IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY
Year:2006 | Volume:18 | Issue:3 (45)|Papers Count:15

Introduction: The main object of this study was to find out the correlation between types of malocclusion and temporomandibular joint (TMJ) disorders among students.Materials and Methods: This study was descriptive and cross-sectional. In this study 425 persons were examined. From this number, 308 persons were male, and 117 were female. All samples were students of Mashhad University of Medical and Dental Sciences. The range in age was 19 to 32 years with a mean of 26.1 years. Samples were selected randomly.Results: The correlation between malocclusion and TMJ discomfort at a level of α=0.05 was not significant. The highest level of correlation existed between TMDs and Cl II malocclusion. The rate of TMJ discomfort in various types of malocclusion was respectively as follow: Cl II>Cl I>Cl III. The correlation between TMJ discomfort and head, neck and back pain was meaningful (P=0.0298). The rate of women with TMJ discomfort to men was 1.6: 1. Most patients with TMJ discomfort complained of joint noises and a small number of them remarked symptoms such as pain, jaw opening limitation, and other symptoms of the disorder. Joint noises were mainly in the form of clicking. TMJ discomfort accompanied by gastric disorder (generally speaking) was meaningful (P=0.0214).Conclusion: From this study it was concluded that there was no significant correlation between malocclusion and TMJ discomfort at a level of α=0.05 among students. The highest level of correlation, which still was not statistically significant, existed between TMDs and Cl.II malocclusion.The correlation between TMJ discomfort and head, neck and back pain was significant. It is suggested that specific studies be done to clear out the exact relation between gastric disorder and TMJ discomfort.

Introduction: The object of this study was to compare EBV antibody titers between various nonnasopharyngeal head and neck SCC and healthy control persons.Materials and Methods: During 2 years period ELISA was used to investigate titer of different classes of antibody against VCA, EA, and EBNA component of EBV in patient and control group.Results: of 41 patients enrolled in the study 21 were diagnosed by pathological study with pharyngeal and 20 with laryngeal carcinoma. All of different classes of EBV antibody except for EBNA (IgG) in patient group were significantly higher than those in control group. Statistical analysis did not show a significant difference in antibody titers between laryngeal and pharyngeal location of disease as well as between tobacco user and non user groups.Conclusion: Based on the present study there is an association between high EBV antibody titers and non nasopharyngeal head and neck squamous cell carcinoma. Further experiments on tissue samples could investigate the role of EBV in tumor genesis of laryngopharyngeal carcinoma.

Introduction: Foreign body aspiration (FBA) is a common cause of respiratory distress in children. Delay in diagnosis and treatment can cause serious complication especially chronic pneumonia. The aim of this study was evaluation of plain chest X- Ray (CXR) as the first and available imaging modality in FBA of children.Materials and Methods: A retrospective analysis was conducted on the records of pediatric patients less than 18 years of age with the discharge diagnosis of FBA from 1999 to 2003 at the Imam Reza Hospital (a large tertiary center in Khorasan province).Results: From 140 patients with FBA 87 (62%) were male. The mean age was 48 month. The most common clinical findings were: history of chocking (77%), decreased breath sounds (42%), wheezing (38%), cough (20%), respiratory distress (15.5%) and fever. CXR was normal in 47% of patients with a sensitivity about 64%. Air trapping (Emphysema) was most common radiological findings (24.5%). Other radiological finding was consolidations (10.5%), atelectasis (6.5%) and opaque foreign bodies (6.5%). In all cases except four cases, aspirated foreign bodies were food materials and watermelone seeds were the commonest one (40%). Bronchoscopic removal of foreign body was done successfully in 133 patients (95%).Conclusion: Although FBA in children diagnosed by history, physical examination and radiographic findings, but this finding may be misleading. Negative CXR should not preclude diagnosis of FBA in children with a strong history of FBA, and early bronchoscopic examination will be safe and life saving.

