Transmission electron microscopy study of suspected primary ciliary dyskinesia patients.

Primary ciliary dyskinesia (PCD) is a rare autosomal recessive condition often presenting with chronic respiratory infections in early life. Transmission electron microscopy (TEM) is used to detect ciliary ultrastructural defects. In this study, we aimed to assess ciliary ultrastructural defects using quantitative methods on TEM to identify its diagnostic role in confirming PCD. Nasal samples of 67 patients, including 37 females and 30 males (20.3 ± 10.7 years old), with suspected PCD symptoms were examined by TEM. The most common presentations were bronchiectasis: 26 (38.8%), chronic sinusitis: 23 (34.3%), and recurrent lower respiratory infections: 21 (31.3%). Secondary ciliary dyskinesia, including compound cilia (41.4%) and extra-tubules (44.3%), were the most prevalent TEM finding. Twelve patients (17.9%) had hallmark diagnostic criteria for PCD (class 1) consisting of 11 (16.4%) outer and inner dynein arm (ODA and IDA) defects and only one concurrent IDA defect and microtubular disorganization. Also, 11 patients (16.4%) had probable criteria for PCD (class 2), 26 (38.8%) had other defects, and 18 (26.9%) had normal ciliary ultrastructure. Among our suspected PCD patients, the most common ultrastructural ciliary defects were extra-tubules and compound cilia. However, the most prevalent hallmark diagnostic defect confirming PCD was simultaneous defects of IDA and ODA.

Emergence and Evolution of Olfactory and Gustatory Symptoms in Patients with COVID-19 in the Outpatient Setting.

The present study aimed at evaluating the prevalence of general and sinonasal symptoms in patients with olfactory symptoms and mild coronavirus disease-2019 (COVID-19) and determining the patterns in emergence and resolution of olfactory/gustatory symptoms relative to general and sinonassal symptoms. This was a prospective cross-sectional study conducted at the outpatient otorhinolaryngology clinic at a COVID-19-designated referral Hospital. We included consecutive patients with new-onset olfactory dysfunction and positive polymerase chain reaction (PCR) assay of COVID-19. We asked the patients to fill in a questionnaire about general and sinonasal symptoms in association with anosmia, hyposmia or hypogeusia, and recorded the time course of the olfactory/gustatory symptoms during 2-weeks of follow-up. 76 patients with average age of 38.5 ± 10.6 years were included. Majority of participants (94.7%) had general or sinonasal symptom. There was anosmia in 60.5% and hyposmia in 39.5%, with sudden onset of olfactory symptoms reported in 63.2% of patients. During the follow-up, 30.3% of patients completely and 44.7% partially recovered from anosmia/hyposmia. Regardless of whether the general or olfactory symptoms appeared initially, the general symptoms resolved first while a degree of olfactory dysfunction persisted during the follow-up. Our study showed that hyposmia and anosmia in mild COVID-19 are frequently associated with general and sinonasal symptoms and tend to persist longer than the general and sinonasal symptoms during the course of the disease.

Assessment of Quality of Life and the Risk of Obstructive Sleep Apnea in Individuals with Chronic Rhinosinusitis who are Candidate for Functional Endoscopic Sinus Surgery.

BACKGROUND: Chronic rhinosinusitis is associated with changes in quality of life (QoL). The present study intended to evaluate the QoL and risk of obstructive sleep apnea in individuals with chronic rhinosinusitis who were candidate for functional endoscopic sinus surgery. To determine the Quality of Life and the risk of sleep apnea in cases with chronic Rhinosinusitis. MATERIALS AND METHODS: A total of 100 patients with drug-resistant chronic rhinosinusitis candidate for functional endoscopic sinus surgery referred to the ENT clinic of Masih Daneshvari Hospital, Tehran, Iran were recruited. SNOT-22 and STOP-BANG questionnaires were filled before the surgery. RESULTS: The mean SNOT-22 score was 40.44, with a standard deviation of 19.27 (ranged from 1 to 94). Also, according to the STOP-BANG questionnaire, 62% of participants were at increased risk of OSA. Based on the cut-off point of 30 for the SNOT-22 score (either larger or lower than 30), patients were categorized into two groups. Sixty-eight percent of participants were categorized in ≥ 30 SNOT-22 score. Age below 50, female gender, and those at high risk of OSA were associated with lower QoL. CONCLUSION: Most patients with chronic rhinosinusitis had a low QoL and were mostly at increased risk of OSA. Being women younger than 50 years and the presence of OSA probably are associated with lower QoL in these patients.

