Background: Regenerating gene (REG) family is composed of antiapoptotic factors and growth factors that affect

epithelial cells within the digestive system. Regenerating gene-I has been studied in different cancers. However, it

has never been studied in head and neck cancer. We investigated the expression of REG-I in head and neck SCC

and its relevance to patient survival rates.

 Methods: Untreated biopsy specimens of 60 patients with stage IV head and neck SCC were collected, and the

expression of REG-I was evaluated using immunohistochemistry. The association between REG-I expression and

clinico-pathological features or survival status of the patients was assessed by Chi-square test, Fisher’s exact test and

Kaplan-Meier method. Cox proportional hazard model was used to identify the independent prognostic factors.

 Results: Incidence of lymphatic permeation, vascular invasion and pathological lymph nodes was significantly

higher in REG-I negative group (p = 0.008, 0.030 and 0.015, respectively). Overall and cancer-free survival rates were

significantly higher in REG-I positive group (p = 0.000434 and 1.0847E-8, respectively). Univariate analysis showed

that REG-I was an independent prognostic factor for predicting long-term overall survival (p = 0.002), and multivariate

analysis showed that REG-I and lymphatic permeation were independent prognostic factors for predicting long-term

disease-free survival (p = 0.001 and 0.022, respectively).

 Conclusion: Our results showed for the first time that, REG-I is expressed in head and neck SCC. REG-I expression is

associated with a longer survival status. We conclude that, REG-I might be a prognostic marker in head and neck SSC

and should be further investigated.

 Introduction: Patency of the eustachian tube has been proved to be mandatory for successful tympanoplasty. Preoperative evaluation of the eustachian tube through Saccharin and methylene blue tests provides adequate information about the mucociliary function and patency of the eustachian tube

 Objective: We aimed to evaluate the mucociliary function of the eustachian tube using saccharin and methylene blue tests, hence we could predict the outcome of tympanoplasty.

Patients and methods: This prospective study was done on 50 adult patients who were diagnosed as having unilateral tubotympanic type of chronic suppurative otitis media. All patients were subjected to preoperative evaluation of hearing and eustachian tube mucociliary function through saccharin and methylene blue dye clearance tests. Then, we correlated the results and the outcome of the surgery.

 Results: According to our results, normal eustachian tube function (ETF) was found in 39 patients, while mild and gross dysfunction was found in eight and three patients respectively. The correlation between ETF and the outcome of tympanoplasty was proved to be statistically significant (P< 0.001), as 85.3% of patients with successful tympanoplasty had a normally functioning ET, while all of the patients with a gross dysfunction of ET had a failed surgery.

 Conclusion: We found that both tests could be a helpful tool to assess the mucociliary function and anatomical patency of the eustachian tube. While, the Saccharin test has the advantages of cost-effectiveness, avoiding the painting produced by the dye, and lacking the need for an endoscope.

Background: One of the most serious complications of temporal bone fracture is facial nerve paralysis. Early diagnosis of traumatic facial nerve paralysis has a very crucial impact on its outcome. Reaching an optimum diagnosis requires good imaging modalities .

Objective: We aimed to determine the validity of multislice computed tomography in temporal bone fracture.

Patients and methods: We enrolled 20 patients with traumatic facial nerve paralysis secondary to temporal bone fracture with a mean age of 23.10±11.44 years. Most of the patients were males, and motor car accident was the most frequent cause of trauma. All patients had preoperative high-resolution CT(HRCT) scanning, and the results were compared with the intraoperative findings.

Results: HRCT had the highest diagnostic accuracy (95%) for the detection of the mastoid process and otic capsule fractures, followed by squamous part fracture (80%). The least diagnostic accuracy was in the detection of fracture of the posterior meatal wall (45%). Fracture of the tympanic portion of the temporal bone was present in three patients while HRCT failed to catch it. Bone chips and edema of the facial nerve were the most frequent findings intraoperatively.

Conclusion: HRCT has an additive role in the assessment of facial nerve injury in case of temporal bone fracture, but should be interpreted with caution where it might underestimate the severity in some cases.

Background& aim: Many previous studies proved that nasal septal deviation has an important effect on the development of the bones of the nose, as well as morphology and other features of facial bones. Assessment of the morphology of the nose helps in obtaining favorable surgical outcomes. We designed this work to discover the association between nasal morphology and nasal septum deviation.

Patients & methods: This study included 120 patients over 18 years old with symptomatic nasal septum deviation who were exposed to CT scanning of the nose and paranasal sinuses. The following parameters were assessed; direction of nasal deviation and its angle in addition to nasal morphology; internasal angle of the nose, the nasal bone length, and the thickness of intermediate and lateral nasal bone on the two sides.

