Otorhinolaryngologic Diseases Commons^™

Editorial Letter

Pan Arab Journal of Rhinology

No abstract provided.

Acute-Phase Reactants Association With Smell Disorders In Coronavirus Disease 2019-Infected Patients, Ahmed A. Nassar, Ahmad M. Eltelety

Pan Arab Journal of Rhinology

Objective Olfaction is a complex sensory process that has not been fully investigated. In this study, we aimed at investigating whether there is an association between acute-phase reactants [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophil-to-lymphocyte ratio (NLR), and serum ferritin] and the presence of smell disorders in coronavirus disease 2019-infected patients. Patients and methods A prospective study was conducted on 61 patients presented to the Otolaryngology Department with a confirmed diagnosis of coronavirus disease 2019 based on the real-time reverse transcription PCR between July 2020 and February 2021. Participants in this study were divided into two groups: group A …

Aberrant Expression Of Soluble Programmed Death-Ligand 1 And Inducible Costimulator Ligand In Patients With Nasal Polyps, Mohamed M. Osmana, Omnia H.B. El-Badaway, Asmaa M. Zahran, Mohamed A.M. Salem, Ahmed G. Abdelraheemd

Pan Arab Journal of Rhinology

Aim We aimed to measure the levels of soluble programmed death-ligand 1 (sPD-L1) and soluble inducible costimulator ligand (sICOS-L) in patients with nasal polyps and to compare their levels between a group with allergic rhinitis (AR) with nasal polyps and another with allergic fungal rhinosinusitis (AFRS). The study also aimed to assess the relationship between their levels and disease severity. Patients and methods The study included 35 patients admitted for endoscopic sinus surgery for nasal polyps, who were divided into 17 with AR and 18 with AFRS and 20 controls. Radiologic computed tomography (CT) score of Lund-Mackay was used to …

Benefits Of Vitamin D Supplementation After Functional Endoscopic Sinus Surgery For Recurrent Nasal Polyposis, Mohammad A. Al-Morsy, Marawan A. Ibrahim

Pan Arab Journal of Rhinology

Background Nasal polyps as a type of nasal masses usually present with nasal obstruction and smell disorders. There is high recurrence following sinus surgery, which motivated us to study the role of cholecalciferol in preventing recurrence of sinonasal polyposis after endoscopic excision of these polyps. Objective The aim of the work was to study the clinical and radiological outcomes of oral cholecalciferol supplementation after functional endoscopic sinus surgery for recurrent nasal polyposis. Patients and methods A total of 62 patients with recurrent sinonasal polyposis were included in our study during the period from January 2019 to May 2022. The patients …

Effect Of Tonsillectomy On Humoral Immunity In Children With Obstructive Sleep Apnea Below The Age Of 3 Years, Ayman A. Mohamdy, Mohammed F. , Shendy, Nahed F. Khater, Mostafa Gomaa Sobhy

Pan Arab Journal of Rhinology

Background

Tonsils are one of the most significant secondary lymphoid organs in immune system. They contain B and T lymphocytes. B cells produce all five classes of immunoglobulins. The tonsillectomy’s effect on the immune system is still up for debate.

Objective

The study was done to observe the effect of tonsillectomy on humoral immunity parameters (IgA, IgM, and IgG) in children with obstructive sleep apnea before and after tonsillectomy.

Patients and methods

A total of 60 patients who were scheduled for tonsillectomy because of obstructive sleep apnea, with ages below 3 years, and diagnosed by clinical findings of adenotonsillar hypertrophy …

Modified Posterior Nasal Nerve Neurectomy With Inferior Turbinoplasty, As A Treatment For Intractable Rhinitis Syndrome: A Long-Term Effect Prospective Cohort Study, Ahmed S. El Sayed Eid Saleh, Hossam M. Kamal Aly Rabie, Tarek A.H. Hamdy

