Background: Tonsillectomy is one of the most widely recognized surgeries for tonsillitis. It is the default surgery option for obstructive sleep apnea, recurrent tonsillitis, and recurrent peritonsillar abscess. However, there are limited risk factor analyses in Saudi Arabia related to tonsillectomy. The goal of study is to evaluate and analyze the risk factors for secondary post-tonsillectomy bleeding in Saudi Arabia. Method: This retrospective review study was directed at King Abdullah Specialized Children’s Hospital, Riyadh, Saudi Arabia. Univariate and multivariate investigations were performed to decide the risk factors. Results: A total of 713 children were included. Post-tonsillectomy bleeding occurred in only 5.3% of tonsillectomies. There was no seasonal variation impact on post-tonsillectomy bleeding rate ( P = .8). The multivariate analysis showed a significant association between post-tonsillectomy bleeding and both age (odds ratio [OR] = 1.156; 95% CI: 1.007-1.326; P = .039) and sleep disorder breathing/obstructive sleep apnea (OR = 3.581; 95% CI: 1.454-8.820; P = .006). Conclusion: This study revealed that age, sleep disorder/obstructive sleep apnea, and longer hospital stay after tonsillectomy are significant risk factors for post-tonsillectomy bleeding. This study provides an important baseline for further local studies in the future.

Objectives: To evaluate coronavirus disease 2019 (COVID-19) patient tracheostomy outcomes. Methods: All COVID-19 patients at the National Guard Hospital, Riyadh, Saudi Arabia, were retrospectively recruited. Those who had tracheostomies between April and December 2020 were included. Results: The population was 45 patients, of which 30 (66.7%) were males, 15 (33.3%) were females and the mean age was 66.76±12.74 years. The tracheostomy indications were anticipated prolonged weaning in 40 (88.9%) and failed extubation in 5 (11.1%) of the patients. The mean intubation to tracheostomy duration was 20.62±7.21 days. Mortalities were high, with most attributed to COVID-19. Mortality and a pre-tracheostomy C-reactive protein (CRP) uptrend were significantly related ( p =0.039). Mortality and intubation to tracheostomy duration were not significantly related. The mean post-tracheostomy time to death was 10.64±6.9 days. Among the survivors, 20 (44.4%) males and 11 (24.4%) females were weaned off mechanical ventilation; 9 (20%) remained on ventilation during the study. The mean ventilation weaning time was 27.92±20 days. Conclusion: The high mortality rate was attributed to COVID-19. Mortality and a pre-tracheostomy CRP uptrend were significantly related; uptrend patients experienced far more mortalities than downtrend patients. Unlike previous findings, mortality and intubation to tracheostomy duration were not significantly related.

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HighlightsSquamous cell carcinomas of the temporal bone are rare malignancies.This is a case of clear cell squamous cell carcinoma.Otalgia, otorrhea, and hearing loss are the usual presenting symptoms.This case of temporal bone SCC was aggressive in nature and presentation.

Background: Pneumolabyrinth consequent to a temporal bone fracture is a rare entity. It occurs when air enters the vestibulocochlear system due to a pathological communication between the middle and the inner ears. The diagnosis is usually confirmed radiologically using high-resolution computed tomography imaging. Pneumolabyrinth is categorized radiologically as follows: vestibular pneumolabyrinth, cochlear pneumolabyrinth and combined pneumolabyrinth. Case Presentation: We herein describe the clinical presentation and management of pneumolabyrinth in a 43-year-old man, following an otic capsule-violating temporal bone fracture. After initially caring for the patient conservatively, without improvement, surgical intervention was undertaken. Unfortunately, hearing was irrecoverable. Conclusion: Delaying medical and surgical intervention and the location of the air bubbles associated with the combined type contribute to the irrecoverable loss of hearing. As otic capsule-violating fractures might not be observed initially on brain CT scans, high-resolution and thin-slice CT scans of the temporal bone is crucial when suspecting temporal bone fracture.