Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Serum Endostatin Levels in Oral Squamous Cell Carcinoma
125
130
EN
Maryam
Mardani
Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
mardanim@sums.ac.ir
Azadeh
Andisheh-Tadbir
Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
andisheh202003@yahoo.com
Mohammad Ali
Ranjbar
0000-0001-6383-9944
Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
dr.ranjbar60@yahoo.com
Bijan
Khademi
0000-0002-8303-6126
Department of Otolaryngology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
khademib@sums.ac.ir
Mohammad Javad
Fattahi
Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran.
fattahimj@sums.ac.ir
Ahmad
Rahbar
Undergraduate Student, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
rahbara@sums.ac.ir
10.22038/ijorl.2018.25759.1850
<strong><em>Introduction</em></strong><strong>:</strong><br /> Endostatin is a C-terminal proteolytic fragment of collagen XVIII and, as with angiostatin and thrombospondin, is known as an antiangiogenic agent. The aim of this study was to assess the level of serum endostatin in patients with oral squamous cell carcinoma (SCC), and its association with the clinicopathological characteristics of the tumor.<br /> <strong> </strong><br /> <strong><em>Materials and Methods:</em></strong><br /> Using an enzyme-linked immunosorbent assay (ELISA) kit, we investigated the circulating levels of endostatin in the blood serum of 45 patients with oral SCC and 45 healthy controls.<br /> <strong><em> </em></strong><br /> <strong><em>Results</em></strong><strong>:</strong><br /> The mean level of serum endostatin in patients was significantly lower (68.8±85 ng/ml) than in healthy controls (175.6±73 ng/ml) (P<0.001). Serum endostatin levels were significantly lower in patients with lymph node metastasis compared with patients without lymph node metastasis (P<0.001). In addition, serum endostatin level was associated with higher histological grade (P<0.001). There were no apparent correlations between serum endostatin concentration and clinicopathological features such as age, gender, and tumor stage (P>0.05).<br /> <strong><em> </em></strong><br /> <strong><em>Conclusion</em></strong><strong>:</strong><br /> Findings of the present study suggest the prognostic and anti-metastatic role of endostatin, and this may be used as a tool for monitoring tumor progression.
Endostatin,Mouth,Serum,Squamous cell carcinoma
https://ijorl.mums.ac.ir/article_10696.html
https://ijorl.mums.ac.ir/article_10696_e0413553c708b504c65fa8de463582aa.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Patient-Based Assessment of Effectiveness of Voice Therapy in Vocal Mass Lesions with Secondary Muscle Tension Dysphonia
131
137
EN
Ahmad Reza
Khatoonabadi
Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
khatoonabadi@tums.ac.ir
Hassan
Khoramshahi
0000-0001-9615-0422
Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
hany552ir@yahoo.com
Seyyedeh Maryam
Khoddami
Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
khoddami@tums.ac.ir
Peyman
Dabirmoghaddam
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
peyman.dm@gmail.com
Noureddin Nakhostin
Ansari
Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
nakhostin@tums.ac.ir
10.22038/ijorl.2018.27299.1895
<strong><em>Introduction:</em></strong><br /> Use of patient-based voice assessment scales is an appropriate method that is frequently used to demonstrate effectiveness of voice therapy. This study was aimed at determining the effectiveness ofvoice therapy among patients with secondary muscle tension dysphonia (MTD) and vocal mass lesions.<br /> <strong> </strong><br /> <strong><em>Materials and Methods:</em></strong><br /> The study design was prospective, with within-participant repeated measures. Thirty-three patients with secondary MTD and vocal mass lesions participated in the study, selected on the basis of voice history, laryngeal palpation, and videostroboscopy examination. An experienced otolaryngologist and one experienced speech language pathologist undertook the diagnostic process. Voice therapy included both direct and indirect techniques and lasted approximately 2 months for all included patients. The voice handicap index (VHI) was used to evaluate the effectiveness ofvoice therapy among included patients. Paired<em> t</em>-test, size of the standardized effect (ES<sub>I</sub>),and mean standardized response (ES<sub>II</sub>) were used to analyze effectiveness of the target voice therapy.<br /> <strong> </strong><br /> <strong><em>Results:</em></strong><br /> The findings of this study indicate astatistically significant improvement after the voice therapy protocol (P<0.05; t>1.96). Results of ES<sub>I</sub> and ES<sub>II </sub>demonstrate that the VHI scale is sufficiently responsive to detect voice therapy change (ES>0.8).<br /> <strong><em> </em></strong><br /> <strong><em>Conclusion:</em></strong><br /> This study recommends a combination of direct and indirect voice therapy in the vocal rehabilitation of patients with secondary MTD and vocal mass lesions. Furthormore, we recommend use of the VHI scale to show voice therapy changes for both clinical and research purposes.
