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Objectives: This study aims to review the relationship between written language skills and factors which are thought to affect this skill such as mean hearing loss, duration of auditory deprivation, speech discrimination score, and pre-school education attendance and socioeconomic status of hearing impaired children who attend 4th-7th grades in primary school in inclusive environment., Patients and Methods: The study included 25 hearing impaired children (14 males, 11 females; mean age 11.4±1.4 years; range 10 to 14 years) (study group) and 20 children (9 males, 11 females; mean age 11.5±1.3 years; range 10 to 14 years) (control group) with normal hearing in the same age group and studying in the same class. Study group was separated into two subgroups as group 1a and group 1b since some of the children with hearing disability used hearing aid while some used cochlear implant. Intragroup comparisons and relational screening were performed for those who use hearing aids and cochlear implants. Intergroup comparisons were performed to evaluate the effect of the parameters on written language skills., Results: Written expression skill level of children with hearing disability was significantly lower than their normal hearing peers (p=0.001). A significant relationship was detected between written language skills and mean hearing loss (p=0.048), duration of auditory deprivation (p=0.021), speech discrimination score (p=0.014), and preschool attendance (p=0.005), when it comes to socioeconomic status we were not able to find any significant relationship (p=0.636)., Conclusion: It can be said that hearing loss affects written language skills negatively and hearing impaired individuals develop low-level written language skills compared to their normal hearing peers.

Objectives: Retropharyngeal abscess is a serious and life-threatening disease due to its anatomic location and potential to obstruct the upper airway. We evaluated the clinical characteristics, diagnosis, and treatment of patients with retropharyngeal abscesses., Patients and Methods: The study included 10 patients (6 males, 4 females; mean age 9+/-11 years; range 4 months to 32 years) who received medical and surgical treatment with the diagnosis of retropharyngeal abscess. The patients were evaluated with respect to etiology, clinical symptoms and signs, treatment, complications, and hospital stay., Results: The most frequent etiological factor was upper airway infection (70%), followed by dental abscess in two patients (20%), and soft tissue injury due to foreign body ingestion in one patient (10%). The presenting symptoms and signs included dysphagia (100%), respiratory distress (80%), limited neck motion (80%), fever (60%), and neck pain (50%). Treatment consisted of surgical drainage and parenteral antibiotic combination of cefazolin sodium and metronidazole. The mean hospital stay was 7.1+/-5.3 days. Complications were seen in two patients, being empyema and upper airway obstruction, respectively., Conclusion: Surgical drainage combined with early antibiotic treatment is an effective method in the management of retropharyngeal abscesses and in preventing complications.

Objectives: We investigated symptoms of otologic diseases in patients with temporomandibular joint diseases., Patients and Methods: The study included 44 patients (26 females, 18 males; mean age 36+/-10.7 years; range 21 to 58 years) with temporomandibular joint disease. A questionnaire was administered to the patients to inquire into otological symptoms accompanying temporomandibular joint disease., Results: Temporomandibular joint disease was bilateral in 11 patients. Accompanying otological symptoms were as follows: click voice with jaw movements (n=21; 47.7%), headache (n=15; 34.1%), pain in the ear with jaw movements (n=14; 31.8%), tinnitus (n=8; 18.2%), fullness in the ear (n=6; 13.6%), vertigo or dizziness (n=6; 13.6%), and hearing loss (n=3; 6.8%). Pure-tone audiometry revealed sensorineural hearing loss in one patient, being 28 dB on the right and 30 dB on the left., Conclusion: Our findings suggest that otologic symptoms may accompany temporomandibular joint diseases, requiring that patients presenting with otologic symptoms must be investigated for temporomandibular joint diseases.

