Volume 4, Issue 2

December 2011

NEWSLETTER OF THE MSO-HNS

INSIDE THIS ISSUE: MESSAGE FROM THE PRESIDENT

It is with a deep sense of have provided that we aspire to Message from the President 1 honor that I take on the role uphold and continue. They have as President of MSO-HNS the challenged us to new heights and Outgoing Message 2 Society has entrusted on me. I am empowered us to achieve them MSO-HNS 2010-2011 also blessed with an Executive as well. Committee of great calibre and Hospital Sultan Ismail - In 2 talent. It is on their shoulders that I look Focus into the future and identify key We stand on the shoulders of challenges that face our fraternity The Nation-wide 5 giants who are our teachers and - a critical lack of public and MSOHNS-MMA ENT past leaders of the Society. It is healthcare provider awareness Primary Care Update their legacy and the direction they in head and neck cancers, the Program ever growing epidemic of the life-threatening airway disease Know It, Detect It, Prevent 6 of obstructive sleep apnea. We It - The Head And Neck Executive Committee are in an opportune position Cancer Awareness Program 2011 - 2012 as experts in the field to push Dr Yap Yoke Yeow the boundaries of our abilities, synergise with other healthcare President MSO-HNS Head and Neck Cancer 8 President Awareness Campaign in providers, advise policy makers, 2011-2012 • Dr Yap Yoke Yeow Resort City, . and reach out to the community in the area of ENT healthcare 1st Ipoh Endoscopic Sinus 10 President Elect needs. 1) Nationwide Primary Care Surgery Course • Dr Primuharsa Putra Sabir Updates in ENT for Doctors I believe they are worthy causes Husin Athar Universal Endoscope 10 for us in the year ahead 2) Nationwide Public Awareness - To educate every Malaysian Campaign on Head & Neck Holder Cum Elbow Immediate Past President & Wrist Support in knowing, preventing and Cancers System: An Ergonomic • Dr Harvinder Singh detecting Head and Neck Assistive Innovation in cancers early, 3) Consensus Statement on the Otolaryngologic Surgery Hon Secretary Management of Dizziness - to defend the livelihood of • Dr Ramiza Ramza Ramli our workforce suffocated by 4) Consensus Statement on the 15th Anniversary of 12 OSA, Management of Adult OSA Cochlear Implant Program Hon Treasurer and The 10th Anniversary • Dr Avatar Singh - to advise lawmakers on the 5) The 1st ASEAN SLEEP of The Speech Centre gravity of these public health CONGRESS “Pusat Tutur” problems, EXCOs 6) Cutting edge CME programs • Assoc. Prof. Dr Goh Bee See The Evolution of 12 - to continue developing in ENT Laryngology in • Dr Ida Sadja’ah Sachlin ourselves to provide the • Dr Irfan Mohamad best evidence-based patient- I humbly call on you to join me in th 14 Asean Orl Head Neck 13 • Dr Jeevanan Jahendran centred care, and the days ahead as One Society, Congress • Dr Arun Kumar to do what only we can do as - to create smart partnerships champions of healthcare needs • Prof. Dr Prepageran Letter to the Editor 14 with frontline Primary Care of the ear, nose, and throat. Narayanan Physicians. Together let us listen to the Up Coming Events 14 • Dr Rosalind Simon needs of the people, breathe • Assoc. Prof. Dr Vincent Tan It is with these goals that we new life into the fraternity and be Editors: have embarked this year on the the voice of transformation for a Dr. Irfan Mohamad following projects: better tomorrow Dr. Ramiza Ramza Ramli Page 2 Volume 4, Issue 2

