Etiological and epidemiological factors in hearing-impaired students in Van, East of Turkey: A case series.

The aim of the present case series was to investigate the causes of hearing loss in the children studying at a primary School for the deaf in Van Province, Turkey. The present series included 95 children with sensorineural hearing loss. Otoscopic and ophthalmological examinations, pure-tone audiometry, and tympanometry were performed for each patient. Measles IgG, rubella IgG, cytomegalovirus (CMV) IgG, toxoplasma IgG, herpes simplex virus (HSV) Type I (HSV-I) IgG, HSV Type II (HSV-II) IgG, and Mycoplasma pneumonia IgG were evaluated in serum samples. Temporal bone anomalies were analyzed on temporal bone computed tomography (CT). A total of 7 radiologically distinct inner ear malformations were detected in 19 children. Twelve children were detected with various fundus pathologies. The most common cause of hearing loss was family-related factors (52%). In conclusion, the etiological and epidemiological factors were consistent with those reported in the literature.

Is Nasal Polyposis Related to Levels of Serum Vitamin D and Vitamin D Receptor Gene Expression?

BACKGROUND Nasal polyposis (NP) is the most frequent cause of nasal masses. Despite considerable research on the subject, its etiology has not been fully elucidated, and effective treatment methods have not been developed. Some etiological factors causing low or high expression of genes in genetically predisposed individuals may play a role in the pathogenesis of the disease. The purpose of this study was to assess the relation between levels of vitamin D receptor (VDR) gene expression and serum vitamin D with NP. MATERIAL AND METHODS The study included 46 subjects with NP (NP group) and 40 volunteers (control group). Nasal polyp tissue samples were taken from the NP group and nasal mucosa samples were taken from the control group. Levels of VDR gene expression in the tissue samples were assessed using the real-time polymerase chain reaction (RT-PCR) method. RESULTS Mean serum 25(OH)D levels were 13.38±14.08 ng/ml in the NP group and 10.57±6.44 ng/ml in the control group (p=0.249). VDR gene expression was present in 17.5% of the NP group and 3.3% of the control group, and the difference between the 2 groups was statistically significant (likelihood ratio χ²=3.887; p=0.049). CONCLUSIONS This is the first study to assess levels of VDR gene expression in subjects with NP. Our results suggest that VDR gene expression may be associated with the pathogenesis or progression of NP.

The Relationship Between Hearing Thresholds and Hyperandrogenism in Polycystic Ovary Syndrome.

BACKGROUND The purpose of our study was to investigate the association between polycystic ovary syndrome (PCOS) and hearing thresholds. MATERIAL AND METHODS Forty women diagnosed with PCOS (mean age, 24.33±6.38 years) and 40 healthy women controls (mean age, 26.38±6.75 years) were included in prospective study. Each case was tested with low (250, 500, 1000, and 2000 Hz), high (4000, 6000, and 8000 Hz) and extended high (EH) (9000-20000 Hz) frequency audiometry. The fasting plasma glucose, insulin, FSH, LH, total testosterone, and sex hormone-binding globulin were measured in all patients. RESULTS The mean hearing thresholds at EH frequencies were statistically significantly higher in the PCOS group than in the control group (p=0.001 right ear and p=0.015 left ear). There were significant positive correlations among free testosterone index (FTI) values and hirsutism scores with EH frequency hearing thresholds. CONCLUSIONS At pure-tone audiometry (PTA) EH frequencies, we detected significantly higher hearing thresholds in PCOS patients than in controls. We also determined that elevated FTI and hirsutism score were positively correlated with elevated hearing thresholds in EH frequencies. These findings support that hyperandrogenism can play a role in the elevation of hearing thresholds in PCOS.

Mean platelet volume, red cell distribution width, platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients with ankylosing spondylitis and their relationships with high-frequency hearing thresholds.

