Papers by Victor Abdullah
Laryngoscope Investigative Otolaryngology
BackgroundExercise‐based swallowing training (EBST) and transcutaneous neuromuscular electrical s... more BackgroundExercise‐based swallowing training (EBST) and transcutaneous neuromuscular electrical stimulation (TNMES) are common modalities used to treat late dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC). We aimed to investigate and compare the efficacies of EBST and TNMES as proactive treatments administered early after radiotherapy.MethodsPatients with early post‐radiotherapy NPC (n = 120) underwent either TNMES or EBST. Flexible endoscopic evaluation of swallowing (FEES), quality of life (QOL), and swallowing function questionnaires were completed before the intervention as well as immediately, 6, and 12 months after the intervention. Outcome measures included the scores for the swallowing function score (SFS), penetration and aspiration scale (PAS), dynamic imaging grade of swallowing toxicity (DIGEST), functional oral intake scale (FOIS), swallowing performance status scale (SPSS), pharyngeal motor impairment (PMI), pharyngeal function impairment (PFI), and fun...
Facial plastic surgery & aesthetic medicine, May 30, 2023
Background: An implant (porous polyethylene) is an alternative to rib cartilage for microtia reco... more Background: An implant (porous polyethylene) is an alternative to rib cartilage for microtia reconstruction but carries a risk of extrusion. Objective: To evaluate the outcome of a hybrid framework of implant with rib cartilage for microtia reconstruction. Methods: Patients who underwent Nagata's technique for microtia reconstruction were reviewed for complications and aesthetic score. In stage 1, a rib cartilage framework or a hybrid framework of implant with rib cartilage was used. In stage 2, the framework was elevated and supported by an implant for projection. Postoperative outcomes were reported for both groups. Results: Forty-four ears of 40 patients underwent surgery. Eleven ears received a rib auricular framework and 33 ears a hybrid auricular framework. The mean postoperative follow-up for the rib and hybrid groups was 76.3 and 43.1 months, respectively. No supporting postauricular implant extruded, whereas stainlesssteel wires extruded in seven ears (15.9%). Five (15.2%) hybrid frameworks were removed due to infection or extrusion. Mean operating time was 2 h shorter in the hybrid group. Aesthetic outcomes were similar for both groups. Conclusion: A hybrid framework of rib and implant that requires less harvested cartilage is feasible for microtia reconstruction, but caution should be used due to its higher explantation rate.
The Cleft Palate-Craniofacial Journal, Nov 1, 2011
The development of children who have syndromes with mental retardation and/or language delay can ... more The development of children who have syndromes with mental retardation and/or language delay can be worsened by sensorineural or conductive hearing loss (HL). Given the existing scarcity of data, we investigated the prevalence of otitis media with effusion and/or HL in 50 children with Cornelia de Lange syndrome (CdLS) aged 1-18 years, and its impact on the children's performance. The children underwent otological and audiological examinations in order to ascertain the relative frequencies of otitis media with effusion and/or hearing impairment; their demographic and clinical data were obtained by questionnaires and from information in their medical charts. Otitis media with effusion was diagnosed in 94%, and its prevalence was similar in all age groups; HL was detected in 40 children (80%). Conductive HL due to middle ear effusion was the main cause of hearing impairment alone (60%) or in combination with sensorineural deficit (20%). HL had a negative impact on performance regardless of the type. A history of routine audiological and/ or otological assessments was reported by a minority of parents. Our findings indicate that otitis media with effusion and/or HL is an important feature of children with CdLS and may negatively affect their performance. Careful follow-up throughout childhood is necessary to detect and treat any hearing loss in children with CdLS in order to minimize its impact on performance.
Archives of Otolaryngology-head & Neck Surgery, Sep 1, 1999
... MA Thorp, FCS(SA) ORL; VJ Abdullah, FRCS(Eng), FRCS(Edin), FCSHK, FHKCORL, FHKAM; Cape Town, ... more ... MA Thorp, FCS(SA) ORL; VJ Abdullah, FRCS(Eng), FRCS(Edin), FCSHK, FHKCORL, FHKAM; Cape Town, South Africa (Dr Thorp), and ... and lead to the development of radiation-induced malignant neoplasms.6 The therapeutic option of interstitial Nd:YAG laser treatment is ...
Otolaryngology-Head and Neck Surgery, Feb 1, 2000
A 50-year-old man had a perforated peptic ulcer and peritonitis. At emergency laparotomy, the ane... more A 50-year-old man had a perforated peptic ulcer and peritonitis. At emergency laparotomy, the anesthetist noted a large mass at the tongue base and had difficulty with oropharyngeal intubation. Nasotracheal fiberoptic intubation was successful.
