Serum Leptin Levels in Patients with Allergic Rhinitis

OBJECTIVE: To investigate the serum leptin levels in patients with allergic rhinitis during the symptomatic period.

STUDY DESIGN AND SETTING: A randomized, prospective study was performed on 26 adult patients with allergic rhinitis and 20 control subjects with similar age, sex and body mass index in a tertiary otolaryngology center.

RESULTS: Leptin levels were 28.8 ± 14.1 ng/mL in the patients with allergic rhinitis, and 20.8 ± 13.5 ng/mL in the control group respectively. The difference between the groups was statistically significant (p = 0.04).

CONCLUSION: Serum leptin levels were found to be significantly higher in patients with allergic rhinitis in symptomatic period.

SIGNIFICANCE: Apart from its primary role in the regulation of body weight and energy expenditure, leptin may have a role in the inflammatory process of the allergic rhinitis.

Facial nerve paralysis due to intra-aural Hyalomma tick infestation

We present the case of a 33 year-old man from a village of the north-eastern part of central Anatolia admitted to the otolaryngology department of Yeditepe University Hospital with right facial asymmetry and pain on the right ear. A tick of the genus Hyalomma was observed in the external auditory canal of the right ear and it was removed with fine cup forceps under otomicroscopy. We are of the opinion that in patients presenting with sudden acute ear pain and facial palsy, the ear canal should be examined to exclude an infestation by ticks.

Prognostic value of expression of p53, proliferating cell nuclear antigen, and c-erbB-2 in laryngeal carcinoma

BACKGROUND

The molecular mechanisms in malignant transformation of laryngeal mucosa are unknown; many clinical and pathological factors affect prognosis. We investigated a possible correlation between overexpression of p53, proliferating cell nuclear antigen (PCNA), and c-erbB-2, and the clinicopathologic features of laryngeal squamous cell carcinoma (SCC) and clarify their prognostic value.

MATERIAL/METHODS

Thirty-three men with laryngeal SCC participated; all underwent primary surgery or surgery plus radiotherapy between 1999 and 2004 at our department. Paraffin sections of laryngeal SCC were immunohistochemically stained for p53, PCNA, and c-erbB-2.

RESULTS

Overall, p53 overexpression was found in 16 patients. There was no relation between p53 immunohistochemical staining and tumor region. PCNA immunostaining was significantly stronger in supraglottic tumors compared with glottic tumors. Immunostaining of c-erbB-2 was not different in either location. There was no relation between the T stage of the tumor and p53 and c-erbB-2 immunostaining. However, there was a statistically significant positive correlation between the PCNA staining and T stage (stronger staining was present in T3 and T4 stages than in T1 and T2 stages).

CONCLUSIONS

We could not find a statistically significant correlation between p53, PCNA, and c-erbB-2 and lymph node status, histologic differentiation, and survival rate. We demonstrated only a statistically significant positive correlation between PCNA staining and T stage. These data suggest that overexpression of p53, PCNA, and c-erbB-2 is not prognostic in laryngeal SCC.

Malignant fibrous histiocytoma of the larynx in a patient with neurofibromatosis type 1

PROBLEM

Soft tissue sarcomas are rare malignancies in the head and neck region. Malignant fibrous histiocytoma is one of the most common types of head and neck soft-tissue sarcomas. Neurofibromatosis type 1 (NF1), or von Recklinghausen disease, is an autosomal dominant condition characterized by the development of multiple neurofibromas that can transform into aggressive sarcomas.

CASE REPORT

We present an unusual case of malignant fibrous histiocytoma originating from the right vocal fold of the larynx associated with NF1 and discuss its histopathological and clinical features in light of the current literature.

CONCLUSION

Because of their increased risk for malignancy, patients with NF1 should be carefully monitored for the development of additional neoplasms. Our experience supports the use of conservative surgery for treating limited lesions of laryngeal malignant fibrous histiocytoma.

