ABSTRACT
Recurrent respiratory papillomatosis is a chronic disease caused by the human papillomavirus and can affect both children and adults. Although it is a benign disease, papilloma growth can cause severe, sometimes life-threatening airway obstruction. We report the case of a 28-year-old male patient who was admitted to the hospital with a fever and prolonged cough. A computed tomography (CT) scan showed solid and cavitated nodules in his right lung and solid nodules on his vocal cords. Bronchoscopy demonstrated polypoid lesions on his vocal cords. Histopathological study of the lesions confirmed a diagnosis of respiratory papillomatosis.Copyright © 2022 Biomedpress.
ABSTRACT
Background: In our multi-disciplinary airways service, we assess refractory breathlessness due to suspected inducible laryngeal obstruction (ILO) and/or breathing pattern disorder (BPD). A significant proportion of patients have evidence of uncontrolled co-morbidity, including rhinitis and asthma, which aggravate airway symptoms. Aim(s): To identify the impact of rhinitis management on i) nasal symptoms ii) asthma control and iii) cough control, for individuals referred with suspected ILO +/- BPD and evidence of rhinitis. Method(s): Patient demographics/clinical data were collected between January 2021 and January 2022. Symptoms were recorded using the Total Nasal Symptom Score (TNSS), Asthma Control Questionnaire (ACQ) in those with asthma and a 10-point self-rating scale in chronic refractory cough (CRC). Result(s): Data were available for 43 patients [72% female, 18% atopic, median (IQR) age 54 (41-64) years] with symptoms of rhinitis, confirmed by nasendoscopy in 41% (not all patients had nasendoscopy due to COVID-19 pandemic). Co-morbidities included asthma 54% (39%, of whom were on biologic treatment), CRC (21%), ILO (35%) and BPD (35%). Rhinitis management comprised education (100%), nasal corticosteroids (91%), saline nasal douche (49%) and antihistamines (10%). TNSS scores improved [from 5 (4-6) to 3 (2-4), p<0.001] following intervention. In those with asthma, there was improvement in ACQ [2.98 (2.15-3.70) to 2.00 (0.95-3.05), p<0.001], and in those with chronic refractory cough in self-rating score [8 (4-9) to 2 (2-6), p=0.11]. Conclusion(s): Optimisation of medical treatment for individuals with rhinitis is important and can improve outcomes in patients with asthma, CRC, ILO and BPD.
ABSTRACT
Insertion of nasogastric tube is one of the commonest clinical procedures. However, very rarely, the tube can coil on itself to form something called a Lariat loop. This is a knot that can cause the tube to get stuck inside the pharynx and can precipitate emergencies like laryngeal obstruction or esophageal rupture. A brief discussion of a case along with the causes and prevention of this complication has been done.