Browse publications by year: 2024

  1. Expressed emotion and help-seeking behaviours among elderly adults with depression symptoms in northeast Malaysia: qualitative findings from a mixed methods investigation
    Sanggar A, Razak AA, Phoa PKA
    Psychogeriatrics, 2024 Nov 18.
    PMID: 39557512 DOI: 10.1111/psyg.13218
    BACKGROUND: Stressful life events greatly increase the risk of depression, which affects about 22% of older persons in northeast Malaysia. But how emotional distress manifests itself in reaction to these stressful events differs from person to person. Therefore, this study aims to delve into the nuances of emotional expression among older adults with depression symptoms in northeast Malaysia, alongside their help-seeking behaviours and utilisation of professional support.

    METHODS: Using a qualitative interpretative phenomenological approach, we conducted in-depth face-to-face interviews with participants, guided by Kleinman's explanatory model of illness. Nineteen older adults who screened positive for depression were included in the research.

    RESULTS: None of the participants explicitly acknowledged experiencing depression. However, they articulated their distress through three primary themes: 'Life is miserable,' 'Depression is a sign of weakness,' and 'Belief in pre-determination.' Remarkably, despite screening positive for depression, participants demonstrated a lack of awareness regarding available professional mental health services. Moreover, they expressed a reluctance to seek such services, citing reasons related to stigma and misconceptions. The predominant themes that emerged concerning help-seeking behaviours were 'Self-efficacy,' 'Social support,' and 'Formal assistance from non-mental healthcare professionals.'

    CONCLUSION: The expression of emotion among older adults is restricted by socio-cultural influences. Thus, there is a need to improve mental health literacy among older adults in Malaysia, and their preferred source of support such as religious leaders and non-mental healthcare physicians.

  2. Mechanisms of S-phase arrest and mitochondrial dysfunction in complex III by DHODH inhibitors in tumorigenic TNBC cells
    Shahhiran MAA, Abdul Kadir MF, Nor Rashid N, Abdul-Rahman PS, Othman S
    Histochem Cell Biol, 2024 Nov 18;163(1):3.
    PMID: 39557682 DOI: 10.1007/s00418-024-02339-0
    Dihydroorotate dehydrogenase (DHODH) inhibitors have recently gained increasing research interest owing to their potential for treating breast cancers. We explored their effects in different breast cancer subtypes, focusing on mitochondrial dysfunction. The sensitivity of different subtypes to the inhibitors was investigated with respect to DHODH expression, tumorigenic, and receptor status. Analysis of respiratory complexes, cell cycle, reactive oxygen species (ROS), and cell differentiation were performed. Four cell lines with different receptor status were included, namely MCF-7, MDAMB-231, SKBR-3, and MCF-10A. We showed that MCF-7 and MDAMB-231 cells of the subtypes (ER+/PR+/HER2-) and (ER-/PR-/HER2-), respectively, were responsive to brequinar. Brequinar (BQR) caused cell cycle arrest in the S-phase in sensitive subtypes of breast cells but induced cell differentiation only in poorly differentiated breast cells. All cell subtypes showed increased generation of ROS, both intracellular and mitochondrial ROS with a greater increase seen in mitochondrial ROS in response to DHODH inhibitor, subsequently contributing to mitochondrial dysfunction. BQR also disrupts the function of complex III in ER+/PR+ and triple negative breast cancer (TNBC) subtypes. Collectively, we have found that MDAMB-231 TNBC cell was the most affected by DHODH inhibition in terms of sensitivity, cell cycle arrest, induction of cell differentiation, production of ROS, and mitochondrial complexes disruption. In conclusion, these findings suggest that DHODH inhibitors can potentially become a valuable targeted therapy for TNBC subtype and further consolidates its therapeutic potential as part of the combinatorial therapy against this resilient breast cancer subtype.
    MeSH terms: Biphenyl Compounds; Enzyme Inhibitors/pharmacology; Female; Humans; Quinaldines; Tumor Cells, Cultured; Cell Cycle Checkpoints/drug effects; S Phase Cell Cycle Checkpoints/drug effects
  3. NEDD4L contributes to ferroptosis and cell growth inhibition in esophageal squamous cell carcinoma by facilitating xCT ubiquitination
    Chen Z, Wang W, Hou J, Gao C, Song M, Zhao Z, et al.
