The ototoxic effect of boric acid solutions applied into the middle ear of guinea pigs.

This study analyzed the ototoxic effects of boric acid solutions. Boric acid solutions have been used as otologic preparations for many years. Boric acid is commonly found in solutions prepared with alcohol or distilled water but can also be found in a powder form. These preparations are used for both their antiseptic and acidic qualities in external and middle ear infections. We investigated the ototoxic effect of boric acid solutions on guinea pigs. We are unaware of any similar, previously published study of this subject in English. The study was conducted on 28 young albino guinea pigs. Prior to application of the boric acid solution under general anesthesia, an Auditory Brainstem Response (ABRs) test was applied to the right ear of the guinea pigs. Following the test, a perforation was created on the tympanic membrane of the right ear of each guinea pig and small gelfoam pieces were inserted into the perforated area. Test solutions were administered to the middle ear for 10 days by means of a transcanal route. Fifteen days after inserting the gelfoams in all of the guinea pigs, we anasthesized the guinea pigs and removed the gelfoams from the perforated region of the ear and then performed an ABRs on each guinea pig. The ABRs were within the normal range before the applications. After the application, no significant changes were detected in the ABRs thresholds in neither the saline group nor the group administered boric acid and distilled water solution; however, significant changes were detected in the ABRs thresholds of the Gentamicine and boric acid and alcohol solution groups. We believe that a 4% boric acid solution prepared with distilled water can be a more reliable preparation than a 4% boric acid solution prepared with alcohol.

Outcome of conservation surgery for laryngeal carcinoma: an 8-year trial.

The purpose of this report is to review the experience of our institution with conservative surgery for laryngeal cancer. In this retrospective study, a review was made of 85 patients treated with conservation surgery between 1998 and 2005. At least 2 years of follow-up period (mean 46.6 months) was achieved for all the patients. We evaluated age, tobacco and alcohol intake, T stage, histopathological differentiation and localization of tumor, subglottic extension, anterior commissure invasion, vocal cord mobility, surgical margins, type of surgery applied, and post-operative radiotherapy (pRT) applied. Local control and 2-year survival rates were estimated. We managed with horizontal, vertical, and horizontovertical laryngectomies in 55, 26, and 4 patients, respectively. 28 patients were scheduled to have pRT. The actuarial and overall local control rates were 82.4 and 94.1%, respectively. On univariable analysis, significant factors for increased recurrences were positive resection margins, low differentiation of tumor, alcohol consumption and incompletion of the planned pRT. The 2-year survival rate was 60 and 95.7% for patients with and without local recurrence, respectively. Conservation surgery is a safe procedure for laryngeal cancer in proper endications.

The burden of headache in neurology outpatient clinics in Turkey.

BACKGROUND AND AIM: The aim of the study was to investigate the burden of headache in neurology outpatient clinics (NOCs) regardless of their primary complaint. METHODS: Patients presenting for their routine appointments in 41 NOCs were screened during the course of 1 week. All eligible subjects (n = 3682; 61.9% female, mean age 45.2 +/- 16.5 years) were evaluated by a neurologist for the headache diagnosis and some demographic characteristics. RESULTS: Of all patients, 66.4% reported headache, and in 35.1% headache was the primary cause for admitting to the NOC. Of 3682 patients, 917 (24.9%) were diagnosed as migraine according to International Headache Society (IHS) criteria. Thirty-three and nine-tenths percent of all patients admitted and 56% of the migraineurs according to IHS had severe headaches. As the headache severity increases, the ratio of the patients admitted with headache as the primary complaint increases significantly. The distribution of burden and other characteristics of headache did not differ in seven geographic regions and 41 different centers. CONCLUSION: Headache complaint caused at least 1/3 of all neurological outpatient visits in Turkey and 2/3 of all patients admitted to NOC had headache. Of these patients, 1/4 had migraine according to IHS with substantial disability and severity level.

Hearing loss effects of administering boric alcohol solution prepared with alcohol in various degrees on guinea pigs (an experimental study).

OBJECTIVE: To investigate the ototoxic effect of boric acid solution prepared with different degree of alcohol. METHODS: This study was performed on 28 young albino guinea pigs. After the animals divided four groups prior to the application of the solution an auditory brainstem response (ABR) test was applied to the each animal under general anesthesia. Their tympanic membranes perforated and test solutions were administrated to the middle ear through the perforation. On 15th day, ABR measurements were carried out and comparison was made with preadministration values. RESULTS: The degrees of hearing loss occurring as a result of the administration of 4% boric alcohol solutions prepared with 60° and 40° alcohol differed significantly (p < 0.001). CONCLUSION: It was established that 4% boric acid solution prepared with 60 alcohol affected hearing in guinea pigs more negatively and an increase in degree of alcohol also increased the ototoxicity of the boric acid solution.