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Background Dentigerous cysts are the second most common form of a developmental cyst. These cysts might be the cause of ectopic teeth. Dentigerous cysts associated with ectopic teeth in the maxillary sinus are seldom seen in clinical practice. Case presentation We reported a 23-year-old woman who presented with nasal obstruction and facial pain on the left side 4 months ago. Three courses of antibiotics and analgesia were prescribed for her without improving the presenting features. Furthermore, extraction of the left upper second premolar and second molar, but the condition persisted. An orthopantogram and computerized tomography scan revealed the ectopic position of the left third upper molar tooth, which was embedded in a cystic lesion occupying the whole maxillary sinus. Removal of the cystic lesion with the ectopic tooth was performed with a Caldwell-Luc procedure. The histopathological evaluation confirmed the diagnosis of a dentigerous cyst. The presenting symptoms were resolved following surgery with no intra- or postoperative complications. Conclusion We are reporting another case of a dentigerous cyst occupying the whole left maxillary sinus with an ectopic left third upper molar tooth. Reporting such a case will enrich the literature regarding this rare clinical entity.

Background Cervical lymphadenopathy in children is a common problem in daily clinical practice. Many cases of cervical lymphadenopathy after the COVID-19 vaccine were reported. However, there is no yet reporting a case of supraclavicular cervical lymphadenopathy due to COVID-19.  Case presentation A 12-year-old girl presented with fever, cough, fatigue, anosmia, and ageusia. COVID-19 was confirmed by real-time PCR. The symptoms were resolved within 10 days. Seven days later, she complained of supraclavicular swelling. Physical examination revealed painless, multiple, and mobile supraclavicular lymph nodes. Ultrasound and fine-needle aspiration cytology were suspicious. Therefore, an excisional biopsy of the largest node was performed. The specimen was sent for histopathology and immunohistochemistry evaluation which confirmed the benign nature of the lymph node. Conclusion To our best knowledge, this is the first case of supraclavicular lymphadenopathy in a child with COVID-19. It is essential to put COVID-19 in the differential diagnosis of cervical lymphadenopathy.

Background Trichoepithelioma is a rare benign tumor. It could be an inherited or acquired condition. Trichoepithelioma has mostly involved the face with bilateral multiple lesions. Involvement of the auricle by this tumor is extremely rare encountered in clinical practice. Case presentation A 36-year-old female presented to the Dermatology Clinic with painless right auricular papules 4 years ago. Examination revealed multiple non-tender, firm, rounded, dome-shaped, flesh-colored, pink, and shiny papules. There was mild bleeding from the lesions after trivial trauma. There was no family history of similar problem. No abnormality was found on other examinations. An excisional biopsy of one lesion was performed under local anesthesia. The histopathological evaluation confirmed the diagnosis of trichoepithelioma. The lesions under local anesthesia were excised with primary closure of the wound. No recurrence was seen during 2 years of follow-up. Conclusion Only five cases of trichoepitheliomas that affected the auricle were reported in the PubMed database. Four of them are affecting both auricles as well as other parts of the body, particularly the face. The fifth case was with a unilateral single giant auricular lesion. Our case was with non-familial multiple unilateral auricular trichoepitheliomas. The tumors responded well on surgical excision and primary closure.

Introduction Lobular capillary hemangioma (LCH) is a benign vascular tumor that rarely affects the nasal cavity. Pregnancy and previous nasal trauma or surgery might be implicated in the pathogenesis of this tumor. However, in the majority of the cases, there is no identified cause. The objective of this study was to characterize the numerous demographic and clinical aspects of intranasal LCH and to find whether there is a link between its likely causation and other parameters. We retrospectively reviewed the medical records (from 2012 to 2021) of subjects with proven cases of intranasal LCH on histopathological evaluation at four main hospitals in Baghdad, Ramadi, Tikrit, and Samawah cities, Iraq. The detailed information concerning the age, gender, duration, clinical features, side, location, type of anesthesia, follow-up period, and recurrence was registered for each participant. Results Of the 82 patients, there were 73.2% females. The majority of the cases (79.3%) were from the age group of 18–40 years. The majority of the patients (74.4%) were seen within 1–2 months. Most of the cases originated from the left side (59.8%) and the nasal septum (81.7%). Epistaxis was the most common presenting symptom (91.5%). No cause was identified in 42.7% of the cases, followed by pregnancy (31.7%) and trauma (25.6%). There was a significant difference between the possible cause and the age and gender ( P -value = 0.000). The recurrence rate was 3.66%. Conclusion Intranasal LCH shows a female predominance and mostly affects the age group of 18–40 years. Most of the cases involved the left side and nasal septum. Epistaxis was the chief complaint in the majority of cases. Age and gender can determine the possible cause of the lesion.

