Displaying publications 1 - 20 of 33 in total

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  1. Tun M, Salekan K, Sain AH
    Malays J Med Sci, 2003 Jan;10(1):86-9.
    PMID: 23365506 MyJurnal
    From 1996 to 2001, 393 thyroidectomies were performed and 25 (6.4%) patients underwent reoperative thyroid surgery at Hospital Universiti Sains Malaysia. All reoperated patients had undergone one prior thyroid operation. All were females with an average age of 39.1 years (18-61 years). The most frequent indication for reoperation was cancer in resected specimen of an originally misdiagnosed carcinoma treated by partial thyroid resection. Final histological diagnosis of 25 reoperations showed thyroid carcinoma in 22 (88%) cases and multinodular goiter in 3 cases. The overall interval between the initial and the reoperative procedures ranged from 3 weeks to 15 years. There was no post-operative mortality after reoperation. Post-operative complications were discovered in 5 patients, as 3 (12%) of whom had transient hypocalcaemia, one (4%) had wound breakdown and one (4%) had permanent recurrent laryngeal nerve palsy. Reoperative thyroid surgery is an uncommon operation with high complication rate.
    Matched MeSH terms: Vocal Cord Paralysis
  2. Teoh CM, Rohaizak M, Chan KY, Jasmi AY, Fuad I
    Asian J Surg, 2005 Apr;28(2):90-6.
    PMID: 15851360
    This study reviewed the incidence of positive pre-ablative diagnostic scan after total thyroidectomy and the efficacy of the current ablative dose. The predictive factors for outcome using a standard ablative dose and postoperative complications of total thyroidectomy were also examined.
    Matched MeSH terms: Vocal Cord Paralysis
  3. Prepageran N, Raman R
    Med J Malaysia, 2005 Aug;60(3):377-8.
    PMID: 16379198
    Radiotherapy is the accepted treatment for early laryngeal carcinomas with the advantage of voice preservation. It is however, not without complications. We report a case of bilateral vocal cord immobility 15 years after radiotherapy. This appears to be due to ankylosis of cricoarytenoid joint and fibrosis of the larynx.
    Matched MeSH terms: Vocal Cord Paralysis/etiology*; Vocal Cord Paralysis/pathology*
  4. Norly, S., Noorizan, Y., Ros’aini, P.
    MyJurnal
    We present a case of 80-year-old man with two-year history of hoarseness of voice secondary to left vocal cord paralysis. CT scanning revealed a saccular thoracic aneurysm compressing the left recurrent laryngeal nerve. A review of literature on Ortner's or cardiovocal syndrome is presented.
    Matched MeSH terms: Vocal Cord Paralysis
  5. Nasir ZM, Azman M, Baki MM, Mohamed AS, Kew TY, Zaki FM
    Surg Radiol Anat, 2021 Aug;43(8):1225-1233.
    PMID: 33388863 DOI: 10.1007/s00276-020-02639-9
    PURPOSE: This study aims to determine laryngeal dimension in relation to all three transcutaneous injection laryngoplasty (TIL) approaches (thyrohyoid, transthyroid and cricothyroid) using three-dimensionally reconstructed Computed Tomography (CT) scan and compare the measurements between sex, age group and ethnicity.

    METHODS: CT scans of the neck of two hundred patients were analysed by two groups of raters. For thyrohyoid approach, mean distance from the superior border of the thyroid cartilage to the laryngeal cavity (THd) and mean angle from the superior border of the thyroid cartilage to mid-true cords (THa) were measured. For transthyroid approach, mean distance from mid-thyroid cartilage to mid-true cords (TTd) and Hounsfield unit (HU) at mid-thyroid cartilage (TTc) were measured. For cricothyroid approach, mean distance from the inferior border of the thyroid cartilage to the laryngeal cavity (CTd) and mean angle from the inferior border of the thyroid cartilage to mid-true cords (CTa) were measured.

