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  Citation statistics : Table of Contents
   2017| January-June  | Volume 19 | Issue 1  
    Online since January 7, 2020

 
 
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CLINICAL CASES
Job’s syndrome with bilateral submandibular abscess a very rare case report
Ibrahim Sumaily, Mohammad Alshareef, Ali Alqahtani
January-June 2017, 19(1):29-31
DOI:10.4103/1319-8491.275310  
We present a very rare case to be encountered by otolaryngologist which may be the first case report in its presentation. A 16 years old boy known case of Job’s syndrome presented to the emergency department with a history of 3 weeks bilateral painful submandibular swellings, This was accompanied by sinuses discharging purulent discharge. Physical examination and imaging study showed bilateral submandibular septated abscesses. Incision and drainage was done.
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Five years audiological outcomes of the first Saudi Auditory Brainstem Implant (ABI)
Murad O Al-Momani
January-June 2017, 19(1):32-34
DOI:10.4103/1319-8491.275311  
Absence of the cochlear nerve (cochlear nerve aplasia) or complete labyrinthine aplasia (Michel aplasia) is a rare inner ear congenital anomaly. Children born with cochlear nerve aplasia and/or Michel aplasia are deaf and cannot develop speech and language. Conventional hearing aids and/or cochlear implant are of no benefit to manage this condition. The only available option to help children with this condition have a sense of hearing is by directly electrically stimulating cochlear nuclei in the brain stem through a device called auditory brain stem implant (ABI). The main objective of this report was to present audiolgical outcomes over 5 years period for a child who received the first ever ABI in Saudi Arabia in 2011. The ABI procedure, programming and follow up were done at King Khalid University Hospital and King Abdulaziz University Hospital in Riyadh. Results revealed good sound detection to both testing stimuli and environmental sounds. The child developed 2 word sentences which helped her communicate more effectively. These results are comparable to results of other ABI centers worldwide. In conclusion; audiological results of the first ABI in Saudi Arabia are positive and very well in agreement with results worldwide.
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ORIGINAL ARTICLES
The effect of sleep disordered breathing on children’s behavior
Ibrahim Khalid Aljabr, Alaa Ali Al Ghanim, Bayan Mohammed Buhaimed
January-June 2017, 19(1):6-10
DOI:10.4103/1319-8491.275312  
Objective: To evaluate the effect of adenoton-sillectomy, adenoidectomy, or tonsillectomy on improvement of attention deficit, hyperactivity, conduct, and oppositional defiant disorders in patients with sleep disordered breathing (SDB) secondary to adenotonsillar hypertrophy. Methods: This was a prospective observational study. It was conducted in Al-Ahsa City in Saudi Arabia, from 10 June 2015 until 25 December 2015. A total of 28 children from a tertiary hospital underwent adenotonsillectomy, adenoidectomy, or tonsillectomy for treatment of SDB. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating scale was distributed to parents before the surgery and 3 months after the surgery. Data were analyzed with SPSS Mac’s software version 20.0. Results: Of the 28 children, 17 (60.7%) were boys and 11 (39.3%) were girls. The age range was from 3 to 11 years; the mean age ±standard deviation was 6.1±1.97. A statistical significant difference (P<0.05) was found when the mean scores of the T-DSM-IV-S for oppositional-defiant, inattention, and hyperactivity disorders were compared before surgery and three months after surgery, while there was no statistical significant difference in the mean scores of conduct disorder (P=0.805). Conclusion: SDB is shown to be associated with many psychiatric symptoms and illnesses. The presence of SDB may even worsen the already present psychiatric illness. Treatment of pediatric patients with SDB secondary to adenoid and/or tonsillar hypertrophy will improve the severity of these psychiatric symptoms. It will also improve learning, behavior and overall quality of life.
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Do blind people have better hearing levels than normal population?
Abdul-Rahman Ali Al-Saif, Kamal-Eldin Ahmed Abou-Elhamd, AbdulRahman Khalid Alabdalali, Sayed Ibrahim Ali
January-June 2017, 19(1):1-5
DOI:10.4103/1319-8491.275306  
Objective: To find out if there is a difference in hearing levels between normal and blind people. To answer the following questions, “Is the concept of losing one sense will improve the other senses right or wrong? If someone born blind, will he have better hearing abilities than those with a good vision?” Study Design: A cross sectional study. Materials and Methods: Forty male students aged between 13-22 years old from two special education schools were randomly selected to evaluate their hearing levels from Eastern district, Saudi Arabia at the period from February 2016 to April 2016. They were divided into two groups. The first group included the student with visual impairment (13 students) and total blindness (7 students) for more than 5 years. The second control group is of 20 students with normal vision. A questionnaire was answered by each one. Anyone with history of ear disease was excluded from the study. A pure tone average thresholds (PTAs) were obtained for left and right ears for the frequencies 0.125, 0.25, 0.5, 1, 2, 4 and 8 kHz. Data were statistically evaluated using SPSS version 20. Results: Hearing levels were normal in most of the participants with mild hearing low average for both ears in the visually impaired plus totally blind subjects compared to the control group was non-significant, P value = 0.829 (>0.05). While, there was significant difference at the hearing levels between pure tone average for both ears in the three groups (visually impaired, totally blind and normally sighted group) using ANOVA test, P value = 0.04 (< 0.05) with the lowest hearing level at the totally blind group. Conclusion: Loss of one sense does not potentiate other senses as some people believe. Blind people have the same level of hearing as normal population.
