Journal Of Research In Medical Sciences (17357136)10(6)pp. 381-383
Background: One of the most common techniques of nasal tip surgery in rhinoplasty is conservative resection of cephalic portion of nasal alar cartilage; although, there is a controversy about its effectiveness on nasal tip rotation in textbooks and articles. Therefore, in this research, we have studied the effect of conservative resection of cephalic portion of alar cartilage on nasal tip rotation. Methods: 35 patients were selected from the patients who were candidates for septoplasty, after getting their agreement. In surgery we performed conservative resection of cephalic portion of alar cartilage. Nasolabial angles were calculated, using the lateral photographs of the patients before and six monthes after surgery. The means of these angles were analyzed with t-paired test. Results: The means and standard deviations of nasolabial angles before and six months after surgery were 91.49±7.35 and 91.57±7.04, respectively. Calculated P-value was 0.52. Conclusion: There was no meaningful difference between means of nasolabial angles before and six months after surgery (P-value was greater than 0.05). Therefore, in this research we concluded that conservative resection of cephalic portion of alar cartilage has no effect on nasal tip rotation.
Amiridavan, M.,
Nemati, S.,
Hashemi, S.M.,
Jamshidi m., M.,
Saberi, A.,
Asadi, M. Journal Of Research In Medical Sciences (17357136)11(4)pp. 263-269
Background: Sudden sensorineural hearing loss (SSNHL) is a perplexing condition for patients and there are many controversies about its etiology, audiologic characteristics, prognostic factors, and treatment. Methods: In this prospective study, we performed some audiologic tests, including PTA, IA, ABR, and OAE (TEOAE) before beginning treatment of 53 patients with SSNHL. We assigned the patients randomly to two treatment groups: oral steroids + acyclovir vs. intravenous urographin. Twenty-eight patients underwent Magnetic Resonance Imaging (MRI) of the Brain. Results: Of 53 patients (22 female and 31 male), 22 (41.5%) had negative or no signal to noise ratio and overall correlation in TEOAE. Twenty-six patients (49%) had positive overall correlations less than 50%, and 5 patients (4.4%) had overall correlations >50%. Fifteen patients (28.3%) responded completely or well, 20 (37.7%) responded partially, and 18 (33.9%) had poor or no response to the treatment. The mean values for overall correlation in 3 subgroups of patients (no response, partial response, and complete response) were - 3.5% (± 1/16%), +11% (± 1/ 99%), and +36.6% (± 3/07%), respectively (P = 0.01). Twenty out of 52 patients had no reproducible wave in ABR (38.5%), and waves I, III, and V were absent in 40 (77%), 31 (59.6%) and 21 (40%) patients, respectively. There were some limitations (false positive and false negative results) in ABR use in our cases, but it may be useful in detecting site of lesion in SSNHL. Overall, according to the results of OAE, ABR, and brain MRI of these patients, 3 were affected by acoustic neurinomas, at least 1 had auditory neuropathy, and the site of lesion was cochlear in 6, and cochlear + retrocochlear in 13 patients. Conclusions: ABR has limitations for use in SSNHL and seems not to obviate the need for brain MRI, but may help in determining the site of lesions such as ischemia or neuropathy. Overall correlation (and S/N ratio) in TEOAE is a valuable prognostic factor in SSNHL, hence we recommend performing TEOAE in every patient with SSNHL.
