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Dive into the research topics where Mohammad Waheed El-Anwar is active.

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Featured researches published by Mohammad Waheed El-Anwar.


International Journal of Pediatric Otorhinolaryngology | 2012

Stentless endoscopic transnasal repair of bilateral choanal atresia starting with resection of vomer

Magdy Abdalla Sayed El-Ahl; Mohammad Waheed El-Anwar

OBJECTIVES To assess the results of a transnasal endoscopic repair of congenital choanal atresia beginning by resection of the posterior portion of the vomer and ending by no stent. METHODS Seven patients with bilateral congenital choanal atresia aged ranging from 3 to 15 days were operated upon between June 2009 and September 2011. This transnasal endoscopic approach allowed resection of the posterior portion of the vomer first then the atretic plates and part of the medial pterygoid plate if needed leaving no stent. Postoperative control included office fiberoptic nasal endoscopy. RESULTS Adequate functional nasal breathing was maintained in all patients during follow up of 11 to 23 months. Apart from one case that complicated by palatal defect, no any other complications were detected. CONCLUSION The described technique was proved to be very effective, allowing fast recovery, and one step surgery with early discharge from hospital using neither stents nor nasal packing. Good patency with no reduction in functional quality was also observed.


Otolaryngology-Head and Neck Surgery | 2013

Olfactory Bulb Volume Changes in Patients with Sinonasal Polyposis: A Magnetic Resonance Imaging Study

Islam R. Herzallah; Sherif M. Askar; Hazem Saeed Amer; Ayman F. Ahmed; Mohammad Waheed El-Anwar; Mohamed H. Eesa

Objectives The olfactory bulb (OB) is thought to be a plastic structure with highly active afferent neurons. The aim of this study was to evaluate the effect of olfactory deprivation caused by sinonasal polyps on OB volume. Study Design Cross-sectional study. Setting Tertiary university hospital, Department of Otolaryngology. Subjects and Methods Twenty-two subjects were included: 11 adult patients with bilateral allergic sinonasal polyposis (patient group) and 11 adult healthy controls (control group). Both study groups were matched for age and sex. OB volumes in all study subjects were evaluated in T2-weighted coronal MRI images by planimetric manual contouring. Results In the patient group, OB volume measurements ranged from 5.2 to 19.5 mm3 (mean ± SD, 10.14 ± 3.8). In the control group, volume measurements ranged from 35 to 75.8 mm3 (mean ± SD, 47.66 ± 10.75). The difference in OB volumes between patient and control groups was statistically significant (P < .001). Conclusion Our study highlights the significant reduction in OB volume in patients with bilateral sinonasal polyposis as compared with its volume in healthy controls. Further studies are required to evaluate the impact of OB volume reduction on olfactory recovery postoperatively.


Auris Nasus Larynx | 2015

Topical use of autologous platelet rich plasma in myringoplasty

Mohammad Waheed El-Anwar; Magdy Abdalla Sayed El-Ahl; Amal A. Zidan; Mohammad Abdel-Rhman Abdel-Salam Yacoup

OBJECTIVE The aim of this study was to assess the topical use of autologous platelet rich plasma (PRP) to improve success rate of myringoplasty. METHODS This study was carried out on 64 patients with large dry central tympanic membrane perforations. Myringoplasty was performed through postauricular approach by underlay graft using conchal perichondrial graft. Patients were classified into two groups: case group included 32 patients who had undergone myringoplasty with use of autologous PRP and control group included 32 patients who had undergone myringoplasty without use of autologous PRP. RESULTS Both groups were statistically matched with regard to age and sex. At 6 months postoperatively, success rate (graft taking) in case group (100%) was significantly higher than in control group (81.25%) (P=0.02). Success in terms of hearing gain (≥10dB) was achieved in 21 patients (65.6%) in case group and 11 patients (34.4%) in control group with statistically non-significant difference (P=0.079). Infection rate in control group (12.5%) was found to be significantly higher than in case group (P<0.0001). CONCLUSION Topical autologous PRP application during myringoplasty is safe and highly efficient and successful with no reported complication. PRP not only enhances healing of chronic TM perforations but also avoids infection and obviates the need for inner EAC pack.


American Journal of Rhinology & Allergy | 2016

Endoscopic repair of bilateral choanal atresia, starting with vomer resection: Evaluation study.

