Volume 2 Issue 1 (2012)

Sudden hearing loss is defined classically as sensorineural hearing loss developing within less than three days which emerges with hearing loss at all three successive frequencies at more than 30 dB. We analyzed 14 patients with sudden hearing loss with known etiologies whom we hospitalized, and treated in our clinics between January 2005 and January 2007. We reviewed etiological factors in patients, and aimed to present grades, characteristics, and treatment responses of hearing loss.

Immune system is a sum of all processes which protect a living organism against diseases, also recognize, and destroy pathogens and tumor cells. Human body protects itself against bacteria, viruses, and other foreign substances via very diverse mechanisms. This protection involves physical barriers, fagocytic cells in blood, and tissues, and various molecules of hematologic origin. These mechanisms can be divided into two interdependent defense systems as non-specific or hereditary immune system and specific or acquired immune system. Non-specific immune system which is the first stage of the defense system discriminates between foreign substances and those belonging to the body, but it cannot distinguish between two types of pathogens. However, specific immune system can discern between those belonging or foreign to the organism, and responds specifically to different pathogens, and foreign molecules. The main objective of this paper is in general to deal with cells, molecules, and tissues involving in immune system, and define normal mechanisms used to defend the body against foreign substances.

The diagnosis of allergic airway diseases is based on symptoms, and the laboratory tests help us to classify the types. A correct diagnosis is important, since the treatment will change in different types of diseases. For example, untreated rhinitis may result in other diseases like asthma, and deteriorate the quality of life. Therefore, early diagnose of allergic airway diseases is important before the disease progresses. This review summarizes the currently known diagnostic tools which can be useful in daily practical life and researches, including assessment of symptoms, physical examination, allergy skin tests, total and specific IgE, nasal provocation test and assessment parameters (symptoms, nasal flow and secretions), nasal mucosal sampling, and pulmonary function test.

Objective: The aim of this study was to investigate the clinical efficacy of modified Fujita technique uvulopalatoplasty (UPPP) with nasal surgery in patients with simple snoring and obstructive sleep apnea syndrome (OSAS).

Methods: A total of 12 consecutive OSAS patients (mean age 46.08±7.16 years) who underwent modified Fujita technique UPPP with nasal surgery were included in the study. Pre and postoperative subjective symptoms and polysomnographic data were compared.

Results: Following simultaneous nasal-oropharyngeal surgery, the AHI significantly decreased (from 41.8±22.5 to 19.3±12.6 events per hour; p0.05).

Conclusion: Single-staged modified UPPP with nasal surgery is an available and relatively safe surgical approach in OSAS patients with nasal obstruction.

Objective: To compare postoperative mucociliary clearance times in patients who had undergone septoplasty operations with or without tampon application.

Methods: This study included 46 patients (20 female, 26 male) with nasal deviations. The patients underwent septoplasty operations under local anesthesia. The patients were divided in two groups. In Group 1 (28 patients) Merocell® tampons were packed into two nasal passages for the stabilization of the septum. On postoperative 2nd day tampons were removed, and nasal irrigation was started using saline solution. In Group 2 (18 patients) transeptal sutures were placed for septal stabilization and nasal irrigation with saline solution was started from postoperative 6th hour. All patients had undergone saccharine clearance test before the procedure, and at postoperative 1st week and 3rd month, and the results were compared.

Results: Preoperative nasal mucociliary clearance times of 46 patients aged 20 to 53 years were as follows: Group 1: 14.65 min at the side of the septal deviation (deviated side), and 14.07 min at the non-deviated side; In Group 2, the corresponding time intervals were 11.9 vs. 13.1 minutes, respectively. At postoperative 1st week, in Group 1, mucociliary clearance times were 12.54 min for the deviated and 11.23 min for the non-deviated nasal septa. While in Group 2, the corresponding times of clearance were 10.1 vs. 10.8 min. At postoperative 3rd month, in Group 1, mucociliary clearance times were 11.6 min for the deviated and 10.4 min for the non-deviated septa. In Group 2, the corresponding clearance times were 6.76 min vs. 7.8 min.

Conclusion: Postoperative mucociliary clearance times of the patients operated for nasal septal deviation were evaluated. We detected shorter mucociliary clearance times in the group operated with suturing technique when compared with the other group.

Objective: The aim of our study is to assess the impact of septorhinoplasty on quality of life (QOL) using general health and disease-specific quality scales and to identify the effect of age, gender and education on the change process of the patient's quality of life.

Methods: The study included patients with septal deviation and external nasal deformity. Short Form 36 and Esthetic Functional Nasal Assessment Form (EFBDF) were used as QOL instruments; and rhinomanometry to measure airway resistance. Tests were conducted just before surgery and three months and one year after surgery.

Results: Forty-one patients (22 males, 19 females, mean age 29.9) undergoing nasal surgery were studied prospectively. Compared to preoperative scores, we found significant improvements in general health, mental health, energy, pain, physical and social function scores of SF-36 subscales conducted in the third month and first year after the surgery. There was no difference in physical role and emotional role subscales. Nasal surgery specific EFBDF scores were significantly improved in two measurement periods following surgery compared to preoperative values. The pre/post-operative rhinomanometric measurements showed an improvement and the difference was also significant. There was no correlation between QOL instruments with sex, age and educational status.

Conclusion: Our study has shown that general and nasal specific QOL was improved with SRP patients assuming that correct indication for surgery is given and correct surgical method is chosen. Also SRP patients were able to breathe more efficiently through their noses after surgery.

Objective: The aim of the present study was to determine the prevalence of otitis media with effusion (OME) among primary school and kindergarten children in provincial and district centers of Diyarbakır.

Methods: The study was conducted at 4 primary schools and 3 kindergartens in the city center, and at 13 primary schools in district centers. Using the combined physical examination and otoscopic and tympanometric evaluations, 256 children out of 1,763 (14.5%) were diagnosed with OME.

Results: Among total OME cases (119 girls, 137 boys) 118 (46.1%) had bilateral while 138 cases (53.9%) had unilateral effusion (89 on left and 49 on right ear). The prevalence of OME among primary school students were 12.6% at the city center, 16.3% at district level schools and 15.2% among kindergarten students. Higher OME prevalence is associated with passive smoking and allergic rhinitis. Age, sex, attending kindergarten and socioeconomic status were not significantly related with OME.

Conclusion: In conclusion, because of high prevalence of otitis media and its possible severe complications screening equipment should be ensured at primary level health institutions. Screening for OME should be a part of preventive health services particularly for all kindergarten and early elementary school students; and should be performed by ENT specialist or pediatricians/general practitioners trained in pneumatic otoscopic and tympanometric evaluation.