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Allergic fungal rhinosinusitis (AFRS) is a relatively new and known disease with effective treatment, which belongs to the group of nasal polyposis diseases. According to high prevalence of AFRS in regions with warm and humid climate, the aim of this study was to detect the frequency of AFRS in patients with chronic rhinosinusitis (CRS) and nasal polyposis in Amir-al-momenin Hospital in Rasht city.
During functional endoscopic sinus surgery, the samples were collected from 55 patients with CRS along with nasal polyposis and were examined in terms of histopathology, mycology, culture and total serum IgE level. Data were analyzed using chi-square and exact Fisher’s tests.
In this study, 17 (30.9%) female and 38 (69.1%) male patients with the mean age of 38.34±12.67 years, were participated. History of Atopia was seen in 54.5% of the patients, asthma in 25.5%, and blood eosinophilia (>6%) in 26.9%. Total serum IgE level was reported higher than natural value in 48.9% of the patients. Based on Kuhn and Benet criteria, the relative frequency of AFRS was 5.5% (3 patients) and nonfungal eosinophilic mucin rhinosinusitis (NF-EMRS) was 16.4% (9 patients). In AFRS patients, 3 cases had atopy, 3 were eosinophilic mucin positive, 2 cases had asthma, 1 direct smear-positive, 3 positive PAS staining, and 1 positive (Aspergillus fumigatus) culture.
In sinus samples of the studied patients, the frequency of eosinophilic mucin was much higher compared to other reports. Although, the frequency of positive smear and fungal culture is lower than other similar studies.

Given the growing elderly population in the country, significant proportion of chronic diseases in this group, and necessity of investigation on aspects of the elderly health in order to prevent disability and reduce the complications of diseases in them, this study was conducted to determine the manifestations of nose, sinus, larynx, head, and neck among the elderly over 60 years in the rural areas around Rasht City.
In this descriptive cross-sectional study, 35 villages of were randomly selected Rasht city from, and 413 elderly subjects randomly entered the study. After obtaining a written informed consent, the elderly were examined by general practitioners and an otolaryngologist.
A total of 413 subjects [195 (47.20%) females and 218 (52.80%) males] with the mean age of 73.47±7.04 participated in this study. The most common sinonasal disorder was septal deviation (60.68%). Other sinonasal disorders were mucosa paleness (18.23%), stuffy nose feeling (12.83%), hyposmia (12.10%), anosmia (3.14%) and nasal polyposis (1.43%). The most common oral disorder was dental problems (88.90%). Other common disorders of the mouth, pharynx, and larynx included dry mouth (46.73%), dysphagia (24.21%), snoring (40.19%), inflamed mucosa (14.50%), and the most common neck disorder was thyroid enlargement (2.56%).
The results of the present study showed that the prevalence of nose, sinus, larynx, head, and neck disorders is significant among the elderly population of Guilan.

Abstract Aging is a physiological process, and it seems that Iranian population progresses to old aging more rapidly. Hearing loss is the most common otolaryngologic manifestation of aging, with direct and indirect expenditure for both the individuals and systems, that remains far from attention in many cases. Evaluation of audiologic disorders in geriatric population of rural areas of Rasht city, Guilan province in north of Iran, given the importance of the issue. In this descriptive cross-sectional study performed in 2013, we randomly selected 35 rural areas and then, elderly population of those areas were selected randomly, with informed consent obtained from them and then they were examined by general practitioners, ENT specialists, and an audiologist. Data were recorded and analyzed. Of the 421 geriatric cases (52.8% male and 47.2% female), 324 underwent audiological testing. Sensorineural hearing loss in the right or left ear of 290 cases (89.5%), conductive hearing loss in 13 ears (4.01%), normal hearing in 20 (6.17%), and mixed hearing loss in one ear (0.3%) were detected. As revealed, 263 (90.68%) were with mild to moderate hearing loss, and 27 (9.31%) had severe hearing impairment. The pattern of hearing loss was in higher frequencies (247 cases: 76.23%), flat hearing loss in 53 patients (16.35%), and in the low frequencies in 4 cases (1.23%), as observed. In the elderly population living in rural areas in Rasht city, hearing disorders are relatively common and noticeable.

