Volume 5 Issue 3 (2015)

Objective: To evaluate the pharmacological effects of the N-acetylcysteine (NAC) on human respiratory epithelial cultures specifically addressing electrolyte transport and cilia beat frequency.

Methods: Well-differentiated human bronchial epithelial cultures grown at an air liquid interface were treated on the apical or basolateral surface with varying concentrations of NAC. The best NAC concentration for ideal cilia beat frequency was found. The effects of NAC were evaluated on cilia beat frequency. After the effect of N-acetylcysteine on beat rate was found, its efficiency was investigated by ATP or IBMX to understand its mechanism of action. Changes in ciliary beat frequency were determined using the Sissons-Ammons video analysis system.

Results: Maximal stimulatory effect on cilia function was evident at 10 mg/ml NAC concentration. After wash up, cilia movement were increased very dramatically. This increase of cilia beat frequency was even higher after NAC plus IBMX and NAC plus ATP washings.

Conclusion: Apical application of NAC prominently stimulates cilia beat frequency and after wash up, cilia movement was increased very dramatically. After NAC use by washing with PBS in clinical efficacy can be enhanced.

Objective: Tonsils and adenoids are the parts of the Waldeyer’s ring. Their basic function is antibody formation which later reacts against a great variety of antigens. Adenoidectomy is the most common operation in small children but the exact reasons of adenoid hypertrophy remain unknown. Therefore, this study aimed at investigating CD14 as surrogate marker of inflammation in children who have to undergo adenoidectomy.

Methods: One hundred pediatric patients with adenoid hypertrophy were included in this study. Intensity of CD14 expression in infiltrating cells was assessed by immunohistochemical methods.

Results: All of the 100 patients underwent adenoidectomies due to chronic adenoid inflammation and hypertrophy. After immunohistochemical analysis, all the specimens were stained as positive (100%) for CD14 expression. Classification of these specimens according to CD14 staining intensity were as follows: 0 as score 0, 36 as score 1, 43 as score 2 and, 21 as score 3. On the other hand, we found statistically significant association between CD14 and age.

Conclusion: In the present study, we showed an increase in the density of CD14 with increasing age.

Objective: In this prospective study, we investigated the serum vitamin D levels [serum 25(OH)D3 levels] in children with allergic rhinoconjunctivitis (ARC).

Methods: Sixty-one children with allergic rhinoconjunctivitis (study group) and 61 healthy children (control group) were included into the study. The children in the study group had an allergy against at least one active agent at skin-prick test; a total of 5 Symptoms Score (T5SS) was obtained for vitamin D [25(OH)D3] levels. Total eosinophil counts and total IgE measurement were performed.

Results: In ARC group, median of T5SS scores was 1.00 for each of the rhinorrhea, sneezing, nasal congestion and nasal pruritis items. In ARC group, total eosinophil count and total IgE values were also higher than the control group. In ARC group, familial atopy was higher, and sunlight exposure was lower than the control group. Serum 25(OH)D3 levels of the ARC group (median: 15.80 ng/ml) were significantly lower than the control group (18.40 ng/ml). Considering the vitamin D levels being as sufficient/or deficient; it was deficient in 80.3% of the children in the study group and in 57.4% of the children in the control group. In the study group, sunlight exposure was insufficient; and familial atopy was present. In children with sufficient sunlight exposure, serum 25(OH)D3 levels were detected as higher. In children with familial atopy, total IgE and total eosinophil counts also increased.

Conclusion: We concluded that vitamin D levels were lower in children with ARC. We recommend children to expose sunlight sufficiently to increase vitamin D levels; and therefore reduce the risk of allergic rhinoconjunctivitis. 

Objective: The aim of this retrospective, case-control study was to investigate the association of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) with tinnitus.

Methods: A total of 51 patients with tinnitus and 42 healthy, age- and sex-matched subjects were recruited for the present study. Audiometric data including pure-tone average (PTA) values, the side of the head in which tinnitus was experienced, duration of tinnitus, tinnitus reaction questionnaire (TRQ), tinnitus handicap questionnaire (THQ), complete blood count (CBC) and biochemical data were assessed from patient records. The mean values of NLR, PLR and MPV were compared between patients with tinnitus and healthy controls.

Results: The difference was not significant for mean serum NLR, PLR and MPV values between patients with tinnitus and healthy controls.

Conclusion: Serum NLR, PLR and MPV levels may not be useful parameters for routine clinical evaluation of tinnitus.

Objective: Reasons such as nasal deviation, which reduces airflow in nose and impairs oxygenation, may affect the maxillary volume. In this study, we aimed to perform a retrospective study between the degree of nasal septal deviations and maxillary sinus volume.

Methods: The files of 103 male and 124 female patients (total n=227) who applied to otorhinolaryngology clinic with nasal septal deviation without coexisting sinonasal morbidity were investigated, and compared with those without nasal septal deviation and coexisting sinonasal morbidity. Three-dimensional paranasal sinus CTs were performed for the diagnosis (CTs were found to be normal, and etiology of chronic intracranial headache could not be determined) and they were evaluated retrospectively. Maxillary sinus volume was calculated for each case in the groups. The relationship between nasal septal deviation and maxillary sinus volume was evaluated.

