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Background: Nasal chondromesenchymal hamartoma (NCMH) is a rare benign tumor almost always found in children. NCMH was first described by McDermott in 1998. To the best our knowledge, about 50 NCMH cases have been reported worldwide with very few adult cases and no long-term follow-ups. Case Presentation: Here, we report a 43-year-old woman who referred to the Otolaryngology Clinic of Payambar Azam Hospital, Bandar Abbas, Iran, in 2008, with a one-year history of progressive left-sided nasal obstruction that had not relieved with topical nasal decongestants and steroid sprays. A unilateral left-sided nasal soft-tissue mass was found upon examination. Histological and immunohistochemical analyses were consistent with NCMH. Trans-nasal endoscopic excision showed good results and no sign of recurrence has been observed after 12 years of regular follow-up. Conclusion: Awareness of imaging and immunohistochemical characteristics of NCMH combined with the probability of presentation in the adult population are necessary for correct diagnosis and adequate therapy.

This multicenter study aimed to evaluate the auditory and speech outcomes of cochlear implantation (CI) in deaf-blind patients compared with deaf-only patients.Retrospective cohort study.Multiple cochlear implant centers.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.Cochlear implantation.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's d was used for effect size estimation.We found no significant differences in the mean CAP and SIR scores between the deaf-blind and deaf-only children before the CI surgery. For both groups, SIR and CAP scores improved with increasing time after the device activation. The mean CAP scores in the deaf-only children were either equivalent or slightly higher than those of the deaf-blind children at "12 months post-CI" (3.94 ± 0.74 vs 3.24 ± 1.25; mean difference score, 0.706) and "24 months post-CI" (6.01 ± 0.79 vs 5.47 ± 1.06; mean difference score, 0.529) time intervals, but these differences were not statistically significant. The SIR scores in deaf-only implanted children were, on average, 0.870 scores greater than the deaf-blind children at "12 months post-CI" (2.94 ± 0.55 vs 2.07 ± 1.4; p = 0.01, d = 0.97) and, on average, 1.067 scores greater than deaf-blind children at "24 months post-CI" (4.35 ± 0.49 vs 3.29 ± 1.20; p = 0.002; d = 1.15) time intervals. We also found an improvement in WRS scores from the "preimplantation" to the "12-month post-CI" and "24-month post-CI" time intervals in both groups. Pairwise comparisons indicated that the mean WRS in the deaf-only adults was, on average, 10.61% better than deaf-blind implanted adults at "12 months post-CI" (62.33 ± 9.09% vs 51.71 ± 10.73%, p = 0.034, d = 1.06) and, on average, 15.81% better than deaf-blind adults at "24-months post-CI" (72.67 ± 8.66% vs 56.8 ± 9.78%, p = 0.002, d = 1.61) follow-ups.Cochlear implantation is a beneficial method for the rehabilitation of deaf-blind patients. Both deaf-blind and deaf-only implanted children revealed similar auditory performances. However, speech perception ability in deaf-blind patients was slightly lower than the deaf-only patients in both children and adults.

Objectives The aim of the present study was to describe and evaluate the results of a new technique in endolymphatic sac decompression surgery. Methods Forty-three patients with intractable unilateral Meniere's disease were selected. Endolymphatic sac was identified after simple mastoidectomy, and its lateral layer was incised, using a sickle knife. Outer layer of the sac was turned around and placed under the anterior bony border. Results Mean duration of the follow-up was 24 months. Mean tinnitus handicap index, pure tone average (PTA) on thresholds at 500, 1000, 2000, and 4000 Hz, mean speech reception threshold, mean speech discrimination score, hearing stage, and mean vertigo score before and after surgery were evaluated. Conclusion The new marsupialization technique with anterior bony border is a safe and effective way to improve tinnitus, vertigo, and ear fullness among these patients. According to PTA and hearing stage, this surgery can control progressive hearing loss. Level of evidence 3.

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 FDA-approved therapeutic target or diagnostic biomarker has been identified for this cancer. To find 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.

