IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY
Year:2004 | Volume:16 | Issue:2 (36)|Papers Count:12

Background: Delyed healing and dehiscence of operative wounds represent a significant clinical problem. Sporadic reports indicate that phenytoin may significantly promote wound healing following topical application. Material & Methods: Ten male rats each received 4 dorsal skin incisions and were sutured immediately on proliferative and early maturation phase. The incisions were infiltrated with phenytoin or normal saline for controls randomly. The wounds were harvested 18 days after wounding and were assessed by tensiometric measurement and microscopic examination. Data was expressed as mean (sd) and were analysed using student"s paired T test. Results: Application of phenytoin, in both proliferative and maturation phases, resulted in a significant increase in wound tensile strength [34.16(8.15) Nand 32.18 (7.43) N in treated wound versus 28.58 Nand 26.7(4.93) N controls respectively. n=20; P<0.01]. Application of phenytoin in these two phases had no difference. The rise in wound tensile strength was associated with increase in wound collagen deposition.

Introduction: Benign positional vertig in one of the most common causes of patient referrence to the otolaryngologist. Maneuver therapy (Epley & Semont) was effective and with few complications. The object of this study was evaluation and comparison of the complications and the number of maneuver needed for recovery in BPPV patients. Methods: Center from April 2001 to September 2002 in 130 patients with The study performed in Ayatollah Kashani Medical confirmed diagnosis of posterior canal Benign positional vertigo with history taking and hall pick testing. The patients were randomely placed in two groups of 65 cases. For these groups respectively Epley and Semont maneuver performed by researcher and during a three months of follow up, each week the patients evaluated for recovery by performing hall pick maneuver and history taking. Results: (P < 0.05). Theses two groups were matched for gender and age The recovery rate of Epley and Semont group at the end of follow up were respectively (93.84% - 76.92%) (P=0.01). 0.082). The complicaion rate were respectively (4.61%-0%) (P=The mean number of maneuver implemented were respectively (1.93±1.09 and 2.1±0.88) (P=0.09). Conclusion: This study showed that both maneuvers were effective, with more efficacy of Epley. These maneuvers have no meaning full difference in complication rate / and the number of maneuvers needed for recovery.

Objective: Endoscopic sinus surgery is a relatively new technique for the manaement of sinusitis refractory to nonivasive therapy. Success depends on the use of newly developed instrument, including endocopes. Follow-up was carried out 143 patients who undervent functional endoscopic sinus surgery at 6 months to 30 months. Method: 143 patients, with chronic rhino-sinusitis underwent endoscopic sinus surgery from March 2000 to May 2003. Result: Immediate postoperative data indicated 8 developed minor complications and no major complicattions. Conclusion: 143 patenits were available for long term follow up at 6 months to 30 months with success rate 95.8% for relief of chronic sinusitis.

In the two past decade Functional Endoscopic Sinus Surgery (FESS) has appeared as a relatively benign surgical technique for treatment of chronic recurrent sinusitis. Coronal sinus CT Scan is the best method for properative evaluation. Identifying the major patterns of inflammatory sinonasal disese in CT scan is very helpful for planning the technique. These five major patterns are I) infundibular, 11) ostomeatal unit or OMU, Ill) sphenoethmoidal recess or SER, IV) sinonasal polyposis or SNP and V) sporadic or unclassifiable. By identifying these patterns more tailored endoscopic sinus surgery is possible. In 77 Consecutive Patients (age: 12Y to 68 Y, mean 32Y) undergoing FESS for treatment of chronic inflammatory sinonasal disaese, coronal sinus CT scans reviewed for the major inflammatory patterns and anatomic variations may attribute to inflammatory disease. Infundibular pattern was identifed in 11 (14%), OMU pattern in 42(55%), SER pattern in 32(42%), SNP pattern in 16(21 %) and sporadic or undclassifiable pattern in 10(13%). The OMU and SER patterns were seen simultaneously (pansinusitis) in 25 (35%). Additional incidental sinonasal anatomic variations were frequently encountered including some degree of nasal septal deviation in 45(59%) and concha bullosa in 32(42%). In patients with concha bullosa more severe patterns were seen with higher incidence. We found higher incidence of more severe patterns and higher incidence of anatomic variations specially septal deviation and concha bullosa in our study. Although our group was surgical but this seems not to be the only reason for dramatic high incidence of the most extensive inflammatory disease. This may perhaps be due to delay in patients presentation in Iran.