Internal jugular vein thrombosis due to distant malignancies: two case reports and literature review

The internal jugular vein is an uncommon site of spontaneous venous thrombosis. Most cases usually result from intravenous drug abuse, jugular vein catheterisation, neck dissection, a hypercoagulable state associated with malignancy (Trousseau's syndrome), neck injury or ovarian overstimulation syndrome. In this paper, we present and discuss two cases of spontaneous jugular vein thrombosis associated with breast and lung malignancies. The possibility of Trousseau's syndrome due to distant malignancy should be considered by otolaryngologists and appropriately investigated.

Paraganglioma of the skull base: a case report

Paragangliomas are rare benign neuroendocrine tumors derived from the extra-adrenal paraganglia of the autonomic nervous system. Here, we described a new case of a 75-year-old woman with paraganglioma arising in the middle and posterior cranial fossa with extended destruction of the skull base and clivus. She was admitted to our department with the complaint of severe respiratory distress due to vocal cord paralysis. We discussed its clinical, radiological, histopathological features and treatment modalities in the light of the current literature.

Autonomic nervous system evaluation using heart rate variability parameters in vasomotor rhinitis patients

OBJECTIVE

To evaluate the autonomic nervous system in vasomotor rhinitis patients using heart rate variability parameters.

PATIENTS AND METHODS

The heart rate variability parameters (SDANN, SDNN, SDNN index, RMSSD, pNN50, triangular index) of 26 patients with vasomotor rhinitis were compared with those of 25 control subjects.

RESULTS

The decrease in the SDANN and SDNN index in the vasomotor rhinitis patients is statistically significant. Likewise, the SDNN and triangular index decreased but not to a statistically significant degree. The decrease in rMSSD and pNN50, which are signs of parasympathetic nervous system hyperactivation, in the patient group is statistically significant when compared with the control group (p < .005).

CONCLUSION

The results of this study suggest that there might be an abnormality in the autonomic nervous system of vasomotor rhinitis patients, which might be due to a hyperactive parasympathetic nervous system.

Serum Nitrite/Nitrate and Arginase Levels in Patients with Allergic Rhinitis

Nitric oxide (NO) plays an important role in the regulation of upper respiratory function. Patients with untreated allergic rhinitis (AR) have an increased level of NO in the nasal cavity compared to normal individuals. We aimed to investigate serum levels of arginase and NO metabolites nitrite/nitrate in patients with AR during the symptomatic period. The patient and control groups consisted of 14 males and 12 females (mean age: 29, range: 20-40 years), and 10 males and 10 females (mean age: 27, range: 22-38 years), respectively. Nitrite/nitrate levels were 0.98 +/- 0.33 ng/ml in the patients with AR, and 0.78 +/- 0.26 ng/ml in the control group (p = 0.03). Arginase levels were 28.8 +/- 14.1 ng/ml in the patients with AR, and 20.8 +/- 13.5 ng/ml in the control group. The difference between the groups was statistically insignificant (p = 0.24). Our results support the view that NO plays an important role in the pathogenesis of AR, and NO metabolites may be used as a marker for monitoring the disease activity and therapy.

Central giant cell reparative granuloma of the mandible caused by a molar tooth extraction: special reference to the maneuver of drilling the surgical field

Central giant cell reparative granuloma (CGCRG) is an uncommon benign, reactive osseous lesion usually located in the mandible and maxilla. Although it is histologically benign, it may be locally destructive. There is still controversy on its development and growth pattern. Surgery is the treatment traditionally recommended. In this article, we presented a 12 year-old girl CGCRG of the mandible caused by a molar tooth extraction and discussed its histopathological, clinical, radiological and therapeutic features in the light of the current literature. Also we described our additional surgical maneuver 'drilling the surgical field' after the removal of the lesion.

Genetic polymorphism of N-acetyltransferase 2 in the susceptibility to laryngeal squamous cell carcinoma

BACKGROUND

The purpose of this study was to investigate whether polymorphism of N-acetyltransferase 2 (NAT2) genotypes are associated with the risk of laryngeal squamous cell carcinoma (SCC).

