An Evaluation of the Vestibular System in Individuals Aged 40-65 Years with Sensorineural Hearing Loss.

Objectives: Vestibular dysfunction occasionally accompanies sensorineural hearing loss (SNHL) due to anatomical proximity of cochlea and vestibule. The aim of the present study was to evaluate the vestibular system objectively and subjectively in 40-to 65-year-old individuals with and without SNHL. Methods: This study included participants of both sexes, between the ages of 40 and 65 years old. There were 31 participants with SNHL and 31 control participants. First of all, participants were grouped in the control and SNHL groups based on the results of their hearing test, which included audiometry and immitance evaluation. Subsequently, for vestibular evaluation, each participant was evaluated subjective with "Dizziness Handicap Inventory" (DHI) as well as with objective tests battery that included positional tests with videonystagmogrophy (VNG) and vestibuloocular reflex (VOR) assessment using the vestibular head impulse test (vHIT). Results: Peripheral nystagmus was found to be significantly higher in patients with SNHL based on the head shake and positional tests (p<0.05). There was a positive correlation between DHI scores and positional test findings of the participants with SNHL (p<0.05). When the VHIT VOR gain values were compared between groups, there was no significant difference (p<0.05). Conclusion: In our study, vestibular involvement was frequently observed in 40- to 65-year-old individuals with SNHL. Therefore, vestibular evaluation should be considered along with the assessment of hearing in individuals with SNHL who are over 40 years old.

Audiological and Vestibular Measurements in Chronic Renal Failure Patients Receiving Hemodialysis Treatment.

BACKGROUND: The aim was to evaluate the changes in the audiovestibular system in adult patients with the diagnosis of chronic renal failure who were treated with hemodialysis. METHODS: Thirty-five patients diagnosed with chronic renal failure and receiving hemodialysis treatment 3 days a week and 35 healthy individuals were tested with pure tone audiometry, video head impulse test, and post-head shake nystagmus test. Dizziness Handicap Inventory was applied to all participants. RESULTS: The Dizziness Handicap Inventory scores of the patient groups are higher than the control groups (P=.001). In the video head impulse test, there is no statistically significant difference between the patient and control groups in terms of gain asymmetry. 17.1% of the patients had both left and right lateral saccades (P=.03). A statistically significant difference was also found after the post-head shake test (P=.025). In the patient group, an inverse relationship between the presence of left anterior right posterior saccades and blood urea nitrogen-creatinine ratio and a direct relationship between the presence of right anterior left posterior saccades and creatinine elevation were determined. The presence of saccades in the video head impulse test increased significantly as the disease duration of hemodialysis patients increased. CONCLUSION: It was determined that the overt and covert saccades in the video head impulse test increased significantly as the creatinine increased and the duration of the disease increased in the patients with chronic renal failure. The common clinical usage of video head impulse test in monitoring the vestibular side effects of creatinine elevation and disease duration in chronic renal failure patients may be possible with future studies.

Effects of Combined Visible and Infrared Light Rhinophototherapy in Patients With Allergic Rhinitis.

BACKGROUND: Intranasal phototherapy offers an alternative treatment method for patients with allergic rhinitis who cannot benefit from intranasal corticosteroids and oral antihistamines. Different wavelengths have been tried with promising results. OBJECTIVE: In this present study, we aimed to investigate the effects of visible light-infrared light phototherapy on clinical improvements together with its cytologic effects in patients with allergic rhinitis. METHODS: Patients with confirmed allergic rhinitis were given a 4-week course of intranasal phototherapy treatment. Weekly symptom questionnaires were applied to monitor clinical effects. Nasal lavage specimens were obtained before the start and at the completion of the 4-week therapy. Fluorescence-activated cell sorting analyses of CD16+, CD24+, and CD 45+ cells were performed. Statistical analyses are performed of weekly changes in symptoms and cell counts. RESULTS: CD45+CD16highCD24+ neutrophil count in nasal lavages decreased significantly whereas CD45+CD16dim/-CD24+ eosinophil counts significantly increased and CD45+ granulocyte counts remained unchanged. Symptom scores including nasal itching, nasal discharge, nasal obstruction, sneezing, eye itching, throat itching, and ear itching all statistically decreased compared to baseline at the end of 4 weeks. CONCLUSION: Four-week course of intranasal phototherapy with visible and infrared light leads to clinical improvement in allergic rhinitis patients.

