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BACKGROUND: Vocal cord scarring is the most crucial obstacle in voice quality after surgery. This study aimed to evaluate the effectiveness of hyaluronic acid (HA)-collagen nanofibers on the healing of vocal cords after surgical trauma. METHOD: Right vocal cords of 12 New Zealand white rabbits were traumatized, and the experimental group was received 1.08 mg/75 ml topical HA-collagen nanofiber (Gelfix® spray) for 3 days. Three animals in each group were sacrificed on the 7th day, and the remaining of the animals were sacrificed on the 21st day. The laryngeal specimens in the experimental and control groups were examined histopathologically. RESULT: The 7th-day H&E staining evaluation revealed pink, dense, and thin collagen fibers. Besides, the collagen content was scattered and irregular in the experimental group. The 21st-day assessment showed that the collagen bundles in the granulation tissue were almost with the same formation in both of the groups. Masson Trichrome staining on the 7th day of the study showed that the collagen fiber bundles were less frequent in the control group than the experimental group. The 7th-day Van Gieson staining analysis showed that the pattern of reticular fibers was more regular with the parallel formation in the experimental group than the control group. CONCLUSION: HA-collagen nanofiber can be used in diseases that impair voice quality due to the thickening of the lamina propria layer in the vocal cord and impaired viscoelasticity due to fibrosis after tissue trauma.
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Nanofibras , Pliegues Vocales , Animales , Colágeno , Ácido Hialurónico/farmacología , Conejos , Cicatrización de HeridasRESUMEN
PURPOSE: To investigate the relationship between sleep-disordered breathing with gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) using a two-channel triple-sensor pHmetry catheter. METHODS: The study was carried out on a total of 34 people with complaints of snoring, witnessed apnea and daytime sleepiness. 24-h pH monitoring with a two-channel, triple-sensor antimony pH catheter was applied to individuals simultaneously with polysomnography (PSG) on the day they would sleep in the sleep laboratory. Obstructive sleep apnea syndrome (OSAS) severity and reflux grade were compared with each other. Data obtained from PSG and pHmetry results were numerically compared with each other. The relationship between apnea, hypopnea, and arousal periods and reflux episodes was then examined by overlaying pHmetry graphics for each patient. RESULTS: A total of 34 individuals (18 males-52.9% and 16 females-47.1%), age ranging from 27 to 71 years (mean 50.5 ± 11.0) participated in the study. GER was detected in 52.9% and LPR in 85.3% of the patients. In 35.3% of cases, pathologic GER was not observed despite LPR detection. No statistically significant relationship was found between the numerical values of apnea-hypopnea index (AHI) and arousal numbers and reflux parameters of individuals and between OSAS severity and LPR and GER (p > 0.05). There was no statistically significant correlation between respiratory events and reflux episodes with regard to timing (p > 0.05). CONCLUSION: The prevalence of GER and LPR is found to be high in patients with sleep-disordered breathing. There is no significant relationship between OSAS severity and GER and LPR grade or respiratory events and reflux episodes with regard to timing.
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Catéteres , Monitorización del pH Esofágico/instrumentación , Reflujo Gastroesofágico/diagnóstico , Reflujo Laringofaríngeo/diagnóstico , Síndromes de la Apnea del Sueño/etiología , Adulto , Anciano , Diseño de Equipo , Femenino , Reflujo Gastroesofágico/complicaciones , Humanos , Reflujo Laringofaríngeo/complicaciones , Masculino , Persona de Mediana Edad , Polisomnografía/métodos , Sueño/fisiología , Síndromes de la Apnea del Sueño/diagnóstico , Síndromes de la Apnea del Sueño/fisiopatologíaRESUMEN
The aim of this study was to determine whether infiltration of local anesthetics with adrenaline improved septoplasty procedure when compared to normal saline. Eight-two patients undergoing septoplasty were randomized into two groups. In group 1, septal mucoperichondrium was infiltrated with lidocaine with adrenaline, and normal saline was used in group 2. Presence of intra-operative septal mucosal injuries, the amount of bleeding, arterial blood pressure, operation time as well as the quality of the surgical field and the convenience of finding the correct surgical plane as determined by the surgeon using a 5-point scale were compared between two groups. There were no significant differences for the amount of blood loss, mean arterial pressure, operation time, or scores for convenience of finding the correct surgical plane between the two groups. There was no significant difference for intra-operative simple (P = 0.631) and total (simple+severe) (P = 0.649) septal mucoperichondrial injuries between groups 1 and 2, either. However, severe mucoperichondrial injury rate was higher in the patients infiltrated with lidocaine and adrenaline (P = 0.026), and the quality of the surgical field was worse in the patients injected with normal saline (P = 0.0179). Infiltration of septal mucoperichondrium with lidocaine and adrenaline instead of normal saline was not advantageous in terms of objective parameters tested, including bleeding amount and duration of surgery as well as the of the total mucosal injury rate in septoplasty procedure.
