Yasser Khafagy | Mansoura University (original) (raw)

Papers by Yasser Khafagy

Research paper thumbnail of Endoscopic management of congenital choanal atresia: Second look is mandatory

Bangladesh Journal of Otorhinolaryngology, 2016

Congenital choanal atresia (CA) is a rare abnormality characterized by unilateral or bilateral ob... more Congenital choanal atresia (CA) is a rare abnormality characterized by unilateral or bilateral obstruction of the posterior end of the nasal cavity. With an incidence of 1:1000 to 1:8000 births, it is more in female than in males and unilateral more common than bilateral. Surgical procedures aim to provide adequate functional choanal patency and a low rate of rest enosis, with shorter surgery and hospitalization times, to minimize morbidity and mortality, this study done to evaluate the effectiveness and safety of endoscopic nasal surgical techniques for the treatment of congenital choanal atresia in patients with unilateral and bilateral atresia and to emphasis in the important of second look procedure at the time of removal of stent to assess the wideness of neochoana, and to remove any granulation tissue ,or polyps, it involved 13 patients, 10 with unilateral CA and 3 bilateral CA, all involved in surgery and second look.

Research paper thumbnail of Allergic fungal rhinosinusitis: detection of fungal DNA in sinus aspirate using polymerase chain reaction

The Journal of Laryngology & Otology, 2009

Objective:This study investigated allergic fungal rhinosinusitis cases, and aimed to compare the ... more Objective:This study investigated allergic fungal rhinosinusitis cases, and aimed to compare the detection of fungi in sinus aspirate by culture and by polymerase chain reaction assay, and to relate the presence of fungi in the nasal sinuses to the type of fungal allergen causing disease.Methods:Sixty-eight cases of allergic fungal rhinosinusitis underwent fungal culture and polymerase chain reaction assay for universal fungal, aspergillus and bipolaris DNA. Aspergillus-specific immunoglobulin E levels were measured in sinus aspirate, and total serum immunoglobulin E levels were calculated. A control group of 10 cases was included in the study.Results:Of the 68 allergic fungal rhinosinusitis cases, only 42 (61.7 per cent) had positive fungal cultures; of the 10 controls, only three (30 per cent) had positive cultures. Species from the dematiaceous family were most commonly grown, being isolated in 30 cases (71.4 per cent). Bipolaris was the most commonly isolated species (18 cases) ...

Research paper thumbnail of Gunshot Injuries of the Temporal Bone

Archives of Otolaryngology - Head and Neck Surgery, 1972

Despite an increasing incidence of gunshot wounds to the temporal bone, there is little in the li... more Despite an increasing incidence of gunshot wounds to the temporal bone, there is little in the literature regarding management of survivors of these serious injuries. Twelve patients were treated for such wounds between 1986 and 1994. The most frequent presentations were cranial nerve injury, especially facial paralysis (9 patients), hearing loss (7), vascular injury (4), and vestibular dysfunction (3). Persistent cerebrospinal fluid otorrhea was uncommon (1 patient) in this series. Computed tomography and audiovestibular testing were helpful in evaluating the severity of injury and guiding the surgical approach when necessary. Electroneurography was helpful in evaluating facial nerve function; however, documented disruption of the facial nerve canal in itself was considered an indication for surgical exploration. Other indications for surgical intervention included evidence of dural tear, vascular injury, and severe disruption of the external auditory canal.

Research paper thumbnail of Endoscopic Repair of Bilateral Congenital Choanal Atresia

The Laryngoscope, 2002

The literature about endoscopic repair of bilateral choanal atresia is scarce. The advantages and... more The literature about endoscopic repair of bilateral choanal atresia is scarce. The advantages and difficulties encountered with this technique are discussed. Prospective case series in a tertiary care center. Nine infants with bilateral choanal atresia underwent transnasal endoscopic repair. On computed tomography scans, six had mixed atresia and three had bony atresia. Extra-long burrs, ear curettes, and dissectors all have been used with 4- and 2-mm, 0 degrees telescopes. The neochoana has been stented for 5 to 8 weeks. All cases were examined with the endoscope on removal of the stent; any granulation or polyps were removed at that time. Five cases remained patent after removal of stenting. Two patients required revision surgery because of repeat stenosis; one case remained patent and the other had repeat stenosis on one side. One infant died because of unrelated medical problems that occurred later. In one case the atretic tissue was thick, and the procedure was stopped because of bleeding; the infant died in the postoperative period after resuscitation. Careful review of the computed tomography scan and experience with endoscopic nasal surgery makes the transnasal endoscopic treatment a safe and effective approach for managing bilateral choanal atresia.

