Vestibular function in meniere's patients

Meniere's disease [MD] is a disorder of the inner ear characterized by episodic attacks of vertigo with hearing loss, tinnitus, and aural fullness. Vertigo is a common feature in MD patients, but the pathophysiology is still largely unknown. Videonystagmography [VNG] is a sensitive tool for oculomotor system and differential diagnosis and treatment monitoring of vestibular system disturbances. The aim of the present study was to explore the VNG findings in patients with severe MD. In a cross-sectional design, we examined 75 [45 males and SO females] 22-47 years-old patients with severe MD who were referred to ENT clinics of Imam Khomeini and Apadana Hospitals, Ahwaz. Balance function was assessed using VNG test-battery comprising of oculomotor [optokinetics, smooth pursuit, saccade and gaze], caloric and positional tests. The results of gaze,optokinetic and smooth pursuit and saccadic eye movement [accuracy, latency and velocity] were within normal limits. Positional evaluation in eye-covered condition was abnormal in 14MD patients. Directional preponderance and unilateral weakness indexes were abnormal in 13.33% and 88.10% of patients, respectively. Fixation index was also normal in all patients. Our findings revealed thatVNG isa suitabletool for vestibular function assessment in Meniere's patients and among its subcomponents, caloric irrigation constitute the most sensitive test

Predisposing factors for the complications of deep neck infection

The outbreak of antibiotics and the improvement in dental hygiene have made the occurrence of deep neck infections less frequent than in the past. Nevertheless, the complications of these infections are often life threatening. The purpose of this study was to review the clinical findings in deep neck infections and identifying predisposing factors of these complications. In this study, 147 patients with deep neck infections were studied in Imam Khomeini Hospital, Ahvaz, from 1997 to 2009. During the treatment, 24 cases of life threatening complications took place. Linear and logistic regressions and chi-square analysis were used to determine the association of the complications of deep neck infections with clinical parameters and longer hospitalization. Analysis showed that patients with older age, patients with involvement of more than two spaces, involvement of cervical spaces, lymphadenitis, septic sore throat, congenital cyst as a source of abscess, odynophagia, dysphagia are those who require longer hospitalization [P<0.05]. Complications are more likely to take place in patients with involvement of more than two spaces, involvement of cervical spaces, septic sore throat and odynophagia. [P<0.05]. Patients with involvement of more than two spaces or and with on underlying disease are at high-risk of deep neck infection complications and should be monitored more closely during hospitalization

Demographic evaluation of laryngo-tracheal stenosis following prolonged endotracheal intubation

Prolonged trans-laryngeal intubation is associated with increased laryngeal injury, glottic and sub-glottic stenosis, infectious complications, and tracheal injury such as tracheomalacia, and tracheal stenosis. Several studies assessing the laryngeal complications are available in Caucasoidpopulations. Minimal data are available in the literature related to Iran. In this study we have evaluated the etiological factors of laryngo-tracheal stenosis following intubation. It was a prospective analytical study in Otolaryngology- Head and Neck Surgery Department, Ahwaz Jondishapour University of Medical Sciences, from 2004 until 2006 [19 months] in Ahwaz, Iran. Ninety eight patients [61 patients were male] who were intubated for more than 48 hours in Imam Khomeini, Golestan and Razi University Hospitals critical care unit with different causes and were referred to Otolaryngology emergency ward with respiratory distress [The prevalent cause was head trauma] were enrolled in the study. All patients underwent laryngeal video endoscopy and laryngeal computed tomography scan at by an otolaryngol-ogist surgeon who was blinded to the intubation variables. Twenty five patients had been presented by laryngo-tracheal stenosis and the most common site of that was sub-glottic area [sixteen patients]. Statistical analytic findings showed that from several factors such as tube size [P=0.088], skill of intubating doctor [consultant or registrar; P =0.146], duration of intubation [P =0.002] and emergency intubation [P = 0.240] only prolonged intubation [P=0.002] was associated with higher incidence of laryngo-tracheal stenosis.In conclusion, laryngo-tracheal stenosis after prolonged endotracheal intubation was directly associated with duration of intubation. The most common site of laryngeal stenosis was sub-glottic area

Foreign body ingestion, an etiology for retropharyngeal abscess in diabetic patients

Pharyngeal abscess including Para and regtorpharyngeal abscess are potentially life-threatening conditions. A review in literature reveals that these infections are more prevalent and more complicated in patients with diabetes rnellitus and their management is more difficult with higher rate of mortality and morbidity. A prospective study on 4 cases during a 21 month period in Imam Khorneini Hospital in the Ahwaz city. Materials and methods: All diabetic patients suspected for retropharyngeal abscess were chosen and history, physical examination, type of antibiotics used, methods for surgery, and outcome were studied thoroughly. Foreign body ingestion is a common etiology for retropharyngeal abscess formation in diabetic patients. Vigorous antibiotic therapy with surgical drainage along with control of glycemic state is essential for successful treatment