Güven Yıldırım

Effects of Electronic Nicotine Delivery System on Larynx: Experimental Study

OBJECTIVE We aimed to assess the effects of electronic nicotine delivery system (ENDS) or also termed electronic cigarette vapor on the laryngeal mucosa of rats. MATERIALS AND METHODS Sixteen female Wistar albino rats were divided into two groups. The study group was exposed to ENDS vapor for 1 hour/day for 4 weeks. The control group was not subjected to any chemical or physical stimulus. The vocal folds of the study and control group rats were evaluated histopathologically by hematoxylin and eosin staining and immunohistochemically by Ki67 staining. Epithelial distribution, inflammation, hyperplasia, and metaplasia were evaluated. RESULTS Epithelial distribution and inflammation did not differ between the two groups. Two cases of hyperplasia were detected in the study group but there was no hyperplasia in the control group. Four cases of metaplasia were detected in the study group and one case in the control group. Statistical analysis revealed no significant difference between the study and control groups (P = 0.131 and 0.106, respectively). CONCLUSIONS Exposure to ENDS for 4 weeks caused hyperplasia and metaplasia of the laryngeal mucosa of rats but this was not significant statistically. These results implemented that further studies with larger cohort and longer duration are required to evaluate long-term effects.

Reconstruction of the orbit with a temporalis muscle flap after orbital exenteration.

Objectives This study presents the role of the temporalis muscle flap in primary reconstruction after orbital exenteration. Methods A retrospective nonrandomized study of orbital exenterations performed between 1990 and 2010 for malignant tumors of the skin, paranasal sinus, and nasal cavity is presented. Results The study included 13 patients (nine men, four women; age range, 30-82 years) with paranasal sinus, nasal cavity, or skin carcinomas. Primary reconstruction of the cavity was performed in all patients after orbital exenteration. No visible defects in the muscle flap donor site were present. Local recurrences were readily followed up with nasal endoscopy, whereas radiology helped to diagnose intracranial involvement in three patients. Two patients died of systemic metastases and five died for other reasons Conclusion The temporalis muscle flap is readily used to close the defect after orbital exenteration, and does not prevent the detection of recurrence.

The effect of coenzyme Q10 on the regeneration of crushed facial nerve.

ObjectiveThe aim of this study is to show the possible positive effect of coenzyme Q10 (Co Q10) on regenerating in facial palsy. Materials and MethodsSixteen female Sprague-Dawley albino rats were randomly divided into 2 groups as Co Q10 and control groups. Group Q10 (n = 8) received Co Q10 of 10 mg/kg/d intraperitoneally for 30 days, and group C (n = 8) received saline solution of 1 mL/d intraperitoneally once daily for 30 days. The right facial nerve stimulation thresholds were determined before crush, immediately after crush, and after 1 month.After determination of the thresholds, the crushed part of the facial nerve was then excised. All specimens were examined by a pathologist using a light microscope. ResultsNo statistically significant difference in stimulation threshold was found between the Co Q10 and saline groups after crushing (P = 0.645). After 1 month of treatment, stimulation thresholds were significantly lower in both the Co Q10 and saline groups (Ps = 0.028 and 0.016). However, the Co Q10 group showed greater improvement than the saline group (P = 0.050).After 1 month of treatment, neither the Co Q10 group nor the saline group had reached the precrushing amplitude levels (Ps = 0.027 and 0.011).Significant differences were found in vascular congestion, macrovacuolization, and myelin thickness between the Co Q10 and control groups by light microscopy (P < 0.05). ConclusionsAlthough many treatment methods have been tried to accelerate facial nerve regeneration after trauma, a definitive method has not been found yet. Co Q for the treatment of acute facial paralysis is promising on both physiologic assessments and pathologic evaluation.

