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European Annals of Otorhinolaryngology,... Apr 2019Based on a review of the medical literature, the authors document the key technical points, variants, technical errors to avoid and main functional results of lateral...
Based on a review of the medical literature, the authors document the key technical points, variants, technical errors to avoid and main functional results of lateral pharyngotomy for resection of cancers originating from the lateral oro and/or hypopharynx.
Topics: Anatomic Landmarks; Humans; Medical Illustration; Pharyngeal Neoplasms; Pharynx
PubMed: 30482706
DOI: 10.1016/j.anorl.2018.10.011 -
Bailliere's Clinical Haematology Apr 1992Onyalai is an acquired form of immune thrombocytopenia which differs clinically, epidemiologically and immunologically from idiopathic thrombocytopenic purpura (Table... (Review)
Review
Onyalai is an acquired form of immune thrombocytopenia which differs clinically, epidemiologically and immunologically from idiopathic thrombocytopenic purpura (Table 4). The clinical hallmark is haemorrhagic bullae on the mucosa of the oronasopharynx. Haemorrhage from ruptured bullae, epistaxis or gastrointestinal bleeding is severe and may cause shock and death. The disease is limited to some black populations of central southern Africa, with a recorded incidence of one per 660 inhabitants per year in the Kavango territory of Namibia. The majority of patients demonstrate both IgG and IgM serum platelet antibodies and serum platelet glycoprotein IIb/IIIa autoantibodies. Chronic thrombocytopenia often ensues and recurrent episodes of clinical bleeding are common. Treatment directed at the prevention of haemorrhagic shock reduced the mortality rate in the acute phase from 9.8 to 2.8%. Standard dose prednisolone does not increase the platelet count. Vincristine sulphate may benefit some patients and splenectomy is indicated in patients with severe uncontrollable haemorrhage. High dose intravenous gammaglobulin may be followed by a rise in the platelet count and cessation of haemorrhage. The aetiology is unknown. The possible aetiological role of mycotoxins from contaminated millet, sorghum or maize requires further investigation.
Topics: Africa; Age Factors; Blister; Female; Hemorrhage; Humans; Male; Mouth; Mucous Membrane; Nasopharynx; Purpura, Thrombocytopenic; Sex Factors
PubMed: 1511183
DOI: 10.1016/s0950-3536(11)80027-2 -
Laryngo- Rhino- Otologie Jul 2017
Topics: Deglutition Disorders; Diagnosis, Differential; Drainage; Dyspnea; Fatal Outcome; Hematoma; Humans; Male; Middle Aged; Pharyngeal Diseases; Pharyngitis; Postoperative Complications; Status Epilepticus; Tomography, X-Ray Computed
PubMed: 28768357
DOI: 10.1055/s-0043-112162 -
The Journal of Craniofacial Surgery Jan 2019Genial tubercle fracture is a rare mandibular fracture. It is classified into 2 different types based on the mechanism of injury, including type I, associated with an...
Genial tubercle fracture is a rare mandibular fracture. It is classified into 2 different types based on the mechanism of injury, including type I, associated with an atrophied edentulous mandible or denture, and type II, associated with mandibular fracture. Although type I usually can be treated by only observation, type II may cause obstruction of the pharyngeal airway due to hematoma and edema of the floor of the mouth. In this report, genial tubercle fracture associated with mandibular fracture caused by a traffic accident was reported. Reconstructed 3-dimensional images of the pharyngeal airway indicated that there was almost no airway space around the intratracheal tube at the naso- and oropharynx.
Topics: Accidents, Traffic; Adult; Atrophy; Hematoma; Humans; Imaging, Three-Dimensional; Male; Mandibular Fractures; Pharynx
PubMed: 30339593
DOI: 10.1097/SCS.0000000000004804 -
BMJ (Clinical Research Ed.) Dec 1990
Topics: Carotid Artery Diseases; Hemorrhage; Humans; Palatine Tonsil; Pharyngeal Diseases; Tonsillitis
PubMed: 2271822
DOI: 10.1136/bmj.301.6763.1233 -
The Laryngoscope Apr 1988Spontaneous tonsillar hemorrhage (STH) of non-iatrogenic causes occurs most frequently from infection. Infection can lead to erosion into a major vessel, such as the...
