Fevzi Sefa Dereköy

Etiology of deafness in Afyon school for the deaf in Turkey

OBJECTIVE Otolaryngologists play an important role in the evaluation of children with a hearing impairment. The group of unknown cause still has a high incidence. The purposes of this study were to determine the etiology of deafness in Afyon School for the Deaf in Turkey and to compare the results with the other studies from Turkey and other countries. METHODS This study was a retrospective analysis of 130 deaf students, aged 5-16 years. Medical and family histories of the children were obtained. Clinical and laboratory examinations were carried out. RESULTS Etiological groups showed the following distribution: febril convulsion, 26.9%; cause unknown, 26.1%; hereditary group, 23.8%; meningitis, 10%; measles, 6.1%; and miscellaneous, 6.6%. A total of 90.3% of the students with hereditary deafness were from consanguineous families. A marital consanguinity was noted in the parents of 64 (49.2%) of all children in the school and this rate was higher than the average in Turkey (P<0.05). Neither syndromic deafness nor maternal rubella was identified. A total of 27.6% of the cases were diagnosed after the age of 30 months. CONCLUSION Febril convulsions and hereditary factors were the major causes of hearing loss in the present study. The high incidence of consanguineous marriage among the parents of the children with hereditary deafness seemed a strong evidence of genetic origin, indicating a close relationship between them. Congenital rubella syndrome did not appear as a significant etiology of deafness in Turkey.

Relationship between Helicobacter pylori Adenotonsillar Colonization and Frequency of Adenotonsillitis in Children.

BACKGROUND There are insufficient data in the literature on the presence of Helicobacter pylori in tonsil and adenoid tissue of patients with only airway obstruction. This study examined the presence of H. pylori in surgical cases with airway obstruction or recurrent infection. AIMS To investigate the relationship between H. pylori adenotonsillar colonisation and the frequency of adenotonsillitis and to compare paediatric and adult patients according to H. pylori tonsillar colonisation. STUDY DESIGN Prospective clinical trial. METHODS PATIENTS SCHEDULED FOR ADENOIDECTOMY OR TONSILLECTOMY WERE CLASSIFIED INTO THREE GROUPS BASED ON INDICATIONS: paediatric infection (n=29), paediatric obstruction (n=29) and adult infection (n=12). Tissue samples obtained from patients were examined for the presence of H. pylori by culture, rapid urease test and polymerase chain reaction. RESULTS Forty-nine tonsil tissues were examined. Positive results were found in two specimens with the rapid urease test (4.1%) and three with polymerase chain reaction examination (6.1%). Only three positive polymerase chain reaction results (5.8%) were identified in 52 adenoid tissue samples. There were no statistically significant differences in the presence of H. pylori between paediatric infection and obstruction groups or between paediatric infection and adult infection groups. CONCLUSION In our study, there was a low incidence of H. pylori colonisation in tonsil and adenoid tissues. Regarding H. pylori colonisation, there was no significant difference between paediatric infection and obstruction groups. Also, no significant difference was found between adult and paediatric cases.

Does topical use of autologous serum help to reduce post-tonsillectomy morbidity? A prospective, controlled preliminary study

BACKGROUND To evaluate the effects of autologous serum usage on throat pain, haemorrhage and tonsillar fossa epithelisation in patients after tonsillectomy. METHODS Thirty-two patients (aged 4-15 years) were included in the study. Tonsillectomy was performed and autologous serum was administered topically to the right tonsillar fossa during the operation, and at 8 and 24 hours post-operatively. The left side served as the control. A visual analogue scale was used to record the patients pain every day. Each patients oropharynx was observed on the 5th and 10th post-operative days to examine bleeding and epithelisation. RESULTS The pain scores for the side administered autologous serum were significantly lower than those for the control side, on the night following the operation and on the 1st, 2nd, 5th and 6th post-operative days. Tonsillar fossa epithelisation was significantly accelerated on the study side compared with the control side on the 5th and 10th post-operative days. CONCLUSION In tonsillectomy patients, topically administered autologous serum contributed to throat pain relief and tonsillar fossa epithelisation during the post-operative period.

Evaluation of the protective effects of hesperetin against cisplatin-induced ototoxicity in a rat animal model.