METHODS

The study group consisted of 45 white patients with laryngeal SCC (42 men, with a mean age of 54 years [range, 37-70 years] and three women, with a mean age of 47 years [range, 32-55 years]) and 104 control subjects (68 men and 36 women; mean age, 50 years; range, 28-73 years). All of the patients were primarily treated with surgical intervention. Blood samples (5 mL) were obtained before surgery or from the patients under follow-up to 5 years after surgery (mean follow-up, 27 months; range, 6-48 months). DNA was extracted from the lymphocytes by high pure template preparation kit. NAT2*5A, NAT2*6A, NAT2*7A/B, and NAT2*14A were detected by use of LightCycler-NAT2 mutation detection kit by real-time polymerase chain reaction with Light Cycler instruments. The association between NAT2 polymorphisms and laryngeal SCC was prospectively modeled through multivariate logistic regression analysis.

RESULTS

We found that the risk of laryngeal SCC was 7.3-fold higher in individuals with NAT2*5 mutant allele, 3.8-fold higher in subjects with NAT2*6 heterozygote allele, and 38.3-fold higher in NAT2*6 mutant allele. We also found that individuals with NAT2*7 heterozygote allele had a 0.2-fold less risk for the development of laryngeal SCC (p = .018).

CONCLUSION

In this population, patients with NAT2*5 mutant and *6 heterozygous and mutant genotypes had a significantly higher risk for development of laryngeal SCC.

Microbiology of cerumen in patients with recurrent otitis externa and cases with open mastoidectomy cavities

This study investigated the common flora of human cerumen in patients with recurrent otitis externa, and subjects who had been operated on and had an open mastoidectomy cavity from chronic otitis media.

Cerumen samples were collected from three groups; group A (n = 20) consisted of patients with recurrent otitis externa, group B (n = 20) consisted of patients with an open cavity and group C (n = 30) consisted of healthy subjects.

The mean of the microbial count was 3.4 × 104 in group A, 3.08 × 104 in group B and 2.48 × 104 in group C. The most commonly isolated microorganism from the three groups was Staphylococcus epidermidis. No growth was observed in five cases (25 per cent) in group A and in three cases (10 per cent) in group C. In groupB antimicrobial growth was observed in all samples. In 46 (65 per cent) of the cerumen samples,the isolates were monomicrobial and 24 (35 per cent) of the cerumen samples were polymicrobial. The isolates were polymicrobial in 65 per cent of group A, 20 per cent in group B and 23.3 per cent in group C.

In the process of investigating the microbial flora of cerumen in all the three groups, microbial growth was observed from all the samples from patients with an open cavity, unlike the other groups, and it was determined that the group with recurrent external otitis had the most abundant microbial flora.

Cytogenetic biomonitoring in children with chronic tonsillitis: micronucleus frequency in exfoliated buccal epithelium cells

OBJECTIVE

To investigate the possible harmful cytogenetic effects associated with chronic tonsillitis by analyzing the micronucleus frequency and other nuclear abnormalities in exfoliated buccal epithelial cells.

MATERIALS AND METHODS

The study consisted of 20 children with chronic tonsillitis, and 20 control subjects with similar age and sex. The ages ranged between 5 and 12 years old (mean age: 7.5). The patients were diagnosed as having chronic tonsillitis on the basis of history, throat culture and clinical examinations. Buccal cell samples were collected with a wooden spatula. The samples were then applied to clean microscope slides. Smears were air dried and fixed in methanol:acetic acid. Then slides were stained by the Feulgen reaction technique. Three slides were prepared for each subject and 1000 cells were evaluated per slide to determine the frequencies of micronucleus and other nuclear abnormalities (binucleats, karyorrhexis and karyolysis). Statistically, Mann-Whitney U-test was used to analyze and compare the data.

RESULTS

The mean micronucleus frequencies in patient and control groups were 5.29+/-1.67 and 1.58+/-0.33, respectively. In the patient group, mean binucleus, karyorrhexis and karyolysis frequencies were 3.13+/-1.2, 2.04+/-0.64, and 1.74+/-0.47, respectively. However, in the control group, mean binucleus, karyorrhexis and karyolysis frequencies were 1.43+/-0.47, 1.26+/-0.45, and 0.88+/-0.27, respectively. The mean frequencies of all parameters in the patient group were higher than the control values, and the difference was found to be statistically significant (p<0.001).

