Recurrent vocal cord granulomas in a twelve-year-old child

Vocal cord granulomas or contact granulomas are benign masses of the vocal fold. They are relatively uncommon. The etiology is usually multifactorial which makes it difficult to treat. The pathogenesis of this condition is still undetermined but can be attributed to three etiological factors: vocal abuse, laryngopharyngeal reflux disease, and laryngeal intubation. Recurrence is high due to the fact that most of the underlying causes are persistent. We report a case recurrent granuloma exacerbated by excision which contributed to its recurrence. Between 2012 to 2017, the patient had multiple microbroncholaryngoscopy [MLB] for excision of the granulomas [twice per year]. Co2 laser was used in some of the procedures. The patient was kept under observation with regular follow-up visits and endoscopies. In May 2018, the patient was symptom free and flexible nasal endoscopy showed normal bilateral vocal cords with disappearance of the granulomas

Congenital arhinia

Congenital arhinia is a rare condition described as the absence of the nose at birth. It is a lifethreatening condition if not managed properly. Due to its low incidence, not much is understood about the condition. We report a case of congenital arhinia diagnosed antenatally and managed in the Neonatal Intensive Care Unit [NICU]. The case was diagnosed at 27 weeks of gestation when fetal ultrasound revealed absence of nasal bones. At birth, the baby was in respiratory distress and required oral intubation followed by elective tracheostomy

Post-tonsillectomy hemorrhage and other complications

Post-tonsillectomy hemorrhage is a serious complication; if not managed properly, it could be life threatening. To evaluate the incidence of post-tonsillectomy bleeding. A Retrospective Study. ENT Department, King Hamad University Hospital, Bahrain. Seven hundred twenty-nine patients operated for tonsillectomy from February 2012 to February 2014 were included in the study. Patients who had tonsillectomy in other hospitals were excluded from the study. Some surgeons used hot technique, others used cold technique. Some patients had been operated for adenoidectomy and turbinate reduction by laser. Data documented were age, gender, type of tonsillectomy technique used, type of hemorrhage [primary or secondary], type of management postoperatively and other postoperative complications. Seven hundred twenty-nine patients were operated for tonsillectomy from February 2012 to February 2014. Twenty-eight [3.8%] patients had post-tonsillectomy bleeding, 9 [1.2%] were children and 19 [2.6%] were adults. Two [0.2%] were primary and 26 [3.6%] were secondary bleeding. Twelve [1.6%] patients underwent tonsillectomy by hot technique and 16 [2.2%] by cold technique. Twenty [2.7%] patients were managed by admission and observation. Eight [1.1%] were managed by cautery or ligation in the operation theater. The female to male ratio was 11:17. Other complications encountered were broken tooth, neck pain, nasal bleeding, and fever. In this study, the incidence of post-tonsillectomy bleeding was 3.8% and no mortality was recorded during the period of the study. Further multicentric study with a larger sample is recommended