Case Report: COVID-19-associated Rhinosinusitis Mucormycosis Caused by Rhizopus arrhizus: A Rare but Potentially Fatal Infection Occurring After Treatment with Corticosteroids.

COVID-19 first emerged in Wuhan, China, in December 2019. Since that time, the frequency of bacterial and fungal coinfections has been continuously increasing. Although invasive pulmonary aspergillosis is being increasingly recognized in association with COVID-19, there is limited information regarding COVID-19-associated mucormycosis. We describe a 50-year-old woman with uncontrolled diabetes who received systemic corticosteroids and remdesevir during her admission for COVID-19. A few days after discharge, the patient was readmitted because of facial swelling and numbness, and a diagnosis of COVID-19-associated rhinosinusitis mucormycosis caused by Rhizopus arrhizus (formerly called Rhizopus oryzae) was confirmed with sequencing of the internal transcribed spacer region of the ribosomal DNA. This report aimed to address the importance of short-term follow-up for COVID-19 patients who have received systemic corticosteroids, particularly those with predisposing conditions, because early detection and prompt, aggressive treatment are essential for the management of invasive fungal infections.

Structural Characteristics of the Iranians Nose: An Anatomical Analysis.

INTRODUCTION: Rhinoplasty is one of the most common surgical procedures performed among Iranians. An important issue to be considered by nasal surgeons is anatomical variations between different ethnic groups. Working on Iranians with the existing ethnic variety encourages the need for an analysis of this particular population. MATERIALS AND METHODS: The present cross-sectional observational study was conducted on Iranian patients who underwent primary open rhinoplasty at a university hospital in Tehran, Iran. The preoperative evaluations included routine aesthetic analysis as well as the measurement of the subcutaneous fat thickness (using ultrasound imaging) and the angle between the anterior nasal spine and the alveolar process of the maxilla. Intraoperative assessments were performed on the alar rim-inferior border of lateral crus distance, maximal width of lateral crus, connection pattern of upper lateral cartilage, and lower lateral cartilage. Alar cartilage thickness was measured with microscopic evaluation. Moreover, the similar studies conducted on other ethnic groups were reviewed as well. RESULTS: In total, 66 cases were included in the study (41 females and 25 males) who were within the age range of 18-38 years old (27.82±5.51). According to the results, nasolabial angles were 93.68°±7.82° and 92.25°±6.98° in females and males, respectively. In addition, a significant correlation was found between the anterior nasal spine-maxilla angle and nasolabial angle (P<0.05). Moreover, the findings revealed a significant but weak negative correlation between alar subcutaneous fat thickness and alar cartilage thickness (0.0002). Maximal width of lateral crus was found to be 11.44mm±2.02 and 10.41 mm±1.72 in males and females, respectively. CONCLUSION: Despite the differences observed between various ethnic groups, drawing a definiteconclusion about these variations needs comparative studies with similar samples (cadaver vs. patients) and measurement techniques.

Correction to: Water-pipe smoke condensate increases the internalization of Mycobacterium Bovis of type II alveolar epithelial cells (A549).

An amendment to this paper has been published and can be accessed via the original article.

Paranasal sinuses computed tomography findings in anosmia of COVID-19.

OBJECTIVE: Olfactory dysfunction in coronavirus disease-2019 (COVID-19) is poorly understood. Thus, mechanistic data are needed to elucidate the pathophysiological drivers of anosmia of COVID-19. METHODS: We performed the current study in patients who presented with anosmia and COVID-19 as documented by the polymerase chain reaction (PCR) assay between April 1st and May 15st, 2020. We assessed for the conductive causes of anosmia with computed tomography (CT) of paranasal sinuses. RESULTS: 49 patients who presented with anosmia and positive PCR assay for COVID-19 were included. The average age was 45 ± 12.2 years. Complete anosmia was present in 85.7% of patients and 91.8% of patients reported sudden onset of olfactory dysfunction. Taste disturbance was common (75.5%). There were no significant pathological changes in the paranasal sinuses on CT scans. Olfactory cleft and ethmoid sinuses appeared normal while in other sinuses, partial opacification was detected only in some cases. CONCLUSION: We did not find significant mucosal changes or olfactory cleft abnormality on CT imaging in patients with anosmia of COVID-19. Conductive causes of anosmia (i.e., mucosal disease) do not seem play a significant role in anosmia of COVID-19.

