Background: Cochlear implantation (CI) has become an effective measure for the treatment of many cases with profound deafness. Although it is viewed as a safe technique, minor and sometimes major complication are still taking place after the procedure. The frequency of these complications varies between operating centers. No previous documentation of the frequency of these complications was carried out in Saudi Arabia. Objectives: This study aimed at describing the pattern of complications following CI in one of the main hospitals in the Kingdom of Saudi Arabia. Methods: Through a retrospective study design, all medical records of cases who received CI in the period between January 2009 to January 2014 were obtained from the Health Information Department in King Fahd Hospital (n=142); a constructed checklist was used to systematically collect information regarding available demographic characteristics and complications after cochlear implantation.Data were coded and analyzed using Statistical Package for Social Science version 16.0 (SPSS program). Results: The overwhelming majority of patients were children;128(90%). The overall number of complications following cochlear implantation accounted for 18 cases who represented (12.7%) of all cases. Most of the complications occurred among children making an age adjusted rate of (11.4%). Overall complications were 4(2.8%) spontaneous device failure, 3(2.1%) device failure due to trauma, 2(1.4%) wound infection, 2(1.4%) wound dehiscence, 1(0.7%) hematoma, 1(0.7%) facial twitches, 1(0.7%) post-operative vertigo and 1(0.7%) otitis media. Conclusion: Cochlear implantation is a safe technique with a relatively low complication rate; the reported rates of complications among our patients are approximately similar to what has been recorded in other health institutions worldwide.

Objective: To determine the prevalence of laryngo-pharyngeal reflux diseases (LPRD) in male teaching staff of Jeddah, Saudi Arabia. Methods: A cross -sectional study was conducted on 258 male teachers, both from private and public sectors. All were above 18 years of age, 162(62.8%) from private sector while 96 (37.2%) were from public sector. All participants completed a questionnaire about their dietary habits, height and weight, presence of stress, smoking and allergies, including the nine-item Reflux Symptom Index (RSI). Those who had RSI >13, were invited to King Abdul Aziz University ENT OPD for their free checkup. This included detailed history, local and systemic examination supplemented by Rigid Laryngoscopy, performed by 2 otolaryngologists, an otolaryngologist, a laryngology fellow, and an otolaryngology resident for physical findings of LPR using the Reflux Symptom Index score (RFS).The participants who had RFS score >7 considered to be positive. The LPRD labeled on the basis of RSI score >13 and RFS score >7. Results: Of the 258 male teachers studied, the prevalence of LPRD was 142 (55%), out which 109 from private sectors while 33 form public sectors (67.2% vs. 34.37%, P < 0.0001). The working hours were more in private sector teaching staff as compared to public sector (72 +/- 8 Vs 48 +/- 4, p- < 0.0001). The other clinical variables did not differ significantly. Conclusion: There is higher prevalence LPRD among teachers that reflects heavy burden on their vocal cords. Because of more working hours in private sector there is more prevalence in this group. Future studies will be needed to clarify whether LPRD in teachers is stress-induced and therefore may be considered as a work-related disease.

Background: Nasolacrimal duct obstruction is a common condition encountered by both ophthalmologist and otolaryngologist with symptoms such as epiphora and recurrent dacryocystitis. The treatment of choice is opening with the lacrimal sac to pass by the obstruction (dacryocystorhinostomy). Most surgeon shift to endoscopic approach instead of the external approach. A lot of varieties in surgical procedures have been described. Our aim in this study was to analyze the success rate in endoscopic dacryocystorhinostomy without using silicon tubes as a stent at the end of surgery. Material And Methods: This was a prospective study carried out between the months of January 2011 to December 2013, which included 40 patients. All patients were diagnosed as having only nasolacrimal duct obstruction were included in this study and underwent 50 endoscopic endonasal dacryocystorhinostomy without using silicone tube at the end of the procedure. Results: Forty adult patient underwent endoscopic dacryocystorhinostomy( EDCR) procedure without insertion of silicone tube at the end of the procedure. There were 16 males (40%) and 24 females (60%). Age ranged between 24 years to 80 years. Eighteen (45%) patient had Left EDCR, 12 (30%) patient had Right EDCR and 10 (25%) patient had bilateral EDCR. The follow up period ranged from 6 months to 19 months. Measures that determine the successful outcome include; relief of symptoms, endoscopic visualization of the patent neo-ostium and sac syringing. Thirty sex patients (90%) fulfilled the criteria of successful outcome. Conclusion: Our results and experience suggest that endoscopic darcryocystorhinostomy without stenting offers the same success rate of primary surgery over EDCR with tube stenting.