Advances in oto-rhino-laryngology, 2017
Box surgery for obstructive sleep apnea (OSA) patients consists of mandibular surgery, including ... more Box surgery for obstructive sleep apnea (OSA) patients consists of mandibular surgery, including genioglossus advancement, hyoid suspension, and maxillomandibular advancement, as an airway reconstruction. This surgery was developed in the early 1980s. Thereafter, techniques were modified in each surgery for the enhancement of outcome and prevention of complications. However, the indication for surgery remains poorly defined due to the dynamicity of the upper airway, variability of the phenotype in OSA patients, and absence of a representative method for the obstruction site in the upper airway. As a result, box surgery is performed restrictively. On the development of an evaluation method including radiologic and endoscopic examination during sleep, the indications and surgical outcomes of each box surgery should be standardized and reevaluated. In this review, the development and limitations of box surgery will be discussed for the positive future of this surgery.
Sleep, May 1, 1998
OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS) in children is a common but frequently under-recognized c... more OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS) in children is a common but frequently under-recognized condition, with an estimated prevalence of 1% to 2% of the childhood population. 1,2 It may lead to a number of serious complications, including cor pulmonale, failure to thrive, behavioral disturbance, and developmental delay. 3 The most common reported cause for OSAS in children is adenotonsillar hypertrophy, 4 but other less-common etiologies including obesity, craniofacial anomalies, pharyngeal flap surgery, neuromuscular disease, and laryngomalacia are also recognized. 5 OSAS in children has unique etiology, pathophysiology, diagnosis, and management to the extent that it is better regarded as a distinct condition from that of adults. 6 Craniofacial anomalies are well documented causes for obstructive sleep apnea syndrome in children. 7-8 These include Treacher Collins syndrome, 9 Crouzons syndrome, 7 and Pierre Robin syndrome. 10 Albeit infrequent, they are extremely difficult to manage and may require a combination of treatment including tonsilloadenoidectomy, oxygen supplementation, nasal mask CPAP, facial bone advancement, and ultimately tracheostomy. 11-14 The mechanism of upper airway obstruction in craniofacial anomaly is not clearly understood and little is known of the natural course of OSAS in these abnormalities. Case Report A family with two brothers (1 and 3 years of age) and their father, all suffering from Crouzons syndrome, is being seen and managed at our hospital. They have clinical features consistent with the syndrome including ocular proptosis, hypertelorism, frontal bossing, maxillary hypoplasia, narrow palate and craniosynostosis (Fig. 1). 15 Both brothers required many hospital admissions for recurrent upper respiratory tract infections leading to respiratory distress since infancy. It was noted that their nasal passages were frequently congested and obstructed. Further Summary: Craniofacial anomalies are recognized causes of obstructive sleep apnea syndrome (OSAS) in children. Current literature is limited due to rarity of cases. Furthermore, the mechanism of upper airway obstruction is not clearly understood. We would like to report a family (father and 2 sons) who are suffering from Crouzons syndrome. The two brothers (ages 1 and 3) were found to have significant obstructive sleep apnea syndrome (OSAS) with failure to thrive. Nasal continuous positive airway pressure (CPAP) markedly improved their OSAS and resulted in accelerated weight gain. The nasoendoscopy and magnetic resonance imaging (MRI) scan taken during natural sleep showed that choanal stenosis, maxillary hypoplasia, posteriorly displaced tongue, lengthened soft palate and adenoid tissues were important in the pathogenesis of upper airways obstruction in Crouzons syndrome. Nasal CPAP improved airway obstruction by opening a narrow slit as demonstrated by MRI. Our results suggest that OSAS occurred in children with Crouzons syndrome and that nasal CPAP was a useful treatment modality.