Effects of serum zinc level on tinnitus

OBJECTIVE The aim of this study was to assess zinc levels in tinnitus patients, and to evaluate the effects of zinc deficiency on tinnitus and hearing loss. METHODS One-hundred patients, who presented to an outpatient clinic with tinnitus between June 2009 and 2014, were included in the study. Patients were divided into three groups according to age: Group I (patients between 18 and 30years of age); Group II (patients between 31 and 60years of age); and Group III (patients between 61 and 78years of age). Following a complete ear, nose and throat examination, serum zinc levels were measured and the severity of tinnitus was quantified using the Tinnitus Severity Index Questionnaire (TSIQ). Patients were subsequently asked to provide a subjective judgment regarding the loudness of their tinnitus. The hearing status of patients was evaluated by audiometry and high-frequency audiometry. An average hearing sensitivity was calculated as the mean value of hearing thresholds between 250 and 20,000Hz. Serum zinc levels between 70 and 120μg/dl were considered normal. The severity and loudness of tinnitus, and the hearing thresholds of the normal zinc level and zinc-deficient groups, were compared. RESULTS Twelve of 100 (12%) patients exhibited low zinc levels. The mean age of the zinc-deficient group was 65.41±12.77years. Serum zinc levels were significantly lower in group III (p<0.01). The severity and loudness of tinnitus were greater in zinc-deficient patients (p=0.011 and p=0.015, respectively). Moreover, the mean thresholds of air conduction were significantly higher in zinc-deficient patients (p=0.000). CONCLUSION We observed that zinc levels decrease as age increases. In addition, there was a significant correlation between zinc level and the severity and loudness of tinnitus. Zinc deficiency was also associated with impairments in hearing thresholds.

Diagnosis of Pediatric Nasopharynx Carcinoma after Recurrent Adenoidectomy

Nasopharyngeal soft tissue is most commonly adenoid hypertrophy in children. Although rare, nasopharyngeal carcinoma (NPC) does occur in children. Nasal obstruction, serous otitis media, hearing problems, and tinnitus are common signs and symptoms of all nasal diseases. For this reason, the majority of NPC presents with advanced disease at the time of the diagnosis. This paper reported 7-year-old boy who was admitted to the hospital for adenoidectomy. He had recurrent adenoidectomy operation due to nasal obstruction. NPC had been diagnosed suspecting the hard mass in the nasopharynx during the operation. Adenoidectomy is the most commonly performed surgical procedure in ENT practice and NPC is unlikely to be considered in the differential diagnosis. Surgeon should be careful about signs and symptoms that alert suspicion.

Objective and Subjective Aspects of Voice in Pregnancy

OBJECTIVE This study aimed to evaluate vocal changes in pregnancy according to trimesters both objectively and subjectively. METHODS Fifty pregnant women and 15 nonpregnant women were included in the study. Eighteen of the 50 pregnant women were in the first trimester, 17 in the second trimester, and 15 in the third trimester of their pregnancies. The fundamental frequency (F0), jitter, shimmer, noise-to-harmonics ratio (NHR), and minimum and maximum pitch were determined during acoustic voice analysis. Laryngologic examination was evaluated via reflux finding score (RFS). Voice Handicap Index 10 (VHI-10) was used for subjective analysis. RESULTS Maximum phonation time (MPT), VHI-10, and RFS were the parameters that differed significantly. MPT was significantly shorter in the third trimester. Acoustic analysis revealed that F0, jitter, shimmer, NHR, and minimum and maximum pitch values were not significantly different in any groups. RFS was higher in the first and third trimesters than the second trimester and control groups. VHI-10 scores were significantly higher in the third trimester. CONCLUSIONS Our results showed that MPT is decreased during the third trimester, although acoustic parameters did not differ. VHI-10 results deteriorated in the third trimester significantly.

Psychological effects of dysphonia in voice professionals.

To evaluate the psychological effects of dysphonia in voice professionals compared to non–voice professionals and in both genders.

How to rehabilitate long-term facial paralysis.

