2024-03-28T23:14:01Z
https://ijorl.mums.ac.ir/?_action=export&rf=summon&issue=908
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Comparison of Titanium vs. Polycel Total Ossicular Replacement Prosthesis
Mohammad
Faramarzi
Reza
Jahangiri
Sareh
Roosta
Introduction: Even though modern technology progresses so rapidly, annals of otology are replete with so many challenging article, which often compare various types of prosthesis. Since there has not been a prospective randomized clinical trial study which compares the hearing result of total ossicular replacement prosthesis made of Titanium with omega connector and Polycel in the literature, we decided to perform a study encompassing this issue. Materials and Methods: 105 patients, who were in the 2nd stage of their operation and who needed total ossicular replacement prosthesis, were included in this prospective single blind randomized clinical trial study. Patients were classified in two groups: titanium Kurz (TTP™ -Vario system, Kurz GmbH, Dusslingen, Germany) with omega connector and Polycel (Sheehy Plastipore Polycel, Medtronic Xomed Inc). The duration of the follow up was 6-12 months. In order to evaluate hearing results, pure tone audiometric in 0.5, 1, 2, and 4 kHz were checked. In addition, speech reception threshold was recorded. A successful surgery was defined as having a postoperative air–bone gap within 20 dB. Results: We accomplished successful hearing in 64.4% of patients with titanium and 65% of patients with a Polycel prosthesis.Improvement in speech reception threshold was 11.5 dB in the titanium group and 13 dB in the Polycel group. In other words, there was no significant difference between the two groups. In addition, air-bone gap improvement after ossiculoplasty was 11.2 dB in the patients with a titanium prosthesis and 12.4 dB in the Polycel group. In fact, the difference was not significant. Conclusion: We found that both the titanium and the Polycel prosthesis improve speech reception threshold and air-bone gap closure in a similar manner.
Chronic otitis media
Ossicular reconstruction
Total ossicular replacement prosthesis
Titanium
Polycel
2016
03
01
89
97
https://ijorl.mums.ac.ir/article_6532_569993d668422733eba5ed9b13449827.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Evaluation of Factors affecting Surgical Outcome of Tympanoplasty
Masoud
Naderpour
yalda
Jabbari Moghadam
Ensieh
Ghanbarpour
Nikzad
Shahidi
Introduction: Tympanoplasty is a standard procedure to repair tympanic membrane perforation. The aim of this study is to evaluate the results of tympanoplasty (hearing improvement and tympanic membrane closure rate) in patients suffering from chronic perforation of the tympanic membrane by considering the prognostic factors. Materials and Methods: In a prospective study, based on the results of tympanoplasty with temporal graft fascia in 60 patients in the ENT department of the Medical Science University of Tabriz, we evaluated prognostic factors, such as age, sex, smoking, size, and site of perforation, for the outcome of this surgery. Results: The rate of surgical success- integration of the graft- was 93.3%. Improvement of hearing, as demonstrated through audiometry, occurred in 93% of cases. We did not find any factors to be statistically significant to affect surgical outcome. Conclusion: Even by considering the influence of different factors on the results of a tympanoplasty operation, according to the statistical results of this study, there is not a significant difference in the results of the operation, neither in the health of the tympanic membrane after surgery nor in hearing development.
Chronic suppurative otitis media
Graft
Tympanoplasty
2016
03
01
99
104
https://ijorl.mums.ac.ir/article_6551_7ca10b1142149663b8866bef49f53047.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Frequency of Congenital Heart Diseases in Prelingual Sensory-Neural Deaf Children
Masoud
Motasaddi Zarandy
mohammad Jafar
Mahmoudi
Iran
Malekzadeh
Sevil
Nasirmohtaram
Introduction: Hearing impairment is the most frequent sensorial congenital defect in newborns and has increased to 2–4 cases per 1,000 live births. Sensory-neural hearing loss (SNHL) accounts for more than 90% of all hearing loss. This disorder is associated with other congenital disorders such as renal, skeletal, ocular, and cardiac disorders. Given that congenital heart diseases are life-threatening, we decided to study the frequency of congenital heart diseases in children with congenital sensory-neural deafness. Materials and Methods: All children who had undergone cochlear implantation surgery due to SNHL and who had attended our hospital for speech therapy during 2008–2011 were evaluated by Doppler echocardiography. Results: Thirty-one children (15 boys and 16 girls) with a mean age of 55.70 months were examined, and underwent electrocardiography (ECG) and echocardiography. None of the children had any signs of heart problems in their medical records. Most of their heart examinations were normal, one patient had expiratory wheeze, four (12%) had mid-systolic click, and four (12%) had an intensified S1 sound. In echocardiography, 15 children (46%) had mitral valve prolapse (MVP) and two (6%) had minimal mitral regurgitation (MR). Mean ejection fraction (EF) was 69% and the mean fractional shortening (FS) was 38%. Conclusion: This study indicates the need for echocardiography and heart examinations in children with SNHL.
