Hypothesis Approximately 25% of patients with congenital sensorineural or mixed hearing loss show... more Hypothesis Approximately 25% of patients with congenital sensorineural or mixed hearing loss show bony inner ear malformations on computed tomography (CT) of the temporal bone, with significantly smaller cochlear height (CH) compared with normal-hearing patients. The miniature cochlea has an apparently normal radiological appearance and could be missed if proper measurements are not taken. Inner ear measurements not only aid in the duplication of radiologically diagnosed inner ear malformation but can also provide additional information about which specific part is abnormal. Aims The aims of the present study were to establish the normal measurements of the height and width of fully developed Egyptian cochleae using high-resolution CT scans of the temporal bone in normal individuals, and to predict the characteristic radiologic sings and measurements of miniature cochlea and its implication during cochlear implant surgery. Study design The authors conducted a prospective, comparativ...
Tonsillectomy usually was a safe procedure; in adults, the risk of agonizing pain and secondary h... more Tonsillectomy usually was a safe procedure; in adults, the risk of agonizing pain and secondary hemorrhage could be serious. We introduced Daflon as a safe and effective complementary medication in reducing these risks. This prospective study was designed to evaluate the effect of using (Daflon oral medication) on post-tonsillectomy pain and hemorrhage rates. This study was conducted on 60 patients of both sexes, above 21 years, and underwent tonsillectomy using bipolar diathermy. Patients were randomly distributed between 2 groups; each group has 30 patients and with the same post-operative protocol; in group 2, an addition of Daflon 500 mg tablet twice daily for 14 days post-operatively was given. In group 2, agonizing pain start day, pain duration, analgesia duration, and need for another type, all were significantly different from group 1, starting day in group 1 (4.3 ± 4.0) and (7.2 ± 1.3) in group 2, pain duration in group 1 (7.3 ± 1.5) and (4.2 ± 1.4) in group 2 and need for ...
This is an open access ar cle distributed under the terms of the Crea ve Commons A ribu on-NonCom... more This is an open access ar cle distributed under the terms of the Crea ve Commons A ribu on-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new crea ons are licensed under the iden cal terms.
Objective This cohort prospective intervention study was initiated to investigate the effectivene... more Objective This cohort prospective intervention study was initiated to investigate the effectiveness of mucolytic nasal wash on postoperative healing after endoscopic nasal surgery (ENS). Patients and methods A total of 60 patients of both sexes, above 21 years, underwent ENS, who were randomly distributed into two groups according to inclusion and exclusion criteria, with 30 patients each. Postoperative hypertonic saline nasal irrigation was used for group A, and in addition of N-acetylcysteine (NAC) in group B. Measurement of outcome was done using modified Symptom based Modified Sino-Nasal-Outcome Test score-22 and Lund–Kennedy endoscopic score. Results We noticed that nasal irrigation with combined hypertonic saline with NAC is effective in reducing postoperative symptoms scores and endoscopic scores for patients following ENS or functional endoscopic sinus surgery. Conclusion NAC combined hypertonic saline irrigation had significant better results than standard hypertonic saline...
Bacterial biofilms have been shown to play a major role in many chronic infections, in addition, ... more Bacterial biofilms have been shown to play a major role in many chronic infections, in addition, there is growing evidence that bacterial biofilms may play a role in some forms of refractory CRS that persists despite proper surgery and culture directed antibiotic therapy. The objective is to determine the effect of application of topical ofloxacin on nasal and sinus mucosa in patients with proven existence of bacterial biofilms and persistent chronic sinusitis after FESS. The study design is a prospective controlled study. The study included a total of 12 patients who had refractory CRS in spite of undergoing FESS for that specific reason (study group), and control group (involved 25 patients), for whom FESS was done, with complete improvement postoperatively in 15 of them, and persistence of symptoms in the other ten. Topical ofloxacin eye drops (0.3 %) tds for 12 weeks were prescribed for (study group), culture and sensitivity and scanning electron microscopy were done for middle meatal mucosal specimens for all patients and controls, all of them were followed up for a minimum of 9 months (range 9-18 months). Of the study group, 80 % showed marked improvement in the structure of the mucosa, with the regaining of normal respiratory epithelium, with complete disappearance of the biofilm surface, and the remaining 20 % showed only reduction in the number of inflammatory cells and regaining cilia with scattered patches of very thin biofilm. Biofilms formation plays an active role in perpetuating inflammation in CRS patients and enhanced the recurrence and resistance in those patients, we found a statistically significant improvement in patients' group (P < 0.001), after 12 weeks of topical ofloxacin (without any evidence of any side effects). So, we concluded that topical ofloxacin seems to be an effective, tolerable, convenient, cheap and even safe mode of treatment of refractory CRS after FESS due to biofilms' formation. Thus, we recommend such modality of treatment postoperatively especially in refractory cases of CRS.
