Results of End-To-Side Hypoglossal-Facial Nerve Anastomosis in Facial Paralysis after Skull Base Surgery
Sasan
Dabiri
Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
author
Mohammadtaghi
Khorsandi Ashtiani
Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
author
Melorina
Moharreri
Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
author
Zahra
Mahvi Khomami
Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
author
Ali
Kouhi
Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
author
Nasrin
Yazdani
Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
author
Pedram
Borghei
Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
author
Kayvan
Aghazadeh
Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
author
text
article
2020
eng
Introduction:The primary aim of facial reanimation surgery is to restore tone, symmetry, and movement to the paralyzed face. Hypoglossal-facial end-to-side anastomosis provides satisfactory facial reanimation in the irreversible proximal injury of the facial nerve. This study discussed the facial function results of end-to-side anastomosing of hypoglossal nerve to facial nerve when the injury occurred during skull base surgery.Materials and Methods:The present study enrolled a total of 10 patients who underwent end-to-side hypoglossal-facial nerve anastomosis after facial nerve paralysis due to skull base surgery. The data of the patients were gathered from hospital records, pictures, and movies during the 18 months of follow-up.Results:At the 18 months of follow-up, seven (70%) and three (30%) patients were reported with grades III and IV of the House-Brackmann scoring system, respectively. In total, out of the seven grade III patients, six subjects underwent early anastomosis (within the first year of the paralysis). On the other hand, among patients with grade IV, two subjects had late anastomosis.Conclusion:It seems that early end-to-side hypoglossal-facial anastomosis can be a favorable surgical option with good facial function results for reanimating the facial function of patients with facial paralysis following skull base surgery.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
133
138
https://ijorl.mums.ac.ir/article_15366_422c2b4258c8852d0617aea892c1fdbb.pdf
dx.doi.org/10.22038/ijorl.2019.36294.2194
Investigation of the Paediatric Tracheostomy Decannulation: Factors Affecting Outcome
Neha
Chauhan
Department of Otolaryngology and Head and Neck Surgery,
Postgraduate Institute of Medical Education and Research, Chandigarh, India.
author
Satyawati
Mohindra
Department of Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
author
Sourabha K
Patro
Department of Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
author
Preethy J
Mathew
Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
author
Joseph
Mathew
Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
author
text
article
2020
eng
Introduction:Evidence for factors determining paediatric tracheostomy decannulation vary extensively; therefore, this prospective observational study aimed to investigate these factors. Materials and Methods:In total, 67 consecutive paediatric patients ( Results:Totally, 61 patients out of 67 cases were successfully decannulated, whereas six children failed the decannulation. Moreover, the duration of tracheostomy (Pearson’s Chi-square 35.330, P=0.013), indication of tracheostomy (Pearson’s Chi-square 21.211, P=0.000), STN X-Ray (Chi-square 43.249, P=0.000), and bronchoscopic findings (Chi-square 67.000, P=0.000) were significantly associated with the outcome of decannulation. However, decannulation outcome had no significant correlation with various factors, such as the duration of intubation preceding tracheostomy, duration of ventilation, tracheal swabs, and antibiotic therapy. Conclusion:The STN X-ray is an independent predictor, and it is recommended for paediatric tracheostomy decannulation. Moreover, bronchoscopic assessment should be performed in children having doubtful infra-stomal airway. Duration of tracheostomy significantly affects decannulation outcome. However, intubation duration preceding tracheostomy and duration of assistive ventilation have no direct effects on the outcome of decannulation. In children, gradual decannulation should be preferred and one month follow up is adequate for deciding decannulation outcome.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
139
145
https://ijorl.mums.ac.ir/article_15396_5e14b35d995133f75a9231b47fd91c34.pdf
dx.doi.org/10.22038/ijorl.2019.37265.2217
Effects of Rheumatoid Arthritis on the Larynx
Mehdi
Dehghan
Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, IR, Iran.
author
Akram
Ahmadi
Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, IR, Iran.
