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Objective: To evaluate and compare choroidal thickness (CT) between patients with Meniere's disease (MD) and a control group. Methods: This case–control analytical study was conducted on 37 subjects with MD and 37 healthy subjects. Subfoveal CT (SCT), large choroidal vessel (LCV) layer thickness, and mean subfoveal LCV thickness/mean SCT ratio were measured using enhanced‐depth imaging optical coherence tomography (EDI‐OCT) in the eyes on the MD side (ipsilateral), the contralateral eyes, and the control group. Results: A statistically significant difference was observed in the mean SCT values between the ipsilateral and control groups after adjustment for age, sex, and migraine (p = 0.04). Moreover, there was a statistically significant difference between the mean subfoveal LCV thickness values and the mean subfoveal LCV thickness/mean SCT ratio between the ipsilateral and control groups (p = 0.006, and p < 0.001, respectively). Patients with a duration of disease over three years had a greater mean subfoveal LCV thickness/mean SCT ratio (67.35 ± 11.56 and 60.66 ± 11.27, respectively), which was statistically insignificant (p = 0.08). Conclusion: We found a thicker choroid and Haller layer, and a greater subfoveal LCV thickness/SCT ratio on the MD side compared to the controls. Furthermore, patients with a greater duration of disease had a lower subfoveal LCV thickness/SCT ratio. These findings may reflect the role of the trigeminal vascular system (TVS) and neurovascular pathophysiology in MD patients. More extensive studies are required to reach more definitive conclusions about the association between CT and MD. Level of Evidence: 4 Laryngoscope, 134:1889–1893, 2024 [ABSTRACT FROM AUTHOR]

In the wake of the COVID-19 pandemic, anosmia, the loss of the sense of smell, has emerged as a curious and widespread symptom. While the sense of smell in many individuals has eventually recovered, some grapple with anosmia for extended periods. In our recent study entitled "magnetic resonance spectroscopy findings of brain olfactory areas in patients with COVID-19-related anosmia," we embarked on a journey to explore the neurochemical underpinnings of anosmia in COVID-19 patients. This commentary extends our original research, providing insights into the evolving landscape of COVID-19-related anosmia and its implications. [ABSTRACT FROM AUTHOR]

Introduction Finding biomarkers for highly lethal cancers is a priority. Objective The current study was designed to understand the clinical significance of vascular endothelial growth factor (VEGF), latent membrane protein 1 (LMP1), and tumor necrosis factor-α (TNF-α) expression as the biomarkers, and evaluate their correlation with each other, in nasopharyngeal carcinoma (NPC) in the province of Guilan, North of Iran. Methods Gene expression was evaluated in 25 formalin-fixed paraffin-embedded (FFPE) blocks from cases of confirmed NPC and 20 FFPE samples of non-NPC by quantifying messenger ribonucleic acid (mRNA) and protein levels, using real-time polymerase chain reaction (PCR) and immunohistochemistry (IHC) methods, respectively. Furthermore, the correlations among the protein levels of different genes, along with the patients' demographic characteristics were assessed. Results Our findings on mRNA and protein levels demonstrated that the expression of the LMP1 gene in the NPC group was significantly elevated compared with that of the non-NPC group. In addition, the protein levels in the NPC group indicated a positive and significant correlation between LMP1 and VEGF expression. It was noted that both protein and mRNA levels showed no significant differences in the expression of TNF-α and VEGF genes between the NPC and control groups. Furthermore, there was no significant relationship between the expression of these proteins and the demographic characteristics of NPC patients. Conclusion Overall, a significant increase in LMP1 expression was observed in NPC patients, which may serve as a diagnostic biomarker for NPC. Also, LMP1 might be involved in NPC progression by inducing VEGF gene expression. [ABSTRACT FROM AUTHOR]

In order to decrease medical errors and improve organized, targeted education pre- and postgraduation, we intended to detect 10 most important concepts that neuro-otologists believe family physicians and general practitioners must know. A multi-center study based on Delphi's method was designed and conducted in three stages. Of 31 topics gathered by expert panel, 10 top priorities were ranked based on 50 neuro-otologists' opinion over the country. Early diagnosis and management of sudden sensorineural hearing loss, foreign body removal from external ear canal, proper management of otitis extern, and management of emergency situations in chronic otitis media gained the highest scores among all. Also, some topics, such as managing serous and acute otitis media, differentiating peripheral vs. central vertigos, and early hearing screening at birth were among top topics, contrary to others, such as surgery in only hearing ears, or hearing losses after COM surgeries. Almost all of the top-ranked topics are among critical/organ saving, or most prevalent medical concerns in all of the world. Sudden deafness, complicated COM, and mis-diagnosing vertigo may be organ/life threatening, while foreign bodies or inflammations of external ear, acute or serous otitis media, and congenital hearing loss are among the most prevalent medical problems worldwide, with numerous malpractices in their diagnosis and management. Regarding educational and practical priorities should be considered a basic step in neurotology field, and targeted programming policies. [ABSTRACT FROM AUTHOR]

