IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY
Year:2008 | Volume:20 | Issue:3 (53)|Papers Count:10

Introduction: Atrophic rhinitis is a chronic nasal disease of unknown etiology, characterized by nasal mucosal atrophy, enlargement of nasal cavity, formation of thick foul smelling, greenish nasal crusts, hyposmia or anosmia. Materials and Methods: This clinical trial conducted between 1996-2005. 30 patients with primary atrophic rhinitis were included in the study. The diagnosis was based on the typical signs of nasal obstruction, enlargement of nasal cavity and greenish nasal crusts in the clinical examination. Patients were treated surgically by a new and simple technique of partial closure of the nasal cavity with the use of intranasal semicircular flap. Degree of patient satisfaction and clinical findings before and after the operation were analyzed statistically.Results: Excellent results were obtained in all patients with complete resolution or improvement of symptoms such as foul nasal crusts smelling, epistaxis, headache, hoarsness and olfaction except for the symptom of nasal obstruction.Conclusion: This simple surgical technique can be performed under local anesthesia with low casts and without any complications such as nasal deformity and flap failure, in contrast to other surgical techniques.

Introduction: Most of the upper airway obstructions are caused by adenotonsillar hypertrophy. Prevalence of nocturnal enuresis in children accompanied with upper airway obstruction is reported in 8-47% of cases. Considering this fact that adenotonsillar hypertrophy is curable by adenotonsilletomy, in present study the effect of this operation in treatment of children with adenotonsillar hypertrophy has been investigatedby comparing the rate of nocturnal enuresis pre and post operation.Materials and Methods: During a period of 18 months, all children referred to otorhinolaryngology department of Ghaem hospital suffering from nocturnal enuresis and adenotonsillar hypertrophy have been surveyed. The patients were evaluated for improvement in nocturnal enuresis after adenotosillectomy for a period of three months.Results: Theaverage age of patients was 6.8 years. 63.8% of children had primary nocturnal enuresis and 36.2% secondary nocturnal enuresis. One month after adenotonsillectomy in 88% of children nocturnal enuresis was completely cured. Using Friedman test we revealed that there was no significant difference in second and third month in comparison with first month. Complete improvement was observed in patients with secondary nocturnal enuresis. Between severity of adenotonsillar hypertrophy and improvement in nocturnal enuresis only in patients with adenoid hypertrophy the result was significant (P<0.0001). Conclusion: All children with secondary nocturnal enuresis who suffered from adenotonsillar hypertrophy were well treated by adenotosillectomy and this improvement was mostly noticed after one month post operation. Adenotonsillar hypertrophy must be considered in differential diagnosis of children suffering from nocturnal enuresis.

Introduction: Various methods for closure of oroantral communication (OAC) and oronasal communication (ONC) have been reported. These are different based on the skill of surgeon, type of communication, size and location of defect and other factors. The purpose of this study was to evaluate the etiologic factors, location, type of treatment and surgical results in patients with oronasal and oroantral communications. Materials and Methods: In this descriptive study, between 2005-2007, 79 patients with OAC or ONC were evaluated for aforementioned factors. The data were statistically analyzed by Chi-square and Odd’s ratio tests. Results: Seventy nine patients including 9 patients with ONC and 70 patients with OAC were studied. The main etiologic factor for both OAC and ONC was tooth extraction. The surgical technique most frequently used for treatment of both OAC and ONC was suturing. Surgical failure occurred in 4 cases with OAC and 3 cases with ONC after first surgery. Conclusion: According to the results of this study, tooth extraction was the most etiologic factor for OAC and ONC. Suturing for small communications and use of a buccal fat pad flap for larger defects, seem to be the best choices for treatment.