Objectives: We investigated the role of Borrelia burgdorferi in the etiology of idiopathic acute peripheral facial palsy., Patients and Methods: Nineteen patients (15 females, 4 males; mean age 38 years; range 14 to 61 years) with acute peripheral facial palsy were studied. Following routine otolaryngologic examination, all the patients underwent taste, Schirmer, and stapedial reflex tests to evaluate the level of the palsy. Laboratory examination included routine biochemistry analysis, serum C-reactive protein, rheumatoid factor, and erythrocyte sedimentation rate. Anti-Borrelia burgdorferi IgM and IgG antibodies were sought by ELISA in venous blood samples., Results: Of the patient group, acute facial palsy was localized on the right in 12 patients (63.2%), and on the left in seven patients (36.8%). None of the patients had bilateral involvement. No IgM or IgG seropositivity for Borrelia burgdorferi was detected in the serum samples., Conclusion: In highly endemic areas, it may be helpful to detect or even to eliminate Lyme disease through screening of serum in patients with acute peripheral palsy.

Objectives: To examine the favorable effects of vitamin E on tympanic membrane perforations induced mechanically in guinea pigs., Study Design: Bilateral tympanic membrane perforations of 1.8 mm were induced in 40 guinea pigs. The animals were randomly divided into two groups equal in number. One group remained untreated, while the other was administered vitamin E (100 mg/kg/day) through intramuscular injections. On days 1, 3, 5, and 7, five animals in each group were randomly sacrificed. Histopathologic changes in the tympanic membranes were evaluated and malondialdehyde levels were determined., Results: Significant increases were observed in epithelial thickness, fibroblastic proliferation, and neovascularization in the study group (p<0.05). Epithelial thickness was found to be increased in both groups beginning from the first day; however, this increase was more rapid in the study group. Although malondialdehyde levels showed significant increases on days 3 and 5 in both groups (p<0.05), they returned to the first day values in vitamin E-treated animals on day 7, whereas controls still maintained high malondialdehyde levels., Conclusion: Vitamin E hastens the healing process of traumatic tympanic membrane perforations.

Objectives: The efficacy and reliability of prophylactic antiemetic therapy with low dose propofol, droperidol, metoclopramide, and ondansetron were evaluated in a randomized, double-blind, and prospective design., Patients and Methods: A total of 101 ASA I-II patients (34 females, 67 males; age range 16 to 53 years) undergoing middle ear surgery for chronic otitis media or its sequelae were randomly assigned to receive prophylactic antiemetic therapy with propofol (n=21, 0.5 mg/kg), droperidol (n=19, 20 mg/kg), metoclopramide (n=23, 0.2 mg/kg), ondansetron (n=21, 4 mg), and placebo (n=20, 0.9% NaCl). All drugs were administered intravenously five minutes before extubation., Results: In the early postoperative period (0 to 3 hours), the percentages of patients free from nausea and vomiting were 100% with droperidol, 71.4% with ondansetron and propofol, 52.1% with metoclopramide, and 35% with placebo. Ondansetron (90.4%) was found the most effective to prevent and control nausea and vomiting during the postoperative 3 to 24 hours, followed by droperidol (84.2%), propofol (57.1%), metoclopramide (47.8%), and placebo (40%). Compared with controls, the number of patients without nausea and vomiting was significantly greater in each treatment group but metoclopramide (p<0.05). No significant differences were detected with respect to adverse effects., Conclusion: Droperidol and ondansetron seem to exert the highest efficacy to prevent nausea and vomiting during the postoperative 0 to 3 hours and 3 to 24 hours, respectively.

Objectives: We evaluated the efficacy of antibiotic treatment with or without topical administration of intranasal budesonide in chronic otitis media with effusion (OME)., Patients and Methods: The study included 62 patients (age range 2 to 12 years) with chronic OME. The patients were randomly assigned to three groups, namely, antibiotic treatment (20 patients, ampicillin/sulbactam, 25 mg/kg/daily), antibiotic treatment combined with intranasal budesonide (20 patients, 200 mg/daily), and no treatment (22 patients). All patients and families were questioned regarding the presence of allergy, frequent upper respiratory tract infections, passive smoking, low birth weight, and pre-school nursery attendance. Otoscopic examination findings and the results of tympanograms obtained at the time of diagnosis, and at the end of four and eight weeks of treatment were evaluated., Results: At the end of eight weeks, significant improvement in tympanograms and otoscopic findings was obtained in both groups when compared with the control group (p<0.05). Resolution rates were 24% (9/37 ears), 39% (14/36), and 5% (2/40) with antibiotic, budesonide, and no treatment groups, respectively. Although budesonide treatment was associated with a higher rate of resolution of effusion compared to that of antibiotic alone, this did not reach significance (p>0.05)., Conclusion: Further studies with larger patient series are required to better evaluate the efficacy of antibiotic treatment and topical intranasal steroid administration in chronic OME.

