MyMedR

Fulltext Asian nasal polyps: a separate entity?

Tikaram A, Prepageran N

Med J Malaysia, 2013 Dec;68(6):445-7.

OBJECTIVE: To determine the pattern of cellular infiltration in nasal polyposis among Malaysian population and to compare the pattern of cellular infiltration in nasal polyposis between Malaysian and other Asian countries.

MATERIAL AND METHOD: This is retrospective study done on patients diagnosed with nasal polyposis from January 2008 to June 2012 in University Malaya Medical Center. Only the patients undergoing first operation for nasal polyp and were confirmed polyp with histopathological sections were included in the study.

RESULT: A total of 80 subjects were included in the study. Of these 48.75% had neutrophil- predominant polyp which was in contrast with the eosinophil- predominant polyp of Caucasian population but similar to other studies done in Asian countries.

CONCLUSION: The etiology of nasal polyposis in Caucasians and Asians may be different and may need to be managed differently. It may be more appropriate to treat nasal polyposis in Asian population with long term antibiotics and more study needs to be done on this.

Fulltext Oropharyngeal rhinosporidiosis in a migrant worker--a delayed presentation

Shailendra S, Prepageran N

Med J Malaysia, 2008 Mar;63(1):65-6.

PMID: 18935739

Rhinosporidiosis is a chronic granulomatous disease caused by an aquatic protistan parasite in the class of Mesomycetozoea, that is endemic in India and the subcontinent. This is a case report of a rhinosporidiosis presenting in an individual from Myanmar, whom had been working in Malaysia for the past four years. The disease is characterized by the appearance of polypoidal, friable growths that contain numerous spore filled cysts that stain with PAS staining. This disease is rarely seen in Malaysians due to the extensive urbanization in Kuala Lumpur, however the increasing numbers of migrant workers in Malaysia today necessitates an increasing awareness in clinicians of the possibility of these conditions.

Fulltext The use of surgicel to stop epistaxis in children secondary to coagulopathies

Prepageran N, Raman R

Med J Malaysia, 2007 Mar;62(1):87.

PMID: 17682585

The management of epistaxis in patient with coagulopathies can be traumatic for both the patient and the attending physician. This can be rather frustrating especially in children with haematological malignancies. Packing these children’s nasal cavity can be difficult and the trauma associated with the packing can further aggravate epistaxis.

Fulltext Delayed complication of radiotherapy: laryngeal fibrosis and bilateral vocal cord immobility

Prepageran N, Raman R

Med J Malaysia, 2005 Aug;60(3):377-8.

PMID: 16379198

Radiotherapy is the accepted treatment for early laryngeal carcinomas with the advantage of voice preservation. It is however, not without complications. We report a case of bilateral vocal cord immobility 15 years after radiotherapy. This appears to be due to ankylosis of cricoarytenoid joint and fibrosis of the larynx.

Hangman's knot in securing bypass tubes in endonasal dacryocystorhinostomy

Prepageran N, Raman R

Rhinology, 2002 Jun;40(2):95.

PMID: 12092002

We performed 15 cases of dacryocystorhinostomy endoscopically with an 86% success rate. Using a Hangman's knot, the bypass tubes were placed in a secure and lasting way.

Fulltext Impact of olfactory dysfunction on quality of life in coronavirus disease 2019 patients: a systematic review

Saniasiaya J, Prepageran N

J Laryngol Otol, 2021 Aug 24.

PMID: 34425929 DOI: 10.1017/S0022215121002279

OBJECTIVE: To outline the impact on quality of life in coronavirus disease 2019 patients with olfactory dysfunction.

METHODS: Five databases were searched for articles referring to the impact on quality of life in coronavirus disease 2019 patients with olfactory dysfunction. The search was conducted for the period from November 2019 to April 2021. The search was conducted over one month (May 2021).

RESULTS: Four studies that met the objective were included. Altogether, there were 1045 patients. Various questionnaires were used to assess quality of life. Overall, the quality of life deficit affected 67.7 per cent of patients. Quality of life domains investigated include overall quality of life (four studies), food and taste dysfunction (two studies), mental health (two studies), cognitive function (one study), functional outcome (one study) and safety domains (one study).

CONCLUSION: Quality of life deficit was reported to be 67.7 per cent among coronavirus disease 2019 patients with olfactory dysfunction. The high prevalence of persistent olfactory dysfunction prompts more serious research, as the long-standing consequences of olfactory dysfunction are detrimental.

Dual laryngeal foreign body

Rahmat O, Prepageran N

Ear Nose Throat J, 2011 Nov;90(11):E26-7.

PMID: 22109930

Fulltext Cerebrospinal fluid otorrhoea from an abnormal communication between the internal auditory meatus and the medial wall of the tympanic cavity

Philip R, Prepageran N, Raman R, Waran V

Med J Malaysia, 2009 Sep;64(3):248-9.

PMID: 20527282 MyJurnal

Patients who have had middle-ear or mastoid surgery are at an increased risk of developing cerebrospinal fluid (CSF) otorrhoea. The CSF leak is usually from defects in the tegmen or posterior cranial fossa. We present a patient with CSF otorrhoea following a modified radical mastoidectomy seven years ago. There was an unusual communication between the internal auditory meatus (IAM) and the middle ear. Radiologic imaging like the MRI is useful in identifying the site of leak.

Fulltext Dizziness, a review of walk-in patients at a specialised neurotology clinic

Philip R, Prepageran N

Med J Malaysia, 2009 Mar;64(1):56-8.

