Prevalence, Etiology, Risk Factors, and Complications of Facial Nerve Palsy at King Abdulaziz Medical City: A Multicenter Study.

BACKGROUND: Facial nerve palsy is a condition of nerve damage that results in impaired facial movement on one or both sides of the face. OBJECTIVES: This multicenter study aimed to determine the prevalence of facial nerve palsy and evaluate the association between its risk factors and complications to identify its etiology among patients admitted to King Abdulaziz Medical City in Jeddah and Riyadh, Saudi Arabia, between 2016 and 2023. METHODS: A retrospective cross-sectional study was conducted to obtain data from medical records using the best care system for patients with facial nerve palsy. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States), Chi-square test, t-test, and ANOVA. The level of statistical significance was set at p<0.05. RESULTS:  The study involved 123 patients, with 0.0164% prevalence. Bell's palsy was the most common etiology, accounting for 81.8% of cases, followed by head injuries, dental trauma, otitis media, stroke, and head and neck tumors. Obesity was the most significant risk factor, followed by upper respiratory problems. Hypertension and diabetes exert similar effects. Facial asymmetry, ophthalmic complications, and eye twitching were the most common complaints followed by speech difficulties, psychological and social effects, mouth twitching, and synkinesis. CONCLUSION:  Facial nerve palsy is common in this region. We recommend health education sessions to increase public awareness and provide preventive strategies to reduce the complications of facial nerve damage. We recommend further research on the association between the risk factors and complications of facial nerve palsy.

Atypical Teratoid Rhabdoid Tumors (ATRT): King Faisal Specialist Hospital and Research Centre experience.

BACKGROUND: Atypical teratoid rhabdoid tumor is an uncommon aggressive central nervous system tumor. All retrospective series have shown a short mean overall survival rate. Considering the rarity of the disease, few prospective clinical trials addressed treatment recommendations for such aggressive tumors, and consequently no definitive treatment guidelines have been established. In this study, we are reviewing our experience in treating atypical teratoid rhabdoid tumor patients. METHODS: We reviewed the medical charts of 43 patients with atypical teratoid rhabdoid tumor who were treated in King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia, between 1996 and 2013. We evaluated the overall survival rate and the influence of different clinical features and treatment protocols on survival. RESULTS: The median overall survival time was 16.9 months (95% Confidence Interval, 5.2-32.9 months) with an estimated 2- and 5-year overall survival of 41.9% ± 9.6 and 27.9% ± 9.2, respectively. Patients receiving trimodal treatment (surgery, chemotherapy, and radiotherapy) exhibited significantly better median overall survival time compared to their counterparts (P value < .001). CONCLUSIONS: Atypical teratoid rhabdoid tumor is rare and aggressive central nervous system tumor. Despite the limitations of the study, our results support several of clinical practice development. Utilization of postoperative radiotherapy and the adoption of trimodal therapy are associated with significant improvement of median survival. Prompt management with aggressive trimodal therapy should be the standard for future treatment protocols.

Fungal Rhinosinusitis: Prevalence and Spectrum in Singapore.

Background Fungal involvement of the paranasal sinuses has been described more than two centuries ago. In the current article, it is referred to as fungal rhinosinusitis (FRS) which is a general term that is used to describe a spectrum of pathologically, immunologically, and clinically different disease entities affecting the paranasal sinuses where fungus is thought to be the major potential etiology. Objective To determine the incidence and spectrum of FRS in Singapore and to compare our findings with international figures through literature review. Methods A retrospective review of the clinical charts, radiological and laboratory results, and operative reports of all patients who underwent endoscopic sinus surgery at an ENT department of a tertiary referral hospital in Singapore over five-year period. Results Out of 533 functional endoscopic sinus surgeries performed during the period of the study for management of chronic rhinosinusitis, 44 (8.4%) were found to fit the criteria for diagnosis of FRS. Twenty (45.5%) were eosinophilic FRS and 24 (54.5%) were fungal balls. Invasive FRS has not been encountered. Clinical presentation, investigations, and management of both groups of patients are discussed. Conclusion Fungal rhinosinusitis is not uncommon in Singapore. Fungal ball and eosinophilic mucin fungal rhinosinusitis are among the most common forms encountered in this part of the world.

Juvenile nasopharyngeal angiofibroma staging: An overview.

Staging of tumors is very important in treatment and surgical decision making, as well as in predicting disease recurrence and prognosis. This review focuses on the different available classifications of juvenile nasopharyngeal angiofibroma (JNA) and their impact on the evaluation, management, and prognosis of JNA. The literature was reviewed, and publications on JNA staging were examined. Our MEDLINE search of the entire English-language literature found no review article on the current available staging systems for JNA. In this article, we review the common JNA classification systems that have been published, and we discuss some of their advantages and disadvantages. The most commonly used staging systems for JNA are the Radkowski and the Andrews-Fisch staging systems. However, some newer staging systems that are based on advances in technology and surgical approaches-the Onerci, INCan, and UPMC systems-have shown promising utility, and they will probably gain popularity in the future.

Nasal septal abscess in children: from diagnosis to management and prevention.

BACKGROUND: Nasal septal abscess (NSA) is an uncommon condition. It is a collection of pus in the space between the nasal septum and its overlying mucoperichondrium and/or mucoperiosteum. If left untreated, there are risks of intracranial complications, facial deformity, and delayed facial growth. There is no universally agreed consensus on the treatment of this condition. This study reviews evidence in the literature to determine its etiology, presentation, investigation, management options, and outcome. METHOD: A structured review of the PubMed, EMBASE and the Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews) was undertaken, using the MeSH terms: nasal septum, nasal cartilage, trauma, hematoma, abscess, reconstructive surgery, rhinoplasty, pediatric, and children. RESULTS: A total of 159 citations from 1920 to date were reviewed regarding nasal septal abscess, of which 81 articles were identified to be relevant to this review. No randomized controlled trials or systematic reviews were found in the Cochrane Collaboration database, PubMed or EMBASE. NSA is more common in children and in male. Nasal trauma and untreated septal hematoma are the leading cause. Staphylococcus aureus is isolated in up 70% of the cases. Clinically, nasal septal swelling, pain and tenderness, with purulent discharge are mostly evident. The immediate management of NSA is incision and drainage and antibiotic therapy. Recent studies suggest early septal reconstruction in children in order to prevent immediate and late facial deformity and nasal dysfunction. Autologous cartilage is the implant material of choice. CONCLUSION: Nasal septal abscess is a serious condition that necessitates urgent surgical management in order to prevent potential life threatening complications. In the growing child, early reconstruction of destructed septal cartilage is essential for normal development of the midface (nose and maxilla).