MyMedR

Fulltext An unexpected lesion in cerebellopontine angle: hemangiopericytoma

Teoh JW, Goh BS, Shahizon Azura MM, Siti Aishah MA, Nor Hafliza MS

Med J Malaysia, 2014 Jun;69(3):146-7.

hemangiopericytoma (hPC) is a rare tumor by definition and intracranial hPC makes up to less than one percent of all the intracranial tumors. It is a dural base tumor and its clinical features and radiological findings are similar to meningiomas. however, cerebellopontine angle hemangipericytoma had only been reported twice and would almost always be misdiagnosed. definite diagnosis is important, as the treatment of hPC is different from meningiomas and acoustic neuromas. we report a case of a young female who presented with atypical symptoms of left cerebellopontine angle mass. A literature review of the nature of the disease, radiological findings, immunohistochemical features and treatment options of the tumor are described.

Fulltext The Prevalence of Sensorineural Hearing Loss in β-thalassaemia patient treated with Desferrioxamine

Kong MH, Goh BS, Hamidah A, Zarina AL

Med J Malaysia, 2014 Feb;69(1):9-12.

PMID: 24814621 MyJurnal

OBJECTIVE: This study aimed to evaluate the prevalence of sensorineural hearing loss (SNHL) in β-thalassaemia patients treated with Desferrioxamine (DFO) and determine the correlation of SNHL with average daily DFO dosage, serum ferritin level and Therapeutic index (T.I).

METHODS: This is a cross sectional descriptive study carried out for a period of 14 months and 54 patients were recruited. The recruited patients are transfusion dependant β- thalassaemia patient aged 3 years and above treated with DFO. An interview, clinical examination and hearing assessment, which included tympanogram, and Pure Tone Audiometry (PTA) or behaviour alaudiometry were performed. The data on age started on DFO, average daily DFO, duration of DFO intake, serum ferritin past 1 year and Therapeutic Index (T.I) were obtained from patients' case notes.

RESULTS: The prevalence of SNHL was 57.4% and majority has mild hearing loss (93.6%). Fourteen patients (25.9%) have bilateral ear involvement and as many as 17 patients (31.5%) have SNHL in either ear. A total of 23 patients (42.6%) have normal hearing level. Although the prevalence of SNHL was 57.4%, only a small percentage of the patient noticed and complained of hearing loss (11.1%). There is no association between age started on DFO, average daily DFO and duration of DFO intake with normal hearing group and those patients with SNHL. Positive correlation was seen between average daily DFO with 2000 and 4000Hz on PTA in the left ear and between serum ferritin level past 1 year with 4000 and 8000Hz in the right ear and 8000Hz in the left ear. No significant correlation was seen between T.I on PTA.

CONCLUSION: The prevalence of SNHL from hearing assessment is high in β-thalassaemia patients in this study. However, it is manifested clinically in a smaller percentage. We suggest a baseline hearing assessment should be carried on all β-thalassaemia patients prior to DFO chelation therapy.

Fulltext Partial Cricotracheal Resection (PCTR), a Rewarding Outcome for Paediatric Subglottic Stenosis: An Early Experience

Goh BS, Roopesh S, Marina MB, Abdullah SM

Med J Malaysia, 2014 Feb;69(1):13-5.

PMID: 24814622

This is a retrospective study examining the outcome of paediatric patients with subglottic stenosis who underwent partial cricotracheal resection (PCTR) as a primary open procedure from 2004 to 2012. There were 5 patients identified aged from 3 to 18 years old. All the subglottic stenosis were acquired type. All of them were secondary to prolonged intubation. Three patients were classified as Myer-Cotton grade III and the other two were Myer-Cotton grade IV. Two of the patients had concomitant bilateral vocal cord immobility. All patients underwent two staged PCTR . All patients underwent two staged PCTR, and one patient underwent posterior cordectomy apart from partial CTR at different setting. All patients were successfully decannulated at various durations postoperatively. Although this is an early experience in our institution, PCTR has shown to be effective and safe procedure in patients with subglottic stenosis especially those with Myer-Cotton grade III and IV.

