Role of methylene blue with fibrin glue in branchial cleft anomaly case report and review of literature.

We report a 3-year-old girl who presented to our clinic with a left-sided neck mass at the junction of the middle and lower thirds of the anterior border of the sternocleidomastoid with a slight tenderness. The patient was then diagnosed with a branchial cleft and was taken for surgical excision. Intraoperatively, we injected methylene blue with fibrin glue using an arterial catheter inside the tract, which facilitated the dissection of the tract.

Assessment of Knowledge, Attitude, and Practice of First Aid Management of Choking Among Primary School Teachers in Riyadh, Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Understanding first aid is crucial for immediate intervention during health emergencies, with choking representing a significant danger, particularly for young children. Obstructed airways commonly lead to choking incidents, carrying substantial risks if not swiftly dealt with. This research endeavors to evaluate the comprehension, perspectives, and implementation of first aid measures for choking incidents among primary school teachers in Riyadh, Saudi Arabia, an area of paramount importance with minimal existing research within this particular demographic. METHODOLOGY: This was a cross-sectional study conducted from the beginning of July till the end of October 2023, among 447 primary school teachers in Riyadh, Saudi Arabia. Data collection was carried out by administering a questionnaire through an online platform. The questionnaire included demographic information, knowledge about signs and symptoms of choking, the attitude of participants, participant's practice, and the relationship between the knowledge level about choking and practice. The data collected were reviewed, coded, and then fed into IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York, United States).  Results: Our study on first aid management of choking among primary school teachers highlighted significant findings. Participants demonstrated high awareness of choking signs with 386 (86.3%) recognizing universal signs and 330 (73.8%) claiming proficiency in first aid. Attitudes favored the importance of immediate treatment in 394 participants (88.1%) and the necessity of first aid knowledge for teachers (92.2%). One-hundred and fifty-one participants (33.8%) reported performing choking first aid with 328 (73.4%) opting for the Heimlich maneuver for a six-year-old. Significantly, higher knowledge correlated with increased first aid performance (p < 0.001) and support for mandatory training (p < 0.001). CONCLUSION: Our study indicates a higher knowledge level in primary school teachers with positive attitudes and practices regarding choking first aid management. It underscores the importance of enhancing first aid training among primary school teachers, emphasizing its positive impact on choking management and the necessity of immediate intervention in such cases.

Extraskeletal Ewing's sarcoma of the head and neck region in pediatric patients: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Extraskeletal Ewing's sarcoma (EES) is a collection of malignant cells that appear small and round and occur mostly in pediatrics and adolescence. Head and neck EES tumors are considered rare and require multidisciplinary care to achieve ideal results in management. CASE PRESENTATION: A 14-year-old boy who complained of a mass protruding from the back of his neck which gradually increased in size in the last few months prior to the diagnosis. He was referred to a pediatric otolaryngology clinic with a one-year history of chronic painless nape swelling. Ultrasound prior to the referral was done and the findings revealed a well-defined rounded hypoechoic lesion with internal vascularity. MRI was done and the impression was a large subcutaneous, well defined enhancing soft tissue lesion which raised the suspicion of sarcoma. The multidisciplinary team decision was to go for complete resection with a free margin followed by chemoradiation postoperatively. No evidence of recurrence was detected throughout the follow-up. CLINICAL DISCUSSION: The literature review included ages of the pediatric group from 4 months up to 18-year-old. Clinical features are highly dependable on the size and site of the lesion. Complete resection of the tumor plays an important role in the local control and prognosis. CONCLUSION: We present a rare case of extraskeletal Ewing's sarcoma of the nape. Computed tomography and magnetic resonance imaging are frequently used as imaging modalities in evaluating and diagnosing EES. Management commonly includes surgery with adjuvant chemotherapy to decrease recurrence and prolong the survival rate.

Quality of Life and Symptoms Before and After Nasal Septoplasty With or Without Turbinoplasty Compared With Control Individuals in Saudi Arabia.

