Foreign bodies or objects in the ear are one of the most common problems encountered by otorhinolaryngologist (ORL) with attendant complications, removal of which requires expertise. Patients with this problem who sought treatment in the otorhinolaryngology clinic of Hospital Universiti Sains Malaysia (HUSM) were studied for duration of one year from January 2010 to December 2010. Specifically, the clinical presentation, type of foreign body and management outcome were analysed. 72 patients were reviewed - 44 (61.1%) males and 28 (38.9%) females. The age range was one year to 75 years with 59.8% being children below 10 years old. Ear pain (56.9%) was recorded as the most common and persistent symptom and insects (54%) were the commonest foreign body encountered. 95% (69) of the foreign bodies were removed under clinic setting with only three (4.2%) cases requiring general anaesthesia. Post-removal complications were noted in only one patient (1.4%). Repeated attempts by untrained personnel should be avoided and timely referral is vital to avoid undesirable complications.

Tracheocutaneous fistula (TCF) is a known complication of tracheostomy. It can cause problems such as saliva leak, predispose to infection from external skin into respiratory tract and cosmetically not acceptable. Treatment of the underlying infection is paramount important. Persistence of tract after sufficient duration of observation period should be surgically treated. Cases reported in the literature are mainly regarding paediatric TCF and the procedures are usually done under general anesthesia. We describe a case of surgical treatment of an adult TCF which was done under local anaesthesia.

Although nasopharyngeal carcinoma (NPC) is common in this part of the world, the incidence among children is still very low worldwide. The diagnosis is sometimes delayed because of the late reporting of the symptom by the patient or parents, or difficulty in reaching the final diagnosis due to its hidden anatomical location. The challenges include the difficult endoscopy in children, inability to differentiate an adenoid from the tumour on radiograph and often the inconclusive fine needle aspiration findings. If the tumour mass at Fossa of Rosenmuller can be clearly appreciated and biopsied with undoubtedly proven histology of NPC, the diagnosis can be straight forward and treatment can be commenced as early as possible. We report a 10-year-old child presented with bilateral neck cervical lymphadenopathy and epistaxis with fine needle aspiration cytology (FNAC) of the neck mass reported as lymphoma. Further work-up confirmed he was suffering from NPC.

A massive goiter may constrict the trachea resulting in shortness of breath. Recurrent laryngeal nerve compression may cause vocal cord paralysis. We highlight a case of a 62- year-old female with a 30 year history of an anterior neck swelling gradually increasing in size. She presented with acute symptoms of upper airway obstruction and voice changes. Emergency thyroidectomy was performed by dividing the middle part of the gland using ultrasonic scissors. The recovery was uneventful and the patient regained normal vocal cord function post operatively.

Oral leiomyomas are rare benign tumour of smooth muscle. The first case of oral leiomyoma was reported by Blanc in 1884 and since then more cases has been published following advancement in immunohistochemical study. This tumour has an excellent prognosis and recurrences are extremely rare. We report a case of a recurrent glossal leiomyoma in a patient with HIV infection and the lesion recurred one year after the first excision.

A laryngocoele is an abnormal dilatation of the laryngeal saccule. It is a rare cause of stridor in the newborn or in early infancy. Most laryngocoeles are asymptomatic but symptoms of hoarseness, feeding difficulty, lump in the neck and upper airway obstruction may occur. We report a case of external laryngocoele causing partial airway obstruction in early infancy. Spontaneous resolution occurred following conservative medical management thus avoiding surgical intervention.
Infant ; Complications ; Respiratory Distress Syndrome, Newborn

Hairy polyps are rare developmental malformations. They are benign lesions presented as a pedunculated mass that may arise from the naso-oropharyngeal region. Larger mass can cause upper respiratory obstruction causing respiratory distress or feeding diffi culty, while smaller mass will present as intermittent respiratory distress due to a ball-valve type of obstruction. They are commonly seen in female, with ratio of 6:1 and majority of the cases occur in the infantile period. We are reporting a case of hairy polyp in a female infant that causing intermittent respiratory distress.

Carcinoma, Ductal ; pathology ; surgery ; Female ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Middle Aged ; Neck Dissection ; Salivary Ducts ; pathology ; surgery

Introduction: Thyroid enlargement is one of the common surgical presentations in the Department of Surgery, Hospital Universiti Sains Malaysia (HUSM). Among them, benign non-toxic multinodular goiter constitutes one third (30%) of patients who underwent thyroidectomy. Common complications of thyroidectomy include recurrent laryngeal nerve (RLN) injury, hypocalcaemia, and recurrence of the thyroid lesion. Objective & Methods: This is a retrospective study of patients diagnosed with multinodular goiter treated in HUSM between January 1996 and December 2005. A total of 111 patients were studied and 52 of them underwent subtotal thyroidectomy while 59 underwent total thyroidectomy. The outcome in terms of RLN injury, hypocalcaemia and mass recurrence were analyzed. Results: Post operative complications were studied in both groups. Permanent recurrent laryngeal nerve injury occurs in 2.4% (1 case) in subtotal thyroidectomy group compared to total thyroidectomy group (3.6%, 2 cases). Five cases from total thyroidectomy group suffered from permanent hypocalcaemia but none in the other group. 70.7% (29 cases) from subtotal thyroidectomy group have functional remnant of thyroid tissue. Recurrence rate post subtotal thyroidectomy after 5 years is only 4.9% (2 cases). Conclusion: The post operative outcome in patients who underwent subtotal thyroidectomy in HUSM from January 1996 to December 2005 was better than total thyroidectomy with significant functional thyroid remnant.

AIMTo identify flutamide regulated genes in the rat ventral prostate.

METHODSTotal RNA from ventral prostates of control and flutamide treated rats were isolated. Differentially expressed transcripts were identified using differential display reverse transcriptase polymerase chain reaction. The effect of castration on the expression of flutamide-regulated transcripts was studied.

RESULTSWe have identified beta2-microglobulin, cytoplasmic FMR1 interacting protein 2 and pumilio 1 as flutamide induced and spermine binding protein and ribophorin II as flutamide repressed targets in the rat ventral prostate. Although flutamide treatment caused an induction of pumilio 1 mRNA, castration had no effect.

CONCLUSIONCastration and flutamide treatments exert differential effects on gene expression. Flutamide might also have direct AR independent effects, which might have implications in the emergence of androgen independent prostate cancer and the failure of flutamide therapy.

Adaptor Proteins, Signal Transducing ; drug effects ; metabolism ; Androgen Antagonists ; pharmacology ; Animals ; Flutamide ; pharmacology ; Gene Expression Regulation ; drug effects ; Intracellular Signaling Peptides and Proteins ; genetics ; metabolism ; Male ; Membrane Proteins ; genetics ; metabolism ; Orchiectomy ; Prostate ; drug effects ; metabolism ; RNA-Binding Proteins ; metabolism ; Rats ; Rats, Wistar ; beta 2-Microglobulin ; drug effects ; metabolism