The amelioration of bilateral otoscopic sign scores in the combination therapy group was statistically significantly greater than in all the other groups (p < 0.05). Improvement in bilateral tympanometric findings in the combination therapy group and montelukast group was greater than in the other groups. However, this difference was not statistically significant (p > 0.05). When we compared the difference between otoscopic sign scores before and after treatment we found that it was statistically significant in every group (p > 0.05). However, the significant improvement in tympanometric findings occurred in all groups except the levocetirizine group (p > 0.05).

We aimed to find out whether snoring relieve with nasal surgery in patients with nasal obstruction. Sixty-four patients who underwent septoplasty under general anesthesia with complaint of nasal obstruction and snoring at Haydarpasa Numune Education and Research Hospital were enrolled in the study. All patients were evaluated by otolaryngological examination. Septal deviation was graded as mild, moderate and severe with endoscopy. Variables examined included age, sex, body mass index. All patients also completed the questionnaires, including Nose Obstruction Symptom Evaluation scale (NOSE), Epworth Sleepiness Scale (ESS), and Snore Symptom Inventory (SSI) before and after septoplasty. NOSE scale, ESS, and SSI scores showed statistically significant improvement after nasal surgery (p < 0.01) but we could not find any statistically significant association between septal deviation grading and improvement in scores of NOSE scale, ESS, and SSI (p > 0.05). Added to this, the association between body mass index (BMI) and improvement in scores of NOSE scale, ESS, and SSI did not reach statistical significance (p > 0.05). Our results demonstrated that septoplasty is effective on the subjective parameters of nasal obstruction in habitual snorers irrespective of the nasal septal deviation and severity of BMI.

No abstract

Biofilms are sessile communities of bacteria embedded in self-produced extracellular polysaccharide matrix and are considered to be responsible for bacterial infections in humans. Topical surfactant use on silicone nasal splints may have a preventive effect on biofilm formation. The objective of this study is to investigate the effect of surfactant-containing nasal solutions on biofilm formation over the surface of silicone nasal splints. Forty patients were randomized after septoplasty to receive surfactant-containing saline solution (group 1) or saline without surfactant (group 2). At the postoperative 48th, 72th and 96th hours, pieces of splint samples were taken and prepared for scanning electron microscopic evaluation. Biofilm formation was observed in 3, 6 and 14 of 20 samples in group 1 (surfactant used) and 3, 14 and 20 of 20 samples in group 2 (control) at 48th, 72th and 96th hours, respectively. Biofilm formation incidences of groups at 48th hour were similar (p > 0.05), whereas it was significantly lower at group 1 regarding 72th and 96th hours (p < 0.05). Surfactant-containing nasal solutions have an inhibitory effect on biofilm formation over the surface of silicone nasal splints especially after 48 h. Surfactant-containing nasal solutions may have an important role in nasal septal dressing in the future.

INTRODUCTIONBroad use of more effective and stronger antibiotics resulted in a decline in the incidence of chronic otitis media (COM) complications; however, the significance of complications has remained stable due to high mortality and morbidity rates [1]. Simultaneous coexistence of complications of COM in the same case is a rare situation, and the present report describes a case of multiple complications of COM. CASE PRESENTATIONA 45-year-old man attended to our emergency department complaining of left otalgia, purulent otorrhea, and pain in the left cervical area with a 15-day history. After consultation to our clinic, the patient was hospitalized with the diagnosis of left COM, mastoiditis, and Bezold abscess and treated ambulatorily with broad-spectrum intravenous antibiotics (tazobactam-piperacillin, teicoplanin, and clindamycin). He complained of hearing loss, frequent ear discharges, and otalgia in left ear of 10-year duration. He smoked cigarets and used alcohol; additionally, he had a history of hospitalization with a diagnosis of meningitis at a different otorhinolaryngology department seven years ago.Otoscopic evaluation showed swelling of the external ear and a foul-smelling purulent discharge in the left ear. Bezold abscess was drained under local anesthesia. Abscess and blood culture were taken. The general condition of the patient was normal initially, but after 24 hours of treatment, he had nausea and vomiting, then his general condition deteriorated. Neck stiffness and positive Kernig's sign were determined in physical examination. We performed a computerized tomography (CT) scan, magnetic resonance imaging (MRI), and lumbar puncture to exclude cranial involvement, and these tests confirmed a left middle ear cholesteatoma associated with ipsilateral lateral sinus thrombophlebitis and meningitis (Figure 1). Therefore, the patient was sent to intensive care unit, and treatment changed to meropenem, and vancomycin, metronidazole, which were more specific antimicrobial agents to treat a cranial nervous system infection.Under these circumstances, we performed radical mastoidectomy. The mastoid cavity, middle ear cavity, and perisinusoidal air cells were filled with cholesteatoma debris. There was bone erosion in the perisinusoidal region (Figure 2). Streptococcus constellatus was iso- Simultaneous Coexistence of Complications of Chronic Otitis Media in the Same CaseChronic otitis media (COM) is a common clinical entity, but the incidence of COM complications has declined recently due to broad use of antibiotics. Independent of this, these complications are still a significant challenge in otorhinolaryngology practice because of high morbidity and mortality rates. The most common etiologic diagnosis was cholesteatomatous COM. Simultaneous coexistence of complications of COM in the same case is a rare situation, and the present report describes a case with mastoiditis, Bezold abscess, lateral sinus thrombophlebitis, meningitis, and paraspinal abscess.