    Cell Death Discov, 2024 Nov 18;10(1):473.
    PMID: 39557844 DOI: 10.1038/s41420-024-02243-5
    The oncogene xCT plays an indispensable role in tumor growth by protecting cancer cells from oxidative stress and ferroptosis. Emerging evidence indicated xCT function is tightly controlled by posttranslational modifications, especially ubiquitination. However, it still remains unclear what specific regulatory mechanism of xCT by ubiquitin ligases in human cancers. Here, we reported that NEDD4L, an E3 ubiquitin ligases, inhibited esophageal squamous cell carcinoma (ESCC) tumor growth and facilitated ferroptosis by ubiquitination of xCT. NEDD4L expression was declined in ESCC and was associated with tumor invasion, lymph node metastasis and distant metastasis. Silencing NEDD4L triggered ESCC tumor growth. Meanwhile, knock down of NEDD4L prevented the accumulation of ROS, elevated the level of GSH, reduced the content of MDA in ESCC cells, thereby inhibiting ferroptosis. Mechanistically, NEDD4L directly bound to the ∆CT domain of xCT through its WW and HECT domain. More importantly, NEDD4L promoted xCT degradation by facilitating its polyubiquitination in ESCC cells. Collectively, these findings suggest that NEDD4L is crucial in governing the stability of xCT and mediating ferroptosis in ESCC.
  4. Fulltext Isolation and characterization of DNA aptamers against the HlyE antigen of Salmonella Typhi
    Ahmad Najib M, Winter A, Mustaffa KMF, Ong EBB, Selvam K, Khalid MF, et al.
    Sci Rep, 2024 Nov 18;14(1):28416.
    PMID: 39557915 DOI: 10.1038/s41598-024-78685-9
    Aptamers have emerged as prominent ligands in clinical diagnostics because they provide various advantages over antibodies, such as quicker generation time, reduced manufacturing costs, minimal batch-to-batch variability, greater modifiability, and improved thermal stability. In the present study, we isolated and characterized DNA aptamers that can specifically bind to the hemolysin E (HlyE) antigen of Salmonella Typhi for future development of typhoid diagnostic tests. The DNA aptamers against Salmonella Typhi HlyE were isolated using systematic evolution of ligands by exponential enrichment (SELEX), and their binding affinity and specificity were assessed utilizing enzyme-linked oligonucleotide assay (ELONA). A total of 11 distinct aptamers were identified, and the binding affinities and species selectivities of the three most probable aptamers were determined. Kd values were obtained in the nanomolar range, with the highest affinity of 83.6 nM determined for AptHlyE97. In addition, AptHlyE11, AptHlyE45 and AptHlyE97 clearly distinguished S. Typhi HlyE from other tested bacteria, such as Salmonella Paratyphi A, Salmonella Paratyphi B, Shigella flexneri, Klebsiella pneumonia and Escherichia coli, therefore displaying desirable specificity. These novel aptamers could be used as diagnostic ligands for the future development of inexpensive and effective point-of-care tests for typhoid surveillance, especially in developing countries of the tropics and subtropics.
    MeSH terms: Antigens, Bacterial/immunology; Antigens, Bacterial/isolation & purification; Bacterial Proteins; Humans; Salmonella typhi*; Typhoid Fever/diagnosis; Typhoid Fever/microbiology
  5. Fulltext Modeling linear and nonlinear viscoelastic oscillatory rheometric stress-strain hysteresis of asphalt binders
    Diab A, You L, Topa A, Saboo N, Sukhija M, Awed A
    Sci Rep, 2024 Nov 18;14(1):28499.
    PMID: 39557937 DOI: 10.1038/s41598-024-78551-8
    Understanding the complex stress-strain hysteresis behavior of asphalt binders under varied conditions is critical for optimizing pavement performance. This study addresses the challenge by analyzing and modeling asphalt binder responses in oscillating shear mode across different aging states (unaged, short-term aged, and long-term aged), stretch amplitudes, frequencies, and temperatures. Fifty-three stress-strain hysteresis loops were meticulously analyzed, revealing distinct stress paths relative to applied stretch levels. A nine-parameter parallel rheological framework model was developed, integrating a four-parameter eight-chain (FEC) hyperelastic model in one network and a FEC hyperelastic model with a linear viscoelastic flow element in series in another. This constitutive model was implemented in LS-DYNA finite element simulations to predict experimentally-measured stress-strain hysteresis loops accurately. The research demonstrates the model's capability to simulate both linear and nonlinear viscoelastic responses of asphalt binders across a wide range of environmental and loading conditions. This approach significantly enhances our ability to capture and understand the stress-strain behavior critical for asphalt pavement durability and performance optimization.
