Displaying publications 1 - 20 of 67 in total

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  1. Tang IP, Prepageran N
    Med J Malaysia, 2007 Oct;62(4):337-8.
    PMID: 18551941 MyJurnal
    We reported a patient with an extensive benign sinonasal squamous papilloma in the right nasal cavity with involvement of right sphenoid, ethmoid, maxillary sinuses and intracranial extension. This tumour is rare with very few reported cases in the literature of such extensive in nature. The tumour is excised completely with combined endoscopic transnasal and transcranial approaches. The patient remains disease free at a year interval of follow-up.
  2. Tang IP, Prepageran N, Shashinder S
    Med J Malaysia, 2008 Mar;63(1):67-8.
    PMID: 18935740
    We report a male patient of Graves' Disease with bilateral exophthalmos who had undergone bilateral transnasal endoscopic orbital decompression with subsequent improvement of 3 mm in orbital proptosis bilaterally without any complications. Transnasal endoscopic orbital decompression is recommended as an alternative to traditional decompression techniques especially for purely cosmetic reasons.
  3. 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.

  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. Zulkarnaen M, Tang IP, Wong SL
    Malays J Pathol, 2012 Jun;34(1):53-5.
    PMID: 22870599 MyJurnal
    We present a case of a papillary tumour at the cerebellopontine angle in a 41-year-old man. He presented with left-sided facial and ear pain associated with dizziness, nystagmus and hearing loss. CT scan of the temporal bone showed a destructive tumour at the left cerebellopontine angle. Surgical excision was performed and the diagnosis of the endolymphatic sac tumour was made. Endolymphatic tumour is a low grade adenocarcinoma that originates from the endolymphatic sac. The definitive diagnosis requires a combination of clinical features, radiological finding and pathological correlation.
  9. Tang IP, Singh S, Krishnan G, Looi LM
    J Laryngol Otol, 2012 Dec;126(12):1284-6.
    PMID: 23084156 DOI: 10.1017/S0022215112002435
    We report a rare case of small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses with intracranial extension, and discuss the management of this rare tumour.
  10. Sia KJ, Tang IP, Tan TY
    J Laryngol Otol, 2012 Jul;126(7):756-8.
    PMID: 22583757 DOI: 10.1017/S0022215112000709
    To discuss the pathophysiology and various treatment methods of multiple symmetrical lipomatosis.
  11. Tang IP, Prepageran N, Ong CA, Puraviappan P
    J Laryngol Otol, 2010 Aug;124(8):913-5.
    PMID: 20426886 DOI: 10.1017/S0022215110000265
    To demonstrate the different clinical presentations of tuberculous otitis media and the management of selected cases.
  12. Tang IP, Lee SC, Shashinder S, Raman R
    Med J Malaysia, 2009 Jun;64(2):155-8.
    PMID: 20058577
    This is a retrospective study. The objective of this study is to review the factors influencing the outcome of treatment for the patients presented with idiopathic facial nerve paralysis. The demographic data, clinical presentation and management of 84 patients with idiopathic facial nerve paralysis (Bell's palsy) were collected from the medical record office, reviewed and analyzed from 2000 to 2005. Thirty-four (72.3%) out of 47 patients who were treated with oral prednisolone alone, fully recovered from Bell's palsy meanwhile 36 (97%) out of 37 patients who were treated with combination of oral prednisolone and acyclovir fully recovered. The difference was statistically significant. 42 (93.3%) out of 45 patients who presented within three days to our clinic, fully recovered while 28 (71.8%) out of 39 patients presented later then three days had full recovery from Bell's palsy. The difference was statistically significant. The outcome of full recovery is better with the patients treated with combined acyclovir and prednisolone compared with prednisolone alone. The patients who were treated after three days of clinical presentation, who were more than 50 years of age, who had concurrent chronic medical illness and facial nerve paralysis HB Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.
  13. Tang IP, Prepageran N, Raman R, Sharizhal T
    J Laryngol Otol, 2009 Dec;123(12):1321-4.
    PMID: 19835642 DOI: 10.1017/S0022215109990806
    To determine whether epithelial migration in the atelectatic tympanic membrane (secondary to any pathology) occurs in a similar fashion to that in the normal (non-pathological) tympanic membrane, by calculating and comparing the epithelial migration rate and pattern.
  14. Tang IP, Prepageran N, Subrayan V, Tajunisah I
    Med J Malaysia, 2008 Oct;63(4):337-8.
    PMID: 19385499 MyJurnal
    Optic neuropathy, an uncommon manifestation occurs in 5% of patients with Graves' ophthalmopathy. Its outcome is good if early and proper treatment given. We reported a 49 years old male patient of Graves' disease with bilateral optic neuropathy. He underwent bilateral transnasal endoscopic orbital decompression with marked improvement of visual acuity bilaterally. The preoperative visual acuity was 6/36 in his right eye and 6/60 in his left eye. Two days after operation, his visual acuity was 6/12 in his right eye and 6/24 in his left eye. Transnasal endoscopic orbital decompression is a choice of treatment in optic neuropathy in thyroid ophthalmopathy after trial of corticosteroids.
  15. Shashinder S, Tang IP, Velayutham P, Rahmat O, Loganathan A
    Med J Malaysia, 2008 Aug;63(3):267-8.
    PMID: 19248709 MyJurnal
    A 12-year-old boy with moderate to severe bilateral mixed hearing loss was planned for hearing aid placement. During the process of making ear mould impression, the impression material accidentally entered the right middle ear. Removal of the ear mould impression was possible permeatally under general anaesthesia.
  16. Tang IP, Shashinder S, Kuljit S, Gopala KG
    Med J Malaysia, 2007 Mar;62(1):53-5.
    PMID: 17682572
    We reviewed the recurrence rate and possible factors influencing recurrence of preauricular sinus after excision. Seventy-one patients with 73 preauricular sinuses seen at our centre from year 2000 to 2005 were reviewed in this study. The overall recurrence rate was 14.1%. Twelve sinuses needed to be drained for an abscess prior to a definitive surgery. Different modalities used in demonstrating the sinus tract between methylene blue alone and probing together with methylene blue, showed different outcomes, which were statistically significant with a p value of < 0.05(chi-square test). A preauricular sinus with a previous history of infection or actively infected during the definitive surgery may have a higher tendency of recurrence. Meanwhile demonstrating the sinus tract by probing with lacrimal probe/sinus probe followed by injection of methylene blue reduces the recurrence rate (p < 0.05 with chi-square test).
  17. 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
  18. 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.
  19. Govindaraju R, Tang IP, Prepageran N
    PMID: 30507693 DOI: 10.1097/MOO.0000000000000508
    PURPOSE OF REVIEW: Sphenoid sinus lateral recess encephalocoeles (SSLRE) are rare occurrences and pose unique challenges due to limited surgical access for endoscopic endonasal repair and also the lack of consensus on optimal perioperative managements specifically in the spontaneous cases, which are also believed to be a variant of idiopathic intracranial hypertension (IIH). Endoscopic endonasal approaches have largely replaced the transcranial route and the techniques are continuously being refined to reduce the neurovascular morbidity and improve outcome.

