JOURNAL OF OTORHINOLARYNGOLOGY AND FACIAL PLASTIC SURGERY
Year:2022 | Volume:8 | Issue:1|Papers Count:25

Background: Tinnitus is an auditory perception that is described as a perception of noise without any external acoustic stimulant. Tinnitus causes many problems including sleep disturbances and difficulty in concentrating for patients. Aim: In this trial we evaluated melatonin as an alternative therapy in tinnitus. Methods: In this clinical trial, tinnitus patients (n = 90) were randomly assigned to 12 weeks of double-blind treatment with melatonin (n = 30) at a fixed-dose (3 mg once daily), sertraline (n = 30) at a fixed dose (50 mg once daily) and placebo (n = 30) once daily. The treatment outcomes were measured using THI (Tinnitus Handicap Inventory), tinnitus loudness score, and tinnitus awareness score after 3 months. Results: The baseline assessment with THI (Tinnitus Handicap Inventory) showed no significant difference in THI score between groups before treatment (p-value = 0. 38). The mean THI score shows a significant decrease in both melatonin and sertraline groups (p-value < 0. 03). Overall, a mean of 20% decrease in tinnitus loudness score and a 2-fold decrease in tinnitus awareness score was seen in the melatonin group. In contrast, a mean of 2% decrease in tinnitus loudness score and 25% decrease in tinnitus awareness score was seen in the sertraline group. Conclusion: Both melatonin and sertraline reduce tinnitus loudness score and tinnitus awareness score within 12 weeks in primary care, but melatonin showed a more significant outcome. Our findings support the prescription of melatonin in tinnitus management.

Background: Several researches have proven that high levels of noise can induce oxidative stress and increase free radical's formation, particularly hydrogen peroxide (H2O2) and nitric oxide (NO) production. Retinoids are polyisoprenoid lipids derived from vitamin A or retinol. These molecules are essential regulatory elements in cell processes. All-trans retinoic acid (ATRA) plays a vital function in cellular growth, apoptosis, reproduction, cell differentiation, and immune feature by binding to its nuclear receptors. Aim: In this study, we studied the protective effect of ATRA on H2O2-induced damage to bone marrow mesenchymal stem cell (BMSCs)-derived hair cells in culture. Methods: Expression of MATH1 and SOX2 genes were assayed by immunocytochemistry (ICC). In order to evaluate the tolerance of ATRA-treated cells, after incubation of hair cells-like cells with ATRA, it was exposed to H2O2 as an oxidative stress model. Then, the apoptosis percentage of cultivated hair cell-like cells was evaluated by acridin-orange staining method. Results: Our findings revealed that apoptotic cells were markedly diminished in the ATRA +H2O2 co-treated cells in comparison with the H2O2 only–, treated group. Conclusion: ATRA has the protective effect against oxidative stress damage in the cultivated hair cells-like cells by reducing the apoptosis.

Background: Rhinoplasty is one of the most common plastic surgeries in the world. At the same time, rhinoplasty is considered one of the most precise, delicate and difficult plastic surgeries. Although this surgery is associated with some complications like any other surgery, because it is carried out to change the person's appearance and increase his/her satisfaction and self-confidence, attempts should be made to prevent the occurrence of complications as much as possible because edema and ecchymosis are considered as two consequences of rhinoplasty. Aim: Considering the severity of edema and ecchymosis after rhinoplasty and limited studies on the effect of non-steroidal compounds, therefore, the present study aims to compare the effect of dexamethasone and ketorolac severity on edema and ecchymosis after rhinoplasty in Loghman-e Hakim Hospital in 2021. Methods: This was a double-blind clinical trial that aims to compare the effect of dexamethasone and ketorolac on the severity of edema and ecchymosis after rhinoplasty among clients referring to the ENT clinic of Loghman-e Hakim Hospital during the year 2021. The study population included 81 patients applying for primary rhinoplasty were randomly divided into two groups using a randomized block design. Results: Although the mean edema and ecchymosis severity in the dexamethasone group was lower than the ketorolac group, the results of chi-square and independent t-test showed no significant difference between dexamethasone and ketorolac groups in terms of the severity of edema and ecchymosis. Therefore, both research hypotheses were rejected and the null hypothesis was confirmed. Conclusion: Despite the difference between the two groups in terms of severity of postoperative edema and ecchymosis, this difference was not statistically significant, which indicates the similar efficacy of the two drugs in reducing edema and ecchymosis after rhinoplasty.