author
Behnaz
Yousefghahari
Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, IR, Iran.
author
Keyvan
Kiakojouri
Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, IR, Iran.
author
Hemmat
Gholinia
Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, IR, Iran.
author
text
article
2020
eng
Introduction:The aim of the present study was to compare the videolaryngostroboscopic findings between patients with rheumatoid arthritis and vocally healthy controls. Materials and Methods:This case-control descriptive study was performed on 113 people, including 50 patients with rheumatoid arthritis and 63 controls. The participants were subjected to videolaryngostroboscopic examinations in order to evaluate fundamental frequency, different structural vocal lesions, patterns of glottal closure, subglottal changes, supraglottis appearance, and movement patterns of the arytenoid cartilage. The obtained results were compared between the two research groups. Data analysis was performed in the Statistical Package for the Social Sciences, version 24.0. A p-value less than 0.05 was considered statistically significant. Results:The results revealed a statistically significant difference between the two groups in terms of the complete pattern (P=0.00) and strained state of glottal closure (P=0.00), pattern of subglottal changes (χ2=25.98, df=2; P<0.001), and movement patterns of the arytenoid (χ2=21.16, df=1; P<0.001). Additionally, based on the obtained frequencies, the two groups showed significant differences regarding the normal state of the larynx (P=0.00), hypertrophy of vocal fold (P=0.007), epithelial change (P=0.007), and Reinke's edema (P=0.001). However, the videolaryngostroboscopic examination results revealed no significant difference between the two groups in terms of polyp (P=0.20), nodule (P=0.57), sulcus vocalis (P=0.08), cyst (P=0.45), and atrophy of vocal folds (P=0.45). Conclusion:It seems that rheumatoid arthritis affects the patterns of arytenoids movement, some kinds of glottal closure patterns, and subglottal changes. As the results indicated, the occurrence of some laryngeal structural changes was higher in patients with rheumatoid arthritis than in individuals without this disorder.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
147
153
https://ijorl.mums.ac.ir/article_15476_b293daa5cc8dbcc357c73c1c1483fc48.pdf
dx.doi.org/10.22038/ijorl.2020.43213.2418
A Dose-Effect Study of Cisplatin Ototoxicity in Albino Guinea Pigs
Negin
Salehi
Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
author
Mehdi
Akbari
Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
author
Akram
Pourbakht
Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
author
Hamid
Haghani
School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
author
Mahyar
Janahmadi
Neuroscience Research Center and Department of Physiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
author
text
article
2020
eng
Introduction:Cisplatin is one of the most commonly used antineoplastic drugs; nonetheless, its ototoxic dose-limiting side effects have remained a significant challenge in clinical practice. The recognition of the exact template of hearing loss induced by multiple low doses of cisplatin could be of great help in managing the treatment process. The present study aimed to investigate the effects of multiple doses of this drug on the auditory system.Material and Methods:The present study was performed using an experimental guinea pig model in four groups as follows:1- 0.9% sodium chloride solution, 2- total dose of 7.5 mg/kg Cisplatin, 3- total dose of 10 mg/kg Cisplatin, and 4- total dose of 12.5 mg/kg cisplatin. The drugs were injected as 2.5 mg/kg/daily IP access in all groups. The auditory brainstem response (ABR) test was performed before the treatment and after every injection on a daily basis up to 72 h after the last injection.Results:There was dose-dependent significant hearing loss in all evaluated frequencies in three cisplatin groups. The general template of induced hearing loss during experimental days was almost the same in groups Cis7.5 and Cis10. In Cis 12.5 group, there was a jump in the threshold shift on the 5th day of the experiment and an upward trend in the function. Conclusion:As evidenced by the obtained results, the monitoring of hearing loss after every injection in patients who receive the drug and detecting the exact dose-dependent pattern of the induced hearing loss is of great help in controlling its undesirable destructive side effects on the auditory system.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
155
161
https://ijorl.mums.ac.ir/article_15326_13edadfec6367f8a641525dab7cc51b8.pdf
dx.doi.org/10.22038/ijorl.2019.41914.2368
Impact of the Angles of the Septal Deviation on the Degree of the Mastoid Pneumatization
Mustafa
Çelik
Department of Otorhinolaryngology-Head and Neck Surgery, Kafkas University, Faculty of Medicine, Kars, Türkiye.
