Browsing by Author "Prakairungthong S."

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    Budesonide Nasal Irrigation: An Effective Alternative Treatment for Allergic Rhinitis
    (2025-01-01) Kasemsuk N.; Kanjanawasee D.; Ngaotepprutaram P.; Suwanwech T.; Thongngam T.; Sompornrattanaphan M.; Wongsa C.; Phonmanee T.; Wiroonpanich N.; Prakairungthong S.; Juntrachu P.; Atipas K.; Tantilipikorn P.; Kasemsuk N.; Mahidol University
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    Destructive foreign body granuloma: A case report
    (2024-01-01) Wongwan P.; Prakairungthong S.; Atipas S.; Thongyai K.; Limviriyakul S.; Suvarnsit K.; Wongwan P.; Mahidol University
    External auditory canal polyps are predominantly inflammatory processes but occasionally indicate more severe pathology. Prolonged conservative management may postpone accurate diagnosis and appropriate therapeutic intervention. This case report presents a 37-year-old woman, previously healthy with a normal ear, who underwent a right myringotomy with the insertion of a pressure-equalizing tube in one hospital after an upper respiratory tract infection. However, due to the pandemic era, she lost follow-up for 2 years and subsequently presented to another hospital with worsening hearing and persistent otorrhea. The attending physician found a large polypoid lesion occupying her right external ear canal. A computerized tomography scan revealed an irregular enhancement mass involving the right ear canal, the middle ear cavity, and mastoid air cells with multiple destruction of the skull base and intracranial involvement in the right middle cranial fossa. The possibility of malignancy was raised, prompting the patient to seek evaluation in a third hospital. A right tympanomastoidectomy was performed, and during a posterior tympanotomy, a pressure-equalizing tube was discovered in her middle ear. The pathological results confirmed the presence of foreign body granuloma. Following surgery, the patient’s otorrhea improved.
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    Eccrine porocarcinoma of the external auditory canal: A case report
    (2024-06-01) Phousamran P.; Suvarnsit K.; Limviriyakul S.; Puriwat C.; Atipas S.; Thongyai K.; Prakairungthong S.; Phousamran P.; Mahidol University
    This study aims to present a case report of an aggressive eccrine porocarcinoma of the ear, focusing on the diagnostic approach and treatment protocol. A 61-year-old woman presented with a mass in the left ear canal. The patient underwent tumor removal followed by adjuvant concurrent chemoradiation therapy. The main outcome measures included the extent of tumor involvement, histopathological confirmation of eccrine porocarcinoma, and postoperative results at the 6-month follow-up. The mass involved the left external auditory canal, middle ear cavity, mastoid cavity, and the deep lobe of the left parotid gland. The biopsy confirmed the diagnosis of eccrine porocarcinoma. The patient showed favorable results at the 6-month postoperative follow-up. This case report highlights the importance of early surgical excision in combination with adjuvant chemoradiation therapy as the recommended treatment approach for aggressive eccrine porocarcinoma of the ear. The findings emphasize the need for a standardized diagnostic and treatment protocol for this rare malignancy.
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    Effectiveness of 1- and 2-per cent acetic acid solutions in the 2-week treatment of granular myringitis
    (2023-01-01) Prakairungthong S.; Werawatganon T.; Chantarawiwat T.; Warnpeurch L.; Atipas S.; Thongyai K.; Suvarnsit K.; Limviriyakul S.; Mahidol University
    Background: Granular myringitis is characterised by de-epithelisation of the tympanic membrane. Patients present with intermittent otorrhoea, otalgia or itching. With improper or inadequate treatment, granular myringitis could cause ear canal fibrosis and stenosis. There are no standard topical ear drops for granular myringitis. Treatments have inconsistent success rates and variable timelines. Objectives: To compare the effectiveness of treating granular myringitis with 1- and 2-per cent acetic acid solutions for 2 weeks. Materials and methods: This double-blind, randomised, controlled trial enrolled and randomly allocated 47 participants to 2 groups between October 2021 and June 2022. Results: After 2 weeks, the groups' treatment success rates did not differ significantly. There was a 10-per cent recurrence rate 8 weeks after treatment completion. All patients tolerated the diluted vinegar. Conclusions: There is no difference in the efficacies of 1- and 2-per cent diluted vinegar in treating granular myringitis for 2 weeks.