Several approaches are used to reconstruct orbital Xoor fractures and restore orbital position an... more Several approaches are used to reconstruct orbital Xoor fractures and restore orbital position and function, but many have the drawback of incomplete visualization, especially of the posterior part of the orbit. The aim is to assess the validity and accuracy of endoscopically aided subciliary approach repair of orbital Xoor fractures, as regards functional and cosmetic outcomes. Nine patients with orbital Xoor fractures were treated with iliac crest bone graft under complete endoscopically aided visualization, through a subciliary approach graft that was placed over the defect under complete visual control using endoscopes, through the same incision, to reconstruct the defect and assess the correction of the posterior edge of orbital Xoor defect. Improvement was assessed 2 weeks postoperatively. All operated cases had satisfactory results, both functionally and cosmetically. No permanent drawbacks from the incision were observed at 6 months follow-up. In case of repair of orbital Xoor fractures via a transciliary approach, the use of endoscopic aid through the same incision, allows better visualization of the posterior edge of the orbital Xoor and facilitates conWrmation that all orbital soft tissues have been accurately elevated from the fracture site and that the bone grafts are placed in proper position. Level of evidence: 1b (individual inception study with >80% F/U).
Leukoplakia is a descriptive clinical term designating a white patch or plaque of the mucosa and ... more Leukoplakia is a descriptive clinical term designating a white patch or plaque of the mucosa and must be complemented by histology, which can range from simple totally benign keratosis with or without atypia up to invasive carcinoma. The aim of this study is to evaluate the accuracy of videostroboscopy in preoperative differentiation of early invasive glottic carcinoma from intraepithelial atypia and dysplasia. 46 patients with a total of 60 leukoplakia lesions on the vocal folds were included in the study. Videostroboscopy was used to divide them into two groups based on preservation of the mucosal wave and this was correlated with the final pathology after treatment. The sensitivity and specificity of videostroboscopy in predicting invasive nature of the lesions based on absence or reduction of the mucosal wave were 96.8 and 92.8 %, respectively, with an overall accuracy of 95 %. We suggest that routine application of videostroboscopy can be an important, simple, non-invasive tool, to achieve, in a single procedure, proper and accurate evaluation of glottic leukoplakia.
Hypothesis Approximately 25% of patients with congenital sensorineural or mixed hearing loss show... more Hypothesis Approximately 25% of patients with congenital sensorineural or mixed hearing loss show bony inner ear malformations on computed tomography (CT) of the temporal bone, with significantly smaller cochlear height (CH) compared with normal-hearing patients. The miniature cochlea has an apparently normal radiological appearance and could be missed if proper measurements are not taken. Inner ear measurements not only aid in the duplication of radiologically diagnosed inner ear malformation but can also provide additional information about which specific part is abnormal. Aims The aims of the present study were to establish the normal measurements of the height and width of fully developed Egyptian cochleae using high-resolution CT scans of the temporal bone in normal individuals, and to predict the characteristic radiologic sings and measurements of miniature cochlea and its implication during cochlear implant surgery. Study design The authors conducted a prospective, comparativ...
Tonsillectomy usually was a safe procedure; in adults, the risk of agonizing pain and secondary h... more Tonsillectomy usually was a safe procedure; in adults, the risk of agonizing pain and secondary hemorrhage could be serious. We introduced Daflon as a safe and effective complementary medication in reducing these risks. This prospective study was designed to evaluate the effect of using (Daflon oral medication) on post-tonsillectomy pain and hemorrhage rates. This study was conducted on 60 patients of both sexes, above 21 years, and underwent tonsillectomy using bipolar diathermy. Patients were randomly distributed between 2 groups; each group has 30 patients and with the same post-operative protocol; in group 2, an addition of Daflon 500 mg tablet twice daily for 14 days post-operatively was given. In group 2, agonizing pain start day, pain duration, analgesia duration, and need for another type, all were significantly different from group 1, starting day in group 1 (4.3 ± 4.0) and (7.2 ± 1.3) in group 2, pain duration in group 1 (7.3 ± 1.5) and (4.2 ± 1.4) in group 2 and need for ...
This is an open access ar cle distributed under the terms of the Crea ve Commons A ribu on-NonCom... more This is an open access ar cle distributed under the terms of the Crea ve Commons A ribu on-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new crea ons are licensed under the iden cal terms.