Background & Objective: Among facial plastic surgical procedures, septorhinoplasty is deemed the most complex. A critical stage in this process is the effective handling of variations in the septum and turbinate. This research aimed to assess the differences and pathological irregularities in the septum and lateral nasal wall of patients scheduled for septorhinoplasty at a university-based hospital in northern Iran. Materials & Methods: This cross-sectional study focused on all septorhinoplasty candidates aged between 18-60 years. Observations during surgery, such as the location and category of septal abnormalities, and the location and type of lateral nasal wall abnormalities (including inferior and middle turbinate hypertrophy, concha bullosa, and paradoxical turbinate) were meticulously documented and analyzed. Results: Of the 672 participants, 469 patients (69.8%) presented with septum abnormalities, while 143 patients (21.3%) demonstrated disorders of the lateral nasal wall. The most frequent findings were spurred vomer (24.6%) and lower turbinate hypertrophy (46.9%). Conclusion: Given the broad range and high incidence of disorders in the septum and lateral nasal wall, it is reasonable to routinely incorporate radiological investigations into the preoperative assessment of rhinoplasty candidates. This approach can potentially identify pathological findings, minimize postoperative complications, remaining symptoms, and optimize the surgical outcomes. [ABSTRACT FROM AUTHOR]

Background: Otomycosis is considered a recurring fungal ear infection. The external auditory canal provides an appropriate and optimal situation for fungal growth. Objectives: The study aimed to identify the causative agents of otomycosis and determine corresponding antifungal drug susceptibility patterns in north‐western Iran. Methods: From October 2020 until November 2021, 200 patients attended an otolaryngology referral centre with otitis externa, and their ear discharge and debris were examined and cultured. The identification of the fungal agents was implemented by polymerase chain reaction‐restriction fragment length polymorphism and sequencing. In vitro antifungal susceptibility testing of the isolates was conducted in accordance with the CLSI broth microdilution protocols. Results: The prevalence of otomycosis was measured 50.5% (n = 101/200). The majority of patients were in their forties (n = 35, 34.6%) and female (n = 57, 56.4%), and the most prevalent symptom was otalgia (56.4%). The most underlying factor was remarked manipulation employing a cotton swab (65.3%). Regarding fungus, Aspergillus section Nigri (58.57%) was the foremost isolate, followed by Aspergillus section Flavi (19.23%) and Candida parapsilosis (14.96%). The predominance of Aspergillus isolates had minimal in vitro sensitivity to tioconazole and nystatin. Candida species represented higher geometric mean minimum inhibitory concentrations (MIC) against nystatin. The MIC of three Aspergillus species isolates shown above the epidemiologic cut‐off values (ECV) against itraconazole. Conclusions: Otomycosis incidence surpassed in comparison with the previous study as the most common cause of otitis externa. The MIC distribution of Aspergillus species isolates against triazole antifungals is close to the defined ECVs and likely outrun it over time. [ABSTRACT FROM AUTHOR]

Background and Aim: COVID-19 is an acute respiratory disease, caused by a coronavirus named SARS-CoV-2. Previous reports suggest an association between COVID-19 infection and Hearing Loss (HL). We have investigated the Universal Newborn Hearing Screening (UNHS) results in the time period of COVID-19 epidemic in Guilan Province, north of Iran. Methods: We analyzed UNHS results from10 major obstetrics hospitals from 20th Mar 2020 to 19th Mar 2021, and compared the total UNHS positive/“refer” and total neonatal HL reports with the same time periods of recent three years. The prevalence of risk factors for HL were analyzed during the same period. Results: The total number of childbirth was decreased significantly from 27735 birth cases in Mar 2017-2018 to 18216 births in Mar 2020-2021 (p<0.001), but the total “refer” rate was significantly increased from 63.0 per 1,000 births in Mar 2019-2020 to 79.8 in Mar 2020-2021 (OR=1.29, 95% CI: 1.19-1.39, p<0.001), and also increased from 74.7 per 1,000 births in Mar 2017-2020 to 79.8 in Mar 2020-2021 (OR=1.07, 95% CI: 1.01-1.14, p=0.020). The HL rate increased from 10.3 per 10,000 births in Mar 2019-2020 and from 11.4 per 10,000 births in Mar 2017-2020 to 18.7 in Mar 2020-2021 (OR=1.81 and 1.63, 95% CI: 1.06-3.09 and 1.10-2.44, p=0.028 and 0.015, respectively). The prevalence of preterm birth (p=0.039) and neonatal intensive care unit stay (p=0.016) was increased significantly during Mar 2020-2021. Conclusion: The chance of “refer” results and neonatal HL, found in the UNHS program, increased during the COVID-19 epidemic in comparison to the past years. [ABSTRACT FROM AUTHOR]

