Yuksel Toplu

Anthropometric growth study of normal human auricle

OBJECTIVE The aim of this study was to reveal the anthropometric growth of auricula from birth to the age of 18 years and to bring out the dynamics of ear growth. MATERIAL AND METHODS A total of 1552 children in 50 groups were evaluated. Six surface measurements were performed directly on the right auricle of the subjects: the length from the superaurale to subaurale, the width from the tragus to helix, the width from the tragus to antihelix, the conchal depth, the height from the helix to mastoid at superauraler level, and the height from the helix to mastoid at tragal level. The frequency of prominent ear deformity and the degree of attachment of the lobule were also noted. RESULTS Vertical auricular growth was complete in girls at the age of 11 and in boys at the age of 12, whereas the auricular width from the tragus to helix, the height from the helix to mastoid at superauraler level and the height from the helix to mastoid at tragal level were found almost complete at the age of 6. The auricular width from the tragus to antihelix attained its full size at 6 months for girls and 12 months for boys. The conchal depth was found almost complete at the age of 5 in both sexes. The incidence of prominent ear deformity and attached lobule was 9.8 and 26.5%, respectively. CONCLUSIONS Different ear growth pattern and maturation size from previously published reports are obtained in different populations. There is still need for future studies comparing populations with different social and ethnic background to interpret common knowledge about the size of the ear. This study gives dimensional information and the growth pattern of the auricle, and therefore may reveal important implications for the adequate timing of the surgical treatment of auricular deformity.

Internal nasal valve: revisited with objective facts.

OBJECTIVES: Comprehensive examination of the internal nasal valve (INV) using objective methods. STUDY DESIGN AND SETTING: In this prospective study, 248 nasal cavities were examined by nasal endoscopy, acoustic rhinometry (ARM), and rhinomanometry (RMM). RESULTS: Endoscopic examination allowed to suggest a novel classification of INV: convex, concave, sharp angle, blunt angle, twisted caudal border, and angle occupied by the septal body. The INV angle occupied with septal body type was found to have increased nasal resistances compared with the sharp-angled internal nasal valve type (P < 0.05). Convex, concave, and sharp-angle types of INV angles were found different (P < 0.01). CONCLUSIONS: INV should be examined objectively before any INV surgery. A novel description of the INV configurations and their effects on nasal respiration found in this study may increase our understanding and lead surgical approaches more adequately. A surgical attempt to augment INV angle value may impact positively on nasal resistance. EBM rating: C-4

Clinical results and health-related quality of life in otoplasty patients using cartilage resection and suturing methods

In this study, we evaluated clinical results and health-related quality of life in our otoplasty patients in whom we used cartilage resection method (CRM) and suturing method (SM). A total of 132 ears of 77 patients (36 males, 41 females; mean age 14.6 ± 6.4) between January 2006 and February 2013 were included in this study. Patients were divided into two groups according to the type of surgery performed: Group 1 was the cartilage resection group (CRG) and Group 2 was the suturing group (SG). CRM was performed on 64 ears of 37 patients (unilateral in 10 cases and bilateral in 27 cases), and SM was performed on 68 ears of 40 patients (unilateral in 12 cases and bilateral in 28 cases). The parameters of the groups, including operation time, measurements of the auriculocephalic distances, complication rates, postoperative satisfaction rates, and health-related quality of life were compared. Mean operation time was 53.7 ± 7.8 min in the CRG and 44.9 ± 4.2 min in the SG (P ≤ 0.05). Mean postoperative auriculocephalic measurements were similar in both groups. The complications were more frequent in the CRG (10/37 patients, 27.02 %) than in the SG (3/40 patients, 7.54 %) with statistically significant difference (P < 0.05). Three months after the surgery, visual analog scale increased from 25 (preoperatively) to 70 in the CRG and from 30 to 90 in the SG, with a statistically significant difference (P < 0.05). Patients’ health-related quality of life showed a statistically significant increase after the operation in both groups (P < 0.05). CRM and SM are effective treatment methods with high success rates for patients with prominent ears. In the selected cases, SM seems to represent a better option for otoplasty than CRM because clinical results, cosmetic outcomes, patient satisfaction, and health-related quality of life scores were better than CRM.

The mean platelet volume levels in children with PFAPA syndrome.

OBJECTIVES To assess whether mean platelet volume (MPV) can be used as a marker in the differential diagnosis of periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome. METHODS The leucocyte counts, thrombocyte counts, and MPV values of 57 children with PFAPA syndrome were recorded during an attack and an attack free period. These values were compared with a healthy control group of 55 individuals. Demographic features of the PFAPA patients group including age, gender and age of first attack, age at diagnosis, frequency of attacks, serum reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were also recorded. RESULTS The MPV values of the children with PFAPA both during an attack and attack free period were found significantly lower than the MPV values of healthy control group (p<0.001). Also, the MPV values of the children with PFAPA during an attack were significantly lower than in attack free periods (p<0.001). The MPV values showed no correlation with leucocytes counts, CRP, and ESR during attacks. A 8.30fl [area under the curve (AUC: 0.965)] optimal cutoff value of MPV with a sensitivity of 89.5% and specificity of 92.8% was determined during an attack in children with PFAPA. CONCLUSIONS The MPV values during an attack and attack free period of patients with PFAPA is lower than in controls. The MPV values may be used as a marker in the differential diagnosis of PFAPA syndrome but more studies are needed and they should be prospective in order to validate this data.

