Objective: The objective of this study was to find out the incidence of various types of cancer of the larynx among patients presented to the Oto-Rhino-Laryngology clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. The clinical presentation and the outcome of using different treatment modalities for cancer of the larynx were reviewed. Materials and Methods: This was a retrospective study of 100 patients that presented to the King Abdulaziz University Hospital, Jeddah, Saudi Arabia with cancer of the larynx between 1993 and 1997. The age at presentation, male to female ratio, history of tobacco and alcohol consumption and the clinical presentation were recorded. The different modalities in diagnosis and treatment of these patients were also noted. Results: Of the hundred cases of the cancer of the larynx reviewed 65% presented with advanced cancer stage (III,IV). Only 35% of the patients presented with cancer stage 1 and II cancer of the larynx. The most common histological type was squamous cell carcinoma. (86%). Fifty percent of the cases underwent surgical treatment as a primary choice, 15% had post-radiotherapy salvage surgery, and 35% of the patients received radiotherapy with chemotherapy as a primary treatment. Conclusion: Using modern diagnostic techniques and different modern treatment modalities including radiotherapy, chemotherapy and different surgical techniques has improved the quality of lifeofthese patients with cancer of the larynx.

Objective: To evaluate the effect of vocal fold polyps on aerodynamic analysis of the voice. Material and Method: An experimental controlled prospective study composed of two groups. Group one contained 31 adult patients with vocal fold polyps on either or both vocal folds. Group two was composed of 30 subjects with normal larynges and respiratory systems. Both groups were subjected to aerodynamic analysis using Aerophone II. Results: Compared to control group, vocal fold polyps caused statistically highly significant increase in: phonation quotient (PQ), mean flow rate (MFR), subglottal pressure (Psub), and glottal power (Pg). They caused statistically highly significant decrease in: maximum phonation time (MPT) and glottal resistance (Rg). There were no statistically significant differences in vital capacity (VC) or glottal efficiency (Eg). Conclusion: Aerodynamic analysis of voice is one of essential investigative tools in assessment of vocal fold polyps.

Objective: To evaluate the use of expandable metallic stents (EMSs} in the management of inoperable tracheal stenosis. Study Design: Thirteen cases of chronic tracheal stenosis not amenable for surgical reconstruction were included in this study. All the cases underwent laser dilation followed by insertion of metallic stents. Fifteen stents were used; 9 Gianturco stents and 6 Ultraflex stents. Postoperative foilow-up by repeated endoscopy, imaging, and respiratory function tests was done. Results: The stents were well tolerated by all patients with immediate postoperative improvement of respiration. No immediate postoperative complications were reported except in one case that showed malposition of Gianturco stent. Follow-up period ranged from 18 to 38 months. Late complications included granulation tissue formation, web formation, restenosis, extratracheal extension, and chest infection. In general, complications were more common with Gianturco stent. Two patients died during the follow-up period. Respiratory function tests showed improvements of the peak expiratory flow rate (PEFR) and the Empey index from 40.25 and 10.80 preoperatively into 65.7 and 7.56 postoperatively respectively. Conclusion: Metallic expandable stents can be used as a safe and effective palliative modality for chronic tracheal stenosis in selected patients for whom formal surgical repair is inappropriate or contraindicated.

Objective: To assess the possible effect of Nigella sativa (N.S) on the different symptoms of allergic rhinitis. Settings: This study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Material and Method: Patients with signs and symptoms of allergic rhinitis as confirmed by skin tests were divided into three groups: Group A received N. sativa. Second, Group B received placebo and Group C received an antihistamine (Loratidine). A comparison was made between the three groups. Results: The whole seed of N. sativa produced a 42% improvement of sneezing and 44% improvement of itching when compared to placebo. However Loratidine was far more effective in alleviating some symptoms of allergic rhinitis. Conclusion: N .sativa may have some effects on the symptoms of allergic rhinitis. However, further research is required to study the effect of the active ingredients of N. sativa on a larger sample of patients.

Objective: To assess speech perception results in both pre-lingual and post-lingual deafened cochlear implantees. Methods: A retrospective analysis of data available from two groups of cochlear implanted patients. The first group; included 6 pre-lingual cochlear implantees; was assessed for closed-set speech perception at different intervals following cochlear implantation. The auditory response to speech was assessed using the Listening Progress Profile (LiP). The second group; included 7 post-lingual cochlear implantees; was assessed for closed-set and open-set speech perception at different intervals following cochlear implantation. The Minimal Auditory Capabilities Test (MAC Test) was administered for monitoring the auditory progress in this group of patients. Result: In the first group the “response to sounds” ranged from 90% to 100% one year after cochlear implantation, while the score for “discrimination between sounds” ranged from 6% to 100%. In the second group the ability of the patients to identify vowels and consonants ranged from 80% to 100% post-implantation, while their ability to recognize high context sentences ranged from 12% to 100% for all the patients except one case. Conclusion: Congenitally deaf children who receive cochlear implants before the age of 5 years have significant closed-set speech perception abilities. The majority of post-lingual cochlear implant patients derive substantial benefit from their devices. Key words: Cochlear implant, speech perception, pre-lingual deafness, post-lingual deafness.