Spontaneous tonsillar hemorrhage (STH) of non-iatrogenic causes occurs most frequently from infection. Infection can lead to erosion into a major vessel, such as the carotid artery or a smaller peripheral tonsil vessel. Whereas fatal erosion into a major vessel from a deep neck abscess was relatively common in the past, it is rare since the advent of antibiotics. Spontaneous tonsillar hemorrhage, when it does occur, appears to occur most commonly in a peripheral tonsil vessel from bacterial tonsillitis. Medical records of 860 patients with conditions considered to be susceptible to STH were reviewed. Ten cases of STH were identified. All were from peripheral tonsil vessel hemorrhage; none was secondary to major vessel erosion. Bacterial tonsillitis was the most common cause of STH and occurred in 8 of 10 cases. This condition accounted for an incidence of STH in tonsillitis of 1.1%. A history of chronic tonsillitis appeared to predispose a patient to STH. Other causes of STH were infectious mononucleosis and neoplasm. Seven of the ten peripheral STHs presented with bleeding from an obvious venous source. The other three patients had significant hemorrhages which led to arteriography. Arteriograms are indicated in patients with clinical features suggesting possible major vessel erosion or in those patients where significant bleeding is not from an obvious peripheral source. A peripheral STH can be successfully managed with local intervention and tonsillectomy.
Topics: Acute Disease; Bacterial Infections; Chronic Disease; Female; Hemorrhage; Humans; Male; Palatine Tonsil; San Francisco; Tonsillectomy; Tonsillitis
PubMed: 3352432
DOI: 10.1288/00005537-198804000-00001 -
Kulak Burun Bogaz Ihtisas Dergisi : KBB... 2015Since the advent of antibiotics, major spontaneous tonsillar hemorrhage is extremely rare. The majority of the spontaneous tonsillar hemorrhage events is associated with...
Since the advent of antibiotics, major spontaneous tonsillar hemorrhage is extremely rare. The majority of the spontaneous tonsillar hemorrhage events is associated with acute or chronic tonsillitis, coagulopathies, or tonsillar cancer. A 36-year-old female patient was admitted to the otolaryngology department with the complaint of tonsillar hemorrhage. The patient had no history of prior trauma, coagulopathy, malignancy and infection sign. Preoperatively, carotid angiography was performed to detect any arteriovenous malformation of tonsillar vessels. The carotid angiography results were within normal ranges. The patient underwent tonsillectomy and no perioperative complication was occurred. Management of idiopathic spontaneous tonsillar hemorrhage may be challenging for the clinician and may require tonsillectomy.
Topics: Adult; Angiography; Diagnosis, Differential; Female; Hemorrhage; Humans; Palatine Tonsil; Tonsillectomy
PubMed: 25935066
DOI: 10.5606/kbbihtisas.2015.34438 -
Brazilian Journal of Otorhinolaryngology 2007
Topics: Adolescent; Female; Hemorrhage; Humans; Palatine Tonsil; Pharyngeal Diseases
PubMed: 17589743
DOI: 10.1016/s1808-8694(15)31082-x -
The American Journal of Case Reports Nov 2022BACKGROUND Spontaneous oropharyngeal hemorrhage is rare and is often associated with other predisposing factors. This can result in hemodynamic instability in the...
BACKGROUND Spontaneous oropharyngeal hemorrhage is rare and is often associated with other predisposing factors. This can result in hemodynamic instability in the presence of other bleeding sources. It is oftentimes difficult to diagnose due to its limitations to visual inspection of the oropharyngeal structures. It is commonly mistaken for hemoptysis or hematemesis upon initial evaluation. Trauma, infection, pulmonary pathologies (ie, lung cancer or tuberculosis), gastrointestinal pathologies (ie, esophageal/gastric varices, Mallory-Weiss tears, esophagitis), coagulopathies, medications, and prolonged intubation have been shown to increase the risk of oropharyngeal hemorrhage. CASE REPORT A 54-year-old man with a medical history of alcohol use disorder, liver cirrhosis, portal hypertension, and gastric varices presented with altered mental status. He was subsequently intubated for airway protection. Bleeding from the oropharynx was later found. Esophagogastroduodenoscopy (EGD) and bronchoscopy were unrevealing. Computed tomography angiography (CTA) of the head and neck revealed active bleeding of the right posterior pharyngeal artery, which was emergently embolized. Over the next few days, he continued to bleed from the oropharynx and became hemodynamically unstable. CTA abdomen showed bleeding from gastric varices and large-volume hemoperitoneum with multiple sources of active bleeding from the liver, duodenum, and jejunum. CONCLUSIONS We present a rare case of spontaneous oropharyngeal hemorrhage and gastric variceal bleeding resulting in hemorrhagic shock in a cirrhotic patient with multiple predisposing factors. If a patient presents with spontaneous oropharyngeal hemorrhage, clinicians should consider bleeding from the oropharynx if EGD and bronchoscopy are unrevealing. Thus, an emergent CTA of the head and neck should be strongly considered to further evaluate a potential source of active bleeding, as delayed diagnosis can be life-threatening.
Topics: Male; Humans; Middle Aged; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Shock, Hemorrhagic; Liver Cirrhosis; Causality; Oropharynx
PubMed: 36322511
DOI: 10.12659/AJCR.937582 -
The New England Journal of Medicine Feb 2022
Topics: Adolescent; Epiglottis; Factor VIII; Hematoma; Hemophilia A; Humans; Male; Oropharynx
PubMed: 35148039
DOI: 10.1056/NEJMicm2114162