This study aimed to evaluate the operative outcomes of using gastric pull-up (GPU), pectoralis major myocutaneous flap (PMMF), and jejunal free flap (JFF) to reconstruct the hypopharynx after resection of hypopharyngeal and cervical esophageal carcinoma. Retrospective clinical study. Otolaryngology Department, Zagazig University Hospital, Egypt and Surgical Department, National Cancer Institute, Cairo, Egypt. Records of 104 patients who underwent resection of carcinoma of the hypopharynx and cervical esophagus were reviewed to determine the indications for radical resection, location, and stage of the primary tumor, gross and pathological surgical resection margins, operative complications, morbidity, and mortality. Reconstruction was performed using the GPU for group (1) (n = 33), PMMF for group (2) (n = 34), and JFF for group (3) (n = 37). The hypopharynx was the most common primary tumor site for group (2) and group (3) whereas group (1) had lesions more frequently in the cervical esophagus. The overall postoperative morbidity rate was 20.2% with a perioperative mortality rate of 6.7% and there was no significant difference between the three groups. There was no graft necrosis in group (1) compared to 5.9% in group (2) and 5.4% in group (3). Pulmonary complications occurred commonly (30.3%) in group (1) compared to 11.8% in group (2) and 10.8% in group (3) The overall 3 years survival rate was 67.3% and there was no significant difference between the three groups. The outcomes of the three techniques are equally successful when used appropriately. The nature of the defect indicates the method of reconstruction. For short reconstruction above the thoracic inlet, PMMF or JFF are equally effective and in tumors requiring total esophagectomy, GPA is indicated.

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Introduction  Otitis media with effusion (OME) is a leading cause of hearing impairment in children. Therefore, early and proper management is essential.Objectives  The objective of this research is to assess the efficacy of intratympanic (IT) steroids injection for management of otitis media with effusion (OME).Methods  This study involved 42 children (84 ears) with bilateral OME. We used tympanometry to confirm the childreńs middle ear effusion and pure tone audiometry to determine hearing threshold. We performed myringotomy and inserted ventilation tubes (VTs) bilaterally, followed by a steroid injection of 0.4–0.6 mL methylprednisolone (40 mg/mL) into one randomly selected middle ear. This procedure was followed by once-weekly administration of steroids (0.5 mL methylprednisolone at a concentration of 40 mg/mL) into the middle ear for three consecutive weeks.Results  We found recurrent OME after VT alone in nine (21.4%) ears; whereas, after VT combined with steroid administration, we found two (4.76%), with statistically significant difference. We noted tympanosclerosis postoperatively in six (12.9%) ears and in one of the injected ears (2.3%) (p = 0.0484). Otorrhea occurred in eight (19%) ears with VT alone and in three (7.1%) injected ears, with non-significant difference. The duration between VT insertion and its extrusion was 6.6 = 1.1 months for ears with VT alone and 6.95 =1.12 months in injected ears (p = 0.1541 NS).Conclusion  IT Steroids injection for treatment of OME is a safe and simple intervention with lower incidence of symptoms recurrence and postoperative complications. Thus, its use in management of OME is recommended.

Background: The cochlear implantation has radically changed the outlook for profoundly deaf adults and children. The cochlear implant can provide sufficient hearing sensations to enable most severely or profoundly deafened persons to continue communicating using speech as their primary means of communication .In Classic cochlear implantation; mastoidectomy is done to help retain the electrode leads within the confines of the mastoid cavity. Then the facial recess should be widely opened followed by cochleostomy which is followed by insertion of the electrode array. Minimally invasive cochlear implant surgery has become the mainstay of most experienced centers. Aim of work: to evaluate the results of using different procedures in cochlear implantation. Patients and methods: The study carried out on 41 patients underwent cochlear implantation, starting from April 2011 till April 2014. Patients were 27 males and 14 females, their age ranged from 2 years to 18 years and all complained of profound sensori-neural hearing loss. We excluded postlingual adults (n=2) and children with congenital anomalies (n=3), post-meningitis cochlear ossification (n=1) and children with chronic suppurative otitis media (n=1). Total number of excluded cases is 7 patients and remains 34 patients. The patients were divided into two groups: the 1st group of patients were implanted by classic approach (n=28) the 2nd group of patients were implanted by the SMA (n =6) and another comparison in which, the patients were divided into patients was implanted by PULSAR ci100 device (5 cases) and the patients were implanted by HI-RES 90K device (29cases); all patients were subjected to full preoperative assessment, and full postoperative assessment of complications (major and minor complications). Results: there is significant relation between the two groups regarding major complications in favor to classic approach but there is significant danger of facial nerve, chorda tympani nerve injury in classic approach, there is no significant difference between the ways of insertion regarding the major complications and there is significant difference between the 2 groups as regard to device migration, electrode extrusion and device malfunction in favor to Hi-res 90k device. Conclusion: classic approach has fewer incidences of major and minor complications than SMA, but there is significant danger of facial nerve, chorda tympani nerve injury in classic approach, Hi-res 90k device is better than PULSAR ci100 device as regard to device migration, electrode extrusion and device malfunction, We still need more assessment for surgical approaches, way of electrode insertion, type of devices.

Background Cochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe to profound hearing loss. Complications due to surgery are minimal and are often encountered in cases with congenital anomalies of the temporal bone and inner ear. Complications in CI are related to malfunctioning of the device or the process of wound healing. In most cochlear implant centers, as the surgeon’s skill and clinical expertise in managing various cochlear implant cases improve with years of experience, the complication rates ideally come down over time. This article is intended to describe the most common surgical complications of cochlear implantation in Zagazig University Hospitals. This retrospective study included 130 patients who underwent cochlear implantation in Zagazig University Hospitals from 2016 to 2018. The patients were 61 males and 69 females; their ages ranged between 2 and 6 years old with a mean age of 4.3. This study aims to provide feedback on the common complications of CI surgery at our institution to help the reduction of its incidence in the future. Results One hundred thirty cases of cochlear implants were performed in our department between 2016 and 2018. Sixty complications were recorded, including 27 cases of minor and 21 cases of major complications. Minor complications were flap wound infection in 4 cases (3.1%), chorda tympani nerve injury in 7 cases (5.4%), postoperative vertigo and vomiting in 3 cases (2.3%), injury of EAC in 7 cases (5.4%), wound seroma/hematoma in 4 cases (3.1%), and facial nerve twitching in 2 cases (1.5%). Major complications were electrode extrusion in 2 cases (1.5%), CSOM in 1 case (0.8%), CSF leak in 8 cases (6.1%), magnet migration in 3 cases (2.3%), total facial nerve paralysis in 5 cases (3.8%), and device failure in 2 cases (1.5%). Conclusion The overall incidence of major complications is low. The majority of minor complications can be effectively managed with conservative measures. Cochlear implantation remains a safe and effective surgical procedure.