Nasopharyngeal Tuberculosis in a Philippine Tertiary General Hospital

@#<p><strong>OBJECTIVE:?</strong> This study aimed to determine the prevalence of nasopharyngeal tuberculosis among patients who were initially assessed to have a nasopharyngeal mass and subsequently underwent biopsy in a Philippine Tertiary General Hospital from 2013 to 2015.</p><p><strong> </strong></p><p><strong>METHODS:</strong>?</p><p><strong>Design</strong>:           Case Series</p><p><strong>Setting</strong>:           Tertiary National University Hospital</p><p><strong>Participants</strong>: All patients with nasopharyngeal mass identified from January 2013 to December 2015 from a hospital wide census who underwent biopsy were investigated using chart and histopathology review. The prevalence of tuberculosis, malignancies and other findings were determined.</p><p><strong> </strong></p><p><strong>RESULTS</strong>:? Among 285 nasopharyngeal biopsies done between 2013 and 2015, 33 (11.6%) were histologically compatible with nasopharyngeal tuberculosis, 177 (62.1%) were different types of nasopharyngeal carcinoma, 59 (20.7%) were chronic inflammation, 4 (1.4%) were lymphoma, 5 (1.8%) were normal, and 7 (2.5 %) had diagnoses other than those above.</p><p><strong> </strong></p><p><strong>CONCLUSION:</strong> This study suggests a relatively high prevalence rate (11.6%) of nasopharyngeal tuberculosis in patients who have a nasopharyngeal mass. This indicates that nasopharyngeal tuberculosis should always be a differential when confronted with a mass in the nasopharynx especially in tuberculosis endemic areas.</p><p> </p><p><strong>KEYWORDS:</strong> nasopharyngeal tuberculosis; prevalence; censuses; tertiary care centers; Philippines; carcinoma; nasopharynx; biopsy; tuberculosis; lymphoma </p><p> </p>

Nasopharyngeal Tuberculosis in a Philippine Tertiary General Hospital

Objectiv@#This study aimed to determine the prevalence of nasopharyngeal tuberculosis among patients who were initially assessed to have a nasopharyngeal mass and subsequently underwent biopsy in a Philippine Tertiary General Hospital from 2013 to 2015. @*Methods@#Design: Case Series. Setting: Tertiary National University Hospital. Participants: All patients with nasopharyngeal mass identified from January 2013 to December 2015 from a hospital wide census who underwent biopsy were investigated using chart and histopathology review. The prevalence of tuberculosis, malignancies and other findings were determined.@*Results@#Among 285 nasopharyngeal biopsies done between 2013 and 2015, 33 (11.6%) were histologically compatible with nasopharyngeal tuberculosis, 177 (62.1%) were different types of nasopharyngeal carcinoma, 59 (20.7%) were chronic inflammation, 4 (1.4%) were lymphoma, 5 (1.8%) were normal, and 7 (2.5 %) had diagnoses other than those above. @*Conclusion@#This study suggests a relatively high prevalence rate (11.6%) of nasopharyngeal tuberculosis in patients who have a nasopharyngeal mass. This indicates that nasopharyngeal tuberculosis should always be a differential when confronted with a mass in the nasopharynx especially in tuberculosis endemic areas.

Auditory steady state response (ASSR) frequency-specific thresholds with absent auditory brainstem response (click-ABR) test results among Filipino children

@#OBJECTIVE: Determine the frequency-specific thresholds of auditory steady state response (ASSR) of Filipino children with absent auditory brainstem response (click-ABR) results.METHODS: This is a cross-sectional study analyzing the frequency-specific thresholds of auditory steady state response (ASSR) of Filipino children with absent auditory brainstem response (click-ABR) results. The study population comprised of 99 pediatric patients referred for hearing assessment using electrophysiologic techniques at the Ear Unit of the Philippine General Hospital. The subjects underwent hearing threshold evaluation using both evoked-potential techniques (click ABR and ASSR) within a one-month period from January 2009 to March 2014. The ASSR results of patients with absent click-ABR were collected and analyzed.RESULTS: There were 99 patients who underwent both ABR and ASSR. Of the 65 patients with absent ABR thresholds results, 13 patients had unilateral absent ABR while 52 had bilateral absent ABR results. The data of hearing tests from the combined 117 ears with absent ABR hearing tests were collected. The proportion of children with ASSR thresholds with absent ABR per frequency were -500 Hz- 45/117 (38.5%); -1000 Hz- 76/117 (64.0%); -2000 Hz- 63/117 (53.8%); and -4000 Hz- 41/117 (35.0%). The proportion of children with ASSR thresholds with absent ABR per number of frequencies were: -4 frequencies- 19/117 (16.2%); -3 frequencies- 32/117 (27.4%); -2 frequencies- 22/117 (18.8%); and -1 frequency- 44/117 (37.6%)CONCLUSION: In the absence of click- ABR response, ASSR may provide information about the levels of severe to profound hearing loss among children. The criteria of selection of candidates for intervention (hearing aids or cochlear implantation) should include results from hearing evaluation not only from behavioral and ABR thresholds but also from ASSR thresholds. This may ensure that exclusion of some children with severe and profound hearing loss who may benefit from the intervention will be minimized.

Embryonal rhabdomyosarcoma of the mandible

Objectives: 1] To describe a case of an embryonal rhabdomyosarcoma presenting as al radiolucent mandibular mass in a 3-year-old child. 2] To review existing literature on the clinical picture and pathophysiology of intraosseous rhabdomyosarcoma. 3] To identify learning points in the diagnosis of intraosseous rhabdomyosarcoma. Design: Case report. Setting: A tertiary referral hospital. Patients: One (1) Results: A case of a 3-year-old child with a radiolucent mandibular mass is described. Thel final histopathologic report turned out to be embryonal rhabdomyosarcoma. Intraosseous rhabdomyosarcomas are rare occurrences (3.5 percent in one review), and clinically present in younger age groups, with a non-tender, enlarging, firm-hard mass over a specific area. A review of the available literature on intraosseous rhabdomyosarcomas, and its proposed pathogenesis, is presented. Conclusion: A case of a radiolucent mandibular mass in a 3-year-old child is presented. Intraosseous rhabdomyosarcomas of the mandible are rare occurrences that pose challenges to the otorhinolaryngologist. Taken separately, the presentation, patient characteristics, clinical course, ancillary laboratories and imaging modalities may lead even the most astute otorhinolaryngologist astray. The whole clinical picture should be taken together so that the correct diagnosis will not be missed despite the rare presentation. (Author)