The Role of Real-Time Elastography in the Differential Diagnosis of Salivary Gland Tumors.

OBJECTIVES: The aim of the study was to scrutinize the value of qualitative elastography in the diagnosis of salivary gland masses. METHODS: Sixty patients were enrolled in this prospective study. Patients aged between 1 and 91 years (mean age, 48.8 ± 20.48) with a salivary gland mass were studied with real-time elastography. All patients were examined by 1 examiner, blinded to all relevant data. On elastography, masses were scored into 4 types according to their stiffness compared to normal tissue. Scores of 3 and 4 were accepted as signs of malignancy. Sensitivity, specificity, and positive and negative predictive value were calculated for elastography in verifying malignancy. RESULTS: Forty-two percent of the masses were located in the parotid, and the rest in submandibular gland. The diameter of the lesions varied between 12 and 60 mm (mean, 24.36 ± 11.98 mm). Forty-four masses were benign (73%), and among them the majority were inflammatory lesions (31 of 60; 51.7%). There were 16 malignant lesions (27%). On elastography, not only all malignant lesions but 15 benign lesions were scored as 3 to 4. All masses scored as 1 to 2 were benign. Sensitivity was 100%; specificity, 66%; positive predictive value, 52%; and negative predictive value, 100%. When only Score 4 lesions were accepted as malignant, these values became 75%, 77%, 55%, and 90%, respectively. CONCLUSIONS: Elastography alone cannot be used to discriminate malignant from benign in the evaluation of salivary gland lesions. However, with its high negative predictive value, it may be used as an adjunct tool to increase the diagnostic value of ultrasonography.

Awareness and daily practices of family physicians and trainees towards laryngopharyngeal reflux.

Laryngopharyngeal reflux (LPR) is a type of reflux, seen with complaints of hoarseness, chronic cough, and globus sensation, different from gastroesophageal reflux disease (GERD). The aim of this study was to evaluate the awareness, knowledge, and practices of family physicians and trainees who were being trained in medical branches other than ENT and to determine the effective factors on decision making for diagnosis of this disorder. The study was designed as a two-stage study. At the first stage, a data collection tool, involving 29 questions by which the knowledge, awareness, and applications of the physicians about LPR would be determined, was developed with 12 specialists, using Delphi method. At the second stage, 101 family physicians replied the questionnaire online. For 45 trainees other than ENT, the questionnaire was filled face-to-face by one of the investigators. In patients admitted with complaints of hoarseness, lasting longer than 2 weeks, cough, lasting longer than 3 weeks, and globus sensation, the physicians considered LPR as the preliminary diagnosis with rates of 88.4, 82.2, and 62.8 %, respectively. 87.0 % of physicians, participating in the study, started treatment for reflux empirically in patients having complaints of hoarseness, chronic cough, and globus sensation; however, only 29.0 % of physicians prescribed this treatment for periods of 3 or 6 months. 69.9 % of physicians, participating in the study, made a diagnosis of reflux in general during their daily practices; only 6.9 % made the discrimination between LPR and GERD. Of all physicians, 27.9 % prescribed double-dose PPI or H2.

Protective effect of Pycnogenol on cisplatin-induced ototoxicity in rats.

CONTEXT: Pycnogenol®, which is French maritime pine bark extract, is a potent antioxidant. It is used in medical conditions caused by oxidative stress. Cisplatin (cis-diamminedichloroplatinum II) is an antineoplastic agent. However, its serious side effects such as ototoxicity limit its usage. OBJECTIVE: Antioxidants can be used to prevent ototoxicity. We investigated the effect of Pycnogenol® on cisplatin-induced ototoxicity. MATERIALS AND METHODS: Rats were randomly assigned to four groups of five. Distortion product-evoked otoacoustic emissions (DPOAE) test was performed for each rat. The experimental groups were as follows: Control Group, Pycnogenol® Group: 10 mg/kg Pycnogenol® intraperitoneally for 7 days, Cisplatin Group: intraperitoneally 15 mg/kg single injection of cisplatin on the fifth day, Cisplatin + Pycnogenol® Group: intraperitoneally 10 mg/kg Pycnogenol® treatment for 7 days, additionally on the fifth day, 15 mg/kg single injection of cisplatin was given. On the eighth day, DPOAE was re-performed and rats were sacrificed. Apoptosis was evaluated histopathologically. RESULTS: Mean percentage of apoptotic cells was 1.5, 3, 30 and 11% in organ of Corti and 2, 2, 40, 15% in spiral ganglion neurons in Control Group, Pycnogenol® Group, Cisplatin Group and Cisplatin + Pycnogenol® Group, respectively. Cisplatin Group and Cisplatin + Pycnogenol® Group were significantly different when compared to Control Group histopathologically both in organ of Corti and spiral ganglion neuron (p <0.001, p = 0.019, p = 0.001, p = 0.015). DPOAE results showed that Cisplatin + Pycnogenol® Group was significantly different when compared to Cisplatin Group at 3, 6 and 8 kHz (p < 0.05). CONCLUSION: Pycnogenol protected against cisplatin ototoxicity. Also, pycnogenol is not ototoxic.

