efficacy of preoperative short course of oral steroids followed by postoperative topical nasal steroids sprays on nasal polyp recurrence after endoscopic nasal polypectomy

To evaluate the effect of preoperative short course of oral steroids followed by postoperative topical nasal steroids sprays on nasal polyp recurrence after endoscopic nasal polypectomy. Sixty patients of both genders with symptoms and signs of nasal polyps were included in this prospective study between January 2004 and December 2007. Their ages ranged between 18 and 60 years. The sample was divided into two groups. Group I constituted 30 patients treated by endoscopic nasal polypectomy without oral and local steroid therapy. Group II consisted of 30 patients also treated by endoscopic nasal polypectomy but received preoperatively 60mg prednisolone tablets daily for one week and postoperatively topical nasal steroid spray [Mometasone furoate suspension] for three months. All patients were followed up for at least one year. Recurrence of nasal polyps was assessed endoscopically at three, six and 12 months after surgery. Any evidence of nasal polyps-formation of whatever size was considered as recurrence. Sixty patients [39 males and 21 females] with sinonasal polyposis were included in this study. Male to female ratio was 2:1. Patients' age ranged from 18 to 60 years; median age was 42 years. Recurrence rates at three, six and 12 months after surgery for the first group of patients were 10% [3 patients], 23% [7 patients] and 40% [12 patients] accordingly, while the recurrence rates for the second group were 3% [1 patient], 7% [2 patients] and 13% [4 patients] accordingly. Preoperative short course of oral steroid followed by postoperative nasal steroid spray show significant reduction in the recurrence rate of nasal polyps after endoscopic nasal polypectomy

[ value of intraopepvative use of topical bupivacaine combined with rectal diclofenac on post tonsillectomy pain and oral intake in children]

To evaluate the efficacy of intraoperative topical bupivacaine combined with rectal diclofenac in reducing postoperative pain and facilitating early oral intake. Between 1 January 2005 and 1 January 2008 one hundred fifty patients aged 5-13 years underwent elective tonsillectomy with adenoidectomy in Prince Rashed Ben Al-Hassan hospital and Prince Zaid Ben Al-Hussein hospital, Jordan. Patients were randomized into two groups; group [1]: 75 patients received 0.5% bupivacaine 2 mg/kg soaked swabs [2x2] inch tightly packed in their tonsillar fossa for five minutes after complete and good hemostasis. Group [2]; 75 patients had soaked swab with normal saline for five minutes also. Three patients excluded for failure to complete the postoperative data and another two patients for postoperative bleeding from the adenoid site. Data from 145 patients were analyzed as five patients were excluded. When comparing the two groups for postoperative pain, less pain was noted in the bupivacaine group, the difference was statistically significant for the first 8 hours and also after 24 hours among treatment group who did not complain of pain postoperatively. The mean time difference of first drink and eat between the two groups was statistically significant. No major complications such as airway obstruction, dehydration or local anesthetic toxicity developed. We concluded that topical bupivacaine combined with rectal diclofenac is safe and easy to administer. Topical bupivacaine use combined with diclofenac reduces postoperative pain and facilitate early oral intake in children

Laryngocele: a case report

This is a case report of a 17-year-old male patient who presented with a symptomless swelling on the right antero-lateral aspect of the neck. The swelling was noticed by the patient 7 months earlier. It has been diagnosed medically and radiologically as an external laryngocele. The laryngocele has been successfully excised using an external approach, and the patient is free of symptoms after 9 months. This is a rare condition especially at this age, which seems to be worth publishing

effect of preoperative intravenous dexamethasone in pediatric adenotonsillectomy

This study aimed at evaluating the efficacy of a single dose of preoperative dexamethasone on adenotonsillectomy postoperative nausea, vomiting, and oral intake. One hundred twenty children aged 4-14 years underwent adenotonsillectomy in Prince Rashed Hospital in Jordan, from January 1998 to March 1999. Sixty two chidren [51.7%] received dexamethasone preoperatively where 58 children did not [48.3%]. All children were observed for postoperative oral intake, vomiting, temperature and complications. Children who received intravenous dexamethasone had signifncantly less vomiting [4.8% vs 15.5%], elevation of temperature 6 hours [3.25% vs 15.5%] after surgery and more oral intake [620 ml vs 410 ml], liquid and soft diet at 24 hours [40.3% vs 18.9%]. Dexamethasone significantly decreased the incidence of postoperative nausea and vomiting in the twenty four hours after discharge with improved oral intake