Muscle tension dysphonia,Voice handicap index,Vocal mass lesions,Voice therapy
https://ijorl.mums.ac.ir/article_10697.html
https://ijorl.mums.ac.ir/article_10697_c6a792c2c03a9626847a5146e7c4ae56.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Evaluating the Effect of Endoscopic Sinus Surgery on Laryngeal Mucosa Stroboscopic Features
139
143
EN
Ebrahim
Karimi
0000-0001-5356-1440
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
karimient@gmail.com
Akbar
Bayat
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
bayatakbar@yahoo.com
Mohammad Reza
Ghahari
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
mr6hahari@yahoo.com
Sara
Rahavi-Ezabadi
0000-0002-3807-0747
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
s-rahavi@student.tums.ac.ir
Mehrdad
Jafari
0000-0002-9278-3916
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
mehrdadj82@yahoo.com
10.22038/ijorl.2018.25089.1815
<em>Introduction</em><strong><em>: </em></strong>
The major presenting symptom of nasal polyps is nasal obstruction. The role of nasal obstruction in the genesis of laryngeal disorders is still unknown.
<em>Materials and Methods:</em>
The aim of this study was to evaluate laryngeal videostroboscopic changes after functional endoscopic sinus surgery (FESS) in patients with nasal polyposis. A longitudinal study was carried out from March 2012 to June 2013. Thirty patients with bilateral nasal polyposis who did not respond to maximum medical treatment and were candidates for FESS were recruited. Laryngeal videostroboscopy was performed before and 3 months after FESS. Glottic gap, true vocal cord (TVC) borders and pliability, false vocal cord (FVC) movement, laryngeal erythema and mucosal edema were documented.
<em>Results:</em>
Laryngeal erythema and TVC edema were significantly decreased after FESS. Laryngeal erythema was documented in 18 patients after a 3-month follow-up. Four patients (13.3%) showed mild-to-moderate TVC edema and 26 patients (86.7%) had normal TVC mucosa.
<em>Conclusion:</em>
The results of this study show that FESS has a significant impact on laryngeal videostroboscopic features including laryngeal erythema and TVC edema.
Endoscopy,Erythema,Edema,Laryngoscopy,Nasal Polyps,Nasal obstruction,Stroboscopy
https://ijorl.mums.ac.ir/article_10698.html
https://ijorl.mums.ac.ir/article_10698_08379b94bab17f0e219e5e0f874ea73b.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Peripheral Facial Palsy in Emergency Department
145
152
EN
Jose
Ferreira-Penêda
Department of Otorhinolaryngology, Centro Hospitalar Vila Nova de Gaia, Espinho, Portugal.
jfpeneda@gmail.com
Raquel
Robles
Department of Otorhinolaryngology, Centro Hospitalar Vila Nova de Gaia, Espinho, Portugal.
raqrobles@hotmail.com
Isabel
Gomes-Pinto
Department of Otorhinolaryngology, Centro Hospitalar Vila Nova de Gaia, Espinho, Portugal.
isagomespinto@gmail.com
Pedro
Valente
Department of Otorhinolaryngology, Centro Hospitalar Vila Nova de Gaia, Espinho, Portugal.
pedrofmvalente@gmail.com
Nuno
Barros-Lima
Department of Otorhinolaryngology, Centro Hospitalar Vila Nova de Gaia, Espinho, Portugal.
nuno.b.lima@gmail.com
Artur
Condé
Department of Otorhinolaryngology, Centro Hospitalar Vila Nova de Gaia, Espinho, Portugal.
