[ prevalence of frontal sinus aplasia in Mashhad, northeast of Iran]

There are various reports of the prevalence of frontal sinus aplasia in different geographical areas and ethnic origins. The size and shape of frontal sinus is different among various populations. This study used CT scan images to investigate the frequency of absence of frontal sinuses in adults of northeastern Iran. The present study was performed retrospectively on the axial and coronal CT scans of the paranasal sinuses from a series of 588 patients who had referred to CT scan ward of Mashhad Imam Reza hospital without any other sinus pathology. The mean age of patients was 44.39 +/- 19.44 years. Unilateral and bilateral aplasia of frontal sinuses was seen in 36 and 51 patients, respectively. The dominant sinus was in the left side in 68.24% of cases. The lower incidence of frontal sinus aplasia in this particular ethnic and geographical area relative to other populations emphasizes the effect of environmental and genetic factors on the development of frontal sinuses

effects of adenotonsillectomy on pulmonary arterial pressure by doppler echocardiography in children

Increeased upper-air way resistance resulting from hypertrophic tonsils and adenoids can cause intermittent airway obstruction, chronic alveolar hypoventilation, and even severe cardiopulmonary complications like pulmonary hypertension and corpulmonale. The aim of this study is to clarify whether tonsillectomy and adenoidectomy have any effect on mean pulmonary arterial pressure. This prospective study was approved by ethic committee. Thirty two randomly selected children [16 male, 16 female] aged between 3.5 and 13 [mean 7.06 +/- 1] with a diagnosis of upper airway obstruction or chronic infections from hypertrophied tonsils and adenoids were included in our study. Mean pulmonary arterial pressure [MPAP] was measured using Doppler echocardiography preoperatively and mean 4.25 +/- 0.46 months postoperatively in all subjects. Comparing preoperative and postoperative mean pulmonary arterial pressure showed a statistically significant decrease in mean pulmonary arterial pressure in these children [Preoperative mean PAP=19.37 +/- 0.82, postoperative mean PAP= 18.10 +/- 0.6]. [p=0.004]. 10 of the 32 subjects in the study group were pulmonary hypertensive preoperatively. MPAPs of 9 of these children decreased to normal range. [P=0.004]. This study showed that obstructive adenoid and tonsillar hypertrophy causes higher MPAP values in children that would be reversible by performing early adenotonsillectomy

[Lymphoid papillary hyperplasia in palatine tonsils]

Lymphoid papillary hyperplasia is a rare benign lesion of the palatine tonsils with a papillary surface configuration so atypical which could clinically be mistaken for a carcinoma or papilloma. The following report describes a 7 year old girl with papillomatous lesions of both palatine tonsils

[Nasopharyngeal carriage rate of Moraxella catarrhalis among children under 6 years of age in Mashhad city and antibiotic-resistance pattern in Moraxella catarrhalis isolates]

Nasopharyngeal colonization of Moraxella catarrhalis were in young children may be important so in this study the nasopharyngeal carriage and antimicrobial susceptibility of Moraxella catarrhalis were among children was surveyed in Mashhad. This cross sectional study was performed from Jan 2005 to Feb 2006. 1161 healthy children aged under 6 years attending day-care centers in Mashhad city were studied. Nasopharyngeal samples were collected by sterile swabs and then inoculated on selective agar. After 24h incubation microbiological tests were performed and antimicrobial sensitivity tests were done. Of 1161 children 572[49.3%] were boys and 589[50.7%] were girls and the mean age was 4.2 years. Moraxella catarrha liswere recovered from 54 [4.65%]. The rate of resistance to at least one antibiotic was 35.2%, 100%, 68.51%, 46.30%, 00%, and 74% to Co-timoxazol, Penicillin, Erythromycin, Cefixime, Amoxicillin clavunic acid, Amoxicillin respectively. Although the rate of the carrier nasopharyngeal Moraxella catarrhalis in the Mashhad city was low [4.65%], the resistant rate to the antibiotics was high. In order to avoid of excessive antibiotic use and subsequently high rate of resistance, enough education not only to the physicians but also general population is necessary

[Involvement of the audiovestibular system in multiple sclerosis]

Multiple sclerosis [MS] is a chronic demylinated disease of central nervous system which strikingly has racial and geographic differences in prevalence and symptoms. Audiovestibular involvement is relatively common in MS. In a descriptive prospective cross-sectional study on 36 patients who fulfill McDonald criteria of MS history of Audiovestibular symptoms was recorded and audiologic assessment including tunning fork, speech and pure tone audiometry, tympanometry and auditory brainstem response [ABR] performed. The mean age was 29 year [range: 18-48] and female to male ratio was 17. The most common symptoms in otoneurologic domain were balance disorders [63.5%] and in 16.7% cases there was true vertigo. In audiometry 22.2% sensoryneural hearing loss mainly unilateral was repotted. ABR in 44.4% had abnormality in morphology or latency. Vertigo in 5.6% and hearing loss in 2.8% were the first symptoms. Audiovestibular involvement is fairly common and occasionally it can be the first symptom in MS, so an otorhinolaryngologist has better consider this diagnosis when a patient refers with this symptom especially in young women

