Canberk Kertmen

Background and Objectives: Noise-induced hearing loss (NIHL) is a major cause of sensorineural hearing loss. However, effective pharmacological treatments remain limited. The aim of this study was to investigate the therapeutic effects of allicin on NIHL in a rat model. Materials and Methods: Forty-two female Wistar albino rats were randomly divided into six groups (n= 7 per group): saline (SF), allicin, dimethyl sulfoxide (DMSO), noise+SF, noise+allicin+DMSO, and noise+DMSO. Noise exposure was performed using 4 kHz octave-band noise at a sound pressure level (SPL) of 120 dB for 4 hours. Allicin (20 mg/kg/day, intraperitoneally) was administered for 7 days following noise exposure. Auditory brainstem response (ABR) thresholds (dB SPL) were measured at 8, 12, 16, 20, and 32 kHz at baseline, 24 hours, and day 7. Histopathological evaluation of the cochlea was performed after euthanasia. Results: Noise exposure significantly increased ABR thresholds in all noise-exposed groups. On day 7, the noise+allicin+ DMSO group demonstrated significantly lower ABR thresholds at 16, 20, and 32 kHz compared with the noise+SF group and at 20 and 32 kHz compared with the noise+DMSO group (p<0.05). No significant differences were observed at lower frequencies. Histopathological analysis showed a trend toward reduced cochlear damage in the allicin-treated group; however, the differences were not statistically significant. Conclusions: Allicin treatment improved high-frequency hearing thresholds in rats with NIHL. However, the absence of significant histopathological and mechanistic findings indicates that further molecular and region-specific studies are required.

BACKGROUND: Facial nerve transection leads to significant functional and aesthetic deficits. Although microsurgical repair is the standard of care, complete functional recovery remains rare. Biological scaffolds and corticosteroids have been explored as adjuncts to enhance nerve regeneration. To evaluate the effects of human amniotic membrane (AM) wrapping and intraperitoneal dexamethasone, used alone or in combination, on facial nerve regeneration in a murine model. METHODS: Twenty-eight male albino mice underwent right facial nerve transection followed by epineural repair and were randomized into 4 groups (n= 7 each): (1) control (repair only), (2) dexamethasone (1 mg/kg IP for 7 days), (3) AM wrapping, and (4) combination therapy (AM + dexamethasone). Functional recovery was assessed using compound muscle action potential (CMAP) recordings on postoperative day 21. Histological analysis included axon count, myelin density, axon diameter, and CD44/Ki-67 immunohistochemistry. RESULTS: Group 4 (combination therapy) demonstrated the highest CMAP amplitude (5.5 ± 2.7 mV), axon count (median: 92.0), and myelin density (median: 50.5). Significant intergroup differences were observed in axon count (P < .001), myelin density (P < .001), and nuclear vacuole reduction (P=.04). Group 4 (combination therapy) demonstrated the highest CMAP amplitude (5.5 ± 2.7 mV); however, this increase did not reach statistical significance when compared with other groups (P=.299). Significant intergroup differences were observed in axon count (P < .001), myelin density (P < .001), and nuclear vacuole reduction (P=.04). Thus, while histopathological outcomes clearly favored Group 4, functional superiority should be interpreted with caution. CONCLUSION: Combined use of AM and dexamethasone synergistically enhanced facial nerve regeneration in this model. This dual approach may serve as an effective adjunct to microsurgical repair in peripheral nerve injuries. Further studies are needed to confirm its translational potential.

Background: Hearing loss reduces quality of life, particularly prevalent in the geriatric population (≥ 65 years). This study aims to evaluate the efficacy of incus interposition in the geriatric population and to compare functional outcomes with those of the adults. Methods: Patients who underwent incus interposition in the clinic were retrospectively reviewed and divided into 2 groups according to age. Cases with ossicular problems other than incus problems, cholesteatoma, and revision surgeries were excluded from the study. The results of pure tone audiometry preoperatively and postoperatively (sixth month) were compared within each group and between the groups. The differences in air conduction, bone conduction, and air-bone gap were analyzed. Results: The study included a total of 76 patients, 44 (57.9%) under 65 years of age and 32 (42.1%) over 65 years of age. The distribution of sex and type of graft was homogeneous between the groups. The preoperative air and bone conduction thresholds were significantly higher in the geriatric group compared to the adult group (P < .001). In the sixth postoperative month, a significant reduction in air conduction thresholds and air-bone gap was observed in both groups (P < .001). When the changes in the air-bone gap between the preoperative and postoperative periods were compared, the adult group showed a significantly greater improvement than the geriatric group (P = .006). Conclusion: Incus interposition is a safe and effective surgical procedure in the geriatric population. The comparatively lower hearing gains observed in the geriatric group may be attributed to age-related pathological changes in the middle ear. Cite this article as: Akı ES, Dalgı. A, Aksoy-Yıldırım G, Kertmen C, Kubilay U. Evaluation of the effectiveness of incus interposition in the geriatric population. B-ENT. 2025;21(2):86-90.

Objective: This study aimed to compare the pharyngocutaneous fistula (PCF) between patients who underwent reconstruction using cervical fascia after total laryngectomy and those who did not and to investigate the factors affecting PCF rates.Methods: We retrospectively compared 22 patients operated between February 2021 and March 2023 who received cervical fascia flap as the study group and 21 patients operated between January 2018 and March 2023 who did not receive fascia flap as the control group. The study included patients who underwent total laryngectomy for Stage 3 and 4 squamous cell laryngeal cancer.Results: We included 43 patients, with 22 (51.2%) and 21 patients (48.8%) in the study and control groups, respectively. The age and sex were not different between the two groups (p = 0.471, p = 0.176, respectively). The distribution of patients as per sex, smoking, alcohol use, chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and multiple comorbidities was similar in both groups (p > 0.05). PCF was observed in one patient (4.5%) and seven patients (33.3%) in the study and control groups, respectively. The PCF rate was significantly lower in the study group (p = 0.021). When the relationship between flap use and risk factors was compared by correlation analysis, a moderate negative relationship was found between flap use and PCF (p = 0.015, r = −0.370).Conclusion: The use of a cervical fascia flap is effective in reducing fistula rates after total laryngectomy. Its main advantages include being technically simpler than alternative techniques, locally available, cost‐effective.Level of Evidence: 3 Laryngoscope, 134:4964–4970, 2024