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Fulltext Painless Giant Submandibular Gland Sialolith: A Case Report

Thong HK, Othman IA, Ramli R, Sabir Husin Athar PP

Cureus, 2021 Nov;13(11):e19429.

PMID: 34926020 DOI: 10.7759/cureus.19429

Sialolithiasis is one of the most common diseases involving the salivary glands. It is a condition that occurs due to an obstruction in a salivary gland or its duct due to a calculus. The formation of a salivary stone is believed to be secondary to the deposition of mineral salts around a nidus, which is frequently associated with a recurrent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. The size of the calculus varies from <1 mm to a few centimeters. The frequency of sialolithiasis is relatively common. It is estimated to affect 12 in 1000 of the adult population. However, the occurrence of giant sialoliths, >15 mm in any diameter, is rare. Here, we describe our experience with a case of giant submandibular sialolithiasis measuring 25 mm presenting as a painless submandibular mass. The patient underwent submandibular gland excision followed by a full recovery.

Fulltext Spontaneous Nasal Septal Abscess: A Case Report

Abd Rahim NN, Thong HK, Sabir Husin Athar PP

Cureus, 2024 Apr;16(4):e58007.

PMID: 38738033 DOI: 10.7759/cureus.58007

Nasal septal abscess (NSA) is considered a rhinologic emergency. Fortunately, the incidence of NSA has markedly reduced due to the introduction of antibiotics and easy access to medical care. NSA commonly results from infection in the space between the nasal septum and the overlying mucoperichondrium and/or mucoperiosteum, typically secondary to nasal septal hematoma, but it can also be idiopathic. Prompt diagnosis and intervention are critical to avoid further complications. This paper reports the case of a 46-year-old man with no known risk factors for NSA. He was treated with broad-spectrum antibiotics, and the surgical treatment involved incision and drainage with the intraoperative placement of a Penrose drain and a silastic sheet on postoperative day five. The patient was discharged without complications such as septal perforation or saddle nose deformity.

Fulltext Facial nerve paralysis: a rare complication of parotid abscess

Sabir Husin Athar PP, Yahya Z, Mat Baki M, Abdullah A

Malays J Med Sci, 2009 Apr;16(2):38-9.

PMID: 22589657

Benign parotid neoplasm and inflammatory processes of the parotid resulting in facial paralysis are extremely rare. We report a 72-year-old Malay female with poorly-controlled diabetes mellitus who presented with a painful right parotid swelling associated with right facial nerve palsy. The paralysis (Grade VI, House and Brackmann classification) remained after six months.

Complications following tracheoesophageal puncture: a tertiary hospital experience

Dayangku Norsuhazenah PS, Baki MM, Mohamad Yunus MR, Sabir Husin Athar PP, Abdullah S

Ann Acad Med Singap, 2010 Jul;39(7):565-4.

PMID: 20697675

INTRODUCTION: In laryngectomised patients, tracheoesophageal speech is the gold standard for voice rehabilitation. This study evaluated complications related to the tracheoesophageal puncture (TEP) and the success rate in voice prosthesis after total laryngectomy at our institution over a 10-year period.

MATERIALS AND METHODS: A retrospective review of 22 TEPs was performed between January 1998 and December 2008. The timing of TEP, type of voice prosthesis, surgical and prosthesis-related complications, and TEP closure were noted.

RESULTS: Eighteen percent of the patients underwent primary and 82% secondary TEP. Our patients were predominantly males (95.4%) of Chinese descent with a mean age of 62.1 years. The types of voice prostheses used were ProvoxTM (n = 15), Voicemasters (n = 6), and Blom-Singer (n = 1). Prosthesis- related complications occurred in 77.3%. Notable complications were leakage (82.5%), prosthesis displacement (41.2%), intractable aspiration (29.4%), and aspiration of prosthesis (23.5%). The most common surgical-related complication was tracheostomal stenosis. An array of interventions comprising resizing or changing prosthesis type, nasogastric catheter insertion, stomaplasty, purse string suturing, and bronchoscopic removal of bronchial aspirated prosthesis were implemented to address encountered complications. In a mean follow-up of 34.8 months, 68.2% of patients achieved functional tracheoesophageal speech (75% of primary TEP and 67% of secondary TEP). There were 7 TEP closures indicated by persistent leakage, recurrent dislodgement, phonatory failure and, in 1 patient, persistent pain.

CONCLUSIONS: TEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specific efforts and specialistic commitments in order to treat them.

Metastasis to the sinonasal tract from sigmoid colon adenocarcinoma

bin Sabir Husin Athar PP, bte Ahmad Norhan N, bin Saim L, bin Md Rose I, bte Ramli R

Ann Acad Med Singap, 2008 Sep;37(9):788-3.

