Blood prestin levels in COVID-19 patients.

BACKGROUND: Many studies have found that viral infections affect different tissues, including the inner ear. Coronavirus disease 2019 (COVID-19), a viral infection, is a significant health problem worldwide. Prestin is a motor protein with important functions both in the outer hair cells of the inner ear and in cardiac tissue. In addition, prestin is promising as an early biomarker in the detection of ototoxicity. To determine the severity of infection in COVID-19 patients and to determine whether other tissues are affected by the infection, lactate dehydrogenase (LDH), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase MB (CK-MB), biochemical markers such as ferritin and D-dimer are used. This study aimed to compare prestin levels in patients with COVID-19 and healthy volunteers. METHODS: In blood samples taken from 45 patients diagnosed with COVID-19 and 40 healthy volunteers, prestin levels were determined with the kit that used an enzyme-linked immunosorbent assay method and was commercially available. At the same time, LDH, CRP, ALT, AST, CK-MB, ferritin, and D-dimer levels were also detected in both patients and healthy control groups and correlations with prestin levels were examined. RESULTS: The main result of our study is that serum prestin levels in COVID-19 patients are significantly higher than in healthy controls ( p < 0.001). In addition, a statistically significant strong positive correlation was found between prestin-LDL ( r = 0.537, p = 0.001), prestin-CRP ( r = 0.654, p = 0.001), and prestin-D-dimer ( r = 0.659, p = 0.001). CONCLUSION: The levels of prestin, a motor protein in inner ear outer hair cells and cardiac myocytes, were found to be higher in COVID-19 patients than in healthy volunteers. It also showed a positive correlation with CRP and D-dimer. This may be associated with systemic dysfunction.

Protective role of resveratrol and apigenin against toxic effects of bisphenol a in rat salivary gland.

OBJECTIVES: The aim of this study was to investigate the cellular changes caused by Bisphenol A (BPA) exposure in salivary gland cells and to examine the protective role of resveratrol (RSV) and apigenin (APG) molecules against the negative effects of BPA. MATERIALS AND METHODS: Forty-two rats were randomly divided into 6 groups as; (i) control, (ii) BPA (130 mg/kg), (iii) BPA + RSV100 (100 mg/kg), (iv) BPA + RSV200 (200 mg/kg), (v) BPA + APG100 (100 mg/kg), and (vi) BPA + APG200 (200 mg/kg). In all experimental groups, the chemicals were given by gavage every day for a total of 28 days. RESULTS: The BPA administration caused a significant increase in tissue oxidative stress parameters as opposed to a significant decrease in tissue antioxidant levels (p < 0.05). On the other hand, it was observed that RSV and APG treatment reversed this situation (p < 0.05). The BPA administration did not cause a significant change in tissue prostaglandin E2 (PGE2) and nitric oxide levels, whereas low-dose RSV significantly reduced the tissue PGE2 levels compared to BPA (p < 0.05). BPA caused cytopathological changes and apoptosis in salivary gland cells. In the BPA group, edema, nuclear pleomorphism, and pyknotic nuclei were observed. Moreover, both RSV and APG were found to provide protection against BPA-induced cellular damage, while RSV provided better cellular protection than APG. The control group had a normal histological structure. CONCLUSION: BPA caused cytopathological changes and apoptosis in salivary gland cells. As a result, it was observed that these phytochemicals probably have cytoprotective effects in BPA intoxication.

The relationship between thiol-disulfide balance and idiopathic sudden sensorineural hearing loss / Relação entre equilíbrio tiol-dissulfeto e perda auditiva neurossensorial súbita idiopática