Fulltext Primary clear cell carcinoma of minor salivary gland of the soft palate: a case report

Saleh KA, Nurishmah MI, Firouzeh GN, Goh BS

Med J Malaysia, 2012 Jun;67(3):335-6.

PMID: 23082431 MyJurnal

Clear cells can be found in numerous salivary and non-salivary tumors in the head and neck region, including metastatic lesions. They are rare low-grade tumors accounting for less than 1% of all salivary gland tumors and occur almost exclusively in the intra-oral minor salivary glands. Hyalinizing clear cell carcinoma (HCCC) is an extremely rare and recently described neoplasm predominantly affecting the oral cavity. Histologically, it is characterized by nests of glycogen-rich monomorphic clear cells within a hyaline stroma. HCCC often follows an indolent course with a limited metastatic potential. It is therefore important to differentiate this entity from other more aggressive clear cell tumors including metastatic tumors such as renal cell carcinoma. We hereby report a case of HCCC localized in minor salivary glands specifically in soft palate for its rarity, as well as to discuss the role of immunohistochemical stains, essential for its definitive diagnosis.

Fulltext Congenital cholesteatoma: delayed diagnosis and its consequences

Goh BS, Faizah AR, Salina H, Asma A, Saim L

Med J Malaysia, 2010 Sep;65(3):196-8.

PMID: 21939167

This is a retrospective review of congenital cholesteatoma cases that were managed surgically. There were 5 cases. The age of presentation ranged from 5 to 18 year old. Three patients presented with complication of the disease. Three patients had intact tympanic membrane, two had perforation at the anterior superior quadrant. All patients had cholesteatoma medial to tympanic membrane. Four cases had extensive ossicular erosion with preoperative hearing worse than 40 dB. Four cases underwent canal wall down mastoid surgery and one underwent canal wall up surgery. One patient had recurrence which required revision surgery. In conclusion, congenital cholesteatoma presented late due to the silent nature of disease in its early stage. Extensive disease, ossicular destruction with risk of complication at presentation were marked in our study. Hence, more aggressive surgical intervention is recommended in the management of congenital cholesteatoma.

Fulltext Retrospective review of surgical management of foreign body ingestion

Shaariyah MM, Goh BS

Med J Malaysia, 2009 Dec;64(4):307-10.

PMID: 20954556 MyJurnal

Endoscopic examination and removal of foreign body under general anaesthesia are recommended for persistent symptomatic patient with or without significant findings on radiological examination. This report evaluates the management outcome of surgical removal of foreign body ingestion in upper gastrointestinal tract. A total of 70 cases with full documentation were reviewed retrospectively from June 1998 until December 2007. There were 32 male and 38 female with age range from 6 months to 87 years old (mean: 36.9 years). Sixty five patients (93%) were adults and 15 (7%) were below 13 years. Fish bones were the most common foreign body found (44.3%). Radiologically, foreign bodies were highly suspicious in 51 cases (76.1%). Intraoperatively, thirty six cases (70.6%) were positive. From 16 cases (23.9%) with normal radiograph, 10 cases (62.5%) were found to have foreign bodies. Therefore the plain radiograph is helpful, but clinical presentation is more reliable to determine surgical removal under general anaesthesia.

Fulltext A ten year retrospective review of orbital complications secondary to acute sinusitis in children

Suhaili DN, Goh BS, Gendeh BS

Med J Malaysia, 2010 Mar;65(1):49-52.

PMID: 21265249 MyJurnal

Acute sinusitis is most often a mild self-limiting disease. However, it may progress into severe and life threatening complications. One of the commonest being orbital complication of which visual loss is a direct consequence. In this 10 year retrospective study, the nature of orbital complication, clinical presentation and treatment modalities and outcome seen in children with acute sinusitis in a tertiary referral institute were reviewed. Of six patients, there was a case of preseptal cellulitis, 4 cases of subperiosteal abscess and one case of orbital abscess. Periorbital swelling was a common presenting feature. In 5 cases this was associated with proptosis with one case of impending optic nerve compression. The value of computed tomography and opthalmological examination as a component in the management plan is highlighted. All patients were treated with intravenous antibiotics but evidence of abscess collection warranted urgent surgical drainage in 5 patients, 3 being endoscopic drainage while external approach was done for the remaining 2 patients. Thus a child exhibiting orbital complication of acute sinusitis, prompt diagnosis and treatment is essential in obtaining the best outcome for the child.

