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Objectives: The aim of this study was to investigate the effects of nasal pathologies in paediatric patients with recurrent epistaxis. Methods: A total of 100 (61 boys, 39 girls) patients aged 2–17 years (mean age: 8.9 ± 3.6 years) were included in this study. Anterior rhinoscopy and flexible nasal endoscopy were used to examine all the patients. The epistaxis duration, treatment in active epistaxis by parents, medical history, medical treatment and interventions were recorded. The location of the epistaxis site, nasal mucosa type, the presence of nasal vestibulitis, nasal septum deviation location and type, adenoid size and the degree of inferior turbinate hypertrophy were recorded. Results: The deviation was present in 31 (62%) patients with recurrent epistaxis and in 14 (28%) patients without epistaxis. The presence of deviation was significantly higher in the epistaxis group than control group (p = 0.001). The nasal mucosa type was friable mucosa in 37 (74%) patients, vascularised mucosa in 11 (22%) patients and friable – vascularised mucosa in 2 (4%) patients in recurrent epistaxis group. A significant relationship was detected between nasal mucosa type and age, the presence of the deviation, deviation location, Mladina type in epistaxis group (p = 0.005, p = 0.004, p = 0.008, p = 0.015). Conclusion: Nasal septum deviation, inferior turbinate hypertrophy and nasal mucosa type are associated with paediatric recurrent epistaxis.

Objective: Otitis media with effusion (OME) is the most common cause of hearing loss in children. Early diagnosis is important as hearing loss affects speech and language development in children. The aim of this study was to compare conventional audiometry with the Android mobile operating system application Hearing TestTM in the evaluation of hearing thresholds in children with OME and to determine the accuracy and reliability of the mobile application. Design and Study Sample: Fifty school-age children aged between 5 and 15 years with OME in at least 1 ear were included in the study. First, hearing thresholds were obtained by conventional audiometric methods and the degree of hearing loss was determined. Then, the hearing thresholds of the patients were measured using the smartphone-based Hearing TestTM application. The data were compared using Cohen’s kappa analysis. Results: OME was detected in 88 ears. There was no statistically significant correlation between the hearing threshold results obtained with the mobile phone and conventional audiometry at 500, 1,000, 2,000, and 4,000 Hz. Conclusion: The Android mobile phone application Hearing TestTM (version 1.1.3) is not an appropriate screening test to detect hearing loss in children with OME.

WOS: 000509687200095 PubMed: 31567763 Objectives: Various techniques have been described to correct caudal septum dislocations but the issue has not been resolved conclusively. This study aimed to describe a suture technique that can be used to correct and stabilize the caudal septum on the maxillary spine and also to evaluate the effects on patientsymptoms. Methods: Fifty-two patients with caudal septal dislocation were included in this study. Nineteen of the patients underwent open septoplasty and 33 patients underwent endonasal septoplasty. The caudal cartilage septums were fixed to the maxillary spine with horizontal mattress suturing in all patients. The patient followed up between 3 and 24th month. The modified "NOSE" survey was used to assess surgical outcome in all patients. The degree of septal correction was also classified. Results: Complete correction was achieved in the postoperative period in 96% of the patients. The status was near complete correction in 2 (3.8%) of the patients. But in these 2 patients, degree of caudal septal dislocation was corrected from severe to moderate after surgery and the fixation suture side is correct and stable. Postoperative modified NOSE survey scores were lower than the preoperative scores in all open and endonasal septoplasty groups (P

