Aim: Pregnancy rhinitis (PR) is characterized with nasal symptoms during pregnancy without any signs of respiratory infection and it usually disappears within 2 weeks after delivery.We aimed to investigate the relationship between pregnancy rhinitis and findings derived from anterior rhinoscopy (AnR), anterior rhinomanometry (ARM) and subjective nasal obstruction score (SNOS).Methods: This prospective, controlled study was performed in otorhinolaryngology and obstetrics and gynecology departments of our tertiary care center.A total of 30 pregnant women in the third trimester and 30 non-pregnant women were involved.All participants underwent otorhinolaryngology examination, as well as clinical evaluation for AnR, ARM and SNOS.Results: Pregnancy rhinitis was detected in 66.7% of the pregnant women.The mean AnR was 3.60 ± 1.35 in pregnant women and 0.77 ± 0.73 in the control group.Total nasal inspiratory resistance (TNID) was 0.46±0.23 in pregnant women and 0.27±0.06 in the control group.The mean SNOS was 1.37±0.72 in pregnant women and 0.57±0.63 in the control group.AnR, ARM and SNOS findings were significantly higher in pregnant women (p<0.05).There is a low positive and significant correlation between AnR, ARM, and SNOS values in pregnant women (p<0.05).Conclusion: Our data yielded that nasal obstruction and pregnancy rhinitis were common in pregnant women.Nasal symptoms and complaints must be carefully examined during pregnancy.Further prospective, controlled, randomized trials on larger series are warranted to elucidate the clinical and pathophysiological features of pregnancy rhinitis.

The aim of the study was to evaluate whether there was a problem in the interneuronal junctions of patients with central sleep apnea using the blink reflex test. Twenty-one (21) patients with central type apneas and/or hipopneas and 21 controls were recruited. The blink reflex test was performed and R1, R2 and contralateral R2 (R3) wave values of both groups were recorded in milliseconds (ms). The results of blink test in patients with central sleep apnea were right side R1 = 9.45 ± 4.35 ms, R2 = 33.35 ± 9.97 ms, R3 = 32.15 ± 10.05 ms and left side R1 = 9.90 ± 3.82 ms, R2 = 31.5 ± 10.5 ms, R3 = 29.00 ± 4.77 ms, (p = 0.49, p = 0.69, p = 0.60, respectively), whereas the results of blink test in controls were right side R1 = 9.25 ± 3.50 ms, R2 = 32.75 ± 11.4 ms, R3 = 32.50 ± 13.12 ms and left side R1 = 7.35 ± 2.6 ms, R2 = 27.75 ± 9.75 ms, R3 = 26.65 ± 14.5 ms. (p = 0.015, p = 0.04, p = 0.035, respectively). All left side (R1, R2, R3) blink reflex of the patients with central sleep apnea was statistically significant prolonged than controls. However, there was no statistically significant difference between women with central sleep apnea and controls regarding all right side (R1, R2, R3) blink reflex. There was statistically significant difference in R1, R2 and R3 waves of left sides blink reflex between two groups. The results may be related to central nervous system damage or/and degeneration in the interneuronal junctions of the brain stem in patients with central sleep apnea syndrome.

Objective:To investigate the outcomes of superficial musculoaponeurotic system (SMAS) flap and classic techniques in superficial parotidectomy in terms of Frey’s syndrome (FS) and cosmetic satisfaction.Methods:In this study, a retrospective chart review of patients that underwent superficial parotidectomy was performed. These patients were divided into two subgroups: group 1 included patients in which the SMAS flap was harvested and group 2 comprised the remaining patients on whom classic superficial parotidectomy was performed. All the patients were evaluated clinically and with Minor’s starch-iodine test for FS. For the evaluation of the cosmetic results, the patient’s satisfaction was queried according to the incision scar and surgical field skin retraction/facial symmetry. Both groups were compared in terms of complications and numbness of surgical area.Results:Fifty-five patients (31 male and 24 female) with a mean age of 50.19 years were included in the study. Thirty-two patients were in group 1 and 23 in group 2. Thirteen patients (23.7%) described as having FS and six of them were in group 1, while seven were in group 2. Minor’s starch-iodine test was positive in nine patients in group 1 (28.1%) and six patients in group 2 (26.1%) (p=1.000). With regard to cosmetic satisfaction, eight patients (25%) stated mild discomfort from the incision scar and two patients (6.3%) stated cosmetic dissatisfaction for facial asymmetry in group 1. In group 2 for the same factors the number of patients were 11 (47.8%) and 2 two (8.7%), respectively (p=0.027). There were no statistically significant differences in means of complication and numbness (p>0.05).Conclusion:According to our study results, there was no superiority between both the groups in terms of FS and incision scar satisfaction. We determined that there was a significant benefit of SMAS flap application in the prevention of volume loss and surgical area retraction.