Growth kinetic study on normal and microtic chondrocytes of human auricular cartilage

Ishak MF, Aminuddin BS, Asma A, Lokman BS, Ruszymah BH, Goh BS

Med J Malaysia, 2008 Jul;63 Suppl A:117-8.

PMID: 19025013

Chondrocytes were isolated from normal and microtic human auricular cartilage after ear surgery carried out at Universiti Kebangsaan Malaysia Medical Centre. Chondrocytes were cultured and expanded until passage 4. After reached confluence, cultured chondrocytes at each passage (P1, P2, P3 and P4) were harvested and assigned for growth profile analysis. There was no significant difference in cell viability between both normal and microtic samples (p = 0.84). Both samples showed no significant differences for growth profile parameters in terms of growth rate, population doubling time and total number of cell doubling, except in passage 1, where there is significant difference in cell growth rate (p = 0.004). This preliminary data has indicated that chondrocytes from microtic cartilage has the potential to be used in the reconstruction of human pinna in the future.

Fulltext Paediatric tracheostomy in Hospital University Kebangsaan Malaysia - a changing trend

Primuharsa Putra SH, Wong CY, Hazim MY, Megat Shiraz MA, Goh BS

Med J Malaysia, 2006 Jun;61(2):209-13.

PMID: 16898313

Indication for pediatric tracheostomy has changed. Upper airway obstruction secondary to infectious disorders is no longer the commonest indication. The aim of this study was to establish data on indications, outcome and complications of pediatric tracheostomy. A retrospective analysis of pediatric tracheostomies carried out between March 2002 to March 2004 was done. Eighteen patients were identified. The commonest indication was prolonged ventilation (94.5%) followed by pulmonary toilet (5.5%). None was performed for upper airway obstruction. Postoperative complications were encountered in six patients (33.3%), the commonest being accidental decannulation notably in children less than six years of age. Twelve patients (66.6%) were successfully decannulated. The mortality rate was 16.6%. All death were non tracheostomy related. The commonest indication for tracheostomy was prolonged ventilation and tracheostomy in children is relatively safe despite complications.

Fulltext Endoscopic repair of spontaneous cerebro-spinal fluid rhinorrhoea: a report of 3 cases

Gendeh BS, Wormald PJ, Forer M, Goh BS, Misiran K

Med J Malaysia, 2002 Dec;57(4):503-8.

PMID: 12733180

Three cases of spontaneous Cerebrospinal Fluid (CSF) rhinorrhea were managed at the National University Hospital, Kuala Lumpur. Case 1 had bilateral leak secondary to empty sella syndrome and the rest two cases had unilateral leak. Four transnasal endoscopic approaches were performed on these three cases since March 1999. The role of intrathecal Sodium Fluorescein is highlighted in localising the CSF fistula. Case 3 required postoperative lumbar drain as an adjunct. No recurrent leak was noted on post operative follow up in Case 2 and 3 ranging from nine to thirty two months. A recurrent left leak at six months was noted in Case 1 which could likely be due to her sudden bout of cough attacks and patient refused further surgical intervention.

Fulltext Multiple metastatic deposits in the head and neck region from a renal cell carcinoma

Ishak AI, Md Pauzi SH, Masir N, Goh BS

Malays J Med Sci, 2010 Oct;17(4):71-4.

PMID: 22135565 MyJurnal

Metastatic renal cell carcinoma (RCC) presenting with multiple deposits in the head and neck region is unusual. It is not uncommon for a RCC to metastasise to a distant site after years of a tumour-free period, but most of it would be expected to have a single site of deposit. We report a rare case of a patient who had a nephrectomy 10 years earlier for RCC and presented with tumours in the frontal sinus and posterior pharyngeal wall. Radiological imaging and histology confirmed metastatic RCC at both sites.

