Labyrinthine window rupture as a cause of acute sensorineural hearing loss

Labyrinthine window rupture (LWR) is one cause of acute sensorineural hearing loss and need for early exploration is clear for good improved hearing. Acute sensorineural hearing loss of 60 dB or more treated from May 2006 to May 2010 were retrospectively analyzed. There were 21 ears of severe deafness, 18 ears of profound deafness, and 10 ears of total deafness. All patients were examined with temporal bone CT. Space-occupying lesions around the labyrinthine windows were suggestive images of LWR. Thirty-five ears were operated for LWR while 14 ears of SHL received conservative treatments. Fifty-seven percent of LWR improved 30 dB or more after sealing of both labyrinthine windows. Of the 15 markedly recovered ears, 14 ears were operated within 2 weeks from the onset. Of the five cured ears, four ears were operated within a week from the onset. As for the hearing prognosis of SHL, 88% of severe and profound deafness improved 30 dB or more but total deafness did not improve more than 30 dB. Exclusion of LWR from SHL and early surgical intervention in LWR will bring about good hearing prognosis to both LWR and SHL

Role of Radiofrequency Cautery in Laryngomalacia: a Study in 12 Patients

Laryngomalacia is the most common condition causing inspiratory stridor at or shortly after birth accounting for approximately 60% of cases. Inspiratory stridor typically occurs after few days or week and is initially mild, but over a period of 6–9 months it gets more pronounced. Spontaneous improvement usually occurs over a period of 18 months to 2 years. Although majority of cases of laryngomalacia have benign course without any long-term sequel. Typically symptoms are worse during sleep and supine position while the same improves in prone position. There are 12 cases in the present study with the average age of the baby was 4.74 months (142 days). Male to female ratio of 1:1. Those babies with life-threatening apnea, significant cyanotic (blue) spells, failure to thrive with feeding difficulty, significant chest wall and neck retractions with breathing and requires oxygen to breathe were included in the study. One patient presented with tracheostomy tube in place. Two babies were preterm. These preterm babies were initially kept on ventilator before the final diagnosis was made. The findings were different in all the cases. The common findings are cyclical collapse of supraglottic larynx with inspiration, short aryepiglottic folds, indrawing of cuneiform and corniculate cartilages forward over the laryngeal inlet resulting in prolapse during inspiration. The surgical procedures in laryngomalacia babies were combined according to the type of laryngomalacia. The procedures performed were supraglottoplasty (Unilateral/Bilateral), epiglottoplasty, aryepiglottoplasty, aryepiglottic fold division, epiglottopexy. The procedures were performed by radiofrequency cautery under general anesthesia. The average hospital stay in nine patients was less then 36 h and more then 7 days in remaining three patients. In tracheostomized patient second surgical procedure was done as after the first procedure failed to decannulate the child. The postoperative period was uneventful. The average follow up was 10 months

The Effects of Some Antioxidant Additives on Spermatological Parameters, Oxidative Stress and DNA Damage After Frozen-Thawed Process in Ram Semen