Background Pregnancy rhinitis (PR) is a relatively common condition with a prevalence of 20%. We aimed to identify the prevalence and risk factors of the PR. A prospective cohort study was conducted at the Obstetric and Gyenocology and Otolaryngology Departments in the Tikrit General Hospital, Tikrit City, Iraq. The study covered 12 months (September 2019–September 2020). Pregnant women were divided into two groups; with and without PR. Data regarding the age, body mass index (BMI), occupation, smoking, clinical features, parity, gestational age, and sex of the baby were recorded. Visual analog scale (VAS) and nasal-obstructive-symptom-evaluation (NOSE) scale were used for the evaluation of the nasal obstruction. Results The prevalence of the PR was 11.65% (110/944 pregnant women). Rhinorrhea was the commonest associated feature with nasal obstruction of the PR ( n  = 48, 43.6%). Ninety percent of the patients were in the age group < 35 years. The majority of the subjects were housewives ( n  = 551, 58.4%), in the second trimester ( n  = 456, 48.3%), and in the parity group 0–2 ( n  = 511, 54.1%). The female baby was found in 56.5% of the patients ( n  = 533). There were statistically significant differences between the two groups: women with and without PR regarding the BMI and gestational age (first trimester) ( P value = 0.001). No history of current smoking was found in all women. Conclusion The prevalence of PR was 11.65% and was mostly seen in the first trimester. High BMI and pregnant women in the first trimester were considered risk factors for the PR.

Background Hearing loss is a common problem worldwide with a global prevalence of 20%. There is no local relevant study from Iraq about the prevalence of hearing loss. Objective To assess the prevalence of hearing loss among patients attending the otolaryngology clinic, Ramadi city, Iraq. Method This retrospective study was conducted at the otolaryngology clinic, Ramadi city, Anbar government, Iraq. Patients with hearing loss were enrolled in the current study. Data were gathered from patients record regarding the age, sex, type, side, and severity of hearing loss. Additionally, the number of cases were registered for each month during the study period. Results Out of 8497, there were 2165 (25.48%) patients with hearing loss. The highest number of cases was registered in April ( n  = 246, 11.4%). The highest age group affected was 18–60 years ( n  = 1125) with slight male predominance (51.64%). The main cause of hearing loss was secretary otitis media ( n  = 762, 35.19/5). The vast majority of cases were with conductive hearing impairment ( n  = 2051, 94.73%). Unilateral hearing loss (50.76%) was slightly more than bilateral one. Mild hearing loss has outnumbered ( n  = 1905, 88%) the other severities. Conclusion The prevalence of hearing loss was 25.48%. Hearing loss could affect any age with slight male predominance. The majority of the cases were with conductive type and mild severity.