Congenital sensory-neural hearing loss
congenital heart disease
echocardiography
Electrocardiography
2016
03
01
105
111
https://ijorl.mums.ac.ir/article_6552_cb9fe8ac55fc29292c0261c5bb19ec98.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Development and Validation of a Persian Version of Dichotic Emotional Word Test
Atefe
Davudazde
Abdolreza
Shaibanizadeh
Zahra
Jafari
Frazin
Fahimnia
Masoud
Haghani
Introduction: Emotional words in comparison with neutral words have different hemispheric specialization. It is assumed that the right hemisphere has a role in processing every kind of emotional word. The objective of the present study was the development of a Persian version of the dichotic emotional word test and evaluate its validation among adult Persian speakers. Materials and Methods: The present study was done on 60 adults, with the age ranging from 18-30 years for both genders, who had no history of neurological disorders with normal hearing. The developed test included eight main lists; each had several dichotic emotional/ neutral pairs of words. Participants were asked to recall as many words in each list as they could after they listened to them. A content validity index was used to analyze the validity of the test. Results: The mean content validity index score was 0.94. The findings showed that in the left ear, emotional words were remembered more than neutral ones (P=0.007). While in the right ear, neutral words were remembered more (P=0.009). There were no significant differences in male and female scores. Conclusion: Dichotic emotional word test has a high content validity. The ability to remember emotional words better in the left ear supports the dominant role of the right hemisphere in emotional word perception.
Dichotic Listening Test
Emotional Aspects
Right Hemisphere
Cerebral Dominance
2016
03
01
113
119
https://ijorl.mums.ac.ir/article_6537_3161ef5d799f9bc9762d9c9cd8ce3de0.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Integrated Internal Stabilization for Saddle Nose Surgery
Ebrahim
Karimi
Jalal
Mehdizadeh
Shahin
Bastaninejad
Mohammad
Koohkan
Introduction: Correction of Saddle nose deformity is one of the most challenging issues in facial plastic surgery. Materials and Methods: In this study, a single structure in the form of L-strut was attempted to be created by using one 0.035" Kirschner wire and an autologous costal graft out of the 10th and 11th ribs. This study involved 13 cases, most of whom were traumatic. The corrective surgical techniques used in this study will be described in detail. Results: There was no warping, no rejection, and no infection in the created L-strut and patients’ satisfaction was very good during the follow up period. Conclusion: Surgical correction of a saddle-shaped nose using the described technique seems to be an acceptable and uncomplicated technique, and the cosmetic result is totally acceptable.
Nasal reconstruction
Wired costal graft
Saddle nose deformity
2016
03
01
121
124
https://ijorl.mums.ac.ir/article_6538_30bf9da9b75af188ccb223a513ae8edd.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Smell Decline as a good Predictor of Sinonasal Polyposis Recurrence after Endoscopic Surgery
Mahdi
Bakhshaee
Mohammad Reza
Sharifian
Amir Hossain
Ghazizadeh
Kianoosh
Nahid
Karim
Jalaeian Samani
Introduction: To evaluate the most sensitive symptom to predict early recurrence of nasal polyposis. Prospective longitudinal cohort study. Tertiary university referral center with accredited otorhinolaryngology residency programs. Materials and Methods: In this prospective study, we evaluated 62 patients with diffuse nasal polyposis. All patients underwent functional endoscopic sinus surgery. The author-devised questionnaire relating to the four major symptoms of chronic rhinosinusitis were answered by patients at the pre-operative visit and at 1, 3, 6, 12, and 24 months after surgery. Patients were followed up with serial endoscopic examinations, and a computed tomography (CT) scan was performed if indicated. Results: All 62 patients (37 male, 25 female) completed the study. The mean age was 41.24 ± 12.47 years. All major symptoms showed significant improvement after surgery (P=0.000); however, the severity of symptoms gradually increased in patients with a recurrence of polyposis, but at different points in time (P= 0.008). Sense of smell was the first symptom to deteriorate in patients with relapse (mean, 6 months) followed by nasal secretion (12 months), obstruction and pain(24 months). Patients with asthma, Samter’s triad, allergic fungal rhinosinusitis (AFRS) and allergic rhinitis showed symptoms of recurrence sooner than other patients (P<0.05). Conclusion: The most sensitive symptom for the early detection of recurrence of nasal polyposis is a decrease in the sense of smell. Nasal obstruction and facial pain were observed in the late stage of relapse when frank polyposis formation was established.
