IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY
Year:2010 | Volume:21 | Issue:1 (59)|Papers Count:13

Introduction: Many people suffer from vertigo. Its origin in 85% of cases is otological while in 15% is central etiology. Benign paroxysmal positional vertigo (BPPV) is the most common cause of the true vertigo. In this research we evaluated the risk factors of acute attack of BPPV. Materials and Methods: This study was performed on 322 patients, presenting with BPPV. Diagnosis was confirmed by history and Dix-Hallpike manoeuvre. The underling risk factors documented carefully. Data analyzed by SPSS and K.square test. Results: Number of 321 patients (including 201 females and 120 males) with BPPV included in our study. Their average age was 41. They showed symptoms for 1 month to 15 years (mean 8 months). Emotional stress was positive in 34% and trauma was the only risk factor in 8.12% patients. Ear surgery and prolonged journey were respectively the main risk factors in 7.2 and 12.8% of patients. Conclusion: The confirmed risk factors of acute attack of BPPV were as trauma, major surgery and ear surgery especially stapedotomy, vestibular neuronitis and prolonged bedrestriction. Meniere was not considered as risk factor. In our study the psychological conflict was the major risk factor for BPPV. Other new risk factors which introduced for first time included; sleep disorder, fatigue, professional sport, starving and prolonged journey.

Introduction: Although there are several methods to evaluate facial nerve palsy, most of them are not objective. In case of symmetric movements of face, photoshop software is useful for objective assessment of facial nerve injuries. Materials and Methods: In this descriptive-analytic study, the facial movements of sixty normal subjects (30 females and 30 males) were photographed. Displacement of facial movements in specific landmarks was measured by Photoshop software. The collected data then were analyzed by SPSS software.Results: The mean displacement of forehead wrinkles and landmarks on cheeks in right and left sides was respectively 10.6 mm, 10.1 mm and 9.4 mm, 9.7 mm. The mean displacement of oral commissure in right and left sides during smile was 11.8 mm and 11.5 mm. The comparison showed no significant difference between both sides (P>0.05). The mean distance between landmarks (lateral canthus, oral commissure and Cheek) and axis of face were compared too. The results showed that both sides were symmetric.Conclusion: Facial movements were measurable by Photoshop software and this method was applicable to assessment of facial nerve palsy and also synkinesis.

Introduction: Chronic otitis media (COM) is regarded as one of the disabling diseases which have a great influence on the quality of life. Because of the surgical approach of cholesteatoma, timely diagnosis is very important in management of patients with COM. The purpose of this study was to assess the frequency of cholesteatoma in patients with COM, demographic factors and disease related factors.Materials and Methods: In this retrospective study, medical records of 100 patients with COM who had surgery since 2005 to 2009 in Imam Reza Hospital were selected. Patients’ age, gender, duration of COM, clinical manifestations, location of perforation of tympanic membrane and presence or absence of cholesteatoma were analyzed by SPSS statistical software and some tables and graphs were planned.Results: patients included 70 males and 30 females with an average age of 23.08±11.35. Mean of COM duration was 8.04±7.14 years. The most common manifestations of the disease were otorrhea (92%) and hearing loss (80%). The most frequent type of tympanic perforation was total perforation. Frequency of cholesteatoma was 42% and it was more common in males than females (42.9% and 40%). Presence of choleasteatoma was related to gender, age, location of tympanic perforation, presence of otorrhea and hearing loss.Conclusion: Prevalence of cholesteatoma in patients with COM in Mashhad is more than other cites of Iran and also other countries, but it is less than prevalence of non cholesteatomatos COM. It is very important to pay more attention to patients with COM who are evaluated about presence of cholesteatoma, specially those with otorrhea, hearing loss, total perforation of tympanic membrane or male gender.

Introduction: The purpose of this study was to evaluate anthropometric parameters of lip - nose complex in 11-17 years old males in Mashhad using photographic analysis.   Materials and Methods: Number of 357 Fars boys (11-17 years old), residence in Mashhad were included in this study. They were all class.I. Some frontal and lateral photographs of natural head position were taken by a digital camera. After landmark determination, anthropometric parameters including alar width, mouth width, nose height, cupid arch width, vertical height of lips, columellar width, nasolabial angle and nasal root slope angle were determined by Smile Analyzer software while Kruskal – Wallis test was used for data analyses.Results: This study revealed that alar width, nasal height and mouth width were increasing gradually within 11 to 16 years of age. But nose height to nose width proportion did not show any significant differences in different age groups (P=0.097). Nasolabial angle in different age groups had no significant statistical differences and it was between 95.83 and 100.05 (P=0.315). However for Cph-Cph, the distance was decreasing first and then increasing with no significant differences among age groups. Conclusion: Except significant differences observed in different age groups about nasolabial angle and nasal index, there were not any other significant differences for other anthropometric parameters. It could be helpful in orthodontic and surgical treatment planning.

