Sakina Ghauth

Artificial intelligence (AI), particularly machine learning and deep learning architectures, has been widely applied to support thyroid cancer diagnosis, but existing evidence on its performance and limitations remains scattered across techniques, tasks, and data types. This systematic review synthesizes recent work on knowledge extraction from heterogeneous imaging and clinical data for thyroid cancer diagnosis and detection published between 2021 and 2025. We searched eight major databases, applied predefined inclusion and exclusion criteria, and assessed study quality using the Newcastle–Ottawa Scale. A total of 150 primary studies were included and analyzed with respect to AI techniques, diagnostic tasks, imaging and non-imaging modalities, model generalization, explainable AI, and recommended future directions. We found that deep learning, particularly convolutional neural networks, U-Net variants, and transformer-based models, dominated recent work, mainly for ultrasound-based benign–malignant classification, nodule detection, and segmentation, while classical machine learning, ensembles, and advanced paradigms remained important in specific structured-data settings. Ultrasound was the primary modality, complemented by cytology, histopathology, cross-sectional imaging, molecular data, and multimodal combinations. Key limitations included diagnostic ambiguity, small and imbalanced datasets, limited external validation, gaps in model generalization, and the use of largely non-interpretable black-box models with only partial use of explainable AI techniques. This review provides a structured, machine learning-oriented evidence map that highlights opportunities for more robust representation learning, workflow-ready automation, and trustworthy AI systems for thyroid oncology.

Objective: This paper aims to introduce our combined approach, which provides definitive treatment for intractable aspiration while preserving phonation and highlights the importance of performing both procedures together.Methods: We describe a case of intractable aspiration requiring a nasogastric tube and a tracheostomy tube. We propose a combined technique consisting of an open medialisation thyroplasty with intra-operative, intra-glandular botulinum toxin injection. The thyroplasty procedure medialises the left vocal fold to overcome glottic insufficiency. Botulinum toxin injection reduces salivary flow and prevents excessive pooling.Results: The patient was followed up for twelve months. Video fluoroscopy demonstrated no evidence of aspiration. The patient was allowed a regular oral diet and decannulated two months post-operatively.Conclusion: This paper demonstrates the feasibility of our combined approach as a viable treatment option for intractable aspiration, particularly in patients with a strong desire for vocalisation. The cases must be selected carefully to ensure a favourable outcome.

Yew Toong liew, Sakina Ghauth; Darling tongue, QJM: An International Journal of Medicine, , hcae180, https://doi.org/10.1093/qjmed/hcae180

Mastoid fistula is a rare condition, its causes include chronic suppurative otitis media and repeated ear surgeries. Management is challenging, simple closure typically leads to recurrence due to surrounding necrotic skin edges. Several surgical techniques have been described. In this paper, we present a case of a 60 year old lady who presented with chronic right ear discharge post radical mastoidectomy due to acquired cholesteatoma. At presentation, there was a mastoid opening found over her auricular sulcus, endoscopic examination showed a well epithelized mastoid cavity with mucopurulent discharge, CT of temporal bone correlated with physical findings. The fistula was surgically closed with a three-layer pedicled flap and the fistula was fully healed at the 1-month follow up.

Case Series of Endoscopic Transoral Excision of Huge Parapharyngeal Tumors: Pushing the Boundaries - Turkish Archives of Otorhinolaryngology

Objective: The primary objective of this study is to review the clinical parameters associated with skull base osteomyelitis (SBO), with a secondary aim of studying their association with patient outcomes 1 and 6 months after treatment initiation.Study Design: This is a single‐center restrospective observational study.Setting: The study was conducted from January 2018 to December 2022 at the University Malaya Medical Center in Kuala Lumpur.Methods: Patients aged over 15 years with a diagnosis of SBO were included in the study. Clinical parameters, investigations, and follow‐up records were recorded. The disease outcomes were analyzed at 1 and 6 months after treatment initiation using multivariable analyses.Results: The study identified 31 patients with SBO, the majority of whom were elderly males with comorbidities such as diabetes and hypertension. Otalgia and otorrhea were the most common symptoms, and computed tomography scans were used for diagnosis. Pseudomonas aeruginosa was the most commonly identified pathogen, and intravenous broad‐spectrum antimicrobials were used to treat all patients. Surgical intervention was required for 25% of patients, and underlying ischemic heart disease, anemia, and single nerve palsy were significantly associated with an unfavorable prognosis. Patients with higher body mass index and elevated C‐reactive protein showed poorer outcomes after 1 and 6 months of treatment, respectively.Conclusion: Early recognition, prompt treatment, better control of comorbidities, nutrition, and monitoring can improve SBO outcomes and reduce complications. Therefore, as the prevalence of SBO increases, diagnostic criteria or management guidelines should be established to guide the best clinical practice.

Background: This paper reports the innovative use of a modified nasopharyngeal airway device as a temporary stent in patients with laryngotracheal stenosis. It also discusses the technique of endoscopic stent placement, and our experience in terms of the indications and suitability.Method: The nasopharyngeal airway device was modified to use as an airway stent by trimming it to the desired length. Next, the stent was inserted endoscopically and anchored using a novel approach.Results: The surgery was performed successfully without complications. The patients had full use of their voice while the stent was in situ. No significant granulation tissue was observed.Conclusion: This paper demonstrates the feasibility of using a nasopharyngeal airway device as a temporary stent to prevent restenosis in cases where the patients have a strong demand for phonation. The modified nasopharyngeal airway device is potentially very promising, but cases must be selected carefully to avoid compromising efficacy and safety.

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.

Background Sarcoidosis is a granulomatous disorder involving multi-systemic organs. Patients invariably have lung involvement but some may have extrapulmonary disease. Rarely, cervical lymphadenopathy is the only sign without mediastinal or pulmonary abnormalities. Case presentation We report a Malay male who complained of neck swelling exclusively. On imaging, multiple enlarged cervical lymph nodes deep to the sternocleidomastoid muscle were seen. An excision biopsy revealed non-caseating granulomas with epithelioid macrophages. Extensive investigations led to the diagnosis of isolated cervical lymph node sarcoidosis. Conclusions Sarcoidosis can present as cervical lymphadenopathy alone, without mediastinal or lung disease. The presence of epithelioid granulomas on histopathology warrants the exclusion of other granulomatous diseases. Isolated cervical lymph node sarcoidosis is only diagnosed in the presence of consistent clinical and radiological findings. In this case, close monitoring for systemic sarcoidosis is important as it can manifest later in life.

Methylene blue has many usages in the field of otolaryngology. We describe a preliminary finding of methylene blue guided neopharynx closure after total laryngectomy. This technique can potentially reduce the risk of pharyngocutaneous fistula and has not been described in the literature. It is also handy in assisting junior surgeons to perform modified Connell suture during neopharynx reconstruction. Concurrently, we reviewed other essential applications of methylene blue in otolaryngology.