OBJECTIVES We aimed to investigate the effects of hesperetin as a flavanon both histopathologically and immunohistochemically on cochlear apoptosis in a rat model of cisplatin-induced ototoxicity (CIO). The evaluation of the effects of hesperetin on cisplatin-induced hearing loss was performed using distortion product otoacoustic emission (DPOAE). METHODS Twenty-eight wistar albino rats were used in the current study. The rats were randomly divided into four groups with seven rats in each group. Group C was exposed to a single dose of cisplatin (12mg/kg) by intraperitoneal injection. Group CH received intraperitoneally cisplatin (12mg/kg) and hesperetin (20mg/kg). Group H was exposed to hesperetin (20mg/kg) intraperitoneally. The sham group (group S) received normal saline (6cc) intraperitoneally. The measurements of DPOAE and signal-noise ratios (SNR) were performed before the treatment and again on the first and 6 days after administration of the drugs. Rats were sacrificed and cochleae were dissected 10 days after drug administration. The cochlear tissue was assessed in all groups by histopathologic, immunohistochemical and TUNEL assay. In addition, serum oxidative stress markers and antioxidant parameters were analyzed. RESULTS There was a significant difference between the basal value and the sixth day at frequencies 8.4, 9.6 and 9.96 for group C. We also found a significant difference between the first and sixth day at frequencies 7.2, 8.4, 9.6 and 9.96. On the 6th day, there were significant differences between C and S groups at all frequencies except 2.4. We showed a significant difference between C and H groups at frequencies 4.8, 6.0, 8.4, 9.6 and 9.96. There was also a significant difference between C and CH groups at frequencies 2.4, and 3.6. We found lower levels of oxidants and higher levels of antioxidants in CH group as compared to C group. C group had a significantly greater number of TUNEL-positive cells than did S, H and CH groups. The number of TUNEL-positive cells in CH group was higher than in S and H groups. There was a significant difference between the positive PCNA cells of CH group compared to S and H groups in spiral ganglion and stria vascularis. In addition, there were no positive PCNA cells in C group. CONCLUSIONS Hesperetin may prevent ototoxicity by increased antioxidant enzymes and reduced oxidant parameters and protected against apoptosis resulting from a proliferation of cochlear cells in CIO.

Agenesis of Submandibular Glands: A Report of Two Cases with Review of Literature

Background. Congenital absence of the submandibular gland (SMG) is a rare condition. Although complaints such as dry mouth, dental problems, or difficulty in swallowing may be seen, the subjects may also be asymptomatic. The absence of the SMG may be associated with hypertrophy of the contralateral SMG. Case Report. We report the case of a 44-year-old woman with incidentally detected left SMG aplasia, with contralateral SMG hypertrophy mimicking a mass, and the case of a 46-year-old woman with incidentally detected bilateral SMG aplasia, demonstrated by computerized tomography (CT) and magnetic resonance imaging (MRI). Conclusion. It is important for the clinician to know that this very rare abnormality may exist. When such a case is encountered, symptoms and findings should be reevaluated and, if necessary, conservative therapy should be initiated. The possibility of observing additional deformities should be kept in mind and an evaluation should be done for other cases in the family.

Tegmen height: preoperative value of CT on preventing dural complications in chronic otitis media surgery☆ , ☆☆

OBJECTIVE The objective was to examine tegmen height in patients with iatrogenic dural exposure in chronic otitis media (COM) surgery. METHODS Computed tomographic (CT) scans of 50 patients who underwent COM surgery were retrospectively examined. Twelve patients with dural exposure were admitted to the dura group. The control group of 38 patients had no dural exposure. Tegmen heights in both groups were compared. RESULTS There was no statistically significant difference between opposite ears (P>.05). Significant difference was found in tegmen height between healthy and operated ears in unilateral COM patients (P=.001). CONCLUSION Preoperative CT assessment of tegmen height is an important parameter in assessing risk of exposing dura during surgery.

Sudden Hearing Loss after Rabies Vaccination

BACKGROUND Sudden hearing loss developing after immunisation is a very rare situation. Rabies is a viral disease characterised by encephalitis and death. Treatment involves active and passive immunisation. Neurologic complications including Guillain-Barre syndrome or facial paralysis are reported in the literature as a side effect after rabies immunisation. CASE REPORT Sudden hearing loss was detected in an 11 year-old male patient who had taken the medication for rabies immunisation. CONCLUSION This study presents a case report of sudden hearing loss developing after rabies immunisation - no other aetiological factors were detected and clinical management is discussed in light of the literature.

