Cigdem Kalaycik Ertugay

Effect of combination of montelukast and levocetirizine on otitis media with effusion: a prospective, placebo-controlled trial

Abstract Conclusion: This study demonstrated that treatment with montelukast in combination with levocetirizine may have a beneficial effect on clinical improvement of middle ear fluid in children with otitis media with effusion (OME). Objective: To evaluate the effect of the combination of montelukast and levocetirizine on shortening the duration of effusion in successfully treated OME in children. Methods: This was a randomized, prospective, double-blind, placebo-controlled trial. The study group consisted of 120 children (age range 2–6 years), who were diagnosed with OME of at least 2 months duration. The children were randomized into one of four groups. The treatment packs containing montelukast 4 mg (tablet) and/or levocetirizine 2.5 mg/5 ml as the active drug or placebo were prepared, numbered, and distributed by the second author. Results: The amelioration of bilateral otoscopic sign scores in the combination therapy group was statistically significantly greater than in all the other groups (p < 0.05). Improvement in bilateral tympanometric findings in the combination therapy group and montelukast group was greater than in the other groups. However, this difference was not statistically significant (p > 0.05). When we compared the difference between otoscopic sign scores before and after treatment we found that it was statistically significant in every group (p > 0.05). However, the significant improvement in tympanometric findings occurred in all groups except the levocetirizine group (p > 0.05).

Hyperbaric oxygen versus steroid in facial nerve injury: An experimental animal study

OBJECTIVE The aim of this experimental study was to evaluate the effects of hyperbaric oxygen, methylprednisolone and combined hyperbaric oxygen-methylprednisolone treatments on traumatic facial nerve regeneration in rats. SUBJECTS AND METHODS After exposure to facial nerve injury, four groups of rats were created with five subjects in each group: Group 1 (hyperbaric oxygen), group 2 (control), group 3 (combined hyperbaric oxygen-methylprednisolone), group 4 (methylprednisolone). Facial nerve specimens from sacrificed animals were examined for axonal degeneration, vascular congestion, macro vacuolization, axon diameter and thickness of myelin sheath. RESULTS There were significant differences with regard to axonal degeneration, vascular congestion and axon diameter between group 3 and the control group. In addition to lower axonal degeneration and vascular congestion, a larger diameter of axons was observed in group 3. There were significant differences with regard to vascular congestion and axon diameter between group 4 and the control group. We observed thicker myelin and lower axonal degeneration in group 3 compared with group 4. CONCLUSION The combination therapy with hyperbaric oxygen and methylprednisolone had an additive beneficial effect on regeneration of the facial nerve and may provide better treatment outcomes than methylprednisolone or hyperbaric oxygen therapy alone.

Adenotonsillar hypertrophy: Does it correlate with obstructive symptoms in children?

OBJECTIVE The goal of this study is to determine the correlation of clinical symptoms of UAO (upper airway obstruction) with radiographic evaluation of adenoidal obstruction and tonsil size in children with adenotonsillar hypertrophy and to evaluate the usefulness of lateral neck radiography. STUDY DESIGN Prospective study. SETTING Haydarpaşa Numune Research and Education Hospital, Istanbul, Turkey. SUBJECTS AND METHODS This study analyses 95 children with one or more of the symptoms of UAO. Clinical symptoms were assessed by a standardized questionnaire evaluating the severity of symptoms. All patients underwent otolaryngologic examination and their tonsil sizes were graded. 74 of 95 patients underwent digital lateral soft tissue radiographs. Assessment of nasopharyngeal obstruction in radiographs was done according to four different methods. RESULTS We did not find statistically siginificant correlation between symptom scores and radiologic measurements according to Johanneson (r=0.072, p=0.544, p>0.05) and Crepeau (r=0.034, p=0.773, p>0.05). The correlations between OSA score and Cohen and Konaks method and AN ratio were weak and not statistically siginificant (p=0.133, r=0.176; p=0.290, r=0.125 respectively; p>0.05). But, we found a statistically siginificant correlation between the tonsil grade and symptom scores (r=0.216, p=0.036, p<0.05). CONCLUSION Our results have demonstrated that radiologic measurements of the nasopharyngeal obstruction do not correlate with clinical symptoms of UAO, but clinical assessment of tonsil size does.

Does desloratadine alter the serum levels of montelukast when administered in a fixed‐dose combination?

The aim of this study was to investigate the serum levels of montelukast when administered alone or in combination with desloratadine.

