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   2018| January-June  | Volume 20 | Issue 1  
    Online since December 23, 2019

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Long-term cosmetic and functional outcomes of rhinoplasty: A cross sectional study of patients’ satisfaction
Sara Howldar, Abdulkareem Fida, Ohoud Allinjawi, Faisal Zaqzoog, Ghofran Qurban
January-June 2018, 20(1):1-12
Objective: To assess patients’ satisfaction about cosmetic and functional outcomes of uncomplicated rhinoplasty and the consequent psychological impact Materials and Methods: A cross-sectional study was carried in adult patients (≥20 years), who underwent primary, functional/cosmetic rhinoplastic surgery at Al Mashfa hospital, Jeddah, before January 2015 (1 year of postoperative follow-up). Patients were contacted for an anonymous telephonic interview using a validated [1], semi-structured questionnaire investigating 7 postoperative satisfaction parameters. Results: Two hundred patients who underwent functional (13.5%), cosmetic (20.5%) or both functional and cosmetic (66.0%) rhinoplasty were included. Satisfaction analysis showed 48.0% satisfied rate. Female and divorced participants had lower satisfaction compared to their counterparts; and divorced women had lowest satisfaction score 28.33/100. Pre- to post-rhinoplasty assessments showed remarkable improvement in nose function (mean±SD=53.72±27.10 to 95.71±8.86; p<0.001), appearance (41.70±26.29 to 95.49±9.18; p<0.001) and patient’s mood (51.34±29.83 to 95.84±11.47; p<0.001), respectively. Change in mood was correlated with both change in function (r=0.412; OR [95%CI]=1.61 [1.39; 1.86]; p<0.001) and appearance (r=0.748; OR [95%CI]=2.30 [2.07; 2.55]; [p<0.001). Conclusion: Patients who underwent primary uncomplicated rhinoplasty have fair satisfaction about functional long-term outcomes but remain relatively dissatisfied esthetically; especially female, divorced and unemployed patients. The functional and cosmetic improvements have positive impact on the patient’s psychological wellbeing.
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Smoked cooked meat as a risk factor for Nasopharyngeal Carcinoma: A case control study among Saudi populations
Khalid Hakami, N Prepageran, Talal Al Thubaity, Eidah Al Juaid, Nawaf Al Solami
January-June 2018, 20(1):13-19
Background: Head and neck cancers constitute about 6% of malignancies diagnosed annually in the Kingdom of Saudi Arabia and represent 33% of these are of nasopharyngeal origin. The epidemiological studies of nasopharyngeal carcinoma (NPC) suggested that factors like viral agents, dietary factors and genetic susceptibility have a major role to play in the disease etiology. Objective: To investigate the possible roles of smoked cooked meat (like Mandi which is traditional dish in Saudi Arabia) in the development of NPC. Subjects and Methods: A case-control study included 43 incident cases of NPC and 84 control subjects was carried out at Otorhino laryngology, Head and Neck Surgery department at Al-Hada Armed Forces Hospital, Saudi Arabia, throughout the period 2014-2015. All information on dietary, environmental, social, and demographic factors was collected. Univariate and multivariate logistic regression analysis using maximum likelihood method was used to analyze data. Results: The study included 43 cases with confirmed nasopharyngeal carcinoma and 84 age and sex matched control subjects. Most of cases 29 (67.4%) were presented with neck mass whereas the remaining 14 (32.6%) presented with otitis media. Multivariate logistic regression analysis revealed that smokers were at almost 3-fold risk to develop nasopharyngeal carcinoma compared to non-smokers (Adjusted “AOR”=3.05; 95% confidence intervals: 1.37-6.79) and consumption of smoked meat as participants consumed it on weekly or monthly bases were at highly significant risk to develop NPC compared to those who never consumed it (AOR=9.32; 95% CI: 1.12—77.39 and 14.44; 95% CI: 1.71-121.81. respectively) [Table 2].However, consumption of Canned Fava beans and Arabic Coffee were not found to be associated with NPC. Conclusion: The rate of consumption of meats was increased in the last tow decades among Saudi population. The N-nitrosamines (NA) is a large group of compounds of which many are carcinogenic. In many studies, the nitrosamines were detected as high level in smoked meat. The results from this study suggested that consumption of smoked cooked meat and cigarette smoking is independent risk factors for NPC in Saudi Arabia.
