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Bone mineral density in patients with obstructive sleep apnea syndrome.

PurposeObstructive sleep apnea syndrome (OSAS) is a disorder that is characterized by repetitive pauses in breathing during sleep. Airway obstruction episodes can lead to ischemia or hypoxia in tissues. Hypoxia may also have an effect on bone metabolism. In this study, we aim to investigate both the bone metabolic abnormalities and bone mineral density (BMD) in OSAS patients compared to individuals without OSAS.MethodsTwenty-one male patients with OSAS and 26 control subjects, also male, enrolled in this study. Serum calcium, phosphorus, alkaline phosphatase, and urinary desoxypiridinoline levels were measured in all participants, and BMD was evaluated using DEXA (Hologic QDR 2000). The BMD was measured in the lumbar spine (L1–L4), the femoral neck, and total femur region.ResultsNo statistically significant difference was noted between the two groups with respect to demographic data, except for body mass index (BMI). We adjusted the statistical analyses in line with the BMI and noted significant differences between OSAS patients and control subjects with regard to lumbar L1–L4 t score, lumbar L1–L4 BMD, and femoral neck BMD values (p ≤ 0.001). We find significant correlations with lumbar L1-L4 BMD (r = −0.4; p = 0.023) and lumbar L1–L4 t score values (r = −0.5; p = 0.012).ConclusionOur study indicates that there is a relationship between OSAS and osteoporosis. However, further controlled studies comprising a greater number of patients are needed to investigate the relationship between osteoporosis and OSAS.

Primary nasopharyngeal tuberculosis in a patient with the complaint of snoring

Isolated nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. The most common presentation of nasopharyngeal tuberculosis is with a cervical lymphadenopathy followed by nasal discharge or obstruction. Here we present a 58-year-old patient with nasopharyngeal tuberculosis whose only complaint was snoring. Her oropharyngeal and anterior rhinoscopic examination was normal. On endoscopic examination, mucosal oedema and hyperaemia of the nasopharynx was observed. There was no cervical lymphadenopathy. The tuberculin skin test was positive and histopathological examination of the biopsy taken from posterior nasopharyngeal wall supported the diagnosis of tuberculosis. After anti-tuberculosis therapy, the snoring stopped and the nasopharyngeal examination was normal.

A case of a large dentigerous cyst containing a canine tooth in the maxillary antrum leading to epiphora

A case of a large dentigerous cyst containing a canine tooth in the maxillary antrum is presented. This case is of interest due because of its extensiveness and the presence of a canine tooth in the roof of the maxillary sinus. In addition, this caused a right-sided epiphora. Enucleation of the cyst containing the ectopic tooth was made.

Effects of rapid maxillary expansion with a memory palatal split screw on the morphology of the maxillary dental arch and nasal airway resistance

The purpose of this study was to investigate the effects of rapid maxillary expansion (RME) with a memory palatal split screw on the morphology of the maxillary dental arch and nasal airway resistance (NAR). The material consisted of the rhinomanometric records and study models of 15 patients (8 females and 7 males) with mean age of 12.89 ± 1.20 years. Data were collected before expansion (T1), immediately after expansion (T2), and after a retention period of 6 months (T3). Maxillary expansion was completed within 8 days in all subjects. The data were analysed by analysis of variance. The least significant difference test was also used to determine between which periods the changes in the measurements were significant. Statistical analyses showed that NAR decreased (P < 0.01) and intermolar and interpremolar distances increased (P < 0.001) significantly at all observation periods, except between T2 and T3. RME using a memory palatal split screw is effective for improvement of nasal respiration via a widening effect on the nasal cavity.

Effect of Web 2170 BS, Platelet Activating Factor Receptor Inhibitor, in the Guinea PIG Model of Middle Ear Inflammation

Platelet activating factor (PAF), a potent inflammatory mediator, is a biologically active phospholipid. Recent studies have shown that PAF may play an important role in the pathogenesis of otitis media (OM). WEB 2170 BS has been shown to be a PAF antagonist both in vitro and in vivo. In this study, the anti-inflammatory effects of WEB 2170 BS were investigated in a guinea pig model of OM induced by middle ear (ME) inoculation of killed Staphylococcus aureus. The outcome of treatment was determined by measurement of myeloperoxidase activity in the samples of ME mucosa, evaluation of temporal bone histopathology, and the presence of ME fluid. The myeloperoxidase activity in the WEB 2170 BS-treated group was found to be significantly lower than that in the control group. Histopathology of the temporal bones indicated decreased inflammation in the treated group as compared to the controls. In addition, ME fluid was absent in 16 of the 20 ears of the 10 treated animals. These results demonstrate that WEB 2170 BS can produce significant anti-inflammatory effects in this model of OM.