OUTGOING MESSAGE MSO-HNS 2010-2011: DR HARVINDER SINGH

Last year I was deeply honoured from all members of the Society. to be elected the 31st President All relevant agencies like the of the Malaysian Society of Ministry of Health, Associations Otorhinolaryngologists Head and of Private Hospitals, Association Neck Surgeons (MSO-HNS). It has of Insurance Companies and given me great pleasure to serve, individual insurance companies with my Executive Committee, were informed on the role of as president of this prestigious this committee and its power of association and now that 1 year representation for MSO-HNS. I am has passed it is time to pass indeed thankful to Dr Arun Kumar the baton to Dr Yap and his and his committee for their hard committee. I am confident that Dr work in revising the fee schedule Yap and his committee - a blend for ENT Procedures which was of youth and experience - will be duly submitted to the relevant able to elevate this association authorities. We hope that the to even greater heights. Ministry of Health will respond Dr Harvinder Singh favourably to our request. Immediate Past President During my tenure as president, Last but not the least many of the planned activities I must also take this opportunity invaluable knowledge that was I would like to thank were successfully implemented. to thank the Sarawak showered upon us all during the Amongst them, the 6th Malaysia- Government and the officials conference, very enriching. my father, my wife Singapore Meeting which was from the Borneo Convention held in Singapore, the Health Centre for welcoming us during My special gratitude and thanks Kiren and my two Camp in Kelantan and our Annual the 14th ASEAN ORL Conference to all our sponsors who made kids, Simran and Scientific Meeting, just to name a which was successfully held the event a tremendous success. few. The Society also collaborated in May 2011. They were very A special note of thanks to our Jasdill. My family has with Merck Sharp & Dohme in helpful and supportive in realising Platinum Sponsors, MSD, Gold always been my pillar continuing medical education. The our dreams. My heartfelt thanks Sponsor, the New Nycomed, and Consensus Guidelines on Allergic to the Organizing Chairman, Silver Sponsor, Abbot for their of strength, more so Rhinitis, Chronic Rhinosinutis and Datuk Dr Kuljit Singh and his invaluable contribution to the in the last year. Their Nasal Polyposis was officially committee for the hard work and Congress. Without your generosity launched in May 2011. perseverance in making the event the event wouldn’t have been a love and tolerance has a great success. I must also thank ‘world class’ conference, thank been invaluable The Society also formed a Fee my Executive Committee for their you once again. Schedule Committee, headed understanding, tolerance, co- by Dr Arun Kumar to look into operation and hard work. It was Last but not the least I would the plight and grouses of our indeed an honour for me to work like to thank my father, my wife colleagues in the private sector. with all of you. Thank you once Kiren and my two kids, Simran This committee worked in tandem again! and Jasdill. My family has always with the Executive Committee been my pillar of strength, more in looking into the complaints I would also like to thank the so in the last year. Their love and by members or insurance faculty that we assembled tolerance has been invaluable. companies. The committee had in . We managed numerous meetings during my to assemble world class It has been an incredible and at tenure and made some very International and ASEAN faculty times, tiring journey to be the important and final decisions members to enrich the congress. I acting President for the past year pertaining to the fees and its hope all the delegates have truly and now it is time for me to bow revision after seeking advice benefited and have found the our gracefully and move on!

HOSPITAL SULTAN ISMAIL - IN FOCUS By Dr Jothi Shanmuganathan

Sultan Ismail Hospital or HSI hospital was set up with the main which is the only tertiary centre in is a specialized tertiary centre aim of offering tertiary medical Johor Bahru. located in Taman Mount Austin care to the east coast of the Perdana, Johor Bahru, which is state and to reduce the burden 15 km from the city centre. This of Hospital Sultanah Aminah,  (Continued on page 3) Newsletter of the MSO - HNS Page 3

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HSI is also one of the ‘paperless HSI is also one of the hospitals’, equipped with an integrated computer system called ‘paperless hospitals’, THIS (Total Hospital Information equipped with an System) and all administrative work and transactions go through integrated computer this system. system called THIS The ORL department of HSI (Total Hospital commenced operation at the time of the reopening of the Information System) hospital with 2 specialists, one and all administrative medical officer, four paramedics and one audiologist. work and transactions go through this system Currently the department has expanded it comprises 4 specialists, 4 medical officers, AJK of our very first seminar “General care in ENT ‘” in 6 paramedics, 4 audiologists, 2007 2 speech therapists and 2 supporting staff. The department is situated on level 2 of the building and is headed by Mr. surgery with Neurosurgical team Implant Update. Tengku Mohamad Izam bin Tengku for skull base tumors. Kamalden. In January 2011, we hosted Medel The department also carried out Workshop and the 1st PROCIJ AGM. Apart from providing general ENT various seminars and updates on PROCIJ is the brainchild of Mr. services we are also the centre ORL related topics for the benefit Tengku. “Persatuan Professional for Neurotology surgery and of doctors, audiologists, speech dan Penyokong Cochlear Implant Cochlear Implant for the southern therapists and paramedics in Johor” is an organization created region. As HSI is also the southern the district and health side. All for the “Implantees”, their families, centre for Oncological services seminars are carried out in order doctors, speech therapists and we provide the support to the to increase awareness of the audiologists involved in Cochlear oncology team in the surgical patients’ problems and to act implant. It is the first of its kind aspect of ENT malignancies. promptly once the patients are and it is a platform to bring diagnosed. together the people involved in As a Neurotology centre, we are cochlear implant in Johor and for proud to claim to be the first Some of the topics covered in them to air their views, feedback hospital in the country to perform our seminars are: General care and grouses and for the medical a Middle Ear Implant surgery in in ENT, Mangement of hearing personnel involved to improve 2010. Cochlear implant surgery Impairment in Children, Allergic the service provided. is being performed on a regular rhinitis Updates, Advances in basis since 2009 and combine Audiology, Vertigo and Cochlear  (Continued on page 4) Page 4 Volume 4, Issue 2

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Unsure what to say with ADUN next to Mr. Tengku!!! Dr Nidzam about to perform Dix-hallpike on our senior MA Zamry, poor chap!!!