Can be compared obstructive respiratory events during drug induced sleep endoscopy (DISE) and nocturnal polysomnography.

PURPOSE: Obstructive sleep apnea (OSA) is a collapse of pharynx muscles during sleep that can cause obstruction in the upper airway. It is better to determine the site and pattern of obstruction in the upper airway with drug-induced sleep endoscopy (DISE) before surgery. OSA usually occurs in a non-rapid eye movement (NREM) sleep and sometimes it gets longer and more intense in REM; hence, the study is meant to explore whether the sleep stage and results in DISE may have any similarity with usual nocturnal polysomnography or not. MATERIALS AND METHODS: In this study, 38 patients with OSA diagnosed on the basis of polysomnography, underwent DISE. Moreover, EEG (12 channels), pulse oximetry and effort channel (respiratory inductance plethysmography) were recorded during DISE to determine the sleep stage and mean respiratory event duration (MRED). RESULTS: Thirty-eight patients were enrolled in this study. Eighty-four percent (84%) of obstructive respiratory events were observed in NREM sleep in Lab-PSG and 71% in DISE. 28.9% of patients' events occurred in the wake state in DISE. The mean respiratory event duration (MRED) values in DISE and nighttime sleep were 24.5 ± 7.5 s and 25.4 ± 7.7 s, respectively without significant difference (P value = 0.744), while the minimum values for SPO2 were 74.0 ± 17.3 and 73.6 ± 20.3, respectively (P = 0.885). CONCLUSIONS: Considering the fact that the majority of respiratory events occurred in NREM sleep stage in both PSG and DISE, DISE results can be trusted. Due to absence of REM stage in DISE, the level of the obstruction may mislead the surgeon.

Eosinophilic Mucin Rhinosinusitis in Iranian Patients Undergoing Endoscopic Sinus Surgery.

INTRODUCTION: Eosinophilic mucin rhinosinusitis is a type of chronic rhinosinusitis (CRS). Diagnosis and treatment of this condition play a significant role in reducing the patients' clinical symptoms. This type of rhinosinusitis has a higher relapse rate, compared to the other types. This disease is more resistant to treatment and more dependent on corticosteroid therapy, compared to the other types of rhinosinusitis. Regarding this, the present study was designed to evaluate the frequency of eosinophilic mucin rhinosinusitis in patients undergoing sinus surgery in a tertiary referral center and examine some clinical and laboratory characteristics regarding this type of rhinosinusitis. MATERIALS AND METHODS: This cross-sectional observational study was performed on patients over the age of 16 years, who were diagnosed with CRS in the otolaryngology clinic of a referral tertiary-level hospital, and were candidates for endoscopic sinus surgery. Based on the detection of eosinophilic mucin, the subjects were divided into two groups of eosinophilic mucin and non-eosinophilic mucin rhinosinusitis (controls). The groups were compared in terms of sino-nasal outcome test (SNOT-22) scores, Lund-Mackay staging scores, osteitis status, immunoglobulin E (IgE) level, and eosinophilia. RESULTS: In this study, 46 subjects participated, 29 (63%) cases of whom had eosinophilic mucin. The SNOT-22 score and serum IgE level were significantly higher in the eosinophilic mucin group, compared to those in the control group. Osteitis and Lund-Mackay scores were also higher in the eosinophilic mucin group than those in the control group; however, this difference was not statistically significant. CONCLUSION: Patients with eosinophilic mucin rhinosinusitis showed a more severe clinical involvement. Seemingly, the Iranian patients have a lower and higher frequency of eosinophilic mucin rhinosinusitis, compared to the patients from the Western countries and East Asia, respectively.

Transcutaneous Columellar Strut for Correcting Caudal Nasal Septal Deviation.

