Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Laryngeal Carcinoma.

Aim of this study; investigate whether neutrophils/lymphocyte ratio (NLR) could be used as a prognostic factor in larynx cancer. The correlation between preoperative peripheral blood NLR and age, gender, smoking, alcohol use, clinical stage and differentiation degree was examined. One hundered fourty-four patients in Dicle University Department of Otorhinolaryngology between the years of 2005 and 2014 were included in the study. Clinical and preoperative laboratory data of patients were screened retrospectively from archive files of otorhinolaryngology and the pathology results were screened retrospectively from archive files of pathology. The study was approved by the local ethics committee of the department and carried out in accordance with the declaration of Helsinki as amended in 2013. Statistical analyses were performed using the SPSS 15.0 software package for Windows (SPSS inc., Chicago, IL, USA). There was a significant difference between NLR and clinical stage (p = 0.003) smoking (p = 0,001) and alcohol use (p = 0.001). When NLR was analyzed in detail according to the degree of tumor differentiation; significant differences were observed between G1 and G2 (p = 0.007) and between G1 and G3 (p = 0.001). Light of these findings, NLR is a cheap and easily accessible marker which can be used as a prognostic faxtor in laryngeal cancer. It is thougkt to shed light on the studies which will be conducted with more patients.

The protective effect of intratympanic dexamethasone on streptomycin ototoxicity in rats.

The purpose of this experimental study was to investigate the protective role of intratympanically administered dexamethasone on the inner ears of rats that were exposed to streptomycin ototoxicity. Twenty-four adult Wistar albino rats were separated into 4 groups: Group 1 (only streptomycin), Group 2 (only intratympanic dexamethasone), Group 3 (streptomycin and intratympanic dexamethasone), and Group 4 (streptomycin and intratympanic saline). All rats were evaluated with distortion product otoacoustic emissions (DPOAE) tests before the start of treatment and on the day it ended. On the 45th day, after the final DPOAE tests, animals of all groups were sacrificed under general anesthesia. The differences between the amplitudes of DPOAE results were determined, and hearing results were statistically analyzed. Also, the cochleas of each rat were histopathologically evaluated under a light microscope with hematoxylin and eosin staining. In the intratympanic dexamethasone group it was observed that cochlear hair cells were mostly protected. No significant difference was seen between the DPOAE results before and after treatment (p >0.05). On the other hand, loss was observed in the hearing functions and hair cells of the rats that received streptomycin and streptomycin plus intratympanic saline (p <0.05). In the streptomycin plus intratympanic dexamethasone group, the cochlear hair cells were partially protected. A significant difference was observed when the DPOAE results (DP-grams) of the streptomycin plus intratypmanic dexamethasone group were compared to those of the streptomycin plus intratympanic saline group (p <0.05). After the experimental study, ototoxic effects of the administration of streptomycin and intratympanic dexamethasone were observed on the rats' cochlear hair cells. We conclude that intratympanic dexamethasone has protective effects against this cochlear damage in rats.

The role of human papilloma virus and herpes viruses in the etiology of nasal polyposis.

BACKGROUND/AIM: The aim of this study was to investigate the etiological role of human papilloma virus (HPV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpes virus-6 (HHV-6) and -7 (HHV-7) in the occurrence of nasal polyposis. MATERIALS AND METHODS: Nasal polyp samples from 30 patients with nasal polyposis and normal nasal mucosa from 10 patients without nasal polyps were obtained. DNA was extracted from tissues. Real-time polymerase chain reaction was performed for all runs. RESULTS: No HSV-1, HSV-2, or VZV was detected in the samples. Among the patient samples, EBV and HHV-7 DNA were detected in 18 (60%), HHV-6 was detected in 20 (66.7%), and HPV was detected in 4 (13.3%) samples. Among the controls, CMV DNA was positive in one (10%). EBV was positive in 5 (50%), HHV-6 and HHV-7 were positive in 7 (70%), and HPV was positive in 2 (20%) samples. No significant difference was found among the groups with any test in terms of positivity. CONCLUSION: The association of Herpesviridae and HPV with the pathogenesis of nasal polyps was investigated in this study and no relationship was found. Thus, these viruses do not play a significant role in the formation of nasal polyps.

