Volume 7 Issue 2 (2017)

Objective: The aim of the present pilot study was to evaluate the effects of a single local dose administration of humic acid on healing of subcondylar mandibular fractures in rats.
Methods: In this study, a randomized experimental protocol was used. The study was conducted with 16 male Wistar-albino rats that were 16–18 weeks old. The rats (n=16) were randomly divided into two groups: Group HA received humic acid (0.3 cc/site, n=8) and Group C received no additional medical administration (control group, n=8). A full-thickness surgical osteotomy was performed in the subcondylar area. A single dose of humic acid (0.3 cc/site) was administered locally by spraying on the bone surfaces of the fracture line. Mandible was dissected on postoperative day 21. Then, fractured hemimandibles were obtained for histopathological examination.
Results: The median score of bone fracture healing was 7.16 (range: 7 to 8) in the Group HA and 7.50 (range: 7 to 8) in the Group C. When the groups were compared in terms of bone healing scores, there was no statistical difference between the Group HA and the Group C (p>0.05).
Conclusion: Results of this study showed that local administration of humic acid was not efficient for healing of bone fractures. However, we are of the opinion that it is required to conduct more comprehensive studies, including humic acid’s different concentrations and administration manners, evaluating the effects of humic acid on tissue both histopathologically
and in terms of inflammatory and proinflammatory cytokine levels.

Objective: Although many genetic and environmental factors are investigated the etiopathogenesis of microtia, it still remains unclear. We investigated the relationship between the variants/expression of pro- and anti-inflammatory cytokines [interleukin (IL) 6, IL-10, tumor necrosis factor-alpha (TNF-α), transforming growth factor beta (TGF-β1), interferon gamma (IFN-γ)] and susceptibility non-syndromic microtia in a Turkish cohort.

Methods: Nineteen unrelated cases with microtia and 40 healthy controls were included in the present study. Cytokine variants were tested by polymerase chain reaction with sequence-specific primers (PCR-SSP) method.

Results: It was found that IL-6 (-174) GG genotype (high expression) was higher in microtia cases than the controls (p=0.010) while IL-6 (-174) GC (high expression) genotype was lower in patients (p=0.003). For IL-6 (-174), patients with GG genotype had a 5895-fold increased risk for microtia. IFN-γ (+874) variant AA genotype (low expression) was lower in microtia cases (p=0.009). IL-6 (-174) Gallele was more prevalent in patient group compared to controls while C allele was lower in patients than controls (p=0.003). IFN-γ (+874) variant T allele was more prevalent in cases while A allele was lowerin cases (p=0.017).

Conclusion: We have demonstrated for the first time that the cytokine variants constitute risk factors for developing microtia. Our study suggests that the IFN-γ (+874) and IL-6 (-174) variants may be considered as a risk factor for microtia in a Turkish cohorts.

Objective: Herbal medicinal products have a well-established role in therapy of upper airway inflammations. Current evidence supports the use of intranasal corticosteroids for improvement in clinical symptoms of uncomplicated acute rhinosinusitis (ARS). We aimed to evaluate efficacy and safety of combined therapy by mometasone furoate nasal spray (MFNS) and oral herbal medicinal product Sinupret in comparison to MFNS monotherapy when treating mild to moderate ARS.

Methods: Forty-six ARS patients were divided into two groups. Group 1 (n=23) received herbal drug Sinupret, 160 mg per os, three times daily and MFNS 200 μg twice daily for 7 days. Group 2 (n=23) received only MFNS 200 μg twice daily for 7 days. We assessed total symptom score (TSS), individual symptom scores for each symptom (nasal obstruction, rhinorrhea, postnasal drip, facial pain/pressure, impaired sense of smell) and endoscopic findings (mucosal edema, mucopurulent secretion), before and after treatment.

