R. Ünal

Effects of otitis media with effusion on the vestibular system in children

Middle ear effusion has been considered the most common cause of vestibular disturbance in children. However, there have been only a few studies on vestibular disturbance in children with otitis media with effusion. We studied the vestibular systems of 30 children with otitis media with effusion aged 8 to 13 years and compared the results with 15 age- and sex-matched controls. A questionnaire relating to vestibular disturbance was given to patients and their parents. Spontaneous nystagmus and positional nystagmus were recorded by electronystagmography as diagnostic tests of the vestibular system. Rombergs and past-pointing tests were performed on children with otitis media with effusion and controls. After vestibular tests were completed, myringotomy was performed, and a ventilation tube was inserted. The questionnaire and the vestibular tests were repeated after the operation and during the first month after surgery. Our study showed that there was a history of vestibular disturbance in 33% of children with otitis media with effusion. Electronystagmography and Rombergs test findings demonstrated that 33% of the children had vestibular dysfunction (p >0.05). After myringotomy with ventilation tube insertion, vestibular test results returned to normal, and symptoms related to vestibular disturbance improved. These findings confirm the assumption that middle ear effusion may affect the vestibular system, which can be resolved after myringotomy with ventilation tube insertion. (Otolaryngol Head Neck Surg 1999;120:117-21.)

Comparison of computed tomography and magnetic resonance imaging in the diagnosis of parotid tumors

OBJECTIVE: The role of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of parotid tumors was investigated. METHODS: Forty patients with the clinical suspicion of a parotid mass underwent both CT and MRI of the parotid region. Two radiologists independently assessed the CT and MRI results with respect to tumor localization, tumor margin characteristics, and infiltration of surrounding tissue. Histopathologic specimens were obtained in all cases and correlated with the radiologic findings. RESULTS: The sensitivity and specificity of CT and MRI were nearly the same for tumor location, tumor margin, and tumor infiltration. CONCLUSION: The 2 imaging techniques provided the same information with respect to the presurgical planning and contribute to the diagnosis and therapy planning of parotid tumors. (Otolaryngol Head Neck Surg 2003;129:726-32.)

Repair of subtotal tympanic membrane perforations with Seprafilm

OBJECTIVES We studied the experimental use of Seprafilm, a sheet-like film form of hyaluronic acid, in the repair of subtotal perforations of the tympanic membrane (TM), and the durability of such repairs. METHOD The research was conducted on 42 Sprague-Dawley rats. Right TMs of all rats were subtotally and thermally perforated in the same fashion. Seprafilm was applied to the perforated TMs of the 21 rats comprising the experiment group. The perforated TMs of the remaining 21 rats, the control group, were left to heal spontaneously. RESULTS The mean healing times were recorded as 7.8 +/- 0.6 days for the Seprafilm group and 14.9 +/- 1.1 days for the control group (p < 0.001). CONCLUSIONS These results suggest that Seprafilm may be a possible first choice (before the decision to operate) in subtotal perforations, considering its easy application and patient follow-up.

Mean Platelet Volume: Is It a Predictive Parameter in The Diagnosis of Sudden Sensorineural Hearing Loss?

The mean platelet volume (MPV) is associated with increased platelet reactivity and increased atherothrombosis. High MPV values are a risk factor for thrombotic vascular diseases. Our aim was to investigate whether a relationship exists between sudden sensorineural hearing loss (SSHL) and a high MPV value. The records of 46 patients who were admitted to the ENT (ear nose throat) ward for SSHL and received medical treatment and 46 patients in a control group were retrospectively screened. The correlation among the levels of the MPV, the number of platelets, and SSHL were evaluated in the two groups. The ages, genders, and the platelet count values of the patients showed a normal distribution in both groups. No significant difference was found for the MPV values between the groups. The MPV is not a predictive parameter in the diagnosis of SSHL.

Changes in IGF-I, IGFBP-3 and ghrelin levels after adenotonsillectomy in children with sleep disordered breathing

OBJECTIVE The aim of this study was to determine the changes in insulin-like growth factor-I (IGF-I), insulin-like growth factor binding protein-3 (IGFBP-3) and ghrelin levels following adenotonsillectomy (T&A) in children with sleep disordered breathing (SDB). METHODS Forty children (mean age 4.85+/-2.15 years) clinically diagnosed with adenotonsillar hypertrophy (ATH) related SDB were enrolled. All children underwent T&A. Serum levels of IGF-I, IGFBP-3 and ghrelin were measured before and 6 months after T&A. RESULTS Serum levels of IGF-I and IGFBP-3 were significantly higher after T&A (p<0.001). Serum ghrelin levels showed a significant decrease after T&A (p<0.001). CONCLUSION Children with ATH related SDB who underwent T&A showed significant increases in IGF-I and IGFBP-3 levels indicating an increase in diurnal growth hormone secretion as well as a significant decrese in ghrelin levels indicating an increased oral food intake in the postoperative period.

