Displaying publications 41 - 60 of 70 in total

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  1. Saniasiaya J, Kulasegarah J, Narayanan P
    Clin Otolaryngol, 2023 May;48(3):371-380.
    PMID: 36640123 DOI: 10.1111/coa.14038
    BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is a debilitating condition that has been significantly described in adults. Recent data points out that BPPV occurs in children as well. Canalith repositioning manoeuvre (CRM) has shown promising results amongst adult patients with BPPV.

    OBJECTIVE: We reviewed the literature to determine the outcome of CRM in children and adolescents with BPPV.

    METHODS: A literature search was conducted over 1 month (March 2022). The primary outcome was defined as the resolution of positional nystagmus and symptoms, and secondary outcomes were determined by the presence of recurrence and the number of attempts of CRM.

    RESULTS: Ten articles were selected based on our objective and selection criteria. A total of 242 patients were included, with a mean of 10.9 years. BPPV was diagnosed based on history and positional nystagmus in all patients (100%). CRM was performed in 97.9% of patients, whereby 80.5% recovered following a single attempt of CRM. Recurrence of symptoms was identified in 10% of patients with no reported major complications.

    CONCLUSION: CRM has demonstrated promising results in children and adolescents. The quality of evidence is limited until a better-quality study involving randomised controlled studies with a larger sample size is completed.

  2. Subramaniam D, Saniasiaya J, Kulasegarah J
    Indian J Otolaryngol Head Neck Surg, 2023 Jun;75(2):1271-1273.
    PMID: 37275052 DOI: 10.1007/s12070-022-03383-9
    BACKGROUND: Foreign body ingestion involving the paediatric age group is a common emergency referral encountered by Otorhinolaryngologists. The cervical oesophagus has been noted as the most prevalent site of impaction. Traditionally, a rigid oesophagoscopy would be required for examination under anaesthesia and removal of the foreign body is found, but this method may miss foreign bodies that are embedded into the mucosa, and faulty technique may result in perforation of the esophagus. Method and results: We present a suspension microesophagoscopy technique using a Lindholm laryngoscope and suspension to retract and suspend the opening of the oesophagus. Conclusion: This technique not only gives the surgeon an advantage to perform a two-handed procedure but also allows for a magnified examination of the oesophageal mucosa with the help of a rigid telescope for a thorough examination.

    BULLET POINT SUMMARY: The best diagnostic and therapeutic method for the management of foreign body in the oesophagus is examination under anaesthesia.Suspension microesophagoscopy can be done in the operation theatre with pre-existing instrument.This technique allows freedom for a two-handed technique.This technique gives a magnified visualisation of the mucosa revealing any embedded foreign body.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-022-03383-9.

  3. Saniasiaya J, Islam MA, Abdullah B
    Laryngoscope, 2021 04;131(4):865-878.
    PMID: 33219539 DOI: 10.1002/lary.29286
    OBJECTIVES/HYPOTHESIS: Olfactory dysfunction has been observed as one of the clinical manifestations in COVID-19 patients. We aimed to conduct a systematic review and meta-analysis to estimate the overall pooled prevalence of olfactory dysfunction in COVID-19 patients.

    STUDY DESIGN: Systematic review and meta-analyses.

    METHODS: PubMed, Scopus, Web of Science, Embase, and Google Scholar databases were searched to identify studies published between 1 December 2019 and 23 July 2020. We used random-effects model to estimate the pooled prevalence with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic and Cochran's Q test. Robustness of the pooled estimates was checked by different subgroup and sensitivity analyses This study is registered with PROSPERO (CRD42020183768).

    RESULTS: We identified 1162 studies, of which 83 studies (n = 27492, 61.4% female) were included in the meta-analysis. Overall, the pooled prevalence of olfactory dysfunction in COVID-19 patients was 47.85% [95% CI: 41.20-54.50]. We observed olfactory dysfunction in 54.40% European, 51.11% North American, 31.39% Asian, and 10.71% Australian COVID-19 patients. Anosmia, hyposmia, and dysosmia were observed in 35.39%, 36.15%, and 2.53% of the patients, respectively. There were discrepancies in the results of studies with objective (higher prevalence) versus subjective (lower prevalence) evaluations. The discrepancy might be due to false-negative reporting observed in self-reported health measures.

