Hassan Ghasemi; Sajedeh Asghari Asl; Mohammad Ebrahim Yarmohammadi; Farhd Jafari; Pupak Izadi
Abstract
Background and Objectives: External dacryocystorhinostomy (DCR) is the method of choice to treat nasolacrimal duct (NLD) obstruction and the other approaches are compared with it, with a failure rate of 4% to 13%. The current study aimed to assess the causes of failure in external DCR by postoperative ...
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Background and Objectives: External dacryocystorhinostomy (DCR) is the method of choice to treat nasolacrimal duct (NLD) obstruction and the other approaches are compared with it, with a failure rate of 4% to 13%. The current study aimed to assess the causes of failure in external DCR by postoperative endoscopic and pathological evaluation. Methods: The current retrospective cross sectional study followed-up113 patients with external DCR and silicone intubation for three months. Silicone tubes were removed after the third months. Failure was confirmed based on the clinical findings and irrigation test. Paranasal sinus computed tomography (CT) scanning, and endoscopic and pathological evaluations were performed in the failed cases. Results: Totally, 113 patients underwent external DCR. The patients included 71 females and 42 males. The mean age of the patients was 55.91 years; ranged from 18 to 86. Epiphora was the most common complaint before surgery (90.3%). Clinically, epiphora continued in 17 cases (15%), of which 94.11% had at least one sinus CT abnormality and 82.35% had at least one endoscopic abnormality. The most common endoscopic findings were deviated septum (70.6%), scar tissue (52.94%), concha bullosa (46.9%), septal adhesion (47.05%), enlarged middle turbinate (41.2%), and sump syndrome (11.7%). The failure was significantly associated with the chronicity of the initial symptoms (P-value=0.00). Pathologically, there were significant relationship amongst the failure rate, scar formation, and allergic rhinitis (P-values =0.00 and <0.05, respectively). Conclusion: Preoperative endonasal evaluation and consultation with an otolaryngologist can improve surgical outcomes and help to have a better conscious to intranasal abnormalities before external DCR surgery.
Hassan Ghasemi; Mohammad Ebrahim Yarmohammadi; Farhad Jafari; Pupak Izadi; Mahdi Faryadras
Volume 5, Issue 4 , September 2010, , Pages 178-183
Abstract
Background and Objectives: Primary acquired nasolacrimal duct obstruction (PANDO) is a common ocular problem. Clinical presentation can range from simple tearing to a life-threatening condition. The exact pathophysiology of obstruction is not completely understood. In this study, therelationship between ...
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Background and Objectives: Primary acquired nasolacrimal duct obstruction (PANDO) is a common ocular problem. Clinical presentation can range from simple tearing to a life-threatening condition. The exact pathophysiology of obstruction is not completely understood. In this study, therelationship between PANDO and nasal mucosal goblet cells was investigated.
Materials & Methods: In this case-control study, 15 subsequent patients with PANDO were enrolled. Patients were operated with endoscopic dacryocyctorhinostomy. A small piece of nasal mucosal biopsy sample was obtained from inferior turbinate. The samples were prepared and stained for mucin. Goblet cells were counted in the specimens. The results were compared with the nasal mucosa of 15 normal persons who were underwent rhinoplasty surgery as control group. Data were analyzed by SPSS version 16 software and were assessed using t-test, analysis of variance, and Pearson correlation test.
Results:In patients group, 13 cases (86.7%) were female and 2 cases (13.3%) were male. The mean age was 42.4±14.3 years (range, 23-68 years). In control group, 9 persons (60%) were female and 6 persons (40%) were male. The mean age was 35.5±12.1 (range, 19-58 years) (P>0.05). All patients had epiphora, and 66.7% of patients had purulent discharge. Duration of symptoms ranged from 1 year to 12 years. The number of goblet cells of the nasal mucosa in patient group was significantly higher than the control group (P<0.001). Inflammation was not related to goblet cell numbers
Conclusion: According to findings of this study, goblet cells have important role in inflammatory process and perhaps obstruction in nasolacrimal duct.