Background: Open rhinoplasty has been performed for over 50 years. Rhinoplasty procedures have a risk of complications and it is important to follow each step diligently in order to avoid complications. Periorbital edema is the most common complication of septorhinoplasty. As far as we are aware, there are no studies in the available literature examining the impact of the septorhinoplasty on intraocular pressure and the retina. Objectives: The aim of this study was to evaluate the effects of septorhinoplasty-related periorbital edema on intraocular pressure and the retina by means of objective tests. Methods: Ten patients with phase 4 periorbital edema (5 males and 5 females) who underwent open rhinoplasty with bilateral lateral osteotomies were enrolled in the study. All the patients were examined by an eye specialist for visual acuity, intraocular pressure, retinal nerve fiber layer, and ganglion cell complex pathologies with optical coherence tomography preoperatively and postoperatively on the seventh day. Results: Preoperative and postoperative best-corrected visual acuity; intraocular pressure; average, superior, and inferior retinal nerve fiber layer thickness; and total, superior, and inferior ganglion cell complex thickness in both eyes for all patients were within normal limits. There was no statistical difference between preoperative and postoperative values ( P > .05). Conclusion: We concluded that periorbital edema after septorhinoplasty causes no significant complications affecting intraocular pressure and visual acuity. We believe that when osteotomies and local anesthetic injections are undertaken correctly, periorbital complications do not affect vision.

This study aims to investigate the effects of inferior turbinate outfracture on the nasolacrimal system and tear flow. Forty-seven patients (26 males, 21 females) between the ages 18 and 52 years (mean age—29.0 ± 9.6 years) were included in the study. Preoperative nasal examinations and paranasal sinus computed tomography of the patients were carried out; the direction, location, nasal septum deviation classification and inferior turbinate hypertrophy size classification were evaluated. Lacrimal irrigation test was performed preoperatively and 14 days postoperatively. The study included 47 patients who underwent septoplasty and inferior turbinate outfracture. The mean duration of lacrimal irrigation test was 2.9 ± 0.8 s on the right side and 3.0 ± 1.1 s on the left side preoperatively, and 2.1 ± 0.8 s on the right side and 2.2 ± 1.0 s on the left side postoperatively. No significant relationship between direction, location classification, angle nasal septum deviation classification and lacrimal irrigation test duration was found. A significant relationship between size classification of the left inferior turbinate and preoperative lacrimal irrigation test duration was noted (p = 0.030). Moreover, a significant decrease between preoperative and postoperative lacrimal irrigation test duration after inferior turbinate outfracture (p = 0.000) was noted. We concluded that outfracture of the inferior turbinate with septoplasty surgery may benefit the regulation of tear flow. In addition, we concluded that lacrimal irrigation test duration may be effective in determining the patients with subclinical nasolacrimal duct partial obstruction due to inferior turbinate pathologies.

Otitis media with effusion is common middle ear mucosa disease that can cause hearing loss in children. Adenoid hypertrophy can cause recurrent acute otitis media in addition to otitis media with effusion as a result of eustachian tube dysfunction and primary infection focus. The aim of this study was to investigate the effect of adenoid hypertrophy on the hearing threshold in children suffering from otitis media with effusion.Children of school age with otitis media with effusion were included in the study. The size and location of the adenoid tissue were determined by examination with a flexible endoscope. Four adenoid size groups were determined according to the percentage of choanal closure. The coverage was 0-25% in the first group, 26-50% in the second group, 51-75% in the third group and 76-100% in the 4th group. The location of the adenoid tissue in the nasopharynx was divided into three groups. In group A, the adenoid tissue was not in contact with torus tubarius. In group B, the adenoid tissue was in contact with the torus tubarius but did not cover it. In group C, the adenoid tissue covered the torus tubarius completely. Bone and air conduction thresholds were determined using standard procedures. The statistical relationship between the size and location of adenoid tissue and the hearing thresholds was investigated.The study was conducted with the 88 ears of 50 children aged 5-15 years. The median values of mean air conduction thresholds at 500 Hz, 1000 Hz, and 2000 Hz in the adenoid tissue size groups 1-4 were 22 dB HL, 20 dB HL, 15 dB HL, and 20 dB HL respectively. The median values of the mean air conduction thresholds were 20 dB HL, 20 dBHL and 18 dB HL in the adenoid location group A-C, respectively. No significant correlation was found between the groups (p:0.213) and the relevant hearing values (p:0.670). Type B tympanogram was identified in 46 ears and type C tympanogram in 42 ears. The mean hearing thresholds were significantly higher in the ears with a type B tympanogram in the otitis media with effusion cases. (P 0.001).There was no significant correlation between the duration of effusion and the adenoid size (p:0.931), adenoid location (p:0.626) and hearing threshold (p:0.815).We concluded that adenoid tissue size and location have no effect on hearing thresholds and the duration of effusion in otitis media with effusion. We suggest caution before deciding on adenoidectomy in otitis media with effusion cases. Adenoidectomy should not be performed in children over 4 years of age unless there is a definite indication such as nasal obstruction or chronic adenitis.