Asthma
Allergic Rhinitis
Endoscopic sinus surgery
Nasal secretion
Nasal obstruction
Recurrence
Sinonasal polyposis
Smell
2016
03
01
125
134
https://ijorl.mums.ac.ir/article_6560_4fa764878cc32f0d5af282fb5ede1f31.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Prevalence of Associated Anomalies in Cleft Lip and/or Palate Patients
Shahin
Abdollahi Fakhim
Nikzad
Shahidi
Alireza
Lotfi
Introduction: Orofacial clefts are among the most common congenital anomalies. Patients presenting with orofacial clefts often require surgery or other complex procedures. A cleft lip or palate can be a single anomaly or a part of multiple congenital anomalies. The reported prevalence of cleft disease and associated anomalies varies widely across the literature, and is dependent on the diagnostic procedure used. In this study we determined the prevalence of associated anomalies in patients with a cleft lip and/or palate, with a specific focus on cardiac anomalies. Materials and Methods: In this cross-sectional study, 526 patients with a cleft lip and /or palate admitted to the children’s referral hospital between 2006 and 2011 were evaluated. All associated anomalies were detected and recorded. Patient information collected included age, gender, type and side of cleft, craniofacial anomalies and presence of other anomalies, including cardiac anomalies. Data were analyzed using SPSS version 16. Results: Of the 526 patients enrolled in the study, 58% (305) were male and 42% (221) were female. In total, 75% of patients (396) were aged between 4 and 8 years and 25% (130) were aged less than 4 years. The most common cleft type in our study was bilateral cleft palate. The most commonly associated anomaly among cleft patients, in 12% of cleft patients, was a cardiac anomaly. The most common cardiac anomaly was atrial septal defect (ASD). Conclusion: The prevalence of associated anomalies among orofacial cleft patients is high. The most common associated anomaly is cardiac anomaly, with ASD being the most common cardiac anomaly. There are no significant relationships between type of cleft and associated cardiac anomalies.
Anomaly
Cardiac
Cleft
Oro-facial
2016
03
01
135
139
https://ijorl.mums.ac.ir/article_6544_3cbb4f7d2774af11e047afb916a7b36c.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Evaluation of Post Laryngectomy Pharyngocutaneous Fistula risk Factors
Sophia
Nitassi
Jihane
Belayachi
Mohammed
Chihab
Ilham
Rkain
Jalila
Benayad
Mohammed Anas
Benbouzid
Abdelillah
Oujilal
Leila
Essakalli
Introduction: Pharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy. Its incidence is extremely variable, with values ranging from 3% and 65%. The management of this problem considerably increases the length and the cost of hospitalization. The aim of this study is to analyze the incidence, predisposing factors, and outcome of PCF in patients undergoing total laryngectomy in a Moroccan teaching hospital in Rabat, Morocco. Materials and Methods: This study is a retrospective study including 136 patients who underwent total laryngectomy for squamous cell carcinoma of the larynx in our institution, between January 2006 and December 2013. Socio-demographical, biological, surgical, and outcome data were included. Risk factors were analyzed for association with PCF formation. Results: The overall PCF rate was 27.8%. The mean age was 58 (32-82 years). Univariate analysis showed age (P= 0,028), hemoglobin (P=0,026), and previous tracheotomy (P=0,028) to be associated with the onset of PCF. However, multivariate analysis revealed that previous tracheotomy (P=0,028) and low level of preoperative hemoglobin (P=0,026) were highly associated with the occurrence of PCF. Conclusion: This is an original work performed in an African country with a large serie. Our findings suggest that age, previous tracheotomy, and low level of haemoglobin are risk factors for PCF onset after total laryngectomy in T4 squamous cell carcinoma.
