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Introduction: The effect of orally consumed monosodium glutamate (MSG), which is a common additive in the food industry, on the cochlea has not been investigated. The present study aimed to investigate the possible cochleotoxic effects of oral MSG in guinea pigs using electrophysiological, biochemical, and histopathological methods. Methods: Thirty guinea pigs were equally divided into control and intervention groups (MSG 100 mg/kg/day; MSG 300 mg/kg/day). At 1 month, 5 guinea pigs from each group were sacrificed; the rest were observed for another month. Electrophysiological measurements (distortion product otoacoustic emission [DPOAE] and auditory brainstem response [ABR]), glutamate levels in the perilymph and blood samples, and histopathological examinations were evaluated at 1 and 2 months. Results: Change in signal-to-noise ratio at 2 months was significantly different in the MSG 300 group at 0.75 kHz and 2 kHz (p = 0.013 and p = 0.044, respectively). There was no statistically significant difference in ABR wave latencies of the guinea pigs given MSG compared to the control group after 1 and 2 months; an increase was noted in ABR thresholds, although the difference was not statistically significant. In the MSG groups, moderate-to-severe degeneration and cell loss in outer hair cells, support cells, and spiral ganglia, lateral surface junction irregularities, adhesions in stereocilia, and partial loss of outer hair cell stereocilia were noted. Conclusion: MSG, administered in guinea pigs at a commonly utilized quantity and route of administration in humans, may be cochleotoxic.

SUMMARY BACKGROUND Easily accessible, inexpensive, and widely used laboratory tests that demonstrate the severity of COVID-19 are important. Therefore, in this study, we aimed to investigate the relationship between mortality in COVID-19 and platelet count, Mean Platelet Volume (MPV), and platelet distribution width. METHODS In total, 215 COVID-19 patients were included in this study. The patients were divided into two groups. Patients with room air oxygen saturation < 90% were considered as severe COVID-19, and patients with ≥90% were considered moderate COVID-19. Patient medical records and the electronic patient data monitoring system were examined retrospectively. Analyses were performed using the SPSS statistical software. A p-value

OBJECTIVES: The aim of the present study was to compare the postoperative morbidity and cosmetic results between the use of the scapha and the use of the tragus as the auricular cartilage graft donor site in patients who had undergone cartilage tympanoplasty. The fascia graft was used as the control. MATERIALS AND METHODS: The patient’s visual symmetry, cosmetic satisfaction, and anthropometric measurements were studied to objectively evaluate the cosmetic condition. The formation of skin scar changes, pigmentation changes, and sensory changes as clinical criteria were compared. RESULTS: A total of 234 patients and their 257 operated ears were included in the study. Forty prospectively operated ears with preoperative findings were also included. All patients (100%) felt that their results were good, as indicated by the visual analog scale, and the anthropometric ear measurements used to reinforce the data showed no significant differences between the groups. A significant difference with respect to clinical sensory changes was found between the groups only in patients undergoing unilateral surgery via the retro auricular approach (p

Background/aim: Activity of the prestin gene may have a role in the pathogenesis of salicylate-induced ototoxicity. We investigated DNA methylation for prestin gene exon 1 in salicylate-injected guinea pigs.Materials and methods: Fifteen guinea pigs (30 ears) underwent audiological evaluation including 1000 Hz probe-tone tympanometry and a distortion product otoacoustic emission (DPOAE) test. The animals were randomly divided into three groups. Groups 2 (8 ears) and 3 (14 ears) were injected with intramuscular saline and sodium salicylate (200 mg/kg), respectively twice daily for 2 weeks. Group 1 (8 ears) received no injection. DPOAE measurements were performed at baseline; after 1, 2, 4, and 8 h (acute effect); and after 1 and 2 weeks (chronic effect). After audiological measurements, the animals were sacrificed for DNA isolation.Results: While a significant decrease (P < 0.01) was found for the acute effect in all frequencies in Group 3 according to baseline measurements, there was no difference in terms of chronic effect. DNA methylation increased during the acute phase of salicylate administration, whereas it returned to initial levels during the chronic phase.Conclusion: Salicylate-induced changes in DPOAE responses may be related to prestin-gene methylation. These results may have important implications for salicylate ototoxicity.

