Objctive: To see if adenoidectomy alone is an effective modality of treatment of children with otitis media effusion(OME) and large adenoids Settings: This study was conducted at King Fahad Hospital of the University in A!-Khobar, Saudi Arabia. Material and Method: A prospective study on 49 children with OME and large adenoid was carried out between October 1998 and March 2000. All children with OME and large adenoid who did not respond to medical treatment for minimum of three months were included in the study. They were divided into two groups. Group A: patients had adenoidectomy alone. Group B: patients had adenoidectomy and myringotomy with ventilation tube insertion if needed. The patient’s parents decided treatment allocation to an either group. Tympanometric findings of type C or A were the criteria for improvement. Results: Fifteen patients had adenoidectomy alone. While thirty- four patients had adenoidectomy and myringotomy with ventilation tube insertion if needed. In group A 85% of the ears improved and 15% of them showed recurrence. While in-group B 81% of the ears improved and 19% of them had recurrence of otitis media with effusion. Conclusion: Adenoidectomy alone is as effective as adenoidectomy and otosurgery in children with otitis media with effusion and large adenoid.

Objective: The objective of the study is to find out the incidence of various types of complications in procedures where airway is shared; outline guidelines to decrease the incidence of such complications in the future. Method: This study was carried out at King Abdulazia University Hospital, Riyadh. Retrospective analysis of the complications occurring among all the airway cases excluding adenotonsillectomies over the last three years period was done. All charts were reviewed in details regarding pre-operative history, type of surgery and anesthesia, intra and postoperative events and complications if any. Results: Complications occurred at a rate of 20% and all due to surgical factors affecting anesthetic management. Out of these, some were due to ventilatory problems secondary to surgical manipulations of the airway and some were due to problems associated with endotracheal tube; others were due to the presenting disease making induction or maintenance of anesthesia difficult. All complications were successfully managed and the patients experienced no untoward effects. Conclusion: We conclude that using modern techniques of delivery of anesthesia relying on good basic skills, and following the guidelines for difficult airway. The complications arising from airway sharing can be successfully managed.

Objective: to investigate the prevalence of hearing impairment in children and in children with occluding wax. This is a part of a national survey of hearing impairment among Saudi children. Subjects and Methods: A survey of 9540 Saudi children under 15 years of age was carried out. The subjects were classified into normal ( with no occluding wax ) and those with occluding wax. Each subject was carefully examined for the hearing status using Madison screening audiometer. Results: Out of 9540 surveyed with complete data, 1229 were found to have occluding wax. Two hundred twenty children were hearing impaired and 53 of them had otitis media with effusion. Conclusion: Occluding wax in the ear is a risk factor that should be borne in mind when evaluating hearing in children. It may obscure the presence of acute otitis media or otitis media with effusion.

Objective This is a retrospective clinical study aiming to come up with an effective and practical monitoring system for the treatment of necrotizing external otitis. Methodology : During the last 6 years ( 1997-2003), 9 patients with the diagnosis of necrotizing external otitis (NEO) were admitted to the ENT-ward at King Fahd Teaching Hospital for treatment. After admission, a detailed history was taken followed by a thorough ENT examination and relevant investigations such as; Diabetes Mellitus Profile (DM), Erythrocytes Sedimentation Rate (ESR), Ear Swab for eulture and sensitivity (C/S), Computed Tomography (CT) and scintigraphy using technicium 99 and/ or Gallium 67, After diagnosis were achieved, treatment of the infection and controlling of D.M. was started and after discharge a long term follow up was initiated. Their treatment were monitored using effective subjective and objective assessment measurements. Results : All cases (apart from 3) responded very well to the antibiotic treatment. Before discharge (7-32 days) patients were put on oral treatment. Patients with cranial nerve involvement (3) showed good to poor improvement. One of them has expired due to carotid artery heamorrhage. Under treatment clinical symptoms such as ear pain, discharges and granulations disappeared. Also ear culture; DM and ESR went back to normal or were controlled. Radiological changes showed remarkable improvement. Conclusion : Clinical and laboratory assessment measurements arc practical and reliable in monitoring patientfs therapy in particular the ESR. The radiological modalities are useful in detecting soft tissue and bony involvement but are not reliable enough in monitoring therapy.

Acinic cell carcinoma occurs most commonly in major salivary glands. Minor salivary glands involvement is uncommon. A review of English literature revealed bout 80 previously reported cases. Here we report a 52-year old Saudi male patient who presented with an ulcerated soft palate mass. Histopathological examination revealed the tumour to be acinic cell carcinoma. The clinical, histopathological features as well as management will be discussed.