Displaying publications 21 - 40 of 67 in total

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  1. Tang IP, Kevin Ng BH, Prepageran N, Donald Ngian SL, Albert Sii HW
    Med J Malaysia, 2018 10;73(5):347-348.
    PMID: 30350824 MyJurnal
    Auditory brainstem implantation (ABI) is the only solution to restore hearing when cochlear nerves are disrupted together with the pathologies where bilateral cochleae do not provide a suitable location for cochlear implantation. We reported first two successful auditory brainstem implantation cases in patients with neurofibromatosis Type II (NF2) with bilateral acoustic neuroma causing bilateral profound sensorineural hearing loss in Malaysia. A good candidate selection, dedicated surgeons and rehabilitation team as well as strong family support are the crucial factors in achieving the best possible surgical, audiological and speech outcomes.
  2. Ngui LX, Tang IP
    J Laryngol Otol, 2018 Aug;132(8):693-697.
    PMID: 30008276 DOI: 10.1017/S0022215118001123
    OBJECTIVES: To investigate the surgical and audiological outcomes of the Bonebridge transcutaneous bone conduction hearing implant among children with congenital aural atresia.

    METHODS: Six children were recruited and underwent Bonebridge transcutaneous bone conduction implant surgery. The patients' audiometric thresholds for air conduction, bone conduction and sound-field tests were assessed pre-operatively and at six months post-operatively. Patients' satisfaction was assessed at six months post-operatively with the Hearing Device Satisfaction Scale.

    RESULTS: No major complications were reported. Mean aided sound-field thresholds improved post-operatively by more than 30 dB for 0.5-4 kHz (p 0.05). All patients were satisfied (scores were over 90 per cent) with the implant in terms of functional outcome and cosmetic appearance.

    CONCLUSION: Bonebridge transcutaneous bone conduction implant surgery is safe and effective among children with congenital aural atresia with conductive hearing loss.

  3. Sow YL, Tang IP, Kho JPY, Prepageran N
    Med J Malaysia, 2018 08;73(4):244-248.
    PMID: 30121688
    INTRODUCTION: Endoscopic sinus surgery (ESS) is the mainstay for treatment of chronic rhinosinusitis versus maximal medical therapy. We propose a more economical option, by using steroid-impregnated Gelfoam instead of Nasopore post ESS, as it is less expensive and has showed effectiveness in preventing post-operative bleeding.

    MATERIALS AND METHODS: A randomised, double-blinded, placebo-controlled trial was carried out in eight patients with chronic rhinosinusitis or nasal polyposis who were planned for bilateral endoscopic sinus surgery. A Peri-operative Sinus Endoscopy (POSE) Score and Lund-Kennedy Endoscopic Score (LKES) were recorded. The use of hydrocortisone-impregnated Gelfoam dressing versus normal saline-impregnated Gelfoam dressing were compared. Scores were repeated post-operatively at one week, three weeks and three months interval.

    RESULTS: For LKES, at the end of three months, 50% of the patients had the same score difference, 37.5% had better results on the study side while 12.5% had better results on the control side. Meanwhile, for POSE Score, at the end of three months, 75% of the patients had better score difference on the study side while 12.5% had better results on the control side.

    CONCLUSION: Gelfoam can be used as nasal packing material to deliver topical steroid after endoscopic sinus surgery. Steroid-impregnated nasal dressing after endoscopic sinus surgery may not provide better long-term outcome.

