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Abstract Background Tetralogy of Fallot (TOF) is a common congenital cyanotic heart disease in which arrhythmias could develop even after successful operative repair. Pulmonary regurgitation and right ventricular dilatation develop in many cases. The relation between arrhythmias and right ventricular dilatation is not established. Our aim is to assess the relation in between the degree of right ventricular volume affection and the severity of the pulmonary regurgitation, associated arrhythmias and the need for pulmonary valve repair in Egyptian pediatric and adolescent cases after successful TOF repair. Results A cross sectional descriptive study was conducted on 32 cases after successful surgical repair. Transthoracic Doppler echocardiography, 24 h Holter monitoring and cardiac MRI for assessment of pulmonary regurgitation fraction (PRF), ventricular volumes and function were measured. Cases were classified according to right ventricular end diastolic volume index (RVEDVI) into 2 groups with cut off value 150 ml/m2. Mean age of the studied cases was (12.96 ± 3.384) years, mean age at time of surgical repair was (34.23 ± 22.1) months, and mean duration postoperatively was (121.72 ± 41.028) months. Eighteen cases (56%) had RVEDVI ≥ 150 ml/m2, PRF was significantly higher in cases with increased RVEDVI (p value 0.007), with positive significant correlation between RVEDVI and PRF (p value = 0.0001, r = 0.61). Arrhythmias were detected in 18 cases (56%), the most common of which was infrequent supraventricular ectopy. No significant difference in incidence of arrhythmias between the 2 groups (p value = 1) with also no significant correlation between arrhythmias and increased RVEDVI (p value = 0.76, r = 0.05). No difference between cases with and without arrhythmias regarding RVEDVI (p value = 0.56) or PRF (p value = 0.5). Conclusion Holter detected arrhythmias after successful surgical repair of TOF were significantly associated with increased postoperative duration but not with PRF or RVEDVI.

Background: Several sinonasal procedures can now be accessed more easily through the endoscopic approach. In addition to magnification, the endoscope may light up sections that are otherwise hard to reach. This research aimed to identify if the endoscopic approach is a viable method for accessing the internal nasal valve for the surgical manipulation and to document if H-shaped graft placed endoscopically widens the nasal valve area. Patients and methods: We carried out this prospective study performed on four female patients who had intractable internal nasal valve dysfunction recruited from the ENT outpatient clinic in Zagazig university hospital. Every patient underwent: Anterior rhinoscopy and nasal flexible fiberoptic nasopharyngeal endoscope. Within two weeks prior to surgery and again at 6 months postoperatively, all patients finished the Rhinoplasty Outcomes Evaluation (ROE) and the Nasal Obstruction Symptom Evaluation (NOSE). Results: As regard nasal congestion and stuffiness: pre-operative all patients 12(100%) complained from severe nasal congestion and stuffiness, whereas post-operative complete relieved of symptom in 9 out 12patients (75%) and 3 patient had mild nasal congestion and stuffiness, with statistically significant difference (p<0.05). The mean ± SD of ROE Function improved from (59.4±6.3) (range 50-62.5) preoperatively to (100±0) (range100-100) postoperatively, with statistically significant difference (p< 0.05). The mean ± SD of total ROE test improved from (86.4±2.08) (range 83.3-87.5) preoperatively to (100±0) (range100-100) postoperatively, with statistically significant difference (p< 0.05). Conclusion: The endoscopic-assisted internal nasal valve reconstruction using H-shaped cartilage graft technique presents a promising solution for patients suffering from nasal valve insufficiency. By combining the spreader and splay effects, the H-shaped graft increases graft stability on the dorsal septum. [ABSTRACT FROM AUTHOR]

Background: Treatment options for benign and malignant parotid gland neoplasms include superficial and whole parotidectomy, however patients often suffer from facial contour deformation in the preauricular and retromandibular regions, as well as Frey's syndrome. Preauricular flushing and sweating following parotid surgery has been noted as a possible side effect. Once thought to be extremely rare, it has been found to occur anywhere from 4% to 62% in postparotidectomy patients within the first six to 18 months following surgery. These outcomes have been attempted to be avoided by the use of certain intraoperative procedures. Dermal-fat-free grafts, fascia lata grafts as well as superficial flaps of the musculoaponeurotic system, vascularized fat grafts, temporoparietal fascia flaps, as well as implants of polytetrafluoroethylene are a few of the other options available. Objective: To evaluate aesthetic and functional outcomes after the use of either superiorly based sternocleidomastoid muscle flap or free abdominal fat after parotidectomy. Methods: The databases were searched for articles published in English in 4 data bases; PubMed, Google scholar, Egyptian Knowledge Bank and Science direct. Boolean operators (AND, OR, NOT) had been used such as [Frey's Syndrome AND Parotidectomy Surgery OR Prevention of Frey's Syndrome] and in peer-reviewed articles between January 2001 and October 2020. Conclusion: Superiorly based Sternocleidomastoid muscle flap improves facial deformity following either superficial or total parotidectomy by lowering the occurence of Frey's syndrome objectively as well as subjectively compared to risks of postoperative complications at the donor site associated with free abdominal fat reconstruction, which has a high incidence of partially fat absorption or liquefaction. [ABSTRACT FROM AUTHOR]