Many children have benefited from cochlear implant device including those with congenital malformation of the inner ear. The results reported in children with malformed cochlea are very encouraging. We describe 2 cases of Mondini's malformation with severe sensorineural hearing loss. Cochlear implantation was performed and both of them underwent post-implantation speech rehabilitation. Post-implantation, both of them were noted to respond to external sound. But the second case developed facial twitching a few months after the device was switched on. It is important to evaluate the severity of the inner ear deformity and the other associated anomalies in pre-implantation radiological assessment in order to identify the problem that may complicate the surgery and subsequent patient management.
Bilateral vocal cord palsy is almost always caused by neck surgery, particularly surgery of the thyroid. We report a case of bilateral vocal cord palsy requiring emergency surgery to relieve the airway obstruction as the sole presentation of acquired syphilis. As the incidence of syphilis worldwide is rising, this unusual presentation may give clinicians a different perspective on the disease.
Vallecular cyst, a benign yet rare laryngeal lesion, may cause stridor and even life-threatening upper airway obstruction in infants. It can cause apnoea and poor feeding habits, thus reducing the chance of survival. Although laryngomalacia remains the most common cause of stridor in this age group, awareness and a high level of suspicion for this condition can help lead to early management and intervention. Direct laryngoscopy is accepted as the gold standard for diagnostic purposes, and marsupialisation of the cyst is the preferred treatment. We describe 2 cases of vallecular cysts in infants admitted to our hospital where timely diagnoses led to appropriate treatment.
We report a case of an inflammatory pseudotumour (IP) involving the floor of the skull base, which demonstrated aggressive behavior both clinically and radiologically. In this case, the diagnosis was established by clinical presentation, magnetic resonance imaging (MRI), histopathological examination (HPE) and the dramatic response towards high dose steroid therapy. The clinical features improved with oral cyclophosphamide in combination with oral steroid, which were given for a period of three months.
We report a 56-year-old Malay woman with a tumour that involved the skin and caused hyoid bone erosion. There was no clinical or radiological evidence of regional lymph node involvement. A modified radical neck dissection with preservation of the accessory nerve and internal jugular vein was performed, followed by an "extended" Sistrunk operation. The surgical defect was reconstructed with a pectoralis major myocutaneous flap. Our literature review showed that this is the first reported thyroglossal duct carcinoma which involved the skin and required a pedicle flap reconstruction.