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1.  The Diagnostic Value of B-Mode Sonography in Differentiation of Malignant and Benign Tumors of the Parotid Gland 
Different imaging modalities are used to evaluate salivary gland diseases, including tumors. Ultrasonography (US) is the preferred method on account of its ease of use, affordability, safety profile, and good tolerance among patients. The aim of this study was to evaluate the role of US in differentiating malignant from benign parotid tumors, in the context of previous controversy in the literature on this subject.
Materials and Methods:
A cross-sectional study was performed in patients who presented to Qaem Medical Center with parotid masses and who were candidates for parotidectomy between June 2013 and January 2015. Patients were initially referred for a diagnostic US of the parotid. US examinations were performed and sonographic features were reported. The tumors were then classified as benign or malignanton the basis of literature descriptions of the US features of parotid tumors, and were next diagnosed pathologically. The sensitivity, specificity, positive predictive value, and negative predictive value of US for the purpose of differentiating malignant from benign tumors were then calculated.
Twenty-eight patients (aged 18–92 years) underwent US of parotid masses. Twenty-three tumors were diagnosed as benign and five were diagnosed as malignant. The final histopathologic examination showed 21 benign and seven malignant tumors. The sensitivity, specificity, positive predictive value, and negative predictive value of US for differentiating malignant from benign tumors were calculated as 57%, 95%, 80%, and 87%, respectively.
US has a high specificity in differentiating between malignant and benign tumors. However, fine needle aspiration or core needle biopsy is advocated for an exact diagnosis.
PMCID: PMC5045700  PMID: 27738606
Benign tumor; Malignant tumor; Parotid; Ultrasonography
2.  Distance between Anterior Commissure and the First Tracheal Ring: An Important New Clinical Laryngotracheal Measurement  
The distance between the anterior commissure of the larynx and the first tracheal ring (AC.T. distance) is of great importance in laryngotracheal surgeries. The amount of narrowing of the subglottic airway is used as a quantitative mean to determine whether the lesion is subglottic or has extended to the trachea and therefore helps in the prediction of the final prognosis.
Materials and Methods:
In this study, the larynx was exposed by direct laryngoscopy under general anesthesia. The case was considered to be difficult because the exposure did not optimally reveal the anterior commissure, therefore a cricoid tape or anterior commissure laryngoscope was used. A zero degree Hopkins lens was used to view the anterior commissure and the first tracheal ring. Special markers were used to mark the two points with the distance between those being considered as the AC.T. distance. The relationship between AC.T. distance and the patient's age, sex, BMI, and laryngeal exposure condition during laryngoscopy was also studied.
Eighty-two patients participated in this study. The mean AC.T. distance was measured and was found to be 32.67±3.34 mm in males and 29.80± 3.00 mm in females. This difference was statistically significant between the two groups (P<0.05). There was no statistically significant relationship between BMI, age, laryngeal exposure condition, and the AC.T. distance.
The AC.T. distance was measured to be around 3 cm; with males measuring greater than females. However, future studies may lead to a more accurate practical scale for laryngotracheal surgeries due to possible technical or human errors, in addition to racial differences.
PMCID: PMC4461842  PMID: 26082900
Airway stenosis; Anterior commissure; BMI; Subglottic; Trachea; Vocal cord
3.  HIV: An Epidemiologic study on Head and Neck Involvement in 50 Patients 
Acquired immunodeficiency syndrome (AIDS) is a worldwide infection. Because of the vast array of manifestations of AIDS and its many atypical presentations, it is becoming increasingly challenging for clinicians to accurately diagnose new lesions.
Materials and Methods:
In a descriptive cross-sectional study conducted from 2007 to 2010, 50 patients with a proven human immunodeficiency virus (HIV) infection were evaluated. Based on the findings of a physical examination and paraclinic tests, HIV signs and symptoms were recorded.
The mean (range) age of the patients was 35.45 ±5.24 (5–55) years. Forty-two (84%) cases were male and eight were female. The mean duration of carrying the virus was 4.51 ±1.03 years. Oral manifestations were the most common (94%), followed by rhinologic (88%), otologic (66%), and finally neck (44%) manifestations.
Head and neck presentations are very common in HIV patients; therefore otolaryngologists, as the first physicians who may encounter such patients, should be aware of this condition.
PMCID: PMC3989874  PMID: 24744998
AIDS; HIV; Head; Neck; Otologic; Oral; Rhinologic
4.  Periorbital Ecchymosis and Subconjunctival Hemorrhage following Ear Surgery 
ISRN Otolaryngology  2013;2013:791068.
Objective. To evaluate the occurrence of two periorbital complications of surgery for Chronic Suppurative Otitis Media (CSOM) and discuss the potential pathophysiologic mechanisms. Materials and Methods. This is a retrospective review of the CSOM surgeries performed between Oct, 2005, and Jan, 2011, in our hospital. The early postoperative conditions of the patients were scrutinized to identify periorbital ecchymosis and subconjunctival hemorrhage. Results. Eight cases out of 756 patients were noted to have periorbital ecchymosis, and two of the patients also had simultaneous subconjunctival hemorrhage. All cases in which the complications occurred had undergone tympanoplasty, and in three patients mastoidectomy had also been performed. The age of the affected patients ranged from 24 to 70 years old. In all of them the condition ensued the day after the surgery and became better within 5 to 10 days. Complete recovery took approximately 1 month. Conclusion. Periorbital ecchymosis and subconjunctival hemorrhage are rare but safe complications of ear surgeries. The conditions are self-limiting and no management is necessary.
PMCID: PMC3806237  PMID: 24198972

Results 1-4 (4)