ABSTRACT: To date, myringoplasty conducted under the operating microscope has been found to have its limitations. With the introduction of the endoscope into other branches of surgery, there have been attempts at its utilisation in otology.
Endoscope-assisted myringoplasty was carried out in 50 patients aged 18-45 years using the temporalis fascia graft. The middle ear was examined through perforation in order to exclude cholesteatoma.
The overall success rate of the graft uptake and improvement in conductive deafness as air-bone gap closure was achieved in 80 percent of cases.
Endoscopic myringoplasty was found to be equally effective, less morbid and very cost-effective in small central perforations. However, it is not applicable in all cases, especially in those with large perforations.
Singapore medical journal 06/2009; 50(5):510-2. · 0.73 Impact Factor
ABSTRACT: Total ectopia of thyroid is a rare phenomenon and malignant change in an ectopic thyroid is even rarer. We report a case of medullary carcinoma in a total ectopic lingual thyroid occurring in a 45-year-old woman who presented with dysphagia, plummy voice and a round sessile mass at the base of the tongue. The mass was extirpated using Trotter's midline approach. Upon examination, it was found to be medullary carcinoma in an ectopic thyroid. Permanent substitution therapy with thyroxine secured the euthyroid status of the patient. The embrylogical basis and a review of literature regarding carcinomatous change in an ectopic thyroid are also discussed. There is a need to investigate for an ectopic thyroid, or even total ectopia, in the case of any smooth mass found at the base of the tongue.
Singapore medical journal 04/2008; 49(3):251-3. · 0.73 Impact Factor
ABSTRACT: Foreign body inhalation in children is not uncommon, and may escape notice by the parents as well as the physicians, because of the lack of knowledge of the exact history and inconclusive radiographical findings.
A retrospective analysis of airway foreign bodies in 132 children (80 males and 52 females) over a period of 20 years was conducted. Rigid bronchoscopy under general anaesthesia was done in 129 cases.
The majority of patients (46 percent) were younger than three years of age. Duration of symptoms varied from less than six hours to three months. Definitive history of foreign body inhalation or sudden choking episodes were present in 71 children. The foreign body was successfully removed in 93.2 percent of the cases. Peanuts were the commonest foreign body. Foreign bodies were found in the right main bronchus in 62 cases, in the left main bronchus in 46 cases, and at vocal cord level in 7 cases. Chest radiographs were normal in 46 cases.
Rigid bronchoscopy usually gives good results in detecting airway foreign bodies. It should be performed at the earliest opportunity even when the definitive history is not forthcoming and the chest radiograph is inconclusive.
Singapore medical journal 10/2007; 48(9):850-3. · 0.73 Impact Factor