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Sacculocolic reflex in patients with dementia: is it possible to use it for early diagnosis?

Alzheimer disease (AD) is a progressive, irreversible entity associated with behavioral changes, memory loss and disturbance of daily life activities. Current diagnostic tools can detect neuronal degeneration in AD only after irreversible damage that already existed. Vestibular evoked myogenic potentials (VEMP) test utilizes the sacculocolic reflex arc and has been used in neuro-otology practice for many years. In this study, we aim to determine if VEMP can be used for diagnostic purposes at the earliest stages of AD. Twenty patients with AD and ten patients with mild cognitive impairment were enrolled in this study. Control group was 30 healthy volunteers with no neurological or otological diseases. Abnormal VEMP responses were found in most of the patients at different stages of AD. VEMP test may be used for early diagnosis of AD. Also, it may provide a novel advancement in understanding of pathophysiology of this disease.

Investigation of the Presence of Biofilms in Chronic Suppurative Otitis Media, Nonsuppurative Otitis Media, and Chronic Otitis Media with Cholesteatoma by Scanning Electron Microscopy

Objective. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma. Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients. Methods. The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM). Results. Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples. Conclusion. In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.

Effect of grapefruit juice on bioavailability of montelukast

The aim of this study was to investigate possible interactions between grapefruit juice and montelukast for up to 4 hours.

Patient-reported outcomes after endonasal rhinoplasty for the long nose.

BackgroundThe long nose with an inferiorly rotated tip commonly results from a discrepancy between tip support and the downward forces of long septum, long upper lateral cartilage, and elongated lower lateral cartilage. Although many techniques have been described for surgical correction, very few studies were designed to include patient-reported outcomes. ObjectiveThe purpose of this study was to introduce our current management of long nose with drooping tips as well as to present the patient-reported outcomes of our case series of endonasal rhinoplasties. MethodsThis study prospectively analyzed 121 patients who underwent rhinoplasty for the correction of long nose with drooping tips. Study participants completed both a baseline questionnaire before the rhinoplasty operation and a postsurgical patient questionnaire 12 months following the operation, including the European QOL Questionnaire and Rhinoplasty Outcomes Evaluation Questionnaire. ResultsMean values corresponding to the European QOL Questionnaire visual analog scale score significantly increased after surgery compared with baseline (P < 0.01). Mean values corresponding to self-care (P < 0.01), usual activities (P < 0.05), discomfort (P < 0.01), and anxiety (P < 0.01) showed significant decrease after surgery. A general and significant improvement of the mean Rhinoplasty Outcomes Evaluation Questionnaire scores by rhinoplasty increased from 20.14 ± 7.38 to 82.05 ± 12.8 (P < 0.01). ConclusionsResection of the caudal portion of upper lateral cartilage may correct aesthetic problems in patients with long nose with a drooping tip in which a reduction in the width and the length of middle third of the nose is required. This study suggested an efficient method for aesthetic correction of long nose with the improved patient-reported outcomes.

Computed tomographic findings of X-linked deafness: a spectrum from child to mother, from young to old, from boy to girl, from mixed to sudden hearing loss.

Purpose Congenital mixed hearing loss associated with fixed stapes footplate is a rare disorder transmitted through X-linked inheritance. The purpose of this study was to report the radiologic findings of X-linked deafness with middle ear anomalies in affected children and young patients and in carrier women. Materials and Methods The computed tomographic and audiometric findings of 7 subjects (4 affected children and young patients, 1 of whom is a girl; 2 carrier mothers; and a man who presented with sudden hearing loss) from different families were analyzed. Results Computed tomography showed bulbous dilatation of the fundi of the internal auditory canals, incomplete bony separation between the basal turn of the cochleas and the lateral ends of the internal auditory canal, deficiency of the modiolus, enlarged first part of the facial nerve, and dilatation of the superior and the inferior vestibular nerve canal and the singular canal. Besides these characteristic findings, dilatation of the vestibular aqueduct was seen except in the man. Middle ear anomalies including oval and/or round window and/or stapes abnormalities were also detected in three affected patients. The carrier mothers had milder forms of some characteristic findings. Conclusions Because of the risks of stapes surgery in X-linked deafness, recognition of the characteristic imaging features of these disorders is important. Especially in young patients with mixed hearing loss, temporal bone computed tomography should be performed before stapes surgery to avoid the complication of stapes gusher. Middle ear anomalies might be highly associated with X-linked deafness.

Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer.

OBJECTIVE The incidence of thyroid gland invasion in patients with advanced laryngeal cancer was reported to be 0-50%. However there is a controversy in necessity and extent of routine thyroidectomy in these patients due to the difficulty in diagnosis of tumor invasion to thyroid gland and the risk of possible postoperative hypothyroidism and hypocalcemia. METHODS The medical files of 47 patients who underwent thyroidectomy as part of surgical treatment for advanced laryngeal cancer were reviewed. RESULTS Fourty-four (93.6%) patients underwent hemithyroidectomy, 3 (6.3%) patients underwent total thyroidectomy. Thyroid gland invasion was found in 2 (4.2%) patients. Hypothyroidism occurred in 15 (31.9%) patients, and their hormone levels were regulated with medical treatment during follow-up. Hypocalcemia was not found in any patients. CONCLUSION We recommend that at least a hemithyroidectomy should be performed in patients with advanced laryngeal cancer, if they have any predictive factor (subglottic extension more than 1cm, invasion of paraglottic space, thyroid cartilage, cricoid cartilage and prelaryngeal tissue detected by radiological examination) for thyroid gland invasion.

