Displaying publications 1 - 20 of 28 in total

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  1. Ramasamy K, Saniasiaya J
    Iran J Otorhinolaryngol, 2021 Jul;33(117):249-251.
    PMID: 34395326 DOI: 10.22038/ijorl.2021.51303.2752
    Introduction: Clicking larynx syndrome is a rare condition that may be intriguing to the attending clinician. Patients typically present with clicking sensations in the neck, often obvious during head movement or swallowing. Due to the scarce presentation of such cases, clicking larynx syndrome harbors a high propensity to be an overlooked diagnosis, resulting in a clinical stalemate.

    Case Report: Herein, we present a case of clicking larynx in a young girl followed by an overview of the latest literature on the aetiology and treatment options. This case aims to reinforce the presence of this entity further and subsequently increase its awareness among clinicians.

    Conclusion: Expeditious diagnosis is imperative not just for the eventual treatment but also for timely relief to the anxious patients who would have been perplexed by the strange clicking in the throat.

  2. Jalaei B, Zakaria MN, Sidek D
    Iran J Otorhinolaryngol, 2017 Jan;29(90):53-57.
    PMID: 28229064
    INTRODUCTION: Noonan syndrome (NS) is a heterogeneous genetic disease that affects many parts of the body. It was named after Dr. Jacqueline Anne Noonan, a paediatric cardiologist.

    CASE REPORT: We report audiological tests and auditory brainstem response (ABR) findings in a 5-year old Malay boy with NS. Despite showing the marked signs of NS, the child could only produce a few meaningful words. Audiological tests found him to have bilateral mild conductive hearing loss at low frequencies. In ABR testing, despite having good waveform morphology, the results were atypical. Absolute latency of wave V was normal but interpeak latencies of wave's I-V, I-II, II-III were prolonged. Interestingly, interpeak latency of waves III-V was abnormally shorter.

    CONCLUSION: Abnormal ABR results are possibly due to abnormal anatomical condition of brainstem and might contribute to speech delay.

  3. Tan SH, Chong AW, Prepageran N
    Iran J Otorhinolaryngol, 2015 Sep;27(82):391-4.
    PMID: 26568944
    INTRODUCTION: Atypical infratemporal fossa infections are rare and potentially fatal.

    CASE REPORT: A case of an aspergillosis localized in the infratemporal fossa and another case of tuberculosis of the infratemporal fossa originating from the maxillary sinus, is described. The first patient was immunocompromised and showed symptoms of facial numbness; whereas the other was an immunocompetent man who complained of trigeminal neuralgia type pain. It was difficult to differentiate between infection and tumour despite the utilization of computed tomography scans and magnetic resonance imaging.

    CONCLUSION: These cases illustrate the need for a high index of suspicion; in addition to endoscopic confirmation and histopathology to establish precise diagnosis and early intervention.

  4. Tan SH, Hindi KW, Chandran PA, Chong AW
    Iran J Otorhinolaryngol, 2015 May;27(80):243-6.
    PMID: 26082908
    INTRODUCTION: A rare case of basaloid squamous cell carcinoma (BSCC) of the larynx, which has not been previously reported, is described.

    CASE REPORT: A 60-year-old man was presented to the Otolaryngology Department with progressive dyspnoea and dysphagia to solids for over a period of 1 week. Direct laryngoscopy revealed a tumour at the laryngeal aspect of the epiglottis, which prolapsed into the laryngeal inlet each time the patient inspired. This resulted in an inspiratory stridor despite adequate glottic opening and normal mobility of the vocal cords.

    CONCLUSION: Therefore, in cases where a ball-valve lesion causes intermittent life-threatening airway obstruction, BSCC of the larynx, though rare, must be considered as a differential diagnosis.

  5. Goh LC, Norain RS, Shifa Z, Manuel AM
    Iran J Otorhinolaryngol, 2019 Nov;31(107):383-386.
    PMID: 31857983 DOI: 10.22038/ijorl.2019.35910.2186
    Introduction: Branchial arch anomalies represent defects in embryological developments whereby parts of the branchial arch persist in the head and neck regions as sinuses, fistulas, or cysts. These anomalies usually present as a unilateral lesion in the head and neck of young adults and children, which are excised upon the emergence of complications.