Evaluation of the hearing status in carpenters.

PURPOSE: Carpenters are constantly exposed to a noise level of 82-100 dB(A) in their professional lives. The aim of this study is to evaluate the hearing status of carpenters with pure -tone audiometry and transient evoked otoacoustic emissions test. METHODS: A total of 62 individuals were enrolled. The study group consisted of 31 carpenters and the controls were age and sex matched healthy individuals who were not exposed to continuous or sudden noise. RESULTS: The average age of the carpenters is 44.58 ± 10.33, the average age of the control group is 41.84 ± 8.65 and there was no statistically significant difference (p = 0.262). There was a significant hearing loss in the study group nearly at all frequencies when compared to the control group (p < 0.05). The emission values of the right and left ears of the carpenters were significantly lower than the controls at 2000 and 2800 Hz (p < 0.05). CONCLUSION: Accordingly, carpenters seem to be susceptible to the development of noise-induced hearing loss.

Audiovestibular Dysfunction in Patients with Fibromyalgia Syndrome.

OBJECTIVES: Fibromyalgia syndrome is a disorder of widespread pain with unknown etiology. These patients frequently suffer from otologic complaints. This study aims to analyze the audiovestibular functions in patients with fibromyalgia syndrome. METHODS: The study included 33 fibromyalgia patients and 33 healthy volunteers. All the study subjects underwent audiological assessment, multifrequency tympanometry, transient otoacoustic emission, and ocular and cervical vestibular-evoked myogenic potentials tests. RESULTS: Pure-tone hearing thresholds of right and left ears were found to be decreased in fibromyalgia patients compared to controls (P < 0.05). Middle ear resonance frequency values were significantly decreased in patients with fibromyalgia syndrome compared to controls (P < .05). The values for signal-to-noise ratios were higher in controls than in the FMS patients. The difference was significant for 1000, 2000, and 4000 Hz (P > .005). Cervical vestibular-evoked myogenic potential waves were obtained in all controls, but could not be obtained in 5 right ears and 4 left ears of the fibromyalgia patients (P < .05). Also, ocular vestibular-evoked myogenic potentials were obtained in all controls, but could not be obtained in 7 right ears and 10 left ears of the patients with fibromyalgia syndrome (P < .05). CONCLUSION: Our findings support the presence of audiovestibular dysfunction in patients with fibromyalgia. Further research that focuses on the pathogenesis of these dysfunctions is required.

Medial olivary complex reflex in term newborns with hyperbilirubinemia.

OBJECTIVE: This study aimed to compare the integrity of the efferent auditory pathways of newborns that had high hyperbilirubinemia levels and required treatment due to these and healthy newborns. METHODS: Term-born (37 weeks or later) infants that were brought to the Newborn Polyclinic of the Baskent University Hospital were included in the study. The study included a total of 84 infants including healthy newborns (n = 42) and those that had jaundice and were receiving phototherapy (n = 42). After conducting a general otorhinolaryngology examination on all newborns included in the study, Transient Otoacoustic Emission (TEOAE) test was carried out in the absence and presence of contralateral noise. The obtained contralateral suppression values were compared between the two groups. RESULTS: In the TEOAE test, the responses obtained at 1 kHz in the newborns receiving phototherapy were found to be lower. The difference between the groups was significant (p = 0.038). The rates of suppression presence at 2 kHz, 2.8 kHz and total OAE were found significantly higher (p < 0.05) in the group not receiving phototherapy. Among the phototherapy-receiving infants, the hyperbilirubinemia levels of the infants in whom suppression was obtained in the contralateral suppression test did not show a statistically significant difference in comparison to those in whom suppression was not obtained (p > 0.05). CONCLUSION: Based on the obtained data, hyperbilirubinemia may have a disruptive effect on the efferent auditory system in newborns. Consequently, we are of the opinion that, in addition to hearing screening in risky newborn infants, a MOC suppression test would be useful.

The Effect of Postmenopausal Osteoporosis on Middle Ear Resonance Frequency.

