Objective: This study was conducted from 1989 to 1999 on patients with atrophic rhinitis with emphasis on the relationship between turbinectomy and the development of atrophic rhinitis. Setting: The Otolaryngology Department at the Military Group Hopsitals in the Royal Medical Services, Jordan. Materials and Methods: This is a retrospective study of 75 patients with the diagnosis of atrophic rhinitis. The patients were divided into two groups: those with atrophic rhinitis who underwent some type of turbinectomy (n=45) and those who had no history of previous surgery (n=30). Results: Analysis of the presenting symptoms. signs, causes, previous surgical procedures, nasal cytology smears and cultures were conducted in the surgical and non-surgical groups. Differences were found between the manifestations of both groups. Conclusion: We suggest avoiding excessive damage and harm to the turbinates in the treatment of allergic or vasomotor rhinitis.

Objectives: A review of the clinical aspects of oesophageal carcinoma in Sudanese patients and a comparison with internationally published series. Patients and Methods: A retrospective study of 84 cases with hisologically proven oesophageal carcinoma which presented to the Ear, Nose and Throat Department, Wad Medani Teaching Hospital, Wad Medani, Sudan from 1995 to 1999. All patients underwent rigid oesophagoscopy under general anaesthesia. Results: A total number of 84 cases were reviewed. The main presenting symptom was dysphagia. Patients ages range was 18-80 years with a mean age of 54.1 years. Thirty seven patients (44%) were 18-50 years of age and 47 patients (56%) were above 50 years. Forty eight patients (57%) were females and 36 patients (43%) were males. Female to male ratio was 1.3:1.0. Seventy five percent of patients belonged to low socioeconomic groups. The most common site was the upper third of the oesophagus (71.4%) followed by the middle third (23.8%) and the lower third (4.8%). In 95.2% the tumour was a squamous cell carcinoma and in 4.8% it was an adenocarcinoma. Conclusion: Oesophageal carcinoma in Sudanese patients is more common in females and occurs at a younger age group. The most affected site (71.4%) is the upper third and the most common tumour (95.2%) is the squamous cell carcinoma.

Objective: To determine and compare the various risk factors for hearing impairment in the four major regions of Saudi Arabia. Materials and Methods: Nine thousand five hundred forty children below the age of 15 were surveyed from the four major provinces of Saudi Arabia. A questionnaire was filled and an ENT examination with audio- logical assessement were carried out for each child. The various risk factors were studied. Results: Nine thousand, five hundred and forty children were screened. Out of these 13% were hearing impaired and 8% were at risk of hearing impairment. Consanguinous marriages, failure to attend antenatal clinics, abnormal pregnancy and labour, prematurity, lack of immunization, xenthematous diseases and jaundice were the risk factors for hearing impairment, The Western and Southern regions of Saudi Arabia were found to have the highest rate of some of these risk factors. Conclusions: Consanguinous marriages should be discouraged . Attendance of antenatal clinics and immunization should be encouraged through proper health education and counseling programmes.

Introduction: Otoscopy, a subjective clinical method, is used by many physicians and nurses to assess the condition of the ear canal, the tympanic membrane and the presence or absence of otitis media. Objectives: To train doctors and nurses working in health centers to perform otoscopy and assess their ability to distinguish between normal and abnormal ears, when to treat or refer patients for further management. Materials and Methods: Twenty doctors and twenty nurses were given basic intensive courses in the ear and the use of otoscopy. They were given 10 patients to examine each, before and after the course. Results: Results showed marked improvement in the average competence level of both doctors and nurses in using otoscopes. Conclusion: If these training courses were adopted for health-care workers the results would help to increase the overall quality of care, rationalize and minimize referral to ENT specialists and help in carrying out the proper treatment at an early stage.

An elderly female with recurrent inverted nasal papilloma is presented. Although these tumours usually arise from the lateral wall of the nose, they may sporadically arise from the paranasal sinuses. In the present study the papilloma was noticed originating from the left ethmoid region with spread to otherunilateral paranasal sinuses and also destroyed the medial wall of the left orbit and extended rctro-orbitally as far posteriorly as the optic foramen. Over a period of two years the tumour recurred exuberantly and was excised four times, twice through external frontoethmoidectomy operations. As the tumour originated primarily from the ethmoid and spreaded posteriorly and laterally the latter approach gave better access for clearance of the paranasal sinusesand the orbit. The difficulty encountered in the histological interpretation regarding malignant transformation of this tumour was noticed and discussed. As this tumour has propensities of recurrence and malignant transformation close follow-up at short interval is mandatory.

A seven years old Sudanese girl presented with heterochromia irides and bilateral profound symmetrical sensorineural deafness. The clinical features were consistent with Waardenburg syndrome type II.