MyMedR

Endoscopic Endonasal Approach in Clival Chordoma Surgery: Case Series

Ngu CYV, Tang IP, Ng BHK, Wong ASIIH, Liew DNS

Indian J Otolaryngol Head Neck Surg, 2021 Jun;73(2):226-232.

PMID: 34150596 DOI: 10.1007/s12070-021-02455-6

Chordomas are rare and slow-growing locally destructive bone tumors that can develop in the craniospinal axis. It is commonly found in the sacrococcygeal region whereas only 25-35% are found in the clival region. Headache with neurological deficits are the most common clinical presentations. Complete surgical resection either via open or endoscopic endonasal approaches are the main mode of treatment. Here, we report a series of 5 cases of clival chordomas which was managed via endoscopic endonasal approaches in our center. A retrospective analysis of patients who had undergone endoscopic endonasal resection of clival chordoma in Sarawak General Hospital from 2014 to 2018. A total of 5 cases were operated on endoscopically via a combine effort of both the otorhinolaryngology team and the neurosurgical team during the study period from year 2013 to 2018. From our patient, 2 were female and 3 were male patients. The main clinical presentation was headache, squinting of eye and nasopharyngeal fullness. All our patient had endoscopic endonasal debulking of clival tumor done, with average of hospital stay from 9 - 23 days. Pos-operatively, patients were discharged back well. Endoscopic endonasal resection of clival chordomas gives good surgical resection results with low morbidity rates and therefore can be considered as a surgical option in centers where the surgical specialties are available.

Fulltext Effectiveness of Direct Transcricothyroid Electromyographic Monitoring in Thyroidectomy Surgery

Ling AOL, Toong LY, Omar TASBTD, Ghauth S

Indian J Otolaryngol Head Neck Surg, 2023 Mar;75(1):193-199.

PMID: 37007880 DOI: 10.1007/s12070-022-03336-2

Thyroid surgeries are associated with complications of vocal cord palsy and hypocalcemia which can be debilitating. The usage of intraoperative nerve monitoring is a useful adjunct to direct nerve visualization in thyroidectomies. We advocate the usage of direct transcricothyroid electromyographic monitoring in identifying recurrent laryngeal nerve. We retrospectively collected data of all patients who underwent thyroidectomies (total thyroidectomy, hemithyroidectomy, isthmusdectomy) using direct transcricothyroid electromyographic monitoring from April 2020 to August 2021. Data was analysed based on patient's demographics, comorbidities, complications post thyroidectomy such as vocal cord palsy, transient and permanent hypocalcemia. 50 thyroidectomies were performed, 10 developed unilateral vocal cord palsy. Out of 22 total thyroidectomies, 7 developed transient hypocalcemia and 4 permanently. 1 patient developed vocal cord hematoma secondary to direct insertion of intraoperative nerve monitor's electrode. Direct transcricothyroid electromyographic monitoring is a feasible and effective method in intraoperative monitoring of recurrent laryngeal nerve during thyroid surgeries.

Fulltext Ectopic Esthesioneuroblastoma of the Sphenoclivus: A Rare Entity

Zahedi FD, Gendeh BS, Husain S, Kumar R, Kew TY

Indian J Otolaryngol Head Neck Surg, 2017 Mar;69(1):125-129.

PMID: 28239593 DOI: 10.1007/s12070-016-0978-0

Esthesioneuroblastoma is a rare malignant neoplasm of oflactory neuroepithelium and usually located at the olfactory cleft at superior nasal cavity. Ectopic localization of esthesioneuroblastoma is even rarer and usually posed with a diagnostic dilemma and delay in the diagnosis and management, We report a rare case of ectopic esthesioneuroblastoma of the sphenoclivus with the presentation of intermittent unilateral epistaxis, intermittent intractable headache without anosmia. Nasal endoscopy findings showed a pulsatile mass at the anterior face of the sphenoid sinus with extension posteriorly towards the clivus region and occupying the floor of the sphenoid sinus. Endonasal transclival endoscopic excision of tumour was performed which involved otorhinolaryngology surgeon and neurosurgeon with intraoperative navigation imaging and frozen section. The histopathological findings was esthesioneuroblastoma. Due to its rarity and unusual presentation, the diagnosis of ectopic esthesioneuroblastoma is difficult and can be misdiagnosed with the other type of malignancy. Therefore, the histopathological result is important in confirming the type of tumour and can lead to the next step of management.

