Evaluation of the Effect of Antibiotics and Splints on the Result of Septal Mucosal Culture After Septoplasty.

Purpose: Post operation infection after septoplasty is very rare, possibly due to excessive nasal blood supply. Most otorhinolaryngologists recommend antibiotics after septoplasty; however, controversial results were available. Therefore, this study was designed to investigate the effect of antibiotics after septoplasty. Methods: In this study, 90 patients who were candidates for septoplasty were entered the study and divided into three groups. The first group did not receive any oral antibiotics after septoplasty. The second group took 500 mg of oral cephalexin. The third group, for whom splints were used, also received cephalexin. The culture of the nasal mucosa was prepared before and two weeks after surgery and compared between groups. Then, the amount and types of mucosa microorganisms were reported. Data were analyzed using SPSS16. Results: The growth significantly increased in the first group (p = 0.051) and reduced in the second group (p < 0.001). While a decreased growth rate was observed in the third group, it was not statistically significant (p = 0.12). Conclusion: The present study highlighted the beneficial role of prophylactic antibiotics administration in patients without splints on bacterial growth, while it had no effect in patients with splints. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03665-w.

Intranasal Corticosteroid Treatment on Recovery of Long-Term Olfactory Dysfunction Due to COVID-19.

BACKGROUND AND AIMS: Olfactory dysfunction is a recognized manifestation in patients infected with Coronavirus Disease 2019 (COVID-19). This investigation aimed to assess the effect of mometasone furoate intranasal spray on the improvement of smell dysfunction in post-COVID-19 patients. MATERIALS AND METHODS: This randomized placebo-controlled trial included 80 non-hospitalized adult patients who had persistent anosmia or severe microsmia for more than 4 weeks due to COVID-19 infection. The participants were randomly allocated to the intervention or placebo group to receive mometasone furoate nasal spray or sodium chloride intranasal spray during 4 weeks of follow-up, respectively. The patients' olfactory dysfunction was assessed in terms of visual analog scale (VAS), and smell test score according to the modified version of the University of Pennsylvania smell identification test for the Iranian population. RESULTS: A total of 70 participants completed the follow-up period and were analyzed in this study. By comparing the olfactory scores including smell test and VAS scores, no significant differences were found between case and control groups at baseline, 2, and 4 weeks intervals. However, the change of both olfactory scores at pre to post-treatment intervals and 2-4 weeks was significantly higher in the mometasone group relative to the placebo group. At post-treatment, the frequency of anosmia was 22.9% reduced in the case group compared to the control group. CONCLUSION: Overall, there was no significant difference in olfactory dysfunction between the two groups during follow-up. However, based on the significant between-group difference in terms of olfactory scores changes, it seems that the nasal corticosteroids may be a positive effect on the recovery process of patients who received more than 2 weeks. LEVEL OF EVIDENCE: 2 Laryngoscope, 132:2209-2216, 2022.

A Pedunculated Cervical Mass: A Case Report.

Introduction: A congenital cervical mass is a considerable health problem worldwide; however, accessory tragus (AT) in the neck is extremely rare. The cervical variant of AT or congenital cartilaginous rest of the neck (CCRN) is a rare anomaly related to the branchial arch located at the lateral of the neck that typically presents as an asymptomatic papule or nodule along the anterior border of sternocleidomastoid (SCM) muscle. It is detected since birth or in the first few years of life. Diagnosis is based on the clinical characteristics of the lesion, surgical findings, and histopathologic studies. Case Report: A young man with no underlying diseases or known congenital anomaly was referred by a dermatologist for an asymptomatic pedunculated papule in the left mid-cervical area. Physical examination reveals a firm and mobile papule with a size of 1*1 cm on the anterior middle 1/3 border of the SCM. Radiologic findings illustrated a mass nearby the SCM with a long tract beneath it extending upward. The lesion was finally resected, and during surgery, a long tract was discovered, and histopathologic examination confirmed the diagnosis of a CCRN. Conclusions: Although rare, the cervical variant of AT or CCRN should be considered in a differential diagnosis of benign masses in the neck.

