The effect of increase in blood glucose level on hearing loss

Abstract Objective: Previous studies have shown that hearing function is also vulnerable to the effects of diabetes mellitus which can be shown by brainstem auditory evoked potential and distortion product otoacoustic emission recordings. This study aimed to investigate the changes of brainstem auditory evoked potential and distortion product otoacoustic emission in hyperglycemia and whether there is a relationship between reactive oxygen substances production and hearing deterioration in the rat model. Methods: 25 streptozotocin induced diabetic rats were divided into three groups: control, high blood glucose, and diabetes mellitus. Brainstem auditory evoked potential and distortion product otoacoustic emission were recorded, and thiobarbituric acid reactive substances levels were measured in the brainstem tissue. Results: At 8 kHz, the latencies of I, II, III, IV, and V brainstem auditory evoked potential waves in high blood glucose and diabetes mellitus groups were elongated, at 16 kHz, only these wave latencies of the diabetes mellitus group were prolonged compared with the control group. A significant decrease was also found in distortion product otoacoustic emission amplitudes at 4, 6, 8, and 10 kHz in the high blood glucose and diabetes mellitus groups compared to the control group. There was a significant increase in thiobarbituric acid reactive substances values due to the increase in blood glucose levels in the high blood glucose and diabetes mellitus groups compared to the control group. Conclusion: These results suggested that high blood glucose levels may cause hearing impairment not only in the diabetic state but also in the period of hyperglycemia before the onset of manifest diabetes mellitus and reactive oxygen substances may play an important role in the pathophysiology of diabetes mellitus. We suggest that regulating high glucose levels even before the onset of manifest diabetes mellitus may prevent hazardous effects on hearing function. Level of evidence: Level 3.

The effect of increase in blood glucose level on hearing loss.

OBJECTIVE: Previous studies have shown that hearing function is also vulnerable to the effects of diabetes mellitus which can be shown by brainstem auditory evoked potential and distortion product otoacoustic emission recordings. This study aimed to investigate the changes of brainstem auditory evoked potential and distortion product otoacoustic emission in hyperglycemia and whether there is a relationship between reactive oxygen substances production and hearing deterioration in the rat model. METHODS: 25 streptozotocin induced diabetic rats were divided into three groups: control, high blood glucose, and diabetes mellitus. Brainstem auditory evoked potential and distortion product otoacoustic emission were recorded, and thiobarbituric acid reactive substances levels were measured in the brainstem tissue. RESULTS: At 8 kHz, the latencies of I, II, III, IV, and V brainstem auditory evoked potential waves in high blood glucose and diabetes mellitus groups were elongated, at 16 kHz, only these wave latencies of the diabetes mellitus group were prolonged compared with the control group. A significant decrease was also found in distortion product otoacoustic emission amplitudes at 4, 6, 8, and 10 kHz in the high blood glucose and diabetes mellitus groups compared to the control group. There was a significant increase in thiobarbituric acid reactive substances values due to the increase in blood glucose levels in the high blood glucose and diabetes mellitus groups compared to the control group. CONCLUSION: These results suggested that high blood glucose levels may cause hearing impairment not only in the diabetic state but also in the period of hyperglycemia before the onset of manifest diabetes mellitus and reactive oxygen substances may play an important role in the pathophysiology of diabetes mellitus. We suggest that regulating high glucose levels even before the onset of manifest diabetes mellitus may prevent hazardous effects on hearing function. LEVEL OF EVIDENCE: Level 3.

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.

Pediatric Tonsillar Synovial Sarcoma- Very Rare Localization: A Case Report and Review of the Literature.

Tonsillar synovial sarcoma is an extremely rare entity and only 9 adult patients have been reported up to now. Here, we describe the first pediatric tonsillar synovial sarcoma of the literature in a patient who presented with a 2-month history of dysphagia and snoring. Clinical and radiological examinations showed that the tumor arose from the right palatine tonsil and narrowed the parapharyngeal space. An incisional biopsy from the palatine tonsil revealed the diagnosis of synovial sarcoma. The patient has underwent total tonsillectomy and received radiotherapy and chemotherapy because of the positive surgical margins. The patient is clinically in good condition and free of tumor 30 months after the initial diagnosis. We achieved a long-term complete remission with a combination of surgery, radiotherapy and chemotherapy in our case. Tonsillar synovial sarcoma should be kept in mind while dealing with tonsillar masses. We can conclude that a multidisciplinary approach is warranted while treating synovial sarcoma with this localization.

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.

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.

True functional reconstruction of total or subtotal glossectomy defects using a chimeric anterolateral thigh flap with both sensorial and motor innervation.