BACKGROUND: The effect of postmenopausal osteoporosis on the middle ear mechano-acoustic system is unknown. The aim of this study is to investigate whether or not middle ear resonance frequency is affected in females with postmenopausal osteoporosis. METHODS: The study included postmenopausal women aged 45-60 years, separated into 2 groups as females with postmenopausal osteoporosis and healthy postmenopausal females (control group). A detailed anamnesis was taken from all subjects and then the ear, nose, and throat examinations were done followed by pure tone audiometry, tympanometry, and multifrequency tympanometry tests. The groups were compared in respect of pure tone average, bone conduction threshold, RF, static admittance, and tympanometric peak pressure values. RESULTS: The mean age of the patients was 59.2 ± 4.53 years (range, 48-65 years) in the postmenopausal osteoporosis group and 57.11 ± 4.27 years (range, 48-65 years) in the control group (P > .05). The mean resonance frequency values for the postmenopausal osteoporosis and control group were 954.41 ± 127.47 and 935.29 ± 126.39 Hz (P > .05 ). The mean static admittance values for the postmenopausal osteoporosis and control group were 0.82 ± 0.33 and 0.85 ± 0.3 mmho, and mean tympanometric peak pressure values were -7.35 ± 18.52 and -6.94 ± 19.52 daPa (P > .05 for both static admittance and tympanometric peak pressure). The mean pure tone averagevalues for the postmenopausal osteoporosis and control group were 20.96 ± 6.82 and 15.60 ± 7.81 dB, and mean bone conduction threshold values were 17.57 ± 6.03 and 12.10 ± 6.52 dB (P < .05 for both pure tone average and bone conduction threshold). CONCLUSIONS: The results showed that the middle ear resonance frequency values were not affected in postmenopausal osteoporosis patients, but there was seen to be greater sensorineural hearing loss in females with postmenopausal osteoporosis compared to healthy postmenopausal females.

Comparison of Rapid Absorbable Sutures with Nonabsorbable Sutures in Closing Transcolumellar Incision in Septorhinoplasty: Short-term Outcomes.

BACKGROUND: Following open rhinoplasty, a postoperative scar at the columellar incision line is a common morbidity. The aim of this study is to compare absorbable and nonabsorbable suture materials which had been used for closing the transcolumellar incision, in the aspect of risk of postoperative infection, wound healing, postoperative columellar scar and patient satisfaction. METHOD: A prospective, randomized, single-blind study was conducted between May 2017 and February 2018. Sixty-four rhinoplasty patients were randomly assigned to absorbable (n = 32) or nonabsorbable (n = 32) groups. The columellar incision was closed with 7 full-thickness skin sutures. Either nonabsorbable 6/0 polypropylene (Group 1) or absorbable 6/0 polyglytone 6211 (Group 2) sutures were placed at the columellar incisions. Polypropylene sutures were removed at the 7th postoperative day. A Mann-Whitney U test and Monte Carlo were used for statistical comparison. Photographs of the patients at the postoperative third month (Fig. 2) were evaluated and scored in terms of scarring, pigmentation, notching, level differences in the incision area by two different otorhinolaryngologists who did not know the randomization. Suture removing discomfort was assessed with visual analogue scale scores. A satisfaction survey was filled out by all the patients completing their third month after the operation. RESULTS: According to the results of both otorhinolaryngologists, there was no significant difference between the two groups in terms of pigmentation, level difference, notching, overall appearance and total score (p = 0.920, p = 0.498, respectively). The mean score on the Wong-Baker scale was 3.19 ± 1.67 in group 1. In the Satisfaction Survey, the average score of the group 1 was 6.90 ± 3.24, while the mean score of the group 2 was 7.062 ± 2.77. There was no statistically significant difference between the two groups (p = 0.715). CONCLUSIONS: Suturing inverted V transcolumellar incisions with rapid resorbable sutures caused significantly less discomfort but no difference in scarring compared to nonresorbable sutures as evaluated by patients and observers. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Does the Efferent Auditory System Have a Role in Children with Specific Learning Disabilities?

OBJECTIVE: This study aimed to compare the baseline transient otoacoustic emission (t-OAE) amplitudes and medial olivo-cochlear (MOC) efferent activity in children with specific learning disability (SLD) and children with normal development. METHODS: The study was conducted in two groups. The patient group included 30 children aged 6 to 10 years and diagnosed with SLD, and the control group included 30 children in the same age range without SLD. The patient group included eight males and 22 females, and the control group included 14 females and 16 males. t-OAE and contralateral suppression test were performed in both groups. RESULTS: In the first t-OAE measurements, a statistically significant difference was observed between the patient and the control group at frequencies of 1400, 2000, 2800, and 4000 Hz, but no such difference was observed at 1000 Hz frequency. In the control group, significantly better emission amplitudes were observed. No differences were found at any frequency between the patient and the control groups after suppression. When the subjects in the two groups were compared among themselves, there was a statistically significant difference between the before and after suppression scores in the patient group except at 4000 Hz. Likewise, an important difference was also observed in all frequencies in the control group. CONCLUSION: This study shows that suppression effects of t-OAE on children diagnosed with SLD and children with no SDL are not significantly different.

