Objective: to evaluate whether nasal surgical procedures done in conjunction with adenoidectomy in children affect the outcome of the procedure. Patients and methods: Patients were classified into 2 groups.Group A included patients undergone adenoidectomy alone, and group B which included patients undergone adenoidectomy and surgical nasal procedure(s). Patients were followed up 1, 2, 4 weeks, 6 months and 1 year postoperatively for presence of edema, discharge, crusts, adhesions and overall nasal patency. Results: No statistically significant differences were observed in the presence of postoperative edema, discharge, crusts, adhesions and nasal patency between the 2 groups. Conclusion: Nasal surgical procedures can be done safely effectively with endoscopic adenoidectomy in children.

Objective: Detect whether bone erosion or destruction alters the ADC value while discriminating benign from malignant sinonasal masses. Patients and methods: Twenty five patients were investigated and operated upon in this study. Preoperative CT scans and diffusion weighted MRI imaging were done within 48 hours prior to surgery. Surgical procedures were done in the form of complete resection or biopsy taking. The ADC values were calculated for sinonasal lesions associated with bone erosion or destruction detected on CT scanning. Results: Histopathological diagnosis revealed benign masses in 44% and malignant tumors in 56% of biopsies. No significant differences between mean ADC values of the first and second ROI in both benign (P value =0.365) and malignant masses (P value =0. 07). Statistical significant difference was found between the ADCL values of benign and malignant sinonasal masses. (P value =0.044). Conclusions: Bone erosion or destruction does not alter the ADC value in differentiating between benign and malignant masses. ADC value does not change with bone erosion or destruction.

Objective: Detect whether bone erosion or destruction alters the ADC value while discriminating benign from malignant sinonasal masses. Patients and methods: Twenty five patients were investigated and operated upon in this study. Preoperative CT scans and diffusion weighted MRI imaging were done within 48 hours prior to surgery. Surgical procedures were done in the form of complete resection or biopsy taking. The ADC values were calculated for sinonasal lesions associated with bone erosion or destruction detected on CT scanning. Results: Histopathological diagnosis revealed benign masses in 44% and malignant tumors in 56% of biopsies. No significant differences between mean ADC values of the first and second ROI in both benign (P value =0.365) and malignant masses (P value =0. 07). Statistical significant difference was found between the ADCL values of benign and malignant sinonasal masses. (P value =0.044). Conclusions: Bone erosion or destruction does not alter the ADC value in differentiating between benign and malignant masses. ADC value does not change with bone erosion or destruction.

Objective: Detect whether bone erosion or destruction alters the ADC value while discriminating benign from malignant sinonasal masses. Patients and methods: Twenty five patients were investigated and operated upon in this study. Preoperative CT scans and diffusion weighted MRI imaging were done within 48 hours prior to surgery. Surgical procedures were done in the form of complete resection or biopsy taking. The ADC values were calculated for sinonasal lesions associated with bone erosion or destruction detected on CT scanning. Results: Histopathological diagnosis revealed benign masses in 44% and malignant tumors in 56% of biopsies. No significant differences between mean ADC values of the first and second ROI in both benign (P value =0.365) and malignant masses (P value =0. 07). Statistical significant difference was found between the ADCL values of benign and malignant sinonasal masses. (P value =0.044). Conclusions: Bone erosion or destruction does not alter the ADC value in differentiating between benign and malignant masses. ADC value does not change with bone erosion or destruction.

Objective: The aim of our study was to evaluate the effects of middle turbinate head resection (MTR) on the outcome of endoscopic sinus surgery. Patients and methods: Patients with bilateral nasal polyps were bilaterally operated upon. In one side, the polyps were removed with preservation of the head of middle turbinate. In the other side, polyps were removed with resection of the head of middle turbinate. Patients were followed up at 1, 2, 4 weeks, 6 months, 1 and 2 years postoperatively for the presence of crusts, adhesions, polyp recurrence, smell affection, frontal sinus drainage pathway obstruction and overall nose patency. The duration of surgery in both sides was also compared. Results: No statistically significant differences were observed in the presence of crusts, adhesions, polyp recurrence, smell affection, frontal sinus drainage pathway obstruction and overall nasal patency between the 2 operated sides. The operative time was significantly shorter in the group with (MTR). Conclusion: Resection of the head of middle turbinate carries no adverse effects and can be done safely in endoscopic sinus surgery.

Objective: The aim of our study was to evaluate the effects of middle turbinate head resection (MTR) on the outcome of endoscopic sinus surgery. Patients and methods: Patients with bilateral nasal polyps were bilaterally operated upon. In one side, the polyps were removed with preservation of the head of middle turbinate. In the other side, polyps were removed with resection of the head of middle turbinate. Patients were followed up at 1, 2, 4 weeks, 6 months, 1 and 2 years postoperatively for the presence of crusts, adhesions, polyp recurrence, smell affection, frontal sinus drainage pathway obstruction and overall nose patency. The duration of surgery in both sides was also compared. Results: No statistically significant differences were observed in the presence of crusts, adhesions, polyp recurrence, smell affection, frontal sinus drainage pathway obstruction and overall nasal patency between the 2 operated sides. The operative time was significantly shorter in the group with (MTR). Conclusion: Resection of the head of middle turbinate carries no adverse effects and can be done safely in endoscopic sinus surgery.