Objectives: The aim of this study was to determine the relationship between septum deviation and anatomic variations of the paranasal sinus. Methods: A total of 157 (79 males, 78 females) patients between the ages of 17 and 77 years (mean age: 33.7 ± 14.9 years) were included in the study. Using paranasal sinus computed tomography imaging, anatomical variations including nasal septal deviation, Agger nasi cells, Haller cells, Onodi Cells, sphenoid sinus pneumatisation, paradoxical middle turbinates, middle turbinate pneumatisation, maxillary sinus septa,vertical septa in the sphenoid sinus, optic nerve dehiscenceand cribriform plate lamina lateralis height were evaluated. Results: Agger nasi cells were present in 47.1% of cases, Haller cells were seen in 5% of cases and Onodi cells were observed in 23.6% of cases. In 70.1% of cases, one vertical septa in the sphenoid sinus was observed. Maxillary sinus septa was observed in 16.5% of cases. There was a significant negative correlation between the female gender and increased sphenoid sinus pneumatisation (p = 0.035). There was a positive correlation between maxillary sinus septa and the presence of Onodi cells (pright =0.045, pleft = 0.017). There was also a negative correlation between maxillary sinus septa and sphenoid sinus pneumatisation (pright = 0.001, pleft = 0.005). Conclusions: In our study, we found that maxillary sinus septa, Agger nasi, Haller cells, cribriform plate lamina lateralis height, sphenoid sinus septation and Onodi cells were interrelated. We recommend that surgeons evaluate patients with these variations to prevent complications.

Objectives: Chronic nasal obstruction is a common disease of childhood. Adenotonsillar hypertrophy plays an important role in obstructive sleep apnea. The topical use of the aerosolized forms of corticosteroids therefore seems the most appropriate route to decrease systemic side effects. The aim of our study is to demonstrate the effect of topical mometasone furoate especially on the adenoid volume in patients without any allergic story. Methods: The study group consisting of 30 males and 25 females was administered topical nasal mometasone furoate steroid treatment. The 20 patients were in the control group where saline solution (0.9% NaCl) treatment was administered consisted of 12 males and 8 females. Nasopharyngeal X-rays before treatment revealed that 25 patients were Grade 2 and 30 patients were Grade 3 according to the Fujioka method. Results: Flexible endoscopy performed before the treatment revealed that 20 patients were Grade 2, 11 patients were Grade 3 and 24 patients were Grade 4. Nasal endoscopies performed after 6 weeks of intranasal topical steroid therapy revealed that 45 patients were Grade 1 and 10 patients were Grade 2. A statistically significant difference was present between endoscopic grades before and after treatment (p < 0.0001). Nasal endoscopies performed after 6 weeks in control group receiving saline solution treatment revealed Grade 2 in 7 patients, Grade 3 in 10 patients and Grade 4 in 3 patients. There was no statistically significant difference between in the prior and later grades of the control group (p = 0.3125). Conclusions: We believe that the use of intranasal steroids (mometasone furoate) for 6 weeks in patients with pediatric chronic nasal obstruction due to adenoid hypertrophy may be an effective treatment modality in alleviating symptoms and decreasing adenoid volume without causing systemic side effects.

