Comparison of Piezosurgery and Hammer-Chisel in Endoscopic Dacryocystorhinostomy.

BACKGROUND: In this study, we compared the advantages and disadvantages of piezosurgery and hammer-chisel used in endoscopic dacryocystorhinostomy (EDCR). MATERIAL AND METHODS: Between January 2012 and January 2016, 10 women and 8 men in whom piezosurgery was used (group 1) and 11 women and 7 men in whom hammer-chisel was used (group 2) during EDCR operations were compared retrospectively. Recurrence, operation time, postoperative bleeding, and operative cost were evaluated in patients who were followed for an average of 11.8 months. In addition, visual analogue scale (VAS) was used to assess pain at 6 hours postoperatively. RESULTS: No recurrence was observed in group 1, but recurrence was observed in 2 patients in group 2 (P = 0.685). There was no postoperative bleeding in both groups. The mean duration of operation was 30.6 ±â€Š8.2 minutes in group 1 and 46.8 ±â€Š9.5 minutes in group 2 (P = 0.038). The VAS score in group 1 was 2.7 ±â€Š1.4 and the VAS score in group 2 was 5.8 ±â€Š2.2 (P = 0.01). Piezosurgery costs an additional $325 for each patient while the use of the hammer-chisel does not incur additional costs. CONCLUSION: Piezosurgery causes shorter operation time, less recurrence, and less pain when compared with hammer-chisel.

Relation between Ossicular Erosion and Destruction of Facial and Lateral Semicircular Canals in Chronic Otitis Media.

Introduction Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications. Objective This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma. Methods We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal. Results Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8-72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant ( p < 0.05). Conclusion Although incus is the most common of destructed ossicles in chronic otitis media, facial canal destruction is more closely related to stapes erosion.

Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Pediatric Patients with Idiopathic Sudden Hearing Loss.

OBJECTIVE: We investigated the significance of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, which have recently been used in adults for the prognosis of idiopathic sudden hearing loss (ISHL), in the prognosis of idiopathic sudden hearing loss in a pediatric population. MATERIALS AND METHODS: A total of 13 males and 8 females younger than19 years with idiopathic sudden hearing loss were retrospectively examined between January 2008 and August 2016.The control group consisted of 12 healthy males and 12 healthy females. Patients were divided into two groups: those who recovered after treatment and those who did not. RESULTS: A statistical significance for the neutrophil-to-lymphocyte ratio was detected between the patient group and control group and between patients who recovered and those who did not (p<0.05). No statistical significance for the platelet-to-lymphocyte ratio was detected between the patient group and control group and between patients with recovery and those without recovery (p>0.05). CONCLUSION: The neutrophil-to-lymphocyte ratio is an important marker for the prognosis of idiopathic sudden hearing loss in pediatric patients, similar to its use in adult patients.

Comparison of Hydroxyapatite Prosthesis and Incus Interposition in Incus Defects.

OBJECTIVE: Chronic otitis media most commonly causes an ossicular chain defect in incus. Different materials can be used for repair of this defect. In this study, the hydroxyapatite prosthesis, used for repair of the incus defect, was compared with the incus interposition. METHODS: Between 2010 and 2016, 27 female and 16 male patients who underwent ossiculoplasty due to an incus defect were studied retrospectively. Patients' hearing results at the sixth month were compared. The hydroxyapatite prosthesis was used in 24 patients (group 1) and incus interposition was used in 19 patients (group 2) for the ossicular chain repair. Hearing gain at 500, 1000, 2000, and 4000 Hz between the two groups and the success rates in the two groups were compared. RESULTS: Successful hearing reconstruction was performed on 10 patients in each group (group 1, 41.6% and group 2, 52.9%). There was no statistically significant difference between groups both in terms of successful hearing and hearing gain at 500, 1000, 2000, and 4000 Hz. There was no extrusion of the materials used in both groups. CONCLUSION: As it does not have any additional cost and is easily shaped and biocompatibility problem is not encountered; we recommend using incus interposition primarily in incus defects.