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Anestésicos Locales/administración & dosificación , Pérdida de Sangre Quirúrgica/prevención & control , Presión Sanguínea/efectos de los fármacos , Epinefrina/administración & dosificación , Lidocaína/administración & dosificación , Tabique Nasal/cirugía , Cloruro de Sodio/administración & dosificación , Vasoconstrictores/administración & dosificación , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perforación del Tabique Nasal/etiología , Tabique Nasal/lesiones , Tempo Operativo , Rinoplastia , Estadísticas no ParamétricasRESUMEN
The aim of this study was to suggest a new cutoff score for the Turkish version of Epworth Sleepiness Scale (ESS) in the patients with obstructive sleep apnea. In this study, the data of 483 patients who were admitted to our clinic with the complaints of daytime sleepiness and witnessed sleep apnea were reviewed retrospectively. The correlation between ESS and polysomnography (PSG) findings were assessed, and cutoff score of the Turkish version of the ESS was investigated. The mean apnea-hypopnea index (AHI) was 27.71 ± 26.69 eV/h, the mean ESS score was 8.42 ± 4.88. According to AHI, a statistically significant difference between ESS scores was detected (p = 0.001; p < 0.01). According to AHI (AHI ≥ 5, AHI ≥ 15 and AHI ≥ 30) the best cutoff score for ESS score was found as 8. The answers that were given to the ESS questions differ according to their sociocultural and economic condition. These results indicate that a score of 8 or higher on the ESS would seem a more appropriate cutoff score to suspect clinically relevant sleepiness in the Turkish population.
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Apnea Obstructiva del Sueño/complicaciones , Trastornos del Sueño-Vigilia/diagnóstico , Sueño/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/fisiopatología , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/fisiopatología , Adulto JovenRESUMEN
BACKGROUND: The effect of division of the stapedial tendon on susceptibility to noise-induced inner ear damage has not been previously studied. This study aimed to evaluate the effects of noise exposure following division of the stapedial tendon in guinea pigs. MATERIAL AND METHODS: Ten adult albino guinea pigs were used. The stapedial tendon of each right ear was cut. The stapedial tendon in each left ear was left intact and these ears served as a control group. DPOAEs and ABR tests were performed before and 10 days after noise exposure. The animals were exposed to a 110-dB noise stimulus for 6 h in a silent room a week after surgery. Cochleas of the animals were removed, and inner and outer hair cells were examined under a light microscope. RESULTS: We found that noise exposure adversely affected DPOAE measurements at all frequencies except 2 KHz in experimental ears. Noise exposure also produced significantly elevated ABR thresholds in experimental ears at 2, 4, 8, and 16 KHz. On histopathological examination, we found a significantly greater prevalence of apoptotic cells in the experimental ears. CONCLUSIONS: Based on these findings, we can conclude that after division of the stapedial tendon, noise exposure may cause damage to the inner ear. This is the first study in the English literature that demonstrates the potential protective effect of the stapedial tendon against acoustic damage.
