Objectives: The aim of this study was to evaluate the effect of the lower implant-supported dentures on speech compared to the lower conventional complete dentures. Material & Methods: Two groups of patients were selected for this study (Test Group N=5; Control Group N=10). Test group was completely edentulous and control group retaining all of their natural teeth. Speech evaluation for the test group was conducted when edentulous, with conventional dentures, one day and then two weeks after fitting of implant dentures. The speech assessment composed of two parts; subjective evaluation using Arabic Articulation Test (AAT) and objective evaluation using Computerized Speech Lab. (CSL). Results: Using AAT, the four tested phonemes showed improvement in pronunciation. Pitch contour and energy contour extracted using CSL proved that energy contour of /z/ had showed statistically significant difference, while in the pitch contour there was no statistically significant difference. The phoneme /z/ did not show any significant statistical difference for both parameters. Conclusion: We can conclude that implant-supported dental prostheses may have a favorable positive effect on articulation compared to conventional dentures.

Objective of the study: The purpose of this study was to establish universal newborn hearing screening (UNHS) program in King Fahd Military Medical Complex (KFMMC) Hospital and to study the prevalence of hearing impairment in neonates delivered in this hospital. Study Design: All neonates delivered normally or by cesarean section in KFMMC from 15 April 2003 to 1st August 2006 were screened for hearing impairment by OAEs then ABR. Results: A total of^[2592] neonates were screened for hearing loss. The prevalence of hearing loss was 0.98% in both ears, 51 out of 5184 ears have hearing loss. 29 (1.1 %) newborn had hearing loss of various degrees, 22 of them were bilateral and 7 newborn had unilateral hearing loss. Conclusion and Significance: The incidence of hearing loss in KFMMC seems to be higher than the international recorded percentage. From this study we conclude that TEOAEs can be used successfully in universal newborn hearing screening and UNHS should be made mandatory in order to allow for early detection and management of hearing loss.

Objectives: To determine the prevalence of allergic rhinitis (AR) in patients suffering from allergic-like symptoms. Material and Methods : Ninety one symptomatic patients were evaluated according to the total IgE level, specific IgE antibodies (Phadiatop ®) and total eosinophils count. Results: Of the symptomatic patients 61.5% were diagnosed to have AR with a higher prevalence in males than in females. Conclusion: The prevalence of Non-AR is high especially in females and the blood investigation is a useful technique to differentiate between AR and Non-AR patients.

Objectives: To study the variations in the course of the facial nerve by studying the second genu angle (S.G.A.) to provide a more detailed description of the anatomy of the nerve to avoid its injury during middle ear surgery. Materials and Methods: We studied 35 adult temporal bones by dissecting them at Temporal bone lab in Ain Shams University Specialized Hospital (ASUSH). We studied the variations in the course of the facial nerve by measuring the length of the tympanic part of the facial nerve, S.G.A. and the distance between the S.G.A. and the oval window niche. We tried to find a certain relation between these 3 variables. Results: We studied 35 adult temporal bones, 28 (80%) had an obtuse S.G.A., 5 (15%) had a right S.G.A. and 2 (5%) had an acute S.G.A. with an overall mean of the S.G.A. = 116.97° (+/- 18.07).The length of the tympanic part of the facial nerve in the 34 temporal bones was = 12.47 +/-0.435 mm. The distance from the oval window niche to the S.J.A. in all the specimens was variable and ranged from 2mm to 4.1 mm (mean=3.314 mm +/- 0.435 mm). We found a relation between the length of the facial nerve, the S.G.A. and the distance of the facial nerve from the oval window niche. The more the tympanic part of the facial nerve is shorter the more obtuse the angle is, the more the nerve comes closer to the oval window and on the other hand the more the tympanic part of the facial nerve is longer, the more acute the angle is and the more the nerve is separated from the oval window. Conclusion: Our pioneer study showed a new way of thinking in the variations of the facial nerve relations according to variations in the nerve parameters. We proved that the measurement of the S.G.A. and the distance between the S.G.A. and the oval window is variable but depends on the length of the tympanic part of the facial nerve. This will help us to anticipate the facial nerve position preoperatively to avoid its injury during middle ear surgeries.

Purpose: The aim of this study was to evaluate the role of endovascular treatment in controlling idiopathic epistaxis. Materials and Methods: Over a five years period, 32 patients with clinically proven idiopathic epistaxis were referred for endovascular embolization. All cases were referred from the Ear, Nose and Throat (ENT) specialty service after failure of conservative treatment. Bilateral selective diagnostic angiography of the Internal and external carotid arteries followed by bilateral embolization of the distal branches of the Internal maxillary arteries were performed in all cases using a combined system of a regular guide catheter and a microcatheter for delivery of Poly Vinyl Alcohol particles. The average clinic follow up duration was 18 months. Results: Out of the 32 cases of idiopathic epistaxis, 26 patients (81%) had immediate complete cessation of epistaxis with no recurrence. Three patients (9.5%) required minor chemical cautery after removal of the nasal pack. Bleeding had completely stopped prior to hospital discharge. Three patients (9.5%) remained with minimal sporadic attacks of epistaxis. Conclusion: Endovascular embolization is successful in treatment of idiopathic epistaxis and should be considered as one of the main therapeutic options.

