IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY
Year:2003 | Volume:14 | Issue:3-4 (30)|Papers Count:12

Functional endoscopic sinus surgery is a relatively new technique for the management of sinusitis refractory to noninvasive therapy. The degree of success in this surgery depends on the use of newly developed instruments and experience of the surgeon.This is a report of 114 cases that began three years ago, patients clinical and pathological data, preoperative complaints, computed tomographic endoscopic and pathologic findings, types of surgery complications and outcome of patients are included. FESS was performed whenever symptoms persisted despite aggressive medical therapy and radiologic evidence of significant sinus abnormality; and pathologic findings and the degree of relationship between pathologic and computed tomographic findings were finally reviewed. Functional endoscopic sinus surgery was popularized by Messerklinger and Stumberger who have written a number of papers on the underlying pathophysiological aspects and techniques of FESS (2, 8, 16). Patients who fail in medical management are treated with FESS. Pathologic findings in 114 of our patients undergoing endoscopic sinus surgery who have been followed more than three years are reported here. Included in this report are 11 cases of malignancies, two of whom had not been diagnosed otherwise.

The over production of collagen is the basic mechanism for keloid formation. Recent studies have shown the inhibitory effect of interferons on deual fibroblast growth and collagen production. Various therapeutic modalities have been used with limited success for the treatment of keloid. In this study, recombinant human interferon a2b was examined for its ability to treak keloid and prevent recurrence. Patients were studied in two groups. Six cases were treated with keloid excision and adjunctive intradermal IFN a2b injections (0.5 mlu/ linear cm every 10 days for two months). In the second group, the same dose of IFN a2b was intralesionally injected. After 10 months, 50% of keloids in the first group recurred, but there was no recurrence in the auricular area. Recurrence was significantly lower in keloids with lower length. (P = 0.049) In the second group, there was 40% reduction in volume and 34% in height of lesions after 4 months (Pvolume = 0.02, Pheight= 0.03). No serious complication was seen. There was no significant relation between treatment response and other factors including, location (H & N vs. others), number of injections, keloid age and previous treatment. Although IFN a2b significantly reduced the size of keloids, lesions were not completely cured. So more extensive studies seem to be required in this regard.

This study aims to assess the diagnostic value of 2% toluidine blue in distinguishing dysplastic precancerous lesions and cancers of oral cavity. Thirty lesions of 26 patients were stained clinically, of which 20 absorbed the characteristic blue color. Results of histopathologic evaluation were assumed the benchmark for comparison with staining records. Only five lesions displayed absence of dysplasia in the histologic view. A total sensitivity of 76% and specificity of 80% were calculated. Due to low negative predictive value (40%) and high rate of false negative outcome (20%), the negative reports of staining are concluded unreliable.

Background: The aim of our study was to determine the expression of Argyrophilic nucleolar organizer region protein (AgNOR) and mean of AgNOR dots as a marker in differentiation between benign and malignant lesion of salivary glands. Methods: AgNORs were studied by light microscope in 54 cases of Normal (N=23). Benign adenoma (n=15), malignant salivary gland tumor (n=16). The investigated parameter included the number of AgNOR dots in nucleoli of one- hundred cells. Results: A stepwise increase in AgNOR from normal salivary gland tissue to benign adenoma and malignant tumor was found. Mean AgNOR number per cell was 1.6, 2.04, 7.14, respectively. Conclusion: The AgNOR dots proved to be the valuable diagnostic criterion for the differentiation between benign and malignant salivary gland tumors.

Due to regional, metastatic and systemic diseases neck masses area relatively common complaint of in and out patients of otolaryngology clinics. Step by step systematic evaluation through history, physical examination, laboratory, imaging FNA, and occasionally endoscopy is the best approach. Sometimes excisional biopsy for definitive diagnosis is necessary. In this survey after omitxing 58 acute infective cases, 203 patients (110 males and 93 females) with a 42 year mean age who had clinically neck mass or masses from the point of age, sex, education, settlement and duration, location, consistency, adhesion, relation to other organs and pathology of lesion were assessed. Some underwent FNA and panendoscopy while ofhes had excisional biopsy for definitive diagnosis. Neoplastic lesions in men and woman were 55% and 36% respectively. The most commonly involved sits and pathologies were anterior middle neck (22%), jugulodigastric lymphodenopathy (21%), SCC (27%), and tuberculosis (11.5%) respectively. Age increases occurrence neoplasm significantly. There is no significant relationship between primary sources and lymphatic chains, perhaps because of inadequate cases for analysis, so later study on more cases is recommended.

