Hearing evaluation with ABR in pediatric patients with celiac disease.

BACKGROUND/AIMS: Celiac disease (CD) is an autoimmune and genetic disease that is triggered by gluten intolerance. We aimed to investigate whether Celiac disease have any effect on Auditory Brainstem Response (ABR) waves compare to a healthy control group, and present its association with sensorineural hearing loss (SNHL). MATERIALS AND METHODS: Thirty-eight patients aged 2 to 16 years old were included in the study. The patients had confirmed diagnosis of Celiac disease through duodenal biopsies and transglutaminase Antibody (Ab) (+). The control group consisted of 18 children aged 3 to 17 years old who were all admitted to the pediatric gastroenterology department due to complaints of constipation and transglutaminase Ab (-).All children underwent Auditory-Brain-Stem-Evoked Responses (ABR). The data were gathered using click stimulus at 10/s frequency 90dB HL. RESULTS: The results of ABR examination did not show any difference between the patient group and control group as regards the latency of the waves I, III, V. No difference was observed between the two groups in the interpeak latecies I-III, I-V and III-V. None of the patients was observed to have clinical hearing loss. DISCUSSION: The exact pathogenesis of neurological damages observed in Celiac disease is still unknown. Humoral immune mechanisms are the most frequently attributed cause. CONCLUSION: Although no significant difference was found in hearing values between the study group and healthy control group, there is a need for further research on this subject.

Noninvasive assessment of oral lesions using elastic light single-scattering spectroscopy: a pilot study.

PURPOSE: In the present study, we investigated the potential application of elastic light single-scattering spectroscopy (ELSSS) as a noninvasive, adjunctive tool to differentiate between malignant and benign oral lesions in vivo. METHODS: ELSSS spectra were acquired from 52 oral lesions of 47 patients prior to surgical biopsy using a single optical fiber probe. The sign of the spectral slope was used as a diagnostic parameter and was compared to the histopathology findings to obtain sensitivity and specificity of the ELSSS system in differentiating between benign and malignant tissues. RESULTS: The sign of the spectral slope was positive for the benign tissues and negative for the malignant tissues. Nine malignant lesions and one high-grade dysplasia were correctly classified as cancerous. Six out of the ten low-grade dysplasia were correctly classified as cancerous, and four of them were misclassified as benign. Thirty benign lesions were correctly classified as benign, and two were misclassified as malignant. Our results indicate that the sign of the spectral slope enables the differentiation between malignant and benign oral lesions with a sensitivity of 80% and specificity of 94%. CONCLUSIONS: ELSSS has the potential to be developed as an adjunctive screening tool in the noninvasive evaluation of oral lesions in vivo. This new diagnostic system may reduce the number of unnecessary biopsies.

The place of hyperbaric oxygen therapy and ozone therapy in sudden hearing loss / O papel da oxigenoterapia hiperbárica e da ozonioterapia na surdez súbita

Abstract Introduction: It is difficult to evaluate the effect of drugs clinically used for idiopathic sudden sensorineural hearing loss, mainly because its underlying mechanism remains unknown. Objective: This study assessed the efficacy of hyperbaric oxygen therapy or ozone therapy in the treatment of idiopathic sudden sensorineural hearing loss, when either therapy was included with steroid treatment. Methods: A retrospective analysis examined 106 patients with idiopathic sudden sensorineural hearing loss seen between January 2010 and June 2012. Those with an identified etiology were excluded. The patients were divided into three treatment groups: oral steroid only (n = 65), oral steroid + hyperbaric oxygen (n = 26), and oral steroid + ozone (n = 17). Treatment success was assessed using Siegel criteria and mean gains using pre- and post-treatment audiograms. Results: The highest response rate to treatment was observed in the oral steroid + ozone therapy group (82.4%), followed by the oral steroid + hyperbaric oxygen (61.5%), and oral steroid groups (50.8%). There were no significant differences in the response to treatment between the oral steroid and oral steroid + hyperbaric oxygen groups (p < 0.355). The oral steroid + ozone group showed a significantly higher response rate to treatment than the oral steroid group (p = 0.019). There were no significant differences between the oral steroid + hyperbaric oxygen and oral steroid + ozone groups (p = 0.146). Conclusion: The efficiency of steroid treatment in patients with severe hearing loss was low. It was statistically ascertained that adding hyperbaric oxygen or ozone therapy to the treatment contributed significantly to treatment success.

Resumo Introdução: É difícil avaliar o efeito dos fármacos clinicamente usados na surdez súbita idiopática, principalmente porque o seu mecanismo subjacente se mantém desconhecido. Objetivo: Avaliar a eficácia da oxigenoterapia hiperbárica ou ozonioterapia no tratamento de surdez súbita, quando uma ou outra terapia é incluída no tratamento com esteroides. Método: Uma análise retrospectiva examinou 106 pacientes com surdez súbita atendidos entre janeiro de 2010 e junho de 2012. Aqueles com uma etiologia identificada foram excluídos. Os pacientes foram divididos em três grupos de tratamento: apenas esteroide oral (n = 65), esteroide por via oral + oxigenoterapia hiperbárica (n = 26) e esteroides por via oral + ozônio (n = 17). O sucesso do tratamento foi avaliado com critérios de Siegel e os ganhos médios com audiogramas pré e pós-tratamento. Resultados: A taxa de resposta mais elevada para o tratamento foi observada no grupo de esteroide + ozonioterapia (82,4%), seguida por grupos de esteroide oral + oxigenoterapia hiperbárica (61,5%) e esteroide oral (50,8%). Não houve diferenças significantes na resposta ao tratamento entre os grupos de esteroide oral e esteroides + oxigenoterapia hiperbárica (p < 0,355). O grupo de esteroide oral + ozônio apresentou uma taxa de resposta significantemente mais elevada ao tratamento do que o grupo de esteroide oral (p = 0,019). Não houve diferenças significantes entre os grupos de esteroide oral + oxigenoterapia hiperbárica e esteroide oral + ozônio (p = 0,146). Conclusão: A eficiência do tratamento com esteroides em pacientes com perda auditiva grave foi baixa. Verificou-se estatisticamente que a adição de oxigenoterapia hiperbárica ou ozonioterapia ao tratamento contribuiu significantemente para o sucesso do tratamento.