Nasal obstruction is a common complaint leading to septoplasty as one of the most common surgical procedures in otorhinolaryngology. This study was done to determine the relationship between patient's satisfaction following septoplasty with rhinomanometry perior and after surgery. This descriptive – analytic study was done on forty-one patients, candidated for septoplasty, from Oct 2012 to Sep 2013. Rhinomanometry were tested perior and 6 months after surgery. At the time of rhinomanometry after surgery, common clinical symtomps and patient's quality of life and their satisfaction from operation were recorded by using GBI questionnaire. Nasal obstruction and congestion, trouble sleeping, insufficient breath during physical activity and difficulty breathing through the nose were significantly reduced after surgery (P<0.05). In overall, patient's satisfaction after septoplasty was 90.24%. Rhinomanometry was not predictive factor for satisfaction after surgery. Six month follow-up after surgery showed high patients satisfaction (90.24%) following nasal septoplasty, but this was not related to rhinomanometry test results.

Abstract Human Immunodeficiency Virus (HIV) can cause some of the symptoms and diseases in ENT field. However, there are a few reports from developing countries and there is not any report on this issue. On the other hand, the prevalence of HIV positive (symptomatic or asymptomatic) patients is increasing across the nation. Awareness of these complications of hearing system can result in early intervention and improve patient's quality of life. Determining the otologic and audiologic findings in HIV positive patients A descriptive, cross-sectional study was performed on the 30 HIV positive patients referred from number-10 medical-therapeutic center of Rasht to Amiralmomenin hospital from April 2011 to March 2012. The senior resident of ENT- HNS took a comprehensive medical history and performed full clinical examination in the auditory system. In all patients, audiometric tests including tympanometry, pure tone audiometry, transient otoacoustic emissions (TOAEs) and auditory brainstem response (ABR) were done. Of the 30 HIV -positive patients, 21 were male and 9 were female. Of these, 2 patients were in the AIDS phase. The mean age of patients was 36.27 ± 9.71 years (range 24-56), and 8 patients complained of otic symptoms: dizziness (7 cases), tinnitus (4 cases), otalgia and fullness (each 3 cases). In audiometry, we found hearing loss in 8 of 60 ears (6 patients). The conductive and sensorineural hearing losses were found in 4 and 4 ears, respectively. As revealed, 21 out of 30 patients (70%) had abnormal TOAE. Also, in 9 out of 30 patients (30%), we observed ABR abnormality, with increased interpeak of wave I-III (14 ears)being the most frequent. Given the high prevalence of TOAEs abnormality in these patients and increased interpeak of waves I-III in ABR, it seems that the locus of ear damage is the outer hair cells of cochlea and distal part of the central auditory pathway and TOAEs is more sensitive than PTA and with ABR test it can help early detection of hearing loss in such patients.

Rhinoplasty is one of the most popular plastic surgery in the world. Edema and ecchymosis are two expected consequences after any planned injuries such as surgery that extend recovery time and cause to distress for the patients and their families. Several drugs (e.g. corticosteroid and tranexamic acid) and herbal extracts (e.g. arnica) are suggested for resolving this problem but there is no comparison between them yet. This study was undertaken to compare the potential benefits of dexamethasone with tranexamic acid on postoperative edema and ecchymosis after rhinoplasty. Determination of dexamethasone and tranexamic acid efficacy on edema and ecchymosis after rhinoplasty. This was a clinical trial cross sectional double blind study. Seventy rhinoplasty candidates were randomized in two groups. In addition to routine management and cold compress after operation, one group received dexamethasone and another group received tranexamic acid injection for both groups 1 dose of drug before and 3 doses per 8 hours after rhinoplasty.. For measurement of edema and ecchymosis, we took digital photos from patients’ face third day of postoperation. Then three colleagues who were blinded to assigned groups, scored edema and ecchymosis level with using 0-4 point standard scale. The α < 0.05 is considered significant statistically. Nineteen men and fifty one women were enrolled. On postoperative day 3, there was no significant difference in the rating of preorbital ecchymosis among two intervention groups (p<0.15). Also there was no significant difference for the edema rating among two intervention groups (p<0.12). According to our results, no significant difference in postoperative edema and ecchymosis was detected among two groups. In regard to similar efficacy of both drugs to decrease edema and ecchymosis after rhinoplasty, we must select one of them according to the other effects of drugs.

Skin thickness has an important role in aesthetic results of rhinoplasty. Currently, some surgeons employ defatting technique to reduce subcutaneous tissues and decrease the thickness of skin during rhinoplasty.