Introduction: Otomycosis which is caused by saprophytic fungi can be treated by topical antifungal agents. Sometimes eradication of the disease is difficult in patients with risk factors. Considering controversies about the anti-microbial effect of cerumen, this research was performed in Babul, was focused on revealing the antifungal effect of cerumen of healthy people on fungi causing otomycosis.Materials and Methods: This experimental study was carried out on the 60 samples of healthy peopleُs ear canal secretion. The average ages of the subjects were between 2-85 years. The antifungal activity of cerumen solution on 4 species of fungi including; Aspergillus fumigatus, Aspergillus niger, Candida albicans (clinical isolate) and standard Candida albicans were analyzed by paper disc diffusion and micro dilution methods. Results: 10% of cerumen showed antifungal activity in paper disc diffusion; whereas in the micro dilution method all of samples had antifungal activity. The most antifungal effect observed was on Aspergillus niger (27 samples) and the least effect on the species of Candida albicans (16 samples). Conclusion: According to the obtained results, cerumen has different effects on fungal growth, thus it is necessary to study more about components of cerumen for new approaches in future.

Introduction: Chronic adenotonsillar hypertrophy is known as subclinical infection of the tonsil’s parenchyma and has various clinical presentations. The absolute cure is tonsillectomy. Since the microorganisms indwelling the central part of tonsils play an important role in chronic tonsillitis, getting to know these germs is of essential importance.Materials and Methods: This study was performed on fifty four (29 boys and 25 girls, 3-15 years old) candidates for tonsillectomy or adenotonsillectomy, referring to Ghaem Hospital through 2007-2008. The aerobes and anaerobes of the tonsils' surface and center were analyzed by smears and appropriate cultures.Results: The most common aerobe on either the surface or centre of tonsils was Streptococus. viridans, and the next common one was Staphilococus aureous. No significant difference was observed between cultured organisms in tonsils' surface and center. Among the anaerobes gram negative cocci, (Villonella) and gram positive cocci, (Peptostreptococcus) were respectively the most common.Conclusion: Using appropriate techniques, we can specify much more easily the microorganisms of tonsils' center by surface sampling.  

Introduction: Gorlin cyst is an odontogenic lesion with different clinical behavior. There are different ideas about its nature as a cyst or tumor. The purpose of this study is evaluation of the frequency as well as clinical, pathological and radiographic aspects and also the related treatment. Materials and Methods: In a retrospective study, archive files of Dental Faculty of Babul from 2003-2009 were evaluated. The records of those patients with Gorlin cyst were excluded. After extraction of all the required information, they were recorded in SPSS, version 17. Frequencies of the mentioned cyst and also patients' recorded information were analyzed by Fisher exact test.Results: From 443 patients with oral lesions; 20 cases were reported with Gorlin cyst (an average age of 28.4), 19 cases with central lesion and 16 cases with mandible lesion and 10 cases were found in male. According to the Radiographic reports; 14 cases were pericoronal radiolucency, 2 cases were periapical radiolucency and 2 cases were radiolucent radiopaque. Only one case was revealed with residual cyst. Various kinds of proliferative (1 case), non proliferative(11 cases), correlate with tumor (5 cases) and ameloblastomatous (3 cases) were observed pathologically. Treatment approaches differed from Enucleation (n=13) to Enucleation and currettage (n=5) to Marginal resection (n=2). Conclusion: Gorlin cyst is less common among all the oral lesions. It was found that Gorlin cyst was more common in mandible in second half of the life and its frequency between male and female was the same. Central lesions were more common than peripheral. The most common radiographic, pathological and treatment aspects of Gorlin cyst sequentially consisted of pericoronal radiolucency, non proliferative and enucleation.

Introduction: Adenoid cystic carcinoma (ACC) is the second most common salivary glands tumor and the most common malignant tumor of minor salivary glands and also submandibular glands; however ACC of the larynx and trachea is rare. These tumors generally present in subglottic region as smooth submucosal solid mass without ulceration. Their primary symptoms are often as respiratory problems.Materials and Methods: This study was done on a woman, 54 years, with subglottic ACC that presented with exertional dyspnea, stridor, cough and hoarseness. After confirmation of diagnosis with biopsy, the patient underwent a total laryngectomy and then postoperative radiotherapy.Conclusion: During one year follow up, the patient did not show any evidence of local recurrence or distant metastasis. Surgery with free margins in combination with postoperative radiotherapy was recommended to treat laryngeal ACC in order to obtain better survival.