Dual Staged Supraglottoplasty for the Treatment of Trapdoor Epiglottis with Underlying Neurodegenerative Disease-Case report and Review of literature

Ng SW, Syafina H, Goh LC

Indian J Otolaryngol Head Neck Surg, 2022 Dec;74(Suppl 3):5033-5036.

PMID: 36742682 DOI: 10.1007/s12070-021-02610-z

To describe the technique and outcome of a novel dual staged supraglottoplasty for the treatment of neurological induced adult onset laryngomalacia. A 55 year old male had a diagnosed neurodegenerative disorder with suspected Pompe's disease associated with Trap door epiglottis and proximal myopathy.This was complicated with emergency airway distress and subsequent tracheostomy.Trap-door epiglottis (also known as adult-onset laryngomalacia) associated with neurodegenerative disorders constitute a surgical challenge as it is often coupled with failure of tracheostomy decannulation when present. The patient underwent a novel dual staged endoscopic supraglottoplasty whereby an initial stage of epiglottopexy and submucosal diathermy was made at the vallecula.This was then followed by an interval of 6 weeks whereby a partial epiglottotectomy was made at the upper 3rd of the epiglottis and reduction of lingual tonsils was done using radiofrequency ablation.Trachesotomy was decannulated 1 month after the second stage procedure and his airway remains asymptomatic after 1 year of surgical treatment. This case report describes the success of tracheostomy decannulation after a novel dual staged supraglottoplasty for adult onset laryngomalcia (also known as trap-door epiglottis) .

Distraction Breathing Exercise in Managing Inducible Laryngeal Obstruction in a Female Patient

Che Ab Rahim NA, Saniasiaya J, Narayanan P

Indian J Otolaryngol Head Neck Surg, 2022 Dec;74(Suppl 3):5169-5171.

PMID: 36742856 DOI: 10.1007/s12070-022-03083-4

Inducible laryngeal obstruction (ILO) describes as inappropriate, episodic, reversible laryngeal closure during inspiration, occurring at the glottic and/or supraglottic level, in response to external triggers causing exertional breathing difficulties. We describe a case of a female patient with an underlying major depressive disorder who presented with sudden onset of stridor and tachypnoea, whereby the external trigger was psychogenic in origin. Bedside flexible nasopharyngolaryngoscopy (FNPLS) showed characteristic findings of paradoxical adduction of vocal cords during inspiration. Arterial blood gas analysis, routine blood tests, chest radiography, and computed tomography (CT) scan of brain, neck, and thorax excluded neurological or airway abnormality. Bedside distraction breathing exercise alleviated the stridor and tachypnoea. The patient was managed by supportive psychotherapy, speech therapy, and anti-reflux medication and was discharged well with resolution of her respiratory distress. We would like to highlight that meticulous history along with physical examinations are imperative especially amongst Otorhinolaryngologists as emergent airway management tracheostomy would have been unnecessary and cause more stress and burden to the patient as well as family members.

Fulltext Development and Evaluation of an Interprofessional Collaborative Practice Module for the Tracheostomy Procedure for Improved Patient Care

Bhargava A, Sahoo S, Mahdi F, Ali Mohammed C, Dandekar S, Rege N, et al.

Indian J Otolaryngol Head Neck Surg, 2022 Jun;74(2):225-233.

