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    Association of Conductive Hearing Loss with the Structural Changes in the Organ of Corti
    (Karger, 2021) Eroglu, Sinan; Cevizci, Rasit; Turan Dizdar, Handan; Tansuker, Hasan Deniz; Bulut, Erdogan; Dilci, Alper; Ustun, Selin
    Objective: The aim of the study was to evaluate the association of conductive hearing loss (CHL) with the structural changes in the organ of Corti. Methods: Twenty ears of 10 healthy adult Wistar albino rats were included in the study. The right ears (n = 10) of the animals served as controls (group 1), and no surgical intervention was performed in these ears. A tympanic membrane perforation without annulus removal was performed under operative microscope on the left ears (n = 5) in 5 of 10 animals (group 2). A tympanic membrane perforation with annulus removal was performed under operative microscope on the left ears (n = 5) of the remaining 5 animals (group 3). Auditory brainstem response testing was performed in the animals before the interventions. After 3 months, the animals were sacrificed, their temporal bones were removed, and inner ears were investigated using scanning electron microscopy (SEM). The organ of Corti was evaluated from the cochlear base to apex in the modiolar axis, and the parameters were scored semiquantitatively. Results: In group 1, the pre- and post-intervention hearing thresholds were similar (p > 0.05). In group 2, a hearing decrease of at least 5 dB was encountered in all test frequencies (p > 0.05). In group 3, at the frequency range of 2-32 kHz, there was a significant hearing loss after 3 months (p < 0.01). After 3 months, the hearing thresholds in group 2 and 3 were higher than group 1 (p < 0.01). The hearing threshold in group 3 was higher than group 2 (p < 0.01). On SEM evaluation, the general cell morphology and stereocilia of the outer hair cells were preserved in all segments of the cochlea in group 1 with a mean SEM score of 0.2. There was segmental degeneration in the general cell morphology and outer hair cells in group 2 with a mean SEM score of 2.2. There was widespread degeneration in the general cell morphology and outer hair cells in group 3 with a mean SEM score of 3.2. The SEM scores of group 2 and 3 were significantly higher than group 1 (p < 0.05). The SEM scores of group 3 were significantly higher than group 2 (p < 0.05). Conclusion: CHL may be associated with an inner ear damage. The severity of damage appears to be associated with severity and duration of CHL. Early correction of CHL is advocated in order to reverse or prevent progression of the inner ear damage, which will enhance the success rates of hearing restoration surgeries. Subjective differences and compliance of the hearing aid users may be due to the impact of CHL on inner ear structures.
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    Evaluation of Main Inflammatory Markers on Peripheral Vertigo Attack
    (Fazile Nur Ekinci Akdemir, 2021) Dilci, Alper; Cevizci, Raşit
    Objective: The aim of this study is to evaluate the main inflammatory markers; neutrophile lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), mean platelet volume (MPV), c reactive protein (CRP), lactate dehydrogenase (LDH) and creatine kinase (CK) in patients with acute peripheral vertigo attack. Methods: The records of patients files and laboratory results were analyzed retrospectively. The measures of complete blood count and basic biochemical test were compared in acute peripheral vertigo attack between patient and control group. Results: The sample consists of 119 patients and 98 healthy controls are included in the control group. There is not any statistically significant change of main inflammatory measures between two groups. Conclusion: Peripheral vertigo can be caused by many diseases with various pathologies. There may be various mechanisms besides inflammation and atherosclerosis of microvascular structures. The results of this study states that etiology of peripheral vertigo attack may not be related with ischemia and inflammation; it may be related with viral etiology.
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    IS GASTROESOPHAGEAL REFLUX A POSSIBLE ETIOLOGIC FACTOR FOR ITCHY EAR CANAL?
    (Carbone Editore, 2019) Dilci, Alper; Cevizci, Rasit
    Introduction: We conducted the study to investigate the relation of gastroesophageal reflux (GER) and proton pump inhibitor therapy with itchy ear canal. Materials and methods: Totally 30 patients with itchy ear canal and GER were retrospectively evaluated. Visual analog score (VAS) was used for severity of itchy ear canal; reflux symptom index (RSI) and reflux finding score (RFS) were used for detecting GER. Proton pump inhibition therapy was offered and scores were re-evaluated for possible relation of these two clinical entities. Results: The study included 19 female and 11 male patients complaining of recurrent itchy ear canal accompanying with GER related symptoms. 13 patients have RSI of >13 score and 4 patients have RFS of >7 in the study. There is a statistically significant decrease in comparison of pre-treatment and post-treatment RSI ( p= 1,112 10(14)). There is a statistically significant decrease in comparison of pre-treatment and post-treatment RFS (p=5,821 10(6)). There is a statistically significant decrease of VAS of itchiness of patients in the study after 3 months PPI therapy (p=3,81 10(8)). In this study, statistically significant decline of RSI and RFS of subjects are shown after PPI therapy. In this study, severity of itchiness of ear canal was decreased after PPI therapy. Conclusion: It results that there could be a relation with GER, PP1 therapy and itchy ear canal etiology. Referred stimulation of sensorial nerve fibers by gastric enzymes related to GER may be the possible etiologic factor for itchiness of ear canal