The purpose of the study is to evaluate the efficacy of double skin paddle anterolateral thigh flap (ALT) to reconstruction of through and through oral cavity defect due to cancer surgery.A prospective review was performed of patients referred to Firoozgar and Erfan hospitals with oral cavity defects with two or more oral cavity subunits and skin simultaneously involvement and immediate reconstruction using double-skin paddle ALT flap at the same time of tumor ablation from January 2019 to November 2020.A total number of 6 patients was evaluated. The mean area of skin paddle was 110.4 cm2 and 92.8 cm2 in distal and proximal paddle respectively. Except one patient was complicated and expired in hospital admission, the remaining 5 patients got fully oral intake and completely survived flaps with primarily closed donor site. Tumor recurrence was not found in the mean follow-up time of 12 months.The double skin paddle anterolateral thigh flap serves as an efficient reconstruction technique in complex and perforating oral cavity defects with the same functional outcome and the same flap related complications as conventional ALT flap.

Introduction Pitch mismatch is one of the most important problems of users of bimodal cochlear implants, which affects their life satisfaction. Children with acquired hearing loss cannot explain their pitch mismatch problems, as they have had no auditory experience. This study tries to diagnose pitch mismatch in these children through the sound-induced flash illusion test. Materials and methods In this study, 20 children with a bimodal cochlear implant and 20 children with normal hearing, within the age range of 8 to 13 years old, were examined using the sound-induced flash illusion test. In this test, participants received one flash with one to four beep sounds, and they were asked to indicate the number of perceived flashes. Results The results revealed that in the bimodal implantation group, when the flash was provided with one beep, at certain frequencies, children expressed that they saw two flashes. However, the results were not the same in children with normal hearing. Conclusion The results indicated that at frequencies where the auditory information of the hearing aids and those of the cochlear implants overlap, pitch mismatch develops, which can significantly affect the auditory performance of bimodal users.

To evaluate the auditory performance and speech production outcome in children with auditory neuropathy spectrum disorder (ANSD). The effect of age on the outcomes of the surgery at the time of implantation was also evaluated.Cochlear implantation was performed in 136 children with bilateral severe-to- profound hearing loss due to ANSD, at four tertiary academic centers. The patients were divided into two groups based on the age at the time of implantation; Group I: Children ≤24 months, and Group II: subjects24 months. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were evaluated after the first and second years of implantation. The differences between the CAP and SIR scores in the two groups were assessed.The median CAP scores improved significantly after the cochlear implantation in all the patients (p value 0.001). The improvement in the CAP scores during the first year in Group II was greater than Group I (p value: 0.007), but the improvement in CAP scores tended to be significantly higher in patients who were implanted at ≤24 months (p value 0.001). There was no significant difference between two groups in SIR scores at first-year and second-year follow-ups. The evaluation of the SIR improvement revealed significantly higher values for Group I during the second-year follow-up (p value: 0.003).The auditory performance and speech production skills of the children with ANSD improved significantly after cochlear implantation, and this improvement was affected by age at the time of implantation.

BackgroundThe lateral skull base lesions are one of the most challenging parts of the head and neck. Surgical approaches for this area are complex and difficult. Although endoscopic approaches in skull base surgeries have progressed dramatically in recent years, there are few studies concerning these approaches.ObjectivesThis study aimed to describe the endoscopic transcanal transcochlear approach (ETTA) to reach the internal auditory canal (IAC) in the cadaveric temporal bone specimen.MethodsFirst, pre- and post-operative high resolution computed tomography (HRCT) images of the transcanal transcochlear pathway were obtained and 3D segmentation was performed using 3D Slicer software. The anatomic landmarks were identified using the endoscopic approach with and without navigation guide. Surgeries were done and the feasibility and challenges were evaluated.ResultsThe internal auditory canal (IAC) was accessed via the ETTA. Anatomic landmarks were looked and a surgical corridor was identified with HRCT segmentations and images obtained during surgery.ConclusionsWe tried to increase our learning curve and extend surgical experience in lateral skull base surgery via minimally invasive ETTA. The increased endoscopic skills and the use of auxiliary tools such as a navigation guide may be helpful for successful access to the lateral skull base.

