Scientific Program

Day 1

Day 1


    Hospital da Luz Arrabida

    Dunja Milicic obtained 1988 MSc in ENT, Maxillo-facial Surgery, Audiology and Phoniatrics by University of Zagreb, Croatia Specialist in ENT , Head &Neck Surgery in 1991, practicing from 1994 in Portugal. Lecturing ENT in Croatia and Portugal ( Medical School University of Zagreb and Porto). Membership in SPORL, APO, EAFPS, IAPO and RSE. Publications and respective citations in ResearchGate.


    In elderly patients, with high risk of morbidity and mortality, a surgical procedure should not be the first option in treatment of chronic ear infection with polyposis. An alternative conservative attitude is offered, by use of low-dose of immunomodulation therapy.

Oral Presentation
  • Cholesteatoma Update
    Aisha Larem
    Hamad Medical Corporation

    Aisha Larem is an ORL-HNS Consultant at Qatari nationality. She graduated from Gulf University Otology subspecialty. She is an Associate Program Director and worked as a Fellowship Program Director and is a Clinical Instructor at Weill corneal at Qatar.


    Cholesteatoma is considered a benign, expanding and destructive epithelial lesion of the temporal bone that is the result of a multifactorial process. If undetected and left treated, cholesteatoma may lead to significant complications including hearing loss, temporal bone destruction and cranial invasion. Recent advances in imaging modalities have allowed for high sensitivity and specificity in identifying the presence of cholesteatoma. Despite these advances, deficiencies exist around the world with access to health care facilities meaning cholesteatoma remains a serious and challenging entity to manage whether found within the pediatric or adult population. Proper diagnosis and management of each form of cholesteatoma is achieved by a thorough understanding of the etiology, classification, clinical presentation and histology, thereby facilitating prevention, early detection and appropriate treatment. Keywords: Cholesteatoma, Middle ear cholesteatoma, Congenital cholesteatoma, Acquired cholesteatoma

  • Trans-Oral Endoscopic Partial Adenoidectomy Doesn't Worsen Speech After Palate Repair
    Asmaa Abdel Hamid
    King Abdallah Medical City
    Saudi Arabia

    Asmaa Abdel Hamid has completed her MD at the age of 32 years from Cairo University, Egypt. She is Assistant professor of Phoniatrics Cairo University, She has many national and international publication, she is a member in Egyptian society and European Society of Phoniatrics , she is a member in cochlear implant teams and post cochlear implants wadi elneel hospital for 7 years and now in king Abdallah medical city team in MAKKAH , KSA


    Introduction: Patients with cleft palate even after repair, should not undergo adenoidectomy unless absolutely needed, and in such situations, conservative or partial adenoidectomy is performed to avoid the occurrence of velopharyngeal insufficiency. Trans-oral endoscopic adenoidectomy enables the surgeon to inspect the velopharyngeal valve during the procedure. Objective: Adenoid hypertrophy may play a role in velopharyngeal closure especially in patients with palatal abnormality, adenoidectomy may lead to velopharyngeal insufficiency and hypernasal speech. The aim of this study was to assess the effect of trans-oral endoscopic partial adenoidectomy on the speech of children with repaired cleft palate. Methods: Twenty children with repaired cleft palate underwent trans-oral endoscopic partial adenoidectomy to relieve their airway obstruction. The procedure was completely visualized with the use of a 70° 4-mm nasal endoscope, the upper part of the adenoid was removed using adenoid curette and St. Claire Thompson forceps, while the lower part was retained to maintain the velopharyngeal competence. Preoperative and postoperative evaluation of speech was performed, subjectively by auditory perceptual assessment, and objectively by nasometric assessment. Results: Speech was not adversely affected after surgery. The difference between preoperative and postoperative auditory perceptual assessment and nasalance scores for nasal and oral sentences was insignificant (p = 0.231, 0.442, 0.118 respectively). Conclusions: Trans-oral endoscopic partial adenoidectomy is a safe method, it does not worsen the speech of repaired cleft palate patients. It enables the surgeon to strictly inspect the velopharyngeal valve during the procedure with better determination of adenoidal part that may contribute in velopharyngeal closure.