    RESULTS: There were statistically significant differences between males and females for all measurements except for CTa (p  0.05). There was a significant fair positive correlation between age and TTc (p = 0.0002). For all measurements obtained, there were moderate to excellent inter-group consistency and intra-rater reliability.

    CONCLUSION: This study demonstrated a significant sex dimorphism that may influence the three TIL approaches except for needle angulation in the cricothyroid approach. The knowledge of laryngeal dimension is important to increase success in TIL procedure.

    Matched MeSH terms: Vocal Cord Paralysis/surgery*
  6. Munshi A, Pandey MB, Kumar L, Karak AK, Mohanti BK
    Med J Malaysia, 2006 Mar;61(1):97-9.
    PMID: 16708743
    Malignancy is the most common cause of tracheoesophageal fistulas. The malignancies commonly implicated in the development of tracheoesophageal fistulas are primary bronchial or esophageal carcinomas. Hodgkins disease rarely leads to such a fistula. We report a case of Hodgkin's disease with a tracheoesophageal fistula as well as a left recurrent nerve palsy at presentation. This presentation has no precedent in literature. The patient was treated with systemic chemotherapy and involved field radiotherapy. On follow up 1 year after the completion of treatment, he was clinically and radiologically disease free.
    Matched MeSH terms: Vocal Cord Paralysis/diagnosis*; Vocal Cord Paralysis/physiopathology
  7. Mohd Umbaik NA, Mohamad I, Nik Hassan NFH
    J Craniofac Surg, 2020 10;31(7):2064-2065.
    PMID: 32890162 DOI: 10.1097/SCS.0000000000006839
    Matched MeSH terms: Vocal Cord Paralysis*
  8. Mohamed AL, Zain MM
    Malays J Med Sci, 2004 Jul;11(2):65-8.
    PMID: 22973129 MyJurnal
    Rheumatic mitral stenosis is prevalent in this part of the world and it gives rise to wide array of manifestations. However, hoarseness of voice secondary to recurrent laryngeal nerve paralysis (Ortner's syndrome) is an uncommon manifestation. This case illustrates an uncommon presentation in a common disease. A 29-year-old lady presented with a 2-year history of hoarseness of voice. Physical examination revealed a mid-diastolic murmur and left vocal cord paralysis. Echocardiography confirmed mitral stenosis with pulmonary hypertension. She underwent percutaneous mitral balloon valvotomy in 1991 with return of normal speech after a few months. The recurrent laryngeal nerve paralysis is mainly due to the compression by an enlarged pulmonary artery as initially thought. This complication is rarely seen nowadays due to greater awareness of the disease and earlier intervention. With the advent of percutaneous transvenous mitral valvotomy in the nineties, effective non-surgical intervention is plausible.
    Matched MeSH terms: Vocal Cord Paralysis
  9. Mohamad I, Jihan WS, Mohamad H, Abdullah B
    Malays J Med Sci, 2008 Jan;15(1):42-3.
    PMID: 22589614
    Bilateral abductor vocal cord palsy is comparatively a rare vocal cord lesion, especially in a patient with no history of neck mass, previous surgery or trauma. Many patients are not stridulous. A patient presenting with stridor may need emergency airway management before the other treatment is commenced. We report a case of bilateral abductor palsy which required an emergency tracheostomy and subsequently a laser posterior cordectomy.
    Matched MeSH terms: Vocal Cord Paralysis
  10. Misron K, Balasubramanian A, Mohamad I, Hassan NF
    BMJ Case Rep, 2014;2014.
    PMID: 24663247 DOI: 10.1136/bcr-2013-201033
    Bilateral vocal cord paralysis is a known possible complication following thyroid surgery. It owes to the close relationship between the recurrent laryngeal nerve and the thyroid gland. The most feared complication of bilateral vocal cord paralysis is airway compromise. We report the case of a 39-year-old woman who underwent total thyroidectomy for multinodular goitre. The surgery was uneventful. However she developed stridor in the recovery bay needing intubation. We postulate that the cause was attributed to bilateral vocal cord paresis due to the use of the intraoperative nerve monitoring (IONM) whose high setting throughout the surgery was overlooked. She made a complete recovery without the need of a tracheostomy. We share our lessons learnt from this case.
    Matched MeSH terms: Vocal Cord Paralysis/etiology*
  11. Mawaddah A, Marina MB, Halimuddin S, Mohd Razif MY, Abdullah S
    Malays J Med Sci, 2016 Jul;23(4):65-70.
    PMID: 27660547 MyJurnal DOI: 10.21315/mjms2016.23.4.9
    Bilateral vocal fold immobility (BVFI) is commonly caused by injury to the recurrent laryngeal nerve (RLN) and leads to stridor and dyspnea of varying onsets. A retrospective study was done at the Department of Otorhinolaryngology of Universiti Kebangsaan Malaysia Medical Centre on laser microsurgical posterior cordectomy for BVFI. The objectives were to identify the average duration of onset of stridor from the time of insult and to evaluate the outcome of laser posterior cordectomy as a surgical option. From 1997 to 2007, a total of 31 patients with BVFI were referred for surgery. Twelve patients had tracheostomy done prior to the procedure, whereas 19 patients were without tracheostomy. Ten patients were successfully decannulated, and only 4 patients had complications related to the procedure. The minimum onset of stridor was 7 months, maximum onset of stridor was 28 years, and the mean onset of stridor was 8.7 years. The commonest complication observed was posterior glottic adhesion following bilateral posterior cordectomy. Laser endolaryngeal posterior cordectomy is an excellent surgical option as it enables successful decannulation or avoidance of tracheostomy in patients with BVFI. The onset of stridor took years after the insult to the recurrent laryngeal nerves.
    Matched MeSH terms: Vocal Cord Paralysis
  12. Mat Baki M, Clarke P, Birchall MA
    J Laryngol Otol, 2018 Sep;132(9):846-851.
    PMID: 30180919 DOI: 10.1017/S0022215118000476
    OBJECTIVE: This prospective case series aimed to present the outcomes of immediate selective laryngeal reinnervation.

