Ediz Yorgancilar

Effects of lidocaine and adrenaline combination on postoperative edema and ecchymosis in rhinoplasty

Nasal osteotomies are the most important cause of periorbital edema and ecchymosis. Injection of lidocaine and adrenaline is recommended to reduce bleeding. Whilst the lidocaine and adrenaline combination (LAC) is claimed to reduce postoperative ecchymosis and edema, this effect remains to be proven conclusively. This study, on 48 patients, was designed to investigate the effects of LAC injection on postoperative edema/ecchymosis in rhinoplasty. LAC was applied at a random side prior to the lateral osteotomy. The opposite side was used as a control. The relationship between edema/ecchymosis and the degree of LAC on the injected and uninjected sides was evaluated on the first, third and seventh day postoperatively. The relationships between edema and ecchymosis with operation time and intraoperative systolic blood pressure were also evaluated. Bleeding was reduced on the side treated with LAC (p=0.050). The degrees of edema/ecchymosis increased with increases in the duration of operation and the systolic blood pressure on the first postoperative day for the LAC-applied side (p<0.05). This correlation was not observed on the opposite side (p>0.05). Application of LAC reduces bleeding during rhinoplasty and pain control postoperatively but reduced edema and ecchymosis should not be expected following LAC application.

Determination of trigeminocardiac reflex during rhinoplasty

In most rhinoplasty procedures, osteotomies are usually required. The osteotomy areas are innervated by sensory branches of the trigeminal nerve. The trigeminocardiac reflex (TCR) is clinically defined as the sudden onset of parasympathetic activity during stimulation of the trigeminal nerve. When an osteotomy is performed or external pressure is applied over the nasal bone, the infraorbital nerve may send signals via this nerve. The aim of this prospective study is to determine the blood pressure changes and occurrence of TCR during rhinoplasty. one hundred and eight patients were enrolled into the study. Lidocaine and adrenaline combination (LAC) was injected only into the left lateral osteotomy sites. All patients underwent median, right-side, then left-side lateral osteotomies and nasal pyramid infracture. The haemodynamic changes were recorded. A 10% or more decrease in the heart rate from baseline was considered a TCR. TCR was detected in nine patients following lateral osteotomies and nasal pyramid infracture procedures (8.3%). The authors determined that LAC injection prior to osteotomy did not prevent TCR. Manipulation at or near the infraorbital nerve during rhinoplasty may cause TCR, even if local anaesthetic infiltration is used.

The protective role of caffeic acid phenethyl ester against streptomycin ototoxicity.

OBJECTIVE The aim of this experimental study was to investigate the efficacy of caffeic acid phenethyl ester (CAPE) in the prevention of streptomycin-induced ototoxicity. MATERIALS AND METHODS Thirty-two adult Wistar albino rats were divided into 4 groups: control (n = 8), streptomycin (n = 8), CAPE (n = 8), and streptomycin + CAPE (n = 8). Rats were tested with distortion product otoacoustic emissions (DPOAEs) before drug administration. The animals in all groups were killed under general anesthesia on the 45th day following last DPOAE measurements. Hearing results were analyzed statistically to determine differences in amplitudes of DPOAE. Also, the cochleas of each rat were evaluated by histopathological and immunohistochemical examination. RESULTS Significant difference was not observed in cochlear hair cells in the control and CAPE groups. In the streptomycin group, severe degeneration of hair cells and increased apoptotic cells were observed. In the streptomycin + CAPE group, although some deteriorations were observed, hair cells were mostly preserved. The DPgram of the streptomycin and streptomycin + CAPE groups was significantly deteriorated (P < .05). The analysis of the DPgram results revealed statistically significant differences between the groups of streptomycin and streptomycin + CAPE (P < .05). CONCLUSIONS Caffeic acid phenethyl ester treatment attenuated hair cells injury in the inner ear, possibly via its antioxidant effect. Prophylactic administration of CAPE for streptomycin ototoxicity ameliorated hearing deterioration in rats.

Management of orbital complications of sinusitis in pediatric patients.

Abstract The most common reason of orbital infections is sinusitis. Orbital complications of sinusitis are mostly seen in children. Loss of vision and intracranial infections are among the complications of sinusitis. Prompt diagnosis and treatment is very important in the management of orbital complications. The orbital complication can be in the form of cellulitis or abscess. A retrospective review of 26 pediatric patients with orbital complications due to sinusitis was presented in this study. Of 26 patients, there were 13 cases of preseptal cellulitis, 2 cases of orbital cellulitis, and 11 cases of subperiosteal abscess. We grouped the preseptal and orbital cellulites in one category and the subperiosteal abscess in the other. All patients in the cellulitis group recovered by medical treatment. All the patients were treated by surgical drainage. Early diagnosis and appropriate treatment method are vital for the treatment of orbital complications secondary to sinusitis.

Evaluation of hyperactivity, attention deficit, and impulsivity before and after adenoidectomy/adenotonsillectomy surgery.