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Delayed Complications of Cochlear Implant Surgical Site, Al Nahdha Hospital 17 Year's Experience
Khalid Al Zaabi, Ammar Al Lawati
January-June 2018, 20(1):29-34
Background: Since the era of Cochlear Implant (CI) has started varies complications were reported in the literature. These complications range from simple wound infection to much more severe and complicated complications such as meningitis and facial nerve paralysis. In Oman we started our CI program in 2000 and we came across several complications over the last decade. Objective: To report our hospital experience in post CI complications at the wound site in the last 17 years. Methods: Retrospective analysis of 350 cases operated at our tertiary hospital in the period of 2000 until March 2017. Results: 11 cases developed wound site complications in which 6 of them needed to be taken to the operating theatre while 5 cases were managed as outpatients. The types of complications were seroma, hematoma, wound infection, Abscess and we had one patient with device extrusion. Conclusion: Post CI wound site complications are uncommon but when present, they might lead to major morbidities. Early detection and management is highly advised.
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Factors influencing career choice in otorhinolaryngology among medical students at King Abdulaziz University, Jeddah, Saudi Arabia
Ghofran Qorban, Talal Al-Khatib, Sara Howldar, Ohoud Allinjawi, Hanan Jawa, Mukhtiar Baig
January-June 2018, 20(1):20-28
Background: Objective: The study was designed to investigate factors influencing career choice among medical students interested in Otorhinolaryngology (ORL) at Faculty of Medicine, King Abdulaziz University (KAU), Jeddah, Saudi Arabia. Methods: In this cross-sectional study, a total of 531 medical students participated. A questionnaire was used to collect the data. Data were analyzed using SPSS-16. Results: A total 531 participating medical students belonged to 4th, 5th, and 6th year. Two hundred twenty-one (41.6%) were interested in ORL specialty. Almost all of the students (95%) agreed that a patient’s ear, nose, throat, and head & neck health plays an important role in their overall health. The majority of the participants (68%) disagreed that that ORL is less important than other specialties. There were several reasons for selecting ORL as career choice such as: a secured and respected job (71%), well-paid job (63%), rewarding work, grateful patients (69%), opportunity to meet people of different age groups and various backgrounds (68%), a window into ordinary people’s everyday life (52%), comprehensive doctor-patient relationships (54%), versatile, challenging work (54%), and long-term doctor-patient relationships (58%). Conclusion: Overall participants’ responses were overwhelmingly positive to pursue a career in ORL specialty.
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Dermatofibrosarcoma Protuberans: An Unusual Parotid Swelling - A Case Report
Ahmad K Alnemare, Abdulaziz Alabidi, Nouraddine Alhasan, Khaled A Abumansour
January-June 2018, 20(1):42-44
Background: Dermatofibrosarcoma protuberans (DFSP) is a slowly growing tumor. It has a high recurrence rate. The tumor is characterized by dermal spindle cell proliferation with infiltration of subcutaneous tissue, and expression of CD34 on immunnohistochemistry is pathgnomic. Main observation: We observed a 46-years-old female patient complaining of recurrent fixed swelling in the parotid region that was diagnosed as DSFP. The tumor had been surgically excised and the patient was referred for adjuvant radiotherapy and a follow-up every month for 2 years with no reported recurrence. Conclusion: Although rare, DFSP requires a high index of suspicion if there is recurrent painless, cutaneous, and multinodular lesion in the parotid region. In this context, wide local excision (>3 cm margins) combined with post-operative radiotherapy plays a fundamental role in the management of DFSP patients.
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Operative challenges in doing cochlear implant in an ossified cochlea, is it worth it? Case report and reviewing the literature
Farid Alzhrani
January-June 2018, 20(1):37-41
In the past, cochlear implantation was a contraindicated procedure in profoundly deaf patients with radical mastoid cavities. This was due to high risk of infection spread into the cochlea with possible destruction of the remainder surviving cochlear neural elements. We report on King Abdulaziz University Hospital, Riyadh, Saudi Arabia experience in managing, two postlingual profoundly deaf patients (both male and adult) with radical mastoid cavities due to chronic cholesteatomatous otitis media by cochlear implantation. Two different open techniques were used, cochlear implantation with (in the first patient) and without (in the second patient) obliteration of the pre-existing mastoid cavity. One patient (first) suffered infection of mastoid cavity with extrusion of electrode, 55 months postimplantation. The infection could not be controlled without explantation, so the patient was explanted. The other (second) patient suffered facial nerve twitching, ear discharge and later failure of the implant as proved by integrity testing, 22 months post-implantation. The infection subsided after explantation. We recommend regular clinical and audiological follow-up of such patients in the same cochlear implantation center to avoid any complications which may lead to implant failure or electrode extrusion. This is also useful to discover and treat early any potential recurrent infection or cholesteatoma. High-resolution computed tomography scan of temporal bone is a good tool in the follow-up of patient with post-implantation complications or those implanted with closed blind sac technique which may be a better alternative technique than the open technique.
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