Results: Studied patients’ mean age was 38.08 ± 17.27 years and the majority (70%) of them were males. Out of studied patients, 64 (53.3%) patients had deviated septum toward the right side while in 56 (46.7%) patients it deviated to the left side. It was observed that there were no important differences between types of deviation direction as regarding age, sex, and deviation angle (P= 0.41, 0.09, and 0.61, respectively). Both sexes had insignificant differences as regarding nasal morphology with exception of significantly higher internasal angle (60.33 ± 8.15 vs. 56.19 ± 9.52 degree; P= 0.02), and left intermediate osteotomy thickness (1.92 ± 0.35 vs. 1.77 ± 0.41mm; P= 0.04) in males’ patients. Severe deviation was presented in 19 (15.8%) patients.

Conclusion: This work concludes that deviation of the septum of the nose might influence the morphology of the nasal bones as the length of nasal bone; thickness and lateral osteotomy thickness on the same side of the deviation were altogether more prominent than on the contralateral.

Introduction: Otitis media with effusion (OME) is defined as an effusion in the middle ear without signs and symptoms of an acute infection.

Objectives: To evaluate the efficacy of nasal steroids in OME in children by compared with oral steroids and with nasal saline spray.

Patients and Methods: This study included 60 children with bilateral OME. The children were divided into three equal groups; group A, 20 children received mometasone furoate nasal spray. In group B, 20 children received oral prednisolone. In group C, twenty children received hypertonic seawater nasal spray. Clinical follow-up was done once per week for four weeks, at the end of treatment, and then monthly for three months. Otoscopic examination, audiological evaluation was done before treatment for each group and repeated at 3,6 months after treatment.

Results: A highly significant difference between systemic or topical nasal steroid and hypertonic seawater nasal spray was detected regarding symptoms improvement, clinical examination, adenoids hypertrophy, and hearing condition. The difference between systemic and topical steroids was statistically insignificant. Conclusion: Nasal steroid spray is an effective treatment for OME, similar to systemic steroid but without the hazard of corticosteroids.

Background: Chronic suppurative otitis media (CSOM) is a long-standing infection of middle ear cleft,

characterized by ear discharge and permanent perforation of tympanic membrane. Surgical treatment of CSOM is

still controversial. Recently many studies have been undertaken to evaluate the prognostic impact of various factors

on the outcomes of tympanoplasty. Nonetheless, only few studies have assessed the clinical preoperative assessment

method that allows for tympanoplasty outcome to be predicted.

Objective: To examine the role of the prognostic factors and middle ear risk index on the success of

tympanoplasty.

Patients and methods: The medical records of 100 patients who underwent type 1 tympanoplasty between 2018

and 2020 were prospectively reviewed. Prognostic factors such as age, sex, presence of systemic diseases, location

and size of perforation, duration of dry period, presence of myringosclerosis, presence of septal and conchal

pathology, operation type, and status of the opposite ear were evaluated. Middle ear risk index (MERI) was calculated

and its correlation with the rate of success of surgery was evaluated.

Results: It was noticed that experience of surgeon more than 5 years, absence of comorbidities and low middle ear

risk score were significant predictors for success of tympanoplasty type 1 (P < 0.001, P < 0.001, P < 0.001

respectively).

Conclusion: We found that younger age, female gender, no comorbidities, and higher surgeon experience were

associated with better outcome. In addition, patients with mild MERI score showed higher rate of success for

tympanoplasty. The surgeon experience and MERI were independent predictors of successful procedure.

Keywords: Factors and Middle Ear Risk Index, Type 1 Tympanoplasty, CSOM.

Introduction: Bilateral vocal fold paralysis (BVFP) is a complicated life-threatening clinical problem. Airway enlargement procedures for bilateral vocal fold immobility, such as cordotomy and arytenoidectomy, permanently impair voice and increase the risk of aspiration. An innovative strategy for restoring ventilation without affecting voice or swallowing is botulinum toxin injection into the thyroarytenoid muscle.

Objective: To investigate the effectiveness of thyroarytenoid muscle chemical denervation with botulinum toxin injection in diminishing dyspnea in BVFP by changing the positioning of the paralyzed VFs.

Patients and Methods: 12 patients suffering from bilateral vocal folds immobility were enrolled in the study. Botulinum toxin injection was performed into each vocal fold via a per-oral approach. Voice evaluation, laryngoscopic examination, and pulmonary function tests were carried out before and 15 days after the injection .

Results: All patients reported improvement of their respiratory symptoms as well as improvement of the pulmonary function studies following the injection. Patients who received repeated injections demonstrated a longer duration of symptoms improvement. Voice handicap index scores were not significantly changed after botulinum toxin injection into each vocal fold.

Conclusion: Botulinum toxin injection is a less invasive, short term treatment option improving ventilation in patients with BFVP with little or no effect on voice or swallowing.