Scientific Program

Day 1 :

Keynote Forum

Dr. Abdulrahman Alghulikah

Dr. Abdulrahman Alghulikah, Senior Resident, King Saud Medical City, Saudi Arabia.

Keynote: The burden of chronic pain after major head and neck tumor therapy

Time : 09:30-10:10


Dr. Abdulrahman Alghulikah,
Senior Resident,
King Saud Medical City,
Saudi Arabia.


INTRODUCTION: Little is known about the burden of chronic pain after major head and neck tumors' therapy. In this study, we aimed to estimate the prevalence of chronic pain, explore the factors associated with the presence of chronic pain, and assess the consequences of chronic pain on the patients' quality of life. METHODOLOGY: This was a cross-sectional survey among patients who had completed their therapy (e.g., surgery, radiotherapy, and chemotherapy) for major head and neck (larynx, nasopharynx, oropharynx, hypopharynx, oral cavity, tongue, and sinuses) tumors after at least 3 months. We collected relevant demographic and clinical data and administered the Brief Pain Inventory-Short Form, Neuropathic Pain Questionnaire-Short Form, and Pain Catastrophizing Scale questionnaires. Possible risk factors were explored using a classification tree model. RESULTS: A total of 102 patients (59 men, 42 women) were enrolled in this study between 3 and 72 months after tumor treatment. 30% of the patients reported having chronic pain after their major head and neck tumors' therapy. The average pain score in the last 24-hr was 3.4 (standard deviation = 2.7). The prevalence of patients with chronic pain was higher (42%) among those who had surgery. Factors associated with chronic pain were female sex, older age, surgery, advanced cancer stage, and radiotherapy. Patients who reported having chronic pain also reported having a lower quality of life manifested by impairments in general activity, mood, walking ability, normal work, and sleeping. Patients who reported having chronic pain had higher Pain Catastrophizing Scale scores. CONCLUSION: Our study highlighted the high burden of chronic pain after therapy for major head and neck tumors. We identified demographic and clinical factors that are associated with the presence of chronic pain. Further studies are required to better understand the risk factors to implement strategies to prevent, alleviate, and treat chronic pain associated with major head and neck tumor therapies.

Keynote Forum

Mohammad Sabir

Masters in audiology and speech therapy, Tawam hospital, Al Ain,UAE.

Keynote: P300 Variability in Individuals with Learning Disability

Time : 10:10-10-55


Masters in audiology and speech therapy,
Tawam hospital,
Al Ain,UAE.


Children with learning disability (LD) represent a unique challenge for audiologists. They have problem in reading, working memory, sensory motor coordination and early sensory processing. Characteristics of children with learning disabilities are many. Soft or mild neurological signs may also be observed in children with learning disabilities. Often poor academic performance in grade school is the first indication of LD (Hall, 1992). P300 is a long latency cortical endogenous potential occurring at about 300 msec (Sutton, Barren, Zubin & John, 1965). P300 can be taken as a measure or index of stimulus processing. It appears to have potential value in the assessment of hearing sensitivity and auditory processing abilities. Another distinct advantage of the P300 response is that it is less dependent on the physical characteristics of stimulus employed than are the exogenous potentials although it does require attention to task relevant stimulus items (Butcher, 1983).Thus main focus on this study is to discuss the use of P300 in the diagnosis of learning disability in which the underlying problem may be connected to cortical or cortical auditory processing. 59 subjects participated in the study out of which 50 ears were selected for the testing. (25 male Participant and 25 Female Participants) based on academic performance with respect to reading, writing and social relationship and speech and language development were included in the study.Age Range: 7 - 20 (Chronological age),Cognitive status (IQ): average IQ Level.   It can be concluded that, Individual with Learning disability (LD) be evidence for poor P300 responses, it can result in better estimation of fine and gross frequency discrimination, and fine will be more exaggerated than that of gross discrimination of acoustic signal according to gender and age. As Learning disability individuals show auditory or cortical processing difficulty, and they needed longer inter stimulus intervals to separate two sounds than did normal individuals. 