PMID: 18989497

INTRODUCTION: Metastatic adenocarcinoma from the gastrointestinal tract to the sinonasal tract is rare. The histological morphology of this lesion is indistinguishable from the colonic variant of primary sinus adenocarcinoma or intestinal-type adenocarcinoma (ITAC).

CLINICAL PICTURE: This is a report of a case of metastatic adenocarcinoma of colorectal origin to the paranasal sinuses in a 52-year-old female who was previously treated for adenocarcinoma of the sigmoid colon. A histologic study of the surgical specimen from the sinonasal cavity demonstrated a tumour identical to the patient's prior primary tumour of the colon. The sinonasal neoplastic tissue showed marked positivity for carcinoembryonic antigen and expressed cytokeratin 20, which differentiates metastatic colonic adenocarcinoma from ITAC.

TREATMENT/OUTCOME: The patient received palliative radiation but died 3 months after the diagnosis.

CONCLUSION: Distinguishing metastatic adenocarcinoma from gastrointestinal tract from ITAC can be difficult. In view of the resemblance, immunohistochemical staining can help in differentiating them. It is important to recognise these as metastatic lesions as the treatment is mainly palliative.

Management of iatrogenic facial nerve palsy and labyrinthine fistula in mastoid surgery

Long YT, bin Sabir Husin Athar PP, Mahmud R, Saim L

Asian J Surg, 2004 Jul;27(3):176-9.

PMID: 15564156

A 6-year review of complications of mastoid surgery between June 1995 and June 2001 revealed five cases with serious iatrogenic complications from mastoid surgery, of which four were facial nerve palsy and two were labyrinthine fistula. One of these patients had concomitant facial nerve palsy and labyrinthine fistula. There were two cases of complete facial nerve palsy (House Brackmann grade VI) and two cases of incomplete palsy (House Brackmann grades IV and V). The second genu was the site of injury in three of the four cases. Of the four cases with facial nerve palsy, two patients had full recovery (House Brackmann grade I), one recovered only to House Brackmann grade III, and one was lost to follow-up. Both patients with labyrinthine fistula had postoperative vertigo and profound sensorineural hearing loss. The site of iatrogenic fenestration was the lateral semicircular canal in both cases.

Fulltext Postauricular neurofibroma - a rare occurrence

Shi Nee T, Ami M, Min Han K, Sabir Husin Athar PP

Braz J Otorhinolaryngol, 2015 12 19;83(5):600-601.

PMID: 26777080 DOI: 10.1016/j.bjorl.2015.09.001

Fulltext Recurrent Submandibular Sialolithiasis in a Child

Thong HK, Mohamad Mahbob H, Sabir Husin Athar PP, Tengku Kamalden TMI

Cureus, 2020 Dec 19;12(12):e12163.

PMID: 33489575 DOI: 10.7759/cureus.12163

Sialolithiasis is a commonly encountered disease of the salivary glands, reported to represent up to 30% of all salivary gland diseases. However, the condition is rarely encountered in the pediatric population. The formation of a salivary stone is believed to be secondary to the deposition of calcium salts around a nidus. The formation of a nidus is commonly associated with desquamated epithelial or sloughing from a recent bacterial infection. Patients with submandibular sialolithiasis usually present with acute swelling over the neck associated with pain, fever, and purulent intraoral discharge. Neglected and poorly treated acute infection may progress to life-threatening abscess formation. Here we are describing our encounter with a 10-year-old boy with recurrent submandibular sialolithiasis. He was initially treated with conservative measures and antibiotics regimen. Failure of medical treatment and recurring symptoms led to submandibular gland excision followed by a full recovery.

Fulltext Acute Tonsillitis With Concurrent Kikuchi's Disease as a Cause of Persistent Lymphadenopathy

Sawali H, Sabir Husin Athar PP, Ami M, Shamsudin NH, Nair G

Malays J Med Sci, 2009 Oct;16(4):73-6.

PMID: 22135516

We present a young adult female with symptoms of acute tonsillitis and tender cervical lymphadenopathy. Despite a full course of oral antibiotics, she had persistent left lower cervical lymphadenopathy measuring 2.0 x 1.5 cm at 2 weeks post-treatment. Rigid and flexible scope examinations did not reveal any abnormalities in the nasopharynx, oropharynx or hypopharynx. Tuberculosis tests were negative and blood index results were normal. Fine needle aspiration cytology revealed a non-specific granulomatous inflammatory process. Excisional lymph node biopsy was performed, and the patient was diagnosed as having Kikuchi's Disease (KD). We would like to highlight the diagnostic challenges in detecting this condition and the importance of differentiating KD from tuberculosis and malignant lymphoma, the latter of which requires aggressive treatment.

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