Evaluation of Nasal Tip Support in Septorhinoplasty.

BACKGROUND: A good understanding of nasal tip support mechanisms is essential for achieving successful and functional rhinoplasty results. The loss of nasal tip support resulting from different maneuvers adopted during rhinoplasty and how this loss is affected by reconstructive applications should be known. This study evaluated and compared changes in nasal tip support perioperatively after different techniques were used during septorhinoplasty. METHODS: Patients who underwent primary open rhinoplasty between January 2018 and March 2018 in a tertiary medical center were included in this prospective blind case series. Nasal tip resistance measurements were taken after perioperative maneuvers by creating enough force to achieve 1 mm, 2 mm and 3 mm of displacement at the tip region. Measurements were obtained during six different stages using a Newton meter: preoperatively, after caudal septal resection, after skin flap elevation, after the columellar strut or tongue-in-groove procedure, after tip suturing and postoperatively. Our hypothesis was that during septorhinoplasty, each maneuver used changes the tip support intraoperatively. The predictor variables were the different rhinoplasty techniques used. The outcome variable was nasal tip resistance to compression intraoperatively and immediate postoperatively. Appropriate statistics were computed, and a p < 0.05 value was considered significant. RESULTS: Ten of the 15 patients were female, and 5 were male. The patient age ranged from 19 to 40 (mean 24.8 ± 4.9). The tongue-in-groove technique was applied in 5 of the patients, while columellar strut grafting was performed in 10. The application of columellar strut grafting did not create a significant increase in nasal tip support (p > 0.05). An increase in nasal tip support was observed at each stage (85%, 53%, 35%) after application of the tongue-in-groove technique (p < 0.05). CONCLUSIONS: A novel and reproducible technique for digitally evaluating manual force is presented for determining changes in nasal tip support with different maneuvers applied in living patients undergoing rhinoplasty. No significant difference was noted between the preoperative and postoperative measurements for columellar strut grafting. The tongue-in-groove technique is an important maneuver that has a significant effect on nasal tip support. According to our data, the interdomal and intercrural ligaments, the medial crus-septum connections and the connections between alar cartilage and overlying skin and muscle tissue are important structures for tip support. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The differences in the expression of fractalkine and its receptor in conditions of tonsillar hypertrophy and chronic tonsillitis.

OBJECTIVE: Fractalkine, member of chemokine family, is involved in many inflammatory processes in the human body. The aim of this study is to compare expression levels of fractalkine ligand and its receptor in chronic tonsillitis and hypertrophic tonsil samples. METHODS: The study was conducted at Baskent University Departments of Otorhinolaryngology and Medical Genetics. It is designed as a prospective, non-randomized, controlled clinical study. Total 97 samples, obtained from adenotonsillectomy due to chronic tonsillitis or tonsillar hypertrophy, were participated in the study. Fractalkine and its receptor expression levels were determined and comparison was made between the tissue groups. c.839C>T (T280M) polymorphism of fractalkine receptor was analyzed, then relationship between polymorphism and the expression level of fractalkine receptor was investigated. RESULTS: Fractalkine receptor expression was significantly higher in the hypertrophic tonsil group than chronic tonsillitis group (p<0.05). CONCLUSION: Fractalkine, member of chemokine family, and its receptor may play role in preventing chronic-recurrent tonsillitis.

The role of meteorologic factors and air pollution on the frequency of pediatric epistaxis.

