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A Review of Surgical Outcomes of Management of Sinonasal Malignancies: A 8-Year of Clinical Experience (2013-2021) at the Tertiary Centre, Sarawak

Yee LW, Jumastapha H, Tang CL, Tang IP

Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):5833-5838.
PMID: 39559088 DOI: 10.1007/s12070-024-05113-9

Sinonasal carcinoma, a rare and challenging malignancy, originating in the nasal cavity and paranasal sinuses, poses diagnostic and management complexities. This 8-year retrospective analysis at Sarawak General Hospital aims to elucidate demographic trends, histopathological entities, and management outcomes, shedding light on this multifaceted malignancy. Emphasizing the significance of accurate histopathological classification, the study explores the impact on prognostication and treatment strategies. Spanning 2013 to 2021, the study involved 54 patients with sinonasal malignancies. Demographic, clinical, and histopathological details were examined, adhered to the AJCC staging criteria. Analysis involved demographic distributions, tumour characteristics, treatment modalities, and instances of treatment failure. Statistical analysis was done using SPSS version 29.02. The cohort, predominantly male (57.4%) and of Iban ethnicity (44.4%), with a mean age of 52.8 years, exhibited diverse histopathologies, with squamous cell carcinoma as the most common (38.9%). Epistaxis and nasal blockage were common clinical presentations. Advanced stages (III and IV) were prevalent, with the nasal cavity as the primary site. Surgical interventions, mainly endoscopic endonasal excision, were complemented by adjuvant therapies. Complications occurred in 24% of cases. The study highlights a male predilection, occupational risk factors, and a significant association between tobacco smoking and sinonasal cancers. Surgical interventions predominantly utilized the endoscopic approach. Despite a mean survival of 46.6 months, treatment failure occurred in 29.6% of cases, with recurrence and metastasis. Histopathological analysis revealed comparable 5-year disease survival rates between squamous and non-squamous histologies. Treatment failure was significantly associated with the mode of surgery, with open surgery showing a lower incidence. However, nodal status, histopathology types, T staging, and overall staging did display positive associations with treatment failure. This 8-year review provides comprehensive insights into sinonasal carcinoma, addressing demographic, clinical, and histopathological dimensions. The study underlines the complexity of managing this challenging malignancy, emphasizing the need for a holistic approach to patient care. The findings contribute to the understanding of sinonasal carcinoma, guiding clinical decision-making and fostering further research.
Ceruminous Adenoma: A Case Report and Review of Literature

Boon WJ, Yee LW, Kin FS, Tang IP, Awang Basry NS, Kevin Ng BH

Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):5459-5463.
PMID: 39559016 DOI: 10.1007/s12070-024-05001-2

Ceruminous adenoma is a rare and benign tumor of the external auditory canal and present with a nonspecific symptom. Biopsy with histopathology examination is required to establish the diagnosis. Wide local excision of tumour shows favourable outcome with a low recurrence rate. Here, we present a case of ceruminous adenoma masquerading as a furunculosis.
A Rare Cause of Acute Dyspnoea: Reinke Oedema

Cheah SC, Yee LW, Kok WL, Nazri Zamri FI, Baki MM

Indian J Otolaryngol Head Neck Surg, 2023 Sep;75(3):2420-2422.
PMID: 37636736 DOI: 10.1007/s12070-023-03714-4

Reinke oedema is a benign condition due to fluid collection within subepithelial space of the true vocal fold. This phenomenon is predisposed by chronic smoking, alcohol consumption and contribution of laryngopharyngeal reflux. Although benign, it may be life threatening when bilateral vocal folds are affected causing airway obstruction. In this report, awake tracheostomy was performed for a 65- year- old lady with stridor secondary to severe Reinke oedema. The importance of establishing a definitive airway is highlighted here in securing a difficult airway.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-023-03714-4.
Correlates of susceptibility to smoking among secondary school students in Kota Tinggi district, Johor, Malaysia

Hock LK, Ghazali SM, Cheong KC, Kuay LK, Li LH, Ying CY, et al.

Asian Pac J Cancer Prev, 2013;14(11):6971-8.
PMID: 24377635

BACKGROUND: Smoking among adolescents has been linked to a variety of adverse and long term health consequences. "Susceptibility to smoking" or the lack of cognitive commitment to abstain from smoking is an important predictor of adolescent smoking. In 2008, we conducted a study to determine the psycho-sociological factors associated with susceptibility to smoking among secondary school students in the district of Kota Tinggi, Johor.
MATERIALS AND METHODS: Two thousand seven hundred students were randomly selected by proportional stratified sampling. Analyses on 1,736 non-smoking students revealed that prevalence of adolescents susceptible to smoking was 16.3%.
RESULTS: Male gender (aOR=2.05, 95%CI= 1.23-3.39), poor academic achievement (aOR 1.60, 95%CI 1.05-2.44), ever-smoker (aOR 2.17, 95%CI 1.37-3.44) and having a smoking friend (aOR 1.76, 95%CI 1.10-2.83) were associated with susceptibility to smoking, while having the perception that smoking prohibition in school was strictly enforced (aOR 0.55, 95%CI 0.32-0.94), and had never seen friends smoking in a school compound (aOR 0.59, 95%CI 0.37-0.96) were considered protective factors
CONCLUSIONS: These results indicate that follow-up programmes need to capitalise on the modifiable factors related to susceptibility to smoking by getting all stakeholders to be actively involved to stamp out smoking initiation among adolescents.
Targeting neutrophils using novel drug delivery systems in chronic respiratory diseases

Chellappan DK, Yee LW, Xuan KY, Kunalan K, Rou LC, Jean LS, et al.

Drug Dev Res, 2020 06;81(4):419-436.
PMID: 32048757 DOI: 10.1002/ddr.21648

Neutrophils are essential effector cells of immune system for clearing the extracellular pathogens during inflammation and immune reactions. Neutrophils play a major role in chronic respiratory diseases. In respiratory diseases such as asthma, chronic obstructive pulmonary disease, cystic fibrosis, lung cancer and others, there occurs extreme infiltration and activation of neutrophils followed by a cascade of events like oxidative stress and dysregulated cellular proteins that eventually result in apoptosis and tissue damage. Dysregulation of neutrophil effector functions including delayed neutropil apoptosis, increased neutrophil extracellular traps in the pathogenesis of asthma, and chronic obstructive pulmonary disease enable neutrophils as a potential therapeutic target. Accounting to their role in pathogenesis, neutrophils present as an excellent therapeutic target for the treatment of chronic respiratory diseases. This review highlights the current status and the emerging trends in novel drug delivery systems such as nanoparticles, liposomes, microspheres, and other newer nanosystems that can target neutrophils and their molecular pathways, in the airways against infections, inflammation, and cancer. These drug delivery systems are promising in providing sustained drug delivery, reduced therapeutic dose, improved patient compliance, and reduced drug toxicity. In addition, the review also discusses emerging strategies and the future perspectives in neutrophil-based therapy.