Recovery of tinnitus and sensorineural hearing loss due to lysis of arachnoid adhesions in the posterior cranial fossa: Is there a novel etiology in neurotological disorders?

WOS: 000408247500032PubMed ID: 28816700We reported the recovery of sensorineural hearing loss and tinnitus in a 22-year-old man after complete removal of intracranial portion of jugular foramen schwannoma via the retrosigmoid approach. The aim of this case report was to present the excision of a large jugular foramen schwannoma via the retrosigmoid approach and to describe the improvement of sensorineural hearing loss related to arachnoid inflammations due to chronic arachnoiditis after suboccipital craniectomy. The recovery of sensorineural hearing loss and tinnitus after release of arachnoid adhesions may indicate the clinical significance of these adhesions or arachnoiditis, which should also be considered and investigated in the etiology of other neurotological diseases

Radiation Induced Sarcoma of Hypopharynx: A Case Report

Radiation-induced sarcoma in the head and neck is a long term rare complication of radiation therapy. The incidence of these sarcomas is, however, likely to increase due to progressive aging of the population combined with improved survival in head and neck cancer patients resulting from better treatment regimes. Diagnosis and management of this problem can be extremely challenging and the overall prognosis of radiation-induced sarcoma is worse than other types of sarcomas at a similar stage. Because of the proximity to vital structures and multifocality, management can be extremely difficult in many cases. This is the case of post radiation sarcoma of the hypopharynx radiated for supraglottic laryngeal carcinoma previously. Here, we wish to share the diagnosis and management strategy in these types of late complications after radiation

Effect of adenoidectomy / tonsillectomy on temporomandibular joint (TMJ) function and mouth opening in early period

Bu çalışmada, adenoidektomi ve/veya tonsillektomi yapılan hastalarda ameliyat sırasında kullanılan ağız ekartörüne bağlı olarak ağız açıklığı derecesinde ve temporomandibular eklemde (TME) etkilenme olup olmadığının dijital kumpas aleti kullanıla- rak değerlendirilmesi amaçlandı. Kasım 2015 - Kasım 2016 yılları arasında üçüncü basamak bir KBB kliniği tarafından ağız ekar- törü kullanılarak adenoidektomi ve/veya tonsillektomi ameliyatı yapılan 30 hasta (6-43 yaşları arası, 17’si erkek ve 13’ü kadın) ile, kontrol grubu olarak septoplasti ameliyatı olan 20 hasta (19- 47 yaşları arası, 12’si erkek ve 8’i kadın ) olmak üzere toplam 50 hastanın ağız çene açıklığı dijital kumpas aleti ile ameliyattan 1 saat önce, 4 saat sonra, 1 hafta sonra ve 1 ay sonra olmak üzere ölçüldü. Adenoidektomi ve/veya tonsillektomi yapılan hastalarda operasyon sonrası 4. saat, 1 hafta sonrası ve 1 ay sonrası ağız açıklığı ölçümlerindeki değişim istatistiksel olarak anlamlı bulun- muştur (p=0,001, p0,05). Her iki gruptaki ağız açıklığı ölçümlerinin yaş ile ilişkisi- ne bakıldığında; yaşla beraber ağız açıklığındaki artışın da %57,5 düzeyinde korelasyon gösterdiği saptanmıştır (r: 0,575, p=0,001, p0.05). There is 57.5% positive correlation betwe- en patients’ age, and range of mouth opening in two groups (r:0.575, p=0.001, p<0.01). As a conclusion; mouth opening and TMJ function might be effected by mouth gag in adenoidectomy / tonsillectomy surgeries depending on the duration of surgery and age of the patient. Small sample size and short follow-up period were limitations of the study

Protein expression levels and expression profiles of genes that play role in inflammation and apoptosis in nasal polyps