Background: Foreign body aspiration is a common accident with life-threatening outcomes. Rigid bronchoscopy is considered an effective tool in the diagnosis and treatment of this complication; however, there is still no agreement on the preferred ventilation method for the treatment of patients with foreign body aspiration. Objectives: This study aimed to compare the cardiovascular and respiratory outcomes followed by ventilation methods in patients with foreign body aspiration undergoing rigid bronchoscopy. Methods: In this cross-sectional study, the information was recorded from 90 patients' files, including age, gender, aspirated foreignbody, interval from aspiration to referral, signs, andsymptoms, comorbidity, bronchoscopic results, ventilationmethod during the procedure, occurrence of respiratory complications, heart rate, blood pressure, arterial oxygen saturation, length of hospital stay, and mortality of patients. The data were analyzed by SPSS software (version 22). A p-value less than 0.05 was considered statistically significant. Results: Out of 90 reviewed cases, 57.67% were male, and the mean age was 2.06-1.25 years. The most common aspirated foreign body was peanuts (38.89%). The mostcommonclinical signs were cough (81.11%) and wheezing (51.11%). The mostcommonsymptoms were wheezing (54.44%) and decreasing respiratory sounds (46.67%). Bronchoscopy was associated with foreign body extraction in 65.6% of the patients. The relationship between the ventilation method with blood pressure changes, length of hospital stay, cardiopulmonary complications, and oxygen saturation was not significant; however, the cases with spontaneous breathing referred at shorter intervals from aspiration and experienced fewer heart rate changes. Conclusions: The results of the present study showed no preference between spontaneous and controlled ventilation during rigid bronchoscopy in patients with foreign body aspiration. [ABSTRACT FROM AUTHOR]

Introduction: Fungal otitis extern or otomycosis, is common worldwide, and resistance of fungal organisms to antifungal drugs has been reported in otomycosis and other fungal infections. This study aimed to evaluate the clinical efficacy of sertaconazole versus placebo, as well as miconazole and clotrimazole topical creams in otomycosis patients. Materials and Methods: In this double-blinded clinical trial, 138 otomycosis patients (230 ears) were evaluated in four groups. After the first session of the ear canal debridement and irrigation with acetic acid 2% solution, the patients were treated with either A) sertaconazole 2% cream, B) miconazole 2% cream, C) clotrimazole 2% cream, or D) placebo. The results of clinical evaluations and response to treatment (complete, partial, and no response) were recorded at the time of the first visit and by the end of the first, second, and fourth weeks of treatment. A p-value less than 0.05 was considered statistically significant. Results: Response results to treatments, ear itching, aural fullness, otalgia, and otorrhea revealed significant differences in either group A or groups B and C, compared to the placebo group (P<0.05). Considering both complete and partial responses together, the sertaconazole group showed a 96.43% response rate. For complete response, miconazole revealed better results, compared to the other two creams; however, the differences for the therapeutic outcomes were not statistically significant. No adverse reactions were observed in the study groups. Conclusions: Sertaconazole had comparable results with miconazole and clotrimazole in the treatment of otomycosis, and especially if complete and partial responses were considered together, it was more efficacious than miconazole and clotrimazole creams. [ABSTRACT FROM AUTHOR]

In this study, we aimed to find the frequency of agger nasi cells (ANC) and their correlation with other anatomical anomalies in dacryocystorhinostomy (DCR) candidates, compared with a control group. The study was conducted on 42 patients with nasolacrimal duct obstruction who underwent DCR surgery. Also, 80 C.T. of healthy sex- and age-matched subjects were selected as the control group. Paranasal sinuses computed tomography scanning was performed preoperatively, and abnormalities including ANC, concha bullosa, osteomeatal complex disease (OMC), nasal septum deviation, and polyposis were investigated and registered. Radiologic findings showed ANC presence in 83.3% of cases, and frequency of concha bullosa was 23.8%, and OMC disease, septal deviation, and nasal polyposis recorded as 11.9%, 85.7%, and 14.3%, respectively. In the control group, ANC was found in 52 subjects (65%), and the difference was statistically significant (P=0.036). There was no significant correlation between the presence of ANC and the coexistence of other mentioned anatomical changes as attributing factors for NLD obstruction. The frequency of ANC was much higher in patients with NLD obstruction compared with the control group, but its association with other anomalies was non-significant. [ABSTRACT FROM AUTHOR]

Background: Epidemiological studies have shown different association between migraine and Meniere's disease (MD). Few studies investigated the frequency of phonophobia in MD. Objectives: This study aimed to determine the frequency of phonophobia and other features of migraine in definite MD. Material and Methods: Patients with definite MD and a group of healthy (non-MD, non-vertiginous) control subjects participated. Demographic data and other clinical features of the two diseases recorded. Data analyzed in SPSS software version 20, by qi square and independent T test and logistic regression model. Results: 69 MD patients (average age: 48.87 ± 12.15 years) and 60 control subjects (average age: 47.58 ± 12.05 years) enrolled. The frequency of migraine headache in MD cases was 16% (45% with aura) compared with 5% in control group (three cases; 2 without and 1 with aura) (p <.001). Family history of migraine was the only determinant of the presence of migraine in MD (p =.001, OR = 15.625, 95%CI: 2.94–88.33). The frequency of phonophobia in MD was very high (88.4%: 54.5% in migraine subgroup and 89.6% in non-migraine cases) and without significant relation to existence of migraine, in contrast to photophobia and osmophobia (p =.064). Conclusions: The frequency of migraine in MD is higher than normal subjects. Phonophobia may be an independent symptom in MD. [ABSTRACT FROM AUTHOR]