Paraoxonase Activity and Oxidative Status in Patients with Tinnitus.

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate serum paraoxanase-1 (PON) activity, total oxidant status (TOS), total antioxidant status (TAS), and the oxidative stress index (OSI) in tinnitus; and to compare the results with data from healthy subjects. SUBJECTS AND METHODS: A total of 114 subjects-54 patients with tinnitus and 60 healthy controls were enrolled in this study. Serum PON activity, TOS, TAS, and OSI levels were measured. RESULTS: In the tinnitus group, TAS, and PON were significantly lower than in the control group (p<0.001). However, the TOS, and OSI levels were significantly higher in the tinnitus group than in the control group (p<0.001). CONCLUSIONS: According to the data obtained from the present study, patients with tinnitus were exposed to potent oxidative stress. Oxidative stress may be the key contributing factor to the pathogenesis of tinnitus.

Is Middle Ear Pressure Effected by Nasal Packings after Septoplasty?

OBJECTIVE: To investigate the effects of different types of nasal packings on middle ear pressure in patients undergoing septoplasty. MATERIALS AND METHODS: Sixty patients who were suffering from nasal obstruction and who had to undergo septoplasty because of nasal septal deviation were included in the study. After the septoplasty, Merocel packings and internal nasal splints were intraoperatively applied in thirty patients each. Middle ear pressure was evaluated by tympanometry. Tympanometric peak pressures were used for this aim. Acoustic impedance measurements were performed in both ears, and the average values of the two ears were calculated. Tympanometric measurements were performed for patients during the preoperative period and on the 2(nd) and 5(th) postoperative days. RESULTS: There were 30 (5 females, 25 males; average age 23 years) patients in the internal nasal splint group and 30 (8 females, 22 males; average age 26 years) patients in the anterior Merocel packing group. When the values obtained by acoustic impedancemetry before the operation and on the postoperative 5(th) day were compared, there was no statistically significant difference between the groups. The middle ear pressure significantly decreased in the anterior Merocel packing group compared with that in the internal nasal splint group. The intragroup comparison of the acoustic impedance measurements of the internal nasal splint group revealed no significant difference between the preoperative acoustic impedance values and the values obtained on the postoperative 2(nd) day. CONCLUSION: Cannulated silicone intranasal splints are better in terms of patient comfort after an intranasal surgery without effecting eustachian tube function.

Efficacy of N-Acetylcysteine on Wound Healing of Nasal Mucosa.

Postoperative nasal mucosa healing is a highly complex and organized process, and the success rates of endoscopic sinus surgery and septoplasty surgeries are closely associated with the postoperative wound healing processes. In this experimental study, the authors' aim was to use histopathologic examination to investigate the effects of N-Acetylcysteine (NAC) on the wound healing of rat nasal mucosa after mechanical trauma. Twenty-one Sprague-Dawley rats were randomly divided into 3 groups: the nontreated group (N = 7), the control saline group (N = 7), and the NAC group (N = 7). No treatment was given to the nontreated group for 15 days. The control saline group received intraperitoneal injection of saline (2.5  mL/kg, intraperitoneal) for 15 days and the NAC group was intraperitoneally injected with NAC at a dose of 300  mg/kg/day for 15 days. At the beginning of the study, unilateral mechanical nasal trauma was induced with an interdental brush inserted through the right nostril in all rats. Samples were stained using hematoxylin and eosin solution, and were examined by a pathologist using a light microscope. The severity of inflammation was milder in the NAC group compared with that in the nontreated and saline groups (P < 0.05). The subepithelial thickness index was lower in the experimental group (P < 0.05). Goblet cell loss was reduced in the experimental group compared with the nontreated and saline groups (P < 0.05). NAC decreases inflammation and goblet cell loss. Therefore, NAC has potential beneficial effects on the wound healing of nasal mucosa in rats.