  6. Fulltext The effects of structured coordinative exercise protocol on physical fitness, motor competence and inhibitory control in preschool children
    Şendil AM, Canlı U, Sheeha BB, Alkhamees NH, Batrakoulis A, Al-Mhanna SB
    Sci Rep, 2024 Nov 18;14(1):28462.
    PMID: 39558052 DOI: 10.1038/s41598-024-79811-3
    The aim of the study was to evaluate the effects of a structured coordinative exercise intervention based on motor skill elements on physical fitness (PF), motor competence (MC) and inhibitory control (IC) in preschool children. A total of 41 kindergarten children (27 boys and 17 girls) aged between 5 and 6 years participated and were divided into exercise (EG; n = 18) and control (CG; n = 23) groups. The exercise group participated in a structured coordinative exercise programme focusing on locomotor and balance skills such as side-stepping, galloping, jumping and running for 30 min, 2 days a week for 8 weeks. The control group followed the normal curriculum. Children participated in measurements before and after 8 weeks, respectively; motor competence was assessed using the Körperkoordinationstest für Kinder (KTK3+) test battery, which includes eye-hand coordination and other coordinative skills. Physical fitness was measured by balance, agility and vertical jump tests. Inhibitory control was assessed using the Go/NoGo test in the Early Years Toolbox. As a result of the two-factor analysis of variance for mixed measures to determine whether being in the exercising group had a significant effect on the test scores, group by time interaction effect showed that the increase in the scores of the exercise group was significantly higher than that of the control group in the parameters of static balance, KTK sideways jump and KTK eye-hand coordination [respectively: F(1-39) = 6.993, p = 0.012; 6.443, p = 0.015; 8.180, p = 0.007). The results show that structured coordinative exercises improve PF and MC but have no significant effect on IC. This study targets the development of motor and cognitive skills considered to be important in preschool children and is one of the few studies to evaluate these parameters simultaneously. It also provides a comprehensive perspective on interventions aimed to positively affect health and development in early childhood.Trial Registration: NCT06631248. Registered on October 07, 2024.
    MeSH terms: Child; Child, Preschool; Postural Balance/physiology; Female; Humans; Male
  7. Fulltext Exploring feature sparsity for out-of-distribution detection
    Chen Q, Li K, Chen Z, Maul T, Yin J
    Sci Rep, 2024 Nov 18;14(1):28444.
    PMID: 39558072 DOI: 10.1038/s41598-024-79934-7
    Out-of-distribution (OOD) detection is a crucial problem in practice, especially, for the safe deployment of machine learning models in industrial settings. Previous work has used free energy as a score function and proposed a fine-tuning method that utilized OOD data in the training phase of the classification model, which achieves a higher performance on the OOD detection task compared with traditional methods. One key drawback, however, is that the loss function parameters are highly dependent on involved datasets, which means it cannot be dynamically adapted and implemented in others settings; in other words, the general ability of the energy score is considerably limited. In this work, our point of departure is to enlarge distinguishability between in-distribution features and OOD data. Consequently, we present a simple yet effective sparsity-regularized (SR) tuning framework for this purpose. Our framework has two types of workflows depending on if external OOD data is available, the complexity of the original training loss is sharply reduced by adopting this modification, meanwhile, the adapted ability and detection performance are enhanced. Also, we contribute a mini dataset as a light and efficient alternative of the previous large-scale one. In the experiments, we verify the effectiveness of our framework in a wide range of typical datasets along with common network architectures.
  8. Fulltext Locomotor performance parameters as predictors of high-performing male soccer teams. A multiple-season study on professional soccer
    Makar P, Musa RM, Silva RM, Muracki J, Trybulski R, Altundağ E, et al.
