Murat Topdag

The effect of etanercept and methylprednisolone on functional recovery of the facial nerve after crush injury.

Objective To establish whether etanercept, a TNF-&agr; antagonist, is an alternative and effective treatment on facial nerve after crush injury. Method Fifty-four rats underwent exposure of the left main trunk of the facial nerve followed by a standard crush injury. Animals were randomly divided into 3 groups: control group, methylprednisolone-treated group, and etanercept-treated group. All these groups were divided into 2 subgroups; animals were sacrificed on the 4th day after facial crush injury in the first subgroup and on the 28th day in the second subgroup. Functional recovery of vibrissae movement, eye blink reflex, and vibrissae orientation was measured on a 3-point scale (1 = no recovery, 2 = partial recovery, and 3 = complete recovery) during the recovery process. Facial nerve, from the main trunk at the stylomastoid foramen to the zygomatic, buccal, and marginal branches, were dissected and postfixed in the same fixative. The paraffin sections were studied with macrophage marker, GAP-43 and T Cell Marker. Results Animals receiving etanercept demonstrated significantly better functional recovery compared with control and methylprednisolone-treated animals. The etanercept-treated group showed highest GAP-43 immunoreactivity in the nerves. After the macrophage marker and T cell marker staining, the etanercept and methylprednisolone groups demonstrated statistically significant difference compared with the control group (p < 0.001). Conclusion The present study demonstrates accelerated functional recovery associated with etanercept treatment after facial nerve crush injury in rats.

Possible Protective Effect of Sertraline against Cisplatin-Induced Ototoxicity: An Experimental Study

Background/Objective. Cisplatin is a widely used chemotherapeutic agent, but its ototoxicity side effect can occur in the majority of patients. Lots of agents were tried to prevent this, but there is not a routine treatment modality yet. The aim of this study was to evaluate the otoprotective effect of sertraline, which is an antidepressant with neuroprotective effects, against cisplatin, in rats. Design. Experimental animal study. Material and Methods. Forty-eight rats were randomly separated in two groups as groups I and II. Group I was identified as the control group and only a single dose of intraperitoneal cisplatin was administered. In group II, in addition to cisplatin, sertraline was administered to the rats through an oral cannula for ten-day period. Distortion product otoacoustic emission measurements were performed at the first day and the 10th day. Results. When the ototoxicity rates after cisplatin in group I and group II in distortion product otoacoustic emission measurements were compared, it was statistically significantly lower in group II in frequencies of 5652, 6165, 6726, 7336, and 7996 Hz (P < 0.05). Conclusion. Sertraline seems to have a protective effect on cisplatin ototoxicity and could be used to prevent the ototoxicity and also to treat the depression that occurred in cancer patients together.

Comparing audiological test results obtained from a sound processor attached to a Softband with direct and magnetic passive bone conduction hearing implant systems.

AbstractThe aim of this study was to compare audiological test results obtained from a sound processor (SP) attached to a Softband with those obtained from direct (abutment connection) bone conduction implant systems and magnetic passive bone conduction implant systems with different magnet strengths on patients implanted at our clinic. Twenty-four patients who were implanted with either an abutment or magnetic bone conduction implant system between January 2012 and December 2014 were analyzed for hearing results, such as free-field hearing thresholds, direct bone conduction hearing thresholds, and speech discrimination scores with aided and unaided conditions Both magnetic and direct osseointegrated bone conduction implant systems, as well as the Softband system, provide good hearing outcomes when compared with unaided performance; however, the abutment connection system gives better hearing thresholds in the higher frequencies. No significant difference in hearing gain was found between the Softband system, magnet 5, and magnet used by the patient. Magnetic and direct bone conduction hearing implant systems are both effective for rehabilitation of conductive and mixed hearing loss when conventional hearing aids cannot be used. However, patients with high-frequency hearing loss may be better suited to an abutment connection system if they are not satisfied with high-frequency hearing gains provided via the trial Softband system preoperatively and should be counseled accordingly.

The Healing Effects of Autologous Mucosal Grafts in Experimentally Injured Rabbit Maxillary Sinuses

Objectives Healing processes of the nose and paranasal sinuses are quite complex, and poorly understood. In this study, we aimed to compare the effect of mucosal autologous grafts on the degenerated rabbit maxillary sinus mucosa with spontaneous wound healing. It is hypothesized that mucosal grafts will enhance ciliogenesis and improve the morphology of regenerated cilia. Methods Ten female New Zealand rabbits were included in the study. They underwent external maxillary sinus surgery through a transcutaneous approach. A total of 20 maxillary sinuses were randomly divided into 2 groups: ‘spontaneous healing group’ and ‘autologous graft group.’ The animals were sacrificed at the 14th day after the surgery. Scanning electron microscope (SEM), and light microscope were used for the evaluation. Results Cellular composition of the graft group is better than the spontaneous healing group. The graft group had larger areas covered with ciliary epithelium than the spontaneous healing group, and the mean length of the cilias were also longer. Additionally, there were wider cilia with abnormal morphology areas in the spontaneous healing group. Conclusion In our opinion, covering of the denuded areas with a graft improves re-epithelization, and may prevent the early complications after sinus surgeries.