Abstract Introduction: Impaired cochlear perfusion is a major etiological factor in idiopathic sudden sensorineural hearing loss. Oxidative stress has been shown to be a risk factor for oxidative damage. Objectives: We investigated the role of oxidative stress in idiopathic sudden sensorineural hearing loss by comparing serum levels of oxidant and antioxidant molecules including thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin and myeloperoxidase in patients who did and did not recover after treatment. Methods: The amount of dynamic disulfide was calculated by determining half of the difference between the total thiols and native thiols. After the determination of native, total thiol, and disulfide amounts, the disulfide/total thiol percent ratio, native thiol/total thiol ratio and disulfide/native thiol percent ratio were calculated and then compared between the two groups. Additionally, clinical relationship between audiological recovery and native thiol, disulfide, disulfide/native thiol percent ratio, and disulfide/total thiol percent ratio levels was investigated. Blood samples were also analyzed for the assessment of thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels. Results: A significant difference was found between the two groups with regard to total oxidant status disulfide, disulfide/native thiol percent ratio, disulfide/total thiol percent ratio, and native thiol/total thiol ratio levels (p = 0.001, p = 0.001, p = 0.001, p = 0.003, p = 0.001, p = 0.002, respectively). However, no significant difference was found between the two groups with regard to thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, ceruloplasmin, and myeloperoxidase levels (p > 0.05 for all). Conclusion: The results supported the common hypothesis that vascular pathologies are the primary cause of idiopathic sudden sensorineural hearing loss and that other etiological factors ultimately result in vascular pathologies. The oxidant-antioxidant and thiol-disulfide balances were impaired in the idiopathic sudden sensorineural hearing loss group.

Resumo Introdução: A perfusão coclear prejudicada é um fator etiológico importante na perda auditiva neurossensorial súbita idiopática (PANSSI). O estresse oxidativo mostrou ser um fator de risco para danos oxidativos. Objetivos: Investigamos o papel do estresse oxidativo na PANSSI mediante a comparação dos níveis séricos de moléculas oxidantes e antioxidantes, inclusive homeostase de tiol/dissulfeto, paraoxonase, paraoxonase estimulada, arilesterase, ceruloplasmina e mieloperoxidase em pacientes com e sem recuperação após o tratamento. Método: A quantidade de dissulfeto dinâmico foi calculada mediante a determinação de metade da diferença entre os tiois totais e os tiois nativos. Após a determinação das quantidades de tiol nativo, tiol total e dissulfeto, as razões percentuais de dissulfeto/tiol total, tiol nativo/tioltotal e dissulfeto/tiol nativo foram calculadas e depois comparadas entre os dois grupos. Além disso, a relação clínica entre a recuperação audiológica e os níveis de tiol nativo, tiol nativo/tiol total, dissulfeto, dissulfeto/tiol nativo e dissulfeto/tiol total foi investigada. Amostras de sangue também foram analisadas para avaliar os níveis de paraoxonase, paraoxonase estimulada, arilesterase, ceruloplasmina e mieloperoxidase. Resultados: Uma diferença significante foi encontrada entre os dois grupos em relação ao estado oxidante total e aos níveis de dissulfeto, dissulfeto/tiol nativo, dissulfeto/tiol total, tiol nativo/tiol total (p = 0,001, p = 0,001, p = 0,001, p = 0,003, p = 0,001, p = 0,002, respectivamente). Porém, não foi encontrada diferença significante entre os dois grupos em relação aos níveis de paraoxonase, paraoxonase estimulada, ceruloplasmina e mieloperoxidade (p> 0,05 para todos). Conclusão: Os resultados apoiaram a hipótese comum de que as doenças vasculares são a principal causa de PANSSI e que, em última análise, outros fatores etiológicos resultam em doenças vasculares. Os equilíbrios de oxidante-antioxidante e tiol-dissulfeto estavam prejudicados no grupo PANSSI.

Vestibular neuronitis associated with an adult male COVID-19 infection: A case report.

In the present era of the coronavirus 2019 (COVID-19) pandemic, it has been observed that the severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2) infection does not only affect the respiratory tract, but also triggers various neurological symptoms in one-third of patients. The most prominent of such symptoms is anosmia, which is independent of rhinologic symptoms such as nasal obstruction, discharge, and pain that cannot be otherwise explained. Vestibular neuronitis ranks third among the causes of peripheral vestibular vertigo, characterized by nausea, vomiting, and dizziness that develops within minutes or hours. Although the etiopathogenesis remains poorly known, neuronitis is generally considered to be attributable to the viral or post-viral inflammation of the vestibular branch of the eighth cranial nerve. This report presents a case of vestibular neuronitis, which is likely to be a manifestation of acute vestibular neuronitis associated with COVID-19.

