Using microgrinding of temporal bones, the Advance Off-Stylet insertion technique was proven to enable more atraumatic insertions of Contour electrodes with Softip and to provide very reliable perimodiolar placements.

Objectives: To evaluate the incidence, presentations and different treatment outcomes of orbital complications secondary to sinusitis.Methods: We conducted a retrospective chart review of patients with orbital complications secondary to sinusitis seen at Ain-Shams University Hospitals (Department of OtoRhinoLaryngology, Cairo, Egypt) over a period of three years. Data obtained from the charts included clinical presentations, contrast enhanced computed tomography data, type of treatment, surgical approaches used and their outcomes.Results: Thirty-five patients (35) presented to Ain Shams University Hospital over the three year period with orbital complication secondary to sinusitis. Medical treatment was successful in 15 patients; surgical drainage was done in 19 cases (13 cases were done endoscopically and 6 were drained externally) including orbital exenteration and Caldwell Luc procedure which were done in the same patient (fungal infection). One case developed coma and passed away the same day of presentation despite aggressive management and neurological consultation.Conclusion: Orbital complications of sinusitis have a good prognosis when detected early and managed appropriately. The key point here should be increasing physician awareness towards this problem as well as encouraging early referral to specialized centers for the proper management of these cases.

Introduction Thyroidectomy is a common procedure. Certain swallowing problems could happen after this surgery and affect the quality of life of the patient. Objective To evaluate swallowing after thyroidectomy in the early and late postoperative periods and to correlate subjective and objective parameters. Methods A prospective study with100 patients who underwent total thyroidectomy at our institution from April 2018 to September 2019. Each patient was assessed by the Arabic version of the Eating Assessment Tool (EAT-10) questionnaire and the fiberoptic endoscopic evaluation of swallowing (FEES) preoperatively, and in the early postoperative (EPO) and late postoperative (LPO) periods. Results The rate of dysphagia was of 82% in the EPO period, and of 36% in the LPO period. Two groups were compared regarding vocal fold mobility using the FEES. Group I included 89 patients with normal vocal fold mobility, 42% of whom had early dysphagia, and only 22% had late dysphagia. Regarding swallowing, we found that in the EPO period, the rates of delayed triggering, aspiration, penetration and residue were of 12.4%, 0%, 0%, and 42.7% respectively. Group II (unilateral immobile vocal fold) included 11 patients in the EPO evaluation, and all of them had early dysphagia. Conclusion Swallowing problems can occur in patients after thyroidectomy regardless of alterations in larynx mobility, and they are characterized by delayed triggering and stasis of food, which are also noticed in the LPO period, though more frequently in the EPO period. Moreover, there is a highly significant correlation between the subjective and objective parameters of swallowing in both EPO and LPO periods.

Background Adenoidal hypertrophy is considered one of the most common diseases in otolaryngology. It is usually associated with nasal obstruction symptoms like snoring and hyponasality. If not treated well, children will encounter many complications like otitis media with effusion and craniofacial abnormalities. Adenoidectomy is the main line of treatment for many otolaryngologists, but recently medical treatment by using intranasal corticosteroids (INCS) has shown beneficial effects in reducing the size of adenoids or improving the obstruction symptoms. Objectives To assess the efficacy of nasal corticosteroids in improving nasal airway obstruction in children with symptomatic adenoidal hypertrophy. Patients and Methods A comprehensive search in MEDLINE and CENTRAL was undertaken (1985–2017). We identified all randomized controlled trials in children with adenoidal hypertrophy that compared the effects of nasal corticosteroids and normal saline nasal spray on different outcomes. The primary outcomes were improvement of nasal obstruction symptoms assessed by any symptoms score and reduction in adenoid size as demonstrated by fiberoptic nasopharyngoscopy or lateral nasopharynx radiograph. Results Twenty-three relevant potential citations were identified and screened for retrieval; nine articles were suitable for these meta-analyses. The included randomized controlled trials were enrolled in five meta-analyses. Three meta-analyses showed significant improvement in adenoid size after the use of INCS with a risk ratio of 0.68, standardized mean difference (SMD)=−2.97, SMD=−0.67, respectively. Two meta-analyses showed insignificant improvement in nasal obstruction symptoms with SMD=−1.53 and SMD=0.67, respectively. Conclusion INCS can be used in children with moderate to severe adenoid hypertrophy to reduce the adenoid size and improve the associated symptoms. Close monitoring of improving of the symptoms is a must to predict the need of nonmedical management.

Objective This study aimed to compare the effect of pneumatised and non-pneumatised mastoid on the success of tympanoplasty in terms of rate of graft uptake and air–bone gap improvement. Method A comprehensive electronic search of PubMed Medline, Scopus, Web of Science and Cochrane Library was conducted in August 2020 for articles from 1990 to 2020. Selected studies were published in the English language, were conducted on human patients, were concerned with evaluating pre-operative mastoid pneumatisation on tympanoplasty success, were not laboratory studies and were not opinion studies. Five studies were included with 178 patients in the pneumatised group and 97 patients were included in the non-pneumatised group. Comparison between both groups was performed in terms of graft uptake rate and air–bone gap improvement. Results Although the pneumatised group showed better graft uptake rate than the non-pneumatised group, there was no statistically significant difference between the two groups in the success rate of tympanoplasty. Conclusion Pneumatisation of the mastoid does not significantly affect the success rate of tympanoplasty.