In June we hosted In May 2011 we organized our “Better Speech and Hearing ‘Vertigo Update’ for Month”. Posters were put up, to the state of Johor, bring awareness to the public regarding speech and hearing which was organized and free hearing screening was to bring awareness performed. about vertigo and In June we hosted ‘Vertigo Update’ for the state of Johor, how to manage the which was organized to bring disease at the primary awareness about vertigo and how to manage the disease at level the primary level. Boss busy at work at our first Medical camp in Kg. Seri The ORL department has also Pantai , Mersing been actively carrying out medical

camps for ENT related patients. So far, we have organized 2 medical camps, both of them were located in Mersing, a town on the east coast of the state of Johor. As the town lies more than 2 hours away from Johor Bahru, the people in the area seldom receive treatment for their problems therefore our audiologists carried out free hearing screening tests.

Both camps were officially opened by the state ADUN, Dr. Robiah Kosai who also volunteered to be the first patient to undergo a hearing screening test which she passed with flying colours. Our Medical camp last year which doubled up as a family day after all the hard work  (Continued on page 6) Newsletter of the MSO - HNS Page 5

THE NATION-WIDE MSOHNS-MMA ENT PRIMARY CARE UPDATE PROGRAM By Dr Yap Yoke Yeow, President MSO-HNS

Although ENT-related problems make up 80-90% of outpatient consults, ENT training in local medical schools receive little emphasis. Our field of ORL and Head & Neck Surgery has seen tremendous advances in the last decade but primary care providers have little access to continuous medical education apart from Panel of speakers at pharmaceutical events. Rhinology Forum in Melaka: Ramiza Ramli, To bridge this chasm of training Dipak Banarsi Dass, & practice, and to narrow the Saraswathy, Ida Sachlin growing knowledge gap between specialist and generalist, we embarked on a National Attentive crowd in Kota Kinabalu ENT Primary Care Update in to increase ease of referrals and partnership with MMA branch accessibility. societies of various states. The 16 topics typically included 3) Miri Mega Hotel, 14 Apart from these primary aims, in these one-day updates are August 2011 – around 60 it is also our goal to expose grouped under Otology, Rhinology, participants primary care providers to ENT Laryngology and Head & Neck specialists in their locality and updates with a focus on accurate 4) Kota Kinabalu Sutera Harbor encourage partnerships so as diagnosis, managing common Hotel, 25 September 2011 disorders confidently, and – around 50 participants referring dangerous and difficult conditions promptly. Practical 5) Ipoh General Hospital points and useful hints for daily Auditorium, 9 October 2011 Primuharsa sharing about use rather than involved scientific – around 100 participants Oral Cancer with GPs in debate and theories were given Kuantan emphasis. 6) Melaka Holiday Inn Hotel, 13 November 2011 – around 70 participants very impressed with the breadth 7) Alor Setar Star City Hotel, 11 of expertise made available to December 2011 – around 70 them in a single meeting and their The panel of speakers at the participants stamina in perservering through a Otology Forum in Shah program of 16 talks from 9am to Alam – Dato Rasan, Mazita, 8) Kuantan Vistana Hotel, 15 5pm definitely testifies to their Khairuzzana, Anitha January 2012 – around 70 relevance and usefulness. participants Pharmaceutical and industry Tan Tee Yong addressing the The remaning events are planned partners that have supported Miri participants for Johor Bharu, Kota Bharu and us in these events include Astra Kuala Lumpur. Zeneca, GSK, Germax, Jetpharma, MSD, Neilmed, RESMED, These events have been a Respironics and Symbiomed and Of the planned 11 events, we mutually beneficial experience for we appreciate their participation. have succesfully conducted 8, in: speakers and participants, where the audience have received many Most of all, I am deeply grateful 1) Penang Traders Hotel, 25 tips & tricks from experienced for the many Society members June 2011 – around 50 specialists, and specialists have who have very willingly supported Pua Kin Choo stressing participants gained a better understanding these events as speakers both the importance of early of the problems faced in the in their own region as well as detection of NPC toGPs in 2) Shah Alam Concorde Hotel, frontline, treating ENT disorders. often travelling hundreds of Penang 31 July 2011 – around 80 A recurring comment from these miles to meet the GPs in various participants forums have been that they were states. Page 6 Volume 4, Issue 2

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Last but not the least in our activities is our annual ‘Family Day’. The event in 2011 was held in Desaru.