The relationship between thiol-disulfide balance and idiopathic sudden sensorineural hearing loss.

INTRODUCTION: Impaired cochlear perfusion is a major etiological factor in idiopathic sudden sensorineural hearing loss. Oxidative stress has been shown to be a risk factor for oxidative damage. OBJECTIVES: We investigated the role of oxidative stress in idiopathic sudden sensorineural hearing loss by comparing serum levels of oxidant and antioxidant molecules including thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin and myeloperoxidase in patients who did and did not recover after treatment. METHODS: The amount of dynamic disulfide was calculated by determining half of the difference between the total thiols and native thiols. After the determination of native, total thiol, and disulfide amounts, the disulfide/total thiol percent ratio, native thiol/total thiol ratio and disulfide/native thiol percent ratio were calculated and then compared between the two groups. Additionally, clinical relationship between audiological recovery and native thiol, disulfide, disulfide/native thiol percent ratio, and disulfide/total thiol percent ratio levels was investigated. Blood samples were also analyzed for the assessment of thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels. RESULTS: A significant difference was found between the two groups with regard to total oxidant status disulfide, disulfide/native thiol percent ratio, disulfide/total thiol percent ratio, and native thiol/total thiol ratio levels (p =  0.001, p =  0.001, p =  0.001, p =  0.003, p =  0.001, p =  0.002, respectively). However, no significant difference was found between the two groups with regard to thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, ceruloplasmin, and myeloperoxidase levels (p >  0.05 for all). CONCLUSION: The results supported the common hypothesis that vascular pathologies are the primary cause of idiopathic sudden sensorineural hearing loss and that other etiological factors ultimately result in vascular pathologies. The oxidant-antioxidant and thiol-disulfide balances were impaired in the idiopathic sudden sensorineural hearing loss group.

Dacryocystitis With Skin Defects Secondary to Septorhinoplasty.

ABSTRACT: Septorhinoplasty is a surgical procedure frequently performed by surgeons dealing with facial aesthetic surgery and includes various risks. All surgical procedures have an increased risk of complications. Complication rate of nasal surgeries is approximately 4% to 19%. Although rhinoplasty is a nonsterile procedure, infections occur in less than 2% of all cases. This rate may decrease as the surgeon gains experience. Lacrimal ducts can be injured during nasal aesthetic surgery due to its anatomical structure. In addition to minor and temporary injuries, major injuries requiring surgical intervention may also occur. Most injuries to the lacrimal system remain asymptomatic. Postrhinoplasty dacryocystitis usually occurs secondary to soft-tissue edema that compresses the lacrimal system and typically resolves within 1 to 2 weeks. After reviewing the literature and examining possible traumatic mechanisms, we recommend that the infections in the lacrimal system should be treated with medical therapy before performing surgical interventions such as dacryocystorhinostomy and abscess drainage. Knowing the complications of surgical interventions before the study and administering some basic principles before and after surgery are highly essential. In this study, we present a relatively rare complication of septorhinoplasty known as acute postoperative dacryocystitis, which is mostly encountered in the early postoperative period.

Residual Dizziness in Elderly Patients after Benign Paroxysmal Positional Vertigo.