Research paper thumbnail of Does Asthma and Aspirin Hypersensitivity Affect the Outcome of Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyps

Journal of Allergy & Therapy, 2011

Journals »». A Accounting & Marketing Addiction Research & Therapy Advances in Automobile Enginee... more Journals »». A Accounting & Marketing Addiction Research & Therapy Advances in Automobile Engineering Advances in Pharmacoepidemiology & Drug Safety Advances in Robotics & Automation Aeronautics & Aerospace ...

Research paper thumbnail of The Prognostic Variables Affecting the Frontal Sinusotomy Patency Outcome and How to Manage: A Prospective Study

Clinical Otolaryngology, Mar 20, 2021

The study aimed to assess the factors affecting the frontal sinus patency after endoscopic fronta... more The study aimed to assess the factors affecting the frontal sinus patency after endoscopic frontal sinusotomy. A prospective cohort study SETTING: Tertiary centre hospital MAIN OUTCOME MEASURES: Fifty patients with refractory chronic frontal sinusitis (83 operated frontal sinuses) had frontal sinusotomy and followed up for six months. Multiple operative factors were included; the type of the procedure, intraoperative sinus findings, degree of mucosal preservation, and middle turbinate stability. Other factors were also assessed, including smoking, the presence of allergic rhinitis, asthma, gastroesophageal reflux, and other associated medical comorbidities. The sinus patency success rate was 75.9%. There was a significant difference regarding the intraoperative anteroposterior sinus ostium diameter (5.36 ± 1.45 mm vs 8.88 ± 2.38 mm, p-value: .001* in the failed group and the success group, respectively). There was a significant association between the patency outcome and the presenc...

Research paper thumbnail of Endoscopic Management of Sinonasal Tumors

Mansoura Medical Journal, Dec 1, 2005

Research paper thumbnail of IgE and Cytokines (IL-6 and IL-13) in Sinonasal Polyposis

Research paper thumbnail of Migrating Laryngeal Foreign Body

Journal of Bronchology & …, 2011

We report the case of a 6-year-old boy who presented with a 2-month history of stridor and respir... more We report the case of a 6-year-old boy who presented with a 2-month history of stridor and respiratory difficulty, preceded 1 month earlier by dry cough. The evaluation before admission revealed glottic narrowing due to diffuse inflammatory changes. On ...

Research paper thumbnail of Endoscopic cauterization of the sphenopalatine artery in pediatric intractable posterior epistaxis

International Journal of Pediatric …, 2011

To evaluate the rule of endoscopic sphenopalatine artery cauterization in posterior intractable e... more To evaluate the rule of endoscopic sphenopalatine artery cauterization in posterior intractable epistaxis in pediatric age group as regard technical difficulty, efficacy, and safety in children. Retrospective study. From March 2008 to February 2011, 7 children (4 male, 3 female) with idiopathic intractable posterior epistaxis, patients' age ranged from 8 to 14 years (10.7 average). All patients underwent preoperative laboratory investigations to exclude bleeding or coagulation disorders and CT paranasal sinus. All patients underwent endoscopic sphenopalatine artery cauterization (7 procedures for 7 patients, 5 were in the right side and 2 were in the left side). postoperative evaluation showed no recurrence for epistaxis during the post operative follow up period. Also, no complications were found. The average follow up period was 17.8 months. Endoscopic cauterization of sphenopalatine artery in pediatric age group was effective and safe technique providing that the surgeon has a good experience regarding pediatric endoscopic sinonasal anatomy. Minimal endoscopic technique in this age group is important to avoid unnecessary operative and postoperative complications. Avoid excessive cauterization to lateral nasal wall in this technique is crucial to avoid unexpected nerve injury or tissue necrosis.

