فهرست مطالب

Otorhinolaryngology - Volume:33 Issue: 3, May-Jun 2021

Iranian Journal of Otorhinolaryngology
Volume:33 Issue: 3, May-Jun 2021

  • تاریخ انتشار: 1400/02/16
  • تعداد عناوین: 10
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  • Carmelo Saraniti *, Giuseppe Greco, Barbara Verro, Norhafiza Mat Lazim, Enzo Chianetta Pages 127-135
    Introduction

    Narrow band imaging (NBI) is a powerful tool that allows visualizing the mucosal and submucosal vasculature. Among the available diagnostic techniques, NBI is one of the most valid for early detection of oral squamous cell carcinoma (OSCC).

    Materials and Methods

    We carried out a bibliographic search in PubMed, Scopus and Web of Science databases using relevant keywords. Articles selected were screened by two independent authors based on inclusion and exclusion criteria. Nine papers were singled out according to the eligibility criteria and included in this review. We investigated the articles for pooled sensitivity, specificity, accuracy, positive predictive value and negative predictive value of pre-operative NBI.

    Results

    The use of NBI examination in the oral cavity revealed higher specificity, sensitivity, positive and negative predictive values and accuracy compared to white light examination for the diagnosis of oral squamous cell cancer (OSCC). In addition, NBI has proved great utility in detecting malignancy features in oral pre-malignant lesions.

    Conclusions

    This review shows that NBI is a powerful tool for examining oral suspicious lesions. Most of the articles examined revealed high values of sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detection of oral malignant and pre-malignant lesions. Therefore, the use of NBI is highly recommended for the early detection of oral cancer and potentially malignant disorders. Future studies should seek to affirm the validity of NBI and in particular to standardize NBI classification.

    Keywords: Cancer, Erythroplakia, Leukoplakia, Narrow band imaging, Oral
  • Arvind Varma *, Chetan Bansal, Virendra Singh Pages 137-142
    Introduction

    In days of scar less surgeries it has become necessary for otologists to concentrate on tympanoplasties without external incisions. This study compares the anatomical and functional results of tragal perichondrium graft and perichondrium-cartilage composite graft for transcanal endoscopic tympanoplasties in Himalayan region.

    Methods and Materials

    This prospective  study included 60 subjects of chronic otitis media (mucosal type), who underwent transcanal endoscopic underlay type I tympanoplasty and were divided into two groups. In 30 cases tragal perichondrium graft and in rest of 30 cases Tragal perichondrium Cartilage composite graft was used. Anatomical and functional outcomes were evaluated at 6 months time.

    Results

    Hearing gain comparing Audiometric data between the tragal perichondrial graft group and tragal perichondrial cartilage composite graft group at 6 months showed no statistically significant differences (P= 0.9533). Assessment of anatomical outcome indicated a greater number of complications in the tragal perichondrial graft group although it was not statistically significant (P=0.6360 in anterior graft failure group , P =0.1322 in reperforation group and P= 0.1056 in retraction group). 

    Conclusion

    Functional results validated both the grafting material while anatomical results are slightly better in tragal perichondrial cartilage composite graft group in term of re perforation and retraction. More over [A1] with[A2]  use of tragal grafts endoscopic tympanoplasty fulfils its true meaning as no visible scar and post operative patient morbidity is prevented.  [A1]Moreover  [A2]delete

    Keywords: Transcanal endoscopic, Tympanoplasty, Tragal
  • Mohammad Faramarzi, Masih Tale, Sheida Khosravaniardakani *, Sareh Roosta, Ali Faramarzi Pages 143-149
    Introduction
    Each type of prosthesis for ossiculoplasty has its advantages and disadvantages, and the choice of the best material has been a matter of various studies. The present study aimed to make a comparison between the hearing outcomes of partial ossicular replacement prosthesis (PORP) using titanium versus Polycel prosthesis.  
    Material and Methods
    A total of 106 patients undergoing PORP as a second stage ossiculoplasty were analyzed in this study. Following that, they were randomly assigned to two groups of titanium (n=54) and Polycel (n=52) prosthesis. Subsequently, pre-and post-operative audiometric data were assessed based on the aim of the study.  
    Results
    In general, the post-operative air-bone gap within 20 dB was given to 63.5% and 55.6% of all ears in the Polycel and titanium groups, respectively, indicating a non-significant difference (P=0.407). Finally, no SNHL was observed in the groups.  
    Conclusion
    Overall, the hearing outcomes and the success rate of PORP are comparable between titanium and Polycel prostheses. Therefore, the selection of these prostheses could be based on the surgeons’ preferences, availability, and cost.
    Keywords: Hearing outcome, Ossiculoplasty, Partial ossicular replacement prosthesis, Polycel, Titanium
  • Abbas Ali Pourmomeny *, Elham Pourali, Ahmad Cheatsaz Pages 151-155
    Introduction
      Chronic facial nerve palsy has long been known to negatively affect the quality of life in patients. The present study aimed to investigate the efficacy of Botulinum Toxin A (BTX-A) and neuromuscular retraining therapy (NMRT) in the symmetry of chronic facial palsy.
    Materials and Methods
    Two groups, namely experimental and control, were considered each consisting of 13 patients. The study population included a total of 15 female subjects. The BTX-A was injected into the synkinetic muscle in the experimental group; nevertheless, the patients in the second group participated in special neuromuscular retraining. The rate of reducing synkinesis and symmetrical improvement was evaluated using the Facial Grading System (FGS) after 4 months of treatment. The independent t-test was performed to compare the two groups.
    Results
    According totheSunnybrook FGS,the mean changes in Sunnybrook scores in the experimental and neuromuscular retraining groups were 3% and 24%, respectively. The comparison of the mean scores of the two groups was statistically significant after the interventions (P=0.033). A variable ratio of statistically significant improvement was observed in synkinesis in both groups following the treatment (P=0.041). In addition, by comparing the synkinesis scores between the two groups, the reduction of synkinesis was observed to be greater in the neuromuscular retraining group (P=0.041) after the treatment.
    Conclusions
    The findings of the current study indicated that special neuromuscular retraining leads to significant improvement in the FGS score, compared to botulinum toxin therapy alone. Moreover, it was observed that facial symmetry can be treated with special neuromuscular retraining and the patient can overcome synkinesis.
    Keywords: Botulinum toxin A, Facial nerve palsy, Neuromuscular retraining, Synkinesis
  • Kapil Soni *, Gopal Bohra, Nithin Nair, Darwin Kaushal, Sourabha Patro, Amit Goyal Pages 157-161
    Introduction