author
Yakup
Yegin
Sadi Konuk Training and Research Hospital, Department of Otorhinolaryngology - Head and Neck Surgery, Istanbul, Turkey.
author
Burak
Olgun
Sadi Konuk Training and Research Hospital, Department of Otorhinolaryngology - Head and Neck Surgery, Istanbul, Turkey.
author
Ahmet
Altıntaş
Department of Otorhinolaryngology - Head and Neck Surgery, Fatih Medicalpark Private Hospital, Istanbul, Turkey.
author
Fatma-Tülin
Kayhan
Sadi Konuk Training and Research Hospital, Department of Otorhinolaryngology - Head and Neck Surgery, Istanbul, Turkey.
author
text
article
2020
eng
Introduction:The aim was to explore the developmental relationships between the angles of septal deviations and the degree of the mastoid pneumatization. Materials and Methods:In total, 143 patients with a diagnosis of septal deviation who underwent septoplasty were included. The patients were divided into three groups in terms of the angles of the septal deviation. The angle of the septal deviations was defined as mild (<9 degrees), moderate (between 9 and 15 degrees) and severe (15 degrees and above). The degree of the mastoid pneumatization of each groups were compared. Results:In right-sided septal deviation subjects, the right mastoid air cell volumes of group mild, moderate and severe were 6,31±2,33 cm3, 5,20± 1,51 cm3, and 5,31±1,57 cm3, respectively. The mean right mastoid volumes of each groups did not differ in right-sided deviations subjects (P>0.05). The mean left mastoid volumes of each groups did not differ in right-sided deviations subjects (P>0.05). In right-sided septal deviation subjects, the mean volume of the right and left-sided mastoid air cells of each groups did not differ (P>0.05). In left-sided septal deviation subjects, the mean volume of the right and left-sided mastoid air cells of each groups did not differ (P>0.05). Conclusions:No developmental relationships between the angles of septal deviations and the degree of the mastoid pneumatization was observed in the study.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
163
168
https://ijorl.mums.ac.ir/article_15147_6354aeb17f9219c438aed9d645d24cc1.pdf
dx.doi.org/10.22038/ijorl.2019.35284.2162
Variations of Ethmoid Roof in the Iranian Population: A Cross Sectional Study
Maryam
Moradi
Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
author
Bahare
Dalili
School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
author
text
article
2020
eng
Introduction:This study aimed to investigate the distribution of ethmoid roof variation and symmetry according to Keros classification. Materials and Methods:This cross-sectional study assessed the paranasal CT scans of 600 patients over 18 years of age with no history of surgery, trauma, or localized fracture in the ethmoid, nose, and anterior skull base. The lateral lamella of the cribriform plate (LLCP) sizes were measured and classified as Keros type I (1-3 mm), II (4-7mm), and III (8-16mm). Moreover, the symmetry was surveyed in accordance with the LLCP measurements on both sides of the ethmoid roof. These variations were analyzed regarding gender and age. Results:In total, 600 patients participated in this study out of whom 311 cases were male. According to the results, the mean age of the participants was 37.50±16.63 years. Furthermore, the mean values of the LLCP height for the right and left sides were 4.17±1.69 and 4.93±1.97 mm, respectively. Moreover, the asymmetry was observed in 38.3% of the cases, and they were classified as 36.7% Keros type I, 50.5% Keros type II, and 12.8% Keros type III. Conclusion:Keros type II and symmetry were the most common variations in this study. In addition, these variations were independent of age and gender.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
169
173
https://ijorl.mums.ac.ir/article_15336_47a07408e05be5263ee2792b42b2afc7.pdf
dx.doi.org/10.22038/ijorl.2019.37340.2220
Metachronous Bilateral Silent Sinus Syndrome: A Case Report
Paolo
Farneti
Bologna University Medical School - Sant’Orsola-Malpighi Hospital, Via G. Massarenti 9 40138 Bologna, Italy.