The mean platelet volume (MPV), red cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) comprise laboratory markers in ankylosing spondylitis (AS). There is a controversy in the literature regarding which type of ear involvement is characteristic of AS. The aim of this study was to simultaneously investigate the MPV, RDW, platelet to lymphocyte (PLR) and NLR in patients with AS and their relationships with high-frequency hearing thresholds. Thirty patients with AS and 35 age-matched healthy subjects were included. Each subject was tested with low- (250, 500, 1000 and 2000 Hz) and high- (4000, 8000, 10,000, 12,000, 14,000 and 16,000 Hz) frequency audiometry. Additionally, the case and control groups were evaluated regarding the average hearing thresholds in bone conduction. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured. The RDW, MPV, neutrophils, lymphocytes and platelet counts were evaluated with the complete blood count. Furthermore, the NLR and PLR were calculated. The complete blood count, platelet numbers, ESR, CRP and NLR levels were significantly increased in the AS patients compared with the healthy controls (p < 0.001, p = 0.007, p < 0.001, p < 0.001 and p = 0.047, respectively). There was no statistically significant difference in the RDW, PLR or MPV levels (p > 0.05) in the AS patients compared with the healthy controls. The BASDAI score and disease duration were not correlated with the ESR, CRP levels, MPV, PLR, RDW or NLR in patients with AS (all; p > 0.05). The AS patients had increased average measurement values for the hearing threshold in both ears at frequencies of 250, 500, 1000 and 2000 Hz; however, there was no statistically significant difference (p > 0.05). The average values of the hearing threshold in both ears at the high frequencies of 4000, 6000, 8000, 10,000, 12,000 and 14,000 Hz were significantly increased in the case group; however, it was not significantly increased at 16,000 Hz. The current study is the first to investigate the PLR, NLR, MPV and RDW levels in acute AS. We identified a significantly increased NLR, leukocyte count, ESR and CRP in AS patients. Sensorineural hearing loss, especially at extended high frequencies, is common in patients with AS and may represent an extra-articular feature of the disease. The combined use of NLR with the leukocyte count and other clinical assessments may facilitate the diagnostic process of ankylosing spondylitis.

Tympanic Membrane Perforation Caused by Thunderbolt Strike.

Thunderbolt strike is a life-threatening entity. In the patients presenting with thunderbolt strike, the central nervous system and the cardiovascular system should be primarily evaluated, followed by tympanic membrane lesions. The most important symptom connected with ear is the loss of hearing. In this report, a 43-year-old male patient with unilateral tympanic membrane perforation, tinnitus, and bilateral sensorineural hearing loss caused by thunderbolt strike is presented through a review of the literature.

Lip cancer: A 16-year retrospective epidemiological study in Eastern part of Turkey.

OBJECTIVE: To review lip cancer patients with respect to age, gender, location and histological type of tumour, and risk factors. METHODS: This retrospective study was conducted at the Yuzuncu Yil University, Van, Turkey, and comprised medical records of the histologically confirmed lip cancer patients who presented between 1994 and 2010. No patient had neck nodes or evidence of distant metastasis. RESULTS: Of the 91 patients 73(80.22%) were men and 18(19.78%) were women. The overall mean age was 62.32±13.88 years (range: 25 to 97 years). Histologically, the tumour was a squamous cell carcinoma in 81(89.01%) cases and a basal cell carcinomas in 10(10.99%) cases. Upon admission, the mean diameter of the tumour in squamous cell carcinoma patients was 2.03±1.23 cm and 1.87±1.29 cm in basal cell carcinoma patients. As for the tumour differentiation, 67(84.72%) of the squamous cell carcinoma cases were well differentiated, while 14(17.28%) were moderately differentiated. CONCLUSIONS: The incidence of lip cancer was found to be higher among men, while the histopathological type was mostly squamous cell carcinoma and well differentiated.

Assessment of adenosine deaminase (ADA) activity and oxidative stress in patients with chronic tonsillitis.

To emphasize the effectiveness of adenosine deaminase (ADA) enzyme, which has important roles in the differentiation of lymphoid cells, and oxidative stress in patients with chronic tonsillitis. Serum and tissue samples were obtained from 25 patients who underwent tonsillectomy due to recurrent episodes of acute tonsillitis. In the control group, which also had 25 subjects, only serum samples were taken as obtaining tissue samples would not have been ethically appropriate. ADA enzyme activity, catalase (CAT), carbonic anhydrase (CA), nitric oxide (NO) and malondialdehyde (MDA) were measured in the serum and tissue samples of patients and control group subjects. The serum values of both groups were compared. In addition, the tissue and serum values of patients were compared. Serum ADA activity and the oxidant enzymes MDA and NO values of the patient group were significantly higher than those of the control group (p < 0.001), the antioxidant enzymes CA and CAT values of the patient group were significantly lower than those of the control group (p < 0.001). In addition, while CA, CAT and NO enzyme levels were found to be significantly higher in the tonsil tissue of the patient group when compared to serum levels (p < 0.05), there was no difference between tissue and serum MDA and ADA activity (p > 0.05). Elevated ADA activity may be effective in the pathogenesis of chronic tonsillitis both by impairing tissue structure and contributing to SOR formation.

