Articles
Publication Date: 2020/09/22
Journal of Isfahan Medical School (10277595)38(586)pp. 563-568
Background: Recently, spray cryotherapy has been used in otorhinolaryngology surgeries. Therefore, due to limited studies in this field, this study aimed to evaluate the effect of spray cryotherapy on tissue repair after endoscopic sinus surgery in patients with nasal polyposis, and compare this method with fluticasone and normal saline spray.Methods: In this clinical trial study, 45 patients with nasal polyps were enrolled according to the inclusion criteria of the study. Then, the patients were randomly assigned into three equal groups. The first group was treated with spray cryotherapy, the second group was treated with fluticasone spray, and the third group received normal saline spray after the operation with four puffs for each group. It should be noted that fluticasone spray was maintained for two weeks after surgery for the three groups. Subsequently, the results of this study were evaluated using Sino-nasal Outcome Test (SNOT-22) questionnaire at intervals of one and three months after the surgical operation.Findings: The mean SNOT-22 score after the surgery significantly decreased in the three groups. There was a significant difference between the three groups concerning the SNOT-22 scores at intervals of one and three months after the surgery, as the SNOT-22 score in the cryotherapy group was lower than the other groups (P < 0.05).Conclusion: Using spray cryotherapy is a safe and effective method after endoscopic sinus surgery compared to the corticosteroid and normal saline spray.
Publication Date: 2023
Journal Of Research In Medical Sciences (17357136)28(1)pp. 12-12
Background: In natural conditions, inhaled fungi are considered a part of the microflora of nasal cavities and sinuses. However, subsequent to the protracted use of corticosteroids and antibacterial agents, suppression of the immune system by chemotherapy, and poor ventilation, these fungi can become pathogens. Fungal colonization in the nose and paranasal sinuses is a prevalent medical issue in immunocompetent and immunosuppressed patients. In this study, we aimed to categorize fungal rhinosinusitis (FRS) among immunocompetent and immunosuppressed patients and identified the etiologic agents of disease by molecular methods. Materials and Methods: A total of 74 cases were evaluated for FRS. Functional endoscopic sinus surgery was performed for sampling. The clinical samples were examined by direct microscopy with potassium hydroxide 20% and subcultured on Sabouraud Dextrose Agar with chloramphenicol. Polymerase chain reaction sequencing was applied to identify causative agents. Results: Thirty-three patients (44.6%) had FRS. Principal predisposing factors were antibiotic consumption (n = 31, 93.9%), corticosteroid therapy (n = 22, 66.6%), and diabetes mellitus (n = 21, 63.6%). Eyesore (n = 22, 66.6%), proptosis (n = 16, 48.5%), and headache (n = 15, 45.4%) were the most common clinical manifestations among patients. Rhizopus oryzae (n = 15, 45.4%) and Aspergillus flavus (n = 10, 30.3%) were the most prevalent fungal species. Conclusion: Diagnosis and classification of FRS are crucial, and a lack of early precise diagnosis can lead to a delay in any surgical or medical management. Since there are a variety of treatments for FRS, accurate identification of etiologic agents should be performed based on phenotypic and molecular methods. © 2023 Journal of Research in Medical Sciences.
Publication Date: 2023
Advanced Biomedical Research (22779175)12(1)pp. 202-202
Background: Tonsillectomy, one of the most common otolaryngology surgeries, often results in postoperative complications such as pain and bleeding. Currently, there is no consensus on postoperative pain management. This study aimed to determine the efficacy of oral prednisolone on postoperative pain after tonsillectomy with sutures. Materials and Methods: This pilot, double-blind, randomized clinical trial was conducted at two tertiary care centers affiliated with Isfahan University of Medical Sciences. Patients who underwent tonsillectomy with sutures were included. Participants were randomly divided into experimental and control groups. In the experimental group, patients received oral prednisolone in addition to acetaminophen; in the control group, patients received acetaminophen and a placebo. Post-operative pain was evaluated by a visual analog scale daily for ten days. Results: Initially, 60 patients were enrolled in the study; however, four were excluded due to non-attendance at follow-up visits. The groups were similar in terms of age and sex (both P values >0.05). In the study, postoperative pain from 1 st day to the 10 th day was lower in the experimental group than in the control group (P value <0.05). Conclusion: Numerous studies have been conducted on the effect of intravenous corticosteroids on this pain. However, there is no consensus on the analgesic role of oral corticosteroids for post-tonsillectomy pain. The present study showed that oral prednisolone is effective on post-operative pain compared to a placebo. © 2023 Advanced Biomedical Research.
