Many difficulties might be encountered during conventional stapes surgery. However, the good exposure provided by the endoscope can facilitate this procedure. The present study addresses the effectiveness of endoscopic stapes surgery with regard to the operation time and patients' convenience and satisfaction. 19 patients underwent endoscopic stapes surgery without packing. 15 patients who experienced the microscopic stapes surgery served as the comparison group. Audiometric results and the patients' satisfaction as measured by visual analog scale in both group were compared. Audiometric results were similar in both groups. Nevertheless, the endoscopic method was accompanied by shorter operation time and more comfort for the patients. Totally endoscopic stapes surgery can be done in much shorter time without major difficulties and without need to pack ear canal after surgery. Far less dissection and incision as well as patients' more satisfaction make this technique as a good alternative to the microscopic approach to stapes surgery.

Background While the number of cosmetic surgeries performed per year continues to increase, many candidates have skin problems. Thick-skinned rhinoplasty patients are a real challenge for surgeons. Fear of performing surgery in patients with history of isotretinoin use is another concern. Objectives The present research was an attempt to study the effects of perioperative isotretinoin on rhinoplasty patient outcomes. Methods This research was conducted on 303 rhinoplasty patients in the control and experimental groups from 2012 to 2015. The experimental group patients were requested to consume isotretinoin from two weeks before surgery to two months following the surgery. A comparison was made between the two groups one, three, six, and 12 months after the surgery. Results Statistical tests indicated that satisfaction of patients of the experimental group in the first and third months following the surgery was significantly higher than the control group (p<0.01). Examination of the nose suggests a lack of evidence of soft tissue repair disturbance and cartilaginous deformities. Nine patients from the experimental group needed revision surgery during the study period and the reason for none of the revision surgeries was logically related to intake of isotretinoin. Conclusions Results of this research suggest that isotretinoin cause no evident disturbance to the recovery of rhinoplastic incisions and internal nose structures. Moreover, none of the members of the experimental group showed hypertrophic tissues and cartilaginous deformities, and the repair was satisfactory similar to the control group. However, patients receiving isotretinoin were more satisfied with their operation outcomes with less skin problems.

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

BackgroundAcute ankle injuries are one of the most common reasons for presenting to emergency departments, but only a small percentage of patients – approximately 15% – have clinically significant fractures. However, these patients are almost always referred for radiography. The Ottawa Ankle Rules (OARs) have been designed to reduce the number of unnecessary radiographs ordered for these patients. The objective of this study was to validate the OARs in the Iranian population.MethodsThis prospective survey was done among 200 patients with acute ankle injury from January 2004 to April 2004 in the Akhtar Orthopedics Hospital Emergency Department. Main outcome measures of this survey were: sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios (positive and negative) of the OARs.ResultsSensitivity of the OARs for detecting 37 ankle fractures (23 in the malleolar zone and 14 in the midfoot zone) was 100% for each of the two zones, and 100% for both zones. Specificity of the OARs for detecting fractures was 40.50% for both zones, 40.50% for the malleolar zone, and 56.00% for the midfoot zone. Implementation of the OARs had the potential for reducing radiographs by 33%.ConclusionOARs are very accurate and highly sensitive tools for detecting ankle fractures. Implementation of these rules would lead to significant reduction in the number of radiographs, costs, radiation exposure and waiting times in emergency departments.

No abstract

Introduction: Using image-guided intra-operative navigation systems in surgeries like functional endoscopic sinus surgery (FESS) has become widely accepted as an effective tool for improvement of surgical outcomes and reduction of complication. Cone-beam CT (CBCT) is a variant of computed tomography imaging that has developed as a cross-sectional and potentially low-dose technique to visualize bony structures in the head and neck. In current study, it was tried to evaluate surgeons’ satisfaction with CBCT intra-operative navigation imaging as well as image quality prior to FESS and post-operative complications. Methods: In this prospective study, the included patients who were candidates for FESS underwent CBCT from January to June 2019. The data regarding demographic information, CBCT findings and diagnosis were extracted. The surgeons’ satisfaction with intra-operative navigation imaging and image quality was quantified using Visual Analogue Scale (VAS) (ranging 0 – 10). Furthermore, patients were contacted 3 months later to ask for their satisfaction with the operation using VAS and post-operative complications evaluated. Results: Totally, 39 patients were included. The mean age was 40.74±5.75 and 20 patients (51.28 percent) were male. Two surgeons performed this operation separately; one of the surgeons performed 20 (51.28 percent) FESS and the other performed 19 (48.71 percent). The mean satisfaction of the surgeons of CBCT guided FFESS was 8.69±0.92. After the 3-month  follow up, patients’ satisfaction score was 8.21±1.89. No postoperative complications were reported. Conclusion: Based on the surgeons’ point of view, CBCT was shown to be reliable for image-guided FFESS. Furthermore, the outcome and complications of performed surgeries were similar to those performed with computed tomography intra-operative navigation imaging.

Bilateral endoscopic transcanal cartilage tympanoplasty can be considered as a safe minimally invasive procedure that can be performed in a same-day surgery. It reduces the costs and operation time and is practical with a low rate of postoperative complications.

Background: Chronic rhinosinusitis (CRS) is a common chronic inflammatory disease. Endoscopic sinus surgery is recommended as a standard method when medical treatment fails. The effectiveness of various complementary surgical methods such as endoscopic partial middle-turbinectomy is controversial in the improvement of CRS symptoms in these patients. This study aimed to investigate the effect of endoscopic partial middle-turbinectomy on the quality of life (QOL) of patients with chronic rhinosinusitis and nasal polyps (CRSwNP) in Iran.Method: Ninety patients with CRSwNP of grades 3 and 4 were randomly assigned to either an intervention (45 patients) or control group (45 patients). In the control group, endoscopic sinus surgery without middle turbinectomy was performed and in the intervention group, endoscopic partial middle-turbinectomy was performed in addition to endoscopic sinus surgery. To evaluate the outcomes, the SNOT-22 QOL questionnaire was used, and the results were analyzed using SPSS version 24.Results: Most of the patients were male and had a mean age of 39 years. The mean SNOT-22 QOL questionnaire scores were 49.13±16.72 and 52.51±16.95 before surgery in the control and intervention groups respectively, which did not show any significant difference. In contrast, after endoscopic surgery these scores changed to 28.46±12.38 and 11.13±5.55 in the control and intervention groups, respectively< and there was a significant difference between both groups. Although there was a significant improvement in both groups, the patients in the intervention group experienced more improvement than the control group (41.4 (±16.46) vs 30.7 (±18.27), respectively Conclusion: According to this study, it appears that the use of endoscopic partial middle-turbinectomy in addition to endoscopic sinus surgery improves CRS symptoms and the QOL of patients compared with endoscopic sinus surgery alone.