  • Revisiting External Laryngeal Nerve : Our Experience
    Manya Thakur Roy
    Pt JNM Medical College

    Dr Manya Thakur has completed her MS ENT & HNS with gold medal at the age of 27 years from SAIMS Medical College Indore, India. She is Assistant Professor in Pt JNM Medical College. She has won Gold Medals in various Poster and Paper presentation in her state. She has been International Visiting Scholar at Asan Medical Centre in Seoul, South Korea and also represented her as young otolaryngologist of the day at ME OTO Dubai. She has presented paper in various National and International Conference in Thailand, South Korea, Dubai etc Recently awarded with Gold Medal in Rhinoplasty and Facial plastic surgery workshop Exam in Indore. She has been active member of organizing committee in various National and International conferences and workshop. She is also serving as an editorial board member of reputed Journals.


    Objectives - To Study Surgical Anatomy of External Laryngeal Nerve and it’s variation in relation to Thyroid Surgery. To sensitize Surgeon about the need of nerve identification & preservation of voice quality in all the patients undergoing Thyroid Surgeries. Methodology – A Non-randomized prospective Study was carried out from July 2011 to July 2014 in patients undergoing Thyroid surgery, attending ENT OPD of SAIMS, Indore. The External Laryngeal nerve was identified and preserved intra operatively. The function of Nerve was assessed and documented by pre op & post op EGG and Video laryngoscopy. Results- Intraoperative identification of ELN leads to significant reduction in morbidity in patient undergoing thyroid surgery and preserves the voice quality. A permanent drop in Fundamental Frequency (Fo) was seen in significant number of patients when the nerve was not identified during surgery. Conclusion - Today in the era of 21st century where we are reaching new horizons, efforts to further refine thyroid surgery continues. Good range of voice is not only important for Singers but for Teachers, Politicians, RJ, public speakers etc too. These are just few examples in which the career depends to an extent on good voice quality. A Surgeon’s attempt to preserve External Laryngeal Nerve by spending few extra minutes confers almost negligible changes in voice quality in post Thyroidectomy patients. Keywords External Laryngeal Nerve,Voice Quality, Thyroid Surgery, Superior Thyroid Pedicle, Fundamental Frequency

  • Dysphonia and its Correlation with Acoustic Voice Parameters
    Tanvi Shrivastava
    Nalanda Medical College

    Dr. Tanvi Shrivastava has completed her ‘Masters in Otorhinolaryngology and Head and Neck Surgery’ at the age of 28, and has worked as a resident at Netaji Subhash Chandra Bose Medical College, India. She has also attained special training as a fellow in Endoscopic ear and nose surgeries. Her papers have been published in prestigious and reputed national and International journals, and have been presented at various otolaryngology conferences.


    Abstract Aim: To evaluate the laryngeal causes of dysphonia, correla­tion of acoustic voice analysis with Indirect laryngoscopic/ endoscopic findings in various voice disorders. Study design: Hospital based prospective observational study. Materials and methods: Forty patients attending the ear nose throat (ENT) outpatient department (OPD) at a Tertiary Care Government Hospital in one year, with dysphonia for more than 15 days were selected. History, examination, endoscopy, voice analysis was done. For consensus auditory-perceptual evaluation of voice (CAPE-V), the voice was analyzed under the following parameters: roughness, breathiness, strain, pitch, loudness, overall severity. Scores were given out of 100. For acoustic analysis, a computer-based software. Praat was used based on jitter, shimmer, noise-harmonic ratio and mean pitch. Result: Benign lesions were most common in adults of age group 21 to 40 years, and malignancy in 41 to 50 years and 61 to 70 years; with male preponderance (4.7:1). Isolated vocal cord palsy (32.5%) was the most common lesion presenting with dysphonia, followed by malignancy (25%). Out of benign lesions, vocal polyp (10%) and nodule (10%) were the commonest, with equal incidence. On analyzing the voice, jitter and shimmer were found to be important parameters depicting the perturbation in frequency and amplitude, respectively. These parameters, indi­rectly, gave an idea about the vibratory motion of the vocal cords. On statistical analysis, jitter and shimmer showed significant direct correlation with the severity of dysphonia (jitter>shimmer). Noise to harmonic ratio (NHR) was raised in a significant number of dysphonic patients, with direct correlation with an increase in jitter. Although a significant relationship between the variation in mean pitch and CAPE V could not be established in this study; instrumental analysis was still useful in documen­tation and quantification of mean pitch in various dysphonic samples. Conclusion: Acoustic measurement of voice is a simple yet powerful tool to analyze the patients with dysphonic voice.