Introduction: Giant cell tumor of bone or osteoclastoma is a relatively rare primary neoplasm of temporal bone. It usually involves the epiphyseal region of long bones. Primary involvement of bones of the skull appears to be uncommon.Case report: we report a case of giant cell tumor of temporal bone arising in a 33 years old man. The presenting symptom is only mild conductive hearing loss. A computed tomography (CT) scan showed a large well circumscribed mass within the right temporal bone, the posterior cranial fossa and the infratemporal fossa. Biopsy and subsequent resection showed a giant cell tumor of bone.Conclusion: Temporal bone tumor may be presented with symptoms such as mild hearing loss or aural fullness. So we always must be attention rare reasons of common symptoms.

Introduction: The authors reported a case of mucoepidermoid carcinoma of esophagus, which is rare primary carcinoma of the esophagus, characterized by a diffuse mixture of squamous and mucin-secreting glandular carcinoma cells.Case reports: The patient was a 54-year-old man with a five-month history of dysphagia and endoscopic biopsy diagnosis of scc. The patient underwent a curative esophagectomy with a regional lymph node dissection. Histopathologic and histochemical study of specimen showed mucoepidermoid carcinoma of the esophagus.

Introduction: Tracheobronchopathia Osteochondroplastica (TO) or Tracheopathia Osteoplastica is a rare disorder of large airways with unknown etiology. The diagnosis is usually made on bronchoscopy and confirmed on histology. Generally it is benign and asymptomatic but it may lead to serious complication like airway obstruction requiring surgical treatment.Case reports: We describe two cases of TO with characteristic bronchoscopic and histological findings. The first one had squamous cell carcinoma of the lung, and the second one had chronic rheumatoid arthritis associated with interstitial fibrosis.

Introduction: Allergic rhinitis is a common disease, and application of an appropriate remedy to melt away the disease signs is essential. Cromolyn Sodium nasal sprays and Beclomethasone are most commonly among the medications prescribed to treat allergic rhinitis. Regarding to differences in their prices and side effects, the present study tries to compare them in use.Materials and Methods: This is a clinical trial conducted in a private ENT clinic in Isfahan. The sample included 52 patients over age 10 referred to this clinic. The samples, diagnosed with allergic rhinitis entered the study and five clinical signs rhinorrhea, nose itching, eyes itching , sneeze and nose congestion were scored based on existence and severity. Then, patients were randomly treated by Beclomethasone or Cromolyn Sodium spray with every other on sequence. Patients were investigated again after one month and the signs regarding existence and severity were evaluated and recorded.Conclusion: Both medications were effective in controlling all the signs of the patients. Regarding similar effect of Beclomethasone spray and Cromolyn Sodium on controlling various signs in allergic rhinitis in all patients, application of Cromolyn with lower complications and price is recommended.

Introduction: Adenotonsillar hypertrophy is the most common cause of upper airway obstruction and sleep apnea syndrome in children, may be an important factor for failure to thrive by decreasing the secretion of serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1).Materials and Methods: This is an experimental interventional study. Fasting serum GH, IGF-1 levels, growth and body mass indexes were measured in 30 children with 3-13 years old at the operation's day and 110 days post-operation.Results: There was no statistical correlation between serum IGF-1 levels before and after adenotonsillectomy in total group patients, but there was a significant statistical correlation between IGF-1 levels with grade III and IV of tonsillar hypertrophy.Conclusion: Grade III and IV of adenotonsillar hypertrophy is an important factor for serum GH and IGF-1 decreasing and failure to thrive (FTT).

Introduction: streptococcus pneumonia is the most common cause of community acquired bacterial respiratory tract infection. It is also a major cause of acute otitis media, bacteremia and meningitis. There are few data on antibiotic- resistant streptococcus pneumonia in Iran. The aim of our study was to determine prevalence of nasopharyngeal carrier of streptococcus pneumonia and their antibiotic resistance pattern in children.Materials and Methods: This cross sectional study was performed from Jan 2005 to Feb2006 .1161 healthy children aged less than 6 years attending day –care centers in Mashhad city were studied. Nasopharyngeal samples were collected by sterile swabs and then inoculated on selective agar. After 24h incubation microbiological tests were performed and antimicrobial sensitivity tests were done.Results: of 1161 children 572 (49.3%) were boys and 589 (50.7%) were girls and the mean age was 4.2 years. Streptococcus pneumonia was recovered from 102 (8.78%). The rate of resistance to at least one antibiotic was 100%, 80.4%, 48.3%, 43.13%, 40.79%, 18.62 %, 22.5 5% to Co-trimoxazol, Penicillin, Erythromycin, Cefixime, Amoxicillin clavunic acid, Amoxicillin respectively.Conclusion: Although the rate of the carrier nasopharyngeal pneumococci in the Mashhad city was low (8.7%). The resistant rate to the antibiotics was high. In order to avoid of excessive antibiotic use and subsequently high rate of resistance, enough education not only to the physicians but also general population is necessary.