Background: Due to the importance of time in diagnosis and treatment and, as a result, the prognosis of patients with neck malignancies, we decided to evaluate the causes of delay in diagnosis of neck masses and their associated factors. Aim: In this study, we have evaluated the delay in diagnosing neck masses and the related factors. Methods: This descriptive-analytical study was performed on 500 patients with a neck mass who were referred to Loghman Hakim Hospital in 2019. Demographic data were recorded. The time of the delay to visit a doctor and the time of the delay to diagnosis were recorded. Factors related to the delay in the patient and physician's diagnosis, including the patient's socioeconomic status, literacy and income level, associated symptoms, history of smoking, infections and underlying diseases, were evaluated. Results: the mean age of patients was 46. 04 years. 50. 4% were female. The mean time interval between feeling neck mass and visiting a doctor was 34. 72 days. This time interval between feeling neck mass and visiting a doctor in patients with higher education levels was less than in illiterate patients with low education levels (p = 0. 046). This interval time in patients with higher income levels was less than in patients with lower income levels (p = 0. 009). This interval was significantly increased with increasing age (p<0. 001). Conclusion: Based on our findings, some factors such as age, income and education level significantly influence the process of diagnosis and treatment. On the other side, the presence of some signs and symptoms like dysphagia, sore throat, weight loss, etc., can remarkably reduce delay in that process. Ultimately it seems helpful to make an application which provides essential training for elderly, low-income or unlearned patients and facilitates consulting and referring to doctors for them.

Background: Alzheimer’, s disease (AD) is a neurodegenerative disease which adversely affects memory and learning skills. Currently, there is no disease-modifying therapeutic approach for AD. Aim: A growing body of literature suggests elderberry as a promising remedy for neurological disorders. This study investigates the therapeutic effects of the elderberry diet on amyloid beta-induced (Aβ, ) rat model. Methods: Initially, Alzheimer’, s model was generated by Aβ,administration followed by the treatment of elderberry diet. Then, short term spatial memory was assessed. Stereology was also performed for the evaluation of density of neurons and dark neuron in the hippocampus. Results: The findings showed that the administration of the elderberry diet in an Aβ,model of Alzheimer’,disease improved memory and learning function and prevented the degeneration of hippocampal neurons. Conclusion: Overall, the findings imply that the elderberry diet attenuates the Aβ,-induced degeneration and improves memory performance. As such, the elderberry diet could be used as a therapeutic procedure for Alzheimer due to its neuroprotective effects.

Background: Definite diagnosis of Chronic rhinosinusitis (CRS) is challenging mostly because of overlapping symptoms with other disorders. Nowadays it is mostly dependent on cross sectional imaging. When considering the prevalence and cost burden of CRS, reducing the frequency of cross sectional imaging by replacing it with endoscopic evaluation could be a cost effective way if the endoscopic examination proved to be a suitable substitution. Aim: The aim of this study is to compare the endoscopy with CT scan-as gold standard method-in diagnosis of CRS without polyp and to find out how well the results of the two correlate with each other. Methods: Adult patients with symptom criteria compatible with EPOS 2020 entered the study. They were evaluated endoscopically, and then scored by Lund Mackay CT score. Cases with obvious polyps seen on rhinoscopy or endoscopic evaluation were not entered the study. Results: A total of 49 patients entered the study. Comparing endoscopic findings with CT scan showed the sensitivity of 69. 70% and specificity of 50%. Cohen Kappa statistics of 0. 191 was obtained. Positive and negative predictive value was 74. 19% and 44. 44% respectively. Of note, all 8 patients with Kennedy score of 4 showed positive CT results, and, all 4 cases with isolated sinusitis had negative endoscopic results. Pearson correlation coefficient was 0. 63, which showed a significant positive correlation between Lund Kennedy and Lund Mackay scores (p<0. 05). Conclusion: Our observations lead us to a possible need for revision in presented endoscopic criteria to increase the diagnostic power of endoscopy in chronic rhinosinusitis sine nasal polyposis.