Effects of shock waves on oxidative stress in parotid gland of rat.

This study was designed to investigate whether extracorporeal shock wave lithotripsy (ESWL) exposure to parotid gland produces an oxidative stress in parotid glands of rats. Twelve male Wistar-albino rats, 6 months of age with an average body weight of 250-300 g, were divided randomly into two groups, each consisting of six rats. The animals in the first group did not receive any treatment and served as control. The left parotid glands of animals in group 2 (ESWL treated) received a thousand 18 kV shock waves after anesthetizing the rats with 50 mg/kg of ketamine. The animals in both groups were killed 72 hours after the ESWL treatment, and the parotid glands were harvested for the determination of lipid peroxidation product malondialdehyde (MDA), antioxidant glutathione (GSH) levels and the activities of antioxidant enzymes such as superoxide dismutase (SOD), GSH-Px and catalase (CAT). It was found that MDA level increased in parotid glands of rats after the ESWL treatment. The SOD, GSH-Px and CAT enzyme activities, and the level of antioxidant GSH decreased in parotid gland of rats after the ESWL treatment. It was concluded that short-term ESWL treatment caused an increase in the free radical production and a decrease in the antioxidant enzyme activity in parotid glands of ESWL-treated rats.

Serum myeloperoxidase activity, total antioxidant capacity and nitric oxide levels in patients with chronic otitis media.

It has been suggested that oxidative stress may play an important role in the pathogenesis of chronic otitis media (COM), but the role of oxidative stress in the pathogenesis of COM has not yet been fully explored. Therefore, the aim of this study was to investigate serum myeloperoxidase (MPO) activity, 4-hydroxynonenal (4-HNE), malondialdehyde (MDA), total antioxidant capacity (TAC) and nitric oxide (NO) in patients with COM. Sixty-one patients with COM and 30 controls were enrolled in the present study. Patients were divided into two groups according to the presence (n = 21) or absence (n = 40) of cholesteatoma. Serum MPO activity and 4-HNE, MDA and NO levels were significantly higher in patients with COM than controls (for all, p < 0.001), while TAC levels were significantly lower (for all, p < 0.001). Serum MPO activity and MDA, 4-HNE and NO levels were significantly higher in patients with cholesteatoma than in those without cholesteatoma, while TAC levels were significantly lower; but the difference between groups was not statistically significant (p > 0.05). Increased oxidative stress seems to be associated with decreased antioxidant levels in patients with COM. Thus, increased oxidative stress may play a role in the pathogenesis of COM. It is believed that the administration of antioxidant vitamins such as A, C and E may be useful in preventing and treating COM.

[Oropharyngeal tularemia in beta lactam-resistant cervical lymphadenitis]. / Beta laktama dirençli boyun lenfadenitlerinde orofarengeal tularemi.

OBJECTIVES: This study aims emphasize oropharyngeal tularemia in the differential diagnosis of infected lymphadenopathy in the neck region. PATIENTS AND METHODS: Twenty patients (13 males, 7 females; mean age 23 years; range 9 to 43 years) diagnosed with tularemia among those who admitted to our clinic between October 2008 - October 2010 with the complaint of lymphadenopathy in the neck, and underwent treatment were included in this study. The radiological, microbiological, histopathological, and laboratory records of the patients were evaluated. RESULTS: All patients with lymphadenitis in neck who were diagnosed with tularemia came from rural areas. Twelve patients had a history of tonsillopharyngitis that pre-existed before the beginning of lymphadenitis or coexisted with lymphadenitis. All lymphadenopathies of the neck was localized in region II, without side predominance. All patients were diagnosed by serological testing. In 12 of the patients who developed abscesses, repeated puncture of the abscess was performed in addition to the medical treatment. Surgical drainage procedure was not applied any patient. CONCLUSION: The tularemia disease should always be considered in the differential diagnosis of patients with neck lymphadenopathy.

Alterations in oxidative stress markers in laryngeal carcinoma patients.

