Journal of Otorhinolaryngology and Facial Plastic Surgery

In this case presentation, the authors discuss the prevalence, diagnosis and surgical treatment of the exceedingly rare primary laryngeal melanoma. The importance of immunohistochemical investigations is emphasised since the condition tends to mimic laryngeal carcinomas. Laryngeal melanomas have a very poor prognosis; their five-year survival is less than 10% in international literature. However, the patient presented in this article is still asymptomatic and has no metastases 7 years after the removal of the lesion with transoral laser microsurgery.

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many centers have noticed a high number of venous thromboembolism (VTE) events among critically ill inpatients with COVID-19 pneumonia. COVID-19 infection is associated with high morbidity and mortality largely due to respiratory failure, with micro vascular pulmonary thrombosis or PE originating from the leg veins playing an additional important pathophysiological role. Having undiagnosed or untreated PE may worsen patient outcomes and use of empiric therapeutic anticoagulation in certain COVID patients who do not have PE/DVT has been advocated. Here, we report a cases of COVID-19, in which massive pulmonary thromboembolism (PTE) occurred a few days after discharge?

This article reports 20 cases elaborating the role of mandibular coronoid process as a graft in reconstruction of small continuity defects of residual or old zygomaticomaxillary complex (ZMC) fractures or the orbital floor fractures associated ZMC fractures. Though different other various autogenous and alloplastic materials are available, coronoid has its own advantages. The most important advantage of using coronoid graft is autogenous bone of intramembranous origin harvested through the same surgical site.

Various authors for small continuity defects have documented its use as a graft. All the cases in this report showed acceptable results. Thus, we recommend the use of coronoid process of the mandible as a source for autogenous bone graft as it can provide sufficient bone in quantity and quality for selected maxillofacial reconstructions.

Chondrosarcoma is a rare tumor of the head and neck with a prevalence of 5-12% of all chondrosarcomas reported. The most common affected site in the head and neck is the larynx. Other sites include the craniofacial, maxilla, and mandible, nasal cavity, and paranasal sinuses. Clinical symptoms usually include a painless mass with bony swelling and one of the symptoms that the patient presents with is epistaxis nasal obstruction. The most appropriate treatment is radical surgery. This article introduces a 72-year-old man with a complaint of left nasal congestion, epistaxis, and swelling of middle canthus area of the left eye.

Background: There were several techniques for reconstruction of nasal tip cartilage. Dome cut is a technique that has recently proposed for nasal tip projection, this method is recently concern regarding its efficacy. 

Aim: This study was performed to determine the outcomes of rhinoplasty with dome cut vs. alternative methods in patients with various nasal tip deformities.

Methods: A retrospective review from 36 cases was conducted. Patients were selected from a computerized rhinoplasty database of operative cases. The database was used to extract a subset population that had received the dome cut procedure and had follow-up data for 6 months or more after surgery. Patient satisfaction, physician evaluation, physical examination, blinded comparison of preoperative and postoperative photographs, and revision surgery necessitation were also analyzed in this review of results and complications.

Results: Initially 41.7 percent had saddle nose deformity, 41.7% had nasal tip deformity, and 16.7% had other types of deformity. 94.4% had successful outcomes whether the technique and type of deformity had no effect on success of results (p > 0.05).

Conclusion: According to the obtained results and comparison with other studies, it may be concluded that rhinoplasty with dome cut is a successful method and various methods and deformities have no effect on the outcomes.

Background: Despite performing surgical treatment, chronic rhinosinusitis coexisting with polyposis has recurrent episodes. Considering the strong association between nasal polyposis and asthma, the role of Vitamin D deficiency has been demonstrated in most of the asthma attacks.

Purpose :To investigate the serum level of 25-hydroxy vitamin D in chronic rhino sinusitis among the patients with and without nasal polyposis.

Methods :In this cross-sectional study, we evaluated the vitamin D deficiency in 38 patients with nasal polyposis and 38 control patients, using immunoassay examination.  Data of the two groups were compared and analyzed via SPSS software version 18. The significant level was considered as less than 0.05.

Results: We found severe vitamin D deficiency in 47.4% of the polyposis patients, while this rate decreased to13.3% in the control group (p=0.004). Based on the age group classification, there was no statistically significant difference in terms of the vitamin D deficiency between the polyposis patients and control group (p=0.66).  