Publication Date: 2023
Advanced Biomedical Research (22779175)12(1)pp. 29-29
Background: Nasal polyp (NP) is the most common benign tumor that can cause nasal obstruction and more annoying problems in patients. Recently, investigators have been focusing on complementary therapies alone or in conjunction with endoscopic nasal and sinus surgery. However, given the association of Vitamin D (VD) deficiency and chronic rhinosinusitis with nasal polyposis (CRSwNP) in previous studies, it may be possible to prevent the recurrence of NP and the development of rhinosinusitis by controlling serum levels of VD and maintaining it at a normal level. The current study aimed to investigate the efficacy of VD supplementation in preventing CRSwNP recurrence after endoscopic surgery. Materials and Methods: This clinical trial composed of vitamin D deficient patients with CRSwNP who were candidates for endoscopic sinus surgery in two groups of cases and controls. After endoscopic sinus surgery for all patients, we administered VD supplementation (50,000 IU) once a week for 8 weeks for cases and no further intervention for controls. The severity of symptoms was assessed using Sino-nasal outcome test (SNOT-22) and NP recurrence and recorded pre- and postintervention. Results: The findings indicated a higher mean change of SNOT-22 in the case group compared to that of the control group (36.03 ± 10.71 vs. 29.90 ± 11.99; P = 0.041). Moreover, the percentage of NP recurrence in cases was lower than controls; so that receiving VD supplementation has significantly reduced the chance of NP recurrence (odd ratio [95% confidence interval]: 0.298 [0.099-0.900]; P = 0.032). Conclusion: According to the result of the study, the administration of VD supplementation after endoscopic sinus surgery can reduce the severity of CRSwNP symptoms and NP recurrence significantly. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Publication Date: 2020
European Journal of Plastic Surgery (0930343X)43(2)pp. 153-158
Abstract: Background: Psychological functioning of rhinoplasty must be evaluated in the community of Iran as the most prevalent center of rhinoplasty worldwide. Making a realistic public view about rhinoplasty psychological outcomes is necessary. In the present study, quality of life, anxiety, depression, and self-esteem alteration in rhinoplasty patients among the Iranian population were assessed. Methods: This is an observational trial study conducted on 41 patients who underwent rhinoplasty in 2017–2018. The Persian version of standard questionnaires “World Health Organization Quality of Life (WHOQOL-26),” “Hospital Anxiety and Depressive Scale (HADS),” and “Eysenck Self-Esteem Questionnaire” were used for this aim. Therefore, questionnaires were filled pre and within 6 months postoperatively and then compared. Demographics including age, gender, marital status, and educational level association with the mentioned factors were assessed as well. Results: The results revealed that rhinoplasty brought significant improvements in all aspects of QOL, including physical (P value = 0.011), psychological (P value = 0.002), relationships (P value = 0.019), environment (P value = 0.032), and general health (P value = 0.005). Depression (P value = 0.010) and self-esteem (P value = 0.004) scores change significantly in a positive manner as well. Anxiety improvement was the least (6.8%) with no significant change (P value = 0.334). None of the demographics including age, gender, marital status, and educational level showed association with psychological indices (P value > 0.05) except for age association with relationships domain of WHOQOL that was significantly higher among those younger than 30 years old (P value = 0.040). Conclusions: Rhinoplasty can improve most of the psychological indices in the Iranian population, regardless of the candidate’s gender, marriage status, educational level, or age group. Level of evidence: Level II, therapeutic study. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