KEYWORDS: Learning disability, P300, odd ball paradigm, Gross and fine stimulus

Keynote Forum


Speech-language pathologist, President of the Lebanese Association of Speech & Language Therapists, Lebanon

Keynote: Optimizing SLP services in community-based models

Time : 10:55-11.35


Speech-language pathologist,
President of the Lebanese Association of Speech & Language Therapists,


SLP often falls under traditional clinical models of care, where interventions are disorder-based in one-on-one settings. In resource-constrained contexts, access to services in mental health can be reduced, with a direct impact on the wellbeing of the patient and his family. This is when a community-based rehabilitation program was established in a MH program in Lebanon, with the aim to improve access to services and to optimize the resources from the patient’s direct environment. This presentation describes the CBR model as a multisectoral approach as noted by WHO, and its implementation in a multidisciplinary team with active partnership with parents. It will also shed light on the course it took in its development, the direct implications in the adaptations of SLP services, outcomes, lessons learnt, and challenges.

Keynote Forum

Karina Mary de Paiva

Prof. Karina Mary de Paiva, Rua Joao Evangelista da Costa Brazil.

Keynote: Attention to elderly: perceptions and practices of the community health agents in a capital of the south of brazil

Time : 11:35-12:15


Prof. Karina Mary de Paiva,
Rua Joao Evangelista da Costa


PURPOSE: In Brazil, The Unified Health System (SUS) is based on the principle of health as a citizen's right and duty of the state. The primary health care has family health as a priority strategy for its organization. In Florianópolis, Santa Catarina, the organizational system of primary health care is composed of health units, subdivided in health districts. This system is in the process of being configured as a gateway to the health system, and integrate the family health strategy (ESF), with the community health agents, in the service network.

OBJECTIVE: To verify the perceptions and practices of Community Health Agents (CHAs) related to speech and language pathology issues, aiming at completeness of attention to the elderly.

METHODS: The present work is a transversal and descriptive study, in which questionaries made to the CHAs in the city of Florianópolis were employed. The approach consisted in analysing recommendations given by the CHAs during house attendances for Elderly Health Promotion. Guidance on aspects such as hearing impairment, dysphagia and speech disorders were embraced. The results were analysed with STATA 11.0 program.

RESULTS: 187 CHAs participated in this study. 88.24% claimed that never received adequate training from a speech therapist. The great majority (84.41%) give guidance to elderly people on hearing impairment, followed by dysphagia (57.84%) and speech disorders (56.99%). Concerning the training provided by Capital Idoso Program, only 46.77% declared to receive. Furthermore, it was found an association linking the Northern Sanitary District's CHAs to a better perception over hearing impairment and a growing number of reports related to general guidance over the analysed aspects.

CONCLUSION: It becomes necessary to provide adequate orientation for CHAs, as well as training by qualified speech therapists. This tutoring represents a matter of great importance in order to achieve a more effective work along with the community.

  • Otorhinolaryngology
Location: London, UK

Session Introduction

Taisa Giannecchini

Dr. Taisa Giannecchini, Speech Pathology and Audiology, University of Sao Paulo, Brazil.

Title: Verbal praxis in Adults: Speech in excellence


Introduction: Speech Motor Control includes the planning, preparation and execution of movement plans to result in muscle contractions and displacement of structures. In this perspective, the non-verbal-stimulation of the Praxis Speech is a theory that aims to improve the orofacial system for use in Speech. Objective: Stimulate Non-Verbal-Praxis of lips and tongue in adults to promote excellence in articulation pattern. Resumed Report: participated in this project 8 adults, mean age of 43.5 years. Speech therapy evaluation was performed with a test scores with orofacial praxis and evaluation and Speech Fluency, with specific text recording to control the Speech patterns. 8 subjects were instructed to perform exercises in sequence of lips and tongue for 60 consecutive days, for 5 minutes and 3 reps a day, and performed weekly speech therapy sessions. At the end of 60 days, participants were reassessed. 5 subjects showed improvement in the test of oral praxis, with score increased by more than 10 points, which featured greater coordination of the muscles involved. The default Speech was marked by increasing speed in reading, improved speech coordination, articulation more precise and clients perceptions. Conclusion: The Stimulation may have contributed to the pattern improves articulation of speech of these adults subjects. This work can opens up the possibility of a more comprehensive work with adults speakers, where the coordination of orofacial structures can enable the best possible muscular performance. This study suggests that the exercise of praxis skills can minimize nonverbal speech disorders.

