Cochlear implantation after kidney transplantation

Patients with chronic renal failure may develop sensorineural hearing loss. Cochlear implantation has rarely done after organ transplantation. Herein, we report on a 33-year-old kidney transplantation recipient who underwent cochlear implantation for her progressive sensorineural hearing loss in Khalili Hospital Cochlear Implant Center, affiliated to Shiraz University of Medical Sciences. The implantation was done successfully with no complications. Cochlear implantation may be an appropriate therapeutic option for sensorineural hearing loss caused by chronic renal failure

quality of life in pre-lingual deaf children after 1.5 years of cochlear implantation from the point of view of parents in Shiraz, Iran

As much of the studies on cochlear implantation [CI] have concentrated on aspects of speech perception and production, we studied the quality of life in pre-lingual deaf children in Shiaz, Iran. Twenty four parents were selected from those families that their children were implanted by Fars CI Center. The quality of life questionnaire was used and after 3 months was evaluated again. Significant changes were noticed in parent's satisfaction. The parents believed that the children communicated better, but they still needed special care to do school works, etc. Also they had still difficulty in articulation. CI was significantly associated with improvement of quality of life, especially in communication, happiness and relations with their friends and family members

[Intraparotid facial nerve schwannoma: Report of two cases]

Intraparotid facial nerve schowannoma is a rare tumor. We reported two cases of this tumor. We presented two cases of intraparotid facial nerve schowannoma. Both patients were presented with asymptomatic parotid mass which mimicked pleomorphic adenoma. No preoperative facial nerve dysfunction was detected. Diagnostic results and surgical management are also discussed

[Two case report of papillary carcinoma of thyroglossal duct cyst]

Thyroglossal duct carcinoma is a rare midline neck carcinoma that is usually diagnosed postoperatively. Its incidence is about 1-1.5%. This article presents two cases of thyroglossal duct cyst carcinoma and their diagnosis and the management methods are described. Our patients were 24 and 16 year old ladies that referred to Khalili hospital with chief complaint of midline neck mass in 1379, 1377. Their para-clinical tests were negative for malignancy but papillary carcinoma was detected after surgery. They have only been followed up for few years without any thyroidectomy and radioiodine therapy. There is high false negativity in fine needle aspiration and sonography for ruling out malignancy in thyroglossal cyst; therefore, para clinical tests cannot rule out malignancy and excisional biopsy is the only definite way for ruling out thyroglossal cyst carcinoma. On the other hand, severe controversy exists in managing of thyroglossal cyst carcinoma. While some surgeons are interested in total thyroidectomy and radioiodine ablation, it is not necessary to do thyroidectomy if the thyroid gland, lymph nodes and excised mass margins are free of malignancy because excellent prognosis of thyroglossal cyst carcinoma and probable thyroid involvement can be found by close follow up

[ effect of dexamethasone on decreasing nausea and vomiting following tympanomastoid surgery]

Nausea and vomiting are common after general anesthesia. Nausea and vomiting are also common after tympanomastoid surgery that may endanger the results of middle ear reconstruction. Medications like dexamethasone have been used to prevent nausea and vomiting. In this study, the effect of dexamethasone on decreasing nausea and vomiting following tympanomastoid surgery has been evaluated. This study is a case control, double blinded, clinical trial that was performed in Dastgheib Hospital affiliated to the Shiraz University of Medical Sciences during 1381-1383. Eighty patients candidate for tympanomastoid surgery who were in physical status I [according to the classification of the American Anesthesiology Association] were selected randomly. These patients were divided into two control and study groups [each group consisting of 40 patients]. Just before induction of anesthesia, 2 ml normal saline was given intravenously to the patients in control group and 2 ml dexamethasone [8 mg] was given to the patients in the study group. The data were collected by a special form, and SPSS software and Chi Square test were used for statistical analysis. There was no significant difference between the study and control groups regarding the mean of age, male to female ratio, and length of anesthesia. Use of dexamethasone resulted in 32.5% decrease in post operative nausea [p=0.002] and 22.5% decrease in vomiting [p=0.04]. It seems that 8 mg intravenous dexamethasone is effective in reducing nausea and vomiting following tympanomastoid surgery and can be used routinely during tympanornastoid surgery

Evaluation of the causes of upper airway obstruction leading to tracheostomy in Shiraz

To determine the causes of upper airway obstruction leading to tracheostomy; endoscopic evaluation was done in Khalili Hospital, Iran. During a 2 year period, 47 patients who underwent tracheostomy, were evaluated endoscopically to determine the causes of airway obstruction leading to tracheostomy. Forty-seven cases were included in the study including 40 males and 7 females with mean age of 31.9 years. The most common cause of obstruction was subglottic stenosis [40.%] and laryngeal carcinoma [38.3%]. The cause of subglottic stenosis in the majority of the patients was prolonged endotracheal intubations [95%]. Other less common causes were direct laryngeal trauma [4.5%], vocal cord paralysis [2.1%], supraglottitis [2.1%], tracheal foreign bodies [2.1%], severe trismus [2.1%], and status asthmaticus [2.1%]. Subglottic stenosis secondary to prolonged intubations is the major cause of upper airway obstruction leading to tracheostomy. Converting endotracheal intubations to tracheostomy in patients who need prolonged ventilator support may prevent subglottic stenosis and decrease the rate of serious complications following prolonged endotracheal intubations