    METHODS: Two middle-aged women with vagal paraganglioma undergoing an excision operation underwent immediate selective laryngeal reinnervation using the phrenic nerve and ansa cervicalis as the donor nerve. Multidimensional outcome measures were employed pre-operatively, and at 1, 6 and 12 months post-operatively.

    RESULTS: The voice handicap index-10 score improved from 23 (patient 1) and 18 (patient 2) at 1 month post-operation, to 5 (patient 1) and 1 (patient 2) at 12 months. The Eating Assessment Tool 10 score improved from 20 (patient 1) and 24 (patient 2) at 1 month post-operation, to 3 (patient 1) and 1 (patient 2) at 12 months. There was slight vocal fold abduction observed in patient one and no obvious abduction in patient two.

    CONCLUSION: Selective reinnervation is safe to perform following vagal paraganglioma excision conducted on the same side. Voice and swallowing improvements were demonstrated, but no significant vocal fold abduction was achieved.

    Matched MeSH terms: Vocal Cord Paralysis/etiology; Vocal Cord Paralysis/surgery
  13. Lum SG, Baki MM, Yunus MRM
    PMID: 33707119 DOI: 10.1016/j.bjorl.2021.01.006
    BACKGROUND: Neurofibromas are benign peripheral nerve sheath tumours. Hypoglossal nerve neurofibromas in cervical region are relatively rare, bilateral occurrence is extremely rare.

    METHODS: A 32-year-old man with type 1 neurofibromatosis presented with bilateral neck masses. Magnetic resonance imaging showed parapharyngeal masses consistent with neurogenic tumours, most likely neurofibromas.

    RESULTS: Surgical exploration through lateral cervical approach revealed unexpected finding of the tumour that arose from the hypoglossal nerve. The tumour had totally engulfed the nerve with no normal nerve fascicles identifiable, thus resected in toto. In the postoperative course, the patient developed right hypoglossal palsy and vocal fold palsy treated with augmentation of the paralysed vocal fold with temporary injection material.

