Objective: To present the clinical profile of patients subjected to closed reduction of fractured nasal bone and review the outcome of the procedure from the patient’s perspective. Methods: Patients with nasal bone fracture treated with closed reduction in King Abdulaziz University Hospital, Riyadh between 1 January 2008 and 31 December 2013 were included. The essential data consisting of personal details, history, examination, details of surgical corrections were charted. Patients were followed-up by a telephonic interview to obtain their level of satisfaction of the outcome. Results: Of the 163 patients who were studied, 147 patients could be successfully contacted and interviewed, and 16 patients could not be contacted. Of the 147 patients, 65 (44%) patients expressed full satisfaction with the functional and aesthetic outcome; 42 (29%) patients were partially satisfied but would not consider revision surgery; 39 (27%) patients were not satisfied and would consider revision surgery. Conclusion: Despite a relatively high patient satisfaction rate with the functional and aesthetic outcome of closed reduction of nasal fracture, a significant number of patients (27%) are unsatisfied.A thorough pre-operative evaluation of the nasal deformity including presence of pre-existing deformities and meticulous surgical correction might reduce the rate of the unsatisfactory outcome of the primary surgical procedure.

Objective: to review our experience in patients with external auditory canal cholesteatoma. Study design: Retrospective chart review Setting: King Abdulaziz University Hospital and Prince Sultan Military Medical City Methods: A retrospective wchart review of all patients between 2009 and 2012 with the diagnosis of external auditory canal cholesteatoma were included. The data included age, sex, presenting symptoms, duration of symptoms, clinical and radiological findings and modalities of management . Patients with incomplete data were excluded. A Microscoft Excel® program (Microsoft Corporation, Seattle, Washington) used for analysis and plotting charts and tables. Results: A total of thirteen patients with 15 ears found. Eight females and five male patients with age range between 12 and 50 years with a mean age of 31 years. The most common presenting symptom was otorrhea. Ten patients had a history of hearing loss. The duration symptoms varied between one to fifteen years. Three patients had history of trauma to temporal bone while seven patients had history of exposure to radiation therapy for nasopharyngeal carcinoma several years previously. In five patients no causes could be identified. Six patients underwent surgery and one of them had developed partial facial paralysis House-Brackmann grade III which recovered completely within six months. Conclusion: External auditory canal cholesteatoma can be easily missed if careful examination is not carried out. Early diagnosis and management is paramount if serious complications are to be prevented.

Background/objective: Dysphagia is a common complaint in patients who developed cerebrovascular stroke. Those patients show different degrees of compliance on swallowing therapy and functional swallowing outcomes. The aim of this work was to evaluate compliance and functional outcome measures after receiving swallowing therapy in patients with oropharyngeal dysphagia post cerebrovascular stroke. Materials and Methods: In this study, behavioral swallowing therapy was applied to 22 patients with oropharyngeal dysphagia post cerebrovascular stroke and the compliance to therapy was evaluated together with the functional swallowing outcome measures. Results: There was significant statistical difference in the compliance to swallowing therapy through different follow up sessions. Also, there was significant improvement of the functional swallowing outcome measures from the bedside initial assessment through the follow up sessions. Conclusion: The results of this study proved the compliance and effectiveness of behavioral swallowing therapy in improving the functional swallowing outcome measures in patients with oropharyngeal post cerebrovascular stroke.

Objective: The aim of this study was to evaluate the value of stepping test in diagnosis of labyrinthine dysfunction Study design: A cross sectional study. Methods: A random sample of 50 female medical students, from second to fifth grade (22 +/- 2 year old) at college of medicine, King Faisal University, Saudi Arabia in May 2014 were examined by the stepping test. Results: Out of 50 students, 27 (54%) showed positive test, 6 of them (12%) were complaining of frequent vertigo, while 21 of them (42%) have no complaint related to the ear. Conclusion: Stepping test is not an effective diagnostic tool for inner ear pathologies. The rotational movement as a positive result, has almost an equal sensitivity but higher specificity than the forward movement. We suggest to consider the test is positive only when both the forward and rotational movements are positive, or at least the rotational movement is positive but not the forward movement. This will increase the sensitivity and specificity of the test.

Objectives: To estimate the incidence and examine the pattern of thyroid malignancy, assess the magnitude of the disease, methods of management and ways of improvement to ease the burden on patients residing in the region of Wadi Al-Dawasir in the south of the Kingdom of Saudi Arabia. Methods: Retrospective cohort study from January 2001 to December 2008 which included all patients with goiter who underwent total thyroidectomy at Armed Forces Hospital, Wadi Al-Dawasir, Kingdom of Saudi Arabia and were followed regularly until end of July 2014. Results: There were 107 thyroidectomy cases during the study period, eight of them proved to be malignant. The malignant cases were all females who received radioactive iodine following their surgery and were followed every 6 months until the end of July 2014. Conclusions: The study showed that the incidence of malignancy among patients with goiter treated surgically at Armed Forces Hospital, Wadi Al-Dawasir, is less than other regions of Saudi Arabia while the average age of patients is younger than that in other areas. Due to remoteness of the region, a full oncology service is needed to lessen the burden on patients seeking cancer treatment.