Fulltext Mastoid abscess in acute and chronic otitis media

Ami M, Zakaria Z, Goh BS, Abdullah A, Saim L

Malays J Med Sci, 2010 Oct;17(4):44-50.

PMID: 22135560 MyJurnal

Mastoid abscess remains a recognised complication of otitis media despite the advent of antibiotics. The objectives of this study were to describe the risk factors in patients with mastoid abscess following acute and chronic otitis media and discuss the management of this infection.

Fulltext Isolated blunt lingual artery injury secondary to a road traffic accident: diagnostic and therapeutic approach

Mawaddah A, Goh BS, Kew TY, Rozman Z

Malays J Med Sci, 2012 Apr;19(2):77-81.

PMID: 22973141 MyJurnal

Neurologic and airway compromise as a result of traumatic vascular injuries to the neck region often lead to more severe complications and thus require special consideration. Furthermore, these cases pose diagnostic and therapeutic challenges to healthcare providers. Here, we report a case of a 28-year-old motorcyclist presenting with progressively enlarged Zone 2 neck swelling on the left side following a high impact collision. There were no symptoms or signs suggesting neurologic or laryngeal injury. Computed tomography angiogram of the neck revealed signs of an active arterial bleed. The apparent vascular injury was managed by close observation for signs of airway compromise, urgent angiogram, and selective catheter embolisation of the left lingual artery. The patient subsequently recovered without further operative exploration of the neck. At 6 months post-trauma, the neck swelling fully subsided with no complications from angioembolisation. This case illustrates the individualised treatment and multidisciplinary approach in managing such cases. We review our rationale for this diagnostic and therapeutic approach.

Quality of life assessment in patients with moderate to severe allergic rhinitis treated with montelukast and/or intranasal steroids: a randomised, double-blind, placebo-controlled study

Goh BS, Ismail MI, Husain S

J Laryngol Otol, 2014 Mar;128(3):242-8.

PMID: 24618303 DOI: 10.1017/S002221511400036X

This study investigated improvements in quality of life associated with eight weeks of montelukast and/or intranasal steroid treatment for moderate to severe allergic rhinitis.

Unilateral tongue angioedema caused by angiotensin-converting enzyme inhibitor

Ee YS, Sow AJ, Goh BS

J Laryngol Otol, 2010 Dec;124(12):1337-9.

PMID: 20529395 DOI: 10.1017/S002221511000143X

We report a case of an elderly man receiving treatment with perindopril, who presented with angioedema of the left side of the tongue, floor of the mouth and upper neck. This affected his speech and swallowing, and occurred one day after a burr hole and evacuation procedure undertaken to treat a subdural haematoma. The patient was kept under close observation and treated with intravenous hydrocortisone. The angioedema resolved completely in two days. This is the third reported case of unilateral tongue angioedema occurring secondary to angiotensin-converting enzyme inhibitor use.

Metachronous inflammatory myofibroblastic tumour in the temporal bone: case report

Goh BS, Tan SP, Husain S, Rose IM, Saim L

J Laryngol Otol, 2009 Oct;123(10):1184-7.

PMID: 19192318 DOI: 10.1017/S0022215109004642

We report an extremely rare case of metachronous inflammatory myofibroblastic tumour in the temporal bone.

Parotid abscess: a five-year review--clinical presentation, diagnosis and management

Tan VE, Goh BS

J Laryngol Otol, 2007 Sep;121(9):872-9.