Concha bullosa or conchal pneumatization refers to the presence of an air cell within a nasal turbinate. Pneumatization is most commonly seen in the middle turbinate followed by the superior turbinate. Pneumatized inferior turbinate is rare, and most of the papers in the literature appear as case reports. In this study, a 33-year-old female patient complaining from unilateral nasal stuffiness and intermittent headache is presented. Symptomatology, diagnostic and therapeutic methods for inferior concha bullosa is discussed. In clinical practice, the pneumatization status should well be studied on the scans before sinus and turbinate surgery and inferior concha bullosa should be kept in mind.

Background/Aims: In this study, we aimed to evaluate the histopathological effects of thymoquinone treatment of the nasal mucosa in a rabbit model of allergic rhinitis, and we compared its effects with those of nasal mometasone furoate. Methods: A total of 24 male New Zealand rabbits were used. The animals were randomly assigned to one of four groups. Group 1 received no treatment, while group 2 underwent ovalbumin (OVA) sensitization only. Group 3 was the study group; after OVA sensitization, the rabbits were treated with intranasal thymoquinone. The group 4 rabbits received mometasone furoate for 7 days after OVA sensitization. Mucosal structures were stained with hematoxylin and eosin, while toluidine blue was used to stain mast cells. Apoptosis was evaluated using a TUNEL assay. Results: In the positive control groups, including the thymoquinone and intranasal mometasone furoate groups, intraepithelial and submucosal inflammation and goblet cell hypertrophy were significantly decreased compared to group 2 (p < 0.001). The cilial structure was normal, as was the chondrocyte structure in both treatment groups. Conclusion: This is the first study to evaluate the histopathological effects of thymoquinone in an allergic rhinitis model. Thymoquinone reduced allergic inflammation and may be valuable for treating allergic rhinitis. However, additional studies are needed.

Juvenile ossifying fibroma (JOF) is a unique fibro-osseous neoplasm. It has 2 histopathological variants. Psammomatoid juvenile ossifying fibroma (PsJOF) and Trabecular juvenile ossifying fibroma (TrJOF) affecting the jaws of children. Only 20% of the patients are over 15 years of age. JOF is more common in maxilla than mandible. It presents as an asymptomatic progressive, rapid expansion of jaws. It has a recurrence rate of 30-58%. Surgery is the only cure for this kind of lesion and total excision should be the goal of the treatment. We present a case report of 12 year-old female patient with clinical, radiographic and histopathological features of Psammomatoid JOF which clinically admitted to our clinic as maxillary sinus mass.

Objective: We aimed to determine the effects of methylprednisolone and thymoquinone on nerve healing in a traumatic facial nerve paralysis animal model.Subjects and methods: Twenty-four rabbits were randomly divided into 4 groups: group I: control group received no medication and no trauma; group II: sham group received no medication after facial nerve trauma group III: 5 mg/kg/day thymoquinone administered; group IV: 1 mg/kg/day methylprednisolone administered. An initial electrophysiological assessment was performed in all the animals. The buccal branch of the facial nerve was then clipped to form a traumatic facial paralysis model. The drugs were administered for two weeks once a day. At the end of the second month, the electrophysiological assessments were performed and the distal part of the traumatic facial nerve were dissected and examined under light microscopy.Results: Best nerve regeneration was observed in the control and the thymoquinone groups, respectively, whereas the weakest regeneration was determined in the sham group. Thymoquinone and methylprednisolone significantly increased nerve recovery, as measured by histopathological scores and electrophysiological assessment. In the thymoquinone group, due to postoperative amplitude, axon diameter and thickness of myelin sheath values were significantly further increased nerve regeneration compared to that of the methylprednisolone group and these values were dose to those of the values of the control group.Conclusion: Thymoquinone was slightly better than methylprednisolone for functional nerve recovery. The neuroprotective effect of thymoquinone was attributed to its antioxidant and anti-inflammatory effects. Thymoquinone can have a new treatment option to ameliorate the nerve jollity. (C) 2016 Elsevier Inc. All rights reserved.

