Sudden Sensorineural Hearing Loss

Sudden hearing loss (SHL) is a common disease in the daily practice of ear-nose-throat (ENT) and audiology clinics. It is usually defined as a sensorineural type hearing loss of 30 dB or greater in three contiguous frequencies. Although several factors were suggested for the etiology of SHL, in most of the cases, no cause could be detected and they were diagnosed as idiopathic cases. Although certain specific treatments might be applied in patients with known etiology, corticosteroids are the main component in the treatment of idiopathic SHL. Many experts and centers have developed different treatment protocols with similar approaches. SHL is considered as an emergency in ENT, as it may cause a permanent loss in hair cells, if it is not treated or the treatment is not initiated at the right time. For patients, who did not or partially benefit from the initial treatment, different salvage treatment protocols had been developed. As SHL severely affects the patient’s quality of life, its diagnosis and treatment should be thoroughly deliberated

Evaluation of Patients with Post-Tonsillectomy Bleeding in a Second-Degree State Hospital Our Patients with Post-Tonsillectomy Bleeding

Aim: Investigation of features of patients with post-tonsillectomy bleeding and evaluation of clinical approach to those patients in a second-degree state hospital. Methods: In this retrospective study we evaluated records of 322 patients who had undergone onsillectomy in the Department of Otolaryngology (ENT) at Babaeski State Hospital, a second-degree state hospital between March 2009 and December 2012. The median age of the subjects was 19.8 (5-45) years. Results: A total of 18 patients (5.5%, 11 female, 7 male) had reported post tonsillectomy bleeding. Two patients had primary (11%), 16 (89%) had secondary bleeding. Admittance days of secondary bleeding patients were recorded (two at the 3rd, two at the 4th, six at the 5th, one at the 6th, four at the 7th and one at the 10th days, post-operatively). Bleeding was controlled in 4 patients using conservative methods. In 14 patients, bleeding was brought under control in the operating room. External carotid artery ligation was not performed in any patient. Conclusion: Tonsillectomy is a common ENT operation. The most important and life-threatening complication of this operation is bleeding. Investigating the clinical features of patients with post-tonsillectomy bleeding may help us in taking appropriate precautions to reduce the incidence of this complication. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 1-4

Diagnostic value of repeated Dix-Hallpike and roll maneuvers in benign paroxysmal positional vertigo

Abstract Introduction: Benign Paroxysmal Positional Vertigo (BPPV) is the most common peripheral vestibular disorder. The Dix-Hallpike and Roll maneuvers are used to diagnose BPPV. Objective: This study aims to investigate the diagnostic value of repeated Dix-Hallpike and Roll maneuvers in BPPV. Methods: We performed Dix-Hallpike and roll maneuvers in patients who admitted with peripheral vertigo anamnesis and met our criteria. The present study consists of 207 patients ranging in age from 16 to 70 (52.67 ± 10.67). We conducted the same maneuvers sequentially one more time in patients with negative results. We detected patients who had negative results in first maneuver and later developed symptom and nystagmus. We evaluated post-treatment success and patient satisfaction by performing Dizziness Handicap Inventory (DHI) at first admittance and two weeks after treatment in all patients with BPPV. Results: Of a total of 207 patients, we diagnosed 139 in first maneuver. We diagnosed 28 more patients in sequentially performed maneuvers. The remaining 40 patients were referred to imaging. There was a significant difference between pre- and post-treatment DHI scores in patients with BPPV (p < 0.001). Conclusion: Performing the diagnostic maneuvers only one more time in vertigo patients in the first clinical evaluation increases the diagnosis success in BPPV. Canalith repositioning maneuvers are effective and satisfactory treatment methods in BPPV

Comparison of temporalis fascia muscle and full-thickness cartilage grafts in type 1 pediatric tympanoplasties

