MyMedR

Carbon dioxide laser stomaplasty for tracheostomal stenosis

Sani A

J Laryngol Otol, 1998 May;112(5):467-8.

A method of treating tracheostomal stenosis post-laryngectomy is described. The carbon dioxide (CO2) laser is used to fashion and ablate two triangular areas lateral to the stenosed stoma to provide an immediate enlarged stoma for comfortable breathing. This simple procedure is done under local anaesthesia, is almost bloodless, safe and takes just 10 minutes. Over the last five years eight patients underwent this procedure and seven had a satisfactory stoma without the need to use a tracheostomy tube.

Sequelae of traumatic laryngotracheal separation: the need for individualized long term treatment plan

Mazita A, Sani A

Auris Nasus Larynx, 2005 Dec;32(4):421-5.

PMID: 16051456 DOI: 10.1016/j.anl.2005.05.002

Laryngotracheal separation is a rare variant of laryngeal trauma. However it is life threatening and potentially fatal. Patients with this injury usually succumb at the site of the accident itself. Here we present two cases of laryngotracheal separation of different etiology and of different outcomes. The treatment advocated for laryngotracheal separation is initially airway stabilization followed by formal repair of the transected trachea. However both our cases illustrates that the outcomes can be different and that a long term treatment plan should be individualized to each patient.

Fulltext Swiftlase assisted CO2 laser ablation in the treatment of nasal obstruction due to hypertrophy of the inferior turbinates

Sani A, Primuharsa P

Med J Malaysia, 2001 Jun;56(2):174-9.

PMID: 11771077

Hypertrophy of the inferior turbinates are the major cause of nasal obstruction. CO2 lasers have been used to reduce the size of the inferior turbinates over the last 20 years. However, the many techniques of delivery of the laser show that there is no one standard method reducing the size of the turbinates. We now describe how the laser can be applied directly to the turbinates using a handpiece with a special nasal tip, thus overcoming the disadvantages delivery via arthroscopic devices, microscopes and fibers. This technique is further enhanced by coupling it with Swiftlase which swirls the focused beam in a 3 mm spot thus ablating tissue more quickly. This procedure is done under local anaesthesia. The ablation of the anterior third of the inferior turbinates effectively overcomes nasal obstruction. This new method was compared to the more traditional submucus diathermy. 22 patients were subjected to laser treatment whilst 20 patients were subjected to diathermy. The outcome was evaluated subjectively by the patients themselves at 2 weeks, 3 months and 6 months. At the end of the study, the laser group reported a more significantly improved nasal airway (91% against 75%) and decreased rhinorrhea (72.7% against 35%) when compared to the diathermy group.

Fulltext Isolated unilateral vocal fold palsy following skull base fracture: a case report

Marina M.B., Hazleigh N.M., Thean, Y.K., Sani A.

International Medical Journal Malaysia, 2018;17(3):95-98.

MyJurnal

Isolated lower cranial nerve (CN) palsy affecting the CN X resulting from a skull base fracture is very rare. The clinical manifestation and natural history is related closely to the complex anatomy of this region and mechanism of injury. Here, we report a case of a 54 year-old man who presented with a delayed onset of dysphonia and dysphagia with aspiration following a closed head injury sustained from a motor vehicle accident. Injection laryngoplasty was implemented to alleviate symptoms of his CN X palsy, which eventually almost completely resolved. High index of suspicion should be maintained when investigating possible skull base fractures, especially with a suggestive clinical presentation of lower CN palsies affecting one or all the lower CNs. Delayed onset of these CN palsies are likely to have more favourable outcomes.

Fulltext Pleomorphic adenoma of the trachea

Ashwaq AM, Sani A

Med J Malaysia, 2007 Jun;62(2):162-3.

PMID: 18705454 MyJurnal

Primary tracheal tumors are very rare. Pleomorphic adenoma is rarely found in the trachea, despite being the most common histological form of salivary gland neoplasm. We present a case of pleomorphic adenoma of the trachea. Bronchoscopic excision using cold instruments resulted in apparently normal tracheal mucosa.

Recurrent respiratory papillomatosis

Long YT, Sani A

Asian J Surg, 2003 Apr;26(2):112-6.