    CONCLUSIONS: The prevalence of olfactory dysfunction in COVID-19 patients was found to be 47.85% based on high-quality evidence. Due to the subjective measures of most studies pooled in the analysis, further studies with objective measures are advocated to confirm the finding.

    LEVEL OF EVIDENCE: 2 Laryngoscope, 131:865-878, 2021.

  4. Ramasamy K, Saniasiaya J, Abdul Gani N
    Ann Otol Rhinol Laryngol, 2021 May;130(5):513-519.
    PMID: 33025798 DOI: 10.1177/0003489420963165
    OBJECTIVE: To investigate the prevalence of olfactory and gustatory dysfunction among patients with COVID-19 infection and the recovery rate.

    METHODS: Adult patients (≥18 years) tested positive for COVID-19 via reverse transcription-polymerase chain reaction (RT-PCR) and admitted in Hospital Tuanku Ja'afar Seremban, Malaysia, were recruited in this study. Patients completed a questionnaire via telephone interview comprising the following details: age, sex, ethnicity, comorbidities, general and otorhinolaryngological symptoms, onset and duration of olfactory and gustatory dysfunction. Patients with persistent olfactory and gustatory dysfunction at the time of the initial interview were followed-up every 3 to 5 days till resolution.

    RESULTS: A total of 145 patients were included in our study. The mean age of patients was 43.0 ± 17.7 (range: 18-86). Fever (44.1%) and cough (39.3%) were the most prevalent general symptoms. Thirty-one patients (21.4%) reported olfactory dysfunction and 34 (23.4%) reported dysgeusia. There was a significant association between both olfactory and gustatory dysfunction (P 

  5. Zubir FS, Saniasiaya J, Abdul Gani H
    Malays Fam Physician, 2021 Mar 25;16(1):133-135.
    PMID: 33948154 DOI: 10.51866/cr1070
    Temporal bone rhabdomyosarcoma is an aggressive entity that simulates chronic otitis ear infection. It is the most common soft tissue sarcoma amongst pediatric patients. Herein, we would like to report a case of temporal bone rhabdomyosarcoma involving a 2-year-old boy who presented with a one-month history of otorrhea with facial asymmetry. Early treatment led to remission of this severe neoplasm.
  6. Saniasiaya J, Islam MA, Abdullah B
    Otolaryngol Head Neck Surg, 2021 07;165(1):33-42.
    PMID: 33320033 DOI: 10.1177/0194599820981018
    OBJECTIVE: The purpose of this meta-analysis is to assess the pooled prevalence of taste disorders and their subtypes in patients with COVID-19.

    DATA SOURCES: PubMed, Scopus, Web of Science, Embase, and Google Scholar databases were searched to identify studies published between December 1, 2019, and June 23, 2020, without language restrictions. There was no restriction on the study design; therefore, observational studies, clinical trials, and case series were included. In addition, preprints were considered if data of interest were reported.

    REVIEW METHODS: Two authors independently screened articles for eligibility. A random effects model was used to estimate the pooled prevalence with 95% CIs. Quality assessment was done with critical appraisal tools of the Joanna Briggs Institute. The robustness of the pooled estimates was checked by subgroup and sensitivity analyses.

    RESULTS: Fifty-nine studies were included (N = 29,349 patients, 64.4% female). The pooled prevalence of taste disorders in patients with COVID-19 was 48.1% (95% CI, 41.3%-54.8%). The prevalence of taste disorders in studies with objective assessments was higher as compared with subjective assessments (59.2% vs 47.3%). The disorders were observed in 55.2% of European patients; 61.0%, North American; 27.1%, Asian; 29.5%, South American; and 25.0%, Australian. Ageusia, hypogeusia, and dysgeusia were detected in 28.0%, 33.5%, and 41.3% of patients with COVID-19. We identified 91.5% of the included studies as high quality.