arturmconde@gmail.com
10.22038/ijorl.2018.24504.1803
<strong><em>Introduction:</em></strong><br /> Peripheral facial palsy (PFP) is commonly diagnosed in every emergency department. Despite being a benign condition in most cases, PFP causes loss in quality of life mostly due to facial dysmorphia. The etiology of PFP remains unknown in most cases, while medical opinion on epidemiology, risk factors and optimal treatment is not consensual. The aim of this study was to review the demographic characteristics of our patients and the medical care administered in our emergency department.<br /> <em> </em><br /> <strong><em>Materials and Methods:</em></strong><br /> Emergency episodes occurring in a 4-year period and codified as facial nerve pathology were analyzed. IBM SPSS software was used for statistical analysis.<br /> <em> </em><br /> <strong><em>Results:</em></strong><br /> In total, 582 emergency episodes were obtained. Due to inexpressive representation of other causes of PFP in our study, we focused our analyses on the 495 patients who were considered to have idiopathic PFP. There was equal distribution among genders, and all age ranges were affected. There were no clear epidemic phenomena. Hypertension was not a statistically significant risk factor for Bell's palsy. Most patients sought medical care in the early stages of the disease and complained of isolated facial weakness. Most patients had mild-to-moderate symptoms. Previous upper way infections (PUAI) were more frequent among children. There was a statistically significant difference regarding computed tomography (CT) scan requests among specialties.<br /> <em> </em><br /> <strong><em>Conclusion:</em></strong><br /> Epidemiologic findings were consistent with most literature on Bell's palsy. Drug therapy is widely used and follows current guidelines. The role of PUAI in the pediatric population must be investigated. Despite evidence of good medical practice, there was an excess of CT scans requested by physicians other than otorhinolaryngologists.
Bell Palsy,Herpes simplex,Otorhinolaryngologic disease,Peripheral Facial paralyses
https://ijorl.mums.ac.ir/article_10699.html
https://ijorl.mums.ac.ir/article_10699_ead2e0f36208ad27e5c751a97009c36f.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Predictors of Thyroid Gland Invasion in Laryngeal Squamous Cell Carcinoma
153
158
EN
Keyvan
Aghazadeh
0000-0001-8349-9473
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
aghazadeh@tums.ac.ir
Sasan
Dabiri satri
0000-0002-9791-6810
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
sasan.dabiri@gmail.com
Amirsina
Sharifi
0000-0002-8694-8278
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
a.s_sharifi@yahoo.com
Maryam
Lotfi
Department of Pathology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
maryamlotfi@yahoo.com
Bita
Maraghehpour
International Campus, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
bitamaraghehpour77@yahoo.com
Arsalan
Hashemiaghdam
Faculty of medicine, Tehran University of Medical Sciences, Tehran, Iran.
arsalanhashemi@gmail.com
10.22038/ijorl.2018.26046.1855
<strong><em>Introduction:</em></strong><br /> Laryngeal squamous cell carcinoma (SCC) can invade the thyroid gland leading to unnecessary thyroidectomies with subsequent hypothyroidism and hyperparathyroidism. Thus, clinicopathological variables should be defined in order to predict thyroid gland invasion preoperatively.<br /> <strong> </strong><br /> <strong><em>Materials and Methods:</em></strong><br /> We performed a retrospective analysis of 1,465 patients with laryngeal SCC referred to our center between March 2009 and January 2016. Among these patients, 60 individuals underwent total laryngectomy and either thyroid lobectomy and isthmectomy or total thyroidectomy.<br /> <strong> </strong><br /> <strong><em>Results:</em></strong><br /> Thyroid gland invasion was observed in 20% of samples. The following variables were associated with thyroid gland invasion: transglottic spread of the tumor (odds ratio [OR]: 2.04, 95% confidence interval [CI]: 1.15–5.81, P=0.004), thyroid cartilage involvement (OR: 1.53, 95% CI: 0.94–2.50, P=0.02), and anterior commissure involvement (OR: 5.75, 95% CI: 0.86–38.42, P=0.01). In addition, the largest dimension of the tumor was significantly associated with thyroid gland involvement (r=0.36, 95% CI 0.05–0.67, P=0.004). Multivariate linear regression analysis confirmed these findings.<br /> <strong> </strong><br /> <strong><em>Conclusion:</em></strong><br /> The rate of thyroidectomies performed in cases of laryngeal SCC is much higher than the actual rate of thyroid gland invasion. Thus, preoperative evaluation to find transglottic spread of the tumor, thyroid cartilage, and anterior commissure involvement should be considered.