PMID: 12732496

A 6-year-review of patients who presented with recurrent respiratory papillomatosis (RRP) to our hospital from January 1996 to December 2001 was carried out. Ten cases were identified, of which six were juvenile-onset RRP. Hoarseness was the most common symptom, noted in nine (90%) patients. Other clinical presentations included cough, stridor and aphonia. All patients had glottic papillomas; two had multiple sites of involvement. One patient underwent a tracheostomy that revealed papillomas over the trachea, bronchus and lung parenchyma. Half of the patients were Chinese. Of the six cases of juvenile-onset RRP, three patients were Malay, two Chinese and one Indian. Three Chinese and one German patient had adult-onset RRP. Among the juvenile-onset RRP cases, the mean age at presentation was 2 years, while for adult-onset RRP, it was 42 years. Juvenile-onset RRP was more common in females. There were more papillomas over more sites in patients with juvenile-onset RRP than with adult-onset disease. Subglottic involvement was noted in the juvenile-onset RRP cases. All patients were treated with CO2 laser therapy, but there was complete remission of the papillomas in only two cases.

Fulltext Carcinoma of the larynx in Malaysia

Sani A, Said H, Lokman S

Med J Malaysia, 1992 Dec;47(4):297-302.

PMID: 1303483

A retrospective study of cases with carcinoma of the larynx seen in the Universiti Kebangsaan Malaysia (UKM) and General Hospital Kuala Lumpur (GHKL) between 1981 to 1988 was performed. The aim was to document the distribution and the pattern of behaviour of this tumour amongst our patients. There were 137 cases, the majority of whom were Chinese (54%). The peak incidence was in the seventh decade and the male to female ratio was 7.6:1. The most common symptom at presentation was hoarseness (90%). The most common histological type was squamous cell carcinoma (87%) whilst by site, transglottic involvement was commonest (55%). The overall 3 year survival rate was 68%. Supraglottic carcinoma behaved differently in that a significantly large number presented with dysphagia (33.3%) and neck nodes (42%). Compared to tumours of other sites of the larynx, they had the poorest 3 year survival rate of 50%. Amongst the T2 and T3 tumours, the results of surgery appeared better than primary radiotherapy. Considering that 26% of patients presented with stridor, 20% with neck nodes and 55% with multiple site involvement, it can be concluded that our patients present themselves late.

Fulltext Intramuscular haemangioma in the head and neck

Nurlizams I, Kenalims MS, Sani A

Med J Malaysia, 2007 Dec;62(5):409-10.

PMID: 18705477 MyJurnal

Intramuscular haemangioma is a rare tumour of the head and neck region. This patient presented with progressive painless swelling in the parotid region since she was three years old. Intramuscular haemangioma of the masseter was diagnosed at the age of 34 and she was successfully treated with surgical excision.

Prevention of aspiration following recurrent dislodgement of voice prosthesis: a patient's innovation

Masaany M, Marina MB, Asma A, Sani A

J Laryngol Otol, 2009 Jun;123(6):680-2.

PMID: 18544175 DOI: 10.1017/S0022215108002958

To demonstrate a simple, practical, cheap method of preventing potentially fatal aspiration of a dislodged voice prosthesis; this method was developed by a laryngectomised patient.

Pyopneumothorax--a rare sequelae of retropharyngeal abscess

Lokman S, Sani A, Sidek DS

J Laryngol Otol, 1993 May;107(5):460-2.

PMID: 8326234

A case of massive pyopneumothorax as a rare sequelae of retropharyngeal abscess following fish bone ingestion is reported. An initial attempt at removal of the fish bone in the oesophagus using the fibroptic oesophagoscope was unsuccessful, causing failure of its removal and the development of this rare and potentially fatal complication. The intercommunication of the retropharyngeal space with other spaces of the neck and thorax that allow this and most other complications to occur is described. Rigid endoscopes are the instrument of choice in retrieving sharp foreign bodies in the oesophagus.

Fulltext Antimicrobial activities of three different seed extracts of Lansium varieties

Alimon, H, Abdullah Sani, A., Syed Abdul Azziz, S. S., Daud, N., Mohd Arriffin, N., Mhd Bakri, Y.

Pertanika Journal of Science & Technology, 2014;22(2):529-540.