Background: Mucoceles are benign encapsulated lesions filled with mucus located in parasinus cavities. The occurrence rate of the anterior clinoid process is varying significantly in different studies. Visual disturbances, diplopia, and retrobulbar pain are among the common manifestations of anterior clinoid process mucocele. To our knowledge, 17 cases of Anterior clinoid process mucocele with visual involvements have previously been reported. Aim: We aim to report a rare case of a middle-aged man with a large sphenoid mucocele admitted due to the loss of vision in his left eye. Case presentation: A 46-year-old man with a sudden vision loss in his left eye was admitted to Loghman Hakim Hospital. In physical examination positive relative afferent pupillary defect (RAPD) was evident. The visual acuity of his right eye was normal, while his left eye had no light perception. Moreover, his visual field was normal on the right side. He had no other medical complaints. Conclusion: Clinoid mucoceles causing cranial neuropathy are extremely rare. The proper diagnosis and prompt treatment are necessary to avoid permanent complications. With proper surgical intervention, recurrence of the mucoceles can be avoided.

Background: In the middle ear inflammation, otitis media with effusion (OME) leads to a sterile effusion. Although most OME resolves without any complications, long-lasting OME may cause conductive hearing loss (CHL). Aim: In this article, we investigate the validity of the Rinne and Weber tests in different frequencies of tuning forks in predicting the conductive hearing loss secondary to OME as diagnosed by more modern audiometric tests. Methods: A case series of 25 consecutive patients visited the Loqman Hakim Hospital clinic. Each patient was evaluated by tuning fork tests (256, 512, 1024, 2048 Hz), audiometry, tympanometry, and tympanocentesis. Results: In evaluation of the hearing status in OME patients, there was no significant association between the Weber test, audiometry, and tympanometry. The 256 Hz Rinne test correlated with the level of hearing loss in patients with OME. Results revealed no relationship between the presence of glue ear, audiometric, tympanometric, and tuning fork tests. Conclusion: 256 Hz Rinne test can predict the presence of CHL in cases suffering from OME. Adhesive otitis does not worsen the hearing condition of patients.

Background: Mucoepidermoid carcinoma is a malignant disease of salivary glands that originates from epithelial cells. These tumors are aggressive and have a poor prognosis. Aim: This study aims to investigate a rare case of nasal mucoepidermoid carcinoma of the nasal ala, and cover the general aspects of the pathogenesis and diagnosis. Case presentation: We reported a case of nasal ala mucoepidermoid carcinoma of unknown origin in a 73-year-old male patient without any symptoms or signs. Conclusion: Mucoepidermoid carcinoma usually involves the ethmoid area and its occurrence in the nose is very rare. Therefore, its formation in this area can be challenging and may not be correctly diagnosed. Therefore, in these cases, accurate and timely diagnosis can be vital for the patient and it is necessary to consider the possibility of mucoepidermoid cancer in the differential diagnosis when faced with a tumor in the nasal area.

Background: Chronic otitis media is characterized by the accumulation of fluid in the middle ear and behind the tympanic membrane without signs of acute infection. The association between a middle ear infection and anatomical and physiological disorders of the Eustachian tube has been reported in several studies and its malfunction is one of the main causes of middle ear infection. Aim: We aim to find the relation between tubotympanic angle of the Eustachian tube and chronic otitis media. Methods: In this study, 100 patients with chronic unilateral middle ear infections were included. To determine the tubotympanic angle of the Eustachian tube, a temporal bone CT scan was used in the radiology department of Loghman Hospital. Eustachian tube angle and ear function were recorded. Results: Among the 100 patients in the study, 42 were men and 58 were women. The mean age of patients in the study was 39. 64±, 12. 64 years. The angle was 3. 79 ±,34. 27 in the healthy ear and 2. 43 ±,31. 06 in the diseased ear, which showed a statistically significant difference between the two groups. Conclusion: Eustachian tube angles in adults may play an important role in the cause of chronic otitis media. In this study, it was found that the horizontalization of the Eustachian tube is associated with chronic otitis media. Besides, determining the angle of the Eustachian tube can help determine the susceptibility to otitis media.