BACKGROUND: The purpose of this study was to report the motor functional outcomes and sensory recovery of patients who had undergone total or subtotal glossectomy for oral squamous cell carcinomas reconstructed with chimeric anterolateral thigh (ALT) flaps. METHODS: Six patients, 4 men and 2 women, with a mean age of 49.5 years (range, 36-73 years) were included in the study. All patients were treated with chimeric ALT, including the vastus lateralis muscle with its motor nerve and skin paddle with its innervating nerve. All patients were administered functional tests involving sensory recovery, intelligibility, and swallowing. Flap sensibility was evaluated using light touch sensation with the Semmes-Weinstein monofilament test, 2-point discrimination according to the Weber sensitive test, warm and cold temperature sensations, and pain sensation. Intelligibility was scored by a speech therapist on a scale from 1 to 5. Swallowing was assessed by electromyography, deglutition scores (on a scale of 1 to 8), and modified barium swallow. Donor-site morbidities were recorded. RESULTS: Mean follow-up was 26.6 months (6 months-5 years). The flaps were successful in all 6 patients. The donor site was closed primarily and no complications were seen in the follow-up period. Normal extension of the knee joint and no evidence of lateral patella instability occurred. Speech intelligibility was good (4) in 3 patients and acceptable (3) in 3. Deglutition scores were 6 in 2 patients, 5 in 2, and 4 in 2. Modified barium swallow revealed that 4 patients experienced bolus transit, but 2 required a liquid swallow to promote bolus transit. Electromyographic recordings showed innervations of the vastus lateralis muscle with active generation of motor unit potentials in 4 patients when trying to elevate the tongue. This was not performed in 1 patient, and 1 other had macroscopic muscle contractions. All sensory tests were satisfactory in all parameters. CONCLUSIONS: The results of this reconstructive option were satisfactory in terms of motor function and sensitive assessment of the neotongue. This technique is strongly recommended for patients with total or subtotal glossectomy.

Parapharyngeal lipoma: a case report.

A 44-years-old male presented with right infraauricular swelling. It had been four months since he was aware of the mass. He had not felt any pain or tenderness. Computed tomograpy demonstrated a homogenous, regular surfaced mass located in the prestyloid and poststyloid parapharyngeal space. Its density was concordant with lipomatous tissue, so it was considered to be an infiltrating parapharyngeal lipoma. Postoperative diagnosis revealed a similar result. We believe that computed tomograpy is an effective method of diagnosing parapharyngeal space tumors and tansparotid approach for this localization is very useful for both preserving facial nerve functions and exposing the mass clearly. We report a case of parapharyngeal lipoma slightly invading the deep lobe of the parotid gland.

Giant cervical lipoma invading carotid artery: a case report.

Lipomas are one of the most frequently encountered benign tumors in any location. There is limited information about head and neck lipomas in the litetature and most data is in the form of case reports. Lipomas can rarely reach gigantic sizes and can invade surrounding tissues, especially skeletal muscles, and in this case they are called infiltrating lipomas. In this manuscript we report a case of cervical giant lipoma surrounding and infiltrating the common carotid artery which was treated by grafting carotid artery, and our diagnostic work-up and treatment procedure are discussed in the light of the literature.

[Internal jugular venous thrombophlebitis secondary to tooth extraction]. / Dis çekimi sonrasi gelisen internal juguler ven tromboflebiti.

A 20-year-old female patient presented with swelling and pain in the neck, difficulty in opening her mouth, dyspnea, nausea, fever, and shivering. She was prescribed amoxicillin for one week due to a teeth infection and had lower molar tooth extraction on the same side two days before. Neck examination showed a swelling, 2 x 3 cm in size, in the carotid triangle and minimal hyperemia on the skin. A diagnosis of internal jugular venous thrombophlebitis was made and parenteral antibiotherapy was administered along with antithrombotic therapy. Complete improvement was observed after 15 days and the patient was symptomless in the eighth month.

Expression of PTEN protein in patients with laryngeal squamous cell carcinoma.

OBJECTIVE: PTEN (phosphatase and tensin homologue deleted on chromosome 10), also referred to as MMAC1 (mutated in multiple advanced cancers) gene was recently identified as a putative tumor suppressor in a variety of malignant tumors. PTEN expression has been investigated in some squamous cell carcinomas (SCC) of head and neck. However, there is only little knowledge about laryngeal malignancies. Therefore, we examined PTEN product protein immunohistochemically in 30 consecutive laryngeal specimens from patients with laryngeal SCC and compared the results according to the clinicopathologic characteristics of the patients. METHOD: Surgical resection specimens of patients with laryngeal SCC were stained for PTEN protein using a primary rabbit polyclonal anti-PTEN antibody. Standard avidin-biotin immunohistochemical analysis was used to process the sections. The extent and intensity of PTEN staining in the specimens were compared according to the age and sex of the patients and localization, differentiation, size and stage of the tumor. RESULTS: Out of 30 tumoral specimens (23 glottic and 7 supraglottic) 22 showed decreased PTEN staining intensity compared to the adjacent normal tissue. The extent of cytoplasmic PTEN staining was significantly less in supraglottic tumors (p < 0.05). When characteristics of the patients were analyzed according to the extent of cytoplasmic PTEN staining no difference was observed according to age, sex, measure, differentiation, T or N status. CONCLUSION: A significant decrease in the extent of PTEN staining was observed in supraglottic SCC. It could be worthwhile to test if PTEN expression is diminished in patients with more aggressive laryngeal tumors, with special attention to tumor localization in larger series.