Is Ozone (O3) Treatment Effective in Atrophic Rhinitis? Experimental Animal Study.

INTRODUCTION: Atrophic rhinitis (AR) is a disease characterized by atrophy of the mucosa, submucosa, bone tissue due to an unknown cause and excessive nasal cavity enlargement. The disease still has no complete treatment, and the treatment of the functional loss of atrophic cells in AR is still a matter to be investigated. Ozone (O3) therapy has been shown to enhance cell metabolism, angiogenesis, fibroblast activity, and collagen synthesis. AIM: To determine whether ozone treatment affects the disease histopathologically, in experimentally created AR. Material - Method: Twelve Wistar Hanover strain albino male rats were included in the study. Atrophic rhinitis was induced in animals by administering Pasteurella multocida toxin diluted with saline for 21 days to both nasal cavities. A total of 12 animals included in the study were divided into 2 groups as control and study. Ozone gas (60 µg/mL) was administered rectally to the study group for 21 days. After 2 weeks, the rats were decapitated, the nasal cavities were removed as a block, and atrophic rhinitis parameters (epithelial hyperplasia, goblet cell loss, cilia loss, inflammatory infiltration, and vascular ectasia) were evaluated under light microscopy by histopathological examination and statistically interpreted. RESULT: The incidence of vascular ectasia was significantly lower in the ozone group compared to the control group (p<0.05). There was no significant difference between the groups regarding other histopathologic findings. CONCLUSION: Ozone treatment was moderate at the histopathological level. We concluded that ozone therapy has no or very limited effect on atrophic rhinitis.

The comparison of edema and ecchymosis after piezoelectric and conventional osteotomy in rhinoplasty.

The basic aim of our study is to compare the results of the conventional and piezoelectric osteotomy in rhinoplasty by complete subperiosteal degloving of nasal bone to minimize soft-tissue injury. The study was designed as a prospective, double-blind, randomized, and controlled study. Setting is a tertiary referral hospital in Turkey. Ninety patients who underwent primary open rhinoplasty with osteotomy, performed by either the conventional instruments or the piezoelectric device. The complete subperiosteal degloving of the entire nasal bone was done up to the nasal maxillary sulcus, medial canthus, and nasion in all patients, independent of the type of osteotomy device used. Patients subsequently underwent median-oblique and lateral osteotomy, either with an ultrasonic device or a conventional 2-mm guarded, straight osteotome. The postoperative edema and ecchymosis were evaluated by another surgeon who was blinded to the osteotomy procedure on postoperative days 2 and 7. The edema scores were significantly increased on the second day compared with the seventh day in both groups 1 and 2. However, there was no significant difference between groups. The ecchymosis scores were slightly higher in postoperative day 2, compared with day 7, in both groups 1 and 2, but statistically not significant. This study showed that the main reason edema and ecchymosis are seen post-rhinoplasty is related to soft-tissue injury during osteotomy.

Extended lateral thoracic fasciocutaneous biosynthetic flap for reconstruction of full-thickness partial external ear defects: an experimental study.

External ear reconstruction is a controversial topic in reconstructive plastic surgery. Here, we prepared a pedicled biosynthetic flap for full-thickness, partial ear defects in rabbits. We operated on six adult female New Zealand rabbits weighing 3-4 kg. The dimensions of the lateral thoracic fasciocutaneous flap were 7 × 6 cm. The flap was elevated based on one of the bilaterally located internal thoracic arteries, which were dissected proximally. The pedicled flap was folded in two, and polypropylene mesh was sandwiched in the middle. The flap was adapted to a defect of 3.5 × 3 cm in diameter. In fact, the defect was created before elevation of the flap. Rabbits were followed up for 4 weeks, at the end of which they were killed and their ears were evaluated histopathologically. The survival rate of the rabbits was 100 %. All pedicled biosynthetic flaps were viable, but one showed partial (20 %) necrosis (1/6) and one was partially detached (1/6). Macroscopic (color, thickness, texture) and histological (polymorphonuclear leukocyte invasion in the skin, subcutaneous tissue, and at the junction between the polypropylene mesh and the flap) features of the flap were compared to the ipsilateral ear. A new technique was developed for partial external ear reconstruction with sufficient inner skeletal support and outer skin lining. Level of evidence Level NA.

