IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY
Year:2009 | Volume:21 | Issue:1 (55)|Papers Count:11

Introduction: There are contradictory reports regarding vestibular function after cochlear implant surgery. In this study, we evaluated the influence of cochlear implant surgery on vestibular function by comparing the results of caloric test in both ears of patients who received implants. Materials and Methods: 24 adult patients who had undergone cochlear implant surgery at least 6 months earlier, were participated in this study. Caloric test with the stimulus of cold and warm water was performed on both ears of each patient and results were compared with each other regarding unilateral weakness, directional preponderance and areflexia. Results: The differences between two ears regarding directional preponderance, unilateral weakness and areflexia were not statistically significant. Conclusion: It seems the pathological cause of deafness is a more influential factor on vestibular dysfunction than the damage following cochlear implant surgery.

Introduction: Vocal cord nodule is one of the most prevalent disorders of laryngeal mucosa which is commonly caused by the overuse of laryngeal vocal function. The aim of this study was to investigate the effect of speech therapy on laryngeal stroboscopic features of patients with vocal cord nodules.Materials and Methods: In this clinical trial, five women with vocal cord nodules aged between 14 and 45 years participated in a speech therapy program. Their laryngeal stroboscopic features were assessed in the first and ninth sessions of therapy.Results: After speech therapy, glottal closure in 3 subjects reached to complete closure or near to it. Symmetry of phases in 3 cases reached to symmetrical condition and periodicity of phases in 1 patient reached to periodical state. After speech therapy, right mucosal wave in 4 subjects reached to normal condition. The left mucosal wave in 1 subject reached to normal and in 1 patient approached to normal form.Conclusion: The results of this study revealed that speech therapy has a gradual influence on treatment of vocal cord nodule which can be evaluated by subjective methods such as therapist's assessment of patient's voice or objective methods such as stroboscopy.

Introduction: Considering the high prevalence of obstructive sleep apnea syndrome (OSAS) and its complications, proper diagnosis and treatment is particularly important. Since the standard diagnostic test for OSAS is polysomnography, which is not widely available, finding a simple, available, and cheap diagnostic method is very helpful. The aim of this study was to evaluate the efficiency of anterior rhinomanometry and upper respiratory tract examination in diagnosis of the OSAS.Materials and Methods: In this observational analytic study, all patients referred to BAMDAD sleep clinic for polysomnography from Feb 2007 to Jul 2007 were evaluated by anterior rhinomanometry as well as upper respiratory tract examination and results were compared with each other.Results: Of 66 patients participated in our study, 31 patients were in the normal group, 19 in mild apnea group, and 16 in moderate to severe apnea group. The results of ENT examination showed clear obstruction in 22 patients. 12 of them were in moderate to severe apnea group, and 9 of them in mild apnea group. Only one patient with abnormal examination was in the normal group. The respiratory tract resistance which was measured by anterior rhinomanometry showed no significant association with positive results of polysomnography. Conclusion: Our study showed that although anterior rhinomanometry is invalid for diagnosis of OSAS, ENT examination (such as noctural oxymetry) can be a useful diagnostic method for OSAS.

Introduction: Dysphagia is a common chief complain of various diseases with different benign or malignant etiologies. Iran is one of countries with a high incidence rate of esophageal cancer. The aim of this study was to evaluate the common causes of dysphagia for earlier diagnosis and treatment of this disease and reduction of its morbidity and mortality rate.Materials and Methods: In this descriptive study, we analyzed the etiology of dysphagia in 200 patients who were admitted to ENT and thorax surgery wards of Mashhad Ghaem Hospital during 2005-2007.Results: Of 200 patients, 79 patients were female and 121 patients were male. The most prevalent cause of dysphagia in these patients was esophageal SCC and the most common endoscopic presentation was the ulcerative view. Other common etiologic factors were esophageal stenosis, adenocarcinoma, mediastinal tumors, achalasia, lyomyoma, sarcoma and diffuse esophageal spasm, respectively.Conclusion: According to these results, the complaint of dysphagia with or without odinophagia has particular clinical importance, especially in our country with high frequency of esophageal malignancies.

