Evaluation of Auditory Changes in Patients Undergoing Temporomandibular Joint Discectomy.

PURPOSE: Discectomy is one of the preferred temporomandibular joint (TMJ) surgical procedures for the treatment of internal derangements when conservative and minimally invasive treatments have failed. The purpose of the current study is to investigate whether a TMJ discectomy operation influences auditory function and clinical variables. METHODS: This prospective study was composed of patients who underwent a TMJ discectomy operation between 2016 and 2020. Auditory function was evaluated with pure tone audiometry, tympanometry, and acoustic reflex tests at preoperatively (T0), postoperative first week (T1), first month (T2), and third month (T3). Clinical parameters including maximum mouth opening (MMO) and TMJ pain were also evaluated at T0, T1, T2, T3, and sixth month (T4). RESULTS: The study consisted of 17 patients (5 males, 12 females) with a mean age of 42.65. A significant reduction in visual analogue scale (VAS) pain scores and MMO values compared to baseline values was achieved in all follow up periods (PT0-T1= .001; PT0-T2/T3/T4 < .001). In pure tone audiometry, a significant increase in T1-T0 comparisons at 1000 Hz, 2000 Hz, 6000 Hz, 8000 Hz frequencies, and pure tone average (P = .008; P = .005; P = .012; P = .002; P = .001) was observed. In T3-T0 comparisons, a statistically significant decrease was observed in pure tone thresholds at 125 Hz and 8000 Hz frequencies (P = .008; P = .01). There was no statistically significant difference in middle ear pressure and compliance values at T1, T2, and T3 compared to T0 (P > .05). Type C tympanogram was seen in 3 patients at T1 and in 1 patient at T2. Acoustic reflex tests were positive in all patients. CONCLUSIONS: Although mild changes occurred in auditory tests in the early postoperative period, TMJ discectomy procedure has no permanent effect on auditory function.

Evaluation of the perioperative effects of dexmedetomidine on tympanoplasty operations.

PURPOSE: This randomized double-blind study aimed to evaluate the effects of dexmedetomidine on hemodynamic parameters and the quality of surgery and recovery criteria in tympanoplasty operations. MATERIALS AND METHODS: A total of 75 patients 18-55 years undergoing tympanoplasty, who were graded as American Society of Anesthesiologists physical status I-II, were randomly divided into three groups. Group 1 included patients receiving remifentanil alone, Group 2 included patients receiving dexmedetomidine + remifentanil and Group 3 included patients receiving dexmedetomidine + ½ remifentanil. Anesthesia was induced with propofol and cisatracurium. For maintenance of anesthesia, a mixture of 2-2.5% sevoflurane, 40-60% oxygen/air was used. The groups were compared in terms of hemodynamic parameters, surgical area, recovery criteria, modified Aldrete, pain scores, additional analgesic requirements and adverse effects. RESULTS: Mean arterial pressure and heart rate values of Group 1 were higher at the time of intubation, incision, spontaneous breathing and extubation compared to Group 2 and Group 3. Surgical field satisfaction was higher in Group 2 and Group 3 than Group 1. Spontaneous breathing, eye opening and verbal cooperation times were shorter in Group 3 compared to Group 2. Eye opening and verbal cooperation times were longer in Group 2 compared to Group 1. The 30-minute modified Aldrete scores was higher in Group 3 compared to Group 1. There was no difference between the groups in terms of postoperative pain and adverse effects. CONCLUSION: The use of dexmedetomidine during tympanoplasty operations may provide better hemodynamic control and surgical view, may provide faster recovery and may reduce remifentanil consumption.

Hyperbaric oxygen therapy in the treatment of complications of irradiation in laryngeal cancer.