    Case Report: Herein, we presented a rare case of a 4-year-old child, who had been diagnosed with a complete bilateral second arch branchial fistula. The excision was made using the bilateral stepladder approach and tonsillectomy.

    Conclusion: The bilateral stepladder approach was a feasible method in excising a complete bilateral branchial fistula. However, larger-scale studies should be conducted on the surgical techniques of bilateral branchial fistulae excision in order to optimize the cosmetic outcome of the surgery.

  6. Faramarzi M, Shishegar M, Tofighi SR, Sharouny H, Rajagopalan R
    Iran J Otorhinolaryngol, 2019 Jan;31(102):11-17.
    PMID: 30783594
    Introduction: There are a few studies that compare the outcomes between primary and revision tympanoplasties. The purpose of the present study was to compare the results of type I tympanoplasty (i.e., synonymous to myringoplasty) and revision myringoplasty based on the closure of tympanic membrane perforation and hearing improvement.

    Materials and Methods: This prospective single-blind study was carried out on a total of 240 patients with tympanic membrane perforation at a tertiary referral center. The subjects underwent primary or revision myringoplasty. Grafting success rate and hearing results were measured and the comparison between the primary and revision groups was drawn.

    Results: Grafting success rate was reported as 96.6% (112 out of 116 cases) for myringoplasty, while in revision myringoplasty the success rate of 78.2% (97 out of 124 patients) was achieved (P=0.001). Speech reception threshold was 23.1±9.2 dB and 24.9±13.1 dB in the primary and revision groups, respectively (P>0.05). However, the percentage of air-bone gap on audiometry≤20 dB were 83.8% and 76% in the primary and revision groups, respectively (P=0.26).

    Conclusion: The findings of the present study have shown that although grafting success was reported significantly better in myringoplasty (tympanoplasty type 1), compared to that in revision myringoplasty, it did not reveal any superiority over revision tympanoplasty regarding the hearing outcomes. No consensus was achieved due to a great number of controversies in the literature.

  7. Sai-Guan L, Husain S, Zahedi FD, Ahmad N, Gendeh BS
    Iran J Otorhinolaryngol, 2020 Jul;32(111):213-222.
    PMID: 32850509 DOI: 10.22038/ijorl.2019.34346.2138
    Introduction: Sniffin' Sticks smell identification test is a tool used for evaluation of olfactory function but the results are culture-dependent. It relies on the subject's familiarity to the odorant and descriptors. This study aims to develop the Malaysian version of Sniffin' Sticks smell identification test suitable for local population usage.

    Materials and Methods: The odorant descriptors and distractors of the original version of Sniffin' Sticks were translated into Malay language. It was then tested for familiarity and identifiability in 30 normosmic subjects. The descriptors were replaced until the familiarity of all descriptors and identification rates of odorants achieved ≥ 70%. The validity of the new cultural-adapted version was tested in 60 hypo-anosmic subjects and 60 normosmic subjects with Student t-test. The test-retest reliability was evaluated after two weeks with interclass correlation.

    Results: Two odorant descriptors and nine distractors achieved familiarity <70% (13.3% - 66.7%) and were replaced. Another three culturally inappropriate distractors were also replaced. The mean score among the healthy subjects was significantly higher than the subject with smell dysfunction [13.7 (1.12) and 7.3 (3.42); t = 7.24 (df = 34.23), P<0.001]. The coefficient of correlation (r) between test and retest scores was 0.93 (P<0.001).

    Conclusion: The cultural adapted Malaysian version of Sniffin' Sticks smell identification test is valid and has high test-retest reliability. This is the first smell identification test validated in Malaysia. It is effective for evaluation of olfactory function in local population.

