Repeated Atmospheric Pressure Alteration Effect on the Cochlea in Rats: Experimental Animal Study.

OBJECTIVE: This study aimed to evaluate the effects of repeated pressure alterations on cochlear structures in rats in an attempt to understand indirectly the inner ear status of flight crew who are repeatedly exposed to pressure alterations.METHODS: There were 12 adult Wistar albino rats equally divided into 2 groups: Group 1 (controls) and Group 2 (study group). The animals in Group 2 were exposed to repeated pressure changes in a pressure cabin which is regulated by manometers. The animals in Group 1 were placed in the cabin without being exposed to pressure changes. Auditory brainstem response (ABR) testing was performed in all animals at the beginning and at the end of the study. After 12 wk the animals were sacrificed and their cochleas were investigated using scanning electron microscopy (SEM).RESULTS: In the study group, hearing decreases at 2 kHz, 4 kHz, 6 dB at 8 kHz, and 32 kHz were encountered at the end of 3 mo. On SEM evaluation of the control group, the outer hair cells (OHC) and stereocilia were normal throughout the cochlea. In the study group, there were irregularities in lateral surface connections and separations, collapse, and adhesions in the basal segment of the cochlea and partial loss of stereocilia throughout the cochlea.CONCLUSION: Repeated alterations in the atmospheric pressure can lead to damage in the inner ear with subtle or evident hearing loss. Frequent flyers like air workers may be at risk of inner ear damage, which may be considered an occupational health problem.Eroglu S, Dizdar HT, Cevizci R, Cengiz AB, Ogreden S, Bulut E, Ilgezdi S, Dilci A, Ustun S, Sirvanci S, Kaya OT, Bayazit D, Caki BO, Oktay MF, Bayazit Y. Repeated atmospheric pressure alteration effect on the cochlea in rats: experimental animal study. Aerosp Med Hum Perform. 2021; 92(7):550555.

Association of Conductive Hearing Loss with the Structural Changes in the Organ of Corti.

OBJECTIVE: The aim of the study was to evaluate the association of conductive hearing loss (CHL) with the structural changes in the organ of Corti. METHODS: Twenty ears of 10 healthy adult Wistar albino rats were included in the study. The right ears (n = 10) of the animals served as controls (group 1), and no surgical intervention was performed in these ears. A tympanic membrane perforation without annulus removal was performed under operative microscope on the left ears (n = 5) in 5 of 10 animals (group 2). A tympanic membrane perforation with annulus removal was performed under operative microscope on the left ears (n = 5) of the remaining 5 animals (group 3). Auditory brainstem response testing was performed in the animals before the interventions. After 3 months, the animals were sacrificed, their temporal bones were removed, and inner ears were investigated using scanning electron microscopy (SEM). The organ of Corti was evaluated from the cochlear base to apex in the modiolar axis, and the parameters were scored semiquantitatively. RESULTS: In group 1, the pre- and post-intervention hearing thresholds were similar (p > 0.05). In group 2, a hearing decrease of at least 5 dB was encountered in all test frequencies (p > 0.05). In group 3, at the frequency range of 2-32 kHz, there was a significant hearing loss after 3 months (p < 0.01). After 3 months, the hearing thresholds in group 2 and 3 were higher than group 1 (p < 0.01). The hearing threshold in group 3 was higher than group 2 (p < 0.01). On SEM evaluation, the general cell morphology and stereocilia of the outer hair cells were preserved in all segments of the cochlea in group 1 with a mean SEM score of 0.2. There was segmental degeneration in the general cell morphology and outer hair cells in group 2 with a mean SEM score of 2.2. There was widespread degeneration in the general cell morphology and outer hair cells in group 3 with a mean SEM score of 3.2. The SEM scores of group 2 and 3 were significantly higher than group 1 (p < 0.05). The SEM scores of group 3 were significantly higher than group 2 (p < 0.05). CONCLUSION: CHL may be associated with an inner ear damage. The severity of damage appears to be associated with severity and duration of CHL. Early correction of CHL is advocated in order to reverse or prevent progression of the inner ear damage, which will enhance the success rates of hearing restoration surgeries. Subjective differences and compliance of the hearing aid users may be due to the impact of CHL on inner ear structures.