Results: Significant improvement of all clinical parameters was found after both treatment modalities (p<0.000). We observed lower post-treatment TSS (p=0.002), nasal obstruction (p=0.001), rhinorrhea (p=0.001), facial pain (p=0.001), impaired sense of smell (p=0.002), mucosal edema (p=0.003) and mucopurulent secretion (p=0.001) in MFNS/Sinupret group than in MFNS group. We found no adverse events in MFNS/Sinupret group, while only 1 patient reported mild epistaxis and 1 patient reported dryness in the nose in MFNS Group.

Conclusion: Our results suggest better efficacy of combined MFNS/Sinupret therapy of ARS on nasal symptoms and endoscopic findings, with the absence of adverse events in comparison to MFNS monotherapy.

Objective: In this study, we aimed to identify the position in which temporal bone anatomical structures and pathologies could be best visualized by applying reconstruction to cross-sections obtained on an axial plane in temporal bone computed tomography (CT) scans.

Methods: Sixty patients were examined with temporal bone CT between July 2008 and March 2009. We obtained multiplanar reformatted images by applying retro-reconstruction on various planes from the axial plane sections.

Results: We determined that the reconstructed images increased the anatomical and pathological details and significantly contributed to evaluating the relationship between anatomical structures and their pathologies with other normal components.

Conclusion: Obtaining multiplanar reformatted images by retro-reconstruction decreased the need for visualization of coronal sections used in standard temporal bone CT exams since the anatomical details were diversified using the new planes. In addition, the dose of radiation received by the patients and the duration of the examination could be reduced by eliminating routine coronal plane sections and obtaining new images using retro-reconstruction.

Objective: Allergic rhinitis (AR) is a globally common inflammatory disease that has a considerable effect on an individual's quality of life. It is estimated that AR affects 10% to 25% of the general population. Both gustatory and olfactory disorders affect the social activities and job performance resulting in impaired quality of life in patients suffering from AR. We think that these problems have not been sufficiently investigated in the past. We, therefore, decided to evaluate the smell-taste disorders in patients suffering from AR. Our objective is to evaluate the chemosensory perception in patients suffering from allergic AR.

Methods: Fifty-four patients with AR and 34 healthy controls were enrolled for the current study. "Sniffin' sticks" test and taste strips were used for chemosensory assessment.

Results: According to the "Sniffin' sticks" test results, patients with AR had significantly lower scores for odor threshold and identification subtasks, whereas there was no difference between the two groups regarding odor discrimination scores (p<0.001, p<0.001, and p=0.3, respectively). After evaluating the taste strip test results, we found that taste scores were significantly low in patients with AR when compared to controls for sweet, salty, bitter and sour tastes.

Conclusion: This study showed clinically important deficiency of chemosensory sensitivity in AR patients. Since chemosensory deprivation in AR patients has tended to be overlooked in the past, these outcomes suggest that chemosensory disorders should be part of the standard evaluation of patients with AR.

Objective: The purpose of this study was to demonstrate the vascular contact patterns of the facial nerve (FN) on three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) magnetic resonance imaging (MRI) and evaluate the correlation between these patterns, House-Brackmann (HB) grades and outcomes in Bell's palsy (BP).

Methods: Fifty-two patients with BP and 25 healthy controls were included in the study. Besides, a third group was formed by the asymptomatic sides of 52 patients. The vascular contact patterns of the FN on 3D-FIESTA MRI were classified with regard to the presence, number and anatomic location of the contact.

Results: A significant difference was found between the groups in terms of vascular contact patterns of the FN (p<0.001). Multiple vascular contacts were more prominent in the symptomatic sides of the patients. There was a positive statistical correlation between vascular contact patterns and HB grades at presentation and at the 3rd week and 3rd month follow-ups (r=0.335; p=0.015, r=0.587; p<0.001 and r=0.493; p<0.001).

Conclusion: Multiple vascular contacts of the FN on 3D-FIESTA MRI were found to be more common and associated with poor recovery in BP. Thus, 3D-FIESTA MRI may provide prognostic information in BP.