OBJECTIVE Medial olivocochlear efferent (MOCE) neurons innervate outer hair cells (OHCs) of the cochlea, which in turn leads to basilar membrane motion. We hypothesized that MOCE-induced alterations in basilar membrane motion, independent of traveling waves, is responsible for the cochlear frequency discrimination of sound. MATERIALS AND METHODS Eleven guinea pigs underwent bilateral otoscopic and audiologic evaluations under general anesthesia. The study comprised two parts. Part I (n=11) included spontaneous otoacoustic emission (SOAE) recordings with or without contralateral pure-tone acoustic stimuli (1 and 8 kHz) at 60 dB sound pressure level (SPL). Part II involved pure-tone (1 or 8 kHz) acoustic trauma in the right ears of two randomly selected subgroups (G1: 1 kHz; n=4 and G8: 8 kHz; n=4). The remaining three animals served as controls. After frequency-specific deafness was confirmed by distortion product otoacoustic emission (DPOAE), SOAEs were recorded in the left ears in the presence of a contralateral pure-tone (1 and 8 kHz) stimulus of 60 dB SPL. Furthermore, the surface of the organ of Corti was examined by scanning electron microscopy (SEM). RESULTS The contralateral pure tone led to frequency-specific activation in SOAEs in part I (without trauma) and part II (with trauma) measurements. SEM showed heterogeneous OHC damage along the cochlea in traumatized ears with pure tone. CONCLUSION We suggest that MOCEs convey acoustic information from traumatized ears to intact ears. Traumatized ears can show frequency-specific activation in the presence of diffuse damage in OHCs that excludes the passive transmission of the pressure wave from the perilymph to the basilar membrane.

Objective The aim of the present study is to compare the tympanometric and functional findings of cartilage palisade tympanoplasty with those of tympanoplasty with temporalis fascia grafting after one-stage surgery in children with tensa cholesteatoma. Study design In children aged 5 to 15 years (mean, 9.5 years) with tensa cholesteatoma, cartilage palisade tympanoplasty was performed in 32 ears and fascia tympanoplasty in 29 ears. Tympanometry was performed in 31 ears with cartilage palisade tympanoplasty (the palisade group) and 28 ears with fascia tympanoplasty (the fascia group) at follow-up a median of 48 months after surgical removal of the cholesteatoma (range, 3-75 months). Main outcome measures Postoperative perforations, tympanometric parameters (tympanogram type, compliance, tympanometric width), and hearing. Results All postoperative re-perforations occurred in the fascia group. However, there was no difference between the palisade group and the fascia group in terms of tympanometric parameters, nor between the two groups when dividing into tensa retraction and sinus cholesteatoma subgroups. When comparing the types of tympanoplasty, the type II group reconstructed with cartilage palisades contained a higher number of ears with a normal compliance (0.2-1.6 mL) but a higher number of ears with a tympanometric width of more than 150 mmH2O. Regarding the number of ears with normal tympanometries, there was no significant difference between the palisade and the fascia group. The late functional hearing results were better in ears reconstructed with cartilage palisades, with functional success in 71%, compared with 54% in the group with fascia grafting. This difference in functional results was particularly pronounced in ears with an abnormal tympanogram (68% vs. 29%). Conclusion Compared to fascia grafting, the present study showed better late functional hearing results after drum reconstruction using cartilage palisades, despite comparable tympanometric findings. Cartilage palisade reconstruction seems to provide better functional results, especially in ears with a poor tubal function, which is the common situation after cholesteatoma surgery.

