Congenital epulis: A rare benign tumour

Congenital epulis is a rare benign pedunculated tumour of the oral cavity arising from the alveolar ridges. It is usually detected in newborns and can be successfully resected surgically. We report a case of a newborn baby who had a 5x3x3cm pedunculated lobar mass arising from the upper alveolar ridge.

Maxillary sinus tumours--a review of twenty-nine patients treated by maxillectomy approach

A retrospective data of 29 patients who underwent various types of maxillectomy from January 1998 till January 2004 in UKM hospital were reviewed. There were 21 males (72%) and 8 females (28%) with mean age of 42 years. Malays were the majority of patients 17 (59%), Chinese 11 (38%) and Indian 1 (3%). Seventeen patients (59%) presented with malignant tumours while 12 patients (41%) with benign tumours. Inverted papilloma (50%) was the commonest benign tumour and squamous cell carcinoma (36%) was the commonest malignancy. Medial maxillectomy was performed in ten patients (35%), total maxillectomy in seven patients (24%), three patients (10%) had near total, three patients (10%) had partial maxillectomy and six patients (21%) underwent inferior maxillectomy.

Paediatric tracheostomy in Hospital University Kebangsaan Malaysia - a changing trend

Indication for pediatric tracheostomy has changed. Upper airway obstruction secondary to infectious disorders is no longer the commonest indication. The aim of this study was to establish data on indications, outcome and complications of pediatric tracheostomy. A retrospective analysis of pediatric tracheostomies carried out between March 2002 to March 2004 was done. Eighteen patients were identified. The commonest indication was prolonged ventilation (94.5%) followed by pulmonary toilet (5.5%). None was performed for upper airway obstruction. Postoperative complications were encountered in six patients (33.3%), the commonest being accidental decannulation notably in children less than six years of age. Twelve patients (66.6%) were successfully decannulated. The mortality rate was 16.6%. All death were non tracheostomy related. The commonest indication for tracheostomy was prolonged ventilation and tracheostomy in children is relatively safe despite complications.

Neck abscess: five year retrospective review of Hospital University Kebangsaan Malaysia experience

The most commonly involved space was the parapharyngeal and superficial anterior triangle followed by submandibular, retropharyngeal, posterior triangle and submental spaces respectively. Thirty-three percent of patients had diabetes mellitus as a predisposing factor. More than half of them had no known aetiological cause for the neck abscess. We encountered one mortality in an elderly patient with diabetes who succumbed to overwhelming septicaemia despite early abscess drainage and intensive medical treatment.

Massive epistaxis secondary to pseudoaneurysm of internal carotid artery

Post-traumatic pseudoaneurysms of internal carotid arteries are uncommon. The patients may present with massive epistaxis due to rupture of the aneurysm into the sphenoid sinus. Early diagnosis and treatment is mandatory as the likelihood of exsanguinations increases with each subsequent episode of epistaxis. The clinical features of unilateral blindness and massive epistaxis after head injury should indicate the diagnosis. The high mortality of this entity underlines the importance of early angiography in these patients to confirm this diagnosis. We present 3 cases of post-traumatic aneurysm of the ICA.

Heterotopic neuroglial tissue presenting as oral cavity mass with intracranial extension

Heterotopic neuroglial tissue is a rare congenital lesion with predilection in head and neck region. We report a case of a newborn who presented with an oral cavity mass with intracranial extension and later respiratory distress that was successfully excised via transcranial and transcervical approach.

Vestibular nerve section in a child with intractable Menière's disease

Clinical presentation of Menière's disease in children is not as typical as in adults. The triad of vertigo, tinnitus and deafness are not usually elicited, diagnosis often being made after years of follow up and batteries of investigation. A case of Menière's disease in a 3-year-old boy is presented. The diagnosis was only obvious at the age of 8 when the triad of vertigo, deafness and tinnitus were present. His disease progressed despite a trial of intratympanic gentamicin injections and endolymphatic sac decompression. Vestibular nerve section was subsequently performed for his intractable disease. Following the procedure he was asymptomatic and able to attend school.