    Sci Rep, 2024 Nov 18;14(1):28547.
    PMID: 39558131 DOI: 10.1038/s41598-024-80181-z
    This study aims to explore the interplay between locomotor demands and goal differentials to better understand their combined influence on overall success. Spanning three competitive seasons within the male Turkish Super League, this study analyzed all participating teams across 124 matches. Locomotor demands, including total distance (m) covered (TD), distances covered (m) at different speed thresholds (0.21-2.0 m/s; 2.01-4.0 m/s; 4.01-5.5 m/s; and 5.5-7.7 m/s), and the number of accelerations in range of 5.5-7.0 m/s (n), were quantified using an optical tracking system. Subsequently, regression models were employed to predict the total points earned by all teams over the three seasons. The logistic regression model, tailored to predict team categorization as high-points earners (HPE) or low-points earners (LPE) based on locomotor variables, exhibited a mean accuracy of 74%. Notably, total distance covered, running speed intervals between 4.4 and 5.5 m/s, and the number of accelerations in range of 5.5-7.0 m/s emerged as significant predictors of team success. Our findings highlight the pivotal role of running speed (4.01-5.5 m/s), number of accelerations, and total distance in predicting success for high-performing teams. Coaches can leverage these insights to refine training programs, thereby optimizing team performance, and fostering success in competitive environments.
    MeSH terms: Acceleration; Adult; Humans; Locomotion/physiology; Male; Turkey; Athletes
  9. Fulltext Prevalence of dual use of combustible tobacco and E-cigarettes among pregnant smokers: a systematic review and meta-analysis
    Bushi G, Khatib MN, Balaraman AK, Ballal S, Bansal P, Tomar BS, et al.
    BMC Public Health, 2024 Nov 18;24(1):3200.
    PMID: 39558300 DOI: 10.1186/s12889-024-20746-9
    BACKGROUND: As e-cigarettes gain popularity as potential tobacco cessation aids, concerns arise about their dual use with traditional cigarettes, especially among pregnant women, potentially subjecting both women and fetuses to heightened risks. This systematic review and meta-analysis aimed to determine the overall prevalence of dual use of tobacco smoking and e-cigarette use in pregnant women.

    METHODS: A literature search was conducted across databases including PubMed, Embase, Web of Science, and Cochrane on October 20, 2023. The included studies reported the number of pregnant women and the count of those who were dual users. Quality assessment was undertaken using the JBI tool. The pooled prevalence of dual use was determined via a random-effects model. All statistical analyses were executed using R software, version 4.3.

    PROSPERO: CRD42023486020.

    RESULTS: Eighteen studies were analyzed, encompassing 5,983,363 pregnant women. The meta-analysis indicated an overall prevalence of 4.6% (95% CI: 2.0-10.3) for dual users with significant heterogeneity (I2 = 100%). Subgroup analysis based on the country showed a prevalence of 4.9% (95% CI: 2.0 to 11.6) for USA and 8.1% (95% CI: 0.00 to 1.00) for UK. Meta-regression revealed reduction of prevalence of dual use from 2019 to 2023. A potential publication bias was indicated by the LFK index and the Doi plot.

    CONCLUSION: The dual consumption of e-cigarettes and traditional tobacco in pregnant women is a significant health concern, with a notable prevalence. Given the established risks of tobacco smoking during pregnancy and the uncertainties surrounding e-cigarettes, more comprehensive research and public health interventions are urgently needed to address this issue.

    MeSH terms: Female; Humans; Pregnancy; Prevalence; Pregnant Women/psychology; Vaping/epidemiology
  10. Psychological factors contributing to the creation and dissemination of fake news among social media users: a systematic review
    Munusamy S, Syasyila K, Shaari AAH, Pitchan MA, Kamaluddin MR, Jatnika R
    BMC Psychol, 2024 Nov 18;12(1):673.