AbstractIntroductionVarious graft materials have been used to close tympanic membrane perforations. In the literature, there are few studies in pediatric populations comparing different graft materials. To our knowledge, there is no reported study that measured the thickness of the tragal cartilage in pediatric tympanoplasties. The tragal cartilage is not of uniform thickness in every patient.ObjectiveTo compare anatomical and functional outcomes of temporalis fascia muscle and full-thickness tragal cartilage in type 1 pediatric tympanoplasties.MethodsIn total, 78 patients (38 males, 40 females; average age 10.02±1.98 years; range, 7–18 years) who underwent type 1 tympanoplasties in our clinic were included. Demographics, anatomical, and functional outcomes were collected. Temporalis fascia muscle and tragal cartilage were used as graft materials. Tragal cartilage was used without thinning, and the thickness of tragal cartilage was measured using a micrometer. Anatomical and functional outcomes of cartilage and fascia were compared. Audiometric results comparing the cartilage and fascia groups were conducted at 6 months, and we continued to follow the patients to 1 year after surgery. An intact graft and an air-bone gap≤20dB were regarded as a surgical success. Results with a p-value<0.05 were considered statistically significant.ResultsThe graft success rate was 92.1% for the cartilage group compared with 65.0% for the temporal fascia group. In the fascia group, the preoperative air-bone gap was 33.68±11.44 dB and postoperative air-bone gap was 24.25±12.68dB. In the cartilage group, the preoperative air-bone gap was 35.68±12.94dB and postoperative air-bone gap was 26.11±12.87dB. The anatomical success rate in the cartilage group was significantly better than that for the fascia group (p<0.01). There was no statistically significant difference in functional outcomes between the fascia and cartilage groups (p>0.05). The average thickness of tragal cartilage in the pediatric population was 0.693±0.094mm in males and 0.687±0.058 mm in females.ConclusionsOur data suggest that the anatomical success rate for a cartilage tympanoplasty was higher than for a fascia tympanoplasty. Functional results with cartilage were not different than with fascia, even though we did not thin the tragal cartilage. However, further studies should focus on the interaction between the thickness of the tragal cartilage and the tympanoplasty success rate

Comparison of temporalis fascia muscle and full-thickness cartilage grafts in type 1 pediatric tympanoplasties

Abstract Introduction: Various graft materials have been used to close tympanic membrane perforations. In the literature, there are few studies in pediatric populations comparing different graft materials. To our knowledge, there is no reported study that measured the thickness of the tragal cartilage in pediatric tympanoplasties. The tragal cartilage is not of uniform thickness in every patient. Objective: To compare anatomical and functional outcomes of temporalis fascia muscle and full-thickness tragal cartilage in type 1 pediatric tympanoplasties. Methods: In total, 78 patients (38 males, 40 females; average age 10.02 ± 1.98 years; range, 7-18 years) who underwent type 1 tympanoplasties in our clinic were included. Demographics, anatomical, and functional outcomes were collected. Temporalis fascia muscle and tragal cartilage were used as graft materials. Tragal cartilage was used without thinning, and the thickness of tragal cartilage was measured using a micrometer. Anatomical and functional outcomes of cartilage and fascia were compared. Audiometric results comparing the cartilage and fascia groups were conducted at 6 months, and we continued to follow the patients to 1 year after surgery. An intact graft and an air-bone gap ≤ 20 dB were regarded as a surgical success. Results with a p-value 0.05). The average thickness of tragal cartilage in the pediatric population was 0.693 ± 0.094 mm in males and 0.687 ± 0.058 mm in females. Conclusions: Our data suggest that the anatomical success rate for a cartilage tympanoplasty was higher than for a fascia tympanoplasty. Functional results with cartilage were not different than with fascia, even though we did not thin the tragal cartilage. However, further studies should focus on the interaction between the thickness of the tragal cartilage and the tympanoplasty success rate

Is the Monocyte/HDL Ratio a Prognostic Marker of Idiopathic Sudden Hearing Loss?

Objective: In this study, our aim was to investigate whether Monocyte/HDL ratio is a marker of the prognosis of the idiopathic sudden hearing loss (ISHL). Study design: Retrospective, case-control clinical trial. Materials and Methods: 45 patients, who were diagnosed with idiopathic sudden hearing loss and were treated with the same therapy regime and 47 healthy volunteers, who applied to the hospital for routine controls and had audiological and laboratory examination between March 2014 and December 2015, were included in the study. Monocyte/HDL ratios of the patients in the study and control groups were calculated from the results of the blood counts and biochemical analysis. Additionally, the study group was divided into two sub-groups regarding their responses (responders and non-responders) to the treatment determined by the audiological examination, which was carried out after 3 months according to the Siegel criteria. The Monocyte/HDL ratios between the groups were statistically evaluated. Results: There was no statistically significant difference between the MHRs of the study and control groups (p=0.574). However, the MHR was significantly higher in the non-responders’ group compared with the responders’ group, although they were treated with the same therapy regimen (p=0.005). Conclusion: There was no difference in MHRs between study and control groups. However, as MHR was higher in the patients with good prognosis compared with the patients with bad prognosis, we believe that regarding the ISHL, MHR is not a predictive value but might have prognostic marker