incidence
Pharyngeal
fistula
Risk Factor
Total laryngectomy
2016
03
01
141
147
https://ijorl.mums.ac.ir/article_6561_46e091832348845220210f421ac2538e.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
A Case of Undiagnosed Sleep Disorder with Hearing Difficulty and Dizziness
Fumiyuki
Goto
Miki
Arai
Mitusru
Kitamura
Akiko
Otomo
Ryoto
Nagai
Shuujiro
Minami
Takanobu
Shimada
Tatsuo
Matsunaga
Kouichi
Tsuoda
Masato
Fujii
Introduction: The aim of this case report was to investigate the relationship between sleep disorders and audio vestibular symptoms. Case Report: A case of undiagnosed sleep disorder, presenting as a temporary auditory processing difficulty, is presented. The disorder was initially treated as sudden deafness with dizziness. A 23-year-old male patient complained of acute hearing disturbance despite normal results on pure tone audiometry. The patient was initially administered a steroid injection in the hospital. After treatment, his hearing symptoms improved only slightly and he reported balance difficulty with rightward spontaneous nystagmus. Vestibular rehabilitation was performed. We also suspected that his hearing symptom was due to an auditory processing difficulty. Despite steroid treatment and vestibular rehabilitation, neither of his symptoms improved. We subsequently identified the presence of insomnia. He was prescribed zolpidem 5 mg, which slightly improved his symptoms, and referred to a sleep specialist for further examination. Polysomnography was performed, which identified restless leg syndrome and sleep disturbance with delayed sleep phase syndrome. After pharmacological treatment, his sleep disturbance, hearing difficulty, and balance disorder completely resolved. Conclusion: Sleep disorders may provoke reversible auditory processing difficulties. We should carefully evaluate patients for a potentially undiagnosed sleep disorder, even in patients chiefly complaining of intractable sensory dysfunction such as hearing or balance disturbance.
vestibular
dizziness
Sleep
insomnia
2016
03
01
149
152
https://ijorl.mums.ac.ir/article_6553_3fe88e9df835b0041ba65d1467f55827.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Congenital Pleomorphic Adenoma in a Submandibular Gland of a Newborn- A Case Report
Roxana
Azma
Minoo
Fallahi
Maliheh
Khoddami
Bibi Shahin
Shamsian
Samin
Alavi
Introduction: Pleomorphic adenoma is a rare benign salivary gland neoplasm in children, which can be treated by simple excision. This tumor is rarely included in the differential diagnosis of solid submandibular masses in children. In the neonates, congenital pleomorphic adenoma usually presents in the nasopharynx. Surgical excision is the treatment of choice and recurrence is not expected. We report what appears to be the first case of congenital pleomorphic adenoma in the submandibular region in a one-day-old newborn. Case Report: The case of a one-day-old term baby is presented with a 5x2 cm left submandibualr mass with extension to the oral cavity. The mass was hard and non-mobile. During Ultrasonography and Contrast-enhanced Computed Tomography (CT) scan, the mass was solid with a heterogeneous internal structure. The tumor was completely excised and proved to be a pleomorphic adenoma during histopathological examination. Conclusion: Congenital pleomorphic adenoma rarely occurs in the nasopharynx and is treated by surgical excision. Our case is unique because the congenital pleomorphic adenoma is located in the submandibular gland of a newborn.
2016
03
01
153
157
https://ijorl.mums.ac.ir/article_6554_9625f3c27ca077beeb02765f8d24e41c.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Autologous Cricoid Cartilage as a Graft for Airway Reconstruction in an Emergent Technique - A Case Report
Farzad
Izadi
Reza
Vaghardoost
Vita
Derakhshandeh
Behnam
Sobouti
Yaser
Ghavami
Introduction: Laryngotracheal stenosis can be caused after traumatic injuries to the neck from the subglottic larynx to the trachea. Patients with laryngotracheal stenosis often need a tracheotomy and occasionally may become tracheotomy dependent. Different procedures have been described for the management of these lesions. Management options include techniques of endoscopic dilation, laser resection, laryngo-fissure, and an innovative array of plastic reconstructions with or without the use of stents. Case Report:This paper presents airway reconstruction in a young patient with severe subglottic stenosis due to a blunt trauma to the neck, who was treated using particles of an autologous fractured cricoid cartilage as the source for airway augmentation. An incision was made in the anterior midline of the cricoid lamina and deepened through the scar tissue to the posterior cricoid lamina. Then two lateral incisions (right & left) were made in the cricoid lamina and fractured cartilage particles and the scar tissue were removed via these two lateral incisions. The mucosal lining at the right and left of the midline incision, after debulking, were sutured to a lateral position. Thereafter three cartilage particles were used to reconstruct the anterior cricoid lamina and augment the lumen. Conclusion: It is worth to mention that an autologus cartilage graft can be used for certain cases with traumatic airway stenosis. Further follow up and more patients are needed to approve this method of reconstructive surgery in emergent situations.