Background: Facial symmetry is determining the attractiveness of the face. It must be taken into consideration and not just the nose in isolation for patients seeking rhinoplasty. It may however exist even in absence of external nasal deformity. Aim: The study was conducted to compare the nature of facial asymmetry and its frequency in patients with and without external nasal deformity. Methods: This observational, analytical study was conducted from September 2020 to October 2021 in the Department of Ear Nose and Throat (ENT) –,Head and Neck Surgery, Tribhuvan University Teaching Hospital (TUTH), Maharajgunj Medical Campus Institute of Medicine, Nepal. Frontal photograph of patients seeking rhinoplasty for external nasal deformity was compared with patients without external nasal deformity visiting ENT Out Patient Department (OPD) for other complaints. Anthropometric measurements based on soft tissue landmarks, starting with an imaginary line from the midpoint of the hairline, crossing midpoint of the nasal bridge, the central point of cupid’, s bow, upper lip, and lowest midpoint of the chin were measured. Distance between this line and medial canthus, lateral canthus, lateral alar margin, oral commissure, and tragus were measured and the means of the ratios were compared. Results: The mean of the ratio of the midline to lateral alar margin showed a significant difference (p<0. 040) with regards to facial asymmetry in patients seeking rhinoplasty for external nasal deformity. Objectively, all the patients had some degree of asymmetry in both groups. Conclusion: Facial asymmetry was found in both patients with and without external nasal deformity indicating that facial asymmetry is a common entity irrespective of external nasal deformity.

Background: Otosclerosis is a primary disease of the temporal bone and otic capsule with autosomal dominant transmission and variable expression. The exact pathogenesis and factors affecting tinnitus in otosclerosis patients are unknown. This study aims to find the effect of stapes surgery on improving tinnitus in otosclerosis patients. Aim: This study aims to find the effect of stapes surgery on improving tinnitus in otosclerosis patients. Methods: Twenty-nine otosclerosis patients with preoperative tinnitus were enrolled in the study. Patients were divided into three groups,patients with high pitch tinnitus (>2 kHz), patients with medium pitch frequency (500-2000 Hz), and patients with low pitch frequency (<500 Hz). In addition, a visual analog scale was used to evaluate tinnitus severity. Results: In our study, 15 (51%) patients' tinnitus showed significant improvement, 5 (17%) patients' tinnitus converted to medium and low frequency, and nine (31%) patients' tinnitus remained unchanged. The majority of subjects (24, 83%) have decreased VAS scores (p= 0. 001), and 5 (17%) patients remained unchanged. Results of pre and postoperative ABG showed that 82. 3% of subjects (n=27) have postoperative ABG<10, and 18% (n=6) have ABG of 10 to 20. The patient's mean ABG was decreased from 35. 9 ±,10. 7 dB before surgery to 9. 03 ±,7. 9 dB after surgery (p= 0. 001). Conclusion: Patients high pitched tinnitus may be a better candidate for stapes surgery, although others can also benefit from surgical intervention.

Background: H-index is one of the main bibliometric indicators for evaluating researchers. It has been criticized due to the effect of self-citation rate on its increase. Aim: This study aimed at analyzing the state of top 1% highly-cited Iranian scientists in medical sciences in ESI for investigating the effect of their self-citations on their h-indices. Methods: Iranian Medical Science Scientometric Information Database, Essential Science IndicatorsTM (ESI) and Scopus indexing/abstracting database were used for data extraction. Data analysis was conducted in Excel and SPSS. . Results: In total, 6. 15% of citations were self-citations that resulted in increase in h-index by 2. 49 units. After excluding self-citations, the h-indexes of 23. 4% of the studied scientists did not change and the mean rate of h-index decreased by 2. 49. A correlational test showed the strong correlation between self-citation count and h-index rate (r=. 718). Conclusion: Self-citation is present as a common phenomenon in all scientific communities and increases in h-index. If not used for manipulating bibliometric indicators, it can make the scientific works more visible for potential readers and consequently receiving more citations.