MyJurnal

Lansium domesticum Corr. is a fruit tree of the Meliaceae family, which is commonly found in SouthEast Asia with a wide range of varieties. This study investigated three varieties of L. domesticum; Duku, Langsat and Dokong for the phytochemical screening and antimicrobial activity. Seeds from the matured fruits were extracted using hexane, methanol and water. The crude extracts were screened for antimicrobial activities toward three bacteria, namely, Pseudomonas aeruginosa, Bacillus subtilis, and Staphylococcus aureus. The findings showed that Langsat seed extracts contained more groups of compounds compared with the other two varieties, and its methanol extract demonstrated the highest inhibition zones against the three bacteria. The crude methanol extract of Duku seeds showed inhibition zones only towards Bacillus subtilis at a high concentration (1.0 mgL-1), whilst the seed extracts of Dokong showed no inhibition zones towards any of the tested bacteria.

Fulltext Cricotracheal separation: a case of delayed diagnosis and treatment

Hashima AR, Marina MB, Sani A

Med J Malaysia, 2011 Jun;66(2):144-5.

PMID: 22106697 MyJurnal

A motorcyclist was involved in a motor vehicle accident and presented with respiratory distress and neck swelling with surgical emphysema. He sustained gross tracheal injury, severe pneumothoraces and lung contusions. As intubation was successful, the tracheal injury was not addressed immediately in view of the other severe respiratory problems. Evidence of aspiration lead to further investigations which confirmed the diagnosis 22 days post trauma. Thyrotracheal anastomosis was carried out without stenting. A complete cricotracheal separation is a rare event and can be easily overlooked in the emergency department.

Fulltext Triple primary cancers of the larynx, lung and thyroid presenting in one patient

Iqbal FR, Sani A, Gendeh BS, Aireen I

Med J Malaysia, 2008 Dec;63(5):417-8.

PMID: 19803306 MyJurnal

Patients with multiple malignant primary tumours are often described, based on their chronology of presentation, as simultaneous, synchronous or metachronous tumours. Lung malignancies presenting in association with head and neck tumours are well documented while there have been small series of thyroid synchronous cancers presenting with laryngeal lesions in literature. No cases, to our knowledge, have been reported in literature of a single patient with all three laryngeal, lung and thyroid malignancies. We report one such case of a 71-year-old Chinese man who had undergone a total laryngectomy for a recurrent cancer of the larynx only to be found to have tumours of the lung and thyroid in the post-operative period and he eventually died of post-operative complications. We also discuss screening for lung and thyroid malignancies in patients with head and neck squamous cell carcinoma (SCC).

Fulltext Concurrent mycobacterial infection and non-Hodgkin's lymphoma at the same site in an AIDS patient

Kenali MS, Fadzilah I, Maizaton AA, Sani A

Med J Malaysia, 2004 Mar;59(1):108-11.

PMID: 15535345

A 31 years old Chinese male with acquired immunodeficiency syndrome (AIDS) presented with concurrent mycobacterial infection and a synchronous non-Hodgkin's lymphoma of the nose. The diagnoses were made over a period of two months. Treatment for the mycobacterial infection was administered but he succumbed to the disease shortly after the diagnosis of NHL was established. This was an unusual case where two pathologies occurred in the same site in a patient with AIDS.

Fulltext Myeloid sarcoma: An unusual and rare laryngeal presentation

Tan SN, Gendeh HS, Sani A, Mat-Baki M

Int J Surg Case Rep, 2016;21:99-103.

PMID: 26957189 DOI: 10.1016/j.ijscr.2016.02.012

Myeloid Sarcoma (MS) or Granulocytic Sarcoma is an uncommon laryngeal malignancy. It may arise from myelodysplastic syndromes, malignancy or de novo. Presentation in the larynx is rare and some may present with Acute Myeloid Leukaemia (AML) whereby the later may be asymptomatic.

Complications of otitis media requiring surgical intervention

Long YT, Mahmud R, Sani A, Saim L

Asian J Surg, 2002 Apr;25(2):170-4.

PMID: 12376240

Although the incidence of complications of otitis media that require surgical interventions has decreased substantially over the past few years, it is a prevailing condition for which clinicians should remain vigilant.

Prevalence of otitis media with effusion amongst pre-school children in Malaysia

Saim A, Saim L, Saim S, Ruszymah BH, Sani A

Int J Pediatr Otorhinolaryngol, 1997 Jul 18;41(1):21-8.

