Histological Study of The Healing of Traumatic Tympanic Membrane Perforation After Vivosorb and Epifilm Application.

BACKGROUND: Untreated traumatic tympanic membrane perforations (TMPs) may lead to permanent perforations and hearing loss. There are many materials that have been previously used for repairing the TMPs. AIMS AND OBJECTIVES: The purpose of this study is to evaluate the clinical and histological effects of Vivosorb (Vv) and Epifilm on healing of TMPs in a rat model. MATERIAL AND METHODS: The posterior-inferior quadrant of the tympanic membranes (TMs) in right ears of 14 rats was perforated using a 20-g needle and then the animals were randomly divided into 2 equal groups (n = 7). The perforated right TMs were treated with either Vv (Vv group) or Epifilm (Ep group). The left TMs of 7 rats were perforated in same way and allowed to close spontaneously without any topical material applications (spontaneous closure group as sham control, SC). The left tympanic membranes of the other 7 rats were not perforated and used as normal controls (NC group). On postoperative 15th day, tympanic bullas were extracted from killed rats and examined morphometrically and histopathologically. RESULTS: Perforation closure rate was 85.7% (6/7) in both Vv and SC groups. Perforations of Ep group closed in 7/7 (100%) ears. The thicknesses of the perforated membranes were increased in SC and especially Vv groups. Also, connective tissue fibrosis, blood clots, and epithelial degenerations were detected in SC and Vv groups. The mean fibroblastic reaction scores of Vv, Ep, and SC groups were 2.14(+), 0.57(+), and 1.71(+) respectively, on comparison with NC group. The mean neovascularization score was 1.42(+) in Vv group, 0.14(+) in Ep group, and 0.57(+) in SC group. CONCLUSION AND SIGNIFICANCE: Vivosorb and especially Epifilm can improve the healing process in traumatic TMPs and additionally, Epifilm might be more preferred for the treatment of TMPs because of causing lesser fibrosis.

Osmophobia and olfactory functions in patients with migraine.

Olfactory dysfunction and migraine has been associated for a long time. In this study, we planned to compare olfactory functions in patients with migraine and osmophobia with patients having migraine but no osmophobia, in addition with a normal control group using "Sniffin' Sticks" test. The main distinction of this study is that all qualitative and quantitative properties of olfactory functions; threshold, discrimination and identification, are evaluated separately and jointly. Thirty healthy person aged between 16 and 56 (18 women, 12 men) and 60 migraine patients aged between 15 and 54 (39 women, 21 man) were included in the study. All patients have been inquired about osmophobia and have been assessed with Hedonic tone assessment. Osmophobia has been tested for perfume, cigarette smoke, leather, stale food, soy sauce, fish, spices and coffee smells. Olfactory functions has been assessed with "Sniffin' Sticks" smell test. Thresholds, discrimination and identification have been determined for each patient. In migraine patients with osmophobia, threshold was 7.75 ± 2.3, in migraine patients without osmophobia threshold was 8.25 ± 1.5 and threshold was 10.75 ± 1.3 for the control group. Discrimination score was 6 ± 1.2 in migraine patients with osmophobia, 9 ± 0.8 in patients without osmophobia and was 12 ± 1.4 in the control group. In migraine patient with or without osmophobia Threshold/Discrimination/Identification (TDI) scores were lower than the control group. The most important parameter in our study is that discrimination scores were especially lower in patients with osmophobia. We believe that this decrease in discrimination in migraine patients with osmophobia; who claim that they smell everything and they are sensitive to all smells, is significant. Further studies about smell discrimination will help better understand some conditions; especially anosmia and hyposmia after upper respiratory tract infections and parosmia.

Study of hearing aid effectiveness and patient satisfaction.

OBJECTIVES: This study aims to investigate hearing aid using rate, patient satisfaction rate and achievements in social communication of patients by assessing the hearing thresholds before and after device use in patients who were determined as suitable for hearing aid use. PATIENTS AND METHODS: Hundred eighty patients who were admitted to Otolaryngology Clinic of Sakarya University Medical Faculty and approved of hearing aid usage between January 2013 and May 2013 were included in the study. Patients (21 males, 26 females; mean age 61.91±12.82; range 24 to 85 years) were performed free field audiometry with and without the device by the same audiometrist and Turkish version of the International Outcome Inventory for Hearing Aids by the same otolaryngologist. RESULTS: Of patients, 14.28% did not obtain the hearing aid even though they received a hearing aid approval report. Assessment of the answers of inventory questions revealed that 87% of patients used hearing aid more than four hours a day, 72% benefited significantly from hearing aid, and 64% had no complaint or had few complaints compared to the before-hearing aid period. CONCLUSION: Using hearing aid affects daily activities of patients slightly or moderately and increases their communication skills.