Research paper thumbnail of Revision stapedectomy with and without the CO2 laser: an analysis of results

The American journal of otology, 1996

A retrospective review is presented of revision stapedectomies performed by the senior authors be... more A retrospective review is presented of revision stapedectomies performed by the senior authors between 1986 and 1994. A total of 106 stapedectomies was performed during that period, of which 30 were revisions. These revisions were within the first 100 stapedectomies performed by the senior authors. Most failures occurred early in the series. The overall success rate for closure to within 10 dB was 52%, and the average closure was 12.72 dB. Five cases were performed without the laser with no successes and an average closure of 27 dB. After the use of the laser, the success rate was 64%, and the average closure was 9.75 dB. There was a statistically significant difference between the hearing results with and without the laser (p < 0.01). The prognosis was better when surgery was performed primarily for hearing loss and with the laser, with success in 13 (72%) or 18 cases. In two cases, there was a sensorineural decline > 10 dB. The only dead ear occurred preoperatively in a pati...

Research paper thumbnail of Areolar Fascia with and Without Conchal Cartilage in Tympanoplasty

Research paper thumbnail of Feasibility of transoral endoscopic enucleation for large odontogenic jaw tumors

Pan Arab Journal of Rhinology, 2021

Objective The aim was to describe a transoral endoscopic approach for large odontogenic jaw tumor... more Objective The aim was to describe a transoral endoscopic approach for large odontogenic jaw tumors and to assess the feasibility of endoscopy in complete enucleation of any tumor remnants. Materials and methods This retrospective cohort study was done on patients presenting with different types of large jaw tumors in the period from 2013 to 2017 at the Department of Otolaryngology – Head and Neck Surgery, Mansoura University, Egypt. All patients were managed endoscopically. with the bony port measured in its largest dimension. Outcome measures were the occurrence of recurrence during the follow up. Follow-up ranged from 6 to 36 months. Results All patients had complete removal of tumor from the cavity with the transoral endoscopic approach through portal opening of the tumor cavity with a mean (SD) of 24.3 (3.12 mm). Various types of odontogenic tumors were included. No recurrence was detected in the follow-up period except for 1 case requiring a second look. Conclusion Management o...

Research paper thumbnail of Endoscopic treatment of odontogenic maxillary mucopyocele

Egyptian Journal of Oral & Maxillofacial Surgery, 2017

Introduction Mucopyocele is a term used to describe a mucocele that gets secondarily infected by ... more Introduction Mucopyocele is a term used to describe a mucocele that gets secondarily infected by pyogenic bacteria and develops pus. Aim This article aimed to evaluate endoscopic treatment of odontogenic maxillary mucopyocele as regards technical considerations, surgical efficacy, and prognosis. Patients and methods A retrospective study was conducted on patients presenting with odontogenic sinusitis complicated with maxillary mucopyocele. A total of 12 patients were included in this study. All patients underwent endoscopic sinus surgery in the form of uncinectomy with wide middle meatal antrostomy to completely expose the medial mucopyocele wall in anterior, posterior, and inferior directions. In three patients with ethmoidal extension, complete ethmoidectomy was performed extending the procedure to be partial medial maxillectomy. Postoperatively, all patients were given topical corticosteroid spray, nasal douches, oxymetazoline hydrochloride spray, and antibiotics. Results This se...

Research paper thumbnail of Endoscopic management of spontaneous CSF rhinorrhea with septal graft and middle turbinate rotational flap technique: a review of 31 cases

Ear, nose, & throat journal, 2014

Spontaneous cerebrospinal fluid (CSF) rhinorrhea poses a major challenge to rhinologists. Much co... more Spontaneous cerebrospinal fluid (CSF) rhinorrhea poses a major challenge to rhinologists. Much controversy attends its cause, pathophysiology, management, and prognosis. It has been suggested that endoscopic placement of a septal graft with a middle turbinate rotational flap may represent the ideal approach to closing skull base defects. We conducted a retrospective chart review to compile the results of this approach in 31 patients with spontaneous CSF rhinorrhea-22 women and 9 men, aged 18 to 67 years (mean 38.5 ± 8.96) at diagnosis. After one surgery, success had been achieved in 27 of these patients (87.1%). The remaining 4 patients underwent a second surgery, and 2 of them experienced a successful closure. In the remaining 2 patients, a third surgery was still unsuccessful, and they were referred to the neurosurgical team for a shunt procedure. Thus, the overall success rate with the septal graft and a middle turbinate rotational flap was 93.5% (29/31). Septal grafts and middle...