  8. Arwanda MD, Haryuna TS, Adriztina I, Khalid K
    Iran J Otorhinolaryngol, 2023 Jul;35(129):189-197.
    PMID: 37497164 DOI: 10.22038/IJORL.2023.71786.3452
    INTRODUCTION: This study, assess the efficacy of curcumin therapy in preventing/improving cochlear damage in Rattus norvegicus ototoxic model as evaluated with OAE examination.

    MATERIALS AND METHODS: This study utilized 27 rats which had been injected with single dose 8mg/KgBB of cisplatin, and then divided into 3 groups. The first group was not given curcumin. The second group received curcumin at a dose of 150 mg/KgBB. The third group received curcumin at a dose of 300 mg/KgBB. Curcumin was given from the time of single dose cisplatin injection (day 0) to day 7. OAE examination was performed on the day before the single dose of cisplatin (day 0), day 3, 4 and 7 after curcumin administration.

    RESULTS: There was a decline in the average value of SNR in all groups starting from high frequency. However, in the rat groups receiving curcumin there was a slow decrease in the SNR value, which also obtained statistically significant differences in the SNR values of all groups.

    CONCLUSION: Administration of certain doses of curcumin may reduce the modest and statistically insignificant decrease in mean SNR values indicating a reduction in ototoxicity from cisplatin.

  9. Lee CH, Hayati F, Azizan N, Sharif SZ
    Iran J Otorhinolaryngol, 2023 Nov;35(131):325-328.
    PMID: 38074483 DOI: 10.22038/IJORL.2023.73099.3471
    INTRODUCTION: Ectopic thyroid is an uncommon condition resulting from the aberrant development of the normal thyroid gland and is usually found along the thyroglossal tract: lingual, submandibular, thyroglossal cysts, intra-tracheal and mediastinal, or, on rare occasions, in the adrenal gland, gallbladder, gastrointestinal tract, pancreas, and struma ovarii.

    CASE REPORTS: We describe a novel case where primary papillary thyroid carcinoma (PTC) was found after a trans-oral excision of a tumor containing ectopic thyroid tissue at the posterior pharynx, an area not known to be a location for ectopic thyroid. Delays due to the COVID-19 pandemic resulted in regional cervical metastases and multifocal PTC. The female patient successfully underwent total thyroidectomy, selective cervical and central lymph node dissection, followed by adjuvant radioactive iodine ablation, with no evidence of distant metastases.

    CONCLUSIONS: Ectopic thyroid tissue is uncommon and may be in the posterior pharynx. The principles of management remain those of differentiated thyroid malignancy: complete surgical resection of any tumor focus, total thyroidectomy, and node dissection of involved lymph nodes, followed by adjuvant radioactive iodine in iodine-sensitive tumors.

  10. Saraniti C, Greco G, Verro B, Lazim NM, Chianetta E
    Iran J Otorhinolaryngol, 2021 May;33(116):127-135.
    PMID: 34222103 DOI: 10.22038/ijorl.2021.51485.2746
    Introduction: Narrow band imaging (NBI) is a powerful tool that allows visualizing the mucosal and submucosal vasculature. Among the available diagnostic techniques, NBI is one of the most valid for early detection of oral squamous cell carcinoma (OSCC).

    Materials and Methods: We carried out a bibliographic search in PubMed, Scopus and Web of Science databases using relevant keywords. Articles selected were screened by two independent authors based on inclusion and exclusion criteria. Nine papers were singled out according to the eligibility criteria and included in this review. We investigated the articles for pooled sensitivity, specificity, accuracy, positive predictive value and negative predictive value of pre-operative NBI.

    Results: The use of NBI examination in the oral cavity revealed higher specificity, sensitivity, positive and negative predictive values and accuracy compared to white light examination for the diagnosis of oral squamous cell cancer (OSCC). In addition, NBI has proved great utility in detecting malignancy features in oral pre-malignant lesions.

    Conclusions: This review shows that NBI is a powerful tool for examining oral suspicious lesions. Most of the articles examined revealed high values of sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detection of oral malignant and pre-malignant lesions. Therefore, the use of NBI is highly recommended for the early detection of oral cancer and potentially malignant disorders. Future studies should seek to affirm the validity of NBI and in particular to standardize NBI classification.