Prognostic Value of Acoustic Rhinometry and Rhinomanometry in Tympanoplasty Surgery.

OBJECTIVE Chronic otitis media (COM) is a disorder characterized by perforation of the eardrum and hearing loss following chronic inflammation of the middle ear cavity, ossicules, and mastoid cells. Eustachian dysfunction plays an important role in COM etiopathogenesis and postoperative prognosis. The determinants of postoperative prognosis are still being researched. This study aimed to research the prognostic value of acoustic rhinometry (ARM) and rhinomanometry (RMM) in COM surgery in terms of eradication of the infection after operation, graft success, and hearing gain in operated cases. MATERIALS AND METHODS This study included 58 patients who underwent surgery with a diagnosis of COM. Patients were assessed in terms of age, gender, COM type, treatment methods used, eradication of infection, graft success, and hearing gain. ARM and RMM measurements were performed in the preoperative period. ARM and RMM values were statistically compared in terms of the existence of postoperative infection, graft success, and hearing gain. RESULTS In terms of ARM and RMM measurements, there was no statistically significant difference between cases where postoperative infection control was assured and cases with ongoing infection; successful and failed cases in terms of grafting; or successful and failed cases in terms of postoperative hearing. When preoperative and postoperative air-bone gap averages were compared, statistically significant differences were observed. CONCLUSION In the presence of a nasal obstruction in cases with chronic otitis, elimination of this situation is the first line of treatment. Infection control, graft success, and improvement of hearing will be possible to a greater extent in the postoperative period for patients with the nasal pathology remedied.

Evaluation of Sleep Quality in Patients With Nasal Septal Deviation via the Pittsburgh Sleep Quality Index.

Objective:To investigate the effect of nasal septum deviation, without obstructive sleep apnea, on sleep quality. Methods:The present case-controlled study enrolled patients older than 16 years with nasal septum deviation who attended the Otorhinolaryngology Clinic between December 2013 and July 2014. The control group was selected from patients attending the clinic for another complaint. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, and differences between the groups were compared using the Mann–Whitney U test. Results:During the study period, 55 patients with nasal septum deviation were included in the study group, and the control group consisted of 51 patients with no complaints of nasal obstruction. Compared with the control group, patients with nasal septum deviation were found to be significantly higher (P <0.05) in all parameters of Pittsburgh Sleep Quality Index. Conclusion:The presence of nasal septum deviation with nasal obstruction should be investigated in patients with sleep disorders. If any pathology is present, opening the nasal passages should be ensured and sleep disorders reevaluated.

Çocuklarda kulak burun boğaz muayene sonuçları ve etkileyen faktörler: Okul tabanlı-kesitsel çalışma

Giris: Calismada okul cagi populasyonunda kulak burun ve bogaz muayenesi yaparak sik gorulen patolojileri ve bu durumlarla iliskili faktorleri saptamak amaclanmaktadir. Yontem: Kesitsel desendeki calisma Eylul-Aralik.2013 tarihleri arasinda Canakkale il merkezindeki ilk ve ortaokullarda yapildi. Ogrencilerin ve ailelerinin hastalik oykulerini ve aliskanliklarini sorgulayan anket uygulandi. Kulak, burun ve bogaz muayeneleri yapilarak, ogrencilerin muayene formlarina not edildi. Bulgular: Calismaya toplam 1938 ogrenci alindi. Ogrencilerin 1369 (%70,6)’u ilkokul, 569 (%29,4)’u ortaokulda egitim gormekteydi. Ogrencilerin yas ortalamasi 8,6 ± 2,3 idi. Calismada sirasiyla tonsiller hipertrofi %25,2, kepce kulak %14,8, otitis media %3,3, anterior nazal deviasyon %10,4 siklikta gozlendi. Kepce kulak erkek ogrencilerde daha fazlaydi (p0,05). Sonuc: Okul cocuklarinda sirasiyla tonsiller hipertrofi, anterior nazal deviasyon ve otitis media en sik saptanmistir. Ogrencilerin ve ailelerinin tibbi oyku ozellikleri ile ailelerin tibbi oyku ve aliskanliklari, kulak, burun ve bogaz patolojisinin varligi icin risk faktoru degildi.