Yew Toong Liew

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 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.

Background: This paper presents our experience in paediatric tracheostomy in a tertiary children’s hospital and to describe the unique multi-racial and multi-ethnic social demographics involved. Moreover, we would like to highlight an unusual social concern in the state of Sabah, Malaysia and its challenges when treating illegal immigrant children.Methods: A retrospective case note review was conducted for all paediatric patients who underwent tracheostomy between January 2014 to December 2018.Results: Seventy-six patients were recruited. Among them thirteen (17.1%) were illegal immigrant children. The commonest indication for tracheostomy was for prolonged assisted ventilation (60.5%), followed by upper airway obstruction (38.2%) and bronchial toileting (1.3%).Conclusions: This study reflects the current trend in regards to the indication for paediatric tracheostomy. The challenges in treating illegal immigrant children need to be considered on a case by case basis encompassing the family’s economic situation, hospital policies and the child well-being.

J Indian Prosthodont Soc, Official publication of Indian Prosthodontic Society