role of Human papilloma virus [HPV] genotyping in recurrent respiratory papillomatosis in Rasoul Akram Hospital

The most common laryngeal mass in children is recurrent respiratory papillomatosis [RRP]. Studies have attempted to correlate viral typing and its aggressiveness. 29 patients with histologically confirmed RRP enrolled in adjuvant therapies. Patients underwent several surgical interventions. HPV genotyping demonstrated 45% HPV-6 and 55% HPV-11. The mean age at the first surgical intervention was 52.39 months [SD=102.28] [range from 4 months to 426 months]. The mean number of surgical intervention was 10.39 [SD=7.76] [range from 2 to 30]. The mean time of surgical intervals was 4.63 months [SD=4.02] [range from 2 to 24 months]. In fourteen patients [48%] tracheotomy was done. All patients who had tracheotomy received alpha-interferon. One of our cases was a male who had pulmonary extension with HPV-6. A review of patients with RRP was regarding to HPV genotyping and need for adjuvant therapy and tracheostomy. Mean number of surgical procedure was 10/40 and nearly fourteen patients [48%] need to tracheotomy. The clinical differences between HPV6 and HPV11 disease may not be accurately predictable. Patients with less age and with HPV-11 seemed to have more severe problems, but these differences were not statistically significant which needs much more investigations for reasonable starting point of evaluation for these differences

Effectiveness of adenoidectomy on tympanostomy tubes retention duration

The children with middle ear effusion need repeated re-tympanostomies. Adenoidectomy is an effective surgical intervention in the management of chronic otitis media with effusion in conjunction with insertion of tympanostomy tubes [TTs]. To find out whether TTs in different positions decrease the rate of re-tympanostomies study was done. The present study retrospectively evaluated the effectiveness of adenoidectomy on retention of Shepard TTs in antero-inferior quadrant [AIQ] and postero-inferior quadrant [PIQ] with chronic, persistent or recurrent otitis media. Eighty-five children [one-hundred and seventy ears] underwent bilateral myringotomy and TTs placement with and without adenoidectomy with informed consent. According to the TTs retention duration rate, there was a significant difference between adenoidectomy and non-adenoidectomy groups in AIQ. It was concluded that TTs placement in the AIQ in conjunction with adenoidectomy showed better improvement and prolonged ventilation. This study suggests that adenoidectomy is an effective surgical intervention in the management of otitis media especially when it is performed in conjunction with insertion of TTs. This significantly decreases tube extrusion rate especially in an AIQ, which might be due to improving eustachian tube function that consequently reduces repeated otitis media

Active anterior rhinomanometric [AAR] evaluation of nasal air-way resistance in normal Iranian sample

The most important and complex phenomenon of respiratory function of the nose is related to different nasal anatomy. The differences in facial anatomic structure between different races may also be reflected in nasal resistance and airflow. Caucasians has different facial anatomic structure which is the reflection of intranasal resistance or consequence of airflow. The active anterior rhinomanometric [AAR] is recommended for objective assessment of nasal airway resistance [NAR] in inspiration and expiration which can be calculated via nasal airflow. This study designed to evaluate the resistance of the nasal airway in Iranian samples and comparing with the standard methods. An epidemiologic case series cross sectional study was designed for 100 Iranian adult volunteer without nasal breathing problems and with AAR inclusion criteria. All subjects had to undergo a primary assessment of relevant symptoms of nasal disease and nasal examination before undergoing AAR assessment. The mean values of total nasal airway resistance sere 0/38 +/- 0/17 pa/cm[2]/s in inspiration and 0/41 +/- 0/27 pa/cm[2]/s in expiration at 150 pas pressure point. Unilateral nasal resistance in right and left in inspiration were respectively 0.88 +/- 0.69 pa/cm[2]/s and 0.90 +/- 0.57 at 150 pa/cm[2]/s pas pressure point. Also unilateral nasal resistance in right and left in expiration were respectively 0.95 +/- 0.72 pa/cm[2]/s and 0.95 +/- 0.57 pa/cm[2]/s at 150 pas pressure point. The study concluded that nasal airway resistance had the same range as the standard in different races and also no correlation exist between nasal resistance and sex, age, height, weight and smoking. Our suggestion is more epidemiologic studies if there are any queries in Iranians' airway resistance in larger sample size and wider areas