Background: Nasal septum deviation is one of the most frequently encountered nasal pathology in otorhinolaryngology clinics. Disease with a high comorbidity such as obstructive sleep apnea syndrome (OSAS), among whose etiology septum deviation takes place, can cause subclinical pathologies like atrial fibrillation. The main objective of this study was to determine the effect of nasal septum deviation on subclinical cardiac pathologies.Methods: The study included a total of 80 patients which were a group of 40 patients who admitted to the otorhinolaryngology department with a complaint of nasal obstruction and were diagnosed as having nasal septum deviation and a control group of 40 patients who admitted to the same department with complaints other than nasal obstruction and had no nasal septum deviation for the period of April 2015-August 2015. Initially, all patients were performed rhinomanometric measurement and then the patients were required to grade their symptoms of nasal obstruction using a 10-unit visual analog scale (VAS). Following that, patients were performed to transthoracic echocardiography by cardiology department and all the results were compared between two groups.Results: In the patient group while the VAS and transnasal pressure were found meaningful higher, the transnasal flow was found meaningful lower than the control group. In the patient group PA septum, PA tricuspide, PA lateral-tricuspide, PA septum-tricuspide values were found meaningful higher than the control group. In the patient group left atrium width (LA), LA volume maximum, LA volume minimum and LA volume p values, which show the size of left atrium, were found meaningful high in comparison to the control group.Conclusions: As a result of the data obtained from this study, the research demonstrates that nasal septum deviation can cause subclinical cardiac pathologies such as atrial fibrillation and these pathologies can be detected with noninvasive methods such as echocardiography.

The objective of this study is to investigate the effect of topical and systemic enoxaparin sodium on the healing pattern of experimentally induced tympanic membrane perforation and formation of myringosclerosis. A total of 24 Wistar-Albino strain rats were included in the study. Standard myringotomies were performed on each rat. In the first group, isotonic serum physiologic was dropped on external ear canal (control group). Topical enoxaparin was dropped on external ear canal and daily topical doses of enoxaparin were dropped on external ear canal of the rats for 14 days (topical treatment group). Third group received subcutaneous injections of enoxaparin for 14 days (systemic treatment group). Five micrometer thick sections of the bullae of the rats were stained with H&E. Inflammation, edema and sclerotic lesions and neovascularization observed in the lamina propria layer of the tympanic membrane, and total thickness of the tympanic membrane were evaluated. In intergroup comparisons, significant difference in the distribution pattern of severity of inflammation in all three groups was not observed (p = 0.784, p > 0.05). Total TM thickness differed among all three groups (p = 0.028, p < 0.05). A statistically significant difference was observed between the systemic enoxaparin and the control groups (p = 0.022, p < 0.05). A statistically significant difference was observed between the topical enoxaparin and the control groups (p = 0.037, p < 0.05). However, comparison between the topical and systemic treatment groups could not reveal any statistically significant intergroup difference (p = 0.682, p > 0.05). A significant difference was not observed among three groups as for the distribution of myringosclerotic plaques, severity of edema and neovascularization in the lamina propria (p = 0.539, p > 0.05), (p = 0.063, p > 0.05), (p = 0.152, p > 0.05). Topical and systemic enoxaparin treatment did not prevent formation of sclerotic plaques; however, it decreased TM thickness significantly in comparison with the control group.

Schwannomlar periferik sinir schwann hucrelerinden kaynaklanan benign tumorlerdir. Bas ve boyun bolgesinde yaygin gorulurler. Orta kulakta nadir gorulmekle birlikte paragangliomalardan sonra ikinci en sik benign orta kulak tumorudur. Orta kulakta en sik fasiyal sinirden ve korda timpani, stapedial sinir gibi dallarindan kaynaklanir. Fasiyal sinir kaynakli schwannomlar fasiyal sinir semptomlarindan ziyade iletim tipi isitme kaybina neden olur. 3 ay once gelisen periferik fasiyal paralizisi olan 59 yasinda erkek hastanin, yaklasik 10 yildir sol kulakta isitme kaybi yakinmasi mevcuttu. Yapilan radyolojik incelemelerde sol orta kulak boslugunu tama yakin dolduran yumusak doku dansitesinde, glomus tumoru, enflamatuar degisiklikler dusunduren patolojik gorunum mevcuttu. Hastaya timpanomastoidektomi yapildi. Orta kulagi dolduran mavi morumsu renkte kitle izlendi. Kitlenin patolojik tanisi schwannom olarak rapor edildi. Bu sunuda nadir gorulen bir orta kulak benign tumoru olan schwannom olgusu sunuldu