Introduction: Endoscopic surgery of pituitary adenoma is a rapidly developing surgical procedure in the field of neurosurgery, with known limitations and advantages. The aim of this study was to evaluate the results of this technique for treatment of a group of patients with pituitary adenoma.Materials and Methods: In the present study, 26 patients with the diagnosis of pituitary adenoma, who were considered for endoscopic operation between 2002-2005 in Sina and Amir Alam hospitals, were included. The following data were registered: age, sex, symptoms of disease, findings of neurological exam, adenoma type (functional versus non-functional), treatment outcome and complications of the procedure and duration of hospital stay.Results: Twenty six patients (14 male and 11 female) included in the study. Most of them were in the 3-6 decades of life. They included 11 non-functional adenoma, 9 GH-producing adenomas, 3 ACTH secreting adenomas and 3 cases with prolactinomas. Seven patients had complications of the operation (reversible in 6 patients and fatal in 1) and 6 of them had recurrence of the tumor during the 2-year follow up.Conclusion: Endoscopic surgery is an invaluable method for treatment of pituitary adenoma, and factors such as decreased complications and duration of hospital stay further adds to its popularity.

Introduction: Cochlear implant, which used in patients with profound hearing loss, may followed by some major or minor complications. These complications depend on age of patient, kind of device, kind of incision, surgical technique and surgeon’s skill. Major complications mostly need surgical intervention for treatment and, may persist for long time. Minor complications need medical treatment and don’t need surgical intervention.Materials and Methods: In this descriptive study between 2004-2007, 100 patients subjected to cochlear implantation were evaluated for post operative complications. Results: Overall complication rate was 14%. We had 4 major complications, including 2 device failure, one misplaced electrode and one cases with major hematoma .These complications managed successfully by surgical intervention or reimplantation. Facial nerve damage or wound breakdown were not seen in these patients. Minor complications including small hematoma, edema, wound infection, dizziness were seen in 10 cases that managed medically.Conclusion: In the recent years complications of cochlear implantation are reduced with increasing surgeon’s skill, new surgical methods and development in device technology.

Introduction: Congenital muscular torticollis is the most common type of congenital painless torticollis. The aim of this study was to determine the frequency of age, sex, signs and symptoms, method of treatment and treatment outcome in this disease.Materials and Methods: In this descriptive study between 1996-2005, 15 patients with congenital muscular torticollis who were admitted to otorhinolaryngology department in Ahwaz, Imam Khomeini hospital, were investigated.Result: Of 15 patients, 60% were males and 40% were females. The mean age of patients was 18.1 years. The most common associated deformity was hip dysplasia. 93.4% had good result after surgery.Conclusion: Muscular torticollis is a congenital disorder causing deformity in the head and neck area. Early treatment have a better final result with fewer complications.

Introduction: Post-traumatic pseudoaneurysm of internal carotid arteries is rare entity. The patients may present with massive epistaxis due to rupture of the aneurysm into the sphenoid sinus. The clinical features of unilateral blindness and massive epistaxis after head injury should indicate the diagnosis. Carotid angiography will lead to the correct diagnosis.Case report: We present a 22-year old man with the history of recurrent epistaxis after head trauma diagnosed with traumatic internal carotid artery aneurysm. Clinical features, diagnostic approaches and patient’s treatments are reviewed.Conclusion: This case report emphasizes the rare but potentially fatal complication of internal carotid artery aneurysm after head trauma. Knowledge of the clinical features causes early and successful treatment.

Introduction: Leukocyte adhesion deficiency syndrome (LADS) is a rare inherited immunodeficiency in which the function of leukocytes, particularly the phagocytes are disturbed. Case report: In the present sudy, we report three cases with LADS (2 male infants and 1 female child) who had a history of delay in separation of umbilical cord. One infant admitted for skin infection and two patients admitted in hospital following bacterial and fungal infections in nose and finger.All cases had a remarkable leukocytosis, neutrophilia and decreased of CD11 and CD18. Conclusion: LADS is a congenital syndrome causes recurrent bacterial and fungal infections. Usually all patients have a history of delayed separation of umbilical cord.