[Detection of bacterial biofilm in human refractory chronic rhinosinusitis with Scanning Electron Microscopy [SEM]]

Bacterial biofilm is a complex organization of bacteria anchored to a mucosal surface. A recent but fascinating notion in the pathphysiology of chronic rhinosinusitis is the role of bacterial biofilms. Biofilms explain why in individuals with normal immunity, antibiotics are unable to resolve bacteria that are sensitive to antibiotics on in vitro testing. This is the first study in Iran, in which we demonstrate the biofilms in ethmoid sinus mucosa of patients with refractory chronic rhinosinusitis after one successful surgery. 10 patients included, all of them had at least one previously technically successful FESS for a diagnosis of chronic rhinosinusitis [CRS] and/or nasal polyposis that were refractory to maximal medical therapy over months previously. Patients were not immune compromised and not taken antibiotics or systemic corticosteroids within a 1 month period previously, but taking nasal irrigation or topical intranasal corticosteroids. During postoperative endoscopy, four punch biopsies were obtained from ethmoid sinus. The specimens were examined by SEM. Photomicrographs were then evaluated for evidence of biofilms. Biofilm in SEM was defined as the presence of microcolonies embedded in a microfilament extrapolysaccharide matrix. The biofilms were not identified within the mucosa, but were identified on the mucosal surface. Biofilms were detected in 6 of 10 patients. Biofilms may play role in refractory chronic rhinosinusitis. Biofilms are refractory to antibiotics and often only cured by mechanical debridement

[Effect of drill-induced hearing loss in the non-operated ear after mastoidectomy by measuring of otoacoustic emission, Amir-Alam and Imam Hospitals [2000]]

Background: The damaging effect of exposure to loud noise on the structures of internal ear has been studied from many years ago. The effect of drill-generated noise on the non-operated ear is one of the problems that are less discussed. This study aims to evaluate the hearing loss that occurs in the non-operated ear in patients who undergo mastoidectomy by use of PTA [pure tone audiometery] and DPOAE [distortion product otoacoustic emission]

Materials and Methods: In this descriptive- analytic study, 49 patients who underwent mastoidectomy in Amir-Alam and Iman Khomeini hospitals, were evaluated for noise trauma generated by drilling on the non-operated ear. Patients were between 9-55 years old [mean age= 29] and they consisted of 25 males and 24 females. The patient's preoperative state were measured by PTA and DPOAE on the opposite ear also the postoperative state were re-evaluated by PTA and DPOAE

Results: As a result, in 4 cases a significant change in PTA thresholds were observed, while two of them showed recovery after one month. Seven cases showed significant change in DPOAE amplitudes, of whom five cases recovered later

Conclusion: In conclusion, the drill-induced hearing loss on the non-operated ear occurs in a few patients and it is often reversible