  11. Tey KJ, Goh BS, Mohd-Zaki F
    Iran J Otorhinolaryngol, 2020 Nov;32(113):391-395.
    PMID: 33282788 DOI: 10.22038/ijorl.2020.45727.2501
    Introduction: Ectopic thymus is an uncommon cause of neck masses in children that frequently present as lateral cervical swelling especially on the right side.

    Case Report: We report two cases with atypical clinical presentation of ectopic thymus and superior herniation of normal thymus. Both of the patients manifested as intermittent midline mass at the suprasternal region during Valsalva manuevre. Unique ultrasound features with the location along the thymic descent together with dynamic assessment of the organ movement were essential to reach the correct diagnosis. Conservative approach was considered in these patients considering the necessity of thymus in the process of puberty.

    Conclusion: High index of suspicion is of utmost importance when encounter patient with similar clinical manifestation to avoid unnecessary diagnostic modalities and surgeries. Accurate diagnosis will also alleviate parents' anxiety.

  12. Wong HT, Sien Hui T, Chong AW
    Iran J Otorhinolaryngol, 2016 May;28(86):183-8.
    PMID: 27429946
    Tonsillectomy is one of the most common procedures performed by Ear, Nose, and Throat surgeon. Usually, the procedure is carried out as an inpatient surgery. With the increasing need to reduce healthcare costs, spare precious hospital beds, and shorten elective surgery lists, there is currently a trend towards performing tonsillectomy on a daycare basis.
  13. Goh LC, Wan MH, Shashi G, Elangkumaran S
    Iran J Otorhinolaryngol, 2018 Jul;30(99):225-229.
    PMID: 30083529
    Introduction: This study aims to report a rare case of a respiratory epithelial adenomatoid hamartoma (REAH) of the lateral nasal wall that had initially presented as a fungating mass, similar to that of a sinonasal malignancy, and its complete removal from the lateral nasal wall.

    Case Report: We report the case of a 58-year-old woman who presented to us with a chief complaint of recurrent right-sided epistaxis and nasal blockage for the past 4 months, which was progressively worsening. Histopathological examination confirmed the presence of a REAH instead of a sinonasal malignancy. The tumor was surgically excised from the lateral nasal wall using electrocautery under endoscopic guidance. The patient was then carefully followed-up after surgery, and the wound was successfully healed 3 months after the initial surgery. There was no evidence of recurrence 6 months after the initial surgery.

    Conclusion: This case demonstrates the rare presentation of a REAH, which had arisen from the lateral nasal wall. Clinically, it is difficult to distinguish a REAH from a more notorious mass such as a sinonasal malignancy. Therefore, biopsy is mandatory in all cases of lateral nasal mass in order to rule out malignancy before confirming nasal REAH. Fortunately, as seen in this case, a lateral nasal REAH, once diagnosed, can be safely and easily removed from the lateral nasal wall using electrocautery with good surgical outcomes and a low rate of recurrence.

  14. Subha ST, Nordin AJ
    Iran J Otorhinolaryngol, 2018 Nov;30(101):361-364.
    PMID: 30560103
    Introduction: Metastatic tumors of the temporal bone are extremely rare. Collet-Sicard syndrome is an uncommon condition characterized by unilateral palsy of the lower four cranial nerves. The clinical features of temporal bone metastasis are nonspecific and mimic infections such as chronic otitis media and mastoiditis.

    Case Report: This report describes a rare case of metastatic adenocarcinoma of the temporal bone causing Collet-Sicard syndrome, presenting with hearing loss, headache and ipsilateral cranial nerve palsies. The patient was a 68-year old woman initially diagnosed with extensive mastoiditis and later confirmed as having metastatic adenocarcinoma of the temporal bone, based on histopathologic findings.

    Conclusion: Clinical presentation of metastatic carcinoma of the temporal bone can be overshadowed by infective or inflammatory conditions. This case report is to emphasize the point that a high index of clinical suspicion is necessary for the early diagnosis of this aggressive disease which carries relatively poor prognosis. This report highlights that it is crucial to suspect malignant neoplasm in patients with hearing loss, headache and cranial nerve palsies.