[Evaluation of smell function changes in pregnancy]. / Gebelikte koku fonksiyon degisiminin degerlendirilmesi.

OBJECTIVES: This study aims to compare the olfactory function changes among pregnant women in varying trimesters and non-pregnant women. PATIENTS AND METHODS: Thirty-five healthy pregnant women and 14 non-pregnant women were included in the study. Volunteer pregnant women were divided into three subgroups including the first trimester, second trimester, and third trimester. All volunteers were tested with the smell bottle test battery. The content of the test was consistent with the Sniffin' sticks including three detailed olfactory function tests, namely olfactory threshold (OT), olfactory discrimination (OD), and olfactory identification (OI). Total results of these three tests were defined as TDI scores. RESULTS: TDI score and test scores of the pregnant women in the first trimester statistically significantly decreased compared to pregnant women in other trimesters and non-pregnant women (p<0.05). Pregnant women in the second and third trimesters had similar olfactory function scores to the non-pregnant women (p>0.05). CONCLUSION: The olfactory function changes are observed in women during pregnancy. In particular, decreased smell sensitivity in the first trimester returns to normal scores towards the end of pregnancy.

Effect of caffeic acid phenethyl ester on myringosclerosis development in the tympanic membrane of rat.

Myringosclerosis is hyalinization and calcification of certain areas of the tympanic membrane, especially the fibrous lamina propria layer and appears as white sclerotic lesions. Ventilation tube insertion is one of the most performed operations in the pediatric otorhinolaryngology practice to treat chronic otitis media with effusion. Myringosclerosis is a very common sequela of ventilation tube insertion. In this experimental study, our aim was to show the histopathological effects of caffeic acid phenethyl ester on myringosclerosis development in rat tympanic membrane after myringotomy. The rats were randomly categorized into four experimental groups including the comparison group (n = 4), non-treated group (n = 7), the saline (control) group (n = 7), the caffeic acid phenethyl ester group (n = 7). Non-treated group did not receive any treatment for 15 days. Saline (2.5 mL/kg, intraperitoneal) was administered to the third group once a day for 15 days. Fourth group received caffeic acid phenethyl ester intraperitoneally once a day at a dose of 10 µmol/kg for 15 days. Myringotomy was performed on the right tympanic membrane of all rats except comparison group using a sterile pick with the help of an operating microscope. Histopathological examination of myringosclerosis formation was done by a pathologist under light microscope. In histopathological analysis of groups, the severity of inflammation was milder in caffeic acid phenethyl ester group compared to non-treated and saline groups (p < 0.05). There was less myringosclerotic plaques in caffeic acid phenethyl ester group than in non-treated and saline groups (p < 0.05). TM thickness measurements were very close to each other in non-treated and saline groups. The tympanic membrane thickness of caffeic acid phenethyl ester group was much thinner than the other two groups (p < 0.05). Caffeic acid phenethyl ester decreases inflammation severity and the formation of myringosclerotic plaques. These two effects resulted in thinner tympanic membranes of rats which were treated with caffeic acid phenethyl ester. As a result, caffeic acid phenethyl ester has potential preventive effects on myringosclerosis development after myringotomy and ventilation tube insertion.

Managment of orbital complications of sinusitis.

