Primary middle ear papilloma: A case report

We report a case of primary middle ear papilloma in a 66-year-old male with underlying chronic suppurative otitis media, presenting with right sided otorrhea with progressive aural mass formation. He underwent right mastoidectomy and tumour excision. Diagnosis of right middle ear papilloma with no malignant features was confirmed with histopathological examination. The patient recovered well with no recurrence up to 12 months

Retropharyngeal Abscess in a Neonate After Extravasation Injury: To Drain or not to Drain?

Neonatal retropharyngeal abscess (RPA) is a rare and life-threatening entity. Most of the cases are idiopathic in nature. We encountered a case of RPA in a newborn secondary to extravasation injury. The presence of neck swelling with clinical deterioration following extravasation of total parenteral nutrition (TPN) infused via a peripherally inserted central catheter at the right upper limb raised the suspicion of neck abscess. This was later confirmed to be RPA based on magnetic resonance imaging of the neck. She was treated with prolonged intravenous antibiotics in the Neonatal Intensive Care Unit (NICU). Her condition gradually improved, evidenced by resolution of the collection on serial imaging. Early recognition and prompt management are crucial to reduce the morbidity and mortality from RPA

A Rare Tumor in the Neck of a Child: Plexiform Neurofibroma

Plexiform neurofibroma represents an uncommon variant of neurofibromatosis type 1, constituting only 5%–30% of all cases. Plexiform neurofibroma is usually diagnosed during childhood and arises from multiple nerves, manifesting as bulging and deforming masses that can also involve connective tissue and skin folds. We report a case of a two-year-old girl who presented with worsening stridor since birth and later exhibited progressively increasing left neck swelling at the age of 10 months old. Ultrasound and magnetic resonance imaging (MRI) showed a lobulated solid mass in the left deep neck space extending to the midline and having a mass effect on the airway with involvement of the supraglottic region. Tracheostomy was done, and a biopsy of the supraglottic lesion revealed a plexiform neurofibroma. The patient was conservatively managed after a discussion with her parents concerning the associated potential of operative morbidity. The patient’s parents had learned about tracheostomy care, and the patient was scheduled for yearly MRI surveillance. MRI was performed again three months after the initial diagnosis and showed stable lesion. Plexiform neurofibroma is a slow-growing tumor. A treatment decision must consider the benefits of surgery and the morbidity of the progressing disease. Hence, airway management is crucial prior to the final decision of such cases

Transforming growth factor beta 3 induced human adipose-derived stem cells for auricular chondrogenesis

The limitation of self-repair and proliferation capacity of chondrocytes in cartilage reconstruction lead to alternative search of cell source that can improve the auricular regeneration. Human adipose-derived stem cells (HADSC) are an alternative cell source that have unique characteristics to self-renew and differentiate into various tissues making it suitable for cell therapy and tissue engineering. This study aimed to examine the chondrogenic differentiation potential of (HADSC) in monolayer culture by the presence of different transforming growth factor beta’s, TFG-β1, -β2 and -β3. HADSC at passage 3 (1.5 × 105 cell/mL) were cultured in chondrogenic medium containing 5 ng/mL of different transforming growth factor beta’s, TFG-β1, -β2 and -β3 for 7, 14 and 21 days. Data analysis was evaluated based on the growth rate of cells, cells morphological changed, production of collagen type II and glycosaminoglycan sulphate (sGAG). The quantitative RT-PCR was carried out to determine the chondrogenic, fibrogenic and hypertrophic gene expression levels. Differentiation of HADSC into chondrocytes using TFG-β indicates the occurrence of the chondrogenesis process. The best chondrogenic differentiation was observed in HADSC induced by TFG-β3 through the chondrocytes-like cells morphology with cells aggregation and high production of proteoglycan matrices compared to other TGF-βs groups. Additionally, the expression of chondrocytes-specific genes such as Type II collagen, Aggrecan core protein, Elastin and Sox 9 was high. In conclusion, this study has showed that TGF-β3 is the potential growth factor in producing chondrogenic cells for auricular cartilage tissue engineering

Association of maternal Vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: the growing up in Singapore towards healthy outcomes study

10.1371/journal.pone.0142239PLoS ONE10111-16GUSTO (Growing up towards Healthy Outcomes

Juvenile xanthogranuloma of the nose

ABSTRACT Juvenile xanthogranuloma (JXG) is a relatively uncommon, benign histiocytic proliferative disorder. One should be aware of this entity in order to make a diagnosis with the possibility of visceral involvement as well as associated medical conditions related to it. The present case report describes a case of JXG in a two-year old boy who presented with a circumscribed papule located over the vestibule of the right nostril. The lesion was histologically diagnosed as a JXG after surgical excision of the mass

Supraglottoplasty for Laryngomalacia: Who Will Benefit?

Laryngomalacia is the most common cause of neonatal and infantile stridor. The aim of this study was to assess the outcome of surgical intervention in children with laryngomalacia. Methods: Between January 1998 and December 2008, IS children with laryngomalacia underwent surgical intervention at the Universiti Kebangsaan Malaysia Medical Centre, from which only eight case notes were available. These were retrospectively reviewed for demographic data, symptoms, comorbidities, operative technique, postoperative recovery, complications, length of hospital stay including intensive care unit (ICU) care, and resolution of symptoms. Results: Patients consisted of seven males and one female. One patient underwent three procedures, resulting in a total of 10 procedures for this study. The mean age was 15.6 months (range: 2–39 months). The most common indication for surgery was severe stridor resulting in failure to thrive. Intra-operatively, all patients were found to have short aryepiglottic folds, and four also had redundant arytenoid mucosa. Supraglottoplasty was performed in 10 patients: three by cold instruments and seven by laser. Successful extubation was achieved in the operating theatre in eight patients while the other two were extubated in the ICU on the same day. Postoperative ICU nursing was required in six patients: three for up to 3 days, and three for longer periods because of medical problems. Resolution of stridor was complete in four patients, partial in one, and no difference in five. Two patients defaulted follow-up. There were no postoperative complications from the procedures. The average length of follow-up was IS weeks (range: 12 days to 7 years). Conclusion: Supraglottoplasty remains an effective method to treat severe laryngomalacia. Patients who will benefit most are those with severe laryngomalacia that is uncomplicated by neurological conditions or multiple medical problems. In our institution, early extubation is the norm, and a significant number of patients can be nursed in the normal wards and be discharged within 48 hours of the procedure

Simultaneous nasopharyngeal carcinoma with laryngeal squamous cell carcinoma and review of literature

The occurrence of second primary carcinomas (SPC) in aerodigestive tract is well recognized in the literature especially the lung and esophagus. The tumors are described according to the chronological presentation as simultaneous, synchronous and metachronous. Occurrence of second primary malignancy can be missed in early examination if they are not actively looked for. We are reporting the first and extremely rare presentation of nasopharyngeal carcinoma (NPC) presented simultaneously with laryngeal carcinoma with literature review and stress on the importance of pan-endoscopy in the management