Background: As an interdisciplinary field, bibliometrics analyses research publications in scientific fields. As a developing medical field, otorhinolaryngology needs to be evaluated from a bibliometric perspective. Aim: This evaluative bibliometric study aimed at analyzing and exploring global research trends in otorhinolaryngology from the beginning to year 2021. Methods: All papers published in otorhinolaryngology field that indexed in Web of Science (WoS) from 1976-2021 were extracted for analysis by conducting a certain search strategy in advanced search section within category of otorhinolaryngology in the WoS. Data were analyzed by Excel and VOSviewer for measuring bibliometric indicators and depicting visualization maps. Results: 217, 027 papers were published during the studied time span. The papers increased from two items in the beginning in 1976 to 9, 759 items in 2021. USA ranked first with publishing 75, 742 papers, followed by Germany with 17, 718 papers and England with 14, 244 papers. League of European Research Universities (LERU) ranked first among research institutes with publishing 6, 517 papers. In journals, Laryngoscope ranked first with publishing 17, 891 papers, followed by Otolaryngology-Head and Neck Surgery with 14, 340 papers and Journal of Laryngology and Otology with 11, 219 papers. The majority of papers were in English (n=199, 069,%91, 725) and original articles (n=167, 724,%77. 28). After otorhinolaryngology as the first-ranked area with full coverage, surgery (n=37, 586) and audiology speech language pathology (n=22, 136) ranked second and third, respectively. 10 highly-occurred keywords were surgery (110), management (94), children (83), quality of life (81), squamous-cell carcinoma (78), cancer (75), head (73), radiotherapy (69), cochlear implant and noise (58) and experience (53), respectively. Co-citation clustering showed Journal of the Acoustical Society of America, Laryngoscope, Otolaryngology–, Head and Neck Surgery and Journal of Allergy and Clinical Immunology as the top cited sources. Conclusion: This study is the first to give a comprehensive bibliometric analysis and visualization of global research publication in otorhinolaryngology. It recognized important and influential papers, journals, authors, research institutions, countries and topic areas as well as main considerable keywords and subject clusters and cited sources.

Background: Hearing loss, especially at a young age, has severe personal and social consequences for a person and brings enormous costs to the treatment system. Considering the vital role of genetics in hearing loss, genetics research creates a suitable platform for progress in the treatment of these patients, so we decided to conduct a study with the aim of early diagnosis and even before symptoms appear in order to reduce possible complications. Aim: In this study early diagnosis of hearing loss and even before symptoms appear in order to reduce possible complications. Methods: Based on the history and phenotype and examination of the medical records of 1249 patients who are candidates for cochlear implantation, genetic testing among the patients suspected of non-syndromic genetic hearing loss, a request for genetic testing of stage one or two or both was made and according to the willingness of the families and their cooperation A total of 138 genetic tests were performed and subjected to genetic analysis. Results: Among 138 tested cases, 71 women and 67 men, NSHL inheritance autosomal recessive pattern was 84/78% and autosomal dominant, 5/07 which is very close to previous studies. There were genetic mutations in the Gjb2 gene in ten cases of patients. Ninety-one patients were negative for GJB2 involvement and were candidates for WES, but unfortunately, many families refused to perform the test due to the cost of this test. Seven patients underwent WES, and several genetic mutations were identified in the thesis. WES was performed for 34 patients according to the investigations carried out directly. Conclusion: Iranian society has played an essential role in improving our understanding of the genes involved in proper hearing functioning and how these genes' variants cause hearing loss. Researchers have worked tirelessly to solve the genetic mystery of hearing loss in Iran, which has been very successful. However, more work is still needed.

Background: There are emerging virtual simulation technologies that allow facial plastic surgeons to accurately and objectively show patients how they may appear following rhinoplasty surgery. There is no collective understanding of which virtual rhinoplasty preoperative planning software exist and their associated features. Aim: This article will synthesise information on smartphone and web-based resources for virtual rhinoplasty planning to provide facial plastic surgeons with an up-to-date understanding of the available technologies. Methods: This was a cross-sectional website and smartphone application software review. The Apple App Store and the Google Play were searched for smartphone applications and the Google search engine was searched for website software. Results: Five websites and six smartphone applications met inclusion criteria. Software features included self-directed simulation, in-app purchases, multiple languages, three-dimensional facial rendering and patient-specific perioperative planning. Conclusion: Many smartphone and website based software exist for surgeons to plan their patients’,rhinoplasties. Further data is needed to understand how facial plastic surgeons and patients perceive this software.