Surgical considerations and safety of cochlear implantation in otitis media with effusion.

OBJECTIVE: To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. METHODS: Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. RESULTS: Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (p<0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. CONCLUSION: There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells.

Recovery of Tinnitus and Sensorineural Hearing Loss Due to Lysis of Arachnoid Adhesions in the Posterior Cranial Fossa: Is There a Novel Etiology in Neurotological Disorders?

We reported the recovery of sensorineural hearing loss and tinnitus in a 22-year-old man after complete removal of intracranial portion of jugular foramen schwannoma via the retrosigmoid approach. The aim of this case report was to present the excision of a large jugular foramen schwannoma via the retrosigmoid approach and to describe the improvement of sensorineural hearing loss related to arachnoid inflammations due to chronic arachnoiditis after suboccipital craniectomy. The recovery of sensorineural hearing loss and tinnitus after release of arachnoid adhesions may indicate the clinical significance of these adhesions or arachnoiditis, which should also be considered and investigated in the etiology of other neurotological diseases.

Craniofacial Deviations in the Children With Nasal Obstruction.

Nasal obstruction mainly caused by adenoid hypertrophy in children affects the craniofacial growth and development process, and the craniofacial deviations and/or differences reported in the children are very similar to those in the adults with obstructive sleep apnea syndrome (OSAS). The authors aimed to look for relationships of the linear craniofacial dimensions in the children suffering from nasal obstruction with age, degree of clinical nasal obstruction score (CNOS), and relative size of the adenoid mass within the nasopharynx in their study.Fifty-five children suffering from nasal obstruction were retrospectively enrolled, and clinical data was used to calculate CNOS. On the lateral cephalometric radiographies, 9 linear variables were measured and adenoidal-nasopharyngeal ratio (ANR) was calculated.The data presented that, not CNOS, but ANR shown decrease by age, while many skeletal variables with exception of the nasopharyngeal and adenoidal postero-anterior dimensions were increased by age. Further, it was found that while CNOS were negatively correlated with the anterior cranial base length, anterior-superior facial height, and maxillary depth, ANR disclosed significant correlation only with the anteriorsuperior facial height. The authors' results support that nasal obstruction in the children was related not only to the adenoidal hypertrophy. Although relative size of the adenoidal mass in relation to the nasopharynx decreased by age, nasal obstruction was still present. Further, these results support that craniofacial deviations and/or differences in the children with nasal obstruction is similar to the adult OSAS patients. Smaller dimensions related to the naso-maxillary complex in the children with more severe nasal obstruction appear to be continuous by age. Hence, it could be said that narrow naso-maxillary complex could contribute to proceed nasal obstruction by age, which may contribute to OSAS in the adults.

Flexible CO2 Laser Treatment for Subglottic Stenosis.

OBJECTIVES: To assess the efficacy and safety of flexible fiber CO2 laser surgery for subglottic stenosis and to present retrospective experience of 14 patients treated with flexible fiber CO2 laser system. To determine the characteristics, management protocols, prognostic factors, and postoperative outcomes of the sample. METHODS: Retrospective review of patients with subglottic stenosis undergoing flexible fiber CO2 laser surgery at the tertiary medical center. All demographic and clinical data were collected, radiologic and endoscopic evaluations were performed to assess the characteristics of stenosis. Myer-Cotton grading scale was used for classification of stenotic area. RESULTS: All patients have subglottic stenosis due to intubation-related causes and inappropriate tracheostomy procedure. The duration of intubation period ranged from 15 days to 4 years; 11 patients have grade III stenosis according to Myer-Cotton system and there was cricoid involvement in 2 patients. The mean follow-up period was 5.2 months and postoperative decannulation was achieved in 10 patients (71.4%). CONCLUSIONS: Subglottic stenosis is the difficult situation to manage minimal invasively. Flexible fiber CO2 laser surgery is safe and effective in the management of properly selected patients and can be used as a first option for patients.