Objective: Elevated levels of serum IgE and eosinophilia are the indicators of atopy and intestinal parasitic infections. We evaluated the effect of Enterobius vermicularis infection (enterobiasis) on blood eosinophil count and IgE levels in allergic rhinitis. Methods: A total of 110 patients diagnosed with allergic rhinitis (with symptoms of rhinorrhea, itchy nose and nasal congestion) consisting of 41 (37.27%) males and 69 (62.73%) females were examined. Forty-one (37.27%) patients with enterobiasis were selected as the study group. The remaining 69 (62.73%) patients accepted as the control group. Results: In the study group the mean serum total IgE level and mean serum eosinophil count were 393.10 ± 159.83 IU/mL and 0.56 ± 0.04 103/mL, respectively. In the control group the mean serum total IgE level and mean serum eosinophil count were 236.91 ± 63.55 IU/mL and 0.37 ± 0.12 103/mL, respectively. The difference between the two groups was statistically significant for serum total IgE levels (p < 0.05) but not for serum eosinophil count (p > 0.05). The correlation coefficients between serum total IgE level and eosinophil count were statistically insignificant (p > 0.05). Conclusions: More comprehensive and long-term placebo-controlled studies should be performed in order to find the answer to the question of whether helminth infections play a role in allergic disease.

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.

WOS: 000399044300046 PubMed: 28959562 Introduction: Aminoglycosides (AGs) have been widely used for potential life-threatening bacterial infections. Although AGs are well known for their ototoxic side effects, some AGs such as amikacin are considered less harmful to auditory functions; thus, auditory monitoring is mostly neglected during treatment with these drugs. Objective: To reflect the potential auditory hazards of repeated amikacin use on the patients with cystic fibrosis (CF). Method: 32CF patients with prior exposure to at least 3 courses of amikacin (the CF group) and 35 non CF patients visiting the outpatient clinic with any complaint other than hearing loss and no history of treatment with any AG( the control, or C group) were compared with pure-tone audiometry(PTA). The diagnosis of CF was made by Nanoduck sweat test. Results: The average age of the participants were 8.25 +/- 2.76 years in the CF group and 8.58 +/- 2.00 years in the C group (ranging from 5 to 13 years). 29 (43.28%) of the cases were female and 38 (56.71%) were male. Clinical SNHL(sensorineural hearing loss) was detected in 4 of the 32 subjects in the CF group. None of the subjects in the C group exhibited clinical SNHL. There was no statistically significant difference between the groups with regard to presence or absence of clinical SNHL (p > 0.05). However, hearing levels of the CF group were around 20 dB(decibel) HL(hearing loss), whereas hearing levels of the C group were around 5 dB. This difference was statistically significant for the pure tone averages of both all frequencies and speech frequencies (p < 0.05). Conclusion: Repetitive exposure to AGs can cause permanent, although mild, sensorineural hearing loss. For prevention, hearing status of the patient should be closely monitored and treatment of choice should be precisely tailored according to the audiological evaluation. This is especially important in patients with CF who frequently experience medical conditions necessitating AGs use. (C) 2016 Published by Elsevier Ireland Ltd.

WOS: 000392937000010 Sialolithiasis is a condition characterized by the obstruction of salivary gland or its excretory duct by a calculus or sialolith. This condition provokes swelling, pain, and infection of affected gland leading to salivary ectasia and even causing the subsequent dilatation of the salivary gland. The aim of this case report is to present a rare condition of sialolithiasis of the submandibular gland with actinomycosis. In this report, we presented a 35-year-old male patient having coexistence of submandibular sialolithiasis and actinomycosis with a literature review. Patient underwent excision of the right submandibular gland due to siaololithiasis. Pathologic examination revealed chronic sialadenitis, sialolithiasis, actinomyces which all necessitate the excision of right submandibular gland with stones with 1.5 cm in diameter. It should be keep in mind that sialolithiasis may be a predisposing factor for submandibular actinomycosis and removal of the sialolith or the entire gland is of particular importance.