Our ‘family day’ which must be attended by everyone, unless there is an emergency, is always filled with fun, games and a lot of food.

Food is an important ingredient that keeps our department together and we all rejoice when Boss making his special good food is available to us. We always have aerobics after eating our hearts out the night “Char Kuoy Teow” for us, before at family day !! from his gerai !

KNOW IT, DETECT IT, PREVENT IT – THE HEAD AND NECK CANCER AWARENESS PROGRAM

By Dr Yap Yoke Yeow, President MSO-HNS

It has been two years since Dr were 2884 cases of Head & Neck Pua King Choo, in her tenure as cancers in Peninsula Malaysia, president, started Head & Neck making it the number one cancer Cancer Awareness Campaign. group apart from female breast cancer (3525), followed by Head and Neck Cancers, as a colorectal cancer (2866) and group, is the most prevalent lung (2048.) cancer in our country for both sexes. In the year 2006, there The lack of awareness of this

Medical students from UPM conduct questionnaire-based screening for head & neck cancers at the Relay for Life even

serious public health threat is The aim of our program remains, critical, and we in MSOHNS are to: 1) promote awareness, 2) committed to educating every encourage early detection, and Malaysian on Head & Neck 3) emphasise the growing impact Cancers and preparing primary of head & neck cancers to the care providers with the necessary Malaysian public. Goh Bee See counselling a member of the public at the skills and knowledge to detect Relay For LIfe event and refer cases of head & neck cancers as early as possible.  (Continued on page 7) Newsletter of the MSO - HNS Page 7

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Students and cancer survivors march round the YB Dato Seri launches the 2012 National Bangi stadium in support of Head & Neck Cancer Awareness Program with an cancer survivors endoscope camera system

In line with these goals, we have In line with these in the last half year, participated goals, we have in and organised numerous events, namely the last half year, participated and 1) Public exhibition and screening in Gurney Mall, organised organised numerous by the ENT Department of Hospital Pulau Pinang, led by events Dr Pua Kin Choo and Ms Tan Ai Dee

2) Public forum in Traders Hotel in Penang

3) Public exhibition and screening at the National Taiji-Qigong Society Carnival – attended by 2000 Taji-Qigong enthusiasts from all over Malaysia and YB Dato Seri Peter Chin Fah Kui officiates the Miri public South-East Asia in Taman forum and campaign Pudu Ulu

4) Public exhibition and screening at the National 5) Public exhibiton, screening 7) Public exhibition in a public Cancer Society of Malaysia and examination in a public mall Alor Setar led by Dr RELAY FOR LIFE event, which mall in Miri, organised by Zulkifli and Dr Masaaany included an all night relay the ENT Department of Miri with NPC surviviors. A group Hospital under Dr Doris Jong, 8) Public exhibition in Kota of 12 student volunteers officiated by Y.B. Dato’ Sri Kinabalu led by Dr Halim from UPM medical school Peter Chin Fah Kui ran with the survivors and conducted questionnaire- 6) Public forum in Klang Hospital, based screening for hundreds led by Dr Pria and Dr Sushil  (Continued on page 8) at the event Brito

1 Malaysian Cancer Statistics – Data and Figures, Peninsular Malaysia, 2006 – National Cancer Registry, Ministry of Health of Malaysia Page 8 Volume 4, Issue 2

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The climax of these events was the Bentong Health Carnival - led by Dr Ida Sadj’aah Sachlin and advised by Datuk Dr Kuljit Singh - where 550 members of the community were screened. 3 cases of head & neck cancers were diagnosed and many referred for further investigation. A group of 20 doctors and 46 paramedics from Hospital Kuala Lumpur, Hospital Temerloh, Hospital TAA Kuantan, and Hospital Sg Buloh made this a resounding success. Taiji-qigong enthusiasts attendind our public exhibition In the Bentong event, the honorable Minister of Health, YB Dato Seri Liow Tiong Lai officiated and launched the 2012 mobile screening clinics, and a Tan, Dr Irfan Mohamad, Datuk Dr Nationwide Head & Neck Cancer national blitz akin to the ‘Tak Nak’ Kuljit Singh, Dr Sushil Brito and Dr Awareness campaign and pledged anti-smoking campaign to make Philip Rajan and all the doctors his support for this crucial effort. this dream a reality – of every and paramedics (too many to be Malaysian knowing, detecting and named here) for their unstinting We are poised now, to take the preventing head & neck cancers. support. Miri is also famous message public in a bigger way. for its beautiful We will be using mass media, I thank my committee, Dr Rosalind internet, public broadcasts, Simon, Dr Avatar Singh, Dr Vincent natural gems such as Gunung Mulu National Park, Lambir National HEAD AND NECK CANCER Park and Niah Caves AWARENESS CAMPAIGN IN MIRI RESORT CITY, SARAWAK.

