[Treatment and outcome of malignant external auditory canal and middle ear tumor in Ghaem hospital - Mashhad]

External Auditory Canal and Middle Ear tumor are rare. Its unspecific symptoms make the physician confuse and has not a good prognosis. The aim of this study was to access the prevalence and comparing of middle and external ear carcinoma [Squamous Cell Carcinoma or Basal cell Carcinoma] in demographic factors and kind of management. In this cross sectional study we evaluated the patients with squamous cell carcinoma and basal cell carcinoma of external and middle ear who treated in ENT ward of Ghaem hospital Mashhad during 1995- 2009. We randomly selected 63 patients and followed them up for 2-24 months. Our findings showed that of total 47 patients with external auditory canal malignant tumors had either SCC [46.81%] or BCC [53.19%]. In the other hand of 16 patients with middle ear malignant tumor showed either SCC [93.75%] or BCC [6.25%]. Two- year survival in external auditory canal malignancies was much better than middle ear malignancies. The rates of recurrence in external auditory canal malignancy and in middle ear malignancy were 13% and 50% respectively. The best management in this malignancies is en block resection

[Etiologic evaluation of patients with dysphagia admitted to ENT and thorax surgery wards of Ghaem hospital, Mashhad, northeast of Iran]

Dysphagia is a common chief complain of various diseases with different benign or malignant etiologies. Iran is one of countries with a high incidence rate of esophageal cancer. The aim of this study was to evaluate the common causes of dysphagia for earlier diagnosis and treatment of this disease and reduction of its morbidity and mortality rate. In this descriptive study, we analyzed the etiology of dysphagia in 200 patients who were admitted to ENT and thorax surgery wards of Mashhad Ghaem Hospital during 2005-2007. Of 200 patients, 79 patients were female and 121 patients were male. The most prevalent cause of dysphagia in these patients was esophageal SCC and the most common endoscopic presentation was the ulcerative view. Other common etiologic factors were esophageal stenosis, adenocarcinoma, mediastinal tumors, achalasia, lyomyoma, sarcoma and diffuse esophageal spasm, respectively. According to these results, the complaint of dysphagia with or without odinophagia has particular clinical importance, especially in our country with high frequency of esophageal malignancies

[Endoscopic and imaging prevalance of nasal mucosal contact point and association between contact point and sinunasal symptoms]

The aim of the present study was to evaluate the prevalence of nasal mucosal contact point in rhinology patients and association between contact point and sinunasal symptoms. We compare the sinunasal problem and contact point [endoscopic and imaging] in 59 patients without [sever septal deviation,chorneal hypertrophy.large ethmoid bula and paradox turbinate] by fisher aaaaaaaa7 chi squre test and review the literature. The prevalance of nasal mucosal contact point in our study is 13/6 percent; there is no association between contact point and patients symptom such as headache, facial pain, nasal blockage. Nasal mucosal contact point occur between the septum and structure of the lateral nasal wall and contact point can be visualized either endoscopically or radiologically on CT scan.The nasal mucosal contact point in the physiological status of the nose is best detected on CT scan of paranasal sinus. As we found no association with headache, facial pain and nasal blockage and contact point, it appears unlikely that surgery is relieving these symptoms permanently by relief of contact points.

[Resolution of enuresis after adenotsillectomy in children with adenotonsillar hypertrophy]

Most of the upper airway obstructions are caused by adenotonsillar hypertrophy. Prevalence of nocturnal enuresis in children accompanied with upper airway obstruction is reported in 8-47% of cases. Considering this fact that adenotonsillar hypertrophy is curable by adenotonsilletomy, in present study the effect of this operation in treatment of children with adenotonsillar hypertrophy has been investigated by comparing the rate of nocturnal enuresis pre and post operation. During a period of 18 months, all children referred to otorhinolaryngology department of Ghaem hospital suffering from nocturnal enuresis and adenotonsillar hypertrophy have been surveyed. The patients were evaluated for improvement in nocturnal enuresis after adenotosillectomy for a period of three months. The average age of patients was 6.8 years. 63.8% of children had primary nocturnal enuresis and 36.2% secondary nocturnal enuresis. One month after adenotonsillectomy in 88% of children nocturnal enuresis was completely cured. Using Friedman test we revealed that there was no significant difference in second and third month in comparison with first month. Complete improvement was observed in patients with secondary nocturnal enuresis. Between severity of adenotonsillar hypertrophy and improvement in nocturnal enuresis only in patients with adenoid hypertrophy the result was significant [P<0.0001]. All children with secondary nocturnal enuresis who suffered from adenotonsillar hypertrophy were well treated by adenotosillectomy and this improvement was mostly noticed after one month post operation. Adenotonsillar hypertrophy must be considered in differential diagnosis of children suffering from nocturnal enuresis

