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Feasibility of Salvage Selective Neck Dissection after Primary Irradiation of Pharyngeal and Laryngeal Carcinoma

Mat Lazim N, Abdullah K, Karakullukcu B, Tan IB

ORL J Otorhinolaryngol Relat Spec, 2018;80(1):10-18.
PMID: 29428959 DOI: 10.1159/000486371

INTRODUCTION: The concept of neck dissection (ND) in the management armamentarium of head and neck squamous cell carcinoma has evolved throughout the years. Nowadays, ND becomes more functional.
METHODOLOGY: A retrospective study of 865 patients was performed at Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital to investigate the feasibility of selective ND (SND). All patients with squamous cell carcinoma of the pharynx and larynx who received primary radiation and underwent salvage ND were included in the study.
RESULT: A total of 29 NDs were analyzed. In 17 neck sides, viable metastases were found (58%), whereas in the other 12 specimens there were no viable metastases. In 16 of the 17 necks (94%), the metastases were located either in level II, III, or IV or in a combination of these 3 levels. Level V was involved in only 1 case (6%).
CONCLUSION: It is well justified to perform a salvage SND (levels II, III, and IV) for pharyngeal and laryngeal carcinoma after primary radiation. In carefully selected cases of supraglottic and oropharyngeal carcinoma, a superselective ND also appears as an efficient option.
Adult Transglottic Haemangioma with Upper Airway Obstruction: Preservation of Airway and Voice

Mahmud KA, Zakaria R, Azman M, Mat Baki M

ORL J Otorhinolaryngol Relat Spec, 2021 05 05;83(4):295-298.
PMID: 33951656 DOI: 10.1159/000515424

Adult laryngeal haemangioma is normally seen in the supraglottic or glottic region. Transglottic haemangioma is unusual, and treatment with primary endolaryngeal surgical excision may lead to undesirable bleeding and poor voice outcomes. A 25-year-old female presented with hoarseness and progressive upper airway obstruction symptoms. Videoendoscopy showed haemangioma involving all unilateral subunits of the larynx obstructing half of the subglottis. The transglottic haemangioma was treated with endolaryngeal ethanol injection with prior tracheostomy under local anaesthesia. Endolaryngeal laser surgery was performed later on to remove small residual haemangioma and granuloma. The haemangioma resolved; however, the ethanol injection to the paraglottic space results in vocal fold immobility but with favourable position and good muscle tone and bulk. The patient was successfully decannulated. Post-intervention subjective and objective voice assessments showed normal parameters except slight impairment of voice handicap index-10 with a total score of 12. Adult transglottic haemangioma can cause upper airway obstruction and requires intervention. Excision of the lesion endoscopically without sacrificing voice is achievable.
The First Report on Incidence of Nasopharyngeal Carcinoma in Sabah, Borneo

Wong EHC, Tan HY, Dompok TM, Mohamad Ishak LA, Loong SP

ORL J Otorhinolaryngol Relat Spec, 2021 06 18;83(4):258-262.
PMID: 34148048 DOI: 10.1159/000516597

BACKGROUND: Nasopharyngeal carcinoma (NPC) is the fourth common cancer in Malaysia. A few studies have looked into the incidence of NPC in Malaysia in general, but there has been no published data on its incidence in Sabah specifically, where NPC is very common among the population. The aim of this study is to present the first report on the incidence of NPC in the state of Sabah, Borneo.
METHODS: Data of all patients diagnosed with NPC over a 5-year period from January 2015 to December 2019 inclusive were collected from the NPC registry of 3 main hospitals in Sabah. Age-standardized rates (ASRs) for different genders, ethnicities, and districts of origin were calculated.
RESULTS: 215 NPC patients were identified with a mean age at diagnosis of 49 (range 9-82). The ASR of NPC was 7.9/100,000 where the average age-adjusted male-to-female ratio was 2.4. The highest ASR was found in Dusun ethnicity in both male (3.19/100,000) and female (1.69/100,000) individuals, followed by Chinese (both genders), and Kadazan (for male individuals) and Bajau (for female individuals). The highest ASR was found in patients originating from Sandakan, Kota Kinabalu, Keningau, and Tawau.
CONCLUSION: This is the first report on the incidence of NPC in Sabah, Borneo. The data suggest high ASRs among the population, especially in male Dusun and Chinese ethnic groups. Further research looking into NPC in this state, especially on risk factors and ways to improve diagnosis and prevention among the population, is recommended.
Malaysian Version of the Sniffin' Sticks Identification Smell Test: Cutoff Points of Hyposmia