CONCLUSION

Our results revealed that children with chronic tonsillitis could be under risk of significant cytogenetic damage.

Glutathione S-transferase gene polymorphisms in presbycusis

HYPOTHESIS

Glutathione and glutathione-related antioxidant enzymes are involved in the metabolism and detoxification of cytotoxic and carcinogenic compounds as well as reactive oxygen species. Reactive oxygen species generation occurs in prolonged relative hypoperfusion conditions such as in aging. The etiology of presbycusis is much less certain; however, a complex genetic cause is most likely. The effect of aging shows a wide interindividual range; we aimed to investigate whether profiles of (glutathione S-transferase (GST) M1, T1 and P1 genotypes may be associated with the risk of age-related hearing loss.

PATIENTS AND METHODS

We examined 68 adults with presbycusis and 69 healthy controls. DNA was extracted from whole blood, and the GSTM1, GSTT1 and GSTP1 polymorphisms were determined using a real-time polymerase chain reaction and fluorescence resonance energy transfer with a Light-Cycler Instrument. Associations between specific genotypes and the development of presbycusis were examined by use of logistic regression analyses to calculate odds ratios and 95% confidence intervals.

RESULTS

Gene polymorphisms at GSTM1, GSTT1, and GSTP1 in subjects with presbycusis were not significantly different than in the controls (p > 0.05). Also, the combinations of different GSTM1, GSTT1, and GSTP1 genotypes were not an increased risk of presbycusis (p > 0.05).

CONCLUSION

We could not demonstrate any significant association between the GSTM1, GSTT1, and GSTP1 polymorphism and age-related hearing loss in this population. This may be because of our sample size, and further studies need to investigate the exact role of GST gene polymorphisms in the etiopathogenesis of the presbycusis.

Malondialdehyde and antioxidant enzymes in children with obstructive adenotonsillar hypertrophy

OBJECTIVE

Free radical induced tissue damage has been implicated in the pathogenesis of several diseases. We aimed to investigate the role of free radicals and scavenging enzymes in children with obstructive adenotonsillar hypertrophy.

MATERIALS AND METHODS

The study consisted of 29 children with obstructive adenotonsillar hypertrophy and 51 control subjects with similar age and sex. All the patients and/or their parents had complaints of snoring, mouth breathing, and pausing of breath during sleep for at least 6 months. All patients underwent an adenotonsillectomy operation under general anesthesia with curettage and cold dissection methods. Venous blood was taken preoperatively and 4 weeks postoperatively. After collection of blood samples into citrate (3.5 mg/ml blood) containing glass tubes, erythrocyte sediments were prepared for the analyses. Then malondialdehyde (MDA) level, and superoxide dismutase (SOD), glutathione peroxidase (GSHPx), and catalase (CAT) activities were measured.

RESULTS

The levels of MDA and activities of SOD and GSHPx were significantly higher in the pre-tonsillectomy period than in the post-tonsillectomy period. However, CAT activity was not different in pre- and postoperative period.

CONCLUSION

Our study supports the notion that oxidant and antioxidant defense mechanisms are altered in children with obstructive adenotonsillar hypertrophy, and this alteration improves after tonsillectomy.

A case of intranasal schwannoma with bilateral nasal polyposis

Schwannoma is a benign neoplasm originating from schwann cells of the peripheral nerve sheath, and its occurrence in the nasal cavity and paranasal sinuses is rare. We present a case of nasal schwannoma originating from the left nasal cavity, accompanied by bilateral nasal polyposis. A 66-year-old man presented with complaints of progressive left nasal obstruction, hyposmia, and headache. Anterior rhinoscopic and endoscopic examinations revealed a mass that almost completely filled the left nasal cavity. A polypoid mass was present in the right nasal cavity, as well. On computed tomography, the mass occupied the left ethmoidal cells, left maxillary sinus, left sphenoid sinus, and posterior area of the left nasal cavity. Endoscopic sinus surgery was performed under general anesthesia and the mass was completely removed via the nasopharynx because of its size. Endoscopic anterior ethmoidectomy was also performed in the right nasal cavity for nasal polyposis. Histopathological diagnosis of the left nasal mass was schwannoma. The patient was symptom-free with no recurrence after nine months.

