Levent Gürbüzler

The effectiveness of steroids for edema, ecchymosis, and intraoperative bleeding in rhinoplasty.

Background The aim of this study was to investigate the dose-related effectiveness of steroids on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open rhinoplasty with osteotomy. Methods Forty patients were divided into three groups: those in group 1 (n = 15) were given a single dose of 1-mg/kg intravenous (i.v.) methylprednisolone, those in group 2 (n = 15) were given a single dose of 3-mg/kg i.v. methylprednisolone preoperatively, and group 3 (n = 10) was the control group. Eyelid edema and periorbital soft-tissue ecchymosis were evaluated separately using a scale of 0–4. Results In groups using the steroid preoperatively, periorbital edema and ecchymosis were significantly lower compared with the control group (p < 0.05). No significant differences were seen clinically or statistically in preventing or reducing either the periorbital ecchymosis or the periorbital edema between groups 1 and 2. Also, there was no significant difference among the groups in terms of bleeding (p > 0.05). No complications with regard to the operation or steroid use were observed. Conclusion Our results support that steroids significantly decrease periorbital ecchymosis and periorbital edema in open rhinoplasty with osteotomy. Additionally, our results suggest that if the dose of steroids is adjusted according to body weight, there is no significant benefit in a single dose of 3 mg/kg of methylprednisolone over a lower dose of 1 mg/kg and there is no need for higher doses of methylprednisolone administration.

Investigating the Effect of Aromatherapy in Patients with Renal Colic

AIM The aim of the present study was to investigate the usefulness of rose essential oil as a supplementary and adjunctive therapy for the relief of renal colic, specifically because rose essential oil is soothing and can act as a muscle relaxant. MATERIALS Eighty patients who were diagnosed with renal colic in the emergency room were included in the study, with ages ranging from 19 to 64 years. Half of the patients (n=40) were treated with conventional therapy (diclofenac sodium, 75 mg intramuscularly) plus placebo (physiological serum, 0.9% NaCl), while the other half (n=40) were given aromatherapy (rose essential oil) in addition to conventional therapy. In each patient, the severity of pain was evaluated using the Visual Analog Scale (VAS) (0 [no pain] to 10 [very severe pain]). FINDINGS The VAS values prior to the start of therapy, and 10 and 30 minutes after therapy were 8.18 ± 1.36, 5.60 ± 2.02, and 3.75 ± 2.08 for the conventional therapy plus placebo group, while for the conventional therapy plus aromatherapy group, the VAS values were 8.63 ± 1.03, 4.25 ± 1.72, and 1.08 ± 1.07, respectively. There was no statistically significant difference between the starting VAS values of the two groups, but the VAS values 10 or 30 minutes after the initiation of therapy were statistically lower in the group that received conventional therapy plus aromatherapy. CONCLUSION This study demonstrated that rose essential oil therapy in addition to conventional therapy effectively reduces renal colic pain.

The comparison of bacteremia and amount of bleeding during adenotonsillectomy

OBJECTIVE Adenoidectomies and/or tonsillectomies are among the most frequently performed otolaryngological surgical procedures.The goals of this study were to investigate the relationship between the amount of bleeding and bacteremia during adenoidectomy and/or tonsillectomy procedures. METHODS Seventy-eight patients who underwent tonsillectomy with or without adenoidectomy and adenoidectomy with or without tube insertion were included in the study. Patients with severe chronic underlying diseases (including cardiovascular disorders, renal or hepatic disease, or immunodeficiency) were excluded from study, as were those who had suffered an acute episode of respiratory infection or had received antibiotics for any reason within three weeks prior to the operation. The amount of bleeding was measured and recorded for each patient during the surgery. Preoperative blood cultures immediately after the induction of anesthesia and postoperative blood cultures 20 min after the operation were collected. RESULTS While none of the blood cultures taken preoperatively was positive for any organisms, the cultures obtained postoperatively were positive in 16 (20.5%) of 78 patients who underwent tonsillectomy with or without adenoidectomy and adenoidectomy with or without tube insertion, and bacteremia was more frequent among those with greater amount of bleeding during the surgery. CONCLUSION The results of this study suggest that although bacteremia had no clinical consequences in patients, it should be kept in mind that patients with greater amount of bleeding are at higher risk for developing bacteremia and it may produce vital results in patients at risk.