PMID: 19852323 MyJurnal

A retrospective review of 100 walk-in patients at a specialized neurotology clinic in dizziness at a tertiary referral centre is presented. The most common cause of dizziness was BPPV, forming 31% of the cases. Other causes in order of frequency include recurrent vestibulopathy, idiopathic causes, Meniere's disease and central causes.
Study site: Neurotology clinic, Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Fulltext Extensive benign sinonasal squamous papilloma

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.

The floppy vocal polyp

Rahmat O, Prepageran N

Ear Nose Throat J, 2008 Dec;87(12):668-9.

PMID: 19105136

Fulltext High grade mucoepidermoid carcinoma of the middle ear treated with extended temporal bone resection

Shailendra S, Elmuntser A, Philip R, Prepageran N

Med J Malaysia, 2008 Aug;63(3):247-8.

PMID: 19248700 MyJurnal

We report a case of High grade Mucoepidermoid carcinoma of the middle ear. A 67 year old gentleman was referred to our centre for persistent otalgia associated with facial weakness for four months. Examination revealed a middle ear mass with House Brackmann Grade 3 Facial Palsy and ipsilateral lymhadenopathy. Biopsies suggested a squamous cell carcinoma of the middle ear, and he successfully underwent an Extended Temporal bone resection with External canal reconstruction and neck dissection. Postoperative Histopathology revealed that the tumour was in fact a High Grade Mucoepidermoid carcinoma. He received postoperative radiotherapy and is well one year post operatively.

Importance of intra-operative imaging for sphenoid sinus disease

Philip R, Prepageran N, Waran V

J Laryngol Otol, 2007 Sep;121(9):e14.

PMID: 17625037

Sphenoid sinus mucoceles comprise 1-2 per cent of paranasal sinus mucoceles. Endoscopic marsupialisation is currently the treatment of choice.

Fulltext Tracheal stent in the treatment of tracheal stenosis

Dipak S, Prepageran N, Rahmat O, Raman R

Med J Malaysia, 2005 Oct;60(4):498-501.

PMID: 16570716

The use of airway stents for the treatment of benign airway stenosis is increasingly advocated. However, the long-term safety and efficiency of these devices has not been established. We present a case of tracheal stenosis. which persisted despite open surgical and laser correction. The patient required tracheal stent insertion and is currently well with no respiratory difficulty. The use of metallic or silicon intraluminal stent remains appropriate in cases in which there is defined and relative short-term end point of treatment.

Fulltext Epidermal cyst of submandibular gland

Prepageran N, Rahmat O, Kuljit S

Med J Malaysia, 2005 Oct;60(4):483-4.

PMID: 16570711

The differential diagnosis of a cystic lesion in the submandibular area can be difficult. We report a case of epidermal cyst of submandibular gland which is relatively rare compared to the commoner epidermoid cyst.

Benign fibrous tumour of the parotid gland

Sreetharan SS, Prepageran N

Asian J Surg, 2005 Jan;28(1):45-7.

PMID: 15691798

The case of a 44-year-old man with left parotid enlargement that was initially diagnosed as cementifying fibroma is presented. The lesion was found in the deep lobe of the parotid gland and was successfully removed. Postoperatively, the patient recovered well with intact facial nerve function and remained asymptomatic after 1 year. Subsequent histology revealed the mass to be a benign fibrous tumour. The diagnosis and management of this rare entity are discussed.

Fulltext Nasal cylindrical cell papilloma

Subha ST, Prepageran N

Med J Malaysia, 2005 Mar;60(1):103-5.

PMID: 16250292

Inverted papilloma is the most common benign tumor of nose and paranasal sinuses arising from lateral nasal wall and middle meatus. Histologically these tumors are composed of epithelial nests that are inverted, exophytic and cylindrical. Here we describe a clinical case of nasal cylindrical cell papilloma, which was treated by endoscopic excision.

Fulltext Benign teratoma of the nasal cavity

Sreetharan SS, Prepageran N

Med J Malaysia, 2004 Dec;59(5):678-9.

PMID: 15889573

A teratoma is a true neoplasm composed of an assortment of tissue often alien to the site from it arises. Teratomas of the head and neck are exceedingly rare and usually present in the neonatal period. Most of these are found in the cervical region and nasopharynx. Though most tumors are benign, they are often malignant with regards to the location. Here we present a rare case of benign teratoma arising from the nasal septum and presenting for the first time in a young adult. Appropriate literature is reviewed.

Papillary carcinoma arising in a thyroglossal duct cyst

Jayalakshmi P, Prepageran N, Jayaram G, Gopalakrishnan

Malays J Pathol, 2002 Jun;24(1):67-70.

PMID: 16329558

A 21-year-old lady was admitted with a one year history of painless swelling in the neck. The clinical features and radiological findings suggested a thyroglossal duct cyst. Histology of the excised duct cyst showed papillary carcinoma. Ultrasound examination of the thyroid gland was normal. The patient is on regular follow-up and is well two years following surgery.

Endoscopic transpterygoidal repair of a large cranial defect with cerebrospinal fluid leak in a patient with extensive osteoradionecrosis of the skull base: case report and technical note

Brand Y, Lim E, Waran V, Prepageran N

J Laryngol Otol, 2015 Dec;129(12):1243-7.

PMID: 26412297 DOI: 10.1017/S0022215115002601

Endoscopic endonasal techniques have recently become the method of choice in dealing with cerebrospinal fluid leak involving the anterior cranial fossa. However, most surgeons prefer an intracranial approach when leaks involve the middle cranial fossa. This case report illustrates the possibilities of using endoscopic techniques for cerebrospinal fluid leaks involving the middle fossa.

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