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Auditory temporal resolution is the main feature of speech processing abilities. Gap in noise test (GIN) is the one of the new tests for assessing auditory temporal resolution. This study aimed to compare temporal resolution ability of subjects who wear cochlear implant (CI) and normal-hearing listeners. In this cross sectional study, GIN was performed on 9 postlingually cochlear implanted patients with mean age of 31.77±6.6 and 17 controls with mean age of 32.76±6.5 years. Following a training period (8 sessions on the average), the cochlear implant users were reevaluated by the same test. Data were analyzed by independent and paired t-test using SPSS software version 18. There was significant difference in approximate threshold and percent of corrected answers between cochlear implant users and normal-hearing controls (p<0.05). The mean approximate threshold and percent of corrected answers of cochlear implant users after training period, was significantly improved (p<0.05). The results demonstrated that patients with cochlear implant have some ability of auditory temporal resolution, and that this ability may be improved by regular training. [ABSTRACT FROM AUTHOR]

Pitch perceptionis the most important factor in perception of phonetic and prosodic features of speech. The difference limen for frequency (DLF) is the index of ability to percept the pitch. The purpose of this study was to examine the ability of people with cochlear implant in pitch perception at the frequencies of 500, 1000, 2000 and 4000 Hz and to compare it with normal healthy counterparts. In this cross-sectional study, DLF test was conducted on 17 normal individuals with an average age of 32.76 ± 6.5 years old and 9 individuals with cochlear implant with an average age of 31.77 ± 6.6 years old who had hearing loss after speech training. After a period of speech training (on average 8 sessions), DLF test was repeated for people with cochlear implant. Data were analyzed with statistical package SPSS using Paired t-test and independent variables tests. In the initial test, the DLF in individuals with cochlear implant in all experimental frequencies was significantly higher than normal people (p <0.05). Considerable improvement was observed in the level of difference limen for frequency of people with cochlear implant after training course (p <0.05).The findings of this study show that people with cochlear implant have partially ability to understand the pitch, especially at low frequencies and this ability improves with regular training. [ABSTRACT FROM AUTHOR]

Foreign body in the esophagus is a common emergency presentation. We reviewed and analyzed our experienceson removing esophageal impactions in patients referred to Ahvaz Imam Hospital during 1994 to 2005to assess our success rates in using esophagoscopy and related treatments for removing esophageal foreign bodies. Seven hundred and five adult patients with suspected impaction of esophageal foreign bodies from 1994 to 2005 at Ahvaz Imam Hospital were reviewed. Plain films were performed in every patient with a suspected esophageal foreign body (EFB). In all patients, rigid esophagoscopy was done under general anesthesia once the diagnosis of impacted EFB is made. The following findings were determined at the time of review: Sex, age, diagnosis on admission, history of preexisting disease, clinical symptoms on admission, type of radiographic investigation, estimated duration and site of impaction, type of management, status of the esophagus at the time of esophagoscopy, type and number of foreign body(ies) removed, complication and duration of hospital stay. Chicken bones were the most frequently responsible foreign body and the area just below the cricopharyngeus muscle was the most frequent level of impaction. Radiographic studies gave false positive and false negative information in 17% of the cases. Rigid esophagoscopy was used successfully for foreign body removal in 99.3%. Foreign body ingestion represents a frequent reason for emergency endoscopy. The endoscopic procedure is a successful technique which allows the removal of the foreign bodies in almost all cases without significant complications. [ABSTRACT FROM AUTHOR]

Despite different studies about the role of cytokines in development of nasal polyps, there are only few studies about the interleukin-4 and the role of this cytokine is not yet clearly known. Hence in this study, the genetic polymorphism in interleukin-4 which is not down-regulated by anti-inflammatory therapeutics was assessed in nasal polyposis patients in comparison with control group. In this cross-sectional comparative study, 152 consecutive subjects attending to a tertiary health care center in 2015 including 76 nasal polyposis patients and 76 control subjects were enrolled. Five milliliters blood sampling was done by single trained subject in sterile conditions and it was stored in EDTA-containing vials and froze in -20 Celsius to extract DNA with real-time PCR. DNA was extracted by chloroform phenol method and the Tag man real time was used for genotyping of C-590 promoter location in patients and subjects by special probes using the Step-one real time PCR (ABI Company). The genotypes were compared across the groups. Chi-Square and Independent-Sample-T tests were used and were considered statistically significant at P values less than 0.05. There were no statistically significant differences (P= 0.404) between genotype in patients in two groups. The age and gender were not significantly related to the genotype in subjects in two groups (P > 0.05). Totally it may be concluded that genetic polymorphism in interleukin-4 gene location in 590 promoter locus is not related to nasal polyposis. However further studies should be carried out to attain more definite results and decrease the controversies about the role of inflammatory cytokines in pathogenesis of nasal polyposis. [ABSTRACT FROM AUTHOR]