Nazal polipozis, sıklıkla lateral nazal duvar ve orta meadan kaynaklanan nazal poliplerin eşlik ettiği kronik rinosinüzit semptomları ile karakterize endoskopik ve tomografik yöntemlerle tanı koyulabilen kronik inflamatuar bir hastalıktır. Hastalığın sık olarak gözlenmesi, tedavi sonrası nüks oranının yüksek olması ve kişilerin sosyal hayatını oldukça etkilemesi nedeniyle günümüzde önemli bir hastalık grubunu teşkil etmektedir. Nazal polipozisin tedavisi hem medikal hem cerrahi yöntemlerle yapılmaktadır. Ancak, her iki tedavi sonrasında da bening bir hastalık olmasına rağmen nükslerle karşılaşılmaktadır. Bu durumun nedeninin hastalığın etiyopatogenezinin aydınlatılamamış ve bu nedenle uygun tedavi stratejileri benimsenmemiş olmasından kaynaklandığı düşünülmektedir. Nazal polipozis etiyolojik açıdan multifaktöriyel bir hastalıktır. Hem kişiye bağlı etkenler hem de çevresel etkenlerin birleşimiyle hastalık ortaya çıkmaktadır. Histopatolojik olarak incelendiğinde ise kronik inflamatuar bir zeminde gelişen mukozal hücrelerin hiperproliferasyonu ve polipleşmesiyle karşılaşılmaktadır. Bu nedenle günümüzde yapılan çalışmalarda nazal polip etiyopatogenezini aydınlatmak için bu basamaklar üzerine yoğunlaşılmaktadır. Günümüze kadar inflamasyon ve hücre proliferasyonunu tetikleyen birçok molekül nazal polip etiyolojisinde araştırılmış ve anlamlı sonuçlara erşilimiştir. Bizim çalışmamızda da, nazal polip ile ilişkili olabileceği düşünülen apoptoz yolaklarında düzenleyici olan ve sonuç olarak hücre proliferasyonuna yol açan ve inflamasyon basamaklarında rolü olduğu düşünülen proteinlerin ekspresyon analizleri yapılmıştır. CD11b, Beclin - 1, Galectin - 1 ve Caspase - 3 proteinlerinin ekspresyon düzeyleri ve ifadelenmeleri nazal polip dokularında incelenmiş ve kontrol grubu hastalarla karşılaştırılarak yorumlanmıştır. Sonuç olarak; CD11b molekülünün ekspresyonunda istatistiksel olarak anlamlı bir artış saptanmış ve inflamasyonda etkili bu proteinin nazal polipozis ile ilişkisi yorumlanmıştır. CD11b nin periferik dolaşımdan nazal mukozaya inflamatuar hücre göçüne ve bu hücrelerin adezyonuna yol açtığı düşünülmüştür. Bunun dışında; Caspase - 3 ve Beclin - 1 gibi apoptotik yolakta etkili olan proteinlerin ekspresyonlarının nazal polipli hastalarda istatistiksel olarak anlamlı şekilde azaldığı tespit edilmiştir. Nazal polip formasyonunda hiperproliferasyon sürecinde pro ve anti apoptoz mekanizmalarının ve bu mekanizmalardaki proteinlerin ilişkisi ortaya konulmuştur. Bunun yanısıra Galectin - 1 proteininin ekspresyonunda da istatistiksel olarak anlamlı olmasa da bir artış saptanmıştır. Bu bilgilerin ışığında nazal polipozis etiyopatogenezinde kronik inflamasyonun yanı sıra hiperproliferasyona yol açan anti apoptotik süreçlerin ilgili olabileceği düşünülmektedir.Nasal polyposis is a chronic inflammatory disease which is accompanied with nasal polyps that is arised from lateral nasal wall or middle meatus. It is diagnosed by history and physical management and is supported with endoscopic evaluation ve tomographic findings. It is very important disease group because of frequency, high recurrence rate despite of medical and surgical therapy, negative effects of social and economic life. Nasal polyposis is treated both medical and surgical treatment ways. Although nasal polyposis is a bening disease, recurrences can be seen frequently. It is thought that etiology of this disease remain unclear and so management is not enough for success in routine clinical practice. Nasal polyposis is a multifactorial disease when you think about the etiology of disease. Both personal and environmental factors are important in formation of nasal polyposis. There is a chronic inflammatory state and hiperproliferation of nasal mucosa and epithelium can be seen in microscopically. So, nowadays a lot of research activities point on these key steps of inflammation, apoptosis and hiperproliferation of cells. There are a lot of molecules that related to chronic inflammation and hiperproliferation of nasal mucosa, is described by current researchs. In our research, we analyze some proteins and their mRNA expression levels which are related with inflammation and apoptosis. CD11b, Beclin - 1, Galectin -1 and Caspase - 3 are examined and analyzed in nasal polyps and the results are compared with healthy mucosa of patients operated for septum deviation . In conclusion, CD11b mRNA expression level is increased in nasal polyps than controls and this level is statistically meaningful. Caspase - 3 and Beclin - 1 mRNA expression levels are decreased in nasal polyps. This result is also statiscally meaningful. It is thought that these proteins and their expression levels are related with nasal polyposis etiology. Galectin - 1 mRNA expression level is increased but this result is not statistically meaningful. We think that, nasal polyposis is formed because of chronic inflammation and hiperproliferation. Apoptotic mechanisms and immunologic inflammatory states effect the nasal polyposis formation

