K. Murat Ozcan

Comparison of glass ionomer cement and incus interposition in reconstruction of incus long process defects

The ossicles may be affected through the mass effect of the pathological tissue in chronic otitis media. Ossicular reconstruction may be accomplished using the patients’ own ossicles or with alloplastic materials. Glass ionomer ossiculoplasty is a fast, efficient, safe and cost-effective method and it has been used more frequently in recent years. Forty-six patients who had surgery for chronic otitis media were included in this study. All patients had an incus long process defect and a normal stapes superstructure. Ossicular reconstruction was performed using glass ionomer cement (GIC) (Ketac-Cem, Espe Dental AG, Seefeld, Germany) in 23 patients (group 1), while incus interposition was performed in other 23 patients (group 2). Preoperative and postoperative air pure tone averages of the group 1 patients were 42.8 and 35.2xa0dB, respectively (pxa0<xa00.01). These values were 42.9 and 34.5xa0dB in group 2 (pxa0<xa00.01). Two groups were similar with respect to postoperative hearing gain (pxa0>xa00.05). The air bone gap of group 1 was 27xa0dB preoperatively and 20.7xa0dB postoperatively. These values were 28.7 and 20.2xa0dB, respectively, in group 2. The closure of air bone gap was statistically significant in both the groups (pxa0<xa00.01, pxa0<xa00.01). The comparison of the mean gains of the air bone gap revealed no difference between the groups (pxa0>xa00.05). In conclusion, the use of both GIC ossiculoplasty and incus interposition are efficient methods for reconstruction of incus long process and one is not superior to the other. A larger study population may be useful for comparison of these methods.

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.

Comparison of the Surface and Core Bacteria in Tonsillar and Adenoid Tissue With Beta-Lactamase Production

Adenoidectomy and tonsillectomy, indicated for children with recurrent or persistent symptoms of infection or hypertrophy, are among the most frequent operations performed in children. This study was carried out for investigating the microbial flora of the tonsils and adenoids regarding to core and surface microorganisms and also pathogen microrganisms’ beta-lactamase production rate. Cultures were taken from the core and surface of tonsils and adenoids of the 91 patients at the time of the surgery for tonsillectomy and adenoidectomy. Aerobic and anaerobic cultures were inoculated and identified. Beta-lactamase production was detected also. The most frequently isolated aerobic microorganisms were Streptococcus viridans and Neisseria spp. The number of the microorganisms isolated from the tonsil core compared to the surface of the tonsils was found statistically insignificant (Pxa0>xa00.05). The number of the adenoid surface aerobic microorganisms was found higher from the adenoid core (Pxa0<xa00.05). The amount of adenoid and tonsil core anaerobic microorganisms were alike. The patients’ preoperative antibiotherapy whether using beta-lactam or beta-lactamase resistant were compared for beta-lactamase producing bacteria production and the number of beta-lactamase producing bacteria were found statistically insignificant (Pxa0>xa00.05). The togetherness of Staphylococcus aureus and other beta-lactamase producing bacteria was found statistically significant (Pxa0<xa00.05). This study demonstrates that there is polymicrobial aerobic-anaerobic flora in both adenoids and tonsils. There was a close relationship between the bacteriology of the tonsil and adenoid flora. Staphylococcus aureus and and other beta-lactamase producing bacteria may be responsible for treatment failures in patients with tonsillitis.

Incidence of hypothyroidism and its correlation with polysomnography findings in obstructive sleep apnea

The aim of this study is to investigate the thyroid functions and its correlation with polysomnography findings in obstructive sleep apnea patients. This study was conducted on 203 patients evaluated with the complaints of snoring, witnessed apnea and daytime sleepiness and established polysomnography (PSG) indication between May 2008 and August 2011. All patients’ nocturnal PSG recordings were carried out. The thyroid function was classified as euthyroid, subclinical hypothyroidism and clinical hypothyroidism after analyzing serum TSH and free T4 values. The correlation between the data obtained from PSG records and thyroid function values was statistically compared. Apnea hypopnea index obtained from PSG was in the range of 5.4–132.9/h, and mean value was 32.7/h. The lowest oxygen saturation level was in the range of 20–92xa0%, and the mean value was 76.4xa0%. According to PSG results, 55 patients (27.09xa0%) had mild obstructive sleep apnea syndrome (OSAS), 48 patients (23.65xa0%) had moderate OSAS and 100 patients (49.26xa0%) had severe OSAS. On evaluation of the thyroid function test results, 10.8xa0% (nxa0=xa022) of the patients were defined to have subclinical hypothyroidism and 1.97xa0% (nxa0=xa04) clinical hypothyroidism. We found a total of 12.77xa0% subclinical and clinical hypothyroidism in patients with OSAS. Though the incidence of hypothyroidism was pretty high in patients with OSA, there was no statistically significant correlation between thyroid functions and polysomnography findings. We suggest that evaluation of the thyroid functions is important and necessary in patients with OSAS. Polysomnography findings do not correlate statistically with thyroid function tests, addressing the need for thyroid screening for all OSAS patients.

