Showing 8 results for Nasal
Baradaranfar M H,
Volume 61, Issue 3 (6-2003)
Abstract
Inverted papilloma is an uncommon benign neoplasm originating from lateral nasal wall. It commonly invades paranasal sinuses and sometimes invasion to orbit and intracranial structures are seen. There are many surgical methods for its treatment, one of them is endoscopic transnasal approach.
Materials and Methods: Between 1997 and 2001, 11 patients with this tumor were operated in Amiralam hospital in Tehran and Shahid Rahnemun in Yazd. Nine patients were operated by endoscopic transnasal route and two patients by combined Caldwell-luc and endoscopic transnasal routes.
Results: Tumors were on the right side in 3 patients, on the left side in 7 patients, and bilateral in one patient. There were no intracranial or orbital extensions. No pathologic report of malignancy was made. Surgical technique included complete tumor resection, anterior and posterior ethomidectomies, sphenoidectomy, frontal recess tumor resection and wide maxillary antrostomy, in cases in whom tumor was attached to lamina papyracea, the lamina was removed without any manipulation to orbital periosteum. Mean follow-up time was 29.8 months. There was no recurrence in 82% of cases. Tumor recurred in 18% of cases. No complications were seen.
Conclusion: Although the standard treatment for this tumor is medial maxillectomy but endoscopic resection is an effective method in surgery of this tumor. It seems that if tumor does not extend to areas unreachable by endoscopic surgery, due to lower morbidity and excellent visualization of tumor, this method is preferable.
Motesaddi Zarandi M, Amirabadi M, Yazdani N, Mohammadi Ardehali M, Torkashvand Z,
Volume 61, Issue 5 (8-2003)
Abstract
Eustachian tube connects middle ear space to the nasopharyngeal space. Upper airway obstruction, with any cause, can derange Eustachian tube function. Nasal septal deviation is one of the prevalent causes of upper airway obstruction which can affects the ventilation function of Eustachian tube.
Materials and Methods: This study was conducted on the patients who underwent septoplasty due to severe septal deviation leading to unilateral nasal obstruction in Amiraalam hospital from summer of 1378 till the spring of 1379.
Results: There was 140 patients whose data were as: female patients 34 (24.3%) male patients 106 (75.7%), mean age (22.7). Median age (20) years and mode of age (18) years of age. they were from 12 to 40 years of age.
Conclusion: Comparison between preoperative and postoperative middle ear pressures shows no any significant statistical difference (p=0.798).
Noyan Ashraf Ma, Azargoon Ar, Abtahi Ha, Safavi E, Piroozbakhsh Sh, Peiravi Sereshke H,
Volume 66, Issue 6 (9-2008)
Abstract
Background: The insertion of endotracheal tube is essential for most surgical operations, mechanically ventilated patient in ICU wards, During cardiopulmonary resuscitation and so for transport of patients. The aim of this study was determination of airway related distances in Iranian patients.
Methods: In a cross- sectional study during year 2007 in Imam Khomeini university Hospital a total of 75 ASA class I and II patients who were admitted to pulmonary ward evaluated for determination of incisor-vocal cord and incisor- carina distances. The nasal nare- vocal cord distance was determined too.
Results: A total of 71 patients, 45(63%) male and 26(36.6%) female were evaluated. The Incisor-vocal cord distance in males and females was 16.83±0.75mm against 15.04±1.12mm (P=0.03). The difference of nare-vocal cords and Incisor- vocal cord distances was 2-3Cm
Conclusions: There was direct association between height and tracheal length in the study patients. The tracheal length (suitable insertion depth) in our patients was different from the recommendations (23 & 21 Cm for men and women) for non- Iranian, 25.9 versus 22.6 for Iranian men and women respectively. The difference of nasal nare-vocal cord and upper incisor-vocal cord distances in our patients was 2-3 cm, the lower range of accepted or reported one. We offer to do another experience with larger study group to apply the data to Iranian population.
Varshosaz M, Sharifi S,
Volume 68, Issue 7 (10-2010)
Abstract
Background: Paranasal sinus disease is one of the most common problems of patients that refer to ENT centers. Adding to clinical examination imaging plays an important role in diagnosis and treatment. Also the imaging of paranasal sinuses is necessary before surgery. Although computed tomography is the modality of choice for these areas, it has some disadvantages which the most important one is its high patient's dose. The aim of this study is the comparison between cone beam volumetric tomography and conventional computed tomography computed tomography, in evaluation of these areas.