ObjectiveThe objective of this study was to determine the severity of attention deficit, hyperactivity, and impulsivity symptoms in patients with obstructive airway problems scheduled to undergo adenoidectomy or adenotonsillectomy operation. The effects of the surgical treatment on these symptoms will also be investigated in a case-control design. MethodsThis prospective study included 63 patients (29 girls, 34 boys) who were operated on at the Department of Otorhinolaryngology, Dicle University Medical School, between January 2010 and May 2011 because of obstructive symptoms caused by adenoid or adenotonsillar hypertrophy. The age range of the patients was between 4 and 13 years. The control group consisted of 33 (17 girls, 16 boys) healthy children. ResultsAmong the patients, 15 children underwent adenoidectomy because of adenoid hypertrophy; 13 patients had adenotonsillectomy because of adenotonsillar hypertrophy, and the remaining patients underwent adenotonsillectomy related with chronic or recurrent tonsillitis with adenoid hypertrophy. Based on the preoperative data, statistically significant difference was observed between the patient and control groups. The patients’ attention deficit, hyperactivity, and impulsivity symptoms preoperatively and postoperatively have shown statistically significant differences. ConclusionsAttention deficit, hyperactivity, and impulsivity symptoms were common among the children who show signs of airway obstruction due to adenotonsillar hypertrophy. Adenoidectomy or adenotonsillectomy operations were both observed to be associated with improvement in these symptoms.

Histopathologic results of long-term sildenafil administration on rat inner ear.

OBJECTIVES Sildenafil, a selective inhibitor of phosphodiesterase type 5, is widely used for the treatment of erectile dysfunction. Although cochlear effects of phosphodiesterase type 5 inhibitors remain still unclear because of inadequate data, some evidence that recently emerged indicates that these medications may be responsible for hearing impairment. In the present study, we aimed to examine the histopathologic effects of long-term sildenafil use on the cochlea in a rat model. METHODS The study was performed with adult male Wistar albino rats. The control group was fed on standard laboratory diet. The study group was applied orally with sildenafil therapy, 1.5 mg/kg once a day for 45 days. Rats were anesthetized and decapitated. Each temporal bone was dissected, and the cochleas were removed en bloc. The inner-ear biopsy specimens were examined histologically with hematoxylin and eosin and caspase 3 immunoreaction under light microscopy. RESULTS Hematoxylin and eosin staining showed no distinctive difference between the control group and the sildenafil group. With immunohistochemical examination, caspase 3 immunoreactivity was observed in the sildenafil group. In the control group, caspase 3 immunoreactivity was not observed. CONCLUSIONS The caspase 3 immunoreactivity in the sildenafil group was strongly associated with an increase in apoptotic events in the cochlea. Long-term use of sildenafil can cause hearing impairment through increased apoptosis.

Relationship between hearing loss and sexual dysfunction.

OBJECTIVE Deafness may be one of the factors that leads to a change in sexual function. This study aimed to assess sexual function, in particular erectile dysfunction, in male patients with hearing loss. MATERIALS AND METHODS We studied two groups: (1) adult men with acquired, bilateral, sensorineural hearing loss, and (2) healthy, adult, married men demonstrated to have normal hearing levels, as the control group. Sexual function was assessed using the International Index of Erectile Functions questionnaire, and quality of life using the 36-Item Short-Form Health Survey. RESULTS There was a statistically significant difference between the groups regarding the International Index of Erectile Functions questionnaire results (p <0.001), both for each of the five questionnaire domain scores and for the total score. CONCLUSION Our results indicate that men with mild or moderate sensorineural hearing loss have poorer sexual health.

The effect of corticosteroid against streptomycin ototoxicity.

Abstract The aim of this experimental study was to determine the possible protective role of corticosteroid in prevention of streptomycin-induced ototoxicity. Twenty-eight adult Wistar albino rats were divided into 4 groups: control (n = 7), streptomycin (n = 7), corticosteroid (n = 7), and streptomycin + corticosteroid (n = 7). Rats were tested with distortion product otoacoustic emissions (DPOAEs) in the beginning and at the end of the study. The animals in all groups were killed under general anesthesia on the 45th day after the last DPOAE measurements. Hearing results were analyzed statistically to determine differences in amplitudes of DPOAE. In addition, the cochleas of each rat were evaluated by histopathologic and immunohistochemical examination. Significant difference was not observed in cochlear hair cells in the control and corticosteroid groups, whereas severe degeneration of hair cells and increased apoptotic cells were observed in the streptomycin group. Moderate degeneration was observed in the streptomycin + corticosteroid group. The hair cells were partially intact. DP-gram of the streptomycin and streptomycin + corticosteroid groups was significantly deteriorated (P < 0.05). The coadministration of steroids with streptomycin, which has a serious ototoxic effect, did not lead to a limitation of this harmful effect.

Effects of Formaldehyde on Respiratory Mucosa in Rats

Es conocido que la inhalacion de formaldehido tiene carateristicas irritantes para la mucosa nasal. En este estudio se examinaron los efectos histopatologicos de la inhalacion de formaldehido en ratas mediante microscopia de luz. Se utilizaron en este estudio 16 ratas Wistar albinas adultas, ocho ratas como grupo control y ocho como grupo experimental. El grupo experimental fue expuesto a 10 ppm formaldehido 8 horas/dia, 5 dias/semana por 8 semanas. La mucosa nasal fue retirada y colocada en formalina al 10%. Las secciones obtenidas fueron tenidas con Hematoxilina-Eosina y observadas al microscopio optico. El epitelio de revestimiento de la mucosa respiratoria mostro una perdida de celulas ciliadas con metaplasia de las celulas caliciformes e hiperplasia de celulas escamosas.

Burun tıkanıklığının nadir bir nedeni: Sfenokoanal polip

Choanal polyps mostly arise from the antrum of maxillary sinus. Sphenochoanal polyp arising from the sphenoid sinus is extremely rare. It presents with similar symptoms of antrochoanal polyps. Radiological examination is important in differentiation of these two types of choanal polyps. Inadequate surgery that leaves some part of the polyp has a high risk of recurrence. We present a case of sphenochoanal polyp treated successfully with endoscopic sinus surgery. The patient is symptom free for 1 year.