The Effect of Spreader Graft and Mattress Suture Technique on Rhinoplasty in Patients With Nasal Hump Smaller Than 3 mm.

INTRODUCTION: Rhinoplasty is a common plastic surgery that potentially has some complications such as postoperative deformities and breathing problems. A humpy nose is among the main reasons for rhinoplasty. Nasal valve (the narrowest part of the nasal airway) collapse may be occurred after nasal hump removal. Spreader graft is essential after more than 3 mm nasal hump removal. But the value of this graft is unknown for patients with nasal hump smaller than 3 mm. Mattress suture is another technique for widening the nasal valve angle. This study compares the effects of spreader graft and mattress suture technique on postoperative deformity and nasal valve patency in patients with nasal hump smaller than 3 mm as compared with control group (no graft and suture). METHODS: In this clinical trial study 210 patients who underwent rhinoplasty with 2 different techniques involved. Their postoperative deformity and nasal valve patency were evaluated by subjective (questionnaire and digital photography) method before and after rhinoplasty during 6 months follow-up. RESULTS: Statistically, nasal obstruction had no significant difference before and after rhinoplasty and no significant difference was observed between spreader graft and mattress sutures (P > 0.05), but significantly better results than control group (P < 0.05). CONCLUSION: In this study the results of nasal valve patency of 2 techniques were similar. Because of several considerations in spreader graft technique such as needing to septoplasty in this technique even in patients without septal deviation that causes longer surgical duration, excessive blood loss, it is recommended to use Mattress suture in patients with nasal hump smaller than 3 mm.

Transtympanic Injections of N-acetylcysteine and Dexamethasone for Prevention of Cisplatin-Induced Ototoxicity: Double Blind Randomized Clinical Trial.

OBJECTIVE: Cisplatin is a potent chemotherapeutic agent that is used against a variety of tumors. The most common side effect of cisplatin is ototoxicity. This dose-related hearing impairment is high frequency, bilateral, and permanent. Unfortunately, there is no prophylactic protocol, and, in current clinical practice, the treatment of cancer with cisplatin is interrupted when ototoxicity develops or the resulting hearing impairment is tolerated as an acceptable side effect of cancer treatment. The aim of this study is to compare transtympanic injections of N-acetylcysteine and dexamethasone (both of which have shown substantial otoprotective activity) for the prevention of cisplatin-induced ototoxicity. METHODS: A double blind randomised clinical trial study of 60 cisplatin-treated patients was performed in Shahid Sadoughi Hospital in 2016-2017. Transtympanic injection of N-acetylcysteine (10%) and dexamethasone was performed. Hearing acuity was evaluated by an audiologist blinded to the treated ears before each cycle with pure tone audiometry (PTA) and six months later. RESULTS: Altogether, 114 transtympanic infusions were performed (57 in each group). The data were analyzed by the Fisher test and chi-squared. In the ears with N-acetylcysteine, no significant changes in auditory thresholds were recorded. In the ears with dexamethasone, cisplatin induced a significant decrease of auditory thresholds at the 8000 Hz frequency band (P = 0.001). CONCLUSION: Transtympanic injections of N-acetylcysteineas a safe and inexpensive antioxidant agent seem to be an effective otoprotective strategy for the prevention of cisplatin-induced ototoxicity and for increasing the quality of life, especially in children.

Effect of dimethyl sulfoxide on bond durability of fiber posts cemented with etch-and-rinse adhesives.

PURPOSE: This study was undertaken to investigate whether use of an adhesive penetration enhancer, dimethyl sulfoxide (DMSO), improves bond stability of fiber posts to root dentin using two two-step etch-and-rinse resin cements. MATERIALS AND METHODS: Forty human maxillary central incisor roots were randomly divided into 4 groups after endodontic treatment and post space preparation, based on the fiber post/cement used with and without DMSO pretreatment. Acid-etched root dentin was treated with 5% DMSO aqueous solution for 60 seconds or with distilled water (control) prior to the application of Excite DSC/Variolink II or One-Step Plus/Duo-link for post cementation. After micro-slicing the bonded root dentin, push-out bond strength (P-OBS) test was performed immediately or after 1-year of water storage in each group. Data were analyzed using three-way ANOVA and Student's t-test (α=.05). RESULTS: A significant effect of time, DMSO treatment, and treatment × time interaction were observed (P<.001). DMSO did not affect immediate bonding of the two cements. Aging significantly reduced P-OBS in control groups (P<.001), while in DMSO-treated groups, no difference in P-OBS was observed after aging (P>.05). CONCLUSION: DMSO-wet bonding might be a beneficial method in preserving the stability of resin-dentin bond strength over time when fiber post is cemented with the tested etch-and-rinse adhesive cements.

Assessing the Ignored Associated Injuries of the Ear, Nose and Throat in Patients with Multiple Trauma in Shahid Rahnamun Hospital of Yazd in 2012 and 2013.

BACKGROUND: Many trauma patients in the Emergency Department are unconscious, and this causes many other problems to go undiagnosed, resulting in the loss of valuable time in initiating the appropriate treatments. The purpose of this study was to determine the prevalence and types of injuries to the ears, nose, and throat that are ignored in patients with multiple traumas in an Emergency Department. METHODS: This study was conducted by assessing patients with multiple traumas who were admitted to the Emergency Department at Shahid Rahnamun Hospital in Yazd, Iran, in 2012 and 2013, and who were advised to acquire diagnostic workups and treatment in the Ear, Nose, and Throat Department. The patients' data were gathered by studying their records and by careful examinations, and the data were analyzed using the chi-squared test by SPSS version 18. RESULTS: Among the 230 patients who were counseled, 170 patients had multiple traumas that were caused by accidents, falls, conflicts between individuals, and natural disasters. Fifty-four patients with low Glassco Coma Scale (GCS) values who were admitted to the ICU were counseled after they regained consciousness. Among the 54 cases, 12 cases (22%) had nasal fractures and four cases had septal hematomas that resulted in infections and severe deformities. Twenty-four cases (44%) had lacerations of posterior auricular components, one case required extended debridement, and two cases had extensive necrosis that required a local flap. Two cases (3%) had paralyzed facial nerves, 8 cases (14%) had fractured mandibles, and 10 cases (18%) had laceration of the oral mucosa (lingual - buccal) that require extended debridement in the operating room. CONCLUSIONS: It is recommended that complete physical examinations be done in patients with multiple trauma after they are stabilized; such examinations would require careful training of the medical staff and also careful and timely counseling.