@article { author = {Ahmed, Mohammed and hamed, mahmood and El Taher, Mostafa and Moussa, Mohammed and Ahmed, Ahmed}, title = {Tongue base schwannoma; a literature review with a new case presentation}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {41-46}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.3168.1006}, abstract = {Head and neck schwannomas represent a considerable percentage of extracranial schwannomas. However, intraoral locations are very rare. Schwannomas of the tongue base have been sporadically reported. The exceedingly paucity of literature reports in this location made them usually skipped out when evaluating a tongue base mass. In this work, we aimed to review the literature about this tumor and to report a new case.A comprehensive review in English literature of tongue base schwannomas was done with extraction of the related articles and descriptive analysis of the collected data. Also, we presented a new case of 20-year old girl that presented with a slowly enlarging mass of the tongue over 11 years duration. CT and MRI revealed a large well-defined tongue base mass. Biopsy revealed schwannoma. Transoral complete resection with safety margins was done.Forty-three cases have been reported in literature with slight female predominance. Transoral approach was the commonest approach (76.7%) with the maximal diameter of schwannoma removed transoral was 7.9 cm.In conclusion; despite their rarity, tongue base schwannomas should be included when ever a benign swelling is suspected. Transoral approach is still the standard approach with the least morbidities and best functional outcomes}, keywords = {lingual,neurilemmoma,neurogenic tumor,schwannoma,tongue base}, url = {https://ejentas.journals.ekb.eg/article_43917.html}, eprint = {https://ejentas.journals.ekb.eg/article_43917_36d4b0cc5bd59954ab97d12a5bb8b1d1.pdf} } @article { author = {El-Badry, Mohamed and Samy, Hesham and abdelkader, Rafeek and Fawzy, Amira}, title = {Cervical Vestibular Evoked Myogenic Potential in Children with Auditory Neuropathy Spectrum Disorder of prelingual onset}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {47-52}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.6389.1055}, abstract = {children with ANSD of pre-lingual onset, and to compare c-VEMP findings to those in children with non- ANSD sensorineural (non -ANSD SNHL) of pre-lingual onset.Methods: The study included 35 children with bilateral ANSD, and 32 children with bilateral non-ANSD SNHL of severe, severe to profound, or profound degree. Both groups of children had the onset SNHL pre-lingually. The study also included 15 control children. Mean age and SD were 6.9 years ± 2.9 for the control children, 7.8 years ± 3.1 for the ANSD children, and 8.8 years ± 3.4 for the non-ANSD children. All participant children were subjected to full history taking, otological examination, hearing assessment, recording for auditory brainstem response and cochlear microphonics, Distortion product otoacoustic emission recording, and c-VEMP recording.Results: Results showed that the vast majority of ANSD children (88% of ears) had intact c-VEMP response. Moreover, there was no statistically significant difference between the ANSD children and control children as regards the VEMP parameters (P1-N1 amplitude, asymmetric ratio, P1 latency, N1 latency, and inter-aural latency differences of P1 and N1). There was no statistically significant difference between ANSD with risk factors and those without risk factors as regards VEMP parameters. Results indicate that the vast majority of ANSD children with pre-lingual onset, even those with risk factors, have normal saccular function along with intact and normally functioning inferior vestibular nerve, and the other central connections responsible for the VEMP response. On the other hand, 53.1% of ears children with non-ANSD SNHL had an absent c-VEMP response, and 46.9% of ears had intact and normal c-VEMP response. The overall results indicate that while the pathology of non-ANSD SNHL involves the saccule in more than half of children, the underlying pathology ANSD spares the saccule and its central connection.Conclusions: Results suggest that the site of lesion in ANSD children of pre-lingual onset is restricted to the auditory system with sparing the vestibular system in the majority of children. These findings support the choice of cochlear implantation as the best line of management in children with ANSD, even in the presence of risk factors. So cochlear implantation in children with ANSD is safer than children with SNHL as there will be no fear of bilateral saccular dysfunction in the case saccular damage occurred in the surgery side as a result of the surgical procedure.