Objectives: The purpose of this report is to provide data on delayed facial palsy (DFP) after mastoid and middle ear surgery, and to discuss the possible etiology. Study Design and Setting: This is a retrospective report carried out at a university-based hospital Patients: The records of 1980 patients with normal facial function before mastoid and middle ear surgery were reviewed. Measures: Delayed facial palsy was defined as facial palsy occurring after the initial postoperative evaluation. Results: During the 6-year period from 1998 to 2003 consecutive mastoid and middle ear operations were reviewed. A total of 7 delayed facial palsies (DFP) were identified. All were incomplete and recovered completely following conservative treatment. The mechanism of DFP was not known in two cases , chorda tympani stretching in one case , iatrogenic facial exposure in two patients and herpes viral reactivation in two patients. Conclusion: DFP occurred in 0.35% after middle ear and mastoid operations. Several factors may contribute to DFP including chorda tympani injury,iatrogenic, infection, facial canal edema ,immune response and recently several reports suggesting strongly viral reactivation as one of the main causes of DFP.

Objective: To compare the radiofrequency tissue volume reduction (RFTVR) with other techniques available for reducing the size of the turbinate, soft palate and uvula. Method: Prospective study of 80 patients who underwent RFTVR to turbinate, soft palate and uvula. Results: Out of the 80 patients 49 patients were males and 31 were females and the age range was 13-66 years. Seventy six patients (95%) were reported “satisfied” and only 2 patients had complications, namely moderate secondary bleeding and pain not controlled by paracetamol. Conclusion: RFTVR is a safe and simple in-office procedure that can be applied widely for the reduction of turbinate, soft palate and uvula.

Sphenoid sinus mucocele is an uncommon lesion with unknown etiology, but their formation is thought to be caused by an accumulation of mucus due to obstruction of the sinus ostium. Many factors including inflammation, trauma , chronic sinonasal disease and tumors, were reported to cause sinus ostium blockage and result in mucocele formation. Diagnosis is mainly depends on radiological studies and intraoperative finding. Headache, visual loss, ophthalmoplegia and proptosis are the main clinical symptoms of sphenoid sinus mucocele. We report an unusual case of acute bilateral loss of vision caused by huge sphenoid sinus mucocele. Diagnosis was made by computed tomography scan , magnetic resonance imaging and intraoperative finding. The patient was successfully treated surgically through an endonasal endoscopic approach. The patient had complete recovery of his vision almost immediately after surgery in both eyes.

Cholesterol granuloma is a pathological lesion affecting the mastoid air cells due to partial obstruction of its aeration. It is commonly unilateral. It is usually associated with glue ear with intact ossicles. Histologically, it is characterized by the presence of large pointed crystals and giant cells. Its treatment is either conservative steroid therapy or surgical removal of the granuloma through simple mastoidectomy. This is a case report of cholesterol granuloma which was a cause of persistent ear infection in a Saudi female patient. In conclusion, if there is persistence of middle ear infection in spite of proper medical treatment the physician should think of mastoid cholesterol granuloma.

Introduction: Sinusitis is a common disease but requires thorough evaluation to rule out complications. Case Report: A patient with 4 months history of sinusitis not responding to medical treatment was found to have osteomyelitis. Conclusion: Sinusitis after trauma not responding to antibiotics requires further investigation to rule out osteomyelitis.

We report a 7 day full term Eritrean male patient who presented to otolaryngology outpatient clinic with a mass on the left side of the tongue dated since birth and interfering with suckling and swallowing. The mass was in the anterio-inferior aspect of the tongue, well demarcated, lobulated, superficial and well covered with mucosa. No other masses were found in the oral cavity or the body. The child has no dysmorphic features. Excision biopsy of the tongue mass was done. The mass was well demarcated and superficial, and did not show deep invasion of the intrinsic musculature of the tongue. Permanent sections were consistent with fetal rhabdomyoma (FR). Follow up for 1 year revealed no evidences of recurrence, however long term follow up is recommended.

Vogt-Koyanagi-Harada disease is a rare disease characterized by bilateral uveitis, hearing loss, alopecia, poliosis, and vitiligo. The exact cause is not known, but an immune response to a human leukocyte antigen (HLA) is suspected. Diagnosis is made by medical history and physical examination. High dose systemic steroids drug therapy is often the treatment of choice. This paper highlights that, the symptoms started during the sixth decade, and the syndrome presented mainly with what looked like pure neurological and CNS signs and symptoms.