Possible Neoplastic or Proliferative Effects of Intra-Tympanic Platelet-Rich Plasma on the MiddleEarMucosa: A Myth or a Fact to Consider?

BACKGROUND: Platelet-rich plasma is a frequently used plasma-derived material; however, a possible neoplastic or proliferative effect is one of the limiting issues in its use. The aim of our experimental study was to investigate the long-term histological effects of platelet-rich plasma on the middle ear mucosa. METHODS: The rats were divided into 2 groups randomly (groups 1 and 2). Group 1 represented the control group and 8 rats were included in this group. To the left ear, 0.3 mL of normal saline solution was administered intra-tympanically. No injections were done to the right ears. Group 2 represented the platelet-rich plasma group and 11 rats were included. To the left ears, 0.3 mL of platelet-rich plasma and to the right ears 0.3 mL of normal saline solution was administered intra-tympanically. The intra-tympanic platelet-rich plasma injections were done twice with an interval of 1 week. All animals were sacrificed in the third month. The degree of mucosal thickness, the presence of metaplasia, atypical cells, myofibroblastic infiltration, angiogenesis, and acute or chronic inflammation were evaluated histopathologically. RESULTS: Histopathological findings in the right and left ears in each group were compared in itself. The degree of inflammation and mucosal thickness were significantly higher in the perforated and saline administered side, in group 1 (P < .001). In group 2, the degree of angiogenesis was significantly higher in the platelet-rich plasma administered side (P < .001). The degree of mucosal thickness was significantly higher in the saline administered side (P < .001). CONCLUSION: Considering the anti-inflammatory and regenerative features and its safety, intra-tympanic-PRP may, in the future, be an alterna- tive to current intra-tympanic treatment modalities.

The effectiveness of repairment of traumatic tympanic membrane perforations with cigarette paper.

BACKGROUND: The aim of this study was to evaluate the effects of repairment of traumatic tympanic membrane perforation (TTMP) with cigarette paper patch (CPP) on perforation closure and hearing functions. METHODS: A retrospective evaluation was made of 67 ears of 61 patients diagnosed with TTMP and treated with CPP in our clinic between January 2015 and 2019. In the classification of TTMP size, the entire tympanic membrane was evaluated as 100%, perforation of <25% was considered small, perforation of between 25% and 50% was considered medium and perforation of ≥50% was considered large. Audiological examination was performed before and at 3 months after the CPP procedure. Air conduction (AC) and bone conduction (BC) pure tone averages (PTAs) and air-bone gap (ABG) at 0.5, 1, 2, and 4 khz frequencies were compared. RESULTS: Perforations were small in 20 (29.9%) of 67 ears, medium in 27 (40.2%), and large in 20 ears (29.9%). AC PTA before CPP was found to be 28.26±5.63 dB hearing level (HL), BC PTA was 8.80±4.35 dB HL and ABG was 19.26±5.80 dB HL. After CPP, the AC PTA was found to be 11.90±6.59 dB HL, BC PTA was 8.29±4.05 dB HL, and ABG was 14.10±4.66 dB HL. TTMP was determined to have improved in 61 ears (91%) in the 1st month after CPP application. There was no statistically significant difference between perforation size and improvement rates (p>0.05). AC PTA values after CPP application were determined to be significantly lower than AC PTA values before CPP application at 0.5, 1, 2, and 4 khz (p<0.001). The ABG values measured at 0.5 khz after CPP were significantly higher than the values measured at 2 khz. and 4 khz. (p<0.001, p<0.001, respectively). The amount of decrease in PTA value after CPP was found to be significantly greater at 0.5 khz than at 2 khz and 4 khz (p<0.001, p<0.001, respectively). CONCLUSION: In the treatment of TTMP, early application of CPP is an effective treatment method in terms of both perforation closure and hearing gain.

The Effect of Curcumin on the Prevention of Myringosclerosis in Rats.