Conclusion: Vitamin D deficiency can be associated with the prevalence of nasal polyposis in the patients affected by chronic rhinosinusitis. Further studies can prove the essential role of vitamin D in pathogenesis of nasal polyposis.  

BACKGROUND: Hydrogen peroxide (H2O2) a key reactive oxygen species, which is made through redox procedure, can induce oxidative damage to several biological macromolecules and play critical role in neurodegenerative diseases.

Aim: The current study examined the neuroprotective effect of Trehalose on hair cells death induced by H₂O₂.

Material and method: Hair cells were co-treated by Trehalose and H₂O₂. The effects of Trehalose on BAX/BCL2 expression ratio and cell viability were assessed by Real time PCR and MTT assay, respectively.

 Result:  The results of Real time PCR and MTT assay indicated that H2O2 induce cell death, and Trehalose have neuroprotective effect and decreases cell death.

Conclusion: Our data showed that Trehalose has the protective effect on hair cells death induced by H202

Background: BMD-15 is a member of the superfamily of transforming growth factor-beta (TGF-β), which has a determinant role in fertility. This protein is essential for the development of ovarian follicles and acts mainly by binding to its receptor on the surface of granulosa cells.

Aim: The aim of this study was to evaluate the effect of BMP-15 on in vitro ovarian follicle growth and embryo development.

Methods: In this study, preantral follicles were isolated mechanically from 12 days NMRI mouse ovaries, then the follicles were cultured in basic growth medium enriched by FBS, FSH, and ITS‏ and BMP-15-enriched for 12 days. During the culture, survival rate and follicular maturation, follicular diameter, level of estrogen, and progesterone secretion and embryo developmental rate were evaluated.

Results: The results of this study showed that the percentage of antral follicles, maturation rate and hormone levels and the diameter of follicles was significantly higher in BMP-15 supplemented media in comparison to basic media. Embryo development was also higher at BMP-15 enriched group in comparison to the group of follicles, which were grown in the basic culture media.

Conclusion: The present study demonstrates that supplemented media with BMP-15 to the ovarian preantral follicle culture enhances the in vitro growth of follicle embryo development.

Background: The case mix index (CMI) represents the average medicare severity-diagnosis related group relative weight over a period of time. The higher the CMI, the more the hospital gets reimbursed, on average. Little has been published in regards to CMI within Otolaryngology particularly in Facial Plastic and Reconstructive Surgery.

Aim: This study was performed to determine the economic impact of Facial Plastic and Reconstructive Surgery has on hospital medicare reimbursements.

Methods: In a retrospective review we analyzed the admissions of facial plastic and reconstructive surgeons as well as general otolaryngologists at a tertiary medical center from October 2015 through May 2018. General otolaryngology excluded pediatrics, otology, and admissions under fellows. The admissions analyzed were limited to patients that required observation or intervention from a plastics perspective. Of the FPRS admissions, there were no patients included that were admitted for oncologic resection or surgeries that would have fallen within other specialties of otolaryngology. The case mix index was then calculated for each admission.

Results: There were two facial plastic and reconstructive surgeons and thirteen general otolaryngology surgeons who admitted patients from October 2015 through May 2018. A total of 103 admissions were found to have plastics-only observation or intervention. The average CMI for these patients was 2.92. Of the 1,918 general otolaryngology admissions, the average CMI was 2.62. There were 14 FPRS admissions that had a CMI of less than 1.00, and five of those did not have a procedure completed during the admission.

Conclusion: At the studied tertiary care center, case mix index values greater than a value of 2.2 indicated that the average medicare reimbursements per admission surpassed the costs of the admission. The result is a profit for the hospital. As demonstrated in our study, FPRS admissions consistently produced a profit for this tertiary medical center. Furthermore, FPRS admissions resulted in a greater average CMI as compared to admissions under general otolaryngologists.

Background: Pulmonary involvement is the main clinical and imaging feature of the novel corona virus disease (COVID-19). However, some patients present with upper airway symptoms.

Aim: In this study, we report upper respiratory manifestations, specifically focusing on smell and taste disorders in COVID-19.

Methods: We performed this cross-sectional prospective study in patients admitted to Masih Daneshvari Hospital, a tertiary referral center in Tehran, Iran, with severe COVID-19 as documented by the polymerase chain reaction assay.