Purpose: We reported on the clinical approaches of ophthalmology and otorhinolaryngology departments in the treatment of the orbital complications of sinusitis. We also included an in-depth literature review. Methods: We retrospectively reviewed the medical files of 51 patients from January 2008 to January 2014. The records were evaluated for age, gender, type of orbital complications, symptoms, predisposing factors, imaging studies, medical and surgical management, culture results, and follow-up information. SPSS version 15.0 software (Statistical Analysis, The Statistical Package for Social Sciences Inc, Chicago, IL) was used for the statistical analysis. Results: Fifty-one patients met the criteria, with available medical records, for the study (29 male, 22 female). Thirty-two (62.7%) were diagnosed with preseptal cellulitis and 19 (37.3%) with postseptal cellulitis. After a detailed evaluation, 15 were diagnosed with a subperiosteal abscess (SPA), and 4 were diagnosed with orbital cellulitis. The age and gender was similar for the two groups. Five patients with medial SPA were treated with endoscopic sinus surgery, one patient with inferior SPA was treated with external surgery, and six patients with other localizations were treated with a combination of endoscopic sinus surgery and external surgery. All patients presented with periorbital erythema and edema. The length of hospitalization and duration of symptoms were similar in both groups. Visual acuity was between 1/10 to 10/10 (mean 7/10) and statistically significant for preseptal and postseptal cellulitis groups (p<0.001). All patients received intravenous antibiotics upon the first day of admission. Conclusion: Orbital complications of acute sinusitis required intensive follow-up and a multidisciplinary approach. A contrast-enhanced paranasal sinus computerized tomography (CT) scan can detect the extent of the infection. An initial trial of intravenosus (IV) antibiotics may be appropriate when close monitoring is possible. Surgery may be indicated when there has been no improvement within 48 hours of intravenous treatment, loss of visual acuity (under 8/10), and a non-medial abscess.

Radiologic and surgical findings in chronic suppurative otitis media.

Our aim in this study was to evaluate the efficiency of preoperative temporal bone computed tomography (CT) in detecting pathologic conditions in patients with chronic suppurative otitis media (CSOM). The intraoperative findings and temporal bone CT results of 350 patients who were diagnosed with CSOM between September 1, 2010, and June 1, 2013, were compared. Comparison parameters were as follows: the presence of cholesteatoma, erosion of the outer ear bone canal, erosion of the middle ear chain, erosion of the dural plate, erosion of the lateral semicircular canal, erosion of the sigmoid sinus wall, and dehiscence of the facial canal. The contribution of CT was limited in showing the outer ear canal destruction, dural plate destruction, facial canal destruction, lateral semicircular canal destruction, and destruction of the sigmoid sinus wall. However, CT was more sensitive in detecting cholesteatoma and erosion of the ossicular chain. These results indicate that preoperative CT of patients with CSOM serves as an important guide for otolaryngologists, although there are limitations in the evaluation of the CT results.

Managment of orbital complications of sinusitis / Tratamento das complicações orbitais da sinusite

Purpose: We reported on the clinical approaches of ophthalmology and otorhinolaryngology departments in the treatment of the orbital complications of sinusitis. We also included an in-depth literature review. Methods: We retrospectively reviewed the medical files of 51 patients from January 2008 to January 2014. The records were evaluated for age, gender, type of orbital complications, symptoms, predisposing factors, imaging studies, medical and surgical management, culture results, and follow-up information. SPSS version 15.0 software (Statistical Analysis, The Statistical Package for Social Sciences Inc, Chicago, IL) was used for the statistical analysis. Results: Fifty-one patients met the criteria, with available medical records, for the study (29 male, 22 female). Thirty-two (62.7%) were diagnosed with preseptal cellulitis and 19 (37.3%) with postseptal cellulitis. After a detailed evaluation, 15 were diagnosed with a subperiosteal abscess (SPA), and 4 were diagnosed with orbital cellulitis. The age and gender was similar for the two groups. Five patients with medial SPA were treated with endoscopic sinus surgery, one patient with inferior SPA was treated with external surgery, and six patients with other localizations were treated with a combination of endoscopic sinus surgery and external surgery. All patients presented with periorbital erythema and edema. The length of hospitalization and duration of symptoms were similar in both groups. Visual acuity was between 1/10 to 10/10 (mean 7/10) and statistically significant for preseptal and postseptal cellulitis groups (p<0.001). All patients received intravenous antibiotics upon the first day of admission. Conclusion: Orbital complications of acute sinusitis required intensive follow-up and a multidisciplinary approach. A contrast-enhanced paranasal sinus computerized tomography (CT) scan can detect the extent of the infection. An initial trial of intravenosus (IV) antibiotics ...