Swab specimens of middle ear exudates were collected from patients suffering from chronic otitis media. These specimens were taken to the microbiology Department School the of Medicine. Each specimen was cultured on suitable media and Gram stained. The Isolated bacteria and their frequency are as follows: aureus (16.6%), Pseudomonas sp. (14.81%). Proteus sp. (12.96%). The results of performing antibiogram test are as follows: staph. Auresus was resistant to Ampicillin (100%); polymyxin B (66.6%) and sensitive to ciprofloxacin and amikacn (100%). Pseudomonass p. was resistant to Ampicillin and Erythromycn (100%) and sensitive to ciprofloxacin (100%) and polymyxin B (93.75%). proteus sp. was resistant to Erythromycin and tetracycline (100%) and sensitive to ciprolfoxacin and ceftizoxime (100%).

We reviewed our 15 years experience with tumors of the submandibular gland to determine factors influences the outcome. The most common benign neoplasm was pleomorphic adenoma (11cases), while among malignant tumors the adenoid cystic carcinoma was predominated (12cases). among patients who had malignant tumors, the 5 year survivals were 61.9% in patients with malignant tumors, histology and size did not affect overall survival factors. the outcome was affectod by extraglandular soft-tissue extension and lymph node metastasis.

Primary chemothrapy as a curative treatment always has been considered in nonmetastatic head and neck carcinoma with the purposes of improving locoregional control, decreasing probability of distant metastasis and improving overall survival. Although its improving effect on locoregional control and increasing probability of organ preservation, especially in laryngeal carcinoma has been shown and there are many reports which suggest at least delyaing distant metastasis with primary chemotherapy however randomized controlled trials have not yet reported significant improvement of overall survival. Though many of these studies have some essentail structural faults, a curative chemotherpy on its own has a relative effect that means with every chemotherapy course one log of tumor cells dies and in spite of several courses it never sterile the tumor. In additon available chemotherapy drugs, single or in combination are not the most effective ones and studies to find more effective drugs continue. On the other hand, locoregional recurrence-synchronous or earlier than metastasis-that is verycommon with low potency locoregional treatments in locally advanced head and neck carcinomas compromise the limiting effect of chemotherapy on overall survival. While enthusiasm on neoadjuvant and concurrent chemotherapy is raising nowadays, and both involve in organ preservation treatments only the latter has a relative effect on survival improvement. Therefore concurrent chemoradiotherapy with insistence on keeping dose intensity of both modalitties while increasing acute but not delayed normal tissue toxicities is the promising measure for operable or inoperable stage III and non metastatic stagelV head and neck carcinomas.

Hemangioma of the nasal cavity has two types: Mucosal and intraosseous. Intraosseous hemangioma is less common than mucosal type. Since this lesion is similar to other non hemorrhagic lesions, it may be mistaken. Therefore, primary consultations are important in preoperavtive preparation and operative planning we present a 33-year oldfemale patient with bulging of the left side of her nose and nasal obstracion of the same side. Based on clinnical and paraclinical evalutions, intraosseous cavernous hemangioma of the middle turbinate is diagnosed. According to our refereneses we were not able to find previous reported case of intraosseus hemangioma of the middle turbinate.

Mobius Syndrome is rare, heterogeneous and nonprogressive congentital disorder that is mostly seen sporadically and has been reported few cases. The principle clinical features of the syndrome are bilateral abducens paresis with different degree, incomplete and bilateral facal nerve paresis, orofacial and limbs anomalies. The main cause of clinical syndrome is agenesis of cranial nerve nucleus in the ponse. Our patient is an 18-Year old man with history of poor sucking, lack of impressions during crawing and bilateral club foot at birth time. His parents noticed disorder of eye movements in the infancy period. these findings had stable, non progressive course. Sign that have been found in the clinical assessment are: Bilateral, peripheral Type facial never paresis more on the left, bilateral club foot, complete inability of conjugated gaze to the right convegence of eyes ant left gaze, divergence of eyes at upward gaze and Goiter of grade two. Paraclinical studies such as brain MRI, Echocardiography, ECG, Liver and kideny fuction tests, thyroid hormones and audiometery were normal. NCV Showed axonal ytpe neuopathy of both facial nerves.