OBJECTIVE: To present two cases in which an improved rhombotrapezius flap design was utilized maximally to cover a wide and deep surgical defect after extirpation of a malignant tumor in the temporo-facial area. SETTING: Tertiary Hospital. PATIENTS AND METHODOLOGY: Two cases of malignancy involving the temporo-facial area of the head are presented. Surgical design for the reconstruction of this defect using rhombotrapezius flap is presented. RESULTS AND DISCUSSION: Large and deep temporo-facial defects are adequately closed by rhombotrapezius flap with adequate tissue coverage. Surgical design proved to be acceptable with good flap take and overall cosmetic result. CONCLUSION: Rhombotrapezius flap can be used to cover a large deep defect and can provide more than adequate tissue coverage and bulk to any temporo-facial defects. (Author)
CASE REPORTS

Report a case of patient Tran Đ.V. born at December 26th 2002 in Ninh Thuan district, Khanh Hoa province, admitted hospital at November 25th 2003 due to hirsutism and developed genitalia. Ultrasound and CT scan examinations showed a mass in his right adrenal gland, which was subsequently removed surgically. The histopathological findings were consistent with an adreno-cortical carcinoma. This is a rare tumor with frequency 1/10.000 adrenal tumors in adult. In children, there are some cases and most frequently in girls. Adreno-cortical carcinoma combining with isosexual precocious pseudopuberty is rarer in boys
Puberty, Precocious ; Case Reports

Study on 3 cases of splenic tuberculosis with HIV(-), without pulmonary lesions, treated in Pham Ngoc Thach Hospital of Ho Chi Minh city. Among them, the first one might be a single splenic tuberculosis patient, because there was not any lesion in other areas; the second case was glandular tuberculosis combined with splenic tuberculosis; the third case perhaps was splenic tuberculosis combined with symptoms of tuberculous meningitis occurred 15 days after splenectomy. All 3 cases had major symptoms including mild fever and dull pain in left slope lasting from several months to a year. Ultrasound and abdominal computed tomography scan (CT-scan) showed numerous lesions in the spleen with <2cm size and unspecific decreased dark level with or without big spleen, however, dark increased area should be seen in ultrasound. 2/3 cases of splenectomy with pathological results was splenic tuberculosis, one case was not indicated surgery, making biopsy found a glandular tuberculosis. Splenic tuberculosis treatment with regime of anti-tuberculosis drug during 12 months was suitable
Tuberculosis, Splenic ; Case Reports

OBJECTIVES: This case report aims to (1) Present the differential diagnosis of chronic cough without neglecting uncommon causes (2) Increase awareness of diagnostic challenges that may arise in the face of a compromised airway (3) Elucidate the therapeutic complexity of airway management; (4) Emphasize the value of a multi-disciplinary team approach in such cases; Illustrate the vital role otolaryngologists play in the diagnosis and management of airway problems DESIGN: Case Report SETTING: Tertiary Care Hospital in Quezon City, Philippines PATIENTS: One Patient RESULTS: This is the case of an eleven-year old male that presented with chronic cough that was refractory to conventional empiric medical therapy. As his symptoms progressed, further evaluation revealed a mass that was obstructing a large portion of the airway. Timely and methodical investigation and intervention proved to be life-saving. CONCLUSION: A working knowledge of the differential diagnoses of chronic cough is crucial in the diagnosis and management of the compromised airway. A high index of suspicion, systematic and thorough investigation and a multi-disciplinary approach are vital components of the treatment plan. Bronchoscopy in the hands of a skilled practitioner is still a diagnostic and therapeutic mainstay. (Author)
CASE REPORTS [PUBLICATION TYPE]

Objective: To describe a novel harpoon design for a low cost, self retaining tympanostomy tube with applicator used in a 38-year-old female for otitis media with effusion. Methods: a. Study design: Instrumental Innovation/Case Report b. Setting: Tertiary Hospital in Metro Manila Results: The tympanostomy tube was inserted under endoscopic guidance within 10 seconds, remained in place for two months with relief of symptoms, and spontaneously extruded by the seventh month of follow-up. Conclusion: The harpoon-designed tube with applicator provided ease of insertion and good anchorage in the tympanic membrane. Maximizing the use of a stylet-needle as both perforator and applicator simplified the tympanostomy and ventilating tube insertion procedures into a single maneuver. (Author)
EAR VENTILATION CASE REPORTS

Case reports remain to be an essential part of knowledge generation in health care. It is a research design that involves writing about a patient’s illness with either an unusual, new, unexpected, or unique characteristic. It can be about new findings, a novel diagnostic test, unfamiliar adverse events or innovative medical and surgical interventions. It is a detailed description of a patient’s course of illness including symptoms, physical examination findings, laboratory results, treatment modalities and outcomes. The essential element of writing a case report or series is to contribute to the generation of new knowledge. Wellwritten manuscripts have a valuable purpose in medicine as they present new illness, unexpected effects of treatment, novel diagnostic exams or unforeseen patients’ outcomes. The sections of a case report include an Abstract, Introduction or Background, Case Presentation [history, physical examinations, investigations or laboratories, differential diagnosis (if relevant), treatment (if relevant), outcome/follow-up, Discussion, Learning points/Take home messages, Patients perspectives and References. Manuscripts written as case reports or case series by nature of their design are not required to get approval from an Ethics Review Board (ERB). However, there should be an institutional process to clear and register papers. Case reports or a case series has its own distinctive writing components and features as not all single or series of clinical cases are reportable. This article aimed to define case reports/series, describe the different parts, how to write and evaluate a case report manuscript using the CARE guidelines.

From the year 1985 – 1997, 250 cases of corneal transplatation were reviewed. The diameter of grafted cornea varied from 8-15mm, among them 113 cases of graft larger than 10mm. After the operation, visual acuty was improved in almost patients. In the case of internal therapy is impossible, this surgery is the only approach to save the eyeball, moreover, the optical function was restored significantly. In the case of progressive infection, which is not responded to the therapy, threatening the eyeball corneal transplantation must be indicated early.
Corneal Transplantation ; Case Reports ; Epidemiology

Ultrasound cross-sectional prospective investigation on 16 patients with Dengue fever, showed that 15/16 cases, gall bladder wall thickness was a factor of prognosis, standard for patients with high risk of volume dropping shock related to kidney syndrome, 12/16 cases with abdominal cavity fluid, 7/16 cases there was perirenal collection of fluid, 3/16 cases of fluid subcapsular collection in the liver, pleural effusion. In addition, there may be large pancreas and spontaneous rupture of the kidney.
Dengue/ultrasonography ; Case Reports ; Gallbladder

A study on 13 communes of 8 districts in B¾c Giang province and results of epidemiological investigation of goiter at 12 communes has shown that the level of iodine and calcium in the soil can be used to forcast the local goiter in B¾c Giang province. The simple, rapid and inexpensive to contribute to prevent, control and eliminate the local goiter in B¾c Giang province.
Goiter ; Case Reports [Publication Type]

The classification, diagnosis and management of the feminized testicle were implemented in the institute of mother and infant protection and care during 1998-1999 showed that the feminized testicle only found after the puberty age with the reasons of the primary menostasis or abnormality of the external genitalia. The clinical condition of 3 patients were typical. The hormone replacement therapy was used after the removal of testicle and reconstruction of the external genitalia.
Testis ; Case Reports [Publication Type]