Bu Tez Afyon Kocatepe Üniversitesi Bilimsel Araştırma Projeleri Komisyonu Tarafından 10.VF.15 Proje Numarası İle Desteklenmiştir.Bu çalışmada, dondurma çözdürme sonrası spermaya katılan antioksidanların spermatolojik, CASA, oksidatif stres parametreleri ve DNA hasarları üzerine etkilerininbelirlenmesi amaçlandı. Afyonkarahisar koşullarında yetiştirilen 2-3 yaşlı Pırlak ırkına ait toplam 10 koçtan alınan spermalar birleştirilip 5 eşit hacme bölünerek kontrol başta olmak üzere taurin, trehaloz, trolox ve lipoik asit içeren Tris bazlı sulandırıcılar ile sulandırıldı. Sulandırılan örnekler 0,25 ml’lik payetlerde 50C’de 3 saat ekilibrasyona tabi tutulduktan sonra sıvı azot buharında dondurularak sıvı azot içerisinde (-1960C) saklandı. Çözdürülen spermalarda subjektif motilite (% 54.6 ±2.25) ve CASA motilitesi (% 24.2±1.84), VAP (98.2 ±2.20 µm/s) ve VSL (80.1±1.88µm/s)açısından taurin grubunda en yüksek değerler tespit edildi.Anormal spermatozoon baş, orta kısım ve akrozom oranı açısından kontrol grubuna göre (% 1.2 ± 0.21, % 1.2 ± 0.21 ve % 13.3 ± 0.70) taurin (% 0.8 ± 0.15, % 0.2 ± 0.08 ve % 10.7 ± 0.51), trehaloz (% 0.5 ± 0.07, % 0.1 ± 0.04 ve % 5.2 ± 0.26), lipoik asit (% 1.0 ± 0.12, % 0.2 ± 0.07 ve % 7.1 ± 0.41) ve trolox (% 0.4 ± 0.08, % 0.1 ± 0.04 ve % 3.6 ± 0.21) gruplarında en düşük değerler elde edildi.Spermatozoon HE-test parametrelerinden H+/E- tip spermatozoonlarda kontrolgrubuna göre (% 22.3 ± 0.72) taurin (% 32.6 ± 1.31), trehaloz ( % 30.2 ± 1.52) ve lipoik asit (% 28.1 ± 1.25) gruplarındaki artışlar önemli (P<0.05) bulunmuştur.DNA hasarında en düşük değer yine kontrol grubuna kıyasla (68.7 ± 4.09 AU) trehaloz (43.5 ± 4.51 AU) ve lipoik asit (48.4 ± 5.27 AU) gruplarında gözlendi. Oksidaitif stres parametrelerinden MDA yönünden lipoik asit (3.7 ± 0.21 nmol/ml) ve trolox (3.6 ± 0.24 nmol/ml) en düşük değeri göstererek koruma sağlamıştır. Sonuç olarak koç spermasının dondurulmasında antioksidan olarak kullanılan taurin, trehaloz, lipoik asit ve trolox’un etkinliklerinin farklılık gösterdiği bunun yanında lipoik asitin gerek oksidatif stres ve gerekse DNA hasarını azaltıcı etkisinden dolayı diğerlerine nazaran üstünlük sağladığı ancak tüm antioksidanların farklı dozajlarda spermatolojik özellikler, CASA, oksidatif stres parametreleri ve DNA hasarı üzerine etkisinin daha geniş hayvan materyali kullanılarak dölverimi sonuçları ilebirlikte değerlendirilmesinin yararlı olacağı kanısına varılmıştır.The aim of this study was to determine the effect of the addition of antioxidants on the post thawed sperm, CASA, oxidative stress parameters and the DNA damage. Semen were collected from 2-3 years of age ten Pirlak rams under Afyonkarahisar conditions and these semen were divided in the five equal aliquots and diluted with the tris base extender containing with taurine, trehalose, trolox, lipoic acid and no antioxidant (control). Diluted samples were submitted to three hour equilibration at 5 oC and frozen 0,25 ml French straws in liquid nitrogen vapour and storage in liquid nitrogen (-196 oC). In thawed semen according to subjective motility (54.6 ±2.25 %) and CASA motility (24.2±1.84 %), VAP (98.2 ±2.20µm/s) and VSL (80.1±1.88µm/s) taurine group indicated the highest value. Abnormal spermatozoon, head, middle piece and acrosome rate comparing with control group (1.2 ± 0.2% 1, 1.2 ± 0.21 % and 13.3 ± 0.70 %) taurine (0.8 ± 0.15 %, 0.2 ± 0.08 % and 10.7 ± 0.51 %), trehalose (0.5 ± 0.07 %, 0.1 ± 0.04 % and 5.2 ± 0.26 %), lipoic acid (1.0 ± 0.12 %, 0.2 ± 0.07 % and 7.1 ± 0.41 %) and trolox (0.4 ± 0.08 %, 0.1 ± 0.04 % and 3.6 ± 0.21 %) in these groups the lowest value were found. In the increases H+/E- type spermatozoon which one of spermatozoon HE-test parameters compared with control group (22.3 ± 0.72 %) then taurine, (32.6 ± 1.31 %), trehalose (30.2 ± 1.52 %) and lipoic acid (28.1 ± 1.25 %) groups were found significantly (P<0.05). In DNA damage, the lowest value trehalose (43.5 ± 4.51 AU) ve lipoic acid (48.4 ± 5.27 AU) were observed in compared control group (68.7 ± 4.09 AU). According to MDA which is one of the oxidative stress parameters, lipoic acid (3.7 ± 0.22 nmol/ml) and trolox (3.6 ± 0.24 nmol/ml) indicated the lowest value that provided preservation. In conclusion that the effects of antioxidants such as taurine, trehalose, lipoic acid and trolox for frozen of ram semen is found to be significant at differences in effectiveness whereas lipoic acid is more effective on reducing oxidative stress and damage in DNA. However in order to understand the positive effects of antioxidants, it is essential to test in different dosages on spermatalogic parameters, CASA, oxidative stres parameters ve DNA damage together with fertility result on large number of animals

Balloon dilation for management of choanal atresia and stenosis.

Objectives: We describe our use of balloon dilation to repair choanal atresia in a series of patients. Study design: Case series. Methods: We performed a retrospective review of patients who underwent repair of choanal atresia using dilation with high pressure, non-compliant airway balloons between January 2009 and September 2010. For primary cases, balloon dilation was used in conjunction with transnasal endoscopic puncture, and repair of bony stenosis with backbiting forceps and microdebrider drill. Results: 5 patients underwent balloon dilation repair of choanal atresia or stenosis. 4 patients presented for primary repair, with a mean age of 2.9. months. 1 patient presented at 10. years of age for revision repair several years after previous attempts performed elsewhere. The average number of procedures was 3.6, with an average of 2 balloon dilations. There were no complications stemming from balloon dilation. Follow-up ranged from 3 to 24. months. All patients demonstrated choanal patency on last follow-up. Conclusions: This is a novel use of high pressure, non-compliant balloons. We found success in dilating membranous stenoses, post-repair granulation, and scar tissue in revision cases. Balloon dilation is an effective adjuvant tool for use in the repair of choanal atresia and stenosis. © 2011 Elsevier Ireland Ltd

Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report

<p>Abstract</p> <p>Background</p> <p>Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis.</p> <p>Case presentation</p> <p>A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma.</p> <p>Conclusions</p> <p>Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.</p