Human Immunedeficiency Virus/ Acquired Immunedeficiency Symdrome (HIV/AIDS) has assumed epidemic proportions. The disease is spreading at an alarming rate globally and it does not discriminate between race, gender or organs. Some features of this multi-organ disease are often missed by clinicians especially those working in busy centers; hence the need to frequently highlighting them. This review draws the attention of the otolaryngologist to the various manifestations of this infection in the Neck and Head region, where HIV disease is associated with a variety of problems and as high as 70% of HIV infected patients eventually develop such conditions. The review is grouped according to anatomic sites in order to facilitate retention and proper management.

Objectives: To compare the success rate and complications of ear syringing versus suctioning technique for removal of ear wax. Setting: ENT department, Buraidah Central Hospital, Buraidah AlQassim, Saudi Arabia. Method and Patients: Out of 1199 cases who attended the clinic for ear wax cleaning from May 1998 to Aug 2000, 300 cases were selected randomly for this study. Patients were equally distributed in a random fashion between two ENT surgeons for the two different techniques. Age and sex of the subjects as well as the indication and complications of these two commonly used techniques were analysed. Results: Males were more than females (M:F =1.2:1) and 45% of the cases were seen in the age group of 10- 40 years. The success rate for ear suctioning was 90.6% (136/150)and syringing was 84%(126/150). Rate of complication was 16%(24/150) for ear syringing technique and 9.3%(14/150) for suctioning with no statistical significance. However, external otitis was significantly more frequent with ear syringing technique. (p=.02) Conclusion: Although impacted ear wax can be removed with relative ease by these two techniques, there are contraindications and cautions should be exercised. Otologic complications do result from these procedures and we noted a higher rate of external otitis with ear syringing. In conclusion ear suctioning is an effective and welt tolerated procedure in the hands of experienced physicians.

Objective: This is a preliminary study to determine the aetiological factors associated with profound sensorineural deafness in Sudanese children. Patients and Methods: A retrospective study of 264 Sudanese children suffering from profound sensorineural deafness with poor or no speech development. A detailed history questionnaire was obtained for all cases. General medical and local E.N.T. examination for all children was carried out by the authors. The audiometric investigations included play-, free field and pure tone audiometry according to the child age. Haematological, biochemical and radiological investigations were performed where indicated. Results: Ages ranged from 14 months to 14 years with a mean age of 5.5 years. The male to female ratio was 1.1:1.0. One hundred ninty eight cases were born as a result of consanguineous marriages and 120 cases had a positive family history of deafness. One hundred and fifty four children were exposed to quinine therapy. Fourteen children had received gentamicin therapy as neonates. Thirty children developed deafness following mumps . Eighteen children acquired deafness after meningococcal meningitis. Syndromic types of deafness accounted for 12 cases. Conclusion: The most common factors associated with the aetiology of profound sensori-neural deafness in Sudanese children were consanguinity, infectious diseases and ototoxic drugs. Measures such as genetic coun- celling, control of infectious diseases, vaccination, careful use and monitoring of ototoxic drugs should play an important role in the ppreve.ation and reduction of the incidence of profound sensorineural deafness in the community.

A 34 years old female Philippine patient complained of neck pain, dysphagia and ncck stiffness following fish bone swallowing of two days duration. Lateral plain x-ray of neck showed suspected shadow at the level of the forth-cervical vertebra with widening of prevertebral space. Endoscopy was performed twice, but no foreign body was detected. Only oedema of vallecula and post-cricoid regions with abscess formation. C.T. showed that the fish bone was penetrating the pharyngeal wall and impacted in the prevertebral tissue. Right lateral Pharyngotomy was performed and the fish bone was removed.

Intraosseous hemangioma of the facial bones is a rare disease and it occurs in the mandible more than in the maxilla ^[1], This paper is a report of a case of intraosseous cavernous hemangioma of the left anterior maxillary wall and presents the modality used for its treatment. Embolization of the nutrient arteries was first applied followed by left subtotal maxillectomy. Reconstruction with rib graft and temporalis fascia pedicled flap was resorted to as an augmentary procedure for the resultant postoperative defect. The patient was followed for one year to assess the final outcome of this therapeutic modality.

Sensorineural hearing loss (SNHL) secondary to sicklc cell anemia ensis is well documented in West Africa, the Middle East, and the United States. However sudden, profound, bilateral (SNHL) is no. found anywhere ,n the hterature. We report the case of an 8-year old female who developed irreversible, profound, bilateral (SNHL) during a severe sicklc cell anemia crisis. The pathophysiology, differential diagnosis and treatment arc also discussed.