Spontaneous assisted ventilation in the extraction of a seed in the lefy main bronchus

We report a six-year-old Egyptian male who had aspirated a sunflower seed in his airway. The seed was removed using a fibreoptic camera and long forceps while he was ventilated using the SAV method

Newborn hearing screening

Background: Congenital hearing loss has a major impact on both cognitive and speech-language development which eventually leads to impaired communication and a lower socio-economic status

Objective: To evaluate the result of newborn hearing screening

Design: A Retrospective Study

Setting: NICU and Post-Natal Ward, King Hamad University Hospital, Bahrain

Method: A total of 1,834 babies were screened at the time of discharge, using Transient-Evoked Oto-Acoustic Emissions. Infants who failed the screening test were scheduled for a second screening test. Infants who failed the second screening test were tested with Auditory Brainstem Response [ABR]

Result: Five infants were identified with hearing impairment out of 1,834 or 272 per 100,000. The incidence was 0.27% in the infants screened from October 2012 to December 2015 in the hospital

Conclusion: Five infants were identified with hearing loss according to JCIH standards and advised early intervention. The study could be used to plan services and strategies in the hospital for newborns identified with hearing loss at a very early age to offset the long term consequences of hearing loss

Unilateral choanal atresia

We report a 24-year-old male, known case of right hemifacial microsomia and microphthalmia with right eye prosthesis who presented to ENT clinic with history of unilateral nasal blockage and rhinorrhea since birth. Physical examination and CT scan imaging confirmed the diagnosis of unilateral bony choanal atresia. He had right endoscopic transnasal repair of the choanal atresia and Mitomycin C application. A palatal perforation complicated the procedure which required surgical repair. The patient was discharged on antibiotics and nasal douches. Six months follow-up revealed a patent nasal airway and complete healing of the palatal perforation. No dilatation was required

Management of a self-inflicted laryngeal injury

We present a case of deliberate self-inflicted trauma to the airway. The patient presented with a slit throat secondary to attempted suicide. The patient had a GCS score of 15 in the emergency department with an ability to maintain his own airway and phonation. A cuffed tracheostomy tube was inserted through the wound to maintain the airway. The patient had full wound exploration and repair of anterior tracheal wall. Repeat laryngoscopy and bronchoscopy was done postoperatively which revealed left vocal cord palsy which recovered completely after 2 weeks

Bilateral diplopia and abducent nerve palsy secondary to odontogenic sinusitis: an unusual presentation

We present a patient with double vision, photophobia, headache and gait disturbance secondary to odontogenic sinusitis. The initial diagnosis was meningitis; the patient had bilateral diplopia, severe unilateral facial pain, nasal blockage, photophobia, headache and gait disturbance. The patient underwent a septic screening and CT scan of the nose and paranasal sinuses which confirmed unilateral pan-sinusitis. MRI revealed enhancement of bilateral abducent nerves secondary to irritation of the meninges by the opacified sphenoid sinus. The abducent nerve is the first cranial nerve to be affected when the dura is inflamed leading to bilateral diplopia. This unusual presentation led to the initial diagnosis of arachnoiditis. Patient underwent a unilateral full endoscopic sinus surgery and dental extraction of the affected tooth and had a full recovery with intravenous antibiotics and intravenous steroids