  4. Ng BHK, Kho GS, Sim SK, Liew DNS, Tang IP
    Br J Neurosurg, 2017 Jun 09.
    PMID: 28597698 DOI: 10.1080/02688697.2017.1335857
    Intracranial fungal infection of the cavernous sinus is a condition that usually affects immunocompromised individuals and is rarely seen in immunocompetent individuals. It is a potentially life threatening condition which requires prompt treatment. Here we present a case of an immunocompetent patient with a fungal infection of the cavernous sinus.
  5. Lau YW, Tharumalingam V, Tan TY, Tang IP
    Med J Malaysia, 2016 Jun;71(3):154-5.
    PMID: 27495895 MyJurnal
    Angioleiomyoma of the nasal cavity is an extremely rare benign neoplasm. It usually occurs in the lower extremities. Up to date, only few cases of angioleiomyoma have been reported. First case of angioleiomyoma of nasal cavity was reported in 1966. We report a rare case of angioleiomyoma arising from the right maxillary sinus.
  6. Tang IP, Brand Y, Prepageran N
    PMID: 26575516 DOI: 10.1097/MOO.0000000000000218
    To review cause, clinical evaluation, medical and surgical management of isolated sphenoid sinus diseases.
  7. Lim EY, Tang IP, Peyman M, Ramli N, Narayanan P, Rajagopalan R
    Eur Arch Otorhinolaryngol, 2015 Nov;272(11):3109-13.
    PMID: 25205300 DOI: 10.1007/s00405-014-3232-y
    High acoustic noise level is one of the unavoidable side effects of 3 T magnetic resonance imaging (MRI). A case of hearing loss after 3 T MRI has been reported in this institution and hence this study. The objective of this study was to determine whether temporary threshold shift (TTS) in high frequency hearing occurs in patients undergoing 3 T MRI scans of the head and neck. A total of 35 patients undergoing head and neck 3 T MRI for various clinical indications were tested with pure tone audiometry in different frequencies including high frequencies, before and after the MRI scan. Any threshold change from the recorded baseline of 10 dB was considered significant. All patients were fitted with foamed 3 M earplugs before the procedure following the safety guidelines for 3 T MRI. The mean time for MRI procedure was 1,672 s (range 1,040-2,810). The noise dose received by each patient amounted to an average of 3,906.29% (1,415-9,170%). The noise dose was derived from a normograph used by Occupational Noise Surveys. This was calculated using the nomograph of L eq, L EX, noise dose and time. There was no statistically significant difference between the hearing threshold before and after the MRI procedures for all the frequencies (paired t test, P > 0.05). For patients using 3 M foamed earplugs, noise level generated by 3 T MRI during routine clinical sequence did not cause any TTS in high frequency hearing.
  8. Jaafar R, Tang IP, Jong DE, Narihan MZ
    Ear Nose Throat J, 2015 Jul;94(7):E8-10.
    PMID: 26214680
    Lipoblastoma is extremely rare and mainly occurs in children younger than 3 years old. It is predominantly found in the extremities and trunk. Head and neck region occurrences are rare; only 4 such cases involving patients who presented with stridor have been previously reported. We report the fifth case of lipoblastoma of the neck with stridor in a 9-year-old girl, which had gradually worsened over the previous year. Imaging showed a retrotracheal mass extending superiorly to the thyroid level and inferiorly to below the carina of the trachea. Total resection of the tumor was performed, and the histopathologic findings were consistent with lipoblastoma. Postoperatively, the patient was well with no complications.
  9. Santhi K, Prepageran N, Tang IP, Raman R
    Otol Neurotol, 2015 Feb;36(2):318-22.
    PMID: 24751743 DOI: 10.1097/MAO.0000000000000378
    The objectives of this study were to determine the presence of epithelial migration in patients with postirradiated nasopharyngeal carcinoma (NPC) and to compare the rate of epithelial migration in the tympanic membrane (TM) and the bony external auditory canal (EAC) of postirradiated NPC ears with normal ears by means of the ink dot method.
  10. Sia KJ, Kong CK, Tan TY, Tang IP
    Med J Malaysia, 2014 Dec;69(6):281-3.
    PMID: 25934961
    CASE REPORT: Five cases of Kimura's disease had been treated in our centre from year 2003 to 2010. All cases were presented with head and neck mass with cervical lymphadenopathy. Surgical excision was performed for all cases. Definite diagnosis was made by histopathological examination of the resected specimens. One out of five cases developed tumour recurrence four years after resection.

    CONCLUSION: Surgical excision is our choice of treatment because the outcome is immediate and definite tissue diagnosis is feasible after resection. Oral corticosteroid could be considered as an option in advanced disease. However, tumour recurrence is common after cessation of steroid therapy.
  11. Tang IP, Singh S, Rajagopalan R
    Ear Nose Throat J, 2014 Sep;93(9):390-4.
    PMID: 25255345
    Nontuberculous Mycobacterium (NTM) middle ear infection is a rare cause of chronic bilateral intermittent otorrhea. We report a rare case of bilateral NTM middle ear infection in which a 55-year-old woman presented with intermittent otorrhea of 40 years' duration. The patient was treated medically with success. We conclude that NTM is a rare but probably under-recognized cause of chronic otitis media. A high index of suspicion is needed for the diagnosis to avoid prolonged morbidity. Treatment includes surgical clearance of infected tissue with appropriate antimycobacterial drugs, which are selected based on culture and sensitivity.
  12. Tang MY, Tang IP, Wang CY
    Med J Malaysia, 2014 Aug;69(4):151-5.
    PMID: 25500841 MyJurnal
    AIM: This was a randomized single blinded study to determine optimal size for Ambu®LMA (ALMA) among Malaysian adult population.

    METHODS: One hundred and twenty six non-paralyzed anaesthetized adult patients were block randomized into size 3, 4 and 5 Ambu®LMA. Optimal size is defined primarily by oropharyngeal pressure (OLP). Pharyngeal injury and ease of insertion are also taken into consideration.

    RESULTS: Mean OLP was significantly higher for Size 4 and 5 compared to size 3 (p<0.001) but similar between size 4 and 5. Number of insertion attempts and insertion time were similar between sizes. Size 5 required more manipulations during insertion (p<0.005) and had higher pharyngeal injury (p=0.001) compared to size 3 and 4.