Fluctuations in atmospheric temperature, humidity, and air pollution are associated with the incidence of epistaxis. To date, no study in the literature has evaluated the effect of air pollution and meteorologic conditions on the pediatric population. We aimed to evaluate the effect of meteorologic factors and air pollution on the frequency of epistaxis in children. Children presenting to an outpatient clinical setting at a tertiary care hospital during a 5-year period (July 1, 2009, to June 30, 2014) and diagnosed with epistaxis formed the study population. Daily temperature and humidity parameters and average daily atmospheric water vapor pressure, average daily concentration of particulate matter <10 µm in diameter, and sulfur dioxide readings were obtained. The distribution of daily parameters was analyzed. Of the 1,559 children with the primary diagnosis of epistaxis, data from 1,330 children were analyzed after excluding patients with coexisting pathologies. Positive correlations were found between the frequency of epistaxis and both the average daily temperature and the difference between the maximum and minimum daily temperature. There was a negative correlation between the epistaxis frequency and the average daily humidity, the difference between the maximum and minimum daily humidity, the average daily concentration of particulate matter, and the sulfur dioxide levels. Our findings suggest that epistaxis in children is related to high temperatures and low humidity.

Effect of Body Mass Index on Middle Ear Resonance Frequency.

OBJECTIVE: Multifrequency tympanometry (MFT) analyzes tympanograms obtained using different probe tones between 226 and 2000 Hz. An important parameter of MFT is resonance frequency (RF). Studies have recently demonstrated that the RF value can vary depending on many factors. To provide new data regarding MFT, middle ear RF values were investigated with regard to body mass index (BMI). MATERIALS AND METHODS: This study included 78 volunteers (i.e., 156 ears) aged 18-40 years who did not have hearing loss and whose otoscopic examinations were normal. Hearing thresholds were measured using pure tone audiometry, and RF values were recorded with immitansmetric measurements. The participants were divided into the following three groups according to their BMI: <18.5 kg/m2, Group 1; 18.5-24.9 kg/m2, Group 2; and >25 kg/m2, Group 3. The RF values were also analyzed. RESULTS: Although there was no significant difference between Groups 1 and 2 in terms of RF values, a significant difference was observed between Groups 1 and 3 and between Groups 2 and 3. CONCLUSION: In the light of these data, BMI values should be considered when middle ear RF values are assessed.

Comparison of clinical outcomes using a Piezosurgery device vs. a conventional osteotome for lateral osteotomy in rhinoplasty.

Our aim for this study was to evaluate and compare the clinical outcomes in patients who underwent lateral osteotomy with a Piezosurgery device or a conventional osteotome in open-technique rhinoplasty. This cohort trial involved 65 patients (36 women and 29 men; average age: 23.6 ± 5.71 yr) who underwent surgery between May 2015 and January 2016. Piezosurgery was used for lateral osteotomy in 32 patients, whereas 33 patients underwent conventional external osteotomy. These 2 groups were compared for duration of surgery, perioperative bleeding, postoperative edema, ecchymosis, pain, and patient satisfaction on the first and seventh postoperative days. The Piezosurgery group revealed significantly more favorable outcomes in terms of edema, ecchymosis, and hemorrhage on the first day postoperatively (p < 0.001 for all). Similarly, edema (p = 0.005) and ecchymosis (p < 0.001) on the seventh postoperative day also were better in the Piezosurgery group. Hemorrhage was similar in both groups on the seventh postoperative day (p = 0.67). The Piezosurgery group not only experienced less pain on the first postoperative day (p < 0.001), but these patients also were more satisfied with their results on both the first and seventh postoperative days. Results of the present study imply that Piezosurgery may be a promising, safe, and effective method for lateral osteotomy, a critical step in rhinoplasty. The time interval necessary for the learning curve is counteracted by the comfort and satisfaction of both patients and surgeons.

Protective Effect of Nigella Sativa Oil on Acoustic Trauma Induced Hearing Loss in Rats.

Acoustic trauma is a common reason for hearing loss. Different agents are used to prevent the harmful effect of acoustic trauma on hearing. The aim of this study was to evaluate the potential preventive effect of Nigella sativa (black cumin) oil in acoustic trauma. Our experimental study was conducted with 20 Sprague Downey female rats (mean age, 12 months; mean weight 250 g). All of the procedures were held under general anesthesia. Following otoscopic examinations, baseline-hearing thresholds were obtained using auditory brainstem responses (ABR). To create acoustic trauma, the rats were then exposed to white band noise of 4 kHz with an intensity level of 107 dB in a soundproof testing room. On Day 1 following acoustic trauma, hearing threshold measurements were repeated. The rats were divided into two groups as the study group (n: 10) and the controls (n: 10). 2 mL/kg/day of Nigella sativa oil was given to the rats in the study group orally. On Day 4 following acoustic trauma, ABR measurements were repeated again. There was no difference between the baseline hearing thresholds of the rats before acoustic trauma (P>0.005). After the acoustic trauma, hearing thresholds were increased and there was no significant statistically difference between the hearing thresholds of the study and control groups (P=0.979). At the 4th day following acoustic trauma, hearing thresholds of the rats in control group were found to be higher than those in the study group (P=0.03). Our results suggest that Nigella sativa oil has a protective effect against acoustic trauma in early period. This finding should be supported with additional experimental and clinical studies, especially to determine the optimal dose, duration and frequency of potential Nigella sativa oil therapy.

