efficacy of clarithromycin in patients with severe nasal polyposis

Although several treatments have been suggested for nasal polyposis, from medical to surgical, there is no standard guideline for the management of this disease. During recent years increasing attention has been directed toward the effects of macrolide antibiotics on chronic sinusitis and nasal polyposis. In this study, the efficacy of clarithromycin on severe nasal polyposis were examined. In a Prospective, before -after study, forty patients with severe nasal polyposis received clarithromycin 500 mg twice a day for 8 weeks. At the beginning and end of treatment, the severity of patients' symptoms [using subjective analogue scale], computed tomography [CT] scan and endoscopic findings were recorded. After treatment, the severity of nasal obstruction, smelling problems, Post Nasal Discharge and rhinorrhea decreased significantly [P0.05]. Furthermore, the degree of sinus opacification in CT scan and endoscopic findings showed significant improvement. Most patients completed their treatment course without significant side effects. Although a course of clarithromycin improved nasal symptoms, polyp size and CT findings, further studies with more patients are required to recommend this drug as a general treatment in nasal polyposis

[Direction of head trauma and its effect on olfactory bulb volume in post-traumatic anosmia]

Anosmia is a physical sign in post-traumatic patients, which significantly reduces the quality of life. Anosmia occurs in up to 30% of cases with head trauma. In this study we aimed to compare the Olfactory Bulb Volume [OBV] in patients with posttraumatic anosmia in different impact positions and also with healthy individuals to find the relation between the two variables. Thirty-eight patients with posttraumatic anosmia and 27 healthy individuals with normal olfactory function were recruited in this case-control study performed in Amir Alam Hospital in Tehran, Iran. Variables of age, sex, time of trauma, site of trauma [frontoparietal/occipital], side of trauma, OBV, the results of olfactory identification tests and olfactory threshold were extracted and evaluated. We used non-contrasted 1.5-Tesla coronal brain MRI for the measurement of OBV. There were no significant differences between cases and controls regarding sex and age. Olfactory bulb volume was significantly smaller in cases compared to the controls [P=0.004]. Among the case group, OBV was smaller in anterior versus posterior head traumas [P=0.02]. OBV was also smaller in ipsilateral rather than the contralateral side of trauma [P=0.01]. The direction of trauma had a significant effect on OBV and it was smaller in traumas to the anterior and also ipsilateral sides of the head. It seems that changes in OBV differ due to the direction of head trauma and it can be helpful in predicting the prognosis of posttraumatic anosmia. Further studies are required for more conclusive statements