Displaying all 13 publications

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  1. Khoo V, Khoo HSJ, Goh LC
    Medeni Med J, 2021;36(3):281-286.
    PMID: 34915688 DOI: 10.5222/MMJ.2021.80445
    IgG4-related disease (IgG4-RD) is a fibro-inflammatory condition associated with tumefactive lesions at multiple sites. IgG4-RD was initially recognized in 2001 in a case of autoimmune pancreatitis. However, the disease was not limited to the pancreas but involved other organs such as the bile ducts, lacrimal glands, lymph nodes and salivary glands. IgG4-RD is rarely seen with an estimated incidence of 0.2 to 1/100.000 as reported in Japan, but with minimal to no incidence data have been published in Western countries. We hereby report a case of an IgG4-related mass arising from the nasolacrimal duct, masquerading as a sinonasal mass.
  2. 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) .
  3. Goh LC, Azman A, Ng BHK, Chew LC, Hufaidah K, Kulasegarah J
    Med J Malaysia, 2020 03;75(2):136-140.
    PMID: 32281594
    INTRODUCTION: To correlate the score obtained using a bilingual (Malay and English) 14 points questionnaire in the detection of hearing loss at the University of Malaya, Medical Centre (UMMC), Kuala Lumpur, Malaysia over a 9 month period.

    METHODS: This is a prospective instrument correlation study done on 93 children aged 1-4 years of age with speech and language delay for at least 3 months. Hearing status was confirmed using otoacoustic emissions, pure tone audiometry and brainstem evoked response (BSER). Hearing status was then compared to the 14-point questionnaire final scores and is statistically correlated.

    RESULTS: There were 26 patients, 15 males (58%) and 11(42%) females who were diagnosed to have hearing loss. The average age of presentation was 2.49 and conductive hearing loss accounted for about 74% of cases of hearing loss. The mean questionnaire score obtained through our patients was 3.83±1.987. Discriminant analysis suggests that a questionnaire score of above 4 was indicative that the child was suffering from hearing loss.

    CONCLUSION: Our study suggests that the low-cost bilingual (Malay and English) questionnaire can be used to detect hearing loss in the Malaysian population and could potentially be useful in rural health centres to help detect hearing loss and to determine the urgency of referral to a tertiary health centre.

  4. Goh LC, Santhi K, Arvin B, Mohd Razif MY
    BMJ Case Rep, 2016 Aug 26;2016.
    PMID: 27566213 DOI: 10.1136/bcr-2016-216676
    An acquired persistent tracheopharyngeal fistula secondary to an infected tracheopharyngeal voice prosthesis is a common cause of recurrent aspiration pneumonia in a postlaryngectomy patient. We report a case of a successfully treated tracheopharyngeal fistula whereby both the sternocleidomastoid muscles were used as muscular flaps to close the defect and its outcome.
  5. Goh LC, Chitra BK, Shaariyah MM, Ng WS
    BMJ Case Rep, 2016 Oct 28;2016.
    PMID: 27793872 DOI: 10.1136/bcr-2016-217514
    Sialolithiasis is among the most common disease affecting the major salivary glands whereby the submandibular gland or its duct is affected in the majority of cases. We report a case of the surgical removal of a giant sialolith along with the submandibular gland using the transcervical approach and its clinical outcome.
  6. Ong HY, Goh LC, Santhi K, Sha'ariyah MM
    Oman Med J, 2018 Mar;33(2):167-170.
    PMID: 29657688 DOI: 10.5001/omj.2018.31
    Langerhans cell histiocytosis (LCH) is a rare proliferative disorder, which commonly arises in the bone and may involve other systems. To date, the diagnosis of temporal bone LCH remains a challenge as it may masquerade as a common ear infection. We report a case of a child who presented to us with persistent bilateral ear discharge for four months and was not responding to treatment. Her condition subsequently worsened, with clinical features and radiological findings suggestive of mastoid cellulitis. Nevertheless, further histopathology study revealed LCH.
  7. Goh LC, Arvin B, Zulkiflee AB, Prepageran N
    Otolaryngol Head Neck Surg, 2018 10;159(4):783-788.
    PMID: 30126325 DOI: 10.1177/0194599818795852
    Objective To objectively compare the nasal decongestion potency of lidocaine/phenylephrine when delivered with a nasal nebulizer and a nasal spray before a rigid nasoendoscopic examination. Study Design Open-label randomized controlled trial. Setting Multicenter study. Methods This prospective clinical trial involved 106 participants with untreated chronic rhinitis. Fifty-three participants had 400 μL of lidocaine/phenylephrine administered into the right nostril with a nasal nebulizer, while the remaining 53 participants had 400 μL administered with a nasal spray. The control was the left nostril. Nasal resistance at 150-Pa fixed pressure was evaluated with an active anterior rhinomanometry at 5, 10, 15, and 30 minutes postintervention. Pain score was assessed subjectively by applying pressure to the inferior turbinate 30 minutes after intervention. Results There was an overall reduction in nasal resistance of the right nostril when lidocaine/phenylephrine was administered with the nasal nebulizer in comparison with the nasal spray. However, a statistically significant difference in nasal resistance was seen only at 5 minutes ( P = .047), 15 minutes ( P = .016), and 30 minutes ( P = .036). The examining endoscopist further supported the degree of nasal decongestion via subjective assessment of the nasal cavity ( P = .001). Pain scores obtained after the intervention showed a significant decrease in pain threshold when the nasal nebulizer was used instead of the nasal spray ( P = .040). Conclusions This study suggests that the delivery of lidocaine/phenylephrine to the nasal cavity by the nasal nebulizer provides better decongestive and analgesic potency as compared with the delivery by nasal sprays.
  8. Goh LC, Wan MH, Shashi G, Elangkumaran S
    Iran J Otorhinolaryngol, 2018 Jul;30(99):225-229.
    PMID: 30083529
    Introduction: This study aims to report a rare case of a respiratory epithelial adenomatoid hamartoma (REAH) of the lateral nasal wall that had initially presented as a fungating mass, similar to that of a sinonasal malignancy, and its complete removal from the lateral nasal wall.