Our Approach to Adult Patients With Epistaxis.

Epistaxis is one of the most frequently encountered emergency problems in our country, as it is throughout the world. In epistaxis, the benefits of implementing clinical guidelines are evident in both daily practice and medical education. In this article, the authors aimed to present their approach to adult patients with epistaxis and to share their experience, which considered the life quality of the patients to be at the forefront, based on some of their patients. In management of epistaxis, the implementation of the simplest method, minimally affecting the life quality of the patient, may be easier with a stepped approach. The authors consider that the stepped approach that they have implemented and presented in their study may lead to using less invasive methods and may accordingly improve the life quality of the patient.

Rarely Seen Nasal Congenital Problems Causing Neonatal Upper Respiratory Obstruction: A Case Series.

Since newborns are obligatory nasal breathers, upper respiratory tract problems may sometimes be life threatening. The most common pathology causing dyspnea and stridor in newborns is laryngomalacia. Nasal cavity pathologies that risk the neonatal airway are more rarely met. These anomalies may be seen either as solitary anomalies or as a part of a syndrome. While choanal atresia is one of the best-known nasal cavity anomalies, choanal stenosis, congenital nasal mid-line masses, congenital nasal pyriform aperture stenosis, and nasal tip anomalies are more rarely seen structural pathologies. Choanal atresia may be present either as an isolated congenital anomaly or as a part of CHARGE syndrome. Some rare chromosome anomalies may also cause significant problems during nasal respiration in newborns. With this study, we presented a case series of newborns with pathologies that affected nasal respiration. Although the diagnosis and treatment of choanal atresia and congenital dacryocystocele are well known, the information on the diagnosis and treatment of the other two uncommon cases are limited. With this study, we aimed to contribute to the literature by presenting our approach in six cases having congenital pathologies that cause nasal respiratory obstruction.

Can tissue adhesives and platelet-rich plasma prevent pharyngocutaneous fistula formation?

OBJECTIVE: One of the frequently encountered disorders of wound healing following laryngectomy is pharyngocutaneous fistula. However, although studies have been performed with the aim of prevention of pharyngocutaneous fistulae, there are very few studies with tissue adhesives and platelet-rich plasma. In this study, our aim was to investigate the histopathologic changes in wound healing caused by various tissue adhesives and platelet-rich plasma, together with their effects on prevention of pharyngocutaneous fistula. METHODS: 40 male rats were randomly divided into five groups: control, platelet-rich plasma, fibrin tissue adhesive, protein-based albumin glutaraldehyde and synthetic tissue adhesive groups. The pharyngotomy procedure was performed and was sutured. Except the control group, tissue adhesives and platelet-rich plasma were applied. Then, the skin was sutured. On the seventh day, the rats were sacrificed. The skin was opened and pharyngotomy site was assessed in terms of fistulae. The pharyngeal suture line was evaluated histopathologically by using Ehrlich Hunt scale. RESULTS: Inflammatory infiltration was found to be higher in "platelet-rich plasma" group than "fibrin tissue adhesive" and "synthetic tissue adhesive" groups. The fibroblastic activity of "platelet-rich plasma", "fibrin tissue adhesive" and "protein-based albumin glutaraldehyde" groups was higher than the control group. The positive changes created by platelet-rich plasma and fibrin tissue adhesive at the histopathologic level were found together with no detected fistula. Among the study groups, there was no statistical difference for pharyngeal fistula development. This result may be obtained by the small number of animal experiments. CONCLUSION: These results shed light on the suggestion that platelet-rich plasma and fibrin tissue adhesive can be used in clinical studies to prevent pharyngocutaneous fistula.

The neutrophil to lymphocyte ratios of our pediatric patients with Bell's palsy.