Objectives: To evaluate the efficacy of topical ciprofloxacin and tobramycin with and without topical dexamethasone in the treatment of chronic suppurative otitis media without cholesteatoma., Patients and Methods: The study included 103 ears of 80 patients (49 males, 31 females; mean age 31 years; range 18 to 60 years) with chronic suppurative otitis media without cholesteatoma. The patients were randomly divided into four groups to receive topical applications of either ciprofloxacin and tobramycin alone, or in combination with dexamethasone. Cultures were obtained from the ears preoperatively and 24 hours after treatment., Results: Aerobic bacteria were isolated in 94.1% of patients before the treatment, the most common being Pseudomonas aeruginosa (38.9%). With dexamethasone, the clinical response for ciprofloxacin and tobramycin increased from 80% to 90% and from 70% to 75%, respectively, but this improvement was not significant (p > 0.03). Addition of dexamethasone to ciprofloxacin decreased the recovery period from 14 days to seven days, whereas no change (7 days) was observed with tobramycin., Conclusion: The efficacy of ciprofloxacin and tobramycin were similar in the treatment of chronic suppurative otitis media. Addition of dexamethasone to ciprofloxacin decreased the treatment period.

Objectives: We evaluated the effects of hyperlipidemia on hearing function., Patients and Methods: The study included 274 hyperlipidemic patients (176 females, 98 males; age range 35 to 60 years) who manifested normal tympanic membrane findings, no history of noise exposure, and chronic systemic or ear diseases. Sixty healthy subjects (36 females, 24 males) with normal serum lipid levels were enrolled as controls. Subjects who had elevated serum total cholesterol, triglyceride, and very low density lipoprotein (VLDL) levels, and normal lipid levels were divided into four groups and their hearing functions were analysed with pure-tone audiometry., Results: Evaluation of all groups showed significantly increased hearing levels at three frequencies in female patients, and at six frequencies in male patients (p < 0.05). Significant increases in hearing levels were observed both in females and males at 8000 Hz in three groups, at 6000 Hz in the VLDL group, and in males at 2000 Hz in the total cholesterol and VLDL groups (p < 0.05). When both female and male patients were evaluated together, the largest difference was detected in the VLDL group at five frequencies., Conclusion: The findings of our study suggest that hyperlipidemia may have a role on the occurrence of sensorineural hearing loss.

Objectives: We evaluated the efficacy of lidocaine hydrochloride aerosol on postoperative pain relief in patients undergoing tonsillectomy., Patients and Methods: The study included 60 patients (25 females, 35 males; mean age 25.43 years; range 16 to 35 years) undergoing tonsillectomy. The procedure was performed by the same surgeons under local anesthesia. The patients were randomly divided into two groups to receive either lidocaine HCl (n = 30) or NaCl (n = 30). A total of 4 mg/kg of 10% lidocaine HCl aerosol and 2 ml of 0.9% NaCl were applied to the tonsillectomy fossa eight times daily, respectively. Evaluation of pain was made on the first, third, and seventh postoperative days using a visual analogue scale., Results: Significant differences were found between the groups on the first, third, and seventh postoperative days (p < 0.05). In each group, patient's evaluation of pain differed significantly (p < 0.05). The significance levels were higher for lidocaine on the first and third days., Conclusion: Our results suggest that lidocaine HCl aerosol exerts a therapeutic effect on postoperative pain control in tonsillectomy patients.