| ORIGINAL ARTICLE | |
| 1. | Genetic sensorineural hearing loss in childhood Onur Turan, Fazıl Apaydın Pages 99 - 105 Objectives: This study aimed to determine the severity, age of presentation, and genetic etiology in hearing handicapped children. Patients and Methods: Three groups of children were studied: children who received treatment for hearing loss at the Otolaryngology Department of Ege University Hospital between 1993 and 1999 (1645 children) and throughout 2000 (212 children), and 443 students of İzmir Tülay Aktaş Deaf School during 1998 and 1999. All the children underwent otolaryngologic examination and a detailed history taking, audiometric examinations were undertaken in the second and third groups, as well. In children suspected of having a genetic etiology, the pedigrees were drawn and the mode of inheritance was determined. Results: In the first group, awareness of the families to hearing loss and the presentation were at ages two and four, respectively. The most common accompanying anomaly was Down syndrome. Consanguinity was found in 27%, 8%, and 33%, respectively. Moderate to severe hearing loss was detected in 44% of the second group, and in 28% of the third group. Of the pedigrees obtained from 123 families, 86 were nonsyndromic and 27 were syndromic. Conclusion: Genetic inheritance plays a substantial role in sensorineural hearing loss in children, with consanguinity being the major culprit. Detection of hearing losses at younger ages will improve the success of hearing rehabilitation programs. |
| 2. | Efficacy of topical ciprofloxacin and tobramycin in combination with dexamethasone in the treatment of chronic suppurative otitis media İrfan Kaygusuz, Turgut Karlıdağ, Üzeyir Gök, Şinasi Yalçın, Erol Keleş, Erhan Demirbağ, Türkkan Öztürk Kaygusuz Pages 106 - 111 FREE FULL TEXT 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. |
| 3. | The effect of hyperlipidemia on hearing function Turgut Karlıdağ, Yasemin Açık, İrfan Kaygusuz, Şinas Yalçın, M. Yüksel Güngör, Erhan Demirbağ Pages 112 - 116 FREE FULL TEXT 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. |
| 4. | The incidence of septal deviation in newborns Kemal Uygur, Murat Yarıktaş, Mustafa Tüz, Fehmi Döner, Asude Özgan Pages 117 - 120 FREE FULL TEXT Objectives: To determine the incidence of septum deviation and dislocation in newborns and to investigate relationships between these pathologies and maternal causes and the mode of delivery. Patients and Methods: The study included 195 mothers and 200 newborns, of which 10 were twins. Vaginal and cesarean deliveries were performed in 147 (73.5%) and 53 (26.5%) newborns, respectively. All newborns were examined with the use of anterior rhinoscopy. The nasal pyramid, columella, and septum were assessed to detect septal deviation or dislocation. Results: Twenty-three cases (15.6%) of vaginal delivery had septal deviation, while five (3.4%) had septal dislocation. In the newborns delivered by cesarean section, eight (15.1%) had septal deviation, but none had dislocation. Significant correlations were noted between pregnancy, delivery period, the way of delivery and the incidence of septal deviation and columella dislocation (p<0.05). There was a significant correlation between head circumference and columella dislocation (p<0.05). Conclusion: Since early reconstruction of the potential pathologies may be problem-solving, a careful rhinologic examination should be carried out in the newborns who have prolonged delivery, increased head circumference, and vaginal delivery. |
| 5. | Patient selection for near-total laryngectomy and oncologic results Erkan Özüdoğru, Emre Cingi, Hamdi Çaklı, M. Cem Keçik, Cemal Cingi, M. Kezban Gürbüz Pages 121 - 125 FREE FULL TEXT Objectives: We reviewed preoperative, perioperative, and postoperative findings and the survival data to determine which patients may be appropriate for near-total laryngectomy. Patients and Methods: We reviewed hospital records of 20 patients (all males; mean age 56.6 years; range 35 to 73 years) who underwent neartotal laryngectomy. Indications for patient selection for near-total laryngectomy and survival data were evaluated in comparison with literature reports. Results: The site of the tumor