Allergic fungal rhinosinusitis (AFRS) is a severe type of chronic rhinosinusitis (CRS) characterized by a high risk of acute vision loss resulting from the affection of optic nerves. This vision loss results from direct pressure upon the optic nerve by the sinus tissues and bone degradation. This is why early involvement of a professional is significant so as not to result in a permanent disability. This systematic review and meta-analysis will analyze the efficacy of surgical operations in enhancing visual outcomes in patients with acute vision loss due to AFRS. A systematic search was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed, Embase, Cochrane Library, and Scopus with the keywords "acute vision loss," "allergic fungal rhinosinusitis," and "surgical intervention." The studies included patients who developed AFRS-related acute vision loss, those assessing the outcomes of the surgical interventions, and those published in English. Two separate researchers extracted data and conducted quality assessments. The data synthesis process employed the R studio software (Posit, Boston, MA). The identified studies for the review constituted 12 and involved 320 patients. The mean pooled event rate regarding acute vision loss of AFRS patients was 33.1%. Ear, nose, and throat surgeries, including functional endoscopic sinus surgery (FESS) and optic nerve decompression, had a mean pooled success in vision recovery of 68%. Early treatment and utilization of other types of corticosteroids were utilized to enhance the results. Hence, early and proper surgery like FESS, optic nerve decompression, and corticosteroid treatment have better visual prognosis in AFRS patients. Standard early diagnosis and management guarantee the prevention of irreversible blindness, which stresses the need for an interdisciplinary approach and further studies.

Cerebrospinal Fluid Leak and Pneumocephalus as Consequences of Sneeze Suppression: A Case Report and Review of the Litrature - Article abstract #951643

Background: Immunoglobulin G4-related disease (IgG4-RD) is a rare autoimmune fibroinflammatory condition that can affect multiple organs. Sinonasal and orbital involvement is exceedingly uncommon and poses significant diagnostic challenges. This study aims to illustrate the diagnostic challenges and management of IgG4-RD. Case Description: We present a case of a 52-year-old male with a history of diabetes mellitus who developed a left-sided nasal mass extending into the orbit, resulting in nasal obstruction, epistaxis, proptosis, and diplopia. Imaging revealed a sinonasal mass with orbital extension. Initial biopsies were inconclusive, with findings of chronic inflammation and no malignancy. After multiple surgical biopsies and persistent symptoms, elevated serum IgG4 and histopathological analysis confirmed IgG4-RD. Treatment with prednisolone and rituximab led to complete resolution and no recurrence at 1-year follow-up. Conclusions: This case emphasizes the importance of maintaining a high index of suspicion for IgG4-RD in patients presenting with sino-naso-orbital masses, considering the disease’s rarity and nonspecific initial symptoms. Early diagnosis and appropriate management can lead to significant clinical improvement.

Background/Objectives: Tinnitus is a significant global health concern with substantial geographic variation in prevalence. However, data on tinnitus epidemiology in southern Saudi Arabia remain limited, despite emerging evidence suggesting a relatively high regional burden. Therefore, this study aimed to estimate the prevalence of tinnitus and identify its epidemiological determinants among adults in southern Saudi Arabia. Methods: A community-based cross-sectional study was conducted among 501 adults from four regions in southern Saudi Arabia (Jazan, Aseer, Najran, and Al-Baha). Data were collected on sociodemographic characteristics, chronic medical conditions, noise exposure patterns, and clinical features of tinnitus. Multivariable logistic regression analysis was used to identify factors independently associated with tinnitus. Results: The overall tinnitus prevalence was 31.1% (156/501). The mean age of participants was 30 ± 11 years, and 61.7% were female. Bilateral tinnitus was the most common (47.4%). Symptom duration was reported as <3 months in 31.4% of cases and between 3 months and 1 year in another 31.4%. The mean severity score was 3.7 ± 1.9. Most affected individuals (76.9%) did not seek medical care. Primary exacerbating factors included sleep deprivation (41.7%), noise exposure (41.0%), and stress (39.1%). Multivariable analysis identified two significant independent predictors: weekly noise exposure exceeding 5 h (odds ratio [OR] = 2.14; 95% confidence interval [CI]: 1.34–3.42; p = 0.001) and higher body mass index (BMI) (OR = 1.06; 95% CI: 1.02–1.10; p = 0.005). The most commonly associated underlying conditions were ear infections (25.6%) and hearing loss (24.4%). Conclusions: Tinnitus prevalence in southern Saudi Arabia (31.1%) substantially exceeds global estimates. Noise exposure and elevated BMI are key modifiable factors associated with tinnitus. The substantial healthcare gap, with most affected individuals not seeking treatment, represents a critical public health challenge requiring targeted prevention programs, provider education, and improved access to evidence-based care.

Lymphatic malformations are rare congenital lesions usually presenting at birth or early childhood, with delayed cases in school-age children being uncommon. We report a 7-year-old girl with a 9-month, painless, enlarging left neck mass without infection or trauma. Exam showed a soft, compressible mass in the posterior cervical triangle. Magnetic resonance imaging revealed a multiloculated cystic lesion consistent with a macrocystic lymphatic malformation. Surgical excision confirmed lymphangioma, and the recovery was smooth. This case underlines the rare delayed presentation of a congenital lesion and the importance of including lymphatic malformations in pediatric neck mass diagnosis, regardless of age, highlighting imaging, and surgery’s role in good outcomes.

Background: Voice disorders (VDs) refer to alterations in the acoustic output of the vocal tract, rendering teachers more susceptible to such health problems including hoarseness, aphonia, weak voice, sore throat, and discomfort due to voice abuse or overuse. Objectives: Our study analyzed the prevalence of VDs among teachers in Jazan, Saudi Arabia, along with their vocal complaints, patterns of seeking treatment, and awareness regarding vocal care practices. Materials and Methods: A descriptive and cross-sectional study was conducted in the Jazan region, Saudi Arabia, with a convenience sample size of 443 participants, including both male and female individuals. A validated assessment tool from a previous study was utilized for data collection, resulting in a finalized questionnaire encompassing five primary categories: Demographic data and living circumstances, teaching circumstances, vocal symptoms, and their impact on teachers. Data analysis was carried out using IBM SPSS Statistics version 27.0.1, NY, USA. All variables were categorical, and frequencies and percentages were calculated and tabulated. Results: A total of 443 participants were recruited for the study, with 64.8% of participants were male and 35.2% were female. Voice problems were notably prevalent among teachers, accounting for 64.6%. The most frequently reported symptoms by the teachers in our study were hoarseness (40.4%), dry throat (38.4%), and sore throat (33.0%). Regarding voice-related factors, exactly half of the teachers (49.9%) reported that they frequently used their voices loudly. Only 32.3% of teachers sought medical intervention for vocal disorders. The factors significantly associated with the prevalence of voice problems included frequent voice raising and a family history of voice problems ( P < 0.001). Among all teaching subjects, only scientific subjects showed a statistically significant association with voice problems ( P = 0.011). Conclusion: Voice-related complaints were highly prevalent among teachers, highlighting the need for interventions and awareness. Our study strongly suggests developing effective strategies for protecting and maintaining the health of teachers’ voices, and by extension, their effectiveness as professionals over the long term.