ABSTRACT
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
ABSTRACT
Fourth branchial pouch anomaly [4BPA] is a rare condition that often presents an extreme diagnostic and therapeutic challenge. It usually causes recurrent left thyroid or perithyroid tissue inflammation, but it can be situated in the right side too. In this case report we present a nine-year-old girl with right sided 4BPA. She was referred for evaluation of recurrent right muscular space mass and fistula that was unresponsive to any medical or surgical procedures. This paper demonstrates the proper technical issues about diagnostic work up and surgical approach that we used to manage her dilemma. In patients with both skin fistula and pyriform sinus opening, external cannulation is more convenient and less traumatizing than internal cannulation