@article { author = {Tizro, Mohsen and Farid Hosseini, Reza and Khoshkhui, Maryam and Fouladvand, Ali and Mohamadi, Mojgan and Sistani, Samane and Jabbari Azad, Farahzad}, title = {Evaluation of SubcutaneousRush Immunotherapy Effectiveness in Perennial Allergic Rhinitis after a Year from Treatment}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {135-139}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.31695.2043}, abstract = {Introduction: Allergen immunotherapy is an effective treatment for allergic rhinitis. Conventional immunotherapy takesat least 5 to 6 months to reach the maintenance dosage; nonetheless, rush immunotherapy accelerates to reach the maintenance dose several months earlier. However, the safety and efficacy of this treatment has not been widely investigated. The objective of the present study was to determine the efficacy of subcutaneous rush immunotherapy in the patients with perennial allergic rhinitis after a year from treatment.   Materials and Methods: This study was carried out on a total of 15 patients with allergic rhinitis who received rush immunotherapy and were evaluated for the quality of life and clinical symptoms improvement with Sino-Nasal Outcome Test Questionnaire (SNOT-22) and Mini Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) before and after a year from treatment. Moreover, specific weed mix Immunoglobulin E (IgE) was measured before and after a year from treatment. Statistical analysis was performed using SPSS software (version 16) (P0.001).   Conclusion: Rush immunotherapy is an effective treatment in the patients with allergic rhinitis. It seems to be an alternative treatment in cases that need more rapid treatment. However, it is recommended to carry out other studiesonthe control group.}, keywords = {Allergic Rhinitis,Immunotherapy,Rush immunotherapy}, url = {https://ijorl.mums.ac.ir/article_12704.html}, eprint = {https://ijorl.mums.ac.ir/article_12704_7805c5945c8ee1ee68f1322be81367f6.pdf} } @article { author = {Bakhtiyari, Jalal and Ghorbani, Raheb and Salmani, Masoomeh and Asadi, Mozhgan and Irani, Sadaf and Esmaeel Abadi, Rana}, title = {Physicians' Perspective on a Multidisciplinary Approach to Dysphagia Management}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {141-146}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2019.35400.2167}, abstract = {Introduction: Professionals need a multidisciplinary approach to manage oropharyngeal dysphagia (OPD). Each team member should be aware of the signs and symptoms of OPD and collaborate with other team members to reach an optimum outcome. This study aimed to evaluate the knowledge and attitude of Iranian physicians regarding dysphagia and speech and language therapy roles in the management of dysphagia.   Materials and Methods: In this nonexperimental descriptive study, 133 physicians filled a researcher-made questionnaire entailing three sections, each of which recorded the participants’ demographic information, OPD knowledge (23 items), and attitude toward OPD (5 items).   Results: Iranian physicians correctly answered 70.3% of the questions indicating that they had a moderate level of knowledge on OPD. However, only 53% of the physicians referred their patients to speech-language pathologists, and almost 50% of them reported a significant recovery after speech therapy in their patients.   Conclusion: It seems that Iranian physicians need to adopt an interdisciplinary approach to manage OPD. Achievement of sufficient knowledge on the pathology of OPD, along with collaboration with other team members, can improve the outcome for patients with OPD.}, keywords = {Attitude,Dysphagia,Deglutition disorders,Knowledge}, url = {https://ijorl.mums.ac.ir/article_12744.html}, eprint = {https://ijorl.mums.ac.ir/article_12744_98b73cf9fd32e8bcc7991700effd262c.pdf} } @article { author = {Kavoussi, Hossein and Ebrahimi, Ali and Rezaei, Mansour and Khazaie, Habibolah and Shakeri, Jalal and Jamshidi, Sajedeh and Kavoussi, Reza}, title = {The Correlation of Acne with Anxiety after Rhinoplasty}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {147-152}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.25799.1842}, abstract = {Introduction: Rhinoplasty is one of the most common cosmetic surgeries occasionally associated with complications, such as acne lesions. Anxiety reportedly leads to the emergence or exacerbation of acne lesions.   