Mohammad Waheed El-Anwar; Ahmad Abdel-Fattah Nofal; Magdy Abdalla Sayed El-Ahl

Background Choanal atresia is the most common inborn nasal anomaly, and its definitive treatment is surgical to achieve proper bilateral nasal patency. Four main surgical approaches were used for repair: transantral, transpalatal, transseptal, and transnasal. The transnasal endoscopic approach is the most widely accepted nowadays. In this study, we aimed to evaluate the long-term results of a transnasal endoscopic repair of congenital choanal atresia started with resection of the posterior portion of the vomer and was completed without the use of stents in a large series of patients. Methods Twenty-five patients (age range, 3-15 days) with bilateral congenital choanal atresia had surgery by using stentless endoscopic transnasal repair by starting with resection of the vomer bone. Postoperative control included office fiberoptic nasal endoscopy. Results During the follow-up period of 15-66 months (mean [standard deviation], 35.76 ± 16.8 months), 18 patients (72%) had a wide choana with adequate nasal breathing; Six patients (24%) had narrowing of the choana (<50%), still with adequate and satisfactory airway without feeding difficulties, and one patient (4%) developed restenosis (>50%) after 7 months, which necessitated repeated surgery. One patient (the fourth case) developed a palatal defect, which healed conservatively. No other complications were detected. Conclusion The described technique proved to be effective and easier, with good long-term satisfactory results in a large series of patients. This technique allows early use of both nasal passages for simultaneous endoscope and instrument insertion to excise both atretic plates without the use of stents or flaps.


International Archives of Otorhinolaryngology | 2015

Voice Outcome after Gore-Tex Medialization Thyroplasty

Ismail Elnashar; Mohammad Waheed El-Anwar; Hazem Saeed Amer; Amal S. Quriba

Introduction Although medialization thyroplasty utilizing Gore-Tex (Gore and Associates, Newark, Delaware, United States) has been discussed in the literature, few reports have assessed voice quality afterward, and they did not use a full assessment protocol. Objective To assess the improvement in voice quality after medialization thyroplasty utilizing Gore-Tex in patients with glottic insufficiency of variable etiology. Methods Eleven patients with glottic insufficiency of different etiologies that failed compensation were operated by type 1 thyroplasty utilizing Gore-Tex. Pre- and postoperative (1 week, 3 months, and 6 months) voice assessment was done and statistical analysis was performed on the results. Results In all postoperative assessments, there was significant improvement in the grade of dysphonia (p < 0.004) and highly significant reduction in the size of glottic gap and prolongation of maximum phonation time (p < 0.0001). The difference in voice parameters in the early (1 week) and the late (3 and 6 months) postoperative period was not significant. None of the patients developed stridor or shortness of breath necessitating tracheotomy, and there was no implant extrusion in any patient during the study period. Conclusion Gore-Tex medialization provides reliable results for both subjective and objective voice parameters. It leads to a satisfactory restoration of voice whatever the etiology of glottic incompetence is. This technique is relatively easy and does not lead to major complications. Further studies with larger number of patients and more extended periods of follow-up are still required to assess the long-term results of the technique regarding voice quality and implant extrusion.


International Journal of Pediatric Otorhinolaryngology | 2014

Objective assessment of endoscopy assisted adenoidectomy

Ismail Elnashar; Mohammad Waheed El-Anwar; Waleed M. Basha; Mohamed AlShawadfy

OBJECTIVES To objectively assess the effectiveness of endoscopy assisted adenoidectomy utilizing adenoid tissue volume measurement and to set some parameters for which patients are more legible to this procedure. METHODS Forty three patients for whom adenoidectomy was conventionally done using adenoid curettes. Surgeons satisfaction for adenoid removal after curettage and digital palpation was reported. The volume of removed adenoidal tissue was measured. The remaining adenoid tissue, if any, was removed transnasally guided by endoscope. Residual adenoid volume was also was measured. The data was tabulated and statistically analyzed. RESULTS The volume of adenoid removed by curettage ranged from 1 to 3.6 ml with a mean of 2.45 ml. The volume of residual adenoid removed by endoscopy after curettage ranged from 0 to 2.9 ml (mean: 0.67 ± 0.58 ml). The volume of residual adenoid after blind curettage was found to have statistically significant relation to older age of patients, preoperative larger adenoid by X-ray and Surgeons dissatisfaction about the completeness of removal after curettage. CONCLUSION Conventional curettage adenoidectomy misses a substantial volume of adenoid tissue. Endoscopy-assisted adenoidectomy is significantly recommended in children age  >10 years, dissatisfied surgeon after curettage and palpation, and grade 3 adenoid enlargement on X-ray.


Clinical Otolaryngology | 2017

Single Triangular Suture: A Modified Technique for Hyoid Suspension as a Treatment for Obstructive Sleep Apnea: our experience with twenty four patients

Sherif M. Askar; Mohammad Waheed El-Anwar; Hazem Saeed Amer; Ali Awad

1 Hyoid suspension is a part of a multilevel surgery concept that is often combined with other procedures as uvulopalatopharyngoplasty to treat obstructive sleep apnea. 2 Between February 2012 and November 2016, twenty- four patients underwent the single triangular suture technique for hyoid suspension as a treatment for obstructive sleep apnea. 3.Successful outcome was reported in 12 patients, while 9 patients were responders (reduced cardiovascular risk). 4.Postoperatively, the mean AHI dropped significantly and the mean lowest oxygen saturation level increased significantly. 5.The procedure is safe, well-tolerated by patients and has a readily progressive learning curve. It is an economic and less traumatic maneuver. This article is protected by copyright. All rights reserved.