Objective: The objective of this study was to review the management of deep neck space infections in pediatric patients and to evaluate the efficacy of intravenous antibiotic treatment alone before surgical drainage, and also to point out the indications for the drainage.

Methods: We reviewed sixty pediatric cases who were treated in our clinic because of deep neck space infections. The details of demographic data, medical history, initial complaints and physical examination, radiological examination, microbiology and laboratory results (C-reactive protein level and leukocyte count), treatment modality and follow-up findings were collected. The bacteriological results, management, complications, follow-up data and outcomes were also noted. A basic treatment algorithm for the management of the pediatric deep neck space infections was constituted.

Results: In 47 (78.3%) of the children, infection did not require any surgical intervention or puncture - in other words, needle aspiration - and it was successfully treated with antibiotic therapy alone. Fifty-six patients (93%) were initially treated with sulbactam-ampicillin.

Conclusion: We advise surgical drainage in cases of fluctuating large abscesses and infections without clinical improvement despite antibiotic treatment, and in complicated or life-threatening cases such as retropharyngeal abscess and mediastinitis. An otolaryngologist should be patient before any surgical intervention.

Objective: To reveal whether if neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) rates are useful or not in children followed-up due to pathological cervical lymphadenopathy (LAP) of unknown etiology who have a normal hematologic examination.

Methods: A total of 100 children admitted to the otorhinolaryngology clinic between 2014 and 2017 with the complaint of swelling in the neck without any etiology revealed on examination and established with the diagnosis of idiopathic pathological LAP were retrospectively included in the study. The control group consisted of 100 children who did not have any infectious condition and could be considered healthy in terms of examination and laboratory findings. Patients' and the control group's age, gender, clinical history, disease course and examination findings were screened from the patients' records in the clinic.

Results: Mean white blood cell and lymphocyte count parameters in the patient group were higher than the control group, and the difference was statistically significant (p=0.008 and p=0.001, respectively). In the patient group, mean NLR and PLR values were significantly lower than the control group (p=0.009 and p=0.020, respectively).

Conclusion: NLR and PLR rates may be well correlated with inflammation in children followed-up due to pathologic cervical LAP with unknown etiology.

In this review, we aimed to report the effects of pregnancy on olfaction function of the women. Since estrogen and progesterone levels change in specific physiological conditions, pregnancy and postmenopausal period exert an effect on the capability to sense and identify smells. Nasal stuffiness increased during pregnancy. 66.6% of the pregnant women were suffering olfactory dysfunction in the second trimester; while 95.8% in the first and third trimesters. Olfactory function was lessened following birth and throughout the first 6-12 weeks; however, it seemed to improve entirely. In pregnant women, olfactory dysfunction was observed in all trimesters; while it was less in the second trimester and high in the first and third trimesters. The smell abnormalities were almost absent at postpartum period. As olfactory functions improved after delivery of the baby, olfactory changes during pregnancy may be accepted as physiological changes which were observed in many pregnant women.

A 24-year-old man referred to our clinic with complaint of intermittent right-sided watery rhinorrhea. Patient underwent nasal septoplasty one year ago and rhinorrhea occurred two weeks after the surgery. Rhinorrhea was ignored and then patient developed meningitis two months after the surgery. Subsequently, meningoencephalocele formation developed. In this case report, we present a case of meningoencephalocele associated with cerebrospinal fluid leak diagnosed one year after the septoplasty. Septoplasty is usually regarded as a relatively safe operation. However, forceful maneuvers to perpendicular lamina of the ethmoid bone may cause breakdown of the skull base structures, particularly the horizontal lamella of the cribriform plate. When this occur, immediate management is necessary to prevent intracranial complications including meningitis, intracranial abscess, and pneumocephalus. Delay in the diagnosis of such injury may cause erosion of the bone and gradual herniation of the intracranial contents through the skull base defect.