  15. Jumaat AF, Mohamad Yunus MR, Yong DJ, Md Zin RR, Mat Baki M
    Iran J Otorhinolaryngol, 2023 Mar;35(127):101-108.
    PMID: 37223400 DOI: 10.22038/IJORL.2023.57806.2995
    INTRODUCTION: An abnormal mass in the head and neck involving the supraglottic and cervical region offers a wide range of differential diagnoses. The pathology is either benign or malignant in nature. Castleman disease (CD) is an uncommon lymphoproliferative disorder characterised by hypervascular lymphoid hyperplasia and is classified into unicentric or multicentric disease. Histopathologically it is divided into hyaline vascular (HV), plasma cell (PC), and mixed cellularity variants. The multicentric disease is linked with PC and has the propensity to progress to lymphoma or Kaposi Sarcoma.

    CASE REPORT: We report a case of a 45-year-old gentleman who presented with a painless anterior neck swelling and left supraglottic mass for six months. Computed tomography (CT) contrast imaging demonstrated a homogenous enhancing lesion at the left supraglottic and the midline of the anterior neck with erosive changes of the thyroid cartilage. A surgical resection of the anterior neck mass was performed. The diagnosis of Castleman disease plasma cell variant was made by histopathologic evaluation. The patient remained well post-resection.

    CONCLUSION: Supraglottic multicentric Castleman disease is the least expected diagnosis in this case. Unicentric disease is treated with surgery. However, limited studies are available in determining the effectiveness of surgery in multicentric diseases. The plasma cell variant requires a multidisciplinary and multimodal approach due to an inclination towards malignancy. Research is needed to determine the role of surgery in multicentric disease and to develop optimum guidelines for managing cases. To date, there is unsubstantial literature describing supraglottic multicentric disease.

  16. Ameen SA, Salina H, Zahedi FD, Primuharsa-Putra SH, Masir N
    Iran J Otorhinolaryngol, 2019 May;31(104):191-195.
    PMID: 31223601
    Introduction: Angiomyolipoma (AML), a benign mesenchymal tumor that commonly arises from the kidney, may be associated with tuberous sclerosis complex and perivascular epithelioid cell tumors (PEComas). Nasal angiomyolipoma is very rare and usually occurs in elderly individuals with epistaxis and nasal obstruction.

    Case Report: We report a rare case of nasal angiomyolipoma in a young male. To the best of our knowledge, this is the first documented case of angiomyolipoma originating from the posterior end of the inferior turbinate, clinically mimicking juvenile nasopharyngeal angiofibroma (JNA). The tumor was removed completely via coblator-assisted endoscopic sinus surgery. The patient was asymptomatic at a 2-year follow-up.

    Conclusion: Nasal AML located in the posterior nasal cavity in a male patient can mimic the presentation of JNA. A computed tomography scan of the paranasal sinuses played an important role in differentiating nasal AML from JNA. The coblator-assisted endoscopic technique is useful in controlling intraoperative hemostasis in the removal of a suspicious vascular tumor.

  17. Sai-Guan L, Min-Han K, Kah-Wai N, Mohamad-Yunus MR
    Iran J Otorhinolaryngol, 2017 Mar;29(91):117-120.
    PMID: 28393061
    INTRODUCTION: Most metastatic lymph nodes from head and neck malignancy are solid. Cystic nodes are found in 33% - 61% of carcinomas arise from Waldeyer's ring, of which only 1.8% - 8% originate are from the nasopharynx. Some cystic cervical metastases were initially presumed to be branchial cleft cyst. This case report aims to highlight the unusual presentation of cystic cervical metastasis secondary to nasopharyngeal carcinoma in a young adult. The histopathology, radiological features and management strategy were discussed.

