Objective: To analyze tracheal specimens obtained during tracheotomy in patients with prolonged intubation and investigate the relationship between intubation duration and the development of histopathological damage. Methods: Forty‐six adult patients undergoing surgical tracheotomy were categorized into three groups based on intubation duration: 7–14 days (Group A), 15–28 days (Group B), and ≥ 29 days (Group C). The control group comprised 20 patients with laryngeal cancer who underwent laryngectomy and tracheotomy. Tracheal specimens obtained during routine procedures were subjected to histopathological evaluation. Results: Significant differences were observed between the intubated groups and the control group in terms of ulceration, inflammatory cell infiltration, granulation tissue formation, microabscess formation, dilatation, neovascularization, desmoplasia, degeneration, perichondritis, and calcification. The incidence of dilatation and perichondritis increased significantly with longer intubation duration. Conclusion: Prolonged endotracheal intubation is associated with various histopathological changes in the trachea. Given that histopathological injury and complication rates increase with intubation duration, performing tracheotomy within the first 14 days may be considered. Level of Evidence: 3.

Purpose: Helicobacter pylori, causing chronic systemic infection, may colonize in middle ear milieu and conduce to effusion collection. Many investigations on relationship between pathogenesis of otitis media with effusion (OME) and Helicobacter pylori yielded conflicting results. We investigated Helicobacter pylori presence in effusion and adenoid samples of children having OME and in middle ear and adenoid samples of children with healthy middle ears to elucidate its role on OME pathogenesis. Methods: This prospective case-control study included 300 patients aged 1–12 years. One-hundred effusion samples collected from 100 children undergoing ventilation tube insertion and adenoidectomy due to chronic OME and adenoid hypertrophy formed study group, and 100 adenoid samples collected from adenoids of these children formed Group-1. One-hundred healthy-looking middle ear irrigation solutions collected from 100 children undergoing cochlear implantation formed Group-2. One-hundred adenoid samples collected from 100 children having no effusion and only undergoing adenoidectomy formed Group-3. After DNA isolation of samples, Helicobacter pylori 16 S rRNA and 23 S rRNA gene for clarithromycin-resistance were investigated by real time-polymerase chain reaction (Rt-PCR). Results: The median age of 300 children was 5, and 179 were boys and 121 were girls. Helicobacter pylori was detected by Rt-PCR in none (%0) of the 400 samples (200 middle ear, 200 adenoid). Conclusion: In this largest sample-size study utilizing updated molecular methods to date, negative results indicate that Helicobacter pylori does not play role as an active pathogen in polymicrobiality of OME, and adenoids do not serve as a reservoir for Helicobacter pylori in this process.

Background: Endoscopes play an important role in otologic surgery. Baby shampoos, known for their hypoallergenic, anti-irritant, and antifogging properties, are increasingly being used. The purpose of this study was to evaluate the safety and ototoxic effects of baby shampoo in ananimal model using both electrophysiological and histological methods. Methods: Twenty-eight male Sprague–Dawley rats were divided into 4 groups: 7 control (group 1), 7 saline (group 2), 7 isopropyl alcohol(70%)+chlorhexidine (2%) antiseptic (group 3), and 7 baby shampoo (group 4). Baseline hearing was assessed by auditory brainstem response(ABR). All groups except the control received 3 doses of their respective substances by intratympanic injection. Auditory brainstem responsemeasurements were performed on day 7 and day 21, after which the temporal bones were dissected. Histological evaluation of the cochlea andvascular endothelial growth factor (VEGF) immunoreactivity studies were performed. Results: Baseline hearing thresholds were similar and within normal limits. On days 7 and 21, hearing thresholds were significantly impairedat all frequencies in the experimental groups. In particular, groups 3 and 4 had higher thresholds than the other groups. Baby shampoo causedsignificant damage to outer hair cells and sustentacular cells and decreased VEGF immunoreactivity in the stria vascularis, spiral ligament, andorgan of Corti.Conclusion: Baby shampoo was found to progressively impair hearing over time, indicating its potential to cause long-term ototoxicity.Cite this article as: Mutlu A, Bakici B, Yasemin Gunduz A, et al. Progressive ototoxicity of baby shampoo as an antifog agent: an experimentalstudy. J Int Adv Otol. 2025, 21(2), 1526, doi: 10.5152/iao.2025.241526.