Otolaryngology-Head and Neck Surgery | 2016

Expansion Pharyngoplasty by New Simple Suspension Sutures without Tonsillectomy

Magdy Abdalla Sayed El-Ahl; Mohammad Waheed El-Anwar

The aim of this study was to introduce and assess a new minimally invasive expansion pharyngoplasty for obstructive sleep apnea (OSA) using bilateral new advancement sutures without tonsillectomy. Among 24 patients who had OSA with Friedman stage II or III and type I Fujita, bilateral sutures were performed to advance and stabilize palatopharyngeus and palatoglossus muscles anterolaterally. Mean apnea hypopnea index decreased significantly from 28.6 ± 4.2 preoperatively to 8.9 ± 4.9 postoperatively. The lowest oxygen saturation increased significantly from 79.25 ± 4.12 to 89.29 ± 4.12. Moreover, the visual analog score showed statistically significant reduction in the snoring intensity from a preoperative mean of 8.2 ± 1.4 to 2.1 ± 1.4 at 6 months postoperatively. Significant improvements were also documented in the Epworth Sleepiness Scale, as its mean decreased from 11.7 ± 2.9 preoperatively to 5.1 ± 2.2 postoperatively. In conclusion, the described new sutures could significantly correct OSA in patients with retropalatal obstruction and lateral pharyngeal walls collapse with easy applicability and no reported complication.


Journal of Voice | 2016

Voice Changes after Late Recurrent Laryngeal Nerve Identification Thyroidectomy.

Ezzeddin Elsheikh; Amal S. Quriba; Mohammad Waheed El-Anwar

OBJECTIVES To assess voice changes in patients after thyroidectomy where the recurrent laryngeal nerve (RLN) was found late in the thyroid dissection and where the RLN was not injured (late RLN identification technique). METHODS This study was conducted on 64 patients who underwent thyroidectomy by late RLN identification technique. Voice was assessed preoperatively, 1 week, 3 months, and 6 months after surgery using the voice assessment protocol and Voice Problem Self-Assessment Scale. The study group was divided into two subgroups (hemithyroidectomy: N = 13 and total thyroidectomy: N = 51). Voice assessments of both subgroups were then compared with a control group (N = 20) of patients who recently underwent extracervical surgeries. RESULTS All voice analysis differences between the control group and the individual study subgroup were nonsignificant. Dysphonia in the study group was significantly worse at 1 week and 3 months postoperatively but became nonsignificant at 6 months postoperatively. The deviations from the preoperative acoustic analysis were significant only in the first week postoperative comparison for fundamental frequency, noise-to-harmonic ratio, and maximal phonation time and thereafter became nonsignificant. Significant Voice Problem Self-Assessment Scale mean score increase (worsening) was also detected only at first week postoperatively. CONCLUSION Minimal voice changes were reported early after late RLN identification thyroidectomy in absence of RLN injury and disappeared gradually in a few months. Those changes are comparable with that of other extracervical surgeries, making thyroidectomy with late RLN identification a relatively safe technique as regard voice.


International Journal of Pediatric Otorhinolaryngology | 2015

Choanal atresia: Histochemical, immunohistochemical and ultrastructure study of the nasal mucosa

Ezzeddin Elsheikh; Mohammad Waheed El-Anwar; Hesham R. Abdel-Aziz; Anan Fatehy Mohamed; Ahmad Annany

OBJECTIVES To study the nasal mucosal changes in cases with choanal atresia at the light and electron microscope and to compare the results with the normal side in unilateral cases. STUDY DESIGN Cross sectional study. SETTING Tertiary University hospital, departments of Otolaryngology and pathology. METHODS Sixteen patients diagnosed to have choanal atresia (seven bilateral and nine unilateral); ranging in age from 3 days to 9 years; were included in this study. During surgical repair, a biopsy of the inferior turbinate mucosa was taken. Biopsy from patent side in unilateral choanal atresia was also taken (as a control). Then biopsies were subjected to histopathological, histochemical, immunohistochemical and ultrastructure studies. RESULTS The nasal mucosa in choanal atresia side (weather unilateral or bilateral) showed distorted cilia, marked increase of mucous submucosal glands associated with marked reduction of goblet cell density and lymphocytic cellular infiltration. The patent side (control) showed normal respiratory epithelium with obviously noted intra-epithelial goblet cells. Submucosal glands were less in number and activity than in the atretic side. CONCLUSIONS Choanal atresia showed a condition of the nasal mucous membrane with characteristic excessive nasal tenacious secretion; mostly actively secreted besides some effect of lack of drainage due to interrupted cilia. Further studies are required to evaluate the impact of atresia repair on detected features.

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