Cavernous Hemangioma Involving the Maxilla: A Case Report

Background: Intraosseous vascular lesions are rare, they seldom occur in facial skeleton and maxilla is one of the least reported sites of involvement.Case Presentation: We report a 45-year-old woman with cavernous hemangioma of maxillary bone involving inferior turbinate. It   showed osteolytic expansile nature in imaging. The mass was approached via facial degloving technique. Histologic evaluation revealed vascular lesion in favor of cavernous hemangioma.Conclusion: Intraosseous vascular anomalies are one of the diagnoses of facial skeletal masses not routinely occurring to the mind especially in adults due to their rarity and various presentations. They can mimic other pathologies with regard to symptoms and imaging characteristics. They also should be differentiated from malignancies, though frequently the definite diagnosis will be uncertain until proven histologically

Comparison of endoscopy and CT scan in diagnosing chronic rhinosinusitis without polyps

Background: Definite diagnosis of Chronic rhinosinusitis (CRS) is challenging mostly because of overlapping symptoms with other disorders. Nowadays it is mostly dependent on cross sectional imaging. When considering the prevalence and cost burden of CRS, reducing the frequency of cross sectional imaging by replacing it with endoscopic evaluation could be a cost effective way if the endoscopic examination proved to be a suitable substitution. Aim: The aim of this study is to compare the endoscopy with CT scan- as gold standard method- in diagnosis of CRS without polyp and to find out how well the results of the two correlate with each other. Methods: Adult patients with symptom criteria compatible with EPOS 2020 entered the study. They were evaluated endoscopically, and then scored by Lund Mackay CT score. Cases with obvious polyps seen on rhinoscopy or endoscopic evaluation were not entered the study. Results: A total of 49 patients entered the study.  Comparing endoscopic findings with CT scan showed the sensitivity of 69.70% and specificity of 50%. Cohen Kappa statistics of 0.191 was obtained. Positive and negative predictive value was 74.19% and 44.44% respectively. Of note, all 8 patients with Kennedy score of 4 showed positive CT results, and, all 4 cases with isolated sinusitis had negative endoscopic results. Pearson correlation coefficient was 0.63, which showed a significant positive correlation between Lund Kennedy and Lund Mackay scores. (p<0.05) Conclusion: Our observations lead us to a possible need for revision in presented endoscopic criteria to increase the diagnostic power of endoscopy in chronic rhinosinusitis sine nasal polyposis

Nasal Valve Area in Iranians, an Imaging Based Study

Background and Aim:The internal nasal valve is the narrowest area of nasal airway bounded by the nasal septum, the caudal edge of upper lateral cartilage and the anterior head of the inferior turbinate. Knowledge about this area is of utmost importance for every nasal surgeon.This study was done to evaluate the internal nasal valve angle and cross sectional area in Iranians.methods:This is a retrospective study done using data from cross sectional imagings available from patients who underwent image guided endoscopic skull base surgery between 2013 and 2017. An image navigation software [Osiri- x: 8.5.2] was used for display of the multidimensional images.Results:Collectively 43 cases (i.e. 86 nasal passages) including 24 males and 19 females in the age range 21 – 74 years (48 ± 13.6) participated in the study.The internal nasal valve angle of naval cavities of the 86 subjects was averaged and the mean value of 17.70º (±3.72) was obtained. Mean value for cross sectional area was of 1.40 cm2(±0.38).There was not a statistically significant difference between males and females in terms of the nasal valve angle and nasal valve cross sectional area.Conclusion: We found some differences between the nasal valve angle and cross sectional area between Iranians and values of Asians / Japanese and Caucasians reported in previous studies. Despite these findings, reaching a conclusion needs further large sample studies in different ethnic groups paying special attention to similar case selection and study design

Evaluation of the relashionship between clinical findings before tympanoplasty and ossicular discontinuity and erosion in patients with chronic otitis media

Background: Chronic Otitis Media (COM) is a relatively common condition and the occurrence of hearing loss is probable. COM may lead to ossicular discontinuity, and unless the operation is performed, it won't be determined. Identifying possible cases of erosion and discontinuity of ossicles is helpful in surgical planning and in anticipation of the probable need for procuring ossicular prosthesis.Purpose: The aim of this study was to evaluate the relationship between preoperative clinical findings and intraoperative findings.Methods: This is a cross sectional study carried out in 2012 in two tertiary referral hospitals of Tehran, (the Loghman and the Taleghani hospitals). The sample under study consisted of COM patients who referred to the otolaryngology clinics and were tymponoplasty candidates. Two hundred and seven  patients with the mean age of 36.2±13.9 (ranging from 9-67 years) were enrolled in the study. Pre-surgical findings were investigated and the relationship between ossicular discontinuity and pre-surgical findings were evaluated.Results: Incus-Stapes discontinuity (IS Discontinuity) and Incus-Malleus discontinuity (IM Discontinuity) were seen in 60 (29%) and 25 (12.1%) patients, respectively. We found IS Discontinuity in 38 (24.1%) patients with central perforation and 22 (48.9%) cases of marginal perforations (P=0.005). IM Discontinuity was observed in 14 (8.9%) cases with central perforation, while this was seen in 11 (22.4%) cases with marginal perforations (P=0.011). On the other hand, 34 (42%) patients with otorrhea had IS Discontinuity whereas 26 (20.6%) cases of dry ears showed this type of ossicular problem (P<0.001). IM Discontinuity was detected in 13 (16%) and 12 (9.5%) cases with and without otorrhea, respectively (P=0.011). IS Discontinuity and IM Discontinuity were significantly more common in the patients with Air Bone Gap of more than 40 db.Conclusion: Our finding showed that surgical results may be unpleasant in the patients with marginal perforation, otorrhea and ABG>40 db

Evaluation of the Concordance of Cytological Findings Based on the Milan System with Histopathological Findings in Salivary Gland Tumors

Background: The goal of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is to standardize the reporting of salivary gland cytology and guide treatment decisions. Considering the newness of this system and the need for more studies in this regard, the aim of this study was to evaluate the concordance of cytological findings based on the Milan system with histological findings in salivary gland masses. Aim: evaluating salivary gland tumors’ cytological findings of Milan system with histopathological findings. Methods: This diagnostic study was conducted on 94 patients with salivary gland masses were referred to the pathology department of Imam Hossein hospital in 2022. FNA was performed for all patients and cytological classification was done based on the latest classification of the Milan system. Cytological findings were compared with histological findings. Results: In this study 10.6% were diagnosed as non-neoplastic, 18.1% with AUS, 37.2% benign neoplasm, 20.2% with SUMP, 5.3% suspicious for malignancy, and 8.5% were diagnosed as malignant. In the pathology results, 18.1% of patients were non-neoplastic, 56.4% had benign neoplasm, and 25.5% had malignant mass. The agreement coefficient between the two methods based on the Kappa coefficient was 40%, which indicates a relatively good agreement. The correlation coefficient between the two methods was 0.70. Conclusion: It is concluded that there is a relatively good agreement between the Milan system in the cytology of salivary gland neoplasms with pathology findings