ABSTRACT
ABSTRACT Objective: Paragangliomas are slow-growing tumours that present with varied clinical spectra. Early recognition is paramount in achieving reduced morbidity and mortality. There is a paucity of data regarding head and neck paragangliomas (HNPGs) in the Caribbean literature. This study aimed to reflect the clinical experience in the management of HNPGs at two Jamaican tertiary referral centres: the Kingston Public Hospital (KPH) and the University Hospital of the West Indies (UHWI). Methods: A retrospective analysis was conducted on all patients presenting to the Ear, Nose and Throat (ENT) departments of the UHWI in 2004-14 and of the KPH in 2012-14 with the diagnosis of a HNPG. Results: There were 15 patients, 1 male and 14 females. The average age at presentation was 47.1 years. The HNPGs in this series included eight patients with glomus tympanicum (GT, 53%), four with glomus jugulare (GJ, 27%), two with carotid body tumours (CBTs, 13%) and one with glomus vagale (GV, 7%). Eight patients underwent surgical resection (two CBTs, four GT and two GJ). Treatment outcomes achieved included: complete resection (four patients), stable with residual disease (two patients), and recurrence (two patients). Seven patients were awaiting definitive treatment, one patient with GJ was referred overseas, and one patient with GV defaulted. Conclusion: Glomus tympanicum is the most common HNPG in this series which contrasts with that of most international series. Despite the limitations within this region, such as limited access to angio-embolization and stereotactic modalities, the management outcomes are similar in some respects to the reported international literature.
RESUMEN Objetivo: Los paragangliomas son tumores de crecimiento lento que se presentan con variados espectros clínicos. Su detección precoz es fundamental para lograr una reducción de la morbilidad y la mortalidad. Hay escasez de datos con respecto a los paragangliomas de cabeza y cuello (PgCC) en la literatura del Caribe. Este estudio tuvo como objetivo reflejar la experiencia clínica en el tratamiento de PgCC en dos centros de remisión terciarios de Jamaica: jamaiquinos: el Hospital Público de Kingston (KPH) y el Hospital Universitario de UWI (HUWI). Métodos: Se llevó a cabo un análisis retrospectivo de todos los pacientes diagnosticados con PgCC que acudieron a los Departamentos de Otorrinolaringología de HUWI en 2004-14 y de KPH en 2012-14. Resultados: Hubo 15 pacientes - 1 varón y 14 hembras. La edad promedio al momento de presentarse fue 47.1 años. El PgCC en esta serie incluyó a ocho pacientes con glomus timpánico (GT, 53%), cuatro con glomus yugular (GY, 27%), dos con tumores del cuerpo carotídeo (TCC, 13%), y uno con glomus vagal (GV, 7%). Ocho pacientes fueron sometidos a resección quirúrgica (dos TCC, cuatro GT, y dos GY). Los resultados logrados con el tratamiento incluyeron: resección total (cuatro pacientes), estables con enfermedad residual (dos pacientes), y recurrencia (dos pacientes). Siete pacientes esperaban un tratamiento definitivo, un paciente con GY fue remitido al extranjero, y un paciente con GV no se presentó. Conclusión: El glomus timpánico es el PgCC más común en esta serie que contrasta con el de la mayoría de las series internacionales. A pesar de las limitaciones dentro de esta región, tales como el acceso limitado a la angioembolización y las modalidades estereotácticas, los resultados del manejo de la enfermedad son similares en algunos aspectos a la literatura internacional reportada.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Paraganglioma/diagnostic imaging , Head and Neck Neoplasms/diagnostic imaging , Paraganglioma/surgery , Tomography, X-Ray Computed , Retrospective Studies , Magnetic Resonance Angiography , Head and Neck Neoplasms/surgerySubject(s)
Humans , Male , Middle Aged , Abscess/microbiology , Methicillin-Resistant Staphylococcus aureus , Nasal Obstruction/microbiology , Staphylococcal Infections/complications , Abscess/complications , Abscess/therapy , Anti-Bacterial Agents/therapeutic use , Drainage , Nasal Obstruction/therapy , Nasal Septum , Pain/microbiology , Staphylococcal Infections/therapyABSTRACT
Vascular injuries from penetrating trauma to the base of the neck are accompanied by significant morbidity and potential mortality. These injuries require several diagnostic adjuncts in order to facilitate early diagnosis and appropriate treatment. Herein reported is the case of a patient who sustained penetrating injury to the thoracic inlet but had a fortuitous anomaly that prevented vascular injury and its attendant complications.
Subject(s)
Humans , Male , Adult , Subclavian Artery/abnormalities , Wounds, Penetrating/diagnosis , Wounds and Injuries , Wounds, Gunshot/diagnosis , Neck Injuries/diagnosis , Subclavian Artery/pathology , Wounds, Penetrating/etiology , Wounds, Gunshot/complications , Wounds, Gunshot/surgery , Neck Injuries/etiologyABSTRACT
A retrospective study was conducted of 97 patients with oesophageal foreign bodies (EFB). The patients were admitted to assess characteristics of EFB, modes of presentation and radiological and endoscopic findings. The patients were from the University Hospital of the West Indies and most (42) were over the fourth decade of life. The commonest EFB were bones. A negative radiological finding was not a reliable means to select patients for endoscopy. Oesophagoscopy is a reliable method in the treatment of EFB impaction. There were no major complications or deaths
Se realizó un estudio retrospectivo a 97 pacientes con cuerpos extraños esofágicos (CEE). Los pacientes fueron ingresados para evaluar las características de los CEE, los modos de presentación, así como los hallazgos radiológicos y endoscópicos. Los pacientes provenían del Hospital Universitario de West Indies, y la mayoría (42%) sobrepasaba la cuarta década de vida. Los CEE más comunes eran huesos. Un hallazgo radiológico negativo no era un medio fiable para seleccionar los pacientes para endoscopia. La esofagoscopia es un método fiable en el tratamiento de impacción de CEE. No hubo complicaciones mayores ni muertes.