Intratympanic Steroid for the Management of Sudden Hearing Loss: Introduction of a Tapering Method.

INTRODUCTION: Sudden sensorineural hearing loss (SSNHL) is a therapeutic challenge. There are several controversies regarding the management protocol of SSNHL. This study aimed to present the results of a novel treatment algorithm, which is a combination of systemic steroids and a tapering intratympanic (IT) dexamethasone regimen. MATERIALS AND METHODS: The past 10 years' medical records of idiopathic SSNHL cases in Ghaem and Emamreza hospital, Mashhad University of Medical Sciences were evaluated. Patients were assessed using standardized methods for pure-tone threshold audiometry. The management method of SSNHL treatment included oral steroids combined with IT administration of dexamethasone once a day for 7 days and continuing it on an alternate day and then weekly basis. Patients' recovery was assessed using Siegel's criteria. RESULTS: This study included a total of 248 cases of idiopathic sudden hearing loss, with a mean age of 40.63±16.19 years. In total, 105 (42.3%) and 143 (57.7%) patients were female and male, respectively. The most common associated symptoms included tinnitus (86.9%, n=205) followed by vertigo (52.1%, n=122). The final hearing outcome of patients showed that 39 (15.7%), 38(15.3%), 86 (34.7%), and 85 (34.3%) patients underwent a complete recovery, partial recovery, slight recovery, and no recovery, based on Siegel's criteria. CONCLUSIONS: The dose, interval, and duration of IT steroid treatment were not universally approved. The treatment method designed based on a tapering of IT steroid injection in combination with already known systemic administration of steroids can be a treatment option in SSNHL patients.

Herbal Medicines and Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study.

Background. The aim of this study was to assess the association between herbal medication and OHSS. Methods. This retrospective cohort study was conducted with 101 polycystic ovary syndrome patients. 66 patients took conventional pharmacological medications and 35 took herbal medications. Data were analyzed by statistical test including Fisher's Exact and binominal logistic regression. P < 0.05 was considered significant. Results. Of the 101 females, 53 were married and 48 were single. There was no significant association between the groups in marriage. No significant association was found in mean age between the two groups (23.9 ± 5.8 years in the control group versus 26.3 ± 6.7 years in the case group). There was a significant difference between the two groups .After adding the dependent (OHSS prevalence) and independent (marriage and group) variables into the model, the Hosmer-Lemeshow test showed suitability. Variances analyzed with this model ranged between 29.4% and 40.7%. Conclusion. The indiscriminate use of herbs is correlated with OHSS. Because patients increasingly consume herbs, they should be aware of potential side effects. However, appropriate dosages of herbs could be obtained for use instead of conventional treatments, which often have side effects.

Comparison of Specificity and Sensitivity of AMH and FSH in Diagnosis of Premature Ovarian Failure.

INTRODUCTION: Anti-Müllerian hormone represents the primitive follicular number and ovarian age. Low level of AMH is in relation to early menopausal state and decreased ovarian reserve. AMH level changes occur prior to FSH level in representing ovarian failure. The aim of this study is to compare sensitivity and specificity of AMH with FSH in diagnosis of POF. MATERIAL AND METHODS: This descriptive study is done on 96 patients referred to Dr. Rasekh Clinic. Serum level of AMH and FSH was measured at Day 3 (3rd day of menstrual cycle) and data were analyzed through SPSS 21 software. RESULTS: Results of AMH and FSH serum level indicate that AMH has more sensitivity (80% versus 28.57%) and almost equal specificity (78.89% versus 78.65%) compared with FSH. Also negative predictive value of AMH (98.61%) and FSH (87.5%) is different. But positive predictive value is the same (17.39%). Diagnostic accuracy of AMH is more than FSH and has significant differences. CONCLUSION: According to the results of this study, AMH serum level is more sensitive than FSH serum level. Also AMH has more negative predictive value. Besides, this hormone can be measured at any time of menstrual cycle, against FSH. AMH seems to be more useful in early diagnosis of POF.