Objective: The purpose of this study was to find out the percentage of patients who had clinical and radiological evidence of temporal bone involvement in basal skull facture.The study also looked at the incidence of otological symptoms and signs reported in the case files during admission and review subsequent patients management. Methods: The case files of 400 patients admitted to Assir Central Hospital with basal skull fractures were retrospectively reviewed. Only 40 met our selection criteria of a clear evidence of basal skull fracture with temporal bone involvement using plain x-ray and computerized axial tomographic scan. Results: The result showed that the parietal area was the commonest site of impact,[40%], followed by the frontal area [12%], the temporal site [12%], and the occipital [4%]. About three-quarters of the patients were bleeding from the external auditory meatus when first seen and 12% had cerebrospinal fluid otorrhoea. All the patients were referred to ear, nose, and throat specialist within 24hours of admission. Conclusion: We propose that all patients with head injuries with one or more symptoms and signs characteristics of temporal bone fracture should automatically have otological assessment at the time of presentation. We also advocate thorough history, physical examination, computerized axial tomographic scan and audiogram for all these patients as early as practicable.

Objectives: To find out the occurrence of anatomical anomalies and pathological changes in patients subjected to CT scanning. Materials and Methods: The CT of 584 patients were studied. Age,sex, anatomical nomalies and pathological changes were recorded . Results: Eighty seven patients had anatomical anomalies and 177 had pathological changes with 296 having combined anatomical and pathological findings. Of the anatomical anomalies, deviated septum was the most common and Haller’s cells were the least common. Pathological changes included mucosal thickening, nasal polypi and hypertrophy of the turbinates. Conclusion: CT scan is a useful diagnostic method in the diagnosis of sinus disease. Deviated nasal septum and mucosal thickening were the common findings seen by this modality of imaging in this series.

Objective: To study the clinical data related to tracheostomy in ICU patients and the recommended methods to get its benefits with the highest margin of safety. Settings: ICU, AI Adan Hospital. State of Kuwait. Patients and methods: A retrospective study reviewing the files of the recorded trachcostomised ICU patients during a 6 years period from January 1st 1994 to December 31st 1999. The patient, ventilation and tracheostomy related data were collected and analyzed. Results: The recorded number of the trachcostomised ICU patients during the study period were 181, i.e. the ICU & population annual mean were 30.1 and 7.5/100 000 respectively and the male to female ratio was 2:1. Road traffic accidents with head injury was the commonest tracheostomy indication in young age groups specially males, while cere- brovasacular accidcnts and chronic obstructive airway disease were the commonest tracheostomy indications among the old age group patients. In comparison to the total, the number of 61-80 years age group patients constituted the highest percentage (33.5%) followed by 21-40 years age group (25.4%). This study revealed that duration of the pre-tracheosto- my endotracheal intubation is relatively short (mean 10.5 days). All tracheostomies were elective and performed under general anaesthesia where patients were in their optimal medical conditions. One hudred sixty tracheostomies were performed in the operation theater, while the remaining 20 were performed at bedside. One hundred sixty three tracheostomies were performed by the classic surgical technique while the remaining 18 were performed by percutaneous dilatation technique. The all over tracheostomy related complications incidence was 12.5%. Conclusion: Road traffic accidcnts was the commonest tracheostomy indication among patients below 40 years specially males, while ccrebrovasacular accidents and chronic obstructive airway disease were the commonest tracheostomy indications in-patients above 40 years. Although tracheostomy has many benefits but is not an absolutely safe procedure. All efforts, such as optimizing the prc-opcrativc patients condition, meticulous surgical techniques, close postoperative observation, care of tracheostomy wound, frequent cuff pressure adjustment to get its benefits with the highest margin of safety, should be made.

Dermoid cysts are uncommon in the neck and the clinical diagnosis is confused with other neck masses. We present a case of dermoid cyst in the submandibular area in a 7 year old boy. The recurrent infections and radiological picture resemble lymphadenitis with abscess formation. The distinction between dermoid cyst and other similar neck masses is important for the correct diagnosis and proper selection of surgical procedure which can save the patient much anxiety and trauma.

Dermoid cysts are uncommon in the neck and the clinical diagnosis is confused with other neck masses. We present a case of dermoid cyst in the submandibular area in a 7 year old boy. The recurrent infections and radiological picture resemble lymphadenitis with abscess formation. The distinction between dermoid cyst and other similar neck masses is important for the correct diagnosis and proper selection of surgical procedure which can save the patient much anxiety and trauma.

Angiolymphoid hyperplasia with eosinophil is a reactive vascular hyperproliferative response of unknown etiology. It has a predilection for the head and neck region. This paper highlights the difference between angiolymphoid hyperplasia with eosinophilia and Kimura’s disease. It also highlights the modality for treatment and diagnosis.

Angiolymphoid hyperplasia with eosinophil is a reactive vascular hyperproliferative response of unknown etiology. It has a predilection for the head and neck region. This paper highlights the difference between angiolymphoid hyperplasia with eosinophilia and Kimura’s disease. It also highlights the modality for treatment and diagnosis.