This study was carried out to determine the relationship of sensorineural hearing loss and drilling in mastoid surgery at Ahvaz Jundishapur University of Medical Sciences in Iran. This was a prospective study conducted on889 patients of chronic middle ear disease, which were surgically treated at the department of otolaryngology of Imam and Apadana Hospitals in Ahvaz during March 2008 to 2015.Drilling duration in tympanomastoid surgery was 22.1±15.1 minutes. The preoperative and postoperative bone conduction thresholds in frequencies 250 to 4000 HZ were obtained one day before and 6 weeks after the surgical procedure by one expert audiologist. The descriptive statistics (frequency, correlation) and inferential statistics (paired t-Test, Chi-square) were utilized to evaluate hearing loss after surgery. The significant level was considered at 0.05 in this study. A total of 889 patients were included in this study. Among them 613 (68.95%) were female and 276 (31.05%) of them were male. The male to female ratio was 1:2.4. The patients ranged in age from 3 to 78 years with a mean of 24.15 years. Statistically significant deterioration in bone conduction thresholds was found only with radical mastoidectomy. There was no change in mean bone conduction thresholds in 819 of patients. A total of 70 patients showed worsening of postoperative bone conduction thresholds. Our study has shown that the middle ear surgery in chronic otitis media in majority of the patients does not affect bone conduction thresholds. It is suggested that all ENT surgeon should do chronic otitis media surgery without being worried, but must take all the precaution. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to investigate the relationship between serum levels of interleukin-6 (IL-6) and the severity and extent of squamous cell carcinoma (SCC) of the larynx based on stage of tumor progression and histological grade. Materials and Methods: All patients with a diagnosis of laryngeal cancer who underwent laryngoscopy and biopsy while hospitalized in Imam Khomeini Hospital in Ahvaz were enrolled. Tumor stage was calculated based on the TNM system, and divided into early (stage 1,2) or advanced stage (stage 3,4). In addition, patients were divided into low-grade (well differentiated) or high-grade (moderate and poorly differentiated) groups based on pathology reports from biopsy specimens. Several healthy volunteers were also enrolled as the control group. After collecting the blood samples, quantitative serum levels of IL-6 were measured (pmol/L) using IL-6 kits (Bender MedSystem, Germany). Results for quantitative variables are presented as mean and standard deviation and qualitative variables as percentages. Mann-Whitney, Kruskal-Wallis and Pearson's chi square tests were used for statistical analyses. P<0.05 was considered statistically significant. Statistical analysis of data was performed using SPSS version 13. Results: Thirty-eight patients (82.6%) were male and eight patients (17.4%) were female. IL-6 serum level was 28.8±4.7 pmol/L in the patient group and 2.64±2.88 pmol/L in the control group (P=0.0001). The serum level of IL-6 was 7.27 ± 5.31 pmol/L in early-stage patients and 54.43 ± 6.06 pmol/L in advanced-stage patients (P<0.0001). IL-6 levels increased significantly with increasing N (according to TNM) (P=0.002). Levels of IL-6 in patients with metastasis were significantly higher than in the group without metastasis (P=0.024). Moreover, IL-6 levels increased significantly with increasing local tumor spread (T) (P<0.0001). Conclusion: This study shows that IL-6 is a gender-independent factor, serum levels of which are higher in patients with laryngeal SCC than in normal subjects. The results of this study also show that serum levels of this cytokine increase significantly with progression of this malignancy. [ABSTRACT FROM AUTHOR]

Introduction: Ingestion of a foreign body is a common problem among all age groups. Most of the foreign bodies in the pharynx are usually lodged at the level of cricopharynx. The diagnosis is based on history, clinical, and radiological examination. Most foreign-body ingestions are accidental, but there may be contributory factors such as mental disorder, alcoholism, and prison incarceration. Toothbrush ingestion is uncommon and requires prompt medical attention. Case Report: In this article, a rare case of a toothbrush foreign body is presented. The ingestion was caused by a seizure and the toothbrush was removed through surgical management. Conclusion: An ingested toothbrush will not pass spontaneously. The best management is early endoscopy performed by a skilled surgeon. If this is unsuccessful, surgical management can be performed. [ABSTRACT FROM AUTHOR]