Background For many years, Canal Wall Down (CWD) tympanomastoidectomy has been the gold standard for treatment of cholesteatoma; however, this method has long-term complications for the patients. The Intact Canal Wall (ICW) tympanomastoidectomy has relatively lower complications, but access to the middle-ear recesses is difficult in this method. Therefore, endoscopy is used to visualize the underexposed recesses. Objective This study aims to compare the incidence of residual cholesteatoma using the two methods of CWD and endoscopic-assisted ICW. Materials and Methods In this prospective randomized clinical trial, participants were 40 patients with cholesteatoma in the middle ear and mastoid who were candidates for tympanomastoidectomy. They were randomly divided into two groups. In the first group, ICW was performed with endoscopic assisted visualization, while in the second group, conventional CWD technique was performed without ossicular reconstruction. All the patients were microscopically examined at 3, 6, 9 and 12 months after surgery. Revision middle ear surgery and possible ossicular reconstruction under local anesthesia were performed one year after the surgery. The presence of cholesteatoma pearl in the middle-ear, evaluated by using a 2.7mm 30° endoscope, was recorded as the sign of residual cholesteatoma. Fisher's exact test and Mann-Whitney U test were used for statistical analysis. Significance level for the tests was set at 5%. Results The incidence of residual cholesteatoma was not statistically significant between the two groups (P>0.05). In each group, 20% (n=4) had residual cholesteatoma. The difference in time interval from the first to second surgery was not statistically significant between the study groups (P>0.05). Conclusion Endoscopic-assisted ICW tympanomastoidectomy is comparable with CWD tympanomastoidectomy in eradication of cholesteatoma, having possibly fewer complications. It is recommended that more studies be conducted with a larger sample size and longer follow-up period. [ABSTRACT FROM AUTHOR]

Introduction: Adenotonsillectomy is the main treatment for symptomatic tonsillar hypertrophy with postoperative pain as the most common associated complication. The present study aimed to compare the efficacy of gabapentin with that reported for acetaminophen on the postoperative pain of adenotonsillectomy in children. Materials and Methods: In this double-blind clinical trial, a total of 60 children within the age range of 7-15 years undergoing adenotonsillectomy were randomly allocated to two groups of gabapentin (n=30) and acetaminophen (n=30). The first group received a 10 mg/kg dose of gabapentin suspension preoperatively and placebo (suppository) after the intubation. The second group received a 40 mg/kg dose of acetaminophen suppository and placebo suspension simultaneous with that in the case group. Using the pain scale (based on the score of visual analog scale, prescribed drugs, dosage as well as incidence of postoperative nausea and vomiting were recorded 0, 2, 4, 6, 12, and 24 h after the surgery. The data were analyzed using SPSS software (version 22.0). A p-value less than 0.05 was considered statistically significant. Results: There was no significant difference between the two groups considering the pain scores at 0, 2, 4, 6, 12, and 24 h after the surgery. In addition, the trend of pain intensity statistically decreased within 0 to 24 h in both acetaminophen (P<0.001) and gabapentin (P<0.001) groups. No statistically significant difference was observed between the two groups regarding the postoperative incidence of nausea and vomiting. Conclusion: The obtained results of the present study showed that the administration of gabapentin and acetaminophen significantly reduced the postoperative pain of tonsillectomy and need for narcotics in these patients after the surgery. However, in this study, there was no particular reported superiority for any of the two groups in terms of the effects of gabapentin suspension and rectal acetaminophen. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed at evaluating the frequency of chemoradiotherapy-induced mucositis (CIM, RIM) and its related risk factors in patients with the head-and-neck cancers (HNCs). Materials and Methods: In this cross-sectional prospective descriptive study, we evaluated a total of 54 HNCs patients referred to the Oncology Chemoradiotherapy Department of Razi and Amiralmomenin University Hospitals of Rasht, for site and grade (WHO classification) of CIM/RIM, based on their demographic features and possible risk factors. SPSS software version 18 and statistical tests (i.e., Fisher's exact test) were used, and the level of significance was considered as P < 0.05. Results: Finally, patients enrolled in the study were 34 men and 20 women (40–72-year-old), of which 43 cases (79.6%) showed signs and symptoms of CIM/RIM (mostly aged 60–69-year-old). Grade 2 mucositis was the most frequent type (18 cases: 33.3%) and mouth floor was the most common site of CIM/RIM (15 patients: 34.9%). Age (P = 0.023), gender (P = 0.012), and the severity of pain (P = 0.018) were significantly related to mucositis in patients with HNCs who underwent chemotherapy or radiotherapy. Conclusion: Mucositis, especially in the oral cavity, is a common complication of chemoradiotherapy in HNCs patients. Age, gender, and the severity of pain are significantly associated with the frequency of CIM/RIM. [ABSTRACT FROM AUTHOR]