Polypropylene mesh for nasal septal perforation repair: an experimental study.

The aim of this study is to determine the effectiveness and biocompatibility of polypropylene mesh for the repair of nasal septal perforations in an animal model on rabbits. A full-thickness nasal septal perforation with a diameter of nearly 10 × 10 mm was created on 12 rabbits, and then the perforation was reconstructed with two different methods. We used mucosal flaps and polypropylene mesh as an interpositional graft in group 1. Only mucosal flaps were used for reconstruction and are identified as group 2. After 4 weeks, we removed the nasal septum of the rabbits and performed histopathological examinations for acute rejection, infection, inflammatory response, fibrosis, and granuloma formation. We found perforation closure rates of 75 and 25 % in groups 1 and 2, respectively. Inflammatory response was seen in all specimens of group 1 (100 %). The inflammatory response was +1 in five of the specimens (62.5 %), +2 in one specimen (12.5 %), and +3 in two specimens (25 %). Mild fibrosis around the mesh was detected in four specimens (50 %), medium-level fibrosis was detected in one (12.5 %), and no fibrosis was detected in three (37.5 %). Severe fibrosis was not seen in any specimens. The foreign-body reaction was limited to a few giant cells, and granuloma formation was seen in two specimens (25 %). The propylene mesh showed excellent biocompatibility with the septal mucosa, and it can, therefore, be used for the repair of septal perforation as an interpositional graft safely.

Effects of ozone (O3) therapy on cisplatin-induced ototoxicity in rats.

The aim of this study is to investigate the effect of rectal ozone and intratympanic ozone therapy on cisplatin-induced ototoxicity in rats. Eighteen female Wistar albino rats were included in our study. External auditory canal and tympanic membrane examinations were normal in all rats. The rats were randomly divided into three groups. Initially, all the rats were tested with distortion product otoacoustic emissions (DPOAE), and emissions were measured normally. All rats were injected with 5-mg/kg/day cisplatin for 3 days intraperitoneally. Ototoxicy had developed in all rats, as confirmed with DPOAE after 1 week. Rectal and intratympanic ozone therapy group was Group 1. No treatment was administered for the rats in Group 2 as the control group. The rats in Group 3 were treated with rectal ozone. All the rats were tested with DPOAE under general anesthesia, and all were sacrificed for pathological examination 1 week after ozone administration. Their cochleas were removed. The outer hair cell damage and stria vascularis damage were examined. In the statistical analysis conducted, a statistically significant difference between Group 1 and Group 2 was observed in all frequencies according to the DPOAE test. In addition, between Group 2 and Group 3, a statistically significant difference was observed in the DPOAE test. However, a statistically significant difference was not observed between Group 1 and Group 3 according to the DPOAE test. According to histopathological scoring, the outer hair cell damage score was statistically significantly high in Group 2 compared with Group 1. In addition, the outer hair cell damage score was also statistically significantly high in Group 2 compared with Group 3. Outer hair cell damage scores were low in Group 1 and Group 3, but there was no statistically significant difference between these groups. There was no statistically significant difference between the groups in terms of stria vascularis damage score examinations. Systemic ozone gas therapy is effective in the treatment of cell damage in cisplatin-induced ototoxicity. The intratympanic administration of ozone gas does not have any additional advantage over the rectal administration.

Evaluation of Inner Ear Damage by Using Otoacoustic Emissions in Patients Who Underwent Mastoidectomy and Tympanoplasty Operations in the Early Period.