Better knowledge and regular vaccination practices correlate well with higher seasonal influenza vaccine uptake in people at risk: Promising survey results from a university outpatient clinic.

BACKGROUND: The knowledge, beliefs, opinions, and attitudes of patients and their relatives regarding seasonal influenza vaccination were evaluated. METHODS: This descriptive study was undertaken in the outpatient clinics of Baskent University Hospital. There were 566 responders who completed a self-administered questionnaire. RESULTS: The mean age of participants was 48.35 years, and 16.8% were ≥65 years. Of the responders, 21.7% were vaccinated this year, whereas 57.8% did not desire to get it. Vaccination rates were significantly higher among responders ≥65 years of age (56.4%), those having at least 1 chronic illness (46.5%), and those who were vaccinated regularly every year (22.2%). Half of the responders did not know that the vaccine was reimbursed for people at risk. The most common reason for refusing the influenza vaccine was not getting the flu frequently (51.2%). Fear of side effects, concerns about vaccine's effectiveness, and belief that vaccine causes the flu were other common reasons for not being vaccinated. Of the responders, 77% believed that getting official information or a recommendation from a physician would influence their decision about seasonal influenza vaccination. CONCLUSIONS: People who are at risk or vaccinated regularly display a higher vaccine uptake and better knowledge of influenza and vaccination. The opinions and attitudes of this study population may assist in developing strategies for changing attitudes of the public toward influenza vaccination.

Vocal cord paralysis: What matters between idiopathic and non-idiopathic cases?

OBJECTIVES: This study aims to evaluate the demographic and clinical characteristics of patients with idiopathic and non-idiopathic vocal cord paralysis (VCP). PATIENTS AND METHODS: This retrospective cohort was performed on data extracted from medical files of 92 consecutive patients (43 males, 49 females; median age 52.1±23.1 years; min. 1 - max. 87) with VCP diagnosed in the otorhinolaryngology department between April 2012 and December 2015. Diagnoses associated with VCP, side of involvement (right, left or bilateral) and previous medical histories were noted and compared between patients with idiopathic and non-idiopathic VCP. RESULTS: Vocal cord paralysis occurred on the left side (n=56, 60.9%), right side (n=28, 30.4%) or bilaterally (n=8, 8.7%). A clinical entity related with VCP was identified in 63 patients (68.5%), while 29 (31.5%) patients had idiopathic VCP. Most common etiologies for VCP were thyroid surgery (n=32, 34.8%), cardiovascular surgery (n=9, 9.8%), lung cancer (n=6, 6.5%) and cardiac anomalies (n=4, 4.3%), respectively. Patients with idiopathic VCP were significantly older (p<0.001), while gender distribution (p=0.121) and side of involvement (p=0.340) did not differ between two groups. CONCLUSION: Vocal cord paralysis is a relatively common clinical entity with substantial rate of morbidity. Identification of the underlying etiology and awareness on the clinical characteristics are keystones for foreseeing complications and determining the appropriate therapeutic modality.

Association of Interleukin-10 gene promoter polymorphisms with obstructive sleep apnea.