BACKGROUND: Data describing how laryngeal cancer affects oxidative stress markers and antioxidants are limited. This study investigated serum antioxidant enzyme activities and oxidative stress markers before and after laryngectomies in patients with laryngeal cancer. METHODS: A total of 29 patients with laryngeal cancer and 25 healthy control subjects were enrolled. Serum malondialdehyde (MDA) levels and superoxide dismutase (SOD), glutathione peroxidase (GSHPx), catalase (CAT), paraoxonase (PON), and arylesterase activities were measured spectrophotometrically. Blood samples were obtained from each patient just before surgery and 1 month after a laryngectomy. RESULTS: The serum PON, arylesterase, CAT, SOD, and GSHPx activities were significantly decreased (all p < 0.001) and serum MDA levels were significantly increased (p < 0.001) in patients with laryngeal cancer, compared with control subjects. In laryngeal cancer patients, the serum GSHPx and arylesterase activity levels increased significantly following laryngectomies (both p < 0.001), whereas the MDA levels decreased significantly (p = 0.007). CONCLUSION: In patients with laryngeal cancer, the oxidant/antioxidant balance shifted toward oxidative stress. In addition, following laryngectomies, laryngeal cancer patients had increases in serum antioxidant enzyme activities and decreases in oxidative stress markers.

Local irritant effects of topical oral sprays on oral mucosa in mice.

Topical oral sprays are frequently used to prevent and manage oropharyngeal inflammation and lesions. This study investigated the histopathologic changes noted in the oral mucosa of mice after topical application of 3 widely prescribed antibacterial products. The 25 animals were divided into 5 groups and treated for 10 days with 2 sprays daily, as follows: group 1-chlorhexidine gluconate 0.12% + benzydamine hydrochloride 0.15%; group 2-benzydamine 0.27 mg/0.18 mL x 30 mL; group 3-chlorhexidine 0.2%; group 4-fusafungine 1%; and group 5 (cohort)-physiologic serum. On day 10 after drug administration, biopsy specimens were taken from the oropharyngeal mucosa of the tongue, the cheek mucosa, and the tongue base; these were examined under a light microscope and were classified as normal or pathologic. All topical oral sprays produced some degree of histopathologic change, such as hyperplasia, fibrosis, low-grade dysplasia, congestion, or edema. The local irritant effects of topical oral sprays should be considered when treatment is selected for patients with oropharyngeal disorder.

The association of obesity with hearing thresholds in women aged 18-40 years.

An elevation in hearing thresholds and decrease in hearing sensitivity in adults, particularly due to aging, are quite common. Recent studies have shown that, apart from aging, various other factors also play a role in auditory changes. Studies on the association of hearing loss (HL) with obesity are limited in advanced age cases and present contradictions. In this study, the association between obesity and hearing thresholds in women aged 18-40 years has been assessed. Forty women diagnosed with obesity (mean age, 31.8 years) and 40 healthy non-obese female controls (mean age, 30.5 years) were included in this prospective study. Each subject was tested with low (250, 500, 1000 and 2000 Hz) and high (4000, 6000 and 8000 Hz) frequency audiometry. In the case and control groups, the average hearing thresholds at low frequencies were 16.03 ± 4.72 and 16.15 ± 2.72 (p = 0.885) for the right ear, respectively, and 16.15 ± 5.92 and 14.71 ± 3.18 (p = 0.180) for the left ear, respectively. The average hearing threshold levels at high frequencies were 20.70 ± 10.23 and 15.33 ± 3.87 (p = 0.003), respectively, for the right ear, and 22.91 ± 15.54 and 15.87 ± 4.35 (p = 0.007), respectively, for the left ear with statistical significance. This is the first report on the association of obesity with hearing threshold in women aged 18-40 years. We have demonstrated that obesity may affect hearing function, particularly that related to high frequencies. Hearing loss can be prevented by avoidance or control of obesity and its risk factors. Moreover, an auditory screening of obese cases at an early stage may provide early diagnosis of HL and may also contribute to their awareness in the fight against obesity.

Effect of inhaled steroids on laryngeal microflora.

Conclusions As is known, this study is the first study to evaluate the effect of inhaled steroids on laryngeal microflora. The data support that ICS usage causes changes in the larynx microflora. Purpose The aim of this study was to determine the alteration in larynx microbial flora of the patients treated with ICS comparing the culture results of a control group. In addition, laryngeal microflora was compared to the smears obtained from the vallecula and pharynx. Materials and methods The study included 39 patients (mean age = 45.56 ± 12.76 years) who had been using a corticosteroid inhaler and control group consisting of 27 persons (mean age = 43.07 ± 13.23 years). Culture samples were obtained from the pharynx, larynx, and vallecula in the patient and control groups, and they were evaluated in the microbiology laboratory. Obtained culture results were named by the same microbiologist according to the basic microorganism classification method. Results Coagulase-negative staphylococci (CNS), Streptococcus viridians (VGS) and candida albicans were detected to grow significantly more in the patient group in all three anatomic localizations compared to the control group. Neisseria spp, basillus spp, and Non-viridans alpha-hemolytic streptococcus were detected to grow significantly more in the control group in all three anatomic localizations compared to the patient group.