The aim of this study was to compare the nasal tip skin thickness with and without nasal tip skin defatting technique and to further evaluate the long term effects of this technique on rhinoplasty patients by sonography.

In a case-control study, 111 rhinoplasty candidates were evaluated at a university referral hospital in northern Iran during January to August 2010. Before operation, all patients were investigated through physical exams. Later, the skin thickness of the tip and supra tip were measured by sonography. Patients with moderate to thick nasal skin were randomly allocated to case and control groups for defatting. Sonography results of 44 patients, obtained one and 12 months after the surgery, were compared with those found in two groups before the surgery using Wilcoxon test and Repeat Measure test.

A total of 111 patients with mean age of 25.1±7.6 years including 16 (14.4%) men and 95 (86.6%) women were enrolled. Based on physical examinations, the skin type was thin in 20 (18.9%), moderate in 68 (59.4%), and thick in 23 cases (21.7%). Considering the sonography results, the skin type was thin in 7 (6.8%), moderate in 83 (80.6%), and thick in 13 cases (12.6%). There was no significant difference in the thickness of tip and supra tip skin between defatted cases and control group measured before surgery and within the follow-up period.

Based on results found through this study, Sonography is a precise instrument in assessing the nasal skin thickness before rhinoplasty. Defatting technique was shown to be of no effect on reduction of skin thickness of tip and supra tip in moderate or thick skins following rhinoplasty.

Multiple sclerosis is one of demyelinating disorder of CNS that is an uncommon cause of the sensorineural hearing loss. This study was done to determine the hearing loss in multiple sclerosis patients. This case-control study was performed on 60 (44 women, 16 men) multiple sclerosis patients and 38 (27 women, 11 men) normal subjects by pure tone audiometery, otoacustic emissions and auditory brainstem responses in Gilan provine, Iran during 2010-11. Data was analyzed by using SPSS-17, Chi-Square and Fischer tests. 12.5% of case and 3.9% of the control ears had abnormal pure tone audiometery (P<0.05). The frequencies of abnormal HF-pure tone audiometery and two modalities of otoacustic emission did not show any significant differences in two groups. Abnormal autidory brainstem response of ears were observed in 20% and 9.2% of cases and controls, respectively (P<0.05). 20% of case and 9.2% of the control ears had abnormal auditory brainstem response (P<0.05). The absolute latencies of waves I, II and V had not significant differences between two groups. Inter peak latencies of I-III and III-V waves were observed in 10% and 11.7% in cases ears and 1.3% and zero percent in controls, respecticely. 6.7% of cases and 2.6% of control ears had retrocochlear abnormality. Hearing loss detected by pure tone audiometery and auditory brainstem response is more common in multiple sclerosis compared to normal population.

Hearing is one the most important senses of human. Hearing loss is one of the greatest chronic disabilities. Noise induced hearing loss (NIHL) is a common occupational disorder and several factors affect its intensity. One of these factors is individual differences. The aim of present study is the assessment of dyslipidemia’s effect on NIHL. This study was conducted to evaluate association between dyslipidemia and noise induced hearing loss.

This was an analytic-descriptive study which was conducted in 2010. The factory workers of Rasht industrial city with the following inclusion criteria were selected: environmental noise above 85dB, age below 55 years, no otologic disease or surgery, and no history of usage of ototoxic drugs. A total of 298 workers were assessed. After physical examination and audiometry, we measured the level of serum cholesterol, triglyceride, high and low density lipoprotein of participants. The results were analyzed with the SPSS version 17.0. The p value < 0.05 is considered significant statistically.

In this study, 250 men and 48 women were assessed. The mean age of participants was 35.8 years. The participants had high noise exposure of 11 years on average (1-26years). Ninty five of them had NIHL (31.8%). The frequency of serum cholesterol, triglyceride, high and low density of this group were 31.5%, 10.8%, 53.2% and 14.3%, respectively. These levels in the group without NIHL (203 workers) were 38.9%, 12.6%, 58.9% and 21.1%, respectively. There was no statistical significance between these levels in the two groups. By backward logistic regression method, we observed that the duration of employment and gender increased the hearing threshold of 4 KHz frequency in the NIHL group. The odd ratio of hearing loss in male gender was 3.36 (95% confidence interval: 1.61-8.95, p= 0.004). The other effective factors on the hearing threshold of 4 KHz frequency had statistical, but no clinical significant difference in two groups.

