Objectives: The study was undertaken to assess the effective duration of nasal packing following routine septoplasty and rhinoplasty surgery with or without turbinate surgery. The aim of the study was to compare the use of nasal packing for two different durations with respect to discomfort and complications. Methods Fifty-four patients who underwent nasal surgery were assigned into one of two groups: 6 hours nasal packing group and 24 hours packing group. The scores of postoperative discomfort or pain and bleeding were recorded. Results The 6 hours packing group showed less postoperative discomfort in comparison with the other group who had packs for 24 hours. There was no significant increase in the incidence of bleeding. Conclusion Septoplasty and rhinoplasty surgeries can be managed postoperatively with packing for only 6 hours with reduced discomfort and complications. Problems and complications attendant with the routine use of nasal packs are explored.

Objectives: The objective of the study was to observe the hemodynamic response to osteotomy during septorhinoplasty under deliberate hypotension induced with 2MAC of isoflurane or sevoflurane. Methods: Ninety six patients, labeled according to the American Society of Anaesthesiologist’s physical status 1 & 2, were randomly divided in to two groups, Iso- Group and Sevo-Group. At induction, all patients received a bolus dose of fentanyl 2 microgram kg-1., propofol 2.0mg.kg-1 and cis-atracurium 0.15mg.kg-1. Anaesthesia was maintained with intermittent positive pressure ventilation, 50% nitrous oxide in oxygen and 2MAC of isoflu- rane in Iso-Group and 2 MAC svoflurane in Sevo- Group. Mean arterial pressure was maintained in the range of 55-65mmHg. Heart rate and mean arterial blood pressure were recorded prior to and after the osteotomy of the nasal bone with periosteum elevation on left side. After five minutes, the same procedure was repeated on the right side without periosteum elevation. Results: In both groups, post osteotomy heart rate and mean arterial blood pressure were significantly higher than the pre-osteotomy values. Conclusion: We conclude that there is an exaggerated hemodynamic response to osteotomy even under hypotensive anesthesia with 2MAC of either isoflurane or sevoflurane.

Objective: To review our cases of recurrent respiratory papillomatosis (RRP), and to compare our data to that available in the international literature. Method: This was a retrospective analysis of the data available in the charts of 9 patients with the diagnosis of RRP at King Abdulaziz University Hospital (KAUH), Riyadh, Kingdom of Saudi Arabia (KSA). Patients were managed between July 1997 and June 2007. Patient’s files were evaluated for demographic data, presenting symptom, types of , frequency of intervention, follow up duration and outcomes. Result: All patients presented with hoarseness, and upper airway obstruction. Approximately 88% of the patients underwent their first endoscopic technique in our institution. The microdebrider was used more frequently than the CO2 laser (29 vs. 6 times) to resect laryngeal papilloma. Adjuvant therapy was used in 2 of the patients in the form of Cidofovir local injection. Conclusion: According to our data diagnosis of RRP at an age of 3 years or less is associated with frequent recurrences. Surgical debulking utilizing microdebrider is safe, less time consuming and is not associate with significant bleeding.

Lobular capillary hemangioma ( LCH) is a benign lesion that may occur on skin or mucosal surfaces. We report two cases of LCH of the nose occurring in a Saudi and an Egyptian patients.. Lobular Capillary hemangioma is more common than it is thought to be.