Objective:To project the surgical resuscitation methods that we apply to the lower part of the face and the eyes with the aim of preventing functional and psychological problems that can occur in patients with facial paralysis. Materials and Methods:Twenty-two patients with facial nerve paralysis due to acoustic neuroma, trauma, cholesteatoma, and parotid carcinoma were included in this study. In the lower facial region, the temporal muscle was suspended to the lower lip. In the upper facial region, eyelid gold implantation was performed. The reanimation results of the upper and lower facial regions were graded as excellent, good, fair, and poor in consideration of the symmetry after rest and smile according to May classification in the third month after the surgery. Results:The study group comprised 15 men (68.2%) and 5 women (31.8 %) (mean age, 63.82 ± 14.18 years; range, 8–78 years). Of the patients, 18.2% (n = 4) had acoustic neuroma, 40.9% (n = 9) had facial trauma, 27.3% (n = 6) had cholesteatoma, and 13.6% (n = 3) had parotid carcinoma.Reanimation techniques were applied to 40.9% (n = 9) of the patients during the first 2–4 years, whereas 59.1% (n = 13) of patients underwent surgery after 4 years.In a total of 17 patients (77.3%) who had lower lip intervention, 4 patients (23.5%) had excellent results, 7 patients (41.2%) had good results, and 6 patients (35.3%) had moderate results.In the 22 patients who underwent the eyelid procedure, 5 patients (22.7 %) had excellent results, 13 patients (59.1 %) had good results, and 3 patients (18.2 %) had moderate results. Poor results were not observed in any patient. Conclusion:Facial paralysis is a disease that causes serious functional and psychological problems in patients. Therefore, the choice of treatment method is dependent on the etiology, duration of paralysis, expectations of the patient, and experience of the surgeon. Being less invasive methods, obtaining immediate results, requiring single surgical stage, and having long-lasting results and dynamic muscle transfer and static suspension methods are preferred.

Effect of Deviated Nasal Septum Type on Nasal Mucociliary Clearance, Olfactory Function, Quality of Life, and Efficiency of Nasal Surgery.

Objective:The aim of this study was to analyze the influence of deviated nasal septum (DNS) type on nasal mucociliary clearance, quality of life (QoL), olfactory function, and efficiency of nasal surgery (septoplasty with or without inferior turbinate reduction and partial middle turbinectomy). Methods:Fifty patients (20 females and 30 males) with septal deviation were included in the study and were divided into 6 groups according to deviation type after examination by nasal endoscopy and paranasal computed tomography. The saccharin clearance test to evaluate the nasal mucociliary clearance time, Connecticut Chemosensory Clinical Research Center smell test for olfactory function, and sinonasal outcome test-22 (SNOT-22) for patient satisfaction were applied preoperatively and postoperatively at the sixth week after surgery. Result:Nasal mucociliary clearance, smell, and SNOT-22 scores were measured before surgery and at the sixth week following surgery. No significant difference was found in olfactory and SNOT-22 scores for any of the DNS types (both convex and concave sides) (P > 0.05). In addition, there was no difference in the saccharin clearance time (SCT) of the concave and convex sides (P > 0.05). According to the DNS type, the mean SCT of the convex sides showed no difference, but that of the concave sides showed a difference in types 3, 4, 5, and 6. These types had a prolonged SCT (P < 0.05). Olfactory scores revealed no difference postoperatively in types 5 and 6 but were decreased significantly in types 1 to 4 (P < 0.05). There was no significant difference in the healing of both the mucociliary clearance (MCC) and olfactory functions. SNOT-22 results showed a significant decrease in type 3. Conclusion:All DNS types disturb the QoL regarding nasal MCC and olfaction functions. MCC values, olfactory function, and QoL scores are similar among the DNS types. Both sides of the DNS types affect the MCC scores symmetrically. Septal surgery improves olfaction function and QoL at the sixth week following surgery but disturbs nasal MCC; thus, the sixth week is too early to assess nasal MCC.

Comparison of two partial middle turbinectomy techniques for the treatment of a concha bullosa

To assess the nasal functions, nasal resistance, and olfactory function in middle turbinate surgery.