    DISCUSSION: We recommend size 4 ALMA as the optimal size for Malaysian adults in view of the higher OLP compared to size 3, yet less pharyngeal injury than size 5 in spontaneously breathing patients.
  13. Tang IP, Freeman SR, Rutherford SA, King AT, Ramsden RT, Lloyd SK
    Otol Neurotol, 2014 Aug;35(7):1266-70.
    PMID: 24841920 DOI: 10.1097/MAO.0000000000000435
    To review the postoperative surgical outcomes of cystic vestibular schwannomas (CVSs), especially facial nerve outcomes, and compare these results with those from matched solid vestibular schwannomas (SVS) resected during the same period at a tertiary referral center.
  14. Tang IP, Chai CK, Kumar G, Prepageran N, Waran V
    Br J Neurosurg, 2014 Jun;28(3):390-2.
    PMID: 23875880 DOI: 10.3109/02688697.2013.817535
    Isolated intrasellar pituitary mucocele following transsphenoidal sinus surgery is extremely rare. The clinical features resemble a pituitary tumor, therefore careful radiological interpretation is crucial to reach the correct diagnosis. We report a case of intrasellar mucocele who had transsphenoidal sinus surgery performed 15 years prior.
  15. Tang IP, Freeman SR, Kontorinis G, Tang MY, Rutherford SA, King AT, et al.
    J Laryngol Otol, 2014 May;128(5):394-9.
    PMID: 24819337 DOI: 10.1017/S0022215114000802
    To systematically summarise the peer-reviewed literature relating to the aetiology, clinical presentation, investigation and treatment of geniculate neuralgia.
  16. Waran V, Tang IP, Karuppiah R, Abd Kadir KA, Chandran H, Muthusamy KA, et al.
    Br J Neurosurg, 2013 Dec;27(6):742-6.
    PMID: 23647078 DOI: 10.3109/02688697.2013.791667
    Abstract The endoscopic transnasal, transsphenoidal surgical technique for pituitary tumour excision has generally been regarded as a less invasive technique, ranging from single nostril to dual nostril techniques. We propose a single nostril technique using a modified nasal speculum as a preferred technique. We initially reviewed 25 patients who underwent pituitary tumour excision, via endoscopic transnasal transsphenoidal surgery, using this new modified speculum-guided single nostril technique. The results show shorter operation time with reduced intra- and post-operative nasal soft tissue injuries and complications.
  17. Chai CK, Tang IP, Tan TY
    Med J Malaysia, 2013 Jun;68(3):269-70.
    PMID: 23749022 MyJurnal
    Primary lacrimal sac lymphoma is rare. The common clinical features are epiphora and medial canthal swelling which mimic nasolacrimal duct obstruction. Histological examination is therefore important to avoid delay in diagnosis and treatment. We report a case of primary lacrimal sac lymphoma in a 72-year-old female who developed a metachronous tumour at the hard palate one year after excision of the lacrimal sac tumour.
  18. Sia KJ, Tang IP, Prepageran N
    Med J Malaysia, 2013;68(1):6-9.
    PMID: 23466758 MyJurnal
    OBJECTIVES: To identify the common bacteria of otorhinolaryngological (ORL) infection in three general hospitals in the state of Sarawak, East Malaysia and to determine the antibiotic sensitivity of the common bacteria to update local antibiotic policy.
    METHODS: All specimens with positive monoclonal culture, received from inpatient and outpatient Otorhinolaryngology Department in the year 2009 and 2010 were included in the study. Patients' demographics, nature of specimens, bacterial isolates and antibiotic sensitivity were analysed by using the Statistical Package for the Social Sciences (SPSS).
    RESULTS: A total 244 positive monoclonal cultures were identified. Staphylococcus species and Gram negative bacilli were the commonest bacteria of ORL infections. Common ORL bacteria remain sensitive to our front line antibiotics. There are a number of multi-drug resistant isolates of MRSA, ESBL Klebsiella pneumoniae and Acinetobacter baumanii in the hospital-acquired infections.
    CONCLUSION: Although resistance to antimicrobial agents is growing worldwide, first line antibiotics still show significant therapeutic advantage in our local setting. The low resistance of bacterial isolates in our community reflects judicious use of antibiotics in our routine clinical practices.

    Study site: Sarawak General Hospital, Sibu Hospital and Miri Hospital
  19. Santhi K, Tang IP, Nordin A, Prepageran N
    J Surg Case Rep, 2012 Dec 11;2012(12).
    PMID: 24968423 DOI: 10.1093/jscr/rjs026
    Congenital cholesteatoma (CC) rarely presents with Luc's abscess. As a result of widespread usage of antimicrobial agents, Luc's abscess is hardly encountered in current clinical practice. Herein, we report a case of Luc's abscess as the first presenting symptom in a 5-year-old boy with underlying CC. Patient's clinical findings, radiological investigations and treatment were also discussed.
  20. Sia KJ, Chai CK, Tang IP, Prepageran N
    Med J Malaysia, 2012 Dec;67(6):625-6.
    PMID: 23770961 MyJurnal
    The Vibrant Soundbridge is a new middle ear implantable hearing device. It was first introduced for adult patients with moderate to severe sensorineural hearing loss. With the innovation of the surgical techniques, its usage had been broadened for children and those patients with conductive and mixed hearing loss. We report first two cases of monoaural Vibrant Soundbridge implantation in Malaysia. They were children with bilateral conductive hearing loss who had failed to benefit from previous hearing aids. Floating mass transducers were attached in oval window and long process of incus respectively. Remarkable hearing yield was observed without surgical complication.
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