The successful treatment of vascular anomalies is closely related to a sound knowledge of the biologic behaviour of vascular lesions and their correct classification. Based on the clinical progress, Mullicken and Glowacki developed a biological classification that was accepted as the official classification system of the International Society for the Study of Vascular Anomalies. (ISSVA) As a result of an extended literature research an overview will be given on the different internationally accepted treatment concepts. Even if a wait-and-see strategy can often be recommended in cases of uncomplicated hemangiomas of infants the rapid proliferative growth of such lesions requires an adequate therapy. In comparison to that vascular malformations that generally persist for lifetime require treatment, in particular when clinical symptoms occur. Based on individual parameters such as diameter, location, or growth behaviour different therapeutic measures might be successfully performed such as for example cryotherapy, corticosteroid application, laser therapy, sclerotherapy, operative interventions, and/or embolisation. However, none of the mentioned strategies represents the only treatment of choice.

Objectives: To evaluate the benefits of coblation against blunt dissection (cold steel) tonsillectomy with bipolar diathermy haemostasis. Comparison was done regarding postoperative bleeding, pain and healing of tonsillar fossae. Materials and Methods: In this prospective study, a comparison between 100 coblation tonsillectomies with 100 blunt dissection tonsillectomies was done. Results: Favorable outcome was demonstrated regarding the postoperative pain and healing of tonsillar fossae with no significant changes noted in the postoperative bleeding rate when using the coblation technique. Conclusion: Coblation tonsillectomy is a safe procedure with less postoperative pain and better healing of tonsillar fossae than blunt dissection tonsil- lectomy but the cost of the disposable hand pieces should be considered.

Objective: Orbital complications of acute sinusitis are common. If not treated promptly and properly, they lead to serious consequences. This study aimed at delineating the clinical , bacteriological and radiological findings and the outcome of management of orbital cellulitis. Materials and Methods: This was a review of 17 cases of orbital cellulitis seen over the period April 2000-November 2007. Al cases received full clinical examination, laboratory testing and CT scanning of the sinuses. All cases were treated conservatively and follow up period was up to 2 years. Results: Seventeen cases were reviewed. The age range was 7 months to 26 years and there were more males than females. The most common presenting feature was proptosis. Treatment consisted of I.V. antibiotics with I.V. Steroids. Local decongestant and steroid were also used. No cases needed surgical interventions except for the incision and drainage of a lid abscess. Conclusions: The addition of I.V. steroids to the management of orbital cellulitis is valuable and with no added morbidity.

Objective: to examine the effect of long term topical (endonasal) treatment with Acetyl salicylic acid (ASA) on the recurrence rates of nasal polyps after endoscopic polypectomy in both aspirin sensitive and aspirin tolerant patients. Mehods: In our study we divided the patients into 2 groups: First group (study group): 36 patients with nasal polyps ( 21 men, 15 women ) aged 18-59 years were enrolled in the study. According to ENT indications, all patients underwent endoscopic removal of nasal polyps. About one month after surgery patients underwent intranasal treatment with increasing doses of lysine acetylsalicylate (LAS) corresponding to 450, 900 and 1800 microgram of LAS diluted in 2 ml normal saline and used as local spray in the nose once daily six times/week. Second group (control group): 40 patients with nasal polyps (26 men , 14 women, aged 18-58) who underwent endoscopic removal of nasal polyps and used saline nasal spray only postoperatively (placebo). Results: The difference between the 2 groups as regard the recurrence rate of the nasal polyps was statistically highly significant with (P<0.001, Fischer’s exact test). No statistical significant difference in the rates of recurrence was found between aspirin tolerant and aspirin sensitive patients (P>0.05). Conclusion:_In conclusion, the postoperative use of local ASA spray in the nose is safe, cost effective and significantly decreases the rate of recurrence of nasal polyps after surgery in both aspirin tolerant and aspirin sensitive patients.

Objective: to study the socioeconomic factors and ethnicity in the course of pediatric allergic fungal sinusitis (AFRS) with bone erosion who underwent endo-nasal endoscopic surgery (EES) in Saudi Arabia and Egypt Design and Setting: Descriptive retrospective review study conducted during 5 years period at the ENT Department of El Menoufyia University Hospital, Egypt, Al Iman General Hospital and Riyadh Medical complex, Saudi Arabia.. Methods:Twenty patients (age range, 5-17 years; mean age, 13.1 years; median age, 13.5 years) met previously published criteria for AFRS. Thirteen patients were males and 7 were females. Thirteen were Saudi and 7 were Egyptian. All underwent endo-nasal endoscopic surgery ( EES) after short period of oral systemic corticosteroids followed by postoperative nasal corticosteroid spray. Age, sex, presentation, preoperative serum IgE levels, radiological extent of disease, intra-operative evaluation and recurrence rates were compared in Saudi and Egyptian patients. Result: Twelve patients (60%) presented with radiographic and intra-operative evidence of intra-orbital extension and /or ventral skull base erosion. They were 9 Saudi (7 male and 2 female) and 3 males Egyptian. Facial dysmorphism, was seen in 9 patients (45 %). Postoperative recurrence was seen in 9 patients (7 Saudi and 2 Egyptian). Conclusion: Although Saudi AFRS patients have higher socioeconomic status than Egyptians (both belong to the same ethnic group), Saudi AFRS patients were found to have a more aggressive form of the disease with more intraorbital and/or intra-cranial extra-dural extension. These finding are in contrast with the previously published series of AFRS patients. However, further studies would be necessary before the results of these studies could be generalized worldwide.

Objectives: to identify some of the risk factors underlying specific language impairment among 2 and 3 years old Saudi children. Methods: All children suffering from delayed language development at the ages of 2 and 3 years have been studied from amongst those attending the speech clinic in King Abdulaziz University Hospital , Riyadh and Ministry of Health in Riyadh ,Saudi Arabia between January 2007 to July 2007.Detailed history was taken including personal history stressing on parental consanguinity, socioeconomic level of the family, the family size, mother’s level of education and vocation and family history of speech/language disorders. This history was complemented by a questionnaire that was filled by parents about all information needed for the history. Any child with problems was excluded. Intelligence tests were done. The sample was composed of 92 children, 2 and 3 years old, of normal prenatal, natal, postnatal and developmental histories, of average intelligence, and of normal hearing on the sensory level. Language assessment using the standardized Saudi Arabic Language Test (S.A.L.T.) was done to assess both receptive and expressive language abilities of these children. Results: Correlating the socio-demographic risk factors with the language performance of the whole sample, results showed that all factors : positive consanguinity, low socioeconomic state, low or no mother’s education and no vocation, were highly significantly correlated with the poor language achievement at P=0.000. Similarly, the presence of recurrent otitis media and the presence of positive family history of speech/language disorders, both showed high significant correlations among the poor language achievement of the sample at P=0.000. Conclusion: In the present study, we evaluated six risk factors influencing language development of 2 and 3 years old Saudi children. Results proved the strong influence of all factors studied.

The author reports a very rare case of mite otoacriasis with review of the world literature. The patient presented with a history of intractable bilateral ear itching for more than two years. The condition defied diagnosis until mite infestation was demonstrated. The diagnosis was established by microscopic ear examination and laboratory examination of the causative arthropods. Mite infestation of the external auditory canal is a very rare condition, which is scarcely reported in the literature . The condition may pose difficulty in diagnosis because live mite are not clearly recognized by the human eye.

We describe three cases with otological complications from impression material used to make hearing aids molds.