Background: The number of patients with COVID-19-induced olfactory dysfunction has consistently increased since the onset of the pandemic. Since a considerable proportion of these patients have olfactory dysfunction for a relatively long period of time, their quality of life (QOL) may considerably be impacted as a result. Aim: The aim of the present study was to investigate the adverse effects of olfactory dysfunction on QOL in patients with COVID-19-induced hyposmia or anosmia. Methods: The data were obtained via self-reported online questionnaire in individuals who met the inclusion criteria. The questionnaire included demographics, olfactory status and Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS). Results: Among1531 participants, 1072 individuals met the inclusion criteria, with 588 (54. 85%) having hyposmia and 484 (45. 15%) anosmia. Average age was 35. 7 in the hyposmic group and 34. 5 in the anosmic group. Concurrent hypogeusia/ageusia was reported in 398 (67. 7%) of cases with hyposmia and in 346 (71. 5%) of participants with anosmia. Lack of enjoyment of eating food was the most negative effect in both hyposmic and anosmic groups, followed by annoyance when eating food and a continuous awareness of the olfactory problem. The mean QOD-NS score was 20. 5±, 10. 2 in the hyposmic group and 23. 3±, 10. 4 in the anosmic group, demonstrating significant adverse impact on QOL. Conclusion: Persistent olfactory dysfunction in patients with COVID-19 has adverse effects on QOL. Early diagnosis and treatment of olfactory dysfunction may be crucial in limiting the adverse impact on QOL by psychological and nutritional support and olfactory rehabilitation.

Background: During the COVID-19 epidemic, we have witnessed numerous manifestations and complications after contracting this disease. One of these complications in patients with COVID-19 is the increased risk of invasive fungal infections due to the suppression of the immune system caused by the disease or due to the use of suppressive drugs such as corticosteroids. Case presentation: Here we report three cases of invasive fungal sinusitis after contracting COVID-19 with recurrence after primary treatment and the measures taken for these patients. Discussion: Invasive fungal sinusitis with involvement of orbit or brain is a known complication in COVID-19 patients especially in diabetics. Recurrence of manifestations of fungal infection after primary treatment and hospital discharge may be related to uncontrolled underlying disease and residual fungal infection especially in necrotic soft tissue or bone. Conclusion: Early diagnosis and management with antifungal drugs and surgical debridement and also close follow up after discharge from hospital is essential for treatment and achieving higher survival in patients with invasive fungal sinusitis.

Background: Benign paroxysmal positional vertigo (BPV) is the most common cause of the high prevalence of vertigo. Today, BPV is caused by the separation of autochthonous particles from the macular atrial. As a result, these particles float in a semicircular canal and change position by gravity. The majority of vertigo causes arise from the inner ear. Aim: This study aims to measure the vitamin D level in patients with BPPV who visited Loghman Hakim Hospital clinics and compare the results with controls. Methods: This comparative study evaluated the effect of vitamin D on reducing BPV. Demographic information of patients was collected through interviews. The physical examinations were recorded through a questionnaire. For the group with BPPV, we did the Epley maneuver and measured the vitamin D level. We compared the vitamin D levels of these patients with the matched control group. Results: In this study, 148 patients were evaluated. Sixty-three patients were male, and 85 patients were female. All case and control patients were tested for vitamin D levels. Of 93 patients with benign vertigo, 39 (41. 9%) patients had normal vitamin D levels, and 54(58. 1%) patients had below normal. In the control group, 43 (78. 2%) patients had normal vitamin D, and 12 (21. 8%) patients had less than normal. There was a statistically significant difference between the two groups. Conclusion: The present study indicated that BPV was more prevalent in people with vitamin D deficiency, and vitamin D treatment could effectively control and reduce the prevalence of this disease.

