Endoscope-Assisted Cochlear Implantation

Objectives Our aim was to present our endoscope-assisted cochlear implantation (CI) technique, in which the middle ear landmarks were identified through the facial recess exposure by using an endoscopic view without elevating the tympanic annulus. The secondary goal was to assess whether the situation of difficult surgical exposure could be predicted by evaluating preoperative axial computed tomography (CT) examinations. Methods CT examinations and surgical outcomes of endoscope-assisted CI surgeries were analyzed. Results A total of 179 CI operations performed in 27 adults (15.1%) and 152 children (84.9%) were retrospectively evaluated. It was found that in 14 cases (7.8%), endoscopic examination contributed substantially in identifying the round window (RW) membrane correctly. Endoscopic identification of the RW through the posterior tympanotomy enabled us to perform a straightforward surgery in all these cases, without the need for switching to a bony cochleostomy or alternative surgical techniques. The difficulty in the surgical exposure was predicted preoperatively by examining the axial CT scans in six of the 14 cases (42.8%) for which endoscopic assistance was necessary in order to identify the RW correctly. Conclusion The main benefit of endoscope-assisted CI is the improved visibility leading to a panoramic view of the RW region. The implementation of transfacial recess endoscopic examination into the conventional CI technique is helpful to avoid problems during surgical orientation. However, the difficulty in the surgical exposure of the RW cannot be reliably predicted by the subjective evaluation of preoperative CT scans and more studies are needed to obtain reliable criteria

3D Model to Understand the Diagnosis and Treatment of Horizontal Canal BPPV

Objective:Our primary objective was to develop a three-dimensional (3D) model of the vestibular labyrinth to understand the pathophysiological mechanisms of benign paroxysmal positional vertigo (BPPV) observed during common diagnostic positional tests. We secondarily aimed to monitor the effects of the repositioning maneuvers and use this tool in teaching.Methods:A 3D model of a human semicircular canals (SSCs) system was created by 3D printing the core and assembling it with silicone tubing filled with lubricant oil containing colored small stones in the lumen mimicking otoconia. We used the model in horizontal canal BPPV diagnostic tests and therapeutic maneuvers. The working mechanism of the model we designed was recorded with video.Results:The model allowed for a clear display of the anatomy and the respective orientations of the SSCs. Otolith movement in the horizontal canals could be imitated during diagnostic positional tests (Dix-Hallpike and Pagnini-McClure) and therapeutic maneuvers (Epley, Semont, Lempert and Gufoni).Conclusion:As well as helping to understand the anatomy and physiology of the SSCs, this simple 3D model also provides a teaching tool for the diagnosis and treatment of BPPV. The mechanism of horizontal canal canalithiasis and the effect of therapeutic repositioning maneuvers could be clearly observed by watching the markers in the lumen demonstrating the progress of otolith movements with changes in head position relative to gravity

Myxoma of the Middle Ear Mimicking Chronic Otitis Media

Myxoma is a benign connective tissue tumor that arises mostly from the heart. Temporal bone myxomas are extremely rare and these patients should be evaluated for the Carney complex association. Herein, our aim was to present a middle ear myxoma case operated with an initial diagnosis of chronic otitis media (COM) and to underline the fact that myxomas should be kept in mind in the differential diagnosis of aural polyps

Epidemic of Postoperative Adenoviral Conjunctivitis

Göz hastalıkları kliniklerinde hastaların muayenesinde kullanılan ortak cihazlar adenovirüs gibi etkenler için bulaş kaynağı olabilmektedir. Bu olgu sunumunda aynı gün katarakt veya pars plana vitrektomi cerrahisi geçiren, rutin 1. hafta kontrolleri yapılmış, postoperatif 10-18(Ortanca: 15. gün) günlerde, gözde kızarıklık, sulanma ve göz kapaklarında ödem şikayetleriyle kliniğimize müracaat eden 7 hastanın 7 gözüincelendi. Hastalardan ve poliklinikte ortak kullanılan cihazlardan ve ameliyathanede kullanılan topikal anestezik ve pupilla dilatasyonu içinkullanılan damlalardan bakteryel kültür ve viral moleküler testler için örnek alındı. Olguların göz örneklerinde ve tonometre ve pakimetre cihazlarında gerçek zamanlı polimeraz zincir reaksiyon ile Adenovirüs tip 8 saptandı. Bakteryel kültürlerde üreme olmadı.The common used devices for clinical examination of patients in the ophthalmology clinics may be infected source for factors such as adenovirus. In this case report, postoperative routine 1st week controls were made in patients who had cataract or pars plana vitrectomy surgery; and 7 eye of 7 patients who were presented to the clinic with complaints of redness, tearing and eyelid edema between 10-18 (Median: 15 days) days were analyzed. The samples were taken from one eye of the patients, and from possibly contaminated sources as tonometry, pachymetry devices and topical anesthetics, and from the drops used for pupil dilation in the operating room for bacterial cultures and viral molecular tests. Adenovirus type 8 was detected with real-time polymerase chain reacyion in the eye samples, and tonometer, and pacimetry equipment. Reproduction in bacterial cultures were negative

Comparison of Audiological Findings in Patients with Vestibular Migraine and Migraine

Objective:The aim of this study was to investigate and compare the auditory findings in vestibular migraine (VM) and migraine patients without a history of vertigo.Methods:This study was conducted on 44 patients diagnosed with definite VM and 31 patients diagnosed with migraine who were followed and treated between January 2011 and February 2015. Also, 52 healthy subjects were included in this study as a control group. All participants underwent a detailed otorhinolaryngological examination followed by audiological evaluation, including pure tone audiometry, speech reception threshold, speech recognition score, and acoustic immitancemetry.Results:In the VM group, there were 16 patients (36.4%) with tinnitus, while in the other groups we did not observe any patients with tinnitus. The rate of tinnitus in the VM group was significantly higher in comparison to other groups (p<0.05). None of the groups had any patients with permanent or fluctuating sensorineural hearing loss.Conclusion:We conclude that patients with VM should be closely and longitudinally followed up for the early detection of other otological symptoms and possible occurrence of sensorineural hearing loss in the long term