Mohammad Ibrahim Yarmohammadi; Horieh Saderi; Pupak Ezadi; Siamak Afshin Majad; Maryam Hashemi
Volume 5, Issue 2 , March 2010, , Pages 72-76
Abstract
Background and Objectives: Nasal polyposis is a diseases resulting from complex pathogenetic mechanisms. Some studies showed that TGFβ1 had significant role in this pathogenesis. In this study, we investigated the roe of cytokines and mediators in polyp development. Material and Methods: ...
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Background and Objectives: Nasal polyposis is a diseases resulting from complex pathogenetic mechanisms. Some studies showed that TGFβ1 had significant role in this pathogenesis. In this study, we investigated the roe of cytokines and mediators in polyp development. Material and Methods: In this case- control study, healthy nasal mucosal samples were obtained from 24 people undergoing septoplasty or rhinoplasty and polyp samples were obtained from 15 patients with nasal and paranasal sinuses polyposis undergoing endoscopic sinus surgery. TGFβ1 concentration was measured with ELISA in homogenized polyp and control samples. The difference of the mean concentrations was analyzed with Mann-Whitney test. Results: We detected TGFβ1 in 11 patients’ samples and in 22 control samples. There was not significant differentiation between the mean of TGFβ1 levels in two groups. Conclusion: Measuring level of TGFβ1 with ELISA technique in homogenized polyp and control samples have not significant differentiation.
Mohammad Ebrahim Yarmohammadi; Horieh Saderi; Tahere Shahrokhtabar
Volume 5, Issue 1 , January 2010, , Pages 14-17
Abstract
Background and Objective: Sinusitis is one of the most common hygienic problems and a large part of the budget has been allocated to its diagnosis and treatment yearly. In this study, the presence of cytomegalovirus in sinuses of patients, undergone operation for treatment, with or without sinusitis, ...
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Background and Objective: Sinusitis is one of the most common hygienic problems and a large part of the budget has been allocated to its diagnosis and treatment yearly. In this study, the presence of cytomegalovirus in sinuses of patients, undergone operation for treatment, with or without sinusitis, was studied. Materials and Methods: This study was an applied and case-control study, which had been performed on 44 HIV negative patients in ENT clinic of Shahid Mostafa Khomeini Hospital in Tehran during 4 months in 2005.Biopsy specimens were taken from left and right of uncinet process mucosa of middle meatus of 22 patients with chronic sinusitis and 22 patients without sinusitis undergo operation for nasal septal deviation. After purification of DNA, PCR test was done for replication of early gene in cytomegalovirus DNA by two kits, which was purchased from Cinnagen Co. and Gen Fanavaran Co. Results: After the electrophoresis of PCR product on agarose gel, neither of samples has shown DNA band same the positive control enclosed in kits. Therefore, all specimens were considered negative for cytomegalovirus DNA. Conclusion: Cytomegalovirus has not been detected in sinunasal mucosa of patients with chronic sinusitis and without sinusitis. Test with more specimens and other diagnostic procedure are recommended for prove of absence of cytomegalovirus in sinunasal mucosa.
Mohammad Ebrahim Yarmohammadi; Horieh Saderi; S.Hadi Saghelaini; Jamshid Narenjkar J
Volume 1, Issue 1 , January 2006, , Pages 31-34
Abstract
Objective: To investigate the presence of Helicobacter pylori in sinonasal mucosa of patients with chronic sinusitis Design: A prospective case-control study Materials and methods: Mucosal specimens were collected from the mid-third middle meatus and lateral side of mid-cornea. H. pylori has been investigated ...
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Objective: To investigate the presence of Helicobacter pylori in sinonasal mucosa of patients with chronic sinusitis Design: A prospective case-control study Materials and methods: Mucosal specimens were collected from the mid-third middle meatus and lateral side of mid-cornea. H. pylori has been investigated using PCR after DNA extraction and urease test. Results: H. pylori was not found in any of the sample taken from both groups (case and control patients). Conclusion: This is the first reported study to investigate the presence of H. pylori in sinonasal mucosa in Iran. In this study, H. pylori was not determined in these sites, although its possible presence could not be excluded. Thus, further investigation on more patients and application of sensitive diagnostic techniques are recommended.