The effect of memantine on functional recovery of the facial nerve after crush injury

The objective of this study is to establish whether memantine is an alternative and effective treatment on facial nerve recovery after crush injury, and also to analyze the effective doses of this promising agent. This is a randomized controlled animal study. 40 rats underwent crush injury to left main trunk of the facial nerve, and divided into 4 groups; (1) control (saline treated), (2) 5-mg/kg memantine, (3) 10-mg/kg memantine, and (4) 20-mg/kg memantine group. Facial nerve functions were evaluated by eye reflex, and whisker movement compared to the unaffected side. They were scored on a 3-point scale. On day 28, the rats were sacrificed, and the facial nerves were dissected. The paraffin sections were studied with caspase-3 immunostaining. According to statistical data, the recovery in Group 4 began significantly earlier than the other groups on the basis of restoring eye blink reflexes and whisker movement. Groups 2 and 3 showed faster recovery than Group 1 on the basis of whisker movement. The caspase-3 positive staining was rarely detected in all groups. The Kruskal–Wallis test revealed that Group 4 showed fewer apoptotic cells than other groups; this was statistically significant. However, the Mann–Whitney U test with the Bonferroni correction did not reveal any significant difference between the groups. In conclusion, this study revealed that memantine acted to restore facial nerve functions, and accelerate recovery after facial nerve injury by inhibiting apoptosis.

Evaluation of the effect of nasal dorsal skin cooling on nasal mucosa by acoustic rhinometry

BACKGROUND The use of cold nasal packs on the nose and nape of the neck is currently recommended for patients with epistaxis as this is thought to induce reflex nasal vasoconstriction, which decreases the bleeding. There have been a few investigations on the effect of cold compress application to the nose, but none of these focused specifically on nasal cooling of the skin of the nose. METHODS Acoustic rhinometry was performed to obtain baseline measurements. Nasal dorsal skin was then cooled with two ice packs that were held on the left and right side of the nose for a total of 10 minutes by the subjects. The rhinometry measurements were taken at the time of initial application (baseline), and after 5 and 10 minutes of ice pack application. RESULTS Comparisons of the first and second minimal cross-sectional area values, and total nasal cavity volume measurements revealed no statistical differences. CONCLUSION The results of this study indicate that one should be sceptical about the efficiency of cold compress application, which is frequently used in clinical practice in cases with epistaxis.

Mean platelet volume: is it a parameter associated with idiopathic sensorineural hearing loss?

cancer, auto-immune diseases, asthma, and the use of antithrombotic agents. For the analysis of MPV and the other parameters, vials containing tripotassium ethylenediaminetetraacetic acid (EDtA) were used. the analyses were performed immediately after phlebotomy to prevent in vitro platelet activation. the SPSS statistical software program (SPSS, version 16.0 for windows; SPSS Inc., Chicago, Illinois, USA) was used to perform statistical calculations. there was no significant difference between the two groups regarding age or gender distribution. the mean values of platelet count, PDW, MPV, white blood cell (WBC) counts and levels of hemoglobin were similar between the groups (table 1). With our results, we cannot state that MPV is an associated parameter with IShL. there are very limited studies in the literature about the association between IShL and MPV counts with different results [2, 3]. Karli et al. [4] studied 92 patients equally to the Editor,

A Comparison Study of Partial Ossicular Reconstruction Prosthesis (PORP) Placement under the Malleus or Tympanic Membrane Graft in the Presence of the Malleus

OBJECTIVE The aim of this study was to compare the hearing results of embedding the partial ossicular reconstruction prosthesis (PORP) underneath the malleus with the malleus relocation technique and tympanic membrane graft in the presence of the malleus. MATERIALS AND METHODS A retrospective review of patient charts and audiometric results in a tertiary referral center was conducted. In total, 83 patients who underwent intact canal tympanoplasty with mastoidectomy between 2010 and 2015 were included and divided into two different groups: malleus assembly to the stapes head (MASH) and tympanic membrane assembly to the stapes head (TASH). Pre- and postoperative audiometric results were assessed. The air-bone gap (ABG) and hearing gains were evaluated according to the groups. RESULTS In MASH, 86.1% (n=31) of the patients were received successful surgery and the postoperative average ABG was 10.41 dB. In TASH, 82.9% (n=39) of the patients were considered successful and the postoperative ABG was 13.27 dB. According to the overall data, MASH was more statistically successful than TASH, and hearing gains at 500 Hz (p<0.036), 2000 Hz (p<0.031), and PTA (p<0.22) were statistically significant better in the MASH group. CONCLUSION Malleus relocation is a successful technique with the presence of the malleus and provides better hearing outcomes than direct placement under the tympanomeatal flap. Both malleus- and tympanomeatal flap-linked groups were successful, but the malleus-linked group showed better ABGs.

A Simple Closure Technic for Tracheoesophageal Puncture Failures

AbstractTracheosephageal puncture is the one of the most favorable methods, and widely used by physicians for voice reconstruction after total laryngectomy. Intractable leakages from the tracheosephageal punctures are the most common complication, and management of these fistulas is still troublesome for the patients and physicians. Local surgical sutures, rotational flaps, injections are reported previously, but in this report the authors aimed to mention on a very simple method with silicone septal button. Insertion of a temporary silicone septal button may be well tolerated by patients and can help to manage this complication easily on exact indications. The authors discussed indications and long-term results of this method with different patients.

Laryngeal verruca vulgaris

Laryngeal verruca vulgaris is a rare disease of the larynx that is easily misdiagnosed as other laryngeal lesions. This article reports three patients with laryngeal verruca vulgaris and discusses the differential diagnosis of laryngeal verrucous lesions to avoid over treatment.