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.

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.

Endoscopic resection of pleomorphic adenoma of the nasal septum.

Pleomorphic adenomas originating from the minor salivary glands are rare in the nasal cavity. Total surgical excision is the preferred treatment for pleomorphic adenomas. Lateral rhinotomy, midfacial degloving, transpalatal surgery and endoscopic surgery are among the surgical approaches. Endoscopic tumor removal produces less morbidity, reduces blood loss during surgery, decreases hospital stay, avoids external scars and excessive unnecessary resection, enables the surgeon to better visualize the tumor margins, and has a low recurrence rate. However, only 3 pleomorphic adenomas of the nasal septum have been removed by the endoscopic approach to date. In this paper we report on a case of pleomorphic adenoma of the nasal septum that was removed successfully by the endoscopic approach without any recurrences.

Prognostic effect of hyperbaric oxygen therapy starting time for sudden sensorineural hearing loss

Sudden sensorineural hearing loss is one of the otological emergencies whose pathogenesis is uncertain and associated with total or partial loss of hearing function. The aim of this study was to investigate whether the hyperbaric oxygen therapy starting time affects the management of sudden sensorineural hearing loss. Fifty-nine patients with sudden sensorineural hearing loss admitted to our clinic between 2008 and 2012 were retrospectively included in this study. All patients received hyperbaric oxygen therapy. In addition, each patient received intravenous piracetam and 37 patients received steroid therapy. Hyperbaric oxygen therapy was initiated between 1 and 7xa0days with 20 patients determined as Group A, between 8 and 14xa0days with 25 patients determined as Group B and between 15 and 28xa0days with 14 patients determined as Group C. Hearing gains of these three groups were statistically evaluated. Each of them showed statistically significant improvement. Lowest hearing gain was observed in Group C and the gain of this group was statistically less than the other two groups. There was no significant difference between the hearing gains of the Group A and Group B. Starting hyperbaric oxygen therapy in patients with sudden sensorineural hearing loss within the first 14xa0days has positive effect on the prognosis of the disease.

Investigation of SCGB3A1 (UGRP2) gene arrays in patients with nasal polyposis

The aim of the current study is to investigate the potential relationship between polymorphisms and nasal polyposis (NP) pathogenesis in the SCGB3A1 (UGRP2) gene, which is a member of the secretoglobin gene super family. Genotypic variations were studied by performing DNA sequencing in blood samples of 80 patients with NP and 70 healthy individuals to evaluate nucleotide changes and their positions that might be in the SCGB3A1 gene (promotor, splicing points, and exon distributions). In the SCGB3A1 gene, three single-nucleotide changes labeled IVS1−89 T>G, c. −183 G>T, IVS1−189 G>A were identified. IVS1−89 T>G and IVS1−189 G>A belong to the first intronic region of the gene, whereas c. −183 G>T was observed in the promoter region of the gene. The IVS1−89 T>G nucleotide change was observed in the patient and control groups, whereas c. −183 G>T and IVS1−189 G>A nucleotide changes were observed in the control group only. SCGB3A1 (IVS1−89) genotype frequencies between patients with NP and control group were not significantly different (pxa0=xa00.311). There was a statistically significant difference in the control group in comparison to patients with NP in terms of SCGB3A1 (c. −183 GT) and SCGB3A1 (IVS1−189 GA) frequency (pxa0=xa00.0045 and pxa0=xa00.009, respectively). The findings of the current study suggest that SCGB3A1−183 T and SCGB3A1 IVS1−189 A alleles might have a protective effect against NP, and that SCGB3A1 (−183 GT and IVS1−189 GA) genotypes should be studied in future population-based studies.