One of the standard treatments in laryngeal cancer is radiotherapy (RT). Many short- and long-term complications can occur in the region that has received radiotherapy. Definitive treatment of the emerging complications is still debatable, and treatment is challenging for radiation oncologists and ear nose throat specialists. Recently, hyperbaric oxygen treatment (HBOT) has become a promising alternative for the treatment of these complications. The aim of this report is to discuss the effectiveness of HBOT in the treatment of late-term RT-related potential complications in a patient with laryngeal cancer. We applied HBOT for a 58-year-old male patient with laryngeal cancer for the treatment of laryngeal oedema, and dyspnoea that developed one year after RT. In a decompression chamber at 2.4 atm pressure, the patient was made to breath 100% oxygen with a mask for 90 minutes. At the beginning, HBOT was planned for 30 days; however, it was terminated upon improvement of the symptoms at the 19th session. The symptoms, which developed one year after RT, were relieved completely with HBOT, and the patient is maintaining his life without any complaint under our control. The HBOT can be an alternative treatment for late-term complications developed after radiotherapy. It can be especially used for laryngeal oedema, and dyspnoea related to the field of radiotherapy.

Efficacy of sublingual immunotherapy for house dust mite allergic rhinitis.

In the present study, we investigated the outcomes of sublingual immunotherapy (SLIT) in house dust mite-induced allergic rhinitis (HDM-AR) patients. In this prospective, multicentric study, 186 patients with AR who had positive skin prick test results for HDMs were included. The patients were administered SLIT using Staloral 300 for 1 year. Evaluation of the patients regarding symptom scores, clinical findings and Rhinitis Quality of Life Questionnaire (RQLQ) scores was performed at baseline, and then at 6 and 12 months of therapy. Our results showed that, for all of the evaluated items (symptom scores, clinical findings and RQLQ scores), 12-month values were significantly lower than those at 6 months and baseline. Similarly, 6-month values were significantly lower than those at baseline. There were no complications in any of our patients. SLIT for HDM-AR is a treatment modality that can be used safely. We obtained better results than expected, and the treatment showed a positive psychological effect; the patients believed that SLIT was the final step of treatment and, which made them feel better.

Erythema multiforme like allergic contact dermatitis associated with laurel oil: a rare presentation.

Allergic contact dermatitis is a common skin disease, which affects approximately 20% of the population. This reaction may present with several clinical manifestations. Erythema multiforme-like allergic contact dermatitis is a rare type of non-eczematous contact dermatitis, which may lead to difficulty in diagnosis.Essential oil of Laurus nobilis is widely used in massage therapy for antiinflammatory and analgesic effects. Laurus nobilis induced contact dermatitis has been reported in the literature but an erythema multiforme-like presentation is rare.

Upper airway obstructions and chronic otitis media: a clinical study.

PURPOSE: To investigate if pathologies causing upper airway obstructions are correlated with chronic otitis media. MATERIALS AND METHODS: One hundred fourteen patients with chronic otitis media and 114 healthy controls were enrolled in this study. Nasal septal deviation, Friedman and Mallampati scores were assessed for upper airway obstructions. Chronic suppurative otitis media was classified into tubotypmanic (n=80) and atticoantral (n=34) subtypes. Number of patients with septal deviation with a convexity to the same side as the affected ear in each CSOM subgroup was compared with chi-square test. The mean Mallampati and Friedman scores in tubotympanic disease group, atticoantral disease group and healthy controls were compared using Kruskal-Wallis test. RESULTS: Septal deviation occurred more frequently on the same side of ear pathology in patients with tubotympanic chronic suppurative otitis media (p=0.0005). Such a difference was not observed between the controls and patients with atticoantral chronic suppurative otitis media (p=0.718). No significant difference was noted between patients and controls in terms of Mallampati and Friedman scores (p=0.602 and p=0.836, respectively). Subtypes of chronic suppurative otitis media were not different from each other in terms of Mallampati and Friedman scores either (p=0.718 and p=0.708). CONCLUSION: Our results indicate that septal deviations may commonly occur on the same side with chronic otitis media. Therefore, septal deviations must be carefully investigated during the preoperative assessment of patients with CSOM. Elucidation of any possible causal relationship calls for further trials in larger series.

Role of leukotriene antagonists and antihistamines in the treatment of allergic rhinitis.