INTRODUCTION: The aim of this study was to compare the effects of Brandt-Daroff (BD) exercise and shopping exercise (SE) on the resolution of residual dizziness (RD) in patients with benign paroxysmal positional vertigo (BPPV) following a successful modified Epley canalith repositioning maneuver (CRP). METHODS: This single-blind, randomized clinical trial included patients with posterior semicircular canal type of BPPV. Following the modified Epley maneuver, patients that experienced RD were randomly assigned to 3 groups: (i) BD, (ii) SE, and (iii) control groups. Primary outcomes were quantified using the Dizziness Handicap Inventory (DHI). RESULTS: Following CRP, 240 (63%) participants experienced RD. All these patients were followed up weekly for RD. After the resolution of RD, patients were followed up monthly for recurrence. Mean time to recovery was 16.4 ± 10 (range, 5-49) days in the BD group, 11.5 ± 4.6 (range, 6-32) days in the SE group, and 23.4 ± 16.8 (range, 6-89) days in the control group. The SE group recovered significantly faster than the BD and control groups (p < 0.001). Baseline emotional DHI (E-DHI) scores were significantly correlated with the duration of pre-CRP symptoms (p < 0.001). Correlation analysis indicated that patients with obesity and diabetes mellitus (DM) recovered later than patients without these comorbidities. CONCLUSION: We found that RD improved significantly in the SE group compared to the BD and control groups. Additionally, a significant relationship was established between RD and high anxiety levels and DM, and obesity had a negative impact on the resolution of RD.

Endaural Over-Underlay Cartilage Tympanoplasty for Repair of Dry Subtotal Perforations.

OBJECTIVES: We explored the auditory and anatomical success of grafting when the cartilage perichondrium (CP) was prepared using two different methods. METHODS: Patients with subtotal or total perforation underwent tympanoplasty with a CP graft. A V-shaped groove for the handle of the malleus was prepared for CP grafts in patients in group 1. Patients in group 2 did not have a groove on the graft. The anatomical success of the graft was evaluated as success, partial success, or failure. Results of auditory evaluations were compared between the two groups. RESULTS: A total of 195 patients were included in the study. The total CP graft integration rate was 96% for both groups. Significant changes were detected in all hearing criteria evaluated 12 months after surgery compared to the preoperative period (P < .05). There were no significant differences between the groups in terms of the relationship between graft technique and postoperative hearing results. However, rates of partial success were significantly higher for group 1 than group 2 (P = .033). CONCLUSION: Cartilage slice support offers an extremely reliable method for reconstruction of tympanic membrane in cases of high-risk perforation. Partial failures are rare, but when they occur, they most often involved anterior graft medialization. When a piece of cartilage is removed at the malleus interface there may be a higher rate of partial failure.

Nasal mucociliary clearance and hearing loss in pseudoexfoliation syndrome.

PURPOSE: To evaluate nasal mucociliary clearance (NMC) and hearing loss in patients with pseudoexfoliation (PEX) syndrome. METHODS: The study included 36 patients with PEX syndrome as the study group, and 39 healthy individuals as the control group. The duration of NMC was measured using the saccharine test. Audiometry was applied at 250, 500, 1000, 2000, 4000, 6000 and 8000 Hz frequencies to determine hearing thresholds and prevalence of hearing loss. RESULTS: No statistically significant difference was determined between the groups in respect of age and gender (p = 0.23 and p = 0.36, respectively). In the saccharine test, the mean NMC time was 18.41 ± 8.53 min for the study group and 11.69 ± 4.96 min for the control group. The mean NMC time of study group was significantly longer than that of the controls (p < 0.001). In the comparisons of the two groups in terms of the prevalence of hearing loss, no statistically significant difference was found at any of the evaluated frequencies (p > 0.05, for all). There was also no statically significant difference between groups in relation to hearing thresholds at these frequencies (p > 0.05, for all). CONCLUSION: The NMC time was significantly prolonged in patients with PEX syndrome. This result indicates that nasal mucosa cilia, which have similar elastic and mobile structures as the iris, are damaged in PEX syndrome, which is an infiltrative disease increasing the rigidity of affected tissues. In upper respiratory tract infections of unknown cause, PEX syndrome should be considered among the etiological factors. In this study, no significant relationship was detected between PEX and hearing loss.

Tonsillotomy versus Tonsillectomy for Chronic Recurrent Tonsillitis in Children.