    PMID: 39558439 DOI: 10.1186/s40359-024-02129-2
    The proliferation of fake news on social media platforms has become a significant concern, influencing public opinion, political decisions, and societal trust. While much research has focused on the technological and algorithmic factors behind the spread of misinformation, less attention has been given to the psychological drivers that contribute to the creation and dissemination of fake news. Cognitive biases, emotional appeals, and social identity motivations are believed to play a crucial role in shaping user behaviour on social media, yet there is limited systematic understanding of how these psychological factors intersect with online information sharing. Existing studies tend to focus on individual aspects of fake news consumption, such as susceptibility to misinformation or partisan biases, leaving a gap in understanding the broader psychological mechanisms behind both the creation and dissemination of fake news. This systematic review aims to fill this gap by synthesizing current research on the psychological factors that influence social media users' involvement in dissemination and creation of fake news. Twenty-three studies were identified from 2014 to 2024 following the PRISMA guidelines. We have identified five themes through critical review and synthesis of the literature which are personal factors, ignorance, social factors, biological process, and cognitive process. These themes help to explain the psychological factors contributing to the creation and dissemination of fake news among social media users. Based on the findings, it is evident that diverse psychological factors influence the dissemination and creation of fake news, which must be studied to design better strategies to minimize this issue.
    MeSH terms: Communication; Humans; Deception*
  11. Exosome autoantibody biomarkers for detection of lung cancer
    Thuya WL, Peyper JM, Myen TT, Anuar ND, Anwar A, Gudimella R, et al.
    Mil Med Res, 2024 Nov 18;11(1):72.
    PMID: 39558443 DOI: 10.1186/s40779-024-00575-y
  12. Honeybee Venom: A Potential Source of Anticancer Components
    Khor SXY, Khongphinitbunjong K, Owatworakit A, Mah SH, Tang YQ
    Protein Pept Lett, 2024 Nov 15.
    PMID: 39558497 DOI: 10.2174/0109298665339355241008104141
    Cancer is a deadly disease that has claimed millions of lives worldwide. Traditional cancer treatments, such as chemotherapy and radiation, have been used for many years but have become less favored due to drug resistance, lack of tumor selectivity, high costs, and various side effects, such as fatigue and hair loss. Many studies have reported that animal venoms, such as those from snakes, scorpions, and bees, contain bioactive peptides that can be synthesized into anti-- cancer peptides (ACPs), which offer a potential alternative to traditional cancer therapies. Apitherapy is an area of growing interest for the development of new cancer treatments using bee venom, which is a complex mixture of biologically active peptides, enzymes, bioactive amines, and nonpeptide components that have been found to have anti-cancer properties. By leveraging these bioactive peptides, researchers could develop ACPs that are more targeted towards cancer cells, reducing the risk of adverse side effects and improving patient outcomes. The use of bee venom components in targeting cancer could provide a more selective, effective, and affordable approach to cancer therapy. While further research is needed, the potential benefits of using bee venom components in cancer therapy are significant and could help improve the lives of cancer patients worldwide. This study aims to review the components of bee venom as potential cancer treatments.
  13. Harnessing bacterial antimicrobial peptides: a comprehensive review on properties, mechanisms, applications, and challenges in combating antimicrobial resistance
    Erriah P, Puan SL, Yahaya NM, Kamil WNIWA, Nordin SA, Muhamad A, et al.
    J Appl Microbiol, 2024 Nov 18.
    PMID: 39558882 DOI: 10.1093/jambio/
    Antimicrobial resistance (AMR) is a significant global health concern, due to the persistence of pathogens and the emergence of resistance in bacterial infections. Bacterial-derived antimicrobial peptides (BAMPs) have emerged as a promising strategy to combat these challenges. Known for their diversity and multifaceted nature, BAMPs are notable bioactive agents which exhibit potent antimicrobial activities against various pathogens. This review explores the intricate properties and underlying mechanisms of BAMPs, emphasizing their diverse applications in addressing AMR. Additionally, the review investigates the mechanisms, analyses the challenges in utilizing BAMPs effectively, and examines their potential applications and associated deployment challenges providing comprehensive insights into how BAMPs can be harnessed to combat AMR across different domains.
  14. Sublingual Ectopic Thyroid Presenting with Congenital Hypothyroidism
    Kashaf N'AFA, Lim CC, Kulasegarah J
    Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):6106-6110.
    PMID: 39558985 DOI: 10.1007/s12070-024-04915-1
  15. A Rare Manifestation of Cutaneous Metastasis from Laryngeal Carcinoma
    Ariffin NINM, Dahari KASA, Gani NA, Mohamad I
    Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):5899-5901.