Objetivo: Relatamos abordagens clínicas dos departamentos de oftalmologia e otorrinolaringologia para tratar complicações orbitais da sinusite. Uma revisão em profundidade literatura é discutida. Métodos: Foram analisados retrospectivamente os prontuários de 51 pacientes no período de janeiro de 2008 a janeiro de 2014. Os registros foram avaliados quanto à idade, sexo, tipo de complicação orbital, sintomas, fatores predisponentes, estudos de imagem, tratamento médico e cirúrgico, resultados da cultura microbiológica e seguimento. Foi utilizado o programa SPSS versão 15.0 (Statistical Analysis, The Statistical Package for Social Sciences Inc, Chicago, IL) para a análise estatística. Resultados: Cinquenta e um pacientes preencheram os critérios, com os registros médicos disponíveis, para o estudo (29 do sexo masculino, 22 do sexo feminino). Trinta e dois (62,7%) foram diagnosticados com celulite presseptal e 19 (37,3%), com celulite posseptal. Depois de uma avaliação detalhada, 15 foram diagnosticados como abscesso subperiosteal (SPA), 4 eram celulite orbitária. A idade e sexo foi similar para ambos os grupos. Cinco pacientes com abscesso subperiosteal medial foram tratados com cirurgia endoscópica, um paciente com abscessso subperiosteal inferior foi tratado com cirurgia externa, 6 pacientes com outras localizações foram tratados com a combinação de cirurgia endoscópica e cirurgia externo. Todos os pacientes apresentaram eritema e edema periorbital. Tempo de internação hospitalar e a duração dos sintomas foi similar em ambos os grupos. A acuidade visual foi entre 1/10 a 10/10 (média de 7/10) e estatisticamente significante para os grupos celulite presseptal e posseptal (p<0,001). Todos os pacientes receberam antibióticos por via intravenosa, no primeiro dia ...

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.

A rare sublingual cyst in an infant: oral heterotopic gastrointestinal cyst.

Oral heterotopic gastrointestinal cyst is rarely seen in the oral cavity. The tongue and floor of the mouth are the most commonly affected sites. These cysts may cause feeding and respiration problems, especially in newborns and infants. A benign mass was considered according to the physical examination and ultrasonography findings. We treated the patient with simple excision. We present a three-month-old female infant who was referred to us with a cystic mass in the sublingual region.

The effects of oral isotretinoin (13-Cis retinoic acid) on the inner ear: a prospective clinical study.

PURPOSE: The purpose of this study was to investigate the effect of oral isotretinoin, a drug used in the treatment of acne vulgaris, on hearing function determined by serial audiology examinations. METHODS: Forty patients with acne vulgaris were included in this study. Nine patients were excluded from the study because of inconsistent follow-up. The hearing of each participant was tested with pure tone audiometry and transient evoked autoacoustic emissions before and two and four weeks after treatment with isotretinoin (0.3-0.6 mg/kg/day) in the remaining 31 patients (62 ears). RESULTS: The differences between the mean values of the pre-treatment and post-treatment pure tone hearing thresholds at 1000, 2000, 4000 and 6000 Hz frequencies were statistically significant (p < 0.05), but there was no significant difference between the pre-treatment and post-treatment values at 250 and 500 Hz frequencies (p > 0.05). The difference between the pre-treatment and post-treatment signal-noise ratio values of the transient evoked autoacoustic emissions was not significantly different (p > 0.05). CONCLUSION: Our results suggest that the use of isotretinoin may cause bilateral hearing threshold changes. Further animal and human studies are required to investigate and characterize isotretinoin-induced neurophysiological alterations in hearing.

Effects of caffeic acid phenethyl ester on wound healing of nasal mucosa in the rat: an experimental study.