Surgical considerations and safety of cochlear implantation in otitis media with effusion

WOS: 000430035900005PubMed ID: 28756095Objective: To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Methods: Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Results: Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60 min (ranged from 28 to 75 min) in non-otitis media group, and 90 min (ranged from 50 to 135 min) in otitis media with effusion group (p 0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. Conclusion: There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells

Flexible CO2 laser treatment for subglottic stenosis

WOS: 000402750600071PubMed ID: 28277485Objectives: To assess the efficacy and safety of flexible fiber CO2 laser surgery for subglottic stenosis and to present retrospective experience of 14 patients treated with flexible fiber CO2 laser system. To determine the characteristics, management protocols, prognostic factors, and postoperative outcomes of the sample. Methods: Retrospective review of patients with subglottic stenosis undergoing flexible fiber CO2 laser surgery at the tertiary medical center. All demographic and clinical data were collected, radiologic and endoscopic evaluations were performed to assess the characteristics of stenosis. Myer-Cotton grading scale was used for classification of stenotic area. Results: All patients have subglottic stenosis due to intubation-related causes and inappropriate tracheostomy procedure. The duration of intubation period ranged from 15 days to 4 years; 11 patients have grade III stenosis according to Myer-Cotton system and there was cricoid involvement in 2 patients. The mean follow-up period was 5.2 months and postoperative decannulation was achieved in 10 patients (71.4%). Conclusions: Subglottic stenosis is the difficult situation to manage minimal invasively. Flexible fiber CO2 laser surgery is safe and effective in the management of properly selected patients and can be used as a first option for patients

Expression profiles of CD11b, galectin-1, beclin-1, and caspase-3 in nasal polyposis

Background/aim: Nasal polyposis is a chronic inflammatory disease affecting the paranasal sinuses and nasal mucosae. It is thought that genetic and molecular mechanisms in inflammatory and apoptotic pathways are the main factors in the etiopathogenesis of nasal polyposis. The aim of this study was to investigate the expression patterns of CD11b, galectin-1, beclin-1, and caspase-3 in nasal polyps. Materials and methods: The mRNA expression levels of CD11b, galectin-1, beclin-1, and caspase-3 protein and western blot analysis of caspase-3 protein were evaluated in inferior turbinate mucosae and nasal polyp tissues. Results: CD11b expression was markedly higher in nasal polyp tissues when compared to turbinate mucosae (5.5 times higher, P < 0.05). Expression of galectin-1 was not statistically higher in nasal polyp tissues when compared to the controls. Beclin-1 expression in nasal polyp tissues was lower than in controls (17 times lower, P < 0.05). Caspase-3 expression was significantly lower in nasal polyp tissues than in controls (5.5 times lower, P < 0.05). Conclusion: Inflammation, apoptosis, and hyperproliferation are the major cellular processes in nasal polyposis and these proteins may take part and play some important roles in formation of this disease and the targeting of new treatment protocols