Background: With the outbreak of the new coronavirus (SARS-COV-2), one of the challenges ahead has been to control the prevalence of the disease in the world. However, because the main way the virus enters the host is through the respiratory tract, the use of a mask is more necessary than in other cases. The medical staff who are in contact with these patients in closed environments in the operating room and other places are forced to use the mask continuously to prevent infection. Aim: Considering the necessity of using a mask in the prevalence of COVID 19, especially in the medical staff and the possible effects of this use on tissue oxygen and exhaled carbon dioxide, the present study investigates the effect of using a mask on health care. the present study investigates the effect of using a mask on health care. Methods: Twenty healthy members of the medical staff (staff working at Masih Daneshvari Hospital in Tehran) entered the study voluntarily according to the inclusion criteria. Everyone wore a mask for 2 hours a day. Brain oxygen delivery percentage was measured using cerebral oximetry and petCO2 with capnogram at 0, 60 and 180 minutes. Demographic information of participants about the age, sex and underlying diseases were also recorded in a pre-prepared questionnaire. Independent t-test, paired t-test and chi-square were used to compare the clinical features of the participants. P-value less than 0. 05 was considered to show statistical significance. Results: The average of petCO2 in time 2 was significantly higher than time 1 and zero (P=0. 001). Likewise, the average petCO2 factor at time one is significantly higher than at time zero. The relationship between BMI and changes in the studied indices shows that the left cerebral oxygenation factor, at times 0-60’,and 30’,-60’,and also the right cerebral oxygenation factor at times 0’,-60’, , have a direct and significant relationship with BMI. Conclusion: Based on the results of the present study, it can be said that the use of surgical masks has significantly increased petCO2 in individuals, while the Pao2 index in some individuals has been associated with a downward trend.

Background: Noise-induced hearing loss (NIHL) is caused by chronic exposure to high-intensity sound. Although noise hazard has been extensively studied in the past decades, cochlear implants and hearing aids are only safe and clinically effective intervention in hearing-impaired person. In recent years, stem cell therapy has been studied to repair damaged inner ear tissue including hair cells and spiral ganglion neurons (SGNs). Because of small size and complex structure of the cochlea, it is difficult to transplant stem cells. It is necessary,stem cell injection procedure has a minimal adverse effect on target tissue. Cochleostomy are currently used to inject stem cells that can impair hearing. In addition, cell viability is an essential factor in the regeneration of damaged hair cells. Aim: The aim of this study was to examine the survival of bone marrow mesenchymal stem cells (BMSCs) injected through the round window of the NIHL rat model. Methods: Adult male rats were exposed to the 110 dB white noise paradigm for 6 hours in 5 days to induce deafness. Distortion-product otoacoustic emission (DPOAE) was recorded before and after noise exposure. Hoechst labeled-cells were transplanted into the rat cochlea through the round window. Hoechst-labelled MSCs were assayed in the endolymph for 24h, 72h, seven and 10 days after injection. Results: Our findings revealed that stem cell transplantation into the cochlea via round window niche is a safe surgical approach. As well, cells transplanted into the endolymph survived for a postoperative period of at least 1 week. Conclusion: BMSC can survive at least one week in adult rat cochlea after injection through the round window niche.

Background: As a new approach and complementary to traditional bibliometrics, altmetrics measures the influence of scientific research in social media tools and applications. Aim: This study aimed at comprehensively analyzing research output in otorhinolaryngology research from its beginning in 1967 to 2021. Methods: Using Scimago Journal Ranking (SJR), 107 otorhinolaryngology journals were retrieved. Of them, 84 journals with their 89044 papers as well as their altmetric scores were extracted from the Altmetric Explorer in 28 February 2022. The citation rates of the top ten papers having high altmetric scores were retrieved from Google Scholar, Scopus, Web of Science and Dimensions. Data were analyzed in excel. Results: 67, 529 otorhinolaryngology papers (75%) were mentioned 2, 901, 187 times in 17 different social media tools. The highest altmetric score of papers amounted to 3, 989. The top-ranked media were Nendeley and Twitter, respectively. The USA was the first ranked country in Twitter and Facebook and the UK was such in News Outlet and Policy. The highest mentioned journal was JAMA Otolaryngology–, Head & Neck Surgery. The top affiliation in sharing papers was Harvard University with 1621 shared papers. All of the top 10 papers in altmetric scores were multi-authored original research articles. . Conclusion: As one of the first altmetric studies in otorhinolaryngology field, this study provided helpful information for potential authors, researchers, research institutes and journals in the field in increasing the reach and influence of their researches.