Allergic rhinitis is the most common atopic disorder seen in ENT clinics. It is diagnosed by history, physical exam and objective testing. Patient education, environmental control measures, pharmacotherapy, and allergen-specific immunotherapy are the cornerstones of allergic rhinitis treatment and can significantly reduce the burden of disease. Current treatment guidelines include antihistamines, intranasal corticosteroids, oral and intranasal decongestants, intranasal anticholinergics, intranasal cromolyn, and leukotriene receptor antagonists. In the mechanism of allergic rhinitis, histamine is responsible for major allergic rhinitis symptoms such as rhinorrhea, nasal itching and sneezing. Its effect on nasal congestion is less evident. In contrast, leukotrienes result in increase in nasal airway resistance and vascular permeability. Antihistamines and leukotriene receptor antagonists are commonly used in the treatment of allergic rhinitis. The published literature about combined antihistamines and leukotriene antagonists in mono- or combination therapy is reviewed and presented.

A rare case of gingival myiasis in a 2-year-old child.

BACKGROUND: Myiasis is the infestation of live human and vertebrate animal with larvae of Diptera fly which feed on the host dead or living tissue. Gingival myiasis is a very rare disease and associated with poor oral hygiene, senility, suppurative oral lesions, mental retardation and other conditions. CASE REPORT: A case of gingival myiasis in a 2-year-old otherwise healthy child is reported. Treatment consisted of mechanical removal of larvae, extraction of the adjacent devitalized teeth and debridement of necrotic tissues. CONCLUSION: Clinicians dealing with oral medicine should be aware of this very rare condition in children.

Clinicopathological Features of Cutaneous Findings of SARS-CoV-2 Infection.

Objective: In December 2019, severe acute respiratory syndrome coronavirus-2, which emerged in Wuhan, China, spread rapidly and created a pandemic. Coronavirus disease-2019 (COVID-19) can affect different organ systems, including the skin. Recently, COVID-19 cases with skin lesions of different clinicopathological features have been published. This study aimed to present the histopathological features of 19 COVID-19 cases with cutaneous findings and discuss them in light of the literature. Methods: Skin biopsy specimens of 19 patients with skin rashes associated with COVID-19 were evaluated histopathologically and clinically. Results: Clinical manifestations of rashes developed in eight female, seven male, and four pediatric patients with COVID-19. Urticaria/urticarial vasculitis (n=7), maculopapular eruption (n=7), panniculitis (n=2), purpuric eruptions (n=2), and livedoid-like lesions were noted. Histopathologically, besides the inflammatory findings, the most striking feature was that the vessels were more or less affected in almost all cases. Conclusions: Cutaneous lesions associated with COVID-19 are increasingly being reported. We believe that every data presented about this disease, which has many unknowns, will shed light on future research. Every case can lead us a new way.

[Fibrous dysplasia of the frontal sinus: a case report]. / Frontal sinüste fibröz displazi: Olgu sunumu.

Fibrous dysplasia is a rare and indolent benign tumor of bone. Although it is a benign tumor, it has malignant transformation potential. Fibrous dysplasia can involve a single or multiple bones. The maxilla and mandible are the most common sites in the head and neck region. Paranasal sinus involvement is rare. Surgical excision is the preferred treatment of patients with symptomatic fibrous dysplasia. In this article, a 54-year-old male patient diagnosed with fibrous dysplasia of the frontal bone is presented.

Correlation of orbital dysmorphisms with nasal polyposis: a clinical study.

We aimed to investigate if orbital dysmorphisms were more common in patients with long-standing and advanced nasal polyposis. A total of 42 nasal polyposis patients and 55 healthy controls were enrolled in this study. The distances between medial and lateral canthi were measured using a sliding caliper, and distances between medial and lateral orbital walls were evaluated on paranasal sinus CT scans. The results were compared using Student's t test and Mann-Whitney U test. The distance between medial canthi was found to be significantly increased in nasal polyposis patients compared to controls (P = 0.004). No difference was observed between patients and controls in terms of distances between lateral canthi, medial orbital walls and lateral orbital walls. Anatomic changes regarding orbital morphology may occur in patients with long-standing and advanced nasal polyposis. Early diagnosis and appropriate treatment is of paramount importance in the management of nasal polyposis, since significant anatomic changes leading to orbital dysmorphisms may occur in advanced and long-standing cases. Studies on larger series must be conducted to unveil the morphologic changes and genetic predisposition in nasal polyposis.