An unusual cause of conductive hearing loss: bilateral complete meatal obstruction following otoplasty.

There are many causes of conductive hearing loss. Otoplasty is a commonly performed cosmetic surgery to correction for prominent ear. We discussed an unusual cause of conductive hearing loss, bilateral complete meatal obstruction following otoplasty, in this article. This complication was probably due to unsuitable placement of the Furnas sutures. In the literature, as a cause of conductive hearing loss, unilateral complete meatal obstruction has been described rarely, but bilateral complete obstruction has not been defined. Hearing loss recovered completely after revision surgery. Correct diagnosis, accurate preoperative or perioperative examination, choice of the proper technique and surgeon experience are essential for avoiding inadequate results or complications of otoplasty. The surgeon should be aware of the cartilage elasticity and suture techniques to avoid this complication.

Fungus ball in concha bullosa: an unusual cause of retro-orbital pain.

Fungus ball in the concha bullosa is an extremely rare disease. We described a case of the fungus ball in the concha bullosa in a 22-year-old woman. Preoperative diagnosis was based on nasal endoscopy and computed tomography scanning. The patient was endoscopically operated on. The examination of the removed material was reported as fungal infection. This case was found worth writing because of the location of the concha bullosa and its rare occurrence in this location.

The role of individual biological rhythm differences and sleep quality on tinnitus symptom severity

Tinnitus is a common health complaint in the general population and many personal and psychological factors play a role in the induction and exacerbation of it. Hence, the aim of the present study was to assess, for the first time in the literature, whether individuals’ biological rhythms differences, i.e. morningness vs. eveningness, have an impact on the severity of tinnitus. We included 93 tinnitus patients who did not have any underlying systemic or metabolic diseases. The morningness–eveningness questionnaire was used to determine chronotypes and the Pittsburgh Sleep Quality Index was used to assess subjective sleep quality. A Visual Analog Scale was used to assess the severity of tinnitus, using a scale from 0 (no tinnitus) to 100 (most severe tinnitus). The evening-type patients reported more severe tinnitus symptoms than morning-types. These findings suggest that individual chronobiological factors affect subjective estimates of tinnitus severity.

All concha bullosa: an undefined abnormality of the lateral nasal wall.

Pneumatization of the turbinates, are the anatomic variations of lateral nasal wall. Turbinate pneumatization, refers to the existence of air cell inside the turbinates. Pneumatization of the middle turbinate is common, whereas rare in the superior and especially inferior turbinate. In this report we presented a case who has bilaterally pneumatization of all conchas.

Acquired capillary hemangioma with features of tufted angioma in the external auditory canal.

Tufted angiomas may occur in the head and neck region, but the external auditory canal is a previously undefined localization. There are only 19 cases of hemangiomas reported in this unique localization. However, this case is the first capillary hemangioma of the tufted variant being reported with a recurrence after 7 years after surgical excision in a 47-year-old male patient.

The Effect of Dexpanthenol on Ototoxicity Induced by Cisplatin

Objectives This study was aimed to investigate the protective effects of dexpanthenol (Dxp) on against cisplatin-induced ototoxicity. Methods To examine this effect, distortion product otoacoustic emissions (DPOAEs) measurements and serum levels of oxidative and antioxidant status (including malondialdehyde, superoxide dismutase, catalase, glutathione, glutathione peroxidase, total oxidant status, total antioxidant status, and oxidative stress index) were evaluated. Thirty-two adult female Wistar albino rats were randomly divided into 4 equal groups; control (K), cisplatin (C), cisplatin plus Dxp (CD), and Dxp (D). In all groups DPOAEs measurements, between 996 and 10,078 Hz as DPOAEs and input/output functions, were performed on days 0, 1th, 5th, and 12th. Prior to death, the last DPOAEs measurements and blood samples were taken. Results In the C group, statistically significant differences were detected at all frequencies between 0 and 5 days and 0 and 12 days measurements (P<0.05). Serum level of oxidant and antioxidant status were detected statistically significantly changed in this group versus K group (P<0.05). Contrary to the C group, in the CD group hearing ability was seen largely preserved at many frequencies and serum levels of all biochemical parameters were shifted toward normal values, similar to the K group. No significant differences were detected in the either D or K group’s measurements. Conclusion According to these results, Dxp may prevent cisplatin-induced ototoxicity.