Premedication Methods in Nasal Endoscopy: A Prospective, Randomized, Double-Blind Study.

OBJECTIVES: To identify the optimal pharmacological method of preparing patients for nasal endoscopy. METHODS: Twenty healthy volunteers were enrolled in this prospective, randomized, double-blind study. Four types of medications were applied in their nostrils with binary combinations of spray bottles on four different days in a random order: placebo (normal saline [NS]+NS), decongestant (NS+oxymetazoline), anesthetic (NS+lidocaine), and decongestant plus anesthetic (oxymetazoline+lidocaine). Rigid nasal endoscopy was performed 10 minutes after spray application. The volunteers evaluated the discomfort caused by each spray application, and nasal pain scores due to the passage of the endoscope. The physicians quantified nasal decongestion using a visual analogue scale. Endoscopy duration as well as pulse and mean blood pressure (MBP) before spray application, 10 minutes after the application, and immediately after endoscopic examination were also recorded. RESULTS: The discomfort caused by lidocaine was significantly higher than that caused by the other sprays (P<0.001). The lowest pain score related to endoscopy was obtained for oxymetazoline+lidocaine (P<0.001). Nasal decongestion was best achieved with NS+oxymetazoline (P<0.001). Endoscopy duration was the shortest for oxymetazoline+ lidocaine (P<0.05). Statistically significant MBP changes were only seen with the application of NS+oxymetazoline (P<0.05). However, neither MBP nor pulse rate change was significant clinically. CONCLUSION: Application of decongestant and anesthetic sprays together seems to be the best method of pharmacological preparation of patients for nasal endoscopy.

A Prospective Experimental Study on the Protective Effect of Resveratrol against Amikacin-Induced Ototoxicity in Rats.

OBJECTIVE: The purpose of this study was to evaluate the protective effect of resveratrol against amikacin-induced ototoxicity in rats by otoacoustic emission and histopathology of the cochlea. MATERIALS AND METHODS: This study was conducted with 31 Sprague Dawley adult female rats that were 20-21 weeks old and 190-245 g in weight. Before the drug administration, distortion product otoacoustic emission (DPOAE) tests were performed in both ears of each rat. The rats were divided into four groups. Group 1 (n=7) received ethanol 1cc 4%, Group 2 (n=8) received 600 mg/kg amikacin, Group 3 (n=8) received 10 mg/kg resveratrol and 600 mg/kg amikacin, and Group 4 (n=8) received 1cc resveratrol at 10 mg/kg. The drugs were administered once a day for 21 consecutive days. Control DPOAE tests were performed at the 7th, 14th, and 21st days after the administration of drugs. At the end of the study, the rats were sacrificed and their cochleae were dissected. The cochleae were evaluated for histopathologic changes. RESULTS: There was no statistically significant difference in the DPOAE measurements before the procedure between groups. The DPOAE measurements significantly decreased after the procedure in the amikacin group. There was no statistically significant difference in DPOAE measurements after the procedure in the amikacin + resveratrol, resveratrol, and ethanol groups. The histopathologic findings supported these results. CONCLUSION: We found that if resveratrol is administered with amikacin, the severity of amikacin-induced hearing loss is decreased. These findings suggest that resveratrol, a strong antioxidant, has a protective effect in amikacin ototoxicity.

Effect of Septoplasty on Voice Quality: A Prospective-Controlled Trial.

OBJECTIVES: The purpose is to investigate effect of septoplasty and widened nasal patency on voice quality. METHODS: Fifty patients who undergone septoplasty were included in the study. Thirty-three people who had similar age and distribution were enrolled as control group. Before and 1 and 3 months after surgery, anterior rhinomanometry, voice analysis by Multi-Dimensional Voice Program, and spectrographic analysis were performed to patients. The recordings of /a/ vowel were used to evaluate average fundamental frequency (F0), jitter percent, and shimmer percent. In spectrographic analyses, F3-F4 values for the vowels /i, e, a, o, and u/, nasal formant frequencies of the consonants /m/ and /n/ in the word /mini/, and 4 formant frequencies (F1, F2, F3, and F4) for nasalized /i/ vowel following a nasal consonant /n/ in the word /mini/ were compared. The differences in nasal resonance were evaluated. All patients were asked whether change in their voices after the surgery. Preoperative and postoperative voice parameters and anterior rhinomanometry results were compared separately with the control group as well as in the patient group itself. RESULTS: Preoperative total nasal resistance (TNR) values of patients were higher than the control group (P=0.001). TNR values of patients measured one day before surgery and after surgery in the 1st and 3rd months were different and these differences were significant statistically (P=0.001). There was no significant difference between the voice analysis parameters in preoperative, postoperative 1st, and 3rd months. As a result of their subjective reviews, 12 patients (36%) noted their voices were better than before surgery and 20 patients (61%) noted no change before and after surgery. CONCLUSION: Providing widened nasal cavity has no effect on voice quality.

Evaluation of the effect of intranasal infiltrated botulinum toxin-A on a model of allergic rhinitis in rabbits: An Experimental Study.

INTRODUCTION: Allergic Rhinitis (AR) effects 20-40% of the global population and its prevalance increases. Medical treatment and immunotherapy could be used in AR management. But they are not definitive solution. Medical treatment must be used a long time and has side effects. Immunotherapy cannot be applied to every patient and it also takes a long time. The aim of this study is to evaluate symptomatic and histopathological effects of intranasal infiltrated Botulinum Toxin-A (Btx-A) on an animal model of AR. MATERIAL-METHOD: 15 rabbits were divided into 3 groups as control, disease and treatment. AR was formed in disease and treatment groups by intraperitoneal and intranasal ovalbumine. Allergic symptoms were observed and serum IgE levels were estimated to prove forming of AR. Btx-A was infiltrated in inferior turbinates of rabbits in treatment group. Rabbits were sacrified on 32nd day. Paranasal structures were disected and investigated histopathologically. RESULTS: Serous nasal discharge and sneezing were observed after ovalbumine applying in disease and treatment groups. Serum IgE levels on 21st day were higher than 1st day and this difference was significant statistically in disease and treatment groups. Serous discharge and sneezing decreased after Btx-A infiltration in treatment group. In histopathological examination, there were significant difference between disease and treatment group in terms of some histopathological findings. CONCLUSION: Considering the effect of Btx-A on AR in animal, it can be said that Btx-A can decrease symptoms and reorganize histopathological findings of AR.