Objectives/Hypothesis: To compare cartilage palisades with fascia grafting in reconstruction of the eardrum after surgery for sinus or tensa retraction cholesteatoma in children, with respect to long-term postoperative eardrum retraction and perforation, cholesteatoma recurrence, and hearing acuity. Methods: A total of 64 children underwent surgery for either sinus or tensa retraction cholesteatoma during the period 1995 to 2000 (mean age 9 years, range 5–15). The eardrum was reconstructed using cartilage palisades in 32 children (32 ears) and fascia or perichondrium in 32 children (33 ears). The patients were followed for at least one year postoperatively and re-evaluated 4 years after surgery, and again recently at a mean of 10 years. The main outcome measures were postoperative drum retraction and perforation, cholesteatoma recurrence, and hearing acuity (pure tone average, speech reception threshold, and pure tone air-bone gap). Results: All but two patients in both groups attended the 10-year follow-up examination (94% attendance). The mean overall follow-up period was 119 months (115 months in the palisade and 125 months in the fascia group). Total number of retractions during follow-up and at the 10-year examination was six (19%) for the palisade group and 14 (42%) for the fascia group (P = .03; chi-square test). The accumulated numbers for a perforation were four (13%) for the palisade group and seven (21%) for the fascia group (difference not significant). Two residual cholesteatomas, which are not related to the graft material, occurred in the palisade group (6%), whereas both recurrencies, which may be related to the graft material, occurred in the fascia group (6%). The hearing acuity for children operated on for a sinus cholesteatoma and for children with type III tympanoplasties was significantly better when cartilage palisade grafting had been employed. Conclusions: The cartilage palisade grafting technique appears superior with respect to prevention of long-term eardrum retraction. The occurrence of cholesteatoma recurrency and eardrum perforation seem to be independent of grafting material, although these results may be due to type 2 error (low number of ears). In sinus cholesteatoma surgery and in type III tympanoplasty, the long-term hearing results appear better when grafting cartilage palisades. Laryngoscope, 2009

Assessment of auditory abilities is important in the diagnosis and treatment of children with autism. The aim was to evaluate hearing objectively by using transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR). Tests were performed on 30 children with autism and 15 typically developing children, following otomicroscopy and tympanometry. The children with autism were sedated before the tests. Positive emissions and normal hearing level at ABR were obtained in both ears of all children in the control group and of 25 children with autism. TEOAE and ABR results varied in the remaining five children with autism. The mean III–V interpeak latencies (IPLs) in both ears of children with autism were longer than those in the control group. Hearing loss may be more common in children with autism than in typically developing children.

Eustachian tube dysfunction plays an important role in the pathogenesis of middle ear barotrauma. This investigation evaluates the predictive value of several parameters related to tubal dysfunction, in relation to symptomatic middle ear barotrauma in divers.Prospective and blinded.Thirty-one sport scuba divers with normal predive audiometry, tympanometry, and general and otorhinolaryngologic examination.After an occurrence of middle ear barotrauma, the individual diver predive data on smoking, mild septal deviation, otitis media history, rhinosinusitis history, Valsalva, Toynbee, and nine-step inflation/deflation tympanometric test, as well as degree of mastoid pneumatization were registered for calculation of predictive value in relation to the barotrauma. All symptomatic ears were examined within 24 hours of diving by the investigator, who was blinded to the predive findings. Barotraumas that occurred during an upper respiratory tract infection were excluded.Divers completed a total of 774 dives (median, 25; range, 3-100). Symptomatic middle ear barotrauma occurred in 19 ears (31%) of 14 divers (45%) at one time or another. The rate of tubal dysfunction measured by the nine-step test and a mastoid pneumatization below average were significantly higher in divers (p0.05) as well as in ears (p0.005) with barotrauma. Positive and negative predictive values of both parameters for subsequent barotrauma were between 69% and 76%. Combining the results into a two-test battery in a strict approach (positive on both) increased the positive predictive value to 86%.Eustachian tube dysfunction measured by the nine-step test and a small size of the mastoid cell system seem to be risk factors for symptomatic middle ear barotrauma in otherwise healthy sport scuba divers. Evaluation of these factors in the predive examination of diving candidates may be useful in the determination of fitness to dive.

