Efficacy of submucosal delivery through a parapharyngeal approach in the treatment of limited cricoid chondroma

Cartilaginous tumors comprise 1% of all laryngeal masses. Since they grow slowly and metastasis is rare, long term survival is expected in cases of chondroma and chondrosarcoma. Thus, based on these facts and the fact that total salvage surgery after recurrence of previous tumor does not influence treatment outcomes, "Quality of Life" must be taken into great consideration. Based on 3 cases of limited condrosarcoma that we have successfully operated on using submucosal delivery through a parapharyngeal approach, after several years of recurrence free follow ups, authors determine this technique as an efficient method of approach to these tumors. Since this technique takes less time and there is no need for glottic incision and the patient is discharged in 2 days without insertion of endolaryngeal stent, we believe this method is superior to laryngofissure or total laryngectomy

[Detection of bacterial biofilm in human refractory chronic rhinosinusitis with Scanning Electron Microscopy [SEM]]

Bacterial biofilm is a complex organization of bacteria anchored to a mucosal surface. A recent but fascinating notion in the pathphysiology of chronic rhinosinusitis is the role of bacterial biofilms. Biofilms explain why in individuals with normal immunity, antibiotics are unable to resolve bacteria that are sensitive to antibiotics on in vitro testing. This is the first study in Iran, in which we demonstrate the biofilms in ethmoid sinus mucosa of patients with refractory chronic rhinosinusitis after one successful surgery. 10 patients included, all of them had at least one previously technically successful FESS for a diagnosis of chronic rhinosinusitis [CRS] and/or nasal polyposis that were refractory to maximal medical therapy over months previously. Patients were not immune compromised and not taken antibiotics or systemic corticosteroids within a 1 month period previously, but taking nasal irrigation or topical intranasal corticosteroids. During postoperative endoscopy, four punch biopsies were obtained from ethmoid sinus. The specimens were examined by SEM. Photomicrographs were then evaluated for evidence of biofilms. Biofilm in SEM was defined as the presence of microcolonies embedded in a microfilament extrapolysaccharide matrix. The biofilms were not identified within the mucosa, but were identified on the mucosal surface. Biofilms were detected in 6 of 10 patients. Biofilms may play role in refractory chronic rhinosinusitis. Biofilms are refractory to antibiotics and often only cured by mechanical debridement