    Association of hearing loss has been found with a couple of febrile illnesses. Dengue fever is an arboviral febrile illness that is transmitted by Aedes mosquito. A case of sensorineural hearing was documented in the literature recently in dengue haemorrhagic fever. We are aiming to find if hearing loss occurs in dengue patients.  

    Methods and Methodology

    We assessed the hearing of ten patients diagnosed with Dengue fever from August 2018 to October 2018, prospectively. Patients who had a prior history of hearing loss or chronic suppurative otitis media were excluded from the study. Brief history, clinical examination and audiological assessment were made for all patients. All patients were followed up for three months with repeat audiological evaluation.  

    Results

    Two patients complained of hearing loss after the onset of fever. They had a bilateral mild sensorineural hearing loss on audiological evaluation. One other patient was found to have bilateral high-frequency hearing loss although there was no complaint of hearing impairment. On three months follow up, both patients had bilateral mild sensorineural hearing loss with no improvement.  

    Conclusion

    Hearing loss in dengue fever, even though being mild in nature is irreversible. The cause of hearing loss in dengue is yet to be found. For the definitive association of hearing loss in dengue fever further studies are required.

    Keywords: Dengue fever, Hearing Loss, Hearing test
  • Mehdi Bakhshaee, Maral Barzegar-Amini, Zohreh Motedayen, Roshanak Khojasteh-Taheri, Mahdi Rafiee, Mahnaz Amini, Parvaneh Layegh, Kamila Hashemzadeh, Delaram Omidvar, Peter H. Hwang, Masoomeh Hosseinpoor * Pages 163-171
    Introduction
    The current study aimed at investigating the occurrence and features of olfactory dysfunction in patients with confirmed coronavirus disease 2019 (COVID-19) infection.  
    Materials and Methods
    Patients with laboratory and clinically confirmed COVID-19 infection were enrolled in this longitudinal study. They were managed in either the inpatient or outpatient setting. The demographic, clinical, and outcome data were retrieved from patients’ medical records. Olfactory dysfunction features, including the onset pattern, duration, and recovery time were investigated. The visual analog scale (VAS) was utilized as a self-rating subjective measurement of olfactory function.  
    Results
    According to the results, the mean age of the patients (n=502) was obtained at 46.8±18.5 years; moreover, 52.4% and 47.6% of cases were female and male, respectively. It was also revealed that 35.4% and 64.5% of the subjects were outpatients and hospitalized, respectively. Based on the findings, 178 (38.4%) subjects had olfactory dysfunction. The mean values of VAS in hyposmic patients were estimated at 2.5±2.5, 8.3 ±2.1, and 9.4±1.6 at the first evaluation, in 2 weeks, and after 1 month of follow-up (p <0.001). The onset of olfactory dysfunction was more suddenly (58.7%). The majority of cases experienced olfactory dysfunction at the same time as other symptoms 72(51.1%). Based on the results, 0.4% of subjects infected with COVID-19 had olfactory dysfunction as an isolated symptom. The olfactory dysfunction was recovered after 2 weeks in 18 (25.3%) anosmic and 37(46.8%) hyposmic patients.  
    Conclusion
    Olfactory dysfunction seemed to be an important symptom of COVID-19 infection. The occurrence of this disturbance as a transient self-limited condition was significantly higher among female subjects.
    Keywords: COVID-19, Olfactory dysfunction, Smell disorder
  • Javad Mohammadi Asl, Nader Saki, Masoud Dehdashtiyan, Mostafa Neissi, Farideh Ghanbari Mardasi * Pages 173-176
    Introduction
    Sensorineural hearing loss is the most frequent type of hearing impairment in the human population. Genetic factors account for over 60% of hearing loss in patients. This is a genetically heterogeneous sensorineural disorder.   Case Report: We carried out whole exome sequencing (WES) to screen hearing loss candidate genes in a member of an Iranian family with hearing loss. The Sanger process was used to sequencing the variant in the family members. A novel mutation (c. 559C > T) was found in the WFS1 gene (in exon 5) in the patient leading to a heterozygous missense mutation (p.L187F). Furthermore, it co-segregated with HL in the family. All affected individuals in the family had severe-to-profound HL.  
    Conclusion
    This survey is the first to describe WFS1 related HL in the Iranian population. Our data propose that the WFS1-p.L187F mutation is the pathogenic variant for autosomal dominant nonsyndromic hearing loss. Our results extend the range of the WFS1 gene mutations.
    Keywords: Hearing Loss, Novel Mutation, Next Generation Sequencing (NGS), Whole Exome Sequencing (WES), WFS1
  • Mohamed -Amin Chaabouni *, Souha Kallel, Rania Kharrat, Ines Kharrat, Manel Mellouli, Bouthaina Hammami, Ilhem Charfeddine Pages 177-181
    Introduction

