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    Chronic Noise Affects Middle Ear Resonance and Absorbance in Industrial Workers
    (Aves, 2022) Yilmaz, Nihat; Soylemez, Emre; Soylemez, Tugce; Sanuc, Merve Betul; Yilmaz, Orhan
    BACKGROUND: The effect of chronic noise on the middle ear is not fully known. This study aimed to evaluate the middle ear functions of metal workers exposed to chronic noise using wideband tympanometry. METHODS: In this study, 62 male workers exposed to chronic noise and 30 healthy men were included. Workers exposed to chronic noise were divided into 2 groups according to their pure tone averages. Totally 30 workers (60 ears) with pure tone average less than 20 dB were included in group I, and 32 workers (64 ears) with pure tone average more than 20 dB were included in group II. All individuals were subjected to wideband tympanometry. Tympanometric peak pressure, equivalent ear canal volume, static acoustic admittance, resonance frequency, and absorbance ratios at peak pressure and ambient pressure values were analyzed. RESULTS: There was no difference between the groups in terms of traditional tympanometric parameters such as tympanometric peak pressure, equivalent ear canal volume, and static acoustic admittance (P >.05). Resonance frequency of workers exposed to chronic noise (group I and group II) was lower than the control group (P <.05). The absorbance ratios of workers exposed to chronic noise at approximately 4 kHz were lower in both peak pressures and ambient pressures (P <.05). CONCLUSION: Chronic noise does not only damage the inner ear but also causes changes in the middle ear structures. Wideband tympanometry can be used to detect minor auditory damage due to noise that cannot be detected by audiogram early. In this way, necessary measures can be taken in the early period before noise-induced hearing loss occurs.
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    PARANASAL SINUS ANATOMICAL DIFFERENCES IN ELDERLY PATIENTS
    (Gunes Kitabevi Ltd Sti, 2020) Yilmaz, Nihat; Mulazimoglu, Selcuk; Oner, Serkan; Nacar, Erkay; Yilmaz, Orhan
    Introduction: Endonasal endoscopic sinus surgeries performed on elderly patients can be challenging due to anatomical variations, and can be studied using preoperative computed tomography. The aim of the present study was to evaluate paranasal sinus anatomical differences in elderly patients compared to a younger control group. Materials and Methods: We retrospectively evaluated paranasal computed tomography scans of 47 elderly patients (>65 years old) (Elderly group) and 47 younger patients (Control group) for midfacial skeletal size (interzygomatic buttress distance, nasion-basion distance), anatomical variations, dimensions, and paranasal sinus volumes. Results: The mean age of the Elderly group was 69.89 years (65- 81 years) and the mean age of the Control group was 33.15 years (20-49 years). There was no significant difference in midfacial size between the two groups. The prevalence of Keros Type Ill olfactory fossa was significantly higher in the Elderly group than in the Control group (p<0.05). The Elderly group had a significantly lower mean maxillary sinus volume (p<0.01) and mean anteroposterior diameter of the sphenoid sinus (p<0.01) compared to the Control group. Furthermore, there was no significant difference in the maxillary sinus volume between the elderly edentulous and dentulous patients(p>0.05). Conclusion: Elderly patients have more Keros Type Ill olfactory fossa, which confers a higher risk of iatrogenic cerebrospinal fluid leakage during endoscopic sinus surgery. The preoperative detailed evaluation of computed tomography scans of elderly patients should include, but not be limited to, the ethmoid roof for deep olfactory fossa, and the sphenoid sinus for its narrow anterioposterior dimention.