Results: We included 268 hospitalized patients, 183 (68.3%) men and 85 (31.7%) women. The average age was 52.8±16.4. The sinonasal symptoms included nasal obstruction (44 [16.4%]), rhinorrhea (31 [11.5%]), sneeze (33 [12.3%]), headache (77 [28.6%]), facial pain (12 [4.5%]), associated with hypogeusia (65 [24.2%]) and olfactory dysfunction (90 [33.5%]). In 35 (38.9%) patients with olfactory symptoms, change in the smell was the sole initial manifestation of COVID-19. On logistic regression, the relationship between the olfactory symptoms and headache (p=0.002), nasal obstruction (p=0.0001) and sneeze (p=0.018) were statistically significant.

Conclusion: We report a considerable prevalence of olfactory and gustatory symptoms in hospitalized patients with COVID-19. Not infrequently, these symptoms were the sole initial presenting symptoms in the course COVID-19. During the current pandemic, we suggest that presence of these symptoms should mandate expedited screening for COVID-19, isolation and close monitoring of the patients for evolution of the clinical course.

The world has faced the coronavirus disease 2019 (COVID-19) pandemic since the H1N1 influenza pandemic in 1918. The symptoms of this disease are spreading rapidly and affect almost all systems of the body. In addition to the common symptoms of the virus, numerous reports of rare symptoms of the virus have also been published. These atypical presentations can result in difficulty in diagnosing the disease. The aim of this work is to summarize “uncommon atypical presentations”, which have not received enough attention in descriptions of the disease presentation to date and the authors specifically discuss the important uncommon atypical presentations of COVID-19.

Background: Human reactions to noise pollution can have detrimental consequences for physical and mental health. Increased infection in the workplace or the surrounding area can cause deafness and its disorders, tinnitus, high blood pressure, coronary artery disease, and sleep disorders. Changes in the immune system and birth defects have also been attributed to exposure to noise pollution. Adverse effects and cardiovascular complications due to constant exposure to noise pollution prevent human blood pressure from experiencing a regular cycle of increase and decrease around the clock. The most important sources of such pollution are cars, airplanes, long-term exposure to loud music, and industrial noise. In the European Union, more than 10,000 people die each year due to the effects of noise pollution. The level of noise pollution during the night causes the production and permanent increase of cortisol, which increases the risk of heart attack.

Aim: The aim of this study was to review the results of research on the role of antioxidants and other protective agents against the destructive effects of free radicals on hearing loss and deafness.

Methods: In this research, using the desired keywords in valid databases (PubMed, Scopus, and Medline), articles from 2016 to 2020 were performed and then this study was written by studying the selected articles.

Results: The results showed that most of the pollution is caused by cars, airplanes, long-term exposure to loud music and industrial sounds, as well as protection and training methods, as well as the use of neurotrophic agents and antioxidants and cell therapy. Gene therapy is effective in treating deafness caused by infection.

Conclusion: The most appropriate method in the treatment of noise pollution and deafness is the prevention of areas with high noise and the use of antioxidants.

Background Hearing loss, which is highly heterogeneous, is the most common sensorineural disorder in humans. More than 50% of the causes of deafness are attributed to genetic factors. Numerous studies have shown the persistent negative impact of deafness on communication and quality of life. Therefore, action to optimize performance and maintain or improve hearing ability seems necessary. In so doing, interventions are performed after assessing hearing loss. The most important intervention is gene therapy; For several genetic diseases, gene therapy is a potential treatment that is being investigated. Gene therapy will restore the ability to hear by overcoming functional defects caused by genetic mutations. Furthermore, gene therapy might potentially be used to trigger the regeneration of hair cells by transferring genes required in the cochlea for hair cell differentiation.

Aim: We review recent research about hereditary hearing loss and technologies in animal.

Methods: In this study, we review current reports in clarifying genomics of hereditary hearing loss and technologies between 2014 and 2020 in PubMed, Scopus, and Google Scholar to create a gene therapy that may soon become a treatment choice. We also discuss recent research applied to animal models of hearing loss by gene therapy.

Conclusion: Gene therapy allows for the treatment of sensorineural hearing loss by restoring and/or preserving the inner ear cells functioning. Hopeful results from recent research have contributed to cochlear gene therapies being created for end-use in patients.