author
Andrea
Bellusci
Bologna University Medical School - Sant’Orsola-Malpighi Hospital, Via G. Massarenti 9 40138 Bologna, Italy.
author
Alfredo
Parmeggiani
Azienda Unità Sanitaria Locale di Bologna, ENT Department Bologna, Via Altura 3 40139 Bologna, Italy.
author
Ernesto
Pasquini
Azienda Unità Sanitaria Locale di Bologna, ENT Department Bologna, Via Altura 3 40139 Bologna, Italy.
author
text
article
2020
eng
Introduction:Bilateral silent sinus syndrome (SSS) is a very rare pathology reported only in few papers in literature. Most of the described cases are simultaneous, and only one had a metachronous presentation. The evolutionary phases of the disease have yet to be well demonstrated and a complete radiological evaluation is needed to demonstrate the pathogenetic mechanisms that cause the disease. Case Report:A 45-year-old male presented with a left SSS and a bilateral concha bullosa. He developed a contralateral SSS two years after an endoscopic uncinectomy and re-ventilation of the diseased maxillary sinus. This case is the second reported in literature with a metachronous presentation. A pure endoscopic approach has led to the resolution of symptomatology and the full restoration of the ventilation of the maxillary sinuses. The key role of the uncinate process in the genesis of the pathology has been well demonstrated by the onset of a contralateral SSS in a normally developed maxillary sinus thanks to a complete radiological follow-up. Conclusion:Bilateral presentation is a rare entity; however, it should be considered in patients with SSS. A minimal endoscopic uncinectomy could also prevent the onset of the disease on the healthy side.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
175
179
https://ijorl.mums.ac.ir/article_15365_2370272d2cc3c79ac63b873fc3d97b05.pdf
dx.doi.org/10.22038/ijorl.2020.42809.2396
Inverted Supernumerary Intranasal Teeth as Unusual Indications of Endoscopic Surgery
Remo
Accorona
Division of Otorhinolaryngology, “San Maurizio” Hospital, Bolzano, Italy.
author
Giovanni
Colombo
Department of Otorhinolaryngology, Humanitas Clinical and Research Center, Rozzano, Milano, Italy.
author
Marco
Ferrari
Department of Otorhinolaryngology and Head and Neck Surgery, University of Brescia, Italy.
author
Enrico
Fazio
Department of Otorhinolaryngology, University of Insubria, Varese, Italy.
author
Andrea
Bolzoni-Villaret
Department of Otorhinolaryngology and Head and Neck Surgery, University of Brescia, Italy.