Objective: It is well documented that children, particularly between the ages of about 2 and 6 years, exhibit a high prevalence and incidence of otitis media. Distortion product otoacoustic emissions (DPOAEs) offer great potential for clinical testing of cochlear function in children. The aim of the present study was to determine the influence of middle ear effusion and physical properties of the effusion on the recording of DPOAE. Methods: Nineteen children (38 ears) undergoing myringotomy and/or tympanostomy tube insertion for secretory otitis media were studied. Pre-operative and post-operative first day DPOAE signal to noise ratios were compared. The results were analyzed by paired samples test and ANOVA statistical methods. Results: We were found significant differences between pre-operative and post-operative first day DPOAE signal to noise at 1, 1.5, 2 and 4 kHz. In addition, comparison of the pre-operative DPOAE signal to noise ratio and per-operative middle ear findings are shown significant differences between glue (thick mucous) and the other three groups (mucous, serous and no-effusion groups) at 2 and 4 kHz, and between glue and no effusion group at 8 kHz. Also post-operative DPOAE signal to noise ratio in relation to per-operative middle ear findings were significantly different at 2, 4 and 8 kHz. The most increase of emissions at the post-operative first day was seen in ears with glue effusion at 1 and 2 kHz. Conclusions: Otitis media with effusion can be monitored by DPOAE measurement pre-operatively and post-operatively. In the pre-operative evaluation, glue effusion may cause a reduction in the emissions at 2, 4 and 8 kHz more than the other kind effusions.

The possible cochlear toxicity of topically applied povidone-iodine solution was investigated in guinea pigs by measuring transiently evoked otoacoustic emissions (TEOAEs). Seven adult pigmented guinea pigs (14 ears) with a normal acoustic pinna reflex were used. After the baseline TEOAE measurements, 0.1mL of povidone-iodine solution was applied transtympanically into the middle ear in the study group. Saline solution and gentamicin were used as negative and positive control, respectively. TEOAE measurements were repeated on the 10th day, and four weeks after the first application. Tympanometric measurements were also carried out for both ears of all animals at the end of the study. Responses in all ears, which had povidone-iodine applied to them, disappeared in a way similar to those recorded in gentamicin-treated ears. Tympanometric measurements at the end of the study showed ’type A’ tympanograms in all ears of all animals. The present study showed that povidone-iodine could have a cochleotoxic effect in guinea pigs. A study in humans with TEOAE before and after middle-ear surgery, where povidone-iodine can reach into the middle-ear cavity, may be useful for evaluating this result for clinical practice.

Taste disturbance is an unusual complication of tonsillectomy of which there are very few reports in the literature. The possible causes of this rare complication are: (1) direct or indirect damage to the glossopharyngeal nerve or its lingual branch (LBGN), (2) lack of dietary zinc, and (3) habitual drug intake.We report a 41-year-old man, who complained of taste disturbance following tonsillectomy that was performed for chronic tonsillitis and unilateral (left) tonsillar hypertrophy. During surgery, hypertrophic tonsils were found to be sited deeply into the tonsillar bed, especially at the lower pole of the left tonsil. Pathologic examination following tonsillectomy revealed a keratinous cyst and chronic infection at the left tonsil, and lymphoid hyperplasia and chronic infection at the right tonsil. Although his complaint had been getting better, qualitative examination of his taste function revealed bilateral impairment of the sense of sweet taste on the base of his tongue two months after the surgery, and a taste disturbance of sweet taste on the left side persisted the 10th month after the surgery. His serum zinc value was normal, and he did not take any drug that could affect his sense of taste. Depending on the literature data, possible indirect damage to the LBGN was suspected as the cause of the taste disturbance. This symptom may be reversible within two years after tonsillectomy, but it can also be irreversible. Therefore, tonsillectomy should be performed with minimal trauma to the tonsillar bed, especially when there is an additional pathology extending into the lower pole, and such a patient should be informed of the risk of post-operative taste disturbance after tonsillectomy as being one of the rare complications of this surgery.

Primary chondroid tumors of the larynx represent less than 1% of all laryngeal tumors. Most of them are chondromas and they often involve to the cricoid cartilage. A 31-year-old male patient applied to the oto-laryngology service with a history of dysphonia and dyspnea. Microlaryngoscopy revealed 2 cm sized, ill-defined, covered with regular mucosa, porous, and hard mass on posterior surface of crycoid cartilage in subglottic area. Following the excision of the lesion, histopathologic examination revealed as chondroma. Two years later, local recurrence was detected and the diagnosis was again chondroma. There was no complaint of the patient in last 3 and half years of follow-up. Chondroma should carefully be differentiated from chondrosarcoma and the patients should be followed for possible recurrences.