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Perioperative antibiotic usage in otorhinolaryngology: A survey of current practice in Saudi Arabia
Ali S Al-Qahtani, Fares N Alsharif, Osama A Al-Qahtaniy, Motaz N Alsharif, Rahaf M Alhayafah, Ashish Kumar
January-June 2017, 19(1):11-16
DOI:10.4103/1319-8491.275307  
Objectives: This study was planned and designed to determine the current practice and trends of perioperative antibiotic usage in Saudi Arabia. Methods: A survey was developed using electronic “Google forms” which included epidemiological data and six questions including practices of prescribing antimicrobials against 14 common surgical otorhinolaryngology procedures, antibiotic preference and awareness about existing supportive evidence for prescribing antibiotics pre or postoperatively. The survey form was mailed to all current members of Saudi society of Otorhinolaryngology in Saudi Arabia, and it was followed by two email reminders. Responses were analyzed by utilizing appropriate statistical tests of significance. Results: A total of 514 surveys were mailed out; 139 fully completed responses were obtained from the central archival system and included in final analysis. A trend of significantly higher usage of antibiotics postoperatively compared to preoperatively was observed in all common surgical otorhinolaryngological procedures. The responders however did not perceive that sufficient evidence was available to support their usage in many surgical procedures. Conclusion: Antibiotic usage in otolaryngology surgery remains a controversial issue that requires further standardized studies. We conclude that in order to reduce the misuse of antibiotics and limit emergence of resistance internationally accepted and approved guidelines for anti-microbial therapy should be adhered to and followed uniformly across the country.
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Recurrence of branchial anomalies after surgical excision: Rate and associated factors
Ibrahim S Alnoury, Saeed A Alghamdi, Moayad O Rayes, Hussein M Etwadi, Mohammed Algarni
January-June 2017, 19(1):17-19
DOI:10.4103/1319-8491.275308  
Background: Branchial anomalies are uncommon of embryonic development that is commonly discovered by otolaryngologists. The recognition of the development of branchial apparatus and their anomalies is important during surgery. Post-operative recurrence is a rare, however possible complication. Objectives: To investigate the post-surgical recurrence among patients who underwent surgical excision of the branchial cleft cysts and its influencing factors. Subjects and methods: This is a retrospective study of twenty cases of branchial anomalies presented to the department of Otolaryngology, Head and Neck Surgery, King Abdul-Aziz Medical City, National Guard, Jeddah, Saudi Arabia, over a period of 12 years from October, 2003 to October, 2015. Patient’s gender, type of lesion (cysts and fistulae), side of lesion (right and left), surgeon (ENT versus non-ENT), FNA histopathological and radiological findings as well as operative complications were noted from the case records. Primary diagnosis was done through FNAC and radiology whereas histopathological examination as a final diagnosis was done and available for all included cases. All patients were operated upon through surgical excision. Results: Twenty patients were included in the study; 13 males and 7 females. Recurrence was reported in only one case (5%). Histopathologically, all cases were benign looking cells. The recurrent lesion was found in a male patient, on right-side, the lesion was fistulous in nature, surgery done by non-ENT surgeon; Fine-needle aspiration cytology (FNAC) was not done, no radiological finding, and with history of postoperative complications. No statistically significant association was found between recurrence of the lesion and all the studied factors, p>0.05 Conclusion: Recurrence of branchial anomalies after surgical excision is rare. However, further multi-centric research is recommended to identify the possible predictors for recurrence.
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Effect of age of hearing aid fitting on cochlear implant outcomes
Farid Alzhrani, Sabah Mohammed Hassan, Abdulrahman AlSanosi
January-June 2017, 19(1):20-24
DOI:10.4103/1319-8491.275309  
Objective: To determine the effect of age of hearing aid (HA) fitting on cochlear implant (CI) outcomes, in terms of language development, auditory skills, speech perception, production outcomes and speech intelligibility skills. Methods: Sixty seven children were included in the study. Children were divided into 2 groups according to age at HA fitting. Group 1 was fitted with HA before the age of 3 years. Children in Group 2 were fitted with HA after the age of 3 years. All children were evaluated preoperatively and at 12, 24, 36 months of device experience using the language screening test, Standardized Arabic Language test, Listening Progress Profile (LiP Test), the Monosyllabic-Trochee-polysyllabic Test (MTP), and Speech Intelligibility Test. Results: Group 1 (n=39) had a mean age at HA fitting of 22.13 months and mean age at implantation of 32.26. Group 2 (n=28) had a mean age of HA fitting of 42.04 months and mean age at implantation of 67.86.Preoperatively, Group 2 had a significantly higher language age, LiP test score, and MTP score than did Group 1. After 36 months of device experience, no significant difference was found between the groups’ results. Group 1 had higher language age, LiP test score,and MTP score. Group 1 had a significantly higher speech intelligibility than Group 2 at 12, 24, and 36 months device experience. Conclusions: Children who were fitted early with HAs were early implanted (under the 3 years of age), and had better auditory skill, speech perception, and language production outcomes. Limited resources and the absence of a national hearing screening program in Saudi Arabia result in the late presentation of children for evaluation and intervention; this late intervention negatively impacts the development of the language skills of late-implanted children.
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