ENT morbidity at high altitude

The Journal of Laryngology & Otology

• FirstView Article
• doi: 10.1017/S0022215110002331 (About doi)
• Published online by Cambridge University Press 17 Nov 2010

B K Prasad

Department of ENT and Head and Neck Surgery, Command Hospital (Eastern Command (EC)), Kolkata, West Bengal, India

Abstract

Background: People suffer unique health problems in high altitude areas, due to such factors as elevation, aircraft ascent and descent, extreme cold, hypoxia, hypobaria, and low relative humidity. This study was conducted to evaluate ENT morbidity at high altitude.

Methods: Serving soldiers introduced to a high altitude environment who presented with various ENT symptoms were examined to identify ENT disease. In addition, patients undergoing hyperbaric chamber therapy, tracheostomy and treatment of cold injuries were also examined for ENT problems.

Results: The following were detected: 13 cases of otic barotrauma, 11 cases of sinus barotrauma, three cases of vertigo, six cases of pinna frostbite, three cases of barotrauma caused by hyperbaric chamber therapy, an unusually high incidence of epistaxis, and innumerable patients with high altitude pharyngitis.

Conclusion: Diseases of the ear, nose and throat contribute significantly to high altitude morbidity. In a military context, health education of troops is necessary to avoid such problems.

(Accepted June 28 2010)

Correspondence:

^c1 Address for correspondence: Lt Col (Dr) B K Prasad, Department of ENT and Head and Neck Surgery, Command Hospital (EC), Alipore Road, Kolkata 700027, West Bengal, India Email: bipin_rupa@rediffmail.com

Footnotes

Presented at the 62nd Annual Conference of the Association of Otolaryngologists of India, 8 January 2010, Mumbai, India

A useful procedure for observing the cervical esophagus via the hypopharynx

Auris Nasus Larynx (Apr 2010)

Nagano H, Yoshifuku K, Kurono Y;

Tags:

• diazepam
• Head and Neck Cancer

OBJECTIVE: The aim of the study was to evaluate upper gastrointestinal endoscopy with movable over tube (i.e., the movable over tube method) for observing the hypopharynx to cervical esophagus, for use in treatment, and to determine its safety.

METHODS: The study population consisted of 28 patients (23 men, 5 women; a mean age of 66.6 years old; age range of 50-80 years old). The patients consisted of nine cases of globus sensation, eight cases of hypopharyngeal cancer (post-chemoradiotherapy), three cases of hypopharyngeal cancer (untreated), two cases of hoarseness, two cases of unknown primary carcinoma, two cases of foreign body, one case of esophageal cancer, and one case of dysphagia. We used upper gastrointestinal endoscopy with movable over tube to examine the hypopharynx to the cervical esophagus in subjects.

RESULTS: With the movable over tube method, which was performed under pharyngeal surface anesthesia and an infusion of diazepam (5-10mg/kg body weight), one could observe from the hypopharynx to cervical esophagus without any blind spots. There were no complications after the examination.

CONCLUSIONS: The results suggest that the movable over tube method is an easy, useful, and safe method to observe the region from the hypopharynx to the cervical esophagus.

Potentially malignant disorders of the oral and oropharyngeal mucosa; present concepts of management

Oral Oncology (Mar 2010)
van der Waal I

In spite of tremendous progress in the field of molecular biology there is yet no single marker that reliably predicts malignant transformation of a potentially malignant disorder of the oral mucosa. Therefore, it is recommended to excise or laser any oral of oropharyngeal leukoplakia/erythroplakia, if feasible, irrespective of the presence or absence of dysplasia. However, it is actually unknown whether such removal truly prevents the possible development of a squamous cell carcinoma. Therefore, lifelong follow-up is recommended at intervals of no more than 6months. At present, oral lichen planus is more or less accepted as being a potentially malignant disorder. There are no means to prevent such event. The efficacy of follow-up of oral lichen planus is questionable.