Bulent Satar

Effects of Tonsillectomy on Speech Spectrum

Changes in the speech spectrum of vowels and consonants before and after tonsillectomy were investigated to find out the impact of the operation on speech quality. Speech recordings obtained from patients were analyzed using the Kay Elemetrics, Multi-Dimensional Voice Processing (MDVP Advanced) software. Examination of the time-course changes after the operation revealed that certain speech parameters changed. These changes were mainly F3 (formant center frequency) and B3 (formant bandwidth) for the vowel /o/ and a slight decrease in B1 and B2 for the vowel /a/. The noise-to-harmonic ratio (NHR) also decreased slightly, suggesting less nasalized vowels. It was also observed that the fricative, glottal consonant /h/ has been affected. The larger the tonsil had been, the more changes were seen in the speech spectrum. The changes in the speech characteristics (except F3 and B3 for the vowel /o/) tended to recover, suggesting an involvement of auditory feedback and/or replacement of a new soft tissue with the tonsils. Although the changes were minimal and, therefore, have little effect on the extracted acoustic parameters, they cannot be disregarded for those relying on their voice for professional reasons, that is, singers, professional speakers, and so forth.

Effect Of Intratympanic Dexamethasone on Noise-Induced Temporary Threshold Shift

Objective: To evaluate the effects of intratympanic treatment of dexamethasone (IT‐DEX) and combination of DEX and hyaluronic acid (DEX/HA) for noise‐induced temporary threshold shift (NITTS).

Effectiveness of hyperbaric oxygen therapy in idiopathic sudden hearing loss

The aim of this study was to investigate the efficacy of hyperbaric oxygen (HBO) therapy in idiopathic sudden sensorineural hearing loss (ISSHL) by comparing hearing gain and improvement rate in patients who have been placed on both HBO and medical treatment (MT) (37 patients), and patients who have received MT only (17 patients). Both groups were compared with reference to pure tone average (PTA) and the number of patients who experienced hearing gain. Of 37 patients (40 ears) who received HBO + MT, 24 (60 per cent) experienced > or = 10 decibels (dB) improvement in PTA compared to 13 (76.4 per cent) of 17 patients who were placed on MT only. Inter- or intra-group comparison of age stratification (< 50 and > or = 50 ages) did not produce significant differences in PTA and in the number of patients who experienced hearing gain. Although there are numerous studies showing efficacy of HBO therapy; this study did not reveal a trend in favour of HBO therapy.

Repair of transected facial nerve with mesenchymal stromal cells: histopathologic evidence of superior outcome.

Despite advanced surgical techniques, clinical results of the transected facial nerve are still far from the desired outcome. Mesenchymal stromal cells (MSCs) were shown to transdifferentiate into Schwann cells and express some growth factors beneficial in peripheral nerve injury. We aimed to document histopathological improvement obtained from application of the homograft bone marrow‐derived MSCs immediately after conventional anastomosis of a transected facial nerve branch in rats, and to compare the results with those nerves anastomosed only.

Case report: nodular fasciitis of the parotid region.

OBJECTIVE To demonstrate the clinical and histopathological features of nodular fasciitis in the parotid region. CASE REPORT A 24-year-old man presented with a palpable mass in the superior border of the parotid gland. The mass was firm and immobile, with a smooth surface. Fine needle aspiration cytology revealed proliferating fibroblasts, macrophages and adipocytes among the blood cells. Although a superficial parotidectomy was initially planned, a total excision was performed, as the mass was observed to be located in the periphery of the parotid tissue. Nodular fasciitis was diagnosed, based on the results of immunohistochemical analysis. CONCLUSION Nodular fasciitis very rarely occurs in the parotid region. These lesions grow quickly, and may be misdiagnosed as sarcoma. Trauma may play a role in their aetiology. Total excision is adequate as treatment.

A comparative study on efficiency of middle ear pressure equalization techniques in healthy volunteers