    CONCLUSIONS: The prevalence of taste disorders in patients with COVID-19 was 48.1%. Objective assessments have higher prevalence than subjective assessments. Dysgeusia is the most common subtype, followed by ageusia and hypogeusia.

  7. Lim CC, Saniasiaya J, Kulasegarah J
    BMJ Case Rep, 2021 Sep 14;14(9).
    PMID: 34521741 DOI: 10.1136/bcr-2021-244769
    Croup (laryngotracheitis) is frequently encountered in the emergency department in a young child presenting with stridor. We describe a rare case of croup secondary to SARS-CoV-2 in an 18-month-old child who presented with stridor and respiratory distress and required urgent intubation. Subsequently, the child developed multisystem inflammatory syndrome in children (MIS-C). The child was monitored in paediatric intensive care unit. We would like to highlight that COVID-19 croup in children may be an indicator for MIS-C, and close monitoring is warranted as MIS-C is a life-threatening condition. Our limited experience suggests that COVID-19 croup especially if associated with MIS-C has an underlying more severe pathology and may require prolonged treatment in comparison with the typical croup or even COVID-19 croup. It is important to recognise this clinical entity during a time when most countries are in a third wave of COVID-19 pandemic.
  8. C A Rahim NA, Saniasiaya J, Kulasegarah J
    J Laryngol Otol, 2021 Oct 15.
    PMID: 34649637 DOI: 10.1017/S0022215121002905
    BACKGROUND: Neonatal nasal obstruction may result in respiratory distress, feeding difficulties, sleep apnoea and failure to thrive; hence, it requires thorough evaluation and prompt intervention. Congenital inferior turbinate hypertrophy is relatively uncommon, and its presentation can mimic other congenital nasal anomalies.

    RELEVANCE: This paper reports two cases of congenital inferior turbinate hypertrophy in neonates that resulted in significant respiratory distress, feeding difficulties and sleep disturbance. Both patients were successfully treated surgically by endoscopic nasal dilatation and stenting. A literature search was performed to identify articles on congenital inferior turbinate hypertrophy in neonates and its management.

    CONCLUSION: Albeit rare, congenital inferior turbinate hypertrophy should be considered a differential diagnosis in newborns presenting with respiratory distress at birth.

  9. Saniasiaya J, Mohamad I, Abdul Rahman SK
    Braz J Otorhinolaryngol, 2016 06 22;86(3):389-392.
    PMID: 27388958 DOI: 10.1016/j.bjorl.2016.05.011
  10. Saniasiaya J, Islam MA, Salim R
    PMID: 36715738 DOI: 10.1007/s00405-023-07842-z
    BACKGROUND: Vestibular dysfunction has been extensively studied amongst the older population. Recently, conditions and management of vestibular dysfunction among children and adolescent has gained attention. Yet, a lack of awareness and expertise in managing children and adolescents with vestibular dysfunction has led to a delay in diagnosis as well as a trifling prevalence rate.

    AIM: To conduct a systematic review and meta-analyses to estimate the overall pooled prevalence of vestibular dysfunction in children and adolescents.

    METHODS: PubMed, Scopus, and Web of Science databases were searched to identify studies published until 29 April 2022. We used a random-effects model to estimate the pooled prevalence with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic and Cochran's Q test. The robustness of the pooled estimates was checked by different subgroups and sensitivity analyses.

    RESULTS: We identified 1811 studies, of which 39 studies (n = 323,663) were included in the meta-analysis. Overall, the pooled prevalence of children and adolescents with VD was 30.4% [95% CI 28.5-32.3%]. The age of the participants ranged from 1 to 19 years. Participants of the included 39 studies were from 15 countries. Among the studies, 34 were cross-sectional, and five were case-control designed. There were discrepancies found in the studies with objective (higher prevalence) versus subjective (lower prevalence) evaluations.

