMI, SSIL, and Fmax values increased at each stage and tonsil/adenoid grade. CONCLUSIONS: SSIL seems to be related to Adenoid and Tonsils size and BMI. As stage increased, both Fmax and SSILs increased proportionally. Also, Fmax values shifted to higher frequencies. Physicians and parents should be aware of snoring, and be informed that a higher frequency and intensity may be related to obesity and/or adenotonsillar hypertrophy. Snoring analysis may be a useful tool for detecting cases of Adenoid and Tonsils hypertrophy and/or upper airway obstruction during sleep.