Introduction: Blood loss is a common concern during functional endoscopic sinus surgery (FESS). The present study aimed to evaluate the efficacy of dexmedetomidine (DEX) in intraoperative bleeding and surgical field in FESS. Materials and Methods: This double-blind randomized clinical trial was conducted on 72 patients within the age range of 16- 60 years who underwent FESS. The subjects were randomly dividedinto two groups. The DEXgroup received 1 mic/kg DEX in 10 min at anesthesia induction followed by 0.4 to 0.8 mic/kg/hour during maintenance, while the control group received normal saline instead of DEX in bolus with the same volumemaintenance. Heart rate, systolic blood pressure, diastolic blood pressure (DBP),mean arterial pressure (MAP),and opioid requirement were evaluated in the 15th, 30th, 60th, and 90thmin of the induction. The surgeon's assessment of the field during surgery and intraoperative bleeding was also recorded in this study. Results: The DEX group had lower bleeding scores (P=0.001) than the control group. Surgeon's satisfaction based on a Likert scale (P=0.001) was lower in the control group. The mean of DBP was lower in the DEX group in the 30th(P=0.001), 60th(P=0.001), and 90th(P=0.01) min of the induction. The MAP was lower in the DEX group in the 30th(P=0.015), 60th(P=0.052), and 90th(P=0.046) min of the induction. There were no postoperative adverse effects in the DEX group. Conclusion: It was observed that DEX improves the quality of the surgical field and hemodynamic stability. In addition, DEX might be safely and effectively used in surgeries in which deliberate hypotension is desirable. [ABSTRACT FROM AUTHOR]

Evaluation of the research status of the academic institution provides it with the possibility of accurate research policymaking. Scientometric indicators are important tools for evaluating scientific activities of individuals, groups, and institutions. The current research aims to analysis the research performance of medical universities in Northern Iran based on quantitative and qualitative scientometric indicators. In this cross-sectional descriptive study, the Scopus-indexed scientific documents provided by medical universities in the Northern Iran have been studied in terms of number of publications, number of citations, average number of Citations per Publication (C/P), Field-Weighted Citation Impact (FWCI), scientific collaborations, the number of in top 10% citation percentile, and the number of publications in top 10% journal percentile according to CiteScore, Source Normalized Impact per Paper (SNIP), and SCImagoJournal Rank (SJR) indicators during a five years period. According to the findings, Mazandaran University of Medical Sciences has gained the highest position in terms of the number of publications and citations, number of publications with international and national collaborations, and academic-industrial collaborations., while Golestan University of Medical Sciences has gained a higher position in terms of scientific outputs in top 10% citation percentile and journal percentile, CiteScore, SNIP, SJR and C/P. In terms of the FWCI indicator, Golestan University of Medical Sciences has achieved the highest value. Considering academic status and research capabilities of medical universities in the Northern Iran, increasing academic-industrial collaboration, expanding academic collaboration with superior universities and institutions around the world can be effective in increasing the quality of research and upgrading academic ranks of universities at national, regional and international levels. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a systemic idiopathic disease, characterized by non-caseating granulomas, primarily affecting the lungs and the lymphatics. Skin involvement is common and lesions may appear in scar tissues. In the present report, four cases of scar sarcoidosis following rhinoplasty are presented which were diagnosed based on serology tests, radiography imaging and histopathology findings. Three women and one man between 32 to 54-year-old are discussed in this report. Skin lesions on their nose were found after an average of 3.8 years of their septorhinoplasty surgeries. Two of the patients had systemic signs such as fever, cough and arthritis. Patients with diagnosed sarcoidosis were treated appropriately. Rhinoplasty is a common procedure today, and the fact that rhinoplasty may lead up to scar sarcoidosis in susceptible people can be an item for surgeons for consideration. [ABSTRACT FROM AUTHOR]

Introduction: Chronic rhinosinusitis (CRS) with and without nasal polyposis is a chronic inflammatory disease of the sinuses and nasal mucosa. Recent evidence has indicated a relationship between serum 25-hydroxyl vitamin D (OH-VitD) deficiency and CRS. Regarding this, the present study aimed to compare the serum level of 25-OH-VitD in CRS patients with and without nasal polyposis and control groups. Materials and Methods: This study was conducted on 117 adult subjects in three groups of CRS with nasal polyposis (CRSwNP; n=32), CRS without nasal polyposis (CRSsNP; n=35), and healthy controls (n=50). The mean level of serum 25-OH-VitD in the three groups was measured by means of enzyme- linked immunosorbent assay. The data were analyzed using SPSS software (version 18). Results: Mean serum levels of 25-OH-VitD in CRSwNP, CRSsNP, and control groups were 12.52, 15.54, and 22.04 ng/ml, respectively. There was a significant difference between the case and control groups in terms of 25-OH-VitD level (P=0.0001). However, no significant difference was observed between the CRSwNP and CRSsNP groups in this regard (P=0.464). The women had a VitD deficiency odds ratio (OR) of 2.47, compared with men (OR=2.47, 95% CI=1.04-5.86). The OR of VitD deficiency with aging was obtained as 0.957 (95% CI=0.925-0.989). In this regard, older patients had a lower probability of VitD deficiency, compared to younger patients. Conclusion: As the findings indicated, serum 25-OH-VitD was significantly lower in CRS patients, compared with that in the non-CRS subjects. [ABSTRACT FROM AUTHOR]