Larynx,Neoplasm invasion,Squamous cell carcinoma,Thyroid
https://ijorl.mums.ac.ir/article_10702.html
https://ijorl.mums.ac.ir/article_10702_766821080184c5fe2646228e7e420d69.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Comparing the Efficacy of Temperature-Controlled Radiofrequency Tonsil Ablation versus CO2-Laser Cryptolysis in the Treatment of Halitosis
159
166
EN
Farnaz
Hashemian
Department of Otolaryngology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
farnazhashemian@yahoo.com
Hoda
Jafari Moez
Department of Otolaryngology,School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
h_jafarimoez@yahoo.com
Mohammad Ali
Seif -Rabiei
Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
seifrabiei@yahoo.cm
Javaneh
Jahanshahi
Department of Otolaryngology,School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
jahanshahi287@gmail.com
10.22038/ijorl.2018.26844.1894
<strong><em>Introduction:</em></strong><br /> Halitosis and foreign body sensation are two common and disturbing symptoms of chronic caseous tonsillitis (CCT). The aim of this study was to compare the efficacy and safety of temperature-controlled radiofrequency (TC-RF) tonsil ablation with CO<sub>2</sub>-laser cryptolysis (CO<sub>2</sub>-LC) in the treatment of patients with halitosis caused by CCT.<br /> <br /> <strong><em>Materials and Methods:</em></strong><br /> Sixty-two patients who suffered from halitosis and/or foreign body sensation due to CCT were enrolled in the present randomized clinical trial, and were randomly assigned into two groups. Group A underwent TC-RF tonsil ablation and Group B received CO<sub>2</sub>-LC. The severity of symptoms including halitosis and foreign body sensation was reported 7 days, 1 month, and 6 months after the procedure. Patient pain levels and amount of bleeding were evaluated as safety outcome measures. Pain levels were evaluated during the intervention, and at Day 1, 3, and 7 following the procedure using a visual analog scale (VAS).<br /> <br /> <strong><em>Results:</em></strong><br /> Mean rank of pain score in the RF tonsil ablation group was found to be higher than in the CO<sub>2</sub>-LC group at all measured timepoints following the procedure. The amount of bleeding in the LC group was found to be significantly less than in the RF group (P<0.05). No significant difference was found between the groups regarding duration of procedure (P=0.157).<br /> <br /> <strong><em>Conclusion:</em></strong><br /> Both procedures were found to be effective and safe in the treatment of CT-associated halitosis. However, LC showed better results based on lower pain levels, lower incidence of bleeding, and faster progression to a routine diet.
Halitosis,Laser,Pain,Tonsillitis
https://ijorl.mums.ac.ir/article_10706.html
https://ijorl.mums.ac.ir/article_10706_0c1c394e966702d12f108692a46429dd.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
The Challenge of Vestibular Rehabilitation in a Patient with Bilateral Vestibular Dysfunction Following Surgery: A Case Report
167
170
EN
Sadegh
Jafarzadeh
0000-0001-8887-7509
Department of Audiology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
jafarzadehs@mums.ac.ir
Mohammad Reza
Golrokhian Sani
Department of Otolaryngoloy, Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
golrokhianmd@gmail.com
10.22038/ijorl.2017.23203.1772
<strong><em>Introduction:</em></strong>
Bilateral vestibular dysfunction (BVD) is an uncommon finding in vestibular assessment, and the combination of BVD and orthopedic problems represents a rare and challenging case for treatment.
<strong><em>Case Report:</em></strong>
The patient had several previous back surgeries and received gentamycin after surgery. After 6 months, she experienced continuous dizziness, unsteadiness and oscillopsia. The patient underwent complete vestibular assessment and received an individualized vestibular rehabilitation program for 9 months. She achieved a complete recovery from all symptoms and returned to active social function.