OBJECTIVE: This study was conducted to compare two different surgical methods; partial tonsil resection using the bipolar technique, tonsillotomy (TT), and total tonsillectomy (TE) (blunt dissection) for recurrent tonsillitis in children. The frequency of recurrent throat infections was determined during postoperative follow-up. METHODS: A total of 393 patients were included in this study. TT was performed on 174 patients (100 males, 74 females) and TE on 219 patients (112 males, 107 females). Following surgery, an analysis was made of treatment outcomes of patients with upper respiratory tract infections. The patients were followed up for 12-48 months. Their parents were also contacted by telephone to determine the frequency of reinfection and their satisfaction with the surgery. Also, parents of the patients completed a questionnaire pertaining to postoperative satisfaction (scale of 1-10). RESULTS: In the TT group, 14 (8.1%) patients had recurrent tonsillitis postoperatively. In the TE group, 12 (5.4%) patients required antibiotherapy due to recurrent pharyngitis after the surgery. There was no significant difference between the two groups in terms of the one-year infection recurrence rate after surgery (p=0.281). Three patients (1.6%) in the TT group and 12 (5.4%) in the TE group complained of bleeding within the first 24 hours. The rate of bleeding was significantly lower in the TT group than the TE group (p=0.001). There were no fatalities in either group. CONCLUSION: In both groups, the rate of reinfection accorded with the requirement for postoperative antibiotics. For recurrent tonsillitis, TT was as effective as TE. However, TT was superior in terms of the risk of bleeding.

Evaluation of the Relationship Between Nasal Septum Deviation and Oxidative Stress Markers.

INTRODUCTION: Nasal septum deviation (NSD) may lead to chronic hypoxia and increased oxidative stress.The main goal of this study was to investigate the effect of NSD on malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and glutathione (GSH) levels. METHODS: There were 30 patients with NSD and 30 healthy subjects in this study. Malondialdehyde, CAT, SOD, and GSH levels were determined in the control and study groups. The measurements were done preoperatively and postoperatively. Study group patients completed the Nasal Obstruction Symptom Evaluation questionnaire preoperatively and postoperatively to determine the success of the septoplasty. RESULTS: Higher CAT, SOD, and GSH levels and lower MDA levels were found in the control group compared with the study group (P < 0.05). After septoplasty, Nasal Obstruction Symptom Evaluation scores improved significantly and CAT, SOD, and GSH levels increased significantly (all, P < 0.05). Malondialdehyde levels did not decrease significantly after surgery (P > 0.05). CONCLUSIONS: Nasal obstruction due to nasal septal deviation led to lower antioxidant enzyme levels, and correction of the septum led to an increase in antioxidant levels.

Comparison of the effectiveness of Brandt-Daroff Vestibular training and Epley Canalith repositioning maneuver in benign Paroxysmal positional vertigo long term result: A randomized prospective clinical trial.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral cause of vertigo. It can be defined as transient vertigo induced by rapid change in head position, associated with a characteristic paroxysmal positional nystagmus. Posterior canal benign paroxysmal positional vertigo is the most frequent form of BPPV. The aim of our study was to investigate and compare the effectiveness of Epley maneuver and Brand-Daroff home exercises for the treatment of posterior canal BPPV. METHODS: A total of 50 patients between 27 and 76 years of age who were diagnosed with unilateral posterior canal into BPPV were randomized prospectively into two groups. In Group-1, modified particle repositioning maneuver and in Group-2 Brandt-Daroff exercises were utilized as treatment. Patients were followed weekly. Cure weeks were recorded. The patients were followed for 12 to 24 months for recurrence. RESULTS: The recovery rates at the first, second and third week controls were 76%, 96% and 100% for Group-1 (modified Epley maneuver) and 64%, 88% and 100% for Group-2 (Brandt-Daroff exercises) respectively. The recovery rates were similar for both groups. The average follow-up duration was 18 months. In Group 1, 7 patients (28%) and in Group 2, 5 patients (20%) had recurrence, which was also similar with no statistical difference. CONCLUSION: It was concluded that both Brandt-Daroff Exercises and Modified Epley maneuvers were almost equally effective in the treatment of BPPV.