Castleman's Disease of the Parotid Gland: A Case Report

Castlemans disease (CD) is a very rare disorder characterized by non‐neoplastic growths in lymph nodes in any body regions, although over 60% of cases are located in the mediastinum. The head and neck is the second most commonly involved site, with up to 14% of cases. Of these, nearly 85% are located in the neck. These lesions rarely occur in the salivary glands. Clinically, CD can be divided into unicentric and multicentric forms. We report an unusual case with unicentric CD presenting as a parotid tumor in a 34‐year‐old woman. The lesion was found coincidentally during routine cranial magnetic resonance imaging in the absence of symptoms such as swelling or a mass in the parotid region.

Evaluation of cochlear function using transient evoked otoacoustic emission in children with Familial Mediterranean Fever

OBJECTIVE The aim of this study was to investigate cochlear functions in children with Familial Mediterranean Fever (FMF). METHODS Fifty-six FMF patients (112 ears) and 30 healthy control subjects (60 ears) were included in the study. Transient evoked otoacoustic emission (TEOAE) was investigated. Numerical measurements of TEOAE, except the correlation percentage (%), included response amplitude (dB) and signal/noise (SN) ratio. RESULTS There was no statistically significant difference in age and sex in the two groups. Mean TEOAE correlation percentage, signal/noise ratio, TEOAE amplitudes in 1, 1.5, 2, 3 and 4 Hz frequency values were not different between the two groups (p>0.05). CONCLUSIONS In this study using the TEOAE test, we found that FMF did not cause outer cell hair damage in children. In the literature, there is no study on outer cell hair damage in children or adults with FMF, so this is the first investigational study.

Impact of adenotonsillectomy on ADHD and nocturnal enuresis in children with chronic adenotonsillar hypertrophy.

OBJECTIVE Children with chronic adenotonsillar hypertrophy (CAH) are more likely to have symptoms of attention deficit hyperactivity disorder (ADHD) and enuresis nocturna (EN) and benefit from surgery. The aim of this study was to evaluate the effect of adenotonsillectomy on ADHD and EN symptoms in children with CAH. STUDY DESIGN Cross-sectional study was conducted. SETTING Parent-based questionnaires. METHODS Parents of children with CAH were given Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV) and Nocturnal Enuresis Questionnaire (NEQ) before and six months after adenotonsillectomy. Inattention (IA) and hyperactivity-impulsivity (HI) subscores of T-DSM-IV were used in the present study. The rates of ADHD and EN were compared before and after surgery. RESULTS A total of 75 children between 5 and 16 years of age and their families participated in the study. All 75 families completed T-DSM-IV and NEQ. Mean IA (5.69 ± 4.88 versus 4.46 ± 4.40) and HI (6.53 ± 5.60 versus 5.93 ± 5.45) scores as well as total ADHD scores (12.22 ± 8.99 versus 10.42 ± 8.70) improved significantly after surgery. This significance was found to be statistically important (p<0.05). Furthermore 26 of the subjects were diagnosed with primer EN before adenotonsillectomy and 14 of these enuretic children had total remission six months after surgery. The frequency of EN dropped from 34.7% to 16.0% and this remission rate was found to be statistically significant (p<0.05). CONCLUSION Children with CAH had high frequency of ADHD and EN symptoms in the present study. Adenotonsillectomy was found to be effective in improvement of these symptoms.

Mean platelet volume as an inflammatory marker of chronic otitis media with effusion

OBJECTIVES Our aim was to investigate whether mean platelet volume (MPV) may be utilized as an inflammatory marker of chronic otitis media with effusion (COME). METHODS Routine hemogram tests were performed preoperatively for 51 patients diagnosed with COME that were to receive ventilation tube insertion. Hemogram tests were performed on age-matched and sex-matched healthy controls (n=54). Moreover, by performing a chart review, white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), hematocrit (Hct), platelet (PLT), and mean platelet volume (MPV) values were compared between COME patients and controls. RESULTS A total of 51 COME patients were included in the study and 45.1% were male. The control group had 54 individuals and 51.9% were male. MPV (p=0.493) and platelet levels (p=0.336) for COME patients group were generally borderline higher than those measured for the control group, but this difference was not statistically significant. CONCLUSION No statistically significant differences were identified between pediatric patients diagnosed with COME and healthy controls in terms of WBC, RBC, Hb, Hct, PLT and MPV levels.