By Dr Doris Evelyn Jong, Miri Hospital

On an auspicious weekend, was first founded and Miri’s donated the site free of charge from 12th to 14th August petroleum industry continues to to our utter delight. In order to 2011, the Department of contribute to the economy of create awareness of the public Otorhinolaryngology in Miri Malaysia. Miri is also famous for on this event, announcements Hospital, was given the great its beautiful natural gems such were made in the newspaper in opportunity by the MSO-HNS as Gunung Mulu National Park, 3 different languages and flyers to organize the Head and Neck Lambir National Park and Niah were distributed to all private Cancer Awareness Campaign. Caves. hospitals, peripheral hospitals, polyclinics, religious bodies and Firstly, I would like to introduce The Head and Neck Cancer NGOs. The activities included the wonderful Resort City known Awareness Campaign comprised were health screening divided into as Miri. Miri is the second largest of 2 events consisting of 2 parts, ENT cancer screening city in Northern Sarawak with a community health / cancer and general health screening. population of about 300,000 screening and ENT primary care The ENT cancer screening was people, Chinese, Iban, Malay, updates. The community health / carried out by the Department of Indian and other indigenous cancer screening was carried out Otorhinolaryngology. There were 3 groups like Melanau, Kedayan, from 12th to 14th August, 2011 specialists, 4 medical officers, 10 Kayan, Kenyah, Kelabit, Bidayuh, at Bintang Megamall. In view of nurses and 2 medical assistants Penan, Lun Bawang, Berawan, this community charity event, the involved in this team. Bisaya, living harmoniously in this venue owner, Professor Datuk Lau lovely Resort City. It was in Miri in Siew Wai and Bintang Megamall 1910 that the petroleum industry management, generously  (Continued on page 9) Newsletter of the MSO - HNS Page 9

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Meanwhile, the general health screening was carried out by 10 medical assistants and nurses from the Miri Divisional Health Office. Body mass index, glucose and blood pressure screening were performed by this team. In addition to the health screenings, seminars on ENT related cancers and general ENT topics were given to increase the public’s knowledge on these ENT conditions. During this event, patients with ENT cancers were also invited to share their experiences with the public. This was also a good opportunity to raise funds for cancer patients Committee members of the Head & Neck Cancer to assist them financially during Awareness Campaign the course of their treatments in order to reduce the government’s A variety of cases financial burden. The funds gathered will be utilized for the great demands from the assistants from both government ranging from simple patients’ transportation and public, those who missed the and private hospital. I must take purchasing of medical items. In opportunity to be screened were this opportunity to express my chronic sinusitis order to create better awareness given out-patient appointments gratitude to all the speakers to advanced and on ENT cancers, posters in 3 in our ENT clinic. Approximately listed below: Dr Yap Yoke Yeow, languages (Bahasa Malaysia, five percent of the people Datuk Dr Kuljit Singh, Dr Zuraida, complicated cases English and Chinese) concerning screened were confirmed to Dr Tan Tee Yong and Dr Tang Ing were demonstrated these topics were displayed. have some ENT cancers and are Ping. We were also very fortunate to currently undergoing treatment. by our International have Dato’ Peter Chin, Minister We managed to raise about Following this campaign, the panel including of Energy, Green Technology and RM15000 which were donated to workload of ENT department Water to officiate the campaign. the Tabung Kebajikan to provide in Miri Hospital has increased Professor Dr Abhilash financial assistance to ENT twofold. Both public and medical Balakrishnan and Dr During the whole 3 days events, cancer patients in Miri Hospital. personnel’s awareness on ENT there were overwhelming related cancers has increased Leong Jern-Lin from responses from the public. Some The second event, ENT primary tremendously. Some of the of them travelled 3-4 hours from care update was held on 14th patients even call in to enquire Singapore Bintulu, Lawas and Limbang in August, 2011 in the Mega Hotel. on uncertainties with regards order to participate in this event. The announcement for the event to their health. There were also A total of 470 people underwent was distributed via the MMA increasing numbers of referrals the health screenings. Some of website. The event was considered from peripheral and private the people could not be screened a huge success receiving a total hospitals with the suspicions of due to the limited availability of of 62 participants including 31 malignancy. Also throughout this instruments and staff. Due to doctors and 31 nurses / medical campaign, among our staff a closer and happier relationship was developed.

