Chemical Composition and Antimicrobial Activity against Phytopathogenic Fungi of Essential Oils Obtained from Echinophora tenuifolia subsp. sibthorpiana Grown in Wild and Cultivated Conditions in Turkey

The hydro-distilled essential oils obtained from aerial parts of the wild and cultivated Echinophora tenuifolia subsp. sibthorpiana have been analyzed by GC-MS and screened for antimicrobial activity. In total, 28 compounds representing more than 99% of the oils were identified. α-phellandrene (13.22% and 55.27%), δ-3-carene (49.29% and 4.03%), and methyl eugenol (22.59-25.69%) were found as the main components for the wild and cultivated oils, respectively. EOs of the wild and cultivated plants differed significantly in both the percentage of the main components and antifungal effect. α-phellandrene was more dominant in cultivated plants (55.27%) than in wild ones (13.22%), while δ-3-carene was more abundant in the wild plants (49.29%). In the antifungal assays, both oils displayed moderate to high activity against three phytopathogenic fungi; Fusarium oxysporum, Rhizoctonia solani, and Alternaria alternata.

An Unusual Location of Osteochondroma: Temporal Bone.

Osteochondromas are the most common benign tumor of the bones which are cartilage-capped exophytic lesions that arises from the bone cortex. They usually seen in the axial skeleton, especially around the metaphysis of long bone but seldom in the head and neck region. The majority of patients in the head and neck region affect the mandibular area. To our knowledge, this is the first reported patient with an osteochondroma of the temporal bone in the English literature. A patient with temporal bone osteochondroma and its surgical treatment are here described.

GEOGRAPHICAL IMPACT ON ESSENTIAL OIL COMPOSITION OF ENDEMIC KUNDMANNIA ANATOLICA HUB.-MOR. (APIACEAE).

BACKGROUND: Kundmannia anatolica Hub.-Mor. is an endemic specie of Apiaceae diversified in Turkey. Several parts of the plant may contain essential oils in different quantity which can be influenced by environmental factors, mainly altitude. The aim of this study was to test whether there is any altitude effect on volatile chemical constituents of essential oil obtained from the fruits of K. anatolica growing spontaneously in different altitudes of Lakes Region in Turkey. MATERIALS AND METHODS: K. anatolica was collected in 2015 at different altitudes (400, 820, 1002 and 1560 m) of Lakes Region Turkey. The fruits of the plants were distilled for 3 h using a Clevenger type apparatus according to the British Pharmacopiea (1980). Essential oils of the fruits were collected using hydro distillation method and analyzed by GC-MS/FID. RESULTS: Essential oil contents of fruits increased by corresponding increase in altitude level. Predominant compounds were a-Pinene (27.87-61.94%) and ß-Pinene (24.92-36.46%) of the total oil of K. anatolica. Other important compounds were α-Thujene (2.66-8.15%), l-Limonene (1.83-8.23%), α-Phellandrene (1.85-5.01%) and these compounds were higher in low altitudes. CONCLUSION: Altitude change affected the terpenoid biosynthesis and oxygenated monoterpenes generally and were greatest when low; while sesquiterpene constituents were greatest at high altitudes. The influence of altitude seems to be an important factor for yielding the chemical profile of K. anatolica essential oils. Thus, the location of the plant must be taken into account depending on the intended use.

Comparison of Cold Technique Tonsillectomy and Thermal Welding Tonsillectomy at Different Age Groups.

The aim of this study is to compare objectively advantages and disadvantages of cold technique tonsillectomy and thermal welding tonsillectomy at the same case. A total of 100 patients, 53 patients younger than 12 years of age and 47 patients elder than 12 years of age, were included in this study. Tonsillectomy was performed by using cold technique on the right side of the palatine tonsils and thermal welding on the left side. Right and left sides were compared regarding perioperative bleeding, surgical dissection time, postoperative pain scale at the 1st and 7th day and postoperative bleeding parameters. Perioperative bleeding was found to be higher in cold technique side in patients younger than 12 years of age (p<0.001). Postoperative pain score on the day 1 was significantly higher in cold technique side, whereas it was found to be higher in thermal welding side at postoperative day 7 (p<0.001). Perioperative bleeding was found to be significantly higher in cold technique side (p<0.001) and surgical dissection time of thermal welding was found to be longer (p<0.001) in patients elder than 12 years of age. Postoperative pain score at the day 1 and day 7 was found to be higher in thermal welding side (p<0.001). Postoperative pain score at the day 1 and day 7 were statistically significantly higher in patients elder than 12 years of age. As a result, both techniques have its unique superior aspects and both can be applied as a routine tonsillectomy technique.