Correction of caudal septal deviation is a challenging issue because of its significant role in tip support mechanisms. Some interventions especially aggressive resection of caudal septum to correct deviation, may compromise external nasal valve, tip ptosis and persistence of nasal obstruction. Many surgical techniques have been suggested to correct this type of nasal septal deviation. This study presents a technique to correct caudal septal deviation without weakening of tip support mechanisms. To evaluate the efficacy of insertion of a transcutaneous columellar strut during correction of caudal septal deviation. The study was performed in patients complaining from nasal obstruction with caudal septal deviation. After intranasal incision and elevation of mucoperichondrial flap, Caudal septum released from anterior nasal spine (ANS) and a band of cartilage removed from inferior and caudal part of septum and septum again fixed to ANS. Through a vertical transcutaneous incision, a cartilaginous strut is placed in columella, between medial crurae. Preoperative and postoperative NOSE score determined and photographs were taken. In 14 patients we performed this technique, the postoperative NOSE score showed significant improvement, (p = 0.001). Nasal breathing improved in all patients without any complication or tip ptosis or worsening of nasal appearance. This septoplasty technique along with placement of transcolumellar strut, is an easy, efficient and complication free method for simultaneously correction of caudal deviation of nasal septum, reinforcing external nasal valve and prevents tip ptosis.

Comparing the Effect of Oral Clonidine and Tranexamic Acid on Bleeding and Surgical Field Quality during Functional Endoscopic Sinus Surgery.

INTRODUCTION: Bleeding during functional endoscopic sinus surgery (FESS) is an important issue for both anesthesiologists and surgeons as it can affect the safety and efficiency of the procedure. We compared the efficacy of tranexamic acid (TXA) and clonidine in reducing blood loss and improving surgical field visualization during FESS. MATERIALS AND METHODS: In a double-blind, randomized, clinical trial, 52 patients, American Society of Anesthesiologists (ASA) physical status 1-2, aged 13-75 years, suffering from rhinosinusitis with or without polyposis, and who were candidates for FESS, were enrolled. The first group received intravenous TXA 15 mg/kg diluted in 100 ml normal saline, administered during 10-min infusion after induction. In the second group, 0.2 mg oral clonidine was given 1 to 1.5 hours before surgery. Duration of surgery, hemoglobin level, heart rate, blood pressure, and quality of surgical field based on Boezzart's scale and surgeon satisfaction based on Likert's scale were recorded in both groups. RESULTS: In total, 52 patients, 27 (51.9%) males and 25 (48.07%) females were studied. Twenty-two (42.3%) and 30 (57.7%) were in the TXA and clonidine groups, respectively. The mean pre- and post-surgical hemoglobin level showed no meaningful difference between the two groups. The same result was obtained for blood pressure and heart rate at different time points (P>0.05). Mean anesthesia time (P=0.859), mean surgical time (P=0.880), surgeon's satisfaction of the surgical field (P=0.757) and surgical field quality at different time points revealed no significant difference between the two groups. CONCLUSION: Premedication with oral clonidine and intravenous TXA has the same effect on bleeding during FESS, surgical field visualization, and surgeon satisfaction.

Evaluation of cerebral oxygen saturation during hypotensive anesthesia in functional endoscopic sinus surgery.

BACKGROUND AND AIMS: Controlled hypotensive anesthesia in endoscopic sinus surgery would provide a clean surgical field. Cerebral oxygen saturation (ScO2) is important in endoscopic sinus surgery patients and it may be low during controlled hypotension. The aim of the present study was to assess ScO2 in these patients. MATERIAL AND METHODS: In this observational study, 41 patients who underwent endoscopic sinus surgery with hypotensive anesthesia were enrolled for the study and all of the patients received the same anesthetic medication, nitroglycerin for controlled hypotension. Variables were measured prior to surgery, after induction of anesthesia, 5 min, and every 30 min after controlled hypotension. Near-infrared spectroscopy was used for ScO2 evaluation. Mean arterial blood pressure (MAP) was maintained at 55-60 mmHg in the surgical duration. We used t-test, Wilcoxon, and repeated measures analysis of variance (ANOVA). We examined the cross-correlation functions of the time series data between end-tidal carbon dioxide (ETCO2)/MAP and ScO2. RESULTS: The mean of intraoperative ScO2 was not significantly different from the baseline evaluation (P > 0.05). ETCO2 was cross correlated with current ScO2 [r: 0.618, confidence interval (CI) 95%: 0.46-0.78]. We found moderate cross correlation between the MAP and current ScO2 (r: 0.728, CI 95%: 0.56-0.88). About 92% of the patients recovered within 30 min. Recovery time was associated with intraoperative MAP (P: 0.004, r: 0.438), intraoperative ETCO2 (P: 0.003, r: 0.450), and ScO2 (P: 0.026, r: 0.348). CONCLUSIONS: Based on our findings, the assessment of ScO2 and maintained MAP >55 mmHg may provide safe conditions for endoscopic sinus surgery.

