Skull base osteomyelitis (SBO) also commonly known as malignant otitis externa was first described by Meltzer and Kelemen in 1959. Prior to the advent of the antibiotic era, this disease carried a poor prognosis with significant morbidity. It often proved fatal with mortality rates as high as 50%. Commonly seen in the immunocompromised patients, diabetes mellitus is an important associated comorbidity in the pathophysiologic development of this disease. Treatment is instituted by medical therapy with surgery having a limited role. Surgical intervention has a limited role, for example, in fungal SBO. Such cases may require local debridement and intraoperative tissue biopsies for histopathologic confirmation. This is to demonstrate fungal invasion into the skull base, as well as to exclude other sinister differential diagnoses like squamous cell carcinoma of temporal bone. In this case report, we present a rare case of candida SBO and the literature review.

Myeloid sarcoma is a rare disease, where a mass (tumour) of either myeloblasts or immature myeloid cells conglomerate in extramedullary anatomic sites. It may arise de-novo or it may present in association with acute myeloid leukemia. It can also occur in patients with myelodysplastic syndromes, myeloproliferative disorders, and as blast transformation in myeloproliferative neoplasia. Myeloid sarcoma of the head and neck area can pose a diagnostic challenge because of the low frequency of occurrence, and the vast diversity of tumours occurring from multiple lineages in this anatomic region. This can lead to a broad spectrum of various differential diagnoses. Therefore, a high index of suspicion is required when dealing with a possible case of myeloid sarcoma, as it is a time sensitive diagnosis with various diagnostic dilemmas. Here, we report an example, a case of tonsillar myeloid sarcoma. We wish to highlight the investigations that helped us procure this diagnosis in a timely manner.

Concha bullosa (CB) is a pneumatised middle turbinate. Although CB is the most common variant of the middle turbinate, the formation of mucocele or mucopyocele of CB has been rarely reported. The inflamed mucosal lining of the concha bullosa may lead to mucocele formation. Infection of the retained secretion will later on lead to mucopyocele. We report a 12-year-old girl presented with right unilateral nasal blockage associated with rhinitis symptoms. She was initially diagnosed as nasal polyp which later on turned out to be a mucocele histpathologically.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.691-693

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The Coronavirus disease 2019 (COVID-19) pandemic is a devastating global pandemic affecting many countries worldwide. It has a huge impact on the country’s healthcare system as well as its socio-economic wellbeing. Majority of elective surgery was deferred in order to provide beds, resources and treat COVID-19 cases. Resumption of elective surgery requires a well-planned process and adherence to standard guidelines to protect both the healthcare providers and patients. Pre-operative COVID-19 screening will be one of the new norms for patients undergoing surgery. This study was aimed to evaluate the pre-operative COVID-19 screening for elective surgery among Otorhinolaryngology (ORL) patients in Hospital Ampang based on the current Malaysian guidelines for undertaking surgery during COVID-19 pandemic and highlight the screening protocols implemented by the Ministry of Health. This retrospective review was conducted in ORL Department, Hospital Ampang. We reviewed the surgical registry of  117 patients who underwent elective surgeries under general anaesthesia from June till September 2020. There were 62 patients (53%) below 18 years old and 55 patients (47%) above 18 years old. There were 76 cases (65%) involving aerosol-generating procedures. A total of 23 patients (19.7%) had COVID-19 screening done pre-operatively based on the Malaysian guidelines patient selection and all results were negative. None of the patients experienced any symptoms, complications or morbidities related to SARS-CoV-2 infection post-operatively. The Malaysian guideline on pre-operative screening for COVID-19 is applicable for institutions with low to moderate local transmission of SARS-CoV-2. Targeted group or risk-based protocols are beneficial for improving cost-effectiveness and reducing workload burden during the critical period. As the pandemic evolved, the guidelines have to be revised based on the prevailing situation to suit the best clinical practice for the benefit of patients and healthcare personnel without disrupting the surgical services.