This article discusses the psychology of cosmetic rhinoplasty in randomly 30 patients who were admitted for rhinoplasty in several Hospitals of the city of Mashhad GHQ (General health questioner) test before Surgery (pretest) and after surgery (posttest) were done. Demographic information (age, sex, education, job, height, weight) were recorded results from this research showed difference between sex was not observed. Eighty percent of the patients were (17.24). Mean age of the patients was 22.4 yr. Before surgery, in the GHQ test, 5 cases were positive (the number of GHQ test 24). After surgery 9 cases were positive in the sub item of test. Somatic symptoms and anxiety increased p=<0.05. Depression before and after surgery did not change. Further more research, are needed, but GHQ test can be used as screening test in the cosmetic surgery patient.

In this study the effect of NIDDM On hearing of patients is investigated. 130 diabetic patients & 100 healthy persons as control group were selected. Diabetic patients were divided in two categories the NIDDM patients and diabetic foot patients. Both groups were exam and tested by audiologisty. Audiologic tests included: PTA, Impedance audiometry. SRT and SDS. PTA was measured in 250, 500, 1000, 2000, 4000 and 8000 HZ. Hearing threshholds were classified in low frequencies (250, 500, 1000, 2000) and high frequencies (4000 and 8000). Patients and control group were compared, with each other. Hearing threshold in two groups was measured and by T-test compared with each other (P<0.05 is significant). In low frequencies 3.5 dB and in high frequencies 11.5 db discrepancies in threshed were detected that is significant mathematically. In patients the mean threshed at all frequencies was 186±9.4 and in control group 126±3.7. There was no difference in hearing loss between diabetic patients and diabetic foot patients. 4 increasing the duration of the disease there is increasing in hearing loss also. Quantitative mean of SDS would be 99% that showed central auditory system is intact. There was no significant change in hearing of right and left ear. In different age groups there was no significant change in hearing.

Objective: Surgical treatment of facial paralysis: Result assessment of 15 cases referring to Amir-Aalam Hospital. Study design: This prospective study was performed on 16 patients referring to Amir-Aalam Hospital due to facial paralysis during 1377-1380.Etiology of facial paralysis: Was trauma in 12 cases, chronic otitis media in 2 cases, and idiopathic in 2 cases.Patients were evaluated based on the House- Brackman grading system. All of them were suffering from complete facial paralysis (grade VI).Surgery was performed of those who demonstrated either more than 90% fibre degeneration in ENOG within 3 weeks of injury or passing more than 4-6 months since the start of paralysis in the absence of regeneration.Conclusion: Overall 12 decompressions only, 1 decompression and End– to– End anastomosis, 3 decompressions and facial nerve grafting were accomplished.All of them were followed for at least 12 months and at most 36 months.Results were good to satisfactory (I-II/VI) in 12 cases, acceptable (III-IV/VI) in 2 cases and no recovery in 2 cases.

Congenital conductive hearing loss is one of the disorders which can be improved by surgical management with regard to its severity and type of anomaly.Because of adverse effects of hearing loss especially in bilateral cases and other associated malformation, evaluation and detection of these patients within early years of life is essential.In this study 46 ears with congenital anomalies of the external and middle ear underwent surgery and information of these patients was analyzed. Based on this information, in 80% of the cases, reconstruction of the anomalic external and Middle ear was possible. Considering the high possibility of surgical reconstruction and low complication rate such as facial nerve injury, surgical intervention for most of congenital conductive hearing loss is recommended after complete imaging evaluation.

Background: Post- tonsillectomy pain is severe, and for this reason traditional methods of analgesia are frequently used with ineffective results. Therefore, it is necessary to evaluate newer analgesics with different mechanisms for post- tonsillectomy pain. Suralfate covers the post- tonsillectomy ulcerated bed and can provide analgesic effect.Methods: In this double blind clinical trial, we evaluated two groups of 35 children who were 8 to 12 years old. All patients used syrops of Amoxicillin Q 8hr and Acetaminophen PRN. Each patient randomly received Sucralfate or vit B1 Solution. They gargled the solution and then swallowed. Throat pain and ear pain intensity and amount of acetaminophen consumption were recorded by patients. All patients were examined for mucosal covering of tonsilar bed and Sucralfate complications of 4th day.Results: Means of throat and ear pain of the first 3 days after Surgery in the Sucralfate group were significantly lower than the placebo. Means of Acetaminophen consumption were significantly lower in the sucralfate than placebo at all times (pv<0.001). On the 4th day after surgery, 13 patients from the sucralfate group and 11 patients from the placebo had mucosal covering of more than 50% on tonsilar bed. This was not significant (pv = 0.06).Discussion: In this study sucralfate could reduce throat and ear pain after tonsillectomy and analgesic consumption in children had no significantly side effect.