Human papilloma virus in head and neck squamous cell cancer

Epidemiologic and molecular evidences have established a strong link between high risk types of Human Papilloma Virus and a subgroup of Head and Neck Squamous Cell Carcinomas [HNSCC]. We evaluated the frequency of HPV positivity in HNSCC and its relationship to demographic and some risk factor variables in an open casecontrol study. Fourteen recently diagnosed patients with squamous cell cancer of oropharynx, hypopharynx and larynx aged 18-50 years were examined from 2008-2010 in Tabriz, Iran. HPV DNA was extracted from paraffin-embedded blocks of each patient's sample for PCR evaluation. Saliva samples of 94 control cancer-free subjects were collected for DNA analysis. Multivariable logistic regression method was used to calculate odds ratio for case-control comparisons. High risk HPV was detected in 6[42.8%] patients, and 6[5.3%] control subjects which was statistically significant [p<0.0001]. HPV-18 was the most frequent type both in the cases and controls. HPV-16 DNA was detected in two patients of the case group, but it was not detected in any of the controls. The relation between demographic and risk factor variables was not statistically significant. HPV infection has a significant impact on HNSCC. Despite HPV-16 stronger impact, HPV-18 is more likely to cause malignant degeneration in such cancers amongst some communities. It is vital to introduce and conduct immunization schedules in health care systems to protect communities to some extent

Dehiscence of facial nerve at surgery of cholesteatoma

Facial nerve dehiscence [FND] is a common problem at surgery of cholesteatoma: The aim of this study was survey of the common site of FND and the common complication of cholesteatoma that coexists with FND. This-cross sectional study was performed from 2001 to 2006. 185 patients with cholesteatoma were studied. Middle ear Findings at surgery of cholesteatoma were surveyed. Data was analyzed using the k[2] and Fisher exact test. of 185 cases, 95 [51.4%] were male and 90 [48.6%] were female and the mean age was 30.5 years. The rate of FND was 29. 73% [55 cases]. The common site of FND was tympanic segment [85.4%]. The positive statistically association between FND incidence and the presence of lateral semicircular fistula was demonstrated. The most common area of facial nerve injury at surgery of cholesteatoma is tympanic segment. Surgeons should always consider that fallopian canal will be eroded and the facial nerve is in direct contact with cholesteatoma whenever a lateral semicircular canal fistula is suspected or vice versa

influence of age at the time of cochlear implantation on hearing threshold in prelingually deaf children

There always has been a question about the best age for cochlear implantation [CI] in prelingual deaf children. The age factor in the outcome of cochlear implantation in prelingual deaf children has been the subject of many studies. The aim of the present study was to find the effect of age at the time of implantation on hearing threshold of these children. One hundred and nine prelingual deaf children who had undergone CI were enrolled. The mean hearing threshold [HT] at octave intervals from 125 to 8000 Hz at different periods from the operation time were compared between those patients whose age at the time of implantation were less than 24 months and those whose age were equal or greater than 24 months. The mean age of patients at the time of implantation was 38.9 months and a half of them had less than 28 months. There was no difference in mean HT between the two age groups across different measurement periods. A multiple regression model showed that device type was the sole significant predictor of mean HT at the first and third months after implantation, where age replaced it at the sixth month. These results suggest that what had been found in other studies as a favorable effect of younger age at the time of implantation on speech perception cannot be explained by a better hearing, and there are other important factors including rehabilitation programs beginning at a younger age that may explain those findings

Study of pharyngeal and esophageal foreign bodies in adults in Tabriz Imam Khomeini hospital during 10 years [1373-1383]

Foreign body swallowing is a common problem in adults and because of its complications, it is an emergency case. The rate of mortality due to foreign body swallowing has decreased by medical developments. Because of its complications, it requires to be diagnosed and treated earlier and this is provide by history, physical examination, radiological studies. The aim of this study was to evaluate pharyngeal and eophageal foreign bodies in Adults in Tabriz Imam Khomeini Hospital. This study has been done on the base of medical documents of patients in the hospital. 210 patients hospitalized in Tabriz Imam Khomeini hospital with foreign body swallowing during 10 years [1373-1383] have been studied. In this study there were 210 patients, 100 women [47.6%] and 110 men [52.3%], ranging in age from 19 to 79 years. The most symptoms were Dysphagia [76.1%] and odynophagia [68.06%]. The most involved site was the proximal of esophagus under cricopharyngeal muscle and occurred in 137[65.2%] cases. The most common foreign body was bone in this study, 4.2% of cases had underlying esophageal disease. We found that delay in diagnosis or the reference of patients cause many complications such as perforation of esophagus, mediastinitis or abcess that occurred in 2 [0.9%] Cases. The complications related to endoscopy occurred in 3 [14%] Cases that were the vascular injuries, pneumothorax and mediastinitis. Our study has some similarities and differences with other studies carried out in the developed countries. We found that rigid endoscopy is reliable and cost- effective technique. The early references of patients, necessary facilities and more attention in special techniques such as endoscopy cause to decrease the secondary complication such as perforation of esophagus. We expect that physician select the true and sufficient way to treat patients with foreign body swallowing