Background: The purpose of this investigation is to determine auditory neuropathy in the students with severe to profound hearing losses in Ahwaz. Materials and Methods: In this cross-sectional study, 212 children of 7-11 year old with severe to profound hearing loss performed ordinary audiometric evaluations as well as ABR and OAE. The patients with normal DPOAE who had no record of acoustic reflex having normal ABR, were considered as the patients with auditory neuropathy. Results: The neuropathic complication found in 14 children was appeared in 8 ones as one-sided (57.14%) and in 6 ones (42.86%) as two-sided. 68% of the patients as diagnosed had a very low Speech Discrimination Score (SDS). Conclusion: we must be very vigilant in auditory neuropathy diagnosis for the purpose to be successful in appropriate treatment of severe to profound hearing losses. [ABSTRACT FROM AUTHOR]

Background and Objectives: Velopharyngeal insufficiency (VPI) occurs in 25 to 43% of patients that undergo cleft palate repair. This disorder has a variety of signs including variations in nasal resonance (hypernasality), misarticulating, turmoil in nasal emissions, and grimacing. VPI can considerably affect social relations and the mental health of patients. Numerous methods have been developed for the treatment of VPI such as speech therapy, continuous positive airway pressure (CPAP), prosthetic treatment, and surgical interventions. The most common method, especially in the past three decades, has been the pharyngeal flap method. The objective of this study was to study the effects of the pharyngeal flap surgical method on the treatment of hypernasality which is a measureable sign of velopharyngeal insufficiency. Methods & Materials: In this cross-sectional study, a total of 112 patients with pharyngeal sphincter insufficiency who aged between 3 and 25 and had visited the otorhinolaryngology clinic of Imam Hospital of Ahvaz were studied from 2008 to 2015. The severity of hypernasality was measured by three speech therapists based on a universal parameter before the superior based pharyngeal flap surgery and 3 to 12 months after the surgery. The significance level for the aforementioned statistical tests was 0.05. Data was also analyzed using SPSS 16. Results: Following the superior based pharyngeal flap surgery, improved hypernasality, mild hypernasaliy, severe hypernasality, and hyponasality were observed in 42%, 6.44%, 6.11% and 8.1% of the patients, respectively. None of the 19-year old or older patients showed improvement of hyponasality and only patients aged between 3 and 6 years showed hyponasality. However, statistical analyses revealed that there was no significant difference between the responses of patients with different ages to treatment with superior based pharyngeal flap surgery (p=671). Conclusion: Results of the present study suggest that 12 months after pharyngeal flap surgery almost 87% of patients experience a complete or relative improvement of hypernasality. This finding complies with the findings of numerous previous studies. [ABSTRACT FROM AUTHOR]

Background & Purpose: Recurrent and chronic infections of the ear, throat and nose are one of the most important health problems worldwide, and they clearly affect the quality of life in adults and children. In spite of proper diagnosis and proper treatment, groups of these patients do not respond to routine treatment and are still being symptomatic and have chronic complications in these patients. Various studies have shown that the immune system is defective in some patients with frequent and chronic infections of the ear, throat and nose. Therefore, the present study was conducted to evaluate the relative frequency of primary immunodeficiency diseases in children with sinusitis and recurrent middle ear infections. Methods & Materials: This study evaluated underlying immune defects in patients with otitis media or recurrent sinusitis. Serum levels of IgA, IgG and IgM were evaluated by nephlometric test. In addition, a complete count of blood cells was also evaluated. The rate of humoral response to diphtheria and tetanus was also assessed. NBT was used to evaluate the immune system. Results: Out of 62 patients, 12 patients (19%) had defects in at least one antibody class. Five patients with IgA deficiency (which 2 of them have also showed IgG concurrent deficiency) were seen. Also, 4 patients had IgG deficiency and 3 patients showed IgM deficiency. None of the patients had abnormal cell count. NBT response was also normal in all patients. Conclusion: In general, the findings of the present study in line with previous studies showed that a large proportion of children with recurrent otitis media and sinusitis have abnormal immunologic function. Therefore, it is recommended that the evaluation of immune deficiency be considered in these patients. [ABSTRACT FROM AUTHOR]