We observed no statistical significance of dyslipidemia frequency between two groups. In addition to duration of employment, male gender was the other observed related factor with hearing loss in the two groups. This effect may be due to protective effect of estrogen on the hearing level. Studies with more sensitive approaches on a larger sample is advised.

Allergic inflammation in upper airways can act as a predisposing factor for infectious ear diseases. There are some evidences about the role of allergic rhinitis (AR) in chronic otitis media with effusion، but its role in establishing Chronic Supportive Otitis Media (CSOM) has not been clearly shown.

To assess the relationship between allergic rhinitis and CSOM in patients referring to Amiralmomenin hospital، Rasht، Iran

61 adult patients with established CSOM were considered as case group and 58 patients with minor head and neck trauma as control group، they were evaluated for the presence of allergic rhinitis. All case and control group were over 15 years old and underwent skin prick test for 23 common regional aeroallergens. Allergic rhinitis was defined with positive symptoms and signs of AR and positive skin prick test.

Allergic rhinitis was diagnosed in 15 (26. 20%) and 8 (13. 80%) of patients and controls، respectively (P=0. 065). By logistic regression equation after corroding the age factor and the difference between two groups became significant (χ2=0. 026، OR=3. 27، CI=1. 15 – 6. 57). Indoor allergens، especially mites and molds، were the most prevalent allergens among both groups، but Outdoor allergens like grass pollen have a low prevalence.

The prevalence of AR in the CSOM patients is more than the controls.

Tonsil reduction by use of Radiofrequency waves is one of the newest therapeutic modalities, especially for obstructive large tonsils. The aim of this study was comparing short term and long term results of radiofrequency tonsillotomy and traditional cold dissection tonsillectomy in adult patients with recurrent tonsillitis.

a prospective randomized clinical trial on 72 adults with recurrent tonsillitis was performed in a tertiary referral university hospital. Traditional tonsillectomy in 34 cases and radiofrequency tonsillectomy (RF) by use of RFITT (Radiofrequency Induced Thermotherapy) probes in 38 cases were performed under general anesthesia. Time of surgery, amount of intraoperative bleeding, recovery time, post-surgical pain, dysphagia, weight loss, and time of return to normal diet and activity were measured. All the patients were followed for 24 months for recurrence of tonsillitis episodes. Statistical analysis was performed by use of SPSS version 16 software and X2 and Mann-Whitney U tests.

Mean time of surgery(16.89 vs. 46.07 minutes) and recovery(14.32 min vs. 17.11 min), and amount of intraoperative bleeding(15-20 cc vs. 250- 300cc) were significantly less in the RF group compared to traditional tonsillectomy group (P<0.005). There was no difference among two groups in the recurrence of tonsillitis episodes after 24 months.

Tonsillotomy with RF is a simple, rapid, and effective method in adult patients with recurrent tonsillitis.

OME is a Common disease in children. over than 90% of children in preschool ages experienced this disease once at least. Despite medical therapy about 10% of the OME patients won't improved and these are the group of patients who referred to as chronic OME patients. Insertion of VT in TM is an accepted therapy for these patients and during surgery for insertion of VT, suctioning of middle ear effusion is done. This suctioning produces noise and this noise can produce SNHL. Further, during suctioning probable traumatization of external ear canal, developing hemorrhage in the canal, obscuring visual field of surgeon, and finally surgical time becoming too long are probably. This double blind clinical trial that included 50 patients with bilateral COME evaluated the effect of suctioning of middle ear effusion before VT insertion on hearing acuity of patients with COME. All selected patients had type B tympanogram and conductive hearing loss over 20db in both ears. The patient with unilateral COME and tympanogram of type C was omitted. In right ear after myringotomy and in left ear after myringotomy and suctioning of middle ears effusion VT was inserted and patients were followed up in one week, three weeks and three months after surgery and in each examination the degree of improvement of hearing was evaluated by mean of audiometery. The results of this trial analyzed by statistical chi-square and t.test. 46 suctioned ear(92.4%) and 34 unsuctioned ear(68%) developed hearing improvement at the end of the first week. Hearing improvement in the two groups at the end of third week and third month was 100%. Therefore, we concluded that the degree of hearing improvement in patients with COME doesn't correlates with middle ear effusion suctioning during surgery for inserting VT.