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Oído Interno/patología , Pérdida Auditiva Provocada por Ruido/patología , Estapedio/patología , Tendones/patología , Animales , Oído Interno/fisiopatología , Cobayas , Células Ciliadas Auditivas/patología , Pérdida Auditiva Provocada por Ruido/fisiopatología , Etiquetado Corte-Fin in Situ , Ligamentos/patología , Ligamentos/fisiopatología , Emisiones Otoacústicas Espontáneas , Estapedio/fisiopatología , Tendones/fisiopatologíaRESUMEN
INTRODUCTION: In the treatment of head and neck cancers, the cochlea may be damaged if it is within the radiotherapy (RT) area; however, the severity and mechanism of such damage have yet to be clearly defined. The purpose of this study was to analyze the rates of early- and late-stage sensorineural hearing loss (SNHL) in patients receiving RT due to head and neck cancer and to investigate the reliability of distortion product otoacoustic emissions (DPOAEs) measurements and audiometric evaluation. STUDY DESIGN: Prospective. METHOD: The study included 38 ears of 19 patients scheduled for RT due to head and neck cancer diagnoses. The patients received RT at a fractioned dose of 200 cGy (5 d/wk) and were evaluated pretreatment and posttreatment (1st and 12th mo), both audiometrically and with DPOAE measurement. Any decrease greater than 10 dB was considered SNHL. The amplitudes of DPOAE measurements were statistically compared. RESULTS: The audiometric evaluation performed in the 1st posttreatment month showed no SNHL in any of the patients, whereas in the 12th month, 47% of the ears had SNHL. In all the patients that developed SNHL, the amplitudes obtained in DPOAE measurements in the first posttreatment month were statistically significantly lower. CONCLUSION: The results of the present study show that DPOAE measurement is a reliable method for determining which patients are at risk of developing SNHL in the early post-RT period.
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Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/radioterapia , Pérdida Auditiva Sensorineural/etiología , Radioterapia/efectos adversos , Adulto , Anciano , Audiometría , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Rayos XRESUMEN
A 54-year-old male patient presented to our outpatient clinic complaining of a mass under his chin, which appeared nearly 1 year earlier. Pathologic diagnosis was atypical lipomatous tumor. To the best of our knowledge, this is the first reported case to localize subcutaneously in the head and neck region. Atypical lipomatous tumors/well-differentiated liposarcomas are rarely reported in the head and neck. We review the clinical and management features of atypical lipomatous tumors.
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Neoplasias de Cabeza y Cuello/diagnóstico , Liposarcoma/diagnóstico , Adipocitos/patología , Biomarcadores de Tumor/análisis , Biopsia con Aguja Fina , Núcleo Celular/ultraestructura , Medios de Contraste , Humanos , Masculino , Persona de Mediana Edad , Proteínas Proto-Oncogénicas c-mdm2/análisis , Proteínas S100/análisis , Células del Estroma/patología , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: The use of tampons after nasal septum surgery is important for both prevention of postoperative bleeding and stabilization of the nasal flaps and the septum. One of the most important factors in achieving rapid postoperative recovery is the choice of the nasal tampon material, among many, to produce minimal damage on the nasal mucosa. In this study, the histopathological effects of the glove finger and merocel tampons, which are commonly used in clinical applications, have been investigated on the nasal mucosa of rabbits. MATERIALS AND METHODS: In this study, merocel and glove finger tampons were used for nasal packing in one-sided nasal cavities of 16 adult New Zealand rabbits. The animals were randomized into two groups, each consisting of eight animals. The tampons were removed after 48 hours. RESULTS: Histological examination showed that if the merocel was in a glove finger, it did not create any damage to mucosal integrity and lamina propria. However, in the group where merocel was used directly, the epithelium of the nasal mucosa was shortened and demonstrated loss of cilia and in four of the eight specimens, it was partly from lamina propria. CONCLUSION: It is concluded that the use of merocel in glove finger tampon leads to a lesser degree of damage in the lamina propria, and may facilitate rapid mucosal wound healing postoperatively.
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Formaldehído/farmacología , Guantes Quirúrgicos , Hemostáticos/farmacología , Mucosa Nasal/efectos de los fármacos , Tabique Nasal/efectos de los fármacos , Alcohol Polivinílico/farmacología , Tampones Quirúrgicos , Animales , Cilios/efectos de los fármacos , Formaldehído/administración & dosificación , Hemostáticos/administración & dosificación , Mucosa Nasal/patología , Mucosa Nasal/cirugía , Tabique Nasal/patología , Tabique Nasal/cirugía , Alcohol Polivinílico/administración & dosificación , ConejosRESUMEN
The aim of this study is to compare the efficacy of levo-bupivacaine, a long-acting local anesthetic and lidocaine in postoperative analgesia following septoplasty. 112 patients randomized into two groups were included in the study. 56 patients were operated using levo-bupivacaine and 56 using lidocaine as the local anesthetic. All patients were asked to mark their pain levels on a Visual analogue scale (VAS) at 1st, 2nd, 4th, 6trh 8th, 12th, and 24th hours postoperatively. In addition, the amount of analgesics used by each patient was recorded. The results indicated that the VAS scores of the levo-bupivacaine patients were significantly lower within the postoperative 4 hours (p < 0.05) compared to the lidocaine group. In the levobupivacaine patients the earliest time for analgesic need was delayed (p < 0.001) and the total amount of analgesics used was significantly lower when compared to lidocaine group (p < 0.001). In conclusion, levo-bupivacaine is effective for obtaining postoperative analgesia following septoplasty with local anesthesia. When compared to lidocaine, it increases the postoperative comfort of the patients by reducing pain levels.
