IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY
Year:2008 | Volume:20 | Issue:1 (51)|Papers Count:9

ntroduction: Although ototoxicity and neuropathy are common side effects of cisplatin, there is no evidence of altered olfactory function in cancer patients receiving cisplatin based chemotherapy. The purpose of this study was to investigate the effect of cisplatin on olfactory function.Materials and Methods: Fifty-eight patients (13 female, and 45 male with a mean age of 54 years) who needed to be treated with cisplatin based chemotherapy at our institution were enrolled in this study. Cisplatin with a dose of 70-100 mg/m2 was administered per cycle in different chemotherapy regimens. Olfactory function and audiometery were tested before beginning chemotherapy (as baseline). Assessment of olfactory function also was carried out before each cycle of cisplatin and finally olfactory test and audiometery was performed at least 3 weeks after the last course of cisplatin based chemotherapy.Results: Of 58 patients enrolled in this study, seven patients died due to their cancer and 51 patients completed the planned chemotherapeutic treatment. The patients received cisplatin at a cumulative dose of 100-700 mg/m2 (mean cumulative dose: 380 mg/m2) during their chemotherapy treatment. Hearing impairment was documented in fourteen patients and four patients developed hyposmia and one patient anosmia that had no hearing loss. The test score changes were not statistically significant but there was a statistically significant correlation between drug dose and hearing loss (P=0.039).Conclusion: The results of this study showed that cisplatin has no statistically significant effect on the sense of smell at doses which cause hearing impairment.

ntroduction: Increased upper-air way resistance resulting from hypertrophic tonsils and adenoids can cause intermittent airway obstruction, chronic alveolar hypoventilation, and even severe cardiopulmonary complications like pulmonary hypertension and corpulmonale. The aim of this study is to clarify whether tonsillectomy and adenoidectomy have any effect on mean pulmonary arterial pressure.Materials and Methods: This prospective study was approved by ethic committee. Thirty two randomly selected children (16 male, 16 female) aged between 3.5 and 13 (mean 7.06±1) with a diagnosis of upper airway obstruction or chronic infections from hypertrophied tonsils and adenoids were included in our study. Mean pulmonary arterial pressure (MPAP) was measured using Doppler echocardiography preoperatively and mean 4.25±0.46 months postoperatively in all subjects.Results: Comparing preoperative and postoperative mean pulmonary arterial pressure showed a statistically significant decrease in mean pulmonary arterial pressure in these children (Preoperative mean PAP=19.37±0.82, postoperative mean PAP= 18.10±0.6). (P=0.004). 10 of the 32 subjects in the study group were pulmonary hypertensive preoperatively. MPAPs of 9 of these children decreased to normal range. (P=0.004).Conclusion: This study showed that obstructive adenoid and tonsillar hypertrophy causes higher MPAP values in children that would be reversible by performing early adenotonsillectomy.

ntroduction: Open bite is concerned as a malocclusion with a difficult treatment and challenging stability . Being aware of etiologic factors of anterior open bite is essential for correct diagnosis and convenient treatment planning. The aim of this study was to evaluate cephalometric criteria in open bite adolescent patients in Mashhad.Materials and Methods: In this retrospective study, Lateral cephalograms of 40 patients with anterior open bite as case group, and 40 patients with normal overbite and classI molar and canine relationship as control group were selected. Cephalometric criteria were determined and compared in two groups. To compare two groups Student's t-test with 0.05 significance level was used. Cephalometric parameters in males and females within each group, and between the total samples of two groups were compared.Results: There was no significant difference between cephalometric parameters of males and females in each group. In comparing the total samples of two groups Yaxis-SN, lower facial height, anterior facial height, FH-SN, ManP-SN, ManP-FH, ManP-PP, U1-SN, U1-FH, U1-PP, and ANB were significantly greater in open bite group while PFH/AFH, UFH/LFH, and IMPA was significantly lower in this group. There was no significant difference between two groups in other cephalometric criteria.Conclusion: This study demonstrated that in open bite patients there is tendency toward:1-ClassII skeletal relationship                  2-Vertical growth and increase in LFH     3-Labial inclination of upper incisors       4- Lingual inclination of lower incisors