    Organized hematoma of the maxillary sinus (OHMS) is a rare benign disease that can be locally aggressive. The diagnosis of this condition is challenging.  

    Case Reports

    We report two cases of OHMS presented with recurrent nasal bleeding, nasal obstruction and anosmia. Radiological findings were suggestive of a vascularised lesion in the first case and a malignant tumor of the maxillary sinus in the second case. Both patients underwent an endonasal endoscopic surgery, There was no recurrence at 19 months’ and six months’ follow-up respectively.  

    Conclusions

    OHMS should be included in the differential diagnosis if a patient presents with history of recurrent epistaxis and nasal obstruction and radiological findings reveal an expansible maxillary mass with or without bone erosion. Correct preoperative diagnosis is important to avoid unnecessary extensive surgery. The prognosis is very good and minimally invasive surgery such as endonasal endoscopic surgery can cure it completely.

    Keywords: Epistaxis, Endonasal endoscopic surgery, Maxillary sinus, Nasal obstruction, Organized hematoma, Sinonasal tumor
  • Mehtab Alam *, Syed Hasan, Kamlesh Chandra Pages 183-186
    Introduction

    Osteochondroma of the coronoid process also known as Jacob’s disease, has rarely been reported in the literature and it posses a challenge as diagnosis may be overlooked in favour of other causes of limited mouth opening.  

    Case Report

    This is a case report of an adult male patient who presented with restricted mouth opening in whom radiological imaging, especially 3D computed tomography, played a role in establishing the diagnosis of Jacob’s disease.  

    Conclusion

    An osteochondroma of the coronoid process of the mandible (Jacob’s disease) is a rare cause of restricted mouth opening and its diagnosis can be overlooked in favour of TMJ ankylosis. The CT scan plays an important role in diagnosis and in planning for surgery.

    Keywords: Jacob’s disease, osteochondroma, Temporo-mandibular disorders, 3D computed tomography, coronoidectomy
  • José-Luis Saavedra-Leveau, Silvana-Lucia Chang-Grozo *, Melissa Dominguez-Prado, Luis-Alfredo Ticona-Zegarra Pages 187-190
    Introduction

    Papillary thyroid cancer (PTC) in thyroglossal duct cyst (TGDC) is an infrequent condition with less than two hundred cases described in literature, with an incidence likely to be close to 1%. While its management is quite straightforward, there exists significant controversy regarding whether additional treatment is needed to manage incidentally noticed carcinoma in TGDCs.  

    Case Report

    A 37-years-old man came to us complaining of a slowly progressive neck mass located in the midline from 4 years ago. Ultrasonography (US) showed a mixed tumor with cyst predominance of 90x79x50 mm and Computed-Tomography (CT) revealed a mixed inframentonian heterogeneous tumor associated with small, mostly peripheral calcifications. The mass was resected using Sistrunk’s surgery. Histologic review reported a moderately differentiated papillary carcinoma in thyroglossal duct cyst, without vascular and lymphatic invasion. After two months, a total thyroidectomy was done, to which the pathological report informed normal thyroid.  

    Conclusion

    Thyroglossal duct cyst carcinoma is a rare entity. Management should be decided on single risk stratification. In all cases, a Sistrunk surgery would be accomplished in order  to remove the tumor. The reason for thyroidectomy in individuals with a normal thyroid is due to the probability of presenting an intraglandular thyroid cancer concomitantly. It also enables the management with radio-iodine and patient follow up by quantifying thyroglobulin levels.

    Keywords: Head, Neck Cancer, surgical management, Thyroglossal duct cyst, Thyroid cancer