    Case Report: We report the case of a 58-year-old woman who presented to us with a chief complaint of recurrent right-sided epistaxis and nasal blockage for the past 4 months, which was progressively worsening. Histopathological examination confirmed the presence of a REAH instead of a sinonasal malignancy. The tumor was surgically excised from the lateral nasal wall using electrocautery under endoscopic guidance. The patient was then carefully followed-up after surgery, and the wound was successfully healed 3 months after the initial surgery. There was no evidence of recurrence 6 months after the initial surgery.

    Conclusion: This case demonstrates the rare presentation of a REAH, which had arisen from the lateral nasal wall. Clinically, it is difficult to distinguish a REAH from a more notorious mass such as a sinonasal malignancy. Therefore, biopsy is mandatory in all cases of lateral nasal mass in order to rule out malignancy before confirming nasal REAH. Fortunately, as seen in this case, a lateral nasal REAH, once diagnosed, can be safely and easily removed from the lateral nasal wall using electrocautery with good surgical outcomes and a low rate of recurrence.

  9. Goh LC, Norain RS, Shifa Z, Manuel AM
    Iran J Otorhinolaryngol, 2019 Nov;31(107):383-386.
    PMID: 31857983 DOI: 10.22038/ijorl.2019.35910.2186
    Introduction: Branchial arch anomalies represent defects in embryological developments whereby parts of the branchial arch persist in the head and neck regions as sinuses, fistulas, or cysts. These anomalies usually present as a unilateral lesion in the head and neck of young adults and children, which are excised upon the emergence of complications.

    Case Report: Herein, we presented a rare case of a 4-year-old child, who had been diagnosed with a complete bilateral second arch branchial fistula. The excision was made using the bilateral stepladder approach and tonsillectomy.

    Conclusion: The bilateral stepladder approach was a feasible method in excising a complete bilateral branchial fistula. However, larger-scale studies should be conducted on the surgical techniques of bilateral branchial fistulae excision in order to optimize the cosmetic outcome of the surgery.

  10. Hafeza S, Firdaus S, Goh LC, Jeyanthi K
    Indian J Otolaryngol Head Neck Surg, 2023 Jun;75(2):1259-1262.
    PMID: 37275017 DOI: 10.1007/s12070-022-03281-0
    Background: Endoscopic nasal surgery is often a tedious process due to repeated removal of the Hopkins rod telescope from the nasal cavity for manual defogging of the tip due to the presence of blood, smoke, and secretions. Objective: To design and print a 3-dimensional (3D) low-cost telescopic sleeve to allow the defogging solution to clean the rigid telescope tip without removing it from the nasal cavity. In addition, the sleeve must also act as a conduit for suction and irrigation to provide a clear surgical field view intraoperatively. Results and conclusion: A 3D printed low-cost telescopic sleeve, when used in conjunction with other add-ons, can be a helpful and cost-effective adjunct during endoscopic nasal surgery.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-022-03281-0.