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Anestésicos Locales/uso terapéutico , Lidocaína/uso terapéutico , Tabique Nasal/cirugía , Dolor Postoperatorio/tratamiento farmacológico , Rinoplastia , Adulto , Bupivacaína/análogos & derivados , Bupivacaína/uso terapéutico , Femenino , Humanos , Levobupivacaína , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Estadísticas no Paramétricas , Resultado del TratamientoRESUMEN
OBJECTIVE: MESNA (Sodium-2-mercaptoethanesulfonate) is a mucolytic substance that is used for chemically assisted tissue dissection in various surgical operations. The aim of this study was to address the issue of possible neurotoxicity from topical administration of MESNA solution on the facial nerve. We used different concentrations of MESNA solution and evaluated their effects on facial nerve by histopathological and functional analysis. MATERIALS AND METHODS: These groups were the saline administered group (control) (3 rats, 6 facial nerves), the 25% MESNA solution group (3 rats, 6 facial nerves), and the 100% MESNA solution group (3 rats, 6 facial nerves). Under general anesthesia (ketamine 150 mg/kg, xylocaine 4 mg/kg), the bilateral facial nerves of rats were dissected. The saline, 25% MESNA, and 100% MESNA solutions. Facial nerve functions of the rats were evaluated using mustachewhisker and blink reflex scores at day 20 days. On day 20, the rats were sacrificed and the buccal and marginal mandibular branches of the facial nerve were removed. The specimens were examined in terms of inflammation, granulation tissue, and foreign body reaction formation around the nerve. The functional and histopathological changes on facial nerves were compared between groups. RESULTS: Mustache and blink reflex scores of the rats were 5 (normal) in both the control and study groups. There were no statistically significant differences between the three groups in terms of facial nerve functions (p=1.00). On histopathologic examination, the 25% and 100% MESNA groups had significantly more inflammation compared with the control group (p=0.038 and p=0.007, respectively). There were no statistically significant differences between the 25% and 100% MESNA groups in term of inflammation (p > 0.05). There were no statistically significant differences between the three groups in terms of foreign body reaction formation (p > 0.05). CONCLUSION: Topical administration of MESNA solution onto the facial nerve causes increased inflammation in both the 25% and 100% concentrations. Nevertheless, it does not cause any facial nerve dysfunction.
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Nervio Facial/efectos de los fármacos , Nervio Facial/cirugía , Mesna/efectos adversos , Administración Tópica , Experimentación Animal , Animales , Nervio Facial/patología , Nervio Facial/ultraestructura , Inflamación/inducido químicamente , Inflamación/patología , Mesna/administración & dosificación , Mesna/toxicidad , Sustancias Protectoras/efectos adversos , Sustancias Protectoras/toxicidad , Ratas , Ratas WistarRESUMEN
OBJECTIVE: An adequate evaluation combined with an easily accessible test would be a useful way to direct the appropriate patients to sleep centers in circumstances with a limited opportunity for polysomnography (PSG). For this reason, it is necessary to use a screening method prior to PSG evaluation. The aim of the present study was to investigate whether the use of body mass index (BMI) and pulse oximetry is sufficient to predict the severity of obstructive sleep apnea syndrome (OSAS) without PSG. METHODS: A total of 956 patients who were admitted to a tertiary referral center with complaints of witnessed apnea, excessive daytime sleepiness, and previously performed PSG were included in the study. Data of PSG (included pulse oximetry) and BMI were investigated for the determination of cut-off points for parameters in the patients. RESULTS: Based on the presence of severe OSAS, the cut-off points were ≥31.7 kg/m2 for BMI, <81% for minimum oxygen saturation (Min O2), and ≥14.1 min for sleep time with oxygen saturation <90% (ST90). Severe OSAS risk was found to be higher in patients with BMI ≥31.7 kg/m2, ST90 ≥14.1 min, and Min O2 ≤81% than in those without (OR: 37.173; 95% CI: 22.465-61.510, p=0.001). Specificity and accuracy were 94.85% and 72.49%, respectively, when all three cut-off scores were provided. CONCLUSION: The appropriate cut-off values obtained from combining BMI and pulse oximetry data can provide accurate results for predicting the severity of OSAS.
