Objective: To find out the incidence of epistaxis that required admission and to evaluate associated factors, demographic data, ,underlying medical disease, , site of epistaxis, and the length of hospital stay. The various treatment modalities and their effect on the outcome of the patient treatment were studied as well. Methods: This study represents a 10 year retrospective review of medical records of 60 patients admitted with the diagnosis of epistaxis or admitted for other medical reasons with the development of concomitant epistaxis at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. All patients records were evaluated for demographic data, underlying medical disease, site of epistaxis, and the length of hospital stay. Treatment methods were divided into two groups; non-surgical and surgical groups. Results: During the 10 year period of the study, 60 patients were found to have epistaxis requiring admission or admitted for other medical conditions in which epistaxis developed. Epistaxis was found to be more common in males than females ( 60%-40%) with a mean age of 29.5 years. The most common associated medical disease was hypertension. Non-surgical approaches were employed in 51.7% of the patients and 48.3% required surgical or interventional approaches. Conclusion: Epistaxis is a common otolaryngological problem. In spite of the incidence of nose bleed in the population being high, only a few patients require admission. The new advances in interventional radiology and the widespread use of nasal endosocpy has improved the outcome of the disease, reduced morbidity, blood transfusion rates, and hospital stay.

Objectives: Sensation of the nasal patency is the primary concern to the nasal patient while the obstruction to the flow of air through the nose is the primary concern to the clinician who tries to manage it medically or surgically.The aim of this study was to evaluate the abilities of acoustic rhinometry as an objective tool in detecting changes in the nasal cavity in different situations, to study the presence of a correlation between the subjective sensation of nasal patency and acoustic rhinometry measurements and to find if the improvement of objective testing after surgery is mirrored with a corresponding improvement in subjective sensation by patients. Study Design: Prospective study. Methods:This study was undertaken at the ENT Department, North Riding Infirmary, Middlesbrough, UK. In 27 patients with nasal obstruction, a comparison between the subjective sensation of nasal patency using the Visual Analogue Scale ( VAS ) and Acoustic Rhinometry ( AR ) as an objective method of assessment pre- and post-operatively. Results:There was a 49% improvement in sensation of nasal patency, a 20.5% increase in the Total Cross Sectional Area ( TCSA ) and a 29% increase in the Total Nasal Volume ( TNV ) postoperatively. Conclusion:In our study, there was no correlation between subjective sensation of nasal patency and acoustic rhinometry measurements.

Objectives: To review partial glossectomy (PG) in children and to discuss the short- and long-term outcomes. Design: A retrospective review of charts for patients who had PG between 1993 and 2003. Setting: Academic tertiary pediatric center. Patients: Seventeen children aged 13 months to 17 years (9 males and 8 females) at the time of surgery. Intervention: All 17 patients underwent PG. Main outcome measures: Resolution of symptoms, length of hospital stay, and complications. Results: Five children had Down’s syndrome, 4 Beckwith-Weidemann syndrome (BWS), 4 lymphatic malformation, 1 venous malformation, 1 Kabuki syndrome, 1 congenital hypothyroidism, and 1 Branchio- Oto-Renal Syndrome. Seven children had anterior PG and 10 children had both anterior and posterior PG. Two patients were operated upon as a day surgery procedure and 15 patients were admitted to hospital (10 intubated). Length of hospital stay ranged from 2 days to 12 days. Anterior PG patients had shorter length of hospital stay compared to the posterior PG (P = 0.03). Additional surgeries were significantly associated with prolonged intubation and longer hospital stay (P = 0.03 and 0.05 respectively). Obstructive sleep apnea syndrome (OSAS) was completely resolved (confirmed by sleep study) in 62% (5/8 patients). Cosmetic appearance was satisfactory in all patients. Dentofacial abnormalities (DFA) improved in 90% (9/10 patients). Anterior PG was highly associated with a good DFA outcome (P = 0.008). There was no long-term effect on speech and swallowing. Complications observed were dehiscence 35% (6/17 patients), bleeding 17.6% (3/17 patients), and airway obstruction 11.8% (2/17 patients). The follow-up ranged from 3 months to more than 7 years. Conclusion: Partial glossectomy in children is indicated for a variety of conditions. Careful patient selection and tailoring the surgery to the specific patient needs are essential to ensure the best outcome. The aim of the surgery is to accomplish an efficient and aesthetic tongue using the most conservative method.

Introduction: Temporo-mandibular joint ankylosis is a common cause of acquired deformity. Purpose: Surgical correction of the ankylosis only leaves the patient with external facial deformity. This study was done to evaluate the use if distraction osteogenesis in mandibular hypoplosia attributable to TMJ ankylosis and to present our protocol in surgical treatment with this relatively new therapeutic option. Material and Methods: This study was done on seventeen patient with temporomandibular joint and mandibular deformity. Intra oral unidirectional bone born distractors were used in this study.Patient were categorized into three group; Group I underwent arthroplasty followed by distraction osteogenesis. Group II patients had simultaneous arthroplasty and distraction osteogenesis and Group III patient underwent distraction osteogenesis to relief upper airway obstruction followed by arthroplasty. Results: All patient had a satisfactory mouth opening on follow-up and satisfactory correction of external facial appearance was achieved in all these patients. Some degree of malocclusion which were managed secondary by orthodontic treatment. Conclusions: Distraction osteogenesis can be used as treatment to correct facial deformity in patient with temporomandibular joint ankylosis. Long term follow up of these patient is needed to decide wether secondary or even tertiary distraction may be required with further growth.

Introduction: Ectomesenchymal chonndromyxoid tumor (ECT) of the anterior tongue was first described in 1995.To date only 25 cases have been reported in the literature. Case report: A 35-year old woman presented with a 2-cm submucosal mass involving the dorsal aspect of the tongue of a 4-month duration. A incisional biopsy of the mass was performed which was diagnosed as ECT. Tumors cells showed an immunoreaction to vimentin, cytokines and glial fibrillary acidic protein (GFAP). They were negative to S-110,desmin, epithelia membrane antigen, and smooth muscle actin. The patient remains free of the disease 3 years later.

Dermoid cyst (DC) is a cystic form of teratoma, They are commonly presented in the midline of the floor of the mouth although they are found in other soft tissue locations. One hypothesis for their etiology is that they arise from entrapment of epithelial debris or rests during the midline fusion of the first 2 branchial arches. Excision of the dermoid cyst is often the treatment of choice. The extraoral approach is necessary when the cysts lies under the geniohyoid muscle causing deglutition and respiratory problems. On the other hand, the intra-oral approach is effective for the treatment of large lesions and led to very good cosmetic and functional results. The different treatment approaches for two large DCs are presented, the extraoral approach was utilized for a patient who presented to the ER with respiratory problem while the intraoral approach was performed and led to good esthetic results without recurrence.

Chronic invasive fungal sinusitis is a slowly progressive fungal infection with a low-grade invasive process that usually occurs in immunocompetent patients. Orbital apex syndrome, which is characterized by a decrease in vision and ocular immobility due to a mass in the superior portion of the orbit, is usually associated with this condition. We report a case of immunocompetent patient with this infection. Its bizarre clinical presentation brought other related diagnosis to our mind before the fungal etiology.