Cervical cystic metastasis of squamous cell carcinoma: a case report with an unusual presentation

Cervical cystic masses may be a diagnostic challenge, especially in patients older than 40 years. We present the case of a 62-year-old male patient with a large cystic metastasis of squamous cell carcinoma to the neck and discuss this rare condition regarding diagnostic, pathologic and therapeutic features.

Glutathione S-transferase M1, T1, and P1 gene polymorphism in laryngeal squamous cell carcinoma

PURPOSE

To investigate the influence of the glutathione S-transferase (GST) M1, T1, and P1 genotypes on the laryngeal squamous cell carcinoma risk.

MATERIAL AND METHODS

The study group consisted of 42 white patients with laryngeal squamous cell carcinoma (39 of them were male, mean age: 53, range: 37-67 and 3 of them were female, mean age: 47, range: 32-55) and 89 control subjects (nonsmokers = 47, smokers = 42) (58 male and 31 female, mean age: 51, range: 30-72). DNA samples were isolated from blood samples using high pure polymerase chain reaction (PCR) Template Preparation Kit. The detection of GST T1, GST M1, and P1 polymorphisms were detected by using real-time PCR.

RESULTS

Gene polymorphisms at GST M1 and P1 were not significantly different in patient and control groups. However, GST T1 null type significantly increased in laryngeal cancer patients when compared with the nonsmoking controls (P =.04).

CONCLUSIONS

There was a significant association between GST T1 null genotype and laryngeal squamous cell carcinoma. However the potential role of GSTs as markers of susceptibility to laryngeal carcinoma needs further studies in a larger number of patients.

The effect of fusafungine on post-operative pain and wound healing after pediatric tonsillectomy

OBJECTIVE

To investigate the effect of fusafungine spray on pain and healing process after pediatric tonsillectomy.

METHODS

Sixty children with ages between 4 and 14 years underwent tonsillectomy or adenotonsillectomy. The patients were randomly divided into three groups and each group consisted of 20 patients. Group 1 was treated with antibiotic (amoxicillin-clavulanic acid) plus analgesic (acetaminophen), group 2 was treated with fusafungine plus analgesic (acetaminophen) and group 3 was treated with only fusafungine. The average ages were 7.8 + 3.4, 6.6 + 2.9, and 8.2 + 3.7 for groups 1, 2, and 3, respectively. Clinical evaluations were made after the operation on the 1st (T1), 3rd (T3), 7th (T7), 10th (T10), and 14th days (T14).

RESULTS

There was no significant difference in post-operative pain between study groups on the post-operative 1st, 3rd, and 7th days (P > 0.05), a statistically significant difference was present between groups 1 and 3, and groups 1 and 2 on the post-operative 10th and 14th day (P = 0.018 and 0.037, respectively). Pain was less in groups 2 and 3 than in group 1 on the 10th and 14th day. Also there was a significant difference in healing time of the tonsillary beds between groups 1 and 2, and groups 1 and 3 on the 10th and 14th post-operative day (P = 0.031 and 0.001, respectively). Healing was better in groups 2 and 3 than in group 1 on the 10th and 14th day.

CONCLUSION

Fusafungine administration after tonsillectomy was found to be beneficial on post-operative pain and wound healing of tonsillary beds in pediatric population.

Brainstem evaluation in children with primary nocturnal enuresis

We investigated the brainstem integrity in children with primary nocturnal enuresis (PNE) using auditory brainstem responses (ABR), blink reflex and exteroceptive suppression of the masseter muscle. We examined 23 children with PNE (16 male, 7 female; mean age: 10.4 years) and 19 control subjects (11 male, 8 female; mean age: 11.8 years). ABR parameters such as wave latencies, amplitudes and interpeak latencies and blink reflex parameters such as R1 and R2 amplitude and latencies were not significantly different between the 2 groups. Although S2 parameters of the exteroceptive suppression of the masseter muscle were easily and completely obtained from the control subjects, in the PNE group S2 onset latency and duration were not recorded in 26% of the study children (n = 6) (P = 0.01). S2 duration time was significantly lowered in the enuretic group (left side: P = 0.001 and right side: P = 0.003). S2 duration time changes in the enuretic group supports a possible brainstem dysfunction in children with PNE.