Research paper thumbnail of Ectopic maxillary sinus third molar with dentigerous cyst in 11 patients: Tailored endoscopic‐assisted approaches for a successful outcome

Clinical Otolaryngology, 2021

OBJECTIVES The objective of this study was to highlight our experience in different less invasive... more OBJECTIVES The objective of this study was to highlight our experience in different less invasive endoscopic / endoscopic-assisted approaches for the proper management of maxillary sinus ectopic teeth associated with dentigerous cyst, according to the location and accessibility of the teeth in the sinus. METHODS This study included 11 patients with ectopic third molar associated with a dentigerous cyst in the maxillary sinus. Patients' demographic data, clinical presentation, operative details, and postoperative outcomes were collected and evaluated. RESULTS Endoscopic-assisted sublabial approach was done in 5 patients who had the tooth located inferiorly in the maxillary sinus. When the tooth was in the medial (n=2) or superior wall (n=2), endoscopic endonasal middle meatal antrostomy was done. When the tooth was located anteriorly (n=1) or laterally (n=1), an endoscopic endonasal prelacrimal approach was performed. All patients were symptom free at the end of treatment, with n...

Research paper thumbnail of The impact of bolgerization versus partial resection of the middle turbinate on frontal sinusotomy patency outcome: A randomised controlled study

Clinical Otolaryngology, 2021

This study aimed to compare the effects of middle turbinate resection vs bolgerization on the inc... more This study aimed to compare the effects of middle turbinate resection vs bolgerization on the incidence of middle meatus synechia and their prognostic value on the patency outcomes after frontal sinusotomy.

Research paper thumbnail of Efficacy of voriconazole in nonsurgical treatment of allergic and chronic granulomatous fungal rhinosinusitis: a preliminary study

The Egyptian Journal of Otolaryngology, 2018

Objective Evaluate the effectiveness and safety of voriconazole in the non surgical treatment of ... more Objective Evaluate the effectiveness and safety of voriconazole in the non surgical treatment of allergic fungal rhinosinustis (AFRS) and chronic granulomatous fungal rhinosinusitis (CGFRS). Also, we present our conservative approach for cases of chronic granulomatous fungal rhinosinusitis with skull base involvement. Patients and Methods 26 Patients with the diagnosis of AFRS (17 patients) and CGFRS (9 patients) have been treated with voriconazole for a period of 3 weeks in AFRS to three months in CGFRS. Results All patients with AFRS have shown marked improvement both clinically and radiologically, recurrence occur in 6 cases, two patients improved medically, and 4 patient required endoscopic sinus surgery. From 9 patients with CGFRS, 6 patients improved completely and did not require surgery, three patients had persistent or residual disease and required surgical interference. Conclusions Voriconazole is effective, and safe in treatment of AFRS as well as CGFRS. This is a prelimi...

Research paper thumbnail of Comparison between the endoscopic scores of bolgerization versus partial resection of the middle turbinate for management of the postoperative lateralization in the early follow-up period after endoscopic frontal sinusotomy: A randomized controlled study

American Journal of Otolaryngology

Research paper thumbnail of Choanal adenoid in adults with persistent nasal symptoms: endoscopic management to avoid misdiagnosis and unsuccessful surgeries

European Archives of Oto-Rhino-Laryngology, 2011

Our objective was to conWrm the necessity of nasal endoscopy in the diagnosis and treatment of ch... more Our objective was to conWrm the necessity of nasal endoscopy in the diagnosis and treatment of choanal adenoid in adult patients with persistent bilateral nasal obstruction and recurrent nasal infections that may lead to repeated unsuccessful medical and surgical procedures. We present a series of 64 adult patients (18-37 years: 40 males, 24 females). All patients had persistent bilateral nasal obstruction and recurrent nasal infections. There was history of repeated medical and surgical unsuccessful procedures. Choanal adenoid was conWrmed by nasal endoscopy and CT scanning. Absence of adenoid tissues in the nasopharynx was conWrmed in all cases. Surgical removal of choanal adenoids was undertaken in all cases endoscopically. Some other surgical procedures like straightening of a deviated septum or reduction of a hypertrophied turbinate were undertaken in some indicated cases. Most of the cases experienced complete relief from obstruction and return of a patent nasal airway, and improvement of associated complaints such as dry mouth and persistent cough. A thorough review of this phenomenon and its clinical relevance, and methods of diagnosis and management are presented. We recommend a thorough nasal endoscopy as a routine in cases of persistent nasal obstruction even in the presence of an apparent cause of obstruction.

