Fungal infection of the paranasal sinuses

This study was done on thirteen patients [nine males and four females] with fungal of paranasal sinuses [PNS]. Their ages ranged between 17-40 years. They were classified into three groups according to the site of the lesion. Group A included three patients with localized unilateral fungal granuloma affecting the anterior group of PNS, Group B included four patients with invasive fungal granuloma affecting anterior and posterior groups of PNS either unilateral or bilateral and Group C included six patients of invasive fungal granuloma of PNS with intraorbital and/or intracranial affection. Description of different methods for proper diagnosis of the fungal infection of PNS and the best method for its treatment were discussed. This study showed that radical surgical removal of the lesions combined with antifungal therapy were the most effective. The use of local antifungal and local instillation of honey is needed for some cases

Snoring and obstructive sleep apnea syndrome: management with and without laser; a new modification in the laser technique

Thirty patients with heavy snoring and obstructive sleep apnea syndrome [OSAS] were included in this study. Group A [15 patients] were treated by conventional surgical uvulopalatopharyngoplasty [UPPP] and group B [15 patients] were treated by CO2 laser under microscope and using micromanipulator. Patients were evaluated by snoring scale, nasopharyngoscopy including Muller's maneuver, polysomnography and pain scale. Patients were followed up at one month and six months. Snoring improved in 60% of patients in group A vs 99.30% in patients of group B. After six months, snoring recurred in 25% of patients in group A vs 80% of patients of group B. Postoperative severe pain existed in 60% of patients of group A vs 6.6% of patients of group B. Postoperative complications like bleeding, nasopharyngeal stenosis and nasal regurgitation were higher in group A. Moreover, hospitalization was less in group B. UPPP with CO2 laser under microscope and using micromanipulator could be considered an optimum procedure in the management of snoring and OSAS. A new modification applied in laser technique could also contribute in reducing postoperative pain and nasopharyngeal stenosis

Elongated styloid process Eagle's Syndrome: a new technique for alleviation of glossopharyngeal neuralgia

In this study, a new surgical technique for treatment of Eagle syndrome [elongated styloid process] was described which is a transtonsillar fossa lateral fracture of the elongated process which presses on the 9th nerve. Its merits and indications were discussed through its application on five patients [three females and two males] with Eagle's syndrome their age ranged between 23-42 years. The results were very satisfactory to the patients and the neuralgia disappeared with no recurrence of symptoms. This procedure is safe, simple and easy to perform and can be done under local anesthesia in patients with history of tonsillectomy