Herpes zoster oticus is a viral disease caused by the reactivation of the varicella-zoster virus at the geniculate ganglion. The hallmark of the condition is multiple unilateral erythematous vesicles, which are distributed over the auricle and preceded by severe otalgia. If these symptoms are associated with facial nerve palsy, the condition is called Ramsay Hunt syndrome (RHS) which is usually accompanied by vestibulocochlear abnormalities. A 42-year-old woman came to our clinic with sudden onset of right-sided severe otalgia and several erythematous vesicles on the auricle two days ago. She provided a history of dysphagia and hoarseness for 10 days. After two days, ipsilateral facial nerve paralysis was noted. The patient was immunocompetent with an unremarkable medical history. Physical examination revealed the following: the vesicles distributed over the right auricle, external auditory canal, and eardrum; right sensorineural deafness; deviated uvula to the left side; absent gag reflex on the right side; right vocal cord palsy; and lower motor facial nerve paralysis of House-Brackmann grade III. The pure tone audiogram confirmed the diagnosis of right-sided sensorineural deafness. Acyclovir therapy and prednisolone tablets at a loading dose were initiated. At the four-month follow-up, the presenting manifestations were improved. Here, we report a case of RHS with early glossopharyngeal and vagus nerve palsy, followed by pain, vesicular eruptions, sensorineural hearing loss, and delayed onset of facial nerve paralysis. The condition resolved completely on medical treatment with acyclovir and prednisolone.Herpes zoster oticus is a viral disease caused by the reactivation of the varicella-zoster virus at the geniculate ganglion. The hallmark of the condition is multiple unilateral erythematous vesicles, which are distributed over the auricle and preceded by severe otalgia. If these symptoms are associated with facial nerve palsy, the condition is called Ramsay Hunt syndrome (RHS) which is usually accompanied by vestibulocochlear abnormalities. A 42-year-old woman came to our clinic with sudden onset of right-sided severe otalgia and several erythematous vesicles on the auricle two days ago. She provided a history of dysphagia and hoarseness for 10 days. After two days, ipsilateral facial nerve paralysis was noted. The patient was immunocompetent with an unremarkable medical history. Physical examination revealed the following: the vesicles distributed over the right auricle, external auditory canal, and eardrum; right sensorineural deafness; deviated uvula to the left side; absent gag reflex on the right side; right vocal cord palsy; and lower motor facial nerve paralysis of House-Brackmann grade III. The pure tone audiogram confirmed the diagnosis of right-sided sensorineural deafness. Acyclovir therapy and prednisolone tablets at a loading dose were initiated. At the four-month follow-up, the presenting manifestations were improved. Here, we report a case of RHS with early glossopharyngeal and vagus nerve palsy, followed by pain, vesicular eruptions, sensorineural hearing loss, and delayed onset of facial nerve paralysis. The condition resolved completely on medical treatment with acyclovir and prednisolone.

Background Benign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. It is a short-lived (seconds) rotatory attack of vertigo in relation to the position of the head. Vitamin D deficiency may be one of the causes leading to BPPV. As there is no relevant local study from Iraq, this study aimed to evaluate the association between BPPV and vitamin D deficiency. Methodology This retrospective, case-control study was conducted at the otolaryngology clinic of Al-Ramadi Teaching Hospital during a 26-month duration. The study included 40 patients clinically diagnosed with BPPV and 80 individuals as controls. Detailed information regarding the demographic and clinical characteristics was obtained from each participant. Serum vitamin D and calcium levels were measured for each participant. Results Both cases and controls were matched regarding age and gender. Serum vitamin D level in cases (15.458 ± 6.14 ng/mL) was lower than controls (23.604 ± 12.58 ng/mL), with a p-value of 0.0001 and large clinical effect size (0.8). Vitamin D deficiency was found in 35 cases and 37 controls, with a highly significant difference (p = 0.0001) and an odds ratio of 8.135. Vitamin D deficiency in BPPV patients with recurrence (12.615 ± 4.096 ng/mL) was lower than those without recurrence (18.3 ± 6.611 ng/mL), with a highly significant difference (p = 0.002) and small clinical effect size (0.3). Older age and vitamin D deficiency were risk factors for recurrence according to the multinominal logistic regression test (p < 0.05). Conclusions Vitamin D deficiency might cause the occurrence and recurrence of BPPV. Older age might be a risk factor for BPPV recurrence.