Oxytocin as a protective agent in cisplatin-induced ototoxicity.

PURPOSE: Cisplatin is a potent chemotherapeutic drug with serious side effects such as ototoxicity which is characterized by irreversible, bilateral, progressive sensorineural hearing loss. Oxytocin, which is a well-known hormone secreting during pregnancy, has antioxidant and antiinflammatory effect. Our study aims to test and compare the effect of intratympanic (IT) and intraperitoneal (IP) oxytocin on cisplatin ototoxicity with DPOAE. METHODS: A total of 24 Wistar albino rats were randomly divided into four groups: Group 1 received 0.1-0.3 ml IT saline + IP saline solutions for 4 days (n = 6), Group 2 received cumulative dose of 20 mg/kg IP cisplatin divided into two equal doses in first and second days of experiment + 0.1-0.3 ml IT saline for 4 days, Group 3 received same dose of cisplatin as Group 2 + 0.1-0.3 ml IT oxytocin for 4 days, and Group 4 received same dose of cisplatin as Groups 2 and 3 + IP oxytocin with dose of 1 mg/kg. DPOAE was performed prior to procedure and at the end of the experiment on day 5. RESULTS: Group 2 showed severe ototoxic effect of cisplatin according to DPOAE result (p < 0.05). When compared with Group 2, DPOAE amplitude reductions were smaller in Group 3 (3.2, 3.8, 4.5, 6.3 and 7.6 kHz) (p < 0.05) and Group 4 which is statistically significant in 5.4, 6.3 and 7.6 kHz (p < 0.05). When Group 3 and Group 4 were compared, reductions were smaller in 2.7 and 3.2 kHz in Group 3 (p < 0.05). CONCLUSION: In this study, we showed the protective effect of IT and IP oxytocin on cisplatin ototoxicity. We suggest oxytocin in cisplatin ototoxicity, especially via IT route even with high-dose cisplatin.

Relationship between smoking and otorhinolaryngological symptoms.

OBJECTIVES: This study aims to investigate the possible relationship between smoking and otorhinolaryngological symptoms in smokers, non-smokers and ex-smokers. PATIENTS AND METHODS: Between March 01st, 2014 and March 31st, 2014, a total of 1,840 patients (823 males, 1,017 females) over 25 years of age who were admitted to the ear nose, and throat (ENT) outpatient clinic were included in the study. The patients who were smoking at least 10 cigarettes daily for at least five years were included in the smokers group (n=514). The patients who did not smoke for at least one year following at least five years of smoking were included in the ex-smokers group (n=268). The patients who never smoked were included in the non-smokers group (n=1,058). A form containing all ENT symptoms was given to all patients and the patients were asked to fill the form with their complaints following being informed by the same doctor. RESULTS: Cough, shortness of breath, reflux, dryness of throat, irritation, taste disorder, bad breath, toothache, nasal congestion, smell disorders, snoring, and nasal discharge were found to be significantly higher in the smokers group, compared to the non-smokers group. Cough, sputum, hoarseness, dysphagia, reflux, sore throat, dryness of throat, irritation, stinging, oral aphthae, taste disorder, toothache, bleeding gums, and bad breath were significantly lower in the ex-smokers group. Nasal congestion, nosebleeds, sneezing, nasal discharge, smell disorders, headache, feeling of facial fullness, ear discharge, hearing loss, pain, fullness, dizziness, and tinnitus were statistically significantly lower in the ex-smokers group. CONCLUSION: Our study results show that smoking causes symptoms particularly associated with upper respiratory tract and these symptoms may persist in ex-smokers.

