a total of 1,178 aspirations of lesions of various organs were performed in the Department of Pathology, King Fahad Hospital, Madina, Al-Munawarah. Of these, 383 (35.2%) aspirations were performed on 353 patients with swelling of the thyroid. Solitary thyroid nodule was the presenting feature in 198 patients. Aspirations were repeated whenever the material was found to be inadequate. Respiration was also carried out after cyst aspiration from solid remnant or after reaccumulation. All the aspirations were carried out by a pathologist. In 28 (8%) patients, insufficient material was obtained for cytologic diagnosis only. Eighty percent of these were Saudi nationals and 20% other nationalities. Female to male ratio was 3.5:1. The youngest patient was 14-years-old and oldest 90-years-old.Non-toxic goiter is a very common condition, whereas thyroid malignancies constitute only 0.5% of all malignancies [1]. Although most malignancies present as cold nodules, more than 90% of cold nodules are benign. Fine needle aspiration biopsy (FNAB) has made it possible to group thyroid nodules into "benign", "suspicious", and "malignant" categories with a reasonable degree of certainty [2,3].In our hospital, FNAB has drastically reduced the number of diagnostic surgical procedures for benign lesions. It is diagnostic as well as therapeutic in most of the cystic lesions of thyroid. Cystic lesions were found in 97 patients (27.4%). The amount of fluid obtained varied from 5 to 20 ml. In 30% of cases, the swelling completely disappeared and in the remaining there was considerable reduction in size. In cases involving cystic goiters, there were two false negative diagnoses. A small papillary carcinoma within a cyst and another follicular adenoma with cyst. FNAB is a therapeutic modality for thyroid cysts and a safe and reliable method of follow-up for patients treated conservatively. Cysts larger than 4 cm or prompt reaccumulation following repeated aspirations should raise the suspicion of malignancy [4]. In our study, 28 cases (8%) were diagnosed as thyroiditis and treated medically. In cases involving thyroiditis, there was an intimate admixture of thyroid epithelial cells and lymphocytes (Table 1).The major limitation of the technique has been the inability to differentiate follicular adenoma, early differentiated follicular carcinoma, and follicular hyperplasia in goiter. We have grouped these together as follicular neoplasms, not further categorizing them and have made histological examination manditory. This does not lessen the value of FNAB because an "intermediate" diagnosis is a clear indication for further investigation or surgical exploration. The pathologist and clinician should be aware of the limitations and should not hesitate in obtaining open biopsy when necessary, particularly when clinical suspicion of malignancy is not confirmed by aspiration [5]. Histopathological comparison is done on cases going for surgery, We have diagnosed 11 cases of papillary carcinoma, nine were new cases and two came for follow-up follow...

Objective: To assess the graft take rate and hearing gain in trans-canal endoscopic tympanoplasty Study Design: Descriptive study. Place and Duration of Study: Pakistan Naval Ship Hafeez, Islamabad Pakistan, form Dec 2015 to Jun 2018 Methodology: All patients with dry central perforations of >3 months history were included in the study. All Patients with perforations of pars tensa were booked for endoscopic cartilage tympanoplasty. All perforations were divided into four types small, medium, large and subtotal or total based on size of the tympanic membrane perforations. Small perforations involving <25% area of Pars Tensa. Medium perforation are Perforations involving 25-50% of Tympanic membrane. Large perforations include Perforations involving 50-75% of pars tensa. Subtotal or total perforations are defined as perforations with >75% perforation of the tympanic membranes. Wet Ears and perforations involving the Pars Flacida were excluded from the study. Preoperative Audiogram was carried out for all patients and A-B Gap were noted for all groups separately so as the demographic data including age and gender. Success was defined as complete closure of Tympanic membrane perforation at 3 months. All patients were operated with 0 Degree 3mm, 14cm rigid endoscope under general anesthesia. Results: Mean age of patients was. 37 years and standard deviation was 12.34 (range 12-58 years). Out of total 157 cases 81 patients male were males (51%) and 76 patients were females (49). Out of 157 ears operated 146 Perforations healed completely an overall success rate of 92%. Patients with small perforations had 100 percent success.....

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Objective: To assess the hearing results of transcanal endoscopic stapedotomy Study Design: Descriptive study. Place and Duration of Study: Pakistan Naval Ship Hafeez Islamabad Pakistan, from Jun 2016 to Jun 2020. Methodology: All patients with surgically confirmed otosclerosis were included in the study. All patients were operated with 0-degree 3mm, 14cm rigid endoscope under general anesthesia. Preoperative and post operative air bone gap was noted along with demographic data, middle ear anomalies (persistent stapedial artery, dehiscent facial nerve, anteriorly placed facial nerve, floating foot plate) and injury to chorda tympani. Postoperative air bone gap (A-B Gap) was documented 12 weeks after surgery. All patients were followed up for 6-12 months Results: Mean age of patients was, 37 years and standard deviation was 12.34 (range 27-52 years). Out of total 45 cases 13 were males (29%) and 32 females (71.%). Four (8.8%) patients had dehiscent facial canal and 1 (2.2%) patient had persistent stapedial artery. Average preoperative A-B gap was 35 db and Average Postoperative A-B Gap was 7 db. Chorda tympani was preserved in all cases. One patient (2.2%) complained of altered taste which resolved after 3 months. Four patients had Postoperative vertigo that lasted 2 days on average. Conclusion: Endoscopic trans canal Stapes surgery is scarless safe effective procedure demonstrable hearing benefits in all patients with minimum complications. The Technique is single handed and has steep learning curve.