Background: Routine wound drainage after thyroid and parathyroid surgery was and still used on no scientific basis. Objective: We aimed to confirm whether drains following thyroid and parathyroid surgery are of any benefit. Method: A retrospective analysis of 232 patients who underwent thyroid and parathyroid surgery were reviewed. Results: A total number of 197 patients had thyroid surgery and 35 patients had parathyroid surgery. Drains were used in 117 patients (50.4 %) (group A) and no drains were used in 115 patients (49.6 %) (Group B). There was no difference between the two groups in terms of major complications that require intervention. The average drainage in group A was 60 ml (range 0-320 ml). All patients in group B developed flaps oedema and suprasternal fullness that resolved spontaneously without intervention and one patient developed wound infection. Conclusion:Routine wound drainage following thyroid and parathyroid surgery is unnecessary and should be used selectively

Objective: This study was conducted to analyze the data concerning adult-onset otitis media with effusion (OME) in order to configure its clinical profile, etiology, diagnostic approaches, and therapeutic management. Design: A retrospective study. Materials and Methods: Sevety seven consecutive eases (105 ears) of OME were seen. All the patients were older than 16 years. Initial symptoms, physical examination, operative findings, underlying diseases, and therapy were analyzed. Results: Hearing impairment (94.8.3%) was the most prevalent initial symptom, followed by ear stuffiness (54.5%). The condition was bilateral in 39 patients (50.6%) and unilateral in 28 patients (49.4%). Both mucoid and serous effusion occurred with predominance of the former.The most common two associated etiological conditions were sinusitis (22.2%) and nasopharyngeal malignancy (11.1%). Other factors included adenoid, allergy, and nasopharyngitis. No etiological factor was detected in 10 patients (13%). Conclusion: Sinusitis and nasopharyngeal carcinoma were the main associated etiologic factors OME in adults. In addition to treatment of sinusitis, nasopharyngeal check-up is mandatory in the management of adults with OME.

Objective: To study the causes of epistaxis and its management and to compare it to the current literature. Setting: A retrospective study of all cases of epistaxis seen between January 1997 - December 1999 in the ENT department of King Fahd Hospital of the University (KFHU), Al-Khobar. Methods: All patients underwent a general evaluation. Vital signs were monitored and resuscitation was carried out when needed. An intravenous line was secured, and a full blood count and coagulation profile were ordered on presentation. All patients were initially treated conservatively, by anterior and/or posterior nasal packing, or by chemical or galvanocautery. Results: There were 204 epistaxis patients during the period under study. Their ages ranged between 2-60 years, and 64.4% were aged 20 or under. Male to female ratio was 2.7:1. The main causes of epistaxis were nose picking in 33%, external trauma 31%, rhinosinusitis in 20%, bleeding disorder in 7.3% idiopathic 6.7%, post septoplasty in 1% and in 1% due to angiofibroma.. Eight per cent were hospitalized. The remaining 92% were treated as outpatients cases. Conservative treatment controlled epistaxis in all but three patients who required surgery. Five patients required blood transfusion (1.96%). At follow-up, 8% reported mild attacks of epistaxis which stopped spontaneously and did not require treatment. Conclusion: Conservative treatment for epistaxis is still successful in controlling epistaxis in the majority of patients. Arterial ligation is rarely required in patients who do not respond to conservative measures. The value of coagulation screening should not be underestimated.

Both post functional endoscopic sinus surgery (FESS) and spontaneous cerebrospinal fluid (CSF) rhinorrhea are rare in rhinologic practice. In the current study five cases are presented, four of which followed functional endoscopic sinus surgery while the fifth is a spontaneous one. All cases were managed promptly via endoscopic approach except one of the post FESS cases which responded well on conservative treatment. The endoscopic repair was done utilizing free fascia lata, muscle and fat with homogenous septal cartilage with or without fibrinogen glue and the success rate was remarkable.

Non-endemic Burkitt’s lymphoma (NEBL) is a high-grade non Hodgkin’s lymphoma of B-cell origin, found sporadically outside Africa. Involvement of extra nodal head and neck sites occurs very infrequently. Two cases of palatine tonsillar swelling are described. Both cases presented mainly with unilateral pharyngeal swelling and change of vioice for few weeks.