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    Factors Influencing Treatment Response in Patients with Malignant Otitis Externa
    (2025-01-01) Wongwan P.; Thongyai K.; Atipas S.; Prakairungthong S.; Limviriyakul S.; Suvarnsit K.; Jenkins H.; Wongwan P.; Mahidol University
    Objective: To identify factors affecting treatment outcomes in patients with malignant otitis externa (MOE). Materials and Methods: A retrospective review of MOE treatment was conducted in patients aged?> 18 years admitted to Siriraj Hospital from January 2007 to December 2022. Predictors of treatment response chosen included duration of hospitalization, duration of antimicrobial treatment, disease-related re-admissions, and mortality. Results: The study included 49 patients (33 males, 16 females) with a mean age of 65±12 years. Comorbidities were present in 90% of patients, with diabetes mellitus being the most common. Pseudomonas aeruginosa was identified in 37% of cases. Bilateral symptoms/infections were reported in 18%. Facial nerve palsy and non-cranial nerve complications were 51% and 12%, respectively. Computed tomography (CT) imaging revealed bony erosion in 75% of patient. Surgical management was performed in 73% of patients. The median duration of hospital stays and antimicrobial treatment were 34 days and 143 days, respectively. Readmissions due to disease progression occurred in 35%, and the mortality rate was 4%. Bone erosion on CT was associated with an increased likelihood of readmission. Prolonged hospital stays were associated with bilateral symptoms and positive CT findings. Extended antimicrobial treatment was linked to multiple comorbidities, bilateral symptoms, non-cranial nerve complications, positive CT findings, and surgical cases. Conclusion: Various factors influence treatment outcomes in MOE patients. Early diagnosis, aggressive treatment, and management of prognostic factors are essential for preventing severe complications and improving survival outcomes.
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    Incidence of Tympanic Membrane Perforation Affected by Intratympanic Steroid Injection: A Retrospective Review
    (2025-01-01) Charoensawatsiri V.; Prakairungthong S.; Atipas S.; Thongyai K.; Limviriyakul S.; Phousamran P.; Suvarnsit K.; Charoensawatsiri V.; Mahidol University
    Objective: This study aims to determine the incidence of persistent tympanic membrane perforation following intratympanic steroid injection and to identify potential factors associated with delayed healing. Additionally, it aims to estimate the time required for perforation closure in prolonged cases to avoid unnecessary interventions. Materials and Methods: Data from patients who underwent intratympanic steroid injections were reviewed. The primary outcome was the incidence of tympanic membrane perforation lasting beyond four weeks post-injection. Secondary outcomes included identifying factors affecting healing duration and closure time in prolonged cases. Results: Of 295 ears treated between March 2018 and March 2021, 3.39% (10/295) experienced persistent perforation at four weeks. Of these, 1.69% (5/295) required intervention, while the rest healed spontaneously. The median closure time was 12 weeks. All patients with persistent perforation were female. No statistically significant differences were found between groups. Hearing recovery was achieved in 29.1% (74/254) of patients with sudden sensorineural hearing loss. Younger age and non-profound hearing loss were favorable prognostic factors. Conclusion: The incidence of perforation in this study is lower than that previously reported but consistent with other studies in the literature. Intratympanic steroid injections remain beneficial, outweighing the risks of complications.
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    Obstructive Sleep Apnea and Sensorineural Hearing Loss: A Systematic Review and Meta-analysis
    (2022-01-01) Kasemsuk N.; Chayopasakul V.; Banhiran W.; Prakairungthong S.; Rungmanee S.; Suvarnsit K.; Atipas S.; Keskool P.; Mahidol University
    Objectives: To evaluate the associations between obstructive sleep apnea (OSA) and sensorineural hearing loss (SNHL) and the effects of continuous positive airway pressure (CPAP) therapy on SNHL. Data Sources: Ovid Medline, Embase, and Scopus databases. Review Methods: A systematic search was done for studies investigating relationships between OSA and SNHL in adults, with manual searches for additional references. The final update was done on December 22, 2021. The Risk of Bias Assessment Tool for Nonrandomized Studies was applied for quality assessments. Results: The 20 included studies had a total of 34,442 participants (66% male; mean age, 46.6 years). The OSA group had a significantly worse mean hearing threshold level (HTL) than the control group for midfrequency ranges (500, 1000, 2000 Hz; mean difference, 4.00 dB; 95% CI, 2.40-5.61) and high-frequency ranges (4000, 8000 Hz; mean difference, 6.24 dB; 95% CI, 2.99-9.49). An association between OSA and SNHL was found. When compared with controls, patients with OSA had an odds ratio of 1.52 (95% CI, 1.12-2.06) for midfrequency hearing impairment and 1.19 (95% CI, 1.05-1.34) for high-frequency hearing impairment. However, we did not find significant improvements in midfrequency HTL after CPAP therapy. Conclusions: HTL was significantly poorer among participants with OSA (especially in severe cases) than non-OSA controls. Studies on patients with OSA with SNHL treated with CPAP did not show significant improvements in midfrequency HTL. Further studies are warranted on these issues.