Kris Chesky

Prof. Kris Chesky, 210 Wellington Oaks Ct Denton, Texas 76210.

Title: An Acoustical Analysis of the Frequency-Attenuation Response of Musician Earplugs


Musician earplugs (MEP) are intended to reduce the risk for noise induced hearing loss among musician populations while providing flat attenuation characteristics. However, survey data suggest that low use rates among musicians are associated with negative listening experiences due to perceived alterations in the spectral characteristics of music. These shortcomings warrant the assessment of how a MEP processes the full frequency and complex spectral nuances of musical sounds. The goal of this study was to assess the influence of musician earplugs on musical stimuli using an acoustic test fixture in order to characterize objectively the influence of custom and non-custom-fit MEPs on both the attenuation levels and the spectral characteristics of music in and over a wide range of intensity levels in a simulated human ear canal. Our objective measurements inside ear of KEMAR confirm that the spectral characteristics of music are altered by MEPs, regardless of whether the earplug was a non-custom or custom earplug. The findings suggest that the claims used to market MEPs to musicians and music schools are misleading and that the discrepancies for claiming attenuation characteristics in response to musical stimuli are related, in part, to the use of the REAT testing procedure. New testing protocols are recommended.



Background: The World Health Organization in 2018 estimated that 466 million people suffer from disabling hearing loss globally with 80% of them residing in low and middle-income countries (LMICs). Unfortunately, most countries especially LMICs do not have any roadmap to tackle the scourge; a WHO multi-country assessment revealed only 42-member states have some form of national or sub-national plan for ear and hearing care in their countries. On the contrary WHO member states ratified the Agenda item 15.8 of 70th World Health Assembly in May 2017 with a resolution enjoining them to develop National Strategic Plans for Ear and Hearing care (NSPEHC) that is integrated into the primary healthcare system under the umbrella of the universal healthcare coverage. SHF has championed the cause to support many countries in developing NSPEHC to include: Kenya, Rwanda, Nigeria, the Gambia, Uganda, Tanzania and Malawi in sub-Saharan Africa, Jamaica and St Lucia in the Caribbean, El Salvador in central America and Armenia in Europe. Objective: To support low and middle-income countries in developing and implementing national plans to improve ear and hearing care, which aims to reduce the prevalence, incidence and impact of hearing loss on individuals, families and communities through public health approaches. Methodology We utilized the WHO ear and hearing care situation analysis tool and the manual for planning and monitoring national strategies as our guiding template. The national strategies were built upon the WHO six health systems building blocks as it relates to ear and hearing care. Summary of steps taken include: initial advocacy visits to the Honorable ministers of health’s team, setting up a technical working group, having 3 technical sessions each lasting 2 days on the average, a validation exercise through an expanded stakeholder’s forum, the document launches and dissemination, inauguration of implementation committee and commencement of implementation. Expected Outcome In the short term, the countries have completed the development of their national plans and are at different stages of implementation. In the long term, a reduction in incidence, prevalence and the negative impact of ear diseases and hearing loss in the countries implementing the national plans. Minimum Learning Objectives • How to advocate to governments on the need for National plans for ear and hearing care • The process of leading the development and implementation of a National plan in low and middle- income countries • Translating the plans into actions that will impact ear and hearing care of the common man in these countries.

Lekha Kapoor

Al Zahra Hospital

Title: Reflux related Ent Problems

Biography: I, Dr Lekha Kapoor, am a professionally qualified ENT (Otolaryngology) Surgeon with more than 20 years of hands on Ear Nose and Throat experience. I started my Otorhinolaryngology training at the prestigious Seth GS Medical College and KEM Hospital in Mumbai in 1998. Here I gained extensive clinical, operative and educational Otorhinolaryngology skills. After completing my Masters in Surgery (Otorhinolaryngology section) from Mumbai University, I moved to London, UK in 2001. Here I worked for 6 years and received further ENT training. I completed my DOHNS exams from Royal College of Surgeons of England and then MRCS from Royal College of Surgeons of Edinburgh. With keen interest in Laryngology I completed my MSc in Voice Pathology with Distinction under eminent Laryngologist Mr John Rubin from University College London in 2007. Since then for refreshing my academic knowledge and learning new perspectives and innovations in the field I have been attending regular hands-on surgical workshops and conferences.