This multicenter study evaluated the auditory performance and speech production outcomes of cochlear implantation in children with inner ear anomaly and compared the outcomes of patients with different kinds of malformation.Cochlear implantation was performed in 107 children with inner ear malformation at four tertiary academic centers. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were evaluated preoperatively and one year and two years postoperatively.Types of inner ear malformation and their frequencies were: incomplete partition type-I, 19 (17.8%) patients; incomplete partition type-II, 31 (29%), common cavity, 17 (15.9%), cochlear hypoplasia, 17 (15.9%), and isolated enlarged vestibular aqueduct (isolated EVA), 23 (21.5%) patients. EVA was the coexisting anomaly in 27(25.2%) subjects. The median CAP and SIR scores improved significantly during the first two years after cochlear implantation in all groups (p-values0.001 and 0.001, respectively). No significant difference was seen in CAP and SIR scores of children with different inner ear malformations (p-value = 0.147 and 0.570, respectively) or in patients with isolated EVA compared to coexisting EVA (p-value = 0.538 and 0.075, respectively).The median CAP and SIR scores two years after surgery were 5 (Understanding of common phrases without lip-reading) IQR: 4-6, and 3 (Connected speech is intelligible to a listener who concentrates and lip-reads within a known context) IQR: 3-4, respectively. Auditory performance and speech production were significantly improved in all inner ear malformation patient groups, and no significant difference was observed between the scores of patients with different types of anomaly.

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

Background: Ménière’s disease (MD) is a common inner ear disorder which is characterized by recurrent attacks of vertigo, fluctuating sensorineural hearing loss (SNHL), tinnitus, and a sense of fullness in the affected ear. MD is a complex disorder; although six genes have been linked to familial autosomal dominant form of the disease, in many cases, the exact genetic etiology remains elusive. Methods: To elucidate the genetic causes of MD in an Iranian family, we performed exome sequencing on all members of the family: consanguineous parents and four children (two affected and two unaffected). Variant filtering was completed using a customized workflow keeping variants based on segregation with MD in autosomal recessive (AR) inheritance pattern, minor allele frequency (MAF), and in-silico prediction of pathogenicity. Results: Analysis revealed that in this family, 970 variants co-segregated with MD in AR pattern, out of which eight variants (one intergenic, four intronic, and three exonic) were extremely rare. The exonic variants included a synonymous substitution in USP3 gene, an in-frame deletion in ZBED2 gene, and a rare, highly conserved deleterious missense alteration in LSAMP gene. Conclusion: The phenotype observed in the proband described here, i.e. vertigo, poor sense of smell, tinnitus, and borderline hearing ability, may originate from aberrant changes in the cerebellum and limbic system due to a deleterious mutation in the LSAMP gene; hence, LSAMP mutation is a possible candidate for the etiology of MD in this family.

Background Meniere's disease is an inner ear disorder presenting with recurrent episodic vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness as its main symptoms. Previous studies have demonstrated the role of blood pressure in Meniere's disease. The purpose of this study was to determine the role of ACE, rs4646994 I/D polymorphism in Meniere's disease. Methods and materials In this case-control study, 67 individuals with Meniere's disease and 100 healthy individuals as a control group were enrolled. Patients DNA samples were extracted from the blood by the phenol-chloroform method. The frequency of genotypes were determined by polymerase chain reaction (PCR) technique. Results The genotypes and allele frequencies were not significantly different between the studied populations (p > .05). There was significant differences for distribution of I/D genotype between females and males (p Conclusions This study demonstrates the gender association of ACE rs4646994 polymorphism with Meniere's disease in an Iranian population.

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.

Cisplatin, as a platinum-based chemotherapeutic medication, is applied for various types of solid tumors. Regarding the treatment of cancer cells, cisplatin is potentially accompanied with some side effects such as nephrotoxicity, neurotoxicity, and ototoxicity in spite of high efficacy of Cisplatin. The present study aimed to determine whether the use of oral sertraline can contribute to preserve hearing threshold among the patients who receive cisplatin or not. This research has done for one year, along with a 3 months course and follow-up. This is a double-blind, randomized, and placebo-controlled trial study. The study was conducted in Oncology Clinic and Audiology Department of Firoozgar University Hospital in Tehran, Iran. Among 112 patients, 79 patients who were suffering from different types of solid tumors and were candidates for receiving cisplatin for chemotherapy treatment were selected. The grade of hearing impairment and otoacoustic emission in the first day and the last stage of the study was used for data analysis. Among 112 patients, 79 patients were randomly selected to receive either sertraline (50 mg/d) as the case group, or placebo as the control group. Before and after the treatments, the patients were assessed by High-Frequency Audiometry and dpOAE tests. First, the two groups were distributed homogeneously based on sex and age. Based on Common Terminology Criteria for Adverse Events (CTCAE), the Ototoxicity Grade indicated a significantly lower grade of deficits in the Sertraline group (p

