Does Type 2 Diabetes Mellitus Affect the Healing of Bell's Palsy in Adults?

Objectives: Bell's palsy (BP) is defined as an acute facial weakness of unknown cause. Many factors affecting the healing of BP have been identified; 1 factor commonly considered relevant is the presence of type 2 diabetes mellitus. Our aim was to investigate the effects of diabetes on the healing of BP. Methods: Sixty patients with BP were followed up for 1 to 3 years and were divided into 2 groups, those with and those without type 2 diabetes. All were prescribed prednisone (initially 1 mg/kg per day, with a tapered dose reduction) and acyclovir (200 mg orally every 4 h, 5 times daily, for 5 days). Their recovery times were compared. Results: The healing times of the patients with and without diabetes did not differ. Conclusions: Diabetes does not affect the severity, recovery rate from or healing of BP. © 2017 Diabetes CanadaObjectifs: La paralysie de Bell (PB) se caractérise par une faiblesse faciale soudaine dont la cause est inconnue. Parmi les nombreux facteurs qui nuisent à la guérison de la PB, le facteur généralement jugé pertinent est la présence du diabète sucré de type 2. Notre objectif était d'examiner les répercussions du diabète sur la guérison de la PB. Méthodes: Nous avons suivi 60 patients atteints de PB durant 1 à 3 ans et les avons répartis en 2 groupes : les patients atteints du diabète de type 2 et les patients non atteints. Tous se sont fait prescrire de la prednisone (ordonnance initiale de 1 mg/kg par jour, suivie d'une réduction progressive de la dose) et de l'acyclovir (200 mg par voie orale toutes les 4 heures, 5 fois par jour, durant 5 jours). Nous avons comparé leur vitesse de guérison. Résultats: La vitesse de guérison des patients diabétiques ou non diabétiques ne différait pas. Conclusions: Le diabète n'a pas de répercussions sur la gravité le taux de rétablissement ou la guérison de la PB

The effects of surgery type and different ossiculoplasty materials on the hearing results in cholesteatoma surgery

To investigate the effects of surgery type [intact canal wall (ICW) or canal wall down (CWD) mastoidectomy] and different ossiculoplasty materials on hearing outcome in single-staged cholesteatoma surgery. A retrospective case–control study. A total of 116 cases (97 adults, 29 children) underwent surgery, including ossiculoplasty, between 2012 and 2015 for cholesteatoma. Patients who had undergone surgery for the first time, and whose grafts were successful, were included in the study. Patients with adhesive otitis media, unsuccessful grafts, revision and recurrent cases, radical mastoidectomy, and craniofacial anomalies were excluded. Audiogram examinations of the enrolled patients were performed 3–6 months after surgery, and the audiometric results were analyzed according to the criteria of the American Academy of Otolaryngology, Head and Neck Surgery. All ossiculoplasties were performed during the first operation. The preoperative average air–bone gap (ABG) of the patients was decreased from 31.37 ± 10.1 to 27.42 ± 10.4 dB; this decrease was found to be highly significant (p = 0.0001). Concerning the ICW technique, statistical evaluation of the hearing gain at frequencies of 500, 1000, and 2000 Hz, as well as the mean frequency, showed a high level of significance. Improvement at 4000 Hz was not found to be statistically significant. When the ABGs at 500, 1000, 2000, and 4000 Hz, and the mean frequency in patients with an hydroxyapatite-partial ossicular replacement prosthesis (HA-PORP) or autograft-partial ossicular replacement prosthesis (APORP), were evaluated, it was found that, at 4000 Hz, the APORP significantly reduced the ABG (p = 0.02). No significant difference was determined between patients with the hydroxyapatite-total ossicular replacement prosthesis (HA-TORP) and those with the autograft-total ossicular replacement prosthesis (ATORP) (p = 0.565). Although the use of the malleus as an APORP was found to be less effective than other autografts, the degree of advantage of using the incus, malleus, cortical bone, and cartilage did not significantly differ between materials (p = 0.152). Despite the effects of the incus, malleus, and cortical bone not differing in terms of the postoperative ABG (p = 0.160), incus usage was highly beneficial for hearing gain (p = 0.009). Despite CWD tympanoplasty affecting all frequencies, it has a particularly negative effect on the hearing threshold at 1000 Hz. In patients with partial ossicular replacement, autogenous grafts are more successful in restoring hearing at high frequencies, particularly at 4000 Hz. Although autogenous materials do not differ in terms of partial replacement effectiveness, the incus has been shown to be most effective for total replacement. © 2016, Springer-Verlag Berlin Heidelberg

Difficult septal deviation cases: open or closed technique? [Casos difíceis de desvio septal: técnica aberta ou fechada?]

Introduction The aim of this study is to compare the functional aspects of open technique (OTS) and endonasal septoplasty (ENS) in “difficult septal deviation cases”. Methods 60 patients with severe nasal obstruction from S-shaped deformities, multiple deformities, high deviations etc. were included in the study. The OTS was used in 30 patients and the ENS was performed in 30 patients. The Nasal Obstruction Symptom Evaluation (NOSE) scale was administered preoperatively and at first month following surgery. Patients were also evaluated for pain postoperatively with Visual Analog Scale (VAS). Results The mean NOSE score was decreased 62.5–11.0 in the OTS group and 61.3–21.33 in the ENS group. Improvement of the symptoms following the two surgical techniques is similar and no statistically significant difference was found between both techniques. Also there was no statistically significant difference in postoperative pain between the OTS and ENS groups evaluated by VAS. Conclusion ENS is as successful as the OTS in management difficult septal deviation cases. In patients with severe septal deformities type of the surgical technique should be selected according to the surgeon's experience and the patient's preference. © 201

Role of Chlamydia pneumoniae and Helicobacteria pylori in the development of tympanosclerosis

The etiology of tympanosclerosis (TS) is not known, but TS commonly develops secondary to acute and chronic otitis media (COM). Since calcification process in TS resembles that of atherosclerosis (AS), pathogens that are related to pathogenesis of AS may be involved in development of TS. This prospective and controlled study, performed at a tertiary referral center, investigated a possible relationship between the presence of Chlamydia (C.) pneumoniae and Helicobacter (H.) pylori and the development of a tympanosclerotic plaque. The presence of C. pneumoniae was examined in the surgical specimens of 62 patients (29 females and 33 males; age range 10–70 years, mean age 30.8 ± 13.3 years), including 30 patients with TS, 14 patients with cholesteatoma, and 18 patients with chronic suppurative otitis media (CSOM). The presence of H. pylori was examined in the surgical specimens of 88 patients (41 females and 47 males; age range 6–70 years, mean age 32.5 ± 14.8 years), including 35 patients with TS, 22 patients with cholesteatoma, 20 patients with CSOM, and 11 patients with otosclerosis. Tympanosclerotic plaques and control specimens from the cholesteatoma, polypoid mucosa, or mucosal portion of the perforations and stapes supra structure were examined for the presence of H. pylori and/or C. pneumoniae using real-time polymerase chain reaction analysis. The analysis demonstrated that specimens from the tympanosclerotic plaques and the other types of COM were all negative for C. pneumoniae and H. pylori. An association between C. pneumoniae or H. pylori infection and the development of TS or other types of COM could not be established. © 2015, Springer-Verlag Berlin Heidelberg