1.The Role of Powered Instrumentation in the Removal of Antrochoanal Polyps: A 10-Year Review
Mohd Tahir J ; Gendeh BS ; Mohd Razif MY
Medicine and Health 2009;4(2):108-114
Antrochoanal polyps are rare lesions. We report a series of 40 consecutive cases of antrochoanal polyps treated in our tertiary centre over a period of ten years between May 1998 and April 2008. The median age of the patients was 37 years. The most common clinical symptom was nasal obstruction (92.5%) followed by rhinorrhoea (45%), postnasal drip (35%) and snoring (22.5 %). The median period of follow-up of these patients was 30 months. Various surgical approaches were used; the commonest was powered endoscopic polypectomy and middle meatal antrostomy
in 28 patients (70%), followed by endoscopic polypectomy and middle meatal
antrostomy in seven patients (17.5%). Five patients (12.5%) underwent powered
endoscopic polypectomy without middle meatal antrostomy. In addition, two patients
had septoplasty and one had a frontal sinustomy. There were six patients (15%) who
had combined sublabial antrostomy. No major complications occurred; four patients
relapsed; three patients had initial operation performed elsewhere and one patient
developed recurrence after the first surgery. The median hospitalization period was
three days. We conclude that, the use of powered instrumentation in the removal of
antrochoanal polyps is safe, effective and associated with minimal morbidity.
2.Retropharyngeal Abscess: A Seven-Year Review - Clinical Presentation, Diagnosis and Management
Abdul Fattah AW ; Marina MB ; Mazita A ; Mohd Razif MY ; Primuharsa Putra SHA
Medicine and Health 2009;4(2):84-90
This was a retrospective study of operative records between 2000 – 2007 from two ear, nose and throat (ENT) referral centers in Malaysia to review demographic patterns, clinical presentations and management of retropharyngeal abscess (RPA). Our case series comprised of eight patients with five females and three males with a median age at presentation of 47 years. Comorbid factor in this series was diabetes mellitus, with four patients having diabetes. There were three cases of fish bone ingestion. The commonest presentation was dysphagia or odynophagia. None of them had fever. All patients were treated with broad spectrum intravenous antibiotics (IV) and drainage was performed for the abscess. Four patients underwent transoral drainage with three having the cervical approach and one having spontaneous rupture. All patients recovered well from the infection and only one patient passed away due to septicaemia. In conclusion, patients with retropharyngeal abscess may present with vague symptoms of sore throat, odynophagia without fever due to partial antibiotics treatment. A correct diagnosis should be made so that adequate treatment can be given to prevent mortality.