Ejder Çiğer

and 2 more

Objectives: This study aims to compare the graft success and hearing results of the palisade and island cartilage graft, with a new wheel-shaped composite cartilage graft for type 1 tympanoplasty. Design: The study was designed retrospectively. Setting: The study was conducted at Katip Celebi University, Ataturk Training and Research Hospital, Otolaryngology-Head & Neck Surgery Clinic. Participants: Only patients with conductive hearing loss and simple pars tensa perforation of the tympanic membrane were included in the study. Main outcome measures: Pure tone average (PTA), air-bone gap gain (ABG), word recognition score (WRS), ABG closure and grafts success were compared between the graft groups. Results: Records of 111 patients were analyzed. The graft success rate was 89.7% for palisade cartilage graft (PCG, n= 39), 86.1% for island cartilage graft (ICG, n=36), and 97.2% for wheel-shaped composite cartilage graft (WsCCG, n= 36) (p=0.244). Average postoperative PTA and ABG values were significantly affected by the cartilage graft type, but WRS was not affected. (p = 0.005, 0.019, 0.306, respectively, One Way-Anova test). Post-Hoc LSD test showed a statistically significant decrease in PTA and ABG averages for WsCCG group compared to the ICG group (p= 0.004; CI%95= 15.1-2.2 dB and p= 0.023; CI%95= 8.2-0.4 dB, respectively). Postoperative PTA and ABG averages for WsCCG and PCG groups were similar (p= 0.069 and p=0.053, respectively). In addition, while there were 2 (5.1%) retractions in the PCG group and 1 (2.7%)in the ICG group, there was no retraction in the WsCCG group. Conclusion: The WsCCG provided comparable results with classical reliable graft techniques (PCG and ICG) and may recommend as a more suitable graft due to hearing results and resistance against retraction.
Objectives: This study aims to investigate the value of Video head impulse test (vHIT) findings in peripheral vertigo diseases, especially in Benign paroxysmal positional vertigo (BPPV) in the acute period. Design: A prospective study was designed. Setting: Otorhinolaryngology and Audiology Clinic of the tertiary university , October 2017-September 2018. Participants: Patients diagnosed with peripheral vertigo included prospectively and consecutively in the study. Main outcome measures: Demographic characteristics of the patients and pathological SCC detected by examination and diagnostic maneuver for BPPV patients were recorded. Vestibulo-ocular reflex (VOR) gain was calculated in all patients and all six SCCs. Two sub-study groups were formed according to age (<50 or >50). Also VOR gain detected for BPPV, Vestibular neuritis (VN), and Meniere’s disease (MD). Results: 74 (82.2%) of the patients were Benign paroxysmal positional vertigo (BPPV), eight (8.9%) of patients were vestibular neuritis (VN), and eight (8.9 %) of them were Meniere’s disease (MD). Pathological deficiency of VOR for SCCs was detected in 49 of 74 (66.2%) patients with BPPV, all eight patients with VN (100%), and four of eight patients with Meniere’s disease (50%). The sensitivity and specificity calculated as 55.4% and 81.2% for BPPV patients. Conclusions: vHIT is a new protocol and provides objective findings for SCC functions in patients with peripheral vertigo. vHIT can be performed faster and easier than the caloric stimulation test for VN diagnosis with comparable results. However, vHIT does not provide sufficient results for BPPV to distinguish from other peripheral vestibular system diseases.

Seval Ceylan

and 3 more

Objectives: In this study, we aimed to compare the ABR’s (Auditory Brainstem Response) estimated behavioral thresholds, wave V latencies, and amplitudes, obtained using Tone Burst and Narrow Band (NB) CE-Chirp stimuli in adults with normal hearing. Design: A prospective study was designed. Setting: Otorhinolaryngology and Audiology Clinic of the tertiary university. Participants: Twenty-four adults with normal hearing (17 males, 7 females) participated in this study. Main outcome measures: ABR was recorded using Narrow Band (NB) CE-Chirp and Tone Burst (TB) for four frequencies (0.5, 1, 2, 4 kHz). Wave V obtained for 60, 40, and 20 dB nHL intensity levels for both two procedures. Behavioral hearing thresholds (BHT) were identified at 0.5, 1, 2, 4 kHz. Duration of TB and NB CE Chirp ABR tests for each ear was recorded. Wave V latencies, amplitudes, BHTs, duration of tests were compared. Results: The thresholds obtained from NB CE-Chirp stimulus (20, 19, 16, 15 dB nHL) at 0.5, 1, 2 and 4 kHz were significantly closer to the behavioral hearing thresholds (11, 10, 9, 9 dB HL) compared to Tone Burst ABR thresholds (25, 23, 20, 19 dB nHL) (at all frequencies p < 0.001, CI = 2.0- 5.9). The absolute latencies of peak V with TB stimuli were significantly longer than latencies obtained with NB CE Chirp stimuli at 0.5, 1, and 2 kHz at all sound intensity levels (p<0.001). The mean test time for NB CE-Chirp ABR was 23.6 ± 3.9 minutes and significantly shorter than the TB ABR test time (28.2 ± 4.5), (p=0.011). Conclusion: Frequency-specific behavioral thresholds are estimated better with NB CE-Chirp than TB ABR.