Materials and Methods: This cross-sectional study was conducted on 147 patients undergoing rhinoplasty. The patients were assigned into two groups of case (with acne lesions) and control (without acne lesions) entailing 52 (45 females, 7 males) and 95 (68 females, 27 males) subjects, respectively. The data were collected using an instrument entailing clinical and demographic data and the state-trait anxiety inventory developed by Spielberger.   Results: According to the results, 70.7% and 71.6% of the patients in the case and control groups were female, respectively. Regarding the education level, 61.5% and 68.4% of the case and control groups had academic education, respectively. Additionally, 61.5% and 42.1% of the subjects in the case and control groups were single with the mean ages of 25.06±5.077 and 27.45±5.909 years, respectively. , 73.1% of the case group indicated grade 2 acne mostly in the face (100%) appearing 1-4 weeks post-surgery (51.9%). The case group had higher mean scores of trait (46.92±12.53) and state (46.21±9.30) anxiety, trait (P=0.001) and state (P=0.019) anxiety severity, as well as the prevalence of cosmetic dissatisfaction (51.9%), compared to the control group. Furthermore, acne severity showed a direct correlation with the severity of trait anxiety (r=0.472, P=0.005) and state anxiety (r=0.443, P=0.013).   Conclusion: As the findings indicated, anxiety could be a major factor in triggering or exacerbating acne lesions after rhinoplasty. The assessment of mental health before the surgery, proper selection of the cases seeking aesthetic surgery, provision of psychological support, lack of medical history of acne lesions, and successful cosmetic rhinoplasty could result in reducing the prevalence of acne lesions after cosmetic surgeries, especially rhinoplasty.}, keywords = {Anxiety,Acne,Rhinoplasty,State-trait anxiety}, url = {https://ijorl.mums.ac.ir/article_12537.html}, eprint = {https://ijorl.mums.ac.ir/article_12537_8f39f1321289fc5cf9ff78e2be2331ca.pdf} } @article { author = {Burduk, Pawel and Sawicki, Piotr and Szylberg, Lukasz and Bodnar, Magdalena and Marszalek, Andrzej}, title = {Expression of Matrix Metalloproteinase-2/9 and Tissue Inhibitor of Metalloproteinase-1/2 as Predictive Factors in Oropharyngeal Squamous Cell Carcinoma}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {153-161}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.27737.1905}, abstract = {Introduction: Metalloproteinases and their tissue inhibitors play an important role in the metastases formation. A multistage process of carcinogenesis requires the involvement of numerous enzymes and compounds that facilitate the expansion of tumor cells. The formation of metastases depends on both metalloproteinases and tissue inhibitors activation leading to the activation of neoangiogenesis. The changes of the expression in stromal and tumor proteins could be prognostic factors in patients with oropharyngeal squamous cell carcinoma.   Materials and Methods: This study was conducted on a total of 34 patients with squamous cell carcinoma of the oropharynx divided into 2 groups, including 20 patients with neck metastasis and 14 patients without lymph node metastasis. Immunohistochemistry was performed with a standard protocol.   Results: The results of the present analysis indicated a higher expression of metalloproteinases 2 in the stroma than in tumor with increasing tumor grade. The dynamics of changes in the expression of metalloproteinases showed the increase in metalloproteinases 2 and the decrease in metalloproteinases 9 depending on the tumor size. Dynamics of changes in the expression of tissue inhibitor 1 in the tumor stroma significantly increased with the tumor stage. In the assessment of nodal staging from N0 to N3, the expression of tissue inhibitor 1 and 2 were higher in the tumor tissues. The increase of metalloproteinases 2, tissue inhibitor 1 in the tumor, and metalloproteinases 9 in the stroma were characterized by a reduction in the odds ratio of patient’s survival.   