Objective
This study aimed to identify associative factors for tracheostomy in patients presenting with airway obstruction.
Methods
Data from a tertiary hospital were reviewed to identify patients who presented with airway obstruction between 2009 and 2020. Patient demographics, causative pathology and treatments were analysed.
Results
The study identified 297 admitted patients. Of these, 66 underwent a tracheostomy and formed the ‘tracheostomy’ group and 231 formed the ‘other intervention’ group. The tracheostomy group had a higher mean age (p = 0.003), and higher percentages of males (p = 0.031) and smokers or ex-smokers (p = 0.020), compared to the other intervention group. The tracheostomy group also had a higher number of patients with a malignancy (p < 0.001) compared to the other intervention group.
Conclusion
Being older, male, a previous or current smoker, or developing airway obstruction due to a malignancy were found to be the main associative factors for requiring a tracheostomy.
Unilateral tonsillar swelling is a fairly common presenting complaint in an Ear, Nose and Throat (ENT) department. It may or may not be associated with any other symptoms. Most of the time, the tonsil asymmetry is secondary to previous history of tonsillitis, quinsy, and tonsil stones. Other benign lesions to cause tonsil swelling may include a mucus retention cyst, lipoma, polyp or papilloma. Sometimes, it is the site of primary malignancy but in these situations, it is often associated with red flag symptoms like pain in the mouth, dysphagia, odynophagia, referred otalgia, weight loss, night sweating, haemoptysis, haematemesis, hoarseness or neck nodes. Most of the patients with suspected tonsillar malignancy have underlying risk factors like smoking and excessive alcohol intake. However, lately, the tonsil squamous cell carcinoma can be found in younger patients with no history of smoking or drinking as there is rising incidence of human papilloma virus related oropharyngeal malignancy. Sometimes, lymphoma may manifest as a tonsil enlargement. If, after detailed history and examination, there remains any doubt about the underlying cause of unilateral tonsil swelling then tonsillectomy should be considered for histological analysis. it is our practice to perform bilateral tonsillectomy in such cases. We present a case of unilateral tonsillar swelling and discuss its management.
Testicular tumours are one of the most prevalent cancers in young males. Teratoma is one type of testicular tumour, which carries a good prognosis if treated appropriately. We describe a case of a 37 year old man, diagnosed with testicular non-seminomatous germ cell tumour in 2005. He underwent left orchidectomy and radical chemotherapy with Bleomycin, Etoposide and Cisplatin. He had involved retroperitoneal lymph nodes at the time of diagnosis and underwent retroperitoneal lymphadenectomy in 2007. He made a good recovery but presented with a left neck lump in 2009, the appearance of which suggested differentiated teratoma on fine needle aspiration cytology. The neck lump was excised without any complications and histology confirmed the mass to be mature teratoma with no undifferentiated elements. He has remained disease free since then and remains under oncological surveillance, in keeping with current protocols.
Arteriovenous fistulae (AVF) of the head and neck region are extremely rare, especially those that occur spontaneously. We present the case of a 58 year old female with a spontaneous postauricular AVF causing troublesome pulsatile tinnitus. In this case a simple surgical procedure completely cured the patient of her symptoms.
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