was the sinus pyriformis in two, and the larynx in 18 patients. Thirteen patients had T3, seven patients had T2 tumors. The lesions were localized in the sinus pyriformis in two patients with T2 tumors. The locoregional control rate at the end of two years was 75%; two- and three-year survival rates were 81.2% and 64.2%, respectively. Conclusion: Following a detailed and meticulous investigation in the preoperative period, near-total laryngectomy seems to be appropriate in selected patients with advanced laryngeal and hypopharyngeal tumors in which partial laryngectomy procedures are not considered. It may both provide cure and preserve phonation. It may also be considered for functional purposes in patients whose pulmonary functions are insufficient for partial laryngectomy, in those in whom food aspiration is inevitable after partial laryngectomy, and in those suffering from lifelong food aspiration due to neurologic causes, and for oncologic reasons in patients who develop local recurrences after partial laryngectomy. |
| 6. | Comparison of palpation, ultrasound, and computed tomography in the evaluation of lymphatic neck metastasis Uğur Çınar, Özgür Yiğit, Ebru Topuz, Gökhan Akgül, Murat Ünlü, Muzaffer Başak, İrfan Çelebi, Burhan Dadaş Pages 126 - 130 FREE FULL TEXT Objectives: We evaluated the diagnostic value of palpation, ultrasonography (US), and computed tomography (CT) in detecting neck metastasis in head and neck cancers. Patients and Methods: The study included 35 patients (34 men, 1 woman; mean age 59 years; range 35 to 72 years) with laryngeal carcinoma. In addition to neck palpation, 17 patients and 27 patients had neck examinations by US and CT, respectively. Histopathologic results of the neck specimens were compared with those obtained from palpation, US, and CT. Results: The accuracy of CT, US, and palpation in the evaluation of lymph nodes of the neck were 85%, 65%, and 80%, respectively. Ultrasonography was found to have the highest sensitivity (100%), but the least specificity (33%). The highest false positive and false negative results were obtained by US (42%) and palpation (10%), respectively. Conclusion: Computed tomography proved superior to palpation and US in the evaluation of neck metastasis in patients with head and neck tumors. |
| CASE REPORTS | |
| 7. | Laryngotracheal reconstruction of the congenital glotto-subglottic stenosis with autogenous thyroid cartilage interposition: a case report* Orhan Özturan, Ahmet Kızılay, Murat Cem Minan, Semih Öncel, M. Tayyar Kalcıoğlu, Tamer Erdem Pages 132 - 137 FREE FULL TEXT Surgical correction of grade III glotto-subglottic stenosis in a two-month-old girl was illustrated in a staged manner. Firstly, a silicone keel was placed via anterior thyrotomy following a tracheotomy. Secondly, laryngotracheal reconstruction was performed by interposing an autogenous thyroid cartilage anteriorly between the edges of the longitudinally divided cricoid cartilage and the upper tracheal rings. A stent was maintained for two months. The glottis and subglottis appeared patent and healed following removal of the stent. A meaningful voice and rather comfortable respiration were observed during a 13-month follow-up.The use of thyroid cartilage autograft offers many advantages in laryngotracheal reconstruction with considerably less technical difficulty |
| 8. | An unusual tracheobronchial aspiration in a patient with total laryngectomy İmran Şan, Necat Alataş, İsmail İynen Pages 139 - 141 FREE FULL TEXT Laryngectomized patients use a variety of tools for tracheostomy cleaning, some of which may vary greatly depending on their sociocultural status. The use of inappropriate tools may lead to complications. A seventyeight- year-old male patient who had a history of total laryngectomy 12 years ago presented with difficulty in breathing and sputum production. Tracheoscopy showed two nails and chest x-rays showed one nail that had been aspirated during stromal care. The three ordinary nails were removed under general anesthesia. This case illustrates the need for detailed and consistent education of laryngectomy patients on proper stomal cleaning and on the associated complications that may arise from the use of inappropriate tools. |