Introduction: There are various reports of the prevalence of frontal sinus aplasia in different geographical areas and ethnic origins. The size and shape of frontal sinus is different among various populations. This study used CT scan images to investigate the frequency of absence of frontal sinuses in adults of northeastern Iran.Materials and Methods: The present study was performed retrospectively on the axial and coronal CT scans of the paranasal sinuses from a series of 588 patients who had referred to CT scan ward of Mashhad Imam Reza hospital without any other sinus pathology.Results: The mean age of patients was 44.39±19.44 years. Unilateral and bilateral aplasia of frontal sinuses was seen in 36 and 51 patients, respectively. The dominant sinus was in the left side in 68.24% of cases. Conclusion: The lower incidence of frontal sinus aplasia in this particular ethnic and geographical area relative to other populations emphasizes the effect of environmental and genetic factors on the development of frontal sinuses.

Introduction: Group A Beta-Hemolytic Streptococcus (GABHS) is the most important and common bacterial cause of acute pharyngitis in children. Nowadays, cases of resistance to antibiotics have been reported due to unnecessary and extensive usage of antibiotics. The aim of this study was to determine the prevalence of healthy pharyngeal carriers and evaluate the antibiotic susceptibility of GABHS.Materials and Methods: In this study among guidance school students of Zahedan aged 12 to 14 years, 1092 cases were selected randomly. After culturing the pharyngeal samples, GABHS was isolated and its susceptibility to different antibiotics was examined. Results were statistically analyzed by Chi-square and Exact fisher tests.Result:76 specimens of GABHS were isolated from 1092 cultivated specimens and the differences in the prevalence of GABHS between different age groups of two sexes and different age groups of each sex were not statistically significant. The antibiotic susceptibility ratios were 98.68% for cephalexin and cefazolin, 97.37% for erythromycin and 92.11% for penicillin and the difference was not statistically significant. The susceptibility to amoxicillin was 80.26%, which was significantly different from susceptibility to cephalexin and cefazolin (p<0.001), erythromycin (p=0.001) and penicillin (p=0.034).Conclusion: In spite of widespread resistance to antibiotics, penicillin still is the first drug of choice for treatment of GABHS pharyngitis and erythromycin is the best alternative drug for patients sensitive to penicillin.

Introduction: Endobronchial actinomycosis is an uncommon disease with symptoms of cough, hemoptysis and endobronchial obstruction. It can imitate the presentations of pulmonary tuberculosis or cancer. Case Report: A 68 year-old male was referred with the complaint of fever, cough and severe hemoptysis. His weight loss during the last 3 months was 8 kgs. Blood tests indicated mild leukocytosis and increased sedimentation rate. In his chest radiography, opacity was observed in the left lower pulmonary lobe. Fiberoptic Bronchoscopy revealed a nodular lesion in the lateral segment of left lower lobe. Pathologic diagnosis confirmed the presence of actinomycosis.Conclusion: Although endobronchial actinomycosis is uncommon, it is included in the differential diagnosis of endobronchial obstructive lesions, especially bronchogenic malignant tumors and bronchial tuberculosis. In areas with high incidence of tuberculosis, endobronchial actinomycosis can mimic its symptoms.

Introduction: Malignant peripheral nerve sheath tumors (MPNSTs) are very rare. Malignant triton tumor is an aggressive variety of MPNSTs with rhabdomyoblastic differentiation. In this study we reported the clinical, radiographic, histopathologic and immunohistochemical features of an intramandibular malignant triton tumor.Case Report: The patient was a 31 year-old male who was referred to maxillofacial surgery ward of Mashhad dental school with a painful swelling in the anterior part of mandible and facial asymmetry. After histopathological evaluation, surgery was performed and immunohistochemical staining confirmed the diagnosis of Triton tumor. Patient was referred for further necessary treatments.Conclusion: In cases of mandibular tumors with initial histopathologic findings of sarcoma, uncommon differential diagnosis such as peripheral nerve sheath tumors must be considered as well.