Effect of melatonin on lipid peroxidation, glutathione and glutathione‐dependent enzyme activities in experimental otitis media with effusion in guinea pigs

Abstract:  Melatonin plays a role in the prevention of oxidative damage. In the present study, we investigated whether the increased oxidative stress in experimental otitis media with effusion (OME) induced by histamine is reflected in erythrocytes and middle ear effusion fluid. Lipid peroxidation in effusion fluid was measured to determine the effects of melatonin on oxidative stress. Erythrocyte and middle ear effusion malondialdehyde (MDA) levels, erythrocyte glutathione (GSH) levels and glutathione peroxidase (GPx), glutathione reductase (GRd) and glutathione‐S‐transferase (GST) activities were measured in three groups of six guinea pigs each at 3 hr after the injection of 0.1 mL of histamine (or saline) into the middle ear. In erythrocyte and middle ear effusion samples, MDA levels showed a significant increase in guinea pigs with experimental OME group when compared with the control animals. Erythrocyte GPx, GST, GRd activities and GSH levels significantly reduced in experimental OME guinea pigs when compared with the control and melatonin‐treated animals. Erythrocyte GPx activity also significantly increased after melatonin treatment when compared with the control group. These findings suggest that reactive oxygen species play a role in histamine‐induced OME. Pretreatment with melatonin increases antioxidant enzyme activities and reduced formation of MDA, an indicator of lipid peroxidation, in histamine‐induced OME.

Anti-inflammatory effect of erythromycin on histamine-induced otitis media with effusion in guinea pigs

In this study, the anti-inflammatory effect of erythromycin was investigated in a model of histamine-induced otitis media with effusion (OME). OME was induced in guinea pigs by the transtympanic injection of histamine solution into the middle-ear cavity. Guinea pigs were randomly assigned to one of three groups: control, erythromycin treatment, or methylprednisolone treatment. After histamine injection, the animals were treated with intraperitoneal medication for five days consecutively. Afterwards, the animals were sacrificed and the temporal bones were removed. The samples were examined stereologically. In the erythromycin-treated group, it was observed that neutrophil infiltration was significantly inhibited when compared to the control group. This result shows that erythromycin may produce a significant anti-inflammatory effect in this model of OME.

Effect of dantrolene on lipid peroxidation, glutathione and glutathione-dependent enzyme activities in experimental otitis media with effusion in guinea pigs

The aims of our study were to assess whether the increased oxidative stress in experimental otitis media with effusion (OME) induced by histamine was reflected in erythrocytes and middle ear effusion fluid by lipid peroxidation; to survey the alterations in antioxidant enzyme activities in experimental OME; and to determine the effect of dantrolene on this oxidative stress. Erythrocyte and middle ear effusion malondialdehyde (MDA) level, erythrocyte glutathione (GSH) and glutathione peroxidase (GSH-Px), glutathione reductase (GRD) and glutathione-S-transferase (GST) activities were measured in three groups of seven guinea pigs, 3 hours after injection of 0.1 mL of histamine (or saline) into the middle ear in guinea pigs with OME (experimental group), in a dantrolene sodium group and in a control group. Erythrocyte and effusion MDA levels in the dantrolene group were significantly lower than those of the experimental group. Erythrocyte GSH-Px, GST, GRD activities, and GSH levels were significantly higher in the dantrolene group than in the experimental group. Dantrolene sodium decreased the erythrocyte and effusion MDA levels, on the other hand, it increased the GSH and GSH-dependent enzymes. These findings suggest that reactive oxygen species (ROS) play a role in histamine-induced OME. Pretreatment with dantrolene sodium increases antioxidant enzymes activities and decreases formation of MDA, the indicator of lipid peroxidation, in histamine induced OME.

Treatment of Sinusitis with Corticosteroids in Combination with Antibiotics in Experimentally Induced Rhinosinusitis

Objectives: The objective of this study was to investigate the effects of corticosteroids, antibiotics, and their combination in the therapy of experimental bacterial rhinosinusitis. Methods: Twenty-eight rabbits underwent experimental induction of bacterial rhinosinusitis with Staphylococcus aureus. The animals were assigned randomly to 1 of 4 treatments (saline solution, methylprednisolone, cefazolin sodium, methylprednisolone–cefazolin sodium) for 7 days. After the treatment period, sinus mucosa samples of the animals were examined stereologically. In addition, mucosa samples were used in the determination of myeloperoxidase (MPO) activity. Results: Methylprednisolone, cefazolin, and methylprednisolone-cefazolin had a positive effect on the reduction of neutrophil infiltration to the sinus mucosa in experimental bacterial rhinosinusitis as compared to the group treated with saline solution. However, the effects of methylprednisolone, cefazolin, and methylprednisolone-cefazolin did not significantly differ (p > .05). Similarly, the use of methylprednisolone, cefazolin, and methylprednisolone-cefazolin decreased MPO activity as compared to the group with saline solution (p < .05), and the difference among methylprednisolone, cefazolin, and methylprednisolone-cefazolin was statistically significant (p < .05). The most significant decrease in MPO (neutrophil marker enzyme) activity was determined in the animals treated with methylprednisolone-cefazolin (p < .05). Conclusions: Administering corticosteroids as an adjunct to antibiotics may accelerate the healing process in experimentally induced rhinosinusitis. In this model of rhinosinusitis, an MPO assay was supportive of this hypothesis, although stereological examination showed no statistically significant difference.

Leiomyosarcoma of the auricle: case report and literature review

Leiomyosarcoma is a malignant tumour of smooth muscle origin. These tumours are rarely encountered in the head and neck region. A case of leiomyosarcoma of the auricle is presented. There are two cases of external auditory canal leiomyosarcoma in the literature. To our knowledge the present case is the first example of leiomyosarcoma of the auricle.