Lymphangiectasia of the vulva accompanying congenital lymphedema.

Lymphangiectasia is a benign condition with multiple dilated lymph vessels in the dermis. Vulvar localization is rare and mostly depends on disturbing the lymphatic flow. We present a patient with vulvar lesions and ipsilateral congenital lower extremity lymphedema. Surgical excision eliminated the lymphangiectasia and improved the appearance of the edematous vulva.

An urticarial vasculitis case induced by glatiramer acetate.

Urticarial vasculitis (UV) is a disease characterized clinically by urticarial skin lesions and histologically by leukocytoclastic vasculitis caused by immunocomplex accumulation in post-capillary venules. Cases induced by various drugs such as cimetidine, diltiazem, potassium iodide, fluoxetine, and non-steroid inflammatory drugs have been reported in the literature. A 48-year-old female who developed pruritus and rash on her body 3 months after starting glatiramer acetate (GA) treatment for multiple sclerosis was diagnosed with UV after clinical and histopathological examination. This report presents the first case in the literature of UV induced by GA.

Presence of a meningioma in a cervical myelomeningocele sac.

An 11-year-old female, presented with a cervical myelomeningocele. Interestingly, the myelomeningocele sac was seen to contain a meningioma. There are no aetiological factors in the embryogenetic period that would lead to such a combination of lesions. In our opinion, the meningioma appeared in a later period because of local factors.

Partial tonsillectomy with scalpel in children with obstructive tonsillar hypertrophy.

OBJECTIVE: To compare postoperative pain of partial tonsillectomy (PT) with scalpel and total classical tonsillectomy (TT). METHODS: Prospective, randomized study at a tertiary care institution. Ninety-six children who were diagnosed with obstructive tonsillar hypertrophy were included to the study. Children's tonsils were removed totally (Group TT) by classical dissection tonsillectomy or partially (Group PT) using scalpel and tissue scissors. The parents were instructed to fill out a form daily for nine postoperative days; recording total amount of analgesics administered that day and a Visual Analog Scale (VAS) each day assessing child's life quality and daily activities. RESULTS: Eighty-one children (2-14 years old) who completed the study were included in the analysis. Total tonsillectomy group (Group TT) consisted of 41 patients and partial tonsillectomy group (Group PT) consisted of 40 patients. There was no difference between two groups' operative parameters such as operation time [21.3 min (PT) and 22.3 min (TT)] and blood loss [44.2 ml (PT) and 46.0 ml (TT)] (p>0.05). PT group received significantly less dosage of analgesics per day; 1.18+/-1.27 vs. 2.00+/-1.45 (p<0.005). Total used analgesic dose in PT group were also lower than TT group (10.7+/-7.13 vs. 18.02+/-6.99 doses). When each day's analgesic use was compared separately a significant difference was found (p<0.05) in all days except 9th postoperative day (p>0.05). There was no difference in the pain scores between two techniques (p>0.05). CONCLUSION: Unlike tonsillectomy, PT aims to remove the tonsilla palatina subtotally. It is especially performed in children with obstructive tonsils. PT with scalpel is an inexpensive and safe method necessitating only standard surgical instruments. It causes less postoperative pain than classical dissection tonsillectomy.

VEMP responses are not affected in non-insulin-dependent diabetes mellitus patients with or without polyneuropathy.

CONCLUSION: Vestibular evoked myogenic responses (VEMPs) are not affected in non-insulin-dependent diabetes mellitus (NIDDM) patients with or without polyneuropathy. OBJECTIVE: To compare VEMP responses of NIDDM patients and healthy subjects. SUBJECTS AND METHODS: VEMP responses were collected from 25 NIDDM patients with polyneuropathy (PNP), 13 NIDDM patients without PNP and 21 healthy subjects using click stimulation. After excluding ears with hearing loss (HL) (worse than 25 dB) the VEMP responses (p13 and n21 latencies and amplitude) recorded in 105 dB stimulus intensity were compared. RESULTS: There was no statistically significant difference between groups. VEMP responses were found to be normal in NIDDM patients with or without PNP.