  • Olfactory Nerve Regeneration Time Period after the Damage
    Hashem Shemshadi
    University of Social Welfare and Rehabilitation Sciences

    Premedicine BSc. (summa cum laude) Sam Houston State University, Huntsville, TX, USA Medical Degree (MD) (magna cum laude), Shiraz Medical School, Shiraz, IRAN Surgery Specialty, (second ranked national board), Shiraz Medical School, Shiraz, IRAN Subspecialty Plastic & Reconstructive Surgery, University of Texas Southwestern Medical School Dallas, TX, USA Professor of Plastic and Reconstructive Surgery, University of Social Welfare and Rehabilitative Surgery Rofeideh Rehabilitaion Hospital-Gheytarieh-Neamati St.


    As the nanoparticles stimulate the olfactory mucosa, an electrochemical initiation will start. The message as an afferent stimulus, passes through the ethmoid bone cribriform plate for delivering such memorandum toward the central nervous system. Sense of smell will be detected and translated to a pleasant and or non- pleasant memory narration. Head injures such as coup-counter coup in a blunt trauma, central nervous system`s infections such different types of meningitis, tumors and surgical shocks such as some nasal operations, may be considered as some the most common cause of olfactory nerve damages. Regeneration of olfactory nerve after the damages due to the aforementioned causes, depends on the cause and the degrees of the damage. Some sever injuries may even cause complete loss and/or a permanent loss of smell(anosmia). Some complete losses me gradually regenerate from anosmia to hyposmia and lead to complete recovery of smell functioning (norm Osmia). We did examine olfactory nerve damage in patients who underwent open rhinoplasty in the past. The enquiry paper was published in November 2008 in PubMed. We sought to investigate "when" the olfactory function recovers to its normal preoperative levels. In this cohort design, 40 of 65 esthetic open rhinoplasty candidates with equal gender distribution, who met the inclusion criteria, were assessed for their olfactory function using the Smell Identification Test (SIT) with 40 culturally familiar odors in sniffing bottles. All the patients were evaluated for the SIT scores preoperatively and postoperatively (at week 1, week 6, and month 6). At postoperative week one, 87.5% of the patients had anosmia, and the rest exhibited at least moderate levels of hyposmia. The anosmia, which was the dominant pattern at postoperative week 1, resolved and converted to various levels of hyposmia, so that no one at postoperative week 6 showed any such complain. At postoperative week six, 85% of the subjects experienced degrees of hyposmia, almost all being mild to moderate. At postoperative six month, the olfactory function had already reverted to the preoperative levels: no anosmia or moderate to severe hyposmia. A repeated ANOVA was indicative of significant differences in the olfactory function at the different time points. According to our post hoc Benfronney, the preoperative scores had a significant difference with those at postoperative week 1, week 6, but not with the ones at month 6. Thus, the primary cosmetic open rhinoplasty may be accompanied by some degrees of postoperative olfactory dysfunction. Patients need a time interval of 6 weeks to 6 months to fully recover from surgical manipulation and respective edema into their preoperative baseline olfactory function.

  • Myringoplasty Modification Adopted to Overcome Some Long and Short Term Surgical Issues
    Raja Salman Khurshid
    Nisar Hussain Madni MMABM Hospital

    Abstract Objective/Hypothesis: We have tried to present some of our concerns regarding the usually adopted surgical techniques of Myringoplasty with their possible solutions. Also we have tried to present digital recordings of pre and post-operative findings in reference cases, which have been provided rarely in available literature. Pre- and post-operative pictures and videos of two representative cases are attached. Study design: This prospective study was carried out in MMABM hospital. Forty six (46) ears, 37 patients underwent tympanoplasty by the modified dual grafting technique and the results were analysed. Results: Objectives of tympanic membrane repair, dry ear, closure of AB gap, and stoppage of tinnitus if any, were achieved in all cases. Small residual perforations which healed over time were seen in two cases in cartilage deficient areas. Conclusion: Dual graft modified techniques served as an effective alternative myringoplasty technique.

  • The Protective Effect of Sertraline in Preventing Cisplatin-induced Ototoxicity in Solid Organ Chemotherapy
    Zahra Karbasi
    Iran University of Medical Sciences

    Zahra K has completed her specialities at the age of 32 years and she is board certified otolaryngology from Iran University of Medical Science , Iran. she is Head & Neck surgery Fellowship assistant of IUMS, Iran. Her fieldwork is cancer surgery and reconstructive surgery and microvascular surgery.