PMID: 35813773 DOI: 10.1007/s12070-021-03041-6

The Interprofesional collaborative practice (IPCP) is the need of the hour for improved patient care. The procedure of tracheotomy is a life saving procedure and the implementation of the Interprofessional collaborative practice module for the same comprising of the ENT surgeon, Physiotherapist, Nursing staff, OT and Trauma technician decreases the number of complications. This study was carried out to develop and evaluate the Interprofessional collaborative practice module for Tracheostomy. The project has been carried out as a prospective before and after study with the departments of ENT, nursing and Allied health sciences. The facilitators were from the above departments.They were sensitized and developed the Interprofessional education (IPE team),which then collaborated to develop the IPCP module.This IPE team after faculty meetings developed the module with learning objectives, teaching learning methods and methods of assessment. Standardized Readiness scale for Interprofessional Learning Scale (RIPLS), was adopted for the module. The questionnaires for assessment and the module were structured and validated.The template of reflection was compiled for the execution of the module. The students training comprised of the demonstration session, baseline Team OSCE, practice sessions and the final Team OSCE. The baseline and final Team OSCE scores,reflections and RIPLS scores were compared. Team OSCE scores baseline vs Final for IPCP competencies i.e. Competency 1-Values and Ethics for Interprofessional Practice, Competency 2-Roles and Responsibilities, Competency 3-Interprofessional Communication, Competency 4-Teams and Teamwork during Pretracheostomy (PreT),Tracheostomy(T) and PostTracheostomy (PostT) were calculated. Faculty observations: TOSCE scores (pre T/T/postT) significantly improved for all the four IPCP competencies (p

Could Cultural and Background Resilience be the Main Culprit for Neglected Vestibular Dysfunction in Children?

Saniasiaya J

Indian J Otolaryngol Head Neck Surg, 2023 Dec;75(4):4114-4115.

PMID: 37974752 DOI: 10.1007/s12070-023-03873-4

Vestibular dysfunction in children and adolescents has recently gained tremendous attention, with more child-friendly investigations and rehabilitation protocols emerging.Reports have shown that children with vestibular impairment tend to develop speech and language acquisition delay, fine and gross motor delay, which in the long-termresults in an overall poor quality of life. In an extreme situation, vestibular dysfunction can lead to dissociative syndromes such as depersonalisation/derealisation symptomsthat occur following a mismatch between the vestibular signals and other sensory inputs, which may, in turn, lead to suicidal thoughts and behaviour 1. Whilst measuresto incorporate vestibular assessment as a part of routine practice in paediatric patients have been carried out in most centres, pediatric vestibular medicine appears to beunfathomed in some parts of the world, notably the South-East Asian region.

Correction: Nasal Sebaceous Carcinoma-Rare Presentation

Sukumaran Y, Lynn JCS, Baba FB, Dam VSKE

Indian J Otolaryngol Head Neck Surg, 2024 Apr;76(2):2155.

PMID: 38566683 DOI: 10.1007/s12070-024-04572-4

[This corrects the article DOI: 10.1007/s12070-023-04439-0.].

Fulltext Cholesterol Granuloma of the Sphenoid Sinus: An Insidious Entity

Lim RCA, Krishnan EK, Husain S

Indian J Otolaryngol Head Neck Surg, 2022 Oct;74(Suppl 2):1450-1452.

PMID: 36452606 DOI: 10.1007/s12070-021-02597-7

Pathology of sphenoid sinus is uncommon and may pose a diagnostic challenge in view of its vague symptoms together with its relatively inaccessible location at the skull base. Radiological imaging is of utmost importance in diagnosis. We present an insidious case of a sphenoid sinus cholesterol granuloma.

Fulltext Challenges in the Management of Laryngo-Tracheo-Bronchial Stenosis Secondary to Tuberculosis

Kamarudin NA, Yeoh XY, Ibrahim MZ, Ab Rahman WI, Azman M

Indian J Otolaryngol Head Neck Surg, 2022 Oct;74(Suppl 2):2652-2655.

PMID: 36452537 DOI: 10.1007/s12070-020-02340-8

Laryngo-tracheo-bronchial tuberculosis may be primary or secondary to pulmonary tuberculosis. It causes stenosis of the airway, leading to life threatening airway obstruction. We herein describe the challenges in managing a case of laryngo-tracheo-bronchial stenosis in a 22-year-old patient who presented with stridor post antituberculous therapy secondary to a malacic airway.

Fulltext Challenges in Managing Intractable Epistaxis in a Post-nasal Surgery and Radiated Cancer Patient: A Case Report and Literature Review

Goh SP, Wilfred R, Husain S, Tang IP

Indian J Otolaryngol Head Neck Surg, 2023 Apr;75(Suppl 1):1096-1100.