Research paper thumbnail of Endoscopic management of congenital choanal atresia: Second look is mandatory

Bangladesh Journal of Otorhinolaryngology, 2016

Congenital choanal atresia (CA) is a rare abnormality characterized by unilateral or bilateral ob... more Congenital choanal atresia (CA) is a rare abnormality characterized by unilateral or bilateral obstruction of the posterior end of the nasal cavity. With an incidence of 1:1000 to 1:8000 births, it is more in female than in males and unilateral more common than bilateral. Surgical procedures aim to provide adequate functional choanal patency and a low rate of rest enosis, with shorter surgery and hospitalization times, to minimize morbidity and mortality, this study done to evaluate the effectiveness and safety of endoscopic nasal surgical techniques for the treatment of congenital choanal atresia in patients with unilateral and bilateral atresia and to emphasis in the important of second look procedure at the time of removal of stent to assess the wideness of neochoana, and to remove any granulation tissue ,or polyps, it involved 13 patients, 10 with unilateral CA and 3 bilateral CA, all involved in surgery and second look.

Research paper thumbnail of Allergic fungal rhinosinusitis: detection of fungal DNA in sinus aspirate using polymerase chain reaction

The Journal of Laryngology & Otology, 2009

Objective:This study investigated allergic fungal rhinosinusitis cases, and aimed to compare the ... more Objective:This study investigated allergic fungal rhinosinusitis cases, and aimed to compare the detection of fungi in sinus aspirate by culture and by polymerase chain reaction assay, and to relate the presence of fungi in the nasal sinuses to the type of fungal allergen causing disease.Methods:Sixty-eight cases of allergic fungal rhinosinusitis underwent fungal culture and polymerase chain reaction assay for universal fungal, aspergillus and bipolaris DNA. Aspergillus-specific immunoglobulin E levels were measured in sinus aspirate, and total serum immunoglobulin E levels were calculated. A control group of 10 cases was included in the study.Results:Of the 68 allergic fungal rhinosinusitis cases, only 42 (61.7 per cent) had positive fungal cultures; of the 10 controls, only three (30 per cent) had positive cultures. Species from the dematiaceous family were most commonly grown, being isolated in 30 cases (71.4 per cent). Bipolaris was the most commonly isolated species (18 cases) ...

Research paper thumbnail of Gunshot Injuries of the Temporal Bone

Archives of Otolaryngology - Head and Neck Surgery, 1972

Despite an increasing incidence of gunshot wounds to the temporal bone, there is little in the li... more Despite an increasing incidence of gunshot wounds to the temporal bone, there is little in the literature regarding management of survivors of these serious injuries. Twelve patients were treated for such wounds between 1986 and 1994. The most frequent presentations were cranial nerve injury, especially facial paralysis (9 patients), hearing loss (7), vascular injury (4), and vestibular dysfunction (3). Persistent cerebrospinal fluid otorrhea was uncommon (1 patient) in this series. Computed tomography and audiovestibular testing were helpful in evaluating the severity of injury and guiding the surgical approach when necessary. Electroneurography was helpful in evaluating facial nerve function; however, documented disruption of the facial nerve canal in itself was considered an indication for surgical exploration. Other indications for surgical intervention included evidence of dural tear, vascular injury, and severe disruption of the external auditory canal.

Research paper thumbnail of Endoscopic Repair of Bilateral Congenital Choanal Atresia

The Laryngoscope, 2002

The literature about endoscopic repair of bilateral choanal atresia is scarce. The advantages and... more The literature about endoscopic repair of bilateral choanal atresia is scarce. The advantages and difficulties encountered with this technique are discussed. Prospective case series in a tertiary care center. Nine infants with bilateral choanal atresia underwent transnasal endoscopic repair. On computed tomography scans, six had mixed atresia and three had bony atresia. Extra-long burrs, ear curettes, and dissectors all have been used with 4- and 2-mm, 0 degrees telescopes. The neochoana has been stented for 5 to 8 weeks. All cases were examined with the endoscope on removal of the stent; any granulation or polyps were removed at that time. Five cases remained patent after removal of stenting. Two patients required revision surgery because of repeat stenosis; one case remained patent and the other had repeat stenosis on one side. One infant died because of unrelated medical problems that occurred later. In one case the atretic tissue was thick, and the procedure was stopped because of bleeding; the infant died in the postoperative period after resuscitation. Careful review of the computed tomography scan and experience with endoscopic nasal surgery makes the transnasal endoscopic treatment a safe and effective approach for managing bilateral choanal atresia.

