Ibrahim Ozcan

Anatomical variations of nasal turbinates.

After the widespread use of endoscopic sinus surgery and paranasal sinus computed tomography, many variations of nasal turbinates have been described. In addition to the most common one-middle turbinate pneumatization (concha bullosa)-superior and inferior turbinate pneumatizations have also been described. Secondary and accessory middle turbinates that can mimic real middle turbinate are anomalies described in recent years. Paradoxical middle turbinate and bifid inferior turbinate are very rarely encountered anomalies and can be easily recognized in paranasal tomography but can be overlooked by endoscopical examination. In the present study, the computed tomography images of 384 patients were evaluated for nasal turbinate variations, as well as their relations to mucosal pathologies. The most frequent variation was found to be concha bullosa; the least frequent one was found to be bifid inferior turbinate. In 1 of our patients, 5 of the 6 turbinates were found to have pneumatization, which is extremely rarely encountered in the literature. In this study, the prevalence of the variations of the turbinates and their association with chronic rhinosinusitis were investigated.

Bifid inferior turbinate: a case report

OBJECTIVES A bifid inferior turbinate is an extremely rare anatomical variation and has been reported in only two cases to date. Including the present report, the uncinate processes were missing in all three patients reported. It is suggested that, in the reported patient, bifid inferior turbinate coexisted with a developmental anomaly of the uncinate process, and that the bifid inferior turbinate represented two separate turbinates originating from the same site. CASE REPORT We present the first reported case of bilateral bifid inferior turbinates, with a secondary middle turbinate, in a patient complaining of nasal obstruction. CONCLUSION We suggest that the superior part of the bifid inferior turbinate may have been formed by severe medial displacement and inferior rotation of the uncinate process, and that the bifid inferior turbinate is an anatomical abnormality of the uncinate process.

The Effect of Topical Doxycycline in the Prevention of Experimental Tympanosclerosis

Objectives: The aim of this study is to determine the effectiveness of topical doxycycline used in the process of experimental myringosclerosis and tympanosclerosis.

The protective role of thymoquinone in the prevention of gentamicin ototoxicity

OBJECTIVE To investigate the potential protective effect of thymoquinone in gentamicin-induced ototoxicity through auditory brain stem responses (ABR) testing and histomorphological evaluation of the cochlea. METHODS This study was conducted on 48 adult female Sprague-Dawley rats that were randomized into 4 groups. Group 1 received intraperitoneal gentamicin; group 2 received intraperitoneal gentamicin plus corn oil solution; group 3 received intraperitoneal thymoquinone; and group 4 received intraperitoneal gentamicin plus thymoquinone. All groups received the drugs (once daily) in the above-mentioned protocols over 15 days. After conducting repeated ABR measurements, the rats were sacrificed, and their cochleae were isolated. RESULTS ABR thresholds were preserved in the gentamicin plus thymoquinone group when compared with the group receiving gentamicin alone. There were fewer TUNEL-positive cells and caspase-3 and caspase-9 expressions were weaker in the inner and outer hairy cells of the organ of Corti in the gentamicin plus thymoquinone group compared with the group receiving gentamicin alone. CONCLUSION The ABR values and number of apoptotic cells did not significantly increase in the group receiving gentamicin plus thymoquinone when compared to the group receiving gentamicin alone. Again, the cochlear histomorphological findings were supportive of the auditory findings. In light of these findings, we conclude that gentamicin-induced ototoxicity may be prevented by thymoquinone use in rats.

Tinnitus after cochlear implantation

OBJECTIVE The purpose of this study was to investigate properties of tinnitus which starts after cochlear implantation. Of the 17 adult patients in our cochlear implant group, four (23.5%) who had no pre-implantation tinnitus were eligible for the study. METHODS Each patient was requested to complete a short questionnaire regarding his or her experience with tinnitus. Tinnitus match test was performed for each patient by using an Interacoustic Clinical Audiometer (model AC40; Assens, Denmark). RESULTS Tinnitus match test revealed a tinnitus frequency of a 4KHz for three and of a 6KHz for one patient. Mean value of the loudness score was calculated as 17.5dB SL. CONCLUSIONS The results of this study emphasize the importance of counseling patients regarding risks of tinnitus after cochlear implantation.