The Evaluation of Relationship Between Body Mass Index and Nasal Geometry Using Objective and Subjective Methods.

INTRODUCTION: It is known that obesity causes obstructive sleep apnea syndrome by increasing upper airway resistance. Also, obese patients are admitted to the ear, nose, and throat clinic very often because of nasal obstruction complaint. The aim of this study is to identify the change and relation among body mass index (BMI), nasal resistance, reduction in nasal ariflow, nasal anatomy, and patients' subjective complaints. MATERIAL AND METHOD: A total of 67 patients admitted to our clinic between August 2013 and January 2014 were included in the study.The study group comprised 33 patients who had a chief complaint-nasal obstruction and the other group consisted of 34 patients who had no complaint and nasal pathology. Both the groups were checked with acoustic rhinometry (AR), active anterior rhinomanometer, nasal obstruction symptom evaluation (NOSE), and visual analog study (VAS) questionnaire. RESULTS: There is a significant statistical correlation between the body mass increase and VAS and NOSE score increase (P < 0.05). But the authors did not find any statistically significant relation between BMI and total inspiratory and expiratory MR and MF measured by anterior active rhinomanometer and left and right nasal cavity MCA, and volume measured by acoustic rhinometery (P > 0.05). CONCLUSIONS: Contrary to belief, obesity does not change the nasal resistance, airflow, and anatomy but it can cause subjective nasal complaints.

Is There a Relationship Between Bell's Palsy and Internal Auditory Canal?

In the present study, we evaluated the diameter of internal acoustic canal in patients with Bells palsy to investigate the role of anatomical differences of the temporal bone in etiology of Bell's palsy. Sixty-four patients who were diagnosed as Bells Palsy and temporal bone computed tomography imagings of them were included into the study group (Group 1). The control group (Group 2) was consisted of 35 healthy subjects without Bell's Palsy. All patients had temporal bone computed tomography imaging. The internal auditory canal inlet, mid-canal, outlet and canal lengths were measured at the most distinctive cross-section of the seventh and eighth cranial nerves bifurcation. In the study group, Bells palsy was on the right side in 26 patients (40.6 %) and on the left side in 38 patients (59.4 %). Initial House-Brackmann (HB) score was HB-2 in 29 patients (45.3 %), HB-3 in 18 patients (28.1 %), HB-4 in 13 patients (20.3 %) and HB-5 in 4 patients (6.2 %). At 6-month evaluation, HB-score of the patients were HB-1 in 37 patients (57.8 %), HB-2 in 25 patients (39.1 %) and HB-3 in 2 patients (3.1 %). Internal auditory canal (IAC) measurements of the groups showed that there were no significant differences between the measurements of right-mid canal, right canal length; and left canal outlet and left canal length of the study and control groups. Right inlet and outlet; and left inlet and mid-canal values of the study group (Bell's palsy) were significantly lower than those of the control group. In Bell's palsy group, left inlet, outlet and canal length values were significantly higher than those of the right ones. Correlation analysis showed that there were no significant correlation between paralysis side; initial HB stage; and IAC measurement results. In patients with higher initial HB score, their 6-month later HB-score was also higher. In patients with higher 6-month HB score; R canal inlet, R mid-canal, L-canal inlet, and L-mid canal values were lower. Lower IAC inlet and mid-canal values were detected in patients with Bell's palsy. Therefore narrow IAC inlet and mid-canal values may be one of the risk factors for Bell's palsy.

Evaluation of the Effect of Betahistine on Noise-Induced Hearing Loss Using Distortion Product Otoacoustic Emission and Scanning Electron Microscopy.