Research paper thumbnail of Does Asthma and Aspirin Hypersensitivity Affect the Outcome of Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyps

Journal of Allergy & Therapy, 2011

Journals »». A Accounting & Marketing Addiction Research & Therapy Advances in Automobile Enginee... more Journals »». A Accounting & Marketing Addiction Research & Therapy Advances in Automobile Engineering Advances in Pharmacoepidemiology & Drug Safety Advances in Robotics & Automation Aeronautics & Aerospace ...

Research paper thumbnail of The Prognostic Variables Affecting the Frontal Sinusotomy Patency Outcome and How to Manage: A Prospective Study

Clinical Otolaryngology, Mar 20, 2021

The study aimed to assess the factors affecting the frontal sinus patency after endoscopic fronta... more The study aimed to assess the factors affecting the frontal sinus patency after endoscopic frontal sinusotomy. A prospective cohort study SETTING: Tertiary centre hospital MAIN OUTCOME MEASURES: Fifty patients with refractory chronic frontal sinusitis (83 operated frontal sinuses) had frontal sinusotomy and followed up for six months. Multiple operative factors were included; the type of the procedure, intraoperative sinus findings, degree of mucosal preservation, and middle turbinate stability. Other factors were also assessed, including smoking, the presence of allergic rhinitis, asthma, gastroesophageal reflux, and other associated medical comorbidities. The sinus patency success rate was 75.9%. There was a significant difference regarding the intraoperative anteroposterior sinus ostium diameter (5.36 ± 1.45 mm vs 8.88 ± 2.38 mm, p-value: .001* in the failed group and the success group, respectively). There was a significant association between the patency outcome and the presenc...

Research paper thumbnail of Endoscopic Management of Sinonasal Tumors

Mansoura Medical Journal, Dec 1, 2005

Research paper thumbnail of IgE and Cytokines (IL-6 and IL-13) in Sinonasal Polyposis

Research paper thumbnail of Migrating Laryngeal Foreign Body

Journal of Bronchology & …, 2011

We report the case of a 6-year-old boy who presented with a 2-month history of stridor and respir... more We report the case of a 6-year-old boy who presented with a 2-month history of stridor and respiratory difficulty, preceded 1 month earlier by dry cough. The evaluation before admission revealed glottic narrowing due to diffuse inflammatory changes. On ...

Research paper thumbnail of Endoscopic cauterization of the sphenopalatine artery in pediatric intractable posterior epistaxis

International Journal of Pediatric …, 2011

To evaluate the rule of endoscopic sphenopalatine artery cauterization in posterior intractable e... more To evaluate the rule of endoscopic sphenopalatine artery cauterization in posterior intractable epistaxis in pediatric age group as regard technical difficulty, efficacy, and safety in children. Retrospective study. From March 2008 to February 2011, 7 children (4 male, 3 female) with idiopathic intractable posterior epistaxis, patients&amp;amp;amp;amp;amp;amp;#39; age ranged from 8 to 14 years (10.7 average). All patients underwent preoperative laboratory investigations to exclude bleeding or coagulation disorders and CT paranasal sinus. All patients underwent endoscopic sphenopalatine artery cauterization (7 procedures for 7 patients, 5 were in the right side and 2 were in the left side). postoperative evaluation showed no recurrence for epistaxis during the post operative follow up period. Also, no complications were found. The average follow up period was 17.8 months. Endoscopic cauterization of sphenopalatine artery in pediatric age group was effective and safe technique providing that the surgeon has a good experience regarding pediatric endoscopic sinonasal anatomy. Minimal endoscopic technique in this age group is important to avoid unnecessary operative and postoperative complications. Avoid excessive cauterization to lateral nasal wall in this technique is crucial to avoid unexpected nerve injury or tissue necrosis.