Salek, M.,
Hashemipour, M.,
Hashemi, S.M.,
Hajrahimi, M.,
Sadeghi, S.,
Farajzadegan, Z.,
Hovsepian, S.,
Hadian, R. Journal of Isfahan Medical School (10277595)25(87)pp. 53-59
Background: Congenital hypothyroidism (CH) has a considerably high prevalence in our country, and without early treatment, it would lead to irreversible sequelae like hearing impairment. This study was aimed to investigate the prevalence of hearing loss in children with CH in comparison with healthy children. Methods: This case-control study was conducted in two groups of children; the case group consisted of 94 children with CH aged more than 4 months under follow up in Isfahan endocrine research center; the control group included 450 healthy infants underwent routine neonatal hearing screening in a private hospital. First, Otto Acoustic Emission (OAE) test was performed, and in the case of being abnormal, then auditory brain stem response (ABR) test was conducted. Children with abnormal ABR were considered to have hearing impairment. Findings: The prevalence of hearing impairment was not significantly different between children with CH and controls (3.2% vs. 0.2%, respectively; p>0.05). The mean age of beginning the treatment for CH was not significantly different between children with or without hearing impairment (13.6±8.3 vs. 16.4±8.05 days, respectively; p>0.05).The mean T4 and TSH was not significantly different between children with CH with and without hearing impairment (5.6±4.2 mg/dl and 133.7±80.3 MIU/l vs. 6.2±3.7 mg/dl and 116.5±92.1 MIU/l, respectively; p>0.05). Conclusion: We did not document any difference in the prevalence of hearing impairment in children with CH and controls; this finding might be because of limited number of subjects studied and the short duration of follow up. There was no difference neither between the age of beginning the treatment for CH and hearing impairment, nor between the mean T4 and TSH at birth and hearing impairment. Hearing loss has no relationship with age at treatment onset and primary T4 and TSH level at diagnoses. © 2007, Isfahan University of Medical Sciences(IUMS). All rights reserved.
Berjis, N.,
Nakhaee, A.,
Narimani, A.A.,
Shahraki, Z.D.,
Hashemi, S.M. Journal of Isfahan Medical School (10277595)25(87)pp. 97-101
Background: This retrospective study was conducted to determine the prevalence of nasopharyngeal angiofibroma according to age, stage, clinical signs and average blood transfusion during surgery in educational hospitals affiliated to Isfahan University of Medical Sciences. Methods: This retrospective study was conducted on 250 records of patients suffering from angiofibroma and hospitalized from 1988 to 2003 in Al-zahra and Ayatollah Kashani hospitals, affiliated to Isfahan University of Medical Sciences. Findings: All cases were male, and the mean age was 16 years with a range of 7 to 41; the highest prevalence was found in the 11-20-year-age group. The most frequent sign was epistaxis (80%) and nasal obstruction (70%). The average volume of blood transfusion during the surgery was 4-5 units. The most frequent stage at the time of diagnosis was IIB and IIC (complete invasion of petrygomandibular fossa and protrusion to infratemporal fossa) and the rarest stage was IA and IIA according to Session classification. Conclusion: Angiofibroma is a rare tumor; however it is the most frequent nasopharyngeal tumor in young adults. Although it has benign histology, but can have important side effects. Its early diagnosis and treatment can prevent its side effects and may facilitate the surgery; hence it should be considered in the differential diagnosis of nasopharyngeal disorders. © 2007, Isfahan University of Medical Sciences(IUMS). All rights reserved.