The demographics and histopathological features of oral cavity cancers in Turkey

Background/aim: This study aimed to examine the demographics and histopathological features of oral cavity cancers (OCCs) managed in our clinic. Materials and methods: Patients who were diagnosed with OCCs in the Gazi University Otorhinolaryngology Department between the years 1993 and 2013 were retrospectively enrolled in the study. Surgical archive charts and pathology records were reviewed in detail regarding the anatomical and histopathological profiles of the tumors, as well as the demographic data of the patients. Results: Out of 230 patients with OCCs, the most common anatomic location and histopathological diagnosis were found to be the oral tongue (41.4\%) and squamous cell carcinoma (SCC) (84.3\%), respectively. A marked predominance of SCC was observed in all subsites of the oral cavity except the hard palate location. The mean age at presentation was 55.5 +/- 13.4 years (+/- SD). The male: female ratio was found to be 2.2:1. A male predominance was also present in all subsites except the retromolar trigon. Conclusion: OCCs particularly concern the elderly population with a male predominance. The most common location and histopathological type are the oral tongue and SCC, respectively

Association of conductive hearing loss with the structural changes in the organ of corti

Objective: The aim of the study was to evaluate the association of conductive hearing loss (CHL) with the structural changes in the organ of Corti. Methods: Twenty ears of 10 healthy adult Wistar albino rats were included in the study. The right ears (n = 10) of the animals served as controls (group 1), and no surgical intervention was performed in these ears. A tympanic membrane perforation without annulus removal was performed under operative microscope on the left ears (n = 5) in 5 of 10 animals (group 2). A tympanic membrane perforation with annulus removal was performed under operative microscope on the left ears (n = 5) of the remaining 5 animals (group 3). Auditory brainstem response testing was performed in the animals before the interventions. After 3 months, the animals were sacrificed, their temporal bones were removed, and inner ears were investigated using scanning electron microscopy (SEM). The organ of Corti was evaluated from the cochlear base to apex in the modiolar axis, and the parameters were scored semiquantitatively. Results: In group 1, the pre- and post-intervention hearing thresholds were similar (p > 0.05). In group 2, a hearing decrease of at least 5 dB was encountered in all test frequencies (p > 0.05). In group 3, at the frequency range of 2-32 kHz, there was a significant hearing loss after 3 months (p < 0.01). After 3 months, the hearing thresholds in group 2 and 3 were higher than group 1 (p < 0.01). The hearing threshold in group 3 was higher than group 2 (p < 0.01). On SEM evaluation, the general cell morphology and stereocilia of the outer hair cells were preserved in all segments of the cochlea in group 1 with a mean SEM score of 0.2. There was segmental degeneration in the general cell morphology and outer hair cells in group 2 with a mean SEM score of 2.2. There was widespread degeneration in the general cell morphology and outer hair cells in group 3 with a mean SEM score of 3.2. The SEM scores of group 2 and 3 were significantly higher than group 1 (p < 0.05). The SEM scores of group 3 were significantly higher than group 2 (p < 0.05). Conclusion: CHL may be associated with an inner ear damage. The severity of damage appears to be associated with severity and duration of CHL. Early correction of CHL is advocated in order to reverse or prevent progression of the inner ear damage, which will enhance the success rates of hearing restoration surgeries. Subjective differences and compliance of the hearing aid users may be due to the impact of CHL on inner ear structures.Medical Specialty Education Commission of Turkiy