    CONCLUSION: The prevalence of VD among children and adolescents was found to be 30.4% based on high-quality evidence. Due to the subjective assessment of most studies pooled in the analysis, the results should be interpreted cautiously until future comparative studies with objective assessments are carried out.

  11. Lau TB, Saniasiaya J, Govindaraju R
    PMID: 37292223 DOI: 10.51866/cr.266
    Evidence suggests that otologic injury from ototopical aminoglycoside preparations is infrequent when used to treat ear infections with an intact tympanic membrane. Meanwhile, parenteral administration of aminoglycosides, is well known to be associated with a significant incidence of cochlear and vestibular damage. The discrepancy between topical and parenteral ototoxic effects is thought to result from a combination of factors, including the protective function of debris overlying the round window membrane, low antibiotic concentrations of topical antibiotic preparations, length of exposure and inability to detect subtle hearing or vestibular changes. Herein, we present a case of acute vestibulopathy following a 2-week course of topical gentamicin otic drops. Awareness of vestibulotoxicity following topical gentamicin therapy is prudent as vestibulopathic symptoms can be severely debilitating.
  12. Che Ab Rahim NA, Saniasiaya J, Kulasegarah J
    BMJ Case Rep, 2021 Apr 12;14(4).
    PMID: 33846192 DOI: 10.1136/bcr-2021-241591
    High-riding jugular bulb (HRJB), although rare, may pose a challenge as it may be mistaken for other non-alarming condition, such as middle ear effusion. Patients with HRJB classically present with pulsatile tinnitus. We report a unique case of a 26-year-old patient with underlying beta thalassaemia who presented with a 2-month history of intermittent epistaxis and rhinorrhoea. Otoscopic examinations revealed a pulsatile bluish mass behind the right tympanic membrane and a dull left tympanic membrane. Imaging performed revealed a finding of dual retrotympanic pathology, which consisted of a right dehiscent HRJB and left cholesterol granuloma. We highlight a rare case of dual retrotympanic mass as well as its management.
  13. Mohd Hamdan MH, Saniasiaya J, Narayanan P
    BMJ Case Rep, 2021 Jul 13;14(7).
    PMID: 34257127 DOI: 10.1136/bcr-2021-243756
    The hyoid bone fracture has traditionally been attributed to strangulation and hanging. Although rare, ensuing its vague presentation, hyoid bone fracture is oftentimes overlooked and missed, leading to delayed complications. Herein, we are reporting an overlooked hyoid bone fracture in a man who attempted suicide by strangulating himself, whereby Valsalva manoeuvre performed during bedside flexible nasopharyngolaryngoscopy revealed the fractured segment. As the patient was stable and asymptomatic, he was successfully managed conservatively. We would like to highlight the awareness of the Valsalva manoeuvre, which could elicit hyoid bone fracture as missing or overlooking the fracture may lead to devastating complications which may ensue, such as respiratory distress.
  14. Ponnuvelu K, Saniasiaya J, Abdul Gani N
    BMJ Case Rep, 2021 Aug 16;14(8).
    PMID: 34400422 DOI: 10.1136/bcr-2021-242122
    Foreign body (FB) in the external auditory canal is more common among the paediatric age group compared with adult patients and it may be deposited in various ways. An accidental animate aural FB is reported to be commonly encountered in adults whereas inanimate FBs are likely to be found among adult patients with learning disability. An elderly man presented with accidental penetration of rattan tree stem into his ear while gardening. Removal of a FB from the external auditory canal requires expertise as deep penetration of a FB into the middle and inner ear may lead grave complications, especially when overzealous removal is attempted by nonear, nose and throat (ENT) personnel. This case emphasises on the importance of awareness of meticulous removal of a FB under proper visualisation so as to avoid unnecessary complications. Additionally, we propose an algorithm for proper removal of aural FB in an acute care setting.
  15. Ngu CYV, Saniasiaya J, Kulasegarah J
    BMJ Case Rep, 2021 Sep 07;14(9).
    PMID: 34493558 DOI: 10.1136/bcr-2021-244012
    Paediatric upper airway obstruction is an emergency that requires immediate intervention. Among the myriad factors that leads to upper airway obstruction in paediatric age group, bilateral vocal cord palsy is not commonly encountered in clinical practice. The underlying cause of bilateral vocal cord palsy requires thorough investigation prior to deciding on the appropriate intervention. Herein, we report a 4-month-old baby boy who presented with recurrent inspiratory stridor with bilateral vocal cord palsy secondary to Arnold Chiari II malformation. Immediate intervention to drain the hydrocephalous resulted in complete resolution of stridor without having to perform a tracheostomy. We highlight the importance of meticulous and thorough investigations especially in children, as emergent airway intervention such as tracheostomy may result in detrimental effect to speech, swallowing as well as quality of life.
  16. Lim CC, Saniasiaya J, Kulasegarah J
    BMJ Case Rep, 2021 Jul 01;14(7).
    PMID: 34210704 DOI: 10.1136/bcr-2021-243412
    Postauricular swelling is usually encountered in an emergency setting in otorhinolaryngology, resulting from complication of acute or chronic suppurative otitis media. Besides that, postauricular swelling may occur secondary to various other conditions including infectious disease, tumour, vascular malformation, granulomatous condition and even trauma. Children less than 2 years old are prone to fall and up to 10% sustain traumatic brain injury without any obvious signs of neurological deficit. We describe a rare case of a postauricular swelling in a toddler which turned out to be salmonella extradural abscess from an infected traumatic haematoma. The importance of high clinical suspicion especially in a child with a history of fall cannot be emphasised more because a missed brain abscess could lead to potentially life-threatening problems. We would like to highlight that meticulous history taking along with prompt assessment and intervention is prudent for a better prognosis and recovery.
  17. Saniasiaya J, Lim SM, Kulasegarah J
    Indian J Otolaryngol Head Neck Surg, 2023 Jun;75(2):1274-1276.
    PMID: 37276073 DOI: 10.1007/s12070-022-03411-8
    BACKGROUND: Airway obstruction in a child requires expedite management in addition to comprehensive discussion between the Otolaryngology and Anaesthesiology team to formulate a treatment plan to ensure safe airway. Juvenile-onset recurrent respiratory papillomatosis (JORRP) is an exophytic benign laryngeal lesion which poses a great challenge when presented with respiratory distress.

