The impact of topical and systemic enoxaparin sodium use on traumatic tympanic membrane perforation and myringosclerosis.

The objective of this study is to investigate the effect of topical and systemic enoxaparin sodium on the healing pattern of experimentally induced tympanic membrane perforation and formation of myringosclerosis. A total of 24 Wistar-Albino strain rats were included in the study. Standard myringotomies were performed on each rat. In the first group, isotonic serum physiologic was dropped on external ear canal (control group). Topical enoxaparin was dropped on external ear canal and daily topical doses of enoxaparin were dropped on external ear canal of the rats for 14 days (topical treatment group). Third group received subcutaneous injections of enoxaparin for 14 days (systemic treatment group). Five micrometer thick sections of the bullae of the rats were stained with H&E. Inflammation, edema and sclerotic lesions and neovascularization observed in the lamina propria layer of the tympanic membrane, and total thickness of the tympanic membrane were evaluated. In intergroup comparisons, significant difference in the distribution pattern of severity of inflammation in all three groups was not observed (p = 0.784, p > 0.05). Total TM thickness differed among all three groups (p = 0.028, p < 0.05). A statistically significant difference was observed between the systemic enoxaparin and the control groups (p = 0.022, p < 0.05). A statistically significant difference was observed between the topical enoxaparin and the control groups (p = 0.037, p < 0.05). However, comparison between the topical and systemic treatment groups could not reveal any statistically significant intergroup difference (p = 0.682, p > 0.05). A significant difference was not observed among three groups as for the distribution of myringosclerotic plaques, severity of edema and neovascularization in the lamina propria (p = 0.539, p > 0.05), (p = 0.063, p > 0.05), (p = 0.152, p > 0.05). Topical and systemic enoxaparin treatment did not prevent formation of sclerotic plaques; however, it decreased TM thickness significantly in comparison with the control group.

Malignant schwannoma located in the retroauricular region.

There have been no reports about malignant Schwannoma located retroauricularly in the medical literature we reviewed. Malignant Schwannoma is a very malignant tumor, which is rare. For diagnosis, microscopic and immunohistochemical studies are needed. It is often seen together with neurofibromatosis. The prognosis is very poor and the only available treatment is surgical excision. Although it is known that both radiotherapy and chemotherapy are not effective, we achieved good outcome with this combination applied postoperatively.

Effect of local use of L-carnitine after myringotomy on myringosclerosis development in rats.

OBJECTIVES: This study aimed to investigate the effect of local and intraperitoneal administration of L-carnitine on the prevention of experimentally induced myringosclerosis, and to compare treatment efficiency. METHODS: Twenty-four Albino-Wistar rats (48 ears) were bilaterally myringotomised and divided randomly into four groups: group one received no treatment, group two received intraperitoneal L-carnitine, group three received local L-carnitine, and group four received both intraperitoneal and local L-carnitine. On the 15th day after treatment, tympanic membranes were harvested and evaluated histopathologically for myringosclerotic plaque formation, fibroblastic proliferation, tympanic membrane thickness and new vessel formation. RESULTS: The group one tympanic membranes showed extensive thickness, and the incidence of myringosclerosis and fibroblast proliferation were greater than in groups two and four. There were statistically significant differences in tympanic membrane thickness between groups three and four, and in myringosclerosis incidence and fibroblast proliferation, comparing groups two, three and four. CONCLUSION: Myringosclerosis development was significantly reduced in rats receiving myringotomy plus intraperitoneal L-carnitine. Intraperitoneal L-carnitine administration prevented fibroblastic proliferation and tympanic membrane thickening (both of which cause further tympanic membrane destruction), thus reducing myringotomy-associated morbidity. Local L-carnitine administration had limited effectiveness in this experimental setting.