Iranian Journal of Otorhinolaryngology最新文献

Introduction: Considering the inconsistent results regarding the association between the severity and duration of olfactory dysfunction (OD), and the viral load in coronavirus disease 2019 (COVID-19) patients, we aimed to conduct this study.

Materials and methods: This is a prospective cohort study in which COVID-19 patients were evaluated for the initial cycle threshold value (Ct values) measured by the nasopharyngeal samples along with olfactory function measured by the University of Pennsylvania Smell Identification Test (UPSIT) within 2 months of COVID-19 onset.

Results: Among 309 COVID-19 patients who were included in this study, 108 (34.9%), 112 (36.2%) and 89 (28.8%) were normosmic, hyposmic, and anosmic, respectively based on the UPSIT. The severity of COVID-19 and the rate of hospitalization were higher in anosmic patients (p<0.0001, and p<0.0001, respectively). Moreover, significant associations between the initial Ct value and the severity of OD at admission and follow-ups were detected (p<0.0001 and p<0.0001, respectively). Anosmic patients had higher Ct values in comparison with hyposmic (approx. 3-fold) and normosmic (approx. 12-fold) patients. The recovery rate after one- and two-month follow-ups was 47% and 84%, respectively. At the follow-ups, OD-recovered patients significantly had lower Ct values (mean Ct value: 27.79 ± 2 and 28.21 ± 2.08) in comparison with those who have not recovered yet (mean Ct value: 30.19 ± 3.36, and 33.6 ± 3.37) (p<0.0001, and p<0.0001, respectively).

Conclusions: Ct value seems to be a significant factor not only in predicting OD severity in COVID-19 patients but also in the OD recovery duration. This finding may be helpful to investigate the underlying mechanisms of OD in COVID-19 patients.

Introduction: The majority of nasopharyngeal cysts are asymptomatic and rare. Nevertheless, these lesions are rarely discovered during regular endoscopies and imaging tests. An upper nasopharyngeal Thornwaldt cyst is a benign, mucosal congenital cyst. Even less frequently, they can cause unexplained sinonasal symptoms such as rhinorrhea, vision problems, and nasal blockage.

Case report: Here, we report a case with new-onset hearing loss after the coronavirus infection, in which his imaging investigation showed a nasopharyngeal mass.

Conclusion: After covid-19 infection we should consider branchial Cyst and Thornwaldt Cyst in a high-risk patients. On the other hand, the progressive hearing loss after covid-19 can occur due to activation of this kind of cysts.

Introduction: Since 20% of the patients with sensorineural hearing loss have confirmed radiographically inner ear malformation, this study aimed to compare the incidence rate of intra and postoperative complications of cochlear implantation amongst the patients with or without inner ear malformations.

Materials and methods: In this retrospective study, we evaluated the medical record of 954 patients who had undergone cochlear implantation. Seventeen patients had inner ear malformations and were selected as the case group, and 25 patients with normal inner ear were selected as the control group. Patient's information; including intraoperative complications, post-operative complications and neural response telemetry (NRT) immediately after the surgery were recorded. Finally, the collected data were analyzed, using the SPSS software, version 21.

Results: According to the CT-scan findings, the most observed internal ear abnormality was the temporal bone Mondini in 8 patients (47%), and the next inline was the common cavity at a frequency of (23.52%). Cerebrospinal fluid (CSF) gusher was detected in 11 patients (64.7%) of the case group, which was significantly higher than the other group. This includes mild CSF gusher in 7 cases (41.17%) and severe CSF gusher in 5 cases (29.41%). Interestingly, no significant post-operative complications were observed in either group, minor side effects were limited and not significantly different.

Conclusion: In conclusion, despite the limitations of cochlear implantation surgery amongst patients with inner ear malformation with potential risk of early or late complications, it can still be recommended as an appropriate procedure to acquire hearing as well as auditory and speech perception.

Introduction: The aim of this study was to investigate hearing outcome of stapes surgery, considering the post-operative air and bone conduction (AC&BC) changes, in a frequency specific approach.

Materials and methods: This was a retrospective cohort study. A total of 245 ears (231 patients), who underwent Stapedotomy at our tertiary referral center in a period of 5 years were enrolled in the study. Pure tone audiometry (PTA) was evaluated preoperatively and one month postoperatively. AC, BC, and Air-bone gap (ABG) were documented. Moreover, one-year post-op PTA was also recorded for more than a quarter of the cases.

Results: Overall, significant improvements were observed in AC thresholds with a mean AC gain of 20.44±13.64 dB. At higher frequencies the results were poorer (AC gain of 27 dB at 250 Hz vs 7 dB at 8000 Hz). ABG significantly improved at all frequencies after one month. BC thresholds were typically better after surgery. However, there appears to be a worsening trend in BC thresholds at frequencies higher than 2000 Hz. In 68 patients with 1-year follow-up, BC thresholds were slightly worse (but not statistically significant) at most frequencies, in comparison to the one-month results.

Conclusions: Stapes surgery significantly improves air and bone conduction hearing, particularly at lower frequencies. Nonetheless, there exists a potential for sensorineural hearing loss (SNHL) at high frequencies. However, the changes are insignificant and not within the speech frequencies. Therefore, patients are typically satisfied with the hearing outcome of the surgery.

Introduction: Multifocal Langerhans' cell histocytosis is a rare condition that can affect multiple organs and manifest in various scenarios. While the condition is more commonly found in children, it can also occur in adults.