BACKGROUND: Neutrophil to Lymphocyte Ratio (NLR) is considered to be a reliable indicator in etiological investigation and identification of the disease severity in inflammatory disorders. There are numerous observations or evidences suggesting that Bell's palsy is an inflammatory disorder. OBJECTIVES: Our aim was to investigate the presence of any clue which might suggest inflammatory etiology and also the presence of compliance between NLR elevation and inflammation severity in children. METHODS: Patients younger than 18 years with Bell's palsy and who had not another inflammatory disorder in addition to Bell's palsy were included. A total of 25 patients and 25 healthy individuals were taken. The patient group and the control group were compared in terms of NLR, neutrophil and lymphocytes. The relationship of NLR with pre-treatment House-Brackmann classification was evaluated. RESULTS: The mean age was 9.86±5.07 in the patient group and 9.14±5.94 in the control group. In all members of the patient group, oral prednisolone (1 mg/kg/d) was administered for 7 days. The post-treatment House-Brackmann classification of all patients was determined as grade 1. The average neutrophil values were significantly higher in the patient group. In terms of average lymphocyte values, no statistically significant difference was found. The average NLR value was 1.78 (0.93-4.58) in the pediatric patient group and 1.1 (0.6-2.05) in the control group. NLR was significantly higher in the patient group. NLR and pre-treatment House-Brackmann classification showed no statistically significant correlation (r=0.173, p>0.05). When cut-off value was taken as 3 for NLR, no statistically significant difference was found between groups. CONCLUSIONS: High NLR values determined in pediatric patients with Bell's palsy support the inflammatory feature of this disease. NLR is recommended as a supportive parameter in the diagnosis of pediatric patients with Bell's palsy.

Effects of adenoidectomy/adenotonsillectomy on ADHD symptoms and behavioral problems in children.

OBJECTIVES: In children, the most common reason of upper airway obstruction (UAO) is adenotonsillar hypertrophy. In literature, the adverse effects of UAO and obstructive sleep apnea syndrome on behavior and attention in children have been reported in several articles. However, the methods used for the evaluation of behavioral disorders have not been standardized in those studies. The aim of this study was to investigate the behavioral and attention characteristics of children before and after adenoidectomy/adenotonsillectomy using an internationally valid method. METHODS: A total of 41 patients, between 6 and 11 years of age and having a medical history of UAO for at least one year for which adenotonsillectomy procedure was indicated, were enrolled in the study. The patients were evaluated for signs of attention/behavioral disorders by a child-adolescent psychiatrist and Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children: Present and Lifetime Version (K-SADS-PL) and The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), before and at the 6th month following the operation. RESULTS: In the preoperative period, a psychiatric disorder was identified by K-SADS-PL in 41.4% (n =1 7) of patients. Of these, 11 patients had attention deficit hyperactivity disorder (ADHD), 6 had enuresis nocturna, and 2 had separation anxiety disorder. Pre- and postoperative mean scores in T-DSM-IV-S parent scale were 31.3 ± 8.5 and 20.2 ± 10.3, respectively, and this difference was statistically significant (p < 0.001). CONCLUSION: The relationship of UAO and attention/behavioral disorders should be taken into consideration by child-adolescent psychiatrists together with ENT specialists and a multidisciplinary approach is important for the treatment team.

Evaluation of Lapatinib and Trastuzumab for Ototoxic Effects.

OBJECTIVE: Trastuzumab and lapatinib are widely used chemotherapeutic agents. Our aim in this study was to assess the possible ototoxicity of these chemotherapeutic agents. MATERIALS AND METHODS: Forty-eight rats were divided into six groups: Group 1 (control, n=8) received intraperitoneal saline for 7 days. Group 2 (n=8) and Group 3 (n=8) received 10 mg/kg and 30 mg/kg single doses of intraperitoneal trastuzumab, respectively. Lapatinib was administered by oral gavage to Group 4 (n=8) at 100 mg/kg/day and to group 5 (n=8) at 300 mg/kg/day for 7 days. Group 6 (n=8) received only one dose of 10 mg/kg intraperitoneal trastuzumab; subsequently, Group 6 received one dose of lapatinib at 100 mg/kg/day by oral gavage for 7 days. Before any medication was administered, distortion product emissions (DPOAE) were obtained. DPOAE tests were performed again on the rats on day 7, after which the mastoid bullas were harvested. The apoptosis degree was evaluated by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) procedure. RESULTS: The lapatinib 300 and lapatinib+trastuzumab groups (p=0.008 and p=0.001, respectively) were significantly different from the control group according to the spiral ganglion TUNEL. Apoptosis in the organ of corti was statistically different compared with the control group in the lapatinib 100, lapatinib 300, and lapatinib+trastuzumab groups (p=0.035, p=0.001, and p<0.001, respectively). Trastuzumab induced damage in only the organ of corti; however, lapatinib induced damage in both the organ of corti and spiral ganglion. The degree of the damage in the organ of corti was high when trastuzumab and lapatinib were concomitantly used. Supporting this data, a reduction in DPOAE amplitudes was observed during the combined usage of the drugs. CONCLUSION: Administering trastuzumab and lapatinib causes ototoxic effects.