The relationship between presbycusis and mastoid pneumatization

Presbycusis is defined as the natural hearing loss accompanying aging, caused by degenerative changes in the inner ear. The etiology of presbycusis is uncertain. However, it would appear that a complex genetic cause is most likely. The determinants of mastoid size continue to be controversial. One of the pneumatization theories is the hereditary theory. In this study, the possible relationship between presbycusis and the extent of mastoid pneumatization was investigated. This study was carried out on 21 patients with presbycusis and 21 normal subjects of similar ages. The pneumatized volume was measured by computerized tomography. The temporal bone was scanned at 2 mm thickness intervals. Exposure (kV 130, mA105). The scan plane was parallel to the orbitomeatal line and the CT images covered the entire mastoid region. The average mastoid pneumatization in presbycusis group was 6.08 +/- 2.52 cm(3) in the right ear and 6.19 +/- 2.93 cm(3) in the left ear. However, in the control group it was 4.69 +/- 3.17 cm(3) in the right ear (p=0.12) and 5.10 +/- 3.49 cm(3) in the left ear (p=0.28). No significant difference was found between the presbycusis patients and normal subjects in terms of the volume of mastoid pneumatization.

[Distribution of allergens among allergic rhinitis patients living in Mersin region]

OBJECTIVES

To determine the distribution of allergens among allergic rhinitis patients living in the Mersin region.

PATIENTS AND METHODS

We investigated 346 allergic rhinitis patients (233 females, 113 males; mean age 32.3+/-14.1 years) who had symptoms and a positive prick test result.

RESULTS

The history and clinical examination revealed that 161 patients (46.5%) had seasonal symptoms and 185 patients (53.5%) had perennial symptoms. Common pattern of multiple allergens were mite allergens (57.8%), grass mixture (32.1%), trees mixture (14.5%), cereals mixture (13.9%), weed mixture (7.2%), dog hair (5.5%), and cat fur (2.9%). According to the prick test results, sensitivity to one allergen was found in 96 patients (27.7%) and sensitivity to multiple allergens in 250 patients.

CONCLUSION

The most common allergens were mites and pollens in the Mersin region. It was concluded that the distribution of allergens was associated with the climatic, environmental and socioeconomic features of the region.

Serum levels of antioxidant vitamins, copper, zinc and magnesium in children with chronic rhinosinusitis

Reactive oxygen species including hydroxyl radicals, superoxide anions and hydrogen peroxide which are produced by activated granulocytes play an essential role in many biochemical processes and diseases. Oxidant-mediated tissue damage may be important in the development of chronic sinusitis. The aim of this study was to investigate the serum levels of antioxidant vitamins and elements in 24 children (14 boys and 10 girls, age range: 7-12 years, mean age: 9.2 years) with chronic rhinosinusitis, compared to 20 age and sex matched healthy children. Blood samples were collected in the morning before breakfast and prior to any medication. Vitamin A, E and C levels were determined using reagent kits for high performance liquid chromatography. Cu, Zn and Mg levels were analyzed by atomic absorption spectrometry. Vitamin E, vitamin C, Cu and Zn levels were significantly lower in the patients group than in the control group. However, vitamin A and Mg levels did not differ. In conclusion, serum levels of antioxidant vitamins and elements may be important in the pathogenesis and treatment of chronic rhinosinusitis in children.

Asymptomatic bilateral mixed-type laryngocele and laryngeal carcinoma

A laryngocele is an abnormal dilatation of the laryngeal saccule. The relationship between layngoceles and laryngeal carcinoma is still debated. We present the case of a 45-year-old male patient with bilateral asymptomatic laryngocele and laryngeal squamous cell carcinoma. We discuss the possible etiopathogenetic influence of increased intralaryngeal pressure with preoperative CT and explorative findings, and the current literature is reviewed.