Case report: A 43-year-old female presented with refractory otorrhea and had a rubbery neck mass in the left mid-cervical area, as well as an itchy eczematoid lesion in the left parietal area. The otic lesion was eventually resected, and histopathologic examination confirmed the diagnosis of Langerhans histiocytosis.

Conclusions: Although rare in adults, Langerhans histiocytosis should be considered as one of the differential diagnoses for ear canal polyps. If diagnosed, medical treatment should be pursued.

Introduction: Cartilage deformation may develop due to congenital and trauma-related hematomas. Early diagnosis and treatment are imperative to prevent aesthetic and functional complications related to alar cartilage hematomas.

Case report: An 8-year-old male presented with a major alar cartilage hematoma with a nasal fracture as a result of trauma. The patient underwent surgery on the 1st day of trauma for alar cartilage hematoma drainage and nasal bone reduction. No functional or cosmetic complications were observed in the patient's postoperative 1st month.

Conclusion: Subperichondral hematomas of the alar cartilage are rarely observed after nasal trauma and early diagnosis and treatment are important to prevent possible complications.

Introduction: Rhinoplasty, a surgery that reshapes the nose to increase facial beauty or to restore the nasal function after a physical defect, is the most popular plastic surgery worldwide and second most common in Saudi Arabia. Regardless of how common this procedure is done in Saudi Arabia, there is a huge lack of studies on how medical students feels and acts towards it. Thus, this study aimed to assess the perception and attitude of cosmetic rhinoplasty among Fakeeh college students in Jeddah, Saudi Arabia.

Materials and methods: A validated questionnaire about participants desire to rhinoplasty was randomly distributed among all Fakeeh College students in a simple random technique.

Results: 306 participants completed the questionnaire Most responders (60.1%) were happy with their noses. A significant association was noted between gender and desire to undergo rhinoplasty (P=0.034). Also, there is a significant relationship between the participant's desire for rhinoplasty and its cost (P = 0.034).

Conclusion: This study showed although rhinoplasty is socially accepted in Saudi Arabia. there is a low desire in college students toward performing rhinoplasty. Factors like cost of surgery or gender affect people's willingness to do rhinoplasty.

Introduction: This study aims to evaluate the effectiveness of simultaneous uvulopalatoplasty and nasal surgery in patients with moderate obstructive sleep apnoea syndrome.

Materials and methods: We studied 48 patients with obstructive sleep apnoea syndrome and nasal breathing disorders. The 1^st group of 20 patients underwent septoplasty and volumetric tissue reduction of inferior turbinates and the 2^nd group of 28 patients underwent septoplasty, volumetric tissue reduction of inferior turbinate, uvulopalatoplasty.

Results: In the 1^st group, the pre-operative apnoea-hypopnea index median decreased from 22.1 ep/h to 14.9 ep/h after the surgery. Pre-operative median of nasal airflow volume grew from 167.0 cm³ to 609.5 cm³ post-operatively and the loudness of snoring decreased from 2.7±0.2 to 0.7±0.2. In the 2^nd group, the apnoea-hypopnea index median decreased from 20.4 ep/h to 5.3 ep./h. The pre-operative median of nasal airflow volume grew from 189.5 cm³ to 519.5 cm³ post-operatively and the loudness of snoring improved from 2.6±0.2 pre-op to 1.1±0.2.

Conclusion: Patients with moderate obstructive sleep apnoea syndrome and nasal breathing disorders are advised to have nasal surgery combined with uvulopalatoplasty for a better outcome.

Introduction: Spontaneous cerebrospinal fluid (CSF) rhinorrhea is rare and may develop secondary to inner ear malformation. A possible diagnosis of CSF leak should be considered in any Pediatric patient who presents with hearing impairment, rhinorrhea, or otorrhea.

Case report: We describe a case of 13 months male infant presenting with rhinorrhoea which on evaluation found to be CSF oto-rhinorrhoea due congenital inner ear malformation. Imaging showed malformed inner ear on both sides with CSF leak on left side with bilateral profound sensory neural hearing loss. A multidisciplinary management was considered. Child underwent CSF leak repair on left side followed by Cochlear implantation on right side in another setting.

Conclusion: This case is a perfect example to describe the cumbersome management of CSF leak with inner ear anomaly addressing the auditory habilitation on the grounds of recent innovations. As per available literature inner ear anomaly is an important subgroup of population of cochlear implant candidates with promising auditory outcomes.

Introduction: This study, assess the efficacy of curcumin therapy in preventing/improving cochlear damage in Rattus norvegicus ototoxic model as evaluated with OAE examination.

Materials and methods: This study utilized 27 rats which had been injected with single dose 8mg/KgBB of cisplatin, and then divided into 3 groups. The first group was not given curcumin. The second group received curcumin at a dose of 150 mg/KgBB. The third group received curcumin at a dose of 300 mg/KgBB. Curcumin was given from the time of single dose cisplatin injection (day 0) to day 7. OAE examination was performed on the day before the single dose of cisplatin (day 0), day 3, 4 and 7 after curcumin administration.

Results: There was a decline in the average value of SNR in all groups starting from high frequency. However, in the rat groups receiving curcumin there was a slow decrease in the SNR value, which also obtained statistically significant differences in the SNR values of all groups.

Conclusion: Administration of certain doses of curcumin may reduce the modest and statistically insignificant decrease in mean SNR values indicating a reduction in ototoxicity from cisplatin.