Nasal septum deviation was associated with higher rates of ET dysfunction, which could be improved by the nasal surgery. However, in some patients, nasal surgery itself caused ET dysfunction in the early postoperative period.
OBJECTIVE:To evaluate the association between nasal airway function and Eustachian tube (ET) functions and their impact on tympanoplasty in patients with chronic suppurative otitis media (CSOM). MATERIALS and METHODS:The study group (CSOM group) consisted of 33 patients scheduled to undergo tympanoplasty for CSOM. Two control groups were formed: a nasal septal deviation (NSD) group of 25 patients scheduled to undergo nasal surgery for NSD, and a control group of 25 healthy individuals with no otologic or rhinologic symptoms. ET functions were assessed tympanometrically with automatic Williams test (ETF1) and modified pressure equalization inflation-deflation test (ETF2) and nasal functions were analyzed using acoustic rhinometry and rhinomanometry. The patients in the CSOM group underwent tympanoplasty, and tests were repeated at the end of the 3rd postoperative month. RESULTS:Both acoustic rhinometry and rhinomanometry revealed similar nasal function in the CSOM and NSD groups, which was inferior to that of the control group. The CSOM group had the worst ET function. Dysfunctional ETs in the CSOM group improved at 3 months postsurgery, and all groups had a similar outcome regarding ET functions. The outcome of ear surgery was not affected by nasal function, and the graft take rate was 90%. CONCLUSION:Patients with NSD had generally poor ET function; however, this did not affect the outcomes of tympanoplasty. The preoperative ET function results were inconsistent with the results following tympanoplasty; therefore, they were not predictive of need for septoplasty. Thus, we do not universally recommend surgical correction of NSD prior to ear surgery; however, this decision should be made on an individual basis.
Objectives: This study aims to compare different therapy methods used for sudden sensorineural hearing losses, to determine the prognostic factors and particularly to investigate the importance of starting the therapy within the first three days of the prognosis. Patients and Methods:Between January 1995 and December 2008, the files of 213 patients who were treated in our clinic were reviewed. A total of 155 patients who met the inclusion criteria were included in the study. The study groups were classified according to the prognostic and audiometric factors. Results:With regard to the effectiveness of treatment options, post-treatment audiometric improvement was significantly better in the patients treated with carbogen in addition to the medical therapy compared to the other groups (p=0.018). In terms of the patient characteristics at the time of admission, having vertigo, presence of a descending type audiogram curve and severe hearing loss affected the success of treatment negatively, while mild hearing loss and presence of an ascending type audiogram curve had a positive effect. The recovery rate was higher in patients who were admitted within the first three days (p=0.005). Conclusion:It was found that starting the therapy within the first three days and adding the carbogen to the conventional medical treatment may improve the outcome of the treatment.Keywords: Carbogen; first three days; prognosis; sudden hearing loss. ÖZAmaç: Bu çalışmada ani sensörinöral işitme kayıpları için kullanılan farklı tedavi yöntemleri karşılaştırıldı, prognostik faktörler belirlendi ve özellikle prognozun ilk üç gününde tedaviye başlamanın önemi araştırıldı. Bulgular:Tedavi seçeneklerinin etkililiği ile ilgili olarak, tıbbi terapiye ek olarak karbojen ile tedavi edilen hastalarda tedavi sonrası odyometrik iyileşme diğer gruplarla karşılaştırıldığında anlamlı olarak daha iyiydi (p=0.018). Başvuru sırasında hasta özellikleri açısından baş dönmesi, odyogramda alçalan eğri ve ciddi işitme kaybı tedavinin başarısını olumsuz etkilerken, hafif işitme kaybı ve odyogramda yük-selen eğrinin varlığı tedavi için olumlu bir etkiye sahiptir. İlk üç gün içinde başvuran hastalarda iyileşme oranı daha yüksekti (p=0.005). Sonuç:Tedaviye ilk üç gün içinde başlamanın ve konvansiyonel tıbbi tedaviye karbojenin eklenmesinin tedavinin sonucunu iyileştire-bileceği gözlendi.Anahtar Sözcükler: Karbojen; ilk üç gün; prognoz; ani işitme kaybı.
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