OBJECTIVE: To evaluate the protective effect of betahistine on noise-induced hearing loss (NIHL) using scanning electron microscopy (SEM) and distortion product otoacoustic emission (DPOAE). MATERIALS AND METHODS: A total of 8 adult albino guinea pigs were used in this study (study group: n=4 and control group: n=4). DPOAE measurements of both groups were performed before the procedure. Two hours before noise exposure, 0.9% NaCl solution was injected perorally to the control group and betahistine was administered through a peroral catheter to the study group. Both groups were then exposed to 105-dB sound pressure level (SPL) 4-kHz frequency-based narrow-band noise for 2 h per day for 5 days. DPOAE measurements were performed again on the 6th day and cochleae were dissected and examined by SEM on the 7(th) day. RESULTS: Regarding the results of DPOAE, NIHL was observed in both groups on the 6th day (p<0.05). Loss, flattening, and fusion, which are findings of permanent hearing loss, were determined in the stereocilia of the inner and outer hair cells by SEM. These findings were evaluated as signs of permanent increase in the threshold. When DPOAE measurements and SEM results were evaluated in the study group, no significant difference was observed in NIHL compared with the control group (p>0.05). CONCLUSION: In our study, it was observed that simultaneous administration of betahistine during noise had no protective effect on permanent increase in the threshold. However, further studies on noise and long-term use of betahistine can be performed.

Is there a relationship between myeloperoxidase activity and conductive hearing loss in chronic otitis media complicated by cholesteatoma?

We conducted a prospective, controlled study of patients with chronic otitis media and cholesteatoma (1) to examine the expression of myeloperoxidase (MPO) using immunohistochemical staining techniques and (2) to investigate the relationship between MPO activity and the degree of conductive hearing loss in these patients. Our study population included 51 adults-26 men and 25 women, aged 18 to 58 years (mean: 37.5)-who had been diagnosed with chronic otitis media and cholesteatoma by physical examination and computed tomography (study group). Another 30 patients-13 men and 17 women, aged 18 to 52 years (mean: 32.7)-who had chronic otitis media without cholesteatoma served as the control group. Following audiometric evaluations, all patients underwent appropriate surgery. Postoperatively, cholesteatoma samples were analyzed by immunostaining for MPO positivity as a marker for acute inflammation. We found that MPO activity was present in all 51 study patients (100%) but in only 10 controls (33.3%); the difference was statistically significant (p< 0.01). In the study group, the degree of MPO activity was slight in 6 patients (11.8%), moderate in 24 patients (47.1%), and intense in 21 patients (41.2%), while in the control group, all 10 MPO-positive cases showed only a slight degree of activity. We also found a statistically significant association in the study group between the degree of MPO activity and the degree of conductive hearing loss (χ(2) = 13.518; p < 0.001). We encourage further study of all steps in the process of cholesteatoma formation.

Sudden hearing loss and vertigo after tooth extraction successfully treated with combined therapy including HBO2: a case report.

Sudden sensorineural hearing loss (SSNHL) is a decrease in hearing of at least 30 dB that occurs within three days and which affects at least three consecutive frequencies in either ear or both ears. This case report describes a woman who had sudden hearing loss and vertigo in the right ear after tooth extraction. As the first-line therapy, systemic and intratympanic steroid injections were used this led to a slight improvement; however, the majority of improvement in hearing was not observed until hyperbaric oxygen (HBO2) therapy was instituted on the 20th day of hearing loss. Sudden hearing loss and vertigo after tooth extraction is an otologic emergency and early evaluation and treatment are effective. HBO2, although employed beyond the Undersea and Hyperbaric Medical Society's recommended initial 14 days of symptom onset, very was effective for this particular case.

Quality of life in patients with persistent allergic rhinitis treated with desloratadine monotherapy or desloratadine plus montelucast combination.

OBJECTIVES: This study aims to compare the effectiveness of desloratadine monotherapy and desloratadine plus montelukast combination therapy on quality of life in patients with persistent allergic rhinitis. PATIENTS AND METHODS: This study consists of 40 patients (28 females, 12 males, mean age 29.8 years; range 17 to 44 years) referred to ear, nose, and throat outpatient clinic between May 2010 and September 2010. A six-week randomized, double-blind, cross-sectional study was performed in two arms: In group 1, 20 patients received desloratadine (5 mg/d) alone; in group 2, 20 patients received desloratadine (5 mg) plus montelukast (10 mg) combination therapy. Quality of life was assessed on the day before starting treatment and on the last day of each treatment period using the Rhinoconjunctivitis Quality of Life Questionnaire and Nighttime Symptom Scores. RESULTS: In group 1, the mean quality of life scores before and after treatment were 3.17 and 2.43, respectively. In group 2, the mean quality of life scores before and after treatment were 2.94 and 1.73, respectively. CONCLUSION: Desloratadine plus montelukast combination therapy may have a positive impact on quality of life, sleep symptoms in particular.

