The effect of N-acetyl cysteine on biofilm layers in an experimental model of chronic otitis media.

OBJECTIVE: The aim of this study was to investigate the efficacy of N-acetylcysteine (NAC) on biofilm layers and on the course of disease in chronic otitis media. METHODS: Twenty-five rats that were induced with chronic otitis media (COM) were separated into three groups. In Group 1 (N = 18), 0.2% ciprofloxacin + 0.1% dexamethasone sodium phosphate + 0.5 mg/ml NAC solution was locally injected to the right ear of the rats; in Group 2, (N=18) 0.2% ciprofloxacin + 0.1% dexamethasone sodium phosphate was locally injected to the left ear of the rats. No treatment was applied to either ear of rats in Group 3 (N = 5). Histopathological and scanning electron microscope (SEM) evaluations were performed in all groups. RESULTS: SEM revealed biofilm formation in all COM induced groups. No significant difference was seen between groups 1 and 2 in terms of suppuration levels, fibrosis, inner ear involvement, infection staging and biofilm formation (p > 0.05). CONCLUSIONS: In this study, while histopathological and SEM evaluation revealed no effect of 0.5 mg/ml NAC on the biofilm layer in COM-induced rats, further studies with NAC at different concentrations are still needed on different types of experimental animals.

Comparison of natural ostiodilatation and endoscopic sinus surgery in the same patient with chronic sinusitis.

INTRODUCTION: Chronic rhinosinusitis is a broad clinical syndrome characterized by mucosal inflammation of the nose and paranasal sinuses. In order for the paranasal sinuses to maintain their physiological functions; the ostiomeatal complex drainage pathways must be open. Surgical procedures are an important treatment option in patients who do not respond adequately to medical treatment. Although the methods and instruments used in functional endoscopic sinus surgery have continued to improve in recent years, the scar tissue formed during operation disrupts the drainage of the sinuses and reduces postoperative success. The natural ostiodilatation method, which is performed by balloon sinoplasty method, has become more and more popular in recent years. OBJECTIVES: To compare the technique of balloon sinoplasty with the classical functional endoscopic sinus surgery method by considering the severity of chronic sinusitis on the same patient. METHODS: Total of 61 chronic sinusitis patients was included in the study. Paranasal sinus tomography of the patients was taken and according to the Lund-Mackay scoring, chronic sinusitis levels were determined. Cases were divided into two groups: Group 1 (severe chronic sinusitis group) and Group 2 (mild chronic sinusitis). RESULTS: There was no statistically significant difference in the results of comparison of sinuses which underwent balloon sinoplasty and classical functional endoscopic sinus surgery in Group 2 after Lund-Mackay scores. However in Group 1, the results of the comparison of postoperative Lund-Mackay scores of the balloon sinoplasty and the classical endoscopic operation were statistically significantly lower than those of the face half operated with the classical functional endoscopic sinus surgery. CONCLUSION: The success of balloon sinoplasty in patients with mild sinusitis is the same as in classic functional endoscopic sinus surgery. However, as the severity of sinusitis increases, the efficacy of balloon sinoplasty decreases.

Insufficiency of positive airway pressure treatment on increased mean platelet volume: a prospective controlled study in patients with obstructive sleep apnea syndrome.

BACKGROUND: To analyze the association between obstructive sleep apnea syndrome (OSAS) and some hematological variables such as mean platelet volume (MPV), platelet distribution width (PDW), and the impact of positive airway pressure (PAP) treatment on these parameters. METHODS: The participants of the present prospective study consist of 36 OSAS patients diagnosed with polysomnography and recommended PAP treatment and 30 healthy members as the control group. Complete blood analyses were conducted to the patient group twice; before the initiation of the PAP treatment and 1 month after regular PAP use. The control group was administered a complete blood analyses only once. Patient and control group were compared in terms of various parameters such as MPV, PDW, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) values, and platelet counts. RESULTS: MPV value of the patient group was before and after PAP treatment significantly higher than the control group (respectively; Z = 2.246; p = 0.025, and Z = 2.033; p = 0.042). However, there were no statistically significant differences in the values before and after PAP treatment in the patient group (Z = 0.727; p = 0.467). In terms of platelet numbers and PDW values, no significant differences were determined (p > 0.05). CONCLUSION: MPV value was significantly elevated in OSAS patients. However, the 1 month of PAP treatment was insufficient in decreasing elevated MPV values.

The effect of inlay butterfly cartilage tympanoplasty technique on compliance.

CONCLUSION: IBCT technique should be preferred owing to its high graft survival rate and ABG gain. While no significant difference was found in middle ear pressures between ears that underwent IBCT and normal ears, compliance values were found to be decreased in patients undergoing IBCT. However, the lack of correlation between ABG gain and compliance values indicated that compliance increase had no effect on post-operative ABG results. OBJECTIVE: The aim of the present study was to compare tympanometric and audiological parameters in patients undergoing inlay butterfly cartilage tympanoplasty (IBCT) with their normal ears and to determine their difference with normal ear tympanometric parameters. METHODS: Overall, 25 patients that underwent an operation between August 2010-May 2014 were included in the present study. In 13 of these patients, the ear that did not undergo operation was normal. 0.5, 1, 2, 4 kHz pure sound average values, tympanometric measurements and compliance values of normal and operated ears were compared. RESULTS: The graft survival rate in patients was found to be 92%. Mean pre-operative air-bone gap (ABG) was 16.4 ± 5.4 in patients, while mean post-operative ABG was 10.9 ± 5.8, with a statistically significant difference (p = 0.001) While there was no significant difference between operated and normal ears of patients in terms of middle ear pressure (0.441), compliance values were significantly higher in normal ears than those in operated ears (0.032). When post-operative ABG gain was compared with compliance values, no significant correlation was found between ABG gain and compliance measurements (r = -0.025 and p = 0.936).

Lingual Thyroid Excision with Transoral Robotic Surgery.

Ectopic thyroid gland may be detected at any place between foramen caecaum and normal thyroid localization due to inadequacy of the embryological migration of the thyroid gland. It has a prevalence varying between 1/10.000 and 1/100000 in the community. Usually follow-up without treatment is preferred except for obstructive symptoms, bleeding, and suspicion of malignity. Main symptoms are dysphagia, dysphonia, bleeding, dyspnea, and obstructive sleep apnea. In symptomatic cases, the first described method in surgical treatment is open approach since it is a region difficult to have access to. However, this approach has an increased risk of morbidity and postoperative complications. Transoral robotic surgery, which is a minimally invasive surgical procedure, has advantages such as larger three-dimensional point of view and ease of manipulation due to robotic instruments. In this report, a case at the age of 49 who presented to our clinic with obstructive symptoms increasing within the last year and was found to have lingual thyroid and underwent excision of ectopic thyroid tissue by da Vinci surgical system is presented.