Conclusion: The complex evaluation of the expression of metalloproteinases and tissue inhibitors may be used for the prognosis of the patient’s survival.}, keywords = {Metalloproteinases,Oropharyngeal cancer,Survival,Tissue inhibitors}, url = {https://ijorl.mums.ac.ir/article_12737.html}, eprint = {https://ijorl.mums.ac.ir/article_12737_1155912780832a33d1f0da30e261fb2a.pdf} } @article { author = {Ahmadi, Mohammad Saeid and Tayebi, Elham and Mazarei, Hamid and Jahanshahi, Javaneh}, title = {Effect of Adenotonsillectomy on Serum Levels of Total Antioxidant-A Prospective Cohort Study}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {163-166}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.30842.2074}, abstract = {Introduction: Antioxidants are essential elements in reducing the harmful effects of free radicals. The aim of this study was to compare the serum levels of total antioxidant before and after adenotonsillectomy procedure.   Materials and Methods: This study was conducted on 41 children with the age range 3-12 who underwent adenotonsillectomy. The total level of antioxidants was measured before and two months after adenotonsillectomy.   Results: The mean±SD level of serum antioxidants raised significantly from 11.17 (15.36) before surgery to 22.19 (10.87) IU/mL after surgery (P<0.001). The mean value was increased from 15.50 (17.97) to 24.89 (12.66) and 6.62 (10.67) to 19.36 (7.98) IU/ml among males and females, respectively.   Conclusion: Adenotonsillectomy can efficiently increase the serum levels of total antioxidant among children with adenotonsillar hypertrophy. Moreover, it can improve the immune system against free radicals.}, keywords = {Adenotonsillectomy,Antioxidants,Free radicals}, url = {https://ijorl.mums.ac.ir/article_12712.html}, eprint = {https://ijorl.mums.ac.ir/article_12712_ad12d4b8482e4ded9a34ccc0d3843219.pdf} } @article { author = {Misale, Priyanka and Lepcha, Anjali and Chandrasekharan, Ramanathan and Manusrut, Manusrut}, title = {Labyrinthine Fistulae in Squamosal Type of Chronic Otitis Media: Therapeutic Outcome}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {167-172}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.27109.1907}, abstract = {Introduction: Labyrinthine fistulae (LF) are the common complications of chronic otitis media (COM) of squamosal variety. The final therapeutic outcome of this condition is to preserve the cochlear and vestibular functions. Herein, we present the data of the cases managed at our institute with respect to their presenting complaints, adopted therapeutic approaches and outcomes.   Materials and Methods: A retrospective chart review was conducted on all cases with COM squamosal type in adult patients. A total of 275 patients were reviewed, out of whom 30 cases had LF. The results were mainly studied with respect to the postoperative improvement of hearing and vertigo.   Results: The incidence rate of LF in the present study was obtained at 10.9%. Only 50% of the cases had the symptoms of vertigo. Furthermore, positive fistula test was elicited in 3.3% of the cases. All cases undergoing preoperative imaging were diagnosed successfully. In addition, 42.85% of the cases had profound hearing loss preoperatively, which sustained after the operation. However, 47.61% of the cases showed an improvement of at least ≥ 10 dB in the air-bone gap. Out of the 15 LF cases with vertigo as the main complaint, only 11 cases referred for follow-up. In this regard, 63.63% of the cases had no postoperative vertigo symptoms.   Conclusion: Patients with LF may not have complaints of vertigo and a positive fistula sign upon admission. Pre-operative imaging facilitates the diagnosis of this condition. The removal of the matrix under constant irrigation, followed by repair with bone wax and/or autologous tissue, is sufficient to preserve the cochlear and vestibular symptoms postoperatively.