OBJECTIVE: The aim of this study was to investigate the preventative effect of oral curcumin (CMN) on myringosclerosis (MS) in an experimental rat model. METHODS: The study included 21 female Wistar albino rats randomly separated into three groups. Group 1 was given no treatment (control group). In Group 2 and Group 3, the tympanic membrane (TM) was perforated using a sterile ear pick. The rats in Group 3 were administered oral CMN 200 mg/kg/day. All rats were sacrificed after 16 days. Otomicroscopic and histopathologic examinations were performed on the tympanic membranes. RESULTS: Histopathologic examinations revealed that there were statistically significant differences between Group 2 and Group 3 in terms of MS degrees (p<0.001) and mean thicknesses of TMs (p<0.001), but there were no differences between Group 1 and Group 3. In respect of MS detected by otomicroscopy, a statistically significant difference was determined between Groups 1 and 2 (p<0.001) and between Groups 2 and 3 (p<0.01), but there was no significant difference between Group 1 and Group 3 (p=0.575). CONCLUSION: Orally administered CMN can prevent myringosclerosis formation in experimentally induced myringotomies.

The Effect of Oral Montelukast Administration in Cholesteatoma Development and Inflammation: An Experimental Animal Model.

HYPOTHESIS: We hypothesized that oral montelukast treatment could inhibit cholesteatoma formation in an experimental animal model. BACKGROUND: Inflammation and excessive proliferation have been described in the histopathology of cholesteatoma. The aim of this study was to determine the effect of oral montelukast on cholesteatoma development. METHODS: Eighteen healthy female Wistar albino rats weighing 250 g were chosen for the study. The animals were divided into two groups: group 1 received montelukast and group 2 was the control group. Intratympanic propylene glycol injection was administered into the left ears and physiologic serum was instilled into the right ears of the animals on the first, eighth, and fifteenth days. The effects of montelukast administration were evaluated by histological examination of the tympanic membrane and middle ear. RESULTS: Group 1 (montelukast group) showed significant differences in terms of cholesteatoma formation, granulation, epithelial invagination, and inflammation. Cholesteatoma formation in the left ear was observed in 2 (22%) and 8 (89%) rats in groups 1 and 2, respectively (p = 0.015). CONCLUSION: Development of cholesteatoma and inflammation was significantly lower in the montelukast-administered group. Thus, oral montelukast was found effective in preventing cholesteatoma formation.

Association of Toll-Like Receptor Polymorphisms With Nasal Polyposis.

Nasal polyposis is a disease characterized with chronic inflammation of the nasal mucosa. Toll-like receptors (TLRs) are defined as essential receptors of the innate immune system and may play in the development of nasal polyposis. A total of 71 patients with nasal polyposis and 74 healthy controls were included in this study. Three single-nucleotide polymorphisms (SNPs); TLR2 (2258 A>G), TLR4 (896 A>G), and TLR4 (1196 C>T) were analyzed in all patients. The degree of pair-wise linkage disequilibrium and the genotype and haplotype analyses were conducted using regression in this logistic model and the Multifactor Dimensionality Reduction (MDR) software package was used to construct all possible interactions among different genotype variants belonging to the TLR gene. There was significant difference in genotype and allele frequencies of the TLR4 (1196 C>T) polymorphism between the nasal polyposis and control groups (0.017). Also, it was observed that the probability of nasal polyposis was 62.7% in the presence of TLR4 (1196 C>T) polymorphism with asthma (P = .007). As a conclusion, this study showed that TLR4 and TLR2 polymorphisms were predisposing factors for nasal polyposis. Further functional studies investigating the consequences of loss of TLR function are needed.

Is there any effect of montelukast on prevention of myringosclerosis after myringotomy in a rat model?

OBJECTIVES: In this study, our aim was to identify the possible effects of montelukast sodium (ML) on the prevention of experimentally induced myringosclerosis. MATERIALS AND METHODS: Twenty-eight female Wistar albino rats were used and they were divided into four groups randomly. Tympanic membranes (TM) of all animals were perforated and then group 1 received no treatment (control group), group 2 was treated with a topical saline solution, group 3 received topically ML and group 4 received orally ML. On the 15th day, all animals were euthanized. Tympanic membranes were evaluated otomicroscopically and histopathologically. RESULTS: The histopathological findings, compared against a control and saline groups, showed the topically and orally ML groups had statistically significant differences of degree of myringosclerosis (p < 0.002) and median thickness of the TMs (p < 0.001). Suppression of inflammation was statistically significant only in the oral ML treatment group (p < 0.002). CONCLUSION: Oral and topically administration of ML reduced myringosclerosis formation in myringotomies rats.