Displaying publications 1 - 20 of 53 in total

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  1. Saniasiaya J, Narayanan P
    J Laryngol Otol, 2023 Jan;137(1):2-6.
    PMID: 35616060 DOI: 10.1017/S0022215122001268
    BACKGROUND: Vestibular dysfunction in children is a debilitating condition that results in countless pernicious effects, such as motor development delay, poor academic performance and psychosocial impairment. Yet, research pertaining to vestibular and balance disorders amongst adolescents is still lacking and remains an enigma.

    METHODS: This paper outlines novel emerging aetiological factors contributing to vestibular dysfunction amongst adolescents by appraising published articles through a narrative review.

    RESULTS: Underlying aetiological factors of vestibular dysfunction can be identified among adolescents with thorough evaluation. Proper diagnostic evaluation of vestibular dysfunction is imperative in providing optimal care and guiding appropriate treatment strategies. The available literature demonstrated multifactorial aetiological factors that contribute to vestibular dysfunction in adolescents.

    CONCLUSION: Outlining the underlying aetiological factors of vestibular dysfunction is vital to ensure that patients receive appropriate care and treatment.

  2. Sharouny H, Narayanan P
    Iran Red Crescent Med J, 2015 Jan;17(1):e17104.
    PMID: 25763256 DOI: 10.5812/ircmj.17104
    INTRODUCTION: Frontal sinus mucoceles are the commonest among all paranasal mucoceles. With introduction of functional endoscopic sinus surgery, surgeons prefer endoscopic management of sinus mucoceles, but lesions that appear in the lateral part of the frontal sinus can be difficult to access and often need external approaches.

    CASE PRESENTATION: We described a lateral frontal sinus mucocele with intra-orbital extension, which was successfully managed by endoscopic sinus surgery.

    CONCLUSIONS: Endoscopic sinus surgery is the treatment of choice in most frontal sinus mucoceles including lateral frontal mucoceles.

  3. Sharouny H, Narayanan P
    Iran Red Crescent Med J, 2014 Jul;16(7):e17133.
    PMID: 25237579 DOI: 10.5812/ircmj.17133
    INTRODUCTION: A mucocele is an epithelial-lined, mucus-containing sac that can fill the sinus completely and expand gradually. Mucopyocele is an infected mucocele.

    CASE REPORT: We presented a case of left maxillary mucopyocele in a 58-year-old man that developed after radiotherapy for nasopharyngeal carcinoma. Computed tomography scan showed opacification of the left maxillary sinus expanding through the medial wall of the antrum with thinning and destruction of the adjacent structures. Endoscopic marsupialization of the lesion and left partial maxillectomy were performed. The cystic mass had yellowish thick mucopurulent fluid that was completely drained.

    CONCLUSIONS: A few cases of sphenoid sinus mucocele as a late complication of radiation therapy have been reported. Maxillary mucocele and mucopyocele can be considered as one of the late complications of radiotherapy to head and neck as a result of occlusion of sinus ostia by scarred mucosa.

  4. Saniasiaya J, Kulasegarah J, Narayanan P
    J Laryngol Otol, 2021 Nov;135(11):953-957.
    PMID: 34496981 DOI: 10.1017/S0022215121002292
    BACKGROUND: Despite the rapidly emerging reports of olfactory dysfunction amongst adult patients with coronavirus disease 2019, cases involving children and adolescents are scarcely reported. The literature was reviewed to elucidate olfactory dysfunction amongst children and adolescents with coronavirus disease 2019.

    METHODS: A search of the literature published from 1 December 2019 to 30 April 2021 was conducted using four databases, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The search was performed over one month (May 2021).

    RESULTS: Only 9 articles were identified, with a total of 316 laboratory confirmed coronavirus disease 2019 positive children and adolescents, of whom 156 reported olfactory dysfunction. Four studies reported olfactory dysfunction based on subjective tests; four studies carried out objective assessment. Most studies reported on olfaction recovery.

    CONCLUSION: The literature review revealed an olfactory dysfunction rate of 49 per cent amongst children and adolescents with coronavirus disease 2019. Persistence of olfactory dysfunction was reported in 7.1 per cent of the patients. Further studies involving objective measures need to be carried out in children and adolescents with coronavirus disease 2019.