OBJECTIVE To investigate the effects of different types of nasal packings on middle ear pressure in patients undergoing septoplasty. MATERIALS AND METHODS Sixty patients who were suffering from nasal obstruction and who had to undergo septoplasty because of nasal septal deviation were included in the study. After the septoplasty, Merocel packings and internal nasal splints were intraoperatively applied in thirty patients each. Middle ear pressure was evaluated by tympanometry. Tympanometric peak pressures were used for this aim. Acoustic impedance measurements were performed in both ears, and the average values of the two ears were calculated. Tympanometric measurements were performed for patients during the preoperative period and on the 2(nd) and 5(th) postoperative days. RESULTS There were 30 (5 females, 25 males; average age 23 years) patients in the internal nasal splint group and 30 (8 females, 22 males; average age 26 years) patients in the anterior Merocel packing group. When the values obtained by acoustic impedancemetry before the operation and on the postoperative 5(th) day were compared, there was no statistically significant difference between the groups. The middle ear pressure significantly decreased in the anterior Merocel packing group compared with that in the internal nasal splint group. The intragroup comparison of the acoustic impedance measurements of the internal nasal splint group revealed no significant difference between the preoperative acoustic impedance values and the values obtained on the postoperative 2(nd) day. CONCLUSION Cannulated silicone intranasal splints are better in terms of patient comfort after an intranasal surgery without effecting eustachian tube function.

AIM:This study was designed to investigate the function of outer hair cells and medial olivocochlear efferents in type II diabetes mellitus (DM).MATERIALS AND METHODS:There were 50 patients with type II DM and 51 age- and sex-matched healthy controls included in the study. Both groups were compared in terms of transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), and contralateral suppression of TEOAE.RESULTS:Pure tone thresholds of the patients with type II DM were significantly higher than in the controls (P < 0.05). The TEOAE amplitudes at 1 kHz and at 1.5, 2, 3, 4, and 6 kHz signal-to-noise ratio amplitudes on DPOAE testing were significantly lower in the patients than controls (P < 0.05). There was no significant difference between the type II DM and control groups regarding contralateral suppression test results of TEOAEs.CONCLUSION:Type II DM seems to impact the auditory system at the cochlear level by affecting the functions of outer hair cells, and it results in elevation of the thresholds on audiometry and a decrease in the amplitudes of otoacoustic emissions.

Aim: Because it is a multistep process, in carcinogenesis it is necessary to determine key genes such as cyclin D1, p27, p21, bcl-2, and p53 that are responsible for uncontrolled proliferation and other mechanisms. The aim of this study was to examine the correlation between the anomalous accumulation of these proteins and the prognosis of laryngeal carcinomas.Materials and methods: In our study, cyclin D1, p27, p21, bcl-2, and p53 expressions were analyzed immunohistochemically in laryngeal squamous cell carcinomas, and the findings were compared with conventional prognostic parameters such as patient age, sex, tumor localization and diameter, tumor differentiation, lymph node status, metastatic lymph node diameter, vascular and neural invasion, clinical stage, and survival in 50 patients.Results: Our results showed a statistically significant correlation between the presence of cyclin D1 expression and shorter survival in patients with squamous cell carcinoma of the larynx. Patients with high p27 expression were found to have a higher risk of vascular invasion, and patients with high bcl-2 expression were found to have a higher risk of cervical lymph node metastasis.Conclusion: A negative correlation was found between cyclin D1 and survival, and a positive correlation was found between both p27 and bcl-2 and laryngeal squamous cell carcinoma prognosis.