[Evaluation of benign vocal cord lesions with laryngeal electromyography]. / Benign vokal kord lezyonlarinin larengeal elektromiyografi ile degerlendirilmesi.

OBJECTIVES: This study aims to identify patients with benign vocal cord lesions using laryngeal electromyography (EMG) and to investigate the presence of accompanying vocal cord paresis. PATIENTS AND METHODS: Twenty-eight patients (18 males and 10 females; mean age 38.6±10.2 years; range 22 to 59 years) who were diagnosed with benign vocal cord lesion using a rigid laryngostroboscopy underwent laryngeal EMG and the presence of neurogenic involvement was investigated. RESULTS: Laryngostroboscopic examination revealed polyp in 85.7% (n=24), Reinke's edema in 10.7% (n=3), submucosal cyst in 10.7% (n=3), and contact granuloma in 3.6% (n=1). Of the patients, 14.2% (n=4) were suspected to have vocal cord paresis. Laryngeal EMG revealed neurogenic involvement in at least one of the larynx muscles in 57.2% (n=16) of the patients. Eight patients (28.6%) had unilateral neurogenic involvement, while three (10.7%) demonstrated isolated recurrent laryngeal nerve paresis two (7.2%) demonstrated isolated superior laryngeal nerve paresis, and three (10.7%) demonstrated combined recurrent and superior laryngeal nerve paresis. Six (21.4%) of eight patients with bilateral neurogenic involvement had paresis in three laryngeal nerves, whereas in two (7.2%) patients four laryngeal nerves were affected. CONCLUSION: Our study shows that vocal cord paresis frequently accompanies benign vocal cord lesions. Laryngeal EMG is useful to identify clinically suspected or unsuspected paresis with physical examination precisely.

Metastasis of non-muscle-invasive bladder cancer into the thyroid gland: a literature review accompanied by a rare case.

Bladder cancer is the most prevalent malignancy of the urinary tract. About 90% of bladder cancers are urothelial carcinomas. Seventy percent of cases newly diagnosed are superficial diseases; roughly 30% of newly diagnosed cases are muscle-invasive metastatic diseases. Bladder urothelial carcinoma primarily metastasizes into regional lymph nodes and then into liver, lung, mediastinum, bone, and adrenal gland. In our case, non-muscle-invasive bladder cancer metastasized into the bone, mediastinum, iliac lymph node, and adrenal and thyroid glands. This is the first reported case in the current literature in which urothelial carcinoma metastasized into the thyroid gland.

Prevalence of otitis media with effusion among primary school age-children and etiopathogenic examination.

A prevalence study was carried out in order to look into the etiopathogenic relation of otitis media with effusion (OME) in primary school-age children. The study included ENT examination and a questionnaire that was carried out in 4 randomly selected schools on 1,165 children. 143 of the cases (12.2%) had OME. A significant relation between OME and adenoid vegetation was found (P<0.01) while no significant relation between EOM and recurrent tonsillitis and allergic rhinitis was found (P>0.05). As a result, OME is a common disease that can lead to other hard-to-cure health problems and be costly if etiopathogenic factors are not resolved on time.

Severe destruction of the upper respiratory structures after brief exposure to a dieffenbachia plant.

Dieffenbachia is a common domestic plant. Oral contact with the plant generally causes slight effects, but when chewed it may result in painful oropharyngeal edema. Even though the mechanism through which this plant causes toxicity is not known, calcium oxalate crystals (rhaphides) and protease in the idioblast of the plant are considered to be the causes. Our aim was to show the lethal effects of a common domestic plant named Dieffenbachia.A 70-year-old male patient applied to our clinic with aphasia, dysphagia, sialorrhea, wounds on the lips and tongue, and swelling on the face. There was edema on his tongue, soft palate, uvula, anterior pharyngeal plica, epiglottis and aryepiglottic fold, and ulceration on the right side of his tongue, the right cheek mucosa, right-lower gingival, soft palate, tongue base, epiglottis anterior surface, and free edge.Dieffenbachia toxicity presents both minimal and serious problems, which can be life threatening, as in our case. Toxic cases resulting in serious clinical pictures due to Dieffenbachia are rare.