    CONCLUSIONS: The authors described a patient with type 1 neurofibromatosis with neurofibroma originating from cervical part of hypoglossal nerve. This paper discussed this rare condition and the management on how to improve the treatment outcome.

    Matched MeSH terms: Vocal Cord Paralysis
  14. Lum SG, Noor Liza I, Priatharisiny V, Saraiza AB, Goh BS
    Malays Fam Physician, 2016;11(1):2-6.
    PMID: 28461841 MyJurnal
    BACKGROUND: Conditions causing stridor in paediatric patients can range from minor illnesses to life-threatening disorders. Proper evaluation and correct diagnosis are essential for timely intervention. The objective of this study was to determine the aetiological profiles and the management of paediatric patients with stridor referred to the Otorhinolaryngology Department of Hospital Serdang.

    METHODS: Medical records of all paediatric patients presenting with symptom of stridor from January 2010 to February 2015 were reviewed retrospectively. The patients' demographic data, clinical notes, laryngoscope findings, diagnosis and management were retrieved and analysed.

    RESULTS: Out of the total 137 patients referred for noisy breathing, 121 patients had stridor and were included in this study. There were 73 males and 48 females-most were of Malay ethnicity (77.7%). The age of presentation ranged from newborn to 10 years, with a mean of 4.9 months. Eighteen patients (14.9%) had associated congenital pathologies. The majority were congenital causes (90.9%), in which laryngomalacia was the commonest (78.5%), followed by subglottic stenosis (5.0%), vallecular cyst (2.5%) and congenital vocal fold paralysis (2.5%). Twelve patients (9.9%) had synchronous airway lesion. The majority of the patients were managed conservatively. Thirty-one patients (25.6%) required surgical intervention, of which only one needed tracheostomy.

    CONCLUSION: Laryngomalacia was the commonest cause of stridor among paediatric patients. A synchronous airway lesion should be considered if the child has persistent or severe symptoms. The majority of the patients were managed conservatively.

    Matched MeSH terms: Vocal Cord Paralysis
  15. Lo SM, Ramarmuty HY, Kannan K
    Respirol Case Rep, 2021 Mar;9(3):e00718.
    PMID: 33614038 DOI: 10.1002/rcr2.718
    Ortner syndrome or cardiovocal syndrome is hoarseness of voice due to left recurrent laryngeal nerve palsy as a result of cardiovascular abnormality. It is not known that pneumothorax has any association with Ortner syndrome. A 56-year-old gentleman, with previous history of 20 pack-year smoking and 1-year history of hypertension, presented to us with cough for two weeks with intermittent haemoptysis, as well as hoarseness of voice for the past one year. Direct laryngoscopy confirmed that he had left vocal cord palsy. Clinical and radiological investigations suggested that he had left pneumothorax. Left chest tube thoracostomy was performed and computed tomography of chest revealed aortic isthmus aneurysm with dissection extending to distal left common iliac artery and residual left hydropneumothorax. The patient was then referred to the vascular team and cardiothoracic team for further management.
    Matched MeSH terms: Vocal Cord Paralysis
  16. Lee SS
    Med J Malaysia, 1990 Sep;45(3):239-43.
    PMID: 2152086
    Six of 16 patients presenting to the University Hospital Kuala Lumpur with unilateral recurrent laryngeal nerve paralysis were treated with teflon injection of the paralysed vocal cord. The results are presented and the role of surgical therapy, in particular teflon injection is reviewed.
    Matched MeSH terms: Vocal Cord Paralysis/pathology; Vocal Cord Paralysis/therapy*
  17. Latiff ZA, Kamal NA, Jahendran J, Alias H, Goh BS, Syed Zakaria SZ, et al.
    J Pediatr Hematol Oncol, 2010 Jul;32(5):407-10.
    PMID: 20505534 DOI: 10.1097/MPH.0b013e3181e01584
    Vincristine-induced vocal cord paralysis is a rare but serious complication. We report 2 patients with acute lymphoblastic leukemia who developed progressive stridor during induction chemotherapy. There were no clinical features of peripheral or autonomic neuropathy. Flexible laryngoscopy confirmed the diagnosis of bilateral vocal cord palsy; interestingly, the nerve conduction test revealed axonal motor neuropathy involving the median and common peroneal nerves in both patients. The first patient required prolonged ventilatory support necessitating unilateral cordectomy before extubation, whereas the second only required supplemental oxygen therapy. There was resolution of stridor in the first patient after cordectomy and gradual clinical improvement in the second. These cases illustrate that a high index of suspicion of vincristine-induced vocal cord palsy with prompt otolaryngology consultation for laryngoscopy is required in the diagnostic evaluation of a patient who has received vincristine.
    Matched MeSH terms: Vocal Cord Paralysis/chemically induced*; Vocal Cord Paralysis/drug therapy
  18. Johari SF, Azman M, Mohamed AS, Baki MM
    J Laryngol Otol, 2020 Dec;134(12):1085-1093.
    PMID: 33308327 DOI: 10.1017/S0022215120002558
    OBJECTIVE: To evaluate voice intensity as the primary outcome measurement when treating unilateral vocal fold paralysis patients.