}, keywords = {}, url = {https://ejentas.journals.ekb.eg/article_29458.html}, eprint = {https://ejentas.journals.ekb.eg/article_29458_4e0d22d6e397e8a6d14d0da47df16122.pdf} } @article { author = {Roos, M. and Sherriff, A. and Seedat, Riaz}, title = {Laryngeal squamous cell carcinoma at a South African referral hospital}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {53-59}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.7058.1067}, abstract = {Introduction and aim: Laryngeal squamous cell carcinoma (LSCC) is the most common tumour of the head and neck region. The aim of this study was to determine the profile of patients with laryngeal carcinoma who presented to Universitas Academic Hospital over a 6 year period and to review their management.Methods: This was a retrospective descriptive cross-sectional study. The records of 250 patients with LSCC between 1 January 2010 and 31 December 2015 were reviewed.Results: The median age at presentation was 60.1 years, with 86.8% being males. Dysphonia was present in 99.6% of patients, but there was also a high prevalence of late symptoms. Most patients (51.6%) presented with Stage IVa disease and 21.6% presented with Stage IVb disease. Nodal metastases were present in 60.4% of patients, while 4.8% had systemic metastases. There was high rate of patients who defaulted treatment and poor patient follow-up.Conclusion: Late presentation is a significant problem at our institution with 95.6% of patients who presented with stage III and stage IV tumours.}, keywords = {Laryngeal neoplasms,laryngectomy,Radiotherapy,South Africa}, url = {https://ejentas.journals.ekb.eg/article_43939.html}, eprint = {https://ejentas.journals.ekb.eg/article_43939_0c6f5c06657f438815622ca5b5d79550.pdf} } @article { author = {Lasheen, Reham and Abu-Zaid, Mohamed and Tabra, Samar}, title = {Evaluation of Auditory Attention and Memory Skills in Autistic Children after Hyperbaric O2 Treatment}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {60-66}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.10954.1087}, abstract = {Introduction: The children with autism often exhibit abnormalities in auditory central processing including both auditory attention and auditory memory.Objective: The aim of this research was to determine the effectiveness of the hyperbaric oxygen therapy in improving auditory attention and auditory memory.Method: The study included 20 children with autism and 20 normally developed children as the control group. The children with autism were evaluated before and after treatment with hyperbaric oxygen using audirory P300 and MMN to evaluate both auditory attention and auditory memory.Results: There was a statistically significant difference of the auditory P300 and MMN latencies in the autistic children before and after treatment with hyperbaric oxygen therapy. There was a decrease of the P300 and MMN latencies, after the hyperbaric oxygen therapy.Conclusion: The children with autism showed improvement in both auditory attention and auditory memory after hyperbaric oxygen therapy.}, keywords = {}, url = {https://ejentas.journals.ekb.eg/article_43943.html}, eprint = {https://ejentas.journals.ekb.eg/article_43943_59c928ad5398a2b584b1782082f45825.pdf} } @article { author = {Samarakkody, Zabrina and Sran, Harvinder and Shukri, Norasnieda and Abdullah,, Baharudin}, title = {Registration accuracy and surface marking of an electromagnetic navigation system for use in endoscopic sinus surgery}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {67-73}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {}, abstract = {Introduction: Since its introduction, surgical navigation systems have become integrated into surgical practices that include complex nasal endoscopic procedures to avoid serious complication such as injury to the optic nerve, the carotid artery, the dura mater and the brain parenchyma.Objective: We aimed to determine the accuracy of image guided system (IGS) by using different timing interval of computed tomography scan of paranasal sinus and our experience in performing the surface marking.Methods: A cross sectional study was done. Subjects were recruited from patients planned for endoscopic sinus surgery with IGS, who met the inclusion and exclusion criteria. The image guided navigation measurements were compared to the actual anatomical measurements of intercanthal distance of both eyes and the tangential line of inverted triangle to the philtrum. The estimated time to register the IGS was recorded. All measurements were done at the same time as the calibration of the IGS.Results: The mean intercanthal distance measured by IGS was 38.17 mm (SD 3.34) whereas the actual intercanthal distance was 38.17 mm (SD 3.37 mm). The tangential line measured by IGS was 46.62 (SD 3.39) whereas the actual measurement of the tangential line was 46.47mm (SD 3.27). The was no significant difference in both measurements between IGS and actual anatomical measurements (p‌=0.804 and 0.496, respectively).Conclusions: Even with the different intervals there was not much deviation from the actual anatomical distance. The IGS is accurate and is applicable for use in Asian patients.