Objective: To evaluate preoperative risk factors of velopharyngeal insufficiency (VPI) after adenotonsillectomy in children. Settings: Tertiary cares medical centres. Design: Retrospective study using patient’s charts review. The aim of this study is to look at the associated risk factors that may explain the presentation of VPI in children following adenotonsillectomy. Methods and Material: Retrospective chart review of 32 children presented with VPI following adenotosillectomy between January 1, 2008 and December 30, 2014 at Asser Central Hospital (ACH) and Abha Private Hospital (APH). The data collected included the total number of adenotonsillectomy cases, patient age at surgery, gender, date of surgery, indications and outpatient postoperative notes. Exclusion criteria included; patients older than 12 years, children diagnosed having velocardiofacial syndrome, submucous clefts and those who had follow up less than 6 months. Results: Total numbers of ten thousand and eighty adenotonsillectomy cases were done in 7 years period. Thirty-two patients (0.3%) presented with postoperative hypernasality and nasal regurgitation. The mean age was 6 years. Females were more predominant than males (21 F, 11 M). The most common indication for surgery was mouth breathing and snoring in 19 (59.38%) patients. Short soft palate was the main cause of VPI in 20 (62.50%) patients. Conclusions: Velopharyngeal Insufficiency, although uncommon, is a well-known complication of adenotosillectomy. Patients presenting with obstructive symptoms and signs of adenotonsillectomy in presence of short soft plate or deep pharyngeal wall should be counseled for possible development of postoperative VPI. Most of symptoms of postoperative VPI resolve spontaneously.

Objective: This article reports evaluation of 30 patients with Vocal Cord Dysfunction (VCD) and the outcome of conservative management program including voice therapy and breathing exercises. Study design: A prospective observational follow up study. Methods: Thirty consecutive referrals of refractory asthma patients and patients presented by laryngeal symptoms diagnosed as having VCD were assessed, treated and followed for at least 6 months after treatments. Results: 53% of patients had adduction of vocal folds during inspiration, 50% had posterior glottis congestion and 95% had constriction of supraglottic area during inspiration. There was highly significant differences in the scores of both self-reported questionnaire and laryngeal parameters before and after therapy with lowering the scores after voice therapy Conclusion: There are signs during laryngeal examination which could be used for diagnosis of VCD in between attacks and we can conclude that voice therapy with psychological counseling and anti-reflux treatments are effective in controlling the manifestations of VCD.

Background/Objective: Thermal stimulation is considered one of the behavioral therapy that is used to improve and facilitate swallowing mechanism in patients with oropharyngeal dysphagia. The aim of this work was to study the effect of thermal stimulation on different temporal measures of oropharyngeal swallowing in patients with oropharyngeal dysphagia post cerebrovascular stroke. Materials and Methods: In this study, thermal stimulation was applied to 23 patients with affected temporal measures (prolonged pharyngeal delay time and pharyngeal transit time) in patients with oropharyngeal dysphagia post cerebrovascular stroke. Results: There was significant statistical difference in pharyngeal delay time pre-thermal stimulation from post-thermal stimulation for all the tested consistencies except thin liquid consistency and significant difference of the pharyngeal transit time only with solid consistency. Conclusion: The results of this study proved the effectiveness of thermal stimulation in improving the affected changes on temporal measures that occurred with certain consistencies in patients with oropharyngeal dysphagia post cerebrovascular stroke.

We present a rare case of intranasal tooth in 22 years old male who was operated before 21 years for cleft lip. This patient presented to otolaryngology outpatient clinic with complaint of long standing unilateral right nasal discharge. It is a rare complication of cleft lip and palate. There are only 7 cases reported in literatures and we believe this is the first case reported in adult patient.

Objective: A 12 year old girl with right cheek mass for 10 months with pain and redness was seen. The swelling was adherent to the skin, mobile over the underlying structures, with mild tenderness. The mass excised and hitopathologically was pilomarixoma.

Laryngeal and hypopharyngeal lipomas are a rare forms of benign laryngeal neoplasm. Spindle cell lipoma is an uncommon histological variant of benign lipoma .This article present a case of spindle cell lipoma, where the patient presented with symptoms of feeling of a mass like ball in the airway without dysphagia,. Examination showed a pedunculated soft tissue mass coming from posterior wall of left pyriform sinus with unspecific finding on CT scan, The mass was excised completely with microlaryngoscopy cold dissection. Histopathology diagnosis came as spindle cell lipoma .With a review of the literature regarding the pathogenesis and treatment .