Introduction: Laryngopharyngeal reflux is the retrograde flow of stomach contents into larynx and pharynx above the upper esophageal sphincter(UES) leading to a variety of ENT problems. It is highly prevalent and expensive disease and currently almost like an epidemic. It is usually caused by failure of the natural physiological barriers letting the refluxate to travel up through UES.

Discussion: Reflux Laryngitis is still to date a controversial diagnosis because of the lack of specificity in the presenting symptoms, clinical signs as well as in the diagnostic procedures available. It has been implicated in variety of common ENT problems like hoarseness, coughing, globus sensation, throat clearing, Reinke’s edema, muscle tension dysphonia, chronic sinusitis, otitis media with effusion, obstructive sleep apnea and even in recurrent respiratory pappillomatosis, laryngeal and pharyngeal carcinomas.

The presenting symptoms usually are hoarseness, throat clearing, sore throat, globus, dysphagia and breathing difficulties. The common clinical findings are edema and erythema of the posterior larynx, subglottic edema, edema or congestion on vocal cords and thick endolaryngeal mucus, however all these appear to be non-specific. Reflux symptom index and Reflux finding score have been used to aid in the diagnosis.

The gold standard investigation in the diagnosis is considered to be pH monitoring but its interpretation and correlation with the disease has also been doubtful. Other investigations available are esophageal impedancemetry, esophagoscopy and sensitive pepsin immunoassay. Treatment is done high dose proton pump inhibitors, antacids and dietary and lifestyle modifications. However evidence shows a lot of placebo effect and non-responders even with long term treatment.

Conclusion: To conclude Laryngopharyngeal reflux remains a very controversial topic to discuss with continuous new innovations in its diagnosis and management. Further discussions in forums not only with otolaryngologists but also other fields like gastroenterology, pulmonology etc will be beneficial.

NzanzuKikuhe Jason

Makerere University, College of Health Sciences; Department of Ear, Nose and Throat, Uganda

Title: Hearing loss among children with sickle cell anaemia in uganda, a case control study

Dr Nzanzu Kikuhe Jason has his expertise in research and evaluation in primary healthcare. He has also expertise in clinical practice medicine and teaching(otorhinolaryngology). He has built his expertise after years of experience in research, evaluation, teaching and administration both in hospital and education institutions. He speaks fluently and writes perfectly in French and English


ABSTRACT Aim: A case control was carried out to study the prevalence, the pattern and associated factors of hearing loss among Ugandan children with sickle cell anemia. Material and methods: One hundred and thirty-two children known sickle cell and one hundred thirty aged matched non SCA controls were recruited after medical ethics committee approval and an informed consent. To obtain information on sociodemographic characteristics, history and examination of the participants, a structured questionnaire was administered. A pure tone audiometry (PTA) was used to assess the hearing in a sound treated room. Results: Twenty two of the children had hearing impairement compared to 6 controls. Prevalence of hearing loss found among children with SCA was 17% but in the control group the prevalence found was 5%. Sensorineural hearing loss (SNHL) affected 39%, conductive (CHL) 25% and mixed (MHL) 14% among cases compared to CHL 7%, SNHL 7% and MHL 7% among the controls. The hearing loss varied from mild to moderate (95%). All sickle cell children had high frequency hearing loss. There was a statistically significant association of hearing loss and neurologic motor deficit. Conclusion: Sickle patients are at risk of developing hearing loss as the studydemonstrated difference in hearing threshold in children living with sickle cell anemia and the controls. High frequencies were more affected. Neurologic motor deficit was highly associated with hearing loss among patients with SCA compared to controls.