[Effects of erdosteine on inflammation and fibrosis in rats with pulmonary fibrosis induced by bleomycin]. / Ratlarda bleomisin ile olusturulan akciger fibrozisinde erdosteinin inflamasyon ve fibrozis üzerine etkileri.

We aimed to investigate the levels of some chemokines, inflammatory cell counts in bronchoalveolar lavage (BAL) fluid, histopathological changes in lung tissue, to determine the effect of erdosteine on acute inflammatory changes and fibrosis in a rat fibrosis model induced by bleomycine (BLM). Forty-five Wistar male rats were taken into the study. On day 0, intratracheal saline to control group (group 1, n= 15), intratracheal BLM 7.5 U/kg to BLM (group 2, n= 15) and erdosteine group (group 3, n= 15) was administered. In group 3, oral erdosteine (10 mg/kg/day) was applied two days before BLM. On day 0, 14, and 29th five rats in each groups were sacrificed, BAL fluid was performed. Malonyldialdehyde (MDA), macrophage inflammatory protein (MIP)-1alpha, MIP-2 levels in BAL fluid, hydroxyproline levels in lung tissue were measured. Histopathological examination was performed. When BLM group compared to erdosteine group, the levels of MDA, MIP-1alpha, MIP-2, and neutrophil counts, the hydroxyproline (OH-P) level of lung tissue were decreased in erdosteine group on acute inflammatory phase (day 14) (p< 0.001, p= 0.017, p= 0.009, p< 0.001, p= 0.009, respectively), and late fibrosis phase (day 29) except BAL MIP-2 (p= 0.022, p= 0.025, p= 0.01, p< 0.001, respectively). Fibrosis level was significantly lower in erdosteine group than BLM group on day 29 (p= 0.01). We conclude that erdosteine may prevent the acute lung inflammation and fibrosis by suppressing the accumulation of neutrophils, inhibition of lipid peroxydation, chemokine production, and release.

The effect of inhaling thinner and/or cigarette smoke on rat kidneys.

Although the effects of cigarette smoking and/or thinner inhalation on various organs have been investigated, there isn't enough study available in literature about their effects on kidneys. Therefore, in this study we investigated the effect of smoking and/or inhalation on the rat kidney. In this study, stand-alone inhalation of thinner and cigarette smoke and their application together were used to determine histopathologic changes, primarily the influences on rat kidneys. The study included 60 Wistar Albino species male rats. The 60 rats were divided into 4 groups of 15 rats each. Of the groups, three were working groups and the fourth was the control group. The rats in the first study group inhaled thinner only (T), those in the second group cigarette smoke only (CS), and the rats in the third group were made to inhale both thinner and cigarette smoke (TC). Each study group was divided into 3 subgroups each comprising 5 rats and inhalation was continued for periods of 2 wk, 4 wk, and 6 wk. Thinner was vaporized into the cage with a millipore pump at a constant pressure twice per day for 1 h for 5 days (toluene 2800-3000 ppm, acetone 500-600 ppm, isobutyl acetate 7000-8000 ppm, and isobutanol 6000-7000 ppm). Cigarette smoke was given 4 times per day for 15 min each, using a mechanism prepared with an aquarium motor (containing 1.2 mg nicotine,13 mg tar, and 13 mg carbonmonoxide; 60 puffs/min). After that, rat kidneys were removed. The kidneys were weighed and were given macroscopic and microscopic examination. There were significant differences for the thinner and thinner + cigarette smoke groups in comparison to the control group, observed in both proximal and distal tubules. However, changes in the cigarette smoke group were only in proximal tubules and were smaller in extent. Thinner has been widely used as a industrial substance. Thinner usage is an important health problem. Those sniffing thinner generally also use cigarettes. The findings of the present study reemphasize the importance of taking immediate measures in order to prevent thinner inhaling among homeless children, who pose an important social problem, and to protect people who work in industrial branches that widely use thinner.