Saleh Mohebbi | Tehran university of medical science (original) (raw)

Papers by Saleh Mohebbi

Anesthesiology and pain medicine, Jun 1, 2024

Journal of medical case reports, Feb 5, 2024

‌Background: Chronic Rhinosinusitis (CRS) is a paranasal sinus inflammatory disease and is divide... more ‌Background: Chronic Rhinosinusitis (CRS) is a paranasal sinus inflammatory disease and is divided into two subgroups defined as CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). CRSwNP displays a T helper (Th)2 biased phenotype, and based on sensitivity or tolerance to aspirin or non-steroidal anti-inflammatory drugs (NSAID), are further subdivided into Aspirin-exacerbated respiratory disease (AERD) and non-AERD groups. Considering the challenge of diagnosis and treatment in patients with CRSwNP, particularly the AERD subtype, and the significance of endotyping in these patients, we examined the immune profile and endotyping based on gene expression analysis in AERD and non-AERD groups of patients with CRSwNP. Material and Method: In this study, 21 patients were enrolled and were categorized into AERD (N=10) and non-AERD (N=11) groups based on their sensitivity to aspirin. After the special washing period, nasal polyps were biopsied in both groups, and the infil...

PubMed, Mar 1, 2023

Introduction: Recent advances have led to the development of sialendoscopy, an accurate, minimall... more Introduction: Recent advances have led to the development of sialendoscopy, an accurate, minimally invasive procedure with high diagnostic and therapeutic capabilities in treating sialolithiasis. This study aimed to evaluate the results and complications of sialendoscopy in patients suffering from sialoadenitis. Materials and methods: This study was a prospective interventional case series study on patients with sialoadenitis due to sludge or stone formation preoperatively confirmed by sonography or computed tomography (CT) scanning. Diagnostic sialendoscopy was performed, and the presence of stenosis, sludge, or stones inside the gland or duct was examined, and surgery was done. During follow-up time (18.8 ± 7.4 months), recurrence of symptoms, the need for reoperation, and postoperative complications were also assessed. Results: The sialendoscopy was performed in 51 patients, including 55 glands. Forty-five Patients (88.2%) reported pain relief, and 46 patients (90.2%) reported that the treatment using sialendoscopy was better than conservative methods. The duct restenosis also occurred in one patient requiring open surgery. In assessing the main factors predicting the need for reoperation, the site of involvement (parotid versus submandibular glands) and the size of the stone were identified as the main determinants. The best cut-off value for stone size in predicting reoperation requirement was 7.0mm, with a sensitivity of 100% and a specificity of 85.7%. Conclusion: Intraoperative sialendoscopy is a successful diagnostic and therapeutic tool with minimal postoperative complications in salivary gland duct involvement patients.

Introduction Otolaryngologists have a major role in the evaluation and management of anterior sku... more Introduction Otolaryngologists have a major role in the evaluation and management of anterior skull base defects that result in cerebrospinal fluid (CSF) leaks and meningoencephaloceles. Improved instrumentation for sinus surgery led to use of the endoscope for repair of CSF leaks by Wigand in 1981. Over the past 20 years, the minimally invasive endoscopic approach has gained widespread acceptance. As diagnostic aspects and surgical techniques have evolved, leading to higher success rates (approximately 90%) and lower morbidity than intracranial techniques for most leaks, the endoscopic approach has become the standard of care [1].

International Journal of Pediatric Otorhinolaryngology, Apr 1, 2023

PubMed, 2019

Background: Rhinosinusitis is an inflammatory disease of the nasal and paranasal sinus mucosa, an... more Background: Rhinosinusitis is an inflammatory disease of the nasal and paranasal sinus mucosa, and it becomes chronic when it lasts longer than 3 months without symptom improvement. The aim of this study was to determine the effect of PRP on improvement of endoscopic sinus surgery. Methods: This was a randomized clinical trial (RCT) designed and implemented on 21 patients with chronic rhinosinusitis in Rasool Akram hospital in Tehran during 2016-2017. In this study, one side of the nose was randomly selected as the control and the other side as the case, and at the end of the surgery, PRP was sprayed onto the surface where the polyp was removed in the side that was intended as the case. The nasal endoscopy findings were graded according to Meltzer's criteria before and after surgery and CT findings were classified according to the Lund-Mackay scoring system. Then, all patients were followed for 6 months. The SNOT-22 questionnaire, charts of Meltzer's criteria, and Lund-Mackay were used for data collection. Kolmogorov-Smirnov test, Wilcoxon Signed Rank test, and Mann-Whitney U test were used to analyze data in SPSS-22 software. P value<0.05 was considered significant. Results: The mean and standard deviation of patients' age were 36.55 and 7.91, respectively. The median Lund-McKay Pre-op CT score before treatment was 10 (9.5-11), and no significant difference was found between the 2 sides of the nose (left and right). The items that showed statistically significant improvement after surgery was SNOT-22 (p<0.05). The mean of Meltzer scores in each side of the nose was significantly different before and after intervention (p<0.05). However, the mean of Meltzer scores in the 2 sides of the nose was not significantly different before and after intervention. Conclusion: The treatment by PRP may be effective in reducing symptoms of patients showing recurrence of CRS symptoms following endoscopic sinus surgery subjectively but not objectively.