Husain S, Hamid IA, Zahedi FD, Wan Hamizan AK

ORL J Otorhinolaryngol Relat Spec, 2022 Jan 25.
PMID: 35078203 DOI: 10.1159/000521488

INTRODUCTION: Cultural backgrounds can influence the smell test because of the unfamiliarity of different populations with a number of odorants. The study aims to determine the cutoff points for hyposmia using the cultural adaptation of the Malaysian version of the Sniffin' Sticks identification smell test among different age groups.
METHODS: In this cross-sectional study, healthy participants were recruited from a hospital, senior citizen homes, and schools from 2019 until 2021. Participants were divided into 5 different age groups (A: children, B: adolescents, C: young adults, D: middle-aged adults, and E: older adults) and underwent the identification smell test. Scores below the 10th percentile in these age groups were used to determine the cutoff points for hyposmia.
RESULTS: The cutoff points for the smell identification scores for hyposmia at the 10th percentile in children, adolescents, and adults (young, middle-aged, and older) were less than 6, 9, and 11, respectively. Pairwise comparisons were made using the Bonferroni post hoc test, with p < 0.001. Scores showed a significant difference between males (mean [SD]: 11.43 [2.42]) and females (12.01 [1.98]); p = 0.005.
CONCLUSION: Our study found that the cutoff points of the identification smell test for hyposmia were lower than those of other studies. It is important to use these cutoff points in our population to establish the correct integrity of olfaction function in the clinic setting and in future research.
Fulltext Smell Outcome and Seropositivity Titre in Post-COVID-19 Patients

Harminder Singh SK, Husain S, Wan Hamizan AK, Zahedi FD, Othman SN, Zainol Rashid Z

ORL J Otorhinolaryngol Relat Spec, 2023;85(6):305-311.
PMID: 37473733 DOI: 10.1159/000531222

INTRODUCTION: The aims of the study were to perform an olfactory assessment on patients active and post-COVID-19 using the culturally adapted Malaysian version Sniffin' Sticks identification smell test (mSS-SIT), to evaluate the patient olfactory outcome using a Malay short version of the Questionnaire of Olfactory Disorders-Negative Statements (msQOD-NS), as well as to evaluate seropositive titre (IgG) response using automated serology method.
METHODS: Score for mSS-SIT was performed during the hospitalization, when patients had tested positive for SARS-CoV-2 (during COVID-19), and repeated after they had tested negative (after COVID-19). Also, each patient completed msQOD-NS and serology SARS-CoV-2 antibodies blood test was evaluated.
RESULTS: During COVID-19, 2 of our patients were anosmia (6.5%), 22 (70.9%) were hyposmia, and 7 (22.6%) were normosmia. We repeated mSS-SIT on these same patients after COVID-19, and none of these subjects were hyposmia or anosmia, as they achieved a score >12. All our patients had scored 21 using msQOD-NS, meaning no impact on quality of life as they had regained their normal olfactory function. In this study also, we obtained no correlation between smell test and seropositivity titre COVID-19, and antibody levels gradually decreased over time till 6 months and remained stable up to 12 months.
CONCLUSION: From this study, we know full recovery of the sense of smell can be expected post-COVID-19 infection and COVID-19 antibody persists in the body up to 12 months of infection.