The Effects of Topical Burow's and Castellani's Solutions on the Middle Ear Mucosa of Rats.

OBJECTIVE: The aim of this study is to investigate the early histopathologic effects of Burow's and Castellani's solutions on the middle ear mucosa of rats. MATERIALS AND METHODS: The study was conducted with 26 Wistar albino female rats. Gelfoam that was soaked in 4% Burow's solution was inserted into the middle ears of the rats in the Burow group (n=10); over 2 weeks, 0.1 mL Burow's solution was administered once a day through perforation into the middle ear. The same procedure was applied to the rats in the Castellani group (n=10) using classical Castellani's solution and to the rats in the control group (n=6) using physiological saline solution. At day 1 after the last administration, all groups were decapitated; their bullas were dissected. The bullas were histopathologically evaluated and graded with respect to increase in leukocytes with polymorphic nuclei, mononuclear cell infiltration, and fibrosis. The data obtained were statistically analyzed. RESULTS: In the Burow group, the fibrosis scores were significantly higher than those in the control group (p=0.039), the scores of leukocytes with polymorphic nuclei were significantly higher than those in the control group (p=0.034), and the total scores were significantly higher than those in the control group (p=0.022). CONCLUSION: We suggest Castellani's solution as a safe alternative in the treatment of otomycosis and external otitis in the presence of tympanic membrane perforation. However, because of the inflammatory changes it causes in the middle ear mucosa, we do not recommend the use of Burow's solution in the presence of tympanic membrane perforation.

Pathogenesis of rhinitis in rats with experimentally induced hypothyroidism.

BACKGROUND: Hypothyroidism is accepted as one of the hormonal factors leading to non-allergic rhinitis. Nasal obstruction and runny nose due to an increase in submucosal connective tissue and mucous gland hypertrophy are the prominent symptoms in hypothyroidism-induced rhinitis at humans. The aim of this study was to analyze the biochemical and histopathological changes in the nasal mucosa of the rats with thyroidectomy-induced hypothyroidism and to compare them with those of a control group. METHODS: A total of 60 adult male Wistar Albino rats were included in the study. The rats constituting the test and the control groups were randomly divided into 3 subgroups (T1-3 and C 1-3). While the rats in the test group underwent thyroidectomy, in the control group the incision was sutured without any interventions after exposure of thyroid tissues of the rats. The nasal and paranasal sinus regions of all the rats were carefully dissected and tissue samples were obtained for pathological examinations. RESULTS: In the rats in T1, T2, and T3, the decrease in serum glucuronic acid levels before and after thyroidectomy was statistically significant (p = 0.001, p = 0.003, and p = 0.002, respectively). The difference between the test and the control groups was statistically significant in terms of inflammation at the end of 12 weeks (p = 0.002). CONCLUSIONS: An increase in acid mucopolysaccharidase production due to TSH has been suggested to cause congestion in tissues. Although our study supports the data in the literature up to date, we consider that further clinical and experimental studies are necessary for this verification.

Pituitary apoplexy: an overview of 186 cases published during the last century.

BACKGROUND: Pituitary apoplexy is a rare and life-threatening complication occurring in 0.6-10.5% of all cases of pituitary adenomas. Although the association between pituitary apoplexy and visual dysfunction has been recognized for a long time, the optimal management of this problem still remains controversial. The purpose of this overview was to present the surgical experience by analyzing the literature on the management of pituitary apoplexy for better treatment of these cases. MATERIALS AND METHOD: To establish a new guideline for the surgical treatment of this entity, publications reported during the last century and databases containing medical literature were analyzed. In addition, an illustrative case with pituitary apoplexy presenting with complaints of sudden onset severe headache associated with nausea, vomiting, and a sudden loss of vision was described. In fact, the experience in our complicated patient prompted us to review the available literature on the management of pituitary apoplexy to date. CONCLUSIONS: Based on an overview of 186 cases of apoplectic pituitary adenoma presenting with monocular or binocular blindness, we highlight the importance of correct diagnosis and an early, but not necessarily emergency, surgery within the first week of admission to optimize visual outcome of such patients. The illustrative case further exemplifies the value of close interaction between members of the management team for optimal outcome.

