Clinical Study INF-and Ototoxicity

Introduction. INF-is a common drug for the treatment of hepatitis B and C. Although a variety of related complications are discussed, possible ototoxic effects of this mediation are not well described. Methods and Materials. In a before-after control study, 24 patients who received INF-for the treatment of hepatitis B and C and 30 normal controls were included. Subjective and objective ototoxicity evaluations via questionnaire, high frequency audiometry, and measuring transiently evoked otoacoustic emissions (TEOAEs) were performed one week before and one month after the prescription of the drug. Results. Subjective hearing complaint, tinnitus, and vertigo were seen in just 3 cases, which was not statistically significant ( = 0.083). In the frequency range of 4000 to 8000 Hz before (9.38 ± 1.0 and 10.7 ± 1.2, resp.) and after (17.9 ± 2.6 and 17.6 ± 2.6, resp.) one month of treatment, a significant difference ( = 0.083) was detected. Progressive decreases in amplitude of the OAE during TEOAE measurement in 1, 2, and 4 frequencies among 41.66%, 18.75 %, and 43.75% were observed, respectively. The hearing loss was seen more among older and male cases significantly. Conclusion. The results showed ototoxicity of INF-that may encourage planning hearing monitoring in patients receiving this drug

Tip Graft and Columellar Strut Using Dorsal Osseocartilaginous Hump

Background: Although, different grafts are used for nasal tipplasty in cases with under projected or ill defined tip, the selectionof a graft material, which provides sufficient amount oftissue with least donor site morbidity and low recipient sitecomplication is challenging. The objectives of the presentstudy were to examine the usefulness of cartilaginous dorsumas a proper material for tip graft, and to introduce the cartilaginousdorsum as an acceptable material for columellar strut.Methods: Fifty six (18 males and 38 females) patients wereoperated for augmentation tip plasty and hump reduction from2004 to 2008. The tailored cartilaginous or ostecartilaginousdorsum was used as a tip graft or columellar strut in 35 and 21cases, respectively. The cartilaginous framework was exposedusing open or close rhinoplasty approach in 41 and 15 cases,respectively. The patients were followed for 12- 36 months.Cosmetic outcomes and patients' satisfaction were obtainedusing qualitative measures.Results: The percentage of patients with very improved, improved,unchanged or unacceptable aesthetic outcome were39.29%, 50%, 3.57% and 7.14%, respectively. Moreover, thepercentages of very satisfied, satisfied, indifferent and unsatisfiedpatients were 66%, 18%, 9%, and 7%, respectively.Conclusion: The procedure provides a well-defined nasal tipwith no evidence of bifidity, angularity, or cartilage graft visibilityand displacement. The use of dorsal osteocartilaginousgraft offers outstanding advantages including ease of harvest,mould, fix, and low resorption

Bilateral Kuttner Tumor of Submandibular Glands: A Case Report

Introduction: Chronic sclerosing sialadenitis is a relatively uncommon disorder of the salivary gland. Because of its clinical similarity to a salivary gland neoplasm, this condition has been known as Kuttner tumor and is classified as a tumorlike lesion. Case Report: This is the first reported case of bilateral Kuttner tumor of the submandibular glands in Iran. It was initially diagnosed as a primary submandibular gland neoplasm whereas histological findings showed chronic sialadenitis. Excision of such masses is the treatment of choice

Metastatic Renal Cell Carcinoma in the Sinonasal Region: A Case Report

Metastatic tumors in the nose and paranasal sinuses are rare. In the present paper, a 68 year old man with metastatic renal cell carcinoma to the left frontoethmoidal region 4 years after initial nephrectomy is presented ..Pathologic diagnosis of the case was Clear Cell Carcinoma. The patient complained of mild nasal obstruction and intermittent  epistaxis, but the significant symptom was  bulging  in medial canthus from 20 days before. Clinical and endoscopic examinations of the left nasal cavity revealed a vascular mass in the axillary of the middle turbinate and anterior ethmoidal sinuses extending to the left orbital cavity .  The patient was treated with partial endoscopic sinus resection and chemoradiotherapy. He had a complete clinical response without any significant complications and recurrence of the tumor after 6 months follow up using interanasal endoscopic examination