Research paper thumbnail of Revision stapedectomy with and without the CO2 laser: an analysis of results

The American journal of otology, 1996

A retrospective review is presented of revision stapedectomies performed by the senior authors be... more A retrospective review is presented of revision stapedectomies performed by the senior authors between 1986 and 1994. A total of 106 stapedectomies was performed during that period, of which 30 were revisions. These revisions were within the first 100 stapedectomies performed by the senior authors. Most failures occurred early in the series. The overall success rate for closure to within 10 dB was 52%, and the average closure was 12.72 dB. Five cases were performed without the laser with no successes and an average closure of 27 dB. After the use of the laser, the success rate was 64%, and the average closure was 9.75 dB. There was a statistically significant difference between the hearing results with and without the laser (p < 0.01). The prognosis was better when surgery was performed primarily for hearing loss and with the laser, with success in 13 (72%) or 18 cases. In two cases, there was a sensorineural decline > 10 dB. The only dead ear occurred preoperatively in a pati...

Research paper thumbnail of Areolar Fascia with and Without Conchal Cartilage in Tympanoplasty

Research paper thumbnail of Feasibility of transoral endoscopic enucleation for large odontogenic jaw tumors

Pan Arab Journal of Rhinology, 2021

Objective The aim was to describe a transoral endoscopic approach for large odontogenic jaw tumor... more Objective The aim was to describe a transoral endoscopic approach for large odontogenic jaw tumors and to assess the feasibility of endoscopy in complete enucleation of any tumor remnants. Materials and methods This retrospective cohort study was done on patients presenting with different types of large jaw tumors in the period from 2013 to 2017 at the Department of Otolaryngology – Head and Neck Surgery, Mansoura University, Egypt. All patients were managed endoscopically. with the bony port measured in its largest dimension. Outcome measures were the occurrence of recurrence during the follow up. Follow-up ranged from 6 to 36 months. Results All patients had complete removal of tumor from the cavity with the transoral endoscopic approach through portal opening of the tumor cavity with a mean (SD) of 24.3 (3.12 mm). Various types of odontogenic tumors were included. No recurrence was detected in the follow-up period except for 1 case requiring a second look. Conclusion Management o...

Research paper thumbnail of Endoscopic treatment of odontogenic maxillary mucopyocele

Egyptian Journal of Oral & Maxillofacial Surgery, 2017

Introduction Mucopyocele is a term used to describe a mucocele that gets secondarily infected by ... more Introduction Mucopyocele is a term used to describe a mucocele that gets secondarily infected by pyogenic bacteria and develops pus. Aim This article aimed to evaluate endoscopic treatment of odontogenic maxillary mucopyocele as regards technical considerations, surgical efficacy, and prognosis. Patients and methods A retrospective study was conducted on patients presenting with odontogenic sinusitis complicated with maxillary mucopyocele. A total of 12 patients were included in this study. All patients underwent endoscopic sinus surgery in the form of uncinectomy with wide middle meatal antrostomy to completely expose the medial mucopyocele wall in anterior, posterior, and inferior directions. In three patients with ethmoidal extension, complete ethmoidectomy was performed extending the procedure to be partial medial maxillectomy. Postoperatively, all patients were given topical corticosteroid spray, nasal douches, oxymetazoline hydrochloride spray, and antibiotics. Results This se...

Research paper thumbnail of Endoscopic management of spontaneous CSF rhinorrhea with septal graft and middle turbinate rotational flap technique: a review of 31 cases

Ear, nose, & throat journal, 2014

Spontaneous cerebrospinal fluid (CSF) rhinorrhea poses a major challenge to rhinologists. Much co... more Spontaneous cerebrospinal fluid (CSF) rhinorrhea poses a major challenge to rhinologists. Much controversy attends its cause, pathophysiology, management, and prognosis. It has been suggested that endoscopic placement of a septal graft with a middle turbinate rotational flap may represent the ideal approach to closing skull base defects. We conducted a retrospective chart review to compile the results of this approach in 31 patients with spontaneous CSF rhinorrhea-22 women and 9 men, aged 18 to 67 years (mean 38.5 ± 8.96) at diagnosis. After one surgery, success had been achieved in 27 of these patients (87.1%). The remaining 4 patients underwent a second surgery, and 2 of them experienced a successful closure. In the remaining 2 patients, a third surgery was still unsuccessful, and they were referred to the neurosurgical team for a shunt procedure. Thus, the overall success rate with the septal graft and a middle turbinate rotational flap was 93.5% (29/31). Septal grafts and middle...