Chronic dacryocystitis is an inflammation of the lacrimal sac that usually occurs because of obstruction of the nasolacrimal duct. The aim of this study was bacteriological evaluation of samples from patients with acquired chronic dacryocystitis that were operated in Amiralmomenin university Hospital, Rasht-north of Iran. This cross sectional study included 50 patients with chronic dacryocystitis who were operated by endoscopic or external DCR (Dacryocystorhinostomy). Specimens were obtained for bacteriological investigation by sterile wiping swab across muco-purulent exudate for pus and a block of medial wall of lacrimal sac for tissue studying. All samples were cultured and microbiological methods used for identification of grown colonies. Antibiogram was performed for isolated bacteria according to CLSI guideline. Among 50 patients (34 female, 16 male), bacterial cultures of exudates were positive in 25 (50%) of cases and tissue samples were positive in 13 (26%) patients. Staphylococcus epidermidis was the most prevalent organism both in exudates and tissue samples (18% and 8%, respectively) that had the most susceptibility to ceftriaxone. Among Gram-negative organisms, a higher incidence of Pseudomonas aeruginosa was achieved in exudates, but not in tissue samples. P aeruginosa was resistant to penicillin, azithromycin, ceftazidime and gentamycin but most strains were susceptible to ciprofloxacin. In our study, the most prevalent organisms were S. epidermidis and P aeruginosa. Our findings suggest that tissue culture is not superior to exudate swabbing in aspect of bacterial isolation in these patients. [ABSTRACT FROM AUTHOR]

Introduction: Nasal tip ptosis or droopy nose tip is a fairly common nasal deformity. Given the importance of correcting nose tip in rhinoplasty and the need to diagnose the causes of tip ptosis. Aims: The current study was performed aimed to investigate the frequency of the causes of this deformity in rhinoplasty candidates. Methods: In this cross-sectional study, 257 patients (205 women and 52 men; mean age: 26.6 ± 1.7 years old) who came to Amiralmomenin Teaching Hospital of Rasht for rhinoplasty in 2011-2012 were selected by simple sampling method. The contributing factors that led to tip ptosis were diagnosed and recorded based on the results of preoperative and the intraoperative clinical observations. Results: In this study, 44% (113 patients) of the patients had tip ptosis. Statistically, no significant difference was observed between the incidence of tip ptosis in men and women (p=0.504). The prevalence of tip ptosis among patients older than 40 years old was significantly greater (p=0.039). Based on the results of preoperative and intraoperative observations, long caudal septum was the most important cause of tip ptosis. The most common coordination between the causes of tip ptosis in preoperative and intraoperative observations was the thick skin of nose lobules. Conclusion: It seems that nasal tip ptosis is common in our rhinoplasty subjects, and there is only a partial correlation between the mentioned causes of tip ptosis in preoperative and intraoperative assessments, hence more consideration is required for a precise diagnosis of tip ptosis. [ABSTRACT FROM AUTHOR]

Introduction: Foreign-body aspiration is still considered one of the most important diagnostic and therapeutic issues for physicians. Mortality rates and the prevalence of diseases caused by foreign bodies in the airway are higher in children because of the relatively narrow airway and immature protective mechanisms. The aim of this study was to study the pattern of foreign-body aspiration in the tracheobronchial tree as well as the success rate of rigid bronchoscopy in children admitted to the Amir-al-Momenin Hospital, Rasht during 2007-2014. Materials and Methods: In this cross-sectional descriptive study, the required data were collected from the medical reports of all children under the age of 14 years with suspected foreign-body aspiration who were admitted and underwent explorative rigid bronchoscopy from 2007-2014. The data recorded in the checklists were analyzed using SPSS V16. Results: Out of 103 children with suspected foreign-body aspiration, a foreign body was seen in 74 children (71.8%) during bronchoscopy. Among 74 patients with a confirmed aspiration, 73% (54) were males and 27% (20) were females (P=0.68). The average age of the subjects was 34.82±33.4 months; 66.2% were aged 1-3 years. The most common complaints (symptoms) of patients were non-productive cough (48.6%), wheezing (44.3%) and respiratory distress (18.6%). The most common physical examination findings were unilateral decreased pulmonary sound (62.3%), generalized wheezing (26.1%), and crackles (17.4%). Sixty-three patients had a suspected history of foreign-body aspiration. The most frequently aspirated foreign bodies were nuts (peanuts). In total, 52.7% of foreign bodies were lodged in the right bronchial tree. In 95.9% of cases, the foreign body was completely extracted by bronchoscope. The majority of cases were admitted more than 24 hours after the occurrence of aspiration, and pneumonia was the most common complication. Conclusion: Patient history, especially initial suspicion of aspiration, coughing, wheezing and respiratory distress, can be helpful in the diagnosis of foreign-body aspiration. [ABSTRACT FROM AUTHOR]