Penetrating globe injury during rhinoplasty surgery; A case report

Complications of the rhinoplasty surgery may involve the orbital contents due to the anatomical proximity to the surgical site. In this article, we report an inadvertent complication of the rhinoplasty in a 32-year-old woman who presented to our clinic with reduced vision of her left eye following the surgery. With diagnosis of a penetrating globe injury, the patient underwent an anterior segment surgery with general anesthesia which included both corneal laceration repair and lensectomy. We suggest that surgeons consider using protective eye shields for their patients during these surgeries depending on their experience and technique

Congenital Vomer Agenesis: Report of Two Cases

Introduction: Congenital vomer agenesis is an extremely rare condition in which the vomer bone does not fully develop, which can lead to septal perforation. Case Report: We report two cases with a defect in the vomer bone in the posteroinferior portion of the septum, found accidentally while performing a pre-operative CT scan for nasal obstruction evaluation. They were diagnosed with congenital vomer agenesis. Conclusion: There are afew reports of vomer agenesis in literatures. By increasing usage of sinonasal endoscopic examination,we expect to address more cases in the future

Epidemiological Survey of Sinonasal Malignancy in North-East Iran

Introduction: Sinonasal malignancies are uncommon neoplasms with several histological subtypes. These malignancies have a poor prognosis and, because of the nonspecific nature of the symptoms, most patients are diagnosed late when the disease is already at an advanced stage. Therefore, most sinonasal malignancies tend to be treated with surgery and postoperative radiotherapy. Understanding the incidence and prevalence of clinical symptoms, pathology, diagnosis, and subsequent prognosis of the disease is important for early diagnosis.   Materials and Methods: Medical records of patients with a confirmed diagnosis of sinonasal malignancy in a tertiary referral center from 1998 to 2009 were retrospectively investigated by chronological examination. Information relating to symptoms, pathology, and treatment of patients were collected from the checklists and used to generate tables and graphs, while descriptive statistical tests were used to compare data.   Results: The records of 69 patients were examined, including 45 (65.2%) male and 24 (34.8%) female patients with a combined mean age of 54.07±16.04 years. Twenty-one patients (30.4%) were aged less than 45 years and 48 (69.6%) were more than 45 years of age. The most common symptom was facial swelling in 46 (66.6%) patients and the most common kind of tumor was squamous cell carcinoma in 28 (40.6%) patients. The primary location of the tumor in most patients was the maxillary sinus (54 patients; 78.3%). A majority of patients present in advanced stage (stage III or more) with intraorbital (39.1%) or intracranial (4.3%) involvement, or regional lymphatic (28.99%) or distance metastasis (7.2%). The most common treatment was surgery (17 patients; 24.6%).   Conclusion:  Due to their nonspecific symptoms, most sinonasal malignancies are diagnosed at an advanced stage of the disease. Therefore, all patients with nonspecific symptoms, especially older males, should be evaluated for sinonasal malignancies in order to eliminate this diagnosis

The Nasal Smear for Eosinophils, Its Value, and Its Relation to Nasal Mucosal Eosinophilia in Allergic Rhinitis

Introduction: There is no single test as a gold standard for the diagnosis of allergic rhinitis (AR). The aim of this study was to assess the usefulness and validity of nasal smear as a quick, easy and inexpensive diagnostic method for diagnosis of allergic rhinitis. Materials and Methods: This study was conducted in a university hospital setting. Nasal smears were taken from 39 patients with a clinical history of nasal allergy and a positive skin prick test to at least one aeroallergen as well as 26 controls without any history and negative test. Biopsy specimens from the inferior turbinate as well as nasal smears of 19 cases including 9 patients and 10 controls with the same criteria were taken. Nasal smears and biopsy slides were stained with Giemsa and Hematoxilin-Eosin and were examined blindly by two separate pathologists. Results: Fifty one percents of the patients and 11.5% of the controls showed eosinophilia in their nasal smear (≥10% eosinophils, P=0.001). The sensitivity of nasal eosinophil count as a diagnostic test for AR was 51.3% with a specificity of 88.5%, a positive predictive value of 87% and a negative predictive value of 54%. Eosinophilia in nasal biopsies was found in 44% and 30% of allergic patients and controls respectively. There was no significant correlation between symptoms or positive skin tests with either smear eosinophilia or tissue eosinophilia. Conclusion: Evaluation of eosinophils in nasal smear is an insensitive but fairly specific test for the diagnosis of allergic rhinitis. It seems that the nasal secretions and nasal tissue represent two distinct cellular compartments