[Prevalence and Antimicrobial susceptibility of Haemophilus influenza among healthy children in Mashhad]

Nasopharyngeal colonization of Haemophilus influenza in young children may be important so in this study the nasopharyngeal carriage and antimicrobial susceptibility of Haemophilus influenza among children was surveyed in Mashhad. The study included 1161 healthy children less than 6 years of age. Nasopharyngeal swabs from these patients were cultured, and Haemophilus influenza were isolated. Antibiotic susceptibility of the strains was determined using disk diffusion. The carriage rate of Haemophilus influenza was 10.76% [125/1161]. High antibiotic resistance was observed against commonly administered antibiotics like Penicillin [82.4%], ampicillin [70.4%], Amoxicillin [79.2%] and trimethoprim sulfamethoxazole [71.2%]. It was found that 68.8% and 42.4% of isolates were susceptible against erythromycin and cefexim, respectively. H. influenza isolates from healthy Children in Mashhad had high resistance rates against ampicillin, Sulphamethoxazole/ trimethoprim and some other antibiotics. So antibiotic susceptibility investigations are important for choice of therapy in every acute respiratory tract infection. And further monitoring of antibiotic resistance among nasopharyngeal H. influenza as a surrogate for invasive H. influenza seems an attractive option

[ case report of kikuchi's disease]

Kikuchi's disease is a necrotizing lymphadenitis that is prevalent in Japan and is being increasingly recognized in other areas of the world. It usually occurs in women in their late 20s or early 30s and manifests as a posterior cervical adenopathy. It resolves spontaneously, usually over a period of several weeks to 6 months. Its initial clinical appearance is commonly similar to that of a lymphoma, and it can be pathologically misdiagnosed as such. We report a case of Kikuchi's disease that occurred in a 51-year-old Iranian woman. We discuss the clinical features, differential diagnosis, and pathology of this case in an effort to assist otolaryngologists in diagnosing this benign and uncommon entity

Takayasu's arteritis: report of a case with unusual jaw pain

Takayasu's arteritis [TA], often referred to as a pulseless disease, is a chronic inflammatory disorder affecting the aorta and its main branches. First reported in 1908 from Japan, it occurs worldwide, but is more prevalent in young oriental females from China and Southeast Asia. The main complications of the disease are due to occlusion of major branches of the aorta. We report a case of an Iranian female who developed left-sided leg intermitent claudication, left arm weakness and left-sided neck and jaw pain

[ prevalence of nasopharyngeal streptococcal pneumonia carriers in Mashhad day care children and their antibiotic resistance pattern]

Streptococcus pneumonia is the most common cause of communityacquired bacterial respiratory tract infection. It is also a major cause of acute otitis media, bacteremia and meningitis. There are few data on antibiotic- resistant streptococcus pneumonia in Iran. The aim of our study was to determine prevalence of nasopharyngeal carrier of streptococcus pneumonia and their antibiotic resistance pattern in children. This cross sectional study was performed from Jan 2005 to Feb2006 .1161 healthy children aged less than 6 years attending day -care centers in Mashhad city were studied. Nasopharyngeal samples were collected by sterile swabs and then inoculated on selective agar. After 24h incubation microbiological tests were performed and antimicrobial sensitivity tests were done. of 1161 children 572[49.3%] were boys and 589[50.7%] were girls and the mean age was 4.2 years. Streptococcus pneumonia was recovered from 102 [8.78%]. The rate of resistance to at least one antibiotic was 100%, 80.4%, 48.3%, 43.13%, 40.79%, 18.62%, 22.5 5% to Co-trimoxazol, Penicillin, Erythromycin, Cefixime, Amoxicillin clavunic acid, Amoxicillin respectively. Although the rate of the carrier nasopharyngeal pneumococci in the Mashhad city was low [8.7%]. The resistant rate to the antibiotics was high. In order to avoid of excessive antibiotic use and subsequently high rate of resistance, enough education not only to the physicians but also general population is necessary

Large giant cell tumor of the temporal bone presenting as mild conductive hearing loss

Giant cell tumor of bone or osteoclastoma is a relatively rare primary neoplasm of temporal bone. It usually involves the epiphyseal region of long bones. Primary involvement of bones of the skull appears to be uncommon. we report a case of giant cell tumor of temporal bone arising in a 33 years old man. The presenting symptom is only mild conductive hearing loss. A computed tomography [CT] scan showed a large well circumscribed mass within the right temporal bone, the posterior cranial fossa and the infratemporal fossa. Biopsy and subsequent resection showed a giant cell tumor of bone. Temporal bone tumor may be presented with symptoms such as mild hearing loss or aural fullness. So we always must be attention rare reasons of common symptoms