The prevalence of allergic rhinitis in patients with chronic rhinosinusitis.

INTRODUCTION: Chronic rhinosinusitis (CRS) is a multifactorial disease. Allergies are considered a predisposing factor to CRS; however, this remains controversial. The objective of this research was to investigate the prevalence of co-morbidities and allergic reaction, and to specify the most common allergens in patients with confirmed CRS. MATERIALS AND METHODS: One hundred patients with signs and symptoms of CRS who met the diagnostic endoscopic and radiologic criteria of chronic rhinosinusitis were selected. They filled out a questionnaire and underwent a skin prick test for the common inhalant allergens. Allergic rhinitis was diagnosed according to the history and positive skin prick tests. RESULTS: The mean age of patients was 34. Males were slightly more involved (54%). The prevalence of polypoid and none-polypoid rhinosinusitis was 54% and 46% respectively. The patients' most common symptoms were nasal discharge (95%), blockage (94%), smell disorders (63%), cough (45%), halitosis (41%), lethargy (37%), and aural fullness (36%). Allergy to at least one allergen was noted in 64% of the CRS patients which is higher than general population in Mashhad, Iran with allergic rhinitis (22.4%). Salsola was the most common allergen. There was no significant difference in allergic reactions between polypoid and non-polypoid CRS patients. CONCLUSION: Allergic reactions was found in Iranian CRS patients with or without polyposis to be much higher than general population in Mashhad with allergic rhinitis alone.

Differentiation between CSF Otorrhea and Rhinorrhea in an Obscure Case of Recurrent Meningitis.

INTRODUCTION: Leakage of cerebrospinal fluid in the skull base may be accompanied with recurrent meningitis. The site of leakage may either be anterior (in the nose and paranasal sinuses) or posterior (in the temporal bone). Various imaging techniques can be used to precisely locate the point of leakage but despite all the advances in imaging techniques there are still some rare cases in which the surgeon can't be sure on the management approach before the beginning of surgery. CASE REPORT: In this article we present one of these cases; we used intrathecal fluorescein to locate the source of the leak and made the final decision on the operating table. CONCLUSION: Intrathecal fluorescein is helpful in locating the leakage in the ear or the nose in ambiguous cases.

Effect of stylet removal on neural response telemetry and stapedial reflex thresholds during cochlear implantation.

OBJECTIVE: The purpose of this study was to analyze changes in neural response telemetry (NRT) and electrically evoked stapedial reflex thresholds (ESRT) before and after stylet withdrawal during cochlear implant surgery. METHODS: Thirty children (21-92 months old) who were candidates for cochlear implantation took part in this study. In all of them Nucleus Contour Advance was implanted. NRT and ESRT responses were recorded initially with the stylet in and then when the stylet was taken out during the implant procedure. The recordings were performed in the basal, middle, and apical areas of the electrode array. RESULTS: The threshold levels required to obtain NRT and ESRT responses after stylet removal were lower. This decrease was observed in all parts of the cochlea. It was statistically significant in all areas with the exception of the basal ESRT measurements. CONCLUSION: Withdrawing the stylet results in better NRT and ESRT responses, most probably due to a favorable position change of the electrode array within the scala tympani.

Hearing impairment in the neonate of preeclamptic women.

OBJECTIVE: Preeclampsia is a critical condition that puts both pregnant women and their offspring at risk for multiorgan failure, including inner ear, due to systemic toxemia and vascular events. This study was done to determine the probable prevalence of hearing impairment in children whose mothers had pregnancy-induced hypertension, compared to those born to healthy mothers. METHODS AND MATERIALS: A cohort study was performed on two groups; the first group was made up of the offspring of preeclamptic women (n = 36) and the second was made up of offspring born to healthy mothers (n = 114). They were matched for sex and age. Other confounding variables that could have influenced the hearing were excluded. Transient evoked otoacoustic emission (TEOAE) and auditory brain response (ABR) tests were performed to screen hearing loss in each group. RESULTS: Failure rates in the first step for cases and controls were 33.33 percent and 12.76%, respectively, which showed a significant difference statistically (P = 0.001). However, the final results of the second TEOAE and ABR between the two groups were not statistically significant (P > 0.05). CONCLUSION: Although it does not seem that pregnancy toxemia plays a role in permanent hearing loss in neonates of affected mothers, it might have a transient effect on hearing.