Background Salivary gland diseases include a variety of conditions (inflammatory, immunological, infectious, or neoplastic pathologies). Salivary gland diseases hold the interest of clinicians and pathologists due to their varied clinical presentation and histological diversity. In this study, we aimed to assess the various aspects of clinical and pathological characteristics of salivary gland diseases. Methodology We reviewed the records of patients with various salivary gland diseases at Ramadi Teaching Hospital, Rashid Hospital, Razi Hospital, and Zuhur Hospital in Iraq. The study covered the years 2010 to 2021. Results Of 159 patients, there were 61.64% female patients. The age group most affected was 51-60 years (26.4%). The most involved salivary gland was the parotid (44.65%). Swelling was seen in 74% of the patients. Obstructive lesions were seen in 52.2% of patients. Obstructive pathologies occurred exclusively in the age group 51-60 years, infective cases involved the age group 71-80 years (64.3%), and tumors affected the age group 41-50 years (77.4%). Women were affected more than men by all pathologies. The parotid gland was mostly affected by tumors (32/71), while other glands were mostly affected by obstructive lesions (17/18). A significant association was found between salivary gland pathologies with age and the affected gland. The most common clinical entity of the obstructive lesions was xerostomia (20.1%). While pleomorphic adenoma was the most common tumor (n = 40/50). The most common cause of xerostomia was smoking (31.2%) and the least cause was antidepressants (9.4%). Conclusions Salivary gland diseases were mostly seen in women and in the age group 51-60 years. Parotid was the most involved gland. A three-quarter of the cases presented with swelling and obstructive pathologies comprise above 50% of causes. The age and the involved gland can determine the type of salivary gland diseases. Xerostomia was the common clinical entity of obstructive pathologies. The most common tumor was pleomorphic adenoma and the most common cause for xerostomia was smoking.Background Salivary gland diseases include a variety of conditions (inflammatory, immunological, infectious, or neoplastic pathologies). Salivary gland diseases hold the interest of clinicians and pathologists due to their varied clinical presentation and histological diversity. In this study, we aimed to assess the various aspects of clinical and pathological characteristics of salivary gland diseases. Methodology We reviewed the records of patients with various salivary gland diseases at Ramadi Teaching Hospital, Rashid Hospital, Razi Hospital, and Zuhur Hospital in Iraq. The study covered the years 2010 to 2021. Results Of 159 patients, there were 61.64% female patients. The age group most affected was 51-60 years (26.4%). The most involved salivary gland was the parotid (44.65%). Swelling was seen in 74% of the patients. Obstructive lesions were seen in 52.2% of patients. Obstructive pathologies occurred exclusively in the age group 51-60 years, infective cases involved the age group 71-80 years (64.3%), and tumors affected the age group 41-50 years (77.4%). Women were affected more than men by all pathologies. The parotid gland was mostly affected by tumors (32/71), while other glands were mostly affected by obstructive lesions (17/18). A significant association was found between salivary gland pathologies with age and the affected gland. The most common clinical entity of the obstructive lesions was xerostomia (20.1%). While pleomorphic adenoma was the most common tumor (n = 40/50). The most common cause of xerostomia was smoking (31.2%) and the least cause was antidepressants (9.4%). Conclusions Salivary gland diseases were mostly seen in women and in the age group 51-60 years. Parotid was the most involved gland. A three-quarter of the cases presented with swelling and obstructive pathologies comprise above 50% of causes. The age and the involved gland can determine the type of salivary gland diseases. Xerostomia was the common clinical entity of obstructive pathologies. The most common tumor was pleomorphic adenoma and the most common cause for xerostomia was smoking.

Background: The anal fissure is frequently seen in surgical practice. It is caused by a longitudinal tear in the anoderm distal to the dentate line. The hallmark feature of the disease is severe pain during defecation. Chronic anal fissure (CAF) causes undue stress that leads to poor quality of life. Different options of treatment, whether medical or surgical, are employed to treat this condition. One of these modalities is lateral internal anal sphincterotomy (LIAS).Objectives: We aimed to assess the safety and efficacy of the LIAS surgical procedure for the treatment of CAF.Materials and methods: This retrospective study was conducted at the Al-Muqdadiya General Hospital, Diala, Iraq, for a period from January 2016 to March 2021. The medical records of the patients with CAF who were subjected to LIAS under local anesthesia were reviewed. Data regarding the age, gender, smoking habit, body mass index (BMI), healing time, complications, and outcome for each participant were recorded.Results: Of 165 participants, there were 91 men. The majority of the cases were ≤ 35 years (78.19%), were non-smokers (80%), and had no history of DM (98.79%). There was complete healing with a resolution of the pain at two months postoperatively in 163 subjects. The most common complication in our study was flatus incontinence (n = 5). All of them were found in the age group > 35 years and women. There were statistically significant differences between the age groups, gender, BMI, and the occurrence of flatus incontinence (P-value = 0.000, 0.012, and 0.009 respectively). However, there was no such association between smoking habit and a history of DM (P-value > 0.05). Conclusion: LIAS is safe and effective in the treatment of CAF, with an excellent outcome in resolving pain and a low complication rate. Age, female gender, and high BMI might affect the occurrence of flatus incontinence.