Background: Nasal polys [NPs] are frequently encountered in otorhinolaryngology practice. It had been proposed to share etiological origin with eosinophilic esophagitis [EOE]. However, there is not yet adequate estimations of this association and incidence of NPs recurrence after endonasal surgery in patients with EOE. Aim of the work: To evaluate incidence of recurrence of NPs after endoscopic endonasal surgery for patients with EOE. Patients and Methods: 150 patients were included and divided into three groups: the control [CG] [50 patients indicated for gastroscopy]. The nasal polyp's subgroups consisted of 100 patients and further subdivided into two groups according to result of nasal biopsy into two subgroups, eosinophilic nasal polyps [ENP] group IIA; non-eosinophilic nasal polyps [NENP] group IIB. In NPs subgroups, sinonasal outcome test [SNOT22] had been performed to measure the health status and quality of life in patients with NPs through questions relating to their symptoms. The recurrence of nasal polyps were investigated after endoscopic sinus surgery and during follow up and outcome had been compared between groups. Results: 22% suffered polyp recurrence after surgery during the follow-up period. Patients with EOE had a significantly higher recurrence rate of nasal polyps [100%] in comparison to 16.4% in EOE patients. These results indicate that, mucosal eosinophilia is a determinant factor in the recurrence of nasal polyps. Hence in patients with EOE [had mucosal eosinophilia] who underwent endonasal surgery, the recurrence of nasal polyps should be highly expected. Conclusion: Mucosal eosinophilia in patients with EOE, and ENP are a more important prognostic factor in recurrence of nasal polyps.

Article informationBackground: Tonsillectomy is the commonest surgical procedure performed by otolaryngologists. Many surgical techniques and instruments are available and continually developed to reduce postoperative complications. However, no consensus exists regarding the standard technique. The Aim of The Work:The current work aimed to compare the incidence of postoperative complications [bleeding and pain], after coblation tonsillectomy with and without sutures. Patients and Methods:The study included 60 patients with chronic tonsilitis scheduled for elective tonsillectomy. They categorized to either coblation with or without sutures. All were preoperatively assessed by history taking, physical examination and laboratory investigations. After surgical intervention, the follow-up was continued for 4 weeks. Any complications [especially pain and hemorrhage] were documented and compared.Results: Both groups were comparable regarding patient's age and sex. In addition, laboratory investigations, and pain at the fourth postoperative week were comparable between groups. Postoperative bleeding was reported in 5.0%, and was restricted to coblation without sutures [3 patients; represented10.0% of the group]; it was mild and treated conservatively [no patient required secondary surgical intervention to control bleeding]. Pain was significantly reduced in coblation with suture than without sutures at the first, the second and the third postoperative weeks [6.40±0.70, 2.90±0.99 and 0.00±0.00 vs 8.8±0.79, 4.33±0.89, and 1.17±0.83, successively]. Pain was completely absent at the fourth postoperative week in both groups. Conclusion:Coblation with sutures is superior than coblation with sutures for tonsillectomy. It is associated with lower postoperative pain and hemorrhage, which reflects the safety and efficacy of the procedure.

Background: Allergic rhinitis is one of the most common diseases, with no consensus on its ideal treatment. Botulinum Toxin-A was proposed to be an effective treatment. Aim of the work: To estimate the outcome of intranasal injection of Botulinum Toxin-A [BTX-A] as a sole therapy for allergic rhinitis. Patients and Methods: Ninty patients with classic symptoms of allergic rhinitis were clinically evaluated and asked to complete the score for allergic rhinitis [SFAR] questionnaire using cutoff at >8 as diagnostic AR. Two blood samples [venous] and nasal smears were obtained at the beginning of the study and at the end of 12-weeks after initiation of therapy for estimation of human immunoglobulin E [IgE] and eosinophilia grading. Control group included patients who chose to receive combined medical treatment. BTX-A, 2.5 units were injected intranasally, under 0o rigid telescope guidance. Study outcome was the treatment success rate at the end of 12-w follow-up period. Results: Intranasal BTX-A injection provided significantly maintained relieve of allergic rhinitis manifestations especially for running nose than combination therapy. The treatment success rate of 1.9 versus 0.7 item/patient in study versus control group with significant difference in favor of BTX-A injection. Serum IgE levels and eosinophilia grades were significantly lower in control patients. Patients' satisfaction grading was significantly more with BTX-A injection. Conclusion: Intranasal BTX injection could be a safe and effective sole therapeutic modality for patients with long-lasting AR.