Research paper thumbnail of Ectopic maxillary sinus third molar with dentigerous cyst in 11 patients: Tailored endoscopic‐assisted approaches for a successful outcome

Clinical Otolaryngology, 2021

OBJECTIVES The objective of this study was to highlight our experience in different less invasive... more OBJECTIVES The objective of this study was to highlight our experience in different less invasive endoscopic / endoscopic-assisted approaches for the proper management of maxillary sinus ectopic teeth associated with dentigerous cyst, according to the location and accessibility of the teeth in the sinus. METHODS This study included 11 patients with ectopic third molar associated with a dentigerous cyst in the maxillary sinus. Patients' demographic data, clinical presentation, operative details, and postoperative outcomes were collected and evaluated. RESULTS Endoscopic-assisted sublabial approach was done in 5 patients who had the tooth located inferiorly in the maxillary sinus. When the tooth was in the medial (n=2) or superior wall (n=2), endoscopic endonasal middle meatal antrostomy was done. When the tooth was located anteriorly (n=1) or laterally (n=1), an endoscopic endonasal prelacrimal approach was performed. All patients were symptom free at the end of treatment, with n...

Research paper thumbnail of The impact of bolgerization versus partial resection of the middle turbinate on frontal sinusotomy patency outcome: A randomised controlled study

Clinical Otolaryngology, 2021

This study aimed to compare the effects of middle turbinate resection vs bolgerization on the inc... more This study aimed to compare the effects of middle turbinate resection vs bolgerization on the incidence of middle meatus synechia and their prognostic value on the patency outcomes after frontal sinusotomy.

Research paper thumbnail of Efficacy of voriconazole in nonsurgical treatment of allergic and chronic granulomatous fungal rhinosinusitis: a preliminary study

The Egyptian Journal of Otolaryngology, 2018

Objective Evaluate the effectiveness and safety of voriconazole in the non surgical treatment of ... more Objective Evaluate the effectiveness and safety of voriconazole in the non surgical treatment of allergic fungal rhinosinustis (AFRS) and chronic granulomatous fungal rhinosinusitis (CGFRS). Also, we present our conservative approach for cases of chronic granulomatous fungal rhinosinusitis with skull base involvement. Patients and Methods 26 Patients with the diagnosis of AFRS (17 patients) and CGFRS (9 patients) have been treated with voriconazole for a period of 3 weeks in AFRS to three months in CGFRS. Results All patients with AFRS have shown marked improvement both clinically and radiologically, recurrence occur in 6 cases, two patients improved medically, and 4 patient required endoscopic sinus surgery. From 9 patients with CGFRS, 6 patients improved completely and did not require surgery, three patients had persistent or residual disease and required surgical interference. Conclusions Voriconazole is effective, and safe in treatment of AFRS as well as CGFRS. This is a prelimi...

Research paper thumbnail of Comparison between the endoscopic scores of bolgerization versus partial resection of the middle turbinate for management of the postoperative lateralization in the early follow-up period after endoscopic frontal sinusotomy: A randomized controlled study

American Journal of Otolaryngology

Research paper thumbnail of Choanal adenoid in adults with persistent nasal symptoms: endoscopic management to avoid misdiagnosis and unsuccessful surgeries

European Archives of Oto-Rhino-Laryngology, 2011

Our objective was to conWrm the necessity of nasal endoscopy in the diagnosis and treatment of ch... more Our objective was to conWrm the necessity of nasal endoscopy in the diagnosis and treatment of choanal adenoid in adult patients with persistent bilateral nasal obstruction and recurrent nasal infections that may lead to repeated unsuccessful medical and surgical procedures. We present a series of 64 adult patients (18-37 years: 40 males, 24 females). All patients had persistent bilateral nasal obstruction and recurrent nasal infections. There was history of repeated medical and surgical unsuccessful procedures. Choanal adenoid was conWrmed by nasal endoscopy and CT scanning. Absence of adenoid tissues in the nasopharynx was conWrmed in all cases. Surgical removal of choanal adenoids was undertaken in all cases endoscopically. Some other surgical procedures like straightening of a deviated septum or reduction of a hypertrophied turbinate were undertaken in some indicated cases. Most of the cases experienced complete relief from obstruction and return of a patent nasal airway, and improvement of associated complaints such as dry mouth and persistent cough. A thorough review of this phenomenon and its clinical relevance, and methods of diagnosis and management are presented. We recommend a thorough nasal endoscopy as a routine in cases of persistent nasal obstruction even in the presence of an apparent cause of obstruction.