Ayça Çiprut

Prognostic Value of Auditory Brainstem Response for Neurologic Outcome in Patients With Neonatal Indirect Hyperbilirubinemia

To investigate the value of the auditory brainstem response as a reliable test for the neurologic prognosis of infants with neonatal indirect hyperbilirubinemia, auditory brainstem response studies were performed in 22 infants. The patients were followed up until 12 months of age. Two patients demonstrated pathologic auditory brainstem response consistent with auditory neuropathy but had no neurologic finding except a lack of speech at 12 months of age. Two other patients had neurologic sequelae, one showing severe dyskinetic cerebral palsy, the other mild hypotonia and motor retardation, but their auditory brainstem response results were normal. These results suggested that auditory brainstem response examination might not provide reliable information for the neurologic prognosis. Neurologic disturbances resulting from bilirubin neurotoxicity can be seen in patients with a normal auditory brainstem response, but patients with an abnormal auditory brainstem response may not have any neurologic dysfunction apart from speech retardation. (J Child NeuroL 2001;16:772-775).

Ototoxic Effect of Burow Solution Applied to the Guinea Pig Middle Ear

Objective: To analyze the ototoxicity of Burow solution as an otologic preparation. Background: Burow solution has been used for years in the treatment of acute or chronic otitis externa and chronic suppurative otitis media. This acidic solution has antibacterial and antiedematous properties. Ototoxic effect of Burow solution has not been known, so the current study was designed to observe the ototoxic effect of Burow solution experimentally. Materials and Methods: Experiments were performed in 32 young, male albino guinea pigs (weight, 450-550 g). Twenty animals in the experimental group were divided into 2 groups of 10 animals each. The first group received 13% Burow solution (13% aluminum subacetate), and the second received 4% Burow solution (4% aluminum subacetate). Twelve animals in the control group were divided into 2 groups of 6 animals each. The first group received gentamicin (40 mg/mL; ototoxic control), and the second received saline solution (negative control). Under general anesthesia, pretreatment auditory brainstem responses (ABRs) from the right ear were obtained from the animals in all groups. The right tympanic membranes were widely perforated, and a small piece of Gelfoam was applied to the middle ear. Ear solutions at concentrations of 0.1 mL were applied through transcanal approach to the middle ear twice a day in 10 days. Under general anesthesia, the Gelfoam was removed from the right middle ear, and posttreatment ABRs were obtained 14 days later after the initial time in all groups. Results: Baseline ABR results were normal in right ears of all animals tested. Animals undergoing placement of Gelfoam with either 13% Burow solution, 4% Burow solution, or saline in the middle ear showed no changes in ABR threshold. The gentamicin group showed significant change in the ABR threshold. Conclusion: Burow solution was considered to be an effective and safe otologic preparation.

Effects of Topical Otic Preparations on Hearing in Chronic Otitis Media

Most of the topical otic preparations have been shown to cause ototoxicity. In this study ciprofloxacin hydrochloride, a relatively new topical agent, and gentamicin sulfate were studied in two groups of 20 patients with chronic otitis media. Patients were randomly selected to receive either ciprofloxacin (200 μg/ml) or gentamicin sulfate (5 mg/ml) locally, five drops three times a day for 10 days. Clinical response was seen in 20 of 20 patients in the ciprofloxacin group compared with 6 of 20 patients in the gentamicin group. Audiometric evaluation revealed no significant ototoxic effect in either group. In fact, hearing thresholds were slightly better than pretreatment levels in both groups.

Ototoxic effect of topical ciclopirox as an antimycotic preparation.