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Squamous cell carcinoma (SCC) is the most common neoplasm of the larynx. There are three variants of SCC. Each variant presents distinctive biologic behaviors and clinical courses. Therefore reaching the exact diagnosis and distinguishing the variants is fateful. We describe a case of spindle cell carcinoma of the larynx with a verrucous carcinoma component. To our knowledge, this entity has never been documented before.
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Carcinoma Verrugoso/diagnóstico , Carcinoma/diagnóstico , Neoplasias Laríngeas/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Biopsia , Carcinoma/patología , Carcinoma/cirugía , Carcinoma Verrugoso/patología , Carcinoma Verrugoso/cirugía , Disnea/etiología , Ronquera/etiología , Humanos , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/cirugía , Laringectomía , Laringe/patología , Masculino , Persona de Mediana Edad , Disección del Cuello , Estadificación de Neoplasias , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Fumar/efectos adversos , Tomografía Computarizada por Rayos X , Parálisis de los Pliegues Vocales/etiologíaRESUMEN
OBJECTIVES: Reactive oxygen species (ROS) play an important role in the pathogenesis of cancer. The aim of this study was to investigate the extent of lipid peroxidation and ROS in laryngeal cancer tissues. PATIENTS AND METHODS: We determined glutathione (GSH) and malondialdehyde (MDA) activities as markers of lipid peroxidation in laryngeal tumor specimens and tumor-free adjacent tissues of 30 patients with squamous cell carcinoma. RESULTS: Compared to the tumor-free specimens, the level of GSH was significantly low (p<0.001) whereas MDA, a lipid peroxidation product, showed a significant increase (p<0.01) in cancer tissues. No significant differences were found in MDA and GSH levels between patients with early (n=14) and advanced (n=16) tumor stages (p>0.05). CONCLUSION: Decreased antioxidant capacity of laryngeal cancer tissues results in elevation of free oxygen radicals and increased lipid peroxidation. Free radical metabolism may be involved in the pathogenesis of laryngeal cancers.
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Antioxidantes/metabolismo , Carcinoma de Células Escamosas/metabolismo , Neoplasias Laríngeas/metabolismo , Peroxidación de Lípido , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Glutatión/metabolismo , Humanos , Masculino , Malondialdehído/metabolismo , Persona de Mediana EdadRESUMEN
Chronic otitis media (COM) and its associated complications are currently less common because of the popularity of imaging modalities such as computed tomography and magnetic resonance imaging and the increased use of antibiotics. Patients can be treated without any complications owing to early diagnosis. Despite all these new developments and opportunities, complications of autogenous cerebellar abscess may develop and be fatal. In this case report, we present our own clinical experience regarding a patient with cerebellar abscess as a complication of COM.
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OBJECTIVE/HYPOTHESIS: This study aimed to compare application of the Müller maneuver (MM) and application of drug-induced sleep endoscopy (DISE) prior to surgery, in addition to MM, to further ascertain the location of an obstruction in the upper airway and whether the location would change the surgical treatment plan in patients with retropalatal obstruction. STUDY DESIGN: Prospective, clinical trial at a tertiary referral hospital. METHODS: This study included 39 obstructive sleep apnea patients who were recommended for surgical treatment. Patients were randomly divided into two groups: The first group (DISE plus MM) underwent a DISE (19 patients), in addition to the planned procedure according to MM. Meanwhile, the second group (MM only) underwent surgery based only on their MM evaluation (20 patients). Patients with retrolingual-localized obstructions were excluded, whereas patients with ≥ third-degree obstructions at the retropalatal level, according to DISE and/or MM, were included in the study. RESULTS: There was a significant improvement between pre- and postoperative polysomnography findings in both groups. However, the postoperative improvements between the groups were not statistically different. Because there was a significant change in the planned surgical procedures in the first group, there were significantly more combined surgeries followed by the DISE procedure. CONCLUSIONS: Although the DISE resulted in more changes in the surgical treatment plan and higher rate of combined treatment compared to MM, we determined that this difference did not result in a significant difference in treatment success. LEVEL OF EVIDENCE: 4.