[Treatment of carotid paraganglioma: review of a 15 - years experience]

Carotid body tumor is a highly vascular mass occurring between the origins of the internal and external carotid arteries, and should be considered in the evaluation of all lateral neck masses. The aim of this study is to review an institutional experience in the management of this tumor. 16 patients with carotid paragonglioma were treated in our institution during a period of 15 years. There were 12 women and 4 men with a mean age of 44 years. A slow growing painless lateral neck mass was the main finding in all patients. There was no evidence of a functional or malignant tumor. Carotid angiography and CT scan with contrast was performed in near all patients to define the vascular anatomy of the lesion. None of them underwent embolization. Complete tumor resection was done in all patients vascular reconstruction was necessary in two patients. Hypoglossal nerve was sacrificed in one patient and transient marginal nerve deficit was existed in one. No stroke occurred. High index of suspicion and earlier detection by radiologic finding and early surgical resection by an experienced team offer a safe and effective method for complete excision of tumor with a reduced morbidity rate

[ results of management of 47 patients with antrochoanal polyps by functional endoscopic sinus surgery]

To introduce the results of the treatment of 47 antrochoanal polyps patients managed by endoscopic procedure. 47 patients with antrochoanal polyposis underwent endoscopic sinus surgery from March 2000 to august 2006. 47 patients [29 men and 18 women] underwent FESS endoscopy. There was no major complication. Only 4 brief epistaxis reported postoperatively. There was no report of recurrence in follow up duration. In 6-45 months follow up of 47 patients with antrochoanal polyps who underwent FESS, we hadn't any complication or recurrence

[Combined septorhinoplasty and functional endoscopicsinus surgery]

To Perform FESS along with septorhinoplasty together and compare the Surgical complication. This is a retrospective study of 51 patients treated at the time of septorhinoplasty for sinusitis by FESS and we report the complication rate for combined and isolated surgeries. Patients' ages ranged 19-47 years [average 26 years] in my 51 cases, there were no major complication and 3 [5.8%] minor complication. [One case [1.16%] of postoperative orbital ecchymosis, and 2 cases [3.92%] postoperative epistaxis]. Performing septorhinoplasty and FEES at the same time had successful results without higher rate of complication

Nasal chondromesenchymal hamartoma in an adolescent: a report of case and review of literature

Nasal chondromesenchymal hamartoma [NCMH] is an extremely uncommon primary benign cartilaginous growth of the nasal and paranasal sinuses. It has been reported almost exclusively in infancy. We report a NCMH in a 23-year-old patient who presented with anosmia, right gaze diplopia and proptosis. CT scan of paranasal sinuses revealed frontal sinus mass extending to the right orbit, ethmoid cells and nose. After an initial inconclusive incisional biopsy, the patient underwent a complete radical resection; and the defect was reconstructed with osteoplastic flap of frontal sinus. Histopathological examination confirmed NCMH, which, we believe, probably had been present and undetected for many years. This report greatly extends the age of NCMH, as part of the differential diagnosis of cartilaginous lesions of the nose and paranasal sinuses

Outcome of 143 patients with chronic sinusitis treated with functional endoscopic sinus surgery technique

Objective: Endoscopic sinus surgery is a relatively new technique for the manaement of sinusitis refractory to nonivasive therapy. Success depends on the use of newly developed instrument, including endocopes. Follow-up was carried out 143 patients who undervent functional endoscopic sinus surgery at 6 months to 30 months

Method: 143 patients, with chronic rhino-sinusitis underwent endoscopic sinus surgery from March 2000 to May 2003

Result: Immediate postoperative data indicated 8 developed minor complications and no major complicattions. 143 patenits were available for long term follow up at 6 months to 30 months with success rate 95.8% for relief of chronic sinusitis