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  1. Bilateral Vocal Cord Immobility After Chemoradiotherapy For Nasopharyngeal Carcinoma
    Vengathajalam S, Maruthamuthu T, Nik Hassan NFH, Mohamad I
    Gulf J Oncolog, 2020 May;1(33):80-83.
    PMID: 32476655
    Post chemoradiation vocal cord immobility is a rare complication and this maybe life threatening when patients present with severe aspiration and recurrent pneumonia or even worse if they have an upper airway obstruction. We report a case of nasopharyngeal carcinoma patient whom after receiving curative concurrent chemoradiotherapy, presented with episodes of shortness of breath and aspiration pneumonia finally diagnosed with bilateral vocal cord immobility. She had no evidence of tumour recurrence.
  2. Fulltext Salmonella Thyroid Abscess Treated by Serial Aspiration: Case Report and Literature Review
    Vengathajalam S, Retinasekharan S, Mat Lazim N, Abdullah B
    Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):823-826.
    PMID: 31742073 DOI: 10.1007/s12070-019-01654-6
    Thyroid abscesses are the most rare conditions of the thyroid gland but it could be potentially life threatening. Most patients are immunocompromised or has an underlying chronic thyroid disorder. We report a case of a 58 year-old lady with underlying uncontrolled diabetes mellitus and a long standing uninvestigated goiter who presented with lethargy, a new anterior neck swelling with dysphagia and change of voice. Ultrasound and computed tomography were performed and showed collection with multiple air pockets in the right thyroid lobule extending to the anterior mediastinum. She was started on intravenous antibiotics and underwent serial bedside aspiration. Her symptoms improved and complete resolution was achieved after serial aspirations and antibiotics.
  3. Fulltext The Clinical and Radiological Characterizations of the Allergic Phenotype of Chronic Rhinosinusitis with Nasal Polyps
    Abdullah B, Vengathajalam S, Md Daud MK, Wan Mohammad Z, Hamizan A, Husain S
    J Asthma Allergy, 2020;13:523-531.
    PMID: 33149624 DOI: 10.2147/JAA.S275536
    Purpose: The allergic phenotype of chronic rhinosinusitis (CRS) and central compartment atopic disease (CCAD) have been described. The CCAD is a radiological phenotype in patients with CRS that presents as a central mucosal disease due to allergy. The subset of patients having chronic rhinosinusitis with nasal polyps (CRSwNP) has not been well characterized. We aim to describe the clinical and radiological characterizations of patients presenting with the allergic phenotype of CRSwNP.

    Patients and Methods: A cross-sectional study at a tertiary hospital was performed. Adult patients diagnosed with CRSwNP who had both allergology and radiological assessments were enrolled. The symptoms of allergic rhinitis, Lund-Kennedy (LK) endoscopic scoring, Lund-Mackay (LM) computed tomography scan of paranasal sinuses (CTPNS) scoring, CCAD features, skin prick test (SPT) and level of specific IgE were assessed. All the patients underwent SPT for house dust mites.

    Results: A total of 38 patients were enrolled. Symptoms, endoscopic and CTPNS scores were higher in the allergy and CCAD groups compared to the nonallergy and nonCCAD groups. The symptom of "need to blow nose" was statistically significant in allergy vs nonallergy (p=0.01) and CCAD vs nonCCAD (p=0.02). There were significant differences in the endoscopic scores in both allergy and CCAD (allergy vs nonallergy, p=0.01; CCAD vs nonCCAD, p=0.03), and CT scores in both allergy and CCAD (allergy vs nonallergy, p=0.02; CCAD vs nonCCAD, p=0.02). All patients with CCAD have worse scoring than nonCCAD (LK score, p=0.03; LM score, p=0.02). Patients with allergy have more polypoidal involvement of the middle turbinates (left middle turbinate, p=0.141; right middle turbinate, p=0.074) and CCAD (left middle turbinate, p=0.017; right middle turbinate, p=0.009) than nonallergy and nonCCAD patients.

    Conclusion: Allergic phenotype of CRSwNP has a worse clinical and radiological disease burden. Optimal treatment of allergy is essential for a better outcome.

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