Introduction Foreign body aspiration is a leading cause of accidental death in children. Clinical presentation varies from non-specific respiratory symptoms to respiratory failure making diagnosis challenging. Objective To review pediatric patients who underwent bronchoscopy due to suspicion of foreign body aspiration at a tertiary center in Malaysia. Methods We retrospectively studied patients < 11 years old who underwent bronchoscopy from 2008 to 2018. Results Over the 10-year period, 20 patients underwent bronchoscopy, and 16 were found to have foreign body aspiration with equal gender distribution. The most common age group was < 3 years old (75%). The most common clinical presentations were choking (82%) and stridor (31%). Foreign bodies were removed using flexible bronchoscope in 8 cases (50%), and difficulties were encountered in 6 cases (75%). Rigid ventilating bronchoscope was used in 8 cases (50%) with no difficulty. The most common object found was peanut (19%). The majority of foreign bodies were lodged in the right bronchus (43%). Eight patients (80%) received delayed treatment due to delayed diagnosis. The length of hospital stay was longer in the younger age groups. Conclusion Clinical presentation and chest radiograph findings were comparable across all age groups. The most difficulties encountered during foreign body removal were via flexible bronchoscope, in children < 3 years old. There was no significant correlation between age and type of foreign body aspiration. The majority of patients who received delayed treatment were < 3 years old. The length of hospital stay was longer in the younger age groups.

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Background Vocal fold myxoma is a rare mesenchymal tumor with unknown exact etiology. The aim of this report is to review current literature on demographic and clinical features of vocal fold myxomas in order to increase awareness among otorhinolaryngologists on management of this rare vocal fold pathology. Case presentation We report a case of a 46-year-old female teacher presented with 1 year history of progressive dysphonia with no airway obstructive or constitutional symptoms. Flexible laryngoscopy revealed a polypoid mass at the anterior two thirds of the left vocal fold. We proceeded with endolaryngeal microsurgery, where a left vocal fold mass with prominent overlying blood vessels was incompletely excised due to poor plane, in an attempt to prevent injury to vocal ligament. The histopathological findings were consistent with myxoma. No evidence of recurrence was noted at 2 months postoperatively. Conclusions Vocal fold myxoma should be considered as a differential diagnosis of vocal fold pathology clinically resembling vocal fold polyp, especially in older male adults. Complete excision with removal of a rim of surrounding tissue is the gold-standard treatment to prevent recurrence. If diagnosis is uncertain, intraoperative frozen section can be performed to ensure margins are free from tumor. Life-long follow-up is recommended in incomplete excision of tumor.

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Introduction: Labyrinthine fistula is an uncommon complication of chronic otitis media with cholesteatoma. Surgical management of labyrinthine fistula is challenging due to high risk of worsening labyrinthine function post-operatively. Case report: We report a case of a 25-year old female presented with one-week history vertigo, vomiting and fever with left intermittent otorrhea for the past one year. High resolution computed tomography (HRCT) of the temporal bone showed total opacification of left mastoid cavity and dehiscence of left lateral semicircular canal (LSCC). Left Modified Radical Mastoidectomy (MRM) was performed and cholesteatoma was found within mastoid and middle ear cavities with dehiscence of arch of left LSCC wall with no perilymph leak observed. Conclusion:The presence of vertigo with or without sensorineural hearing loss in patients with chronically discharging ear must raise suspicion of labyrinthine fistula. Definitive diagnosis can only be made intraoperatively. The current recommendation on management is open surgery with removal of cholesteatoma and sealing of fistula using soft tissue graft which provides favourable outcome.