Water-pipe smoke condensate increases the internalization of Mycobacterium Bovis of type II alveolar epithelial cells (A549).

BACKGROUND: Tuberculosis (TB) is a major global health problem, and there is an association between tobacco smoke and TB. Water pipe smoking has become an increasing problem not only in Middle Eastern countries but also globally because users consider it as safer than cigarettes. The presence of high levels of toxic substances in water-pipe smoke may be a predisposing factor that enhances the incidence of pulmonary disorders. For example, uncontrolled macropinocytosis in alveolar epithelial cells following exposure to water-pipe smoke may predispose subjects to pulmonary infection. Here, we studied the effects of water-pipe condense (WPC) on the internalization of Mycobacterium Bovis BCG by macropinocytosis in the alveolar epithelial cell line A549. METHODS: A549 cells were exposed to WPC (4 mg/ml) for 24, 48, 72 and 96 h. Cell viability was studied using the methyl thiazolyldipenyl-tetrazolium bromide (MTT) reduction assay and proliferation by bromodeoxyUridine (BrdU) incorporation. Cells were exposed to FITC-Dextran (1 mg/ml) (as a control) and FITC-BCG (MOI = 10) for 20 min at 37 °C before cells were collected and the uptake of BCG-FITC determined by flow cytometry. Similar experiments were performed at 4 °C as a control. The Rho-associated protein kinase (ROCK) inhibitor Y-27632 (1 µM) was used to assess the mechanism by which WPC enhanced BCG uptake. RESULTS: WPC (4 mg/ml) increased the uptake of BCG-FITC after 72 (1.3 ± 0.1 fold, p < 0.05) and 96 (1.4 ± 0.05 fold, p < 0.05) hours. No effect on BCG-FITC uptake was observed at 24 or 48 h. WPC also significantly increased the uptake of FITC-Dextran (2.9 ± 0.3 fold, p < 0.05) after 24 h. WPC significantly decreased cell viability after 24 (84 ± 2%, p < 0.05), 48 (78±, 3%, p < 0.05), 72 (64 ± 2%, p < 0.05) and 96 h (45 ± 2%, p < 0.05). Y-27632 completely attenuated the increased uptake of BCG by WPC. Cell proliferation showed a decreasing trend in a time-dependent manner with WPC exposure. CONCLUSION: WPC exposure increased epithelial cell endocytosis activity and death as well as enhancing their capacity for macropinocytosis. Our in vitro data indicates possible harmful effects of WPC on the ability of lung epithelial cells to phagocytose mycobacterium.

Otologic Manifestations and Progression in Patients with Wegener's granulomatosis: A Survey in 55 Patients.

INTRODUCTION: Granulomatosis with polyangiitis (GPA; also known as Wegener's granulomatosis) is a primary systemic vasculitis involving the ear, nose and throat system (ENT) and lower respiratory tract. Because of the lack of knowledge regarding the clinical findings of GPA due to the limited number of studies, the current study was designed to investigate the prevalence and nature of the otology manifestations in the disease course. MATERIALS AND METHODS: In the current prospective study, patients with a diagnosis of GPA from 2012-2016 were included. A definitive diagnosis was made based on the history, physical examination (otomicroscopy, Rinne and Weber test), audiometry, tympanometry, cytoplasmic and perinuclear anti-neutrophil cytoplasmic antibody (C-ANCA and P-ANCA) investigations, and pathologic studies. RESULTS: Twenty-seven male and 28 female patients aged 41.6±15.3 years were enrolled. Ear involvement was found in 20 patients (36.3%), and the most prevalent symptom was loss of hearing followed by otalgia and tinnitus. Tinnitus improved in none of the patients. The most prevalent sign was otitis serous followed by mastoiditis and external otitis. The most important audiometry finding was sensorineural hearing loss. Pathological studies using pulmonary samples were more useful for diagnosis. CONCLUSIONS: Precise clinical examination is crucial for the early diagnosis of GPA. Otological manifestations are common, especially loss of hearing and otitis serous, and can be the first sign of this disease. Early diagnosis can lead to better treatment of Wegener's granulomatosis.

In vitro differentiation of neural stem cells derived from human olfactory bulb into dopaminergic-like neurons.