INTRODUCTION Actinomycosis is a slowly suppurative infection caused by Actinomyces sp. which are gram positive, facultative anaerobic, branching, acid-fast negative bacilli, belonging to the normal flora of the oropharyngeal cavity. Cervicofacial actinomycosis is uncommon. The diagnosis of cervicofacial actinomycosis is also challenging as high index of suspicion is required to clinch the diagnosis. We herein present a case of recurrent paratracheal abscess which was proven to be actinomycosis.

ABSTRACT Actinomycosis is a slowly suppurative infection caused by Actinomyces sp. which are gram positive, facultative anaerobic, branching, acid-fast negative bacilli, belonging to the normal flora of the oropharyngeal cavity. Cervicofacial actinomycosis is uncommon. The diagnosis of cervicofacial actinomycosis is also challenging as high index of suspicion is required to clinch the diagnosis. We herein present a case of recurrent paratracheal abscess which was proven to be actinomycosis. Keywords: Actinomycosis, Neck abscess, Actinomyces sp.

CASE REPORT A 25-year old female came with the history of neck pain from 1 week. Patient also complained of pain and difficulty in swallowing from 4 days. No history of fever was complained. Patient had history of recurrent episodes (three) of paratracheal abscesses which were drained and treated with intravenous antibiotics. Last episode was 2 years back. The computed tomography (CT) neck showed ill-defined soft tissue density lesion in paratracheal region with air pockets which was suggestive of organized abscess. Pus culture had grown beta haemolytic Streptococci during first episode and no growth in the further episodes. All the three times Ziehl Neelson stain of pus was negative for acid fast bacilli. But during the third episode antitubercular treatment was given empirically for 6 months.



Allergic rhinitis is one of the most common chronic respiratory diseases, with an increase in prevalence, a negative impact on daily activities, sleep disturbance, and a steady increase in associated diseases such as asthma. Allergic rhinitis is a much more complex problem than the classic symptoms that accompany it. Its negative impact on daily activities and sleep in adults and children has been proven. According to epidemiological studies, 15-30% of adults and 40% of children worldwide suffer from allergic rhinitis. Compared to twenty years ago, the number of patients has almost doubled with a tendency for further growth. The aim of our study is to determine whether determining the number of eosinophils in the nasal secretion and the total number of eosinophils in the blood, are reliable and useful diagnostic procedures in diagnosing allergic rhinitis and monitoring the effect of treatment with intranasal corticosteroids. The study included 60 patients with allergic and non-allergic rhinitis. Patients were divided into two groups of 30 subjects. A prospective study was conducted, case series, in season, from 01.08.2014. until 31.07.2015. to cover all three significant pollinations: trees (mid-February to early May), grass (May to mid-July), weeds (mid-May to November) and year-round mite allergen. The examination was conducted at Kikinda General Hospital. The diagnosis of allergic rhinitis was made on the basis of history, clinical presentation and results of in-vivo diagnostic tests. The sensitivity and specificity of the tests were 80% and 100% for the number of eosinophils in the nasal secretion and the number of eosinophils in the blood. Differences in pre-therapeutic and post-therapeutic values of eosinophils were statistically significant (p <0.05).Conclusion: Within the test sample we have shown that tests, determination of the number of eosinophils in the nasal secretion and the total number of eosinophils in the blood, have high specificity and sensitivity and can be used in everyday practice.

Ashkon Ansari

From the Department of Emergency Medicine, Los Angeles County-University of Southern California, Los Angeles, CA.

Title: Roller Coaster-Induced Subdural Hematoma in a Previously Healthy Teenager


Of the multitude of neurologic injuries related to roller-coaster rides, a majority of them are reported about adults. In this case, we present a patient who presented to the pediatric emergency department with new-onset seizure and hemiplegia 2 days after a roller-coaster ride. She was ultimately diagnosed with a subdural hematoma. The acceleration and G forces of roller coasters are hypothesized to cause enough stress and shearing forces that are thought to directly cause subdural hemorrhage. Advances in roller-coaster technology may surpass the passenger's physical capacity for acceleration and rotary forces, and we may see an increased number of medical complications after these rides. We recommend that emergency and pediatric health care providers consider amusement park thrill rides as a possible cause of subdural hematomas in previously healthy patients with new neurologic complaints.