Introduction: Chronic sinusitis afflicts a significant percentage of the population and causes long-term morbidity. Common use of broad-spectrum antibiotics may alter pattern and frequency of bacterial pathogens. Regarding the fact that postnasal discharge (PND) is a common symptom and sign in patients, in this study we evaluated not only the bacteriology of sinuses but also we assessed the relationship of sinus culture results and PND culture results.Materials and Methods: It is done as a prospective study in 50 patients (21 female and 29 males). In spite of long-term broad-spectrum use of antibiotics at least for 3months, they had persistent chronic sinusitis. In next step we suggested them endoscopic surgery. Endoscopic visualized swab samples from afflicted meatus and nasopharynx were obtained and cultured in aerobic and anaerobic condition and results were compared with each other.Results: Coagulase negative staphylococcus (36%) staphylococcus aureus (20%) and Entrobacter auroginosa (36%) were the commonest bacteria cultured in sinuses. Culture was positive in 96% and negative in 4%. Concerning sinus and nasopharynx, statistical significant correlation was found in all three bacteria mentioned above in culture results.Conclusion: In comparison with other studies, it showed similar results even in long-term antibiotic treated patients, and it had less effect on bacteriologic composition. On the other hand, nasopharynx culture was a reliable marker for sinus bacteriology.

Introduction: Cleft lip and palate is one of the most common congenital abnormalities in the head and neck area. Disturbance in primary sutures fusion can cause this problem in different parts of head and neck. So our goal to fulfill this research is to find some special facial anthropometric indices in parents that may have correlation with cleft lip and palate in children in order to separate families with genetic aptitude for cleft lip and palate. Materials and Methods: In this case – control study 57 couples of healthy parents with a child with unilateral or bilateral cleft lip and palate were chosen in the epithet of case group and 57 couples of healthy parents with at least two healthy children, without a child with cleft were introduced as control group. 16 craniofacial anthropometric indices were measured by a digital caliper with 0.01 mm accuracy and a soft measuring tape and the findings were compared in two groups by using t- test and mann-withney test.Results: This research indicates that head width, minimal frontal width, head length and face width in fathers with a child with cleft are significantly less than the fathers in control group and face height, ear width and maxillary arch length are significantly more than fathers in control group. It also illustrates that minimal frontal width and facial width in mothers have a child with cleft are significantly less than the mothers in control group and face height, ear width, inner canthal width, outer canthal width, maxillary and mandibular arch length and head circumference are significantly more than the mothers in control group.Conclusion: We can conclude with attention to this research that craniofacial complex is under the heavy control of genetic factors thus the future investigations on the controlling genes concerning this index seem to be necessary.

Case report: A 60-year-old woman presented to the Ear, Nose, Throat out patient clinic of Imam hospital, Hamedan, with history of slowly progressive dysphagia and snoring. She did not know anything about beginning of her history. Clinical examination revealed a soft mass: measuring approximately 6×6 cm. in the right side of the neck, just under sternocleidomastoid muscle. Inspection of the oropharynx demonstrated a submucosal bulging of the posterior pharyngeal wall which on palpation was homogeneous and doughy, and the overlying mucosa was normal. CT study with contrast revealed a huge radiolucent mass extending from nasopharynx to the level of the hyoid bone and which displaced the larynx and trachea anterolaterally and carotid sheet posterolaterally. The mass was resected en bloc by a transcervical approach, and all neurovascular in that region were preserved. Histological evaluation revealed a lipoma measuring 10×8×4cm.