This study describes a new accessible source of neuronal stem cells that can be used in Parkinson's disease cell transplant. The human olfactory bulb contains neural stem cells (NSCs) that are responsible for neurogenesis in the brain and the replacement of damaged cellular components throughout life. NSCs are capable of differentiating into neuronal and glial cells. We isolated NSCs from the olfactory bulb of brain-death donors and differentiated them into dopaminergic neurons. The olfactory bulb tissues obtained were cultured in Dulbecco's modified Eagle's medium/nutrient mixture F12, B27 supplemented with basic fibroblast growth factor, epidermal growth factor and leukemia inhibitory factor. The NSCs and proliferation markers were assessed. The multipotentiality of olfactory bulb NSCs was demonstrated by their capacity to differentiate into neurons, oligodendrocytes and astrocytes. To generate dopaminergic neurons, olfactory bulb NSCs were differentiated in neurobasal medium, supplemented with B27, and treated with sonic hedgehog, fibroblast growth factor 8 and glial cell-derived neurotrophic factor from the 7th to the 21st day, followed by detection of dopaminergic neuronal markers including tyrosine hydroxylase and aromatic l-amino acid decarboxylase. The cells were expanded, established in continuous cell lines and differentiated into the two classical neuronal phenotypes. The percentage of co-positive cells (microtubule-associated protein 2 and tyrosine hydroxylase; aromatic l-amino acid decarboxylase and tyrosine hydroxylase) in the treated cells was significantly higher than in the untreated cells. These results illustrate the existence of multipotent NSCs in the adult human olfactory bulb that are capable of differentiating toward putative dopaminergic neurons in the presence of trophic factors. Taken together, our data encourage further investigations of the possible use of olfactory bulb NSCs as a promising cell-based therapeutic strategy for Parkinson's disease.

Comparative Study of Apo-Cetirizine Single Therapy and Intermittent Sequential Therapy with Cetirizine, Loratadine and Chlorpheniramine in Allergic Rhinitis.

There are limited numbers of articles, studying combined use of antihistamines. In this study, we compare single therapy of Apo-Cetirizine with a new regimen of intermittent sequential therapy with cetirizine, loratadine and chlorpheniramine in treatment of seasonal allergic rhinitis. This randomized clinical trial was performed between April and September at the peak prevalence of seasonal allergic rhinitis. Fifty-four eligible patients diagnosed clinically to have seasonal allergic rhinitis were randomized in two groups: 24 cases in single therapy arm, received Apo-Cetirizine 10 mg tablet daily and in other arm, 30 patients received sequential regimen of cetirizine 10 mg tablet, loratadine 10 mg tablet and chlorpheniramine 4 mg tablet, one tablet each day. Major Symptom Complex Score (MSCS) and Total Symptom Complex Score (TSCS) of patients were recorded before treatment and after 30 days of treatment in two groups. The average post-treatment MSCS and TSCS in combination therapy group showed better improvement than single therapy group but difference was not statistically significant (p value = 0.053 and p value = 0.104 respectively). Combination therapy regimen was better in improvement of nasal congestion (p value = 0.006). There were no significant difference between two groups in efficacy, side effects and patient's satisfaction. Combination therapy would be effective on a wide spectrum of symptoms with lower price and theoretically offers lower chance of tolerance and re-appearance of complaints.

Incidence Trends and Geographical Distribution of Nasopharyngeal Carcinoma in Iran.

BACKGROUND: Nasopharyngeal carcinoma (NPC) has known as a highly distinct kind of head and neck cancer. This distinction has been due to its clinical presentation, epidemiology, outcome, and treatment. There have not been any reports of epidemiological analysis of NPC in Iran. This study has evaluated the incidence rates and trends of nasopharyngeal carcinoma in the Iranian population during 2004 to 2009. METHODS: The data have collected from the Iranian national cancer data system registry. All the cases of nasopharyngeal carcinoma (with the topography code 11 and histology of carcinoma) have retrieved and analyzed from an overall cancer database during a 6-year period. The data have analyzed by using the SPSS, version 16. RESULTS: To determine the current incidence of NPC in Iran, we have examined the NPC cases from 2004 to 2009. A total of 1431 cases (981 male and 450 female NPC patients) have analyzed epidemiologically in this study. The mean age of the patients was 47.1 years. The incidence was 0.33 per 100000 persons. The overall incidence rate have increased annually (p<0.05). The incidence of NPC gradually increased with age. Prefectures that bordering the Caspian Sea have proved to have a higher incidence than the other studied areas. CONCLUSION: Our study has indicated an increasing trend in the incidence of nasopharyngeal carcinoma. Therefore; attempts should be precipitated for prevention.