}, keywords = {Electromagnetic navigation system,Endoscopic sinus surgery,registration accuracy,surface marking}, url = {https://ejentas.journals.ekb.eg/article_43946.html}, eprint = {https://ejentas.journals.ekb.eg/article_43946_a165bc4a3916664f8bb5a16f23835847.pdf} } @article { author = {Elmoursy, Mohamed and Bakr, Mohamed and Sayed, Samy and Ali, Mostafa and Mohamed, Enass}, title = {Vestibular and radiological evaluation of hearing impaired children with delayed Motor development}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {74-83}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.4233.1024}, abstract = {Background: Combined hearing and vestibular loss in children pose potentially significant problems. Children and infants with vestibular problems are faced with motor problems that could limit their normal development.Objectives: the aim of the study is to assess the relationship between the vestibular disorders and the delayed motor development in hearing impaired children as well as to assess the integrity of the vestibular system through clinical testing and radiological imaging in those children with delayed motor development.Methods: Thirty hearing impaired children with history of delayed motor milestones, and a control group of 10 hearing impaired children with normal motor development were included with variable degree of hearing loss. Each child was subjected to careful history taking, general examination, otoscopic examination, motor and balance questionnaires were answered by the parents or caregivers, audiological evaluation either through conditioned play audiometry or conventional audiometry, speech audiometry and Immittancemetry. Vestibular evaluation through cVEMP and caloric tests and finally the radiological studies through CT and MRI of the petrous bone.Results: There were variable degrees of hearing loss among both groups. In the control group (10 HI children, 20 ears), 18 ears (90%) had VEMP response, while two ears (10%) had absent VEMP, while in the study group (30 HI children, 60 ears), 48 ears (80%) had VEMP response, while 12 ears (20%) had absent VEMP. All children in the control group had normal caloric response, while in the study group, 23 children (77%) had normal response, and seven children (23%) had abnormal caloric response, 4 children had bilateral weakness and 3 had unilateral weakness. CT and MRI study of petrous bone was done for the control group and revealed normal radiology, while in the study group, 21 children had normal imaging (70%) and the last 9 children (30%) had abnormal findings, the most common abnormalities was enlarged vestibular aqueduct (13%), followed by common cavity (7%).Conclusion: Children with hearing loss, irrespective of the degree of hearing loss, the vestibular system should be screened, assessed as it may be responsible for co-morbidities in fine and gross motor difficulties. Early intervention and effective therapy will be the proper way to get good outcome.}, keywords = {delayed motor function,hearing impaired children,radiological evaluation,vestibular}, url = {https://ejentas.journals.ekb.eg/article_43953.html}, eprint = {https://ejentas.journals.ekb.eg/article_43953_6dc923b567ae20d58cc3898d0e3da4ce.pdf} } @article { author = {Sadek, Ahmed and Abdel-Naby, Osama and Talaat, Mostafa}, title = {Mitomycin-C Prevents Post-Operative Adhesions after Endoscopic Nasal Surgery}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {84-88}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.4621.1031}, abstract = {Purpose: To assess the role of mitomycin-c (MMC) in preventing synechia formation and ostial stenosis following endoscopic nasal surgery.Patients and methods: This is a prospective comparative study on a total of thirty patients of different ages including both sexes. Patients were divided in two groups (A and B, 15 each). Group (A) had FESS operation and group (B) had partial inferior turbinectomy. In Group (A) 15 primary FESS procedures were performed in 15 patients: nine patients had bilateral pansinusitis, and six cases had bilateral nasal polyposis. MMC was applied at the site of middle meatal antrostomy on one side and the contra-lateral side served as the control. In Group (B), 15 endoscopic bilateral partial inferior turbinectomy was performed in 15 patients. MMC was applied between residual of right inferior turbinate and the septum, while the contra-lateral side served as a control. The data were analyzed after two months of follow up.Results: One patient (6.7%) had adhesion at Rt. Side and seven patients (46.7%) had adhesions at Lt. Side, while 14 patients (93.3%) had no adhesion at Rt. Side and eight patients (53.3%) had no adhesion on Lt. Side (P=0.013). In Group (B), three patients (20%) had adhesion at Rt. Side and nine patients (60%) had adhesions at Lt. Side, while 12 patients (80%) had no adhesion at Rt. Side and 6 patients (40%) had no adhesion on Lt. Side (P=0.025).Conclusion: Topical use of MMC is safe and beneficial in decreasing adhesion formation after endoscopic nasal surgery.