Pan Arab Journal of Rhinology

Background Allergic and vasomotor rhinitis are a well-known medical entities affecting a huge population. In most cases, medical therapy helps these people. However, sometimes these treatments are often ineffective. The surgical treatment of intractable rhinitis had been introduced a long time ago, starting from vidian nerve neurectomy to a recently introduced more simple and safe procedure [endoscopic posterior nasal nerve (PNN) neurectomy]. This study combined two valid and widely used surgical procedures for intractable rhinitis surgical management, that is, modified PNN neurectomy and inferior turbinoplasty (IT), aiming to ensure long-term results. Patients and methods A total of 30 adult patients …

Dilemma Of Prolonged Post- Covid 19 Anosmia Treatment, Abdelhakeem Mahmoud Ali Ragaee

Pan Arab Journal of Rhinology

Context: Anosmia is one of the pathognomonic neurological symptoms of COVID-19 since its begging at the end of 2019. Many patients suffered persistently for prolonged time after infected with this virus. Aims: The aim of this study was to recognise the predisposing factors, to identify possible treatment regimens and to assess the prognosis of prolonged post- COVID-19 anosmia. Settings and Design: retrospective observational study

Methods and Material: study conducted among patients with post COVID-19 anosmia. Thirty-four patients sought medical advice for having prolonged post-COVID-19 anosmia between the period of August 2020 and October 2021 and assessed for predisposing factors. They …

Direct Transnasal Dural Suturing After Endoscopic Hypophysectomy: Promising Outcomes, Ahmed Abdelwahab, Abdelwahab Rakha, Mohammed Abdelwab, Yasser Khfagy, Hossam Elsisi

Pan Arab Journal of Rhinology

Background Endoscopic endonasal transsphenoidal surgery is the gold standard method for surgical management of pituitary adenomas; yet the troublesome issue is the potential of cerebrospinal fluid (CSF) leak with possible persistent leak and meningitis. Sellar reconstruction is a prerequisite to prevent postoperative CSF leak. Watertight dural stitching is a reliable method of closure of intraoperative defects, but this was always challenging due to the narrow and deep operative field and the need of special designs of surgical instruments. We present a simple, easy to use direct dural suture with no need to additional surgical instrument for closure of dural tear …

Editorial, Reda Kamela, Ahmed El-Faroukb

Pan Arab Journal of Rhinology

No abstract provided.

Outcomes Of Middle Turbinate-Septal Adhesion Technique And Trans-Septal Middle Turbinate Suture Technique To Prevent Middle Turbinate Lateralization: A Comparative Study, Muaid I. Aziz Baban, Hiwa A. Rawandizi, Hozan F. Ali, Sahar J. Hadi, Shkar N. Mohammed

Pan Arab Journal of Rhinology

Background Middle turbinate lateralization (MTL) is the most common undesirable sequela after functional endoscopic sinus surgery (FESS), which can result in recurrent sinusitis. Objectives To examine the efficacy and outcomes of different techniques to prevent failure of the primary surgery. Patients and methods Eighty patients who presented with chronic rhinosinusitis listed for FESS were enrolled in this study. Patients were divided randomly into two groups, with 40 patients each. In group A, middle turbinate (MT) was stabilized by adhesion technique, and in group B, MT was stabilized via suture technique. A comparison of the effectiveness and the outcomes of both …

Treatment Outcome Of Rhino-Orbital-Cerebral Mucormycosis Patients: A Retrospective Institutional Study, Nishant S. Saxsenaa, Amrita Srivastavaa, Madhu Yadav, S.K. Kanaujia, H.K. Gautama, Shalani Tripathia, Shaleem Khana, Tripti Agrwala

Pan Arab Journal of Rhinology

Introduction Rhino-orbital-cerebral mucormycosis is an acute fungal infection characterized by fungal hyphal invasion of blood vessels resulting in thrombosis and infarction of the nasal, paranasal sinus, orbital, and cerebral tissues. Patients and methods This was a retrospective study conducted on 80 patients with biopsy-proven mucormycosis. The study was carried out in the Mucormycosis Ward of a Tertiary Care Medical College and Hospital during a period of 6 months from May 2021 to October 2021. Results Among 80 patients, 50 (62.5%) were males and 37 (37.5. %) were females. Of the patients, 53.75% were in the age group of 51–70 years. …

