"Mucosal pocket" myringoplasty: a modification of underlay technique for anterior or subtotal perforations.

PURPOSE: Chronic otitis media surgery is the most common procedure in otology in developing countries. Subtotal and total tympanic membrane (TM) perforation with inadequate anterior remnant is associated with higher rate of graft failure. It was the goal of this study to test the anatomical and functional outcomes of a modified underlay myringoplasty technique. MATERIALS AND METHODS: In a prospective clinical study, 45 patients with subtotal or total TM perforation and inadequate anterior remnant underwent tympanoplasty (+/-mastoidectomy). The anterior tip of the temporalis fascia was secured in a mucosal pocket on the lateral wall of eustachian tube orifice. Data on graft take rate, preoperative and postoperative hearing status, and intraoperative findings were analyzed. RESULTS: We achieved the graft success rate of 91.1%, without lateralization, blunting, atelectasia, or epithelial pearls. Approximately 24% patients had air-bone gap within 25 dB before intervention, which increased to 71% postoperatively (P < .001). CONCLUSION: We believe that this technique could be a convenient and suitable method for cases with subtotal or total TM perforation and inadequate anterior remnant.

Intraoperative findings in revision chronic otitis media surgery.

In this study, we reviewed the surgical findings in a series of revision tympanomastoidectomy to determine the most common causes of failure in chronic otitis media surgery. The intraoperative findings at revision mastoidectomy with tympanoplasty of 116 patients were analyzed. The most common sites of pathologic tissue at revision surgery (with cholesteatoma and/ or granulation tissue) were unexenterated cells of the sinodural angle. The most common mechanical cause of retention of debris in canal wall down procedures was facial ridge.

Application and usage of tactile aid in Iran.

BACKGROUND: Most deaf and severe to profound sensorineural hearing loss patients are incapable to communicate well because of a lack of receiving sound signals. Cochlear implant is one of the effective measures, which has been of great help to the deaf. Up to now, more than 1000 cochlear implants have been accomplished successfully in Iran. Since cochlear implantation is faced with numerous problems and difficulties, we should establish other methods for sound communication. Tactile aids can be a very effective help regarding this issue. METHODS: We designed and accomplished a study on the use of tactile aid, along with rehabilitation and training of these patients in our department. We designed four educational stages to check the improvement of subjects who used one-, two-, and seven-channel tactile aids. RESULTS: Hundred percent of the cases passed the first stage (detection) successfully. In the second stage (beginning pattern perception) all the cases with two and seven channel tactile aids were able to distinguish all kinds of sounds. They could differentiate between speech and non-speech sounds. In the third stage (recognition of speech), all the cases were able to recognize environmental and "sound maker" sounds, but only 43% of the individuals were able to recognize speech sounds and repeat correctly with two-channel tactile aids. In the fourth stage (comprehension of words), identification and repetition of the words were only possible with seven-channel tactile aids. CONCLUSION: The results of our study show that tactile aids are well accepted by the patients with severe to profound sensorineural hearing loss who do not benefit from usual hearing aids.

Numerical analysis of micro- and nano-particle deposition in a realistic human upper airway.

A computational model was developed for studying the flow field and particle deposition in a human upper airway system, including: nasal cavity, nasopharynx, oropharynx, larynx and trachea. A series of coronal CT scan images of a 24 year old woman was used to construct the 3D model. The Lagrangian and Eulerian approaches were used, respectively, to find the trajectories of micro-particles and concentration of nano-particles. The total and regional deposition fractions of micro/nanoparticles were evaluated and the major hot spots for the deposition of inhaled particles were found.

Frequency of sensory neural hearing loss in major Beta-thalassemias in southern iran.

OBJECTIVE: The thalassemias are among the most common genetic disorders worldwide, occurring more frequently in the Mediterranean region. The aim of this study was to determined frequency of sensory-neural hearing loss in major ß- thalassemias transfusion dependent patients in south of Iran. METHODS: A cross sectional study on 308 cases of major beta-thalassemia patients referring to Thalassemia Center of Shiraz University of Medical Sciences between 2006-2007 years. The diagnosis of ß- thalassemia major was based on clinical history, complete blood count and hemoglobine electrophoresis. Clinical data such as serum ferritin level, deferoxamine (DFO) dose, mean daily doses of DFO (mg/kg) and audiometric variables was recorded. FINDINGS: Out of 308 cases, 283 (96.5%) had normal hearing and 10 (3.5%) sensorineural hearing loss. There was no statically significant difference between two groups regarding mean age, weight, age at the first blood transfusion, age at the first DFO infusion. CONCLUSION: We found the lowest incidence of sensorineural hearing loss in a large population of patients suffered from major thalassemia who received DFO. We show that DFO is not ototoxic at a low dose. When considering all related literature, as a whole there has been much critical misrepresentation about DFO ototoxicity.

IgM, IgG Serum Levels and Lymphocytes Count before and after Adenotonsillectomy.

BACKGROUND: Tonsils and adenoids are involved in both local immunity and immune surveillance for the development of immune defence mechanisms. A number of investigators have found decreased immunoglobulin levels after adenotonsillectomy while others have failed to find significant changes. The effects of adenotonsillectomy on the cellular immunity of children have not been investigated extensively. OBJECTIVE: To observe the change in humeral and cellular immune systems before and after operation in patients undergoing adenotonsillectomy. METHODS: The study comprised 102 patients; all of the patients underwent adenotonsillectomy. The levels of IgG, IgA, and IgM were measured for humoral immunity and the percent of CD7 and CD19 positive cells were determined in blood samples taken from these patients 24 hours before operation and also 2 and 8 weeks after the operation. The results were subjected to statistical analysis. RESULTS: The present study shows that the serum level of IgA would raise few weeks after the operation. Changes in the IgM and IgG level were not statistically significant postoperatively. In addition, no significant change was detected in B lymphocyte count before and after adenotonsillectomy.In our study, there was a slight decrease in the T lymphocyte count in the early stage of post operation, which returned to normal preoperative value after 8 weeks. CONCLUSION: Several immune system parameters maintain its normal status several weeks after adenotonsillectomy.