Purpose: Congenital cytomegalovirus (CMV) infection is the most common congenital infection in developing countries with sensorineural hearing loss (SNHL) being the most important of its long-term sequelae. The aim of this research was to evaluate the amount of CMV DNA in perilymph of patients with SNHL undergoing cochlear implant (CI) procedure by Polymerase chain reaction (PCR) technique. Materials and methods: This cross-sectional and prospective study was conducted in a group of patients with ages ranging from 1 to 7 years. The perilymph was extracted preoperatively using a Yale spinal needle after opening of the round window. 25 microliters of perilymph was extracted and stored at -80 degrees centigrade. PCR technique was employed to detect CMV DNA. The data was collected and statistically analyzed. Results: A sample size of 41 patients with bilateral profound SNHL was selected. After cochlear implantation, CMV DNA evaluation was performed which was found positive in 18 patients (43.9%) and negative in 23 patients (56.09%) with a statistically significant relationship. No statistical relationship was found with gender, age and other comorbid disorders. 3-6 months' follow-up was individually performed to compare Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) tests in CMV DNA positive and negative patients, yielding different results which were statistically insignificant. Conclusion: The early detection of CMV infection with real time PCR technique enables us to perform viral screening tests in patients with SNHL. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the current study was to investigate plasticity of auditory system following cochlear implants (CI) in prelingually severe to profound hearing-impaired children using cortical auditory evoked potentials (CAEPs) and correlate it with auditory perception performance. Methods: A total of 28 (15 boys, 13 girls) children with profound hearing loss, who underwent CI at Ahvaz Jundishapur University of Medical Sciences, Iran, were included in this study. Their mean age at the time of implantation was 21.3 months. All children were evaluated before implantation and 3 months after implantation using the CAEPs and categorical auditory performance (CAP). For CAEP measurement, the stimuli on the HEARLab system (/m/, /g/, and /t/) were extracted from running speech and presented at 65 dB SPL. Results: The mean CAP and P1 amplitude values were increased from pre-CI condition to 3-month post-CI condition (Paired t-test, p<0.001). We found a positive correlation between P1 amplitude and CAP score changes from pre- to post-implantation stages (Pearson's r=0.62, p=0.018). There was no significant difference in CAP and P1 amplitude values between boys and girls (p >0.05). Conclusion: The present study indicated that early cochlear implantation, will improve cortical auditory plasticity and auditory performance ability in pre-lingual hearing-impaired children. [ABSTRACT FROM AUTHOR]

Background: Around 95% of the world’s population are infected with the Epstein-Barr virus (EBV), which can persist latent in B lymphocytes and epithelial cells life-long. EBV has been linked with lymphoid and epithelial cancers and persistence of EBV infection in lymphoid or epithelial cells may result in virus-associated B-cell tumors or nasopharyngeal carcinomas (NPC). This study was conducted to determine the frequency of EBV DNA in nasopharyngeal carcinoma tissue of Iranian patients. Materials and methods: A total of 50 blocks of formalin-fixed paraffin-embedded tissue of NPCs from 38 (76 %) male and 12 (24%) female patients were collected from archives of Ahvaz hospitals. Sections were cut at 5 μm and DNA was extracted for detection of EBV DNA and EBV typing by mested PCR. DNA sequencing was performed to confirm PCR results. The distribution of EBV DNA was compared among WHO histological subtypes of NPC. Results: Some 3 female and 11 (22%) male NPC samples showed positive for EBV DNA type 1, 2/14(22.2%)WHO histological type II and 12/41(29.3%) WHO histological type III. Conclusions: The frequency of EBV DNA among NPCs in Iranian patients was found to be 28%, EBV type I predominating. Both WHO histological type II and III NPC subtypes demonstrated approximately the same detection prevalence., (Creative Commons Attribution License)

Introduction: One of the main treatments of chronic otitis media with effusion is ventilation of the middle ear with a ventilation tube (VT). The objective of this study was to determine the incidence and the types of VT complications in children with otitis media with effusion in Ahwaz., Materials and Methods: In this prospective study, the medical records of 208 children (52 male and 35 female) in Imam Khomeini and Apadana hospitals were reviewed. The children were between 10 months and 6 years old. The patients were followed up 12-18 months after ventilation tube insertion. We reviewed age, sex, postoperative otorrhea, eardrum atrophy, tympanosclerosis and persistent perforation. In all these patients, the indication for surgery was chronic middle ear effusion. The data were analyzed and presented as numbers and percentages using SPSS17.0., Results: Transient otorrhea occurred in 12.5% and delayed otorrhea in 8.2%. Otorrhea non-responsive to medical treatment was seen in 1.9%. Complications after tympanostomy tube extrusion included atrophy (27.8%) myringosclerosis (37.9%), and persistent perforation (2.4%).The average extrusion time was 10.5 ±5 months (ranging between 3-22 months)., Conclusion: After extrusion of the ventilation tube, patients should be followed up regularly for recurrence of OME. Myringosclerosis, tympanic membrane atrophy and otorrhea are the most common complications of otitis media with effusion. However, they are generally insignificant. Consequently, in the majority of these complications, there is no need for any treatment.