[Postoperative use of antibiotics in septoplasty cases: is it really necessary?]. / Septoplasti olgularinda ameliyat sonrasi antibiyotik kullanimi: Gerçekten gerekli mi?

OBJECTIVES: This study aims to investigate the efficacy of postoperative antibiotic use in the prevention of the surgical site infection. PATIENTS AND METHODS: Eighty patients who underwent septoplasty in our clinic between July 2012 and September 2012 were followed. Forty of them received preoperative antibiotic prophylaxis and postoperative oral antibiotics (group 1). The other 40 received only preoperative antibiotic prophylaxis (group 2). The patients were assessed at the time of removing packings and postoperative first and second week in terms of infection criteria; endoscopic examination was performed and complete blood counting, and C-reactive protein (CRP) levels were studied. Fifteen patients in each group who completed their follow-up were included in the study. RESULTS: Two patients receiving postoperative antibiotics in addition to the prophylaxis developed infection during follow-up. No infection was seen in the prophylaxis group. CONCLUSION: According to the comparison of the two groups, we conclude that there is no need to use postoperative antibiotics to prevent surgical site infections.

An evaluation of biodegradable synthetic polyurethane foam in patients following septoplasty: a prospective randomized trial.

OBJECTIVE: The purpose of this study is to examine the usability of biodegradable synthetic polyurethane foam (BSPF) after septoplasty by comparing it with Merocel and silicone intranasal splints as packing materials in terms of patient comfort and efficiency. STUDY DESIGN: A prospective, unmasked, randomized trial. SETTING: A tertiary referral center. SUBJECTS AND METHODS: This study was designed to be a prospective, randomized clinical trial. Sixty-eight patients who underwent septoplasty were included in this study. The patients were randomized to receive Merocel, silicone intranasal septal splint (INS), or BSPF after septoplasty. Clinical efficacy on bleeding, pain, and subjective symptoms related to packing materials was evaluated. RESULTS: There was a statistically significant difference between the Merocel group and the other 2 groups in terms of bleeding and adhesion. The average score on the pain scale was 2.47 ± 1.01 for BSPF, 3.68 ± 1.27 for INS, and 6 ± 2.21 for Merocel. Scores on general satisfaction scales were 6.95 ± 1.42 for Merocel, 8.44 ± 2.12 for INS, and 8.28 ± 1.88 for BSPF. CONCLUSION: The efficacy of BSPF was comparable with that of Merocel and INS. Biodegradable synthetic polyurethane foam significantly reduced pain and patient discomfort during packing and removal, followed by INS, compared with Merocel.

Do silicone nasal septal splints with integral airway reduce postoperative eustachian tube dysfunction?

OBJECTIVE: This study aims to compare the effects of Merocel nasal packs and silicone nasal septal splints with integral airway on the ventilation and pressure of the middle ear when applied intranasally after septoplasty for isolated septal deviation. STUDY DESIGN: A prospective, randomized trial. SETTING: A tertiary referral center. SUBJECTS AND METHODS: Fifty-one patients who underwent septoplasty for nasal respiratory impairment caused by septal deviation were randomized into 2 groups. After septoplasty, bilateral anterior Merocel nasal packs were applied in one group, while silicone nasal septal splints with integral airway were applied in the other group. Middle ear pressures were compared using preoperative and post-operative tympanometry. RESULTS: Pathological decrease in the middle ear pressure in at least 1 ear was determined in 17 patients (73.9%) in the Merocel group compared with only 6 patients (21.4%) in the silicone nasal septal splint group at the 48th postoperative hour. In the first 24 hours following surgery, decreases in tympanometric pressures were seen in both groups, but more in the Merocel group. After 24 hours, middle ear pressures continued to decrease in the Merocel group but started to increase in the silicone nasal septal splint group. CONCLUSION: Because they allow inhalation through the nose and cause less Eustachian tube dysfunction than Merocel, using silicone nasal septal splints with integral airway instead of packing after septoplasty seems a more reasonable option.