Objective This cohort prospective intervention study was initiated to investigate the effectivene... more Objective This cohort prospective intervention study was initiated to investigate the effectiveness of mucolytic nasal wash on postoperative healing after endoscopic nasal surgery (ENS). Patients and methods A total of 60 patients of both sexes, above 21 years, underwent ENS, who were randomly distributed into two groups according to inclusion and exclusion criteria, with 30 patients each. Postoperative hypertonic saline nasal irrigation was used for group A, and in addition of N-acetylcysteine (NAC) in group B. Measurement of outcome was done using modified Symptom based Modified Sino-Nasal-Outcome Test score-22 and Lund–Kennedy endoscopic score. Results We noticed that nasal irrigation with combined hypertonic saline with NAC is effective in reducing postoperative symptoms scores and endoscopic scores for patients following ENS or functional endoscopic sinus surgery. Conclusion NAC combined hypertonic saline irrigation had significant better results than standard hypertonic saline...
Bacterial biofilms have been shown to play a major role in many chronic infections, in addition, ... more Bacterial biofilms have been shown to play a major role in many chronic infections, in addition, there is growing evidence that bacterial biofilms may play a role in some forms of refractory CRS that persists despite proper surgery and culture directed antibiotic therapy. The objective is to determine the effect of application of topical ofloxacin on nasal and sinus mucosa in patients with proven existence of bacterial biofilms and persistent chronic sinusitis after FESS. The study design is a prospective controlled study. The study included a total of 12 patients who had refractory CRS in spite of undergoing FESS for that specific reason (study group), and control group (involved 25 patients), for whom FESS was done, with complete improvement postoperatively in 15 of them, and persistence of symptoms in the other ten. Topical ofloxacin eye drops (0.3 %) tds for 12 weeks were prescribed for (study group), culture and sensitivity and scanning electron microscopy were done for middle meatal mucosal specimens for all patients and controls, all of them were followed up for a minimum of 9 months (range 9-18 months). Of the study group, 80 % showed marked improvement in the structure of the mucosa, with the regaining of normal respiratory epithelium, with complete disappearance of the biofilm surface, and the remaining 20 % showed only reduction in the number of inflammatory cells and regaining cilia with scattered patches of very thin biofilm. Biofilms formation plays an active role in perpetuating inflammation in CRS patients and enhanced the recurrence and resistance in those patients, we found a statistically significant improvement in patients' group (P < 0.001), after 12 weeks of topical ofloxacin (without any evidence of any side effects). So, we concluded that topical ofloxacin seems to be an effective, tolerable, convenient, cheap and even safe mode of treatment of refractory CRS after FESS due to biofilms' formation. Thus, we recommend such modality of treatment postoperatively especially in refractory cases of CRS.
Several approaches are used to reconstruct orbital Xoor fractures and restore orbital position an... more Several approaches are used to reconstruct orbital Xoor fractures and restore orbital position and function, but many have the drawback of incomplete visualization, especially of the posterior part of the orbit. The aim is to assess the validity and accuracy of endoscopically aided subciliary approach repair of orbital Xoor fractures, as regards functional and cosmetic outcomes. Nine patients with orbital Xoor fractures were treated with iliac crest bone graft under complete endoscopically aided visualization, through a subciliary approach graft that was placed over the defect under complete visual control using endoscopes, through the same incision, to reconstruct the defect and assess the correction of the posterior edge of orbital Xoor defect. Improvement was assessed 2 weeks postoperatively. All operated cases had satisfactory results, both functionally and cosmetically. No permanent drawbacks from the incision were observed at 6 months follow-up. In case of repair of orbital Xoor fractures via a transciliary approach, the use of endoscopic aid through the same incision, allows better visualization of the posterior edge of the orbital Xoor and facilitates conWrmation that all orbital soft tissues have been accurately elevated from the fracture site and that the bone grafts are placed in proper position. Level of evidence: 1b (individual inception study with >80% F/U).
Leukoplakia is a descriptive clinical term designating a white patch or plaque of the mucosa and ... more Leukoplakia is a descriptive clinical term designating a white patch or plaque of the mucosa and must be complemented by histology, which can range from simple totally benign keratosis with or without atypia up to invasive carcinoma. The aim of this study is to evaluate the accuracy of videostroboscopy in preoperative differentiation of early invasive glottic carcinoma from intraepithelial atypia and dysplasia. 46 patients with a total of 60 leukoplakia lesions on the vocal folds were included in the study. Videostroboscopy was used to divide them into two groups based on preservation of the mucosal wave and this was correlated with the final pathology after treatment. The sensitivity and specificity of videostroboscopy in predicting invasive nature of the lesions based on absence or reduction of the mucosal wave were 96.8 and 92.8 %, respectively, with an overall accuracy of 95 %. We suggest that routine application of videostroboscopy can be an important, simple, non-invasive tool, to achieve, in a single procedure, proper and accurate evaluation of glottic leukoplakia.
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