Intraoperative assessment of laryngeal malignancy using elastic light single-scattering spectroscopy: A pilot study.

OBJECTIVES/HYPOTHESIS: The elastic light single-scattering spectroscopy (ELSSS) system is a new tool for the real-time diagnosis of cancerous lesions. In the current study, we have employed ELSSS to investigate its ability in differentiation between normal and cancerous larynx tissues ex vivo. STUDY DESIGN: Basic science study in assessment of laryngeal malignancy using spectroscopy. METHODS: ELSSS spectra of the larynx tissue were acquired using a single-fiber optical probe. Ex vivo spectroscopic measurements were acquired on 95 laryngeal lesions of 40 patients. Average slopes of the spectra in the wavelength range of 450 to 750 nm were calculated. The signs of the spectral slopes were positive for benign and negative for cancerous larynx tissues. Histopathology results were used as a gold standard to define sensitivity and specificity. RESULTS: The ELSSS system correctly defined 38 out of 41 malignant tissues as cancerous; three of them were misclassified as benign. All benign tissues were correctly classified. Moderate, severely dysplastic, and malignant tissues were correctly classified as cancerous. The system could not classify mild dysplastic tissues either benign or cancerous, whereas nearly half of them were classified as benign and the other half as malignant. The signs of the spectral slopes were used as a discrimination parameter between benign and cancerous (moderate, severely dysplastic, and malignant) lesions with a sensitivity and specificity of 94% and 100%, respectively. CONCLUSIONS: The ELSSS system has the potential to be used as an adjunctive tool in the diagnosis of cancerous laryngeal tissues in real time and noninvasively. This new diagnostic technique may reduce the number of negative biopsies. LEVEL OF EVIDENCE: NA Laryngoscope, 127:611-615, 2017.

The place of hyperbaric oxygen therapy and ozone therapy in sudden hearing loss.

INTRODUCTION: It is difficult to evaluate the effect of drugs clinically used for idiopathic sudden sensorineural hearing loss, mainly because its underlying mechanism remains unknown. OBJECTIVE: This study assessed the efficacy of hyperbaric oxygen therapy or ozone therapy in the treatment of idiopathic sudden sensorineural hearing loss, when either therapy was included with steroid treatment. METHODS: A retrospective analysis examined 106 patients with idiopathic sudden sensorineural hearing loss seen between January 2010 and June 2012. Those with an identified etiology were excluded. The patients were divided into three treatment groups: oral steroid only (n=65), oral steroid+hyperbaric oxygen (n=26), and oral steroid+ozone (n=17). Treatment success was assessed using Siegel criteria and mean gains using pre- and post-treatment audiograms. RESULTS: The highest response rate to treatment was observed in the oral steroid+ozone therapy group (82.4%), followed by the oral steroid+hyperbaric oxygen (61.5%), and oral steroid groups (50.8%). There were no significant differences in the response to treatment between the oral steroid and oral steroid+hyperbaric oxygen groups (p<0.355). The oral steroid+ozone group showed a significantly higher response rate to treatment than the oral steroid group (p=0.019). There were no significant differences between the oral steroid+hyperbaric oxygen and oral steroid+ozone groups (p=0.146). CONCLUSION: The efficiency of steroid treatment in patients with severe hearing loss was low. It was statistically ascertained that adding hyperbaric oxygen or ozone therapy to the treatment contributed significantly to treatment success.

Diagnosis and treatment of malignant lymphomas of parotid gland.

OBJECTIVES: This study aims to report surgical outcomes of primary parotid lymphomas and to discuss the histopathological subtypes, incidence rates, and clinical course. PATIENTS AND METHODS: Between January 2002 and December 2014, eight patients (2 males, 6 females; man age 46.6 years; range 25 to 60 years) who were diagnosed with primary parotid lymphoma and underwent parotidectomy were retrospectively analyzed. Demographic characteristics of the patients, histopathological subtypes, disease stage, and survival rates were recorded. RESULTS: The ratio of the patients diagnosed with lymphoma was 2.82% among all patients, while 18.1% of the malignancies were lymphomas. Fine needle aspiration biopsy was non-diagnostic. CD20-positive low-grade B-cell lymphoma was the most common histopathological subtype in 37.5% of the patients. CONCLUSION: Based on our study results, the fine needle aspiration biopsy is not helpful in the diagnosis of the lymphomas of the parotid gland. Although rarely seen, lymphomas of the parotid gland should be considered in the differential diagnosis.