Review Of First 60 Pituitary Adenoma Cases Of A Skull Base Team, One Center Experience, Osama Hassan, Mohamed Fatthallah, Mohamed El Mallawany

Pan Arab Journal of Rhinology

Background: Endoscopic endonasal transsphenoid approach of pituitary gland is being effectively replacing microscopic approach. This approach need a lot of training and stepwise learning to reach perfection. This study discuss the experience and pitfalls of an evolving skull base team in one institute. Aim of the work: Analysis of first sixty pituitary adenomas patients operated by an evolving skull base teams in one institute, and highlighting modifications introduced in their technique. Methodology: This is a retrospective analytical study of the medical records of first 60 pituitary adenoma patients who had presented to one center and had endoscopic trans-nasal trans-sphenoidal approach …

Chronic Qat Chewing Effects On Nasopharynx, Oropharynx, And Laryngopharynx, Ahmed Mahmoud El Batawi, Ahmad M. Eltelety, Mohamed Abd Elmottaleb Sabaa

Pan Arab Journal of Rhinology

Background Qat (also known as Khat, Kat, Miraa) is a green plant Catha edulis planted mainly in East and South Africa, and The Arabian Peninsula. It is widely and traditionally consumed by people in some regions. It has general effects on different systems such as cardiovascular and nervous system. Local effects were mainly described in the oral cavity such as periodontitis and white keratotic lesions. Scarce studies proved its relationship with cancer development. To date, there is a literature gap in reporting other local manifestations. In this study, the authors discuss additional local manifestations noted with chronic qat chewing. Aim …

Topical Application Versus Intraturbinate Injection Of Botulinum Toxin Type A In The Treatment Of Noninfectious Chronic Rhinosinusitis, Naslshah G. Kazem, Mohamed A. Elsaid, Aya L. Hassan, Abdelrahman A. Abdelalim

Pan Arab Journal of Rhinology

Background Chronic rhinosinusitis is a very common disorder caused by chronic inflammation or irritation of nasal mucosa. Objectives The purpose of this study was to evaluate the efficacy and safety of topical application of botulinum toxin type A (BTX-A) compared with intraturbinate injection for the treatment of noninfectious chronic rhinosinusitis. Patients and methods This prospective comparative study was carried out on 30 patients with noninfectious chronic rhinosinusitis. Patients were divided randomly into two groups. BTX-soaked merocel was applied topically in group A (topical group), which included 15 patients. Intraturbinate BTX injection was applied in group B (injected group), which included …

Anosmia And/Or Ageusia In Coronavirus Disease 2019-Infected Patients: Role Of Early Corticosteroids And Timeline, Naslshah G. Kazema, Emad R.H. Issakb

Pan Arab Journal of Rhinology

Aim An increasing number of coronavirus disease 2019 (COVID-19) cases have started to experience unusual symptoms to the virus such as olfactory and gustatory dysfunctions. The study aimed to compare the effects of early corticosteroids (CS) administration versus no administration in the time-to-recovery from olfactory dysfunction in COVID-19. Patients and methods This comparative, nonrandomized study has been conducted at Benha University Hospital and another Primary Health Center in Cairo, Egypt, from January 2021 to June 2021. A total of 83 patients who have met the inclusion criteria were assigned into two groups: early-CS group (41 cases) and no-CS group (42 …

Editorial Letter, Reda Kamel, Ahmed Elfarouk

Pan Arab Journal of Rhinology

No abstract provided.

Editorial Letter, Reda Kamel, Ahmed Elfarouk

Pan Arab Journal of Rhinology

No abstract provided.