Yara Harb

Dr. Yara Harb, 522 Petrichore Crescent, K4A 0Y4 Ottawa, Ontario Canada.

Title: Achieving Desired Listening and Spoken Outcomes in Children through Auditory Verbal Therapy

Yara has expertise in early intervention techniques with children with hearing loss. Graduated from the Lebanese University with an honors degree in Speech and Language Pathology. Having a brother with hearing loss, Yara was driven by passion and motivation to study in-depth and updated techniques in helping children with hearing loss match their normal hearing peers in listening and language skills. Finishing her postgraduate in auditory verbal studies in London, Yara is now studying to become a Listening and Spoken Language Specialist (LSLS Cert. AVT); 85% of the children in her caseload have reported normal speech, language, and listening skills, which was a breakthrough in a small country like Lebanon.


Abstract Children born with hearing loss or who have experienced acquired hearing loss, have had the stigma of not achieving spoken language. One approach, which is breaking this stigma, is Auditory Verbal Therapy (AVT). AVT is evidence -based listening and spoken language approach used to develop the child’s brain into achieving the desired listening and spoken language outcomes. With the help of technology, early childhood screening tests, and the choice of early intervention, AVT allows children to develop age appropriate spoken language skills, social skills, and listening skills. As a speech and language pathologist who has studied and worked with AVT, I would like to elaborate on this approach and discuss the following in my presentation: 1. History, Techniques and Parental Coaching in Auditory Verbal Therapy I will discuss the history of auditory verbal therapy and the research behind the technique. With the use of video examples, conference attendees will learn about the techniques used and how to train the parents to become the primary language supporter for their children with hearing loss. 2. Listening and the Brain I will also explain the process of hearing through the brain. This includes the neurologic synapses of the brain from birth into early childhood, and how children with hearing loss are able to form auditory brain connections, and how they compare to children with normal hearing. 3. Speech Acoustics and Testing the Technology Speech sounds have different frequencies and intensities. Technology such as hearing aids or cochlear implants, do not give normal speech sound perception. This is why under this category, I will discuss the importance of hearing checks, the type of sounds we need to check, and how speech sounds are interpreted by the brain. 4. A Glimpse of an Auditory Verbal Session I will go over AVT session rules, discuss the parents’ roles, the appropriate choice of words, as well as provide examples from real AVT sessions. I hope to introduce and explain the AVT approach to conference attendees.

Hau Nguyen xuan

Department of Oncology, Hanoi Medical University, No 1 Ton That Tung Street, Dong Da, District, Hanoi 100000, Vietnam.

Title: Feasibility and Safety of Endoscopic Thyroidectomy Via a Unilateral Axillobreast Approach for Unilateral Benign Thyroid Tumor in Vietnam


Abstract: The purpose of this research study was to assess the safety and surgical outcomes of endoscopic thyroidectomy applied via a unilateral axillobreast approach with CO2 insufflation to one-sided benign thyroid tumors in Vietnam. Only 1 patient of the 50 (2%) had a postoperative hematoma at the surgery site. Open surgical conversions did not occur. The duration of postoperative drainage was from 3 to 8 days, or 4.86±1.24 days on average. The length of stay in the hospital after surgery was 4 to 9 days, or 5.9±1.2 days on average. The postoperative pain in the first postoperative days was lower in intensity compared with open surgeries. The given method provided better results in terms of patient satisfaction with the cosmetic effect of the surgery compared with up-front surgery, minimally invasive video-assisted thyroidectomy, and endoscopic procedures via the breast approach, and 96% of patients were completely satisfied.



Suffocation, due to a foreign body in the airway, is the most common cause of accidental death in toddlers and children under 5 years of age. My study started in November 1996 and was conducted both at Aleppo University Hospital and during my subsequent private practice It includes 2840 patients, the majority aged less than 6 years old I will present the development of bronchoscopy, since first described in 1896 by Killian, and then my own practice in the evaluation of patients & operative techniques that I have used. I will tabulate the complication rates and my results, with statistical analysis, and finally derive my personal recommendations