Cüneyd Üneri

Protective role of resveratrol against cisplatin induced ototoxicity in guinea pigs

OBJECTIVE The aim of this study was to evaluate the effectiveness of systemic administration of resveratrol against cisplatin-induced ototoxicity in guinea pigs. MATERIALS AND METHODS Healthy guinea pigs (n=24) were randomly divided into four groups. Group 1 (n=6) received resveratrol+cisplatin, group 2 (n=6) received 4% ethanol+cisplatin, group 3 (n=6) received cisplatin, and group 4 (n=6) received saline. Cisplatin was administered at a dose of 10mg/kg/day on days 14 and 15 of the study. Resveratrol (10mg/kg/day), 4% ethanol, and saline were administered throughout the study. Baseline auditory brainstem responses (ABR) (4 kHz, 8 kHz, and click stimulus) were determined for all groups. ABR was repeated 72 h after the last dose of cisplatin in order to record the threshold shifts. The ABR threshold shifts for the click stimulus, 4-kHz- and 8-kHz-frequency stimuli were compared after drug administration. After follow-up ABRs the animals sacrificed under deep sedation and their cochleae were removed. Left cochleae were immediately harvested for measurement of level of reactive oxygen species (ROS). Right cochleae were prepared for histological changes which were observed by scanning electron microscopy (SEM). RESULTS For the all stimulus, there was a significant threshold difference among the groups (p<0.01). Group 3 had a significantly higher threshold shift at all stimuli when compared with groups 1 and 4. There was no significant threshold shifts in all stimuli between groups 2 and 3. The resveratrol-treated group 1 showed preservation of threshold in ABR (p ≤ 0.05). SEM showed that inner and outer hair cells were preserved in the group 1. Level of reactive oxygen species (ROS) were significantly higher in groups 2 and 3 compared with groups 1 and 4 (p ≤ 0.05). CONCLUSION These results indicated that systemic administration of resveratrol afforded statistically significant protection to the cochlea of guinea pigs from cisplatin toxicity. Experimental dose of resveratrol injections may have a protective effect against cisplatin ototoxicity in guinea pigs.

Determination of Reactive Oxygen Species in Myringotomized Tympanic Membranes: Effect of Vitamin E Treatment

Objectives/Hypothesis Recent studies have established a strong relationship between the development of myringosclerosis and reactive oxygen species (ROS). The aims of the present study were to directly detect ROS in the tympanic membrane and middle ear mucosa of rats by measuring luminol amplified chemiluminescence, to evaluate the changes in the levels of ROS after treatment with vitamin E, and to examine the possible changes in the tympanic membranes otomicroscopically and histologically.

Effects of Vitamin E on Cigarette Smoke Induced Oxidative Damage in Larynx and Lung

Objectives: Cigarette smoke (CS) contains a large variety of compounds, including many oxidants and free radicals (also known as reactive oxygen species), that are capable of initiating or promoting oxidative damage, which leads to various degenerative pulmonary and cardiovascular diseases as well as cancer. Recent studies have established a strong relationship between CS and development of reactive oxygen species (ROS). The aim of the present study was to detect ROS levels in laryngeal and lung tissues of rats by measuring luminol‐amplified chemiluminescence and to determine the changes in ROS levels in lung and laryngeal tissues induced by exposure to CS, with and without concurrent treatment with vitamin E.

Vitamin e-coated tympanostomy tube insertion decreases the quantity of free radicals in tympanic membrane.

Objective: Tympanosclerosis is a common sequela of ventilation tube treatment of otitis media with effusion causing hearing disability. It is associated with an increased production of free radicals (also known as reactive oxygen species) after myringotomy. Vitamin E is a scavenger of different free radicals by working as an antioxidant. The aim of the present study was to evaluate the effect of vitamin E‐coated tympanostomy tube insertion at quantity of free radicals in rat tympanic membrane.

Endoscopic endonasal management of cerebrospinal fluid rhinorrhea.

Abstract The authors review their 5 years’ experience with endonasal endoscopic repair of the anterior skull base fistulas presenting with cerebrospinal fluid (CSF) rhinorrhea. A total of 12 patients were managed endoscopically between 2004 and 2008. Seven patients (58.3%) had nonsurgical posttraumatic CSF rhinorrhea, 2 patients (16.7%) had CSF rhinorrhea due to surgical/iatrogenic trauma, and 3 patients (25%) had spontaneous onset of CSF rhinorrhea. Radiosurgical correlation for CSF fistula identification was positive in all patients. The most common site of leak was the fovea ethmoidalis. The repair method consisted of an extradural underlay closure of a defect with fascia lata. The largest diameter of a defect to be closed was 15 mm. Immediate results were good in all patients, but later in the follow-up, CSF rhinorrhea recurred in 2 patients, and each patient had a revision 2 times. In the first revisions, transcranial approach was used, whereas in the second revisions endonasal endoscopic route was resorted. The primary closure rate was 83.3%, and the overall closure rate was 100%. The average follow-up period thus far is 21 months. Endonasal endoscopic technique well known to otolaryngologists should be considered as the first choice of surgery in the repair of CSF rhinorrhea because of low morbidity and a higher closure rate. The possibility of revision with the same technique makes this approach ideal for the repair of cranionasal osteodural defects.

Histologic Changes in Eustachian Tube Mucosa of Rats After Exposure to Gastric Reflux

Objective: Reflux is thought to be a risk factor for middle ear disease, but the mechanism underlying this relationship is unclear. In this study, we evaluated the effects of reflux on the eustachian tube (ET) mucosa.