OBJECTIVE To compare success rates of middle ear inflation device (Ear Popper (©)), Valsalva maneuver and Toynbee maneuver in middle ear pressure equalization in healthy adults. MATERIALS AND METHODS Adult volunteers with otoscopically healthy ears were enrolled to the study. In a prospective setting, 60 ears of 35 volunteers were divided into two groups according to eustachian tube (ET) functions tested using the nine step inflation deflation test. Group A: good eustachian tube function at nine step inflation deflation test (30 ears), Group B: possible dysfunction of the ET at nine step inflation deflation test (30 ears). All the volunteers performed Valsalva maneuver, Toynbee maneuver and Ear Popper(©) application, respectively. The efficiencies of all the three techniques were statistically compared first overall, then paired-wise between the two groups. RESULTS There was no statistical difference in success rates of middle ear pressure equalization techniques in 60 ears, regardless of ET function results (Valsalva and Toynbee maneuvers 51.7% effective, Ear Popper(©) 43.3% effective). There was also no statistical difference among the middle ear pressure shifts obtained by these three techniques. In almost half of the subjects in whom at least one technique was unsuccessful, the other two was effective. When the groups were separately compared; there was no significant difference between Valsalva and Toynbee maneuvers, whereas Ear Popper(©) was found more effective in Group A (56.7% vs. 30%, p=0.037). CONCLUSION No statistical difference in equalization of the middle ear pressure was found among Valsalva maneuvers, Toynbee maneuvers and Ear Popper(©) in healthy adults under physiological conditions. Using alternative techniques may improve the success individually when a technique fails.

Tumor necrosis factor-α and interleukin-1 β levels in recurrent and persistent otitis media with effusion

OBJECTIVE: Based on interleukin (IL)-1β and tumor necrosis factor (TNF)-α levels in effusions, our goals were to specify either recurrent or persistent otitis media with effusion (OME) is a mid stage in the development of chronic disease and to identify the factors that have an influence on cytokine levels. STUDY DESIGN: Samples from groups with recurrent (n = 15) and persistent (n = 39) OME were essayed for IL-1 β and TNF-α. Children were also grouped with respect to age, sex, quality of effusion, and the presence of pharyngeal adenoid tissue. SETTING: Tertiary referral center. RESULTS: In recurrent and persistent OME groups, IL-1β was higher than TNF-α (P < 0.01). IL-β was higher in recurrent OME than in persistent OME (P < 0.05). CONCLUSION: Recurrent OME seems to be closer to the chronic stage of the disease relative to persistent OME in terms of higher IL-1 β levels. Each exacerbation of acute disease in recurrent otitis media is likely to be mediated by IL-1 β. SIGNIFICANCE: We were able to clarify that recurrent OME is a stage that occurs before chronic OME. Therefore, the prevention of acute attacks in recurrent disease would also impede long-term damage to the middle ear.

Laryngeal paraganglioma. A review and report of a single case

Laryngeal paraganglioma originates in the neural crest cells in the laryngeal paraganglia. Two distinct types may be cited on the basis of clinical features, but biopsy is essential for diagnosis. By light microscopy, the Zellballen pattern appears pathognomonic. The treatment consists of surgical excision. In this article, due to the rareness of the tumour, one case of laryngeal paraganglioma is presented. The general knowledge and the available literature are reviewed. The difficulties in the differential diagnosis are stressed and treatment principles are discussed.

Evolving acoustic characteristics of the canal wall down cavities due to neo-osteogenesis by periosteal flap.

Objective To determine whether the acoustic properties of the canal wall down cavity would come closer to those of the normal ear canal as the cavity is lined with periosteal flap. Study Design Prospective study. Setting Tertiary referral center. Patients Twenty one subjects who underwent canal wall down mastoidectomy and total ossicular replacement prosthesis tympanoplasty were selected. Interventions Canal wall down cavities were lined with postauricular periosteal flap. The acoustic properties of 21 canal wall down cavities (mastoidectomy ears) and 16 contralateral normal ears (control ears) were measured with a hearing aid fitting system. Main Outcome Measures Frequency, amplitude, bandwidth, and Q factor of the resonance curve along with the loss in amplitude below 1 kHz were compared in a paired-wise manner between the first and third months and the third and sixth months postoperatively in mastoidectomy ears, and also between mastoidectomy and control ears. Results In the mastoidectomy ears, the peak resonance frequency and bandwidth significantly increased at the end of the third and six months as the volume of the cavity decreased (p < 0.05). However, the amplitude and Q factor of the resonance curve remained stable. At the end of the first month, all parameters were different in both groups (p < 0.05). At the end of the sixth month, the frequency and bandwidth of the resonance curve in both groups were not different. The mastoidectomy ears had some decibel-amplitude loss below 1 kHz. Only its frequency changed as the cavity became smaller (p < 0.05). Conclusions New bone formation facilitated by a periosteal flap in the posterior part of the CWD cavity behind the facial ridge may provide acoustic properties similar to those of the normal ear canal.

A meta‐analysis of surgical success rates in Congenital stapes fixation and juvenile otosclerosis

To assess published reports in the literature on surgical success rates in patients with congenital stapes fixation (CSF) and juvenile otosclerosis (JO).