WOS: 000270437200007 PubMed: 19360433 We investigated hearing functions in patients with rheumatoid arthritis (RA) using audiological tests and transient evoked otoacoustic emissions (TEOAEs). The study group consisted of 20 adult patients with RA (7 males, 13 females); 20 adult healthy subjects without RA (7 males, 13 females) were recruited as controls. All patients were evaluated by pure tone audiometry, high frequency audiometry, tympanometry and TEOAEs. There were no statistical differences between the study and control groups with respect to the pure tone and high frequency audiometries. TEOAE results of 1.0-2.0 kHz % and of 1.5 and 3.0 kHz amplitude values were significantly lower, and ipsilateral stapes reflex threshold value at 1.0 kHz was significantly higher in the study group when compared to respective values in the control group. In elderly patients and those with longer disease duration, RA nodules and higher methotrexate cumulative doses, hearing thresholds increased and TEOAE values decreased. In active stage of the disease, hearing thresholds diminished and in higher Brinkman Index values, TEOAE values decreased. Compliance values decreased in patients with higher Ritchie Articular Index, C-reactive protein, erythrocyte sedimentation rate and platelet counts, and longer disease duration. Sensorineural hearing loss is generally observed in patients with RA, and this condition may be detected by TEOAEs in an early period of the disease. Inflammation during the active stage of the disease and the subsequent fibrosis may cause conductive hearing loss of varying degrees. In those patients detected as having initiation of TEOAE decrease, vasodilator treatment and antioxidant drugs may be useful in protecting the inner ear.

Objective: Tinnitus can cause psychological problems, which can affect sexual performance. The aim of this study was toinvestigate sexual disturbance related to the psychological problems of patients with subjective tinnitus.Materials and Method: The subjective tinnitus group with normal hearing levels consisted of 20 patients (10 male, 10 female)who were nonpsychiatric. The control group consisted of 20 healthy patients (10 male, 10 female) with normal hearing levels who didnot have tinnitus and were nonpsychiatric. All subjects were married and had an active sexual life. Using a questionnaire, thesubjective tinnitus loudness level score (STLL-Sc) was found. Using Zung Anxiety and Depression Scale, self-rating depression scale(SDS) was found in the study and control groups. Sexual function was assessed in all male subjects with the International Index ofErectile Functions (IIEF) and in all female subjects with the Female Sexual Function Index (FSFI).Results: In females, the satisfaction subscore was slightly lower than normal limits in both the study and control groups. Inmales, the IIEF showed an insignificant, negative correlation with the STLL-Sc and the SDS and a positive correlation with tinnitusduration. In females, the FSFI showed an insignificant negative correlation with the STLL-Sc and a positive correlation with tinnitusduration and the SDS.Conclusion: Sexual disturbance is seen in very quiet- and intermediate-level tinnitus sufferers in the early period of the disease.Over time, they become used to living with their tinnitus, and no loss in sexual performance is seen. In the future, we plan toinvestigate the sexual disturbance of patients with severe STLL-Scs.SOMMAIREObjectif: L’acouphe`ne peut causer des proble`mes psychologiques qui par la suite peuvent affecter la performance sexuelle. Lebut de cette e´tude est d’e´valuer les proble`mes de performance sexuelle associe´s aux proble`mes psychologiques chez le patient avecacouphe`ne.Me´thode: Le groupe avec acouphe`ne subjectif pre´sente un niveau d’audition normal et consiste en 20 patients (10 hommes et 10femmes) qui ne pre´sentent aucun proble`me psychiatrique. Le groupe controˆle est forme´ de 20 patients en sante´ (10 hommes, 10femmes) avec une audition normale, aucun acouphe`ne et aucun proble`me psychologique. Tous les sujets sont marie´s et ont une viesexuelle active. Par questionnaire, nous avons e´value´ le niveau subjectif d’intensite´ sonore de l’acouphe`ne (subjective tinnitusloudness level score (STLL-Sc)). Nous avons mesure´ le niveau de de´pression par l’e´chelle d’e´valuation de l’anxie´te´etdelade´pression‘‘Zong’’, une e´chelle d’auto e´valuation de la de´pression (EAED) dans les groupes a` l’e´tude et de controˆle. Un questionnaire sur lafonction sexuelle a e´value´ tous les hommes d’apre`s l’index international de la fonction e´rectile (IIFE) et chez les femmes d’apre`sl’index fe´minin de la fonction sexuelle (IFFS).Re´sultats: Chez les femmes, le score de satisfaction e´tait juste un peu plus bas que la limite normale dans les deux groupes Chezles hommes, l’IIFE ne montre pas de diffe´rence significative avec, une corre´lation ne´gative avec le STLL-SC et le EAED mais unecorre´lation positive avec la dure´e de l’acouphe`ne. Chez les femmes, (IFFS) de´montre une corre´lation ne´gative mais non significativeavec le STLL-Sc; et une corre´lation positive avec la dure´e de l’acouphe`ne et l’EAED.Conclusion: On rencontre des proble`mes sexuels dans les tous premiers moments chez le patients atteints d’acouphe`nele´ger ouinterme´diaire. Avec le temps, le patient s’habitue a` vivre avec son acouphe`ne et on ne voit plus de perte de performance sexuelle.Nous pre´voyons e´tudier plus spe´cifiquement les patients avec un acouphe`ne se´ve`re.Key words: depression, sexual dysfunction, subjective tinnitusReceived 10/24/05. Accepted for publication 11/13/05.Nuray Bayar Muluk and Ogˇuzhan Dikici: Otolaryngology Department,Mehmed Murad Bas¸ar: Urology Department, and O¨ mer Ogˇuztu¨rk:Psychiatry Department, Faculty of Medicine, Kirikkale University,Kirikkale, Turkey.Address reprint requests to: Nuray Bayar Muluk, MD, Birlik Mahallesi,Zirvekent 2. Etap Sitesi, C-3 blok, No: 62/43, 06610 C¸ankaya/Ankara,Turkey; e-mail: nbayarmuluk@yahoo.com; nurayb@hotmail.com.DOI 10.2310/7070.2007.0002The Journal of Otolaryngology, Vol 36, No 2 (April), 2007: pp 77–82

