Synchronous Occurrence of Bilateral Malignant Otitis Externa: Report of a Rare Case / 가정의학회지

Malignant otitis externa (MOE) is a rare and potentially life-threatening disease of the ear and temporal bone. Bilateral simultaneous MOE is extremely rare. Due to bilaterally symmetrical facial nerve palsy, it can easily be missed at the initial presentation, causing delay in management. Here, we report a case of bilateral MOE managed aggressively with regular ear toileting, ear packing with a ribbon gauze soaked with topical antimicrobials, and long-term intravenous and oral antibiotics. The patient showed good improvement in pain control, facial nerve status, and ear findings.

The Test-Retest Reliability of Subjective Visual Horizontal Testing:Comparisons between Solid and Dotted Line Images

The present study aimed to determine the test-retest reliability of subjective visual horizontal(SVH) testing when tested with solid and dotted line images. In this repeated measures study,36 healthy young Malaysian adults (mean age=23.3±2.3 years, 17 males and 19 females)were enrolled. All of them were healthy and had no hearing, vestibular, balance, or vision problems.The SVH angles were recorded from each participant in an upright body position using acomputerized device. They were asked to report their horizontality perception for solid and dottedline images (in the presence of a static black background). After 1 week, the SVH procedurewas repeated. The test-retest reliability of SVH was found to be good for both solid line[intraclass correlation (ICC)=0.80] and dotted line (ICC=0.78). As revealed by Bland-Altmanplots, for each visual image, the agreements of SVH between the two sessions were within theclinically accepted criteria (±2°). The SVH testing was found to be temporally reliable, which canbe clinically beneficial. Both solid and dotted lines in the SVH testing are reliable to be usedamong young adults. J Audiol Otol 2020;24(2):107-111

Sudden sensorineural hearing loss: A missed opportunity for treatment

@#Sudden sensorineural hearing loss (SSNHL) is an otology emergency and carries significant morbidity if the diagnosis is missed. It can present to any specialty but in our local setting the patient usually presents to primary care as it is easily accessible. We present a case of SSNHL that was initially presented to a primary care centre and the patient was reassured without any investigation being carried out. SSNHL has many causes thus making diagnosis difficult. However, with knowledge of its possible, a diagnosis can be made and appropriate management can be advocated to the patient. Hence, we discuss the three main causes of SSNHL, while emphasizing the immune system-mediated mechanism as the main cause in this case.

Clinical Characteristic of Vertigo in Children

Objective: To review the clinical characteristic of vertigo in children Method: A retrospective observational study was done on children who presented to a specialised vertigo clinic over period of six years. The patients’ case notes were retrieved from the medical record unit and reviewed. All patients were seen by an otologist who thoroughly took down history, completed ear, nose, throat and neurological examination. Result: Seven different causes were identified in 21 patients (86%) while no diagnosis was reached in three patients (12.5%). The most common cause of giddiness was childhood paroxysmal vertigo (33%) followed by benign paroxysmal positional vertigo (16.6%) and sensorineural hearing loss (12.5%). Other causes include chronic suppurative otitis media and anxiety disorder each accounting for 8.3%, one case of cholesteatoma and another case of ear wax each accounting for 4.1%. Conclusion: It is not uncommon for the children to be affected by vertigo. Management of vertigo in children should include a detailed history, clinical examination, audiological and neurological evaluation. Imaging should be performed in selected patients. The main cause of vertigo in our series is CPV. The outcome of most of the patients is good.

Antifungal Effect of Malaysian Neem Leaf Extract on Selected Fungal Species Causing Otomycosis in In-Vitro Culture Medium

Azadirachta indica (neem) has been used for a long time in agricultural and alternative medicine. Neem had been proved effective against certain fungi that could infect human body. This pilot study aims to demonstrate the antifungal effect of Malaysian neem leaf extracts on the pathogenic fungi in otomycosis, Aspergillus niger and Candida albicans. This is a laboratory-controlled prospective study conducted at Universiti Sains Malaysia. The powder form of Malaysian neem leaf was prepared. Ethanol and aqueous extracts of the neem leaf was diluted with sterile water to establish five different concentrations of 50 g/ ml, 25 g/ml, 12.5 g/ml, 6.25 g/ml and 3.125g/ml. The extract was tested on Sabouraud Dextrose Agar suspended with Candida albicans and Aspergillus niger respectively. Well diffusion method was used and zone of inhibition was measured. Growth of the fungi was inhibited in both alcohol and aqueous extract concentrations. The minimum inhibitory concentration (MIC) of Malaysian neem aqueous extract against Candida albicans was 11.91 g/ml, neem ethanol extract against Candida albicans was 5.16 g/ ml, neem aqueous extract against Aspergillus niger was 7.73 g/ml and neem ethanol extract against Aspergillus niger was 9.25 g/ml. Statistical analysis showed that the antifungal activity of Candida albicans is better in alcohol neem than aqueous extract (p<0.001) but aqueous neem extract is better than alcohol extract (p<0.001) for Aspergillus niger.Malaysian neem has significant antifungal effect towards Aspergillus niger, best in aqueous extract and towards Candida albicans, was best in alcohol extract.

The routine histopathological examination of tonsillectomy specimens at Hospital Universiti Sains Malaysia – A retrospective study and its implication

Tonsillectomy is performed for several indications, the two commonest in practice are infective (chronic tonsillitis) and obstructive symptoms such as sleep apnea. The objective of this study is to determine the necessity of routinely performed histopathological examination of fonsillectomy specimens. In this paper, a retrospective evaluation of 480 specimens from 241 patient who had undergone tonsillectomies in Hospital Universiti Sains Malaysia between January 2004 and October 2005 was done. It was found that 462 (96.25 %) were reactive lymphoid hyperplasia and 18 (3.75 %) were follicular hyperplasia. None of them were found to be malignant. The result of this study indicates that routine histopathological examination of tonsillectomy specimens are unnecessary and results only in added cost and a loss of man hours.

The routine histopathological examination of tonsillectomy specimens at Hospital Universiti Sains Malaysia- Retrospective study and its implication

Tonsillectomy is performed for several indications, the two commonest in practice are infective ( chronic tonsillitis ) and obstructive symptoms such as sleep apnea. The objective of this study is to determine the necessity of routinely performed histopathological examination of specimens post-tonsillectomy . In this paper, a retrospective evaluation of 480 specimens from 241 patient who has undergone tonsillectomies in Hospital Universiti Sains Malaysia between January 2004 and October 2005 was done. It was found that 462 ( 96.25 % ) were reactive lymphoid hyperplasia and 18 ( 3.75 % ) were follicular hyperplasia. None of them were found malignant. The result of this study indicate that routine histopathological examination of tonsillectomy specimens are unnecessary and results only in added cost and a loss of man hours.