Solitary extramedullary plasmacytomas are rare, discrete mass of neoplastic monoclonal plasma cells in the soft tissue with no evidence of multiple myeloma. They constitute 3 % of all plasma cell tumors and less than 1 % of head and neck malignancies. A 43 year old lady presented to our clinic with complains of diplopia and headache for 4 weeks. Computed Tomography scan showed a mass lesion in the sphenoid sinus eroding the sinus floor, right wall, basisphenoid and parasellar area. A biopsy of the mass reported as plasmacytoma. Systemic examination revealed no evidence of dissemination of the disease confirming the diagnosis of a solitary extramedullary plasmacytoma. The patient was subjected to 25 fractions of radiotherapy. Here, we report a rare case of solitary extramedullary plasmacytoma of the sphenoid sinus.

No abstract

INTRODUCTION: Eustachian tube dysfunction (ETD) is commonly left unidentified, and clinicians often had to deal with its consequences. Hence, ETD symptoms should be routinely explored to unmask the diagnosis. The seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) is a user-friendly and disease-specific instrument introduced by McCoul et al. to assess the severity of ETD symptoms and treatment effectiveness. However, there is no Malay version of ETDQ-7 [ETDQ-7(M)] available for local population. This study aims to translate and validate the ETDQ-7 in Malay language. MATERIALS AND METHODS: The ETDQ-7 was translated and culturally adapted into Malay language. 68 adult patients with ETD and 68 healthy patients who served as control completed ETDQ-7(M). It was repeated on patients with ETD after two weeks. Statistical analysis was performed to determine the psychometric properties of ETDQ-7(M). RESULTS: ETDQ-7(M) displayed excellent internal consistency (Cronbach’s α = 0.93) which is comparable to the original questionnaire. There was excellent test-retest reliability (r= 0.86 – 0.99). No significant difference in total scores was observed between the first and second evaluations. The mean total score for patients with ETD and control group was 25.8 and 8.4 respectively. Discrimination between ETD and control group using a cut-off point of 13.5, yielded sensitivity and specificity of 100% respectively (area under curve=100%). CONCLUSION: ETDQ-7(M) is a validated questionnaire recommended for use in the management of ETD as a diagnostic tool and in treatment monitoring with excellent reliability and validity.

<p class="abstract">Primary thyroid lymphoma and laryngeal lymphoma are rare malignancies of the head and neck region. Airway obstruction caused by primary thyroid lymphoma is mainly by means of direct compression of trachea by huge thyroid mass. We present the first case report of diffuse large B cell lymphoma of thyroid gland with extension to pyriform fossa, in the absence of preexisting chronic thyroiditis. In this case, emergency airway obstruction was caused by direct extension of disease into pyriform fossa, occluding laryngeal inlet. We reviewed English literature between 1981 and 2018 for cases of primary thyroid lymphoma. There are no reported cases of primary thyroid lymphoma with direct extension into pyriform fossa. This presentation posed a great challenge in securing a patent airway by means of oral intubation and tracheostomy.</p><p class="abstract"> </p>

Introduction: Sniffin’ Stick test is a quantitative olfactory test first introduced in the 1990s and has since been used in several countries after cultural-based modifications. Objective: To develop a culturally adapted Sniffin’ Stick test suitable for a Malaysian population. Methods: The study was done in 3 phases. The first phase involved a questionnaire rating the familiarity of 70 odors based on a Likert scale. Sixteen items were then selected for the second phase where subjects were tested on the identification of the 16 odors. Odors recognized by less than 75% of the subjects or their distractors were replaced. These steps were repeated until all 16 odors were recognized by more than 75% of the subjects. In the final phase, the mean Odor Identification (OI) scores utilizing the newly selected 16 odors were collected among healthy individuals. Results: A total of 417 subjects participated in the study. In the first-phase, 5 odors from the original Sniffin’ Stick Test which were unfamiliar were replaced for the phase 2 of the study. In the second-phase, modifications were performed 3 times requiring change of 41 distractors and an additional odor. Finally, using the modified Sniffin Stick test version-4, preliminary results of the mean odor identification scoring for the age groups 16-35,36-55 and more than 55 years of age were obtained which showed age-related variations. Conclusion: Our study revealed cultural modifications to the original Sniffin’ Stick Test are required to validate its use in a Malaysian population.