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    Prevalence of Positive Skin Prick Test in Thai Adults with Chronic Tympanic Membrane Perforation
    (2023-11-01) Thongyai K.; Prakairungthong S.; Limteerakul P.; Atipas S.; Limviriyakul S.; Talek K.; Thongyai K.; Mahidol University
    Objective: To find the frequency of a positive skin prick test (SPT) in patients that experienced chronic tympanic membrane perforation (TMP). Materials and Methods: Thai patients aged 18 years or older who experienced chronic TMP and presented at the Otorhinolaryngology Outpatient Unit, Siriraj Hospital, were recruited and underwent a SPT covering 18 kinds of indoor and outdoor allergens. Patients with active middle ear disease or conditions that made them unsuitable for the SPT and pregnant patients were excluded. Results: Forty-five participants were enrolled in the present study. The frequency of a positive SPT was 33.3%. Among the positive SPT group, 80% had polysensitization. Dermatophagoides pteronyssinus (mite Dp) was the most frequent positive allergen at 66.7%. The most common cause of chronic TMP in the present study was trauma. The patients’ demographic profiles in the positive and negative SPT groups showed no statistically significant differences. Conclusion: The frequency of allergy in the chronic TMP population in the present study was close to that of the normal population. Overall, the present study population had positive sensitization only to indoor allergens.
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    The Outcomes and the Affecting Factors of Stapes Surgery for Otosclerosis
    (2025-05-01) Prakairungthong S.; Atipas S.; Thongyai K.; Limviriyakul S.; Suvarnsit K.; Phousamran P.; Phousamran P.; Prakairungthong S.; Mahidol University
    Objective: The primary objective of the present study was to estimate the success rate of stapes surgery for otosclerosis. The secondary objective was to find the factors affecting the outcomes. Material and Methods: This study was a retrospective study that included the ears of otosclerosis patients who underwent stapes surgery between January 2015 and December 2021. The successful outcome was the postoperative air-bone gap of 10 dB or less without sensorineural hearing loss. Results: One hundred fifty-five ears were included in the present study. The short-term success rate was 87 out of 155 (56.1%). After follow-up, eleven (7.1%) operated ears underwent revision surgery, and the long-term success rate was 72 out of 96 (75.0%). From multivariate analysis, A-ABG of 35 dB or less and BMI of 25 kg/m2 or less had adjusted OR 4.6 (95% CI 2.0 to 10.2), p<0.01 and 2.4 (95% CI 1.1 to 5.0), p=0.02, respectively. Conclusion: The success rates of stapes surgery were 56.1% in the short-term and 75.0% in the long-term post-operation. Factors influencing the outcome included preoperative air-bone gap and body mass index. It is recommended that a prospective study be conducted to address the limitations of the present study.
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    Video head impulse testing before and after canalith repositioning for benign paroxysmal positional vertigo
    (2026-01-01) Vongviriyangkoon T.; Limviriyakul S.; Thongyai K.; Atipas S.; Prakairungthong S.; Suvarnsit K.; Vongviriyangkoon T.; Mahidol University
    Objective: To evaluate video head impulse testing (vHIT) outcomes in patients with benign paroxysmal positional vertigo (BPPV) before canalith repositioning maneuver (CRM), immediately after treatment, and 1 week post-treatment. Study design: Prospective before–after study. Setting: Tertiary referral center. Patients: Of 156 patients with vertigo and positional nystagmus, 63 were diagnosed with BPPV using standard maneuvers; 51 had posterior canal BPPV, 11 had lateral canal BPPV and 1 had anterior canal BPPV. All underwent vHIT to assess vestibulo-ocular reflex (VOR) gain across all 6 semicircular canals and completed the Dizziness Handicap Inventory before and after treatment. Interventions: CRMs specific to the affected canal. Main outcome measures: VOR gain and Dizziness Handicap Inventory scores before and after CRM. Results: At pre-treatment, 59 patients (93.7%) exhibited VOR gains within normative limits. Only four patients (6.3%) showed decreased VOR gains, all of whom were diagnosed with posterior canal BPPV. VOR gain did not differ significantly across pre-treatment, immediate post-treatment, and 1-week assessments. No corrective saccades were detected. Conclusions: vHIT showed no significant post-treatment changes and may have limited incremental value in the routine evaluation of isolated BPPV cases.