}, keywords = {Cholesteatoma,Hearing Loss,Labyrinth diseases,Middle Ear,vertigo}, url = {https://ijorl.mums.ac.ir/article_12706.html}, eprint = {https://ijorl.mums.ac.ir/article_12706_eee89bb6c2cb09f0e876f3db5574981f.pdf} } @article { author = {Ansari, Mohammed-Humaam and Gujrathi, Atishkumar-Balajirao and Ambulgekar, Vijayalaxmi}, title = {Extraskeletal Ewing’s Sarcoma of Neck in a Child- A Case Report}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {173-176}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.33075.2101}, abstract = {Introduction: Ewing's sarcoma (ES) is an extremely rare bone malignancy observed in otorhinolaryngeal practice. In otorhinolaryngology, it sometimes involves the facial bones and cervical vertebrae. In children, ES is the second most common primary malignancy of bone after osteosarcoma. Extraskeletal Ewing’s sarcoma (EES) is an extremely rare malignancy of mesenchymal cell origin. The EES is observed in the trunk and lower extremities. The neck is an extremely rare primary site for EES.   Case Report: A 3-year-old female child referred with a rapidly enlarging right-sided neck swelling since 2 months ago. Physical examination and preoperative investigations suggested the diagnosis of a carotid body tumor and histopathological findings were similar. However, the results of immunohistochemistry revealed a confirmatory diagnosis of ES. Conclusion: Hereby, we presented a case of EES of the neck in a child, which was completely misdiagnosed preoperatively due to its rare incidence. The incidence of EES in the head and neck region can be successfully managed with radical excision and radiotherapy.}, keywords = {Child,EES,Extraskeletal,Ewing’s sarcoma,Neck}, url = {https://ijorl.mums.ac.ir/article_12754.html}, eprint = {https://ijorl.mums.ac.ir/article_12754_092ef21b284cc614e8519bfaabd1623d.pdf} } @article { author = {Alvaréz-Neri, Hiram and Sadowinski, Stanislaw and De La Torre, Carlos and Villamor, Perla}, title = {Hamartoma of the Vallecula in a Five-Month-Old Infant- A Case Report}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {177-180}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.26869.1892}, abstract = {Introduction: Hamartomas is a neoplasms composed of mature tissue elements from the affected site with disproportion between their components. Although lingual hamartomas are traditionally infrequent in the head and neck, a significant number of case reports with this disorder in infancy are arising from the literature.   Case Report: We present a remarkable case of a vallecular hamartoma in a 5-month-old infant. Moreover, the value of histopathological diagnosis was highlighted regarding the differentiation between hamartomas and other benign/reactive lesions.   Conclusion: Surgical excision is regarded as the treatment of choice for vallecular hamartomas; in addition, no recurrence has been reported after complete resection.  }, keywords = {Hamartoma,Infancy,Pharyngeal Neoplasm}, url = {https://ijorl.mums.ac.ir/article_12713.html}, eprint = {https://ijorl.mums.ac.ir/article_12713_6fe8e1ba4286508a8bbea5037843527d.pdf} } @article { author = {Dosemane, Deviprasad and Khadilkar, Urmila and Khadilkar, Meera and Anwar, Fayis}, title = {Seek the Spindle Tumor in Submandibular Space}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {181-184}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2019.28427.1931}, abstract = {Introduction: Submandibular region is surgically significant in the head and neck field and a mass in this region may have multiple differential diagnoses.   Case Report: An elderly man came with a single 4×2.5 cm swelling in the neck on the right side, just below the lower jaw, since one month. Ultrasound showed an irregular heterogeneous hypoechoic lesion in the right submandibular space measuring 37×23 mm with mild internal vascularity. The submandibular gland appeared separate but compressed. Fine needle aspiration was suggestive of spindle cell neoplasm. The swelling was excised under general anesthesia. By histopathological examination, the lesion was diagnosed as anaplastic lymphoma kinase-negative inflammatory myofibroblastic tumor (IMT) based on focal immunoreactivity with cyclin D1. The patient then received radiotherapy 60 Gray divided into 30 fractions over 6 weeks. The case had no evidence of recurrence or residual disease six months post-surgery.   