IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY
Year:2002 | Volume:13 | Issue:3-4 (28)|Papers Count:11

Proboscis lateralis is a rare congenital deformity of the nose in which one of the nasal foramen is not formed, and this is a proboscis like process from skin and soft tissue in the lateral part of the nasal root. There is a lack of clinical reports from 1980 up to now, and this is due to the fact that it is a very rare malformation. There is one available report by Biber in 1949 (1) in which the clinical problem is reported in detail. We are reporting a new case with the complete clinical picture. One surgical intervention is also included.    

Nonmelanotic skin cancer (NMSC), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common carcinomas, although SCC is less common than Bcc. I have reviewed cancer cases between the years 1993 in Omid and Ghaem Hospitals. There were 439 NMSC among 5490 patients during these five years of which 302 were BCC and 137 were SCC. The Common sites of NMSC were nose, cheek, eyelid and ear.

Background Objective: Hemodialysis is used as a means to eliminate the waste from the body fluids and a substitute for renal function. Although it would greatly help patients with renal failure, its prolonged use would cause several side effects. Hearing loss, common finding in patients with chronic renal failure, is suspected to be a side effect of hemodialysis. In the present study we evaluated the effect of regular hemodialysis on the hearing status of patients. Methods: Pure Tone Audiometry was performed in 100 patients undergoing hemodialysis for several years. Patients fall into the following 3 groups regarding the time they have been under this treatment: 1. Duration less than 12 months 2. Durations between 13 and 24 months 3. Durations greater than 24 months Previous history of Chronic Otitis, Trauma of the ear and Alport disease were used as the exclusion criteria. Following parameters of blood biochemistry analysis were also evaluated in patients: Calcium, Phosphours Urea, Creatinin, Para thormone, Hemoglobulin and Hematocrit. Results: One hundred patients with the mean age of 45.2±17 were enrolled in our study. Sixty percent of patients were male and 40% female. The average time they were under hemodialysis was 23.5±21.2. In all cases hearing loss was sensoryneural. Duration of dialysis had no significant relation with the status of hearing (P=0.64). Severity of hearing loss increased with the increment of age (P=0.000). Sex did not influence the status of hearing (P>0.05). None of the blood analysis parameters had a significant relation with the status of hearing. Discussion: In general it appears that regular hemodialysis in durations that approximate that of our study dose not affect the status of hearing. Besides the known relation of age and hearing status that was demonstrated in this study, the status of hearing had no significant relations with other suspected parameters. Increased mean age of patients undergoing hemodialysis and premature development of presbycusia in these patients can be an explanation for the demonstrated relation of age and hearing status.

Conventionally, the nature of most tumors is diagnosed histologically by light microscopy. However, this may not be sufficient for improving clinicians’ knowledge about the biologic process and the outcome of the present disease. Here we review a rare case of subglottic carcinoma in which, immunohistochemistry method helped significantly in approaching the correct tissue diagnosis. We present a 55 year-old women whit a T4 subglottic carcinoma in whom the primary diagnosis by light microscopy was Malignant Small Round Cell Tumor, .This diagnosis was later changed by immunohistchemisrty into an Undifferentiated Small Cell Carcinoma of the Larynx.

To investigate the following factors on otitis media with effusion, Eustachian tube dysfunction, sinusitis, hypertrophied tonsils and/ adenoid and mouth breathing a prospective analysis on 134 patients in two groups of children (67 cases with otitis media as patient group and 67 cases with out otitis media as control group) was done in the department of otolaryngology, Loghman Hospital between 1373-1375 for ineffectiveness of interaction factors, two groups matched in age, sex, economic, social position parents education, time of presentation and urban rural. Incidence of otitis media with effusion was equal in both sexes and 4-6 years old group were more than in other ages. Season prevalences were in winter and spring. Otitis media with effusion were more common in cities and crowded areas. Our study showed no difference between breast feeding and bottle feeding, although it is necessary to have more study. Eustachian tube dysfunction was seen in 95% of patient groups. The presentation of sinusitis, hypertrophied tonsi is and adenoids, and mouth breathing was not significantly different in the two groups.