[The effect of mometasone furoate on mucociliary clearance in patients with perennial allergic rhinitis]

OBJECTIVES

We investigated the effect of mometasone furoate on mucociliary clearance in patients with perennial allergic rhinitis.

PATIENTS AND METHODS

The study included 25 patients (16 females, 9 males; mean age 30 years; range 18 to 50 years) with perennial allergic rhinitis. Mometasone furoate (nasal spray) was administered at a dose of 2 puffs (100 microgr) to each nostril daily for a month. Mucociliary clearance was evaluated by the saccharin test before and after treatment.

RESULTS

The mean mucociliary clearance time was 6.89 +/- 0.64 minutes before the treatment and 7.18 +/- 0.54 minutes after the treatment. No significant delay in the mucociliary clearance was detected (p > 0.05). The mean mucociliary clearance time did not differ significantly between male and female patients (p > 0.05).

CONCLUSION

The results suggest that mometasone furoate do not affect mucociliary clearance in patients with perennial allergic rhinitis.

The effect of L-carnitine on the prevention of experimentally induced myringosclerosis in rats

The objective of this study was to investigate the possible effect of L-carnitine on the prevention of experimentally induced myringosclerosis. Twenty Sprague-Dawley rats were bilaterally myringotomized. The rats were divided into two groups randomly: group 1 which were intraperitoneally administered saline and group 2 which were intraperitoneally administered L-carnitine. Blood samples were collected for biochemical evaluation and the tympanic membranes were harvested after 28 days. Histopathological and immunohistochemical evaluation were done under light microscopy. The mean malondialdehyde levels were 3.9+/-0.9 in group 2, and 7.9+/-1.1 in group 1 (P<0.001), nitric oxide levels were 25.6+/-6.4 in group 2 and 30.8+/-8.2 in group 1 (P=0.14) and acetylcholinesterase was 1035+/-60 in group 2 and 678+/-35 in group 1 (P=0.001). Myringosclerosis was more frequent and severe in group 1 than group 2 (P<0.007). Immunoreactivity was seen in 16 of 20 tympanic membranes in group 2 and six of 20 tympanic membranes in group 1 (P=0.005). We conclude that L-carnitine diminishes the occurrence of myringosclerosis in rats after myringotomy possibly by antioxidant activity and decreasing the formation of reactive oxygen species.

Prevention of laryngotracheal stenosis with carnitine after tracheotomy: an experimental study on rats

OBJECTIVE

We investigated the effect of carnitine on wound healing of trachea in tracheotomyzed rats. This study was undertaken to test the hypothesis that treatment with carnitine would protect the wound tissue, which was evaluated by measuring nitrite and nitrate, thus nitric oxide, malondialdehyde and cholinesterase in blood, and examining the histopathological changes.

METHODS

Standard vertical tracheotomy was performed on 24 Wistar-Albino type rats. Then the animals were randomly divided into two groups; group A (the study group) was administered intraperitoneal carnitine 100 mg/kg for 10 days; group B (the control group) was administered intraperitoneal saline for 10 days. On the 10th day, all animals were decanulated. Three weeks later, cardiac blood samples were taken for biochemical assays and trachea specimens were harvested for histopathologic examination.

RESULTS

In the carnitine-administered group, granulation tissue thickness resulting from the wound healing in the level of tracheotomy incision was lower compared to the control group (P < 0.01). When serum malondialdehyde levels were considered, a lower malondialdehyde level was found in the carnitine-administered group (P < 0.01). However, serum nitric oxide levels were close to each other in both groups (P > 0.05), while serum cholinesterase level was higher in the carnitine-administered group than in the control group (P < 0.01).

CONCLUSION

Carnitine treatment partially prevents and significantly reduces the severity of tracheotomy induced laryngotracheal stenosis.

Has cerumen a protective role in recurrent external otitis?

PURPOSE

We investigated the bactericidal activity of the cerumen in patients with recurrent otitis externa.

