Hüseyin Altun

Effectiveness of hyaluronic acid in post-tonsillectomy pain relief and wound healing: A prospective, double-blind, controlled clinical study

OBJECTIVES To find the effectiveness of hyaluronic acid in post-tonsillectomy pain relief and wound healing. METHODS Fifty patients were included in this prospective, double-blind, controlled clinical study (20 males, 30 females mean age of 13.56 years). Hyaluronic acid was applied to one side and the other side was used as a control during tonsillectomy. Therefore, the same patient evaluated and scored the post-tonsillectomy pain, excluding individual bias. RESULTS Results indicated that patients had significantly lower pain scores for hyaluronic acid treated side (p<0.001). At the end of two weeks follow-up period, the wound in the hyaluronic acid side was almost completely healed, indicating that the healing was faster with hyaluronic acid compared to control side (p<0.001). CONCLUSION Hyaluronic acid could be recommended as an effective treatment for the management of post-tonsillectomy pain and wound healing.

Improved Gustatory Sensitivity in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy

Introduction: The reduction in the preferences for sweet and fat containing tastes in obese patients who underwent bariatric surgery was relatively well shown; however, there are only limited data on the changes in the sensitivity of other tastes like sour, salty, and bitter. Methods: We investigated the changes in gustatory sensitivity of 52 morbidly obese patients (M/F, 22/30; age range, 19-60 years; BMI range, 32.5-63.0 kg/m2) after laparoscopic sleeve gastrectomy. The surgery was performed by the same surgeon using 5 ports technique. Gustatory sensitivity was tested preoperatively and 1 and 3 months after the surgery using standardized Taste Strips test. Results: There was a statistically significant improvement in the taste acuity to sweet, sour, salty, and bitter tastants in morbidly obese patients after the laparoscopic sleeve gastrectomy during the follow-up period of 3 months. Median whole test scores of the patients were increased from 11.5 preoperatively to 14 in the first and third months. Conclusion: In this study, we were able to show the significant improvement in gustatory sensitivity of morbidly obese patients after laparoscopic sleeve gastrectomy for the first time in literature.

Olfaction improvement after nasal septal perforation repair with the "cross-stealing" technique.

Background The surgical treatment of nasal septal perforation is known to improve nasal respiratory airflow and, thereby, should be beneficial to the patients olfactory abilities. However, there are only limited data on the effect of nasal septal perforation repair (NSPR) on olfaction, and most studies reported contradictory results. Objective The aim of this prospective study was to investigate the change in the olfactory abilities of 42 patients with a primary concern of nasal septal perforation. Methods NSPR was performed with the “cross-stealing” technique. The inferior-based mucoperichondrial flap in one side and the superior-based mucoperichondrial flap from the other side of the nasal septum were passed to the opposite sides through the perforation. Surgery was completed by placing an interpositional graft between the flaps before suturing. The interpositional grafts were residual cartilage. The olfactory performance of the patients before and at 1, 3, and 6 months after the closure of the nasal septal perforation was measured by using an olfaction test kit. Results The success rate with complete closure of nasal septal perforation with the “cross-stealing” technique was 92.8%. Analysis of the data indicated statistically significant improvement in olfactory function scored as odor threshold (T), odor discrimination (D), odor identification (I) and TDI at 1, 3, and 6 months after NSPR (p < 0.001 for all). The mean TDI score evaluated 6 months after NSPR was improved by 64%. Analyses of variance indicated statistically significant improvement in olfactory scores within time factors were calculated as preoperative versus 1, 3, and 6 months; 1 versus 3 and 6 months; and 3 versus 6 months (p < 0.001 for all). Analysis of the present data indicates a beneficial effect of NSPR on olfactory abilities of patients with perforation. Conclusion Our data on the short- and long-term olfactory abilities of 42 patients with nasal septal perforation after NSPR when using an olfaction test kit indicated statistically significant improvement in olfactory function.

Cinnamaldehyde is an effective anti-inflammatory agent for treatment of allergic rhinitis in a rat model.