Survay of the results of surgical treatment of otosclerosis

Otosclerosis is the most common cause of conductive hearing loss in population between the ages of 15 to 50 years. The treatment of otosclerosis has been largely restricted to surgical efforts to reconstruction of the conductive hearing loss. Stapedectomy and stapedotomy have been the common surgical techniques for clinical otosclerosis and have a high success rate. Objective of this study was to investigate the results of the surgical treatment of otosclerosis. We did a retrospective study of 50 patients who had undergone stapes surgery. Among these 50 patients, 39 cases at Tehran Amir Alam hospital and 11 cases at Tabriz Emam Khomeini hospital, had been operated by a single surgeon. 32 cases were stapedotomy and 18 Cases were stapedectomy. 32% of patients had pre - operative air-bone gap of more than 40dB, the postoperative air - bone gap closure was

case report of malignant hyperthermia following to the administration of succinyl choline and halotan in a patient with previous non complicated surgery with halotan

Malignant hyperthermia is amongst the most life-threatening complications of surgery. The most classical type occurs following to the administration of agents used for induction of anesthesia. The patient was 56 years old male being scheduled for Tympanomastoidectomy due to chronic otitis media. Induction of anesthesia was performed via Thiopental sodium, Fentanyl, Succinyl choline and lidociane. After 75 minutes of induction of anesthesia, the patient experienced increase in blood pressure, heart rate, body temperature, acid-base and electrolyte impairment being suggestive of malignant hyperthermia. Regarding to its life-threatening feature, the occurance of malignant hyperthermia is probable during surgery even in patients with previous non-complicated surgeries. Therefore, continuous monitoring, and appropriate history, early diagnosis and reduction of side effects are necessary

[ case report of malignant hyperthermia foil owing to the administration of Succinyl choline and Halotan in a patient with previous non-complicated surgery with Halotan]

Background: Malignant hyperthermia is amongst the most life-threatening complications of surgery. The most classical type occurs following to the administration of agents used for induction of anesthesia

Case report: The patient was 56 years old male being scheduled for Tympanomastoidectomy due to chronic otitis media. Induction of anesthesia was performed via Thiopental sodium, Fentanyl, Succinyl choline and lidociane. After 75 minutes of induction of anesthesia, the patient experienced increase in blood pressure, heart rate, body temperature, acid-base and electrolyte impairment being suggestive of malignant hyperthermia

Conclusions: Regarding to its life-threatening feature, the occurrence of malignant hyperthermia is probable during surgery even in patients with previous non-complicated surgeries. Therefore, continuous monitoring, and appropriate history, early diagnosis and reduction of side effects are necessary

Emotional changes in children undergoing cochlear implantation through evaluation of their drawings

Background: the emotional changes of patients undergoing cochlear implantation [CI] has been addressed in a few studies. To date, no special test has been developed to measure these Changes

Objective: to measure the emotional status of children undergoing CI by interpreting their drawings

Methods: a prospective longitudinal study on prelingually deafened children from 4-14 years of age undergoing CI and sex and age-matched non-CI candidate deaf children comprised the study population. Drawings were produced before implantation and after 1, 3, 6, and 12-month intervals. These were scored with regard to a questionnaire developed in Amir Aalam Hospital Hearing Research Center, Tehran, Iran

Results: the prevalence of drawings with cues of rage/anxiety decreased from 35% to 21.9%. Similarly, sadness prevalence dropped from 36.8% to 20% and the prevalence of immaturity was reduced from 20% to 7.1%

Conclusion: we recommend drawing to be included in the rehabilitation program of children undergoing CI and used as a practical measure of their emotional progress