Methods: In this descriptive-analytic study Coronal computed tomography imaged and cone beam volumetric tomography images were performed for 40 patients referred to ENT department of Amir Aelam Hospital in Tehran, Iran. Computed tomography images were observed by general radiologist and cone beam volumetric tomography images by Maxillofacial radiologist and their results' were recorded. Also ENT surgeon recorded her observations during surgery. Data were analyzed using McNemar test with Kappa and weighted Kappa agreement coefficient.
Results: No statistical difference was shown between the efficacy of computed tomography and cone beam volumetric tomography in evaluation of paranasal sinuses (p> 0.05).
Conclusion: As there was not any difference between conventional computed tomography and cone beam volumetric tomography in the assessment of paranasal sinuses and additional advantages of the later, cone beam volumetric tomography is suggested for paranasal sinus imaging before surgery.
Farhadi M, Tabatabaee A, Shekarabi M, Noorbaksh S, Khatib M, Javadinia Sh,
Volume 69, Issue 9 (12-2011)
Abstract
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Background: Too many studies are in the process
of determining the probable role of immune system in the etiopathogenesis of
nasal polyposis. This study was designed to identify the probable participation
of Th1, Th2 lymphocytes in the induction and progression
of nasal polyposis.
Methods: Seventy-five patients, 42 male and 33 female, with
nasal polyposis were examined for total serum IgE, specific serum IgE and reaction to skin test for differentiating allergic from
non-allergic participants in Rasoul Akram Hospital during 2010. To determine the possible correlation of allergic
reactions in the upper respiratory tract and nasal polyposis, cytokine gene
expression was evaluated on the extracted RNA by
RT-PCR. The data were analyzed by using c2, independent t-test, correlation and
Receiver operating characteristic (ROC)
curve.
Results: The mean
age of participants was 38 years (18-81 years). IFN-γ
and IL-4 gene expressions were more prevalent
in allergic than non-allergic individuals (IFN-γ:
39.5% vs. 14.2%, P=0.3 and IL-4: 44.7% vs. 18.9%, P=0.02, respectively). IL-10 and IL-12 (P35 and P40 fractions) genes were not
significantly different between the two groups. IL-10 and IL-12 (P35, P40) genes did not differ significantly either.
Conclusion: This research suggests that overproduction of
cytokines and an imbalance of Th1
and Th2 cell production may
play an important role in the pathophysiology of allergic or non-allergic nasal
polyp formation. Thus, although nasal polyposis is a multifactorial disease
with several different etiological factors, chronic persistent inflammation is
undoubtedly a major factor irrespective of the etiology.
Mohammad Farhadi, Mehdi Shekarabi, Shima Javadinia, Samileh Noorbaksh, Mahmood Faramarzi, Mohammad Reza Shokrollahi, Azardokht Tabatabaee,
Volume 71, Issue 8 (11-2013)
Abstract
Background: Nasal polyp (NP) is a benign mucosal mass located in both sinuses and nares which is mostly seen in association with cystic fibrosis, asthma or oversensitivity to aspirin. The prominent histological feature of NP is inflammatory cell infiltration with eosinophil predominance. Superantigens role in causing NP complications is already proven. Superantigens, which are mostly originated from Streptococci and Staphylococci, activate T cells strongly and increase the process of production and release of cytokines, and secretion of IgE from B cells, which in turn directly affects proinflammatory cells such as eosinophils, both in their tissues infiltration and functions.
Methods: The samples are collected from patients referring to ENT clinic in Rasoul Akram training Hospital in Tehran after thorough clinical and paraclinical examinations. For control group the samples collected from patients undergoing rhinoplasty. All the samples kept frozen and sent to immunology lab. The DNA of the excised tissues extracted and amplified by using the superantigens specific primers and PCR product detected by gel electrophoresis. The date analyzed by using mean and SD and χ2 analytical tools.
Results: Fifteen healthy individuals, 25 patients with rhinosinusitis and 24 with polyposis entered this trial. Group A Streptococcus toxin detection was significantly more frequent in those with nasal polyp and rhinosinusitis compared to healthy individuals (P=0.001 and 0.005, respectively), but the results were almost the same for those with nasal polyp and rhinosinusitis (P=0.4).