Bulletin of emergency and trauma, Nov 5, 2019

Nasopharyngeal masses in young males, first of all presumes Juvenile Nasopharyngeal Angiofibroma ... more Nasopharyngeal masses in young males, first of all presumes Juvenile Nasopharyngeal Angiofibroma (JNA) in the mind, but other benign or malignant tumors should be considered for successful and adequate management of patients and also for minimizing morbidity from unnecessary interventions. We herein present a patient with nasopharyngeal carcinoma (NPC) mimicking JNA. The patient was presumed as JNA and underwent excessive surgical intervention and the final histopathology report was NPC. The aim of our case report is to highlight the importance of complete clinical examination and preoperative imaging in differentiating and ideal management of nasopharyngeal masses.

Immunopathologia Persa, Feb 15, 2020

Mucormycosis, an uncommon and rapidly progressive fungal infection, is mainly seen in immunocompr... more Mucormycosis, an uncommon and rapidly progressive fungal infection, is mainly seen in immunocompromised patients. However, immunocompetent individuals can also be infected. Here, we present a rapidly progressive orbito-cerebral mucormycosis in an immunocompetent patient, who had a history of entry of an insect into his eye. We report an immunocompetent patient, who had a history of entry of an insect into his eye, presented with left eye panophthalmitis, cellulitis and loss of vision. He underwent orbital exenteration. Then, mucormycosis was diagnosed and amphotericin B was initiated. Left cavernous sinus and internal carotid artery involvement were found in brain magnetic resonance imaging (MRI) and cerebrovascular accident (CVA) was diagnosed. Surgical debridement of necrotic tissue was performed, and postoperatively, our patient died following CVA. Mucormycosis, as a fatal fungal infection, requires early diagnosis, appropriate early surgical and rapid antifungal management so that successful outcome can be achieved.

Journal of neurological surgery, Feb 18, 2015

ABSTRACT Introduction: Internal auditory canal (IAC) tumors are one of the most common lesions in... more ABSTRACT Introduction: Internal auditory canal (IAC) tumors are one of the most common lesions in the skull base area. Image guided surgery significantly improved the safety and accuracy of surgery and decreased the complications. Available image guided systems do not provide submillimeteric accuracy in standard setting, as required for skull base surgery. Optical coherence tomography (OCT) is a high resolution imaging system. It captures micrometer resolution, three-dimensional images. OCT is an interferometric technique, typically employing near-infrared light. The use of relatively long wavelength light allows it to penetrate into the scattering medium. It can reject the background signal and so build up clear 3D images. We intend to use the OCT as a more accurate, real-time guiding system for different IAC approaches. Material and Methods: At first, a novel and specific combined OCT and drill holder were designed. Accurate angel between OCT view and drill tip was a critical point. Then, the standard IAC approaches (translabyrinthine [TL], retrosigmoid [RS], and middle cranial fossa [MCF]) were done on the different human cadavers. Guiding by OCT image, the important structures were navigated. At the end of the procedure, the entire of IAC was exposed safely and vital structure saved. Result: OCT images provide a very high accurate image of subsurface area. Image resolution was 10µm. The acceptable image depth was 300 to 500 µm that is enough for blue lining the semicircular canals or exposing the cochlea, vestibule, and IAC contents. Handling device was very helpful to fix the OCT view on surgical site and provide continuous image. Conclusion: OCT can use as a real-time navigation system to find the important landmark during difficult surgeries. More accurate and fine surgery is possible using this system.

International Journal of Pediatric Otorhinolaryngology, May 1, 2018

European Archives of Oto-rhino-laryngology, Feb 25, 2017

Background and Objectives：The goal of this study was to examine insertion depth, intracochlear po... more Background and Objectives：The goal of this study was to examine insertion depth, intracochlear position and insertion trauma with the stimulation electrode of the Nurobiosys cochlear implant. Subjects and Method：Four electrodes were implanted in fresh temporal bones of the human cadavers using realistic surgical procedures. Plain film X-ray images were taken from the electrode inserted in the specimens to estimate the insertion depth. After the electrode implantation, all human temporal bones were trimmed to extract the cochleae. The extracted cochleae from the temporal bone were immersed in acrylic resin to fix the position of electrode placed in the scala tympani. The resin treated cochleae were cut in radial section and polished. All crosssections were imaged with a microscope to assess the trauma by the electrode implantation. Results：The mean insertion depth was about 300°with the cochlea angle. The insertion trauma was observed in one section of a temporal bone. The mean distance from electrode to modiolus was about 0.75 millimeter. Conclusion：The incidence, severity of trauma and insertion depth of the studied electrode showed similar results with that of other straight type electrode in literature. (Korean J Otorhinolaryngol