ntroduction: Jaundice is a commen prablem in newborns and clinical presentations resulting from early stages of hyperbilirubinemia toxicity. ABR is useful test to recognize the primary brain stem encepholapathy. This study has been carried out with the objective of evaluating the ABR in recognizing hearing disorders in newborns suffering from Jaundice.Material and Methods: In this study, we describe ABR obtained in 60 full term newborns, with birth weight more than 2500 gr,and Bilirubin concentration Between 18-54mg/dl without immune hemolysis and hearing disorder risk factor, from march 2005 until January 2006. ABR was carried out before commencing therapy ,While first ABR was abnormal, repeated ABR was done after treatment exactly after 3 months.Results: In this study, sixty newborns were evaluated by ABR for detecting early hearing disorder. Mean weight were 3000±250 gr, Gestational age 38±1 weekes, bilirubin concentration 36 mg/d.l±9 (18-54 range).17 patients had abnormal ABR pretreatment, and 12 patients done normal ABR second evalution after treatment (Bili: 26±3), 5 patients had persistent abnormal (mean Bili: 43±5). ABR abnormalities includes latencies wave I,III,V and loger duration interpeaks I-V,I-III and III-V. (Mean values of ABR latencies when compared with a group of normal babies as a control group were significantly increased before treatment, but returned to normal value after treatment (P=0.001).Conclusions: Our study proved that newborns with serum bilirubin ranging from 18 to 54 mg/dl would be increase in ABR waves I,III,V and also increase in interpeak I-III,III-V,I-V that may be irreversible in those infants with bilirubin more than 32 mg/dl.

ntroduction: Facial nerve dehiscence (FND) is a common problem at surgery of cholesteatoma: The aim of this study was survey of the common site of FND and the common complication of cholesteatoma that coexists with FND.Materials and Methods: This-cross sectional study was performed from 2001 to 2006. 185 patients with cholesteatoma were studied. Middle ear Findings at surgery of cholesteatoma were surveyed. Data was analyzed using the k2 and Fisher exact test.Results: Of 185 cases, 95 (51.4%) were male and 90 (%48.6) were female and the mean age was 30.5 years. The rate of FND was 29. 73% (55 cases). The commen site of FND was tympanic segment (85.4%). The positive statistically association between FND incidence and the presence of lateral semicircular fistula was demonstrated.Conclusion: The most common area of facial nerve injury at surgery of chlesteatoma is tympanic segment. Surgeons should always consider that fallopian canal will be eroded and the facial nerve is in direct contact with cholesteatoma whenever a lateral semicircular canal fistula is suspected or vice versa.

ntroduction: infections of the head and neck spaces are serious and dangerous due to vicinity to the great vessels and mediastinum. The most common source of infection leading to head and neck space abscess, are dental infection. This retrospective study was performed to determine the prevalence of head and neck space infections following dental infections, the spaces involved, the most common microorganisms involved in these infections and to determine the prevalence of head and neck space infections according to age and sex of the patients.Materials and Methods: In this retrospective study, the charts of 241 patients with head and neck space infections referring to Khalili hospital during the past 10 years was reviewed and data well assessed.Results: The most common source of head and neck space infections was dental infections occurring in 141 patients (58.5%). From these 141 patients, 79 patients were male and 62 patients were female. The most common age of involvement was the 3rd decade (39 patient 27 6%). The second most common cause was tonsillitis occurring in 33 patients (13.7%). The most common spaces involved in 141 patients with head and neck space infection following dental infections, were: simultaneous involvement of submandibular, sub mental and sublingual space bilaterally (Ludwig's angina) in 53 patients (37.6%) followed by sumbandibular space in 45 patients (31.9%) and Para pharyngeal space in 37 patients (26.2%).  Culture has been performed in only 34 patients from which bacterial growth occurred in 18 cases. The most common organism was non hemolytic streptococci (11 cases).Conclusion: Head and neck space infection are dangerous and life threatening conditions that occur most commonly following dental infections so it seems that escalating the general knowledge about oral health, increasing dentistry centers and early and proper management of dental infections have a major role in reducing the incidence of head and neck abscesses.

ntroduction: Cleft lip and palate are believed to be caused by multi factorial inheritance in which genes interact with environmental agents. Thus the main aims of this study were to find out seasonal variations in the birth date as well as the sex distribution in the birth of children with cleft lip and palate.Materials and Methods: In this retrospective study, the birth dates of 358 children born in Khorasan Razavi state from 1992 to 2007 with a diagnosis corresponding to cleft palate, or cleft lip with or without cleft palate, were obtained from Cleft Lip and Palate Research Unit in Mashhad Dental School. The data were analyzed by Chi -square test to look at the sex distribution and seasonal variation.Results: The results showed the peak incidence of cleft palate birth in autumn. Cleft lip and palate showed a different seasonal trend, with the peak occurrence in the spring and autumn for males and in the winter for females. Additionally, this study showed the yearly rate for cleft lip, isolated cleft palate and cleft lip and palate decreased from 1992 to 2007.Conclusion: These seasonal trends may act as a pointer to the environmental factors active in the multi factorial etiology of cleft lip and cleft palate.

ntroduction: Metastatic carcinoma of the temporal bone is rare and its clinical presentation depends on the site of bone involvement. The most significant symptom is hearing loss, but facial paralysis, vertigo and tinnitus have also been reported. Metastasis to the Endolymphatic sac presenting as a sudden hearing loss accompanied by meniere-like symptoms has not yet been reported. Herein we report a case of sudden SNHL due to metastasis from breast carcinoma.