Topical Application of Calcium Channel Blockers to Reduce the Progression of Experimentally Induced Myringosclerosis and Tympanosclerosis

Objectives: This study aimed to evaluate the ability of topically applied calcium channel blockers (diltiazem) to reduce the progression of experimentally induced myringosclerosis and tympanosclerosis.

Activation of vocal fold healing with topical vitamin A in rabbits

Conclusion. The results suggest that vitamin A can prevent scar formation in the vocal fold after surgery. Objectives. This study aimed to evaluate the effects of topically applied vitamin A on healing after vocal fold trauma. Materials and methods. Vocal folds of 20 adult rabbits were traumatized unilaterally. Ten of them were treated with topical application of vitamin A and the others served as controls. All animals were sacrificed after 10 days. Vocal folds were resected for analysis by light microscopy. Results. The untreated vocal folds showed extensive deposition of collagen and fibroblast on light microscopy and vocal folds treated with vitamin A showed less deposition. There was a significant difference between the two groups according to the percentage of collagen and fibroblasts in the lamina propria (p<0.01).

Comparison of Histopathological and CT Findings in Experimental Rabbit Sinusitis

The aim of this study was to investigate and compare histopathological and computerized tomographic (CT) findings of experimental acute sinusitis in an animal model. The noses of five healthy rabbits were inoculated with a gelatin sponge impregnated with a solution containing Staphylococcus aureus, and one healthy rabbit acted as the control. The animals were sacrificed on the tenth day, following the acquisition of paranasal CT scans. Specimens were obtained from the lateral nasal walls, and the ethmoid and maxillary sinuses of the animals for histopathological examination. Histopathological and CT findings were compared. Various degrees of epithelial disorganization, foci of ruptured epithelial cells, and inflammatory cell infiltration in the lamina propria were seen in the histopathological examinations of the five study rabbits, and mucosal thickening and soft tissue density were noted in their CTs. There was no correlation between the histopathological and CT findings. It was shown that CT did not reflect the acute changes in the sinus mucosa. Patients with chronic sinusitis must be evaluated for a chronic process. Computerized tomographic scans should not be obtained in acute sinusitis cases. In this way, both unnecessary radiation exposure and economic waste can be avoided.

Quercetine attenuates the gentamicin-induced ototoxicity in a rat model §

OBJECTIVES The aim of this study is to evaluate the protective role of quercetin in gentamicin-induced ototoxicity through an auditory brainstem response (ABR) test and a histopathological evaluation of the cochlea. METHODS In this study, 48 female adult Sprague-Dawley rats aged 20-22 weeks and weighing 200-250g were used. An ABR test was carried out on all rats prior to drug administration, after which, the rats were divided into four groups of 12 animals each. Drug administration was gentamicin 120mg/kg plus ethanol in group one; gentamicin 120mg/kg plus quercetin 15mg/kg in group two; quercetin 15mg/kg in group three; and ethanol in group four. The drugs were administered intraperitoneally once a day for two weeks, and the ABR test was repeated after drug administration. Subsequently, the rats were sacrificed and their cochleae were dissected and examined histopathologically. RESULTS There was no significant difference between the pre-treatment ABR measurement values of the groups. However, a significant increase was detected in the ABR values in the group of rats that were administered gentamicin plus ethanol, while no statistically significant increase was found in the ABR values in the groups administered with gentamicin plus quercetin; quercetin alone; and ethanol alone. The number of TUNEL positive cells in the inner and outer hair cells in the Corti organ was found to be fewer, and Caspase 3 and 9 expressions were found to be weaker in the group receiving gentamicin plus quercetin than in the group receiving gentamicin plus ethanol. CONCLUSIONS Auditory function was detected to be significantly protected and apoptotic cells were found to be decreased when quercetin was administered together with gentamicin. From these results it was concluded that quercetin, a powerful antioxidant, attenuates ABR thresholds and histopathological lesions in the cochlea in gentamicin-induced ototoxicity in rats.

Tortuous internal carotid artery narrowing pyriform sinus: two cases

An elongation of the internal carotid artery should be classified as a tortuosity or a kink. Tortuosity of the carotid artery is rarely seen in otolaryngologic practice. In videolaryngoscopic examination, bilateral pyriform sinus narrowing was found in one patient and unilateral pyriform sinus narrowing in the other patient. Computed tomographic scans showed tortuous internal carotid artery in both patients. Awareness of the possible internal carotid artery tortuosity is very important to prevent serious complications during laryngeal and pharyngeal surgical procedures.