The Relation of Allergy to Adenoid Hypertrophy and Otitis Media with Effusion: A Cross-sectional Study

The exact mechanisms of Adenoid hypertrophy (AHT) pathogenesis and otitis media with effusion (OME) are unclear but there is increasing evidence that allergies may play a role. We aimed to investigate the prevalence of atopy and the effect of anti-allergic drugs in patients with AHT and OME. In a non-randomized, prospective cross-sectional study, 122 patients younger than 18 years of age with AHT or OME were included. Atopic patients based on clinical symptoms of allergic disorders and/or elevated levels of total serum immunoglobulin E (IgE) were referred to allergists and tested for allergen sensitization by skin prick test (SPT). Atopic patients were treated with nasal corticosteroids and antihistamines. Response to treatment was evaluated by comparing symptoms score before and after the treatment. In this study 122 patients were evaluated, 116 of them had AHT and 30 patients had OME. The mean age of participants was 6.7±2.4 years old and 68 of them (55.7) were male. Allergic symptoms were observed in 38 patients with AHT (32.7) and nine patients with OME (30). Among the total cases, 34 patients (28) were considered atopic. SPT was performed on 25 (73) cases of atopic patients, with 11 (44 ) positive results. The mean symptom score of AHT and OME decreased significantly after treatment respectively, (p=0.001, p=0.007). According to this study, atopy was relatively common in patients with AHT and OME. Treatment with nasal corticosteroid and antihistamines were effective in these patients

Human papilloma virus and nasopharyngeal carcinoma: pathology, prognosis, recurrence and mortality of the disease

Background: One of the malignant tumors among head and neck cancers is nasopharyngeal carcinoma. Many studies consider human papilloma virus (HPV) as a cause for nasopharyngeal carcinoma. Methods: 41 paraffin-wax-embedded block samples were examined to detect HPV DNA and its subtype’s presence by polymerase chain reaction. The recurrence, prognosis and survival were evaluated for an average of 48 months. Results: HPV DNA was positive in 9 patients (22%). The overall recurrence rate was 75% in HPV negative patients and 11% in HPV positive ones. The mortality rate in HPV negative and positive patients was 37.5% and 0%, respectively. Conclusion: HPV type 18 and 16 were the most common subtypes. Also, it can be implied that patients which are HPV positive had better prognosis and also less recurrence. Key Words: human papilloma virus, nasopharyngeal cancer, polymerase chain reaction, prognosis, recurrence

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Effect of Corticosteroids in Routine Treatment of PeriTonsillar Abscess

Introduction: There are controversies regarding treatment of peritonsillar abscess as a common infection of head and neck, especially for prescription of corticosteroids. According to review of articles, use of corticosteroids in management of this abscess is increasing, but more controlled and comparative studies are needed. In this clinical trial study, we evaluated corticosteroid as an adjutant therapy for peritonsillar abscess. Methods: This clinical trial study was done on 50 hospitalized patients divided into 2 groups; steroid and placebo. Antibiotic therapy and method of abscess drainage was the same in both groups. A special questionnaire included characteristics, symptoms, clinical course and complications of patients. Data was filled and analyzed by SPSS software using chi square, repeated measurement and t tests. Results: Normalization of body temperature within 12 hours after treatment and mean time of painless swallowing was 100% and 9 hours in the steroid group as compared to 84% and 15 hours in placebo group (p value=0.04). Trismus recovery was faster in steroid group. Hospitalization period was 3 and 4 days in steroid and placebo groups, respectively (P value>0.05). Fewer complications were reported in steroid receiving patients. There was one case of relapse in the steroid group and 5 cases in the placebo group (P value=0.09). Conclusion: According to our findings, it seems that corticosteroid adjuvant therapy of peritonsillar abscess is effective and doesn’t lead to any important complicatio

Assessment of Surgical Success Rate and Acoustic Test Findings in Children after Tympanostomy Tube Insertion

Introduction: Otoacoustic emissions are low density sounds produced from intact cochlea measureable in the presence of an intact conduction structure. The goal of this study was to assess the surgical success rate after tympanostomy tube insertion by Distortion Product Otoacoustic Emission (DPOAE) and Transient Evoked Otoacoustic Emission (TEOAE) as methods of evaluation of postoperative hearing. Methods: A descriptive-analytic study was conducted on 130 patients with OME. Audiometrical tests included TEOAE, DPOAE that were performed before, one month and three months after surgery on patients and results were compared. Results: Prior to surgery, TEOAE and DPOAE responses were not recordable in any of the patients, whereas after surgery, the responses were significant. Conclusion: OAE tests can be used as objective, simple tests in children, especially in toddlers who are not able to cooperate in performing PTA before surgery. These tests can be also be used for follow up of patients for hearing loss improvement and resolvement of middle ear effusion

Effect of topical furosemide on intraoperative bleeding during functional endoscopic sinus surgery

Intraoperative bleeding reduction during functional endoscopic sinus surgery is a key factor in preventing surgery complications. That is implemented through prescribing systemic corticostroid before surgery. This study aimed to explore an efficient nasal Furosemide versus systematic corticosteroids to reduce intraoperative bleeding. Study Design: This study was conducted on 40 patients with bilateral nasal polyps who undergone functional endoscopic sinus surgery. The patients were randomly divided into 2 groups of furosemide and corticosteroids. Methods: The first group was treated with prednisolone for a week before surgery (1 mg/kg daily) and twice-daily spray by saline as placebo. The second group was treated a week before surgery by topical furosemide nasal spray and placebo pill. The surgeons' opinions about the surgery field and intraoperative blood loss were recorded in both groups. Results: Regarding intraoperative bleeding loss, the difference between furosemide group (262.1545.57 cc) and corticosteroid (232.7556.08) was not statistically significant (P value0.077). Time operation in the furosemide group was 112.812.46 minutes and in the corticosteroids was 105.7512.59 minutes that was not significant (P value0.83). No statistically significant difference was found between the median of both groups in terms of the surgery field (P value0.17). Conclusion: According to this results, when there is a restriction for the use of corticosteroids, 1 week before functional endoscopic sinus surgery the use of topical nasal furosemide can be as effective as the use of oral prednisone to reduce intraoperative bleeding. Copyright © 2016 Mutaz B. Habal, MD