Middle ear (ME) barotrauma, the most common disorder encountered in diving, results from inadequate pressure equilibration between the ME and the ambient environment. Eustachian tube function plays a key role in the pathogenesis of barotrauma. This study was designed to investigate the predictive value and efficiency of tympanometric tests of Eustachian tube function (Valsalva test, Toynbee test and nine-step inflation/deflation test) in predicting ME barotrauma in 44 ears of 22 sports scuba divers who had normal audiometry, tympanometry and otorhinolaryngological examination without previous history of ear disease. The divers were counselled to refer to the investigators if any symptoms occurred during and/or after diving. All symptomatic ears were examined within 24 hours of diving by one investigator who was unaware of the pre-symptomatic test results. Decision matrix analysis was applied to the results of Eustachian tube function tests for predicting ears with barotrauma. Values were also evaluated for a battery of tests by 'Lax' (positive on A, B or C) and 'Strict' (positive on A, B and C) criteria. The nine-step test was found to be the most efficient (93%) test with highest predictive values (PPV 83%; NPV 95%), whereas the Valsalva and Toynbee tests were unreliable in predicting barotrauma, whereas the Valsalva and Toynbee tests were unreliable in predicting barotrauma (PPV of the Valsalva and Toynbee tests were 0% and 25% respectively). Combining the nine-step and Toynbee tests into a two-test battery in a strict approach increased the PPV (100%). It appears that the nine-step inflation/deflation test is a reliable method of predicting ME barotrauma sufferers, especially when applied with the Toynbee test. The nine-step test may have value in the evaluation of Eustachian tube function of sports scuba diving candidates after routine otorhinolaryngological, audiological and tympanometric evaluation.

Objective: Otoscopic examination can be carried out by using four main methods. These include otoscopic examinations made with head mirror, auriscope, otomicroscope and video-endoscope. We aimed to compare four otoscopic examination methods with respect to their accuracies in identification of pathologies and normal structures in external ear canal and tympanic membrane. Methods: Our study involved 99 patients and their 151 ears. According to the gold standard parameters, we calculated sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the otoscopic examination methods in determining otoscopic diagnostic parameters. Results: in determining 16 main and 77 sub-parameters which were in otoscopic examination form with four different methods, although head mirror method was insufficient in %43.8, handle otoscopy was in %25, otomicroscopy was in %12.5 of 16 main parameters, otoscopic examination with video-endoscopy was determined all of 16 main parameters. Conclusions: Our results indicate that otoscopy with video-endoscope is superior to the other 3 examination modalities with respect to identification of external ear canal, tympanic membrane and normal or pathologic structures in these locations. Otomicroscopy seems to be the most trustworthy method after video-endoscopy. Even though auriscope is a better diagnostic tool than head mirror, it is not enough for recognition of many anatomic structures.

We present a rare case of unilateral phlebectasia of the anterior jugular vein in a 56-year-old male patient whose complaint is a neck swelling that appears during talking. Although in this age group the most common cause of such a mass in the anterior aspect of the neck increasing in size during any type of straining or Valsalva manoeuvre is a laryngocele, phlebectasia of the anterior jugular vein should be considered in the differential diagnosis. Doppler ultrasound and computed tomography are the most useful and non-invasive methods to use for the investigation. Treatment should be conservative.

Summary Background The present study was designed to assess how anaerobic exercise affects auditory brainstem response (ABR) parameters, and whether one night of sleep deprivation could alter these possible exercise-induced changes in ABRs. Methods Seven healthy, audiologically normal male students (mean age 22·4 ± 1·0 years) participated in the study. All subjects underwent anaerobic Wingate test for three times: (i) baseline, (ii) following a full-night of habitual sleep and (iii) following one night of sleep deprivation. ABR measurements were performed before and after the second and the third Wingate tests. Oral body temperatures were recorded at the beginning of all ABR measurements. Results The latencies of wave III and V significantly shortened by anaerobic loading performed in the day after habitual sleep (4·13 ± 0·10 versus 4·01 ± 0·17 ms, P

