Displaying publications 21 - 40 of 51 in total

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  1. Razak A, Goh BS, Rajaran JR, Nazimi AJ
    BMJ Case Rep, 2018 May 14;2018.
    PMID: 29764822 DOI: 10.1136/bcr-2017-223586
    A 51-year-old woman a known case of stage 2 breast carcinoma in 2006 and underwent left mastectomy performed in the same year presented with bilateral lower limb pain suggestive of spinal pathology, and left chin numbness, both of 2 weeks' duration. Examination revealed left mandibular hypoesthesia without any other sign or symptoms. Orthopantomogram was unremarkable apart from mild alveolar bone expansion at tooth 36 area, which was extracted 3 months earlier. Subsequently, a full-body positron emission tomography contrast enhanced computer tomography revealed hypermetabolic lesions of her axial (excluding skull) and appendicular skeleton. In the head and neck region, left mandibular foramen and oropharynx bilaterally showed increased metabolism suggestive of tumour metastasis. The diagnosis was numb chin syndrome secondary to mandibular metastasis. Apart from supportive treatment, she was started on palliative chemotherapy and radiotherapy. At the time of discharge, there were no active complaints other than the aforementioned hypoesthesia.
  2. Rahim SA, Goh BS, Zainor S, Rahman RA, Abdullah A
    PMID: 29456939 DOI: 10.1007/s12070-017-1193-3
    The cross sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center (UKMMC), Malaysia from August 2012 to December 2013. All patients implanted with in UKMMC from December 2001 until December 2012 was included. Glasgow Benefit Inventory (GBI) questionnaires and UKMMC questionnaires were used as part of the assessment tool. The GBI is a scoring which measures the change in health status produced by surgical interventions. UKMMC questionnaires was invented by our department to assess questions related to social and life style of patients and also the cosmetic perspective Baha implant and other daily related activities. The audiological assessment was assessed using hearing aid gain threshold. Complication with regards to skin reaction was graded using Holger Skin Classification. A total of 40 patients underwent Baha implant were recruited but only 35 patients fulfilled the criteria and included in this study for analysis. Age of patients ranged from 5 year old to 38 year old, with median of 13 years old. There were 22 patients (62.8%) were male and 13 patients (37.1%) were females. Almost all cases were canal atresia except one adult patient was a case of bilateral chronic discharging ear with chronic irritation with ear mould. Majority of patients 21 (60%) have hearing level of moderate to severe hearing loss (40-89 dB) and 14 patients (40%) have mild to moderate hearing loss (20-39 dB). The level of hearing was retested post operatively. All of the patients have improvement in their aided hearing with the range of 10-25 dBL which is statistically significant at p value of <0.05. The GBI was scored positively in all subscales. Majority of patients (91.4%) used BAHA more than 4 h per day and 88.6% agreed that BAHA is cosmetically acceptable. All patients experienced some form of skin irritation (Holger grade 1-2) however only 20% required surgical intervention. All our patients have range of 10-25 dB improvement of their aided hearing which is statistically significant at p value of <0.05. BAHA has been proven to show significant benefit in audiological improvement and quality of life.
  3. Goh BS, Fadzilah N, Abdullah A, Othman BF, Umat C
    Int J Pediatr Otorhinolaryngol, 2018 Feb;105:27-32.
    PMID: 29447813 DOI: 10.1016/j.ijporl.2017.11.024
    OBJECTIVES: Cochlear implant (CI) greatly enhances auditory performance as compared to hearing aids and has dramatically affected the educational and communication outcomes for profoundly deaf children. Universiti Kebangsaan Malaysia (UKM) pioneered CI program in 1995 in the South East Asia. We would like to report the long-term outcomes of UKM paediatric cochlear implantation in terms of: the proportion of children who were implanted and still using the device, the children's modes of communication, their educational placements, and their functional auditory/oral performance. We also examined the factors that affected the outcomes measured.

    STUDY DESIGN: This was a cross sectional observational study.

    METHODS: Two sets of questionnaires were given to 126 parents or primary caregivers of the implantees. The first set of questionnaire contained questions to assess the children's usage of CI, their types of education placement, and their modes of communication. The second set of questionnaire was the Parent's Evaluation Of Aural/Oral Performance of Children (PEACH) to evaluate the children's auditory functionality.

    RESULTS: Our study showed that among the implantees, 97.6% are still using their CI, 69.8% communicating orally, and 58.5% attending mainstream education. For implantees that use oral communication and attend mainstream education, their mean age of implantation is 38 months. This is significantly lower compared to the mean age of implantation of implantees that use non-oral communication and attend non-mainstream education. Simple logistic regression analysis shows age of implantation reliably predicts implantees (N = 126) would communicate using oral communication with odds ratio of 0.974, and also predict mainstream education (N = 118) with odds ratio of 0.967. The median score of PEACH rating scale is 87.5% in quiet, and this significantly correlates with an earlier age of implantation (r = -0.235 p = 0.048).