    METHODS: This prospective observational study comprised 34 newly diagnosed unilateral vocal fold paralysis patients undergoing surgical interventions: injection laryngoplasty or medialisation thyroplasty. Voice assessments, including maximum vocal intensity and other acoustic parameters, were performed at baseline and at one and three months post-intervention. Maximum vocal intensity was also repeated within two weeks before any surgical interventions were performed. The results were compared between different time points and between the two intervention groups.

    RESULTS: Maximum vocal intensity showed high internal consistency. Statistically significant improvements were seen in maximum vocal intensity, Voice Handicap Index-10 and other acoustic analyses at one and three months post-intervention. A significant moderate negative correlation was demonstrated between maximum vocal intensity and Voice Handicap Index-10, shimmer and jitter. There were no significant differences in voice outcomes between injection laryngoplasty and medialisation thyroplasty patients at any time point.

    CONCLUSION: Maximum vocal intensity can be applied as a treatment outcome measure in unilateral vocal fold paralysis patients; it can demonstrate the effectiveness of treatment and moderately correlates with self-reported outcome measures.

    Matched MeSH terms: Vocal Cord Paralysis/diagnosis; Vocal Cord Paralysis/surgery*
  19. Jaafar R, Mohamad I
    Malays Fam Physician, 2014;9(1):25-7.
    PMID: 25606294 MyJurnal
    Unilateral vocal cord palsy secondary to thoracic aortic aneurysm is a rare occurrence. Direct compression of the enlarging thoracic aneurysm on the left recurrent laryngeal nerve causes neuronal injury of the nerve, which is manifested as hoarseness. We present a rare case of unilateral vocal cord palsy in a 60-year-old healthy gentleman caused by a large thoracic aortic aneurysm. This rare presentation, with a serious underlying pathology might be misdiagnosed or delayed. Therefore, it is important for us to have high index of suspicion in cases with a rare presentation such as this.
    Matched MeSH terms: Vocal Cord Paralysis
  20. Irfan M, Yaroko AA, Soleh MN, Periasamy C
    Med J Malaysia, 2013 Apr;68(2):183-5.
    PMID: 23629575
    A massive goiter may constrict the trachea resulting in shortness of breath. Recurrent laryngeal nerve compression may cause vocal cord paralysis. We highlight a case of a 62- year-old female with a 30 year history of an anterior neck swelling gradually increasing in size. She presented with acute symptoms of upper airway obstruction and voice changes. Emergency thyroidectomy was performed by dividing the middle part of the gland using ultrasonic scissors. The recovery was uneventful and the patient regained normal vocal cord function post operatively.
    Matched MeSH terms: Vocal Cord Paralysis*
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