Introduction: Obstructive sleep apnea-hypopnea syndrome (OSAS) manifests with recurrent upper airway obstructions. The prevalance of OSAS increases with aging. The major risk factors affecting the occurance of OSAS are considered to be age, gender and obesity. In our study we assessed the risk factors in geriatric OSAS patients.Materials and Method: This is a retrospective study comprising 55 patients aged over 65 (37 men and 18 women). BMI was under 30 in 31 patients and it was 30 or over in 24 patients. Of the patients, 24 had hypertension, 6 had type II diabetes mellitus, and 6 had coronary heart disease. We evaluated the effect of obesity, gender and systemic diseases on polisomnographic findings and ESS (Epworth Sleepness Scale).Results: ESS and polisomnographic findings were similar for both genders. 55.6% of women and 37.8% of men were obese. No significant difference in ESS scores was found between the obese and the non-obese groups. The AHI (Apnea-Hypopnea Index) in the obese group was higher than that found in the non-obese group. There was no significant difference in the prevalance of systemic diseases between the patients with and without OSAS.Conclusion: Among these risk factors only obesity was associated with higher AHI. There was no relation between the other risk factors examined and OSAS.

Hearing loss has commonly been reported in association with thyroid disorders and during treatment with propylthiouracil. The relationship between hyperthyroidism and the auditory system has not been previously investigated. The aim of this cross-sectional, case-control study was to investigate hearing loss in patients with Graves' disease (GD). The study population consisted of patients with newly diagnosed GD and healthy controls. Pure tone audiometry at frequencies of 250, 500, 1000, 2000, 4000 and 8000 Hz, along with immittance measures including tympanometry and acoustic reflex tests, were performed in all participants. Twenty-two GD patients and 22 healthy controls consented to inclusion in the study. The differences between groups with regards to age and gender distribution were statistically insignificant (P = 0.567 and P = 0.757, respectively). The hearing thresholds of right and left ears were also similar in both groups (P > 0.05). When single-ear evaluations were taken into account (total of 44 ears for both groups), hearing thresholds in the GD group were significantly higher than healthy controls at all frequencies (P < 0.05). Following testing at the designated frequencies, the only significant effect of thyrotoxicosis was observed with frequencies of 4000 and 8000 Hz. The odds ratio for having hearing loss at a frequency of 8000 HZ associated with GD was 14.97 (95% confidence interval 4.03-55.64). In patients with GD, right and left pure tone audiometric findings at a frequency of 8000 Hz correlated positively with FT3, FT4 and negatively with TSH. Our results are highly suggestive of a decrease in hearing ability in patients with GD, particularly at high frequencies. Further studies are needed to help elucidate the mechanisms behind hearing loss which develops in association with GD.

Isotretinoin is widely used in the treatment of extensive and nodulocystic acne. The objective of this prospective study was to investigate whether oral isotretinoin could affect the hearing system. Thirty-eight patients with acne vulgaris (76 ears) who were diagnosed and treated at the Department of Dermatology were included in the current study. Study evaluation visits were performed at baseline and at Weeks 1, 2 and 3. Pure-tone averages (PTAs) of air conduction thresholds at 250 Hz (PTA1); 500, 1000, and 2000 Hz (PTA2); 4000, 8000, and 10,000 Hz (PTA3); and 12,500, 16,000, 18,000 and 20,000 Hz (PTA4) for each ear were calculated separately. Assessment of the efficacy was based on the audiometric findings. Compared with pre-treatment evaluation, the PTAs of patients were found to be significantly different at the first week for PTA2 (P = 0.033) and PTA3 (P = 0.001), at the second week for PTA1 (P = 0.036), and at the third week for PTA4 (P = 0.002). Our results suggest that the oral isotretinoin (13-cis retinoic acid), which is a derivative of retinol (vitamin A), improved the hearing level of the patients in all audiometric frequencies in a short-period follow-up.

Acquired external auditory canal (EAC) stenosis is described as resulting from a number of different causes such as infection, trauma, neoplasia, inflammation and radiotherapy. Human papilloma virus (HPV) type 6, a deoxyribonucleic acid (DNA) virus, is considered to cause squamous papilloma of the EAC. In this article, we report a case of a 56-year-old male with warty lesions in the left external ear and a totally stenotic right external ear which had similar lesions one year before the involvement of his left ear. On computed tomography of the temporal bone, there was soft tissue obstruction of the right EAC, and thickening in the skin of the left EAC. The middle ear structures were normal on both sides. Biopsy was performed from the lesion in the left ear, and revealed squamous papilloma. We presented this case because squamous papilloma related bilateral acquired EAC stenosis is a rare entity.