Rheumatoid arthritis (RA) is an autoimmune disease which is characterized by the passage of primarily CD4 (+) T cells and monocytes into the intravenous inflamed synovial tissue and synovial fluid. The effect of RA on hearing is an issue being discussed. Hearing loss can be conductive, sensorineural or mixed. Conductive hearing loss occurs with the involvement of tympano-ossicular system. Sensorineural hearing loss may have arisen due to the neuritis, vasculitis or ototoxic effects of the drugs used during the treatment. In addition to hearing disorders, RA may also cause vestibular system disorders. Pathophysiology of the vestibular disorders are still unclear. In this review, the effects of RA on hearing and vestibular system were presented with the literature survey.Key words: Rheumatoid artritis, hearing, conductive hearing loss, Sensorineural hearing loss, vasculitis, vestibular disorder, Romatoid artrit (RA), CD4 (+) T hücreleri ve monositlerin, damardan inflamasyonlu sinoviyal dokuya ve sinoviyal sıvıya geçmesiyle karakterize, otoimmün bir hastalıktır. RA’nın işitmeye olan etkisi tartışılmaya devam etmektedir. İşitme kaybı sadece sensörinöral veya iletim tipinde olabilir. Ayrıca mikst tip işitme kaybı şeklinde de görülebilmektedir. İletim tipi işitme kaybı, timpano-ossiküler sistemin etkilenmesi ile ortaya çıkmaktadır. Sensörinöral kayıp ise nörit, vaskülit veya hastalığın tedavisi sırasında kullanılan ilaçların ototoksik etkilerine bağlı olarak ortaya çıkabilmektedir. RA, işitme bozukluğuna ek olarak vestibuler sistem bozukluğuna da sebep olabilmektedir. Vestibuler bozukluğun fizyolojisi tam açıklanamamıştır. Bu derlemede, RA’nın işitme ve vestibüler sistem üzerindeki etkileri, literatür bilgileri ışığında sunulmuştur.Anahtar kelimeler: Romatoid artrit, işitme, iletim tipi işitme kaybı, sensörinöral tip işitme kaybı, vaskülit, vestibüler bozukluk