Objective: To assess the ability of Mitomycin-C (MMC) to eradicate human papilloma virus (HPV)-infect- ed tissues from the airway, and to correlate histopathologic features, with the results of polymerase chain reaction (PCR), and the clinical course of recurrent respiratory papillomas (RRP). Study Design: Ten patients with a previous histologic diagnosis of RRP were included in this randomized prospective study. Under general anesthesia, each palient underwent standard microscopic-controlled carbon dioxide (C02) laser excision of all visible papillomas, followed by topical application of Icc of 0.5 mg/ml MMC. The procedure was repeated weekly until no visible papillomas could be microscopically detected. The obtained specimens were studied histopathologically, and tested for the presence of HPV DNA using polymerase chain reaction (PCR) technique. ResuIts:Clinical remission was achieved in eight of the patients (80%), a fact that was confirmed histopathologically and by PCR data that failed to identify any HPV DNA in all remission specimens. Conclusion:Our result suggests that topical application of MMC may act adjunctively to laser surgery for RRP.

Objective: To apply a technique of parathyroid allotransplantation (AT) to preserve the parathyroid function after total thyroidectomy Study Design: One hundred and five patients underwent total thyroidectomy. Intraoperative identification of parathyroid g^,ands was done using anatomical dissection and sinking-density test in 95 patients, and parental injection of 1 % Toluidine blue in ten. Scalpeled parathyroids were autotransplantcd (ATed) in small pockets in the sternocleidomastoid or brachioradialus musde. Clinical assessment of patients and their serum biochemical markers; calcium, phosphorous, and parathyroid hormone (PTH) were measured preoperatively, and on days 1.2. 10. 20. 30. 40. 50. 60, 90 and 120 postoperatively. Light & Electron microscopic (LEM) examination of parathyroid glands implanted in the brachioradialus was carried out in six consented patients. All patients were followed up for at least 12 months. Results: Early recovery of serum biochemical markers was achieved in patients ATed with 2-3 glands while delayed recovery was the pattern in that ATed with one gland. During the long-term follow-up. all the values of the biochemical markers were within the normal range. The incidence of permanent hypoparathyroidism in our study was zero %. LEM showed viable parathyroid cells with high secretory activity starting from 40th day onward. Conclusion: Parathyroid gland AT is quite successful, cost-effective and physiological solution after total thyroidectomy.

Objectives: To find the incidence of abnormal findings of the paranasal sinuses on MRI of the brain in patients being investigated for non-ORL diseases in a hospital population. Materials and Methods: This is a retrospective study of the MRI of the brain findings in patients being investigated for non-ORL conditions The reports for the period - were reviewed and data relating to age, sex, diagnosis and imaging findings were recorded. Results: The number of patients undergoing MRI of the brain for non-ORL diseases in the period was 2188. The number of patients with incidental findings of paranasal sinus abnormalities was 330 (15%). The most commonly involved sinus was the maxillary sinus. Mucosal thickening was the most frequent abnormality reported. Conclusion: Incidental findings of paranasal sinuses abnormalities constitute 15 % of patients undergoing MRI of the brain for non-OTL conditions.

Objective: The conventional teaching has always emphasized the complete removal of inflammatory maxillary sinus diseases to achieve a cureTThe aim of this study is to establish the efficacy of endoscopic management of maxillary sinus antrochoanal polyps, retention cysts and mucocoele and their recurrent rates after surgery. Study Design: This was a retrospective review of 45 patients who underwent endoscopic sinus surgery for antrochoanal polyps (n=30), retention cysts (n=10) and mucocoele (n=5) of maxillary sinuses Patients and Methods: Between 1998 and 2002 the medical records of 45 patients who underwent endoscopic sinus surgery for maxillary inflammatory diseases were reviewed for presenting symptoms, recurrence of disease, surgical outcome and need for revision surgery. Results: Recurrence of antrochoanal polyps was seen in 10 patients (30 %). six of the 10 (66.6 %) patients required revision surgery and the remaining 4 opted for medical treatment or declined our advise for revision surgery. There were no recurrences in the patients with retention cysts and mucocoele. Conclusion: There is increasing evidence in the literature that endoscopic management of maxillary sinus inflammatory diseases result in long-term control. In our study the recurrent rates for antrochoanal polyps were very significant.

Unilateral tonsillar masses are common in children and are usually due to simple infection. However, underlying malignancy cannot be roled out specially when there are associated risk factors. We report a 10 years old boy with a large pedunculated tonsillar mass that turned out to be a benign hyperplasia. The literature will be reviewed.