To evaluate the ototoxicity of ciclopirox-containing solution as an otologic preparation for the treatment of otomycosis. Background: Ciclopirox is a synthetic antimycotic agent available in a variety of formulations to treat superficial fungal infections. Ciclopirox has demonstrated both fungicidal and fungistatic activity in vitro against a broad spectrum of pathogenic fungi. It also possesses a broad-spectrum antibacterial properties, anti-inflammatory, and antiedema effect. The ototoxic effect of ciclopirox-containing solutions has not been known, so the current study was designed to observe the ototoxic effect of this solution experimentally. Materials and Methods: Experiments were performed in 22 young male albino guinea pigs (weight, 450-550 g). The 10 animals in the experimental group received ciclopirox solution, and the control group was divided into two groups of six animals each. The first group received saline solution (negative control) and the second received gentamicin (40 mg/mL; ototoxic control). Under general anesthesia, pretreatment auditory brainstem responses (ABRs) from the right ears were obtained from the animals in all groups. The right tympanic membranes were totally perforated, and a small piece of Gelfoam was applied to the middle ear directly to the round window membrane. Ear solutions were applied through transcanal approach to the middle ear twice a day in 2 weeks. Twenty-two animals of perforated tympanic membrane were observed during a 2-week period. Posttreatment ABRs were obtained in all groups in a week after the last administration. Results: Baseline ABR results were normal in right ears of all animals tested. Animals undergoing placement of Gelfoam with either ciclopirox solution or saline in the middle ear showed no changes in the ABR threshold. The gentamicin group showed a significant change in the ABR threshold. Conclusion: In the guinea pig, when applied topically to the middle ear, ciclopirox does not cause a reduction in the ABR threshold. Because its safety has not yet been confirmed in patients, caution should be observed when prescribing this agent.

Cochlear implantation in patients with bilateral cochlear trauma

PURPOSE Temporal bone fracture, which involves the otic capsule, can lead to complete loss of auditory and vestibular functions, whereas the patients without fractures may experience profound sensorineural hearing loss due to cochlear concussion. Cochlear implant is indicated in profound sensorineural hearing loss due to cochlear trauma but who still have an intact auditory nerve. MATERIAL AND METHODS This is a retrospective review study. We report 5 cases of postlingually deafened patients caused by cochlear trauma, who underwent cochlear implantation. Preoperative and postoperative hearing performance will be presented. These patients are cochlear implanted after the cochlear trauma in our department between 2001 and 2006. RESULTS All patients performed very well with their implants, obtained open-set speech understanding. They all became good telephone users after implantation. Their performance in speech understanding was comparable to standard postlingual adult patients implanted. CONCLUSION Cochlear implantation is an effective aural rehabilitation in profound sensorineural hearing loss caused by temporal bone trauma. Preoperative temporal bone computed tomography, magnetic resonance imaging, and promontorium stimulation testing are necessary to make decision for the surgery and to determine the side to be implanted. Surgery could be challenging and complicated because of anatomical irregularity. Moreover, fibrosis and partial or total ossification within the cochlea must be expected.

[Publication rates of audiology master and doctoral theses in peer-reviewed journals].

OBJECTIVES Theses are the prime indicators of the scientific productivity of a country and one of the main and strongest resources for the emergence of scientific articles. This study aims to examine, by using the survey method, how many of the audiology master and/or doctoral theses in Turkey were turned into a scientific work. PATIENTS AND METHODS Individuals who received a masters degree in audiology were surveyed whether their theses had been reviewed as a paper or publication. RESULTS Forty-five of the 230 audiology specialists and 22 audiologists with a doctorate degree working in Turkey participated in the study by answering the survey questions. In general, while 45.4% of master theses were presented orally or as a poster presentation in a national convention, 20.4% were presented orally or as a poster presentation in an international convention. While 18.1% of theses were published as an article in a national journal, 15.9% were published as an article in an international SCI or SCI-E journal. The distribution of the doctoral theses is 26.6%, 33.3%, 13.3% and 26.6%, respectively. CONCLUSION We found the rate of theses in audiology turning into a scientific article to be below the desired level, as in other fields. The reasons for this should be emphasized and efforts should be made to raise these rates to the desired level.

Effects of residual speech and auditory deprivation on speech perception of adult cochlear implant recipients

OBJECTIVE Possible predictive factors of cochlear implant (CI) outcomes have been extensively reported in literature for different user groups such as prelingual pediatric or postlingual adult users. However, there remains unexplained outcome variability among adult CI users; therefore, research concerning these patients continues and many different variables have been reported. This study aimed at evaluating the relationship between preoperative speech reception capacity, residual hearing, duration of deafness, age of implantation, and postoperative monosyllabic word recognition scores (WRSs) in postlingual CI users. METHODS Effect of onset age of hearing loss, duration of hearing loss, cochlear implantation age, pre CI speech reception thresholds (SRT) and pre CI WRS on the post-CI WRS of 76 adults were analyzed. RESULTS There are statistically significant relationships between hearing loss duration, pre-CI WRS, residual hearing and the post CI WRS. We observed that patients with shorter auditory deprivation with measurable speech perceptions and residual hearing might perform better with CI. CONCLUSION Ear selection in cases of unilateral CI should be considered on an individual basis with respect to the speech perception abilities.