<strong><em>Conclusion:</em></strong>
Vestibular rehabilitation could be an effective treatment for complicated cases of BVD. Adaptation exercises may be useful in young patients with BVD.
<strong> </strong>
Adaptation,Bilateral vestibular dysfunction,Gentamicin,Ototoxicity,vestibular rehabilitation
https://ijorl.mums.ac.ir/article_10707.html
https://ijorl.mums.ac.ir/article_10707_fb3900e75a30799b5cafc3327dc40d05.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Pediatric Inflammatory Myofibroblastic Tumors of the Airway: Two Case Reports with Varying Clinical Presentation
171
176
EN
Nuthan
Kumar
Department of Pediatric Hematology and Oncology, Kanchi Kamakoti Childs Trust Hospital And The Childs Trust Medical Research Foundation, Nungambakkam, Chennai – 600034,Tamil Nadu State, India.
nuthanraga28@gmail.com
Thirunavukkarasu
Saravanamuthu
Department of Pediatric ENT, Kanchi Kamakoti Childs Trust Hospital And The Childs Trust Medical Research Foundation, Nungambakkam, Chennai – 600034,Tamil Nadu State, India.
thiruairway@gmail.com
Arathi
Srinivasan
Department of Pediatric Hematology and Oncology, Kanchi Kamakoti Childs Trust Hospital And The Childs Trust Medical Research Foundation, Nungambakkam, Chennai – 600034,Tamil Nadu State, India.
drarathi@gmail.com
Thulasiraman
Ramalingam
Department of Pathology, Kanchi Kamakoti Childs Trust Hospital And The Childs Trust Medical Research Foundation, Nungambakkam, Chennai – 600034,Tamil Nadu State, India.
drthulas31@gmail.com
Julius-Xavier
Scott
Department of Pediatric Hematology and Oncology, Kanchi Kamakoti Childs Trust Hospital And The Childs Trust Medical Research Foundation, Nungambakkam, Chennai – 600034,Tamil Nadu State, India.
jxscott@hotmail.com
10.22038/ijorl.2017.22449.1740
<strong><em>Introduction:</em></strong>
An inflammatory myofibroblastic tumor (IMT) is a rare tumor of intermediate malignant potential. It may occur in a wide range of anatomical locations. One-third are found in the respiratory tract. We report two cases of IMT of the airway diagnosed at our institution.
<strong><em>Case Report:</em></strong>
Case 1: A 6-year-old male child presented with a 1-month history of hoarseness of the voice. On evaluation, a polypoid nodule was noted in the right vocal cord which was excised through the endolaryngeal route. Histopathology was suggestive of anaplastic lymphoma kinase (ALK)-negative IMT. He presented with recurrence after 4 months, for which he underwent endolaryngeal reexcision and tracheostomy for airway protection. A third recurrence after 6 months was managed with laser excision, and the patient was started on oral celecoxib. After 1.5 years of follow up, endoscopic examination showed no recurrence, and celecoxib was continued. Case 2: A 7-year-old male child presented with cough and respiratory distress. Bronchoscopy and high resolution computed tomography showed a polypoidal lesion with calcification arising from the left anterolateral wall of the trachea with significant narrowing of the lumen. The patient underwent biopsy followed by endoscopic excision, and was diagnosed with IMT. Currently the patient is under follow up with no recurrence.
<strong><em>Conclusion:</em></strong>
IMT indicates a proliferative myofibroblastic growth. Surgical resection should be recommended for all lesions if not prohibited by anatomic location or morbidity. Patients should be followed up closely for recurrence. In most cases, complete surgical excision will suffice; however multiple recurrences can be managed with chemotherapy. These two cases highlight the importance of a multidisciplinary approach in rare tumors in difficult anatomical locations.