Radiographic Changes Of The Nasal Septal Swell Body In Patients With Sinonasal Polyposis, Yasser Mohammed Hassan Mandour, Ahmed Soliman El Kady, Hamada Mohamed Khater, Mohamed Afify Mohamed Afify, Samer Badie Kamel, Abdelrahman Ahmed Abdelal

Pan Arab Journal of Rhinology

Background: The nasal septal body is a dilated section of the anterior nasal septum that is situated anterior to the middle turbinate and around 0.7–1.5 cm above the nasal floor.

Aim: This study analyses the measures taken from patients without sinonasal polyposis in order to identify the structural alterations in the nasal septal body (NSB) among patients with sinonasal polyposis.

Patients and methods: This retrospective study was conducted between April 2021 and February 2022 involving a review of paranasal sinus computed tomography (PNS CT) scan among patients with sinonasal polyposis and without sinonasal disease. The anterior part (A) was measured …

Olfactory Function As A Postoperative Parameter For Success Of Functional Endoscopic Sinus Surgery In Chronic Rhinosinusitis With Nasal Polyps, Wael S. Mohamed, Mohamed T. El-Ghonemy

Pan Arab Journal of Rhinology

Introduction : allergic nasal polyps associated with chronic rhinosinusitis always leads to disturbed sense of smell and impaired life quality. After failure of medical treatment in the form of anti-histaminic and local steroids, we usually proceed to functional endoscopic sinus surgery (FESS) to improve life quality.

Materials and methods : Total 48 patients were comprised in this work. All patients were subjected to routine nasal examination, nasal endoscopy and CT scans paranasal sinuses axial and coronal cuts before surgery and 3 months after operation. We used Sniffin’ sticks to assess psychophysical olfactory function.

Results : Disturbance of sense of smell …

Transnasal Endoscopic Piezoelectric Surgery For Repair Of Choanal Atresia, Ramez Sabry Fahim, Mohammed Sayed Abd El Azeem Fawaz, Ashraf Mahmoud Khaled, Maie Mohammed Hossam El-Den, Rabie Sayed Youssef

Pan Arab Journal of Rhinology

Background: Restenosis and reclosure of the choana are challenging complications after repair of choanal atresia (CA). Modifications to bone drilling with no injury to surrounding nasal soft tissues may reduce postoperative reclosure. Objectives: Our study aims to assess the effectiveness of piezoelectric device in preservation of muco-periosteal flaps and its outcome in reducing postoperative granulation tissue formation and restenosis. Methods: 20 patients with unilateral boney or boney membranous choanal atresia underwent removal of the atretic plate using the piezoelectric device with preservation of the muco-periosteal flap to cover the borders of the neo-choana. Checkup of the cases ranged from 6 …

Endoscopic Dacryocystorhinostomy With Nasal Mucosal Flaps: A Comparative Study, Heba Mohamed Mahmoud Hamdy, Mohammad Abdelaziem Mohammad, Ismail Seddik Elnashar, Wael Fayez Nasr, Waleed Mohamed Basha Amin Mohamed Khamis, Ahmed Ibrahim Elsayed

Pan Arab Journal of Rhinology

Introduction:

Endoscopic dacryocystorhinostomy is a procedure employed to treat epiphora caused by anatomical obstruction of the nasolacrimal pathway. Its principle is to create a connection between the lacrimal sac and the nasal cavity to bypass the obstruction and restore the tear flow. Diverse modifications to conventional endoscopic dacryocystorhinostomy have been developed to improve its success rate. The present study aims to compare the results and assess the outcome of endoscopic dacryocystorhinostomy using a novel flap technique, inferiorly-based nasal mucosal flap, versus the posteriorly-based flap in cases of epiphora due to primary acquired nasolacrimal duct obstruction.