Results: Our study determined that there was statically no significant difference between the maxillary volumes of the group with (29.34±7.46 cm3 ) or without nasal septal deviation (27.89±8.51 cm3 ) (p>0.05). No matter what the right nasal septal deviation angle is, it did not affect the right, left and total maxillary sinus volumes. Both left- and right-sided nasal septal deviations did not have any effect on the right, left and total maxillary volumes.

Conclusion: Any difference was not observed between the maxillary sinus volumes of the children in the pediatric age group with and without nasal septal deviations, and it was concluded that the existence or severity of the septal deviation did not have any effect on the maxillary sinus volume. 

Objective: This study investigated the effects of device treatments on weight changes in obstructive sleep apnoea syndrome (OSAS) patients.

Methods: The study included 256 patients who underwent polysomnography to evaluate snoring and suspected OSAS. They were grouped according to the apnoea hypopnoea index (AHI) and device usage for OSAS as follows: Group 1 included patients who were established with OSAS diagnosis and used device for treatment purpose (n=101); Group 2 included patients who were established with OSAS diagnosis but could not adapt to the devices recommended for medical purposes (n=76); and Group 3 included patients who were established with ordinary snoring diagnosis but did not have OSAS, (n=79). Group 1 used CPAP, Auto CPAP, or BiPap. For all groups, BMI and neck circumference data were obtained from sleep centre records (baseline values) and invited to visit again for followup measurements in otolaryngology outpatient clinic (control values).

Results: In Group 1, both BMI and neck circumference were increased at follow-up compared with the baseline measurements (p<0.05) while no significant change was detected in the other two groups (p>0.05). The BMI and neck circumference did not differ among the devices used in Group 1 (CPAP, Auto CPAP, and BiPap) (p>0.05).

Conclusion: Devices used to treat OSAS tend to enhance weight gain. Such patients should be closely monitored and the required measures should be taken in terms of obesity. 

Objective: Our aim was to investigate contralateral suppression of otoacoustic emission for the evaluation of auditory reflex in patients with migraine which is a disease that may cause dysfunction of sensorial modulation.

Methods: Voluntary migraine patients without vestibular symptoms who consulted to Neurology Clinic, and diagnosed according to the IHS 2004 criteria, and healthy volunteers were included in the study. All volunteers underwent complete otorhinolaryngologic and puretone audiometric examinations. Thirty voluntary migraine patients with bilateral otoacoustic emission measurements, and 30 healthy volunteers matched in terms of age and sex were included in the study. Otoacoustic emission measurements were obtained with 65 dB SPL click stimulus with and without mask by masking with contralateral 50 dB SPL broad band noise. Responses were compared between two groups.

Results: Positive result was obtained in suppression tests in 40 of 60 (67%) ears of healthy volunteers and in 30 of 60 (50%) ears of migraine patients. However, there was no statistically significant difference between groups regarding positive suppression frequency and suppression values. Even though a statistically significant difference between migraine patients without vestibular involvement and control group was not seen, there was a decrease in contralateral suppression responses in the migraine group.

Conclusion: Although it is statistically insignificant, we have demonstrated that migraine patients without vestibular symptoms showed a decrease in the suppression values compared to the healthy volunteers. We believe that in new studies with larger series, contralateral otoacoustic emission suppression test can be used as an early tool to diagnose audiovestibular symptoms in migraine patients without any vestibular involvement. 

Objective: The aim of the present study was to analyse the clinical, radiographic, and surgical outcomes of paranasal fungus ball.

Methods: A retrospective data analysis was performed on 16 patients who underwent endoscopic sinus surgery for paranasal sinus fungus ball between December 2005 and November 2014. The patient’s demographic data, clinical presentations, radiological findings and surgical outcomes were analysed.

Results: There were 10 female (62.5%) and six male (37.5%) patients with a mean age of 53.6 (range: 32 to 74) years. Most common symptoms were headache and facial pain. Computed tomography showed a hyper-dense area in 12 patients (75%) and sclerosis in bony walls of the sinus in 13 patients (81.3%). Magnetic resonance imaging revealed a marked low intensity on T2 weighted images in all cases (100%). All patients were treated with functional endoscopic sinus surgery. Only one patient had a recurrence in the postoperative period.

Conclusion: The surgical opening of affected sinus ostium and removal of the fungal concentration were the treatment of choice in all cases.

Myrrh and borax (combined in a tincture) can be used as a mouthwash. Myrrh gum is used to treat indigestion, ulcers, colds, coughs, asthma, lung congestion, arthritis pain, and cancer. Myrrh has been shown to exert analgesic effects on mice in which pain was induced. Myrrh is used as an astringent, antiseptic (to treat inflammed lesions of the throat and mouth), and antispasmodic to treat cancer and infectious disease. In this paper, we review the literature on myrrh tinctures, peppermint oil, and menthol.