author
text
article
2020
eng
Introduction:Supernumerary teeth are frequently reported in dental clinical practice; however, eruption in nasal cavities and paranasal sinuses is an extremely rare clinical entity. Case Report:We report two cases with a history of recurrent nasal discharge and obstruction. In both cases, clinical and radiological findings confirmed the presence of an inverted supernumerary tooth erupted in the sinonasal cavities (i.e., the right nasal fossa and left maxillary sinus, respectively). We managed the cases with transnasal endoscopic approach. A survey of the English literature identified 69 documented cases with intranasal supernumerary teeth within January 1st, 1886 to December 31st, 2017. Conclusion:Inverted supernumerary teeth should be considered among the potential causes of unilateral nasal obstruction and rhinosinusitis and included in differential diagnoses among the fibro-osseous lesions of the sinonasal cavities.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
181
186
https://ijorl.mums.ac.ir/article_15501_9a0ad1a67e56f0de7201b641fdad5bee.pdf
dx.doi.org/10.22038/ijorl.2019.38918.2284
Paraglottic and Pre-epiglottic Space Abscess in Adults: Report of Two Cases
Giorgos
Sideris
Department of Otolaryngology, "Attikon" University Hospital, Athens, Greece. Rimini 1, Chaidari, Athens 124 62, Greece
author
Marilia
Sapountzi
Department of Otolaryngology, "Attikon" University Hospital, Athens, Greece. Rimini 1, Chaidari, Athens 124 62, Greece
author
Pavlos
Maragoudakis
Department of Otolaryngology, "Attikon" University Hospital, Athens, Greece. Rimini 1, Chaidari, Athens 124 62, Greece
author
Alexander
Delides
Department of Otolaryngology, "Attikon" University Hospital, Athens, Greece. Rimini 1, Chaidari, Athens 124 62, Greece
author
text
article
2020
eng
Introduction:Acute epiglottitis or supraglottitis is a rapidly progressing upper respiratory tract infection that can often threaten the airway patency. Epiglottic abscess that expands to the paraglottic (PGS) or preepiglottic (PES) space and acute airway obstruction constitute rare complications, exclusively presented in adults. Case Report:We report two cases. In the first case flexible fiberoptic Rhino-Pharyngo-Laryngoscopy showed epiglottitis that was obstructing the airway and abscesses on the lingual surface of the epiglottis. Abscesses were opened using laser CO2. In the following days flexible fiberoptic endoscopy revealed persisting protrusion of the left hemilarynx. A CT scan was performed showing an abscess in the paraglottic space. Under direct laryngoscopy the abscess was drained. In the second case endoscopic examination revealed epiglottitis that did not cause airway obstruction. The patient was admitted for follow-up and treated with intravenous antibiotics. On the 5th day showed an exacerbation of her symptoms. A CT scan was performed that showed the existence of an abscess in the preepiglottic space. She was taken to surgery and the abscesses were drained through a cervical- U shaped- incission. Conclusion:Existance of an abscess means, by default, an adequate surgical treatment to ensure the airway, and immediate drainage under direct laryngoscopy or through an external approach. Diagnosis is based exclusively on medical history and clinical examination. CT scan is necessary to reveal “secret” abscesses and “silent” extension of the infection inside pre-epiglottic and paraglottic space even if epiglottitis is mild. Postoperative management includes proper care of the surgical wound and antibiotics.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
187
191
https://ijorl.mums.ac.ir/article_15148_2acbce0e798661268ed909856daffcbe.pdf
dx.doi.org/10.22038/ijorl.2020.42184.2375
Isolated Primary Rhinosporidiosis of the Parotid Duct: A Rare Presentation
Swagatika
Samal
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Pin-751019 Bhubaneswar, Odisha, India.
author
Pradeep
Pradhan
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Pin-751019 Bhubaneswar, Odisha, India.
author
Chappity
Preetam
Department of Otorhinolaryngology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India, Pin-751019.
author
text
article
2020
eng
Introduction:The primary involvement of the parotid duct in rhinosporidiosis is very rare in clinical practice. Here, we present a case of rhinosporidiosis primarily involving the parotid duct, which was successfully excised through transparotid and transoral approaches. Case Report:A 51-year-old male presented with a painless progressive swelling over the left cheek for nine months. It was diagnosed as a parotid cyst or a mucous retention cyst based upon the radiological and cytological features. The cyst was completely excised with transparotid and transoral approaches, and the final diagnosis was confirmed to be rhinosporidiosis.Conclusion:Although the nose and the paranasal sinus are the common sites to be involved in rhinosporidiosis, the affection of the parotid duct is very unusual in clinical practice.
Iranian Journal of Otorhinolaryngology
Mashhad University of Medical Sciences (MUMS)
2251-7251
32
v.
3
no.
2020
193
196
https://ijorl.mums.ac.ir/article_15500_2946f254af484329d31f396f57ea0cba.pdf
dx.doi.org/10.22038/ijorl.2020.43051.2408