OBJECTIVE: We aim to demonstrate inner ear damage caused by drilling in the early period. Healthy contralateral ears of patients who underwent mastoidectomy using drill or tympanoplasty without using drill were compared. METHODS: A total of 38 patients (mastoidectomy: 22, tympanoplasty: 16) who were diagnosed as chronic otitis media and were scheduled for surgery were included. Distortion product (dp) otoacoustic emissions measurements were performed on healthy contralateral ears of patients on pre- and post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day. RESULTS: In mastoidectomy group, dp otoacoustic emission values on post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day at a frequency of 4000 Hz were significantly lower than in tympanoplasty group (p<0.05). In mastoidectomy group, dp values on post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day at 4000 Hz significantly decreased in comparison with pre-operative period (p<0.05). In comparison with pre-operative period, decrease in dp values on post-operative 1. hour, 1. day, and 2. day at 4000 Hz in mastoidectomy group is significantly higher than those in tympanoplasty group (p<0.05). In tympanoplasty group, dp values on post-operative 1. hour at 4000 Hz significantly decreased in comparison with pre-operative period (p<0.05). CONCLUSION: Drilling used in mastoidectomy operation damage healthy contralateral ears by causing acoustic trauma. This damage can be determined by otoacoustic emissions in the early period. According to our study, hearing loss is temporary and more distinct at higher frequencies.

Case study of a parotid gland adenocarcinoma dedifferentiated from epithelial-myoepithelial carcinoma.

Dedifferentiation is defined as high-grade malignant tumor development out of a low-grade malignant tumor. We present an adenocarcinoma tumor of the parotid gland that was dedifferentiated from a low-grade epithelial-myoepithelial carcinoma and was followed up for 3 years. Our patient, a 46-year-old female, presented with a left parotid mass of 20-year duration. Histopathologic results showed that there was only one area of typical epithelial-myoepithelial carcinoma, with foci of poorly differentiated adenocarcinoma (not otherwise specified; NOS) and clear cytoplasm in the parotid gland. Immunohistochemical staining results showed SMA (+), P63 (+), CK8 (+), and S100 (+) on epithelial cells. A review of the literature revealed 22 previously reported cases of dedifferentiated epithelial-myoepithelial carcinoma. In these cases, the malignant tumors that dedifferentiated from epithelial-myoepithelial carcinoma were adenoid cystic carcinoma, actinic cell carcinoma, polymorphous low-grade adenocarcinoma, mucoepidermoid carcinoma, and intraductal carcinoma. In our case, the malignant tumor that dedifferentiated from the epithelial-myoepithelial carcinoma was a poorly differentiated adenocarcinoma. Histopathological results showed that metastases were not seen in the neck-dissection material. As a result, our case will make a contribution to the literature in terms of prognosis, because there are very few reported cases of dedifferentiated adenocarcinoma development arising from epithelial-myoepithelial carcinoma.

The impact of pharyngeal repair time and suture frequency on the development of pharyngocutaneous fistula after total laryngectomy.

OBJECTIVE: Pharyngocutaneous fistula (PCF) is the most common postoperative complication after total laryngectomy. The aim of this study was to determine the relationship between PCF with pharyngeal repair time and the number of mucosal sutures. METHODS: The medical records of 47 patients who underwent total laryngectomy were assessed prospectively. The pharyngeal repair time and the number of horizontal, vertical, and cricopharyngeal muscle sutures were recorded. We observed the occurrence of PCF in 14 patients (29.8%). The mean time for pharyngeal repair in the PCF group was 22 minutes 59 seconds ± 5 minutes, and the mean number of vertical, horizontal, and cricopharyngeal muscle sutures was 8.57 ± 2.6, 11.14 ± 2.1, and 8.45 ± 1.9, respectively. The mean time for pharyngeal repair in the non-PCF group was 22 minutes 21 seconds ± 5 minutes, and the mean number of vertical, horizontal, and cricopharyngeal muscle sutures was 9.54 ± 2.6, 10.84 ± 2.3, and 7.36 ± 2.7, respectively. The differences in the pharyngeal repair time and the number of vertical, horizontal, and cricopharyngeal sutures between the 2 groups were not statistically significant (P > 0.05). Besides, there was no statistically significant difference between the mean suture counts per centimeter in horizontal plane (1.46 ± 0.35) and vertical plane (0.98 ± 0.25) in the PCF group and the mean suture counts per centimeter in horizontal plane (1.42 ± 0.37) and vertical plane (1.13 ± 0.3) in the non-PCF group (P > 0.05). CONCLUSIONS: There was no relation between PCF development with pharyngeal repair time, mucosal suture count, and suture frequency after total laryngectomy.