Background: Introduction of the novel imaging modalities such as optical coherence tomography and scanning laser optical tomography allow the morphological and functional evaluation of the intracochlear structures up to the histological details. The prerequisite of these modalities is the preparation of the membranous labyrinth by removing the dense otic capsule to enhance the optical penetration depth. In the present study, a combination of the chemical decalcification and bone drilling method was explained for the preparation of the human inner ear structures for further studies. Methods: In this study, nine human temporal bones were used and trimmed in cubes containing middle and inner ear structures. The samples were immersed in 5% nitric acid, 20% EDTA, and 10% EDTA solutions, respectively. The samples were brought out and rinsed every 90 minutes, and mechanical removal of the softened bone was performed with surgical drill system until the complete decalcification of the samples was confirmed by X-ray imaging. The prepared samples were evaluated by microcomputed tomography imaging for anatomical distortions caused by the preparation process. Results: Complete decalcification and preparation of the samples were obtained in average of 10.5 ± 0.5 hours. No obvious morphological changes were observed in microcomputed tomography images, except for fracture of the remnant bony shell at the apex of cochlea in one sample. Conclusions: The combination of the chemical decalcification and mechanical removal of the softened bone can accelerate the sample preparation for high resolution imaging studies without significant morphological changes.

This study was conducted to evaluate the effect of the round window membrane accessibility on the residual hearing after cochlear implantation surgery in adults. Moreover, the effects of the other demographics and intra-operative factors on the residual hearing loss have been evaluated. The hearing preservation cochlear implantation surgery was performed on 64 adults with residual hearing thresholds ≤80 dB at 250 and 500 Hz, who had referred to our tertiary academic center. All the patients underwent a standardized surgical approach with the same straight electrode inserted through the round window membrane. The hearing thresholds at 250, 500, and 1000 Hz were compared in pre-operative and 1 month postoperative pure-tone audiograms. The average hearing threshold shifts at these frequencies was used to evaluate the hearing preservation. The effects of the round window accessibility and other factors (including gender, age, side of the surgery, necessity of anterior-inferior drilling of the round window margin and average insertion speed) on hearing threshold shifts were analyzed. The mean low-frequency hearing threshold shift was found to be 17.5 dB for all the patients. The hearing preservation goal (threshold shifts ≤30 dB) was achieved in 58 patients. Among the evaluated parameters, only accessibility of the round window membrane could change the hearing threshold shifts significantly (p = 0.026), and was a predictor for the hearing loss (B coefficient = 7.5, p = 0.006). Incomplete accessibility of the round window membrane may be a predictor for increased hearing threshold shifts in short-term evaluations after cochlear implantation.

The aim of the study was to evaluate insertion forces during manual insertion of a straight atraumatic electrode in human temporal bones, and post-implantation histologic evaluation of the samples to determine whether violation of intracochlear structures is related to insertion forces. In order to minimize intracochlear trauma and preserve residual hearing during cochlear implantation, knowledge of the insertion forces is necessary. Ten fresh frozen human temporal bones were prepared with canal wall down mastoidectomy. All samples were mounted on a one-axis force sensor. Insertion of a 16-mm straight atraumatic electrode was performed from different angles to induce “traumatic” insertion. Histologic evaluation was performed in order to evaluate intracochlear trauma. In 4 of 10 samples, dislocation of the electrode into scala vestibuli was observed. The mean insertion force for all 10 procedures was 0.003 ± 0.005 N. Insertion forces measured around the site of dislocation to scala vestibuli in 3 of 4 samples were significantly higher than insertion forces at the same location of the cochleae measured in samples without trauma (p

(Headache 2010;50:242-248) Background.— Some types of headaches with sinonasal origin may be present in the absence of inflammation and infection. The contact points between the lateral nasal wall and the septum could be the cause of triggering and sustained pain via trigeminovascular system. Objective.— The aim of this study was to evaluate the feasibility and effectiveness of endoscopic surgery in the sinonasal region for treatment of headache with special attention paid to specific diagnostic methods and patient selection. Methods.— This was a prospective, non-randomized and semi-quasi experimental research study. Thirty-six patients with chronic headaches who had not previously responded to conventional treatments were evaluated by rhinoscopy and/or endoscopy, local anesthetic tests and computed tomography scans as diagnostic criteria. These patients were divided into 4 groups based on the diagnostic methods utilized. The intensity of headaches pre- and post-operatively were recorded by utilizing the visual analog scale scale and performing analysis with analysis of variance test comparison and Statistical Package for Social Sciences. Average follow-up was 30 months. Results.— Our overall success rate approximated 83% while the complete cure rate was 11%. Patients in group 4 achieved the best results. In this group all diagnostic criteria were positive. In addition, patient responses were statistically significant in groups with more than one positive criteria compared with group 1 who only had positive examination. The positive response of 14 migrainous patients diagnosed with migraine prior to treatment was 64%. Conclusion.— Surgery in specific cases of headaches with more positive evidence of contact point could be successful, particularly if medical therapy has failed.