Conclusion: Streptococci may play an important role in induction or clinical exacerbation of polyposis and group A Streptococcus pyogenes exotoxin (SPEs) with superantigenic effects may have a crucial role in etiology and pathogenesis of polyps with or without rhinosinusitis. It is postulated that, T cells polyclonal activation by SPEs may cause recruitment of inflammatory cells in nasal mucosa. These inflammatory cells include IgE producing B cells laeding to allergic and inflammatory reactions in NP.
Hamidreza Shetabi, Khosrow Naghibi , Alireza Peyman, Shima Taghizadeh,
Volume 79, Issue 6 (9-2021)
Abstract
Background: The risk of anesthesia increases with age, so it is necessary to choose a safe and effective method. In this study, we compared the effectiveness of intranasal fentanyl with intravenous fentanyl in patients undergoing cataract surgery.
Methods: This study was a triple-blind prospective randomized clinical trial (The patient, physician, and data analyzer were unaware of the patient grouping). The study was performed from April 2017 to March 2019 in Feyz Hospital, Isfahan, Iran. 90 patients over 18 years of age who were candidates for cataract surgery were included in the study and were divided in two groups receiving intravenous fentanyl (IVF) or intranasal fentanyl (INF). The dose of fentanyl in both groups was 1.5 μg/kg with a maximum of 100 μg. In the IVF group, 1 ml of normal saline was dripped into each nasal passage 10 minutes before surgery and intravenously fentanyl was injected 2 minutes before surgery. In the INF group, 1 ml of fentanyl was administered into each nostril 10 minutes before surgery and 2 ml of saline was administered intravenously two minutes before surgery.
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Results: In this study, there was no significant difference between the two groups in terms of mean heart rate (P=0.762), mean arterial blood oxygen saturation (P=0.262), mean systolic blood pressure (P=0.264), mean arterial blood pressure (0.462), satisfaction rate Patient (P=0.231), duration of surgery (P=0.612) and pain intensity (P=0.87). But in the intravenous fentanyl group (IVF), the level of sedation (P=0.002) and the level of surgeon satisfaction (P<0.001) were higher than intranasal fentanyl group (INF). There was no significant difference between the two groups in terms of side effects (P=0.171) and surgery time (P=0.612). The mean VAS was not significantly different between the two groups.
Conclusion: The study showed that intranasal administration of fentanyl compared with intravenous administration of fentanyl provided similar sedation and cardiovascular response. Intranasal administration of fentanyl is a non-invasive, safe and effective method, that is easy to use and can be a viable alternative to intravenous administration.
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Hamidreza Shetabi , Khosro Naghibi, Alireza Peyman, Hamed Norouzi,
Volume 80, Issue 8 (11-2022)
Abstract
Background: To improve the quality of sedation in procedures, different medications are used alone or in combination with each other, but so far, no administration method that is agreed upon by anesthesiologists has been presented. This study aimed to investigate the effectiveness and safety of intranasal ketamine in comparison with intravenous ketamine in cataract surgery.
Methods: This clinical trial was performed from December 2016 to March 2017 in Feyz Hospital, Isfahan. Ninety patients over the age of 18 who were candidates for cataracts surgery were randomly assigned to receive 1 mg/kg ketamine through the nasal route (INk) or intravenously (IVK). Ten minutes before the surgery, ketamine was administered in the INK group and intranasal saline in the IVK group. Two minutes before the start of surgery, normal saline was administered in the INK group and ketamine was administered intravenously in the IVK group. Patients received intravenous midazolam 0.04 mg/kg during prep and drape. The quality of sedation and analgesia, vital signs, patient and doctor satisfaction, and side effects were recorded during the study period. Data were analyzed using of SPSS software, version 23 (IBM SPSS, Armonk, NY, USA).
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Results: In this study, 90 people were included in the study, 53 of whom (58.9%) were men. The mean age of the patients was 61.5±10.6. Two groups had a significant difference in terms of gender (P=0.696), age (P=0.960), weight (P=0.212), height (P=0.632), underlying disease (P=0.094), and type of disease (P=0.090). Two groups were not significantly different in terms of mean heart rate (P=0.77), mean arterial blood pressure (P=0.13), mean blood oxygen saturation (P=0.58), patient satisfaction (P=0.470) and surgeon satisfaction (P=0.115), pain intensity (P=0.506), level of sedation level (P=0.477) and side effects (P=0.221).
Conclusion: Intranasal administration of ketamine provides similar sedation and cardiovascular response compared to intravenous administration of ketamine. Administering ketamine intranasally is a non-invasive, safe and effective method with easy application and can be a suitable alternative to intravenous administration.
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