No abstract

Objective of this study is to determine the etiology of patients applied with revision endoscopic dacryocystorhinostomy (DCR) and to evaluate the operation results.The patients were retrospectively evaluated in respect of demographic data, the time from primary to revision surgery, revision etiology, the use of bicanalicular silicone nasolacrimal tube (BNLT), the time to postoperative removal of the silicone tube, and the success of the revision surgery.The study included 27 patients applied with revision endoscopic DCR between January 2013 and January 2016. The mean age of the patients was 46.7 ± 11.7 years. The mean time from the first operation to revision surgery was 7.2 ± 6.1 months (range, 1-24 months). During the endoscopic DCR, synechia was observed in 2 (7.4%), granulation tissue in 7 (25.9%), inadequate bone window in 5 (18.52%), and membranous scar around the ostium in 22 (81.4%) patients. More than 1 etiologic problem was determined in 8 patients. During the revision procedure, BNLT was applied to 12 (44.4%) patients. At the final follow-up examination, the complaint of epiphora had completely recovered in 18 (66.6%) patients and there were in 9 (33.3%) patients. The mean time to removal of the BNLT was 1.7 ± 0.57 months (range, 1-3 months).The most common cause of recurrent epiphora in endoscopic DCR was the formation of membranous scar. The use of the mucosal flap technique in primary surgery and the application of BNLT to all patients in revision surgery may increase the functional success rate.

The findings suggest that continuous dexamethasone infusion is beneficial for preventing the loss of hair cells and neurons associated with early and late periods of intracochlear electrode trauma.

Objective: The purpose of this study is to investigate the effect of steroids on postoperative hearing outcome in patients with a clinical diagnosis of otosclerosis, who received intraoperative steroid treatment during surgery for conductive-type hearing loss. Methods: Between January 2014 and January 2017, 106 patients, comprising 43 men (40.6%) and 63 women (59.4%) between the ages of 18-64 (mean age: 44.1 ± 11.5 years), who had been diagnosed with otosclerosis resulting in conductive-type hearing loss, were included in the study. The audiometric values obtained for patients who had received intraoperative intravenous steroids were analysed on a retrospective basis by comparing the pre-and post-operative situation. The group of all patients was then subdivided into two groups on the basis of whether or not they had received intraoperative steroids. These groups were then evaluated in terms of pre-and post-operative bone and air conduction levels and the differences investigated statistically. Results: Postoperative bone conduction averages for all the patients in both Group 1 and Group 2 were significantly improved at all frequencies, except at 4000 Hz, compared to the preoperative mean value. However, there was no statistically significant difference observed between patients who did receive intra-operative single-dose IV corticosteroid injections and patients who did not receive IV corticosteroid injections group in terms of preoperative and postoperative air-bone conduction levels. Conclusion: It is not necessary routinely to administer systemic corticosteroids in order to prevent perioperative sensorineural hearing loss during surgery for otosclerosis. However, perioperative corticosteroids may be helpful in preventing sensorineural hearing loss when there are conditions present that can lead to inner ear damage during the operation.

The cartilage shoe method for titanium TORP stabilization that is used for ossicular reconstruction during CWDT has been found to have a beneficial effect on auditory outcomes. Cartilage shoe application increases positive effects on hearing outcomes, particularly if the middle ear mucosa is granular and edematous.