Background and purpose: There have been few studies to estimate the prevalence of Bell’s palsy (BP) in Arab countries. A community-based study was conducted to estimate the prevalence, incidence rates, precipitating factors, and outcome of BP in Qena Governorate, Egypt. Subjects and methods: A door-to-door survey was carried out, with random sampling of 10 districts, involving 9303 inhabitants, 51.1% males and 48.9% females. Seventeen subjects were positive in screening questionnaire and referred to Qena University hospital and were subjected to a full clinical examination, House Brackmann’s Facial grading system. Results: In a total population of 9303 individuals, 15 cases were confirmed as having BP giving a prevalence rate (PR) 161/105 for all ages 95%CI (80–243). It was slightly but not significantly higher among women and the rural community. The incidence rate of BP was 107/105. The highest age-specific rate was 40–49 years age. The most frequent precipitating factors for an episode of BP were exposure to air draft in 40%, physical stress (13.3%), and upper respiratory tract infection (13.3%). Moreover, 46.7% had predisposing risk factors, DM and hypertension in 33.3%. Sixty percent of cases had complication and poor outcome. Conclusion: The overall prevalence and incidence rates of BP in Qena governorate were high. This could be related to the variation in day and night temperature in our community and the susceptibility to air draft exposure during the night. The high frequency of poor outcome among studied cases suggests that better local guidelines should be implemented to recognize and treat BP.

Background and purpose: There have been few studies to estimate the prevalence of Bell’s palsy (BP) in Arab countries. A community-based study was conducted to estimate the prevalence, incidence rates, precipitating factors, and outcome of BP in Qena Governorate, Egypt. Subjects and methods: A door-to-door survey was carried out, with random sampling of 10 districts, involving 9303 inhabitants, 51.1% males and 48.9% females. Seventeen subjects were positive in screening questionnaire and referred to Qena University hospital and were subjected to a full clinical examination, House Brackmann’s Facial grading system. Results: In a total population of 9303 individuals, 15 cases were confirmed as having BP giving a prevalence rate (PR) 161/105 for all ages 95%CI (80–243). It was slightly but not significantly higher among women and the rural community. The incidence rate of BP was 107/105. The highest age-specific rate was 40–49 years age. The most frequent precipitating factors for an episode of BP were exposure to air draft in 40%, physical stress (13.3%), and upper respiratory tract infection (13.3%). Moreover, 46.7% had predisposing risk factors, DM and hypertension in 33.3%. Sixty percent of cases had complication and poor outcome. Conclusion: The overall prevalence and incidence rates of BP in Qena governorate were high. This could be related to the variation in day and night temperature in our community and the susceptibility to air draft exposure during the night. The high frequency of poor outcome among studied cases suggests that better local guidelines should be implemented to recognize and treat BP.

Abstract BACKGROUND: Repeated session of repetitive transcranial magnetic stimulation (rTMS) over motor cortex have been reported to produce significant improvement of motor performance in patients with parkinson's disease (PD). In addition, it is known that a single session of rTMS over motor cortex transiently increases DA in striatum. Here, we test whether repeated sessions of rTMS increase serum dopamine in PD patients and whether this correlates with changes in clinical rating scales. MATERIAL AND METHODS: Twenty untreated PD patients with moderate to severe symptoms (Hoehn & Yahr state III-V 1967) were assessed on the Unified Parkinson's Disease Rating Scale (UPDRS), and with an enzyme immunoassay for quantitative determination of plasma dopamine before and after six daily sessions of 25 Hz rTMS with 3,000 stimuli over the right and left hand and leg motor cortex. RESULTS: There was significant improvement in UPDRS compared with the baseline. Serum dopamine level also was significantly elevated over the same interval. There was a significant correlation between UPDRS and serum dopamine level before and after treatment. CONCLUSION: Improved motor performance in PD after repeated session of rTMS may be related to an elevation of serum dopamine concentration.

Abstract BACKGROUND: Repeated session of repetitive transcranial magnetic stimulation (rTMS) over motor cortex have been reported to produce significant improvement of motor performance in patients with parkinson's disease (PD). In addition, it is known that a single session of rTMS over motor cortex transiently increases DA in striatum. Here, we test whether repeated sessions of rTMS increase serum dopamine in PD patients and whether this correlates with changes in clinical rating scales. MATERIAL AND METHODS: Twenty untreated PD patients with moderate to severe symptoms (Hoehn & Yahr state III-V 1967) were assessed on the Unified Parkinson's Disease Rating Scale (UPDRS), and with an enzyme immunoassay for quantitative determination of plasma dopamine before and after six daily sessions of 25 Hz rTMS with 3,000 stimuli over the right and left hand and leg motor cortex. RESULTS: There was significant improvement in UPDRS compared with the baseline. Serum dopamine level also was significantly elevated over the same interval. There was a significant correlation between UPDRS and serum dopamine level before and after treatment. CONCLUSION: Improved motor performance in PD after repeated session of rTMS may be related to an elevation of serum dopamine concentration.