PMID: 17112392

Parotid abscess is an uncommon complication of suppurative infection of the parotid gland parenchyma, commonly bacterial or viral. Ductal ectasis, primary parenchymal involvement, or infection of the intraparotid or periparotid lymph nodes can result in abscess formation. Parotid abscess may arise from ductal ectasis, primary parenchymal involvement, or infection of the subcapsular lymph nodes. The operative records for all the patients who underwent surgeries in the Department of Otorhinolaryngology, Head and Neck Surgery of the National University Hospital, Kuala Lumpur, Malaysia between January 2001 and December 2005 were retrospectively reviewed. Our case series comprises 15 patients, with 10 males and five females with a median age at presentation of 51 years old. Diabetes mellitus is a significant comorbid factor, with six patients being diabetics. Among the diabetics, two patients presented with facial nerve palsy and one of them also died due to overwhelming septicaemia. Here, we discuss the presenting symptoms, predisposing factors, investigations, microbiology and complications of this condition.

Cochlear nerve canal stenosis and associated semicircular canal abnormalities in paediatric sensorineural hearing loss: a single centre study

Zainol Abidin Z, Mohd Zaki F, Kew TY, Goh BS, Abdullah A

J Laryngol Otol, 2020 Jul;134(7):603-609.

PMID: 32713375 DOI: 10.1017/S0022215120001334

OBJECTIVE: This study aimed to evaluate the association between cochlear nerve canal dimensions and semicircular canal abnormalities and to determine the distribution of bony labyrinth anomalies in patients with cochlear nerve canal stenosis.

METHOD: This was a retrospective study in which high-resolution computed tomography images of paediatric patients with severe-to-profound sensorineural hearing loss were reviewed. A cochlear nerve canal diameter of 1.5 mm or less in the axial plane was classified as stenotic. Semicircular canals and other bony labyrinth morphology and abnormality were evaluated.

RESULTS: Cochlear nerve canal stenosis was detected in 65 out of 265 ears (24 per cent). Of the 65 ears, 17 ears had abnormal semicircular canals (26 per cent). Significant correlation was demonstrated between cochlear nerve canal stenosis and semicircular canal abnormalities (p < 0.01). Incomplete partition type II was the most common accompanying abnormality of cochlear nerve canal stenosis (15 out of 65, 23 per cent).

CONCLUSION: Cochlear nerve canal stenosis is statistically associated with semicircular canal abnormalities. Whenever a cochlear nerve canal stenosis is present in a patient with sensorineural hearing loss, the semicircular canal should be scrutinised for presence of abnormalities.

Long-term status of middle-ear aeration post canal wall down mastoidectomy

Ezulia T, Goh BS, Saim L

J Laryngol Otol, 2019 Aug;133(8):662-667.

PMID: 31267884 DOI: 10.1017/S0022215119001385

BACKGROUND: Retraction pocket theory is the most acceptable theory for cholesteatoma formation. Canal wall down mastoidectomy is widely performed for cholesteatoma removal. Post-operatively, each patient with canal wall down mastoidectomy has an exteriorised mastoid cavity, exteriorised attic, neo-tympanic membrane and shallow neo-middle ear.

OBJECTIVE: This study aimed to clinically assess the status of the neo-tympanic membrane and the exteriorised attic following canal wall down mastoidectomy.

METHODS: All post canal wall down mastoidectomy patients were recruited and otoendoscopy was performed to assess the neo-tympanic membrane. A clinical classification of the overall status of middle-ear aeration following canal wall down mastoidectomy was formulated.

RESULTS: Twenty-five ears were included in the study. Ninety-two per cent of cases showed some degree of neo-tympanic membrane retraction, ranging from mild to very severe.

CONCLUSION: After more than six months following canal wall down mastoidectomy, the degree of retracted neo-tympanic membranes and exteriorised attics was significant. Eustachian tube dysfunction leading to negative middle-ear aeration was present even after the canal wall down procedure. However, there was no development of cholesteatoma, despite persistent retraction.

Fulltext Hearing rehabilitation in congenital canal atresia

Mazita A, Fazlina WH, Abdullah A, Goh BS, Saim L

Singapore Med J, 2009 Nov;50(11):1072-6.

PMID: 19960162

The purpose of this study was to review the results of our patients with congenital canal atresia after implantation of bone-anchored hearing aids (BAHA). The occurrence of complications was also reviewed.

Displaying publications 1 - 20 of 51 in total