Outcome of management of otosclerosis by stapedotomy compared to stapedectomy in a Jordanian population

To study the success results rates and complications of stapedotomy compared to stapedectomy in the operative management of otosclerosis. This is a retrospective study of 50 patients who were treated surgically for otosclerosis. The medical records of these patients were reviewed for the type of operation performed, complications and the serial pure tune audiometries pre- and postoperatively for at least one year. Patients with conductive hearing loss not due to otosclerosis were excluded from this study. The medical records of equal number of patients [25 patients with stapedotomy and 25 patients with stapedectomy] were analysed for hearing improvement or loss, postoperative nausea, vomiting, vertigo, nystagmus, perilymph fistula, reparative granuloma, labyrinthitis, tinnitus and perforation of the tympanic membrane All operations were performed by the senior consultant-otologists of our department. Stapes superstructures were removed by crural scissors and stapes footplate was perforated by microdrill. Out of 25 patients with stapedotomy, 22 [88%] developed complete closure [

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

Relationship between the onset of facial palsy during pregnancy and the development of gestational complications

To asses the relationship between the onset of facial palsy during pregnancy and the increased incidence of gestational and foetal complications. This is a retrospective study of thirty six female patients who presented with facial palsy during pregnancy or puerperium, and were identified by hospital records in the ENT and obstetric gynaecology clinics at King Hussein Medical Centre in Jordan over ten years period between January 1995 and January 2005. Information were recorded about medical and obstetrical history, time of onset of facial palsy and associated maternal complications including gestational hypertension and pre-eclampsia, delivery mode, premature delivery and increased incidence of caesarean section as well as foetal complications such as low infant birth weight, congenital abnormalities and twin births. Over a period of 10 years, 36 pregnant women with facial palsy were seen in the ENT and obstetric gynaecology clinics at King Hussein Medical Centre. The peak time of onset of facial palsy was in the 34[th] week of gestation. Pre-eclampsia was diagnosed in nine pregnant women [25%], while gestational hypertension was diagnosed in three patients [8.3%]. The overall incidence of both pre-eclampsia and gestational hypertension was 33.3% [12 patients], which is six times more than in general population. The incidence for caesarean section is 38.9% [14 patients], and 33.3% [12 patients] for induced vaginal delivery, 25% [nine patients] for preterm delivery, and 19.4% [seven neonates] for low birth weight [less than 2500g]. These rates were also higher than in general population. It has been found that the incidence of congenital anomalies 2.7% [one baby] and twin births 5.6% [two twins] are within the general population rates. Facial palsy in pregnancy is associated with gestational and foetal complications, particularly in the third trimester. This information should be taken into consideration by all physicians involved in the counselling of these patients. Further studies are advised to support the results of this study

Waardenburg syndrome. A case report and review of literature

Waardenburg syndrome is an autosomal dominantly inherited disorder with variable penetrance affecting 3% of all deaf children[1]. Genetic studies revealed a mutation in the PAX3 geneon the 2Q35 region. The major characteristic features are: Dystopia canthorum; Synophrys; Broad nasal root; Depigmentation of hair, skin or both with white forelock; Heterochromic or hypochromic irides and congenital deafness. Genetic heterogenicity has led to classification of affected families as type I with dystopia canthorum, or type II, without dystopia canthorum disease. This article reviews the literature and describes a case of Waardenburg syndrome type I in a twelve month old male child