    Abstract Cisplatin, as a platinum-based chemotherapeutic medication, is applied for various types of solid tumors. Regarding the treatment of cancer cells, cisplatin is potentially accompanied with some side effects such as nephrotoxicity, neurotoxicity, and ototoxicity in spite of high efficacy of Cisplatin. The present study aimed to determine whether the use of oral sertraline can contribute to preserve hearing threshold among the patients who receive cisplatin or not. This research has done for one year, along with a 3 months course and follow-up. This is a double-blind, randomized, and placebo-controlled trial study. The study was conducted in Oncology Clinic and Audiology Department of Firoozgar University Hospital in Tehran, Iran. Among 112 patients, 79 patients who were suffering from different types of solid tumors and were candidates for receiving cisplatin for chemotherapy treatment were selected. The grade of hearing impairment and otoacoustic emission in the first day and the last stage of the study was used for data analysis. Among 112 patients, 79 patients were randomly selected to receive either sertraline (50 mg/d) as the case group, or placebo as the control group. Before and after the treatments, the patients were assessed by High-Frequency Audiometry and dpOAE tests. First, the two groups were distributed homogeneously based on sex and age. Based on Common Terminology Criteria for Adverse Events (CTCAE), the Ototoxicity Grade indicated a significantly lower grade of deficits in the Sertraline group (p<0.001), compared to that of the control group. In addition, a significant difference was observed between the two groups regarding the changes in the threshold of dpOAE (p=0.000). The daily consumption of sertraline (50 mg/d) among the adults who were candidates for chemotherapy treatment with cisplatin could result in preserving the hearing threshold significantly. Keywords: sertraline, cisplatin, ototoxicity, otoacoustic emissions, hearing loss.

  • The Quality of Life and Its Associated Sociodemographic and Clinical Factors among Toddlers and Young Children with Cochlear Implant in Saudi Arabia
    Ola Mohammed Alnuhayer
    king Saud university
    Saudi Arabia

    Ola Alnuhayer, medical student at King Saud University, Saudi Arabia


    Abstract Aim To assess the Quality of Life (QoL) in Toddlers and Young Children with Cochlear Implant (CI), and to look for sociodemographic and clinical factors that have an impact on the perceived QoL. Material and methods A cross-sectional study comparing the QoL of children with CI with healthy children using PedsQL™ 4.0 - Generic core scale. A self-administered questionnaire was sent to parents of pediatric patients who had cochlear implantation at King Abdulaziz University Hospital (KAUH), from March 2016 to March 2018. Mothers of age-matched healthy children who attended the obstetrics and gynecology clinics at King Khalid University Hospital (KKUH) in November 2019 were included as a control group. Results Currently, we are in the process of finalizing data collection. Conclusion This study will give us insight in patient outcome at our center and will help us to modify and implement new management strategies if needed. Key words: Cochlear Implant (CI); Quality of Life (QoL); PedsQL; Toddlers; Young Children

  • Aphasia Disorder Paper
    Reem Aldhuwilae
    Noura Bint Abdulrahman University
    Saudi Arabia

    A Speech Language Pathologist, Graduated from Princess Noura Bint Abdulrahman University in Riyadh, Saudi Arabia. Currently working in King Saud Medica City as Speech Language Pathologist with Adult population.


    This paper will discuss Aphasia disorder “Etiology, Classification, Symptoms, Assessment and Treatment” and the role of speech language pathologist. Aphasia is a disorder resulting from damage to the certain parts of the brain that deal with language. The areas of damage are typically called lesions. This disorder can lead to impairments in reading, writing, producing speech and the ability to understand speech. Aphasia typically takes place suddenly after a head injury or stroke, although, some cases can arise over time; a good example of this is when a brain tumor develops. A number of classification systems are used to describe the various presentations of aphasia. The outcome of aphasia varies from person to person. The most predictive indicator of long-term recovery is initial aphasia severity, along with lesion site and size, Other predictors of long-term recovery include age, gender and education level. Speech-language pathologists play a central role in the screening, assessment, diagnosis, and treatment of persons with aphasia. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research. A person with Aphasia can be assessed with: Screening is an invaluable tool in the appropriate referral of persons with aphasia to speech-language pathology services and is an important first step in determining the need for treatment. Assessment can be static (i.e., using procedures designed to describe current levels of functioning within relevant domains) and/or dynamic (i.e., ongoing process using hypothesis-testing procedures to identify potentially successful intervention and support procedures). Assessment protocols can include both standardized, and nonstandardized tools and data sources. Treatment is individualized to address the specific areas of need identified during assessment, including specific goals identified by the person with aphasia and his or her family.

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