Johor Specialist Hospital (“JSH”), part of KPJ Healthcare Berhad's (“KPJ Healthcare” or the “Group”) network of hospitals, has successfully performed Malaysia's first awake mastoid and eardrum repair surgery, marking a significant milestone in specialised otorhinolaryngology (“Ear, Nose and Throat” or “ENT”) care under the KPJ Health System (“KPJHS”). Performed under local anaesthesia, the procedure offers an alternative treatment approach for carefully selected patients who may require additional clinical consideration before undergoing general anaesthesia.
The pioneering procedure was performed by Dr Shankar Ramasundram, Consultant Otorhinolaryngologist (ENT Specialist), together with JSH's multidisciplinary surgical team. The surgery was successfully carried out on an 83-year-old patient who presented with persistent ear discharge arising from a chronic ear condition affecting the middle ear that required surgical treatment.
Conventionally, such procedures are performed under general anaesthesia, requiring patients to remain fully unconscious throughout the operation. While general anaesthesia remains safe and appropriate for many patients, it may present additional considerations for elderly individuals and those with certain underlying medical conditions. In contrast, the awake approach allows the patient to remain conscious and responsive throughout the procedure while maintaining comfort and safety.
The technique enables continuous communication between the patient and surgical team during surgery while reducing exposure to general anaesthesia where clinically appropriate. It requires careful patient selection, meticulous planning and advanced surgical expertise, making it a highly specialised procedure currently performed in only a limited number of centres internationally.
Commenting on the milestone, Chin Keat Chyuan, President and Managing Director of KPJ Healthcare said, “This milestone reflects the growing depth of specialised expertise across the KPJ Health System and our commitment to expanding treatment possibilities for patients with diverse clinical needs. While not every patient will be suitable for this approach, the ability to offer an additional treatment option where clinically appropriate highlights how specialised care continues to evolve to meet the changing needs of patients. As Malaysia's first private Academic Health System, we continue to strengthen the capabilities that support clinical excellence, continuous learning and innovation across our network. As we progress, we aim to advance more personalised, predictive and outcome-focused healthcare while ensuring patients continue to benefit from access to specialised expertise and treatment approaches.
Dr Shankar Ramasundram, Consultant Otorhinolaryngologist at JSH said, “What makes this approach particularly unique is the ability to maintain communication with the patient throughout the procedure while performing delicate ear surgery. This allows closer interaction with the patient during surgery and can be beneficial in carefully selected cases. The successful outcome reflects not only technical expertise, but also the importance of matching the most appropriate treatment approach to each patient's individual circumstances. Ultimately, our goal is to ensure every patient receives care that is tailored to their clinical needs while maintaining the highest standards of safety and quality.”
This milestone reflects the continued advancement of specialised services across the KPJ Health System, where Practice, Education, Research and Innovation work together to strengthen patient care and improve outcomes. It also highlights the value of a more connected healthcare ecosystem that supports the exchange of expertise, adoption of advanced treatment approaches and development of specialised capabilities across the network, enabling more patients to benefit from advanced and specialised care.
For more information on JSH, visit https://kpjhealth.com.my/johor/.
This content is provided by KPJ Healthcare Berhad
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