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BACKGROUND: Patients with cancers in the head and region are at increased risk of developing synchronous primary cancers. AIM: The aim of this study is to see the role of endoscopy in the pre‑therapeutic works‑up of patients with the cancers in the head and neck region. MATERIALS AND METHODS: Data of head and neck cancer patients from January 2010 to December 2011 were obtained from the hospital cancer registry for retrospective analysis of patients with synchronous cancers. All synchronous malignancies were analyzed for distribution of sites, association with smoking history and the average age of patients at presentation with synchronous cancers. The Chi‑square test for association of upper aero digestive tract (UADT) and smoking and statistical formula of mode for average age have been employed for analyzing results. RESULTS: Incidence of synchronous primaries has been found to be 1.43% and mostly males were affected. The common index sites for synchronous primaries are oropharynx 22 (36.6%), oral cavity 14 (23.3%), hypopharyx 12 (20%) and larynx eight (13.3%) cases in decreasing order, 58.3% synchronous occurred at esophagus and 0.83% of all head and neck cancers developed synchronous primary at esophagus. Association of UADT synchronous cancers with smoking (odds ratio = 13.42, Chi‑square 7.12 at 95% confidence interval, P = 0.0076) is highly significant and the average age is 62.6 years in males and 62 years in females. CONCLUSION: Endoscopy can be rationally used during the pre‑therapeutic work‑up of patients with a history of smoking and/or in patients over the age of 62 years. Instead of complete upper gastro intestinal endoscopy up to the second part of duodenum, only esophagoscopy is needed for the detection of synchronous primary of upper aero‑digestive tract in cancers of the head and neck region.
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Background: Foreign-body ingestion and aspiration are common childhood adverse events, hence are commonest causes of morbidity and mortality in infants and children worldwide. Aim of current study was to identify the patients with foreign-body ingestion and aspiration, develop a suitable algorithm for their management and study various complications following their removal. Methods: The present study was carried out in G.R. medical college, Gwalior, M. P. during last one year on hundred patients diagnosed as case of foreign-body in upper aero-digestive tract on the basis of history, examination and investigations. Results: Foreign-bodies in upper aero-digestive tract were seen mostly in children less than 10 years of age (91%). The youngest was 8 months old and the oldest 48 years. Coins were the most common foreign-bodies in oesophagus (90%) while whistle in the upper airway (40%). Right bronchus is the commonest site of impaction in the airway (50%), while cricopharynx is most common in the oesophagus (95.55%). Patients with oesophageal foreign bodies presented mostly with the chief complaint of foreign body sensation (63.4%) in the throat whereas those with airway foreign body presented mostly with dyspnoea and choking sensation (60%). Pooling of saliva was most commonly seen in patients with oesophageal foreign bodies (43.3%). Tachypnoea was the most common sign in cases of tracheabronchial foreign bodies (80%). Positive radiological evidence was present in 88% of upper aero-digestive foreignbodies. Only 2.2% cases showed complications following oesophagoscopy. Tracheo-bronchial foreign-bodies were removed by emergency bronchoscopy. 20% cases had complications post-operatively. Conclusion: Early detection by meticulous history, imaging modality & prompt management remains basis for favourable outcome and prevents fatal complications.
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Background: Cancers of the upper aero-digestive tract (UADT) constitute 3.5-4% of all malignancies. Majority of cases are squamous cell carcinomas which are related with various epidemiologic factors. Aims & Objective: The objective of this study is to know the histopathological spectrum of tumours of UADT. Material and Methods: This study comprises of 156 cases of histopathological diagnosed tumours of upper aero digestive tract who attended new civil hospital, government medical college, Surat, from August 2010 to august 2012. All prospective and neoplastic cases were included and retrospective and non- neoplastic cases were excluded. Routine paraffin sectioning and staining was done and immunohistochemistry was applied when required. Results: Out of total 156 cases of UADT, 129 malignant, 19 cases benign and 8 were carcinoma in-situ cases. In malignant cases, 124 (96.00%) cases of carcinomas, 1 (0.80%) case of sarcoma, 2 (1.60%) cases of melanoma, and 2 (1.60%) cases were of lymphomas. Most common site of carcinoma was oral cavity (tongue). Most common carcinoma was Squamous cell carcinoma. Most common site of SCC was hypo pharynx (pyriform Fossa), followed by oral cavity (tongue) and larynx (supra glottis). In benign tumours, most common site was nasal cavity (7 cases) and common varieties were Angiofibroma and Capillary Haemangioma. Conclusion: Tumours of UADT are predominant in males affecting older age group. People with tobacco chewing, smoking, alcoholism, poor socioeconomic background, mixed diet and poor oral hygiene are more vulnerable.
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Background: Patients with cancers in the head and region are at increased risk of developing synchronous primary cancers. Aim: To see the epidemiology of synchronous cancers of the head and region and identification of high-risk factors for the development of synchronous primary in the head and neck cancers. Materials and Methods: Data of head and neck cancer patients from January 2010 to December 2011 were obtained from the hospital cancer registry for retrospective analysis of patients with synchronous cancers. All synchronous malignancies were analyzed for distribution of sites, association with smoking history, stage of index head, and neck tumor and the average age of patients at presentation with synchronous cancers. The Chi-square test for association of upper aero digestive tract (UADT) and smoking and statistical formula of median for calculating the average age have been employed for analysis. Results: Incidence of synchronous primaries has been found to be 1.33%, majority were seen at the oropharynx (39.2%) and 60.7% synchronous occurred at the esophagus, 0.81% of all head and neck cancers developed synchronous primary at the esophagus. Approximately, 65% of all synchronous primaries were in Stage III and Stage IV disease and 88.2% esophageal synchronous had Stage II disease. Association of UADT synchronous cancers with smoking is highly significant, relative risk = 1.95 95% confidence interval for relative risk 1.05-3.64 P = 0.00010981 (P < 0.05) and the average age is 62.4 years in males and 57.8 years in females. Conclusion: Patients who are at the high-risk for the development of synchronous primary tumors in the cancers of the head and neck region are patients with oropharyngeal carcinoma, smoking population, patients over the age of 62 years in males, and 57 years in females and in patients with higher staged index tumor.