Objective: To review the clinical outcomes of patients with subglottic stenosis treated using a graftless four-quadrant cricoid division laryngotracheal reconstruction technique. Materials and Methods: This study is a retro- spectivereview of 20 patients with subglottic stenosis who underwent graftless four-quadrant cricoid division laryngotracheal reconstruction during an 8-year period (2006-2013) at a single tertiary care center. Results: During the study period, 20 patients (13 males and 7 females) aged 6 months to 48 years underwent this procedure. Of these, 60% had other comorbid diseases. Using the Myer Cotton Grading System, one patient had grade II subglottic stenosis, 12 had grade III, and seven had grade IV subglottic stenosis. All patients underwent graftless four-quadrant cricoid division laryngotracheal reconstruction with the insertion of a Montgomery T-tube stent. Two patients had a successful outcome, defined as successful decannulation and no further surgeries needed; 16 patients required additional intervention; and two patients required a permanent tracheostomy. Two patients were lost to followup. Conclusion: The findings of the current study demonstrate that graftless four-quadrant cricoid division laryngotracheoplasty often requires further surgical intervention to resolve the stenosis.

Objectives: The aim of this study was to determine the self-perceived burnout among residents of Saudi board of otolaryngology-head and neck surgery. In addition, to identify the potential stressors that can be modified to minimize burnout. Method: The survey instrument in the form of the self-administered close-ended questionnaire was distributed to all otolaryngology residents between second year through fifth-year training. All residents were registered with the Saudi board of otolaryngology–head and neck surgery in the academic year 2013. The survey included all four settings of training in Kingdom of Saudi Arabia (Central, Western, Eastern and Southern). The main variables included the Maslach Burnout Inventory–Human Services Study (MBI-HSS) and demographic information. Results: The response rate was 67% (72/108). All the returned questionnaires were fromcurrent second- through fifth-year otolaryngology residents. Burnout was strikingly prevalent in our study, with 70% of residents expressed either high (45%) or moderate (25%) level of emotional exhaustion. This was highly associated with high levels (60%) of depersonalization and low levels (45%) of personal accomplishment. Burnout was almost equivalent across residents in all years of residency with no significant difference between males and females. Conclusions: The results of this study agree with cited evidence that burnout is likely to be more prevalent among residents. Modification of risk factors, such as confrontations with others and allowing sufficient faculty time for learning and research, should be undertaken to limit the development of burnout and its deleterious sequelae.

Bilateral vocal fold paralysis after thyroidectomy is a devastating complication. Visually intact trunk of the recurrent laryngeal nerve (RLN) does not mean physiologically functioning nerve. We present a case and elucidate possible mechanisms of bilateral vocal cord palsy after thyroidectomy in visually intact recurrent laryngeal nerve.

Background: Tuberculous (TB) otitis media is a comparatively rare variety of TB usually seen secondary to pulmonary tuberculosis or associated with it ^[1],[2]. Tuberculosis is one the major infectious disease with predominant involvement of lung and lymph nodes but tuberculosis of the middle ear is relatively rare ^[3]. Incidence of tuberculosis (per 100,000 people) in Saudi Arabia was 15.00 as of 2012 according to the World Bank data ^[4]. Tuberculous otitis media is difficult to diagnose because it might easily be confused with other middle ear problems, acute or chronic. Complicating this situation is the fact that physicians are generally unfamiliar with its typical presentation. The final diagnosis is challenging because it needs specific culture and pathologic studies ^[5]. Early diagnosis and effective treatment may prevent ear damage as well ascentral nervous system complication. The objective of this study was to report a rare case of bilateral tuberculous otitis media to alert physicians to rare presentation of the disease as well as to discuss the diagnosis and management plan based on literature review.

Endoscopic sinus surgery became the goldstone surgical procedure in treating paranasal sinuses pathology. This surgery is not free of serious complications including optic nerve injury especially with the wide variation of sphenoid sinus pneumatization which changes their anatomical relationship. We present a case of bilateral freely passing optic nerves through the sphenoid sinus associated with bilateral anterior clinoid processes (ACP) pneumatization, in addition to bilateral vidian nerves (VN) protrusion with pterygoid processes (PP) pneumatization.