Patients and Methods:

Under general …

Piezosurgery Versus Conventional Osteotomies And Rasping In Open Rhinoplasty, Amr Gouda Shafik, Mohamed Sherif Abdelmonem, Ashraf Mahmoud Khaled, Tamer Abdelmonem Azzam, Khaled Abd El Moaty Hafez

Pan Arab Journal of Rhinology

Background: Piezosurgery is appropriate for all bony surgeries, but it is predominantly helpful when access is limited and/or the bones are close subtle soft tissue, Aim and objectives; this work aimed for comparing conventional osteotomies and rasping with the Piezosurgery medical device, as regard operative time, post-operative edema, ecchymosis, and pains in open rhinoplasty patients. Subjects and methods: It is a prospective study done at our university hospital from June 2019 to December 2020. This study included 40 patients, 20 done with Piezosurgery technique in osteotomy and rasping, other 20 with conventional technique in osteotomy and rasping. This study involves …

Myofunctional Therapy For Treatment Of Obstructive Sleep Apnea: A Narrative Review, María Teresa García Iriarte, Laura Rodriguez Alcala, Peter Baptista, Guillermo Plaza, Carlos O’Connor-Garcia, Carlos O’Connor-Reina

Pan Arab Journal of Rhinology

Obstructive sleep apnea (OSA) is a serious and prevalent public health disorder that can have long-term detrimental effects on the cardiovascular, nervous, and metabolic systems, and increase the risk of accidents and mortality. Newly identified pathophysiological traits of OSA include decreased upper airway pharyngeal dilator muscle responsiveness. Myofunctional therapy (MT) has been proposed as a treatment to improve dilator tone by performing isotonic and isometric exercises of the tongue and other upper airway muscles. This article reviews the beginnings of this therapy and describes systematic reviews and meta-analysis published until February in 2023 focusing in our experience using MT as …

Comparative Study Between The Efficacy Of Azelastine-Fluticasone Nasal Spray Combination And Fluticasone Nasal Spray Combined With Oral Cetrizine In Allergic Rhinitis, Irinie Georges Makarious Soliman, Ahmed Ashraf Salah Elhamshary, Mostafa Gomaa Sobhy El Shahat

Pan Arab Journal of Rhinology

Aim: Comparison between administering intranasal AZE/FLU combination, and the conventionally used oral Cetrizine, with intranasal Fluticasone for Allergic Rhinitis. Methods: A prospective randomized controlled study, where 100 patients were enrolled to two groups; Group A patients received AZE/FLU twice daily, while Group B patients received Fluticasone propionate once daily in the morning PLUS oral Cetrizine at night. Patients recorded nasal and ocular symptoms scores daily in a diary using a clear Arabic printout of VAS score. Pre- and post-treatment scores were collected at regular visits. Results: Regarding progression of symptoms through checkpoints over trial time; on days seven, 14 and …

Impact Of Nasal Septum Surgery On Sinonasal Symptoms In Patients With Nasal Septum Deviation, Mahmood A. Hamed, Noha M. Elsherif, Mostafa A. Eltaher

Pan Arab Journal of Rhinology

Objectives: The nasal septum is an important physiological and support structure of the nose. Nasal septal deviation is common in population and reported to be between 18.8-57.6%. In this study we aimed to evaluate the impact of nasal septal surgery on sinonasal symptoms using pre and post-operative sinonasal outcome test (SNOT-22) questionnaire as a subjective measure for the disease and improvement. Methods: We had 40 patients presented with nasal complaints due to deviation of the nasal septum to whom septal correction was performed. Pre and 3 months post-operative SNOT 22 were compared. Results: A highly significant difference was found between …

Egyptian Clinical Pathway For Post Covid-19 Acute Invasive Fungal Rhinosinusitis, Ashraf Khaled, Ismail Elnashar, Ahmed Hassan Sweed, Ahmaed Elfarouk, Hossam Elsherif, Ahmed Ragab, Zakareya Elraei, Mohamed Elsharnouby, Baleegh Hamdy, Alaa Ghita, Omar Elbanhawy, Reda Kamel