  5. Ambu VK, Narayanan P, Ratnasingam V
    J Laryngol Otol, 2001 Sep;115(9):740-2.
    PMID: 11564306
    Laryngeal foreign bodies, especially in children, mostly present as an acute emergency. Few cases of long-standing laryngeal foreign bodies have been reported in the literature. This case illustrates one of the sequelae of a neglected laryngeal foreign body, resulting in significant granulation tissue formation in the larynx, and its management.
  6. Saniasiaya J, Kulasegarah J, Narayanan P
    PMID: 34423675 DOI: 10.1177/00034894211041340
    OBJECTIVE: Eustachian tube dysfunction (ETD) is a chronic entity that has been historically managed with adenoidectomy and ventilation tube insertion. Recently, balloon dilation of the eustachian tube has shown promising results in recalcitrant eustachian tube dysfunction. We reviewed the literature to determine the outcome of eustachian tube balloon dilation in children.

    METHODS: A literature search was conducted for the period from 1990 to 2020 by searching several databases over a 1-month period (January 2021) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews for Interventions. Primary outcome was defined as the success of the intervention determined by the resolution of symptoms, and secondary outcome was determined by revisions surgery and presence of complications.

    RESULTS: Only 7 articles were identified based on our objectives and selection criteria. All studies included are retrospective cohort case series (Level IV) and 1 cohort of matched controls (Level III). A total of 284 patients were included in this review, with a mean age of 7.8 years. A total of 463 balloon dilation were performed either bilaterally or unilaterally. The most common finding of ETD is middle ear effusion in 5 studies. Balloon dilation of eustachian tube was second-line treatment in 6 studies and first-line treatment in 1 study. Improvement of symptoms was identified in all studies through various assessments performed. Revision surgery was performed in 1 study with no major complications reported.

    CONCLUSIONS: Balloon dilation of the eustachian tube may be considered as an alternative procedure following failed standard treatment in children. The quality of evidence is inadequate to recommend widespread use of the technique until a better-quality study has been completed. Future randomized controlled studies with a large sample size are warranted to determine the efficacy of this procedure amongst children.

  7. Saniasiaya J, Kulasegarah J, Narayanan P
    Ear Nose Throat J, 2023 Apr;102(4):NP201-NP202.
    PMID: 33645290 DOI: 10.1177/0145561321995008
  8. Saniasiaya J, Kulasegarah J, Narayanan P
    Clin Otolaryngol, 2023 May;48(3):371-380.
    PMID: 36640123 DOI: 10.1111/coa.14038
    BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is a debilitating condition that has been significantly described in adults. Recent data points out that BPPV occurs in children as well. Canalith repositioning manoeuvre (CRM) has shown promising results amongst adult patients with BPPV.

    OBJECTIVE: We reviewed the literature to determine the outcome of CRM in children and adolescents with BPPV.

    METHODS: A literature search was conducted over 1 month (March 2022). The primary outcome was defined as the resolution of positional nystagmus and symptoms, and secondary outcomes were determined by the presence of recurrence and the number of attempts of CRM.

    RESULTS: Ten articles were selected based on our objective and selection criteria. A total of 242 patients were included, with a mean of 10.9 years. BPPV was diagnosed based on history and positional nystagmus in all patients (100%). CRM was performed in 97.9% of patients, whereby 80.5% recovered following a single attempt of CRM. Recurrence of symptoms was identified in 10% of patients with no reported major complications.

    CONCLUSION: CRM has demonstrated promising results in children and adolescents. The quality of evidence is limited until a better-quality study involving randomised controlled studies with a larger sample size is completed.