BACKGROUND: Interleukin-10 (IL) is an anti-inflammatory cytokine that regulates normal sleep patterns, and recent studies have reported that it is a potential useful biomarker to identify presence and severity of sleep apnea syndrome (OSAS). Promoter polymorphisms of IL-10 gene have been associated with altered expression levels, which contributes to OSAS. OBJECTIVE: The aim of this study was to determine the prevalence of -1082 G/A, -819 C/T, and -592 C/A promoter polymorphisms of IL-10 gene in individuals with OSAS and controls. SUBJECTS AND METHODS: An open-label study was performed in the Otorhinolaryngology and Sleep Disorders Outpatient Clinics. One hundred four cases with OSAS were included as the study group, and 78 individuals without OSAS were included as the controls. DNAs were extracted from peripheral blood leukocytes, and the sites that encompassed those polymorphisms were identified by DNA sequencing analyses. Data were analyzed with SNPStats and multifactor dimensionality reduction (MDR) software. RESULTS: The prevalence of OSAS was higher in males in the study group when compared to controls (P = 0.0003). The IL-10-1082 G/A, -819 C/T, and -592 C/A SNPs, and their minor alleles were associated with a significantly increased risk for OSAS compared to the controls (P ˂ 0.05 for all). Furthermore, ATA haplotype frequency was significantly higher in the study group compared to the control group, but the GCC haplotype frequency was lower (P = 0.0001 and P = 0.0001). As indicated in MDR analysis, combinations of IL-10 gene were associated with OSAS in single-, double-, and triple-locus analyses. CONCLUSION: The prevalences of the IL-10 gene promoter polymorphisms were different in OSAS patients and the controls in Turkish population. IL-10 gene polymorphisms may lead to altered inflammatory cascade, which might contribute to OSAS. Further studies on larger cohorts are needed to validate our findings.

Submandibular Gland Surgery: Our Clinical Experience.

OBJECTIVE: The aim of this study was to assess the demographic findings and surgical results of patients who underwent submandibular gland excision at a tertiary care center. METHODS: The clinical characteristics and histopathological results of 45 patients who had undergone submandibular gland excision between 1997 and 2014 were evaluated in detail. RESULTS: Twenty-eight (62.2%) and 17 (37.8%) patients presented with a complaint of a painful mass and painless mass, respectively. Histopathologic investigation of the surgical specimens revealed sialolithiasis in 14 patients (31.1%), chronic sialadenitis in 16 (35.6%), benign tumor in 12 (26.7%), malignant tumor in two (4.4%), and mucocele extravasation in one. As complications, permanent paralysis of the marginal mandibular branch of the facial nerve was seen in one patient (2.2%), temporary paralysis of the marginal mandibular branch of the facial nerve was seen in seven (15.6%), orocutaneous fistula was seen in one (2.2%), and temporary paralysis of the hypoglossal nerve was seen in one (2.2%). CONCLUSION: This study revealed that in patients presenting with complaints of a submandibular gland mass, sialolithiasis, sialadenitis, and benign masses were the mostly diagnosed disorders. Transcervical submandibular gland excision is a satisfactory procedure with low complication and recurrence rates when it is performed on selected patients and obeyed to surgical techniques.

Single-Nucleotide Polymorphisms on the RYD5 Gene in Nasal Polyposis.

Nasal polyposis (NP) is a chronic inflammatory disease. Several genes play major roles in the pathophysiology of the disease. We analyzed RYD5 gene polymorphisms to determine the effect of these variants or their genetic combinations on NP. We genotyped the RYD5 gene in 434 participants (196 patients with NP and 238 controls). Data were analyzed with SPSS, SNPStats, and multifactor dimensionality reduction (MDR) software. We genotyped 10 single-nucleotide polymorphisms (SNPs) in the RYD5 gene. RYD5 (+152G>T) (p.Gly51Va) has not been reported previously. The PolyPhen and PROVEAN predicted the missense mutation as deleterious, but sorting intolerant from tolerant (SIFT) did not. In the genotype analysis, we found that four SNPs (RYD5 [-264A>G], [-103G>A], [+57-14C>T], and [+66A>G]) were significantly associated with NP. The individuals with combined genotypes of six risk alleles (RYD5-264G, -103A, +13C, +57-14T, +66G, and +279T) had significantly higher risks for NP compared with the ones with one or four risk alleles. Haplotype analysis revealed that the two haplotypes were associated with risk of NP. As indicated by MDR analysis, RYD5 (-264A>G and -103G>A) and RYD5 (-264A>G, -177C>A, and -103G>A) were the best predictive combinations and they had the highest synergistic interaction on NP. In addition, RYD5 (+13C>T) was significantly associated with increased risk of both NP with asthma and NP with allergy and asthma. Some SNPs and their combinations in the RYD5 gene are associated with increased probability for developing NP. We emphasize the importance of genetic factors on NP and NP-related clinical phenotypes.