OBJECTIVES The effect of cinnamaldehyde on the treatment of allergic rhinitis (AR) was investigated in rat model. METHODS Twenty-eight female Wistar albino rats were randomly divided into four groups: Group 1 (control) (C), Group 2 (AR with no treatment) (AR+NoTr), Group 3 (AR+Azelastine HCl) (AR+Aze), and Group 4 (AR+cinnamaldehyde) (AR+Cin). At day 21, AR+Aze rats were given an Azelastine HCl drop, and AR+Cin rats were given cinnamaldehyde intranasally. In all groups, allergic symptoms histopathological results were evaluated. RESULTS The AR+NoTr group showed the worst allergic symptoms, cilia loss and greater inflammation. In the AR+Aze and AR+Cin groups, allergic symptom scores were higher than those in the control group. However, between AR+Aze and AR+Cin groups, there were no significant differences in the allergic symptom scores Histopathological analysis revealed vascular congestion and an increase in goblet cell numbers in the AR+Cin group. However, AR+Cin rat nasal mucosa had less plasma cell infiltration compared with the AR+NoTr group. In rats from the AR+Aze group, analysis of the nasal mucosa revealed less eosinophil infiltration than that seen in the AR+NoTr group. A lower score for mast cell (MC) infiltration was observed in the nasal mucosa of rats treated with Azelastine HCl compared with cinnamaldehyde. CONCLUSIONS In this study we observed that both Azelastine HCl and cinnamaldehyde reduced allergic symptoms in an AR rat model. Cinnamaldehyde decreased vascular congestion as well as plasma cell, eosinophil, and inflammatory cell infiltration into the lamina propria.

Comparison of Three Techniques for the Management of Concha Bullosa on Nasal and Olfactory Functions

Background: Different techniques were described for the management of concha bullosa. However there is still no consensus on which technique should be preferred. Objective: To evaluate the most effective technique for the management of concha bullosa in terms of improvement in nasal and olfactory functions. Study Design: Prospective, randomized controlled trial. Methods: A total of 95 patients were randomly divided into three groups; medial laminectomy (n = 31), lateral laminectomy (n = 32), and crushing of the middle turbinate (n = 32). Patients were evaluated using visual analogue score (VAS), sinonasal outcome test-22 (SNOT-22), peak inspiratory flow (PNIF), and Sniffin’ Sticks Extended Test preoperatively and 3 months postoperatively. Results: The age range of the study patients was 18 and 56 years (mean age 35.2±9.4 years). There was no statistically significant difference between the baseline characteristics of the patients including age and gender. There was a statistically significant improvement in headache, obstruction, PNIF, SNOT-22 scores and olfactory performances of the patients 3 months after the surgery ( P P = 0.011). In addition, there was a significant improvement in odor discrimination in medial laminectomy group when compared to crushing of middle turbinate ( P = 0.011). Conclusions: Although all three techniques are comparable with respect to improvement in nasal and olfactory functions, we recommend medial laminectomy as the surgical technique for the management of concha bullosa.

Prevalence of benign paroxysmal positional vertigo among motocross racers: a case-control study.

OBJECTIVES This study aims to investigate the prevalence of benign paroxysmal positional vertigo (BPPV) among motocross racers after cross-country up and downhill activities. PATIENTS AND METHODS This case-control study included 40 motocross racers (39 males, 1 female; mean age 26 years; range 21 to 43 years) and 40 healthy controls (30 males, 10 females; mean age 28 years; range 22 to 43 years) who had no hearing or balance problems. The Dix-Hallpike maneuver was applied to confirm the diagnosis of BPPV. Patients with BPPV were administered the Epley maneuver every week for one month and followed-up for treatment response assessment. RESULTS Motocross and control groups were similar in terms of demographic and laboratory parameters. While BPPV was detected in four motocross racers (10%) according to Dix-Hallpike maneuver outcome and clinical findings, there was no BPPV in the control group. Of the motocross racers with BPPV, three had unilateral, one had bilateral disease. Of these patients, Epley maneuver was applied two times in two patients and three times in the other two patients. There was no vertigo or nystagmus in any of the patients with BPPV in one month. CONCLUSION Intensive motocross activity is a cause of post-traumatic BPPV developing without head trauma. Large-scale, randomized controlled studies are needed to establish the post-traumatic etiology of BPPV in motocross racers.