Choanal adenoids in adults: diagnosis and treatment

Choanal adenoids, a rather rarely defined phenomenon, is the presence of adenoid tissues in the choanae, without being extension of the commonly well-known nasopharyngeal adenoids. We present a series of 22 adult patients [17-38 years; 15 males, 7females], with persistent bilaeral nasal obstruction and recurrent nasal infections, and with history e of repeated unsuccessful medical and, in many cases, repeated surgical procedures, in whom choanal adenoids was diagnosed by nasal endoscopy and/or CT scanning. Absence of adenoid tissues in the nasopharynx was confirmed in all cases. Surgical removal of choanal adenoids was undertaken in all cases endoscopically. Some other surgical. procedures like straightening of a deviated septum or reduction of a hypertrophied turbinate were undertaken in some indicated cases. Most of cases experienced complete relief of obstruction and return of a patent nasal airway and improvement of associated complaints as dry mouth and persistent cough. A thorough review of this phenomenon and its clinical relevance and methods of diagnosis and management are presented. We recommend a thorough nasal endoscopy as a routine in cases of persistent nasal obstruction even in the presence of an apparent cause of obstruction

Well tolerated videotelelaryngography in the office

Living direct sight is the best method of documentation, both for the patient and physician. Our study aims to get a precise and well tolerated system for routine diagnostic living documentation of the larynx in the office. This was achieved by using the wide angled 70 degrees telescope sinoscope and attaching it to an endovision telecam, videorecorder and monitor. The slimline telescope, 4 mm diameter and 18 cm long, shows a precise image and is easily tolerated by most patients without topical anaesthesia. The magnified image by telecam is viewed on monitor and recorded by videorecorder as a permanent documentation. This system is applied on our patients from 4 months old. It could be tolerated in up to 100% of patients and resulted in minimizing the failure rate of visualizing the larynx to a very low extent [3%]

Stapes surgery in children and young patients

Thirty two stapes procedures in children and young patients were reviewed. There were 18 males and 14 females. The mean age at the time of surgery was 16 years with a range from 8 to 20 years. Stapedectomy was performed in 12 cases and stapedotomy in 20 cases. Follow up period ranged from 6 monthes to 12 years with an average of 3 years. Our results showed an average postoperative air-bone gap of 9.8 dB and an average hearing improvement of 19.5 dB. The best results were obtained when the small fenestra technique was used. According to our results, we conclude that stapedectomy in children is satisfactory and the results are comparable to the other published results