  9. Waran V, Sek K, Bahuri NF, Narayanan P, Chandran H
    Minim Invasive Neurosurg, 2011 Oct;54(5-6):279-81.
    PMID: 22278798 DOI: 10.1055/s-0031-1297997
    In endoscopic neurosurgery problems with haemostasis due to poor access exist. We have developed a system which allows the delivery of a variety of haemostatic agents in a more efficacious manner. The system has been used successfully in endoscopic skull base surgery and endoscopic surgery within the parenchyma of the brain using tube systems.
  10. Narayanan P, Meng OL, Mahanim O
    Metab Syndr Relat Disord, 2011 Oct;9(5):389-95.
    PMID: 21718129 DOI: 10.1089/met.2011.0014
    OBJECTIVE: The aim of this study was to determine the prevalence of metabolic syndrome and the most common combination of cardiometabolic disorders among different ethnic groups of obese adolescents in Malaysia.
    RESEARCH DESIGN AND METHODS: A cross-sectional study among 335 obese adolescent boys and girls aged 12-18 years from 10 randomly selected schools was conducted. After recording blood pressure and waist circumference (WC), a fasting blood sample was obtained and analyzed for glucose and lipids. Metabolic syndrome was diagnosed on the basis of adolescent metabolic syndrome criteria specified by National Cholesterol Education Program Adult Treatment Panel III if three of the five risk factors--hypertriglyceridemia, hyperglycemia, hypertension, low high-density lipoprotein C, and increased WC--were present. The prevalence among different ethnic groups was analyzed.
    RESULTS: The obesity rate among adolescents was 8.4%, and nearly one-third of the obese adolescents had metabolic syndrome. More than 90% of obese adolescents had at least one metabolic abnormality. Metabolic syndrome was more prevalent among obese boys (40.2%) compared to obese girls (17%). Boys had significantly higher mean WC and triglycerides and lower HDL-C (P value 0.0001). Increased WC and triglycerides and high blood pressure comprised the most prevalent (34.3%) risk factor combination followed by WC, low HDL, and high blood pressure (22.5%). Over all, Indians had the highest prevalence of metabolic syndrome (36.4%), followed by Chinese (33.8%) and Malays (27.4%). Elevated triglyceride levels were more prevalent among Chinese, hypertension among Malays, and the other three abnormalities among Indians.
    CONCLUSION: Indians had the highest prevalence of metabolic syndrome. Increased WC and triglycerides and high blood pressure comprised the most prevalent risk factor combination.
  11. Puraviappan P, Dass DB, Narayanan P
    Asian J Surg, 2007 Jul;30(3):209-15.
    PMID: 17638641
    The efficacy of relocating the submandibular duct to treat drooling in children with cerebral palsy was studied.
  12. Liew KY, Narayanan P, Waran V
    J Neurol Surg B Skull Base, 2018 Feb;79(2):S203-S204.
    PMID: 29404252 DOI: 10.1055/s-0037-1620243
    Objectives  To demonstrate, step-by-step, the technique and efficacy of endoscopic transsphenoidal approach in resection of a suprasellar craniopharyngioma. Design  The video shows a step-by-step approach to the resection, covering the exposure, access, resection, and confirmation of resection and reconstruction. Setting  The surgery was performed in the University of Malaya Medical Centre, a tertiary referral center in the capital of Malaysia. Participants  Surgery was performed jointly by Professor Prepageran from the department of otorhinolaryngology and Professor Vicknes Waran from the division of neurosurgery. Both surgeons are from the University of Malaya. Video compilation, editing, and voice narration was done by Dr. Kong Yew Liew. Main Outcome Measures  Completeness of resection and avoidance of intra- and postoperative complications. Results  Based on intraoperative views and MRI findings, the tumor was completely resected with the patient suffering only transient diabetes insipidus. Conclusion  Central suprasellar tumors can be removed completely via an endoscopic transsphenoidal approach with minimal morbidity to the patient. The link to the video can be found at: https://youtu.be/ZNIHfk12cYg .
  13. Tang IP, Shashinder S, Gopala Krishnan G, Narayanan P
    Singapore Med J, 2009 Mar;50(3):261-4.
    PMID: 19352568
    This is a retrospective study that aimed to examine the outcomes of patients presenting with juvenile nasopharyngeal angiofibroma (JNA) at a tertiary centre in Malaysia.
  14. Mohd Hamdan MH, Saniasiaya J, Narayanan P
    BMJ Case Rep, 2021 Jul 13;14(7).
    PMID: 34257127 DOI: 10.1136/bcr-2021-243756
    The hyoid bone fracture has traditionally been attributed to strangulation and hanging. Although rare, ensuing its vague presentation, hyoid bone fracture is oftentimes overlooked and missed, leading to delayed complications. Herein, we are reporting an overlooked hyoid bone fracture in a man who attempted suicide by strangulating himself, whereby Valsalva manoeuvre performed during bedside flexible nasopharyngolaryngoscopy revealed the fractured segment. As the patient was stable and asymptomatic, he was successfully managed conservatively. We would like to highlight the awareness of the Valsalva manoeuvre, which could elicit hyoid bone fracture as missing or overlooking the fracture may lead to devastating complications which may ensue, such as respiratory distress.
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