This is a descriptive- analytic study which reviews the causes of Sensorineural Hearing Loss among hearing impaired children who were admitted to the Deaf Welfare Center of Tehran. The community which was studied consisted of 450 children. Of those children 320 cases (70.7%) had SNHL. The remaining 130 cases with conductive hearing loss (29.3%) were omitted. Most of the cases admitted were from 3 to 6 years old. At the point of diagnosis, according to the result of this study, 28.8% of the described cases had congenital genetic hearing loss, 20.9% acquired sensorineural hearing loss, 41.9% uncertain or undetectable among several factors, and 8.4% were of unknown origin. In the analysis of acquired causes, the most important finding was low birth weight, birth trauma and kernicterus which are the common causes of acquired hearing disorders in children. As mentioned in this paper, neonate mortality decreased but hearing complications increased. These data are comparative to Michael Strepple’s study in Germany 1998. Hearing loss spectrum was from mild to profound and included 5% mild, 14.4% moderate, 21.7% severe, 26.2% moderate to severe and 33.1% profound hearing loss. As it was explained, most of these children had profound hearing loss; and more than 90% of them had the same intensity of HL in both ears. From the point of rehabilitation, the most important finding in this study was a 1.8 year delay in diagnosis and a 2.6 year delay in beginning the aural rehabilitation. So, the golden time of aural rehabilitation had mostly been missed.  

The goal of this study was evaluation of the relation between nasal fungal infection and nasal polyp. In this study 28 cases, 24 males (86%) and 4 females (14%), without any immunological disorder, diabetes mellius or history of radiation or chemotherapy, who were candidates for nasal polypectomy, were selected as the patient group. 28 cases, without any immunological disorders, diabetes mellitus, or history of radio or chemotherapy, we selected as the control group. Nasal polyps were studied for fungal granuloma, hyphae or charcot-liden crystals. Polyp and nasal secrations of both groups were cultured in methenomine silver for fungus. There was history of asthma in 3 (10.7%), sensitivity to aspirin and asthma in 1 (3.5%), history of allergy in 17(60.7%), and previous surgery for polyps in 13(46.4%) cases. Nasal obstruction was the first complaint in 20 persons (71.4%). Bilateral nasal polyp was seen in 27(96.4%) cases, Sinusitis of bilateral maxillary and ethmoid was seen in 20(71.4%). Involvement of other sinuses was as follows: sphenoid sinus in 13(46.4%), frontal sinus in 11(39.2%), and pansinusitis in 8(28.5%) cases. No thick mucinoid secretion was seen in the nasal cavity. Histopathologic results for all patients were inflammatory polyps with no charcot-liden crystal defects. Culture was negative for fungus in both groups.

This study introduces otosclerosis which is a disease of the otic capsule. Otosclerosis is an important auditory and vestibular disease that cab be treated effectively. According to the incidence of disease, lack of complete data in Iran, capability of prevention and treatment of hearing loss disabilities in society, we reviewed this disease in Isfahan. Of the 10,400 patients who were examined for our study, 48 patients had otosclerosis. The incidence of the disease is 5 in 1,000. From 48 cases of otosclerosis in this study, 26 cases had surgery (stapedectomy and insertion of Teflon piston). The results of surgery were excellent; all cases had improvement in hearing level and decreased air bong gap. In four patients who had active phase of disease, Na-F was used until the disease was stabilized.

Microscopic and macroscopic surgery is practicable with laser in ENT and larynx. In this type of surgery, hemostasis practiced satisfactorily. The rate of complications in this type of surgery is minimal. The purpose of this study is to report 154 patients who had laser surgery in the Ghaem and Musabne Jafar Medical Centers. Patients with oral, throat, nose and larynx lesions are operated by laser, 102 tonsilectomy patients were also operated with laser. The complication rate of this experience is less than 2%, and the only complicaton that was seen was post- operation hemorrhage. Six patients with subglottic and tracheal stenosis by fibrotic ring and granulated tissue treated by laser were associated with relapse. Patients who were treated by laser therapy tow or there times did not have good prognosis. The laser is a precise but potentially dangerous surgical instrument that must be used with caution. Although distinct advantages are associated with the use of laser surgery in the management of certain benign and malignant diseases of the upper aerodigestive tract. These advantages must be weighed against the risks of complications.

Primary mucosal melanoma of the tongue is a very aggressive but rare neoplasm. As far as I know, only 28 cases have been reported in the literature. More common in males mostly between the ages of 50 and 70, it is clinically manifested as a brown to black macula with irregular margin, or brown to red polypoid tumor. Cytomorphologically, mucosal melanoma is classified as melanoma with epitheloid or spindle- shaped cells with trabecular, alveolar, solid features of a combination of these types. The diagnostic gold standard of melanoma is the immunohistochemical method. The treatment of choice is radical; excision of the tumor and surrounding tissues, but the outcome is unfortunately very poor and disappointing. In this article, a 75-year-old female with this diagnosis is reported. The clinical course was complicated by pulmonary metastasis, and finally, after seven fractions of radiotherapy (total dose 2100 Rads), she passed away with the clinical setting of severe respiratory infection.