Association of COL1A1 polymorphism in Turkish patients with otosclerosis

OBJECTIVE To evaluate the role of COL1A1 gene polymorphism in the etiology of otosclerosis. MATERIAL AND METHODS Peripheric blood samples are obtained from 28 patients diagnosed with otosclerosis and 50 control subjects. DNAs of all samples are isolated and amplified by using the PCR technique. The products are restricted by appropriate enzymes and the allele distributions were compared. RESULTS SS (homozygous normal), Ss (heterozygous mutant) and ss (homozygous mutant) alleles of the otosclerotic and control subjects were significantly different from each other. CONCLUSION Otosclerosis is a disease with progressive hearing loss. There are viral, hormonal, immunologic and genetic hypothesis of etiology. In this study, we concluded that the polymorphism seen in the COL1A1 gene resulting in production of excessive type 1 collagen, could play a role in the pathogenesis of otosclerosis.

A Rare Tumor of Nasal Cavity: Glomangiopericytoma

Glomangiopericytoma is a rare vascular neoplasm characterized by a pattern of prominent perivascular growth. A 72-year-old woman was admitted to our clinic complaining of nasal obstruction, frequent epistaxis, and facial pain. A reddish tumor filling the left nasal cavity was observed on endoscopy and treated with endoscopic excision. Microscopically, closely packed cells interspersed with numerous thin-walled, branching staghorn vessels were seen. Glomangiopericytoma is categorized as a borderline low malignancy tumor by WHO classification. Long-term follow-up with systemic examination is necessary due to high risk of recurrence.

Simultaneous Coexistence of Complications of Chronic Otitis Media in the Same Case

Chronic otitis media (COM) is a common clinical entity, but the incidence of COM complications has declined recently due to broad use of antibiotics. Independent of this, these complications are still a significant challenge in otorhinolaryngology practice because of high morbidity and mortality rates. The most common etiologic diagnosis was cholesteatomatous COM. Simultaneous coexistence of complications of COM in the same case is a rare situation, and the present report describes a case with mastoiditis, Bezold abscess, lateral sinus thrombophlebitis, meningitis, and paraspinal abscess.

Efficacy of Multimodality Approach at Sudden Hearing Loss

Objective: The etiological spectrum of sudden hearing loss is ample and ambiguous. The combined form of different treatment modalities geared toward the hypothetical etiologies given at once must work better theoretically . This study is a trial to see whether addition of intratympanic steroid to systemic steroid and hyperbaric oyygen treatment works better or not. Method: Prospective randomized study in a tertiary referral hospital. Fifty-eight patients who presented with sudden hearing loss between 2008 and 2011 were enrolled into the study. Twenty patients who had received systemic steroid and hyperbaric oxygen composed group I while 38 patients who had received intratympanic steroid in addition to systemic steroid and hyperbaric oxygen composed group II. Results: Posttreatment hearing improvement was statistically significant in both groups in terms of pure tone average according to Siegel’s criteria (P < .05). Treatment was successful for 55% of patients in group I and 63% in group II. Although there is an increase in success rate with the addition of intratympanic steroid, this was not statistically significant (P > .05). Regarding profound hearing loss over 90 dB, there seems a strong statistically significant difference. Treatment didn’t work in group I for a total of 6 patients (0%) while addition of intratympanic steroid to the protocol yielded success for 6 patients over 12 (50%) in group II (P < .05). Conclusion: Addition of intratympanic steroids to systemic steroid and hyperbaric oxygen yielded better results, but this was not statistically significant in general. However, intratympanic steroid injection seems beneficial for patients with profound sudden hearing loss.

Hyperbaric Oxygen versus Steroid on Facial Nerve Injury

Objective: Our aim in this experimental study was to evaluate the effects of hyperbaric oxygen (HBO), methylprednisolone (MP), and combined HBO-MP treatments on traumatic facial nerve regeneration by histopathological examination of the facial nerve in rats. Method: Four groups of rats were created with 5 subjects in each group after exposure to facial nerve injury: group 1 (HBO), group 2 (control), group 3 (HBO-MP), and group 4 (MP). Sacrified specimens were examined according to axonal degeneration, vascular congestion, macrovacuolization, axon diameter, and the thickness of myelin sheath. Results: There was significant difference regarding axonal degeneration, vascular congestion, and axon diameter between group 3 (combined HBO-MP) and the control group. Besides lesser axonal degeneration and vascular congestion, larger diameter of axons were observed in group 3 (combined HBO-MP). There was significant difference regarding vascular congestion and axon diameter between group 4 (MP) and the control group. Furthermore, we observed thicker myelin and lesser axonal degeneration in group 3 (combined HBO-MP) in comparison to the group 4 (MP). However, there was no significant difference in the histopathological findings between group 1 (HBO) and the control group. Conclusion: The histopathological results in our study suggested that the combination therapy with HBO and MP had additive beneficial effect on the regeneration of facial nerve in an experimental animal model and may provide better treatment outcomes than isolated MP or HBO therapy.