Human papillomavirus in rare unilateral benign intranasal tumours.

BACKGROUND: Inverted papilloma (IP), oncocytic papilloma (OP), respiratory epithelial adenomatoid hamartoma (REAH) and capillary hemangioma (CH) are benign and rare tumours. OP and IP are associated with squamous cell carcinoma (SCC). Human papillomavirus (HPV) may play a role in malignant transformation. AIM: We aimed to investigate the presence of HPV, inflammation, epithelial dysplasia, and prognostic markers including proliferative cell nuclear antigen (PCNA), epidermal growth fac- tor receptor (EGFR) and p53 in tissue specimens from rare unilateral intranasal benign tumours. METHODS: Presence of HPV DNA was detected by PCR. Proliferative cell nuclear antigen, EGFR, p53 expression and the presence of HPV type 16 in tissues were determined by immuno-histochemical analysis. RESULTS: We determined the presence of HPV DNA in 2 of 6 IP cases, in one CH patient and one OP patient, but the REAH patient was negative. Histologically, only one specimen with IP was positive for HPV type 16 being the high risk type. The remaining cases were considered as low risk type HPV. CONCLUSION: Although our patient numbers are limited, there is a significant association between IP and HPV. This is the first study showing the cooccurrence of CH and OP with HPV.

A case of naso-ophthalmic myiasis.

Myiasis is defined as an occupational disease and it is mainly seen in people who are in contact with animals, in particular sheep. We detected nasal and external ophthalmomyiasis caused by Oestrus ovis in a 33-year-old male who worked as a research assistant in the faculty of agriculture. The presenting complaints were severe foreign body sensation and discharge in the nose, cough, and foreign body sensation in the right eye. Ophthalmologic examination revealed many moving larvae in the right eye of the patient. Larvae were removed and nasolacrimal duct irrigation was performed through the inferior canaliculus. Endoscopic nasal examination also showed larvae colonies. The larvae were removed under local anesthesia and were taken to the parasitology laboratory, wherein Oestrus ovis was identified. Minimal endoscopic sinus surgery showed nonspecific chronic inflammation.

Characterization of fungi in chronic rhinosinusitis using polymerase chain reaction and sequencing.

The role of fungi in chronic rhinosinusitis (CRS) remains unknown. Fungi were also determined as one of the responsible agents in the etio-pathogenesis, while several studies found fungi in 6-93% of the cases. The aim of this study is to test the presence of fungi in samples taken from the middle meatus of patients with CRS, using traditional culture methods and polymerase chain reaction (PCR), and to compare the efficacy of these methods. Thirty patients diagnosed with CRS, with or without nasal polyposis, undergoing an operation in the Otorhinolaryngology Clinic, were prospectively included in the study. Nasal mucosa samples from ten patients, who were operated for pathologic evaluation, and without CRS, were used as controls. Nasal samples were taken from each patient by swabbing with a cytology brush. Middle meatus culture samples were taken by using nasal cotton swab, and the polyp and/or sinus mucosa samples were taken during endoscopic sinus surgery. Fungal specific PCR, using 18S rRNA primers and standard cultures, were performed on every sample. All amplicons were sequenced. There was no fungal growth in the Sabouraud dextrose agar (SDA) medium from middle meatus samples and tissue parts. Of 30 tissue and brush samples, 3 and 2 were positive for fungal DNA, respectively. Sequence analysis showed that four amplicons were homologus to Cladosporium herbarum and one to Aspergillus amstelodami. We concluded that fungal etiology is overestimated and fungi rarely play a role in patients with CRS. Large-scale studies should be done using molecular methods.

The prevalence of allergic rhinitis in adults in Aydin, Turkey.