    OBJECTIVE: This paper presents a novel, safe and cost-effective approach to temporary tracheal ventilation of the obstructed airway in a child with juvenile-onset recurrent respiratory papillomatosis using the laryngeal suction tube connected to general anaesthetic (GA) machine.

    RESULT AND CONCLUSION: Rigid laryngeal suction tube is placed through the side-port of Lindholm laryngoscope and connected to breathing circuit of GA machine. Manual bagging ventilation with 100% FiO2 achieved good oxygenation throughout the debulking of the papilloma without hindering the surgical field. Our technique utilizes the readily available equipment whilst enabling safe anaesthesia and providing good surgical field during excision of obstructive papillomatous airway lesion.

  18. Ganeson SK, Saniasiaya J, Mohamad I, Abdul Gani N
    Gulf J Oncolog, 2020 Sep;1(34):83-86.
    PMID: 33431368
    INTRODUCTION: Basaloid squamous cell carcinoma of the nasopharynx is a rare entity with only scarce cases reported in the English Literature. It is a histological variant of squamous cell carcinoma with aggressive nature and comprises of both basal cell carcinoma and squamous cell carcinoma.

    CASE PRESENTATION: Herein, we report on a middleaged male who presented with left-sided spontaneous epistaxis and aural fullness with no neck node which turned out to be basaloid cell carcinoma of nasopharynx.

    DISCUSSION AND CONCLUSION: We highlight high clinical suspicion of rare variant of nasopharyngeal carcinoma although no palpable node was evident upon presentation.

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