Could cellular proliferation be a predictive index for the relapse of nasal polyposis and down-regulated by nasal steroid treatment?

The aim of this article is to identify the cellular mitotic activity using Ki-67 monoclonal antibody for predicting relapses of nasal polyposis after surgery. A prospective study was conducted at Kartal Training and Research Hospital Otolaryngology Department between January 2006 and September 2008. Nasal polyps were obtained from all patients and pathological materials were analyzed for the Ki-67 staining using immunohistochemistry. Patients were followed after surgery for 12 months for relapse. There was no statistically significant difference between recurrent and nonrecurrent polyps. Polyp recurrence has a multifactorial origin. Ki-67 index alone does not provide sufficient information about polyp recurrence before the operation.

Fibromyxoma of the frontal sinus.

Fibromyxomas are uncommonly encountered pathologies in the head and neck region. They are slow growing, which result in expansion of the surrounding bony cortices. In this article, we report an extremely rare case of frontal sinus fibromyxoma which occluded the frontal sinus and expanded anterior ethmoid cells and nasal dorsum. Initially, it was suspected to be a mucocele. Surgical resection with a wide excision was performed and it was diagnosed as fibromyxoma, histopathologically.

Huge internal carotid artery aneurysm presenting as tonsillar asymmetry.

Aneurysms of the extracranial portion of the carotid artery are extremely rare. Internal carotid artery aneurysm is an uncommon cause of tonsillary asymmetry. Although internal carotid artery aneurysms usually remain asymptomatic, the clinical manifestation requires the tonsillar enlargement. Asymmetry as a sole determining factor for tonsillectomy may lead to unnecessary operations. We report a patient with a giant internal carotid artery aneurysm presenting as tonsillary asymmetry that might be mistaken for a tonsillar neoplasia. When faced with a tonsillar asymmetry, an otolaryngologist must keep aneurysms in mind.

Carotid body tumors and our surgical approaches.

Glomus tumors known as paragangliomas are neoplasms arising from the neural crest. They are named according to the place they originate from. Tumors originating from the carotid body at the carotid bifurcation are called Carotid Body Tumors (CBT). Surgical intervention is planned according to the Shamblin classification. 17 patients were operated after being diagnosed with CBT in our clinic between February 2007 and June 2010. 12 (70.5%) of the patients were male, and 5 (29.4%) of the patients were female. The average age was 42 (ages ranging between 32 and 47). Nine of the patients were diagnosed and treated with Shamblin type I tumor, seven of the patients with type II and one patient with type III. Only one patient had bilateral carotid tumor. In all patients with Shamblin type I and II, blunt dissection of the tumor was conducted smoothly by means of thermal cautery in the subadventitial plane. The patient with Shamblin type III had tumor invasion in the carotid artery and adjacent tissues were in an adherent state. Therefore mass resection was carried out by resecting 2 cm of the distal portion of the common carotid artery and 3 cm of the proximal portion of the internal carotid artery. 6 mm of synthetic polytetrafluoroethylene graft was interpositioned between the common carotid artery and the internal carotid artery. External carotid artery was anastomosed to this graft in an end-to-end fashion. The patient developed vocal cord paralysis postoperatively on the lesion side. The patient who underwent bilateral tumor excision developed Baroreflex Failure Syndrome. In the two patients thrombus developed in the internal carotid artery in the early postoperative period. These patients underwent thrombectomy and developed hemiplegia on the lesion side. One of them died on the seventh post-operative day while in follow-up in the intensive care unit. Surgical resection is the recommended treatment for carotid body tumors. Shamblin I and II type tumors' dimensions and pathological characteristics allow dissection. However Shamblin III tumors may require carotid artery resection and reconstruction due to tissue invasion. The possibility of post-operative cranial nerve paralysis and arterial thrombosis should be taken into account.