OBJECTIVES: Nasal septal deviation is a common health issue that can significantly impact the quality of life. Although nasal septoplasty is commonly performed in Otolaryngology practice, its effectiveness has been questioned. This was the first study to assess disease-specific quality of life in patients undergoing nasal septoplasty with or without turbinoplasty in Saudi Arabia. METHODS: This was a prospective observational study of patients undergoing nasal septoplasty with or without turbinoplasty for nasal obstruction due to septal deviation with or without inferior turbinate hypertrophy. Nasal Obstruction Symptom Evaluation (NOSE) scores were collected preoperatively and 3 months postoperatively and were compared with controls. RESULTS: This study involved 200 subjects, including 40 patients in the case group and 160 individuals in the control group. The mean preoperative and 3-month postoperative NOSE scores of the case group were (58.4±23.7 and 15.0±18.6, P <0.001), respectively. However, the postoperatively NOSE score did not reach NOSE score in control group (13.28±8.13, P =0.377). All nasal symptoms statistically and clinically improved postoperatively. There were no significant differences in NOSE score changes among cases preoperatively and postoperatively according to age, sex, or the presence of allergic rhinitis or asthma. CONCLUSIONS: Nasal septoplasty with or without turbinoplasty leads to improvements in disease-specific quality of life as assessed by NOSE scores and significantly improved nasal symptoms 3 months after surgery.

Impact of COVID-19 on otolaryngology head & neck speciality and residency program in Saudi Arabia.

The SARS-CoV-2 virus, which causes coronavirus disease 2019 (COVID-19), has rapidly swept worldwide since its identification in December 2019. As the spread of the disease accelerated both in Wuhan and elsewhere globally, the WHO declared it a pandemic. There is sound evidence to argue that otolaryngologists run high risks of occupational SARS-COV2 among health care workers due to high viral load in upper respiratory examinations. This review article was conducted to determine the effect of the COVID 19 pandemic on the otolaryngology department and residency program in Saudi Arabia. Since the pandemic outbreak, the government of Saudi Arabia has taken severe measures and issued several decisions to limit the spread of the virus. These decisions included operations, procedures, outpatient clinics by prioritizing emergency and time-sensitive cases while rescheduling all electives and routines once. As a result, the residency program was also affected by the substantial reduction of daily surgical activity and preventing endoscopic tests in the clinics, which led to a notable decrease in residents' involvement and risk of procedural skills deterioration which became a concern to many doctors of residency programs. It is difficult to deny that the epidemic will negatively impact. However, adhering to well-prepared guidelines and giving residents an excellent opportunity to overcome the defects will deliver training and patients' care while also protecting safety and health.

Dandy-Walker syndrome with bilateral choanal atresia: A case report.

INTRODUCTION: Dandy-Walker syndrome is a rare congenital brain malformation characterized by cerebellar vermis agenesis or hypoplasia, cystic dilatation of the fourth ventricle and a large posterior fossa causing upward displacement of tentorium and torcula. In this paper, we present a case of bilateral choanal atresia with Dandy-Walker Syndrome in a female newborn. CASE PRESENTATION: We present a case of a female patient who was born at 38th weeks of gestation via emergency cesarean section due to non-reassuring cardiotocography and abnormal antenatal ultrasounds findings. The imaging revealed the presence of Dandy-walker malformation. The patient presented with cyanosis and respiratory distress. Bedside flexible nasoendoscopy revealed bilateral choanal atresia which is confirmed by computed tomography of sinuses. Endoscopic bilateral choanal atresia repair was performed. On postoperative follow up, nasal endoscopy showed bilateral intact flap and patent neochoana. DISCUSSION AND CONCLUSION: Dandy-Walker syndrome is a congenital disorder that can be diagnosed prenatally. The syndrome is associated with multiple anomalies. However, there are few published reports of bilateral choanal atresia in Dandy-Walker Syndrome. Bilateral choanal atresia is considered a life-threatening condition in newborns that requires early surgical intervention.