Airway,Children,Inflammatory,Myofibroblastic,Recurrence
https://ijorl.mums.ac.ir/article_10708.html
https://ijorl.mums.ac.ir/article_10708_bb764d4d8511d6172f23cb61a5fce176.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Pneumocephalus after Tympanomastoidectomy: A Case Presentation
177
180
EN
Mohammad Hossein
Baradaranfar
0000-0002-3995-6822
Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
baradaranfar@yahoo.com
Sedighe
Vaziribozorg
0000-0001-7749-6196
Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
s.vaziribozorg1408@gmail.com
Mojtaba
Mirzadeh
Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
m.mirzade2017@gmail.com
Mostafa
Salari
Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
m.salari@gmail.com
10.22038/ijorl.2018.27854.1913
<strong><em>Introduction:</em></strong><br /> Pneumocephalus is the presence of air or gas within the cranial cavity. It can occur following otorhinolaryngological procedures. A small pneumocephalus spontaneously heals without any treatment. In severe cases, conservative therapy includes a 30-degree head elevation, avoidance of the Valsalva maneuver, analgesics, osmotic diuretics, and oxygen therapy.<br /> <strong> </strong><br /> <strong><em>Case Report:</em></strong><br /> A 56-year-old woman was referred to the emergency department due to a severe headache in the frontal area for 2 days before admission. The patient experienced nausea and vomiting in the morning and had no history of seizures or decreased consciousness. Examination of neurological symptoms was completely normal and showed no symptoms of meningeal irritation. In terms of past history, the patient had undergone tympanomastoidectomy surgery and resection of the cholesteatoma 1 week previously. The Mount Fuji sign was found on the brain computed tomography (CT) scan of the patient. Treatments such as CBR (complete bed rest), 30-degree head elevation, anti-fever, analgesics and oxygen therapy, along with anti-compulsive drug (phenytoin), were prescribed. At the end of 5 days, the patient's pneumocephalus was resolved completely.<br /> <strong> </strong><br /> <strong><em>Conclusion:</em></strong><br /> Pneumocephalus should be considered a post-operative complication of tympanomastoidectomy. In most cases, pneumocephalus responds to conservative therapy. Supplemental oxygen increases the rate of absorption of pneumocephalus. Serial imaging is needed to ensure gradual reduction of the pneumocephalus<strong>.</strong>
Mount Fuji sign,Mastoidectomy,Pneumocephalus
https://ijorl.mums.ac.ir/article_10709.html
https://ijorl.mums.ac.ir/article_10709_b349c1b3ce213471e596190c9e23a744.pdf
Mashhad University of Medical Sciences (MUMS)
Iranian Journal of Otorhinolaryngology
2251-7251
2251-726X
30
3
2018
05
01
Complication of an Odontogenic Infection to an Orbital Abscess: The Role of a Medical Fraudster (“Quack”)
181
184
EN
Nikhil
Arora
0000-0003-2884-1680
Department of Otorhinolaryngology and Head and Neck Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi-110002, India.
for_nikhilarora@yahoo.com
Ruchika
Juneja
Department of Otorhinolaryngology and Head and Neck Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi-110002, India.
junejaruchika1@gmail.com
Ravi
Meher
0000-0002-3060-1443
Department of Otorhinolaryngology and Head and Neck Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi-110002, India.
ravimeher@gmail.com
10.22038/ijorl.2017.20807.1775
<strong><em>Introduction:</em></strong><br /> Complication of an odontogenic infection to an orbital abscess is not a common presentation. The progression from a simple toothache to a condition that may lead to loss of vision is sudden and severe.<br /> <br /> <strong><em>Case Report:</em></strong><br /> We report a rare case in which a patient developed facial cellulitis that progressed to orbital abscess after unsterile dental manipulation by a medical fraudster (“quack”). The patient was initiated on high-grade antibiotics, which resolved the facial cellulitis. However, the patient developed orbital abscess with restricted mobility of the right eye in the lateral gaze. After radiological confirmation of the abscess, it was drained by an external approach. Due to timely intervention, the extra-ocular mobility was regained, and the vision remained unaffected.<br /> <br /> <strong><em>Conclusion:</em></strong><br /> Knowledge of the routes of the spread of dental infection to the vital structures and the urgent need for aggressive multidisciplinary management is paramount. Furthermore, awareness of the rising quack culture in developing nations needs to be increased.
Orbital abscess,odontogenic infection,facial cellulitis
https://ijorl.mums.ac.ir/article_10710.html
https://ijorl.mums.ac.ir/article_10710_6dcd2abf7cbbd554f48214d25be6fdad.pdf