PMID: 9279632 DOI: 10.1016/s0165-5876(97)00049-9

A cross-sectional screening test was done to determine the prevalence of otitis media with effusion amongst, preschool children in two district in Malaysia, namely Kuala Lumpur an urban district and Kuala Selangor a rural district. It involved 1097 preschool children aged between 5 and 6 years old. Presence of otitis media effusion (OME) is based on abnormal otoscopic finding, Type B tympanogram and absence of ipsilateral acoustical reflex. The overall prevalence rate of OME was 13.8%. The prevalence in Kuala Lumpur was 17.9%, while in Kuala Selangor it was 9.48%. Bottle feeding during infancy and high socioeconomic status of the parents was statistically associated with higher incidence of OME. Other factors such as race, premature delivery, passive smoking, allergy, asthma and family size, had no influence on the prevalence of otitis media with effusion.

Fulltext Insulin resistance using HOMA model in obstructive sleep apnea: a cross sectional study

Azman M, Sani A, Kamaruddin NA

Ann Saudi Med, 2014;34(6):476-81.

PMID: 25971819 DOI: 10.5144/0256-4947.2014.476

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is a common disease affecting middle-aged patients and is associated with significant cardiovascular, cerebrovascular, and metabolic complications. Current evidences show inconclusive association between OSA and insulin resistance (IR). This study aims to examine the possible correlation between OSA parameters and IR.

DESIGN AND SETTINGS: This was a cross-sectional study to examine the association between OSA parameters and IR using homeostasis model assessment (HOMA) on patients who underwent polysomnogram (PSG) in a tertiary center between March 2011 and March 2012 (1 year).

PATIENTS AND METHODS: A total of 62 patients underwent PSG within the study period, of which 16 patients were excluded due to abnormal fasting blood sugar. Information on patients' medical illnesses, medications, and Epworth sleepiness scale (ESS) was obtained. Patients' body mass index (BMI), neck circumference, and waist circumference (WC) were measured. Blood samples were collected after 8 hours of fasting to measure HOMA-IR value. Overnight PSG was performed for all patients. Data was recorded and analyzed using SPSS, version 12.0 (SPSS Inc, Chicago, USA).

RESULTS: The prevalence of IR in OSA patients was 64.3%. There was significant correlation between OSA parameters (apnea-hypopnea index, ESS, BMI, and WC) and HOMA-IR with correlation coefficient of 0.529, 0.224, 0.261, and 0.354, respectively.

CONCLUSION: A linear correlation exists between OSA parameters and IR concluding a definite causal link between OSA and IR. IR screening is recommended in severe OSA patients.

Empirical treatment with pantoprazole as a diagnostic tool for symptomatic adult laryngopharyngeal reflux

Masaany M, Marina MB, Sharifa Ezat WP, Sani A

J Laryngol Otol, 2011 May;125(5):502-8.

PMID: 21356141 DOI: 10.1017/S0022215111000120

To determine the sensitivity and specificity of intensive empirical treatment with pantoprazole in diagnosing laryngopharyngeal reflux in adults.

Ultrasound-guided botulinum toxin A injection: an alternative treatment for dribbling

Marina MB, Sani A, Hamzaini AH, Hamidon BB

J Laryngol Otol, 2008 Jun;122(6):609-14.

PMID: 17640435

Dribbling (sialorrhoea) affects about 10 per cent of patients with chronic neurological disease. The variety of treatments currently available is unsatisfactory. This study was a clinical trial of the efficacy of ultrasound-guided, intraglandular injection of botulinum toxin A for dribbling, performed within the otorhinolaryngology department of the National University of Malaysia. Both pairs of parotid and submandibular glands received 25 U each of botulinum toxin A. Twenty patients were enrolled in the study. The median age was 15 years. All 20 patients (or their carers) reported a distinct improvement in symptoms after injection. Using the Wilcoxon signed rank test, there were significant reductions in dribbling rating score, dribbling frequency score, dribbling severity score, dribbling visual analogue score and towel changes score, comparing pre- and post-injection states (p<0.001). There were no complications or adverse effects during or after the injection procedure. Intraglandular, major salivary gland injection of botulinum toxin A is an effective treatment to reduce dribbling. Ultrasound guidance enhances the accuracy of this procedure and minimises the risk of complication.

Displaying publications 1 - 20 of 30 in total