Head & neck, Nov 15, 2011
BackgroundSinus histiocytosis with massive lymphadenopathy or Rosai–Dorfman disease (RDD) is a ra... more BackgroundSinus histiocytosis with massive lymphadenopathy or Rosai–Dorfman disease (RDD) is a rare benign disease with nodal and extranodal involvement.Methods and ResultsHerein, we report 3 cases in which the patients presented with nasal masses. In addition, 2 of the 3 patients had subglottic lesions. Only 2 of the 3 patients had cervical lymphadenopathy, which is the commonest presentation of RDD. Histopathology via fine‐needle aspiration cytology (FNAC) or open biopsy is required for diagnosis. Emperipolesis with S‐100 immunohistochemical staining is characteristic. The disease runs a benign course and the literature reports that treatment can vary from steroids, to cytotoxic chemotherapy to radiotherapy with variable outcomes. Surgical intervention may be necessary for airway protection.ConclusionRDD is self‐limiting, but can sometimes be a life‐threatening condition. Treatment should be tailored to the individual patient. © 2011 Wiley Periodicals, Inc. Head Neck, 2013
CRC Press eBooks, Aug 12, 2005
American Journal of Neuroradiology, Feb 1, 2004
Vascular malformations arising from the wall of the external jugular vein are rare. This case ser... more Vascular malformations arising from the wall of the external jugular vein are rare. This case series discusses the sonographic and MR imaging appearances of four such cases and reviews the literature. The diagnosis should be suggested preoperatively particularly because of the close relationship such malformations to the external jugular vein, as this helps surgeons to plan the operative procedure. The imaging appearances are similar to those of other vascular malformations elsewhere in the head and neck. Mulliken and Glowacki, in 1982, proposed a classification of vascular lesions based on endothelial characteristics (1) that gained wide acceptance. In this scheme, vascular lesions were separated into two major groups: infantile hemangiomas and vascular malformations. Hemangiomas are characterized by endothelial cellular hyperplasia and proliferation, characteristically grow rapidly for 6-8 months after birth, and then regress to a variable extent. On the other hand, vascular malformations have a normal endothelial cell cycle and do not involute. Intrinsic vascular lesions arising from the wall of the external jugular vein are very rare. This case series discusses the sonographic and MR imaging appearances of four cases of vascular malformations of external jugular venous wall, highlighting the imaging appearances that help to make the preoperative diagnosis. The differential diagnosis and clinical appearances are discussed and the literature reviewed. Case Reports Case 1 A 31-year-old Indonesian woman presented with a left neck mass that progressively increased in size for 3 years. No fever or other constitutional symptoms existed. On physical examination, there was a 2-cm soft, nontender mass in the left posterior
Journal of Laryngology and Otology, Dec 1, 1993
We report a case of primary middle ear lipoma diagnosed in the right ear of a five-year-old child... more We report a case of primary middle ear lipoma diagnosed in the right ear of a five-year-old child with concurrent bilateral middle ear effusions. The lipoma occupied a site favoured by congenital cholesteatoma and was occlusive to the eustachian tube contributing to its dysfunction. This is the first case of de novo middle ear lipoma diagnosed in the UK, and the third in world literature. Our CT scans are suggestive of a similar but smaller lesion in the left ear of the same child.
Thorax, Sep 23, 2009
Aims: The natural history of mild childhood obstructive sleep apnoea (OSA) was examined and facto... more Aims: The natural history of mild childhood obstructive sleep apnoea (OSA) was examined and factors associated with disease progression were identified. Methods: Subjects were recruited from an epidemiological study which examined the prevalence of OSA in Chinese children aged 6-13 years. The first 56 consecutive children identified with mild OSA (apnoeahypopnoea index 1-5) were invited for a repeat assessment 2 years after the diagnosis.
CRC Press eBooks, Apr 25, 2008
Journal of the National Cancer Institute, Feb 1, 2023
Case Reports in Ophthalmology, Dec 18, 2012
A 64-year-old man with a known history of diabetes and hypertension presented to the Accident and... more A 64-year-old man with a known history of diabetes and hypertension presented to the Accident and Emergency Department with a 2-day history of sudden decreased vision in the right eye. Temporal arteritis was suspected with an elevated erythrocyte sedimentation rate (71 mm/h), and oral prednisolone was started immediately. Four days later, the patient's right eye vision deteriorated from 0.6 to 0.05, with a grade-4 relative afferent pupillary defect and ophthalmoplegia. Computed tomography showed a contrast-enhancing orbital apex mass in the right orbit abutting the medial and lateral portions of the optic nerve with extension to the posterior ethmoid and sphenoid sinuses. A transethmoidal biopsy was performed which yielded septate hyphae suggestive of Aspergillus infection. Ten days later, the patient's right eye vision further deteriorated to hand movement with total ophthalmoplegia. MRI of the orbit showed suspicion of cavernous sinus thrombosis. A combined lateral orbitotomy and transethmoidal orbital apex drainage and decompression were performed to eradicate the orbital apex abscess. Drained pus cultured Aspergillus. The patient was prescribed systemic voriconazole for a total of 22 weeks. The latest MRI scan, performed 8 months after surgery, showed residual inflammatory changes with no signs of recurrence of the disease. To our knowledge, this is the first case report which describes the use of a combined open and endoscopic approach for orbital decompression and drainage in a case of orbital aspergillosis. We believe the combined approach gives good exposure to the orbital apex, and allows the abscess in this region to be adequately drained.
