1.Relapse of B-cell acute lymphoblastic leukaemia presenting as right aural polyp with facial and mandibular nerves palsy
Chew Shiun Chuen ; Mohd Khairi Md Daud ; Nur Asyilla Che Jalil ; Hilma Hazmi
The Medical Journal of Malaysia 2017;72(5):317-320
A patient presenting with an ear polyp is a common finding
in otorhinolaryngology practice. The common causes
include chronic otitis media and cholesteatoma. We report
an adult female patient with a history of acute leukaemia
presenting with chronic otitis media symptoms and right ear
polyp. She was subsequently diagnosed as relapse of B-cell
acute lymphoblastic leukaemia based on histopathological
examination. The presentation may be similar to an
inflammatory pathology of the middle ear, making it
misleading.
Leukemia
;
Polyps
2.The efficacy of intratympanic steroid injection for the treatment of idiopathic sudden sensorineural hearing loss
Chew Shiun Chuen ; Mohd Khairi Md Daud
The Medical Journal of Malaysia 2020;75(1):74-77
Objective: A systemic steroid is known to have a potential to
recover hearing after idiopathic sudden sensorineural
hearing loss (ISSHL). However, lately many centres have
introduced the use of intratympanic (IT) steroid therapy as
an option. We reviewed our experience in the treatment of
patients with ISSHL looking at the overall success of using
systemic steroid, IT steroid injections as salvage therapy
and primary IT steroid injection.
Methods: A retrospective study was conducted on 20
patients who had suffered from ISSHL from January 1, 2012,
to December 31, 2017. ISSHL is defined as a rapid decline in
hearing over three days or less affecting three or more
frequencies by 30dB or greater. Comparison between the
mode of steroid therapies and improvement in patients was
done. At least 15dB improvement in pure tone audiogram
(PTA) was considered as successful therapeutic
intervention.
Results: Twenty male and female patients who fit the
inclusion and exclusion criteria were included. The mean
age of the patients was 41.4 years with a range from 13 to 72
years. Ninety percent patients presented with unilateral
ISSHL involvement. Eight ears of patients who received
systemic steroid therapy alone had improved hearings
(75%). Out of seven ears from six patients who received
salvage therapy, four ears (57.1 %) had improvement in PTA.
Seven ears showed improvement in PTA from a total of eight
patients who primarily received IT injections.
Conclusions: IT steroid therapy promises a favourable
outcome in the improvement of the hearing, as compared to
systemic steroid administration. Its usage is recommended
not only for salvage therapy but should be used as primary
treatment especially in those with co- morbiditie