The aim of the present study is to evaluate the effect of swallowing type (dry versus wet) on the outcome of a nine-step inflation/deflation tympanometric Eustachian tubefunction (ETF) test in healthy adults.Fourteen normal healthy volunteers, between 19 and 28 years of age, were included in the study. The nine-step test was performed in two different test procedures: (1) test with dry swallows (dry test procedure) and (2) test with liquid swallows (wet test procedure). If the equilibration of middle-ear (ME) pressure was successful in all the steps of the nine-step test, ETF was considered ‘Good’. Otherwise, the test was considered ‘Poor’, and the test was repeated at a second session.In the dry test procedure, ETF was ‘Good’ in 21 ears at the first session and in 24 ears after the second session (p > 0.05). However, in the wet test procedure, ETF was ‘Good’ in 13 ears at the first session and in 21 ears after the second session (p < 0.05).At the first session, ETF was ’Good’ in 21 and 13 ears in the dry and wet test procedures, respectively. The difference was statistically significant (p < 0.05). However, after the second session, the overall number of ears with ‘Good’ tubal function was almost the same in both test procedures (24 ears at dry test procedures versus 21 ears at wet test procedures;p > 0.05).Dry swallowing seems to be more effective for the equilibration of ME pressure. Thus, a single-session dependent evaluation of ETF may be efficient for the dry test procedure of the nine-step test. Swallowing with water may be easier for subjects, but a repetition of the test at a second session may be necessary when the test result is ‘Poor’.

The combined Heermann and Tos (CHAT) technique is the combination of Heermann’s ’cartilage palisade tympanoplasty’ and Tos’s ’modified combined approach tympanoplasty = modified intact canal wall mastoidectomy’. The first author (Cem Uzun) performed the CHAT technique as a one-stage operation in 15 ears of 15 patients with cholesteatoma. Two patients (one with a follow up of less than six months and one who did not show up at the final re-evaluation) were excluded from the study. Median age in the remaining 13 patients was 37 years (range: 14–57 years). Cholesteatoma type was attic, sinus (Tos tensa type 1) and tensa retraction (Tos tensa type 2) in six, five and two ears, respectively. Cholesteatoma stage was Saleh and Mills stage 1, 2, 3, 4 and 5 in one, three, four, four and one ear, respectively. The eustachian tube was not involved with cholesteatoma in any ear. After drilling of the superoposterior bony annulus, transcanal atticotomy with preservation of thin bridge and cortical mastoidectomy with intact canal wall, the cholesteatoma was removed, and the eardrum and atticotomy were reconstructed with palisades of auricular cartilage. Type I tympanoplasty was performed in two ears, type II in nine ears and type III (stapes absent) in two ears, with either autologous incus (eight cases), cortical bone (two) or auricular cartilage (one). No complication occurred before, during or after surgery. Oto-microscopy and audiometry were done before and at a median of 13 months after surgery (mean 14 months, range 7–30 months). There was no sign of residual or recurrent cholesteatoma in any patient during the follow-up period. At the final examination, all ears were dry and had an intact eardrum except one with a small, central hole, which had been seen since the early post-operative period. Clean and stable attic retraction with a wide access was observed in two ears. Post-operative hearing at the final evaluation was better (change > 10 dB) than the pre-operative one in nine ears and did not change in the remaining four. Pre- and post-operative mean hearing values were, pure-tone average 47 and 35 dB (p = 0.01) and air-bone gap 30 and 20 dB (p = 0.02), respectively. With the CHAT technique, cholesteatoma can be completely and safely removed from the middle ear, and a durable and resistant reconstruction of the middle ear with reasonable hearing can be achieved. However, a further study should analyse long-term results of a larger patient group.