Introduction: Chronic suppurative otitis media (CSOM) is considered one of the most common causes of acquired hearing impairment in developing countries. CSOM is a multifactorial persistent inflammatory disease of the middle ear. A distinct pathophysiologic mechanism linking allergic rhinitis (AR) and CSOM remains to evolve. The purpose of this study was to investigate the association between AR and CSOM in adults. This was a case-control study. Materials and Methods: The subjects were 62 adults (23 male, 39 female) with established CSOM and 61 healthy controls. CSOM was diagnosed when there was a history of chronic (persisting for at least 3 months) otorrhea, accumulation of mucopurulent exudates in the external auditory canal or middle ear and/or perforated tympanic membrane on otoscopy. All participants were evaluated for the presence of AR by clinical evaluation of allergic symptoms, and underwent a skin-prick test for 23 common regional allergens. Statistical analysis was performed using SPSS version 16. Results: The prevalence of clinical rhinitis (allergic and non-allergic) was significantly higher among the cases compared with controls (62.5% vs. 37.5%, P=0.02). The prevalence of AR (proven by positive skin-prick test) was also significantly higher among affected adults than controls (24.6% and 13.8%, respectively). Adjusting for age, a logistic regression model showed that there was a significant difference between the two groups. Patients with AR and non-AR were at 3.27- (95% CI=1.15-9.29; P=0.036) and 2.57-(95% CI=1.01-6.57; P=0.048) fold increased risk of developing CSOM, respectively, compared with healthy individuals. Conclusion: The study showed a higher prevalence of AR in CSOM patients than in controls. It may be valuable to evaluate and control this factor in these patients. [ABSTRACT FROM AUTHOR]

While most tinnitus cases have some degree of hearing impairment, a small percent of the patients admitted to Ear, Nose and Throat Clinics or Hearing Evaluation Centers are those who complain of tinnitus despite having normal hearing thresholds. Present study was performed in order to better understanding of the probable causes of tinnitus and to investigate possible changes in the cochlear and auditory brainstem function in normal hearing patients with chronic tinnitus. Altogether, 63 ears (31 ears with tinnitus and 32 ears without tinnitus) were examined. The prevalence of transient evoked otoacoustic emissions and characteristics of the auditory brainstem response components including wave latencies and wave amplitudes was determined in the two groups and analyzed with appropriate statistical methods. There was no difference between the prevalence of transient evoked emissions in the two groups. The mean difference between absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that were not statistically significant. Also, the interpeak latency values of I-III, III-V and I-V in both groups had no significant difference. Only the V/I amplitude ratio in the tinnitus group was significantly larger than the other group (p =0.04). The changes observed in amplitude of waves, especially in the later ones, can be considered as an Audiologic finding in normal hearing tinnitus subjects and its possible role in generation of tinnitus in these patients must be investigated. [ABSTRACT FROM AUTHOR]

Background and Aim: While most of the people with tinnitus have some degrees of hearing impairment, a small percent of patients admitted to ear, nose and throat clinics or hearing evaluation centers are those who complain of tinnitus despite having normal hearing thresholds. This study was performed to better understanding of the reasons of probable causes of tinnitus and to investigate possible changes in the auditory brainstem function in normal-hearing patients with chronic tinnitus. Methods: In this comparative cross-sectional, descriptive and analytic study, 52 ears (26 with and 26 without tinnitus) were examined. Components of the auditory brainstem response (ABR) including wave latencies and wave amplitudes were determined in the two groups and analyzed using appropriate statistical methods. Results: The mean differences between the absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that was not statistically significant. Also, the interpeak latency values of waves I-III, III-V and I-V in both groups had no significant difference. Only, the V/I amplitude ratio in the tinnitus group was significantly higher (p=0.04). Conclusion: The changes observed in amplitude of waves, especially in the latter ones, can be considered as an indication of plastic changes in neuronal activity and its possible role in generation of tinnitus in normal-hearing patients. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis Nasal skin thickness has an important role in aesthetic results of rhinoplasty. The aim of this study was to evaluate the long-term results of tip and supratip skin defatting technique in rhinoplasty subjects using ultrasonography. Study Design Prospective, randomized, case-control study. Methods Among 111 rhinoplasty cases referred to a university hospital between February 2010 and September 2011, after physical examination and measuring the nasal tip and supratip skin thickness by ultrasonography, a total of 55 patients with thick and moderate skin were randomly allocated for rhinoplasty using one of the following methods: rhinoplasty with (case group) and without (control group) defatting tip and supratip skin. Ultrasonographic evaluation of the skins was repeated 1 and 12 months after surgery, and the data were analyzed by Wilcoxon and repeated measure tests using SPSS 17 software. Results Twenty-eight of 55 candidates (10 men, 45 women; mean age, 25.1 ± 7.6 years) underwent skin defatting during rhinoplasty; the other 27 patients did not undergo this procedure. Forty-four patients completed the study. Thickness of tip and supratip skin was not statistically different before surgery and during follow-up evaluations in defatting and nondefatting technique groups ( P = .7). Conclusions Defatting techniques have no effect on reducing tip and supratip skin thickness after rhinoplasty in moderate to thick skins. Laryngoscope, 123:2131-2135, 2013 [ABSTRACT FROM AUTHOR]