Serum paraoxonase and arylesterase activities in patients with chronic otitis media.

OBJECTIVES: Paraoxonase-1 (PON1) prevents oxidative stress by inhibiting the oxidation of cell membrane lipids by the reactive oxygen species that form during acute and chronic inflammation. The aim of this study was to investigate serum PON1 activity and oxidative stress in patients with chronic otitis media (COM). METHODS: Fifty consecutive patients with COM and 55 controls were enrolled in the present study. The patients were divided into two groups according to the presence of cholesteatoma. The serum PON1 arylesterase activities and lipid hydroperoxide (LOOH) levels were determined. RESULTS: Serum paraoxonase and arylesterase activities were significantly lower in the COM patients than in the controls (P < 0.001 for all comparisons), whereas the LOOH levels were significantly higher (P < 0.001). DISCUSSION: These results indicated that a lower level of PON1 activity was associated with an oxidant-antioxidant imbalance. In addition, decreased PON1 activity may play an important role in the pathophysiology of COM.

Report of an infant with noma (cancrum oris).

Noma (cancrum oris) is an infectious disease that destroys the oro-facial tissues and other neighboring structures in its fulminating course. The starting point of the disease is acute ulcero-necrotic gingivitis, which results in an extensive gangrenous plaque destroying all of the soft tissues of the face. It predominantly affects children aged 2-16 years and is primarily seen in areas where the socioeconomic standards are low and there is poor hygiene, as in developing countries. We discuss possible predisposing factors in cancrum oris such as malnutrition, infectious diseases, HIV infection, and immune compromise conditions. Poverty is the most important risk factor. We report the case of a 6-month-old child with noma and review the characteristic features of this disease.

Laryngeal amyloidosis: a rare cause of laryngocele.

Laryngocele may be defined as an abnormal dilatation of the saccule of the ventricle and its pathogenesis is uncertain. We report a laryngocele caused by amyloidosis localized to larynx in a 60-year-old male patient. We would like to mention that amyloidosis should be evaluated in the etiology of patients diagnosed as having a laryngocele.

Effects of topical chlorhexidine applied to the rabbit nasal mucosa.

OBJECTIVE: To search the effects of administration of various concentrations of a wide-spectrum antimicrobial agent, chlorhexidine, to the nasal mucosa. MATERIAL AND METHODS: About 0.20, 0.12, 0.06 and 0.03% concentrations of chlorhexidine gluconate were applied to the rabbit nasal mucosa as one puff twice a day throughout 5 days. Another group, treated with serum saline to the nose, behaved as the control group. On the fifth day following drug administration, specimens were taken from nasal mucosa of the rabbits and examined under light microscope. RESULTS: As a result of comparison between drug treated group and control group, with increasing drug concentrations progressively increased neutrophil infiltration in mucosa, ciliary loss in cells, and occasional metaplasia were observed. CONCLUSION: There is a linear, positive and strong association between concentrations of chlorhexidine and its irritative effects on rabbit nasal mucosa. While 0.20 and 0.12% concentrations of chlorhexidine cause excess irritation on the nasal cavity, 0.06 and 0.03% concentrations of chlorhexidine gluconate causes lower irritation and effects on the animals which have experimentally induced rhinosinusitis must be evaluated.

Nasopharyngeal rhabdomyosarcoma in a patient with hypohidrotic ectodermal dysplasia syndrome.

Hypohidrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome) is characterized by partial or complete absence of sweat glands, hypotrichosis, hypodontia, prominent frontal ridges and chin, saddle nose, sunken cheeks, thick, everted lips, large ears and sparse hair. While association of other ectodermal dysplasia syndromes with tumors such a non-Hodgkin's lymphoma, hamartoma, keratoakanthoma, Merkel-cell cancer, squamous-cell carcinoma, syringofibroadenomatosis has been reported, association of hypohidrotic ectodermal dysplasia and a tumor has not been reported. In a five-year-old male patient admitted with nasal obstruction and nasal mass complaints, we have reported firstly an association of hypohidrotic ectodermal dysplasia and nasopharyngeal rhabdomyosarcoma.