Objetives: The aims of this study were to determine the effects of laryngectomy on olfaction, taste and ciliary beat frequency and to determine whether anosmia in laryngectomees reflects diminished transport of odorants to the olfactory epithelium or olfactory epithelial damage. Methods: We studied changes occurring in olfaction, taste and Ciliary Beat Frequency (CBF) in 20 cases with total laryngectomy after different follow up periods. Ciliary Beat Frequency was studied by the microphotometric technique, olfaction by the Erlangner olfaction test kit and taste with the Innsbrucker taste evaluation kit. Results: Ciliary Beat Frequency is mildly reduced after laryngectomy with a mean of 9.9 Hz. Olfactory and taste ability are markedly reduced after laryngectomy. The reduction in olfactory and taste ability is directly proportional to the period of follow up (P< 0.05). Conclusions: We conclude that olfactory and gustatory dysfunction after laryngectomy could be related to the deficient nasal airflow and also structural changes in the olfactory epithelium that takes some time to occur postoperatively.

Objective: To compare the clinical efficacy of two antibiotics, cefuroxime and amoxicillin in tympanoplasty. Method: This study was carried out at the ENT Department King Abdulaziz University Hospital, Riyadh, Saudi Arabia. One hundred and fourty three patients with chronic suppurative otitis media were enrolled in the study, and were assigned to receive 5 day prophylactic treatment with cefuroxime 1.5 gm intravenously by at time of surgery followed by cefuroxime axetil 250 mg twice daily (n = 74) or amoxicillin 500 mg three times daily (n = 69). Results: The results showed that prophylactic antimicrobial therapy with cefuroxime is more effective in preventing early post-operative infection as compared to amoxicillin therapy. Conclusion: No significant difference in regard to late post-operative infection, or late atrophy of the graft was observed between the two drugs.

Background: Clinical studies have shown that tympanosclerosis is a common chronic middle ear disease which in turn may lead to hearing impairment. Although investigators have dealt with different aspects of the condition, little is known about the degree and configuration of hearing loss in relation to intra-operative findings in tympanosclerosis. Objectives: To define the degree and configuration of hearing loss in tympanosclerosis and to correlate them with intra-operative findings. Setting & Methodology: A retrospective study of the audiometric and intra-operative findings in 88 patients of chronic suppurative otitis media with tympanosclerosis in a teaching hospital. The degree of air bone gaps in different frequencies was correlated with the intra-operative findings of tympanosclerosis and mobility of ossicles. Results: Ninety four percent of the 88 patients presented with hearing loss. Tympanosclerosis was found in the tympanic membrane in 42.2%, in the middle ear cavity in 37.6%, and in both in 17.8% of the patients. The average hearing loss as shown by pure tone audiometry was 43.6 dB. Low frequencies were affected more than higher frequencies. The air bone gap in the low frequencies was 42.9 dB while 28.6 dB in the high frequencies. Involvement of the middle ear with fixation of the ossicles was associated with higher air bone gap while drum involvement had less fixation ( p+0.006 ). Conclusion: Intra-operative findings in Chronic Suppurative Otitis Media with tympanosclerosis correlated the degree and configuration of hearing loss to the extent of middle ear involvement and ossicular fixation. The low frequencies are affected more in both sexes are affected equally.

Objective: The present long-term study aims at determining the extent of reduction of intake of different classes of symptomatic medication under specific sublingual immunotherapy in patients with IgE-mediatcd allergic reactions to aeroallergcns. Method: One hundred and eighty two patients treated with sublingual immunotherapy were included in this study. The course of therapy was documented on patients with IgE mediated allcrgic rhinitis conjunctivitis and / or asthma. The treatment consisted of graded amounts of soluble allergen extracts. Patients received increasing doses of the extracts sublingually. Symptoms were scored on a 5=point verbal rating scale and analysis made. Results: The study included 1K2 patients with a mean age was 27.9 years. 94.5% suffered from rhinitis and/or conjunctivitis. The duration of complaints was 5.7 years. One hundred sixty eight (92.3%) patients had positive prick test. Concomitant diseases were prevalent up to 34.5%. The number of used allergens ranged from 1-7. For Summer pollens spring/summer pollens, mite/dust/moulds were used as allergens. There was a marked reduction in symptomatic medication and in allcrgic symptoms. Conclusion: The sublingual immunotherapy showed a striking improvement of symptoms and a distinct reduction in the use of symptomatic antiallergic drugs. This therapy will be beneficial to the patients who do not comply with injection treatment.

