ABSTRACT
The aim of our study is to analyze changes occurring in the auditory brainstem response (ABR) according to stimulus parameters in unilateral cochlear hearing loss cases. Twenty-nine cases (14 male, 15 female) with unilateral sensorineural hearing loss (SNHL) were investigated. All cases had cochlear SNHL on one side whereas normal hearing on the other side. All cases underwent ABR testing with varying stimulus intensity levels and stimulus repetition rates (SRRs). Results were compared and their correlation with audiogram shapes investigated. As stimulus intensity levels decreased on both ears, latencies expanded and amplitudes decreased in all traces of ABR. Latencies of ears with cochlear hearing loss were observed to be longer than those in normal ears. Responses to SRR increases were similar on both ears. Audiogram shapes should be taken into consideration while performing ABR in order to address asymmetric SNHL. The interpretation of ABR changes with various stimulus levels may provide a better understanding of cochlear pathologies associated with hearing loss in the future.
ABSTRACT
Necrotizing fasciitis is a rapidly progressing and life-threatening soft tissue infection that often affects the abdominal wall, perineum, or extremities following surgery or trauma. It predominantly occurs in elderly and immunocompromised patients. It is rarely seen in the head and neck region. Necrotizing fasciitis of the head and neck carries high rates of morbidity and mortality. Symptoms usually develop quickly and well-timed diagnosis is critical to optimizing outcome. Diagnosis is based on a combination of clinical history, Gram staining and culture, imaging and surgical exploration. Early and aggressive surgical management and urgent parenteral antibiotic therapy are critical to optimizing outcome.
ABSTRACT
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.