Trauma is the fourth major cause of mortality in the Western countries, of which approximately one half involve maxillofacial injury. Statistics reported by emergency room officials show motor vehicles cause many of the injuries and deaths that occur in Iran. Having completed a retrospective descriptive study of 200 patients who experienced maxillofacial trauma, the authors report its occurrence with respect to age, sex, trauma type, and site of injury so as to evaluate the operational functionality of the Department of Otolaryngology and Head & Neck Surgery of Hazrat-e Rasoul Akram Hospital from 2000 to 2004. Mandibular fractures (36.2%) occurred in the subsequently listed sites and at the specified frequencies: mandibular angle (9.7%), mandible body (6.9%), parasymphysis, ramus and subcondyle at 5.6% each, and symphysis at 2.8%. No condylar fractures were reported. Frontal bone fracture was observed in 9.7% of the patients with eye globe injury occurring simultaneously in 8.3% of corresponding cases. Orbital fracture (63.9%) also occurred in various cases as follows: orbital floor 39%, lateral rim 24%, inferior rim 22%, medial wall 11%, and the superior rim and orbital roof at 2% each. Motor vehicle accidents were the most common causes of trauma (42%). The most common fracture was in the zygoma (43%) with 8.3% of them being orbital injury. Fractures of mandibular bones (36.2%) and the maxilla (33%) were the most commonly seen in trauma occurring to the maxillomandibular region.

The present study focuses on the application of scanning laser optical tomography (SLOT) for visualization of anatomical structures inside the human cochlea ex vivo. SLOT is a laser-based highly efficient microscopy technique which allows for tomographic imaging of the internal structure of transparent specimens. Thus, in the field of otology this technique is best convenient for an ex vivo study of the inner ear anatomy. For this purpose, the preparation before imaging comprises decalcification, dehydration as well as optical clearing of the cochlea samples in toto. Here, we demonstrate results of SLOT imaging visualizing hard and soft tissue structures with an optical resolution of down to 15 μm using extinction and autofluorescence as contrast mechanisms. Furthermore, the internal structure can be analyzed nondestructively and quantitatively in detail by sectioning of the three-dimensional datasets. The method of X-ray Micro Computed Tomography (μCT) has been previously applied to explanted cochlea and is solely based on absorption contrast. An advantage of SLOT is that it uses visible light for image formation and thus provides a variety of contrast mechanisms known from other light microscopy techniques, such as fluorescence or scattering. We show that SLOT data is consistent with μCT anatomical data and provides additional information by using fluorescence. We demonstrate that SLOT is applicable for cochlea with metallic cochlear implants (CI) that would lead to significant artifacts in μCT imaging. In conclusion, the present study demonstrates the capability of SLOT for resolution visualization of cleared human cochleae ex vivo using multiple contrast mechanisms and lays the foundation for a broad variety of additional studies. © 2017 Tinne et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Objectives Tonsillectomy is one of the most common operations performed in pediatric population. One of the most prevalent tonsillectomy complications is early or delayed post-operative hemorrhage. Other important morbidity is post-operative pain. Historically, honey has been used for wound control, reducing the inflammation, and healing acceleration. The aim of this study is to investigate the effect of honey on reducing pain after tonsillectomy in children 5–15 years old. Methods After tonsillectomy, 80 patients were randomly divided in two equal groups. Patients in the first group were treated with antibiotic and acetaminophen, while those in the second group were treated with antibiotic, acetaminophen and honey. Data was gathered via a questionnaire and observation of tonsillar bed healing. Data was analyzed by SPSS17 software and related tests. Results Pain comparison between two groups showed that the average time required for pain relief in patients who received honey was less than the control. The pain intensity was higher during the first 9 days post-operatively in control group. Results also showed that acetaminophen consumption in patients who received honey is lower. In the case group, the average time to resume regular diet and the frequency of awakening at night is significantly less than the control group. Conclusion Honey administration after tonsillectomy has valuable effect in pain relief and it can be used as an adjunctive regimen after surgery for better pain control.