  11. Goh LC, Shakri ED, Ong HY, Mustakim S, Shaariyah MM, Ng WSJ, et al.
    J Laryngol Otol, 2017 Sep;131(9):813-816.
    PMID: 28841131 DOI: 10.1017/S0022215117001505
    OBJECTIVE: To evaluate the clinicopathological and mycological manifestations of fungal rhinosinusitis occurring in the Tengku Ampuan Rahimah Hospital, in Klang, Malaysia, which has a tropical climate.

    METHODS: Records of patients treated from 2009 to 2016 were analysed retrospectively. Data from the records were indexed based on age, gender, clinical presentations, symptom duration, clinical signs and mycological growth.

    RESULTS: Of 80 samples, 27 (33.75 per cent) had fungal growth. Sixteen patients were classified as having non-invasive fungal rhinosinusitis and 11 as having invasive fungal rhinosinusitis. The commonest clinical presentation was nasal polyposis in non-invasive fungal rhinosinusitis patients (p < 0.05) and ocular symptoms in invasive fungal rhinosinusitis patients (p < 0.05). The commonest organism was aspergillus sp. (p < 0.05) in non-invasive fungal rhinosinusitis and mucorales in invasive fungal rhinosinusitis.

    CONCLUSION: There is an almost equal distribution of both invasive and non-invasive fungal rhinosinusitis, as seen in some Asian countries. Invasive fungal rhinosinusitis, while slightly uncommon when compared to non-invasive fungal rhinosinusitis, is potentially life threatening, and may require early and extensive surgical debridement. The clinical presentation of nasal polyposis was often associated with non-invasive fungal rhinosinusitis, whereas ocular symptoms were more likely to be associated with invasive fungal rhinosinusitis.

  12. Cheah PF, Punithamalar K, Kong LSS, Goh LC, Yeoh AG, Mohd Razif MY
    Indian J Otolaryngol Head Neck Surg, 2022 Dec;74(Suppl 3):6032-6038.
    PMID: 36742789 DOI: 10.1007/s12070-021-02680-z
    Preoperative radiological assessment of parotid tumours represents a crucial step in the planning of a parotidectomy in order to avoid post-operative facial nerve paralysis. The purpose of this study is to determine the reliability of the novel 'M-line' in predicting the facial nerve position and compare it to various radiological methods in the same context. 66 patients whom had underwent parotidectomy for parotid tumours from January 2012 to February 2021 were analyzed. Parotid tumour location were identified using the retromandibular vein, facial nerve line, Conn's arc, Utrecht line and the 'M'-line were compared to the intraoperative location of parotid tumours.The 'M'-line is a novel hypothetical line (drawn between the lateral surface of the mandible to the lateral border of the mastoid process) used to identify the location of the facial nerve radiologically. The 'M-Line' and other methods of radiological assessments were associated with statistical significance in predicting if the parotid tumours were superficial or deep to the facial nerve (p-value 
  13. Goh LC, Azman A, Siti HBK, Khoo WV, Muthukumarasamy PA, Thong MK, et al.
    Int J Pediatr Otorhinolaryngol, 2018 Jun;109:50-53.
    PMID: 29728184 DOI: 10.1016/j.ijporl.2018.03.010
    OBJECTIVE: To study the audiological outcome and early screening of pre-school going children with craniosynostosis under follow-up at the University of Malaya Medical Center(UMMC), Kuala Lumpur, Malaysia over a 10 year period.

    METHODS: A retrospective descriptive cohort study on the audiological findings detected during the first hearing assessment done on a child with craniosynostosis using otoacoustic emissions, pure tone audiometry or auditory brainstem response examination. The main aim of this study was to evaluate the type and severity of hearing loss when compared between syndromic and non-sydromic craniosynostosis, and other associated contributory factors.

    RESULTS: A total of 31 patients with 62 ears consisting of 14 male patients and 17 female patients were evaluated. Twenty two patients (71%) were syndromic and 9 (29%) were non-syndromic craniosynostosis. Amongst the syndromic craniosynostosis, 9 (41%) had Apert syndrome, 7 (32%) had Crouzon syndrome, 5 (23%) had Pfieffer syndrome and 1 (4%) had Shaethre Chotzen syndrome. Patients with syndromic craniosynostosis were more likely to present with all types and severity of hearing loss, including severe to profound sensorineural hearing loss while children with non-syndromic craniosynostosis were likely to present with normal hearing (p 

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