International Journal of Pediatric Otorhinolaryngology, May 1, 2020

This series plays a role as a clinical reference in the rapidly evolving subspecialty of modern o... more This series plays a role as a clinical reference in the rapidly evolving subspecialty of modern otology and neurotology. Written by prominent academic authorities, this series integrates contents from all fi elds of medicine and covers every aspect of the fi eld, including surgical issues in pediatric audiology, neurotology and neurology, genetic testing, oncological study in auditory and vestibular organs, geriatric audiology and neurotology, and new clinical application of bone conduction hearing etc. Historical developments and unsolved problems of each fi eld will also be described in detail to help readers' understanding.The editors and contributors hope that this book series will contribute to medical residents and experts of otolaryngology and related clinical medicines in the evaluation of patients with otological and neurotological disorders.

Research Square (Research Square), Jul 6, 2022

Adenoid cystic carcinoma (ACC) is a slow-growing malignancy that most often occurs in the salivar... more Adenoid cystic carcinoma (ACC) is a slow-growing malignancy that most often occurs in the salivary glands. Although reasonable local control is usually achieved by tumor surgery and subsequent radiation therapy, recurrence at the same or distant site is the cause of treatment failure. Currently, no FDAapproved therapeutic target or diagnostic biomarker has been identi ed for this cancer. To nd the therapeutic and diagnostic targets for ACC, we extracted the gene expression information from two GEO datasets. Different expression genes (DEGs) between ACC and normal samples were extracted and used to explore the biochemical pathways involved in ACC and create a protein-protein interaction (PPI) network. After analyzing the PPI network, 20 hub genes were introduced that have potential as diagnostic and therapeutic target. Among them, PLCG1 and EZH2 were introduced as new biomarkers in ACC that might have a high value in the diagnosis and treatment of ACC. Furthermore, by studying the roles of the hub genes in the enriched biochemical pathways, we found that most likely, IGF-1R/IR and PPARG pathways play a critical role in tumorigenesis and drug resistance in the ACC and have a high potential for selection as a therapeutic target in future studies.

... Clinic for their assistance in this study We also wish to acknowledge the contribution ol the... more ... Clinic for their assistance in this study We also wish to acknowledge the contribution ol the following individuals for finalization of this manuscript: Faramarz Safari Sabet as ... A: Cobiation assisted tonsillectomy Egypt J. Qtoiolaryngo/ June 2002 19(2) 193-95 6 Arya A, Donne AJ. ...

Otology & Neurotology

Objective This multicenter study aimed to evaluate the auditory and speech outcomes of cochlear i... more Objective This multicenter study aimed to evaluate the auditory and speech outcomes of cochlear implantation (CI) in deaf-blind patients compared with deaf-only patients. Study Design Retrospective cohort study. Setting Multiple cochlear implant centers. Patients The current study was conducted on 17 prelingual deaf-blind children and 12 postlingual deaf-blind adults who underwent CI surgery. As a control group, 17 prelingual deaf children and 12 postlingual deaf adults were selected. Intervention Cochlear implantation. Main Outcome Measure(s) Auditory and linguistic performances in children were assessed using the categories of auditory performance (CAP) and Speech Intelligibility Rating (SIR) scales, respectively. The word recognition score (WRS) was also used to measure speech perception ability in adults. The mean CAP, SIR, and WRS cores were compared between the deaf-only and deaf-blind groups before CI surgery and at “12 months” and “24 months” after device activation. Cohen&#...

Imaging

Background and aimDespite improvements in the imaging modalities, the optimal protocol for extrac... more Background and aimDespite improvements in the imaging modalities, the optimal protocol for extracranial facial nerve imaging using 1.5 T MRI is still debatable. Pre-operative mapping of the facial nerve could provide valuable information for surgeons. The current study aimed to evaluate and choose proper 1.5 T MRI protocols for the extracranial segment of facial nerve pre-op imaging.Patients and methodsExtracranial facial nerves on the tumoral and normal side of 19 patients (38 nerves) were imaged by 1.5 T MRI, using five sequences including T1-weighted, T2-weighted, T1-weighted-fat-saturated with contrast, Three-dimensional (3D) T1-weighted and 3D T2-weighted. The visibility of each of the three segments of the extracranial facial nerve (the main trunk, cervicofacial and temporofacial divisions and terminal branches) in each sequence was assessed.ResultsOn the normal side, segments 1 and 2 of the nerve were identifiable in all patients and segment 3 was identifiable in 89.5% of pat...

The Journal of Laryngology & Otology

Bulletin of Emergency and Trauma, Nov 5, 2019