Pan Arab Journal of Rhinology

Acute invasive fungal rhinosinusitis (AIFRS) is a rare but fatal disease, particularly in immune-compromised patients, including those with hematological malignancies, poorly controlled diabetes mellitus (DM), and those who received immunosuppressive treatment following organ transplantation or chemotherapy for solid organ malignancies. Mortality rates remain high, around 50-80%, though some recent studies have shown higher survival rates with early diagnosis and complete surgical resection. Surgical debridement, systemic antifungal therapy, and prompt correction of the underlying systemic disease are necessary for treatment of AIFRS. During the COVID- 19 pandemic, an increased rate of AIFRS was reported in the course of; or following COVID-19 …

Clinical Outcomes After Septoplasty Using Cartilaginous Batten Graft In The Management Of The Caudal Septal Deviation, Abdelrahman Ahmed Abdelalim, Ashraf Alhamshary, Ibrahim Said Reyad, Ayman Abdelaal Mohamady

Pan Arab Journal of Rhinology

Background: Caudal septal deviation is a major cause of nasal obstruction. This problem greatly inhibits normal nasal breathing by narrowing of the nostril and external nasal valve area. It also represents a clear aesthetic problem due to the asymmetry of the nostrils Objectives: To evaluate the clinical outcomes of septoplasty using cartilaginous batten graft in cases with caudal septal deviation regarding the relief of nasal obstruction and aesthetic results. Materials and methods: This prospective single armed study was conducted on twenty patients suffering nasal septal caudal deviation. Septoplasty was performed using a caudal septal batten graft with different technique in …

Piezo Assisted Turbinoplasty: A Nopel Rapid And Safe Technique

Pan Arab Journal of Rhinology

No abstract provided.

Endoscopic Dacryocystorhinostomy For Recurrent Epiphora After Previous Nasolacrimal Duct Surgery, Mostafa Talaat, Balegh H. Abdelhak, Ayman Samir Megahed, Mohamed Esmail Khalil, Raafat Abdelrahman Abdallah, Ahmed Abdel Rahman Abdelaziz

Pan Arab Journal of Rhinology

Background: Revision of external DCR may be required due to various factors, including complications of the initial surgery or unaddressed concurrent nasal pathologies. This study focuses on endonasal revision DCR for patients with persistent epiphora symptoms after failed external DCR. Methods: We included 67 patients (19 male and 48 female), aged 19–45, who had previously undergone primary external DCR and presented with persistent epiphora symptoms after at least 12 months of the primary procedure. All patients were clinically examined for concurrent nasal pathology by exploratory endoscopy and computerized tomography (CT) of the nose and paranasal sinuses. Revision endonasal DCR was …

The Egyptian Clinical Practice Guidelines Of Otorhinolaryngology, Audio-Vestibular & Phoniatrics (Ecpg-Orlap)

Pan Arab Journal of Rhinology

1. Acute Rhinosinusitis: Adapted Egyptian Clinical Practice Guidelines
Ahmed Ragab, Reda Kamel, Ashraf Khaled, Baliegh Hamdy, Ahmed Elfarouk, Mohamed Elsharnouby, Hossam Elsherif

2. Chronic Rhinosinusitis: Adapted Egyptian Clinical Practice Guidelines
Ahmed Elfarouk, Magdy Eisa, Mohamed Osama Tomoum

3. Allergic Rhinitis: Adapted Egyptian Clinical Practice Guidelines
Ahmed Ragab, Reda Kamel, Mohamed Gamea, Ayman Medani, Zeyad Mandour

4. Epistaxis: Adapted Egyptian Clinical Practice Guidelines
Ibrahim Rezk Mohammed, Diaa Elhennawi, Mohamed Rifaat Ahmed

5. Cerebrospinal Fluid Rhinorrhea (CSF): Adapted Egyptian Clinical Practice Guidelines
Ismail Elnashar, Mostafa A. El Taher, Ashraf Elhosini, Tamer Orabi

6. List of Contributors

7. Acknowledgement