}, keywords = {Endoscopic nasal surgery,FESS,mitomycin-C,turbinectomy}, url = {https://ejentas.journals.ekb.eg/article_43963.html}, eprint = {https://ejentas.journals.ekb.eg/article_43963_874da42a7dcf6bb76255daba529daadb.pdf} } @article { author = {Talaat, Hossam and Zein El Abedein, Ahmed and Abd Elkawy, Fatma}, title = {Validation of the modified Arabic version of Activities Specific Balance Confidence Scale (ABC) among Egyptian patients with vestibular disorders}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {89-93}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.9643.1078}, abstract = {Background: The ABC scale is a questionnaire to evaluate the risk of fall in people with imbalance.Objectives: Modify and validate the Arabic form of the ABC scale on the Egyptians with vestibular disorders.Methods: The Arabic version of the ABC scale has been revised and modified to replace the words that is ambiguous on the Egyptians. The revised version has been back translated and judged by expert committee to confirm its matching with the original English version.The final form is applied to the control group which is composed of 100 healthy Egyptians with age (18 - 45) years and a study group composed of 60 Egyptian patients having vestibular disorders (VD) that match the control group in age and sex.Results: The results gave excellent reliability with Cronbach’s alpha (0.94) among patients and (0.75) among controls and the corrected item-total correlation > 0.3 for all items. The repeatability was found high for control and VD group. The total scores for VD patients were significantly different from the controls.Conclusion: The modified Arabic ABC scale is reliable and valid subjective tool in the assessment and follow up of VD among Egyptiansز}, keywords = {Arabic,ABC scale,Egyptians}, url = {https://ejentas.journals.ekb.eg/article_43965.html}, eprint = {https://ejentas.journals.ekb.eg/article_43965_81b0b3cacd764e7e2246a759844f975b.pdf} } @article { author = {El-Hennawi, Diaa El-Din and El Tabbakh, Mohamed and Sabek, Nagwan and Abou-halawa, Ashraf and Fareed, Amr}, title = {High Mobility Group A2 (HMGA2) and Matrix Metalloproteinase 12 (MMP12) Genes Expression in Egyptian Patients with Laryngeal Squamous Cell Carcinoma}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {94-98}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.6403.1056}, abstract = {Background: genetic studies of laryngeal squamous cell carcinoma (LSCC) are rare in Egypt. Increased expression of some relevant genes may have diagnostic and therapeutic implications.Aim of the study: to compare the expression of HMGA2 and MMP12 genes in LSCC tumor tissue with their expression in adjacent non-tumor tissue.Type of the study: Descriptive studySetting: Tertiary referral hospital-Ismailia-EgyptPatients and Methods: 24 male patients (age range 49-78 years) with LSCC were included in the study. Under general anesthesia, two biopsies were taken: one from the tumor tissue and the other from the adjacent normal tissue and they were examined histopathologically and then analyzed for level of expression of MMP12 and HMGA2 genes.Results: Median expression levels of HMGA2 and MMP12 in the whole group were 0.98 and .8 (fold change) in normal tissue and 6.49 and 122.6 (fold change) in tumor tissue respectively. There was higher expression of the HMGA2 and MMP12 genes in tumor tissue compared to normal tissue (P <0.0001). Also there was positive correlation of level of expression of the two genes with the degree of tumor differentiation (P <.0001 and p<.0008)Conclusion: Expression of HMGA2 and MMP12 genes is higher in LSCC compared to normal tissue samples. The higher the level of expression of the two genes, the poorer the degree of differentiation of the tumor Further studies should be pursued to determine the diagnostic, therapeutic and prognostic implications of this in management of LSCC.}, keywords = {carcinoma,HMGA2,laryngeal,MMP12}, url = {https://ejentas.journals.ekb.eg/article_43967.html}, eprint = {https://ejentas.journals.ekb.eg/article_43967_8125f788358b4c4dd92ead402ff9c558.pdf} } @article { author = {Safuraa, Sharifah and Putra, Primuharsa and Abu Bakar, Saraiza and Hashim, Dina and Nasseri, Zara}, title = {A rare case of tuberculous abscess causing airway obstruction in a paediatric patient in South-East Asia}, journal = {Egyptian Journal of Ear, Nose, Throat and Allied Sciences}, volume = {20}, number = {2}, pages = {99-103}, year = {2019}, publisher = {Egyptian Society of Ear Nose Throat and Allied Sciences}, issn = {2090-0740}, eissn = {2090-3405}, doi = {10.21608/ejentas.2019.4118.1022}, abstract = {A 6-year old girl, presented with symptoms of obstructive sleep apnoea. She was referred to our centre when she developed obstructive symptoms such as stridor and dysphagia a month later. She was found to have a right neck swelling with a posterior pharyngeal wall mass, which caused upper airway obstruction. A computerized-tomography scan of her neck showed a very narrowed upper airway with a retropharyngeal abscess without prevertebral or vertebral involvement. She had a challenging intubation and underwent an emergency intraoral incision and drainage. Pus that was drained revealed acid fast bacilli and histopathological examination showed necrotizing granulomatous inflammation, in favour of a tuberculous abscess. Post operatively, her symptoms resolved and her intraoral wound healed. She completed anti-tuberculous treatment and has remained well at 6 months follow up. Our case illustrates how a cold retropharyngeal abscess can masquerade as obstructive sleep apnoea, with a compromised airway as it increases in size.}, keywords = {Paediatric airway,retropharyngeal abscess,snoring,stridor,tuberculosis}, url = {https://ejentas.journals.ekb.eg/article_68386.html}, eprint = {https://ejentas.journals.ekb.eg/article_68386_818dad050686e0bf4940fc7ee0e443f8.pdf} }