    CASE REPORT: A 36-year-old man presented with a solitary cystic cervical swelling, initially diagnosed as branchial cleft cyst. Fine needle aspiration yielded 18 ml of straw-coloured fluid. During cytological examination no atypical cells were observed. Computed tomography of the neck showed a heterogeneous mass with multiseptation medial to the sternocleidomastoid muscle. Histopathological examination of the mass, post excision, revealed a metastatic lymph node. A suspicious mucosal lesion at the nasopharynx was detected after repeated thorough head and neck examinations and the biopsy result confirmed undifferentiated nasopharyngeal carcinoma.

    CONCLUSION: Cystic cervical metastasis may occur in young patients under 40 years. The primary tumour may not be obvious during initial presentation because it mimicks benign branchial cleft cyst clinically. Retrospective review of the computed tomography images revealed features that were not characteristic of simple branchial cleft cyst. The inadequacy of assessment and interpretation had lead to the error in diagnosis and subsequent management. Metastatic head and neck lesion must be considered in a young adult with a cystic neck mass.

  18. Zazali S, Retinasekharan S
    Iran J Otorhinolaryngol, 2022 Mar;34(121):135-138.
    PMID: 35655770 DOI: 10.22038/IJORL.2021.58379.3014
    INTRODUCTION: The connection between parotid gland and external auditory canal has long been described throughout the centuries. It can act as a gateway for infectious or neoplastic material to spread between those two structures.

    CASE REPORT: To our surprise, this naturally occurring defect can serve as an option to conservatively treat a parotid abscess. We report a case of a parotid abscess with a concurrent presentation of an ipsilateral ear discharge. The purpose of our study is to highlight a unique process of resolution of parotid abscess through an opening in the ear canal.

    CONCLUSIONS: In spite of the fact that the fissure of Santorini is known as the gateway and tunnel for a disease to spread, it has proven to serve as a pathway for disease elimination as well.

  19. Subha ST, Bakri MA, Salleh H, Doi M, Nordin AJ
    Iran J Otorhinolaryngol, 2018 Jan;30(96):49-54.
    PMID: 29387664
    Introduction: Papillary thyroid carcinoma (PTC) constitutes 75-85% of all thyroid cancers. PTC usually presents as a subtle, commonly slow-growing, painless thyroid mass or a solitary nodule in the neck. This presentation of a cystic neck lump, without the presence of a thyroid nodule, may imitate the course of a benign disease, thus delaying diagnosis and proper treatment.

    Case Report: Three cases that had been initially presented as a cystic neck lesion in which a benign etiology was considered primarily were compiled in this study. PTC was only diagnosed after surgical excision of these cystic neck lesions in the first two cases, and after performing fine needle aspiration cytology (FNAC) and an 18fluorine-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET CT) scan in the latter case.

    Conclusion: PTC can sometimes present as a cystic neck mass; a presentation which is usually related to a benign lesion. This case series emphasizes that patients who appear to have a solitary cystic neck mass must be treated with a high index of clinical suspicion. Although not a first-line imaging modality, 18F-FDG-PET can be extremely useful in assessing patients with a cystic neck lesion, where diagnosis is still uncertain after standard investigations such as ultrasonography and FNAC have been performed.

  20. Subha ST, Abu-Bakar S, Prepageran N
    Iran J Otorhinolaryngol, 2019 Sep;31(106):315-318.
    PMID: 31598500
    Introduction: Parotid gland squamous cell carcinoma is an uncommon aggressive neoplasm with poor prognosis. Aural polyps are usually the presenting features of chronic suppurative otitis media, tuberculous otitis media, and adenoma or carcinoma. The malignant aural polyp is very rare. Parotid gland carcinoma masquerading as an aural polyp has rarely been described in the literature.

    Case Report: We report a case study of parotid squamous cell carcinoma in a 29-year-old male masquerading as an ear polyp.

    Conclusion: Parotid gland primary squamous cell carcinoma is a rapidly advancing neoplasm which carries poor prognosis despite multimodality treatment. Diligent clinical and histopathological evaluation is imperative to discriminate this rare aggressive disease from the metastatic and other primary cancers of the parotid. A high index of suspicion is crucial in refractory aural polyps to arrive at early diagnosis.

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