PMID: 37206815 DOI: 10.1007/s12070-023-03625-4

Recurrent epistaxis represents an alarming sign that may suggest a sinister aetiology, especially in patients with previous head and neck malignancy. The recognition of certain potentially life-threatening conditions, namely pseudoaneurysm or tumour recurrence, remains prudence to avoid disastrous repercussion. Nasal endoscopy has become an essential tool in otolaryngology. It can aid identify the underlying cause of epistasis and facilitate therapeutic management. On the other hand, radio imaging is highly sensitive in detecting vascular lesions, besides providing a pre-operative mapping if surgical intervention is planned. This paper reported a patient with sphenoidal sinus squamous cell carcinoma in remission presented with torrential epistaxis not relieved with nasal packing. Despite a repeated angiogram and magnetic resonance image, the identification of the source of bleeding remained futile, culminating in an examination under general anaesthesia. The diagnosis of carotid blowout syndrome was made intraoperatively, and the bleeding was temporarily secured with a muscular patch, preceded by the insertion of a vascular stent. The authors wish to highlight the importance of examination under general anaesthesia if radio imaging does not correlate to the clinical findings. Management options for carotid blowout should be tailored to the patients' medical conditions.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-023-03625-4.

Case Report: Metastatic Neck Nodes of Unknown Origin with Concurrent Tuberculous Lymphadenitis. Is Fine Needle Aspiration and Cytology (FNAC) Adequate?

Subramaniam SD, Tuang GJ, Zainal Abidin ZA, Abdullah S

Indian J Otolaryngol Head Neck Surg, 2022 Dec;74(Suppl 3):5888-5892.

PMID: 36742794 DOI: 10.1007/s12070-021-02497-w

Presentation with cervical lymphadenopathy would usually have an aetiology of neoplasm, infection or reactive cause. Dual pathology of regional metastasis with simultaneous occurrence of tuberculous lymphadenopathy is rather rare. Herein the authors present a case of primary occult carcinoma and tuberculous lymphadenopathy in an unfortunate patient. The reliability of fine-needle aspiration cytology as a first-line investigation, with alternative methods in approaching cervical lymphadenopathy, was further dissected.

Fulltext Bone Changes in Chronic Rhinosinusitis: Pathological or Physiological?

Pokharel M, Khadilkar MN, Sreedharan S, Pai R, Shenoy V, Bhojwani K, et al.

Indian J Otolaryngol Head Neck Surg, 2022 Jun;74(2):178-184.

PMID: 35813780 DOI: 10.1007/s12070-020-02076-5

Bone remodelling is a normal physiological process which occurs in all bones. Hence bone changes should also be detected in undiseased or minimally diseased ethmoids as well as in chronic rhinosinusitis (CRS) patients. To test this hypothesis, we compared ethmoid bone histology between two groups of patients; a study group of CRS patients and a group of patients whose radiological, endoscopic and symptom scores were significantly less when compared to the CRS group. The study group had 75 patients who underwent functional endoscopic sinus surgery for CRS. The control group included 16 patients who had significantly different endoscopic and radiological scores from the study group. On histopathology, the bone harvested from the ethmoid sinuses were grouped as no remodelling activity (Score 1), mild activity (Score 2) and marked activity (Score 3). Thirty-six percent of patients in the study group and 37.5% of patients in the control group had Score 2 and 3 bone changes and the difference was not statistically significant (χ2 = 1.824, p = 0.402). Correlation of bone changes in CRS done with parameters like Lund-Mackay radiological, surgical and symptom scores and Lund-Kennedy endoscopic scores showed no statistical significance. Similar bone changes were detected in CRS patients and the control group. The bone changes seen in histopathology in CRS patients could partly be due to the normal physiological remodelling occurring in all bones.

Bilateral Vestibular Atelectasis with Tullio's Phenomenon

Roy S, Kumarasamy G, Salim R

Indian J Otolaryngol Head Neck Surg, 2019 Nov;71(Suppl 2):1599-1602.