Introduction: Otosclerosis is a disease of bony labyrinth. Structural changes in the labyrinth often cause ossicular fixation, and thus conductive hearing loss. The purpose of this study was to evaluate middle ear exploration findings and frequency of ossicular and footplate area anomalies in patients with suspected otosclerosis referred to Amiralmomenin and Golsar Hospitals in Rasht, Iran. Materials and Methods: In 47 patients undergone middle ear exploration in Amiralmomenin and Golsar hospitals from April 2001 to March 2011, the intraoperative findings, and other data were extracted from the medical records of the patients. The data was analyzed using SPSS 17 software. Results: Frequency of fixation of stapes, malleus, and incus by age and sex in patients undergoing middle ear exploration showed that stapes had been fixed in 39 patients, malleus in 6 patients, and incus in 21 patients. Analysis of data showed that there was no significant association between sex and age with fixation of any of ossicles (P>0/05). Middle ear anomalies were seen in 16 cases (34.0%). Overhanging of facial nerve in 4 cases, thick stapedial crura in 5 cases, and perilymph gusher in 2 cases were the most frequent anomalies. Conclusion: This study show that the results of middle ear explorations in our patients in the north of Iran is somehow different from the typical otosclerotic cases, although the frequency of ossicular anomalies is better to be evaluated and compared in different areas of Iran, and other countries. [ABSTRACT FROM AUTHOR]

Multiple Sclerosis (MS) is a demyelinating disorder of Central Nervous System. It involves 8th cranial nerve and its central nuclei and is an uncommon cause of the sensorineural hearing loss. For determining the prevalence of hearing loss (HL) especially retrocochlear type in MS, a cross-sectional study was designed using Pure-Tone Audiometry (PTA), Otoacustic Emissions (OAEs), Auditory Brainstem Responses (ABRs) compared with the control group. Data were analyzed by Qui² & Fischer exact test in SPSS 17 software. Among 60 patients (44 women & 16 men) and 38 controls (27 women & 11 men) with a mean age of 29.9±9.8 and 31.4± 8.3 years, 12.5% of case ears and 3.9% of the control ears had abnormal PTA (P= 0.043). Frequency of abnormal high frequency-PTA and two modalities of OAEs were not significantly different between case and control ears. The means of overall correlation were 75.9±23.8 in cases and 70.0±27.2 in controls (P= 0.111). 20% of case ears, and 9.2% of the control ears had abnormal ABRs (P= 0.044). The absolute latencies of waves I, II & V had not significant difference, but 10% and 11.7% of case ears and 1.3% & none of the control ears had increased inter peak latencies of I-III, and III-V respectively (P<0.05). 6.7% of case ears and 2.6% of control ears had retrocochlear abnormality (P=0.181). In conclusion, HL is more common in MS patients, especially when determined by using PTA and ABR. [ABSTRACT FROM AUTHOR]

Introduction: High prevalence of rhinoplasty in the community and lack of structured studies about its minor skin and soft tissue complications, point out the necessity of performing precise and comprehensive studies. The aim of this study was to determine the frequency of minor cutaneous and soft tissue complications of rhinoplasty. Materials and Methods: 110 patients (30 Male and 80 Female, Mean age: 26.3± 6.8) participated in this study. Before surgery all of them were checked for having each of intended complications, and 1 and 3 months after the surgery, they underwent serial visits for monitoring skin & soft tissue complications. The software used for data analysis was SPSS ver.16. Results: Acne exacerbation was seen in 27% of cases in first post-surgical visit. Nasal tip paresthesia was the most frequent complication in both postsurgical visits (49.6% in first and 36.3% in second visit), followed by eyebrow loss (31.8%), complaint of increased yawning (31.8%), periorbital hyperpigmentation (21.8%) in first visit, and, hyperpigmentation (19.1%), complaint of increased yawning (10%) and surgical site scar (7.2%) in second visit respectively. The frequency of complications was highest in younger than 25 year old age group. Conclusion: Having knowledge about these complications helps us to know which of them needs prompt medical intervention and which of them will resolve with time and just needs giving reassurance to the patient. [ABSTRACT FROM AUTHOR]