Conclusion: Tumefactive spindle-cell lesion in the head and neck can comprise inflammatory conditions, benign and malignant neoplasms or borderline neoplasms, such as nodular fasciitis and IMT. The definitive histologic diagnosis of IMT helps in tailoring the treatment modality based on its locally aggressive biologic potential.}, keywords = {immunohistochemistry,Inflammatory myofibroblastic tumor,Spindle neoplasm,Submandibular}, url = {https://ijorl.mums.ac.ir/article_12714.html}, eprint = {https://ijorl.mums.ac.ir/article_12714_536123fcce9233efbb43837336b31638.pdf} } @article { author = {Singh, Anup and Handa, Aru-Chhabra and Sachdev, Ritesh}, title = {Synchronous Parotid and Homolateral Submandibular Gland Pleomorphic Adenoma}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {185-190}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.31957.2052}, abstract = {Introduction: Pleomorphic adenomas are benign neoplasms of salivary glands. The simultaneous homolateral occurrence of these tumors in salivary glands is exceedingly rare.   Case Report: An adult female presenting to our OPD with the swelling of right-sided preauricular and submandibular regions was diagnosed with the pleomorphic adenoma based on fine needle aspiration cytology. The patient was subjected to the excision of both swellings under general anesthesia. Postoperative facial nerve functions were within normal limits and final histopathology confirmed pleomorphic adenoma involving both the sites. A pertinent detailed literature review of English and non-English studies was indicative of only nine such cases.   Conclusion: Simultaneously occurring pleomorphic adenoma involving homolateral parotid and submandibular glands is a rare phenomenon that should be kept in mind when examining the swelling of the unifocal salivary gland.}, keywords = {Pleomorphic adenoma,salivary glands,Synchronous,surgical treatment}, url = {https://ijorl.mums.ac.ir/article_12736.html}, eprint = {https://ijorl.mums.ac.ir/article_12736_cc708f141e83f33c9463662d4c923d89.pdf} } @article { author = {Ameen, Saiful-Azhar and Husain, Salina and Zahedi, Farah-Dayana and Sabir -Husin- Athar, Primuharsa -Putra and Masir, Noraidah}, title = {Nasal Angiomyolipoma (AML) Mimicking Juvenile Nasopharyngeal Angiofibroma}, journal = {Iranian Journal of Otorhinolaryngology}, volume = {31}, number = {3}, pages = {191-195}, year = {2019}, publisher = {Mashhad University of Medical Sciences (MUMS)}, issn = {2251-7251}, eissn = {2251-726X}, doi = {10.22038/ijorl.2018.25430.1836}, abstract = {Introduction: Angiomyolipoma (AML), a benign mesenchymal tumor that commonly arises from the kidney, may be associated with tuberous sclerosis complex and perivascular epithelioid cell tumors (PEComas). Nasal angiomyolipoma is very rare and usually occurs in elderly individuals with epistaxis and nasal obstruction.   Case Report: We report a rare case of nasal angiomyolipoma in a young male. To the best of our knowledge, this is the first documented case of angiomyolipoma originating from the posterior end of the inferior turbinate, clinically mimicking juvenile nasopharyngeal angiofibroma (JNA). The tumor was removed completely via coblator-assisted endoscopic sinus surgery. The patient was asymptomatic at a 2-year follow-up.   Conclusion: Nasal AML located in the posterior nasal cavity in a male patient can mimic the presentation of JNA. A computed tomography scan of the paranasal sinuses played an important role in differentiating nasal AML from JNA. The coblator-assisted endoscopic technique is useful in controlling intraoperative hemostasis in the removal of a suspicious vascular tumor.}, keywords = {Epistaxis,Endoscopic sinus surgery,Nasal angiomyolipoma,Perivascular epithelioid cell tumor (PEComa),Juvenile nasopharyngeal angiofibroma}, url = {https://ijorl.mums.ac.ir/article_12705.html}, eprint = {https://ijorl.mums.ac.ir/article_12705_d0f41567743fb3ff0bbfac2543602cb8.pdf} }