Background: Bibliometrics evaluates the scientific publications in different fields from different aspects. However, the bibliometric state of global research publications on Laryngeal Mask Airway (LMA), as a main progressive medical field, is unknown. Aim: This study aimed to conduct a bibliometric analysis and scientific visualization for inspecting some main bibliometric indicators of the research publications in the field. Methods: This study is a descriptive cross-sectional applied study that used bibliometric techniques. MeSH-retrieved synonyms for LMA were searched in Scopus and the bibliometric indicators of retrieved papers in the field were measured and visualized in Excel and VOSviewer. Results: In total, 9, 783 papers were published on LMA during 1952-2021, starting from one paper in 1952 and amounted to 255 in 2021. With ups and downs in the annual publication growth, steady trend was seen in the growth coefficient of publications (R², =. 1652). The first to third ranks in publishing countries belonged to the United States with 1, 783 papers (18. 22%), the United Kingdom with 1, 632 papers (16. 68%) and Japan with 729 papers (7. 45%), respectively. Among active research institutes, Cairns Hospital from Australia ranked first with publishing 284 papers, followed by the University of Queensland again from Australia with publishing 141 papers and Royal United Hospital from England with 117 published papers, respectively. Anaesthesia ranked first highly-publishing journal with 1, 049 published papers, followed by Anesthesia and Analgesia with 487 published papers and Pediatric Anaesthesia with 448 published documents. Anaesthesia was the main cited source, too. The top three highly-frequent keywords were laryngeal mask airway (N=223), equipment (N=132) and airway management (N=116), respectively. Co-occurred keywords were in four subject clusters. Conclusion: This study is the first to give a relatively comprehensive bibliometric analysis and visualization of the global research publication and a guide for researchers and research policy-makers in LMA, as a progressive medical discipline.

Background: Repeated transcranial magnetic stimulation (rTMS) is an important non-invasive technique with several protocols to treat a wide variety of neural disorders. This method utilizes a strong power supply to discharge high currents in a single or dual flat spiral coil with specific characterizations. It makes a magnetic field that promotes neuroplasticity by applying the field distribution on the appropriate brain zone and requires adjusting time and frequency relating to intervention protocols. Aim: This study investigates components of an rTMS machine to describe development approaches to increase performance, specifically in the binary mode of recovering proportionally with brain and heart signals. Methods: The proposed method achieves an rTMS and probe-set coil prototypes whose performance is approved with some statistical modelings and experiments analysis. Results: Results show that the physical properties of the coil are proportional to the power supply effect and the magnetic field distribution in front of the probe set. Conclusion: By clarifying the mechanism of oscillator switching modes and the location of the processing unit in rTMS, this paper is directed to utilize external sensors to create a smart stimulator with touch EEG or ECG signals through the most accurate intervention.

Background: Ingestion of foreign body by children is one of the common problems that society and medical staff are always struggling with. Due to the fact that children put any nearby objects in their mouths during the phase of knowing the world around them, they are prone to swallowing a foreign object and getting it choked. It also happens during eating. The best method to diagnose and manage a foreign body aspiration is bronchoscopy, but this procedure has its own problems, such as the need for anesthesia. Aim: In this study, we decided to investigate the accuracy of CT scan with the COVID-19 protocol in detecting the location of foreign body aspiration. Methods: In this diagnostic study, all children with foreign body aspiration referred to Mofid Children Hospital from March 2018 to September 2021 were evaluated. Patients' information, including age, sex, locations of foreign body, radiographic report, bronchoscopy report, and CT scan report were checked and recorded. The diagnostic values of CT scan were compared with the diagnostic values of bronchoscopy results as a standard method. Results: 193 children were evaluated. The mean age was 26. 01 ±,21. 83 months and 65. 3% were boys. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of this method were 95. 52%, 97. 96%, 98. 46%, 94. 12%, and 96. 55%, respectively. Conclusion: CT-scan with the COVID-19 protocol is a good method to localize the location of the foreign body.