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Obstrucción de las Vías Aéreas/cirugía , Anestésicos Intravenosos/administración & dosificación , Cirugía Endoscópica por Orificios Naturales/métodos , Paladar Blando/cirugía , Apnea Obstructiva del Sueño/cirugía , Sueño/efectos de los fármacos , Obstrucción de las Vías Aéreas/complicaciones , Obstrucción de las Vías Aéreas/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Apnea Obstructiva del Sueño/etiología , Apnea Obstructiva del Sueño/fisiopatología , Resultado del Tratamiento , VigiliaRESUMEN
Accessory parotid gland is a small salivary gland tissue separated from main part of parotid gland. It is located on the masseter muscle anterior to the Stensen's duct. Tumors of accessory parotid gland are rare. In this article, we report an unusual case of adenoid cystic carcinoma involving accessory parotid gland. The patient presented with a progressively growing mass in the middle portion of her cheek. She underwent a partial parotidectomy including both the superficial and accessory lobes. The histopathologic diagnosis was adenoid cystic carcinoma of cribriform type.
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Carcinoma Adenoide Quístico/diagnóstico , Neoplasias de la Parótida/diagnóstico , Adulto , Biopsia con Aguja Fina/métodos , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética/métodos , Glándula Parótida/patología , Conductos Salivales/patología , Ultrasonografía Intervencional/métodosRESUMEN
INTRODUCTION: Several theories attempt to explain the pathophysiology of sudden hearing loss. OBJECTIVE: The objective of this study was to investigate the possible role of inflammation and atherothrombosis in sudden hearing loss patients through the neutrophil-to-lymphocyte ratio and mean platelet volume. METHODS: Study design - retrospective cross-sectional historical cohort. This study was conducted on two groups: one with 59 individuals diagnosed with sudden hearing loss, and other with 59 healthy individuals with the same characteristics of gender and age distribution, neutrophil-to-lymphocyte ratio and mean platelet volume levels were measured in patients diagnosed with sudden hearing loss as well as in the control group, and it was verified whether these results interfered for a better or worse prognosis with treatment of sudden deafness. RESULTS: Neutrophil-to-lymphocyte ratio levels are much higher in patients diagnosed with sudden hearing loss compared to the control group. Similarly, mean levels of neutrophil-to-lymphocyte ratio are higher in non-recovered versus recovered patients (p=0.001). However, we could not find a correlation with mean platelet volume levels (p>0.05). CONCLUSION: Neutrophil-to-lymphocyte ratio is a quick and reliable indicator regarding diagnosis and prognosis of sudden hearing loss; on the other hand, mean platelet volume may be considered a less important indicator in this aspect.
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Pérdida Auditiva Súbita/sangre , Linfocitos , Neutrófilos , Adulto , Biomarcadores , Estudios de Casos y Controles , Estudios Transversales , Femenino , Pérdida Auditiva Sensorineural/fisiopatología , Humanos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios RetrospectivosRESUMEN
OBJECTIVE: The aim of this study was to investigate the role of inflammation and atherothrombosis in Bell's palsy (BP) by using neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV), respectively, and to study their relations with the facial nerve enhancement on temporal gadolinium-enhanced magnetic resonance imaging (TGd-MRI). STUDY DESIGN: Case control study. SETTING: Tertiary health institution. SUBJECTS AND METHODS: This study was performed on 65 patients who were diagnosed with BP and a control group of 35 healthy individuals. The BP patients were also divided into 2 groups, those with facial nerve enhancement on TGd-MRI and those without enhancement. The NLR and MPV of each group were compared. RESULTS: The NLRs of the BP patients were significantly higher than control group (P = .001). The NLRs of patients with facial nerve enhancement on TGd-MRI were significantly higher than patients without enhancement (P = .001). There was a positive and significant correlation between NLR and House-Brackmann (HB) grade of the patients (r = 0.641; P < .05). MPV did not show any significant correlation with any of the parameters studied (P > .05). CONCLUSION: NLR can be used as a new and important marker in BP since it is high in BP patients and significantly correlated with HB grade and facial nerve enhancement on TGd-MR. On the other hand, MPV does not have such correlations. These results offer evidence to support an inflammatory theory rather than microvascular response theory in the etiopatogenesis of BP.