Expression profiles of CD11b, galectin-1, beclin-1, and caspase-3 in nasal polyposis

Background/aim: Nasal polyposis is a chronic inflammatory disease affecting the paranasal sinuses and nasal mucosae. It is thought that genetic and molecular mechanisms in inflammatory and apoptotic pathways are the main factors in the etiopathogenesis of nasal polyposis. The aim of this study was to investigate the expression patterns of CD11b, galectin-1, beclin-1, and caspase-3 in nasal polyps.Materials and methods: The mRNA expression levels of CD11b, galectin-1, beclin-1, and caspase-3 protein and western blot analysis of caspase-3 protein were evaluated in inferior turbinate mucosae and nasal polyp tissues.Results: CD11b expression was markedly higher in nasal polyp tissues when compared to turbinate mucosae (5.5 times higher, P < 0.05). Expression of galectin-1 was not statistically higher in nasal polyp tissues when compared to the controls. Beclin-1 expression in nasal polyp tissues was lower than in controls (17 times lower, P < 0.05). Caspase-3 expression was significantly lower in nasal polyp tissues than in controls (5.5 times lower, P < 0.05).Conclusion: Inflammation, apoptosis, and hyperproliferation are the major cellular processes in nasal polyposis and these proteins may take part and play some important roles in formation of this disease and the targeting of new treatment protocols.

The demographics and histopathological features of oral cavity cancers in Turkey.

BACKGROUND/AIM: This study aimed to examine the demographics and histopathological features of oral cavity cancers (OCCs) managed in our clinic. MATERIALS AND METHODS: Patients who were diagnosed with OCCs in the Gazi University Otorhinolaryngology Department between the years 1993 and 2013 were retrospectively enrolled in the study. Surgical archive charts and pathology records were reviewed in detail regarding the anatomical and histopathological profiles of the tumors, as well as the demographic data of the patients. RESULTS: Out of 230 patients with OCCs, the most common anatomic location and histopathological diagnosis were found to be the oral tongue (41.4%) and squamous cell carcinoma (SCC) (84.3%), respectively. A marked predominance of SCC was observed in all subsites of the oral cavity except the hard palate location. The mean age at presentation was 55.5 ± 13.4 years (±SD). The male:female ratio was found to be 2.2:1. A male predominance was also present in all subsites except the retromolar trigon. CONCLUSION: OCCs particularly concern the elderly population with a male predominance. The most common location and histopathological type are the oral tongue and SCC, respectively.

Salivary gland tumors in Turkey: demographic features and histopathological distribution of 510 patients.

The aim of this study was to evaluate the demographic and clinicopathologic data of salivary gland tumors managed at a tertiary referral medical center in Turkey. The data of 510 patients with salivary gland tumors managed during the period of January 1984 to May 2012, were reviewed. Only primary neoplasms derived from salivary glands were included. Out of 510 neoplasms, 352 (69.0 %) were classified as benign and 158 (31.0 %) were classified as malignant. There was a male predominance and male:female ratio was 1.23 (281/229). The most common location was parotid gland (372/510, 72.9 %) followed by minor salivary glands (97/510, 19.0 %) and submandibular gland (40/510, 7.9 %). The malignancy rates were 21.5, 40.0, and 56.7 % in parotid, submandibular, and minor salivary glands locations, respectively. The most common location for minor salivary gland neoplasms was oral cavity (61/97, 62.9 %). Pleomorphic adenoma (PA) was the most common histopathological type (45.3 %) in the whole study group and also among pediatric patients. The most common malignant neoplasms were adenoid cystic carcinoma (39/510, 7.6 %) and mucoepidermoid carcinoma (5.7 %). Salivary gland tumors are more common in men. The malignancy rate is almost three times higher in neoplasms derived from minor glands when compared to parotid gland. PA is the most common histopathological tumor type in all locations and in all age groups.