    PMID: 39558993 DOI: 10.1007/s12070-024-04981-5
    Cutaneous metastasis from laryngeal carcinoma is an uncommon occurrence. We reported a man with laryngeal squamous cell carcinoma developed cutaneous metastasis on his neck and anterior chest wall after undergoing treatment. Thus, new skin lesions in laryngeal cancer patients may indicate cutaneous metastasis and it signifies poor prognosis.
  16. Ceruminous Adenoma: A Case Report and Review of Literature
    Boon WJ, Yee LW, Kin FS, Tang IP, Awang Basry NS, Kevin Ng BH
    Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):5459-5463.
    PMID: 39559016 DOI: 10.1007/s12070-024-05001-2
    Ceruminous adenoma is a rare and benign tumor of the external auditory canal and present with a nonspecific symptom. Biopsy with histopathology examination is required to establish the diagnosis. Wide local excision of tumour shows favourable outcome with a low recurrence rate. Here, we present a case of ceruminous adenoma masquerading as a furunculosis.
  17. Skull Base Osteomyelitis and Parapharyngeal Abscess as Complications of Otitis Media in a Young Immunocompetent Man
    Salim I, Mohd Saad MS, Ahmad Kailani AAA, Md Daud MK
    Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):6009-6012.
    PMID: 39559024 DOI: 10.1007/s12070-024-05054-3
    Skull base osteomyelitis (SBO) is a rare and lethal infection of temporal bone, uncommonly caused by purulent otitis media. Although uncommon, a young and immunocompetent person is not exceptional to develop SBO as in our case. We reported a case of SBO in a young, immunocompetent gentleman who presented with right otorrhea associated with fever, trismus, headache, and neck stiffness, which was unresponsive to oral and topical antibiotics. Examination revealed fullness at the right mastoid tip with no evidence of mastoid abscess, trismus, with restrictions of neck movements. Otoscopy of right ear showed mucopus with 10% anterosuperior tympanic membrane perforation without keratin or granulation tissue. Pus for culture and sensitivity grew Klebsiella pneumonia and computed tomography (CT) showed osteomyelitic changes with associated parapharyngeal collection. The patient was started on intravenous antimicrobial therapy and responded well to the treatment.
  18. Anaplastic Thyroid Carcinoma: The Great Masquerader
    Razuan NA, Baghawi A, Mohd Tamrin MI, Raja Gopal N, Saniasiaya J
    Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):6046-6050.
    PMID: 39559026 DOI: 10.1007/s12070-024-05080-1
    Anaplastic thyroid carcinoma (ATC) has been regarded as the rarest form of thyroid malignancy, which entails around 2% of thyroid malignancies. It traditionally presents with rapidly enlarging anterior neck swelling with obstructive symptoms. Due to its rich blood supply and lymphatic drainage, the thyroid gland is resistant to infection. Parallel to that, the presentation of thyroid abscess frequently points towards an underlying upper respiratory tract infection. We present a case involving an elderly female presenting with a thyroid abscess, which later turned out to be ATC following a histopathological diagnosis of the thyroid gland. The initial cytology workout was negative for malignancy. We highlight the relatively uncommon presentation along with its management.
  19. Surgical Odyssey in Treating Recurrent Congenital Nasal Pyriform Aperture Stenosis
    Md Ali SRA, Mohd Nor K, Abu Bakar S, Sheikh Ab Hamid S
    Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):5861-5863.
    PMID: 39559060 DOI: 10.1007/s12070-024-04924-0
    We present a case report of congenital nasal pyriform aperture stenosis, in which the child was managed with a series of less invasive surgical procedures, which were eventually followed by repair via a sublabial approach. This case report aims to highlight that in severe stenosis, earlier open surgical intervention with bone drilling is suggested, as dilatation alone will result in recurrent stenosis. Open surgery with bone drilling not only facilitates faster recovery but also aids in oxygen weaning, shortens hospitalization duration, and reduces the risk of complications.
  20. Novel Technique Closure of Mastoid Fistula with Three-Layer Pedicled Flap: A Case Report and Literature Review
    Ghauth S, Yew Toong L
    Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):5847-5851.
    PMID: 39559073 DOI: 10.1007/s12070-024-04847-w
    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.
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