Giant polypoid tumor of the esophagus

Abstract A patient with a giant polypoid tumor of the esophagus, measuring 22 cm in length is described in this report. The patient presented with cough attacks and respiratory distress. Diagnostic and therapeutic intervention required aggressive airway management, radiographic and endoscopic evaluation, and definitive surgical treatment. Benign esophageal tumors are rarely seen and originate from the upper third of esophagus, frequently close to the cricopharyngeus muscle. They may attain giant proportions. A variety of clinical presentations are described, the most serious being asphyxia secondary to laryngeal obstruction [1] . We observed a giant esophageal tumor which was interpreted as angiofibromyolipoma that caused laryngeal obstruction. We present the clinical picture and histopathological findings of the tumor.

The relationships between the clinical and polysomnographic findings and the olfactory function in patients with obstructive sleep apnea syndrome

PurposeThis study aimed to investigate the relationships between the clinical and polysomnographic findings and the olfactory test results in patients with obstructive sleep apnea syndrome (OSAS).MethodsFour groups were established: non-snoring controls (group 1), non-apneic snorers (group 2), mild–moderate OSAS (group 3), and severe OSAS (group 4). The polysomnographic findings, otorhinolaryngologic findings, Epworth Sleepiness Scale (ESS), and Sniffin’ Sticks olfactory test results of the four groups were compared. The relationships between the clinical data and the olfactory parameters were evaluated.ResultsGroup 4 had the worst odor identification and discrimination scores. Non-apneic snorers also had worse odor parameters compared with the non-snorer controls. A significant negative correlation was found among the ESS, apnea–hypopnea index (AHI), mean arterial oxygen saturation, and odor identification and discrimination. Significant negative correlations were found between the tongue and tongue base sizes and among all olfactory parameters.ConclusionOur study revealed olfactory dysfunction in patients with OSAS. A strong negative correlation between the olfactory parameters and the severity of sleep apnea was also found. Olfactory tests may be used to predict the presence and severity of OSAS in the future.

Evaluation of olfactory function in adults with primary hypothyroidism

Sufficient clinical data are not available on the effect of hypothyroidism on olfactory function in adults. In this study, we aimed to evaluate the olfactory function of adult patients diagnosed with primary hypothyroidism.

Validity of Acoustic Rhinometry in the Evaluation of Patients With Adenoid Hypertrophy

Abstract Reliability of acoustic rhinometry (AR) for preoperative diagnosis and decision of surgery in children with adenoid hypertrophy were investigated in this study. Fifty-five children who cannot tolerate nasal endoscopic examination were included. The AR was performed preoperatively and postoperatively 1 month later. The volume of distance between the 6th and 10th centimeters in rhinogram curve was calculated for evaluating the adenoid notch (AN) region. The volume of AN region was compared with each patient’s volume of the adenoid tissue removed with adenoidectomy. Whereas the median adenoid specimen volume was 2.0 (1.0–2.0) cm3 in 23 patients with complaint of nasal obstruction, median AN volumes in the rhinogram curve was 2.3 (0.8–5.2) cm3. All children whose preoperative nasopharyngeal volume was 4.2 cm3 or less had increased volume in the area representing the nasopharynx on rhinogram. We found a statistically significant relationship between the AN and the adenoid specimen volume (P = 0.000, r = 0.797). The sensitivity and specificity were found as 61.2% and 95.8%, respectively. We concluded that the children whose preoperative nasopharyngeal volumes were measured as 4.2 cm3 or less by AR could benefit more from adenoidectomy.

An evaluation of olfactory function in adults with gastro-esophageal reflux disease

Abstract Conclusion: To the best of the authors’ knowledge, this study is the first to evaluate the olfactory function of adult patients diagnosed with GERD. The results revealed that adults with GERD have diminished olfactory function. Objective: This study aimed to evaluate the olfactory abilities of subjects using the ‘Sniffin’ Sticks’ olfactory test. Methods: A total of 35 men and women aged 18–60 years with a diagnosis of GERD and 45 healthy controls were included in the study. The Sniffin’ Sticks olfactory test results of the two groups were compared, and the relationship between the study findings and the olfactory parameters was evaluated. Results: The odor threshold (10.1; 9.5, p = 0.016), odor identification (9.6; 8.1, p < 0.001), and odor discrimination (10.7; 8.9, p < 0.001) of the GERD group were significantly lower than those of the control group. A statistically significant positive correlation was detected between the accompanying chronic pharyngitis, chronic sinusitis, and odor parameters. A significant correlation was not detected between the laryngeal findings and the olfactory parameters.