    CONCLUSIONS: UKM Cochlear Implant Program has achieved reasonable success among the pediatric implantees, with better outcomes seen in those implanted at the age of less than 4 years old.

  4. Goh BS, Che Omar SN, Ubaidah MA, Saim L, Sulaiman S, Chua KH
    Acta Otolaryngol, 2017 Apr;137(4):432-441.
    PMID: 27900891 DOI: 10.1080/00016489.2016.1257151
    CONCLUSION: In conclusion, these result showed HADSCs could differentiate into chondrocytes-like cells, dependent on signaling induced by TGF-β3 and chondrocytes. This is a promising result and showed that HADSCs is a potential source for future microtia repair. The technique of co-culture is a positive way forward to assist the microtia tissue.

    OBJECTIVE: Reconstructive surgery for the repair of microtia still remains the greatest challenge among the surgeons. Its repair is associated with donor-site morbidity and the degree of infection is inevitable when using alloplastic prosthesis with uncertain long-term durability. Thus, human adipose derived stem cells (HADSCs) can be an alternative cell source for cartilage regeneration. This study aims to evaluate the chondrogenic potential of HADSCs cultured with transforming growth factor-beta (TGF-β) and interaction of auricular chondrocytes with HADSCs for new cartilage generation.

    METHODS: Multi-lineages differentiation features of HADSCs were monitored by Alcian Blue, Alizarin Red, and Oil Red O staining for chondrogenic, adipogenic, and osteogenic differentiation capacity, respectively. Further, HADSCs alone were culture in medium added with TGF-β3; and human auricular chondrocytes were interacted indirectly in the culture with and without TGF-βs for up to 21 days, respectively. Cell morphology and chondrogenesis were monitored by inverted microscope. For cell viability, Alamar Blue assay was used to measure the cell viability and the changes in gene expression of auricular chondrocyte markers were determined by real-time polymerase chain reaction analysis. For the induction of chondrogenic differentiation, HADSCs showed a feature of aggregation and formed a dense matrix of proteoglycans. Staining results from Alizirin Red and Oil Red O indicated the HADSCs also successfully differentiated into adipogenic and osteogenic lineages after 21 days.

    RESULTS: According to a previous study, HADSCs were strongly positive for the mesenchymal markers CD90, CD73, CD44, CD9, and histocompatibility antigen. The results showed HADSCs test groups (cultured with TGF-β3) displayed chondrocytes-like cells morphology with typical lacunae structure compared to the control group without TGF-β3 after 2 weeks. Additionally, the HADSCs test groups increased in cell viability; an increase in expression of chondrocytes-specific genes (collagen type II, aggrecan core protein, SOX 9 and elastin) compared to the control. This study found that human auricular chondrocytes cells and growth factor had a positive influence in inducing HADSCs chondrogenic effects, in terms of chondrogenic differentiate of feature, increase of cell viability, and up-regulated expression of chondrogenic genes.

  5. 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.

  6. Teoh JW, Goh BS, Shahizon Azura MM, Siti Aishah MA, Nor Hafliza MS
    Med J Malaysia, 2014 Jun;69(3):146-7.
    PMID: 25326360 MyJurnal
    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.
  7. 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.
  8. 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.
  9. 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.
  10. Asma A, Ubaidah MA, Hasan SS, Wan Fazlina WH, Lim BY, Saim L, et al.
    PMID: 24427576 DOI: 10.1007/s12070-013-0621-2
    Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9 %) patients had bilateral microtia and canal atresia, 3 (9.1 %) patients had unilateral microtia and canal atresia and 1 (3.0 %) patients have SSD following labyrinthitis. One patient (3.2 %) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1 %). Of these 7 patients, 4 patients required 3-4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7 %). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.
  11. Iqbal FR, Goh BS, Mazita A
    Otolaryngol Head Neck Surg, 2012 Aug;147(2):329-34.
    PMID: 22496101 DOI: 10.1177/0194599812444528
    To establish the efficacy of proton pump inhibitors (PPI) in the treatment of adenoid hypertrophy in children.
  12. 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.
  13. 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.
  14. Ishak MF, Chua KH, Asma A, Saim L, Aminuddin BS, Ruszymah BH, et al.
    Int J Pediatr Otorhinolaryngol, 2011 Jun;75(6):835-40.
    PMID: 21543123 DOI: 10.1016/j.ijporl.2011.03.021
    This study was aimed to see the difference between chondrocytes from normal cartilage compared to chondrocytes from microtic cartilage. Specific attentions were to characterize the growth of chondrocytes in terms of cell morphology, growth profile and RT-PCR analysis.
  15. Zainal A, Goh BS, Mohamed AS
    Asian J Surg, 2011 Apr;34(2):92-6.
    PMID: 21723473 DOI: 10.1016/S1015-9584(11)60026-2
    Laryngomalacia is the most common cause of neonatal and infantile stridor. The aim of this study was to assess the outcome of surgical intervention in children with laryngomalacia.
  16. 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.
  17. 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.
  18. 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.
  19. 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.
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