BACKGROUND: Allergic rhinitis is the most common allergic disease in Turkey. Our objective was to determine the prevalence of allergic rhinitis among adults living in Aydin, Turkey. METHODS: A population-based survey was undertaken among adults aged 16-64 years. Allergic rhinitis was confirmed in the subjects screened positive by the clinical examination and specific immunoglobulin E testing. RESULTS: A total of 465 interviews were conducted in spring 2005. The prevalence of allergic rhinitis in the past 12 months was 14.0%. The prevalence rate of clinically confirmable AR was computed as 11.4%. The prevalence was significantly higher among females and in urban areas. Specific IgE were detected for at least one of tested aeroallergens in 34.8% of the subjects with self-reported AR. CONCLUSION: Our study revealed that the prevalence of allergic rhinitis among adults living in the city of Aydin was as high as the prevalence in other regions of Turkey but less than in Europe.

[Evaluation of predisposing factors and bacteriologic agents in pediatric rhinosinusitis]. / Cocukluk çagi akut rinosinüzitlerinde predispozan faktörler ve bakteriyel etkenlerin degerlendirilmesi.

OBJECTIVES: This study was conducted to investigate the predisposing factors and bacteriologic agents of acute rhinosinusitis in children. PATIENTS AND METHODS: The study included 76 patients (47 girls, 29 boys; mean age 10.2 years; range 4 to 18 years) with acute rhinosinusitis. Following a detailed history, the patients were investigated by otolaryngologic examination including nasal endoscopy, allergy tests, Water's graphy, and aspiration cultures from the middle meatal region. RESULTS: The leading complaints were nasal obstruction (92.1%), rhinorrhea (89.4%), and headache (51.3%). Allergy tests were positive in nine of 23 patients (30.3%) with a history of allergy. Concerning smoking, 39 patients (51.3%) had a secondary, two patients (2.6%) had a primary history. Sixteen patients (21.1%) had septal deviation, and 25 patients (32.9%) had benign adenoid tissue obstructing choanal spaces. Water's graphies showed pathology in 69 patients (93.2%). Cultures were positive in 51 patients (67.1%), with Streptococcus pneumoniae in 23 (41.1%), Haemophilus influenzae in 17 (30.4%), and beta-hemolytic streptococci in eight patients (14.2%). Treatment was comprised of ampicillin-sulbactam in 31 (40.8%), loracarbef in 20 (26.3%), and amoxicillin-clavulanate in 13 (17.1%) patients. After a year follow-up, recurrence was detected in 12 patients (15.8%). No significant effect of the size of adenoid tissue and allergy was found on the success of treatment (p>0.05). CONCLUSION: Smoking, choanal obstruction by the adenoid tissue, anatomical variations, and allergy were the most frequent predisposing factors, while S. pneumoniae and H. influenzae were the commonest pathogens.

Early and late effects of capsaicin pretreatment in otitis media with effusion.

PURPOSE: Discovery of the role of the neurogenic inflammation in the formation of otitis media with effusion has led to the investigation of the place of some neuropeptide antagonists in the treatment. In the current study, we investigated the effect of capsaicin (CP) pretreatment on the inflammation and proliferation in the middle ear mucosa and on the nerve fibers containing substance P, vasoactive intestinal polypeptide, and calcitonin gene-related peptide. METHODS: Seventeen Wistar rats were used in the study. Ten rats were given CP on 3 consecutive days, and seven rats were given isotonic saline solution. Seven days after the third injection, animals were operated on, and their eustachian tubes were occluded. On the seventh day after the operation, five rats from the test group and three from the control group were killed. The others were killed 21 days after the operation. In the histopathologic examination of the sections, acute inflammation and proliferation scores were determined. Gland degeneration, goblet cell hyperplasia, and the density of mast cells were evaluated. Neural elements were stained immunohistochemically. RESULTS: The acute inflammation score in the test group was lower, but the difference was insignificant (p > 0.05). The proliferation score in the test group was lower, and the difference was significant (p = 0.02). In the control group, gland degeneration was significantly higher (p = 0.044). Goblet cell hyperplasia demonstrated no difference between two groups (p > 0.05). Mast cell density was higher in the control group, but the difference was not significant (p > 0.05). Substance P immunoreactivity (IR) was significantly higher in the control group (p = 0.015). calcitonin gene-related peptide-IR and vasoactive intestinal polypeptide-IR were limited in both groups. CONCLUSIONS: That CP pretreatment reduces inflammatory proliferative findings, and gland degeneration leads us to consider that it could be effective in both treatment of experimental otitis media with effusion and prevention of its complications.