I would like to express my extreme gratitude to MSO-HNS, all Miri Hospital staff and Miri Divisional Health staff for their support, diligence and commitment to make the campaign a huge success. In addition, I really appreciate the sponsors from various companies for their kind contributions and support. I hope that similar ENT roadshows will be held in the future to create and increase public as well as medical personnel awareness on Registration for the ENT health screening ENT discipline. Page 10 Volume 4, Issue 2

1 ST IPOH ENDOSCOPIC SINUS SURGERY COURSE

Dr Harvinder Singh, Course Director

The ENT Department of Hospital Singh Sethi from Singapore. On panel will include Prof Raymond Raja Permaisuri Bainun Ipoh the second and third day, there Sacks from Sydney, Australia just concluded its inaugural was continuous “Live Surgery”. plus Prof Sethi, Prof Bala & Dr Endoscopic Sinus Surgery Course A variety of cases ranging Leong Jern-Lin from Singapore. from the 14 - 16 October 2011. from simple chronic sinusitis The tentative dates are 12 - 14 It was an overwhelming success to advanced and complicated October 2012! So please write it with over 150 participants cases were demonstrated on your diary and make sure you attending from all over Malaysia by our International panel come to IPOH! plus 3 delegates from Indonesia. including Professor Dr Abhilash This 3 day workshop emphasized Balakrishnan and Dr Leong Jern- on basic and advanced FESS Lin from Singapore. Course Director Techniques. On the first day, Dr Harvinder Singh there was live fresh cadaveric Next year, we plan to have hands- Consultant Rhinologists demonstration by the world on cadaveric dissection plus live Hospital Raja Permaisuri Bainun, re-known Professor Dharambir surgery as well. Our international Ipoh

UNIVERSAL ENDOSCOPE HOLDER CUM ELBOW & WRIST SUPPORT SYSTEM: AN ERGONOMIC ASSISTIVE INNOVATION IN OTOLARYNGOLOGIC SURGERY

By Prof Dr Rahmat Omar, Universiti Malaya Medical Centre (UMMC)

The objective of this innovation achieve during surgery whenever which the vertical height ii. A detachable universal is to have a comprehensive all- the endoscope is being held by and support angle can endoscope holder than can in-one assistive platform that the surgeon or his assistant be adjusted depending on hold various types of camera can support and stabilize the and when holding it for quite a the surgeon’s heights and head with attached rigid or forearm during laryngeal surgery long time can cause fatigue and comforts. A useful stand- flexible endoscope. A useful and which can also acts as an tiredness of the upper limbs. alone forearm support innovation for endoscope- endoscope holder for those system for microscopic based procedure or surgery procedures or surgery assisted This innovation consists of laryngeal procedure or especially for larynx. by endoscope view. The idea for several components: surgery (Non chair-based or its usage? When stability and i. The flat platform which operating table-based). consistent view are difficult to supports the forearms in  (Continued on page 11) Newsletter of the MSO - HNS Page 11

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The surgeon correctly positioned with the forearm resting comfortably on the adjusted platform during an endoscopic laryngeal surgery. The endoscope being is held steadily at a desired view without the need of an assistant. This allows for both hands to be used simultaneously with the axis of movements at the wrist joint

The support platform being used during transoral laser surgery with the endoscope holder removed. In this instance, it going to be very beneficial for microlaryngeal or laser surgery for which stable forearm support is necessary for precision or minimally invasive surgery

Patent submission was done via UM Centre of Innovation and Commercialization and it is currently being processed by Bustaman IP. I’m looking forward to its commercialization and I believe that this versatile innovation will be very beneficial in the future.