Survival of diced and block cartilage grafts in combination with injectable calcium hydroxylapatite

Dorsal nasal irregularities after trauma, and various procedures such as excessive nasal hump resection, are major problems for patients who have undergone rhinoplasty. Many grafts have been described for the correction of dorsal nasal irregularities. In this study, we used an injectable implant, in combination with diced or block cartilage grafts, to test the efficacy of injectable calcium hydroxylapatite on the survival of diced or block cartilage grafts.

Occupational safety threats among dental personnel and related risk factors.

Abstract Occupational diseases are primarily considered to be important health problems for individuals with occupations in heavy industry fields. Although dentists work in very clean and elegant offices, they are frequently exposed to various chemicals and high-intensity, sound-producing instruments, such as compressors and aerators. In our study, we aimed to investigate the risk for occupational hearing loss of dental personnel, by performing pure-tone audiometry in 40 dentists and comparing the results with those of healthy individuals. We also sampled the nasal mucosa to investigate the effects of occupational chemicals on the nasal mucosa of the dentists. The pure-tone audiometric thresholds at 5 different frequencies (1000, 2000, 4000, 6000, and 8000 Hz) and working time were evaluated as potential risk factors. The pure-tone audiometric results (as decibels) at each frequency and the median values for each side (right and left ears) were significantly higher for dentists than for the control group (P < 0.05). The pure-tone audiometric results did not significantly differ between the women and men in the study group (P > 0.05). The findings in the nasal mucosa (goblet cell hyperplasia, neutrophil/eosinophil/basophil distribution, metaplasia, dysplasia, premalignant or malignant cells) were similar in the study and control groups (P > 0.05). In conclusion, our study indicated that high-intensity, sound-producing equipment is an important occupational threat for dentists, whereas chemical agents have minimal hazardous effects.

Vocal fold hyperplastic lesions: an evaluation of surgical outcome with videolaryngostroboscopy.

BACKGROUND Vocal fold hyperplastic lesions are premalignant lesions that can be treated effectively by removal of the lesions surgically. AIMS The aim of this study was to discuss the success of surgery in patients with vocal fold hyperplastic lesions in terms of preserving vibratory function by comparing the preoperative and postoperative videolaryngostroboscopy findings. STUDY DESIGN The medical charts and videolaryngostroboscopic recordings of patients diagnosed with hyperplastic lesions on the vocal folds were reviewed retrospectively. METHODS Twenty seven patients with unilateral lesions who underwent type1 subepithelial cordectomy were enrolled in the study. The videolaryngostroboscopic recordings were evaluated by three raters who were not the operating surgeon and who were blinded to the histology of patients. To evaluate the videolaryngostroboscopic findings, a form, which is a modification of criteria described by Hirano and Bless, was used. Preoperative and 6th month postoperative videolaryngostroboscopic recordings were compared with each other and with recordings of the control group, which included 50 healthy volunteers. RESULTS All videolaryngostroboscopic findings, except false cord vibration, were significantly improved after surgery. CONCLUSION The principle of vocal fold surgery in patients with benign lesions is to preserve the vibratory tissue. This principle also applies to patients with hyperplastic lesions that are premalignant. The hydrodissection technique may be beneficial for this purpose.

Evaluation of the Vestibular System and Etiology in Children with Unilateral Sensorineural Hearing Loss.

OBJECTIVE The aim of this study was to evaluate the vestibular system of children with unilateral sensorineural hearing loss (USNHL), investigate the etiological factors of USNHL and analyze whether a genetic predisposition exists. MATERIALS AND METHODS Thirty-three children aged less than 18 years with USNHL, who visited the ear, nose, and throat (ENT) department between January 2004 and December 2012, were included in this study. Cases with conductive hearing loss were excluded from the study. The patients were subjected to etiologic, genetic, and ophthalmologic evaluation; radiologic imaging; electronystagmography (ENG); and vestibular evoked myogenic potential (VEMP) tests. The control group, which included 25 healthy children (13 males and 12 females), had undergone audiological assessment and were subjected to ENG and VEMP tests. RESULTS All of the patients had severe-to-profound hearing loss. Mumps immunoglobulin G was positive in 22 (66.7%) of 33 patients. The 35delG mutation was not found in any of the patients. All of the patients underwent temporal computed tomography (CT) and magnetic resonance imaging (MRI). Inner ear anomaly was present in 51.5% of the patients. Overall, 21 of 31 ENG patients had canal paresis in the affected ear. The VEMP response was absent on the affected side in three patients. The n23 latency average of the patient group was longer than that of the control group. CONCLUSION Because USNHL causes irreversible problems in children, early diagnosis and auditory rehabilitation are very important. As USNHL is accompanied by inner ear anomaly, children with USNHL should undergo temporal bone CT and MRI. To evaluate the vestibular system, ENG and VEMP are non-invasive and diagnostic tests.