PURPOSE: Wound healing of the nasal mucosa is a highly complex process that restores the anatomical and functional integrity of tissue that has been exposed to trauma. In this experimental study, our aim was to use histopathological examination to investigate the effects of caffeic acid phenethyl ester on the wound healing of rat nasal mucosa after mechanical trauma. MATERIALS AND METHODS: The rats were randomly divided into 3 experimental groups: a non-treated group (n=7), a control saline group (n=7) and a caffeic acid phenethyl ester group (n=7). The non-treated group received no treatment for 15 days. The second group was administered saline (2.5 mL/kg, intraperitoneal) once a day for 15 days. The third group received caffeic acid phenethyl ester intraperitoneally at a dose of 10 µmol/kg once a day for 15 days. At the beginning of the study, unilateral mechanical nasal trauma was induced on the right nasal mucosa of all rats in the three groups using a brushing technique. Samples were stained using hematoxylin and eosin solution and were examined by a pathologist using a light microscope. RESULTS: The severity of inflammation was milder in the caffeic acid phenethyl ester group compared with that in the non-treated and saline groups (P<0.05). The subepithelial thickness index was lower in the experimental group (P<0.05). Goblet cell and ciliated cell loss was substantially reduced in the experimental group compared with the non-treated and saline groups (P<0.05). CONCLUSIONS: Caffeic acid phenethyl ester decreases inflammation and the loss of goblet cells and ciliated cells. Therefore, caffeic acid phenethyl ester has potential beneficial effects on the wound healing of nasal mucosa in the rat.

Patients with congenital choanal atresia treated by transnasal endoscopic surgery.

Congenital choanal atresia (CCA) is defined as a congenital failure in the development of communication between the nasal cavity and nasopharynx in newborns. It is the most common congenital anomaly of nose. Most of the patients presented with unilateral CCA. Neonates with bilateral CCA have severe respiratory distress after birth. Airway control with orotracheal intubation should be done immediately to save the life of neonate with bilateral CCA. After airway control, surgery should be performed as soon as possible. The aim of surgery is to create a patent nasal passage and to prevent restenosis with minimal morbidity. Transnasal endoscopic surgery of CCA has become the most popular treatment method. The retrospective review of 33 patients with CCA was presented in this study. The patients who were diagnosed at the neonate period and operated on in 6 months after birth were grouped as I (neonate). The patients who were diagnosed 6 months after birth were grouped as II (child-young adult). All patients were treated by transnasal endoscopic surgery. Stent were put in all patients to prevent restenosis. Although the restenosis rate was higher in group I (53.8%) than in group II (23.1%), it did not cause a statistically significant difference. Overall success rate of our surgical approach was 61.5%. Despite the surgical developments and many treatment modalities, restenosis is still the most challenging problem in CCA.

Serum omentin levels in patients with obstructive sleep apnea.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is associated with increased rates of cardiovascular diseases (CVD). The basic mechanisms involved in the increased cardiovascular risk of OSAS remain unclear. Recent discoveries of fat-secreted substances which serve endocrine roles improve our understanding of the relationship between OSAS, CVD, and the metabolic syndrome. In this study, we aimed to examine associations between omentin levels and OSA. METHODS: Forty-six newly diagnosed OSA patients and 35 non-apneic controls were enrolled in this study. Demographical data, cigarette smoking status, previous history of chronic diseases including CVD and metabolic diseases and drugs, and habits were obtained using a standardized questionnaire. All patients underwent polysomnographic evaluation. Omentin was measured the following morning. RESULTS: The mean age was 48.1 ± 12.5 (24-74) years in the OSA group and 42.8 ± 14.1 (21-69) years in the control group. Of the 81 patients, 46 (34 males and 12 females) were classified as having OSA and 35 patients (20 males and 15 females) as control. Plasma levels of omentin were found to be markedly higher in OSA patients (570.8 ng/ml) than in the control group (432.0 ng/ml; p < 0.001). In addition, plasma levels of omentin were found to be high in all OSA subgroups than in controls. The plasma omentin levels were significantly correlated only with age in patients with OSA. CONCLUSIONS: We conclude that circulating omentin levels are elevated in OSA patients. To the best of our knowledge, this is the first clinical study that demonstrated the association between omentin and OSA.