MATERIALS AND METHODS

Cerumen samples were collected from 2 groups. Group A (n = 20) consisted of patients with recurrent otitis externa (2 or more acute otitis externa attack in the current year) and group B (n = 30) consisted of cerumen from a healthy population. We examined the bactericidal activity against the common microorganisms (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus) that encounter the recurrent otitis externa.

RESULTS

A significant decrease in the count of S epidermidis was observed in group A (P <.05) and B (P <.01) was observed. A comparison of decreases and increases in the percentages of microorganisms between the groups A and B showed that there was a significant difference only in the count of E coli (P <or=.05). The count of E coli decreased in cerumen suspension in group A, but it increased in the normal population.

CONCLUSION

We did not confirm that cerumen from patients with recurrent otitis externa had less bactericidal activity than from a healthy population.

Expression of inducible nitric oxide synthase in antrochoanal polyps

OBJECTIVE

Antrochoanal polyp (ACP) is a polypoid lesion originating from the maxillary sinus, emerging from the ostium and extending to the choana. Although the etiologic causes of ACP are not known completely, it presents a fairly uniform clinical appearance. Nitric oxide (NO) has an important role in non-specific immunoreactions and inflammation in various tissues and has a main regulatory role in airway function and seems to involve in pathomechanism of several respiratory system diseases. NO is synthesized by the effect of three isoforms of nitric oxide synthase i.e. inducible NOS (iNOS). Some studies revealed that ACP has some different characteristics from the ordinary nasal polyps. In the present study, in order to compare ACP with allergic and non-allergic nasal polyps (NANP), we detected and localized the iNOS expression and also evaluate some histological parameters.

METHODS

Twenty-six cases were chosen from the files and four controls were used. The cases were separated as follows: normal inferior turbinate mucosa as control (n=4) ACPs (n=8), allergic nasal polyps (ANP) (n=9), and NANP (n=9). Five-micrometer thick sections were prepared from the paraffin sections of polyps and normal nasal mucosa to quantify the iNOS expression. iNOS protein was observed in the cytoplasm of epithelial and stromal inflammatory cells. iNOS protein expression in the groups was assessed according to the intensity of staining and histomorphological parameters, oedema, lymphocytic and eosinophilic cell infiltration were detected semi quantitatively.

RESULTS

iNOS expressions, either stromal or epithelial, were not different from each other among the four groups. Although it is not statistically significant, we noted that ANP and ACP frequently showed moderate and severe iNOS protein expression in epithelial and stromal parts when compared with NANPs and controls. Also, iNOS expression was significantly higher in the stroma of the ANPs than NANPs (P=0.012).

CONCLUSIONS

ACPs and ANPs have frequently showed moderate and significant epithelial and stromal iNOS expression. Further studies are needed in large groups to elucidate differences between ACP and the other nasal polyps.

[A review of antrochoanal polyps in 14 cases]

OBJECTIVES

We evaluated the clinical results of surgical treatment for antrochoanal polyps.

PATIENTS AND METHODS

The study included 14 patients (9 males, 5 females; mean age 23 years; range 7 to 48 years). Skin prick test was performed and specific IgE responses were determined. Treatment involved endoscopic sinus surgery in 13 patients, and polypectomy combined with Caldwell-Luc operation in one patient. Follow-up examinations were performed in the postoperative first and sixth months.

RESULTS

The polyps originated from the right (n=8) and from the left (n=6) maxillary sinuses. Nasal obstruction was found in all cases, with accompanying nasal discharge, sneezing, and postnasal discharge in four; snoring and mouth breathing during sleep in five patients, and sore throat and rhinorrhea in one patient. Allergy was determined in three patients. Computed tomography showed coexistent sinus diseases in nine patients. During surgery, the precise origin of the polyp was detected in four cases; being in the lateral wall in two, and in the posterior wall in two patients. Complications were minor hemorrhage in two cases, and synechia in three. Recurrence was observed in two patients.

CONCLUSION

Endoscopic sinus surgery proved an ideal approach for antrochoanal polyps as it enables complete removal of the antral portion of the polyp, and simultaneous intervention to other sinus diseases.