Pleomorphic adenomas recurrences within the parapharyngeal space.

This study was undertaken to evaluate and concentrate on the recurrent pleomorphic adenomas (PAs) of the parapharyngeal space. The records of 9 patients treated for recurrent PAs occupying parapharyngeal space were retrospectively reviewed. The study population comprised 6 women and 3 men with a mean age of 51 (range, 35-79 years). Before the first revision surgery, imaging studies and clinical examinations showed 1 solitary mass in 4 patients, 2 solitary masses in 3 patients, and 3 or more masses in 2 patients. After first revision surgery, 4 patients had rerecurrences with multinodular disease. Two of 4 patients underwent radiation therapy (RT), and the other 2 patients underwent second revision surgery, among whom 1 patient underwent third revision surgery, and the other one was also submitted to RT. Overall, 12 reoperations were performed, and at the end of all operations, 4 patients had rerecurrences and residual disease. In conclusion, we recommend RT to patients with multinodular disease, known tumor spillage, and residual tumor in addition to revision surgery. Histopathologic features, surgical resection, relationship to surrounding vital tissues, and postoperative adjuvant radiotherapy are the most important determinants for recurrent PAs.

Isolated fracture of the malleus handle

A61-year-old male patient with a history of right-sided sudden hearing loss in 1980 presented with progressive deterioration of hearing bilaterally for five years. In 1980, the patient consulted a local otolaryngologist with the complaints of sudden onset hearing loss and otalgia in his right ear after manipulation of his ear canal with his index finger while showering. The diagnosis at that time was otitis, and he began a course of antibiotics. Since 1980, the patient had been seen by various otolaryngologists and the problem that was causing the hearing loss was unnoticed. In our examination, otomiscroscopy showed an intact right tympanic membrane with an abnormal contour of the manubrium handle (Fig 1). Testing with a 512-Hz tuning fork was positive bilaterally for the Rinne test, whereas the Weber test lateralized to the right. Audiological evaluation showed a mild, sensorineural-type hearing loss in the left ear, and a mixed-type hearing loss with a 20to 45-dB air-bone gap that increased from mid to high frequencies in the right ear. Tympanometry showed increased mobility on the right. The patient refused any kind of surgery and was referred for hearing-aid evaluation. This report was approved by the local ethics committee of our department and carried out in accordance with the Declaration of Helsinki.

Ossicular Reconstruction for Incus Long-Process Defects: Bone Cement or Partial Ossicular Replacement Prosthesis

Objective The objective of this study was to compare hearing results in patients undergoing ossiculoplasty with bone cement (BC) vs partial ossicular replacement prosthesis (PORP) in cases of incudostapedial discontinuity during tympanoplasty surgeries. Study Design Case series with chart review. Setting Tertiary referral center. Subjects A total of 44 patients with incudostapedial discontinuity, 21 operated on with BC and 23 operated on with PORP, were enrolled in this study. Methods Preoperative and postoperative audiograms at 12 months were evaluated. Pure-tone averages and air-bone gaps (ABGs) were calculated according to the guidelines. Results The ABG was 26.61 dB preoperatively and 9.76 dB postoperatively in the BC group. The hearing gain in ABG was statistically significant (P = .0001). The preoperative and postoperative ABGs in the PORP group were 29.48 and 8.89 dB, respectively. The hearing gain in ABG was statistically significant (P = .0001). When the groups were compared for mean gains in the ABG, the difference was not statistically significant (P = .192). The postoperative ABG of less than 20 dB was achieved by 90.4% in the BC group and 86.9% in the PORP group. This difference was not statistically significant (P = .745). No adverse reactions or complications were observed. Conclusions Both BC and PORP are reliable and efficient methods for the repair of incudostapedial joint defects. There is no difference between these 2 methods, based on the hearing results. Additional research is necessary to determine the maximum incudostapedial defect length suitable for bone cement repair.

Chemiluminescence assay of reactive oxygen species in laryngeal cancer

OBJECTIVE This study aimed to evaluate the presence of reactive oxygen species in laryngeal cancer tissue, using a luminol-amplified chemiluminescence method. MATERIALS AND METHODS Fourteen patients with histopathologically diagnosed laryngeal squamous cell carcinoma were enrolled. Patients with recurrent tumours or a history of prior chemotherapy or radiotherapy were excluded. Tissue specimens were harvested both from the tumour itself and from the neighbouring, apparently normal mucosa (immediately after tumour removal). Tissue specimens were washed with ice-cold saline solution and processed immediately, without storage. The level of reactive oxygen species was measured quantitatively by a luminol-amplified chemiluminescence method. RESULTS The mean luminol-amplified chemiluminescence values for tumour and control tissue were 140.52 (standard error of the mean 40.21) and 121.36 (standard error of the mean 35.33) relative light units/mg tissue, respectively. Furthermore, mean tumour and control luminol chemiluminescence values were compared for stage one and two tumours versus stage three and four tumours. Both the tumour and the control luminol chemiluminescence values for the latter tumour group were significantly higher than those for the former tumour group. CONCLUSION This study measured directly the levels of reactive oxygen species in samples of laryngeal cancer tissue and normal mucosa. Higher levels of reactive oxygen species were found in laryngeal cancer tissue, suggesting a relationship between reactive oxygen species and laryngeal cancer.