Clinical investigation of the transient evoked otoacoustic emission test in Crimean-Congo hemorrhagic fever.

OBJECTIVE: The aim of this study was to investigate cochlear damage in Crimean-Congo hemorrhagic fever (CCHF) infection. METHODS: Thirty-two CCHF patients (study group) and 13 healthy people (controls) were included in the study. CCHF patients were also grouped for the presence of fever. CCHF was diagnosed with the presence of CCHF virus-specific IgM antibody or CCHF virus (CCHFV) antigen by ELISA. Cochlear damage was determined by a 'fail' in the transient evoked otoacoustic emission (TEOAE) test. RESULTS: The proportion of TEOAE test 'fail' results in the CCHF patients was significantly higher than in the control group (p<0.05). We found no increase in the proportion of TEOAE test 'fail' results related to fever in the study group. CONCLUSIONS: CCHF disease damages cochlear function regardless of fever.

Karyometric analysis of nasal polyps.

OBJECTIVES: Nuclear characteristics of epithelial cells in nasal polyps were analyzed. PATIENTS AND METHODS: The slides of 35 patients who underwent surgery for nasal polyposis and 18 slides of normal mucosa were examined. The specimens were stained with hematoxylin-eosin. Tissue sections were analyzed by a CCD camera and the Karyotype Program of Human Cytogenetics Nomenclature System on a Macintosh computer (OS 9). Fifty epithelial cells in each slide were randomly selected and transferred to the automated karyotyping system and photographed. The diameters of the nuclei were measured and some peculiar nuclear features were examined, including unsmooth appearance of the nuclear membrane, anaphase-bridge, and binucleation. RESULTS: There were significant differences between nasal polyp and normal mucosa groups in terms of nuclear diameter, perimeter, and volume, with all variables being greater in the nasal polyp group (p=0.001). Unusual nuclear features differed significantly (unsmooth nuclear membrane appearance, p<0.001; anaphase-bridge, p=0.041; binucleation, p=0.018), as well. CONCLUSION: Epithelial cells of nasal polyps exhibit nuclear instability.

Fracture of skull base with delayed multiple cranial nerve palsies.

This report describes a pediatric case of delayed glossopharyngeal nerve, vagus nerve, and facial nerve palsies after a head injury. Computed tomography scan of the skull base revealed the fracture of the petrous part of the temporal bone, and the fracture involved the tip of petrous pyramid, in front of the jugular foramen. The anatomical features, mechanisms, diagnosis, and treatment are discussed.

Early effect of exogenous Na hyaluronate on mucociliary clearance.

BACKGROUND: An animal study is performed to determine the early effect of 1% Na hyaluronate on mucociliary clearance function. METHODS: One percent of Na hyaluronate was introduced into the maxillary sinuses of rabbits by anterior antrostomy. A physiological solution of 1% NaCl was introduced into the maxillary sinuses of a control group to equalize the influence of Na for both groups. The treatment material was sprayed with an atomizer for coating the maxillary sinus lining. Technetium-99m diethylenetriamine pentaacetate dynamic scintigraphic imaging was performed to evaluate mucociliary clearance function on all rabbits 72 hours after the surgical procedure. RESULTS: Although the mean rate of mucociliary clearance of the Na hyaluronate group was slightly worse than the control group; there was no statistically significant difference between them. CONCLUSION: There is no early effect of exogenous 1% Na hyaluronate on mucociliary clearance function.

Effect of intratympanic dexamethasone on noise-induced temporary threshold shift.

OBJECTIVE: To evaluate the effects of intratympanic treatment of dexamethasone (IT-DEX) and combination of DEX and hyaluronic acid (DEX/HA) for noise-induced temporary threshold shift (NITTS). MATERIALS AND METHODS: NITTS was experimentally performed in 60 rats. Electrophysiologic hearing thresholds of the rats were measured before and right after noise exposure. Then, the rats were placed into two groups, the first 30 rats in an IT-DEX group and the second in an IT-DEX/HA group. Treatments were performed in the two subgroups (30 ears in one subgroup) of each group. In the IT-DEX group, one ear of each rat was treated with 0.02 mL IT-DEX, and the other ear was treated with IT 0.02 mL physiologic solution of serum saline. In the IT-DEX/HA group, one ear of each rat was treated with combination of 0.01 mL IT-DEX and 0.01 mL HA, and the other ear was treated with IT 0.02 mL of physiologic solution of serum saline. One week after the treatments, electrophysiologic hearing thresholds of all rats were measured again. RESULTS: No statistically significant difference was observed in recovery values of electrophysiologic hearing thresholds between IT-DEX and serum saline (P = .641) in the IT-DEX group. Also, we found no statistically significant difference in the recovery values of electrophysiologic hearing thresholds between IT-DEX/HA and serum saline (P = .344) in the IT-DEX/HA group. CONCLUSION: There is no effect of either IT-DEX and DEX/HA for NITTS.

Nasal septal suture technique versus nasal packing after septoplasty.

BACKGROUND: The aim of this study was to compare eustachian function and blood gas changes with nasal packing (NP) and nasal septal suturing (NSS) after septoplasty. METHODS: Eighty patients who have nasal septal deviation and who otherwise are healthy were studied. Forty of these patients had finger glove NPs in their nasal cavities for 48 hours after septoplasty. Another 40 patients had NSS performed after septoplasty. Acoustic tympanometry and pH, P(CO2), and P(O2) analyses of arterial blood were performed preoperatively and 48 hours postoperatively. RESULTS: We observed a statistically significant increase in middle ear pressure (p < 0.001) and a significant reduction of P(O2) (p < 0.001) and increase of P(CO2) (p = 0.041) in the NP group but no difference in the NSS group, postoperatively. CONCLUSION: NSS should be preferred as an alternative to intranasal packing.

Bacteriology in patients with chronic sinusitis who have been medically and surgically treated.

Chronic sinusitis is a disease that afflicts a significant percentage of the population and causes considerable long-term morbidity. The common use of multiple broad-spectrum oral antibiotics and endoscopic sinus surgery to treat this condition may alter the pathogenes that promote persistence of chronic sinusitis. Forty-eight culture-positive patients with chronic sinusitis who had been medically treated for at least 3 months and had undergone sinus surgery were bacteriologically evaluated. Swab specimens of the middle meatus and sphenoethmoid recess were aseptically obtained endoscopically and cultured for aerobes. Coagulase-negative staphylococci were the most common isolates (45.8%), followed by Streptococcus pneumoniae (16.7%), Enterobacteriaceae (16.7%), Staphylococcus aureus (10.4%), and Pseudomonas aeruginosa (10.4%). Coagulase-negative staphylococci were the most frequently isolated organisms in our study, as in many other studies. Despite the significant predominance of these organisms, they have always been assumed to be contaminants, and their presence in culture has been discounted. Coagulase-negative S aureus may be a pathogen in the chronic sinusitis process, and sensitivities of this isolate should be obtained for evaluation and possible treatment of the disease.

Larsen's syndrome with dental anomalies: report of a case.

Dental anomalies and mixed-type hearing loss are extremely rare symptoms of Larsen's syndrome that is characterized by multiple joint dislocation and flat face. A 15-year-old Turkish girl affected with Larsen's syndrome exhibiting many characteristic facial and skeletal features plus hitherto unreported oral and oral-facial anomalies including, maxillary prognathi, malocclusion, supernumerary teeth, macroglossia and microdontia is reported.