Objective: To study the effect of topical mitomycin C 2 mg/ml in cases of laryngeal stenosis [subglottic stenosis and laryngeal web] and whether there is any difference in the outcome between the two different concentrations 2 mg/ml for 4 minutes and 0.4mg/ml for 4 minutes. By reviewing the literature there was no study found comparing the outcome of different concentrations of mitomycin C. Patients and Methods: This is a retrospective study of fifteen patients with laryngeal stenosis that were managed at King Abdulaziz University Hospital, King Saud University between June 2008 and February 2010. All patients underwent microlaryngoscopy and laser dilation followed by topical mitomycin C. The outcome of the single use of topical mitomycin C in two concentrations (2 mg/ ml and 0-4 me/ml) for 4 minutes was compared. Results: Twelve (80%) out of 15 with laryngeal stenosis improved after microlaiyngoscopy, laser dilation and the application of mitomycin C 2mg/mi, compared to 5 (42%) out of 12 patients who underwent the same procedures but with the application of mitomycin C 0.4mg/ml. Conclusion: According to our data, there was more benefit of the use of mitomycin C in higher concentration (2mg/ml for 4 minutes) and the observed difference was statistically significant p=0.025.

Objective: The aim of this study was to present our results of fat graft myringoplasty. Due to its simplicity and reliability, this technique seems to be as efficient as other classical graft techniques. Patients and Methods: We analyzed data from 131 patients operated in our hospital for a tympanic perforation between 2002 and 2010 using an endoscope-guided techniques with adipose graft. Patients were evaluated postoperatively at seven days, one month, three months and one and two years. Criteria of success were the complete closure of the tympanic membrane, absence of lateralization of the tympanic membrane and no audiometric impairment. Results: Treatment was successful in 92 % of adult patients and 94 % of pediatric patients with at least two years follow-up. The failures occurred in patients with contraindications such as myringosclerosis, myringitis and perforation size greater than 50% of the tympanic surface. Conclusions: Endoscopic-guided myringoplasty using an adipose tissue graft is a rapid, safe, reliable and efficient procedure that should be performed in first intention for selected indications .

Objectives: To better define the limits of normal swallowing in the elderly, our study aims to relate objective sensory and mechanical deficits measured during flexible endoscopic evaluation of swallowing with sensory testing(FEESST) to subjective quality of life data from patients and evaluate the significance of these changes. Methods: Patients with perceived normal swallowing were recrtuited from the Montreal General ifospital. The study group were > 65 years of age and the control group <65 years of age. All patients underwent FEESST and filled the MD Anderson Dysphagia Inventory. Clinical findings and subjective opinion about swallowing capacity were assessed. Results: The mean age was 76 in the elderly group and 21 in the control group. Patients in the study group demonstrated some mechanical impairment. There was no significant difference in sensory testing between groups. There was a significant difference in swallowing-associated quality of life between the two groups. Conclusion: Changes in swallowing occur as a continuum over time and elderly have significant changes in function that can alter normal physiology. The normal physiology of swallowing while aging needs to be better defined to define the limits of normal and allow true definition of pathology requiring intervention.

Infantile hemangioma (IH) is a benign neoplasm that commonly develops in neonates within their first few months of life ^[1]. For reasons that arc not clear, hemangiomas are approximately 3 times more common in female infants and are also more common in whites. Most infantile hemangiomas undergo rapid initial proliferation, with a subsequent plateau in infants aged about 9-10 months; finally, they involute. The involuting phase extends from 1 year until 5 to 7 years of age ^[2]. Different modalities of management are described in the literature which can be classified as conservative policy, medical treatment and surgical intervention. We present a case of infantile hemcngioma which was managed successfully using medical treatment.

Arteriovenous hemangiomas are benign vascular lesions. A network of arterial and venous structures is characteristic of these cutaneous vascular tumors. Vascular lesions are commonly found in the head and neck region. These lesions may involve the ear, usually extending from external ear canal to involve the tympanic membrane. Lesions limited to the external ear canal without involvement of tympanic membrane are very few and those reported may be counted on fingers. However there is no documented cases of lesions involving and limited only to the concha of the external ear in the English literature. Here we report the first such case of arteriovenous hemangioma involving and limited to the concha of external ear.