Airway trauma
Autologus Cricoid Cartilage
Reconstruction
2016
03
01
159
162
https://ijorl.mums.ac.ir/article_6555_4fba7f555d561c431eb7bd52665c446e.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Ortner’s Syndrome-A Rare Cause of Hoarseness: Its Importance to an Otorhinolaryngologist
Vanita
Sarin
Bhanu
Bhardwaj
Introduction: Cardiovocal hoarseness (Ortner’s syndrome) is hoarseness of voice due to recurrent laryngeal nerve involvement secondary to cardiovascular disease. Recurrent laryngeal nerve in its course (especially the left side) follows a path that brings it in close proximity to numerous structures. These structures interfere with its function by pressure or by disruption of the nerve caused by disease invading the nerve. However painless asymptomatic intramural hematoma of the aortic arch, causing hoarseness as the only symptom, is a rare presentation as in this case.
Case Report: We report a case of silent aortic intramural hematoma which manifested as hoarseness as the only presenting symptom. A detailed history and thorough clinical examination could not reveal the pathology of hoarseness. The cause of hoarseness was diagnosed as aortic intramural hematoma on contrast computed tomography. Thus the patient was diagnosed as case of cardiovocal hoarseness (Ortner’s syndrome) secondary to aortic intramural hematoma. Conclusion: A silent aortic intramural hematoma with hoarseness as the only presenting symptom is very rare. This particular case report holds lot of significance to an otolaryngologist as he should be aware of this entity and should always consider it in the differential diagnosis of hoarseness.
Cardiovocal
Hoarseness
Ortner’s syndrome
2016
03
01
163
167
https://ijorl.mums.ac.ir/article_6568_0720862d22643f80bab8254a701453c0.pdf
Iranian Journal of Otorhinolaryngology
2251-7251
2251-7251
2016
28
2
Management of Large Tongue Schwannoma – A Short Report
Jayanta
Medhi
Hanifa
Laskar
Deepanava
Das
N Brian
Shunyu
Ankit
Jitani
Vandana
Raphael
Rajni
Thabah
Schwannoma is a benign nerve sheath tumor composed of schwann cells. Oral cavity is a rare site for schwannomas, tongue being the most common location. Here we are presenting a case of a young adult who presented with a huge swelling in the tongue which was removed by mandibulotomy approach and pre-operative tracheostomy. A 22-year-old male patient presented to the outpatient department with a history of swelling in the tongue for the last 4 years with progressive difficulty in swallowing food and change of voice over the last few months. Upon examination a large swelling was observed on the posterior part of the tongue compromising the oropharyngeal inlet. The approximate size of the swelling was 5cmx4cm. After proper clinical evaluation the patient was advised to obtain a magnetic resonance imaging (MRI) study of the oral cavity, which showed it to be a nerve sheath tumor (Schwannoma) originating from the hypoglossal nerve branch. The patient was admitted for surgery. As difficult intubation was anticipated, pre-operative tracheostomy was performed. The tongue mass was approached by right paramedian mandibulotomy using a transcervical lip split incision. Post operative histopathological examination of the removed specimen showed hypercellular ‘Antony A’ area with plump spindle cells and hypocellular ‘Antony B’ area in a Hematoxylin & eosin stain (200x). This confirmed the diagnosis for a schwannoma. As each and every case is unique in its presentation, so is the management. The idea of presenting the above case is to emphasise the role of selection for the proper approach and foresee the preventable complications while working around the airway.
2016
03
01
168
168
https://ijorl.mums.ac.ir/article_6566_f4e4b3613f2845abcae664b66f3c68ea.pdf