To compare the Eustachian tube patency and function after tympanoplasty with either cartilage palisades or fascia grafting after one-stage surgery in children with tensa cholesteatoma.In children operated for tensa cholesteatoma, cartilage palisade tympanoplasty was performed in 32 ears and fascia tympanoplasty in 29 ears. The patency of the Eustachian tube was evaluated by the Valsalva maneuver before the operation, 1 to 3 months after the operation, and at a follow-up examination 46(1/2) months later (median). Eustachian tube function was evaluated by the nine-step inflation/deflation tympanometric test and the Toynbee test at the follow-up examination. Otomicroscopy and hearing evaluation were performed before and after surgery as well as at the follow-up.Eustachian tube patency and function. Hearing, postoperative eardrum perforation/retraction, and cholesteatoma recurrence.The Valsalva maneuver was positive in 30% of the ears before the operation, in 65% primarily after the operation, and in 78% at the follow-up examination. A poor tubal function was found in 57% at follow-up. Overall, the late functional hearing results were better in ears with a positive Valsalva maneuver. There were no differences in tubal patency or function in relation to graft material, cholesteatoma, and tympanoplasty type. In ears with a poor tubal function, the hearing results were significantly better in the palisade group (63% success), compared with the fascia group (17% success). All of the four perforations, most of the retractions, and a single moist eardrum were found in the fascia group at the reevaluation. We found no correlation between the condition of the eardrum and the Eustachian tube function at the last evaluation. However, in ears with a poor tubal function, a nonretracted, nonperforated drum was found with higher frequency in the palisade group. Decision matrix analysis showed that the last postoperative Valsalva maneuver was the best predictor of the drum condition at the reevaluation.The Eustachian tube patency frequently improves after tympanoplasty after cholesteatoma surgery in children, regardless of graft material. The patency and function of the Eustachian tube seem to be without relation to graft material, cholesteatoma, or tympanoplasty type. Cartilage palisade tympanoplasty may be a better reconstruction technique after cholesteatoma surgery, especially in ears with a poor tubal function.

We investigated the eustachian tube function and the incidence of alternobaric vertigo (AV) in 29 sport self-contained underwater breathing apparatus (SCUBA) divers with, or without, some possible risk factors for AV. The divers had normal audiological and otoscopic findings at the pre-dive examination. We used the nine-step inflation/deflation tympanometric test and Toynbee test for evaluation of eustachian tube function, and the Valsalva manoeuvre for patency. Information on divers, their history, and their otolaryngologic examination were obtained in the pre-dive examination. Divers performed 1086 dives (mean 37, range: 3–100) during the observation period. Four divers (14 per cent) experienced AV during five dives (0.46 per cent), (one diver experienced AV two times). It was found that having an otitis media history or eustachian tube dysfunction determined with the nine-step inflation/deflation tympanometric test before diving, or difficulty in clearing ears during diving could be important risk factors for AV in sport SCUBA divers (p

Objectives/Hypothesis Previous studies have shown a relationship between eustachian tube function and size of mastoid pneumatization, as well as eustachian tube function and middle ear (ME) barotrauma. The purpose of this study is to investigate a possible relationship between size of mastoid pneumatization and ME barotrauma in sports scuba (s elf-c ontained u nderwater b reathing a pparatus) divers. Study Design Prospective, blinded. Material and Methods Twenty-four sports scuba divers (48 ears), who were fit to dive in the predive and otolaryngologic examination, were included in the study. Size of mastoid pneumatization was measured by simplified rectangular dimension method on a mastoid x-ray taken at Schuller's view. Divers were counseled to refer to the investigators if any symptoms occurred during and/or after diving. All symptomatic ears were examined within 24 hours of diving by the same investigator, who was blinded to the degree of pneumatization. Results ME barotrauma occurred in 15 ears (31%) of 11 divers (46%) at one time or another. The median degree of pneumatization in ears with barotrauma (22.9 cm2) was significantly smaller than that in unaffected ears (34.1 cm2; (P

Sixty-eight patients who presented with glottic and glottosupraglottic squamous cell carcinoma and who were managed in this department with supracricoid partial laryngectomy (SCPL) with either cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP), were retrospectively reviewed. The authors analysed the functional and oncological results of the patients. The median follow-up period was 62 months. The average times until decannulation and nasogastric feeding tube removal were 27.7 and 26.4 days, respectively. All patients were successfully decannulated. All patients were able to swallow, but one patient was unable to swallow and had recurrent aspiration. Better functional results were achieved in patients managed with CHEP procedure than the patients managed with CHP procedure. The five-year absolute and cause-specific actuarial survival rates (Kaplan-Meier method) were 78.6 per cent and 93.9 per cent, respectively. The five-year actuarial local control and nodal control rates were 89.5 per cent and 90.4 per cent, respectively. Local recurrence was statistically more likely in patients with positive resection margins (p