Objective: To analyze the outcome of treatment of sudden sensorineural hearing loss (SSNHL) and to identify prognostic factors and literature review. Design: Retrospective chart review. Setting: King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. Patients and Methods: Twenty-seven patients diagnosed with SSNHL were studied. There were 19 males (70.3%) and 8 females (29.6%), aged 7-64 (mean age 31) years.. Twenty-four patients received treatment, 4 of them surgically. Bed rest and multidrug regimen were the mainstay of treatment. Daily pure tone audiograms (PTA) were performed. The outcome of treatment is the mean hearing recovery compared to the audiogram at presentation or to the unaffected ear at three adjacent frequencies. The results were divided into 4 groups: (1) complete recovery, (2) marked improvement, (3) fair improvement, and (4) no change. Results: Out of 24 patients treated, 7 (29.2%) had complete recovery, 5 (20.8%) had marked improvement, 5 ( 20.8%) fair improvement, and 7 (29.2%) had no change. Two of 4 patients treated surgically had marked improvement (50 %), and 2 ( 50%) did not improve. Younger patients and patients who presented earlier had a better outcome. Concomitant tinnitus and vertigo had no effect on outcome. Conclusion: Treatment of SSNHL is directed towards all possible aetiologies. Multidrug therapy is the mainstay of treatment. Exploratory tympanotomy was performed when inner ear membrane rupture was suspected. The most important prognostic factors are time of presentation, age and type of PTA.

The relationship between diabetes and sensorineural hearing loss has been controversial, and very few studies have been conducted on the pediatric population. Objectives: To comparc the auditory function in young Type I (insulin dependent) diabetic subjects, to the auditory function in an aged-matched group normally hearing non-diabetic children. Also to identify the relationship between age and sex of the patient, duration, complications and control of diabetes, to hearing loss. Settings: Otolaryngology and Paediatric Endocrinology Departments at King Fahad Hospital of the University, Al-Khobar, Saudi Arabia. Patients and Method: 38 Type I diabetic patients from the Pacdiatric Endocrinology Clinic were studied, of these 35 patients were included in this study. Eighteen patients were males and 17 were females. Their age ranged from 3 to 15 years (average 8.6 years). All patients underwent audiological assessment by pure tone audiogram and were compared to 15 age and sex matched non-diabctic control group. They were further evaluated regarding the relationship of hearing level to age, sex, duration of diabetes, control of diabetes and other diabetic complications. Results: No statistically significant difference in hearring thresholds was noted between diabetic patients and the control group, male and female diabetic patients and between diabetics for up to two years and more than two years. It was found that poorly controlled diabetics and those with other diabetic complications had lower hearing thersholds in comparison to well-controlled and uncomplicated diabetics, but this difference was not statistically significant. Conclusion: Diabetes mellitus had no significant effect on the auditory function of young children studied in King Fahad Hospital of the University, although well-controlled and uncomplicated diabetics had better hearing than the poorly controlled and complicated diabetics. Audiological assessment and careful monitoring of this group of patients is advisable.

Rhabdomyosarcoma is considered as the most common primary malignant tumor of the head and neck during the first two years of life. In the United States, rhabdomyosarcoma strikes approximately five in every one million children each year. It is a curable disease in the majority of children who receive optimal therapy, with more than 60% five years survival rate. We report a case of lateral nasal wall rhabdomyosarcoma and literature review

Esthesioneuroblastoma (ENB) is a rare tumor of neuroepithelial origin. It usually presents as a nasal roof mass with epistaxis, obstruction, anosmia, pain, and mass effect. Two cases of esthesioneuroblastoma are presented one of which showed up as an ethmoidochoanal polyp and the other as polypoidal mass from the medial surface of the middle turbinate. The different presentations for these malignant tumor are discussed hand in hand with the treatment modalities.