    RECENT FINDINGS: Transpetrygoid is the most utilized approach with modifications suggested to limit bone removal, exposure and preservation of the neurovascular structures as dictated by the extent of the lateral recess. As more experience is gained, extended transphenoidal techniques were also successfully used for access. Lateral transorbital is a new approach to the lateral recess investigated in cadavers. IIH treatment is still controversial in the setting of SSLRE, but it appears rationale to evaluate, monitor and treat if necessary.

    SUMMARY: SSLRE management should be tailored to the specific anatomical variances and cause. Modifications of techniques have been described giving different options to access the lateral recess. Successful repair for spontaneous SSLRE may require treatment of IIH if present, but the long-term outcome is still unclear.

  20. Tang IP, Ling XN, Prepageran N
    Med J Malaysia, 2018 10;73(5):276-280.
    PMID: 30350804 MyJurnal
    OBJECTIVES: To investigate the surgical and audiological outcome of Bonebridge (BB) at tertiary centres in Malaysia.

    STUDY DESIGN: Prospective, intra-subject repeated measurements of which each subject is his/her own control, from year 2012 to 2016 at two tertiary referral centres.

    METHODS: Twenty patients with hearing loss who fulfilled criteria for BB and showed good response to bone conduction hearing aid trial were included. Implantations of BB were carried out under general anaesthesia with preoperative computed tomography (CT) planning. Complications were monitored up to six months postoperatively. Subjects' audiometric thresholds for air conduction, bone conduction and sound field at frequencies of 250Hz to 8kHz were assessed preoperatively and at six months postoperatively. Subjects' satisfaction was evaluated at 6 months post operatively with Hearing Device Satisfaction Scale (HDSS) questionnaire.

    RESULTS: There was no major complication reported. Mean aided sound field thresholds showed significant improvement for more than 30dB from 500 to 4000kHz (p<0.05). There was no significant change in mean unaided air conduction and bone conduction thresholds pre and post operatively from 500 to 4000kHz, with a difference of less than 5dB (p>0.05). All the patients were very satisfied (>80%) with the implant, attributing to the promising functional outcome and acceptable cosmetic appearance.

    CONCLUSIONS: BB implantation surgery is safe and is effective in restoring hearing deficits among patients aged five and above with conductive or mixed hearing loss and single-sided hearing loss.

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