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Parálisis de Bell/sangre , Parálisis de Bell/diagnóstico , Nervio Facial/patología , Linfocitos , Imagen por Resonancia Magnética , Neutrófilos , Adulto , Estudios de Casos y Controles , Medios de Contraste , Femenino , Gadolinio , Humanos , Aumento de la Imagen , Recuento de Leucocitos , Imagen por Resonancia Magnética/métodos , Masculino , Volúmen Plaquetario Medio , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
We investigated relation of the site of obstruction detected on Muller maneuver (MM) with polysomnography (PSG) and physical examination findings. Data of 703 patients admitted to Ankara Numune Education and Research Hospital Sleep Laboratory between 2008 and 2013 were analyzed retrospectively; 394 patients with apnea-hypopnea indexes (AHI) ≥5/h were included. Site of collapse on MM was determined at retrolingual level at anteroposterior (M1) and lateral-lateral (M2) directions; at retropalatal level at anteroposterior (M3) and lateral-lateral (M4) directions. There were 125 (31.7 %) females and 269 (68.3 %) males. BMI had significant positive correlations with M2 (p < 0.001) and M4 (p = 0.002) scores, ESS (p = 0.013) and AHI (p = 0.001). AHI had significant positive correlations with ESS (p = 0.003), M2 (p < 0.001), M3 (p = 0.037) and M4 (p < 0.001) scores and NC (p = 0.001). Minimum oxygen saturation had significant reverse correlations with M1 (p = 0.046), M2 (p < 0.001), M3 (p = 0.003), M4 (p < 0.001), AHI (p < 0.001), ESS (p = 0.003) and BMI (p = 0.001). In OSAS patients, increased BMI, NC and AHI are correlated with lateral pharyngeal wall (LPW) collapse in retropalatal and retrolingual levels on MM. LPW collapse is more valuable to predict OSAS compared to anteroposterior collapse. LPW collapse on MM may be used as a selection criterion for ordering PSG. Further studies are needed to better clarify importance of LPW in OSAS surgery.
RESUMEN
BACKGROUND: Laryngeal carcinogenesis is a multifactorial process that has not been fully elucidated. Despite extensive research, reliable markers with diagnostic and prognostic value are still lacking. It was recently reported that an elevated preoperative neutrophil-to-lymphocyte ratio (NLR) may correlate with an increased risk of recurrence, tumor aggressiveness and poorer prognosis in various malignancies. The aim of this study was to examine whether NLR could be used as an inflammatory marker to differentiate laryngeal squamous cell carcinoma (LSCC) patients from benign laryngeal lesion (BLL) and precancerous laryngeal lesion (PLL) patients. MATERIALS AND METHODS: This retrospective study was performed on 209 patients admitted to a tertiary referral center with laryngeal lesions and undergoing biopsies to establish their histopathological diagnosis. We reviewed the patient files for their clinical, histopathological and laboratory data. The patients were divided into three groups according to their histopathological findings, as BLL, PLL and LSCC groups. The patients in the PLL group were also divided into three subgroups as mild, moderate and severe dysplasia/ carcinoma in situ (CIS) subgroups. The groups were compared for NLR and the other laboratory data. RESULTS: The mean NLRs of the BLL, PLL and the LSCC groups were 2.12 ± 0.86, 2.32 ± 0.68 and 3.46 ± 1.51, respectively, and the difference was statistically significant (p = 0.001). The mean NLRs of the patients with PLL and LSCC were significantly higher than the patients with BLL (p = 0.031 and p = 0.001, respectively). The mean NLRs were similar among mild dysplasia, moderate dysplasia and severe dysplasia / CIS groups (p > 0.05). CONCLUSIONS: To our knowledge, this is the first study investigating NLR in BLL, PLL and LSCC. NLR is an inexpensive, reproducible and widely available blood test, and could be a useful inflammatory marker to differentiate LSCC from BLL and PLL.