Submandibular mass excision in an Asian population: a 10-year review.

OBJECTIVES: The objectives of this study were to compare the prevalence of submandibular gland neoplasia in an Asian population with a Western population and to evaluate the accuracy of fi ne needle aspiration cytology (FNAC) and computed tomography (CT) scan in the study of submandibular gland pathologies. MATERIALS AND METHODS: We conducted a 10-year retrospective review of 101 submandibular mass excisions. Data on the demographic profi le of patients, clinical features, correlation of fi ne needle aspiration cytology, CT scans and histology and morbidities related to surgery were collected. RESULTS: The prevalence of submandibular gland neoplasia was 27.1%. Most (78.9%) of these were benign. FNAC and CT scans were accurate for benign neoplasia. However, the accuracy of FNAC and CT scans for sialadenitis without sialolithiasis was low. CONCLUSION: The prevalence of submandibular gland malignancy was lower in the Asian population. FNAC and CT scans were accurate for benign neoplasia of the submandibular gland.

Successful rehabilitation with cochlear implant in post-irradiation induced hearing loss in nasopharyngeal carcinoma patient.

INTRODUCTION: We report a case of successful rehabilitation of hearing with a cochlear implant in a patient with nasopharyngeal carcinoma who developed post-irradiation hearing loss following treatment. CLINICAL PICTURE: A 55-year-old Chinese lady suffered from radiation-induced sensorineural hearing loss due to treatment for nasopharyngeal carcinoma. Audiological tests and imaging studies showed an intact retrocochlear pathway. TREATMENT: Cochlear implantation. OUTCOME: Cochlear implant was done with successful rehabilitation of hearing until the time of this report. CONCLUSIONS: If functionally active auditory fibres survive with no recurrent tumour, successful rehabilitation of post-irradiation induced sensorineural hearing loss is possible with a cochlear implant in a patient with nasopharyngeal carcinoma.

Repair of nasal septal perforations using auricular conchal cartilage graft in children: report on three cases and literature review.

OBJECTIVES: Repair of nasal septal perforation is a challenging procedure. Numerous methods have been described to close nasoseptal perforations with varying degrees of success. The lack of a consensus on nasoseptal perforation repair reflects the shortcomings of each method. There has been a paucity of literature on nasoseptal repair in the paediatric age group. We report our experience of repair of nasal septal perforation secondary to button battery injury using auricular conchal cartilage in the paediatric population. METHODS: Retrospective review of case notes and close regular follow-up of the patients since their first presentations with button batteries as foreign bodies in the nose. RESULTS: Three out of the three children who underwent repair of the nasal septum achieved successful closure of the nasal septum. One child with a large septal perforation required three procedures to achieve closure of the perforation. CONCLUSIONS: Repair of nasal septal perforations is a challenging procedure especially in children. Good results can be achieved with auricular conchal cartilage graft.

Pediatric tracheotomies in an Asian population: the Singapore experience.

OBJECTIVE: Over the past 2 decades, tracheotomy in children and infants has evolved from a primarily emergent procedure for upper airway obstruction into a semielective procedure for airway access in assisted ventilation. We present a 12-year retrospective review of tracheotomies performed in the pediatric population in Singapore. STUDY DESIGN AND SETTING: We reviewed all tracheotomies performed in children below the age of 16 years in 2 tertiary pediatric medical centers in Singapore from January 1991 to December 2003. Indications for surgery are reviewed, and outcomes in terms of morbidity rate, mortality rate, postoperative rehabilitation, and duration of decannulation process were analyzed. RESULTS: Tracheotomies were performed in 48 children during the study period. The mean age of patients was 3.24 years, with ages ranging from 16 days to 14 years. Sixty-three percent of tracheotomies were done within the 1st year of life. The chief indication was airway access for assisted ventilation. The overall complication rate was 31%. There were 13 attempts at decannulation, with 9 successes. No tracheotomy-related deaths occurred. CONCLUSION: Tracheotomy is a relatively safe procedure in children and infants. Lower decannulation rates and the evolving role of tracheotomy for early access in assisted ventilation permits earlier discharge with tracheotomy in situ.