PMID: 31750223 DOI: 10.1007/s12070-019-01685-z

Vestibular dehiscence or atelectasis is a rarity known to cause vertigo. This pathology poses many challenges especially in diagnosis and treatment simply due to the scarcity of reported cases. The etiologic factors, disease pathophysiology and complications remain unclear. We report a young adult female who presented with unsteadiness for 2 years associated with headache. Tullio's phenomenon was observed which led to a finding of bilateral vestibular dehiscence involving the medial walls on high resolution computed tomography.

Fulltext Anterior external bony ear canal bulge

Rajagopalan R

Indian J Otolaryngol Head Neck Surg, 2010 Jan;62(1):90-1.

PMID: 23120691 DOI: 10.1007/s12070-010-0001-0

To study the prevalence of anterior external bony ear canal bulge.

Fulltext Annular bony spur

Raman R

Indian J Otolaryngol Head Neck Surg, 2000 Jul;52(3):318.

PMID: 23119711 DOI: 10.1007/BF03006219

A micro anatomical feature in the ear useful in surgery is described.

Fulltext An alternate approach to the mastoid antrum

Raman R

Indian J Otolaryngol Head Neck Surg, 1998 Apr;50(2):193.

PMID: 23119414 DOI: 10.1007/BF02991691

An alternate approach to the mastoid antrum for acellular mastoid is presented.

An Unusual Presentation of Midline Lethal Granuloma

Chin EW, Saniasiaya J, Hitam S, Hassan E, Kah Wai N

Indian J Otolaryngol Head Neck Surg, 2024 Apr;76(2):2137-2140.

PMID: 38566723 DOI: 10.1007/s12070-023-04466-x

Extranodal natural killer T-cell lymphoma, nasal type (ENKTCL), is a rare form of non-Hodgkin lymphoma that is strongly related to Epstein-Barr Virus (EBV) infection and commonly presents as "midline lethal granuloma." Herein, we report a middle-aged lady who presented with a two-week history of fever, sore throat and constitutional symptoms. Intraoral examination revealed a lacerated soft palate with an ulcerated uvula. A diagnosis of ENKTCL was confirmed through deep biopsies under general anaesthesia supplemented with a positive serum EBV genome. Unfortunately, she succumbed due to disease progression with left frontal brain metastasis with concurrent pulmonary tuberculosis before treatment was completed. The recommended treatment is multimodality with L-asparaginase-containing regimes chemotherapy in an advanced stage, relapsed, or refractory ENKTCL for better outcomes. The quantification of circulating plasma EBV deoxyribonucleic acid (DNA) is helpful as the baseline of tumour load and a biomarker for monitoring treatment response and prognostication. We advocate repeated and deeper core tissue biopsies.

An Unusual Delayed Complication of Rib Graft Microtia Reconstruction After Two Decades: A Case Report

Tuang GJ, Mansor M, Abdullah A

Indian J Otolaryngol Head Neck Surg, 2022 Dec;74(Suppl 3):3671-3674.

PMID: 36742599 DOI: 10.1007/s12070-020-02316-8

Microtia comprises a spectrum of congenital malformation characterized by partial deformities of the auricular components to complete absence of pinna. Surgical reconstructions of this anomaly are often complex and technically challenging. Infection, hematoma, and skin necrosis with resultant exposed cartilage graft tend to occur in the early phase of post-operative care. Herein, we report a case of a spontaneous auricular abscess with exposed cartilage framework 20 years following rib cartilage reconstruction. To our knowledge, this is the first case of such an occurrence. The treatment options are discussed, along with the review of the literature.

Fulltext Adenoid Cystic Carcinoma of the Nasopharynx: A Case Series

Ng BHK, Tang IP

Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):731-733.

PMID: 31742052 DOI: 10.1007/s12070-018-1523-0

Adenoid cystic carcinomas are tumors that are more commonly seen in the salivary glands than in the nasopharynx. Nasopharyngeal adenoid cystic carcinomas are rare and cases that are reported in the literatures are few. Treatment is mainly by surgical resection. Here, we report 2 cases of nasopharyngeal adenoid cystic carcinoma.

Displaying publications 61 - 80 of 95 in total