The idea came to me when I was The detachable endoscope holder being used alone for static suffering from bilateral shoulder viewing purpose during tonsillectomy. Angled endoscope strain due to frequent and being used for this purpose depending on the area to prolonged poor posture during be visualized. This is particularly useful for intraoral or surgery, as at time we didn’t use oropharyngeal procedure or surgery in which the assistant or proper surgeon’s stool during teaching consultant could not see the view at the same time, laryngo-tracheal surgery. I had to unless microscope or head band mount camera being used Gold Medal Award and undergo prolonged physiotherapy (This is a very common problem faced by surgeon when Certificate during Malaysia sessions and it was then that I supervising new trainees) Technology Expo 2011 came up with the first prototype. It was subsequently revised twice until the present one. iii. Extender and accessory useful innovation for teaching conclusion that no such innovation I hope it will be available in the component for still image in a large group or during a with its multi-purpose functions is market in 1 or 2 years time and and video recording without live surgery workshop. available in the market. I currently I am currently applying for a needing an assistant coming use this innovation for the above pre-commercialization fund for in close contact with to Having read and researched mentioned indications and I find it further developments. patient for similar purpose. A extensively, I have come to the to be very helpful and safe. Page 12 Volume 4, Issue 2

15 TH ANNIVERSARY OF COCHLEAR IMPLANT PROGRAM AND THE 10 TH ANNIVERSARY OF THE SPEECH CENTRE “PUSAT TUTUR”

By Professor Dr Asma Abdullah and Siti Salbiah Hassan, Universiti Kebangsaan Malaysia

The UKM Cochlear implant team was created in 1995. The team made history by successfully performing the first cochlear implant surgery in Malaysia on the 15 December 1995. It was the first ever cochlear implant surgery done in Malaysia and in the ASEAN region.

Up to now, the team which comprises the department Ear, Nose and throat Surgery specialist, the audiologist and the speech therapies from both Allied Health Faculty and UKM Medical Center, has performed numerous such surgeries and has worked on hearing rehabilitation and speech therapies with over 295 patients who were diagnosed with severe to profound sensori- neural hearing loss. The team also as a token of appreciation together with their family its skill to implement their ‘vision is headed by Professor Dato’ for their efforts in the running of members, VVIP, VIP, the board of and mission’ to help people with Dr Lokman Saim, thanks to him the program. director of UKM, Yayasan Budi hearing disabilities to improve the and his teamwork efforts, a high Penyayang, LABCHEM (supplier qualities of their lives by regaining standard of practice and quality in The objective of the Program is to for cochlear implant) and the their hearing abilities. the management of the patients, give a second chance to children Director of PPUKM and Dean of has been maintained throughout. who have severe hearing problem UKM Medical Center. The event We hope and wish that the so that they can hear and speak was held at the Marriott Hotel on UKM cochlear implant team will On the 15th anniversary of first like normal children thanks to the 2nd June 2011, from 12 pm continue successfully with their cochlear implant program and the the hard work of the specialists until 2 pm. and was officiated by efforts in giving the best possible 10th anniversary of the speech involved. the Minister of Education, Dato’ service to all individuals with centre “Pusat Tutur” a ceremony Seri . hearing disabilities. was held, to celebrate all the hard The anniversary celebration Throughout the last 15 years, the work of the team members and was attended by 30 patients cochlear Implant team has used

THE EVOLUTION OF LARYNGOLOGY IN MALAYSIA

By Professor Dr Abdullah Sani Mohamed, Universiti Kebangsaan Malaysia

Evolution is defined as change over lamps or head mirrors. Instead the better understanding of the are the days where one biopsy time. Laryngology has certainly demand is now on for more rigid micro layers of the glottis has forceps fit all lesions, now micro changed over time since I first wide angled scopes, flexible video lead to better voice outcomes scissors, microsuction and even practiced otorhinolaryngology scopes or even stroboscopes. in the microsurgery of the disposable sickle knives are the in 1985. Starting from the Narrow band imaging and auto larynx. Understanding that the norm. Each pathology is carefully basic larynx examination, most fluorescence is the new science epithelium can regenerate separated by hydrodissection clinicians now use the 70 degrees just in the horizon which literally whilst the superficial laminar leaving the non involved tissues rigid scope instead of the mirror may change the way we look into propia, in contrast, can never be intact and removing just the examination. In fact, I foresee the larynx in the near future. replaced has made demands on lesion. that not many clinics will place the serious phonosurgeons to orders for new mirrors, new Bull In the field of phonosurgery, respect the laminar propia. Gone  (Continued on page 13) Newsletter of the MSO - HNS Page 13

14 TH ASEAN ORL HEAD NECK CONGRESS

By Datuk Dr Kuljit Singh Organizing Chairman 14th ASEAN ORL HEAD NECK CONGRESS

MSO HNS was privileged to organize the 14th ASEAN ORL head neck congress in Kuching in the month of May 2011. It was well attended by 800 delegates throughout ASEAN and it was one of the most successful congresses. The event was held at the Borneo Convention Centre Kuching and it marked a landmark in the ASEAN ORL history as the first congress conducted in a convention center. This meeting also installed the new President of ASEAN ORL, Dr Harvinder Singh and also we were honored to install our own MSO HNS President, Dr Yap Yoke Yeow. Kuala Lumpur and Kuching. There speaking: Prof Dr Jatin Shah, Prof The next congress will be in This congress had several pre were 3 main symposia with some Charles Cummings and Assoc Philippines 2013. congress workshops held in plenaries, which had world icons Prof Dr Sethi from Singapore.

