EFFECT OF TRANSTYMPANICALLY APPLIED GASTRIC CONTENT ON DISTORTION PRODUCT OTOACOUSTIC EMISSIONS IN RABBITS Halil Emre GÖĞÜŞ, MD; Erdem EREN, MD; Mehmet Sinan BAŞOĞLU, MD; Hale ASLAN, MD; Sevinç İNAN, MD; Hatice Efsun KOLATAN, MD; Sedat ÖZTÜRKCAN, MD; Hüseyin KATILMIŞ, MD İzmir Katip Çelebi Üniversitesi Atatürk Eğitim Araştırma Hastanesi, KBB, İzmir, Türkiye Bayındır Devlet Hastanesi, KBB, İzmir, Türkiye Celal Bayar Üniversitesi Tıp Fakültesi, Histoloji ve Embriyoloji, Manisa, Türkiye Dokuz Eylül Üniversitesi, Deney Hayvanları Bilim Dalı, İzmir, Türkiye

Objective: Ossicular chain reconstruction in chronic otitis media is still a matter of investigation. Many types of prostheses have been defined. We present biocompatibility-tested golden wire prosthesis used in the presence of a damaged or missing incus and the functional results of chain reconstruction.Materials and Methods: This report describes a prospective case review from a tertiary referral center. The study was approved by ethics committee of Izmir Ataturk Training and Research Hospital.Ossiculoplasty between the malleus and stapes was performed on a total of 20 patients, including 14 intact-wall tympanoplasty and 6 canal-wall-down tympanoplasty (CWDT) procedures. Wire prostheses were inserted between the malleus and stapes and the stapedial tendon. Pure tone average thresholds were calculated at 500, 1000, 2000, and 3000 Hz. Preoperative and postoperative air-bone gaps (ABGs) and air-conduction gains (ACs) were compared. An ABG <= 20 dB and AC >= 20 dB were accepted as successful hearing gains.Results: The placement of the prosthesis was successful in all patients. The mean follow-up period was 11.9 (3-24) months. The preoperative average ABG was 38.25 +/- 11.98 dB, and the postoperative average ABG was 17.25 +/- 9.92 dB. The preoperative average AC was 53.90 +/- 14.99 dB, and the postoperative average AC was 34.05 +/- 18.50 dB. These results were statistically significant (P = 0.001). We reached the goal of an ABG <20 dB in 9 (64.3%) of 14 patients who underwent canalwall-up tympanoplasty (CWUT) but in only 2 (33.3%) of 6 patients who underwent CWDT. This difference was statistically significant (P = 0.033).Conclusion: Despite the limited number of patients, this study demonstrated the effectiveness of the golden wire prosthesis in reconstructing the ossicular chain in the presence of a damaged or missing incus. Biocompatibility, easy accessibility and application of the golden wire, and low cost are the advantages of this technique.

Nasal breathing is completely ceased after total laryngectomy. This results in some structural changes in the nasal mucosa, which has been described in numerous studies. This study investigates the changes that appear in the paranasal sinus mucosa. Eight patients who had undergone total laryngectomy at least 1-year ago were enrolled. Under general anesthesia, maxillary sinuses were examined with an endoscope inserted through canine fossa. 1-2 mm mucosal tissues for biopsy were taken from posterior wall of the maxillary sinus. Specimens were evaluated under an electron microscope. Control tissues for biopsy were obtained from two patients who had been operated for other reasons and analyzed under transmission electron microscopy. Results showed that in the control specimens, the epithelial cells appeared normal under transmission electron microscopy. Samples taken from two larygectomees in their first postoperative year were also completely normal. Samples from other larygectomees demonstrated ciliary loss, abundant degenerative vacuoles in ciliated epithelial cells and detachments in the interepithelial junctional complexes. The intracellular respiratory mechanisms such as the mitochondria, golgi complex and endoplasmic reticulum cisternae, and the integrity of the cellular or the nuclear membrane were spared. We conclude that the cessation of nasal breathing resulted in degenerative changes that could be reversible in the transmission electron microscopic examination of maxillary sinus mucosa. These changes emerged after 2 years following total laryngectomy. Nevertheless, these changes did not have any negative influence on the clinical outcome in this group of patients.

Objective; We aimed to weaken structure of sclerotic plaques in tympanic cavity by using bacteria and fungi that decompose calcium and phosphate in calcium and phosphate crystals. Study Design; Experimental prospective in-vitro study. Materials & Methods; We used the sclerotic plaques extracted from 10 patients who had undergone tympanoplasty due to advanced tympanosclerosis. These plaques and ossicles taken from fresh cadavers and approximately 20 mg promontorium bone were kept in separate tubes with E.coli, Bacillus subtilis and Aspergillus niger. These tubes which were also containing a brain\heart broth medium were incubated for two weeks. Calcium and phosphate amounts in the medium were then re-measured after 2 weeks. Results; We found that calcium and phosphate departed in all groups, particularly in the E. coli group and that the plaque broke down. No change was seen in ossicles. Conclusion; Naturally existing bacteria and fungi, particularly E. coli, can decompose tympanosclerotic plaques. We observed that no change occurred when we applied the same study on human middle ear ossicles. We believe that the effect of otitis media-causing, acid phosphatase-active bacteria on Ca-P metabolism might shine a light on tympanosclerosis etiology.