Sonbolestan s.m., ,
Barzegar f., ,
Jamshidi m., M.,
Hashemi, S.M.,
Honarmand a., Tehran University Medical Journal (17357322)66(6)pp. 402-407
Background: Post-tonsillectomy pain is often severe and usually prevents patients from routine eating and drinking. A new option for reducing postoperative pain is "preemptive analgesia", the pre-, intra-or post-operative administration of analgesic agents. Ketamine, an N-methyl D-aspartate receptor antagonist, has recently received attention for this aim. Herein, we study the effect of submucosal injection of ketamine in the tonsillar bed for the reduction of post-tonsillectomy pain. Methods: In this double-blind clinical trial, three groups of patients underwent infiltration of 0.5mg/kg ketamine, 1mg/kg ketamine or normal saline in their tonsillar bed. Age, sex and weight of patients, duration of surgery, systolic and diastolic blood pressure (before and after surgery), volume of blood loss, reoccurrence of bleeding, time to initiation of oral intake, nausea, vomiting, pain score and dysphasia were recorded in information sheet. Data analysis was performed by one-way ANOVA and chi squared tests, with significance at a P value of <0.5. Results: There is no significant difference between the three groups with regard to age, sex, weight, duration of surgery, blood pressure (before surgery), volume of blood loss, nausea and vomiting. However, for the ketamine groups, pain score, dysphasia, need for opioid administration and time to initiation of oral intake is significantly lower (P<0.00). Reoccurrence of bleeding was observed in one patient in the lower-dose ketamine group, which is not statistically significant. The effectiveness of the two doses of ketamine is similar, with no statistical difference between the two groups (P=0.84). Conclusions: This study demonstrated that a submucosal injection of ketamine into the tonsillar bed preoperatively is a safe option for reducing post-tonsillectomy pain, dysphasia, need for opioid and time to initiation of oral intake, without increasing the risk of excessive bleeding, reoccurrence of bleeding, nausea and vomiting. © 2008, Tehran University of Medical Sciences. All rights reserved.
Hashemi, S.M.,
Rogha, M.,
Miralahi, S.,
Nakhaei, A.,
Khodami, A.R. Journal of Isfahan Medical School (10277595)27(98)
Background: Intratympanic steroid injection is an effective method in treatment of sudden sensorineural hearing loss in cases resisted to systemic therapy. The purpose of this study was to determine the efficacy of intratympanic injection. Methods: This case-series study was carried out on fifteen patients with sudden sensorineural hearing loss that had failed systemic therapy. Audiometric evaluation (PTA) performed before and after treatment and intratympanic dexametasone injection performed and the amount of improvement evaluated. Data Analysis was done using SPSS11. Findings: In male patients, 33.3% partial and 33.3% complete improvement and in female patients, 18.6% partial and 50% complete improvement was reported. In cases with lower degrees of hearing loss, total improvement was 66.7%; also earlier time of treatment had better results. Conclusion: Intratympanic injection of steroid is one effective modality in treatment of sudden sensorineural hearing loss in cases with no response to standard systemic therapy. It can improve the hearing level of patients while its complication rate is low and as degree of hearing loss increases the results decrease earlier treatment have a better results. © 2009, Isfahan University of Medical Sciences(IUMS). All rights reserved.
Okhovvat, A.R.,
Karim, M.,
Hashemi, S.M.,
Hashemi, S.M.,
Berjis, N.,
Amiridavan, M. Journal of Isfahan Medical School (10277595)27(103)
Background: We report the diagnosis, treatment and follow–up process of 22 cases of fungal sinusitis. Methods: This case- series study was carried out on 22 patients with fungal sinusitis that had treatment of endoscopy and antifungal drug. Past medical history, pathology, CT scan findings and treatment of patients were evaluated. Data analysis was done using SPSS. Findings: Twelve male (57%) and 10 female (43%) patients with the age of 16-73 years were a ssessed. Mucormycosis was seen in 18 (82%) and Aspergilosis in 4 (18%) patients. Diabetic mellitus (71%), chronic renal failure (CRF) (14.3%), and leukemia (9.6%) were reported as the most common underlying diseases. Maxillary and etmoid sinuses were the site of involvement. The most common sign was unilateral periorbital edema and proptosis (95%), and the most common symptom was unilateral change of visual acuity and cheek sensation (95%). All the patients had endoscopy surgery and treated with amphotricine B or ithraconazole and ceftrinaxone, metronidazole and vancomycine. Death was reported in 5 patients (22%) and renewed functional endoscopic sinus surgery (FESS) in 1 (4.8%). Conclusion: Functional endoscopic sinus surgery with amphotncine B or ithraconazole and follow-up are effective for fungal sinusitis. © 2010, Isfahan University of Medical Sciences(IUMS). All rights reserved.