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In managing unilateral vocal cord that has been well received radiotherapy. Whereas before others who suffer from spasmodic palsy, Teflon has been abandoned not only in Malaysia, but also the only choice left was total dysphonia, oromandibular and Gore Tex thyroplasty has in Singapore and a few other laryngectomy, now laser excision dystonia, essential tremors of the taken its place. Some centers neighboring countries. of residual T1 and T2 tumours voice, Botox injection has given even use Titanium implants. can be offered. them useful functional voice. In the near future injectable Another evolution seen in thyroplasties done under local Malaysia is the introduction For functional disorders of the What is important for laryngology anaesthesia in the clinic will be of Wolfgang Steiner’s laser voice such as muscle tension in Malaysia is nurturing and the norm. The only limiting factor treatment for early cancer of dysphonia, the wider availability igniting the interest in this field. is finding the most cost effective the larynx and hypopharynx. of speech therapists and Only with enthusiasm, can material in Malaysia. This has given patients another increased awareness of the progress be made. choice besides radiotherapy. Its role of laryngopharyngeal reflux I take special pride in organizing strength must surely be salvaging has brought much relief to the an annual phonosurgery course small tumours that have failed suffering of patients. Yet for Page 14 Volume 4, Issue 2

LETTER TO THE EDITOR

To MSOHNS,

First and foremost, I would like to congratulate MSOHNS for the success of a recent event held on 13 November 2011 at Holiday Inn, Melaka. This event, titled “ENT Primary Care Update” caught my attention because of the interesting and relevant topics discussed and the expert panel of speakers lined up for the day.

As a primary care practitioner, be it in a private or government setting, ENT cases constitute a large percentage of patients we see everyday. This course successfully covered all the important topics and amazingly, it was done in a day! From the common cold to the more sinister neck lumps, it provided useful information and update on the latest practices.

I would also like to thank MSOHNS for inviting such esteemed speakers from all over country and thank to the speakers for making the effort to share their knowledge and experience with us. The speakers were all very professional in conducting the course, making the information clear and precise.

I would like to recommend this course not only to those interested in otorhinolaryngology but also to all those involved in a primary care setting.

From Dr Lai Shau Kong Klinik Kesihatan Sungai Udang, Melaka

UP COMING EVENTS

6th Langkawi International Temporal Bone Course & 15th Asian Research Symposium In Rhinology Scientific Meeting 24 May 2012 - 26 May 2012 14 February 2012 - 16 February 2012 Venue : Orchard Hotel, Singapore Venue : Awana Porto Malai, Langkawi, Kedah, Malaysia For more information, please visit our website at Theme : The Power of Hearing And Balance www.arsr2012.org For registration and more information, please visit our website at www.ukmches.com.my Laryngology 2012 1 June 2012 - 3 June 2012 3rd ENT Allergy Certicifate Course Venue : Kuala Lumpur, Malaysia 1st March 2012 - 2nd March 2012 For further information and continuous updates visit at Venue : Renaissance Hotel, Kota Bharu, Kelantan www.laryngologyconference.com

th ENT Primary Care Update Inaugural Asean Sleep Congress and 4 Malaysian 3rd March 2012 International Otorhinolaryngology and Head & Neck Venue : Renaissance Hotel, Kota Bharu, Kelantan Conference Time : 8.30 am - 5.00 pm 28th June 2012 - 30th June 2012 For more information, please visit our website at Venue : Kuala Lumpur Convention Centre www.msohns.com For further information and continuous updates visit at http://aseansleepcongress.com/welcome.php Global Postlaryngetomy Rehabiliation Academy 16 March 2012 - 17 March 2012 20th World Congress of the International Federation of Venue : Department of Otorinolaryngology Head & Neck Surgery, UKMMC, Kuala Lumpur Oto-Rhino-Laryngological Societies For more information, please visit our website at 1 June 2013 - 5 June 2013 www.msohns.com Venue : COEX Convention Center. Seoul, South Korea For inquiries and information, please visit our website at www.ifosseoul2013.com ASOHNS 2012 ASM 31 March 2012 - 04 April 2012 Venue : Adelaide Convention Centre, Adelaide SA For more information, please contact please log on our website at www.asohns.consec.com.au Newsletter of the MSO - HNS Page 15 Page 16 Volume 4, Issue 2