Journal of Laryngology and Otology, Jul 1, 2009
in patients who take angiotensin-converting enzyme (ACE) inhibitors for treatment of hypertension... more in patients who take angiotensin-converting enzyme (ACE) inhibitors for treatment of hypertension, likely secondary to higher levels of bradykinin, a protein that is usually inactivated by ACE. When there is evidence for tongue edema, the patient should have an endoscopic evaluation of the airway to look for supraglottic edema. The laryngeal edema can continue to worsen despite a substantial decrease in the tongue edema to the steroids and antihistamines (Fig 1). Early, elective fiberoptic-assisted orotracheal intubation may be necessary to avoid the potential for a surgical airway. The patient is extubated when the clinical parameters are met with a sufficient air leak and a favorable fiberoptic examination of the supraglottis.
Anaesthesia and Intensive Care, Oct 1, 2001
We present a case of a ten-month-old boy with Goldenhar's syndrome and significant retrognathia i... more We present a case of a ten-month-old boy with Goldenhar's syndrome and significant retrognathia in whom a tracheostomy was performed to relieve upper airway obstruction. Tracheal intubation was facilitated by direct suspension laryngoscopy using a slotted rigid laryngoscope. We propose this technique as an alternative method for tracheal intubation in infants and young children with a difficult airway. The management of the difficult airway in children with Goldenhar's syndrome is discussed.
Laryngoscope, May 1, 2003
To investigate whether autologous ossicles can be safely used in ossicular reconstruction in chol... more To investigate whether autologous ossicles can be safely used in ossicular reconstruction in cholesteatoma surgery after attempting cholesteatoma removal under the operating microscope. Study Design: A prospective fine-section histological study of formalin-stored ossicles, harvested from cholesteatomatous ears, to evaluate for existence of residual cholesteatoma after surface disease clearance under the operating microscope. Methods: One hundred four ossicles were harvested from 76 patients with cholesteatoma for the study. These malleus heads and incudes were categorized into three groups: group 1, ossicles with retained shape and useful bulk, treated by microscopic stripping alone; group 2, ossicles with retained shape and useful bulk, treated by microscopic stripping and drilling; and group 3, badly eroded ossicles, treated by microscopic stripping alone. These treated ossicles were then subjected to 4-m histopathological study. Results: Residual disease was identified in 6 of the 104 ossicles. Residual disease was found only in badly eroded ossicles that are not suitable for reconstruction. All the usable ossicles were free of disease. Conclusions: Autologous ossicles that have retained body and bulk are safe to use for reconstruction after surface stripping under the operating microscope. Additional burring probably adds a further margin of safety.
Acta Paediatrica, Oct 1, 2006
Congenital giant ranula causing life‐threatening upper airway obstruction is a rare condition. A ... more Congenital giant ranula causing life‐threatening upper airway obstruction is a rare condition. A well‐planned ex utero intrapartum treatment (EXIT) procedure for aspiration and decompression of the cystic lesion is simple, efficacious and effective in securing a patent airway before the fetus is completely delivered, and may prevent lifelong neurodevelopmental complications associated with perinatal asphyxia in such cases. Conclusion: EXIT could be a life‐saving procedure for congenital giant ranula.
Laryngoscope, Nov 30, 2009
Objectives/Hypothesis:To assess the contribution of laryngopharyngeal sensory deficits and impair... more Objectives/Hypothesis:To assess the contribution of laryngopharyngeal sensory deficits and impaired pharyngeal motor function to aspiration in patients irradiated for nasopharyngeal carcinoma.Study Design:A retrospective study at a tertiary referral university teaching hospital.Methods:One hundred consecutive patients who underwent radiotherapy for nasopharyngeal carcinoma referred to a dysphagia clinic underwent sensory testing of their laryngopharynx and endoscopic evaluation of their swallowing. The sensory threshold of the laryngopharynx was determined, the pharyngeal contraction assessed, and the status of the larynx and hypopharynx documented before and after swallowing. The presence of laryngeal penetration and aspiration was noted.Results:The average time from radiation therapy to assessment was 10.2 years, and the mean duration of swallowing symptoms was 27 months. Laryngopharyngeal sensation was deficient in 89% of patients and the pharyngeal contraction impaired in 93% patients. Laryngeal penetration and aspiration occurred in 87% and 74% of patients, respectively. Aspiration was associated with food residue in the pyriform fossae after swallowing (P < .001) and impaired pharyngeal contraction (P < .001), but not with laryngopharyngeal sensory deficiency. There was no association between a laryngopharyngeal sensory deficit and impaired pharyngeal contraction.Conclusions.Impaired pharyngeal contraction and food bolus clearance from the hypopharynx during swallowing are more important than laryngopharyngeal sensory deficiency in predicting aspiration in patients who underwent radiotherapy for nasopharyngeal carcinoma. Laryngoscope, 2010
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Papers by Victor Abdullah