Jab1 expression is associated with TGF-β1 signaling in chronic rhinosinusitis and nasal polyposis

Jab1, which is a fifth component of COP9 signalosome, plays an essential role in cell growth and proliferation. Jab1 is also shown to regulate transforming growth factor-beta (TGF-β) signaling in carcinoma cells. The aim of the present study was to investigate the expression and the correlation of Jab1 and TGF-β1 in chronic rhinosinusitis and nasal polyposis. Here, we show the elevated expression of Jab1 and TGF-β1 in diseased mucosa without nasal polyps and a correlation between Jab1 and TGF-β1 expression. Forty-six samples (26 patients with nasal polyps, 10 patients with chronic rhinosinusitis and 10 control subjects) were included to this study. Immunohistochemistry and Western blotting were performed for the assessment of Jab1 and TGF-β1 localization and the expression of proteins. Double staining of both proteins showed that Jab1 and TGF-β1 were colocalized in the epithelium, inflammatory cells and the vascular endothelium of nasal mucosa. There was a significant increase in the expression of TGF-β1 and Jab1 in patients without nasal polyps and a significant decrease in patients with nasal polyps compared to controls. Moreover, correlation was detected between the expression of Jab1 and TGF-β1 in chronic rhinosinusitis and nasal polyposis. Our results demonstrate that chronic rhinosinusitis is characterized by elevated expression of Jab1 and TGF-β1 compared to nasal polyposis and Jab1 may play a vital role in the pathogenesis of both chronic rhinosinusitis and nasal polyposis.

Manganese-superoxide dismutase and glutathione peroxidase 1 polymorphisms in recurrent tonsillitis and tonsillar hypertrophy

OBJECTIVES To investigate the association of manganese-superoxide dismutase and glutathione peroxidase 1 polymorphisms with susceptibility to recurrent tonsillitis and tonsillar hypertrophy. METHODS The study consisted of 103 patients with recurrent tonsillitis, 105 patients with tonsillar hypertrophy and 106 control subjects with similar age and sex. Genomic DNA was extracted from peripheral leukocytes of whole blood which were obtained from all patients and control subjects. Genotyping was performed to identify MnSOD Ala-9Val and GPx1 Pro198Leu polymorphisms by a method based on PCR amplification and detection of polymorphisms with hybridization probes labeled with fluorescent dyes. Genotype and allele frequencies were compared between patients with recurrent tonsillitis and tonsillar hypertrophy and 106 healthy control subjects. RESULTS The genotype distribution of the MnSOD Ala-9Val single nucleotide polymorphism was significantly different for the controls and the recurrent tonsillitis patients (P=0.009). Whereas, no significant difference was found between the patients with tonsillar hypertrophy and the control group (P=0.369). The frequency of the MnSOD CC genotype was lower, and that of the T allele was significantly higher, in recurrent tonsillitis patients than in control subjects. In addition, the frequency of tonsillitis was significantly higher in recurrent tonsillitis patients with the MnSOD Ala-9Val polymorphism than the patients with wild-type (P=0.008). Also, no significant difference was found between patient groups and control subjects in the distribution of the genotype and allele frequency of the GPx1 Pro198Leu single nucleotide polymorphism. CONCLUSIONS The MnSOD Ala-9Val polymorphism causes susceptibility to recurrent tonsillitis in Turkish children. And we suggest that there may be a possible relation between local and recurrent infections or inflammation of the tonsillar tissue and the MnSOD Ala-9Val single nucleotide polymorphism in pediatric patients with RT.

The Anti-Inflammatory and Antioxidant Effects of Curcumin in Middle Ear Infection.

Aim:To investigate and analyze the anti-inflammatory and antioxidant efficacy of curcumin in experimentally induced middle ear infection. Method:Twenty-four Wistar albino rats with otomicroscopic examination findings within normal limits were included in the study. Study groups were established after Streptococcus pneumoniae was inoculated into the middle ear cavity of all rats. No medication was administered to Group 1, the control group. Group 2 was administered 50 mg/kg/day amoxicillin intraperitoneally. Group 3 was administered 50 mg/kg/day amoxicillin together with 30 mg/kg/day curcumin intraperitoneally. Blood specimens and temporal bones were collected on the 10th day of medication from the 22 rats in which acute otitis media developed. Serum glutathione peroxidase and superoxide dismutase activities and malondialdehyde levels were measured. Inflammatory cell infiltration, vascular proliferation, and epithelial proliferation were assessed histopathologically in middle ear mucosa specimens, and the results were compared among the groups. Results:Malondialdehyde levels in the group given curcumin were significantly lower than those of the control group, while serum glutathione peroxidase activity was also lower compared to that of the control group. No significant difference was observed among the groups in terms of superoxide dismutase activity. Although there were no significant findings in terms of histopathological data, epithelial proliferation in the groups receiving antibiotherapy was suppressed compared to the control group. Similarly, curcumin was observed to have a positive effect on inflammatory cell infiltration. No significant changes were observed in terms of vascular proliferation. Conclusion:With its wide and safe dose range, curcumin represents grounds for optimism in terms of anti-inflammatory treatment in acute otitis media.